Media reviews

Of the three films reviewed in this issue, only the first, All Women Have Periods, deals with both areas of sexuality and disability. The second film, A Masturbatory Story, deals with sexuality but not disability. The third film, A Different Approach, deals with disability but not sexuality. The reason I have included the last two films are that A Masturbatory Story is one of the best, most permission giving films I have seen on the subject of masturbation and A Different Approach while focusing on employment of the disabled, is one of the most entertaining and effective films I have seen dealing with attitudes.     

Comparison of attitudes toward transsexuality and homosexuality

Attitudes toward transsexuality and homosexuality were compared in a sample of 318 university students. More people felt that homosexuality was wrong than felt that transsexuality was wrong. This difference in favor of transsexuality was more pronounced in female than in male respondents. In addition, more people rejected the notion that biological factors were responsible for homosexuality than was the case for transsexuality. General attitudes about the morality of transsexuality and homosexuality, however, were not mirrored in response to questions pertaining to job discrimination. To the contrary, male respondents, especially, were more inclined toward equal opportunity for homosexuals than for transsexuals. One hypothesis supported by this study was that homosexual denial and homophobia in some transsexuals may, in part, be a reflection of society's greater moral condemnation of homosexuality relative to transsexuality.     

Making sense of illness: late-in-life migration as point of departure for elderly Iranian immigrants' explanatory models of illness

This article is based on data gathered through 60 qualitative interviews conducted within the realm of three research projects that have used culture-appropriate lenses to study the postmigration situation of late-in-life Iranian immigrants to Sweden. The findings gathered through these studies were interpreted against the backdrop that culturally appropriate nursing theories provide. This meant that it was, at times, these elders backgrounds as cultural others that were implicitly used to make sense of the various issues that were brought to the fore by these studies. The particular issue with which this article is concerned is the unusualness of these elders explanatory models of illness. Inspired by the concept definition of situation in the symbolic interactionist perspective and by the feeling that this perspective might bring about a different interpretation of the original findings regarding their understandings of illness and disease, we set out to conduct a secondary analysis of these elders explanatory models of illness. The findings presented in this article will show how the elderly Iranian immigrants interviewed in these three studies utilize the process of late in life migration as a point of reference for their understandings of what has caused the illnesses from which they suffered. Hereby we will suggest that the unusualness of their explanatory models of illness might be best understood if we focus on what they shared as immigrants (i.e., the fact that the process of late-in-life migration has made their culture obsolete) as opposed to what they shared as Iranians (i.e., their culture of origin).     

Internal exposure to organic substances in a municipal waste incinerator

Summary Fifty-three persons occupied in a municipal waste incinerator were examined with respect to their internal exposure to organic substances which may be produced during pyrolysis of organic matter. For this purpose the levels of benzene in blood, polychlorinated biphenyls (PCBs) and hexachlorobenzene (HCB) in plasma, and mono- (MCPs), di- (DCPs), tri- (TCPs), tetra-(TECPs) and pentachlorophenol (PCP) and hydroxypyrene in urine were determined. For control purposes, 431 men and women were examined. Significantly higher values for the workers were found for the excretion of hydroxypyrene [median (m): 0.24vs 0.11 g/l; non-smokers], 2,4/2,5-DCP (m: 10.5 vs 3.9 g/l) and 2,4,5-TCP (m: 1.2 vs 0.8 g/l) and for the HCB level in plasma (m: 4.4 vs 2.8 g/l). For the concentrations of 4-MCP and 2,3,4,6/2,3,5,6-TECP, the controls had significantly higher concentrations in urine than did the workers in the incineration plant (m: 4-MCP 1.7 vs 1.2; 2,3,4,6/2,3,5,6-TECP: 1.2 vs 0.3 g/l). No significant differences between workers and controls were detected with respect to benzene in blood (m: 0.20 vs 0.28 g/l; non-smokers), 2,4,6-TCP and PCPs in urine (m: 0.85 vs 0.60 and 2.2 vs 2.2 g/l) or the levels of PCB congeners in plasma (m: 138, 153, 180: 5.6 vs 4.1 g/l). The elevated levels of hydroxypyrene, 2,4/2,5-DCP, 2,4,5-TCP and HCB in biological material may be related to the incineration of the waste. These elevations, however, are very small and are of interest more from the environmental than from the occupational point of view.     

