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PubMed1988

Case-control studies of the effect of environmental sanitation on diarrhoea morbidity: methodological implications of field studies in Africa and Asia.

The problems and prospects in the use of case-control studies to assess the effects of improvements in environmental sanitation on diarrhoea morbidity are discussed on the basis of two field studies. It is concluded that an adequate design is available for assessing the effects of a single improvement on diarrhoeal disease. The estimates of effect appear to be valid and sufficiently precise. For addressing more complex questions of interactions, sample sizes would have to be increased substantially. The experience with two field studies suggests that there is hope that a simpler protocol may be feasible, in which only limited information is collected, in which few home visits are made, and in which analytical techniques are simple. Until more field studies have been conducted definitive conclusions cannot be reached on the applicability of such a simple, rapid and inexpensive approach.

Child, Preschool↗
PubMed1988

The use of network sampling for locating the seriously ill.

Network sampling, based on the experience of conducting the large-scale 1986 Robert Wood Johnson Foundation National Access to Health Care Survey, was shown to be a viable alternative to more conventional procedures for oversampling persons with a low incidence and prevalence of health conditions. The network sampling approach was a more economical and methodologically less obtrusive means of increasing sample size of persons with desired characteristics than conventional procedures. The approach requires estimating the incidence, prevalence, or both of the required characteristics in the population. As the proportion of persons in the population with the characteristic increases, network sampling may lose its attractiveness. However, this has to be judged both in economic terms and in terms of the methodologic consequences of using other procedures to increase the size of subgroups of interest. As discussed, additional methodologic work is required on the consequences of network sampling for study group representativeness and sampling bias. However, network sampling, in the authors' opinion, is sufficiently promising to warrant methodologic explorations to answer these and other relevant questions about its use.

Adult↗
PubMed1989

[Coping with disease from the psychosomatic-psychotherapeutic viewpoint exemplified by pancreatectomized patients].

In the past few years psychosomatic medicine, apart from investigating the psychosocial sources of bodily disorders, has begun to focus also on the opposite side of the problem, the question of how people experience illness and cope with it. This "somatopsychic" view can be regarded as a supplement to the so far prevailing psychosomatic perspective and its approach. The present study describes and analyzes various strategies of coping with illness as observed in a group of pancreatectomized patients, a group of patients which has not been investigated before in this field of research. Based upon the experience of long-term psychotherapeutic care, the study differentiates between the more problematic and the more beneficial forms of coping, and empirically verifies their prevalence and adaptivity in a sample of pancreatectomized patients, not selected with regard to the extent of care needed. The findings are discussed from the methodological and the psychosomatic-psychotherapeutic point of view.

Adaptation, Psychological↗
PubMed1979

Menu planning competencies in administrative dietetic practice. II. Practitioners' ratings of competence.

A nationwide sample of administrative and generalist dietitians rated five competencies with sub-competencies and ninety-two descriptors related to menu planning. Each item was rated numerically for importance and frequency of time consideration. Data were grouped according to three levels of practitioner experience. It was concluded that an effective methodology was developed for analyzing competencies for dietetic practice.

Administrative Personnel↗
PubMed1975

A generalized modified-chi2 analysis of categorical bacteria survival data from a complex dilution experiment.

A well-known method of estimation for the density of bacteria in a sample solution is the most probable number (MPN) procedure. This paper considers the change in density through time of bacteria populations which are undergoing extinction. The MPN with its estimated variance for a fixed time point is a basic module of these investigations and is treated as a general implicit function of the cell proportions in linear categorical data analysis. These quantities are then used to fit exponential decay models over time by weighted least squares. When such models are supported by the data, comparisons of decay rates between populations under possibly different experimental conditions can be undertaken. This methodology is illustrated with an example pertaining to the survival experience of Leptospira autumnalis.

Bacteriological Techniques↗
PubMed1990

Novel strategies for clinical drug analysis with new column technology in liquid chromatography.

Clinical drug analysis has been the focus of much attention and controversy because of the increase in substance abuse testing of addicts, patients, employees and others, in addition to the rapidly growing fields of therapeutic drug monitoring and clinical toxicology. This review focuses on the latest methodological and technological advances in liquid chromatography (LC) as it is applied to clinical drug analysis. Based on the author's experience, key chromatographic parameters such as carbon load, functionalities and temperature are proposed for the separation of structurally similar metabolites and for resolving chromatographic interferences by other drugs and metabolites. Novel sample preparation for cyclosporine and gradient elution of its metabolites are reviewed, followed by an update on monitoring of 3'-azido-3'-deoxythymidine with emphasis on automated sample preparation. Various approaches of direct sample analysis are advocated for increased efficiency as a result of minimal sample preparation and potential advantages such as decreased exposure of personnel to infectious samples. An update of microbore LC indicates that 2-mm columns may be readily used for clinical paediatric and neonatal analysis without dedicated chromatographs. Potential applications of multidimensional-multimodal chromatography include analyses of a cocaine impurity, anticonvulsants, antidepressants, and five ingredients of a common cold medication.

Body Fluids↗
PubMed1992

Salivary excretion of drugs in children: theoretical and practical issues in therapeutic drug monitoring.

