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PubMed1994

The U.K. Working Party's Diagnostic Criteria for Atopic Dermatitis. I. Derivation of a minimum set of discriminators for atopic dermatitis.

A working party of 13 dermatologists, two family practitioners and a paediatrician was assembled, with the aim of developing a minimum list of reliable discriminators for atopic dermatitis. Each physician was asked to select 10 consecutive new cases of unequivocal mild to moderate atopic dermatitis and 10 controls with other inflammatory dermatoses. Each subject was examined by two independent observers, who were blind to the clinical diagnosis and study aim, with regard to 31 clinically useful diagnostic features for atopic dermatitis. Two hundred and twenty-four patients were studied (120 cases and 102 controls). Using the key physician's clinical diagnosis as a gold standard, the sensitivity and specificity of each of the 31 diagnostic criteria were tested. Using multiple logistic regression techniques, a minimum set of diagnostic criteria for atopic dermatitis was derived. These were: history of flexural involvement, history of a dry skin, onset under the age of 2, personal history of asthma, history of a pruritic skin condition, and visible flexural dermatitis. Adjustment for age, sex, region, social class and ethnic group did not alter the choice of final criteria. The discriminatory value of these criteria was also satisfactory when tested against a further sample of 150 patients drawn from the community, who did not have skin disease.

Adolescent↗

PubMed2003

Contribution of pilA to competitive colonization of the squid Euprymna scolopes by Vibrio fischeri.

Vibrio fischeri colonizes the squid Euprymna scolopes in a mutualistic symbiosis. Hatchling squid lack these bacterial symbionts, and V. fischeri strains must compete to occupy this privileged niche. We cloned a V. fischeri gene, designated pilA, that contributes to colonization competitiveness and encodes a protein similar to type IV-A pilins. Unlike its closest known relatives, Vibrio cholerae mshA and vcfA, pilA is monocistronic and not clustered with genes associated with pilin export or assembly. Using wild-type strain ES114 as the parent, we generated an in-frame pilA deletion mutant, as well as pilA mutants marked with a kanamycin resistance gene. In mixed inocula, marked mutants were repeatedly outcompeted by ES114 (P < 0.05) but not by an unmarked pilA mutant, for squid colonization. In contrast, the ratio of mutant to ES114 CFUs did not change during 70 generations of coculturing. The competitive defect of pilA mutants ranged from 1.7- to 10-fold and was more pronounced when inocula were within the range estimated for V. fischeri populations in Hawaiian seawater (200 to 2,000 cells/ml) than when higher densities were used. ES114 also outcompeted a pilA mutant by an average of twofold at lower inoculum densities, when only a fraction of the squid became infected, most by only one strain. V. fischeri strain ET101, which was isolated from Euprymna tasmanica and is outcompeted by ES114, lacks pilA; however, 11 other diverse V. fischeri isolates apparently possess pilA. The competitive defect of pilA mutants suggests that cell surface molecules may play important roles in the initiation of beneficial symbioses in which animals must acquire symbionts from a mixed community of environmental bacteria.

Amino Acid Sequence↗

PubMed2005

UML as a cell and biochemistry modeling language.

The systems biology community is building increasingly complex models and simulations of cells and other biological entities, and are beginning to look at alternatives to traditional representations such as those provided by ordinary differential equations (ODE). The lessons learned over the years by the software development community in designing and building increasingly complex telecommunication and other commercial real-time reactive systems, can be advantageously applied to the problems of modeling in the biology domain. Making use of the object-oriented (OO) paradigm, the unified modeling language (UML) and Real-Time Object-Oriented Modeling (ROOM) visual formalisms, and the Rational Rose RealTime (RRT) visual modeling tool, we describe a multi-step process we have used to construct top-down models of cells and cell aggregates. The simple example model described in this paper includes membranes with lipid bilayers, multiple compartments including a variable number of mitochondria, substrate molecules, enzymes with reaction rules, and metabolic pathways. We demonstrate the relevance of abstraction, reuse, objects, classes, component and inheritance hierarchies, multiplicity, visual modeling, and other current software development best practices. We show how it is possible to start with a direct diagrammatic representation of a biological structure such as a cell, using terminology familiar to biologists, and by following a process of gradually adding more and more detail, arrive at a system with structure and behavior of arbitrary complexity that can run and be observed on a computer. We discuss our CellAK (Cell Assembly Kit) approach in terms of features found in SBML, CellML, E-CELL, Gepasi, Jarnac, StochSim, Virtual Cell, and membrane computing systems.