Assessment of occupational exposure to 4,4′-methylene-bis-(2-chloroaniline) “MOCA” by a new sensitive method for biological monitoring

Summary A new specific and sensitive method for the urinary determination of 4,4-methylene-bis-(2-chloroaniline) (MOCA), a known carcinogen in rats, mice and dogs, has been developed. After a brief study on rats to determine some peculiarities in MOCA urinary excretion, this method was used to assess occupational exposure in French industrial firms. Both the manufacture of MOCA and its use as a curing agent in the production of polyurethane elastomers were surveyed. MOCA excretion levels were distributed from non-detectable (<0.5 g/l) up to 1600 g/l. Concentrations of N-acetyl metabolites, when present, were largely lower than MOCA levels. The results seemed to reflect workers' overall exposure fairly. Preventive measures following analytical determinations often led to an obvious lowering of excretion levels.     

Isomer-specific analysis and toxic evaluation of polychlorinated biphenyls in striped dolphins affected by an epizootic in the western Mediterranean sea

Isomer-specific concentrations of polychlorinated biphenyls (PCBs) including planar, mono- and di-ortho congeners and concentrations of DDT were determined in striped dolphins affected by a morbillivirus epizootic in the western Mediterranean in 1990. Extremely high concentrations of PCBs ranging from 94 to 670 g/g (wet wt) were detected in the blubber. Similarly, DDT concentrations were high, between 22 and 230 g/g (wet wt). The concentrations of three non-ortho coplanar PCBs were 43 (3,3,4,4-T₄CB), 6.8 (3,3,4,4,5-P₅CB), and 7.8 (3,3,4,4,5,5-H₆CB) ng/g (wet wt), respectively, the highest residue levels reported to date. The estimated 2,3,7,8-TCDD toxic equivalents of non-, mono- and di-ortho PCB congeners in striped dolphins were several times higher than those observed for other marine mammals and humans. Mono-ortho congeners contributed greater 2,3,7,8-TCDD toxic equivalents than non-ortho members. The higher ratio of 3,3,4,4,5,5-H₆CB/3,3,4,4,5-P₅CB (IUPAC 169/126) suggested a strong induction of mixed function oxidase enzymes and highlighted the possibility of using this ratio as an index for risk assessment of PCB contamination in marine mammals. Elevated concentrations of PCBs may have played a role in the immune depression in striped dolphins, ultimately leading to the development of morbillivirus disease.     

Polychlorobiphenyls, ΣDDT,and hexachlorocyclohexane isomers in the western North Pacific ecosystem

Polychlorobiphenyls (PCBs), DDT (p,p-DDT,p,p-DDD, andp,p-DDE and HCH isomers (hexachlorocyclohexanes including , , and isomers) were determined in a marine food chain, including seawater, zooplankton, myctophid, squid and striped dolphin collected from the western North Pacific waters. The concentrations of these pollutants increased in higher trophic levels, where the highest bioconcentration factors (concentration ratio in organisms to water), as much as 10⁷, were obtained from both PCBs and DDT in striped dolphin. The proportions of highly chlorinated biphenyls,p,p-DDE and -HCH increased in higher-ranking predators. These observations suggest that the bioaccumulation mechanisms in lower trophic levels depend primarily on the physicochemical properties of pollutants, whereas those in higher trophic levels are affected by the biodegradability of the pollutants and the metabolic capacity and life-span of the organisms.     

Influence of different kinds of noise on the ear and some physiological and psychological parameters

Summary The reactions of the human organism to noise are complicated and difficult to separate from other stressors, with the exception of hearing damage. After thorough experimental planning and a rigorous selection of sample persons, the reaction to noise of varying structures was studied by reactions of heart rate, blood pressure, reaction time, the temporary threshold shift (TTS) of hearing and the psychological parameters Mood (in German Befinden). We found a special kind of TTS dependent on the structure o noise and no effect of physiological parameters. The psychological parameter tended to have a significant influence on individual factors.     

Managing for health: why health care?

Health and health care are increasingly big business. The challenge is to apply our knowledge and skills to meet people's needs, if not their demands as efficiently, effectively and beneficially as possible. Value for money is the slogan. For those who deliver the goods as required, the converse, money for value should equally apply, and not only in a market driven system. This paper offers a very personal view of these issues in the light of recent UK policy developments.     

Die Rolle der Disposition bei der Entstehung der Dekompressionskrankheit

Zusammenfassung 1. Die Rolle der Disposition zur Dekompressionskrankheit erscheint auch in der Form einer natürlichen Auswahl.2. Die Gewöhnung spielt bei der Erkrankungsfrequenz keine Rolle.3. Die Druckprobe ergibt weder für Feststellung der konstitutionellen noch der konditionellen Disposition Hinweise.4. Für die ärztliche Vorbeugung stehen die sorgfältige Eignungsuntersuchung, die periodische Kontrolluntersuchung und die genaue Analyse der einzelnen Erkrankungsfälle zur Verfügung.     

