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PubMed1985

Peptide alcohols as promoters of nitrate and ammonium ion uptake in plants.

Several aryl-carbamoyl dipeptide alcohols increased the uptake of nitrate and ammonium ions into corn root segments by up to 50% and 90%, respectively. The most effective one was N-carbobenzoxy-l-prolyl-l-valinol. Foliar application of this compound to underfertilized corn plants caused an increase in the rate of plant growth in the greenhouse and provided modest (6-10%) corn yield increases in field tests in Delaware.

Journal Article↗
PubMed2005

Herbal and homeopathic medication use in pediatric surgical patients.

BACKGROUND: Patients who present for surgery may be using herbal or homeopathic preparations; adverse effects of some of these substances include bleeding, cardiovascular changes, and liver dysfunction. Little information is available on the frequency of use in the pediatric surgical population. METHODS: With institutional approval, a survey was conducted to assess the use of vitamins, nutritional supplements, or herbal or homeopathic preparations in children presenting for surgery in five geographically diverse centers in the USA. RESULTS: A total of 894 completed surveys showed that overall, 3.5% of pediatric surgical patients had been given herbal or homeopathic medications in the 2 weeks prior to surgery. Most substances were prescribed by parents. The use of these medications did not differ between children with coexisting diseases and those without; use was also not different among ethnic groups or by residence setting (city, suburban, rural). There was a significant difference between the west coast centers in the study compared with the rest of the country (7.5% of patients in Palo Alto, CA; 5.5% of patients in Seattle, WA; 1.5% of patients in Chicago, IL; and 1.9% in Virginia and Delaware used herbal or homeopathic remedies). The most prevalent substance given to children presenting for elective surgery was Echinacea. CONCLUSIONS: Herbal and homeopathic medications are used by a small percentage of pediatric patients presenting for elective pediatric surgery patients. Use of these substances should be addressed in the preoperative history.

Adolescent↗
PubMed1997

Hospital breastfeeding policies in the Philadelphia area: a comparison with the ten steps to successful breastfeeding.

BACKGROUND: The purpose of this study was to describe the current status of hospital breastfeeding policies and practices in the southeastern Pennsylvania Delaware Valley and the degree to which the hospitals are implementing the WHO/UNICEF Ten Steps to Successful Breastfeeding. METHODS: A descriptive case study design was used to collect data. From 38 hospitals with maternity services in the Philadelphia area, maternal and child health directors, nurse managers, staff nurses, lactation consultants, and childbirth educators were interviewed to determine each hospital's policies and practices, using a questionnaire addressing formal and informal breastfeeding policies. Information from the interviews was used to compare each hospital's policies with the WHO/UNICEF Baby-Friendly Hospital Initiative. A classification system was developed to classify hospitals by level of implementation for each of the Ten Steps. RESULTS: Most surveyed hospitals were implementing four of the steps and partially implementing the remaining six. Thirty-seven percent of the surveyed hospitals were classified as high implementers and 63 percent as partial implementers of the Ten Steps overall. Key issues that affect implementation of each step were identified through in-depth discussion of several questions. CONCLUSIONS: Areas identified as needing the greatest attention by hospitals were health care professional breastfeeding education, breastfeeding initiation, and support of the breastfeeding mother, particularly in the postdischarge stage.

Breast Feeding↗
PubMed1992

Major surgery in nursing home patients: procedures, morbidity, and mortality in the frailest of the frail elderly.

OBJECTIVE: To determine the surgical procedures being done on long-term care (level 2) nursing home residents and the resultant in-hospital morbidity and mortality. DESIGN: A retrospective chart review of inpatient medical records from two hospitals, identified by computerized search of medical records and/or referral by directors of nursing of area nursing homes. SETTING: Patients originated in skilled-care nursing homes in New Castle County, Delaware, USA. Surgery was performed in the area's two major hospitals, one a 1000-bed regional referral and teaching hospital, and the other a 300-bed community hospital. PATIENTS: Residents of skilled-care nursing homes (level 2) who underwent major surgery between January 1979 and December 1989. MEASUREMENTS AND MAIN RESULTS: Eighty procedures were performed in 74 patients. Many different types of procedures were done. After primary repair of hip fracture the most common procedures were non-orthopedic extremity and abdominal surgeries. Three deaths occurred (mortality 3.8%), and all were in patients undergoing emergency surgery who were classified above American Society of Anesthesiology Class 3. Serious complications occurred in 43% of the procedures and were most commonly cardiopulmonary and psychiatric, including profound depression in four. Antibiotic-associated colitis occurred in three patients and required a second surgical procedure in one. Fewer adverse outcomes were seen in patients undergoing elective surgical procedures with spinal or local anesthesia than in patients receiving general anesthesia. CONCLUSIONS: Although retrospective and limited to inpatient data, in-hospital surgical mortality in this very frail population was low, comparable to series in unselected geriatric populations. However, major complications were very common. Primary hip surgery repair may have been too frequently done. A multi-institution, prospective trial would be useful to assess functional outcome of surgery in this population.