Algorithms↗

PubMed2025

A genome-scale metabolic reconstruction resource of 247,092 diverse human microbes spanning multiple continents, age groups, and body sites.

Genome-scale modeling of microbiome metabolism enables the simulation of diet-host-microbiome-disease interactions. However, current genome-scale reconstruction resources are limited in scope by computational challenges. We developed an optimized and highly parallelized reconstruction and analysis pipeline to build a resource of 247,092 microbial genome-scale metabolic reconstructions, deemed APOLLO. APOLLO spans 19 phyla, contains >60% of uncharacterized strains, and accounts for strains from 34 countries, all age groups, and multiple body sites. Using machine learning, we predicted with high accuracy the taxonomic assignment of strains based on the computed metabolic features. We then built 14,451 metagenomic sample-specific microbiome community models to systematically interrogate their community-level metabolic capabilities. We show that sample-specific metabolic pathways accurately stratify microbiomes by body site, age, and disease state. APOLLO is freely available, enables the systematic interrogation of the metabolic capabilities of largely still uncultured and unclassified species, and provides unprecedented opportunities for systems-level modeling of personalized host-microbiome co-metabolism.

Humans↗

PubMed2000

Practice of pediatric pulmonology: results of the Future of Pediatric Education Project (FOPE)

In 1996, the Future of Pediatric Education (FOPE) Project of the American Academy of Pediatrics (AAP) developed surveys to describe the nature of pediatric practices, recent trends in clinical practice, and anticipated workforce needs for both pediatric generalists and pediatric sub-specialists. A survey was specifically developed to describe the features of pediatric pulmonology as self-reported by pediatric pulmonologists. The survey was distributed to members of the AAP Pulmonology Section, the Pediatric Assembly of the American Thoracic Society, and certified pediatric pulmonologists recognized by the American Board of Pediatrics. Of the 535 respondents (67% of those invited to respond), the responses of 388 certified and 94 trained but not board-certified pulmonologists were included in the results. The characteristics of certified and non-certified respondents were the same for most survey questions. Clinical activities occupy 73 +/- 29% of professional time. Most pulmonologists work in urban, inner city, or suburban settings and 85% are affiliated with a medical school. One third are in private practice. As a group, research activities occupy less than 15% of their time. Most pediatric pulmonologists maintain a referral practice and use physician extenders to provide care. Patients with asthma and cystic fibrosis comprise 60-70% of patient volume. Both the volume and complexity of patients are increasing, as is competition for pediatric sub-specialty services. Pediatric pulmonary practices vary in size and in volume of patients that they manage in various settings. Forty percent of respondents identify allergists and other pediatric pulmonologists as sources of competition. Sixty-nine percent of respondents do not believe that there is a current need for additional pediatric pulmonologists in their respective communities. Only 15% of respondents plan to retire in the next decade.

Adult↗

PubMed2005

Disease and injury among participants in the Agricultural Health Study.

The Agricultural Health Study (www.aghealth.org) is a cohort of 89,658 pesticide applicators and their spouses from Iowa and North Carolina assembled between 1993 and 1997 to evaluate riskfactorsfor disease in ruralfarm populations. This prospective study is just now reaching sufficient maturity for analysis of many disease endpoints. Nonetheless, several analyses have already provided interesting and important leads regarding disease patterns in agricultural populations and etiologic clues for the general population. Compared to the mortality experience of the general population in the two states (adjusted for race, gender, age and calendar time), the cohort experienced a very low mortality rate overall and for many specific causes and a low rate of overall cancer incidence. A few cancers, however, appear elevated, including multiple myeloma and cancers of the lip, gallbladder, ovary, prostate, and thyroid, but numbers are small for many cancers. A study of prostate cancer found associations with exposure to several pesticides, particularly among individuals with a family history of prostate cancer. Links to pesticides and other agricultural factors have been found for injuries, retinal degeneration, and respiratory wheeze. Methodological studies have determined that information collected by interview is unbiased and reliable. A third round of interviews scheduled to begin in 2005 will collect additional information on agricultural exposures and health outcomes. The study can provide data to address many health issues in the agricultural community. The study investigators welcome collaboration with interested scientists.