Studies suggest that saliva could be used instead of blood in the therapeutic monitoring of many drugs. This has distinct advantages in pediatrics and neonatology as saliva sampling is painless and spares blood. Stimulation of saliva secretion with a chemical stimulus (i.e. citric acid applied over the tongue) facilitates the study of younger patients. Secretory and reabsorptive processes which take place in the ductal system of the salivary glands, and the rate of flow of the secretion play major roles in the determination of the concentration of solutes in saliva. Drug passage into saliva follows the general principles of movement of drugs across biologic membranes. Only the unbound fraction of the drug in plasma is available for diffusion into saliva and a relationship exists between saliva pH and the saliva/plasma concentration ratio of many polar drugs (tolbutamide, propranolol, procainamide, etc.). However, deviations from the pH theory exist and the inter -and intra-individual variations in saliva/plasma concentration ratios of salicylate and procainamide cannot be explained solely on the basis of fluctuations of salivary pH; on the other hand, a useful relationship exists between plasma and saliva phenobarbital concentrations with no need to correct for saliva pH. The use of stimulated saliva has several advantages over resting saliva: a larger volume of the sample is obtained, the pH gradient between plasma and saliva is smaller, the variability in saliva/plasma concentration ratios of some drugs is narrowed, and less specimens are too viscous or discolored to allow drug analysis. Thorough rinsing of the mouth is required prior to saliva sampling as remnants of orally administered medicines may contaminate saliva specimens and give spuriously high values. Deviation from a simple but strict methodology accounts for some of the discrepancies found in the literature. Studies in children uniformly recommend saliva for therapeutic monitoring of phenytoin, carbamazepine and phenobarbital. Saliva sampling for therapeutic monitoring of ethosuximide, primidone and digoxin in infants and children, and of theophylline and caffeine in the neonate is promising, but little pediatric experience is available as yet. The value of saliva in therapeutic monitoring of theophylline in children is still controversial. Little of highly polar compounds such as aminoglycosides, and of polar highly protein bound drugs such as valproic acid is present in saliva. More data are still needed on the excretion of drugs in saliva in infants and in acutely ill children, and few data exist in the premature and full-term neonate.

Child↗
PubMed1976

Testosterone in human urine as determined by gas-liquid chromatography.

A simple and accurate gas chromatographic method for the determination of testosterone in human urine is described. Radioactive testosterone was added to samples to correct methodological loss. A mild acid hydrolysis under protection of benzene layer gave a single estimate of testosterone glucuronate and sulphate. Paper chromatography and rechromatography on chromatoplate served for preliminary qurification. Testosterone was gas chromatographed as acetate and guantitated by the internal standard procedure and flame ionization detector. Results of control experiments, normal values for female and male subjects and estimations in patients with alterations of androgen hormone metabolism are presented.

Adolescent↗
PubMed1991

Mutagenicity study of urine from smoking and non-smoking road tanker drivers.

Urine from 32 road tanker drivers handling petrol, diesel, paraffin and white spirit was tested in the Salmonella/microsome mutagenicity system using tester strains TA98 anbd TA100. Urine samples were collected before and after tanking and were concentrated 250-fold on XAD-2 columns before testing. Controls were 33 office employees from the same plant. No effect on urinary mutagenicity of occupational exposure to petroleum products was found. Significant differences in mutagenic effect were demonstrated between smokers and non-smokers. Methodological experiments demonstrated a dose/response effect of smoking on urinary mutagenicity. A modified test using a preincubation period and an increased concentration of bacteria was more sensitive than the standard Ames test to mutagens from tobacco smoking.

Dose-Response Relationship, Drug↗
PubMed1975

Measurement of bacterial and fungal contributions to respiration of selected agricultural and forest soils.

A technique using selective inhibitors was used to estimate the relative contributions of bacterial and fungal populations to the respiration of six soils and one litter sample. The ratios of bacterial to fungal respiration in the four agricultural soils, given in percentage of the total microbial activity, ranged from 10/90 to 35/65, with the average ratio being about 30/70. In the forest soils, the ratios were 20/80 and 30/70, and in a beech litter sample, the ratio was 40/60. The fungi clearly dominated in all samples. The ratios were not found to be pH related. The difficulties which had previously limited the use of selective inhibitors for in situ soil ecological investigations, such as insufficient inhibitor specificity, inhibitor inactivation or degradation, and errors of measurement caused by elimination of competitor populations, were either resolved or methodologically avoided in the experiments. Inhibitor selectivity was demonstrated using both mixed and pure cultures of microorganisms from each soil. Through the use of experiments with short incubation periods (6-8 h), problems with population shifts and inhibitor degradation were eliminated.

Actinomycetales↗
PubMed1991

An improved dot-blot method for virus detection in chicken embryo fibroblast cultures.

