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Biomedical subjects

R Quick

Publications and source records attributed to R Quick.

13 recordsLinked to original sources
PubMed2006

Sustained high levels of stored drinking water treatment and retention of hand-washing knowledge in rural Kenyan households following a clinic-based intervention.

Nyanza Province, Kenya is characterized by poor water quality and high diarrhoea prevalence. To address these problems, nurses in a maternal and child health clinic in Homa Bay, Kenya were trained in household water chlorination with a locally available, social marketed product, and in six steps of proper hand washing. They were asked to communicate this information to their clients. Interviews immediately following the training by nurses were conducted on 220 clients, of whom 168 (76%) reported being taught both procedures during their clinic visit. After 2 weeks, free chlorine residuals were present in stored drinking water in 67 out of 98 (68%) clients' homes and, 1 year later, in 36 out of 51 (71%) clients' homes. After 2 weeks, all six hand-washing steps were correctly demonstrated by 41 (44%) out of 93 clients, and by 17 out of 51 (34%) 1 year later. This brief, practical intervention shows promise for vulnerable populations.

Adolescent↗
PubMed2003

Changing community behaviour: experience from three African countries.

In the developing world, more than 1 billion people lack access to safe water. To address this problem, the US Centers for Disease Control and Prevention developed the Safe Water System (SWS), a household-based intervention with three elements: water disinfection, safe storage and behaviour change techniques, and tested these in three countries. In Zambia, social marketing (SM) was used to implement the SWS, and 100 randomly selected households also received motivational interviewing (MI). In Madagascar, the SWS was implemented using SM and community mobilisation (CM). In rural Western Kenya, the SWS was also implemented with SM and CM. In Zambia, 3 months after the SM project launch, 14% of households in the SM-only group had adopted the disinfectant compared with 78% of households in the SM plus MI group. Through SM, over 1 million bottles of disinfectant were sold in 3 years in Zambia. In Antananarivo, Madagascar, 6 months after launch of the water disinfectant, 8% of households in an early stage of the CM process were using the disinfectant compared with 20% in households at a late stage of the CM process. In 1 year, over 500,000 bottles of disinfectant were sold in Madagascar. In Kenya, adoption of the water disinfectant exceeded 60% in intervention households and diarrhoea rates decreased by 58% in children < 5 years. Social marketing permits widespread dissemination of interventions, but may have limited penetration into economically disadvantaged communities. Additional, targeted interventions, such as MI and CM, can increase product adoption. A combination of behaviour change interventions can increase project impact.

Communicable Disease Control↗
PubMed2000

Traveler's diarrhea at sea: three outbreaks of waterborne enterotoxigenic Escherichia coli on cruise ships.

Enterotoxigenic Escherichia coli (ETEC) has become the leading bacterial cause of gastroenteritis outbreaks on cruise ships. Investigation of recent outbreaks of ETEC gastroenteritis on 3 cruise ships indicated that all were associated with consuming beverages with ice cubes on board the ship (relative risk [RR], 1.4, 95% confidence interval [CI], 1.0-1.9, P=.02; RR, 1.9, 95% CI, 1.3-2. 9, P<.001; and RR, 1.3, 95% CI, 1.0-1.6, P<.01), and 2 were associated with drinking unbottled water (RR, 2.7, 95% CI, 1.8-4.1, P<.001; RR, 1.7, 95% CI, 1.3-2.3, P<.001). Multiple ETEC serotypes were detected in patients' stool specimens in each of the 3 outbreaks, and 12 (38%) of 32 isolates were resistant to > or =3 antimicrobial agents. ETEC appears to be emerging as a waterborne pathogen on cruise ships. Water bunkered in overseas ports was the likely source of ETEC infection in these outbreaks. To ensure passenger safety, cruise ships that take on water in foreign ports must ensure that water treatment and monitoring systems function properly.

Adult↗
PubMed1998

The role of inducible nitric oxide synthase in the host response to Coxsackievirus myocarditis.

The host response to Coxsackievirus infection is complex, including T lymphocytes, B lymphocytes, natural killer cells, and macrophages. Although Coxsackievirus infection induces expression of inducible nitric oxide synthase (NOS2; EC 1.14.13.39) in macrophages, the precise role of NOS2 in the host response to Coxsackievirus myocarditis has been unclear. We show, by using mice homozygous for a disrupted NOS2 allele, that Coxsackievirus replicates to higher titers in NOS2(-/-) mice, that the host lacking NOS2 clears virus more slowly than the wild-type host, and that myocarditis is much more severe in infected NOS2(-/-) mice. These data show that NOS2 is crucial for the host response to Coxsackievirus in the mouse.

Animals↗
PubMed1997

Etiology of bloody diarrhea in Bolivian children: implications for empiric therapy. Bolivian Dysentery Study Group.

