BEST at home: a pilot evaluation of a home-based strength and balance exercise program.

Issue Addressed: Home-based exercise with home visits has been shown to improve strength and balance and reduce falls in older people. This pilot study aimed to determine whether a home-based exercise program (delivered via workshops instead of home visits) improved strength and balance and reduced falls in adults aged 60 years and over.

Methods: Participants attended two workshops over a six-month period and were instructed in the exercises by physiotherapists.

A qualitative study about smoking cessation with clients of community service organisations that work with disadvantaged families.

Issue Addressed: To determine whether clients of community service organisations (CSOs) that work with disadvantaged families consider the organisation to be a suitable avenue for the delivery of smoking cessation assistance, and to explore clients' knowledge and attitudes on smoking, and barriers to quitting.

Methods: Seven focus groups were undertaken with clients from CSOs that work with disadvantaged families. Participants were asked questions on effects of smoking on health, barriers to quitting smoking and whether CSOs could provide smoking cessation support.

Open-label, randomised, parallel-group, multicentre study to evaluate the safety, tolerability and immunogenicity of an AS03(B)/oil-in-water emulsion-adjuvanted (AS03(B)) split-virion versus non-adjuvanted whole-virion H1N1 influenza vaccine in UK children 6 months to 12 years of age.

Objective: To evaluate the safety, tolerability and immunogenicity of an AS03(B)/oil-in-water emulsion-adjuvanted (AS03(B)) split-virion versus non-adjuvanted whole-virion H1N1 influenza vaccine in UK children aged 6 months to 12 years.

Design: Multicentre, randomised, head-to-head, open-label trial.

Setting: Five UK sites (Oxford, Bristol, Southampton, Exeter and London).

Safety and immunogenicity of AS03B adjuvanted split virion versus non-adjuvanted whole virion H1N1 influenza vaccine in UK children aged 6 months-12 years: open label, randomised, parallel group, multicentre study.

Objectives: To compare the safety, reactogenicity, and immunogenicity of an adjuvanted split virion H1N1 vaccine and a non-adjuvanted whole virion vaccine used in the pandemic immunisation programme in the United Kingdom.

Design: Open label, randomised, parallel group, phase II study.

Setting: Five UK centres (Oxford, Southampton, Bristol, Exeter, and London).

Improving children's physical activity in out-of-school hours care settings.

Issues Addressed: Improving children's opportunities for and participation in physical activity at out-of-school hours (OOSH) care.

Methods: A needs assessment, 12-month implementation and evaluation were conducted. Strategies included feedback and support to improve physical activity programs and policies; staff training; resource distribution; and grants to disadvantaged services.

Improving the food provided and food safety practices in out-of-school-hours services.

Issue Addressed: Food provided and food safety and serving practices in out-of-school-hours (OOSH) services.

Methods: Health promotion strategies, developed in partnership with an advisory committee, were directed at three main areas: supporting local services; developing statewide training and resources; and advocacy.

Results: Significant improvements were seen in the food provided, food safety and serving practices and the number of services with planned menus and nutrition and food safety policies.

An evidence and consensus based guideline for acute diarrhoea management.

Objective: To develop an evidence and consensus based guideline for the management of the child who presents to hospital with diarrhoea (with or without vomiting), a common problem representing 16% of all paediatric medical attenders at an accident and emergency department. Clinical assessment, investigations (biochemistry and stool culture in particular), admission, and treatment are addressed. The guideline aims to aid junior doctors in recognising children who need admission for observation and treatment and those who may safely go home.

Determining the common medical presenting problems to an accident and emergency department.

All accident and emergency (A&E) attendances over a one year period were prospectively studied in order to determine common medical presenting problems. Data were collected on children (0-15 years) attending a paediatric A&E department in Nottingham between February 1997 and February 1998. A total of 38 982 children were seen.

Accounting for overlap? An application of Mezzich's kappa statistic to test interrater reliability of interview data on parental accident and emergency attendance.

