Arkansas adds PPD tests as nursing home entrance requirement.
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Arkansas↗
SEARCH · PubMed Health
Results for “home testing”
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Reimbursement for organ procurement and histocompatibility testing and for home dialysis equipment.
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Financing, Government↗
Implementing chlamydia screening: what do women think? A systematic review of the literature.
BACKGROUND: Chlamydia trachomatis is a common sexually transmitted infection that can have serious consequences. It is universally agreed that screening for chlamydia infection should be offered to sexually active young women. We undertook a literature review to document the views, attitudes and opinions of women about being screened, tested and diagnosed with Chlamydia trachomatis. METHODS: Online databases (MEDLINE, Meditext, PsycINFO, Web of Science) and reference lists searched up to August 2005. Search terms: chlamydia, attitude, attitude to health, interview, qualitative, women. ELIGIBILITY CRITERIA: about chlamydia, included women, involved interviews/surveys/focus groups, looked at women's views/opinions/attitudes, published in English. Thematic analysis identified the main and recurrent themes emerging from the literature. We compared our thematic analysis with the Theory of Planned Behaviour to provide a model that could assist in planning chlamydia screening programs. RESULTS: From 561 identified articles, 25 fulfilled inclusion criteria and were reviewed. 22: USA, UK; 3: Holland, Sweden, Australia. Major themes identified: need for knowledge and information, choice and support; concerns about confidentiality, cost, fear, anxiety and stigma. Women are more likely to find chlamydia screening/testing acceptable if they think chlamydia is a serious, common condition which can cause infertility and if they understand that chlamydia infection can be asymptomatic. Women want a range of options for chlamydia testing including urine tests, self-administered swabs, pelvic exams and clinician-collected swabs, home-testing and community-based testing. Tests should be free, easy and quick. Women want support for dealing with the implications of a chlamydia diagnosis, they feel chlamydia diagnoses need to be normalised and destigmatised and they want assistance with partner notification. Women need to know that their confidentiality will be maintained. CONCLUSION: Our review found that women from various countries and ethnic backgrounds share similar views regarding chlamydia screening, testing and diagnosis. The acknowledged importance of women's views in planning an effective chlamydia screening program is expanded in this review which details the nature and complexity of such views and considers their likely impact.
Attitude to Health↗
Chemistry, coeliac-toxicity and detection of gluten and related prolamins in foods.
Some recent advances in the understanding of the chemistry of gluten proteins and its relationship to the toxicity of different fractions in coeliac disease (gluten intolerance) is reviewed. Most recent studies on gluten toxicity have used in vitro analyses of cellular immune activation by gluten fractions and peptides. Our work indicates that gliadin is the most active of the different protein families found within the wheat grain and that a specific peptide sequence located in the amino terminus domain of alpha-gliadin and containing the sequence proline-serine-glutamine-glutamine was most active. Improvement in the dietary management of coeliac disease is possible by use of test kits for the detection of gluten in foods. Both laboratory kits and home test kits (suitable for use by individual coeliacs) are available and reliably detect gluten from wheat, rye and barley even after cooking or baking.
Celiac Disease↗
Tuberculin testing in residential homes for the elderly.
BACKGROUND: Evidence from the United States has shown that tuberculin sensitivity increases with length of stay among residents in homes for the elderly, implying an increasing risk of infection. There is no evidence as to whether or not residents in homes in the United Kingdom have a similar risk. METHODS: A study was undertaken to determine whether residence in a home for the elderly increases the risk of tuberculosis infection. Over a six month period all residents in homes for the elderly in Liverpool received a tuberculin test. A health questionnaire was completed by the field team for each resident. A total of 2665 residents in homes for the elderly were surveyed. RESULTS: Heaf test grade positivity declined with age, the odds ratio being 0.71 for each 10 year period. Adjusting for age, there was no change in Heaf test grade with length of stay in the home. Heaf test positivity was stronger in smokers (odds ratio 1.59) than ex-smokers (odds ratio 1.20) and non-smokers. Heaf test grade positivity was directly related to pack years. Allowing for age and smoking, the odds ratio for men compared with women for a positive test was 1.62 (95% confidence interval 1.32 to 1.99). CONCLUSIONS: Heaf test positivity declines with age. Residence in a home for the elderly is not associated with increased rate of tuberculosis sensitivity. Smoking and male gender is associated with increased Heaf test positivity.
