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PubMed1993

[Cleaning and disinfection of endoscopes in general practice and ambulatory care].

The legal conditions in Germany for cleaning and disinfection of endoscopes depend on the terms of reference of the "Bundesgesundheitsamt (BGA)" and the "Deutsche Gesellschaft für Hygiene und Mikrobiologie (DGHM)" and the "Unfallverhütungsvorschrift (UVV) der Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege". The different regulations and the resulting practical consequences for manual and mechanical cleaning and disinfection of rigid and flexible endoscopes are described. Particularly the HBV-HIV-problems as well as the respective inactivation times resulting there from, standby times and concentrations of different solutions for disinfection are discussed. Presentation of the practicability of the different steps in daily ENT-practice and ambulance.

Communicable Disease Control↗

PubMed2004

The effects of delayed physical prompts and reinforcement on infant sign language acquisition.

Researchers and clinicians have recommended that sign language be taught to typically developing children during their first 2 years of life; however, existing research does not provide adequate information regarding appropriate methods of sign training. We used delayed physical prompting and reinforcement to teach manual signs to 3 children between the ages of 6 and 13 months. Data were collected on the occurrence of prompted and independent signs as well as crying. Sign training was successful in producing independent signing in all 3 children in under 4 hr of training per child.

Communication↗

PubMed2005

Music therapy for schizophrenia or schizophrenia-like illnesses.

BACKGROUND: Music therapy is a psychotherapeutic method that uses musical interaction as a means of communication and expression. The aim of the therapy is to help people with serious mental illness to develop relationships and to address issues they may not be able to using words alone. OBJECTIVES: To review the effects of music therapy, or music therapy added to standard care, compared to placebo, standard care or no treatment for people with serious mental illnesses such as schizophrenia. SEARCH STRATEGY: The Cochrane Schizophrenia Group's Register (July 2002) was searched. This was supplemented by hand searching of music therapy journals, manual searches of reference lists, and contacting relevant authors. SELECTION CRITERIA: All randomised controlled trials that compared music therapy with standard care or other psychosocial interventions for schizophrenia. DATA COLLECTION AND ANALYSIS: Studies were reliably selected, quality assessed and data extracted. Data were excluded where more than 30% of participants in any group were lost to follow up. Non-skewed continuous endpoint data from valid scales were synthesised using a standardised mean difference (SMD). If statistical heterogeneity was found, treatment 'dosage' and treatment approach were examined as possible sources of heterogeneity. MAIN RESULTS: Four studies were included. These examined the effects of music therapy over the short to medium term (1 to 3 months), with treatment 'dosage' varying from 7 to 78 sessions. Music therapy added to standard care was superior to standard care alone for global state (medium term, 1 RCT, n = 72, RR 0.10 CI 0.03 to 0.31, NNT 2 CI 1.2 to 2.2). Continuous data suggested some positive effects on general mental state (1 RCT, n=69, SMD average endpoint PANSS -0.36 CI -0.85 to 0.12; 1 RCT, n=70, SMD average endpoint BPRS -1.25 CI -1.77 to -0.73),on negative symptoms (3 RCTs, n=180, SMD average endpoint SANS -0.86 CI -1.17 to -0.55) and social functioning (1 RCT, n=70, SMD average endpoint SDSI score -0.78 CI -1.27 to -0.28). However these latter effects were inconsistent across studies and depended on the number of music therapy sessions. All results were for the 1-3 month follow up. AUTHORS' CONCLUSIONS: Music therapy as an addition to standard care helps people with schizophrenia to improve their global state and may also improve mental state and functioning if a sufficient number of music therapy sessions are provided. Further research should address the dose-effect relationship and the long-term effects of music therapy.

Humans↗

PubMed2005

Classification of vascular dementia in the Cardiovascular Health Study Cognition Study.

