Guidelines for oral health care for long-stay patients and residents

People in residential or continuing care have an equal right to good oral health as people residing in the community. Entry to residential or continuing care provides an opportunity to assess need, identify problems, improve oral and dental health thereby contributing to improved general health and quality of life. This document provides guidance to establish standards for oral health care which are appropriate to the needs, demands and choices of individuals whether they live in continuing or residential care (Appendix 5).     

Complete Genome Sequence of a Novel Avian-Like H3N2 Swine Influenza Virus Discovered in Southern China

We report here the complete genomic sequence of a novel avian-like H3N2 swine influenza virus containing an H5N1 highly pathogenic avian influenza virus segment that was obtained from swine in southern China. Phylogenetic analysis indicated that this virus might originate from domestic aquatic birds. The sequence information provided herein suggests that continuing study is required to determine if this virus can be established in the swine population and pose potential threats to public health.     

Community-based mental health care in Africa: mental health workers’ views

The World Health Organization (WHO) has for long proposed the development of community-based mental health services worldwide. However, the progress toward community mental health care in most African countries is still hampered by a lack of resources, with specialist psychiatric care essentially based in large, centrally located mental hospitals. It is again time to reconsider the direction of mental health care in Africa. Based on a small inquiry to a number of experienced mental health professionals in sub-Saharan Africa, we discuss what a community concept of mental health care might mean in Africa. There is a general agreement that mental health services should be integrated in primary health care. A critical issue for success of this model is perceived to be provision of appropriate supervision and continuing education for primary care workers. The importance of collaboration between modern medicine and traditional healers is stressed and the paper ends in a plea for WHO to take the initiative and develop mental health services according to the special needs and the socio-cultural conditions prevailing in sub-Saharan Africa.     

The ridiculous notion of assessing ecological health and identifying the useful concepts underneath

The notion that the ecological health of the environment can be assessed is a ridiculous notion in a scientific context because there can be no objective definition of ‘health’ or method for defining degrees of health. Ecological health is a value judgement. A potentially useful concept embedded within the notion of ecological health is that environmental monitoring programs need to adopt a more holistic, ecosystems approach than has been used hitherto. In this paper, I outline a framework for ecosystem monitoring and discuss some of the variables that might be incorporated to assess ecosystem structure and processes. The interpretation of the data produced by ecosystem monitoring programs is problematic. Defining control or reference sites is virtually impossible; data can only be assessed with reference to extant ecosystems or to past situations.     

Bayesian monitoring of clinical trials with failure-time endpoints

This article presents an aid for monitoring clinical trials with failure-time endpoints based on the Bayesian nonparametric analyses of the data. The posterior distribution is a mixture of Dirichlet processes in the presence of censoring if one assumes a Dirichlet process prior for the survival distribution. Using Gibbs sampling, one can generate random samples from the posterior distribution. With samples from the posterior distributions of treatment-specific survival curves, one can evaluate the current evidence in favor of stopping or continuing the trial based on summary statistics of these survival curves. Because the method is nonparametric, it can easily be used, for example, in situations where hazards cross or are suspected to cross and where relevant clinical decisions might be based on estimating when the integral between the curves might be expected to become positive and in favor of the new but toxic therapy. An example based on an actual trial illustrates the method.     

Continuing Medical Education in Midpassage

Mandatory continuing education for physicians and other health professionals raises numerous problems. Issues that were considered academic when continuing education was voluntary now take on major practical and political significance. There is the risk that future legislation will mandate activities and methodologies which have not been proven. Research and development in continuing education must be accelerated so that decisions can be based on proper data. Centers of research and development should be established to encourage research and provide a sound foundation for the future of continuing education.     

Musculoskeletal disorders: primary and secondary interventions.

In the United States alone, the annual cost associated with the diagnosis and care of musculoskeletal trauma amounts to tens of billions of dollars [Occupational Musculoskeletal Disorders: Function, Outcomes and Evidence. Lippincott Williams and Wilkins, Philadelphia]. Moreover, these costs are continuing to increase at an alarming rate. In fact, in the United States today, occupational musculoskeletal disorders are the leading causes of work disability. Changes in health care policy and demand for improved allocation of health care resources by the Federal government have also recently placed greater pressure on health care professionals to provide the most cost-effective treatment for these disorders, as well as to validate treatment effectiveness. Indeed, treatment-outcome monitoring has assumed new importance in medicine. It is particularly essential in musculoskeletal care, which is currently targeted for attention by health care planners because of its high cost and perceived traditional inefficient care. With these facts in mind, the purpose of the present article is to review the status of current primary and secondary interventions for musculoskeletal disorders. Before doing so, a brief discussion of the biopsychosocial model of pain and disability, which is currently the most heuristic approach to intervention, will be provided.     

