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PubMed1996

Urinary schistosomiasis: options for control within endemic rural communities: a case study in south-west Nigeria.

A preliminary investigation was conducted into factors that may bring about control of morbidity due to endemic urinary schistosomiasis in rural communities. A Knowledge, Attitudes, Practices and Beliefs (KAPB) study was conducted among primary schoolchildren (those with more than four years elementary education) in Ogbagba village, Osun State, Nigeria, from October 1990 to December 1993, to ascertain their understanding of urinary schistosomiasis. The study further assessed the potential of subjective haematuria, i.e. asking children with haematuria in the recent past to so indicate, in detecting urinary schistosomiasis. It was established that subjective haematuria is both sensitive and specific for detecting urinary schistosomiasis in endemic communities. The study also established that subjective haematuria offers a valid, easy to recognize target for morbidity control in endemic situation. It is proposed that with appropriate health education; availability of safe, effective, easy-to-administer drugs, such as praziquantel, morbidity control of urinary schistosomiasis is feasible within the primary health care system with the lower cadre health worker or even a volunteer village health worker (VVHW) at the centre of the control effort.

Adolescent↗
PubMedDate not supplied

[Protocol to evaluate the effectiveness of a consciousness-raising and training intervention for primary care professionals, in order to improve detection of domestic violence (ISFVIDAP)].

OBJECTIVE: To evaluate the effectiveness of an intervention aimed at primary care physicians and nurses to improve the detection of domestic violence. DESIGN: Community intervention study with control, randomized in clusters, pragmatic, open, and with parallel groups. SETTING: Primary care centres in Spain. POPULATION: Primary care physicians and nurses from the entire country who agree to participate in the study. UNIT OF ANALYSIS: The basic care team (BCT) of doctor and nurse looking after a list is the unit of analysis for evaluating the number of cases detected; and their clinical records are the units of analysis for evaluating recorded cases (suspicion and/or confirmation of mistreatment). SAMPLE SIZE: Sixty eight BCT in each group (136 in the 2 groups) and 1700 clinical records per group (25 per BCT). Altogether, they will cover some 130,000 women of 14 and over. INTERVENTION: A short training programme with homogeneous training contents, aimed at raising the awareness of health professionals and teaching them how to identify risk factors, situations of special vulnerability and alarm signals. The programme also aims to provide health professionals with tools to make the clinical interview easier, when they suspect mistreatment and how to tackle a case once it is detected. MEASUREMENTS: The main measurement will be the mean variation between intervention and control groups in the number of cases of domestic violence detected during the study, through specific recording and mean variation between the initial and final variations in each group. ANALYSIS: A weighted student's t test or, if covariates need to be adjusted, a regression analysis will be used for comparison. All analyses will be based on intention to treat.

Awareness↗
PubMed2004

Phylogenetic analysis and in situ identification of the intestinal microbial community of rainbow trout (Oncorhynchus mykiss, Walbaum).

AIMS: To identify the dominant culturable and nonculturable microbiota of rainbow trout intestine. METHODS AND RESULTS: Microbial density of rainbow trout intestine was estimated by direct microscopic counts (4',6-diamidino-2-phenylindole, DAPI) and by culturing on tryptone soya agar (TSA). Differential gradient gel electrophoresis analysis of bacterial DNA from intestinal samples, re-amplification of bands and sequence analysis was used to identify the bacteria that dominated samples where aerobic counts were < or =2% of the DAPI counts. 16S rDNA gene sequences of 146 bacterial isolates and three sequences of uncultured bacteria were identified. A set of oligonucleotide probes was constructed and used to detect and enumerate the bacterial community structure of the gastrointestinal tract of rainbow trout by fluorescence in situ hybridization (FISH). Members of the gamma subclass of Proteobacteria (mainly Aeromonas and Enterobacteriaceae) dominated the bacterial population structure. Acinetobacter, Pseudomonas, Shewanella, Plesiomonas and Proteus were also identified together with isolates belonging to the beta subclass of Proteobacteria and Gram-positive bacteria with high and low DNA G + C content. In most samples, the aerobic count (on TSA) was 50-90% of the direct (DAPI) count. A bacterium representing a previously unknown phylogenetic lineage with only 89% 16S rRNA gene sequence similarity to Anaerofilum pentosovorans was detected in intestinal samples where aerobic counts were < or =2% of direct (DAPI) counts. Ten to 75% of the microbial population in samples with low aerobic counts hybridized (FISH) with a probe constructed against this not-yet cultured bacterium. CONCLUSIONS: Proteobacteria belonging to the gamma subclass dominated the intestinal microbiota of rainbow trout. However, in some samples the microflora was dominated by uncultivated, presumed anaerobic, micro-organisms. The bacterial population structure of rainbow trout intestine, as well as total bacterial counts, varied from fish to fish. SIGNIFICANCE AND IMPACT OF THE STUDY: Good correlation was seen between cultivation results and in situ analysis, however, a molecular approach was crucial for the identification of organisms uncultivated on TSA.

