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PubMed2002

Environmental public health research: engaging communities.

Environmental public health research is a multi-disciplinary and multi-institutional field of endeavor that is changing. New and innovative approaches are vital to researchers and communities. Partnerships and collaborations also are part of the equation. Thus, engaging communities is a necessary component for successful environmental public health research. The federal government has a fiduciary and a moral responsibility to provide ethical research in communities with the same integrity as required for individuals. There is an inherent distrust by many communities, especially minority communities, in light of past public health research failures. Communities targeted by public health researchers may be aware of the need to improve the community's environmental health and quality of life but are unsure of the methods and benefits. This in turn requires competent and attentive collaborations between the community and the researcher(s). Communities are indeed more astute to their physical surroundings, but may still not understand the nature and intent of the research process. Therefore, the collaboration and partnership should start as early in the design, planning, and execution of the project as possible. Future challenges in genetic screening and research will only increase the need for communities to be engaged in public health research.

Community-Institutional Relations↗

PubMed1994

Iterative concurrent reconstruction algorithms for emission computed tomography.

Direct reconstruction techniques, such as those based on filtered backprojection, are typically used for emission computed tomography (ECT), even though it has been argued that iterative reconstruction methods may produce better clinical images. The major disadvantage of iterative reconstruction algorithms, and a significant reason for their lack of clinical acceptance, is their computational burden. We outline a new class of 'concurrent' iterative reconstruction techniques for ECT in which the reconstruction process is reorganized such that a significant fraction of the computational processing occurs concurrently with the acquisition of ECT projection data. These new algorithms use the 10-30 min required for acquisition of a typical SPECT scan to iteratively process the available projection data, significantly reducing the requirements for post-acquisition processing. These algorithms are tested on SPECT projection data from a Hoffman brain phantom acquired with a 2 x 10(5) counts in 64 views each having 64 projections. The SPECT images are reconstructed as 64 x 64 tomograms, starting with six angular views. Other angular views are added to the reconstruction process sequentially, in a manner that reflects their availability for a typical acquisition protocol. The results suggest that if T s of concurrent processing are used, the reconstruction processing time required after completion of the data acquisition can be reduced by at least 1/3T s.

Algorithms↗

PubMed1996

Long-term survival following cladribine (2-chlorodeoxyadenosine) therapy in previously treated patients with chronic lymphocytic leukemia.

PURPOSE: To assess long-term survival following cladribine salvage treatment for previously treated patients with chronic lymphocytic leukemia. PATIENTS AND METHODS: Fifty-two patients aged 39-84 years with previously treated CLL received cladribine 0.12 mg/kg/day in 2-hour infusions for 5 days in monthly courses. Two-thirds were refractory to previous therapy, and 8 had prior fludarabine. RESULTS: Sixteen (31%) patients achieved complete response (CR) and 14 (27%) partial remission (PR) according to consensus criteria. Response correlated with clinical stage, number of previous treatment regimes, blood lymphocyte count, and lymphocyte halflife following the first cladribine course. Toxicity included pneumonia (n = 9), herpes zoster (n = 7), and septicemia (n = 2). Four patients in CR underwent high-dose chemotherapy with autologous blood stem cell support, and 2 remain in CR 48 and 60 months from start of cladribine, and 2 had relapse at 42 and 48 months, respectively. Median progression-free survival (Kaplan-Meier analysis) for CR patients was 23 months from start of cladribine treatment, and for PR patients 16 months. The projected overall survival was 80% at 3 years for CR patients, and the median survival 28 months for PR patients and 4 months for non-responding patients. CONCLUSIONS: Our previous finding of durable CRs from cladribine in advanced CLL is thus confirmed in a larger patient material, and follow-up indicate that long-term survival may be achieved.

Adult↗

PubMed1983

The Community Project: the teaching implications of applied epidemiology.

