“I never thought I'd make it quite this far”: A personal journey in international understanding

The author provides a brief account of her travel and experiences in several developing countries and explores some of the resulting personal transformations in her attitudes, assumptions and understandings. Persons working with children and youth can learn much from those countries which are economically under-developed, but which retain a simplicity in daily life and a commitment to the central importance of family and community.     

Psychosocial stressors associated with Mexican migrant farmworkers in the midwest United States

Although estimates suggest that there are upwards of 5 million migrant farmworkers in the United States, scant research has explored the stressors associated with their lifestyle. Contrary to previous work, the present study directly explored migrant farmworkers' own perceptions of what is difficult in their lives. The purposes of the present study were to qualitatively explore, from a phenomenological standpoint, the stressors associated with living as a migrant farmworker in the Midwest United States; and to determine the stressors that were most strongly related to symptoms of anxiety and depression. The findings indicated that 18 stressors were commonly experienced by the migrant farmworkers and that the farmworkers experienced overall elevated levels of anxiety and depression. A number of stressors that were not previously reported in the literature were identified. The stressors of rigid work demands and poor housing conditions were significantly associated with higher levels of anxiety and low family income/living in poverty and rigid work demands were significantly associated with depression. Implications of findings and prevention strategies are discussed.     

An evaluation of psychometric properties of the client's questionnaire of the Wisconsin Quality of Life Index-Canadian version (CaW-QLI)

Psychometric properties of Client's questionnaire from the Canadian version of the Wisconsin Quality of Life-Index (CaW-QLI) were assessed with two groups, 89 English (E) and 94 French (F) individuals with schizophrenia or schizoaffective disorder. Sub-samples of 40E and 36F were re-interviewed within a 2-week period. Spearman correlations-SC between each domain and CaW-QLI global Score ranged from 0.39 to 0.76, while inter-domain correlations were low, confirming the multidimensional properties of the scale. Cronbach's (internal consistency) were 0.78(E) and 0.70(F) for the CaW-QLI global scores and, from 0.45 to 0.88 among seven of eight domains. Test–retest (Concordance Correlation Coefficient-CCC) ranged from 0.36 to 0.80 among the domains, and from 0.80(E) and 0.85(F) between CaW-QLI global scores. Regarding convergent validity, SC between CaW-QLI global score and Spitzer's QOL-Index were 0.72(E) and 0.58(F). As hypothesized, there were higher correlations between CaW-QLI global scores (E and F) and SF-36 scales related to mental health than those related to physical health. Minor changes in the scoring are proposed to enhance face and content validity.     

Health-related quality of life in a rare disease: Hereditary hemorrhagic telangiectasia (HHT) or Rendu–Osler–Weber Disease

The levels of the health-related quality of life (HR-QoL) were analyzed in hereditary hemorrhagic telangiectasia (HHT) patients. The Short Form-36 Health Survey (SF-36) was administered to 50 HHT patients and scores were compared to a cohort of 2301 normal subjects. Clinical variables were patient age, illness duration, number of epistaxis episodes in the previous year and hemoglobin levels. Physical functioning, physical role limitations, bodily pain, social functioning, emotional role limitations and the physical component scores were lower among females. In multivariable analyses increasing age was related to lower physical functioning (P<0.04), physical role limitations (P<0.008), bodily pain (P<0.05) and emotional role limitations (P<0.01), while higher hemoglobin levels improved physical functioning(€P<0.03). The number of epistaxis episodes was negatively associated with physical role limitations (€P<0.009), vitality (P<0.002), social functioning (P<0.001), physical component summary (€P<0.001) and bodily pain (P<0.01). Illness duration was negatively related to the mental component summary (P<0.004). HHT patients had a lower HR-QoL with respect to normal controls in all domains except for bodily pain. Females had lower scores for several domains. Epistaxis was the most important clinical variable.     