Animals↗
PubMed2002

Characterization of the microbial community in an anaerobic ammonium-oxidizing biofilm cultured on a nonwoven biomass carrier.

The enrichment and characterization of anaerobic ammonium-oxidizing biofilm cultures are ongoing in our laboratories. Biomass, with a predominately red color, demonstrating simultaneous removal of ammonium and nitrite under autotrophic and anoxic conditions, which is characteristic of anaerobic ammonium-oxidizing planctomycetes, was enriched and maintained for an extended period on a polyester nonwoven carrier. To investigate the bacterial composition of the mature biofilm community, 16S rDNA sequences were amplified by PCR and comparative analyses using DNA databases were conducted. Only one sequence had a notable similarity (92.2%) to that of the first discovered anaerobic ammonium-oxidizing planctomycete and lesser, yet significant, similarities to the 16S rDNA sequences of other recently reported anaerobic ammonium-oxidizing strains. The newly discovered strain (designated KSU-1) reported here was dominant among detectable members of the biofilm community. By fluorescence imaging, KSU-1 was shown to form spherical clusters wrapped in a thin layer of Zoogloea sp. Possible interactions and interdependencies of these two species are discussed with regard to the putative unculturability of the anaerobic ammonium-oxidizing planctomycetes.

Journal Article↗
PubMed2025

Artificial Intelligence in Diagnosing Depression Through Behavioural Cues: A Diagnostic Accuracy Systematic Review and Meta-Analysis.

AIM: To synthesise existing evidence concerning the application of AI methods in detecting depression through behavioural cues among adults in healthcare and community settings. DESIGN: This is a diagnostic accuracy systematic review. METHODS: This review included studies examining different AI methods in detecting depression among adults. Two independent reviewers screened, appraised and extracted data. Data were analysed by meta-analysis, narrative synthesis and subgroup analysis. DATA SOURCES: Published studies and grey literature were sought in 11 electronic databases. Hand search was conducted on reference lists and two journals. RESULTS: In total, 30 studies were included in this review. Twenty of which demonstrated that AI models had the potential to detect depression. Speech and facial expression showed better sensitivity, reflecting the ability to detect people with depression. Text and movement had better specificity, indicating the ability to rule out non-depressed individuals. Heterogeneity was initially high. Less heterogeneity was observed within each modality subgroup. CONCLUSIONS: This is the first systematic review examining AI models in detecting depression using all four behavioural cues: speech, texts, movement and facial expressions. IMPLICATIONS: A collaborative effort among healthcare professionals can be initiated to develop an AI-assisted depression detection system in general healthcare or community settings. IMPACT: It is challenging for general healthcare professionals to detect depressive symptoms among people in non-psychiatric settings. Our findings suggested the need for objective screening tools, such as an AI-assisted system, for screening depression. Therefore, people could receive accurate diagnosis and proper treatments for depression. REPORTING METHOD: This review followed the PRISMA checklist. PATIENTS OR PUBLIC CONTRIBUTION: No patients or public contribution.

Humans↗
PubMed1993

Effects of lindane on macroinvertebrates and periphyton in outdoor artificial streams.