The use of the epidemiological method in primary health care (PHC) has become an accepted part of the service. The team will utilize community-oriented data in order to assess the health needs of the population, perform continued surveillance of changes in the health of the people served and for service evaluation. This development in health services has to find its counterpart in the training programme for the future doctor. This paper describes a 6-year experience with a community project carried out in the framework of a clinical clerkship in Family and Community Medicine. The students were able to define the project, collect the data and analyse it, and frequently see the start of the implementation of the recommendations.

Clinical Clerkship↗

PubMed1992

Exhaustive matching of the entire protein sequence database.

The entire protein sequence database has been exhaustively matched. Definitive mutation matrices and models for scoring gaps were obtained from the matching and used to organize the sequence database as sets of evolutionarily connected components. The methods developed are general and can be used to manage sequence data generated by major genome sequencing projects. The alignments made possible by the exhaustive matching are the starting point for successful de novo prediction of the folded structures of proteins, for reconstructing sequences of ancient proteins and metabolisms in ancient organisms, and for obtaining new perspectives in structural biochemistry.

Amino Acid Sequence↗

PubMed2006

Bacillus subtilis gene cluster involved in calcium carbonate biomineralization.

Calcium carbonate precipitation, a widespread phenomenon among bacteria, has been investigated due to its wide range of scientific and technological implications. Nevertheless, little is known of the molecular mechanisms by which bacteria foster calcium carbonate mineralization. In our laboratory, we are studying calcite formation by Bacillus subtilis, in order to identify genes involved in the biomineralization process. A previous screening of UV mutants and of more than one thousand mutants obtained from the European B. subtilis Functional Analysis project allowed us to isolate strains altered in the precipitation phenotype. Starting from these results, we focused our attention on a cluster of five genes (lcfA, ysiA, ysiB, etfB, and etfA) called the lcfA operon. By insertional mutagenesis, mutant strains carrying each of the five genes were produced. All of them, with the exception of the strain carrying the mutated lcfA operon, were unable to form calcite crystals. By placing transcription under IPTG (isopropyl-beta-d-thiogalactopyranoside) control, the last gene, etfA, was identified as essential for the precipitation process. To verify cotranscription in the lcfA operon, reverse transcription-PCR experiments were performed and overlapping retrocotranscripts were found comprising three adjacent genes. The genes have putative functions linked to fatty acid metabolism. A link between calcium precipitation and fatty acid metabolism is suggested.

Bacillus subtilis↗

PubMed2006

Preliminary initiatives in a bridge building project between conventional and alternative practitioners in Denmark.

BACKGROUND: A growing number of the approximately 7,400 persons with multiple sclerosis (MS) in Denmark use alternative treatments. The Danish Multiple Sclerosis Society has been experiencing an increasing demand for research on the effects of combined conventional and alternative treatments. For this reason, the Society has initiated a bridge building project to be implemented from 2004-2011 at a specialized MS hospital. In that project, a team of five conventional and five alternative practitioners works together and offers integrative treatments to a total of 400 MS patients. OBJECTIVE: The overall purpose of the project is to examine if integrative treatments may optimize treatment results for people suffering from MS, and to develop a model for a bridge building cooperation of conventional and alternative practitioners in the future. MATERIAL AND METHODS: In this article we give an overview of the steps taken before establishing the hospital- based team of practitioners: (1) a public hearing attended by conventional and alternative practitioners experienced in treating MS patients; (2) qualitative interviews among conventional practitioners at a specialized MS hospital; (3) a literature study on the use and effects of alternative treatments and integrative treatments related to MS. RESULTS: The knowledge gained in the preliminary steps of the project showed that we had to add a preparatory phase to the project focusing on the development of the team before it would start treating MS patients.

Combined Modality Therapy↗

PubMedDate not supplied

Sentinel node detection with imaging probe.

