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PubMed1995

RFLPs in mitochondrial and nuclear DNA indicate low levels of genetic diversity in the oak wilt pathogen Ceratocystis fagacearum.

Genetic diversity in the oak wilt pathogen Ceratocystis fagacearum was assessed using restriction fragment length polymorphisms (RFLPs) of the mitochondrial DNA (mtDNA) and anonymous RFLP loci in the nuclear DNA (nuDNA). No genetic variation was detected in the mtDNA among 27 isolates sampled from a broad geographical area. Southern hybridization to 100 anonymous, random, nuDNA probes detected a low level of variation among nine of the isolates. Only 35 out of 437 probe-enzyme combinations detected RFLPs. Most of the RFLPs appeared to result from insertions and deletions of less than 200 bp. A composite multilocus haplotype based on hybridization to six anonymous probes could differentiate each of the nine isolates tested, suggesting that these probes may be useful for further studies of the population biology and epidemiology of this pathogen. Hypotheses are presented to account for the low level of genetic variation.

Ascomycota↗
PubMed2006

Respondent-driven sampling of injection drug users in two U.S.-Mexico border cities: recruitment dynamics and impact on estimates of HIV and syphilis prevalence.

Respondent-driven sampling (RDS), a chain referral sampling approach, is increasingly used to recruit participants from hard-to-reach populations, such as injection drug users (IDUs). Using RDS, we recruited IDUs in Tijuana and Ciudad (Cd.) Juárez, two Mexican cities bordering San Diego, CA and El Paso, TX, respectively, and compared recruitment dynamics, reported network size, and estimates of HIV and syphilis prevalence. Between February and April 2005, we used RDS to recruit IDUs in Tijuana (15 seeds, 207 recruits) and Cd. Juárez (9 seeds, 197 recruits), Mexico for a cross-sectional study of behavioral and contextual factors associated with HIV, HCV and syphilis infections. All subjects provided informed consent, an anonymous interview, and a venous blood sample for serologic testing of HIV, HCV, HBV (Cd. Juárez only) and syphilis antibody. Log-linear models were used to analyze the association between the state of the recruiter and that of the recruitee in the referral chains, and population estimates of the presence of syphilis antibody were obtained, correcting for biased sampling using RDS-based estimators. Sampling of the targeted 200 recruits per city was achieved rapidly (2 months in Tijuana, 2 weeks in Cd. Juárez). After excluding seeds and missing data, the sample prevalence of HCV, HIV and syphilis were 96.6, 1.9 and 13.5% respectively in Tijuana, and 95.3, 4.1, and 2.7% respectively in Cd. Juárez (where HBV prevalence was 84.7%). Syphilis cases were clustered in recruitment trees. RDS-corrected estimates of syphilis antibody prevalence ranged from 12.8 to 26.8% in Tijuana and from 2.9 to 15.6% in Ciudad Juárez, depending on how recruitment patterns were modeled, and assumptions about how network size affected an individual's probability of being included in the sample. RDS was an effective method to rapidly recruit IDUs in these cities. Although the frequency of HIV was low, syphilis prevalence was high, particularly in Tijuana. RDS-corrected estimates of syphilis prevalence were sensitive to model assumptions, suggesting that further validation of RDS is necessary.

Adolescent↗
PubMed1997

Using the World Wide Web--a new approach to risk identification of diabetes mellitus.

Diabetes mellitus is a major health problem with a rising tendency world-wide. A new strategy for risk evaluation and data collection of undiagnosed non-insulin-dependent diabetes mellitus (NIDDM) using the World Wide Web (WWW) is presented. An easy-to-handle questionnaire on typical risk factors was converted into an interactive WWW document. The Internet provides the suitable platform for the net-based distribution of the questionnaire form as well as the computer-assisted entering and interpretation of the data (http:(/)/www.uni-leipzig.de/-diabetes). The analysis program, installed on our WWW server, interprets the information and sends the assessment on-line back to the inquiring user PC. The data are also collected anonymously in a database for epidemiological studies. In the test period, 744 world-wide accesses were registered: 433 men, mean age 39.8 +/- 14.4 years (range 10-83) and 311 women, mean age 36.7 +/- 12.7 years (range 11-77). An increased risk for undiagnosed diabetes was identified to 43.6%. The risk profile of male and female users showed no significant gender-related differences. Using the WWW technology can support early detection and adequate treatment of undiagnosed diabetes. This innovative strategy to screen for a high risk profile is an useful, cost-effective and up-to-date tool for broad community health education and epidemiological studies world-wide.