Study Rationale: The number of interview studies with service users is rising because of growth in health services research. The level of agreement between multiple interview data coders requires statistical calculation to support results. Basic kappa statistics are often used but this depends on having mutually exclusive data.

Teaching smoking cessation skills to senior medical students: a block-randomized controlled trial of four different approaches.

Background: Medical practitioners have considerable untapped potential to assist patients in stopping smoking. However, marked deficits have been found in the amount and type of training medical practitioners receive in smoking cessation counseling with little attention paid to determination of effective training methods.

Method: A randomized controlled trial was conducted to examine the relative effectiveness of four different educational programs in teaching smoking cessation skills to 5th-year medical students in an Australian medical school.

Smoking-related knowledge and attitudes of senior Australian medical students.

Objective: To assess the smoking-related knowledge and attitudes of senior medical students and to compare knowledge and attitude changes in students exposed to four different smoking cessation skills training interventions.

Design: A survey questionnaire, assessing knowledge and attitudes, was administered pre- and post-intervention for each of the four intervention conditions.

Subjects: A cohort of 219 fifth-year medical students at the University of Sydney.

Neurons of the peripheral nervous system express thymidine phosphorylase.

Platelet-derived endothelial cell growth factor (PD-ECGF) is an angiogenic factor which recently has been shown to be identical to thymidine phosphorylase. We describe here, high levels of expression of PD-ECGF/thymidine phosphorylase in neurons of the peripheral nervous system (PNS) but very little in the central nervous system (CNS). Monoclonal and polyclonal antibodies were used for the staining of sections of dorsal root ganglia, sympathetic cervical ganglia and the enteric plexus as well as the brain and spinal cord.

Expression of platelet-derived growth factor (PDGF) and PDGF alpha- and beta-receptors in the peripheral nervous system: an analysis of sciatic nerve and dorsal root ganglia.

Previous studies have shown that cultured Schwann cells secrete platelet-derived growth factor (PDGF) and express PDGF receptors which transmit a mitogenic response particularly when their levels are upregulated by elevation of intracellular cAMP. In this study the expression of PDGF and PDGF alpha- and beta-receptors in the peripheral nervous system (PNS) has been examined by studying dorsal root ganglia and sciatic nerve. Using the monoclonal anti-PDGF antibody, PGF-007, relatively high levels of PDGF were detected in cells of the neonatal rat dorsal root ganglia and sciatic nerve.

Interaction between cAMP elevation, identified growth factors, and serum components in regulating Schwann cell growth.

Most previous studies on Schwann cell proliferation in vitro have used serum-containing media. This complicates the analysis of agents required for cell division since serum contains an ill-defined mixture of hormones and growth factors. Serum-free medium has therefore been used to analyse the response of Schwann cell to previously identified Schwann cell mitogens.

Spontaneous immortalisation of Schwann cells in culture: short-term cultured Schwann cells secrete growth inhibitory activity.

In the developing peripheral nerve, Schwann cells proliferate rapidly and then become quiescent, an essential step in control of Schwann cell differentiation. Cell proliferation is controlled by growth factors that can exert positive or inhibitory influences on DNA synthesis. It has been well established that neonatal Schwann cells divide very slowly in culture when separated from neurons but here we show that when culture was continued for several months some cells began to proliferate rapidly and non-clonal lines of immortalised Schwann cells were established which could be passaged for over two years.

Schwann Cells Secrete a PDGF-like Factor: Evidence for an Autocrine Growth Mechanism involving PDGF.

We have investigated the influence of platelet-derived growth factor (PDGF) in peripheral nervous system gliogenesis using two types of Schwann cell cultures. Short-term Schwann cell cultures grow very slowly, but when maintained in culture for several months the division rate of some cells increases, and cell lines can be established. We show that Schwann cells in both short- and long-term culture possess PDGF receptors and synthesize DNA in response to PDGF.

Transforming growth factor-beta and gamma-interferon have dual effects on growth of peripheral glia.