Correlation between vibration-induced white finger and symptoms of upper and lower extremities in vibration syndrome

Summary The correlation was investigated between the frequency of attacks of vibration-induced white finger (VWF) and numbness or coldness of the fingers and legs in patients with vibration syndrome. Some 1687 patients with vibration syndrome were examined and of these 342 chain-saw operators and 277 rock-drill operators had no disease other than vibration snydrome. Then subjects were matched by age and period of treatment within three years. In the last analysis, 20 in the VWF almost everyday group or in the never group, and 40 in the occasionally group were selected from the chain-saw operators, and from the rock-drill operators 32 in the VWF everyday or the never group and 64 in the occasionally group. The present study showed that, with the frequency of VWF attacks, patients had a higher prevalence of coldness not only in the fingers but also in the legs. These findings suggest a correlation between the severity of circulatory disturbances of the upper extremities and that of the lower ones in patients with vibration syndrome. Further studies on circulatory disturbances in the leg are required.     

Dimensionen der Zufriedenheit im Alter

Zusammenfassung In einer Interview-Studie von 480 Betagten in städtischen Verhältnissen wurden neben anderen Fragen auch solche zur Zufriedenheit gestellt. Eine Faktoranalyse der Antworten erlaubt die Unterscheidung eines Faktors Depressivität von einem Faktor Zufriedenheit mit Sozial-kontakten und einer gesundheitlichen Dimension.

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Dimensions of satisfaction among old people

Summary In an interview study of 480 aged persons, questions on satisfaction with several aspects of life were included. A factor analysis allows to distinguish a factor relating to depressivity from a factor satisfaction with social contacts and a health-related dimension.

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Dimensions de la satisfaction des personnes âgées

Résumé Das une enquête d'un échantillon de 480 personnes âgées, des questions concernant leur satisfaction ont été inclues dans l'interview. Une analyse factorielle permet de distinguer un facteur associé à la dépressivité d'un facteur satisfaction avec les contactes sociaux et d'une dimension santé.

     

Accumulation of Selenium and Lack of Severe Effects on Productivity of American Dippers (Cinclus mexicanus) and Spotted Sandpipers (Actitis macularia)

Selenium has been found at elevated concentrations in water, sediments, and aquatic biota in the Elk River (British Columbia, Canada) and some of its tributaries downstream of several coal mines. Selenium water concentrations in those areas exceed Canadian and British Columbia guidelines and are above levels at which adverse effects to fish and waterfowl could occur. We compared selenium concentrations in the eggs of two riverine waterbirds, American dippers and spotted sandpipers, with measures of productivity: the number of eggs laid, egg hatchability, and nestling survival. In American dippers, the mean egg selenium concentration from the exposed areas, 1.10±SE 0.059 g/g wet weight, was indistinguishable from the reference areas, 0.96±SE 0.059 g/g wet weight. For spotted sandpipers, the mean egg selenium concentration in the exposed areas, 2.2±0.5 g/g wet weight, was significantly higher than in the reference areas, 1.2±0.14 g/g wet weight, but less than reported thresholds for waterfowl and other shorebirds. There were no significant differences in egg hatchability between dippers in reference and exposed areas, but reduced hatchability was apparent for sandpipers in exposed locations. Despite the slightly reduced hatchability in sandpipers, overall productivity was higher than regional norms for both species; thus, selenium did not affect the number of young recruited to local populations. We did not observe teratogenic effects in either species, although none was expected at these concentrations. Despite moderately high selenium concentrations in the water, mean egg selenium concentrations were less than predicted from uptake models. We hypothesise that the relatively low uptake of selenium into the eggs of the two waterbirds in this study is likely due to their lotic environments low biological transformation and uptake rates.     

Prevention's technology

This paper describes each of the tools preventionists use to promote health and reduce the incidence of illness. Examples of each tool in use are provided.     

Chromatographic determination of dicofol and metabolites in egg yolks

Egg yolk was spiked withp,p-dicofol (p,p-DCF) (0.1–2.0 g/gm),p,p-dichlorobenzophenone (p,p-DCBP) (0.1–2.0 (g/gm), and 1,1-bis(4-chlorophenyl)-2,2-dichloroethylene (p,p- DDE) (0.05–1.0 g/gm). The fortified egg yolk (2–5 g) was mixed with acetonitrile to extract non-fat organic materials. After removal of acetonitrile, the spiked chemicals were separated with a column chromatograph packed with acid alumina. Recovery efficiencies forp,p-DCBP andp,p-DDE were determined by gas chromatography, and forp,p-dicofol by high performance liquid chromatography. The recovery efficiencies forp,p-dicofol,p,p-DCBP andp,p-DDE were 77.2–93.8%, 84.1–101.1%, and 88.5–96.0%, respectively.     