OBJECTIVE: To describe the diagnostic classification of subjects with incident vascular dementia (VaD) participating in the Cardiovascular Health Study (CHS) Cognition Study. METHODS: The CHS classified 480 incident cases between 1994 and 1999 among 3,608 CHS participants who had brain MRI in 1992 through 1994 and in 1997 through 1998. The patients were diagnosed before and after reviewing the brain MRI. RESULTS: The pre-MRI classification showed that 52 participants had VaD and 76 had both Alzheimer disease (AD) and VaD. The post-MRI classification showed that the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria classified 61 subjects as having VaD, the National Institute of Neurological Disorders and Stroke-Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) criteria classified 43 subjects as having probable VaD and 10 as possible VaD, and the State of California Alzheimer's Disease Diagnostic and Treatment Center (ADDTC) criteria classified 117 as having probable VaD and 96 as possible. The combination of the ADDTC and National Institute of Neurological and Communication Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria was used to examine the spectrum of vascular disease in dementia. The dementia was attributable to only vascular factors in 56 cases (probable VaD); VaD coexisted with AD in 61 cases, although the VaD component was the leading cause of dementia (probable VaD with AD); AD was the leading cause of dementia in 61 cases (possible VaD and probable AD); and in 29 cases, it was not clear that either AD or VaD was the primary diagnosis (possible AD and possible VaD). CONCLUSIONS: None of the clinical criteria for VaD identified the same group of subjects. The diagnosis of vascular dementia is difficult in epidemiologic studies because poststroke dementia can be due to Alzheimer disease (AD) and evidence of vascular disease can be found in the MRI of dementia cases without clinical strokes. Whether the clinical progression is related to AD pathology or vascular disease is difficult to establish.

Aged↗

PubMed1998

Recommendations of the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians: use of reminder and recall by vaccination providers to increase vaccination rates.

This statement by the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP) presents and recommends a programmatic strategy-the use of a reminder and/or recall (R/R) system by vaccination providers-to increase vaccination rates. In 1992, a national survey indicated that 8% of pediatricians and 5% of family physicians had implemented a manual vaccination R/R system and 6% and 5%, respectively, used a computer-based system for vaccination R/R messages. In 1993, the National Vaccine Advisory Committee issued the "Standards for Pediatric Immunization Practices," which recommend that all public and private health-care providers use a vaccination R/R system. These standards were endorsed by ACIP, AAP, and AAFP. By 1995 a survey indicated that R/R systems were used by 35% of pediatricians and 23% of family physicians (R. Zimmerman, University of Pittsburgh School of Medicine, personal communication, 1995).

Child↗

PubMed2001

Knowing the risk: relationships between risk behaviour and health knowledge.

Communicating risk is a key public health strategy. The implicit assumptions are that the public interprets risk information in a logical fashion and adopts behavioural changes to reduce risk. We assessed risk behaviour, and knowledge and perception of voluntary and involuntary risks using an anonymous questionnaire completed by 472 students. Risk-taking behaviour was measured as the number of different risk behaviours undertaken in the previous 12 months. Knowledge and perception were measured by the extent to which subjects agreed with statements of risk-related information. These varied in complexity from simple statements linking a behaviour with a health risk to numerical statements describing the strength of such relationships. Risk-taking behaviour was highest amongst younger people, males, people whose parents were in non-manual occupations, and people who believed in God (risk-taking behaviour was not related to voting preference or birth order). Overall, knowledge was not significantly related to risk-taking behaviour (P=0.889). However, risk-taking was positively related to more accurate responses to numerical risk questions (P<0.001) and risk-takers were also more likely to perceive both voluntary and involuntary risks as less risky (P<0.05). At least in this cohort, more information about risk is not related to lower risk behaviour. In fact, those individuals with a better understanding of the precise risk associated with certain behaviours were more likely to be higher risk-takers while those who consistently over-estimated risks were low risk-takers. Overall, knowledge and perception of risk explained relatively little of the variance in behaviour. Although these findings need further examination within the general population, public health measures should not assume that information campaigns will necessarily lead to a reduction in risk behaviour.

Adolescent↗

PubMed2005

Characteristics of fetal anticonvulsant syndrome associated autistic disorder.

The aim of this study was to evaluate the clinical features and frequency of autistic disorder or Asperger syndrome (AS; according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition [DSM-IV] criteria) in children exposed to anticonvulsant medication in utero. During a 20-year study period, 626 children were born in Aberdeen to mothers taking antiepileptic drugs (AEDs). The study examined long-term effects of prenatal exposure to AEDs in 260 children (122 males, 138 females). Of these, 26 (16 males) were reported by parents to have social or behavioural difficulties. Eleven children (6 males, 5 females) fulfilled the DSM-IV criteria for autistic disorder and one (female) fulfilled the DSM-IV criteria for AS. These children comprised 4.6% of the exposed children studied, and 1.9% of all exposed children born during the study period. Mean age of these children at diagnosis was 5 years 4 months (SD 2y 11mo) and 9 years 10 months (SD 3y 10mo) at the time of this study. Other children from the group of 26 had difficulties in areas of speech and language development and social communication but did not meet the criteria for an autism spectrum disorder (ASD). Sodium valproate was the drug most commonly associated with autistic disorder, five of 56 (8.9%) of the study children exposed to sodium valproate alone had either autistic disorder or AS. It was concluded that prenatal exposure to anticonvulsant medication is a risk factor for the development of an ASD. Fetal anticonvulsant syndrome associated autistic disorder is characterized by an even sex ratio, absence of regression or skill loss, and language delay in the absence of global delay.

