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PubMedDate not supplied

Cataract blindness and barriers to cataract surgical intervention in three rural communities of Oyo State, Nigeria.

BACKGROUND: The study was a community based field survey that used a rapid assessment method to determine the prevalence of cataract blindness in people aged 50 years and above in 3 rural communities. OBJECTIVE: The purpose of the study was to determine the prevalence of cataract blindness and barriers to cataract surgical intervention in an area served by a health facility managed by a tertiary institution. METHOD: Abedo, Akinyele and Ketepe Villages in Akinyele Local Government Area of Oyo State Nigeria were selected based on their nearness to the primary health care centre in Abedo. RESULT: A total of 477 persons aged 50 years and above were seen being 73.3 percent of expected. Those with visual acuity of less than 3/60 in an eye and those with visual acuity of less than 3/60 in the better eye were examined in more details using a pen torch, an ophthalmoscope and tonometer to determine the cause of blindness. All persons who have had surgery were examined. The prevalence of blindness in persons aged 50 years and above was 1.47% and that of cataract blindness in the same age group in the villages was 0.84% constituting 57.14% of blindness. The main barriers to hospital presentation were cost of surgery (52.8%) and distance to hospital (33.8%). The constraints and limitations encountered during the study included rural-urban migration and population discrepancies between what obtained at the villages and those supplied by the Local Government Population Commission. CONCLUSION: It is hoped that this study will serve as a preliminary survey and a base line for further studies and the initiation of a blindness prevention programme in the area.

Aged↗
PubMed2004

Mounting a community-randomized trial: sample size, matching, selection, and randomization issues in PRISM.

This paper discusses some of the processes for establishing a large cluster-randomized trial of a community and primary care intervention in 16 local government areas in Victoria, Australia. The development of the trial in terms of design factors such as sample size estimates and the selection and randomization of communities to intervention or comparison is described. The intervention program to be implemented in Program of Resources, Information and Support for Mothers (PRISM) was conceived as a whole community approach to improving support for all mothers in the first 12 months after birth. A cluster-randomized trial was thus the design of choice from the outset. With a limited number of communities available, a matched-pair design with eight pairs was chosen. Sample size estimates, adjusting for the cluster randomization and the pair-matched design, showed that with eight pairs, on average, 800 women from each community would need to respond to provide sufficient power to determine a 3% reduction in the prevalence of maternal depression 6 months after birth-a reduction deemed to be a worthwhile impact of the intervention to be reliably detected at 80% power. The process of selecting suitable communities and matching them into pairs required careful collection of data on numbers of births, size of the local government areas (LGAs), and an assessment of the capacity of communities to implement the intervention. Ways of dealing with boundary issues associated with potential contamination are discussed. Methods for the selection of feasible configurations of sets of pairs and the ultimate allocation to intervention or comparison are provided in detail. Ultimately, all such studies are a balancing act between selecting the minimum number of communities to detect a meaningful outcome effect of an intervention and the maximum size budget and other resources allow.

Adult↗
PubMed2002

Attitudes of suburban Western Australians to proposed cat control legislation.

OBJECTIVE: To determine the knowledge, attitudes and practices of cat-owners and non-owners in suburban Perth, Western Australia, on issues relating to proposed local government regulation of cat-ownership. DESIGN: The 1,261 respondents to a mailed survey were ranked on issues regarding restrictions on cat-ownership and cat roaming (control scale), attitudes to wildlife in suburbia and putative impacts of cats on wildlife (wildlife scale), knowledge of cat behaviour and husbandry (knowledge scale) and attitudes and practices regarding cat sterilisation (sterilisation scale). Age, gender and cat-ownership status of the survey respondents were explored to see if any of these factors influenced the position of respondents on the scales. RESULTS: Cat-owners, particularly female owners, scored significantly higher on the knowledge scale than non-owners, whilst non-owners scored significantly higher than cat-owners on the control and wildlife scales. Women were more likely to favour compulsory sterilisation of pet cats than men, but men were more willing to implement controls on cat-ownership. Age was also a significant factor, with older people more willing to implement controls. Analysis of specific questions showed that both cat-owners and non-owners agreed that there was a need for cat control legislation and supported measures such as compulsory sterilisation, registering of cats, restricting cats' ability to roam and stipulating a maximum number of cats per property. Nevertheless, both groups rejected the idea that local governments should enforce cat-free zones. CONCLUSION: Cat legislation that avoids or educates about the contentious issue of cat-free zones should receive solid community support.