A once-square-inch-field-of-view mini gamma camera, whose first prototype was built by us in 1998 and given the name imaging probe (IP), was initially employed in sentinel lymph node (SLN) detection. This is probably the best way of learning how to use it. In the present work IP was used for SLN localization by a medical team that, after having been trained by the group of nuclear physicians of "La Sapienza" University who designed and first used the detector, used IP at their own hospital to 1) acquire experience for future use during surgery (a cooperative project on IP-radioguided orthopedic surgery is ongoing) and 2) start multicenter trials with IP. The SLN was identified and localized with IP and a non-imaging probe, Neoprobe 2000, in six patients with breast cancer who underwent lymphoscintigraphy for SLN biopsy. The operators who used Neoprobe and IP were blinded to each other's findings and to the results obtained with the large-field-of-view Anger camera that was used for lymphoscintigraphy. The Anger camera, IP and Neoprobe detected seven SLNs in six patients. The mean detection time was 2 mins 6 s (standard deviation (SD) 26 s) with IP, and 2 mins 18 s (SD 47 s) with Neoprobe 2000. The SLN that was most difficult to find was detected in 2 mins 56 s with IP and 3 mins 45 s with Neoprobe. The operators' subjective impression of having detected the SLN was "absolutely sure" for 7/7 nodes with IP and "absolutely sure" for 5/7 nodes with Neoprobe.

Breast Neoplasms↗

PubMed2002

NSF regulates membrane traffic along multiple pathways in Paramecium.

N-ethylmaleimide (NEM)-sensitive factor (NSF), a regulator of soluble NSF attachment protein receptors (SNAREs), is required for vesicular transport in many eukaryotic cells. In the ciliated protozoon Paramecium, complex but well-defined transport routes exist, constitutive and regulated exocytosis, endocytosis, phagocytosis and a fluid excretory pathway through contractile vacuoles, that can all be studied independently at the whole cell level. To unravel the role of NSF and of the SNARE machinery in this complex traffic, we looked for NSF genes in Paramecium, starting from a partial sequence found in a pilot random sequencing project. We found two very similar genes, PtNSF1 and PtNSF2, which both seem to be expressed. Peptide-specific antibodies (Abs) recognize PtNSF as a 84 kDa band. PtNSF gene silencing results in decreasing phagocytotic activity, while stimulated exocytosis of dense core-vesicles (trichocysts), once firmly attached at the cell membrane, persists. Ultrastructural analysis of silenced cells shows deformation or disappearance of structures involved in membrane traffic. Aggregates of numerous small, smooth vesicles intermingled with branches of ER occur in the cytoplasm and are most intensely labeled with anti-NSF Ab-gold. Furthermore, elongated vesicles of approximately 30 nm diameter can be seen attached at cortical calcium storage compartments, the alveolar sacs, whose unknown biogenesis may thus be revealed. Involvement of PtNSF in some low frequency fusion events was visualized in non-silenced cells by immuno-fluorescence, after cautious permeabilization in the presence of ATP-gamma-S and NEM. Our data document that PtNSF is involved in distinct pathways of vesicle traffic in Paramecium and that actual sensitivity to silencing is widely different, apparently dependent on the turnover of membrane-to-membrane attachment formation.

Amino Acid Sequence↗

PubMed2005

[Effects of volcanic sulfur dioxide on reconstruction workers and residents returning to Miyake Island].

Four and half years have passed since Mt. Oyama in Miyake Island erupted. Ambient sulfur dioxide (SO2) is still above the environmental air standard in parts of the island, even though emission of the volcanic gas has diminished. Reconstruction of life-support infrastructure in the island and safety measures started in July 2002, and a short-term trial stay project for former residents was completed in April 2003 for the total rehabilitation of the island. We conducted health examinations, and questionnaires on clinical symptoms among the reconstruction workers in January 2003, as well as questionnaires on respiratory symptoms among former residents who joined the trial stay, in late fall of 2003. The peak expiratory flow rate and symptoms of the workers and the symptoms of the short-term residents were not correlated to SO2 concentrations. In addition, we investigated the medical histories of outpatients at Miyake-mura National Insurance Center Clinic. We could not recognize any cases directly connected with higher ambient SO2 concentration in the area of the island, but there was a male worker, in his thirties, who suffered an initial attack of bronchial asthma, which required intensive care and treatment. As a general rule, all the workers and the residents are asked to wear gas masks for SO2 when its concentration is above 2.0 ppm and to stay in the house with desulfuration facilities as a precautionary measure at night. The residents are now well informed about the risks of volcanic gas and preventive measures for adverse health effects. We could not evaluate correlations between SO2 exposure indices and health effects sufficiently due to the limitation of the field study, but this study presents useful pieces of information as a risk communication for reconstruction workers and former inhabitants to the island.