Adolescent↗
PubMed2001

Anaesthetic management of the airway in The Netherlands: a postal survey.

BACKGROUND AND OBJECTIVE: A postal survey was conducted in order to investigate current practice in airway management amongst Dutch anaesthetists and to investigate the role of recent training and the role of an 'Access to the Airway' airway management course. METHODS: A questionnaire containing 27 questions was sent to all practising anaesthetists in The Netherlands. Questionnaires were returned anonymously and were analysed using the Pearson chi(2)-test (P < 0.05) with the SPSSR version 8.0 statistical software program. RESULTS: The response rate was 42%. Of the respondents, 78% claim often or always to assess the expected degree of difficulty in tracheal intubation as part of routine preoperative assessment. The American Society of Anesthesiologist's Difficult Airway Algorithm was used by 19% of respondents. A wide variety of airway management techniques is being used. In 36% of all general anaesthetics a laryngeal mask airway is used. In 1.1% of all general anaesthetics tracheal intubation is performed with the flexible fibrescope. CONCLUSIONS: Dutch anaesthetists, who commenced anaesthetic training after 1988, and those who attended the airway management course 'Access to the Airway' are significantly more likely to follow the American Society of Anesthesiologist's Difficult Airway Algorithm and to use adjunctive techniques for airway management.

Airway Obstruction↗
PubMed1996

Egg-sharing in assisted conception: ethical and practical considerations.

The present acute shortage of eggs for donation cannot be overcome unless adequate guidelines are set to alleviate the anxieties regarding payments, in cash or kind, to donors. The current Human Fertilisation and Embryology Authority (HFEA) guidelines do not allow direct payment to donors but accept the provision of lower cost or free in vitro fertilization (IVF) treatment to women in recognition of oocyte donation to anonymous recipients. Egg-sharing achieved in this way enables two infertile couples to benefit from a single surgical procedure. However, the practical guidelines related to this approach are ill-defined at the present time leading to some justifiable uncertainty. A pilot study was therefore undertaken in order to establish the place of egg-sharing in an assisted conception programme. The current HFEA guidelines on medical screening of patients, counselling, age and rigid anonymity between the donor and recipient were followed. The study involved 55 women (25 donors and 30 recipients) in 73 treatment cycles involving fresh and frozen-thawed embryos. Donors were previous IVF patients who, regardless of their ability to pay, shared their eggs equally with matched anonymous recipients. They paid only for their consultations and tests right up to the point of being matched with a recipient. The sole recipient paid the cost applicable in egg donation of a single egg collection, although both received embryo transfers. The results indicate that although the recipients were older than the donors (41.4 +/- 0.9 versus 31.6 +/- 0.5 years), and there was no difference in the mean number of eggs allocated, the percentage fertilization rates, or the mean number of embryos transferred, there were more births per patient amongst recipients than amongst donors (30 versus 20%). We conclude that providing the donors are selected carefully, this scheme whereby a sub-fertile donor helps a sub-fertile recipient is a very constructive way of solving the problem of the shortage of eggs for donation. There are also the advantages of including a group of women who would otherwise be denied treatment. Problems related to 'patient coercion' can, in our view, be fully overcome by the application of strict common-sense safeguards. The ideal of pure altruism is not without its medical and moral risk. The success of egg-sharing depends on shared interests and a degree of altruism between the donor, the recipient and the centre. The current HFEA guidelines should be applauded for enabling a highly effective concept of mutual help to develop.

Adult↗
PubMed1999

Assessment of risk of eating disorders among adolescents in Appalachia.

OBJECTIVE: Students from 5 public schools in east Tennessee in grades 6 through 10 were assessed for their risk of eating disorder. METHOD: The Eating Attitudes Test (EAT40), a self-administered questionnaire, was given anonymously to 1,302 male and female adolescents. RESULTS: The results showed that 19.8% of females and 3.7% of males scored above 29, indicating high risk for development of an eating disorder. There was also a trend toward increased prevalence of risk in areas that are more rural. CONCLUSIONS: These findings suggest that the risk for eating disorders may be greater in rural areas than has previously been believed. This has implications for understanding the etiology of these diseases as well as demonstrating the need for more research in these often underserved areas.