Real-time remote monitoring of water quality: a review of current applications, and advancements in sensor, telemetry, and computing technologies

Recent advances in communication and sensor technology have catalyzed progress in remote monitoring capabilities for water quality. As a result, the ability to characterize dynamic hydrologic properties at adequate temporal and spatial scales has greatly improved. These advances have led to improved statistical and mechanistic modeling in monitoring of water quality trends at local, watershed and regional scales for freshwater, estuarine and marine ecosystems. In addition, they have greatly enhanced rapid (e.g., real-time) detection of hydrologic variability, recognized as a critical need for early warning systems and rapid response to harmful algal bloom events. Here, we present some of the landmark developments and technological achievements that led to the advent of real-time remote monitors for hydrologic properties. We conclude that increased use and continuing advancements of real-time remote monitoring (RTRM) and sensing technologies will become a progressively more important tool for evaluating water quality. Recent engineering and deployment of RTRM technologies by federal and state regulatory agencies, industries, and academic laboratories is now permitting rapid detection of, and responses to, environmental threats imposed by increased nutrient loadings, development of hypoxic and anoxic areas, toxicants, and harmful algal bloom outbreaks leading to fish kill events and potential human health impacts.     

继续医学教育项目" 过程管理模式" 体会

继续医学教育项目是开展继续医学教育的重要形式之一,是卫生专业技术人员获取新知识、新理论、新技术、新方法的重要途径。项目执行的质量将直接体现继续医学教育质量。因此规范项目管理程序,建立有效的运行体系,建立严格奖罚制度,进行"过程跟踪管理"是保证项目执行质量的有效措施。     

继续医学教育项目”过程管理模式”体会

继续医学教育项目是开展继续医学教育的重要形式之一,是卫生专业技术人员获取新知识、新理论、新技术、新方法的重要途径。项目执行的质量将直接体现继续医学教育质量。因此规范项目管理程序,建立有效的运行体系,建立严格奖罚制度,进行”过程跟踪管理”是保证项目执行质量的有效措施。     

Pathways coordinating oocyte attrition and abundance during mammalian ovarian reserve establishment

The mammalian ovarian reserve is comprised of a finite pool of primordial follicles, representing the lifetime reproductive capacity of females. In most mammals, the reserve is produced during embryonic and early postnatal development with oocyte numbers peaking during mid‐to‐late gestation, and then experiencing a dramatic decline continuing until shortly after birth. Oocytes remaining after the bulk of this attrition are subsequently surrounded by a layer of somatic pre‐granulosa cells with these units then referred to as “primordial follicles.” The complex and varied cell death mechanisms intrinsic to this process are not only characteristic of, but also essential for, the proper formation of this pool of follicles, and as a result must be immaculately balanced to ensure long‐term fertility and reproductive health. Too few follicles can lead to Primary Ovarian Insufficiency, resulting in fertility loss and other features of aging, such as an overall shorter lifespan. On the other hand, whereas an excess of follicles might extend reproductive lifespan, this might also be the underlying etiology of other ovarian pathologies. The last decade, in particular, has vastly expanded our understanding of oocyte attrition and determinants of ovarian reserve abundance. By continuing to decipher the intricacies underlying the cell death processes and development of the initial primordial follicle pool, we may be in a much better position to understand idiopathic cases of premature follicle depletion and improve ovarian health in reproductive‐age women.     

An overview of diversity,occurrence, genetics and toxin production of bloom-forming Dolichospermum (Anabaena) species

The new genus name Dolichospermum, for most of the planktonic former members of the genus Anabaena, is one of the most ubiquitous bloom-forming cyanobacterial genera. Its dominance and persistence have increased in recent years, due to eutrophication from anthropogenic activities and global climate change. Blooms of Dolichospermum species, with their production of secondary metabolites that commonly include toxins, present a worldwide threat to environmental and public health. In this review, recent advances of the genus Dolichospermum are summarized, including taxonomy, genetics, bloom occurrence, and production of toxin and taste-and-odor compounds. The recent and continuing acquisition of genome sequences is ushering in new methods for monitoring and understanding the factors regulating bloom dynamics.     