Adult↗
Trials of teaching methods in basic life support (3): comparison of simulated CPR performance after first training and at 6 months, with a note on the value of re-training.
A randomised controlled trial comparing staged teaching of cardiopulmonary resuscitation (CPR) with conventional training provided the additional opportunity to investigate skill acquisition and retention in those attending conventional CPR classes. All subjects were tested immediately after their first instruction period and again at 6-9 months at an unheralded home visit. We were able to assess how far performance was related to poor acquisition of skills and how far it was related to skill decay. Out of 262 subjects who were randomised to receive conventional CPR instruction, 166 were available for home testing at 6-9 months. An invitation to attend for re-training had been accepted by 39 of them. The remaining 127 who attended only a single class comprise the principal study group, with additional comparative observations on the smaller re-trained cohort. Important failings were observed in the acquisition of skills in all modalities tested after the initial instruction. These were particularly marked in skills related to ventilation. Immediately after a class, 68% of trainees performed an effective check of breathing, but only 33% opened the airway as taught and no more than 18% provided an ideal ventilation volume. The technique of chest compression was also less than ideal. Although 80% of subjects placed their hands in an acceptable position, compression to an adequate depth and an adequate rate of compression were achieved by 54 and 63%, respectively. Seventy-eight percent demonstrated a careful approach, and 46% remembered to call for help. A carotid pulse check was simulated by 61% of trainees. When tested 6-9 months later, skill deterioration from this baseline was observed in all modalities tested except for the ventilation volume. The skill decay was significant (P<0.05) for the careful approach, performing an effective breathing check, the carotid pulse check, placing the hands in an acceptable position for chest compression, and compressing at an optimal rate. The minority who attended for re-training showed a trend to protection against skill decay for seven of the ten variables, compared with those who had attended only one training session. This improvement was significant for only two of them, but all were relatively small with limited practical value. Many who attend conventional CPR classes fail to acquire the necessary skills, and the skills that are acquired decline appreciably over the subsequent 6-9 months. The value of conventional re-training was modest in this study of community volunteers.
Adult↗
Rapid tests for detection of viral markers in blood transfusion.
Since the early 1990s, rapid tests have been available for detection of HIV infection. They were intended for field diagnosis, emergency and home testing. In addition, rapid tests for anti-HIV, hepatitis B surface antigen and antihepatitis C virus have been used for blood screening in many resource-poor areas to save resources and overcome lack of funding, equipment and electrical supply. The performance of rapid tests varies widely but some have sensitivity and specificity levels that meet standards established by enzyme immunoassays for anti-HIV. Compared with genomic detection of hepatitis B virus, hepatitis B surface antigen rapid tests and enzyme immunoassays have insufficient sensitivity. The clinical consequences of this performance deficit remain to be clarified. Anti-hepatitis C virus rapid tests detect chronically infected individuals who are viremic, however, further studies are required to fully assess their performance. In settings where few blood donations are collected and equipment is unavailable, rapid tests provide a flexible, technically undemanding and relatively inexpensive approach to ensuring a safer blood supply. When utilized for predonation screening in areas of high endemicity of viral markers, rapid tests provide the means to limit blood bag wasting, store only clinically usable blood and inform and counsel deferred donors. As with any laboratory assay, adequate training and sustained quality assurance programs are critical to maintain a safe supply of blood. As a means of achieving a safe blood supply, rapid tests for viral markers and nucleic acid testing have a place next to classic enzyme immunoassays in the definition of strategies that are adapted to a setting's epidemiology, the size and type of donor base, equipment, staff training and resources.
Blood↗
Relationship between soil and dust lead in a lead mining area and blood lead levels.
UNLABELLED: The relationship between lead mining waste and childhood lead poisoning is poorly understood. This study evaluates the contribution of soil lead to blood lead levels. METHODS: 125 children between 6 and 71 months of age living in a lead mining area of southwestern Missouri were evaluated for blood lead and their homes tested for lead in soil, dust, and paint. These results were compared to 26 control children. RESULTS: Homes in the lead mining area had significantly increased soil and dust lead levels and significantly higher blood lead levels. The primary source of dust lead was soil lead. There was a strong relationship between blood lead levels and dust, soil, and paint lead. CONCLUSION: Soil lead related to mining operations plays a significant role in contributing to blood lead levels in children.
