Low-bandwidth,low-cost telemedicine consultations in rural family practice

BACKGROUND: Telemedicine, based on the use of interactive video consultations, is being used more commonly in rural settings. This development is potentially important to rural patients because there are fewer physicians, particularly specialist physicians, in rural areas. Declining costs of telemedicine equipment and transmission have created increased access to these technologies for rural family physicians and their patients. METHODS: This study considers satisfaction levels of rural family physicians, academic-based specialists, and rural patients in 130 consultations between rural physicians, rural patients, and urban academic specialists. To increase the practicability for rural use, low-cost equipment and low-bandwidth digital telephone transmission lines were utilized. Data were collected using questionnaires that were completed by patients, family physicians, and specialist consultants after each consultation. RESULTS: All categories of participants noted very high levels of satisfaction. CONCLUSION: Telemedicine-based consultations are well accepted by rural patients, rural family physicians, and urban academic specialist consultants. This approach could offer a useful adjunct to rural health care.     

Nutrient intakes and food consumption patterns among Ontario students in grades six, seven, and eight

BACKGROUND: The increased prevalence of overweight in Canadian children has stimulated interest in their lifestyle behaviours. The purpose of this research was to investigate dietary intake and food behaviours of Ontario students in grades six, seven, and eight. METHODS: Males and females from grades six to eight were recruited from a stratified random selection of schools from Ontario. Data were collected using the web-based "Food Behaviour Questionnaire", which included a 24-hour diet recall and food frequency questionnaire. Nutrients were analyzed using ESHA Food Processor and the 2001 Canadian Nutrient File database. Body Mass Index (BMI) was calculated based on self-reported weight and height, and classified according to the Centers for Disease Control BMI for age percentiles. RESULTS: The sample included males (n = 315) and females (n = 346) in grades 6, 7, and 8 from 15 schools in Ontario. According to Canada's Food Guide to Healthy Eating (CFGHE), median intakes were below recommendations for all participants, with the exception of meat and alternatives. Participants consumed a median of 54%, 15%, 31%, 11%, and 8% of total energy from carbohydrates, protein, total fat, saturated fat, and added sugars, respectively. Participants consumed 25% of total energy from foods from the "other" food group (CFGHE). Males had higher intakes of energy, carbohydrates, fat, saturated fat, monounsaturated fat, protein, thiamine, niacin, iron, and zinc than females (all p < 0.05), and consumed more grain products servings (p < 0.05). CONCLUSION: The high consumption of "other" foods, at the expense of nutrient-dense food groups, may ultimately be contributing to the increased weights in childhood and adolescence.     

Self-concept: younger vs older black pregnant adolescents

This article compares the self-concept scores on the Offer Self-Image Questionnaire (OSIQ) of younger versus older black pregnant adolescents and nonpregnant adolescents. It was hypothesized that the self-concepts of adolescents differed from one another on the basis of age, race, and pregnancy. Two alternative schools for first-time pregnant teenagers were used as data collection sites for the pregnant adolescents, and published data was used for the nonpregnant adolescents. The results indicated that 141 pregnant subjects (13 to 15-year-olds and 16 to 19 year-olds) had almost identical self-concept scores, but their scores differed significantly from the nonpregnant adolescents.     

Interferon-γ is expressed in both gut and spleen during Eimeria tenella infection

The effect of primary infection and subsequent challenge with Eimeria tenella on interferon-γ (IFN-γ ) production in the spleen and caeca of Light Sussex chickens was assessed. The ability of splenocytes to proliferate and produce IFN-γ in response to mitogen stimulation ex vivo was determined. Differences in the kinetics of IFN-γ production suggested that the spleens of infected birds contain a subpopulation of T cells, primed to produce IFN-γ , which migrate from the spleen in response to a secondary infection. IFN-γ mRNA expression was detected by hybridization of an anti-sense chicken IFN-γ riboprobe to splenic sections from infected birds and caecal sections from challenged birds. Hybridization was to T-cell areas in the spleen, and to cells in the lamina propria and intraepithelial compartments of the caecum. This is the first direct demonstration of IFN-γ expression in chickens at the site of E. tenella infection, and also the first indication that IFN-γ may be involved in the immune response to challenge.     

Effect of a novel phyto-compound on mucosal candidiasis: further evidence from an ex vivo study

OBJECTIVE: To isolate, identify and determine the prevalence of yeasts in the oral cavity of individuals and to test the minimum inhibitory dilution (MID) of Kolorex against the yeasts isolated. METHODS: Twenty‐nine individuals of both sexes aged on average 61.3 years were evaluated at the dental clinic in order to isolate and identify yeasts from their oral cavity, with and without lesions, and to determine the MID of the commercial phyto‐product Kolorex against the strains isolated. The antifungal activity of the product tested was determined by the technique of dilution on a solid medium. Monocyte chemoattractant protein 1 (MCP‐1) was measured by biotinylated antibody assay by an enzyme‐linked immunosorbent assay (ELISA). RESULTS: Yeasts of the genus Candida were detected in the saliva of 45.4% of the 11 individuals with a clinically healthy mouth and in 88.2% of 17 individuals with oral lesions. In the group with oral candidiasis we isolated in tongue and lesion, respectively, for each species: C. tropicalis (5.8% and 11.7%), C. glabrata (5.8% and 5.8%) and C. parapsilosis (0% and 5.8%), in addition to C. albicans as the only species or in association with others, respectively (64.7% and 70.5%). The total clonal formation unit (CFU) (counts/mL) in the saliva showed a higher mean value in the group with oral candidiasis (158.3 × 10³) than in the control group (64.6 × 10³). Most of the 70 test strains (95.7%) were sensitive to Kolorex by presenting a MID of 1:20. Sixty percent of strains from the 70 healthy sites showed results similar to those obtained with strains from oral lesions. Different results were mainly observed among different species. Patients with oral lesions showed a significant time‐course increase of the level of monocyte chemoattractant protein 1 (MCP 1) as compared to those without lesions or to healthy people in whom Candida has not been detected (P < 0.05). Co‐culture with Kolorex using aliquots from the same patients with oral lesions inhibited such event (P < 0.05). CONCLUSION: Although this study was focused on oral cavity candidiasis, the results indicate the possibility of a broader use of the antifungal Kolorex in the prevention and treatment of mucosal candidiasis located elsewhere.