Using evidence in health promotion in local government: contextual realities and opportunities.

Issue Addressed: New national and state preventive health investments have provided significant funding for local governments (LGs) to be involved in planning and implementing health promotion interventions. There is an expectation that this work is evidence based; however, inadequate support and systems exist for evidence-informed planning and decision making in LGs. Previous initiatives have aimed to build capacity and leadership in LG health promotion, but the training, support and infrastructure have been sporadic.

An uncemented metal-backed glenoid component in total shoulder arthroplasty for osteoarthritis: factors affecting survival and outcome.

Background: The reported survivorship of total shoulder replacement (TSR) is variable. This is probably related to implant design. We report the outcome and survivorship of the uncemented glenoid in patients with osteoarthritis receiving a TSR with an intact or repairable rotator cuff at surgery.

Assessment of shoulder function using the coronal plane angle.

Background: Assessment of shoulder function is an essential part of clinical practice. Current scoring relies on multiple subjective and / or objective components. We present a single angular measurement, the coronal plane angle, which relates to the functional assessment of the shoulder.

The metal-backed glenoid component in rheumatoid disease: eight- to fourteen-year follow-up.

Hypothesis: We believe the variable reported survivorship of the metal-backed glenoid is related to the design of the component. This study reports the outcome and survivorship of the uncemented glenoid in rheumatoid patients with an intact or repairable rotator cuff at surgery, and considers the key design features that may predict longevity of this component.

Method: Forty-six shoulders in 39 patients (31 women), with a mean age of 55 years (range, 35-86 years) received a total shoulder replacement with a screw-fixed porous coated metal-back glenoid.

Injury to the axillary artery, a complication of fixation using a locking plate.

The proximal humerus internal locking system is an internal fixation device consisting of a low-profile plate and locking screws, which is used for the fixation of three- and four-part fractures of the proximal humerus. We describe a case in which the screws cut out of the humeral head causing injury to the axillary artery necessitating urgent removal of the implant.

Flow-induced enhancement of vasoconstriction and blockade of endothelium-derived hyperpolarizing factor (EDHF) by ascorbate in the rat mesentery.

Background And Purpose: We previously reported that ascorbate inhibits flow- and agonist-induced, EDHF-mediated vasodilatation in the bovine ciliary circulation. This study examined whether ascorbate had similar actions in the rat mesenteric vasculature.

Experimental Approach: The effects of ascorbate were examined both in rat second order mesenteric arterial rings suspended in a static wire myograph and the rat mesentery perfused at different rates of flow.

Ascorbate elevates perfusion pressure in the bovine extraocular long posterior ciliary artery: role of endothelium-derived hyperpolarizing factor (EDHF).

Ascorbate blocks agonist-induced, endothelium-derived hyperpolarizing factor (EDHF)-mediated vasodilatation in the bovine perfused ciliary artery and this is associated with a rise in perfusion pressure. We now report the origins of this ascorbate-induced rise in perfusion pressure. In segments of ciliary artery perfused at 2.

Souter-Strathclyde total elbow arthroplasty in rheumatoid arthritis: medium-term results.

We present the outcome of 47 Souter-Strathclyde replacements of the elbow with a mean follow-up of 82 months (12 to 129). The clinical results were assessed using a condition-specific outcome measure. The mean total score (maximum 100) before the operation was 47.

Requirement for flow in the blockade of endothelium-derived hyperpolarizing factor (EDHF) by ascorbate in the bovine ciliary artery.

We previously reported that ascorbate inhibits endothelium-derived hyperpolarizing factor (EDHF)-mediated vasodilatation in the bovine perfused ciliary circulation and rat perfused mesentery, but not in rings of bovine or porcine coronary artery. In this study, we have compared the ability of ascorbate to inhibit EDHF-mediated vasodilatation in a single vessel, the bovine long posterior ciliary artery, when perfused and when mounted as rings in a myograph. Both in segments perfused at a flow rate of 2.

Potent vasodilator responses to human urotensin-II in human pulmonary and abdominal resistance arteries.

The peptide human urotensin-II (hUT-II) and its receptor have recently been cloned. The vascular function of this peptide in humans, however, has yet to be determined. Vasoconstrictor and vasodilator responses to hUT-II were investigated in human small muscular pulmonary arteries [approximately 70 microm internal diameter (ID)] and human abdominal resistance arteries (approximately 200 microm ID).

Contractile responses to human urotensin-II in rat and human pulmonary arteries: effect of endothelial factors and chronic hypoxia in the rat.

Responses to human urotensin-II (hU-II) were investigated in human and rat pulmonary arteries. Rat pulmonary arteries: hU-II was a potent vasoconstrictor of main pulmonary arteries (2 - 3 mm i.d.

Genetic heterogeneity of Escherichia coli O157:H7 in Scotland and its utility in strain subtyping.

From April 1994 to March 1995, seven outbreaks of Escherichia coli O157:H7 infection occurred throughout Scotland, including the largest milk-borne outbreak to date worldwide. Various vehicles of infection were identified, and there were 144 confirmed cases in total. All isolates associated with the outbreaks were subjected to detailed subtyping: phage typing, testing for carriage of verotoxin genes (VT), and pulsed-field gel electrophoresis.

The consequences of punching glass.

We carried out a retrospective and prospective study of 67 patients who had sustained hand injuries from punching glass over a period of 33 months. All had consumed alcohol and had argued with a partner. The mean age was 25 years, 90% were male and 56% were unemployed.

Repair of acute scapho-lunate dissociation facilitated by the "TAG" suture anchor.

A case of acute scapho-lunate dissociation is described in which the operative treatment was facilitated by the use of the "TAG" suture anchor.

Freeze-thawed muscle grafting for painful cutaneous neuromas.

We used freeze-thawed muscle grafts to restore continuity to the affected nerve in 22 painful cutaneous neuromas. In 11 of the 15 neuromas in the upper limb, pain was partially or completely relieved; in six of these there was some recovery of distal sensation. Partial pain relief was achieved in only two of the seven neuromas in the lower limb.

Surgery of the rheumatoid cervical spine. Correlation of the pathology and prognosis.

Twenty-eight rheumatoid arthritis patients with symptomatic subluxation of the cervical spine had 34 operative procedures in the period from 1983 to 1989. Two distinct groups are noted with regard to management and prognosis. The treatment of isolated atlantoaxial instability has been straightforward and the morbidity low.

The terminal branch of posterior interosseous nerve: a useful donor for digital nerve grafting.

The anatomical relationships of the terminal branch of posterior interosseous nerve have been studied in 57 cadaver and amputation specimens. Removal of the nerve leaves the patient with no apparent sensory deficit. In all dissections the nerve was present and its location was constant.

Follow-up studies in 50 totally colectomised children.

We report on 50 totally colectomised children, most of whom suffered from Hirschsprung's disease. Of the 50, one child died postoperatively of enteritis. On an average, the children were re-examined 5 1/2 years after the colectomy.