Accidents, Occupational↗

PubMed1998

Potential influence of migration bias in birth cohort studies.

OBJECTIVE: To assess the potential bias, due to migration from the community, in a birth cohort study of learning disability in Olmsted County, Minnesota. MATERIAL AND METHODS: The 1976 through 1982 birth cohort consisted of 8,548 children born to mothers who were residents of Rochester, Minnesota, at the time of delivery. The current status of all children was determined for the 1995 to 1996 school year with the resources of Independent School District #535, the Rochester Epidemiology Project, and the Rochester Reading Center. Information from birth certificates was compared between migrants and nonmigrants with use of standard statistical tests. RESULTS: The cumulative probability of migration by age 5 years was 32.2% (95% confidence interval, 31.2 to 33.2%). When migrants were compared with nonmigrants, the distributions of Apgar scores, father's age, gestational age at birth, and number of children in the family were virtually identical. In contrast, migrants were more likely to be nonwhite (6% versus 2%), be born to a single parent (11% versus 7%), and have a congenital defect noted at birth (1.5% versus 0.7%). When considered simultaneously in a logistic regression model, the parents of migrants were more highly educated, migrant mothers were younger and had fewer prenatal visits, and migrant children were more likely to be black. CONCLUSION: This report demonstrates the extreme effort that must be made to assemble a birth cohort in our mobile society. Furthermore, the results suggest that only slight differences exist between migrants and nonmigrants; these are unlikely to compromise the future results of the ongoing learning disability study.

Adolescent↗

PubMed1975

[Analysis of mortality in the Zilina district].

From death certificates assemble in the Zilina district in three years (1968-1970) the authors prepared and coded questionnaires with 29 criteria. In the present article they submit some results obtained by automatic computing and biometric evaluation of these data. In the introduction they draw attention to and explain the rising trend of mortality in the Zilina district as well as in the Slovak Socialist Republic. Significant differences were revealed in the marital status of men and women with a predominance of married man and widows. The investigated variations of the number of deceased per day or week is not statistically significant; they were significant only in the course of the year with the maximum of deaths in March and the minimum in August. The specific mortality by decades revealed that men have from birth throughout life a higher death rate than women. As regards causes of death according to the 17 classes of the International Classification four classes dominate similarly an in the entire Slovak Socialist Republic, i. e. cardiovascular diseases 40.8%, tumours 17.8%, respiratory diseases 17.2% and accidents 7.5% all diagnoses. The order of diseases is the same for men and women only in the five most numerous classes and even there is a significant difference in the mortality level in three. Trichotomic classification of communities throws some light on the problem of causes of death of the rural and urban population. The last doctor attending the patient before death was in 48,3% the health community doctor, in 39,1% the hospital, in 8,9% (accidents and acute attacks) nobody whereby the percentage structure of men and women differs significantly also in this indicator. Finally the authors draw attention to the fact that the number of post mortem examinations (31,8%) is highest, as compared with the Central Slovak region (19,9%), the Slovak Socialist Republic (21,1%), the Czech Socialist Republic (29,8%) and the CSSR (27,6%).

Adolescent↗

PubMed2001

A 3-year follow-up study of social, lifestyle and health predictors of cognitive impairment in a Chinese older cohort.

BACKGROUND: Longitudinal data on the older population in the Asian setting are limited. This paper reports the factors associated with the development of cognitive impairment (CI) in a cohort of Chinese elderly aged > or =70 years. METHODS: The study cohort comprising 2030 subjects aged > or =70 years was assembled in 1991-1992 and followed for 36 months. Baseline information on cognitive function, as well as a number of social and health variables were obtained through face-to-face interview at the respondent's place of residence. The outcome variable was the development of CI among 988 cohort members who were initially free from CI, and who could be contacted at the 36-month follow-up. The instrument used to assess CI was based on the information/orientation part of the Clifton Assessment Procedure for the elderly (CAPE), using a cut-off point of 7. RESULTS: Of the men, 6.7%, but 22.2% of women had CI at 3-year follow-up. The age-adjusted annual incidence of CI was 1.52% in men, and 6.37% in women. Multivariate logistic regression analysis showed that women had a 2.5-fold increased risk of having CI, compared with men. The risk increased by about 1.5-fold with every 5-year increase in age. Slow gait time, as assessed by the 16-foot walk, was a predictor of CI in both sexes (odds ratio [OR] = 1.03 per second increase, 95% CI : 1.0-1.07). Men residing in institutions had a 4.4-fold increased risk of having CI (95% CI : 1.7-11.1) compared with those residing in community, while the OR among women was 2.5 (95% CI : 1.3-4.9). Among women, no formal education increased the risk of having CI by 3.2-fold (95% CI : 1.8-5.5). Income dependency also increased the risk of CI by about fourfold, and no exercise at baseline was associated with a twofold increased risk of CI. Incident stroke during follow-up also increased the risk of CI (OR = 8.4, 95% CI : 1.2-59.4). CONCLUSIONS: Older age and female sex were independent factors associated with CI. No formal education, slow gait time and institutionalization increased the risk of CI in both sexes. While education had a stronger effect in women, institutionalization had a stronger effect in men. Financial dependency, lack of exercise and incident stroke played a significant role in women.