Comprehensive pediatric primary care vs traditional care in an israeli population: Their influence on pediatric emergency room use and hospitalization

Emergency room (ER) utilization and hospitalization were studied as indicators of the impact of improvements in pediatric primary care services in an Israeli development town, Ofakim, population 12,000. One of the two pediatric services was upgraded in 1976 through the introduction of pediatric faculty, integration of preventive and curative services and conversion of the medical records to a problem-oriented format ( experimental clinic B ). The primary care system remained unchanged in the second clinic ( traditional clinic A ). During 1980, ER utilization by the B clinic population was 9.3/100 compared with 17.6/100 for the A clinic population. Fifty two percent of the B clinic population patients reaching the ER were hospitalized compared with 25% of A clinic patients.The lower ER utilization rate represents a significant saving for the health services, and educational interventions are suggested from the study. Analysis of ER utilization data seems to offer useful information for overall planning and monitoring of ambulatory services for a community.Corresponding author.     

Employment status and quality of life in patients with chronic obstructive pulmonary disease

Objectives: Recently, the conditions for disability benefits were redefined in several countries, stimulating employees to participate on the labour market as long as reasonably possible. Little is known of labour participation and quality of life (QoL) of employees with chronic diseases. This study examines the associations between employment status and QoL in COPD patients. Additionally, the role of lung function, and work-related symptoms and exposures on QoL were explored. Methods: Secondary analyses were conducted on baseline data from a randomized control trail. Patients were categorized as: paid-workers; voluntary non-paid workers (e.g., early retired, house wives) or disabled for work. QoL was assessed by the Chronic Respiratory Questionnaire (CRQ). Between-group differences in CRQ scores, and associations between work-related symptoms or irritants and CRQ scores were uni- and multivariately analysed. Results: Two hundred and ten patients with COPD were included [mean age 53.9 (SD 6.8) years, FEV₁ %predicted 63.5 (SD 18.5)]. No statistically significant differences in lung function between the employment status subgroups were observed. Multivariable analysis showed that the disabled had lower CRQ scores as compared with paid workers (0.52 point difference, p<0.001). The CRQ scores of voluntary non-paid workers were not significantly different from paid workers. Within the group paid workers, patients with many work-related clinical symptoms and being susceptible to various work-related irritants experienced a lower QoL than patients who had respectively no symptoms, or who were not susceptible to these factors. Conclusions: Patients with COPD who were disabled for work showed equal severity of airflow limitation but worse QoL, as compared with paid workers.     

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.

     

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.     

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.     

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.     

Lung contamination among foundry workers

Summary Ten iron foundry workers representing typical foundry occupations were examined. The amount of lung contamination was estimated after the workers' thoracic area had been magnetized and the remanent magnetic field measured. Chest radiographs were classified according to the siderotic, silicotic, and nonspecific changes found; and the changes were then divided into four categories.The preliminary results of the electron micrographs indicated that the size and shape of the pollutants varied greatly according to the type of foundry site. In addition, the estimated amount of lung contaminants in the subjects varied between 30 and 600 mg. A good correlation (r=0.86) was obtained between radiological siderotic and silicotic changes, and the correlation between both of these radiological findings and the measured average permanent magnetic field was rather good (r=0.60). There was no correlation between the estimated exposure (neither length nor magnitude) and the amount of retained lung contaminants, and therefore a balance between retention and clearance seemed to have been achieved. These results indicate that the magnetic measuring method can be used to evaluate the amount of lung contaminants retained by foundry workers.     

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.     

Mutagenicity of urine from young male smokers and nonsmokers

Summary The mutagenicity of urine from a healthy population of young adult men (average age of 23 years), including 61 smokers and 107 nonsmokers, was investigated with the Salmonella/microsome test using the tester strain S. typhymurium TA98. In quantifying the assay, the use of dichloromethane was suitable for eluting the mutagenicity of smokers' urine from the XAD-2 resin column. We assayed mutagenicity in condensates of such dichloromethane eluates and found that the mutagenicity of smokers' urine was significantly higher than that of nonsmokers' urine. In the smokers' group, correlation coefficient between the mutagenicity of the urine and the actual number of cigarettes smoked on the day of urine collection or the average number of cigarettes smoked per day was statistically significant at 0.266 or 0.454, respectively. Our results suggest a correlation between the increase of mutagens in urine and smoking habits.     

