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PubMed2002

Periodic limb movement in a community population detected by a new actigraphy technique.

BACKGROUND: Periodic limb movements (PLMs) have been studied in both community and sleep clinic populations using polysomnography. An alternative detection method is actigraphy. Our aims were to determine the frequency of PLMs, measured by actigraphy in a community sample, and to assess the relationships of PLMs with age, gender, and reported sleep-related symptoms. METHODS: Volunteers had bilateral foot actigraphy (Cambridge Neurotechnology) at home and completed sleep questionnaires. Actigraphy was scored for PLMs per hour in bed (PLMI) and statistical analysis performed to assess possible associations. RESULTS: PLMI (mean of two nights) ranged from 0 to 60.3 and 37% of the sample had a PLMI> or =5. Men had significantly higher PLMIs than females (P=0.003) but PLMI was not correlated with age. There was a modest but significant correlation between subjectively reported restless leg severity and PLMI (r=0.238; P=0.003), but none with reported sleepiness. CONCLUSIONS: This actigraphy technique is a practical and reliable tool for community studies. A large proportion of this community sample, particularly men, had PLMs. PLMI was not correlated with age or Epworth Sleepiness Score.

Journal Article↗
PubMed1999

Helicobacter pylori in the Canadian arctic: seroprevalence and detection in community water samples.

OBJECTIVE: Many North American arctic communities are characterized by risk markers associated with Helicobacter pylori (H. pylori) infection, including overcrowded housing and inadequate water supply and sanitation systems. Our aim was to determine the seroprevalence of H. pylori infection in two traditional Inuit communities in the central Canadian arctic and to test for the presence of H. pylori, by polymerase chain reaction (PCR), in local water supplies. METHODS: Samples of venous whole blood from adults and capillary blood from children were collected and analyzed by enzyme immunoassay and Helisal Rapid Test, respectively, for IgG antibody to H. pylori. Antibodies to CagA were detected by enzyme immunoassay, and ABO and Lewis antigens were also determined. Demographic and clinical information were collected by questionnaire. Water samples from each community were tested for H. pylori by PCR. RESULTS: One hundred-thirty (50.8%) of 256 subjects from the two communities were positive for H. pylori IgG antibodies. Seropositive subjects were more likely to be male, compared with seronegative individuals (p = 0.01). Antibody status did not differ with respect to age, community, alcohol or cigarette use, number of persons per household, gastrointestinal complaints or previous investigations, medications, or presence of blood group O, Lewis a-b+. CagA antibodies were detected in 78 (61.9%) of 126 H. pylori-seropositive subjects tested; however, 41 (35.3%) of 116 H. pylori-seronegative subjects were also CagA positive. Water samples taken from the water delivery truck in Chesterfield Inlet and two lakes near Repulse Bay were positive for H. pylori. CONCLUSION: The seroprevalence of H. pylori in the study group was higher than rates in southern Canadian populations, but lower than the seroprevalence previously documented in a Canadian subarctic Indian (First Nations) community. The detection of H. pylori in local water supplies may indicate a natural reservoir for the organism or possible contamination from human sewage.

ABO Blood-Group System↗
PubMed2005

Group-specific primer and probe sets to detect methanogenic communities using quantitative real-time polymerase chain reaction.

Real-time polymerase chain reaction (PCR) is a highly sensitive method that can be used for the detection and quantification of microbial populations without cultivating them in anaerobic processes and environmental samples. This work was conducted to design primer and probe sets for the detection of methanogens using a real-time PCR with the TaqMan system. Six group-specific methanogenic primer and probe sets were designed. These sets separately detect four orders (Methanococcales, Methanobacteriales, Methanomicrobiales, and Methanosarcinales) along with two families (Methanosarcinaceae and Methanosaetaceae) of the order Methanosarcinales. We also designed the universal primer and probe sets that specifically detect the 16S rDNA of prokaryotes and of the domain Bacteria and Archaea, and which are fully compatible with the TaqMan real-time PCR system. Target-group specificity of each primer and probe set was empirically verified by testing DNA isolated from 28 archaeal cultures and by analyzing potential false results. In general, each primer and probe set was very specific to the target group. The primer and probe sets designed in this study can be used to detect and quantify the order-level (family-level in the case of Methanosarcinales) methanogenic groups in anaerobic biological processes and various environments.