Adolescent↗
PubMed2004

Extrinsic tooth discolouration in 11-16 year-old Nigerian children.

This study was done to ascertain the prevalence and aetiology of extrinsic stains among 11-16 year-old school children in Surulere, which is one of the Local Government Areas (LGAs) in Lagos, Nigeria. 600 school children were randomly selected from 6 schools, 3 primary and 3 secondary, in the LGA. About 100 children were examined from each age category of 11 to 16 years for extrinsic stains, and information on their dietary and oral habits was obtained. A 64.0% prevalence of extrinsic stains was found among the study population (boys =64.5%, girls = 63.4%). The colour of the extrinsic stains ranged from yellow, brown, green, orange, black to red and were mainly due to poor oral hygiene. The extrinsic stains were derived mainly from food consumption and the action of chromogenic bacteria. The high level of extrinsic stains seen in this study is also a reflection of the low utilisation of dental services and subsequently of professional oral prophylaxis among the subjects as 91.5% had never visited a dentist and 94.8% had never had a professional oral prophylaxis. The prevalence of stains seen in the study population is higher than would be expected in adolescents who should be rather self-conscious at that age, the older adolescents even having a significantly higher prevalence of stains than younger adolescents (p < 0.05). No statistical difference in extrinsic stains prevalence was found among the sexes (p = 0.7) or among social classes (p> 0.05). The establishment of a school oral health care programme in the Local Government Area is advocated, as this may be the only source of oral care for these children. Dental health education and promotion services should be the main thrust of such services, which may be in form of fixed or mobile dental clinics.

Adolescent↗
PubMed1997

A comparison of independently conducted dose assessments to determine compliance and resettlement options for the people of Rongelap Atoll.

Rongelap Island was the home of Marshallese people numbering less than 120 in 1954; 67 were on the island and severely exposed to radioactive fallout from an atomic weapons test in March of that year. Those resident on Rongelap were evacuated 50 h after the test, returned 3 y later, then voluntarily left their home island in 1985 due to their ongoing fear of radiation exposure from residual radioactive contamination. Following international negotiations in 1991, a Memorandum of Understanding (MOU) was signed in early 1992 between the Republic of the Marshall Islands Government, the Rongelap Atoll Local Government, the U.S. Department of Energy, and the U.S. Department of the Interior. In this MOU it was agreed that the Republic of the Marshall Islands, with the aid of the U.S. Department of Energy, would carry out independent dose assessments for the purpose of assisting and advising the Rongelap community on radiological issues related to a safe resettlement of Rongelap. The MOU enacted two action levels which were agreed to be used to establish whether mitigation should be considered as a condition for resettlement of Rongelap Island: (1) no individual should receive an annual dose in the future of 1 mSv or more, above that from natural background radiation, assuming that his/her diet consists of only locally produced foods, and (2) the total surface soil concentration of plutonium and other transuranic elements must be less than 629 Bq kg(-1) (averaged over the top 5 cm). Environmental radiological data and dietary information were collected over two years (1992-1993) for the purpose of predicting future potential doses to Rongelapese who might resettle. In 1994, four independent assessments were reported, including one from each of the following entities: Marshall Islands Nationwide Radiological Study; Lawrence Livermore National Laboratory; an independent advisor from the United Kingdom (MCT); and a committee of the National Research Council. All four assessments concluded that possibly more than 25% of the adult population could exceed the 1 mSv y(-1) dose level based on strict utilization of a local food diet. The purpose of this report is to summarize the methodology, assumptions, and findings from each of four assessments; to summarize the recommendations related to mitigation and resettlement options; to discuss unique programmatic aspects of the study; and to consider the implications of the findings to the future of the Rongelap people.

Adult↗
PubMed1996

Product stewardship of Paraquat in Indonesia.