Adolescent↗
PubMed2004

Burnout in residency: a statewide study.

OBJECTIVE: To determine the prevalence of burnout in residents in obstetrics and gynecology through the use of a validated tool. METHODS: The Maslach Burnout Inventory Human Services questionnaire is a previously validated tool that measures burnout. Obstetrics and gynecology residents from Texas were invited to participate in this study in 2002. The Maslach Burnout Inventory Human Services questionnaire and a demographic survey were distributed to each resident. Responses were anonymous and returned by mail. Contingency coefficient and chi2 tests were used for analysis; values of P < 0.05 were significant. RESULTS: Residents (n = 368) from 17 programs in Texas were surveyed. Responses were received from 14 programs (82.4%), with 136 surveys (37%) returned. Overall, 38.2% reported high emotional exhaustion, 47.1% reported high depersonalization, and 19.1% reported reduced personal accomplishment. The number of residents experiencing true burnout (high emotional exhaustion, high depersonalization, and low personal accomplishment) was 17.6% (n = 24). CONCLUSIONS: High levels of emotional exhaustion and depersonalization occur in some residents. Burnout in residents included in this study was approximately 18%.

Burnout, Professional↗
PubMed2002

A biochemical prevalence study of smoking in pregnancy for a cross-section of women in Christchurch, New Zealand.

OBJECTIVE: To biochemically measure and compare the prevalence of maternal smoking by trimester in a cross-section of pregnant women residing in Christchurch, New Zealand, during 1997. METHODS: Residual sera from routinely collected blood samples drawn in early and late pregnancy over a 12-month period, 1 January 1997 to 31 December 1997, was accumulated and anonymously assayed. Cotinine levels were measured by an ELISA test with a result greater than 14 ng/mL indicative of active smoking. RESULTS: Analysis was conducted upon 4,178 samples collected from 3,082 women. Adjusted cotinine validated smoking rates in the first, second and third trimesters were 26.8% (95% CI 24.5-29.2%), 25.0% (95% CI 22.3-27.8%) and 23.0% (95% CI 20.8-25.2%), respectively. This represents an absolute reduction in smoking rates of 4.7% (p = 0.02), 6.6% (p = 0.04) and 3.8% (p = 0.04) for the first, second and third trimesters, respectively, among pregnant women in Christchurch since 1994. CONCLUSION: Smoke reduction and cessation programs implemented locally and nationally have been effective in significantly reducing the biochemically measured prevalence of maternal smoking in pregnancy within a three-year period. IMPLICATIONS: Cigarette smoking during pregnancy is an important yet preventable factor affecting rates of prenatal, perinatal and paediatric morbidity and mortality. Reliable and repeated surveys of pregnant women are necessary to accurately measure changes in the maternal smoking prevalence and determine the efficacy of smoke reduction and cessation programs.

Cotinine↗
PubMed2006

Refocusing health promotion for syphilis prevention: results of a case-control study of men who have sex with men on England's south coast.

BACKGROUND: Prevention interventions have had little impact on syphilis outbreaks among men who have sex with men (MSM) and diagnosis rates continue to rise rapidly. Detailed studies of the determinants of syphilis transmission are needed to inform new prevention interventions. OBJECTIVE: To investigate factors associated with recent syphilis diagnosis and recommend strategies for improved prevention interventions. METHODS: A case-control study of MSM attending genitourinary medicine (GUM) and HIV outpatient clinics. Cases were MSM testing positive for early syphilis, based on either laboratory or microscopy results, with those testing negative being controls. All participants completed the same anonymous questionnaire covering demographics, lifestyle, sexual behaviour, and sexual partnerships. RESULTS: 50 cases and 108 controls returned questionnaires. Syphilis diagnosis was significantly associated with sexually transmitted infection history, recent recreational drug use, receptive anal sex practices, but not insertive ones, higher numbers of oral sex partners, but not specific oral sex practices. Overall, there were no differences between HIV positive and HIV negative/untested men in reporting of sexual behaviours or partnership combinations. The use of public sex settings (backrooms, saunas, "cruising grounds," etc) was reported by 68% of all participants and not significantly associated with syphilis diagnosis. CONCLUSIONS: Many key behavioural and partnership risk factors for syphilis are also risk behaviours for HIV transmission and point to the need for integrated strategies that tackle the two infections together. Simplified procedures for syphilis screening should be available in GUM clinical settings, along with targeted community outreach prevention interventions.

