SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
In this document, the fellows apothecaries complain of the burdonsome costs imposed upon them by the community masters in order for them to be granted their own masterships.
Too serious to ignore any longer, the world's rampant urban health deterioration now requires serious and fast rescue efforts by not only the health authorities but all government and community sectors. One impetus to national plans of action was the technical discussions at this year's Forty-fourth World Health Assembly whose goal was to map out "strategies for Health for All in the face of rapid urbanization." It became evident that primary health care should be made as relevant to the inmates of the cities' shantytowns as it is to rural inhabitants. ICN's statement at the discussions (p. 108) shares WHO's preoccupation with the unacceptable urban environmental health standards and recommends a strategy based on a primary healthcare approach and intersectoral cooperation. During the talks ICN nurse consultants also voiced ICN's views on mobilizing the communities and the necessary involvement and education of women, who are considered the best representatives from among the urban poor to be involved in community health. Nurses are an indispensable part of these urban health teams and, if they are not already, should start now to become involved in urban policymaking and planning and consider how their national nurses' association can individually or collaboratively support healthy city projects and national healthy city networks. Some guidelines for future strategy can be derived from the following overview of the magnitude of the urban crisis and the WHA technical discussions.
Large-scale processes are known to be important for patterns of species richness, yet the ways in which local and larger scale processes interact is not clear. I used metacommunities consisting of five interconnected microbial aquatic communities to examine the manner in which processes at different scales affect local and metacommunity richness. Specifically, I manipulated the potential dispersal rate, whether dispersal was localized or global, and variation in initial community composition. A repeated-measures ANOVA showed that a low dispersal rate and intermediate distance dispersal enhanced local richness. Initial assembly variation had no effect on local richness, while a lack of dispersal or global dispersal reduced local richness. At the metacommunity scale, richness was enhanced throughout the time course of the experiment by initial compositional variation and was reduced by high or global dispersal. The effects of dispersal were contingent on the presence of initial compositional variation. The treatments also affected individual species occupancy patterns, with some benefiting from large-scale processes and others being adversely impacted. These results indicate that the effects of dispersal on species richness have a complex relationship with scale and are not solely divisible into "regional" vs. "local" scales. Finally, predictions of the manner in which dispersal rate structures communities appear dependent upon species compositional variation among communities.
Bacterial pathogens spread in clinical and environmental settings, and mobile genetic elements (MGEs), such as plasmids and phages, mediate the transfer of virulence factor genes (VFGs) and antimicrobial resistance genes (ARGs) among bacterial communities. Metagenomic analysis of environmental and wastewater samples using highly accurate long-read sequencing technologies, such as Pacific Biosciences (PacBio) HiFi sequencing, provides valuable insights into monitoring the regional spread of VFGs and ARGs, including dissemination mediated by MGEs. No visualization tool is currently available for the comprehensive display of numerous resulting circular metagenome-assembled genomes (cMAGs) with functional gene annotations. Here, we developed visualization of circular metagenome-assembled genome (VicMAG), a visualization tool for highly complex cMAGs derived from long-read metagenome assemblies annotated using updated databases of VFGs, ARGs, and MGEs. Using 353 cMAGs from PacBio HiFi sequencing of a wastewater sample, we demonstrated the utility of VicMAG for metagenome visualization. VicMAG provides comprehensive, size-aware visualization of cMAGs representing bacterial chromosomes and plasmids, annotated with VFGs, ARGs, and phages. By simultaneously visualizing all cMAGs in a framework, VicMAG facilitates a holistic understanding of the distribution and genomic context of VFGs and ARGs across complex microbial communities. This tool supports integrated surveillance of bacteria associated with virulence and antimicrobial resistance across clinical, environmental, and One Health contexts.