A system of six outdoor artificial streams (dimensions 5.0 X 0.35 X 0.25 m) was used to study the biological effects of lindane in flowing water. Lindane was continuously applied during 28 days to four of the streams while two were left as untreated controls. The nominal concentrations were 4.0, 8.0, 16.0, and 32.0 micrograms liter-1 and the mean measured concentrations of lindane in stream water over 28 days were 3.1, 5.7, 11.1, and 20.3 micrograms liter-1. Effects were observed on population densities of the freshwater shrimp Gammarus pulex, drift of G. pulex and mayflies (Baetis spp.), and on community photosynthesis. An increase in photosynthetic production of oxygen, a result of increased periphyton standing crop, followed the loss of macroinvertebrates, via drift, from the treated streams. This established a clear link between a direct effect of lindane on macroinvertebrates and an indirect effect on periphyton production. Drift and community photosynthesis were the most sensitive of the biological parameters measured and effects were detected in all treated streams. During a 28-day experiment with lower concentrations of lindane, nominally 0.25 and 1.0 micrograms liter-1, there were minor effects on the drift of Baetis spp. but only at the higher concentration. There were no detected effects on population densities or on community photosynthesis. Results from the two experiments provided a measured no observed effect concentration for lindane of 0.2 micrograms liter-1 and the threshold concentration for sustained effects on the stream communities was in the range 0.8 to 3.1 micrograms liter-1.

Animals↗
PubMed2002

[Virtual colonoscopy--chances for a screening procedure?].

In principle, virtual colonoscopy is capable to be used as method for early detection of colorectal cancer (CRC), even if the accuracy of the method and radiation exposure are matters discussion in the radiological community. Virtual colonoscopy is able to detect any pathology which is relevant for early detection of CRC especially when using multislice CT, but also with single slice CT. The diagnosis of small lesions, less than 7 mm in diameter (polyps and flat lesions) is still problematic as it is in conventional colonoscopy. The exposure to x-rays in asymptomatic patients, without any increased risk of developing cancer is highly problematic and should be reduced to a minimum. Using special post processing filters on the volume dataset it can be shown that a tube current of 20 mAs is sufficient without any loss in accuracy. Measurements on the Alderson-phantom showed, that an effective dose exposure of 1.2 mSv is obtained using these reduced mAs values. It has to be differentiated between virtual colonoscopy for early detection of polyps and CRC in individual patients or as a screening examination of a large population. Virtual colonoscopy as a screening examination necessitates reduction of radiation dose, a high degree of automatization in 3D reconstructions as well as the assessment of the entire mucosa. High risk patients, whom refuse fibreoptic colonoscopy should undergo virtual colonoscopy. Virtual colonoscopy has a good chance to become an accepted tool for general screening, if efficient dose reduction, complete visualization of the colon mucosa and automatization of the post processing procedures can be achieved.

Colonic Polyps↗
PubMed2000

Modified leprosy elimination campaign (MLEC) for case detection in a remote tribal area in the State of Orissa, India.

A leprosy project was established in a difficult to reach area under guidelines of Government of India. The leprosy services were provided by Koraput Leprosy Eradication Project (KORALEP) and general health services by Primary Health Care (PHC). Leprosy elimination campaigns (LECs) were suggested by WHO to detect more cases in the community. A modified leprosy elimination campaign (MLEC), carried out utilizing the services of primary health care workers is discussed in this paper. Apart from the trained health workers, Anganwadi workers along with some literate people from the district were also included in the search teams. In all, 1543 cases were shortlisted from the suspects identified and on re-examination 576 cases were confirmed as active cases. Sixty percent of the cases detected were very early cases with two to three skin lesions. This could be achieved with a very brief training of health workers and involving village voluntary workers. MLEC was found to be a useful tool for case finding in such areas.

Adolescent↗
PubMed2003

[Targeted bacteremia surveillance throughout a year--comparison of community-acquired and hospital-acquired infection].