Adult↗
PubMed2002

Request solicitation and semantic evocation of freedom: an evaluation in a computer-mediated communication context.

The "But you are free of..." technique is a compliance procedure which solicits someone to comply with a request by simply telling him that he is free to accept or to refuse the request. This semantic evocation leads to increased compliance with the request. A new evaluation of the generality of this technique was tested in an experiment in which subjects received an anonymous electronic mail which asked them to consult the site of a humanitarian association for children. Analysis showed that, when the semantic evocation of freedom is included in the message, a higher compliance rate was observed than in a situation in which this evocation was omitted.

Advertising↗
PubMed1992

[Heart transplantation in the doctors' opinion (results of a questionnaire)].

This report presents the results of the survey aimed to evaluate physicians' attitude and personal opinion on heart transplantation. The study comprised 124 people: 92 physicians (internal medicine) and 32 students of the Faculty of Medicine (sixth year) in Cracow. None of the responders was directly or indirectly involved in cardiac transplantation. Responders were assessed using questionnaire consisting of 17 questions. Participation was voluntary and anonymous. Percentage analysis and non-parametric chi-2 test were applied in statistical analysis of the results. As many as 91.9% responders declared themselves as heart transplantation supporters. As the most important causes of small number of heart transplantations in Poland the following factors were considered: inadequate quantity of cardiosurgical centers and qualified medical staff (72%), shortage of heart donors (53%), insufficient knowledge of the physician on donor's qualification (49%), excessive cost of transplantation and postoperative management (46%). Only 11.3% responders have chosen right criteria for brain death out of given possibilities, 4% identified the factors excluding potential heart donors, 89.5% have known who was authorized to diagnose brain death and 59.6% knew where to refer the donor. The fact that after cardiac transplantation the patient requires long-term immunosuppressive treatment was recognized by 87%. Only 8.3% was able to indicate the essential drug - cyclosporin A, whereas 56.1% of responders were willing to treat the patients after heart transplantation. No statistical correlation between the above-mentioned results and the place of work, degree of specialization, professional experience of the physician was found.(ABSTRACT TRUNCATED AT 250 WORDS)

Health Knowledge, Attitudes, Practice↗
PubMedDate not supplied

[Seroprevalence of human immunodeficiency virus infection among pregnant women in Brazzaville].

A serological study aimed at measuring the distribution and extent of the HIV infection in the population was carried out from 1 October to 30 November 1990 among 689 pregnant women seen during prenatal consultations in the Health Centers of the National Social Security Service. Serological tests according to ELISA method were used. They were anonymous and uncorrelated. Specific seroprevalence was found to be high among young women between 20 and 29 years (10.10%) and among nulliparous women. Some correlation was observed between the parity and the seropositivity; the seroprevalence was higher among nulliparous women (chi 2 = 52.4; ddl = 4; p < 0.001). The authors recommend the reinforcement of preventive measures and the establishment of counselling in Mother and Child Health Care Centers (MCH).

Adolescent↗
PubMedDate not supplied

[Tools for assessing the quality of care in health facilities. Experience in Ferrara].

Studies of health care quality are based on the evaluation of the way of how knowledges and available resources interact in order to guide individual behaviour as well as organisational planning. We have tested a sample of patient's impressions, using an anonymous questionnaire. During a period of 12 months 1039 patients have been questions. The result of our study demonstrates the necessity of a closer cooperation between general practitioner and in-hospital physician even in order to guarantee communication and promote trusting between hospital and patients.

Female↗
PubMed2005

Evaluation of rapid tests for anti-HIV detection in Brazil.

OBJECTIVES: This assessment in Brazil was to evaluate the performance of commercially available HIV rapid test (RT) against the gold standard testing and to establish a highly sensitive and specific RT algorithm for HIV diagnosis. DESIGN: A prospective, anonymous and unlinked study. METHODS: An evaluation of seven commercially available RT to compare their performance against the gold standard tests for Brazil. This includes two competing enzyme immunoassays plus a Western blot for confirmation. After informed consent, whole blood samples were collected from volunteers in voluntary counselling and testing sites (n = 400), antenatal clinics (n = 500) and from HIV-positive controls in AIDS treatment centres (n = 200). Two seroconversion panels, one HIV-1 subtype (B, B', C and F) panel and an operational assay performance evaluation were also part of the study parameters. RESULTS: For the seven RT the clinical sensitivity ranged from 97.74 to 100% and clinical specificity from 99.43 to 100%. However, only four RT were considered acceptable after full evaluation. The two EIA had a clinical sensitivity of 100% and clinical specificity of 99.32 and 99.66%. Two RT had the same performance on the seroconversions panels as the EIA. The operational assay performance evaluation for the RT indicated that Hexagon and Capillus could not be classified as simple assays. CONCLUSION: We have provided evidence that RT assays can perform equally or better than EIA for the detection of HIV antibodies. The simplicity and rapidity of the RT warrants its utilization in an algorithm for a rapid diagnosis of HIV infection.