The defective parvovirus, adeno-associated virus (AAV), is under close scrutiny as a human gene therapy vector. AAV's non-pathogenic character, reliance on helper virus co-infection for replication and wide tissue tropism, make it an appealing vector system. The virus' simplicity and ability to generate high titer vector preparations have contributed to its wide spread use in the gene therapy community. The single stranded AAV DNA genome is encased in a 20-25 nm diameter, icosahedral protein capsid. Assembly of AAV occurs in two distinct phases. First, the three capsid proteins, VP1-3, are rapidly synthesized and assembled into an empty virion in the nucleus. In the second, rate-limiting phase, single-strand genomic DNA is inserted into pre-formed capsids. Our rudimentary knowledge of these two phases comes from radioactive labeling pulse-chase experiments, cellular fractionation and immunocytological analysis of infected cells. Although the overall pattern of virus assembly and encapsidation is known, the biochemical mechanisms involved in these processes are not understood. Elucidation of the processes of capsid assembly and encapsidation may lead to improved vector production. While all of the parvoviruses share the characteristic icosahedral particle, differences in their surface topologies dictate different receptor binding and tissue tropism. Based on the analysis of the molecular structures of the parvoviruses and capsid mutagenesis studies, investigators have manipulated the capsid to change tissue tropism and to target different cell types, thus expanding the targeting potential of AAV vectors.
The Qinghai-Xizang Plateau (QXP), harboring the planet's highest density of plateau lakes, offers an exceptional biogeographic environment for studying extremophilic microbial communities and their adaptation to salinity. Through deep metagenomic sequencing, we construct the Qinghai-Xizang Lake Sediment Genome (QXLSG) catalog, a high-resolution genomic catalog comprising 5,866 metagenome-assembled genomes (MAGs), 58.16 million non-redundant protein encoding genes, and 19,008 biosynthetic gene clusters. Notably, 80.78% of the 2,742 species-level MAGs represent undescribed taxa, significantly expanding the known microbial diversity. Salinity emerges as the primary environmental factor influencing microbial community. Functional annotation highlights that the "salt-out" strategy, particularly the uptake of glycine betaine, is the main mechanism for salinity tolerance. This strategy is prevalent in both hypersaline lake communities and the dominant microbial phyla. Overall, this study provides a crucial genetic resource for future bioprospecting and deepens our understanding of the fundamental mechanisms of microbial adaptation to extreme saline environments.
BACKGROUND: The inclusion of fibre in domestic pig diets is favourable from a digestive health, environmental, and socio-economic perspective. Unlike the highly optimized formulated diets of domestic pigs, wild boars feed opportunistically, consuming a broad range of foods that consist predominantly of plant materials. Consequently, the intestinal microbiota of wild boars is thought to be adapted to a versatile, fibre-rich diet and may represent a valuable source of probiotics for enhancing fibre degradation. However, comprehensive studies characterizing the wild boar gut microbiome, particularly its community structure and carbohydrate utilization potential, and comparison to that of domestic pigs are still lacking. RESULTS: We collected 89 faecal samples from wild boars across four countries and analysed them primarily using metagenomic sequencing. De novo assembly yielded 3,288 high- and medium-quality metagenome-assembled genomes (MAGs) representing 968 distinct species, of which 538 were previously unknown. Incorporating these MAGs enabled robust microbiome comparisons with 125 previously published samples largely from domestic pigs, which revealed significant structural and functional differences. These differences resolved into two community types, determined not by host species but by diet and lifestyle: C1 comprising 81% of samples from free-ranging, foraging wild boars and C2 consisting of 93% of samples from captive, fed domestic pigs. The lower alpha-diversity observed in C1 likely reflected the impact of highly fluctuating dietary resources and environmental conditions, resulting in dominance of fewer resilient or adaptable taxa. Nevertheless, both community types maintained substantial carbohydrate utilization potential: while C2 exhibited a higher relative abundance of CAZymesub genes associated with a broader range of carbohydrate substrate (CHO) classes, C1 was enriched in individual species that were generally richer in CAZymesub genes and CHO classes. To leverage this potential, we curated a catalogue of carbohydrate degraders from both community types and identified 47 highly versatile species, with several novel species amongst them. CONCLUSIONS: This study uncovered the previously untapped microbial diversity in the wild boar faecal microbiome and demonstrated that the faecal microbiome of Sus is primarily shaped by diet and lifestyle. The two community types identified, which differed both structurally and functionally, represent alternative states of microbiome homeostasis in wild versus domesticated Sus populations. The curated catalogue of carbohydrate degraders provides a valuable resource to guide tailored probiotic supplementation during dietary transitions to novel fibrous feedstocks. Video Abstract.