In a Secular Spirit: Strategies of Clinical Pastoral Education

The Clinical Pastoral Education (CPE) model forthe provision of spiritual care represents theemergence of a secularized professionalpractice from a religiously-based theologicalpractice of chaplaincy. The transformation ofhospital chaplaincy into spiritual careservices is one means by which religioushealthcare ministry negotiates modernity, inthe particular forms of the secular realm ofbiomedicine and the pluralism of thecontemporary United States healthcaremarketplace. Spiritual is a labelstrategically deployed to extend the realm ofrelevance to any patient's belief system,regardless of his or her religious affiliation.Theological language is recast as a tool forconceptualizing the spiritual lens. Suchmoves transform chaplaincy from a peripheralservice, applicable only to the few religiouspatients, into an integral element of patientcare for all. Such a secularized professionalpractice is necessary to demonstrate therelevance and utility of spiritual care for allhospital patients in an era of cost-containmentpriorities and managed care economics.     

What is a normal family? Common assumptions and current evidence

The social and applied human sciences have been built upon the assumption that the normal family consists of a first-marriage conjugal couple cohabiting with biological children. It is taken for granted that the wife should be responsible for child and domestic work, and that the husband should be the family's economic provider and ultimate authority. In the professional literature such traditional family structure is often described as normal in the sense of most common, as well as normal in the sense of well-functioning. Current psychological, sociological, anthropological and historical studies, however, do not support the assumption that the traditional nuclear family is the most natural, common, and/or healthy form of family arrangement. The idealization of the traditional nuclear family has had implications for theory, research, mental health practice, and social policy. Scientists and practitioners have been slow to recognize pathology in traditional nuclear families. Families other than traditional nuclear ones have been rendered invisible or pathologized. It is time for contemporary social and applied human sciences to recognize that the traditional nuclear family is a culturally- and historically-specific construct. It is also time for contemporary social and applied human sciences to develop an account of, and a research agenda about, families that take into consideration their variations across time, place, social class, ethnicity, and culture.     

Interregional foodborne salmonellosis outbreak due to powdered infant formula contaminated with lactose-fermenting Salmonella virchow

Spain's Salmonella surveillance system backed by regionally-based epidemiologists around the country made it possible to detect and halt the spread of a foodborne salmonellosis outbreak due to powdered infant formula contaminated with a lactose-fermenting strain of Salmonella virchow. Forty-eight cases involving children, mostly under 7 months old, were detected in 14 out of Spain's 17 Regions. The outbreak started in January and ended in June 1994. All cases were microbiologically confirmed. The implicated strain had a 3.6 kb plasmid, was susceptible to all antimicrobials tested except nitrofurantoin and was phagetype 4a. Isolates from 8 of 24 Brand A milk samples tested had the same characteristics as case isolates. All affected/suspect batches of Brand A milk were destroyed and the product withdrawn from sale, which led to the end of the outbreak. This incident underscores the importance of maintaining surveillance systems able to detect and prevent foodborne outbreaks and alert to the possibility of isolating unusual lactose-fermenting Salmonella serotypes in especially sensitive food products.     

Hard hats vs. soft hearts: The conflict between principles and reality in child and adolescent care and treatment programs

Much of child care in volves quick reactions based on one's automatic pilot derived from how we were parented. This paper is about two seemingly universal automatic pilot systems—the hard hats and the soft hearts. Hard hats are behavior management and modification oriented, while soft hearts are psychodynamically and counselling oriented. Typically, the hard hats tend to have the upper hand due to the nature of our culture, and they therefore have the effect of preventing the contributions of the soft hearts from being realized. That all too frequently sets up a dominant culture and a resentful minority situation. To correct this imbalance, a value orientation from the top which emphasizes mutual respect and utilization is suggested.Grateful acknowledgement is made to Ray Peterson for his helpful suggestions in the preparation of this paper.     

Levels of organochlorine pesticides and polychlorinated biphenyls (PCBs) in mothers' milk collected in Osaka prefecture from 1969 to 1976

Long-term investigations of polychlorinated hydrocarbon levels in mothers' milk were made from 1969 to 1976. The levels ofp,p-DDE, p,p DDT, dieldrin and PCB in mothers' milk were within the range reported by others. However, -BHC(Hexachlorocyclohexane) levels in the milk were 10 times that found in non-Japanese. A gradual decrease in the -BHC level in the milk was observed during this period. In contrast, the levelsof p,p-DDE,p,p-DDT, dieldrin and PCB were consistent for the 7-year period. A significant correlation between the levels of PCB andp,p-DDE in mothers' milk and blood was observed in the 1974–1976 samples. However, after prohibition of the use of chlorinated hydrocarbons, this relationship was less apparent in the 1972–1973 samples.