AIDS Serodiagnosis↗
PubMed2003

[Education of clinical laboratory medicine in the premedical course of Fukushima Medical University].

Education of clinical laboratory medicine in the medical course of Fukushima Medical University School of Medicine is described. It include lectures (90 min, 15 times) for the 4th grade students and practices for the 5th grade students (one week/2 w, 16 times) and for the 6th grade students (one week/2 w, 4-5 times). In the practice course of 5th grade students, subjects concerning preanalytical issues have been employed to understand the importance. Specimens for practices are taken from every student, which include urines for urinalysis, feces for occult blood test, bloods for Wright-Giemsa staining and cell morphology and coagulation tests, and pharyngeal fluids for Gram staining. In the 6th grade course, residual specimens from anonymous patients are used, and ECG examination is performed by the permission of patients. Through the experiences of sample collections and practices of elementary laboratory tests, students are expected to realize anxiety and pain of patients, to understand the importance of preanalytical variables and to master fundamental laboratory techniques as physicians.

Clinical Laboratory Techniques↗
PubMed1995

Testing patients for HIV before surgery: the views of doctors performing surgery.

The aim of this study was to investigate the attitudes of doctors performing surgery to the HIV antibody testing of surgical patients. Fifty of eighty (62.5%) doctors performing surgery who are working in two London teaching hospitals returned completed anonymous postal questionnaires. Sixty-six per cent of the sample would like some form of compulsory testing of pre-operative patients, although most of them feel that this is only necessary for patients considered to be in 'high-risk groups'. Eighty-four per cent believe that this would ensure their safety from infection during surgery. Forty-eight per cent agreed with testing patients without their consent. Results suggest that most of the doctors performing surgery in this study agree with compulsory HIV antibody testing of pre-operative patients in the belief that this would protect them from infection during surgery. The problems associated with compulsory testing and relying on such testing in order to protect doctors from infection during surgery are discussed.

AIDS Serodiagnosis↗
PubMed1997

End-Epi: an application for inferring phylogenetic and population dynamical processes from molecular sequences.

MOTIVATION: Phylogenetic trees constructed from molecular sequences contain information about the evolutionary or population dynamical processes that created them. Here we describe a computer package (End-Epi) that uses graphical methods to allow researchers to make inferences about these processes from their data. Statistical analyses can be performed to test the consistency of the data with various competing hypotheses. AVAILABILITY: End-Epi can be obtained by WWW from http://evolve.zoo.ox.ac.uk/ and by anonymous FTP from ftp://evolve.zoo.ox.ac.uk/packages/End-Epi10.hqx. This file contains the compiled application, the manual and a test tree.

Algorithms↗
PubMed1987

Accountability and judgment processes in a personality prediction task.

In this experiment, we investigated the impact of accountability--social pressures to justify one's views to others--on cognitive processing in a personality-prediction task. Subjects were presented with the responses of actual test-takers to 16 items from Jackson's Personality Research Form (PRF) and asked to predict how these individuals responded to an additional set of 16 items from the same test. Subjects were assigned to a no-accountability condition (they learned that all of their responses would be anonymous), a preexposure-accountability condition (they learned of the need to justify their responses before seeing the test-takers' PRF responses), and a postexposure-accountability condition (they learned of the need to justify their responses after seeing the test-takers' PRF responses). Preexposure-accountability subjects reported more integratively complex impressions of test-takers, made more accurate behavioral predictions, and reported more appropriate levels of confidence in their predictions than did either no-accountability or postexposure-accountability subjects. We conclude by considering possible psychological mediators of these effects as well as the broader theoretical implications of the findings for the development of contingency models of judgment and choice.

Humans↗