Aged↗

PubMed2025

Fishing for a reelGene: evaluating gene models with evolution and machine learning.

Assembled genomes and their associated annotations have transformed our study of gene function. However, each new annotated assembly generates new gene models. Inconsistencies between annotations likely arise from biological and technical causes, including pseudogene misclassification, transposon activity, and intron retention from sequencing of unspliced transcripts. To evaluate gene model predictions, we developed reelGene, a pipeline of machine learning models focused on (1) transcription boundaries, (2) mRNA integrity, and (3) protein structure. The first two models leverage sequence characteristics and evolutionary conservation across related taxa to learn the grammar of conserved transcription boundaries and mRNA sequences, while the third uses the conserved evolutionary grammar of protein sequences to predict whether a gene can produce a protein. Evaluating 1.8 million transcript models in Zea mays ssp. mays (maize), reelGene classified 28% as incorrectly annotated or non-functional. We find that reelGene classifies 92.2% of genes in the maize proteome and 99.2% of genes within the maize classical gene list as functional. reelGene also provides a way to further investigate genome biology- for instance, reelGene indicates that 10.3% of dispensable genes in B73 are functional, and within retained duplicate genes, reelGene identifies a 30% bias toward the retention of the M1 subgenome when one copy is functional and the other is non-functional. As an annotation-evaluating tool, reelGene is directly applicable to species of the Andropogoneae tribe, including other important crops like sorghum and miscanthus. As a community resource, reelGene has been integrated onto MaizeGDB both as a browser track and as an individual Shiny App, allowing researchers to evaluate gene model accuracy and further investigate genome biology.

Machine Learning↗

PubMed1990

Haiti. Educating factory workers.

There are approximately 50,000 workers employed in the light assembly industry in Haiti. About 70% are women, the majority of whom are aged between 25 and 34 years, and are either single or in a nonpermanent relationship with the father of their children. Many live and work in appalling conditions, surviving on very low wages to support several children and an extended family. The acquired immunodeficiency syndrome (AIDS) is now a visible problem in many factories. In October 1988, the Center for the Promotion of Women Workers (Centre de Promotion des Femmes Ouvriers/CPFO) launched a pilot AIDS education program for factory women. The Center, based in a large industrial zone near the airport, runs a health clinic and courses in literacy, communications skills, health promotion and family planning. The new AIDS program allowed CPFO staff to gain entry into factories for the 1st time. Other courses were held outside working hours and outside factory premises. Staff contacted manages by telephone to arrange a meeting to discuss AIDS and to ask permission to hold educational "round tables" with workers. Of 18 managers in the factories approached over a 12-month period, only 2 refused entry to CPFO staff. Almost all managers reported they had registered between 2 and 5 deaths from AIDS among their employees over the past couple of years. A total of 85 educational sessions, each lasting about 2 hours, were held within 28 different factories, community or labor organizations reaching 3063 workers (male and female). In each session, the presentation was carried out by 2 CPFO trained monitors and included a slide show, flip charts, and the video "Met ko," originally produced for Haitian immigrants in New York. The most important aspect of the program was the training of 38 volunteer factory-based health promoters. These promoters attended the round table sessions, where they facilitated discussion and distributed condoms and were subsequently available for counseling co-workers. Initially, the Center intended to recruit only literate women as promoters, but several nonliterate women were selected for training by labor organizations 18 hours of tuition and discussion of AIDS/human immunodeficiency virus were held over 2 1/2 weeks, including sessions on group dynamics and organizational skills. To improve communications skills, sessions included role play exercises which were videotaped and played back to trainees. Training in communication skills also helps promoters participate in activities aimed at supporting a broader range of workers' rights.