To keep an eye on severe nosocomial infection and to evaluate the clinical difference of blood-stream infection between community-acquired and hospital-acquired infection, a survey of blood culture was performed in National Tokyo Medical Center from the period between November 2000 and October 2001. There were 252 episodes detected in 219 patients (80 community-acquired episodes in 80 patients and 172 hospital-acquired episodes in 139 patients). The three most common foci of infection/pathogens were as follows: in the community-acquired cases; urinary tract, pneumonia, infective endocarditis/Escherichia coli, viridant group of streptococci, Streptococcus pneumoniae, and in the hospital-acquired cases; intra-venous catheter, urinary tract, neutropenia-related bacteremia/Staphylococcus aureus, coagulase negative Staphylococcus, Enterococcus. Fifteen patients with community-acquired bacteremia and 37 patients with hospital-acquired bacteremia had been died within a month of the episode; the mortality was not significantly different between the both. The average of peak serum concentrations of C-reactive protein during the episodes of community-acquired bacteremia was higher than that of hospital-acquired bacteremia. These findings probably show that life threatening bloodstream infections seemed to be more common in the community. The rate of nosocomial bacteremia was approximately 1%, and no outbreak was observed during the period. Targeted bacteremia surveillance is maybe useful and efficient method to detect severe hospital-acquired infections.

Adolescent↗
PubMed2002

Screening for HIV infection in high-risk communities by urine antibody testing.

OBJECTIVES: To evaluate the effectiveness of urine screening to detect HIV-infected individuals in high-prevalence communities. METHODS: Urine HIV testing was performed at 16 discrete events and four ongoing testing sites in Baltimore communities with a high incidence of HIV infection. When possible, positive urine test results were confirmed by blood testing. In addition, we attempted to obtain blood samples from subjects who reported a possible exposure to HIV but did not have a positive urine test. RESULTS: From February 1998 to August 2001, we screened 1718 persons. Overall, 210 persons (12%) were HIV-positive, of whom 169 (80%) had never previously tested positive; 87% of those who tested positive received their results, and most were referred for medical care. CONCLUSIONS: Urine-based screening for HIV infection in high-prevalence inner city communities can be an effective tool for identifying and treating infected persons who are unaware of their infection.

Baltimore↗
PubMed2007

In vitro and in vivo effects of hydrolysates from conglycinin on intestinal microbial community of mice after Escherichia coli infection.

AIMS: To detect the effect of pepsin-hydrolysate conglycinin (PTC) on the growth of Escherichia coli O(138)in vitro, and investigate the effect of PTC on intestinal microbial community of mice after E. coli infection. METHODS AND RESULTS: Serial dilution method was used to detect the antibacterial activity of PTC in 96-well cell-cultivated plates. Fifty-five KM mice were randomly assigned to five groups: normal, feeding-E. coli control, HCl-full hydrolysis of conglycinin, conglycinin and PTC. Orally administrated with hydrolysates from conglycinin for 21 days, each mouse was fed with 2 x 10(8) CFU ml(-1) of E. coli O(138) on the 22nd day. The mice activities were monitored and polymerase chain reaction-denaturing gradient gel electrophoresis was used to analyse the microbial community in mice faeces. The results showed that PTC could inhibit growth of E. coli O(138) at nitrogen concentrations of more than 520 mg l(-1). There was high similarity of intestinal microbial community in mice between PTC and normal groups. CONCLUSION: PTC inhibits growth of E. coli O(138), keeps mice healthy following oral administration of E. coli infection and maintains a balanced active microbial community in their gastrointestinal tract. SIGNIFICANCE AND IMPACT OF THE STUDY: This study demonstrated the antibacterial activity of PTC against E. coli and its ability to maintain healthy intestinal microbial community in mice even after they were infected with E. coli. This observation is significant in the application of PTC to prevent gastrointestinal diseases caused by E. coli and unbalanced intestinal microflora.

Animals↗
PubMed1982

Impact of hexazinone on invertebrates after application to forested watersheds.