Aged↗
PubMed1993

The effects of age and diabetes mellitus on nerve function.

OBJECTIVE: This project evaluated the association of age and vibratory thresholds (assessment modality of large sensory nerve fibers) in subjects with and without diabetes mellitus. DESIGN: Cross-sectional study. SETTING: Medical Research Institute of Delaware. PARTICIPANTS: Individuals with non-insulin-dependent diabetes mellitus and non-diabetic control subjects. MEASUREMENTS: Vibratory thresholds were examined in four age groups (ie, < 45 yrs, 45-54 yrs, 55-64 yrs, > or = 65 yrs). The independent association of age, duration of diabetes, height, gender, glycemic control, and smoking history were analyzed in terms of their relationship to vibratory thresholds. MAIN RESULTS: Vibratory thresholds increased with age for both control and diabetic subjects. Comparing controls with diabetic subjects in the same age categorizes revealed significant differences for vibratory thresholds only in the > or = 65 year old age group. Modeling with vibratory thresholds as the dependent variable showed that age and male gender were independently associated with vibratory thresholds for the controls and explained the majority of the variability (R2 = 0.79). Age, duration of diabetes, and height were independently associated with vibratory thresholds for the diabetic subjects but explained much less of the variability (R2 = 0.39). CONCLUSIONS: The results suggest an acceleration of the natural aging process for large sensory nerve fiber function in diabetic subjects. Thus, young diabetic subjects may be at a risk of lower extremity complications as a result of injuries similar to that older non-diabetic individuals.

Adult↗
PubMedDate not supplied

Evidence for regular sporulation by Haplosporidium nelsoni (MSX) (Ascetospora; Haplosporidiidae) in spat of the American oyster, Crassostrea virginica.

The spore stage of Haplosporidium nelsoni, the ascetosporan parasite causing multinucleated sphere unknown (MSX) disease in oysters, Crassostrea virginica, has been reported so rarely (less than 0.01% of infected oysters) that a second host has been postulated. However, recent intensive sampling of young (less than 1 year) oysters in Delaware Bay, U.S. suggests that spore formation occurs regularly in this group and that spores are produced in at least 75-85% of all infections reaching the advanced stage. Sporulation was seasonal, occurring over two to three weeks in late June/early July and again in late summer/early fall. Our data indicate that sporulation by H. nelsoni in oysters is more common than previously suspected, occurring in a segment of the host population that may not have been sufficiently sampled in the past, and that a direct life cycle should be reconsidered.

Animals↗
PubMed2001

How gastroenterologists inform patients of results after lower endoscopy.

OBJECTIVE: Little is known about how gastroenterologists communicate endoscopic findings and biopsy results to their patients. We sought to determine the factors that may influence this behavior. METHODS: A survey questionnaire was developed and mailed to the 80 members of the Delaware Valley Society for GI Endoscopy. Information was obtained on the demographic characteristics and responses to six case vignettes prepared to examine communication patterns. We determined possible influences of conscious sedation and the benignity or severity of findings on communication practices. RESULTS: Sixty-one surveys (76%) were completed and analyzed. Endoscopists immediately inform patients of normal results. For abnormal results, 92% would immediately inform nonsedated patients versus 79% that would inform sedated patients (p < 0.008). Analysis of responses to the case vignettes indicated that 82% of endoscopists would immediately reassure the patient about a benign appearing (< 1 cm) polyp, but only 70% would do so for a polyp > 2 cm (p < 0.01). In contrast, when presented with a frank malignancy, 94% would inform the patient. Eighty-four percent of endoscopists would telephone results of a benign pathology report, but only 34% would telephone report a dysplastic lesion (p < 0.001). There was no correlation between the response rate and various demographic parameters such as physician age, type of, or length of time in practice. CONCLUSIONS: Gastroenterologists usually report normal findings immediately, but are less likely to do so after use of sedation or encountering abnormal findings. Most of those surveyed would use the telephone to communicate abnormal findings.

Adult↗
PubMed1978

Survey of state funds available for rehabilitation of patients with cleft lip/palate.