The influence of transforming growth factor-beta (TGF-beta) and gamma-interferon on DNA synthesis in Schwann cells and enteric glia in culture has been studied. TGF-beta stimulated the DNA synthesis of short-term (less than 2 weeks in culture) Schwann cells, whereas gamma-interferon was ineffective. The stimulatory effect of TGF-beta was additive to the stimulation of DNA synthesis due to axonal membrane fragments.

Control of peripheral glial cell proliferation: enteric neurons exert an inhibitory influence on Schwann cell and enteric glial cell DNA synthesis in culture.

Neuronal membranes from rat dorsal root ganglia provide a mitogenic signal to cultured Schwann cells and it has been suggested this is an important factor in regulating Schwann cell numbers during development. In this study, the influence of enteric neurons on the DNA synthesis of both Schwann cells and enteric glia has been investigated as well as the effect of axonal membrane fractions (axolemma) on enteric glia. The proliferation rate of rat Schwann cells and enteric glia was assessed in culture using [3H]thymidine uptake and autoradiography in combination with immunolabelling to identify cell types.

Type I collagen preparations inhibit DNA synthesis in glial cells of the peripheral nervous system.

The mechanisms underlying cessation of glial proliferation in the developing peripheral nervous system are obscure. One possibility, as yet little explored, is that mitotic inhibitory signals play a part in regulating glial cell numbers. In this study we demonstrate that type I collagen preparations from several different sources can inhibit the rate of DNA synthesis in purified populations of enteric glia and both short-term and long-term secondary Schwann cells in dissociated cell cultures.

Control of peripheral glial cell proliferation: a comparison of the division rates of enteric glia and Schwann cells and their response to mitogens.

The enteric nervous system comprises neurons and a relatively homogeneous population of glial cells, which differ considerably from those found in other parts of the peripheral nervous system and resemble more closely astrocytes from the central nervous system. It provides a simple model system for the study of neuron/glial interactions and glial cell development. In this study the proliferation rates of purified populations of enteric glia and Schwann cells and their response to several mitogens in vitro were compared.

Postnatal development of rat peripheral nerves: an immunohistochemical study of membrane lipids common to non-myelin forming Schwann cells, myelin forming Schwann cells and oligodendrocytes.

Interest in the role of membrane lipids in Schwann cell function prompted this study of lipid antigens on myelin- and non-myelin forming Schwann cells. Using the monoclonal antibodies 07, which recognises galactocerebroside, 08, 09 and 011, the distribution and time course of expression of the 4 membrane lipids have been determined in Schwann cells of the rat sciatic nerve and sympathetic trunk, derived from 1-60-day-old rats. The proportion of Schwann cells binding each monoclonal antibody was found by dissociating the nerves and allowing 3 h for the cells to attach to coverslips, prior to double label immunofluorescence, using the monoclonal antibody in conjunction with antibodies to S100 as a general Schwann cell marker, or P0 to distinguish cells which had formed myelin.

Search for antibodies to galactocerebroside in the serum and cerebrospinal fluid in human demyelinating disorders.

To determine if galactocerebroside (GalC) is a target antigen in the human demyelinating disorders multiple sclerosis, Guillain-Barré syndrome, and chronic demyelinating inflammatory polyneuropathy, we examined the serum and cerebrospinal fluid from patients with these disorders and from control subjects using four assay systems. In none of these assays could we detect significant differences in anti-GalC antibody titer between patients with demyelinating diseases and normal subjects or patients with other neurological disorders. Our data suggest that there is no humoral immune response to GalC in human demyelinating disorders.

Fibroblast growth factor is a mitogen for oligodendrocytes in vitro.

The effect of fibroblast growth factor (FGF) on oligodendrocyte development has been studied using dissociated mixed brain cells, cultured in a previously described serum-free medium. A greater number of galactocerebroside-positive oligodendrocytes could be demonstrated after 7 days in the presence of FGF than in control values. Using combined immunofluorescence and autoradiography an increased [3H]thymidine incorporation by galactocerebroside-positive oligodendrocytes was demonstrated after various times of exposure to FGF.