The impact of the herbicide, hexazinone, was assessed on aquatic macrophytes, aquatic and terrestrial invertebrate communities within forested watersheds in the Piedmont region of Georgia. Four replicate watersheds received hexazinone on April 23, 1979, and were subsequently monitored for eight months. Residue levels in terrestrial invertebrates were a maximum of two orders of magnitude greater than comparable levels (0.01 to 0.18 ppm) found in forest floor material. Aquatic organisms in a second order perennial stream were exposed to intermittent concentrations of hexazinone (6 to 44 ppb). Hexazinone and its metabolites were generally not detected (less than 0.1 ppm) in aquatic invertebrates and macrophytes. No major alterations in species composition or diversity were detected in the aquatic macroinvertebrate community. Terrestrial microarthropod samples collected near the end of the study period revealed no major community changes.

Animals↗
PubMed2002

MDON: a network of community partnerships.

This model for strengthening diabetes care in communities teams the public health system with the professional and lay community to address prevention, early detection, and treatment of diabetes. This article describes how the Michigan Diabetes Outreach Network (MDON) develops local, regional, and statewide partnerships to increase professional and public knowledge and to improve care delivery for this chronic and complex disease.

Community Health Services↗
PubMed1992

Community participation in malaria surveillance and treatment. I. The Volunteer Collaborator Network of Guatemala.

The Volunteer Collaborator Networks (VCNs) of Latin America are one of the oldest and most successful examples of community participation in malaria control. They are made up of unpaid community volunteers, known as Volunteer Collaborators, who are selected by their neighbors and are trained and supervised by a member of the National Malaria Service (NMS). When a febrile patient visits the home of a Volunteer Collaborator, the volunteer worker takes a thick blood smear, completes a patient report form, and administers a presumptive treatment for malaria. The blood smear is examined in an NMS laboratory, and if malaria parasites are found, a radical or curative treatment is forwarded to the Volunteer Collaborator so that it can be administered to the patient. There is no charge for either the blood smear or the antimalarial medication. The VCN of Guatemala was established in 1958. Currently, more than 5,000 Volunteer Collaborator posts are operating throughout the malarious areas of the country. The volunteers range in age from 12 to 76 years old and 61% are men. Approximately 15% have no formal education, and only 27% have a sixth grade or higher education. The median length of service is 35 months (range three months to 26 years); 33% have worked for five or more years. Male Volunteer Collaborators had significantly lower turnover rates than females, as did married Volunteer Collaborators when compared with single volunteers. An inverse relationship was noted between the amount of education a Volunteer Collaborator had and his length of service. With modifications tailored to meet the objectives of a malaria control program and the local epidemiologic setting, the VCN can serve as an excellent model for community participation in malaria case detection and treatment in other regions of the world. In particular, in areas where the primary goal of the malaria program is to prevent mortality and morbidity through the provision of readily accessible, appropriate drug therapy, VCNs are an attractive alternative to self-medication and an effective adjunct to treatment of malaria at health posts which are often located at a considerable distance from the patient's village. Experience gained with this system can be valuable in developing approaches to community involvement in other efforts to improve the health of villagers in developing countries.

Adolescent↗
PubMed1990

Hypertension control in a rural community. An assessment of community-oriented primary care.

To determine the effectiveness of a community-oriented primary care approach for the detection, treatment, and control of hypertension, data were analyzed from a survey of all 3094 adults living in a geographically well-defined rural community. Among the 2939 (96.1%) persons who completed the survey, 587 (20%) were found to meet study criteria for the diagnosis of hypertension. Hypertensive adults who identified a neighborhood health center with a community-oriented primary care philosophy as their source of care were more likely to have their disease detected, treated, and controlled than were hypertensive adults who identified other sources of care. The improved control was most evident for men and for blacks, but in every race-sex stratum, hypertensive patients of the neighborhood health center were more likely to be under control. Even when controlling in logistic models for age, race, and sex, identification of the neighborhood health center was associated with better control of hypertension (beta = 0.591, P = .004). In this rural community, community-oriented primary care delivered through a neighborhood health center appears to be associated with increased likelihood of detection, treatment, and control of hypertension.