Anticonvulsants↗

PubMed1998

Guidelines of the Office International des Epizooties for laboratory quality evaluation, for international reference standards for antibody assays and for laboratory proficiency testing.

Three guidelines, adopted by the International Committee of the Office International des Epizooties (OIE), have been combined for publication in a single document. The Guidelines for evaluating laboratory quality (adopted in 1995) form part of the OIE Guidelines for evaluating Veterinary Services. General requirements for equipment, staffing and management of laboratories are outlined. The guidelines for international reference standards for antibody assays (adopted in 1998) provide general rules governing the preparation of immune sera by OIE Reference Laboratories. A data sheet should accompany each preparation dispatched from the laboratory, and details are given of the information to be contained in the data sheet. The guidelines are to be used in conjunction with the OIE Manual of standards for diagnostic tests and vaccines. Guidelines on the proficiency of laboratory testing (adopted in 1996) describe how the operation of a laboratory can be assessed by inter-laboratory testing, and by voluntary participation in an accreditation (quality assurance) audit, operated by an independent authority. Criteria for assessing serological testing are provided.

Accreditation↗

PubMedDate not supplied

Qualitative and quantitative analysis of nonneoplastic lesions in toxicology studies.

A pathology report is written to convey information concerning the pathologic findings in a study. This type of report must be complete, accurate and communicate the relative importance of various findings in a study. The overall quality of the report is determined by three Quality Indicators: thoroughness, accuracy, and consistency. Thoroughness is the identification of every lesion present in a particular organ or tissue, including spontaneous background lesions. Experienced pathologists familiar with background lesions may disregard certain types of lesions or establish a threshold or a severity above which background lesions are diagnosed. Accuracy is the ability to make, and precisely communicate, correct diagnoses. Nomenclature of lesions is a matter of definition and experienced pathologists generally agree as to what terms are to be used. Consistency is the uniform use of a specific term to record a defined lesion and implies that the same diagnostic criteria are being followed for each type of diagnosis. The relative severity of nonneoplastic lesions can be recorded either semiquantitatively or quantitatively. Semiquantitative analysis involves the application of defined severity grades or ranges for specific lesions. Quantitative analysis (counts and measurements) can be performed manually or electronically, utilizing image analysis and stereological techniques to provide numerical values. When both qualitative and quantitative parameters are applied in preparation of a pathology report, the recorded pathology findings can be interpreted and put into perspective. The use of this approach assures a reader that the pathology report meets the highest standards.

Animals↗

PubMed2002

A question for DSM-V: which better predicts persistent conduct disorder--delinquent acts or conduct symptoms?

BACKGROUND: Conduct disorder (CD), a psychiatric index of antisocial behaviour, shares similarities with delinquency, a criminological index. This study sought to examine which factors in childhood predict a repeated diagnosis of CD in adolescence, and whether self-reported delinquent acts enhance the utility of symptoms of CD in predicting later persistent CD. METHOD: Longitudinal data used in this paper come from a clinic-referred sample of 177 boys, along with their parents and teachers, who were assessed using a structured clinical interview. The boys also reported on their delinquent behaviours, as well as a broad range of other family and life events. RESULTS: Before age 13, 77 boys met criteria for CD according to their parent, 69 according to their own report, and 36 reported three or more delinquent acts. Forty-eight boys (29%) met criteria for CD three or more times between 13 and 17. In childhood, delinquency overlapped, but was distinct from CD. Both were present in 28 cases, while 41 cases had CD without delinquency, and eight had delinquency without CD. When tested as predictors of later persistent CD, child-reported CD was the strongest predictor of later persistent CD, but self-reported delinquency was stronger than parent-reported CD. A final model of significant predictors included child-reported CD, delinquency, poor child communication with parents, and maternal prenatal smoking. CONCLUSIONS: It appears that delinquency does add uniquely to the prediction of persistent CD. It may be useful to expand the diagnostic criteria for CD accordingly.