The Hygia Project and Hygia Chronotherapy Trial: insights of we clinical investigators on the impact of the embedded continuing medical education on primary-care practice and improved patient cardiovascular health

ABSTRACT

The participating doctors of the Hygia Chronotherapy Trial (HCT) are aware of the criticisms of its published findings, which have been unjustifiably misrepresented in letters to the editors and commentaries, perhaps because of lack of understanding of the foundations of the Hygia Project, in which the HCT is nested. Thus, our purpose through this communication is to highlight the unique features of the Hygia Project and HCT in terms of: (i) organization, management, and quality control, (ii) physician training/continuing medical education, and (iii) impact on every-day primary-care clinical practice specifically improved patient care through 48 h ambulatory blood pressure monitoring to diagnose and optimally manage by bedtime hypertension chronotherapy true arterial hypertension to markedly improve the cardiovascular health of our patients.     

Coral reef conservation in Bali in light of international best practice,a literature review

Bali, Indonesia sits within the coral triangle and is internationally recognised for its high coral reef diversity. The health of Bali’s marine ecosystems has declined in recent decades, and this is thought to be due to threats from climate change, destructive fishing practices, pollution, outbreaks coral eating invertebrates, coral disease and unsustainable tourism. As a response, multiple conservation strategies have been introduced by the island’s communities, non-government organisations and governments, with the aim of preventing further decline, as well as restoring already degraded coral reefs. This literature review provides an in-depth analysis of the tools used to conserve Bali’s coral reefs, and compares them to those used in other countries. In light of international ‘best practice’ in coral reef conservation, this review makes suggestions on how Bali could better conserve its coral reef ecosystems. These include (1) increasing its designation of official Marine Protected Areas (MPAS) and strengthening management of existing ones, (2) creating an MPA network, (3) substantially reducing marine plastic pollution, (4) continuing artificial reef construction in degraded habitats, (5) continuing to develop Bali as an ecotourism destination, (6) increasing engagement in global science to inform marine conservation decision-making, and (7) developing more marine monitoring programmes.     

In Vivo Bioluminescent Imaging of Influenza A Virus Infection and Characterization of Novel Cross-Protective Monoclonal Antibodies

Influenza A virus is a major human pathogen responsible for seasonal epidemics as well as pandemic outbreaks. Due to the continuing burden on human health, the need for new tools to study influenza virus pathogenesis as well as to evaluate new therapeutics is paramount. We report the development of a stable, replication-competent luciferase reporter influenza A virus that can be used for in vivo imaging of viral replication. This imaging is noninvasive and allows for the longitudinal monitoring of infection in living animals. We used this tool to characterize novel monoclonal antibodies that bind the conserved stalk domain of the viral hemagglutinin of H1 and H5 subtypes and protect mice from lethal disease. The use of luciferase reporter influenza viruses allows for new mechanistic studies to expand our knowledge of virus-induced disease and provides a new quantitative method to evaluate future antiviral therapies.     

Whaleworms as a tag to map zones of heavy-metal pollution

Biological monitoring refers to the use of living organisms to evaluate environmental conditions. Of particular relevance to the health of marine ecosystems is the improvement of methodologies of biological monitoring to provide highly ecologically sensitive indices of exposure. We have shown that anisakid nematodes, a parasite group widely distributed in oceans that infects a wide range of host species, can accumulate essential and non-essential metals to levels far in excess of their host tissues. The fact that they could be used as biomarkers of trace-metal contamination in studies of environmental impact suggests a potential use as a monitor species in a marine ecosystem under anthropogenic stress because they might produce a warning or alert signal of high ecological relevance.     

实验鼠群的健康监测管理

虽然实验鼠种群的总体健康水平得到了显著的提高,但还是有很多重要的传染性病原体在实验鼠群中流行.实验鼠群的健康状况对于动物福利、科学研究甚或人类健康都很重要.所以必须要对实验鼠群进行健康监测.笔者依据自身的实践和经验,对鼠群健康监测的基本原理进行了分析,包括以下的内容：鼠群健康监测的必要性、健康检测规程的建立、哨兵鼠、常用的监测力法、样本采集原则、对检测结果的解读和应对.相信读者在了解这些基本的原理后,能设定出符合自身设施实际的鼠群健康监测计划并逐步在实践中完善.     