Adult↗
PubMed1999

Fluorescence in situ hybridization using 16S rRNA-targeted oligonucleotides reveals localization of methanogens and selected uncultured bacteria in mesophilic and thermophilic sludge granules.

16S rRNA-targeted in situ hybridization combined with confocal laser scanning microscopy was used to elucidate the spatial distribution of microbes within two types of methanogenic granular sludge, mesophilic (35 degrees C) and thermophilic (55 degrees C), in upflow anaerobic sludge blanket reactors fed with sucrose-, acetate-, and propionate-based artificial wastewater. The spatial organization of the microbes was visualized in thin sections of the granules by using fluorescent oligonucleotide probes specific to several phylogenetic groups of microbes. In situ hybridization with archaeal- and bacterial-domain probes within granule sections clearly showed that both mesophilic and thermophilic granules had layered structures and that the outer layer harbored mainly bacterial cells while the inner layer consisted mainly of archaeal cells. Methanosaeta-, Methanobacterium-, Methanospirillum-, and Methanosarcina-like cells were detected with oligonucleotide probes specific for the different groups of methanogens, and they were found to be localized inside the granules, in both types of which dominant methanogens were members of the genus Methanosaeta. For specific detection of bacteria which were previously detected by whole-microbial-community 16S ribosomal DNA (rDNA)-cloning analysis (Y. Sekiguchi, Y. Kamagata, K. Syutsubo, A. Ohashi, H. Harada, and K. Nakamura, Microbiology 144:2655-2665, 1998) we designed probes specific for clonal 16S rDNAs related to unidentified green nonsulfur bacteria and clones related to Syntrophobacter species. The probe designed for the cluster closely related to Syntrophobacter species hybridized with coccoid cells in the inner layer of the mesophilic granule sections. The probe for the unidentified bacteria which were clustered with the green nonsulfur bacteria detected filamentous cells in the outermost layer of the thermophilic sludge granule sections. These results revealed the spatial organizations of methanogens and uncultivated bacteria and their in situ morphologies and metabolic functions in both mesophilic and thermophilic granular sludges.

Anaerobiosis↗
PubMed1995

Development of a community mammography registry: experience in the breast screening program project.

PURPOSE: To assess the formation, implementation, and operation of a community mammography registry, which is a consolidated database for all mammography and breast biopsy reports within a community. MATERIALS AND METHODS: A registry was created in Lee County, Fla. Mammography interpretation data were provided by 13 facilities and 38 radiologists organized in several private practice groups. RESULTS: The registry contains data on 87,926 mammograms and 3,234 breast biopsies performed between June 1991 and May 1994. The registry calculates individual and group mammography interpretation accuracy measures, such as sensitivity, specificity, positive predictive value, false-positive and false-negative rates, and clinical outcome measures such as sizes and stages of malignant lesions detected. CONCLUSION: The registry allows community radiologists and mammography practices to compare their outcomes with those of their local peers and to published data and encourages focused interventions for quality improvement based on objective experience.

Adult↗
PubMed1999

Frequency of tau mutations in three series of non-Alzheimer's degenerative dementia.

Splice-site and missense mutations have been identified in tau associated with frontotemporal dementia with parkinsonism linked to chromosome 17. In this study we assessed the genetic contribution of tau mutations to three patient series with non-Alzheimer's (non-AD) degenerative dementia. The groups included (1) a community-based dementia series from Minnesota, MN; (2) a referral series with clinicopathological tauopathy; and (3) a pathologically confirmed familial frontotemporal dementia series from Manchester, UK. Comparing the three clinical series: in the stringently diagnosed Manchester frontotemporal dementia series, tau mutations were present in 13.6% of cases (three splice-site mutations); in the clinicopathological referral series that used more general inclusion criteria, 3 cases with P301L mutations were observed, which represents a lower mutation frequency of 3.6% (9.4% in familial cases); in contrast, tau mutations were not detected in the Minnesota community-based dementia series, suggesting the occurrence of these mutations in dementia generally is rare (<0.2%). These data identify the prevalence of mutations in three different clinical settings and indicate that this figure is sensitive to the diagnostic criteria used in each patient series.

Adult↗