An effort was made to determine the amount of funds budgeted in each of the 50 U.S. states for total rehabilitation of patients with cleft lip and/or cleft palate. Questionnaires were sent following a pilot letter to the directors of each state Department of Health. Total funds per patient ranged from $17,442 for Delaware to a low of $426 for Wisconsin. Dental funds per patient ranged from $4,214 dollars for Wyoming to a low of $192 for New York.

Cleft Lip↗
PubMed1999

Shear bond strengths of one-bottle adhesives to moist enamel.

PURPOSE: This study evaluated bond strengths of six one-bottle bonding agents and a control (primer plus unfilled resin) to moist enamel. MATERIALS AND METHODS: One-hundred and five bovine teeth were randomly assigned to seven groups of 15. Enamel was etched for 15 seconds with 35% phosphoric acid. Etched enamel was rinsed, and excess water was blotted with tissue paper. Following application of the adhesive, composite resin was bonded using a gelatin capsule technique. Shear bond strengths to enamel were determined using a universal testing machine (Instron Corp., Canton, Massachusetts). RESULTS: Mean bond strengths ranged from 21.9 MPa for OptiBond Solo (Kerr Corp., Orange, California) to 29.6 MPa for Prime & Bond 2.1 (Dentsply/Caulk, Milford, Delaware). Prime & Bond 2.1 had a significantly higher mean bond strength than the other adhesives. CLINICAL SIGNIFICANCE: The results of this study suggest that all of the one-bottle systems tested should provide clinically acceptable bonding to moist enamel.

Animals↗
PubMedDate not supplied

Back diffusion of chlorinated solvent contaminants from a natural aquitard to a remediated aquifer under well-controlled field conditions: predictions and measurements.

Vertical profiles of tetrachloroethene (or perchloroethylene, PCE) and trichloroethene (TCE) were used to validate a diffusion process in a natural aquitard at Dover Air Force Base, Delaware. PCE and TCE distributions in the aquitard underlying an unconfined aquifer were sampled from core tubes obtained at four times over the course of a 35-month field investigation within "test cells" that were isolated from the surrounding ground water by means of grout-sealed steel sheetpile barriers (Mackay et al. 2000). For the final 23 months of this period, boundary conditions at the aquifer/aquitard interface were such that a "back diffusion" of contaminants from the aquitard was induced. Modeling predictions of concentration changes were made on the basis of the earliest coring results and an assumption of sorption-retarded diffusion and using laboratory information about sorption and diffusion characteristics of the media. The predictive modeling was complicated by the fact that "initial" and "final" PCE and TCE distributions in the aquitard were measured at different (albeit proximate) coring locations, such that results reflect spatial variations in aquitard characteristics. This problem was solved by means of an inverse interpretation that involved spatial "translation" of observed profiles on the basis of the laboratory characterizations and assuming a common aquifer-side contaminant history. Predictions indicated substantial change in PCE and TCE concentrations within the upper aquitard (near the aquifer/aquitard interface) and the development of a back-diffusion profile up into the aquifer. Modeling also predicted comparatively minor profile changes in the deeper aquitard, and especially in the deep layer where sorption was strongest. All of these predicted effects were observed in the coring results. Although not exact, the agreement between predictions and observations was sufficiently good to justify the basic tenets of the diffusion model and to support a conclusion that major processes of advection and/or transformation were unimportant within the 35-month time scale of this work.

Diffusion↗
PubMed2000

Human immunodeficiency virus infection in rural areas and small cities of the southeast: contributions of migration and behavior.

The design of education and prevention strategies to stem the spread of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in rural areas depends on having accurate patterns of risk behavior and transmission in local areas. Interviews were conducted with people in rural areas and small cities in Delaware, Florida, Georgia and South Carolina who were at least 18 years old and infected with HIV in order to describe demographic characteristics, migration patterns and risk behaviors. Interviews were conducted with 608 people. Most respondents were male (66 percent), black (63 percent of men, 85 percent of women) and had been infected through sexual contact (67 percent of men, 66 percent of women). Most (65 percent) had lived away from a rural area or small city for at least one month; of those, 71 percent had moved from an urban area. Twenty-seven percent of respondents indicated they had been infected locally. People with a history of injection drug use were less likely to have been infected locally than those who had no history of injection drug use (6 percent vs. 26 percent among men, 3 percent vs. 40 percent among women, P < 0.001). Further understanding of the role of socioeconomic factors in HIV transmission in rural areas and small cities is needed. Programs designed to prevent HIV acquisition among people living in rural areas and small cities in the Southeast should focus on sexual behavior.