Child, Preschool↗
Urinary HIV-1 antibody patterns by western blot assay.
Diagnosis of human immunodeficiency virus infection (HIV-1) is normally carried out by serum testing for HIV-1 antibody. Recently, antibody testing in other body fluids such as saliva and urine have been attempted. In this study, we examined HIV-1 antibody patterns in urine by Western blot assay as compared to that found in serum. Out of 44 sero-positive samples by Western blot assay we found 43 to be HIV-1 antibody positive in the urine, whereas all 40 sero-negative samples were negative in urine. Thus the sensitivity of urine testing was 97.7% with 100% specificity when compared to serum testing by the Western blot assay. In the analysis of the antibody pattern in urine, we found 6.8% of p17, 68% of p24, and 47.7% of p39 in the core proteins; 72.7% of p31, 61.4% of p51, and 68.2% of p66 in the polymerase; and 63.6% of gp41, 75% of gp120, and 97.7% of gp160 in the envelope proteins. The data obtained supports the selection of the HIV-1 antigen subtype-E to develop a home test kit using urine. Urine testing for HIV-1 antibody is convenient, non-invasive, safe, and easily performed at home. However, if the urine is positive, the confirmation test on serum is needed.
AIDS Serodiagnosis↗
Home environmental intervention in inner-city asthma: a randomized controlled clinical trial.
BACKGROUND: Airborne pollutants and indoor allergens increase asthma morbidity in inner-city children; therefore, reducing exposure, if feasible, should improve asthma morbidity. OBJECTIVE: To conduct a randomized controlled trial of methods to reduce environmental pollutant and allergen exposure in the homes of asthmatic children living in the inner city. METHODS: After the completion of questionnaires, spirometry and allergen skin tests, home inspection, and measurement of home air pollutant and allergen levels, 100 asthmatic children aged 6 to 12 years were randomized to the treatment group (home-based education, cockroach and rodent extermination, mattress and pillow encasings, and high-efficiency particulate air cleaner) or to the control group (treated at the end of the 1-year trial). Outcomes were evaluated by home evaluations at 6 and 12 months, clinic evaluation at 12 months, and multiple telephone interviews. RESULTS: In the treatment group, 84% received cockroach extermination and 75% used the air cleaner. Levels of particulate matter 10 microm or smaller declined by up to 39% in the treatment group but increased in the control group (P < .001). Cockroach allergen levels decreased by 51% in the treatment group. Daytime symptoms increased in the control group and decreased in the treatment group (P = .04). Other measures of morbidity, such as spirometry findings, nighttime symptoms, and emergency department use, were not significantly changed. CONCLUSIONS: A tailored, multifaceted environmental treatment reduced airborne particulate matter and indoor allergen levels in inner-city homes, which, in turn, had a modest effect on morbidity.
Air Pollution, Indoor↗
Development of a protocol for capillary blood glucose testing in nursing home and rehabilitation settings.
OBJECTIVES: To develop an algorithm to standardize capillary blood glucose (CBG) testing in nursing home and rehabilitation patients. DESIGN: Descriptive study in which an interdisciplinary team from a nursing home, a rehabilitation center, and a diabetes mellitus care program developed and tested a protocol to standardize diabetes management parameters and CBG testing frequency. SETTING: Department of Veterans Affairs nursing home and rehabilitation unit. PARTICIPANTS: One hundred one patients admitted to the units during the 6-month study period who had orders for CBG testing. INTERVENTION: Use of a standardized CBG testing protocol. MEASUREMENTS: Use of management goal, use of CBG testing protocol, total CBG tests/month. RESULTS: One hundred one subjects received orders for CBG testing; 72 (72%) received orders for a management goal, and 69 (69%) received orders to use the CBG protocol. Of these 69 patients, 22 met their CBG goals and were advanced to less-frequent CBG testing using the protocol, and 15 did not meet their CBG goals and were not advanced. An additional 15 patients were advanced to less-frequent CBG testing but not using the protocol. In all, 54 of 69 patients (78%) were advanced or could have been advanced by protocol to less-frequent CBG testing. Total CBG testing per month did not change before, during, or after the study period. CONCLUSION: This protocol would be useful in long-term care facilities and in other congregate living settings where patients with diabetes mellitus have staff assisting with their diabetes management. Barriers to successful implementation are discussed.