Exposing culprit organic pollutants: a review

There is a continuing need for monitoring the health of the environment due to the presence of pollutants. Here, we review the development and attributes of biosensors by which bacteria have been genetically modified to express the luminescence genes, i.e. to glow, in a quantified manner, in response to pollutants. We have concentrated on the detection of organic hydrocarbon pollutants and discussed the molecular mechanisms by which some of these chemicals act as effector molecules on the respective regulatory systems. The future of environmental biosensors is predictably bright. As more knowledge is gathered on the sensing regulatory component, the possibility of developing targeted or pollutant-specific biosensors is promising. Moreover, the repertoire of biosensors for culprit organic pollutants is expected to be enlarged through advances in genomics technology and identification of new sensory or receptor molecules. The need for pollutant detection at concentrations in the parts per trillion range or biosensors configured in a nanoscale is anticipated.     

Nesfatin-1 and ghrelin levels in serum and saliva of epileptic patients: hormonal changes can have a major effect on seizure disorders

Nesfatin-1 and ghrelin are the two recently discovered peptide hormones involved in the control of appetite. Besides its main appetite-control function, ghrelin also has anticonvulsant effects, while nesfatin-1 causes depolarization in the paraventricular nucleus (PVN). The aims of this study, therefore, were to investigate: (i) whether there are differences in the concentrations of nesfatin-1 and ghrelin in saliva and serum samples between eplilepsy patients and normal controls and (ii) whether salivary glands produce nesfatin-1. The study included a total of 73 subjects: 8 patients who were newly diagnosed with primary generalized seizures and had recently started antiepileptic drug therapy; 21 who had primary generalized seizures and were continuing with established antiepileptic drug therapy; 24 who had partial seizures (simple: n = 12 or complex: n = 12) and were continuing with established antiepileptic drug therapy; and 20 controls. Salivary gland tissue samples were analyzed for nesfatin-1 expression by immunochemistry and ELISA. Saliva and serum ghrelin levels were measured by ELISA and RIA, and nesfatin-1 levels by ELISA. Nesfatin-1 immunoreactivity was detected in the striated and interlobular parts of the salivary glands and the ducts. The nesfatin-1 level in the brain was around 12 times higher than in the salivary gland. Before antiepileptic treatment, both saliva and serum nesfatin-1 levels were around 160-fold higher in patients who are newly diagnosed with primary generalized epilepsy (PGE) than in controls; these levels decreased with treatment but remained about 10 times higher than the control values. Saliva and serum nesfatin-1 levels from patients with PGE and partial epilepsies who were continuing antiepileptic drugs were also 10-fold higher than control values. Serum and saliva ghrelin levels were significantly (twofold) lower in epileptic patients before treatment than in controls; they recovered somewhat with treatment but remained below the control values. These results suggest that the low ghrelin and especially the dramatically elevated nesfatin-1 levels might contribute to the pathophyisology of epilepsy. Therefore, serum and saliva ghrelin and especially the remarkably increased nesfatin-1 might be candidate biomarkers for the diagnosis of epilepsy and for monitoring the response to anti-epileptic treatment.     

3,4 Dichloroaniline-haemoglobin adducts in humans: preliminary data on agricultural workers exposed to propanil

Propanil is one of the major herbicides used on rice-paddies and is thought to produce adverse health effects through the action of its metabolite 3,4-dichloroaniline (3,4-DCA). T he feasibility of monitoring human exposure to propanil on the basis of 3,4-DCA adducts to haemoglobin (Hb) was investigated. We developed a method based on gas chromatography negative ion chemical ionization-mass spectrometry (NICI-GC-MS) to quantify 3,4-DCA released from human Hb after alkaline hydrolysis of the protein. 3,4-DCA-Hb adducts were identified in agricultural workers exposed to propanil and were detectable even 4 months after the last herbicide application. Urine samples collected at the same time had no measurable level of 3,4-DCA. 3,4-DCA-Hb adducts might be useful for monitoring human exposure to 3,4-DCA from agricultural sources.