Adolescent↗
PubMed2006

Prevalence and trends in smoking: a national rural study.

CONTEXT: Cigarette smoking is the leading preventable cause of death in the United States. PURPOSE: To estimate the prevalence of and recent trends in smoking among adults by type of rural location and by state. METHODS: Random-digit telephone survey of adults aged 18 years or older who participated in the Behavioral Risk Factor Surveillance System in 1994-1996 (n = 342,055) and 2000-2001 (n = 385,384). The main outcome measure was current cigarette smoking, defined as persons who smoke every day or some days, while nonsmokers were those who smoke not at all or reported never having smoked as many as 100 cigarettes. FINDINGS: The prevalence of smoking changed little from the mid-1990s; in 2000-2001, it was 22.0% in urban areas, 24.9% in rural adjacent areas, 24.0% in large rural nonadjacent areas, and 24.9% in small rural nonadjacent areas. For rural locations combined, smoking prevalence was not below the 12% goal of Healthy People 2010 for any state, although the 12.5% prevalence in rural Utah approached this target. Prevalence was > or = 28% for rural residents of Kentucky, Ohio, and Indiana. Since the mid-1990s, the prevalence of smoking for rural respondents decreased by more than 2 percentage points in 6 states: California, Connecticut, Maryland, North Carolina, Tennessee, and Utah. However, it increased by 2 percentage points or more in 10 states: Alabama, Delaware, Georgia, Massachusetts, Michigan, Mississippi, New Hampshire, Oklahoma, South Carolina, and Texas. CONCLUSIONS: Smoking remains a refractory public health problem. Better ways to curb smoking in rural America are needed.

Adolescent↗
PubMedDate not supplied

Tracking and improving influenza immunization rates in a high-risk medicare beneficiary population.

Immunization rates for end stage renal disease (ESRD) patients were well below the 80% target set by Healthy People 2000 and Centers for Medicare and Medicaid Services. The authors sought to increase documentation of immunization status, and influenza immunization rates of these patients. A survey was distributed to dialysis facilities to determine immunization practices. Facilities were provided with an immunization toolbox and spreadsheets to document the immunization status of patients. A total of 102 facilities (53%) provided data for three collection periods (1999, 2000, and 2001). Immunization rates for each influenza season increased significantly from 62.1% and 61.4% in 1998-1999 to 80.3% and 80.0% in 2000-2001 (Pennsylvania and Delaware respectively).

Aged↗
PubMed1978

Interactions between the diatom Thallasiosira pseudonanna and an associated pseudomonad in a mariculture system.

The marine diatom Thallasiosira pseudonanna (3H) and several bacteria associated with it were isolated from batch cultures at the University of Delaware mariculture facility. The interaction between the algae and each of the bacteria was investigated. One of the isolates, T827/2B (Pseudomonas sp.), was incapable of surviving in f/2 culture medium unless the algae were present. When the algae and T827/2B were grown together in the f/2 medium, the bacterial growth was stimulated and the algal growth was inhibited. Bacterial filtrate had a similar effect on the algae, indicating that the bacterial effect is an indirect one most likely resulting from the excretion of a harmful compound into the medium. Preliminary characterization of the material excreted by the bacteria indicates that it s proteinaceous in nature. The interactions observed does not fit into any single category of interactions but can be explained as a combination of competition and indirect parasitism.

Antibiosis↗
PubMed1982

Use of nitrifier activity measurements to estimate the efficiency of viable nitrifier counts in soils and sediments.

A procedure for estimating the efficiency of the most-probable number (MPN) technique for counting ammonium-oxidizing bacteria was tested on sediments and soils collected from Delaware Inlet, Nelson, New Zealand. The procedure involved estimating the nitrifier populations required to produce observed activities and comparing these estimates with the MPN-countable populations. MPN counts ranged between 0.15 x 10 to 3.0 x 10 cells g in sediments and between 4.4 x 10 to 19 x 10 cells g in soils. These counts were only 0.1 to 5.0% of the estimated populations that would be required to produce the observed activity. Similar efficiency calculations were made for data already in the literature, and these calculations gave much higher percentages. Thus, we concluded that for the soils and sediments we studied, the MPN counting technique greatly underestimated the populations present and that the efficiency calculation could be used as a counting efficiency index.

Journal Article↗
PubMed1989

Free-living pathogenic and nonpathogenic amoebae in Maryland soils.