Adult↗

PubMed1997

Evolution of a regional health-care information system--the design phase.

In 1996 a program of the Soros Foundation was launched to study a regional health care inodel Main stake holders of health care financing and providing in three counties in South-Western Hungary found the idea appealing and the Soros Model Region Program was started. This paper outlines the activity of the second sub-project of the model region program: the development of a regional health care information system. The build-up of a data and knowledge base serving the differing needs of mentioned goals is based on international standards. Availability and user involvement is based on different media for presenting the information as printed publications, CD-ROM data bases and World Wide Web availability. A congruency and coherency principle is maintained by a unified data model used for different purposes and a planned unified communication protocol among all participants in the model region program. Studies regarding health care status, economics and financing on regional level show that a better fitting health care services profile and a more flexible resource management might be achieved based on the mentioned regionality principle.

Computer Systems↗

PubMed2001

Functional Food Science in Europe.

The goal of the Functional Food Science in Europe (FUFOSE) concerted action was to reach consensus on scientific concepts of functional foods in Europe by using the science base that supports evidence that specific nutrients positively affect physiological functions. The outcome proposes "a working definition" of functional foods: foods can be regarded as functional if they can be satisfactorily demonstrated to affect beneficially one or more target functions in the body, beyond adequate nutritional effects, in a way relevant to an improved state of health and well-being and/or reduction of risk of disease. Functional foods must remain foods and they must achieve their effects in amounts normally consumed in a diet. Evidence from human studies, based on markers relating to biological response or on intermediate endpoint markers of disease, could provide a sound scientific basis for messages and claims about the functional food products. Two types of claims are proposed that relate directly to these two categories of markers: Enhanced function claims (type A) and reduced risk of disease claims (type B). A new EU Concerted Action will start with, and build upon, the principles defined within FUFOSE. This project PASSCLAIM will (i) produce a consensus on principles for the scientific substantiation of health-related claims for food and food components, (ii) select common criteria for how markers should be identified, validated and used in well-designed studies to explore the links between diet and health and (iii) to evaluate critically the existing schemes which assess the scientific substantiation of claims.

Biomarkers↗

PubMed2002

Online resources for spinal cord injury nursing research.

Selected online resources for nursing research related to SCI were explored. Online resources cited here provide a tremendous amount of information at your fingertips. These resources are not meant to be all-inclusive, but may serve as a good starting point to find valuable research information for a future research project related to SCI.

Humans↗

PubMedDate not supplied

[Analysis of the health care system transition: what the health care users think].

The project "Analysis of transition of health care system in Croatia" was started in order to research the effects of health care system changes. The aim was to research specific characteristics of transitional period through evaluation of health status, quality of life, and quality of health care. Total of 331 general practitioners, 2,252 patients and 5,048 inhabitants were included in the research. The Croatian version of SF-36 questionnaire was licensed to Andrija Stampar School of Public Health in order to assess health-related quality of life. Men, younger and better-educated respondents achieved higher scores in SF-36 quality of life assessment. Quality of life is lower in Croatia than in Western European countries. 85.3% of respondents were satisfied with physicians' behaviour. Two components of physician's behaviour were obtained--competence/expertise and empathy. These results could contribute to better understanding of health care reform effects.

Adolescent↗

PubMed2005

Home visiting and child health surveillance attendance.

This project tested the hypothesis that low attendance rates at a Sure Start child health surveillance session might increase if appointments were preceded by intervention home visits from research assistants drawn from the local community. The assistants would explain the purpose of surveillance and discuss problems preventing attendance. A randomised control trial showed no increase in surveillance attendance after two-thirds of the intervention group were successfully visited. This negative finding was despite the partnership with local people acting as research assistants working well. Other factors that might have influenced attendance were investigated at an evaluation interview undertaken by community members in homes after the surveillance date. Only 55 per cent of the families could be contacted for evaluation. Six out of 10 of those who had no evaluation were the same families who had not attended the surveillance session. The reasons why these families missed surveillance sessions is yet to be identified. Further research is needed that explores the reason why some families do come for surveillance, the nature of the barriers to attendance in those who do not attend and to look for opportunities for fresh interventions that might give more children access to pre-school facilities.