Acquired Immunodeficiency Syndrome↗

PubMed1967

A light and electron microscope study of long-term organized cultures of rat dorsal root ganglia.

Dorsal root ganglia from fetal rats were explanted on collagen-coated coverslips and carried in Maximow double-coverslip assemblies for periods up to 3 months. These cultured ganglia were studied in the living state, in stained whole mounts, and in sections after OsO(4) fixation and Epon embedment. From the central cluster of nerve cell bodies, neurites emerge to form a rich network of fascicles which often reach the edge of the carrying coverslip. The neurons resemble their in vivo counterparts in nuclear and cytoplasmic content and organization; e.g., they appear as "light" or "dark" cells, depending on the amount of cytoplasmic neurofilaments. Satellite cells form a complete investment around the neuronal soma and are themselves everywhere covered by basement membrane. The neuron-satellite cell boundary is complicated by spinelike processes arising from the neuronal soma. Neuron size, myelinated fiber diameter, and internode length in the cultures do not reach the larger of the values known for ganglion and peripheral nerve in situ (30). Unmyelinated and myelinated nerve fibers and associated Schwann cells and endoneurial and perineurial components are organized into typical fascicles. The relationship of the Schwann cell and its single myelinated fiber or numerous unmyelinated fibers and the properties of myelin, such as lamellar spacing, mesaxons, Schmidt-Lanterman clefts, nodes of Ranvier, and protuberances, mimic the in vivo pattern. It is concluded that cultivation of fetal rat dorsal root ganglia by this technique fosters maturation and long-term maintenance of all the elements that comprise this cellular community in vivo (except vascular components) and, furthermore, allows these various components to relate faithfully to one another to produce an organotypic model of sensory ganglion tissue.

Animals↗

PubMed2002

September 11, 2001. A CEO's story.

On the day of the terrorist attacks on New York's World Trade Center, 1,779 employees of Marsh & McLennan Companies had office space in the twin towers, and another 129 were visiting that day. From his office at MMC headquarters in midtown, CEO Jeffrey Greenberg watched in horror as the second plane hit. By the time the towers fell, he had gathered a team of his colleagues to begin to outline how the company would respond. In this first-person account, Greenberg relates what it was like to manage through the unimaginable. The needs of MMC's people, and the families of employees who perished, took top priority. In the midst of chaos and unforeseeable problems, Greenberg and his colleagues improvised ways of communicating and assembled a broad-based program of support. Help appeared from all sides, from people of various ranks, titles, and functional expertise within MMC as well as past chairmen, outside directors, and retired executives. An emergency communications center was immediately set up at MMC headquarters and became a centralized location for messages and information and a memorial to colleagues lost in the attacks. The company arranged for grief counselors and established a family assistance center and a Family Relationship Management Program for those who had lost MMC employees. It has also provided families with access to long-term psychological and financial counseling. At the same time, Greenberg offers lessons about leadership, company culture, and adaptability. He and his colleagues held responsibility for a business beset by operational destruction and financial losses and facing dramatically changed market conditions. Their resolve was not simply to keep it on course but to come back stronger than ever.

Administrative Personnel↗

PubMed1991

The prognosis of hospital-referred transient ischaemic attacks.

A cohort of 469 hospital-referred patients with transient ischaemic attacks (TIA) of the brain (66%) or eye (34%) due to presumed atheromatous thromboembolism, lipohyalinosis or cardiogenic embolism, without prior stroke, was assembled between 1976-86. Follow up was prospective and complete until the patients death or the end of 1986. During a mean period of follow up of 4.1 years there were 82 deaths (58 vascular, 24 non-vascular), 63 first-ever strokes and 58 patients with coronary events. A coronary event accounted for 51% of deaths whilst stroke was the cause in 12%. The average risk of death over the first five years after TIA was 4.5% per year. The risk of stroke was 6.6% in the first year and 3.4% per year on average over the first five years. Stroke occurred in the same vascular territory as the initial TIA in about two-thirds of cases, and was of lacunar type in one fifth of these strokes. The average risk of a coronary event over the first five years after TIA was 3.1% per year, similar to that of stroke. However, the risk of a coronary event, and also death, was fairly constant each year after a TIA, in contrast to the risk of stroke which was highest in the first year. The average risk of stroke, myocardial infarction or vascular death over the first five years after TIA was 6.5% per year and the average risk of stroke, myocardial infarction or death from any cause was 7.5% per year. The prognosis of this cohort of hospital-referred TIA patients was better than that of TIA patients in the same community who presented to the Oxfordshire Community Stroke Project (OCSP), and reflected the impact of referral bias. The hospital-referred patients were younger, assessed at a later date after their last TIA, and comprised a greater proportion of patients who had had a TIA of the eye (amaurosis fugax), which had a better prognosis than TIA of the brain. Knowledge of the prognosis of different populations of TIA patients not only enhances understanding and interpretation of previous studies but is also required for optimal patient management and the planning of treatment trials.