In Indonesia, paraquat products play an important role in controlling weed in plantation estates, small-holders farming land and potentially in tidal swamp areas to be converted to tidal rice farming. Laboratory and field data which showed that paraquat did not cause a health hazard to users/farmers if used normally or as recommended, and the virtual absence of environmental impact, were important information conveyed to the customers in the product stewardship activities. Education and training have been implemented in 11 provinces, covering 4934 farmers group, 206 Zeneca field staffs and 100 local government staffs since January 1993. Using interactive method and field practicals, significant improvements in the knowledge and skill of safe and effective use of pesticide have been achieved. The success of this stewardship initiative lies upon good relationship with government authorities and informal local leaders, besides careful planning.

Animals↗
PubMed2002

Anatomical origins of the classical receptive field and modulatory surround field of single neurons in macaque visual cortical area V1.

From the analyses of our own and others' anatomical and physiological data for the macaque visual system, we arrive at a conclusion that three pathways can provide the V1 neuron with access to information from the visual field and affect its response. First, direct thalamic input can determine the size of the initial activating RF at high contrast. Second, lateral connections can enlarge the RF at low contrast by pooling information from larger regions of cortex that are otherwise ineffective when high contrast thalamic input is driving the cortical neuron. Thirdly, feedback from extrastriate cortex (possibly together with overlap or interdigitation of coactive lateral connectional fields within V1) can provide a large and stimulus specific surround modulatory field. The stimulus specificity of the interactions between the center and surround fields, may be due to the orderly, matching structure and different scales of intra-areal and feedback projection excitatory pathways. The observed activity changes of single recorded excitatory neurons could be a result of the relative weight of excitation on the excitatory neurons themselves and on local inhibitory interneurons that synapse on them. Inhibitory basket neurons, driven by the local excitatory neurons, could govern local interactions between cortical patches of different tuning properties, resulting in more distant changes in excitatory input in the laterally connected intra-areal neuronal pools.

Animals↗
PubMed2003

A C-terminal EGF-like domain governs BAD1 localization to the yeast surface and fungal adherence to phagocytes, but is dispensable in immune modulation and pathogenicity of Blastomyces dermatitidis.

BAD1, an adhesin and immune modulator of Blastomyces dermatitidis, is an essential virulence factor that is released extracellularly before association with the yeast surface. Here, deletion of the C-terminal EGF-like domain profoundly affected BAD1 function, leading to non-association with yeast, extracellular accumulation and impaired yeast adherence to macrophages. In equilibrium binding assays, DeltaC-term BAD1, lacking an EGF-like domain, bound poorly to BAD1 null yeast, yielding a low affinity (Kd, 3 x 10(-7) M versus 5 x 10(-8) M) and Bmax (1.9 x 10(5) versus 7.9 x 10(5)) compared with BAD1. Similar protein binding profiles were observed using chitin particles, reinforcing the notion that chitin fibrils are a receptor for BAD1, and that the EGF-like domain is critical for BAD1 interactions with chitin on yeast. DeltaC-term strains bound poorly to macrophages, compared with parental or BAD1-reconstituted null strains. However, DeltaC-term strains and the purified protein itself sharply suppressed tumour necrosis factor (TNF)-alpha release by phagocytes in vitro and in lung in vivo, and the strains retained pathogenicity in a murine model of blastomycosis. Our results illustrate the previously undefined role of the EGF-like domain for BAD1 localization to yeast surfaces during cell wall biogenesis. They also demonstrate that the requirements for host cell binding and immune modulation by BAD1 can be dissociated from one another, and that the former is unexpectedly dispensable in the requisite role of BAD1 in pathogenesis.

Amino Acid Sequence↗
PubMed2001

Mechanisms governing subcellular localization and function of human RGS2.

RGS proteins negatively regulate heterotrimeric G proteins at the plasma membrane. RGS2-GFP localizes to the nucleus, plasma membrane, and cytoplasm of HEK293 cells. Expression of activated G(q) increased RGS2 association with the plasma membrane and decreased accumulation in the nucleus, suggesting that signal-induced redistribution may regulate RGS2 function. Thus, we identified and characterized a conserved N-terminal domain in RGS2 that is necessary and sufficient for plasma membrane localization. Mutational and biophysical analyses indicated that this domain is an amphipathic alpha-helix that binds vesicles containing acidic phospholipids. However, the plasma membrane targeting function of the amphipathic helical domain did not appear to be essential for RGS2 to attenuate signaling by activated G(q). Nevertheless, truncation mutants indicated that the N terminus is essential, potentially serving as a scaffold that binds receptors, signaling proteins, or nuclear components. Indeed, the RGS2 N terminus directs nuclear accumulation of GFP. Although RGS2 possesses a nuclear targeting motif, it lacks a nuclear import signal and enters the nucleus by passive diffusion. Nuclear accumulation of RGS2 does not limit its ability to attenuate G(q) signaling, because excluding RGS2 from the nucleus was without effect. RGS2 may nonetheless regulate signaling or other processes in the nucleus.