Adult↗

PubMed1990

[History of psychiatric facilities in the Silesian region in the 19th century].

A historiographic paper in which the authors--psychiatrists--deal, based on research in archives, with the period preceding by approximately 100 years the opening of the psychiatric sanatorium in Opava. The beginnings of institutional care of the mentally sick in the Silesion region were in 1841 and were associated with the construction of an "asylum" on the grounds of the newly built hospital in Opava, a small house for 20-24 patients kept under inhuman conditions. An advance was the provisional arrangement involving the lease of a castle in Albrechtice for 36 and finally 90 patients in 1873. The regulations of the institute and rules of behaviour of the keepers were already on an advanced level of psychiatric in-patients care. The concept of the Opava sanatorium was according to documents in the archives elaborated by the 51-year-old Dr. Franz Köstl, one of the founders of Prague psychiatric institutions. His project has been preserved. The Opava sanatorium was opened and work started on March 29, 1889.

Czechoslovakia↗

PubMed1996

Operational evaluation of the EXEMSI project. Experimental Campaign for the European Manned Space Infrastructure.

In general the EXEMSI project has proved to be very successful mission. It has demonstrated that it is indeed possible to perform a major and useful project in a short time and on a moderate budget. In addition to achieving the scientific objectives, this simulation project provided valuable experience in the training of members of chamber crew and ground control crew for their tasks. It covered all aspects of a mission from call for experiment proposals, crew selection and training, integration and testing of the facility and its equipment, to daily monitoring and managing of the mission, and finally post-isolation data collection and evaluation. These other activities were accomplished by a small team of experts in the astoundingly short time of 8 months. What was lacking in manpower, time and funds, was more than made up for by enthusiasm, expertise, team spirit, hard work and long hours well beyond the call of duty of all those involved. In addition to the specific and technological objectives reached, many lessons learned in this operation have been identified, which could help to improve future missions. The experience has shown pitfalls to be avoided in future mission, as well as points where some small increase in effort can make a considerable difference. With the prospect of long-term manned spaceflights looming in the near future and the ever increasing costs of such endeavors, the possibilities offered by running simulated missions on the ground should be seriously considered. Such simulations permit the study of scientific and operational aspects of a space mission prior to its actual implementation. A ground based simulation of an extended space mission may be run at a fraction of the cost of an in-orbit precursor mission of even one-week duration. However, careful planning of the simulation mission is required so that it may yield relevant information and useful experience. Lessons learned from the EXEMSI project should be taken into account in such planning. At the start clear goals should be formulated, that can provide clear guidelines for building up the infrastructure and defining the operational scenario. A long duration mission simulating the conditions on the Russian space station MIR could provide a valuable source of information and experience in preparing for the MIR '95 Mission.

Astronauts↗

PubMed1997

Computerised tomography evaluation of the frontal recess in inflammatory diseases of the frontal sinus: standardisation of a new technique.

The authors present a new investigation technique by means of CT of the frontal sinus drainage pathway, the frontal recess, which could be of considerable help in defining its potential role in determining a chronic or recurrent inflammatory process of this cavity. Among the main characteristics of this technique are: (1) a clear presentation of the course and conformation of the recess and its relations with surrounding structures; (2) speedy, and therefore economical, operation (12 min for a complete examination); and (3) tolerability, because this examination starts off with axial-scans, which, compared to CT coronal projections and MRI scans, are less prone to defects and do not require strained postures. This this means that all kinds of patients can be assessed, which is a basic requirement for achieving standardisation. With axial scans the authors work from paraxial reconstructions (oblique sagittal) which, in their opinion, give the best definition of the frontal recess so far recorded.

Adult↗