Aged↗
Test conditions influence the response to a drug challenge in rodents.
These studies were conducted to examine the differential response to a drug challenge under varied experimental test conditions routinely employed to study drug-induced behavioral and neurophysiological responses in rodents. Apomorphine, a nonselective dopamine agonist, was selected due to its biphasic behavioral effects, its ability to induce hypothermia, and to produce distinct changes to dopamine turnover in the rodent brain. From such experiments there is evidence that characterization and detection of apomorphine-induced activity in rodents critically depends upon the test conditions employed. In rats, detection of apomorphine-induced hyperactivity was facilitated by a period of acclimatization to the test conditions. Moreover, test conditions can impact upon other physiological responses to apomorphine such as drug-induced hypothermia. In mice, apomorphine produced qualitatively different responses under novel conditions when compared to those behaviors elicited in the home test cage. Drug-induced gross activity counts were increased in the novel exploratory box only, while measures of stereotypic behavior were similar in both. By contrast, apomorphine-induced locomotion was more prominent in the novel exploratory box. Dopamine turnover ratios (DOPAC:DA and HVA:DA) were found to be lower in those animals exposed to the exploratory box when compared to their home cage counterparts. However, apomorphine-induced reductions in striatal dopamine turnover were detected in both novel and home cage environments. The implications of these findings are discussed with particular emphasis upon conducting psychopharmacological challenge tests in rodents.
Analysis of Variance↗
Measurement strategy and instrumental performance of a computer screen photo-assisted technique for the evaluation of a multi-parameter colorimetric test strip.
A measuring strategy for the evaluation of a seven parameters colorimetric test using a computer screen photo-assisted technique (CSPT) is demonstrated. CSPT is a versatile approach aimed at point of care or home tests that uses regular computer sets and web cameras as the whole instrument. Issues such as the stability and the equivalency on different platforms of the determinations have been addressed in the present work. The method uses an embedded local reference simultaneously measured with the tests and solves the evaluation as a classification problem. The achieved performance tested along 580 classifications covering all the ranges of the assay, using synthetic samples, yielded 97.2% correct determinations compared with 89.7% for the case of colorimetric determinations. The errors were concentrated in only two parameters that show a significant correlation with a set of quality indices used to assess the performance of the classification.
Colorimetry↗
The incidence of gastroesophageal reflux in preterm infants.
We observed an increased incidence of gastroesophageal reflux (GER) in a group of preterm infants. Seventy-five infants (birth weight 1117 +/- 242 gm, gestational age 30 +/- 3 weeks) were tested within 1 week before hospital discharge (37 to 38 weeks postconceptional age). All of the infants had a two-channel pneumocardiogram and a 1-hour esophageal pH study (Tuttle test). Home monitors were used for all infants after hospital discharge and their use was maintained until standard discontinuation criteria were achieved. The Tuttle test was abnormal in 47 (63%) of the infants. Of the 47 infants with GER, 22 (47%) had evidence of obstructive apnea during the periods of reflux and 32 (68%) had an abnormal PCG result. Thirty-eight (81%) of the infants with GER had episodes of either obstructive or central apnea. The diagnosis of GER is important in premature infants because of the high association with recurrent or obstructive apnea.
Apnea↗
Seroprevalence of Bartonella henselae in cattery cats: association with cattery hygiene and flea infestation.
We attempted to determine what factors were common to catteries with high Bartonella henselae antibody prevalence compared with catteries with low prevalence, in order to contribute to better guidelines for the choice of a safe pet cat. The overall seroprevalence in 11 catteries from diverse geographical locations in North America in the present study was 35.8%. There was evidence of B. henselae exposure in all 11 homes tested, with 5 catteries being heavily infected. The distribution of B. henselae exposure was bimodal in catteries: either most or all cats in the home had been exposed, or very few or no cats had been exposed. Prevalence per home was also correlated with the home mean antibody titre. Flea infestation was the most important risk factor for high B. henselae seroprevalence in the catteries we surveyed. Individual cat titres were comparable for male and female cats, cats of various ages, and cats with concurrent infectious diseases. There was no association of B. henselae with cattery size, husbandry practices, presence or absence of rescued cats, dog ownership, attending cat shows, routine visits to a veterinarian, and outside travel. In summary, cattery cats can be easily identified as high or low risk to new potential cat owners.
