Helicobacter pylori prevalence in non-ulcer dyspepsia ethnic and socio-economic differences

Helicobacter pylori is an important cause of gastritis and a number of therapeutic. trials suggest that it may be important in the genesis of duodenal ulcer recurrence. The reported prevalence of gastric colonisation by the organism varies considerably. The aiIn of this cross-sectional survey was to determine its prevalence in non-ulcer dyspeptics and to determine whether this is influenced by age, race, sex, socio-economic status, educational level and the nwnber of persons sharing accommodation. One hundred and sixty-nine patients underwent endoscopy; biopsy speciInens were taken from the antrwn and H. pylori status was determined histologically. Gastric colonisation was found in 106 patients (63%). The prevalence showed a marked ethnic difference: 40% in whites and 71% in coloureds (P < 0,001). The ethnic groups were characterised by significant differences in socio-economic status (P < 10-6), educational level (P < 10-6), number of persons sharing accommodation (P < 10-6 ) and age (P < 0,001). These same differences were found when comparing the H. pylori-positive and negative groups, but were less marked and could be attributed to the marked differences between ethnic groups. We conclude that H. pylori prevalence differs between the ethnic groups studied. This may be because of varying degrees of exposure risk

60. Factors detremining local control in patients (Pts) with locally advanced breast cancer (Labc) managed with radiotherapy (RT) as the primary locoregional treatment

IntroductionRT plays an important role in the management of LABC, yet clinical outcomes still remain far from satisfactory. The aim of this study was to evaluate retrospectively factors determining local control in a large series of consecutive LABC pts managed with RT as the primary locoregional treatment.Material and methodsThe records of 261 primarily inoperable LABC pts treated between 1991 and 1997 at two institutions: Medical University of Gdansk, Poland and Velindre NHS Trust, Cardiff, UK were analysed. All pts received megavoltage RT to the breast with two tangential fields, and the adjacent lymph node areas were irradiated using customised fields. Due to a large scale of RT doses and fractionation schedules, normalised total dose (NTD) was calculated for all patients using a linear quadratic model. In 241 pts RT constituted the only local treatment and the remaining 20 pts were subsequently subjected to mastectomy. Most pts received chemotherapy and/or endocrine therapy prior or after RT.ResultsWithin the median follow-up of 37 months, locoregional recurrence occurred in 95 of 251 evaluable pts (38%). Three-year and five-year locoregional-free survival rates were 59% and 48%, respectively. At multivariate analysis of variables predicting the risk of locoregional relapse, inflammatory carcinoma (

Structure and magnetism in the bond-frustrated spinel ZnCr2Se4ZnCr_2Se_4

The crystal and magnetic structures of stoichiometric $ZnCr_2Se_4$ have been investigated using synchrotron x-ray and neutron powder diffraction, muon spin relaxation ($μSR$), and inelastic neutron scattering. Synchrotron x-ray diffraction shows a spin-lattice distortion from the cubic $Fd\bar3m$ spinel to a tetragonal $I4_1/amd$ lattice below $T_N = 21 K$, where powder neutron diffraction confirms the formation of a helical magnetic structure with magnetic moment of $3.04(3) μ_B$ at 1.5 K, close to that expected for high-spin $Cr^{3+}$. $μSR$ measurements show prominent local spin correlations that are established at temperatures considerably higher (100 μs^{-1}\)) muon relaxation rates are suggestive of rapid site hopping of the muons in static field. Inelastic neutron scattering measurements show a gapless mode at an incommensurate propagation vector of k = [000.4648(2)] in the low-temperature magnetic ordered phase that extends to 0.8 meV. The dispersion is modeled by a two-parameter Hamiltonian, containing ferromagnetic nearest-neighbor and antiferromagnetic next-nearest-neighbor interactions with a $J_{nnn}/J_{nn} = -0.337$