Amino Acid Sequence↗
PubMed1993

Exofacial epitope-tagged glucose transporter chimeras reveal COOH-terminal sequences governing cellular localization.

The insulin-regulated adipocyte/skeletal muscle glucose transporter (GLUT4) displays a characteristic steady-state intracellular localization under basal conditions, whereas the erythrocyte/brain transporter isoform (GLUT1) distributes mostly to the cell surface. To identify possible structural elements in these transporter proteins that determine their cellular localization, GLUT1/GLUT4 chimera cDNA constructs that contain the hemagglutinin epitope YPYDVPDYA (HA) in their major exofacial loops were engineered. Binding of monoclonal anti-HA antibody to non-permeabilized COS-7 cells expressing HA-tagged transporter chimeras revealed that expression of transporters on the cell surface was strongly influenced by their cytoplasmic COOH-terminal domain. This method also revealed a less marked, but significant effect on cellular localization of amino acid residues between transporter exofacial and middle loops. The subcellular distribution of expressed chimeras was confirmed by immunofluorescence microscopy of permeabilized COS-7 cells. Thus, HA-tagged native GLUT4 was concentrated in the perinuclear region, whereas a chimera containing the COOH-terminal 29 residues of GLUT1 substituted onto GLUT4 distributed to the plasma membrane, as did native GLUT1. Furthermore, a chimera composed of GLUT1 with a GLUT4 COOH-terminal 30-residue substitution exhibited a predominantly intracellular localization. Similar data was obtained in CHO cells stably expressing these chimeras. Taken together, these results define the unique COOH-terminal cytoplasmic sequences of the GLUT1 and GLUT4 glucose transporters as important determinants of cellular localization in COS-7 and CHO cells.

Amino Acid Sequence↗
PubMed2000

Historical analysis of the development of health care facilities in Kerala State, India.

Kerala's development experience has been distinguished by the primacy of the social sectors. Traditionally, education and health accounted for the greatest shares of the state government's expenditure. Health sector spending continued to grow even after 1980 when generally the fiscal deficit in the state budget was growing and government was looking for ways to control expenditure. But growth in the number of beds and institutions in the public sector had slowed down by the mid-1980s. From 1986-1996, growth in the private sector surpassed that in the public sector by a wide margin. Public sector spending reveals that in recent years, expansion has been limited to revenue expenditure rather than capital, and salaries at the cost of supplies. Many developments outside health, such as growing literacy, increasing household incomes and population ageing (leading to increased numbers of people with chronic afflictions), probably fueled the demand for health care already created by the increased access to health facilities. Since the government institutions could not grow in number and quality at a rate that would have satisfied this demand, health sector development in Kerala after the mid-1980s has been dominated by the private sector. Expansion in private facilities in health has been closely linked to developments in the government health sector. Public institutions play by far the dominant role in training personnel. They have also sensitized people to the need for timely health interventions and thus helped to create demand. At this point in time, the government must take the lead in quality maintenance and setting of standards. Current legislation, which has brought government health institutions under local government control, can perhaps facilitate this change by helping to improve standards in public institutions.

Adult↗
PubMed2004

An estimate of the U.S. Government's undercount of nonfatal occupational injuries.

Debate surrounds the size of the underestimate of nonfatal occupational injuries produced by the U.S. Bureau of Labor Statistics (BLS). We developed models that separated categories of injuries: BLS Annual Survey, federal government, agriculture, state and local government, self-employed outside agriculture, and all other. The models generated varying estimates depending on the assumptions for each category pertaining to job risks and amount of underreporting. We offered justification for the assumptions based on published studies as well as our own analyses of BLS data. The models suggested the Annual Survey missed from 0% to 70% of the number of injuries (from private firms, excluding the self-employed) it was designed to capture. However, when we included firms and governments the Annual Survey was not designed to capture, and considered reasonable assumptions regarding underreporting, we estimated the BLS missed between 33% and 69% of all injuries. We concluded that there was substantial undercapture in the BLS Annual Survey, some due to the excluded categories of government workers and the self-employed, as well as some due to underreporting.