Carotid Artery, Internal↗

PubMed2026

Potential survival strategies of novel comammox and nitrite-oxidizing Nitrospira synthesizing osmoprotectants in a wastewater microbiome treating high-ammonia brackish landfill leachate.

BACKGROUND: In the late stages of landfill operation, leachate becomes brackish and contains high concentrations of ammonia with limited organic carbon. At leachate treatment facilities, it is typically subjected to nitrification followed by denitrification, with methanol supplied as an external electron donor. This unique environment may harbor novel microorganisms, including nitrifiers. Although a variety of microorganisms are involved in nitrification, their substrate specificity and salinity tolerance remain insufficiently understood. In this study, a genome-centric metagenome analysis was conducted on the microbiome from a leachate treatment facility at a closed landfill. RESULTS: A total of 68 metagenome-assembled genomes (MAGs) were reconstructed, including 64 putative novel species. Among these, two Nitrospira MAGs were recovered: a novel complete ammonia-oxidizing bacterium (comammox), Nitrospira LAS72 (88.72% completeness, 2.10% contamination), and canonical nitrite-oxidizing Nitrospira LAS18 (99.98% completeness, 2.29% contamination). Comparative genomic analysis with 260 publicly available Nitrospira genomes revealed that LAS18 represents a new sub-lineage within lineage VII of the Nitrospira genus. Two ammonia-oxidizing archaea (AOA), Candidatus Nitrosocosmicus LAS21 and Nitrosarchaeum LAS73, were also identified, while canonical ammonia-oxidizing bacteria were not detected. Given the brackish conditions (1.23% salinity) and the methanol-fed operation of the treatment facility, the genomic potential for osmotic stress adaptation and methanol metabolism was investigated. Comammox Nitrospira LAS72 harbors biosynthetic pathways for several compatible solutes (osmoprotectants), including glycine betaine, proline, trehalose, and L-glutamate. Moreover, comammox Nitrospira LAS72 possesses genetic potential for oxidizing formaldehyde, suggesting that it may exploit these methanol-derived intermediates as energy sources. These features indicate that LAS72 may withstand osmotic fluctuations through the production of various osmoprotectants and thrive under the unique conditions of a methanol-fed environment. CONCLUSIONS: The discovery of novel comammox Nitrospira and canonical Nitrospira forming a new sub-lineage within lineage VII of the Nitrospira genus in an ammonia-rich brackish environment provides the first genomic evidence for evolutionary adaptation among nitrifiers to saline, methanol-fed environments. These findings enhance our understanding of the ecological and evolutionary dynamics shaping nitrifier communities in complex treatment ecosystems. Video Abstract.

Ammonia↗

PubMed1986

[Evaluation of stomatological care in Santiago de los Caballeros, Dominican Republic, stage 1].

In Santiago de los Caballeros, Dominican Republic, a study was done of the status of dental care with the long-run aim of reforming the system and increasing the integration of education and service. The study centered on the current status of that integration, which is taking place between the Federal Secretary of Public Health and Social Welfare and the Universidad Católica Madre y Maestra, respectively the service and education establishments concerned. The study is being done in two stages. In the first, carried out in 1983 and described in the article, the chief aim was to assemble information on the system considered. The methodology consisted in the selection of a sample of 61 patients treated at three centers of basic dental care in the area; use of the techniques of direct observation, interviews, measurement of the time spent on each operation, and the building up of files; and a study of all the variables that could have influenced an assessment of the situation at the time and of projections for the future. Some of the variables were the priority group, the age group, health status, progress of the treatment, and the reason for seeking care and choosing the center. It was found that 81,97% of the patients were under 14 years of age and 78,69% were between 5 and 14 years old. Most of the patients said they were in good health, although a high percentage reported having had certain diseases. Of all patients studied, 73,77% were discharged--a satisfactory figure. The main reasons for coming to the center were personal initiative and the recommendation of another, not medical referral, and the reason for choosing the center was its proximity to the patient's home. On the basis of the study the research team recommended a revision of the standards for dental services nationwide, adaptation of the work done to the physical premises, planning for the integration of education and service, the encouragement of innovative attitudes in service and education professionals and, lastly, extension of the manpower training program--with the integration of education and service--to the communities and instead of confining it to intramural instruction.