Мастерство педагогического труда и мотивация учебной деятельности у студентов

Aim To gain insight into community nurses' experiences and how they make sense of the expertise they offer in their role Background Globally, the spotlight is currently on community nursing expertise because of the movement of hospital-based to community- based care. Caring for people at home is no longer solely concerned with prevention, but delivering complex care to patients who are acutely unwell or at the end of their life. Little is known about the distinct expertise of community nurses, or their contribution to patient outcomes. There is a need to examine expertise in this group in order to inform current and future care provision within community settings. Design A hermeneutic, phenomenological study. Method Semi-structured interviews were conducted with eight community nurses in Scotland, UK, who hold an additional post-registration, professional qualification. Participants also kept audio-journals. Data were analysed using Interpretive Phenomenological Analysis. Findings Participants described their expertise in three themes; negotiating a 'way in' to care, managing complexity, and 'thinking on your feet'. They did not refer to themselves as specialist practitioners, nor did they perceive that they were viewed as specialist by colleagues or management. They appeared to dismiss their range of expertise which included forming trusting relationships, anticipating care needs and problem-solving, enabling them to undertake complex care management. Conclusions Expertise of community nurses in this study is dynamic, contextualised and action-oriented enabling them to be creative problem-solvers. It reflects engagement with patients and families and all aspects of the setting where care is provided, rather than being solely an identifiable set of specialist skills, Relevance to clinical practice It is vital to recognize community-based expertise internationally, especially if current WHO aims for community-based health care are to be achieved. Highlighting this expertise contributes to current discourse and may be considered in education and practice reviews. This article is protected by copyright. All rights reserved.sch_nur27pub4806pub3-

Characterization of Aquifex aeolicus ribonuclease III and the reactivity epitopes of its pre-ribosomal RNA substrates

Ribonuclease III cleaves double-stranded (ds) structures in bacterial RNAs and participates in diverse RNA maturation and decay pathways. Essential insight on the RNase III mechanism of dsRNA cleavage has been provided by crystallographic studies of the enzyme from the hyperthermophilic bacterium, Aquifex aeolicus. However, the biochemical properties of A. aeolicus (Aa)-RNase III and the reactivity epitopes of its substrates are not known. The catalytic activity of purified recombinant Aa-RNase III exhibits a temperature optimum of ∼70–85°C, with either Mg2+ or Mn2+ supporting efficient catalysis. Small hairpins based on the stem structures associated with the Aquifex 16S and 23S rRNA precursors are cleaved at sites that are consistent with production of the immediate precursors to the mature rRNAs. Substrate reactivity is independent of the distal box sequence, but is strongly dependent on the proximal box sequence. Structural studies have shown that a conserved glutamine (Q157) in the Aa-RNase III dsRNA-binding domain (dsRBD) directly interacts with a proximal box base pair. Aa-RNase III cleavage of the pre-16S substrate is blocked by the Q157A mutation, which reflects a loss of substrate binding affinity. Thus, a highly conserved dsRBD-substrate interaction plays an important role in substrate recognition by bacterial RNase III

On the Perils of Stabilizing Prices When Agents are Learning.

We show that price level stabilization is not optimal in an economy where agents have incomplete knowledge about the policy implemented and try to learn it. A systematically more accommodative policy than what agents expect generates short term gains without triggering an abrupt loss of con- fidence, since agents update expectations sluggishly. In the long run agents learn the policy implemented, and the economy converges to a rational expectations equilibrium in which policy does not stabilize prices, economic volatility is high, and agents suffer the corresponding welfare losses. However, these losses are outweighed by short term gains from the learning phase

Monoclonal antibody ONS-M21 recognizes integrin α3 in gliomas and medulloblastomas

The monoclonal antibody ONS-M21 recognizes an antigen found on the surface of glioma and medulloblastoma cells but does not react with the antigens of normal brain tissue. We purified and identified the 140-kDa protein by means of an antibody-binding affinity column. This 140-kDa antigen has sequences homologous to the amino-terminal region and five parts of the internal domain of integrin α3. When the integrin α3-related sequences was amplified and used to analyse the mRNA of glioma and medulloblastoma surgical specimens, the transcription level of integrin α3 mRNA appeared to be quantitatively correlated with the grade of malignancy. These findings suggest that the ONS-M21 antibody, which reacts with integrin α3, might be useful in the diagnosis of gliomas and medulloblastomas. © 1999 Cancer Research Campaig

Improving local health through community health workers in Cambodia: challenges and solutions

Volunteer community health workers (CHWs) are an important link between the public health system and the community. The ‘Community Participation Policy for Health’ in Cambodia identifies CHWs as key to local health promotion and as a critical link between district health centres and the community. However, research on the challenges CHWs face and identifying what is required to optimise their performance is limited in the Cambodian context. This research explores the views of CHWs in rural Cambodia, on the challenges they face when implementing health initiatives