Adolescent↗

PubMed2005

Regulation of latent sensory hair cell precursors by glia in the zebrafish lateral line.

The lateral line is a placodally derived mechanosensory organ in anamniotes that detects the movement of water. In zebrafish embryos, a migrating primordium deposits seven to nine clusters of sensory hair cells, or neuromasts, at intervals along the trunk. Postembryonically, neuromasts continue to be added. We show that some secondary neuromasts arise from a pool of latent precursors that are deposited by the primordium between primary neuromasts. Interneuromast cells lie adjacent to the lateral line nerve and associated glia. These cells remain quiescent while they are juxtaposed with the glia; however, when they move away from the nerve they increase proliferation and form neuromasts. If glia are manually removed or genetically ablated by mutations in cls/sox10, hypersensitive (hps), or rowgain (rog), neuromasts precociously differentiate. Transplantation of wt glia into mutants rescues the appropriate temporal differentiation of interneuromast cells. Our studies reveal a role for glia in regulating sensory hair cell precursors.

Animals↗

PubMedDate not supplied

Development of bilingual tools to assess functional health patterns.

TOPIC: The theory and process of developing bilingual assessment tools based on Gordon's 11 functional health patterns. PURPOSE: To facilitate assessing the individual, family, and community in a student clinical practicum in a Spanish-speaking country. SOURCES: Multiple family and community health promotion theories; translation theories, Gordon's Manual of Nursing Diagnosis (1982); translation/back-translation involving Ecuadorian faculty and students; student community assessments; faculty and staff workshops in Ecuador. CONCLUSIONS: Bilingual, culturally sensitive health assessment tools facilitate history taking, establish nursing diagnoses and interventions, and promote mutual learning. These outcomes demonstrate potential application to other systems in the international nursing community.

Boston↗

PubMed1996

Finfish health protection regulations in Canada.

The Fish Health Protection Regulations (FHPR) in Canada were implemented under the Fisheries Act in 1977. These Regulations are based on the principle of controlling the movement of fish and eggs carrying infectious diseases of concern. Source facilities require a history of inspections to demonstrate the absence of named diseases and disease agents. Since the FHPR were implemented, no disease agents of concern are known to have been transferred with egg and fish shipments approved under these Regulations. Changes to the Regulations are needed, however, for the following reasons: -to incorporate new knowledge on salmonid diseases and their distribution -to cover transfers of other finfish species which present a risk of introducing or spreading infectious disease agents to Canada or between provinces -to eliminate unnecessary controls -to specify the new authorities needed to protect effectively the health of fisheries resources -to reflect emerging international standards. The author describes the authority, administration, requirements and procedures for the current FHPR and the corresponding 'Manual of Compliance', and the proposed amendments to the Regulations and Manual. Issues related to fish health protection in Canada are discussed, including the following: -industry concerns with the FHPR -the need for quality assurance/quality control guidelines for diagnostic laboratories -consistency with international trade standards -the need to consider genetic and ecological factors, as well as fish health, when assessing impacts of introductions and transfers.

Animals↗

PubMedDate not supplied

[Phonatory rehabilitation via esophageal voice and the laryngophone].

Esophageal voice obtained through logopedic treatment and speech produced by electronic prostheses is the principal means of verbal communication of laryngectomized patients. Several factors condition the success of logopedic rehabilitation: entity of hypopharyngeal surgical exeresis and scar repairing modalities; rehabilitation technique employed; patient's skill in controlling pharyngo-esophageal tract and articulation organs; patient motivation. A previous study executed by our School reported that only the 20% of the patients who did not practise logopedic therapy employed the laryngophone. Reduced use of electronic prosthesis depends on three factors: acoustic products of poor quality; evidence of anatomic and functional impairment pointed out by laryngophone use; limitation of manual activity during phonation. Electronic prostheses have a precise indication in the following cases: immediately after surgery; in case of logopedic treatment failure and when tracheo-esophageal prosthesis are contraindicated; when the esophageal voice has an insufficient volume or in noisy environments. Finally indicative criteria to introduce patients to the most suitable rehabilitation modality are reported.

Humans↗

PubMed1989

Distributed computer system for capture, analysis and display of biological data.