DNA Primers↗
PubMedDate not supplied

Effect of a training program on community pharmacists' detection of and intervention in drug-related problems.

OBJECTIVE: To develop and present a pharmaceutical care training program for pharmacists, and to examine the ability of these pharmacists to provide pharmaceutical care in a community pharmacy setting. DESIGN: Prospective, randomized study. INTERVENTION: A 40-hour pharmaceutical care training program was developed and presented to pharmacists, and 1,078 patients were randomly assigned to receive either (1) traditional pharmacy services or (2) pharmaceutical care, consisting of initial patient work-up and follow-up with documentation in a patient record. MEASUREMENTS: The study period was six months. Pharmacists documented problems identified, actions taken, and time required for all patients. RESULTS: Pharmacists consistently identified and intervened to address problems in both study groups. Patients receiving pharmaceutical care were more than seven times as likely to have any problems identified (odds ratio [OR] 7.5; confidence interval [CI] 4.2-13.1), more than eight times as likely to have an intervention performed (OR, 8.1; CI 4.7-14.2), and more than eight times as likely to have a drug-related problem identified (OR 8.6; CI 4.8-15.5) than were patients receiving traditional pharmacy services only. Time spent counseling patients was similar for the two groups. CONCLUSIONS: The training program proved to be an effective way to increase the number of problems identified and addressed by pharmacists.

Community Pharmacy Services↗
PubMed2002

Effects of above-ground plant species composition and diversity on the diversity of soil-borne microorganisms.

A coupling of above-ground plant diversity and below-ground microbial diversity has been implied in studies dedicated to assessing the role of macrophyte diversity on the stability, resilience, and functioning of ecosystems. Indeed, above-ground plant communities have long been assumed to drive below-ground microbial diversity, but to date very little is known as to how plant species composition and diversity influence the community composition of micro-organisms in the soil. We examined this relationship in fields subjected to different above-ground biodiversity treatments and in field experiments designed to examine the influence of plant species on soil-borne microbial communities. Culture-independent strategies were applied to examine the role of wild or native plant species composition on bacterial diversity and community structure in bulk soil and in the rhizosphere. In comparing the influence of Cynoglossum officinale (hound's tongue) and Cirsium vulgare (spear thistle) on soil-borne bacterial communities, detectable differences in microbial community structure were confined to the rhizosphere. The colonisation of the rhizosphere of both plants was highly reproducible, and maintained throughout the growing season. In a separate experiment, effects of plant diversity on bacterial community profiles were also only observed for the rhizosphere. Rhizosphere soil from experimental plots with lower macrophyte diversity showed lower diversity, and bacterial diversity was generally lower in the rhizosphere than in bulk soil. These results demonstrate that the level of coupling between above-ground macrophyte communities and below-ground microbial communities is related to the tightness of the interactions involved. Although plant species composition and community structure appear to have little discernible effect on microbial communities inhabiting bulk soil, clear and reproducible changes in microbial community structure and diversity are observed in the rhizosphere.

Bacteria↗
PubMed1999

Accuracy of ICD-9-CM codes in detecting community-acquired pneumococcal pneumonia for incidence and vaccine efficacy studies.

Studies have used medical record discharge data as coded by the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) to estimate pneumococcal pneumonia incidence and vaccine efficacy. However, the accuracy of coding data to identify laboratory-confirmed pneumococcal pneumonia is not known. With the use of information collected in Ohio for a community-based pneumonia incidence study, the authors calculated the sensitivities, specificities, positive predictive values (PPV), and negative predictive values (NPV) of specific codes for pneumococcal pneumonia among hospitalized patients with community-acquired pneumonia. Sensitivities of the most common ICD-9-CM codes listed in the first five positions for patients with laboratory-confirmed pneumococcal pneumonia were 58.3% (code 481.0, pneumococcal pneumonia), 20.4% (38.0, streptococcal septicemia), 19.2% (38.2, pneumococcal septicemia), 15.0% (518.81, respiratory failure), 14.2% (486.0, pneumonia, organism unspecified), and 11.3% (482.3, streptococcal pneumonia). Using the first five listed ICD-9-CM codes rather than just the first listed code increased sensitivity without causing substantial change in specificity, PPV, and NPV. Sensitivity, PPV, and NPV of individual and groups of codes varied with different case definitions of pneumococcal pneumonia. Incidence and vaccine efficacy studies with the ability to validate diagnoses by medical chart review can use a combination of many ICD-9-CM codes to maximize sensitivity. However, without the ability to review medical charts, researchers must carefully decide which codes would best suit their studies.