As poor Americans look for work, healthcare facilities face a shortage of workers. One facility, Saint Francis Medical Center in Grand Island, NE, found a way to help some of the area's financially disadvantaged persons receive technical training and employment as it eased its own personnel shortage. Saint Francis leaders assembled a team of representatives from the hospital's staff, the Greater Nebraska Job Training Program, Lincoln, and Central Community College, Grand Island, to establish the Rural Allied Medical Business Occupations program. The team reviewed several job descriptions to help it decide which jobs to include in the program and surveyed area hospitals to ensure the positions selected were experiencing shortages. The program received a grant as a demonstration project from the U.S. Department of Education. After identifying participants who had the aptitudes and interests for the jobs, the Rural Medical Allied Medical Business Occupations program arranged for participants' training and assistance with items such as tuition, child care, and transportation. Participants received training at Central Community College and at Saint Francis Hospital. Saint Francis Medical Center deemed the program a success. The hospital has hired seven healthcare workers who would not have been available if they had not been trained through this program. Moreover, the program provides yet another way for the hospital to help fulfill a major portion of its mission: to help the poor.
OBJECTIVES: To determine the prevalence of drug injection among drug users, the seroprevalence of HIV and risk factors for HIV infection among injecting drug users (IDU), and to determine heterosexual transmission of HIV among IDU and their spouses in southwest China. METHODS: Using a cross-sectional design, we conducted an HIV seroprevalence and behavioral survey in three rural counties of Yunnan province, Ruili, Longchuan and Luxi in southwest China, bordering Myanmar (Burma). A total of 860 drug users were recruited in randomly selected communities at the three study sites (response rate, 97%). In addition, a random sample of 62 wives of HIV-infected IDU were assembled from 460 known HIV-positive IDU in Ruili and Longchuan (response rate, 81%). RESULTS: In the sample of 860 drug users, 33% reported injecting drugs. Among the 282 subjects who injected drugs, 82% began intravenous drug use after 1988; 64% injected drugs at least once every day. All subjects shared needles but none cleaned the injection equipment with alcohol or bleach. Overall, 49% tested HIV-positive. HIV seropositivity was independently correlated with a longer history of drug injecting, daily injecting, frequent needle-sharing, being younger, and living in Ruili county. Among the 62 wives of HIV-positive IDU, none used condoms during sex and 10% tested HIV-positive. CONCLUSIONS: We conclude that the introduction of HIV into drug-using communities and the rapid increase in heroin injecting in this population appear to have triggered an explosive HIV epidemic among IDU in southwest China. We recommend that AIDS prevention efforts should begin immediately and focus on discouraging the shift from opium smoking to heroin injecting, needle-sharing, and unprotected sex among drug users and their partners.
The idea that a single molecule might function as a self-contained electronic device has been of interest for some time. However, a fully integrated version--the biochip or the biocomputer, in which both production and assembly of molecular electronic components is achieved through biotechnology-is a relatively new concept that is currently attracting attention both within the scientific community and among the general public. In the present article we draw together some of the approaches being considered for the construction of such devices and delineate the revolutionary nature of the current proposals for molecular electronic devices (MEDs) and biochip computers (BCCs). With the silicon semiconductor conductor industry already in place and in view of the continuing successes of the lithographic process it seems appropriate to ask why the highly speculative MED or BCC has engendered such interest. In some respects the answer is paradigmatic as much as it is real. It is perhaps best stated as the promise of the realm of the molecular. Thus it is envisioned that devices will be constructed by assembly of individual molecular electronic components into arrays, thereby engineering from small upward rather than large downward as do current lithographic techniques. An important corollary of the construction technique is that the functional elements of such an array would be individual molecules rather than macroscopic ensembles. These two aspects of the MED/BCC--assembly of molecular arrays and individually accessible functional molecular units--are truly revolutionary. Both require scientific breakthroughs and the necessary principles, quite apart from the technology, remain essentially unknown. It is concluded that the advent of the MED/BCC still lies well before us. The twin criteria of utilization of individual molecules as functional elements and the assembly of such elements remains as elusive as ever. Biology engineers structures on the molecular scale but biomolecules do not seem to be imbued with useful electronic properties. Molecular beam epitaxy and thin-film techniques produce electronic devices but they "engineer down" and are currently unable to generate individual molecular units. The potential of the MED/BCC field is matched only by the obstacles that must be surmounted for its realization.