Accidents, Occupational↗
PubMed1997

Not in our back yard: media coverage of community opposition to mobile phone towers--an application of Sandman's outrage model of risk perception.

Australia has the world's second highest per capita use of mobile phones. To meet rapid expansion in use, transmission towers are being erected hastily, backed by federal government exemptions from normal local government planning procedures. In a case study of media reportage of a successful resident protest about the placement of transmitters adjacent to a kindergarten, uncertain risks to health were the ostensible concerns voiced by the protesters. Eleven of the 12 primary components and six out of eight secondary components of Sandman's model of community risk perception were consistent with both the protesters' expressed concerns about the transmission towers and the way in which the issues involved were framed by the media.

Attitude↗
PubMed1979

Penetration enhancers and other factors governing percutaneous local anaesthesia with lidocaine.

The percutaneous penetration of the local anaestetic lidocaine was investigated in the guinea-pig. Three different types of composition were employed: lidocaine hydrochloride in aqueous solution, lidocaine base in an aqueous alcoholic solvent mixture and lidocaine base in aqueous solutions of dipolar aprotic solvents. The latter solvents included simple tertiary aliphatic amides, amides related to dimethylacetamide, some cyclic amides as well as a number of miscellaneous compounds. The degree of dermal anaesthesia was noted in each case. In addition, the uptake and distribution of lidocaine in the skin and its absorption into the blood were studied using tritium-labelled drug. The results show that the percutaneous penetration of lidocaine is dependent on the concentration of the agent, the time of epicutaneous application of the composition, whether the agent was used as salt or free base, and the nature of the solvent medium. Lidocaine base in aqueous dimethylacetamide was most effective in producing percutaneous local anaesthesia.

Amides↗
PubMed2001

Political strategy 101: how to make health policy and influence political people.

Many health policy decisions that affect how health care professionals care for their patients are made by the federal government or state and local governments. For most health care professionals, the policy-making process is a mystery. Health policy decisions made by elected and appointed officials in various branches of government are influenced by political factors often unfamiliar to the decision-making process of health care professionals. With some guidance on how to think critically about politics, health care professionals can influence the development, passage, and implementation of government-sponsored health policies that affect their patients. Based on insights gleaned from experience, accounts of the policy-making process, and political science literature, this article describes a process of gathering and analyzing political information that can aid physicians in developing a strategy that will help them influence the political agenda and their patients' care.

Child↗
PubMed2000

Healthy City Kwachon 21 Project: a community health promotion programme in Korea.

Disease patterns of Koreans changed from infectious disease to non-infectious disease in the 1970's. Even though there has been a need for a health promotion programme, it was hard to find the programme in the community before 1985 in Korea. In 1985, the Public Health Promotion Law was enacted and the Korean government started to encourage local government to plan and conduct community health promotion programs. Healthy City Kwachon 21 (HCK21) is a health promotion programme for all residents in Kwachon, a city which has about 70,000 population and is located adjacent to Seoul, Korea. HCK21 launched in 1998 with three guiding principles: 1) programs should be accessible to all citizens; 2) Programmes should stimulate strong community participation and 3) Programmes should change environment and society. The long term goal of HCK21 is to increase the healthy life span of citizens in Kwachon. HCK21 is a collaborative project between Kwachon and the Institute for Health Promotion of the Graduate School of Health Science and Management, Yonsei University. It has seven components: 1) Publication of Monthly Health Newsletter; 2) Smoking Cessation and Tobacco Prevention Program; 3) Community Nutrition Program; 4) Maternal and Women's Health Programme; 5) Programme for Development of District Health Management Information System; 6) Hypertension Prevention and Control Programme and 7) Physical Activity Programme. HCK21 is now being implemented in the third year program since the program conducted in 1998 and 1999 was successful with received support from the citizens. It is recommended that HCK21 be a model for an integrated community-based health promotion programme in developing countries.

Adolescent↗