Tests for potentially pathogenic amoebae were carried out on soil samples from the following sites: (i) farmlands fertilized with municipal sewage wastes, (ii) a stream receiving sewage effluent from a sludge lagoon, (iii) a ravine receiving storm runoff from a cattle farm, (iv) farmlands not fertilized with sewage wastes, and (v) a vegetated shoreline of a waterfront estate not used for farming or livestock production. Study sites were located on the eastern shore of Maryland, bordered to the north by Delaware and to the south by Virginia. Twenty-four species of soil amoebae, including five potentially pathogenic Acanthamoeba species (members of the family Acanthamoebidae), were identified. All of the sites yielded two or more of the potential pathogens.

Acanthamoeba↗
PubMed1990

Symbiotic effectiveness of indigenous soybean bradyrhizobia as related to serological, morphological, rhizobitoxine, and hydrogenase phenotypes.

A Collection of 360 isolates of Bradyrhizobium japonicum was developed from soybean (Glycine max [L.] Merrill) nodules taken from 18 locations in Delaware. The isolates were characterized serologically with an enzyme-linked immunosorbent assay, morphologically by colony type on yeast extract-mannitol agar, and for production of rhizobitoxine symptoms with soybean plants. These analyses revealed 12 and 3 groups based on serology and morphology, respectively. The more common identifiable isolates were in serogroups 94, 6, 122, and 76. Nearly 33% of the isolates were rated nonreactive with all of the antisera tested. Overall, 18% of the isolates produced rhizobitoxine symptoms, and these were associated with five known serogroups (31, 46, 76, 94, and 130) and the nonreactive grouping, but with only one colony type. A subsample of 92 isolates was rated for N(2)-fixing ability in the greenhouse and for hydrogenase phenotype in the laboratory. The nitrogen content of plant shoots was strongly and comparably related to both the serological and morphological groupings. Rhizobitoxine and hydrogenase phenotypes were relatively poor predictors of symbiotic effectiveness. Among the serologically reactive isolates, those in serogroups 38-115, 122, and 110 fixed the most N(2), whereas one colony type (that containing isolates producing rhizobitoxine) was clearly inferior to the remaining two morphological groupings. Isolates displaying hydrogenase activity (approximately 15% of the isolates tested) correlated with three serologically reactive groupings (serogroups 110 and 122 and a 122/123 cross-reactive group) and two colony types, none of which coincided with groupings containing bradyrhizobia rated positive for rhizobitoxine production.

Journal Article↗
PubMed1999

Use of a sentinel system for field measurements of Cryptosporidium parvum oocyst inactivation in soil and animal waste.

A small-volume sentinel chamber was developed to assess the effects of environmental stresses on survival of sucrose-Percoll-purified Cryptosporidium parvum oocysts in soil and animal wastes. Chambers were tested for their ability to equilibrate with external chemical and moisture conditions. Sentinel oocysts were then exposed to stresses of the external environment that affected their viability (potential infectivity), as indicated by results of a dye permeability assay. Preliminary laboratory experiments indicated that temperatures between 35 and 50 degrees C and decreases in soil water potential (-0.003 to -3.20 MPa) increased oocyst inactivation rates. The effects of two common animal waste management practices on oocyst survival were investigated on three dairy farms in Delaware County, N.Y., within the New York City watershed: (i) piling wastes from dairy youngstock (including neonatal calves) and (ii) spreading wastes as a soil amendment on an agricultural field. Sentinel containers filled with air-dried and sieved (2-mm mesh) youngstock waste or field soil were wetted and inoculated with 2 million oocysts in an aqueous suspension and then placed in waste piles on two different farms and in soil within a cropped field on one farm. Controls consisted of purified oocysts in either phosphate-buffered saline or distilled water contained in sealed microcentrifuge tubes. Two microdata loggers recorded the ambient temperature at each field site. Sentinel experiments were conducted during the fall and winter (1996 to 1997) and winter (1998). Sentinel containers and controls were removed at 2- to 4-week intervals, and oocysts were extracted and tested by the dye permeability assay. The proportions of potentially infective oocysts exposed to the soil and waste pile material decreased more rapidly than their counterpart controls exposed to buffer or water, indicating that factors other than temperature affected oocyst inactivation in the waste piles and soil. The effect of soil freeze-thaw cycles was evident in the large proportion of empty sentinel oocysts. The potentially infective sentinel oocysts were reduced to <1% while the proportions in controls did not decrease below 50% potentially infective during the first field experiment. Microscopic observations of empty oocyst fragments indicated that abrasive effects of soil particles were a factor in oocyst inactivation. A similar pattern was observed in a second field experiment at the same site.

Animal Husbandry↗