A simplified dot-blot procedure is described for the detection of fowlpox virus (FPV) in infected monolayers of chicken embryo fibroblasts (CEF) cultured in 96-well microtiter plates. The relative resistance of DNA to hot NaOH, which hydrolyzes other macromolecules including RNA and protein, was exploited to solubilize virus infected cells and denature intracellular DNA in a simple, quick manner. Moreover, there was no need to purify virus or isolate viral DNA from cellular DNA prior to dot blotting. After incubation of CEF with FPV, the extracellular fluid from infected cells was collected for storage in 96-well microtiter plates. The remaining cell monolayers in each well were then solubilized with hot NaOH. The solubilized and denatured DNA was transferred to a nylon membrane using a dot-blot vacuum filtration manifold. Hybridization was carried out with a 32P-labeled FPV DNA probe. With this methodology it was possible to detect specific viral DNA sequences following the infection of cell monolayers with as little as 1 infectious unit per well. The ability to detect specific viral DNA sequences in infected cells, without the need to isolate pure viral DNA, made it possible to analyze large numbers of samples in a single experiment. Moreover, sufficient fowlpox virus was present in the extracellular media from each well for further amplification and analysis of selected samples.

Animals↗
PubMed1991

Dentists' perceptions of HIV/AIDS as an occupational hazard: a qualitative investigation.

The aim of this study was to explore in depth a sample of dentists' perceptions of HIV/AIDS in the context of an investigation into their feelings towards occupational hazards. To fulfil this aim a qualitative research method, the Repertory Grid Technique, was employed. Twenty-three dentists were involved in the study. The main findings of the research were that a complex array of views were expressed by the sample, but that issues relating to concern and control were seen as being of greatest relevance and importance. The methodological technique used enabled a two-dimensional diagrammatic image to be created representing the samples' view of HIV/AIDS. Most of the dentists perceived HIV/AIDS as being of low to moderate concern and under moderate to high control. The older male dentists expressed higher levels of concern and lower levels of control. Those dentists with the greatest experience of dealing with people affected by HIV/AIDS expressed lower concern and higher control. When compared with other occupational hazards, the sample viewed HIV/AIDS in a very similar way to eye injury, mercury, radiation and herpes, in terms of concern and control. It was evident, however, that occupational stress was the hazard that provoked the highest degree of concern for the sample, and not HIV/AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1979

The hormonal basis of breast cancer.

Both animal experiments and certain well-established breast cancer risk factors suggest that risk to the disease is fundamentally determined by the hormones of the pituitary-gonadal axis. Although international comparisons of urinary estrogens have given support to this ypothesis, case-control studies and international comparisons of plasma estrogens and prolactin have not. Methodological problems and sampling biases probably account for the inconsistency of these investigations. Taking advantage of the known familial increased risk to breast cancer, we conducted comparative studies of teenage daughters of patients with breast cancer, including a group of girls whose mothers had bilateral breast cancer when they were less than 50 years old. The results of these studies revealed that these high-risk girls appear to have elevated levels of estrogens, prolactin, and progesterone.

Adolescent↗
PubMed1988

Researching the symptoms of menopause: an exercise in methodology.

This paper deals with the methodological problems involved in the measurement of physical and psychological morbidity among menopausal women. A sample of 477 women were interviewed six times over a 3-yr period. In addition to questions about their menstrual status, the women were asked at each interview to complete a checklist of physical, menopausal, and psychological symptoms. Factor analysis was performed on the symptom experience to determine if symptoms could be grouped together in ways which would demonstrate clinically useful constructs and be stable over time. One-way analysis of variance showed a significant relationship only between the vasomotor symptoms and menopausal status.

Adult↗
PubMed1976

Quantity conceptions in university students: another look.

One hundred and thirty-eight post-graduate students enrolled in a Diploma in Education course were tested for their ability to converse weight and volume. A methodological criticism of the earlier work or Elkind (1962) and Towler & Wheatley (1971) is offered which casts doubt on the extremely high proportion of non-conservers of volume reported in those studies. Nevertheless, using a modified version of Elkind's methodology, 18 per cent of our sample were non-conservers of volume, a result providing some support for the generaltiy of Elkind's findings. The results are discussed under the four headings of horizontal decalage, sex differences, possible effects of pre-graduate courses of study and educational implications. The importance of the individual as constructor and interpreter of his own experience is emphasized.

Adult↗
PubMed1976

Methodological simplifications in radioimmunoassay of urinary aldosterone.

Simplification of radioimmunoassay procedures of urinary aldosterone-18-glucuronide was attempted, taking into consideration the aspects implied by the hydrolysis of urine and the assay itself. The procedure standardized for the hydrolysis step (samples diluted with a two-fold volume of 0.2 N HCl and incubated at 30 degrees C for 16-24 h) proved suitable in terms of practicability and accuracy. Aldosterone antisera, raised in the rabbit against an aldosterone-3-bovine albumin conjugate, were selected according to their specificity towards competing steroids. Depending on the characteristics of the antisera used, an assay of extracts, or even direct measurements of hydrolyzed urines excluding any extraction, were found to yield reliable results. In the case of a high-quality antiserum, evidence for the adequacy of assay on non-hydrolyzed urine extracts for the measurement of the excretion of unconjugated aldosterone was provided by some preliminary data. The results of the experiments, directed at the methodological and clinical validation of the simplified procedures, are reported and discussed in this paper.

Aldosterone↗