Financial “Rules” for Child and Youth Care Managers

Contemporary realities demand that child and youth care managers cast off their traditional avoidance of all things financial. This article offers a jargon-free list of twelve financial rules for thriving in turbulent times. Grounded in a concept of client-centered, results-based agency performance, rules include promoting an entrepreneurial spirit throughout the organization, destroying the taboo on open discussion of financial matters, slashing program development time, and spending lavishly on recruitment and universal staff training.     

“In vitro” measurements of spontaneous smooth muscle contractions: A screening method for “invivo” exposure

Conclusion The in vitro recording of spontaneous contractions was selected as a neuromuscular screening method for in vivo exposure to pollutants. The rate of contraction was determined by interval histogram measurements. The method was assessed for effects of age, sex, pH, Ca⁺⁺ concentration, temperature, and circadian rhythm. Male rats were shown to develop a slower rate of contraction with age. The rate of contraction was temperature and pH dependent. An effect was demonstrated for in vivo exposure to Baygon and Carbaryl at a level which did not produce overt symptoms.     

An evolutionary perspective of sex-typed toy preferences: pink,blue, and the brain

Large sex differences in children's toy preferences are attributed to gender group identification and social learning. The proposal outlined in this paper is that contemporary conceptual categories of masculine or feminine toys are also influenced by evolved perceptual categories of male-preferred and female-preferred objects. Research on children exposed prenatally to atypical levels of androgens and research on typically developing infants suggest sex-dimorphic preferences exist for object features, such as movement or color/form. The evolution and neurobiology of mammalian visual processing—and recent findings on sex-dimorphic toy preferences in nonhuman primates—suggest further that an innate bias for processing object movement or color/form may contribute to behaviors with differential adaptive significance for males and females. In this way, preferences for objects such as toys may indicate a biological preparedness for a masculine or feminine gender role—one that develops more fully as early perceptual preferences are coupled with object experiences imposed by contemporary gender socialization.     

Determinants of household health expenditure on western institutional health care

We try to identify determinants of illness reporting, provider choice and resulting expenditure with different econometric models using data from a representative household panel survey of 800 households in Nouna health district, Burkina Faso, during 2000–2001. The factors being an adult, married, illness occurred in rainy season and severe illness significantly increased the magnitude of health expenditure. Compared to malaria, individuals spent more on other infectious diseases, injury and the other disease category. In contrast, people were less likely to spend on chronic illness. An individual who belonged to a household headed by a female, a literate household head and with a higher household expenditure had a significantly positive association with the magnitude of expenditure. Findings from this study can be used for policy implication to improve health system performance in Burkina Faso through enhancing health care utilization.     

Pesticide residues in human colostrum: Seasonal variations,Yugoslavia

Levels of HCH, HCH, HCH,o,pDDE,p,pDDE andp,pDDT were measured in 59 samples of colostrum collected in the autumn 1982 and the spring 1983 from healthy nursing mothers on the third day after delivery. Pesticide residues were identified and quantitated on a gas chromatograph. Concentrations of HCH were significantly higher in the autumn (mean, 1.71g/L) than in the spring (0.67g/L), while concentrations of HCH were significantly lower in the autumn (0.49g/L) than in the spring (1.50g/L). The differences between the two seasons were not statistically significant for HCH (0.95 g/L vs 0.88g/L),o,pDDE (0.73g/L vs 1.34g/L),p,pDDE (68.63g/L vs 53.72g/L) andp,pDDT (20.00 (g/L vs 14.29 (g/L).Calculated average daily HCH (Lindane) intake of 0.04g/kg body wt (b.w.) and total DDT intake of 4.16 (/kg b.w. in a 3.5 kg newborn, ingesting 60 ml/kg b.w. of colostrum on the third day of life was below the upper limit of FAO/WHO Acceptable Daily Intake (ADI) (0.01 mg/kg b.w. for Lindane and 0.005 mg/kg b.w. for DDT) in the spring. In the autumn, Lindane intake of 1.10k/kg b.w. was below the FAO/WHO ADI and total DDT intake of 5.36 g/kg b.w. was slightly above the FAO/WHO ADI.