A distributed real-time computer system has been developed to automate the collection, analysis and display of biological (pharmacological) data. It comprises a series of laboratory interface devices (CED 1401/1609) connected to a micro-VAX II via multiple IEEE-488 buses. The micro-VAX II is integrated to the main site computers using Ethernet running DECnet. The micro-VAX II system supports a multi-user, multipreparation and multitasking environment and it provides rapid transfer, storage, analysis and display of data. The system saves the pharmacologists from the manual analysis of their data, typically saving them four days of analysis per experiment and has improved both the quality of data detected and their subsequent analysis. Also, the development of a standard data capture procedure on common hardware along with the modular design of application software has almost quartered project development times.

Computer Communication Networks↗

PubMed2024

A framework for automated scalable designation of viral pathogen lineages from genomic data.

Pathogen lineage nomenclature systems are a key component of effective communication and collaboration for researchers and public health workers. Since February 2021, the Pango dynamic lineage nomenclature for SARS-CoV-2 has been sustained by crowdsourced lineage proposals as new isolates were sequenced. This approach is vulnerable to time-critical delays as well as regional and personal bias. Here we developed a simple heuristic approach for dividing phylogenetic trees into lineages, including the prioritization of key mutations or genes. Our implementation is efficient on extremely large phylogenetic trees consisting of millions of sequences and produces similar results to existing manually curated lineage designations when applied to SARS-CoV-2 and other viruses including chikungunya virus, Venezuelan equine encephalitis virus complex and Zika virus. This method offers a simple, automated and consistent approach to pathogen nomenclature that can assist researchers in developing and maintaining phylogeny-based classifications in the face of ever-increasing genomic datasets.

Animals↗

PubMed2000

Food safety through the meat supply chain.

Food poisoning in humans can be caused by many different bacterial genera. While the incidence of food poisoning in England, Wales and Scotland from Salmonella has reached a plateau, there has been an increase in the incidence from Campylobacter. The incidence from Escherichia coli O157:H7 rose to 1997 but declined slightly in 1998 (data from the Public Health Laboratory Service and the Scottish Centre for Infection and Environmental Health). This organism has a high virulence in humans and a very low infective dose. Infection can produce a wide range of responses, including death. The low infective dose presents a major threat. The organism is relatively heat-sensitive and the cooking of food products to achieve a centre core temperature of 70 degrees C for 2 min is sufficient to destroy it. It is relatively acid-tolerant and will survive for several weeks at pH 4.2. Several foodstuffs, as well as water, have been implicated in world-wide outbreaks. The E. coli O157:H7 food-borne outbreak in Lanarkshire in 1996 led to 21 fatalities. The Pennington Group report, issued in April 1997, reported on the circumstances leading to this outbreak, the implications for food safety and the lessons to be learnt. Four areas covered within the Pennington Group report specific to meat hygiene are reviewed in this paper. On-farm practices must ensure the presentation of clean animals for slaughter. There is a requirement for the development and introduction of risk assessment techniques based upon Hazard Analysis of Critical Control Points in abattoirs, and the Meat and Livestock Commission (MLC) is producing a manual for use by the abattoir sector. The Pennington report stated that there was a need for research into the potential use of end-process treatments such as steam pasteurization. The MLC is involved in evaluating such a system. Meat production premises and butchers' shops in England are introducing HACCP through an MLC scheme funded by the Department of Health. At the point of consumption, food safety is improved by the provision of practical guidelines regarding the handling of meat and meat products. These are distributed at retail outlets and communicated to secondary schools via MLC's educational publications.

Abattoirs↗

PubMed1995

Home mechanical ventilation in the aftermath of the Hanshin-Awaji earthquake disaster.

Children who were dependent upon home mechanical ventilation (HMV), suffered in various ways from the disastrous Hanshin-Awaji earthquake disaster. The earthquake abruptly cut the supplies of water, gas and electricity, causing intense anxiety for those families. Through loss of the respirator function, some of them experienced an unexpected catastrophe. In the disaster area, there were children who were dependent upon HMV (19 cases) and children who were preparing for HMV in hospitals (nine cases). Information was gathered from questionnaires about the disaster, communication and correspondence with families. None of the 28 cases died or were injured. Nineteen cases had a variety of problems. In eight cases, respiratory support problems were acute. Nevertheless, all of them survived the crisis successfully even in the midst of such a catastrophic situation. An organization of HMV children's families, called the Baku-Baku Club, helped families with HMV problems by supplying water, food, oxygen and compressed air cylinders among other things. Additional outside batteries for portable respirators are essential equipment for HMV, especially for emergencies. A manual for clarifying the system for support in the Baku-Baku Club and a registration system for public medical service should be established in preparation for such a crisis.

Child↗