Dental Care↗

PubMed2004

American society of health-system pharmacists' pain management network.

The American Society of Health-System Pharmacists' (ASHP) Pain Management Network is one of several informal networking groups of pharmacist practitioners who specialize in a clinical practice area. Pharmacy practitioners are showing an increased interest in the management of pain because of expanding clinical roles, the Joint Commission on Accreditation of Health Care Organizations' development of pain management standards, and involvement with performance improvement and quality initiatives. The Pain Management Network is one of the American Society of Health-system Pharmacists (ASHP) Section of Clinical Specialists and Scientists specialty practice networks. The Network serves as an informal venue for practitioners interested in pain management to gather and share information. Pain Management Network Assemblies are held at each ASHP national meeting. Practitioners communicate between meetings via the Section's e-mail list server. Pharmacists who participate in the Pain Management Network have a variety of roles in both acute and chronic pain management. Their roles may be consultative in nature or they may be involved in the actual medication management as part of a collaborative drug therapy management agreement with a physician. Pharmacists are involved with acute pain, cancer-related pain, and chronic nonmalignant pain management. Current issues involve education of pharmacy students and practicing pharmacists as well as the use of meperidine as an analgesic agent. Compounding of non-sterile drugs for intraspinal use is another current issue. Access to evidence-based pain management resources may be difficult to locate and access but is essential to good pain management. The ASHP Pain Management Network has proven to be a valuable way for participants to gather and exchange new information and share in their clinical practice experiences.

Community Pharmacy Services↗

PubMedDate not supplied

A status report on the characterization of the microgravity environment of the International Space Station.

A primary objective of the International Space Station is to provide a long-term quiescent environment for the conduct of scientific research for a variety of microgravity science disciplines. Since continuous human presence on the space station began in November 2000 through the end of Increment-6, over 1260 hours of crew time have been allocated to research. However, far more research time has been accumulated by experiments controlled on the ground. By the end of the time period covered by this paper (end of Increment-6), the total experiment hours performed on the station are well over 100,000 hours (Expedition 6 Press Kit: Station Begins Third Year of Human Occupation, Boeing/USA/NASA, October 25, 2002). This paper presents the results of the on-going effort by the Principal Investigator Microgravity Services project, at NASA Glenn Research Center, in Cleveland, Ohio, to characterize the microgravity environment of the International Space Station in order to keep the microgravity scientific community apprised of the reduced gravity environment provided by the station for the performance of space experiments. This paper focuses on the station microgravity environment for Increments 5 and 6. During that period over 580 Gbytes of acceleration data were collected, out of which over 34,790 hours were analyzed. The results presented in this paper are divided into two sections: quasi-steady and vibratory. For the quasi-steady analysis, over 7794 hours of acceleration data were analyzed, while over 27,000 hours were analyzed for the vibratory analysis. The results of the data analysis are presented in this paper in the form of a grand summary for the period under consideration. For the quasi-steady acceleration response, results are presented in the form of a 95% confidence interval for the station during "normal microgravity mode operations" for the following three attitudes: local vertical local horizontal, X-axis perpendicular to the orbit plane and the Russian torque equilibrium attitude. The same analysis was performed for the station during "non-microgravity mode operations" to assess the station quasi-steady acceleration environment over a long period of time. The same type of analysis was performed for the vibratory, but a 95th percentile benchmark was used, which shows the overall acceleration magnitude during Increments 5 and 6. The results, for both quasi-steady and vibratory acceleration response, show that the station is not yet meeting the microgravity requirements during the microgravity mode operations. However, it should be stressed that the requirements apply only at assembly complete, whereas the results presented below apply up to the station's configuration at the end of Increment-6.

Acceleration↗