In Bolivia, few data are available to guide empiric therapy for bloody diarrhea. A study was conducted between December 1994 and April 1995 to identify organisms causing bloody diarrhea in Bolivian children. Rectal swabs from children <5 years old with bloody diarrhea were examined for Salmonella, Shigella, and Campylobacter organisms; fecal specimens were examined for Entamoeba histolytica. A bacterial pathogen was identified in specimens from 55 patients (41%). Shigella organisms were found in 39 specimens (29%); 37 isolates (95%) were resistant to ampicillin, 35 (90%) to trimethoprim-sulfamethoxazole, and 24 (62%) to chloramphenicol, but all were susceptible to nalidixic acid. Only 1 of 133 stool specimens contained E. histolytica trophozoites. Multidrug-resistant Shigella species are a frequent cause of bloody diarrhea in Bolivian children; E. histolytica is uncommon. Clinical predictors described in this study may help identify patients most likely to have Shigella infection. Laboratory surveillance is essential to monitor antimicrobial resistance and guide empiric treatment.

Animals↗
PubMed1996

Low-cost safe water for the world: a practical interim solution.

A very large segment of the world's population is without a microbiologically safe water supply. It is estimated that in Latin America more than 40% of the population is utilizing water of dubious quality for human consumption. This figure is probably even higher in Africa and areas of southeast Asia. Water used for drinking and food preparation can be an important route of transmission for many of the most widespread and debilitating of the diseases that afflict humans. The cholera pandemic which struck Latin America in January 1991, and has become endemic in many of the countries, continues to exemplify the public health significance of contaminated drinking water. Ideally, this neglected segment of the world's population should be served with piped water systems that provide a continuous supply of microbiologically safe water, but this would require such enormous investments of financial and human resources that it is not reasonable to expect that it will be accomplished. Interim practical measures to assure microbiologically safe water are necessary. The public health intervention to accomplish this is described in this paper and has an annual per family cost of which ranges between $1.50 and $4. It consists of providing individual households with one or preferably two suitable water containers in which to disinfect and store the essential quantities of water that need to be free of pathogens, with the containers of a design that will preclude recontamination of the contents and enable the production and distribution of the water disinfectants to be managed at the local level. It includes the necessary component of public education, promotion and involvement to establish the sustainability of the measures as a community-based endeavor. Investigation and demonstration projects are being carried out in II countries to determine and perfect and appropriate intervention, and it has been proven that it is economically, technically and socially feasible to assure microbiologically safe water for the world's population that is threatened by waterborne diseases. Carefully controlled microbiological analysis of the untreated and treated water shows that waterborne pathogens can be destroyed or inactivated, and carefully controlled epidemiological studies being carried out by the Centers for Disease Control and Prevention show that this intervention achieves considerable reduction in the incidence of water borne disease. It is recommended that all developing countries initiate programs to replicate the health measure described in this paper in order to test its validity and to adapt it to their local conditions.

Costs and Cost Analysis↗
PubMed1992

Restaurant-associated outbreak of giardiasis.

An outbreak of giardiasis occurred among staff of a job training center after a meeting at a restaurant. Twenty-seven (75%) of 36 attendees became ill compared with 1 (3%) of 31 staff members not attending (relative risk, 23.3; 95% confidence interval, 3.4-161.4). Because most attendees ate all items on a fixed menu, no individual food item could be conclusively associated with illness. Circumstantial evidence suggests, however, that ice contaminated by a food handler may have been the vehicle. The restaurant had multiple sanitary violations, and 2 employees, 1 with asymptomatic giardiasis and the other with a Giardia-infected, diapered child, served ice to the attendees. This outbreak demonstrates the potential for restaurant-based giardiasis outbreaks.

Adolescent↗
PubMed1991

Health attitudes and behaviours of Native Alaskans.

Health attitudes and behaviours were determined for residents of Western Alaska in a survey administered during the winter of 1988-89. One third of the villages in this region were randomly selected for inclusion in he study and one in three households in these villages were randomly selected to be interviewed. Bilingual interviewers successfully completed questionnaires for 477 households (77%). The vast majority of the sample population believed that a balanced diet, weight control, regular physical exercise, stress avoidance, regular medical attention and cessation of smoking and excessive drinking were important to health. Nevertheless 41% of respondents did not deny smoking, and 50% of these did not believe smoking cessation was important for health. Similarly, 34% of the population did not deny heavy drinking, and 38% of them did not think it was important to stop. When those who did not deny smoking were asked if they had tried to stop, 36% said they did not try. Of those who did not deny drinking heavily, 26% did not try to stop. Western Alaska has high rates of alcohol-related health problems and growing rates of tobacco-related diseases. The attitudes and behaviours with respect to alcohol and tobacco use exhibited in this study suggest a great need for health education and promotion activities directed at these habits.

Alaska↗
PubMedDate not supplied

What price protection?

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Confidentiality↗
PubMedDate not supplied

Lost in America.

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Community Mental Health Services↗