We present the findings of research designed to identify the social and environmental precursors of heavy drinking in a population of white assembly-line workers. Using a primarily qualitative approach, we examine alcohol use in relation to the sociocultural characteristics of individuals' community and workplace environments and their early-life socialization experiences. The sample consists of 30 men--15 heavy drinkers and 15 moderate drinkers--who were drawn from the workforce of a large durable goods manufacturing plant that closed in 1982. Workers' accounts of their own and coworkers' drinking suggest that a heavy drinking subculture existed in the workplace. Within this culture, drinking was a normal part of work life, and served to improve social relationships, reduce boredom and dissatisfaction, and to express solidarity in defiance of management rules and working conditions. Membership in this subculture, we believe, was most important for those men who had no interests or social involvements outside the workplace. We compare the characteristics of workers who chose to join this subculture (the heavy drinkers), with those who did not (moderate drinkers). Factors that predicted involvement in the heavy drinking subculture were: a sociocultural background where heavy male drinking was normative, lack of extra-work social resources, and leisure activities restricted to coworkers and work-related contexts. Conversely, moderate drinkers tended to come from moderate drinking backgrounds, and had considerable community and social group involvements that included family and peer networks to the virtual exclusion of coworkers.
The seriousness of hepatitis B (HBV) as an occupational hazard to health care workers is well documented. The prevalence of serologic markers for this disease in the general US population is less than 5%, but in medical and dental workers it is significantly higher: 16% in general dentists, 28% in surgeons, 23% in anesthesia personnel, and 30% in emergency department nurses. This study, done under the auspices of the American College of Emergency Physicians (ACEP), focused on the prevalence of HBV markers in emergency physicians. Twenty-five percent of the 1983 ACEP Scientific Assembly attendees participated in the serosurvey. Physicians already vaccinated against hepatitis B were excluded. The majority of participants (58%) were community emergency physicians between 30 and 39 years of age who had six or more years in emergency medicine. A total of 94% of the physicians indicated no prior history of hepatitis, and of these 13.1% had serologic markers for HBV. Including the 10 physicians with both HBV markers and history of hepatitis, the overall prevalence for markers in this study was 15.5%. This prevalence was five times greater than the general population. Emergency physicians should be considered a high-risk group for HBV infection.
Advances in bacterial genetics came with the discovery of the genetic code, followed by the development of recombinant DNA technologies. Now the field is undergoing a new revolution because of investigators' ability to sequence and assemble complete bacterial genomes. Over 200 genome projects have been completed or are in progress, and the oral microbiology research community has benefited through projects for oral bacteria and their non-oral-pathogen relatives. This review describes features of several oral bacterial genomes, and emphasizes the themes of species relationships, comparative genomics, and lateral gene transfer. Genomics is having a broad impact on basic research in microbial pathogenesis, and will lead to new approaches in clinical research and therapeutics. The oral microbiota is a unique community especially suited for new challenges to sequence the metagenomes of microbial consortia, and the genomes of uncultivable bacteria.
The 1996-2001 Kerala People's Campaign for Decentralized Planning has provided much new information about the possibilities and potential of decentralizing public health and health care services. Analysis of investment patterns of the various government levels involved in the campaign, supplemented with case study materials, allows for an evaluation of the decentralization project against its own stated goals. These included (1) creating a functional division among government levels appropriate to the health tasks each level can best perform; (2) generating projects that reflect the felt needs of the people, as voiced through local participatory assemblies; (3) maintaining or increasing levels of equality in health, especially with regard to income, caste, and gender; (4) stimulating communities to mobilize voluntary resources to supplement devolved public funds; (5) stimulating communities to create innovative programs that could become models for others; and (6) making the health services function more effectively overall. The analysis supports the conclusion that the campaign achieved each of the goals to a large degree. Shortcomings arose from the inexperience of many local communities in drafting effective projects as well as problems deriving from the fact that some sections of the health bureaucracy could not be decentralized. Lessons of the campaign are already being applied to new programs in Kerala.