Animal Husbandry↗
Virtual Visit: improving communication for those who need it most.
We are developing a videoconferencing system designed specifically to cater to the needs of the elderly and their distant friends and family. Focus group research has led to the incorporation of several key features that enhance the usability of the system. Audio and video transmission quality are optimized by separation, using the proven and familiar capability of analog phone for voice and the slightly less reliable, but faster data transmission of broadband Internet for video. A simple and intuitive user interface was designed based on the familiar steps of an actual household visit. The graphical interface is presented on the user's conventional television receiver and controlled by a simple seven-button remote control with integrated wireless microphone, which provides high quality audio pickup. The system can be remotely activated by a wearable wireless alarm button or by visitors with passkey privileges. A functional prototype has been developed and is currently undergoing field-testing. Preliminary response has been very encouraging. Future plans include extended focus group research, collaboration to integrate improved video transmission schemes, and in-home testing by seniors to gauge long-term user response.
Aged↗
Home prothrombin time monitoring after the initiation of warfarin therapy. A randomized, prospective study.
STUDY OBJECTIVE: To evaluate the efficacy and accuracy of monitoring prothrombin times at home. DESIGN: Randomized, prospective cohort study. SETTING: Outpatients discharged from a university hospital or a community hospital. PATIENTS: Fifty patients started on warfarin for the first time who demonstrated an ability to use the monitor and who had not achieved a stable response to warfarin in the hospital. INTERVENTION: Oral anticoagulation therapy managed using a portable prothrombin time monitor compared with specialized anticoagulation clinic care. MEASUREMENTS AND MAIN RESULTS: In the 46 patients who completed the 8-week study, the median percentage of time that patients in the home-monitor group (n = 23) were within a range equal to the target prothrombin ratio +/- 0.3, but always above 1.25, was 93%, compared with 75% for patients in the clinic group (n = 23) (P = 0.003). There was no significant difference between groups in the percentage of time above the therapeutic range; however, the percentage of time that patients were subtherapeutic was significantly greater in the clinic group (P less than 0.001). There were no major thromboembolic or hemorrhagic complications in either group. Differences between home monitor measurements and corresponding clinical laboratory measurements using blood samples drawn within 4 hours of the home test were comparable to differences observed between measurements using two different clinical laboratory instruments. CONCLUSIONS: Use of a portable prothrombin time monitor by patients at home is feasible and provides accurate measurements. Patients doing home monitoring achieve superior anticoagulation control compared with those receiving standard anticoagulation clinic care.
Adult↗
Fetal monitor for non-stress-test screening at home.
A fetal monitoring device developed for non-stress-test (NST) screening at home works on battery power, and is so small and lightweight (152 x 120 x 64 mm, 600 g) that a pregnant woman can monitor fetal Doppler ultra-sound and record fetal heart rate (FHR) and uterine contraction (UC) data on an attached memory IC card at any time and in any place away from a hospital. The physician can evaluate these data, transmitted via public telephone lines, using a built-in modem in the monitor. The combination of the memory IC card as a temporary storage device with the intermittent data transmission to the host provides endless data storage. The input-output relationship of the device was quantitatively evaluated using a Doppler ultrasound heart rate simulator. Forty pregnant women participated in an evaluation of this system. The total number of NST data transmissions was 648, and the total amount of data received was more than 6.7 Mbytes. Of the 648 transmissions, 475 were adequate for clinical interpretation. Of the 101 failed NST data transmissions, 85 resulted from patient handling errors. However, 82.4% of these errors resulted in reexamination and transfer of new data by the patients, who were aware of the insufficiency of the original data. The main cause of the noise in the data was zero-count data; this noise rate accounted for 4.1% of the data abnormalities. A questionnaire survey found that 96% of the participants wanted to use the monitor again in their next pregnancies, and 83% would recommend its use to pregnant friends. The system was easily used and accepted by pregnant women, and the NST data obtained were sufficient for clinical interpretation.
Computer Communication Networks↗