Adolescent↗
PubMed2002

Sensitivity of rhythm disturbance detection by community hospital telemetry.

Telemetry is done in a variety of settings with different levels of sophistication. The American College of Cardiology has made suggestions for telemetry monitoring but these are not in place in many smaller community hospitals that do telemetry monitoring. The objective of this study was to compare prospectively telemetry without a dedicated monitor watcher or full disclosure to results obtained on full disclosure. Patients included were admitted to a single community hospital with an indication for telemetry as judged by their primary physician. Telemetry results reported by the hospital staff were compared to over-read of full disclosure traces by an academic cardiology service and the patient was used as his own control. Significant rhythm disturbances including pauses of 2 seconds or greater and short runs of ventricular and supraventricular tachycardia were frequently missed when a dedicated monitor watcher and full disclosure were not in use. When a dedicated monitor watcher and full disclosure are not in use, telemetry results should be accepted with caution and attempts should be made to improve monitoring.

Aged↗
PubMedDate not supplied

Report on the American Cancer Society Workshop on Community Cancer Detection, Education, and Prevention Demonstration Projects for Underserved Populations.

The American Cancer Society has been funding six pilot projects organized with the stated purpose of demonstrating how to implement cancer prevention and control projects for socioeconomically disadvantaged and underserved populations. This article reports on the results of a workshop held to evaluate project experiences and develop recommendations for the future.

Adult↗
PubMed2002

Evaluation of a forage allocation model for Theodore Roosevelt National Park.

We developed a forage allocation model using a deterministic, linear optimization module in a commercially available spreadsheet package to help resource managers in Theodore Roosevelt National Park (TRNP), North Dakota determine optimum numbers of four ungulate species, bison (Bison bison), elk (Cervus elaphus), mule deer (Odocoileus hemionus), and feral horses, in the Park. TRNP staff actively managed bison, elk, and feral horse numbers within bounds suggested by our model from 1983 to 1996. During this period, we measured vegetation at 8 grassland and 12 wooded sites at 1-3 year intervals to determine if model solutions were appropriate for maintaining stable conditions in important plant communities in the Park. The data we recorded at these sites indicated minimal change in plant communities from 1983 to 1996. Changes in most vegetation categories that we expected when animal numbers exceeded model optimums for short periods (decreases in coverage/stem numbers of palatable plant species, increases in bare ground or unpalatable plant species) did not occur consistently under high or low precipitation conditions. The lack of sensitivity of our model to decreases in overall production of palatable plant species that occurred due to drought, fire, expansion of black-tailed prairie dog (Cynomys ludovicianus) colonies, and the spread of leafy spurge (Euphorbia esula) in areas of the Park where we did not have monitoring sites suggested that the model under-estimated the total number of ungulates that the Park could support. Management for population levels of ungulates defined by the model probably led to over protection of common plant communities and insufficient protection of rare plant communities. Detecting changes in rare plant communities could have been accomplished by re-designing our vegetation monitoring program, but changing emphasis to protection of rare plants would have likely promoted under use of grazing-tolerant habitat types, dissatisfaction in tourists visiting the Park to see large mammals, and large increases in cost and intrusiveness of management activities such as fencing and control of ungulate populations. The model was a flawed representation of grazing dynamics in TRNP, but we believe it succeeded in making management personnel aware of the biological constraints they face when making management decisions.

Animals↗
PubMed1988

Community models for cancer prevention and detection.

Optimal community programs in cancer prevention and detection have as their goals the lowering of incidence, complications, and mortality from cancer in a population, and are characterized by efficiency, self-sustainability, and generalizability. Programs fall into three categories according to their degree of integration into the normal health-care system. "Extra-systemic" programs are temporary demonstration activities, which may have research goals. "Quasi-systemic" activities include public health department programs, worksite programs, and specialized centers such as breast screening centers. "Systemic" activities involve counseling and screening in routine medical practice. The greatest potential for reaching the indicated goals lies in facilitating systemic activities by allowing primary-care practitioners to define their own prevention goals, to make changes in their practices to address these goals, and to educate consumers of the need to demand preventive services.

Community Health Services↗