INTRODUCTION: The Ministry of Health and Long-Term Care mandated a rapid and thorough change in the delivery of cancer services in Ontario to integrate ambulatory services offered by Cancer Care Ontario (CCO) with the inpatient services of affiliated hospitals. The CCO Surgical Oncology Program held a strategic planning retreat to establish the basis upon which to implement surgery-specific changes. METHODS: Participants completed a pre-retreat survey. Based on survey results, the retreat was organized around 4 themes: role of the Surgical Oncology Program; knowledge transfer; funding for cancer surgery; and research priorities. These topics were discussed in small breakout groups and by the entire assembly. RESULTS: Retreat participants (n = 55) included hospital CEOs, vice-presidents of cancer services, surgeons from cancer centres and community hospitals, academic chairs of surgery, clinician researchers and managers from CCO. Responses to the pre-retreat survey (n = 38) and recommendations made by retreat participants showed strong support for the Surgical Oncology Program to take a leadership role in the development and monitoring of quality indicators, research related to cancer surgery and the creation of regional communities of practice. Funding mechanisms for cancer surgeons and hospitals performing cancer surgery were also highlighted. CONCLUSION: The Surgical Oncology Program used the results to develop a strategic plan that was approved by retreat participants and the board of the CCO. The program has embarked on a multifaceted approach to facilitate, monitor and report on the organization and delivery of cancer surgery in Ontario.
Recent announcements in the news of HIV/AIDS contraction by famous sports figures have focused world attention on the fact that athletes are not immune to this deadly virus. In view of this, we reviewed the literature to examine what studies have been directed specifically at the athletic population and HIV/AIDS. Unfortunately, because of the relatively new nature of this problem, little data exists for examination. A panel of experts was assembled to participate in a Delphi methodology project. This educational study was designed to examine three issues surrounding the athletic community and HIV/AIDS. The three questions examined in this study were: 1) should medical testing be undertaken within the athletic community to determine exposure to the virus; 2) if testing is undertaken, what privacy/confidentiality measures should be incorporated to protect the individual and the results of the test; and 3) what educational interventions should be developed and implemented to help the athlete understand the disease and prevent the spread. The responses from the Delphi participants indicate that the HIV/AIDS dilemma is a societal issue and should not single out a segment of the population-in this case the athletic community. The panel also indicated that privacy and confidentiality are crucial in protecting the individual athlete and test results. The development and implementation of educational interventions is the most important component in the entire issue of HIV/AIDS and the athletic community.
We report here metagenome-assembled genomes from a long-term laboratory culture of the nitrogen-fixing cyanobacterium Nostoc sp. TISTR 8405, originally sourced from a Thai freshwater lake. The community consists of two additional co-occurring microorganisms, Erythrobacter sp. THAI-01 and Allorhizobium sp. THAI-01, and contains putative plasmids associated with Nostoc and Allorhizobium, respectively.
Rehabilitation care for persons with disabilities who live in zones distant from the hospital of reference represents a challenge even for the Health Services of the most advanced countries. The requirements of the principles of "Health for All in the Year 2000" of the 1981 WHO Assembly, fully assumed by Foral Law 10/1990 (integral conception of health, efficiency, equity, decentralisation, quality and humanisation in the service) have stimulated the initiatives proceeding from the Rehabilitation Service of the "Virgen del Camino" Hospital orientated towards the pragmatic application of those principles to the reality our Community. The result has been the creation of an outpatient care network with units in both the Specialties Units and the Health Centres. As in other neighbouring Communities, we are witnessing a growing increase in the demand for rehabilitation treatment; to a great extent this is due to the increasing age of the population. This must be regulated in order to guarantee access to quality rehabilitation for every person who requires it. In order to achieve the complete fulfillment of the objectives of the WHO we propose the co-ordination between levels of attention (Primary care and Specialised care), consolidation of the figure of the rehabilitation doctor as a specialised individual providing support to Primary care in the whole community, and the realisation of certain protocols for rehabilitation referral agreed upon with the Primary care doctors