Percutaneous absorption of N,N-dimethylformamide in humans

Summary Skin penetration fo N,N-dimethylformamide (DMF) liquid or vapour was studied in volunteers. Exposure to liquid DMF was performed in two ways: in a dipping experiment, one hand was dipped up to the wrist in DMF for 2–20 min, while in a patch experiment, 2 mmol DMF was applied to the skin and allowed to be absorbed completely. The period of exposure to DMF vapour (50 mg · m^–3) was 4 h. The DMF metabolites N-hydroxymethyl-N-methylformamide (MF), N-hydroxymethylformamide (F), and N-acetyl-S-(N-methylcarbamoyl)cysteine (AMCC) were monitored in the urine. Liquid DMF was absorbed through the skin at a rate of 9.4 mg · cm^–2 · h^–1. Percutaneous absorption of DMF vapour depended strongly on ambient temperature and humidity and accounted for 13%–36% of totally excreted MF. The results suggest that skin absorption of liquid DMF is likely to contribute to occupational exposure substantially more than penetration of DMF vapour. The yield of metabolites after transdermal DMF absorption was only half of that seen after pulmonary absorption. Elimination of MF and F but not that of AMCC was delayed, which supports the contention that AMCC should be used instead of MF as the most suitable biomarker of DMF in cases where percutaneous intake can occur.     

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.     

Advancing child and youth care: A model for integrating theory and practice through connecting education,training, and the service system

This article presents a comprehensive model for enabling connections to be made between theory and practice in the field of child and youth care, based on an analysis of current training and education in the field and a multi-step concept of theory-to-practice and practice-to-theory. The model presents a logical sequence of activities that generate and convey knowledge from two sources. One is formal empirical and research information; the other is the conceptualization of practitioners' direct experience. Both are reinforced by trainers and educators with dual connections with practice and training and education settings. The paper stresses that academic programs are a significant component of any profession, in that they are responsible for collecting and codifying emergent knowledge gathered from multiple sources.There is nothing so practical as a good theory. —Kurt Lewin (quoted in Hunt, 1987, p. 4) There is nothing so theoretical as good practice. —David Hunt (1987, p. 11)An earlier version of this paper was the winner of the 1989 Albert E. Trieschman Prize Competition, published author category, for the best original contribution to the literature of child care.     

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.     

Air-borne B. subtilis enzymes in the detergent industry

Summary Air-borne dust was collected on stationary and portable filters in two factories producing biological detergents. In one factory (Factory A) the detergent base was mixed with enzyme (subtilisin) powder, and the handling of the enzyme was done without effective protection. In the other factory (Factory B) the enzyme was encapsulated in granules before mixing the with detergent base, and the production line was shielded to prevent the spread of dust.Both the amount of air-borne dust and the relative enzyme activity of the dust were greater in Factory A than in Factory B in spite of the considerably larger production of enzyme detergents in the latter factory. The workers studied in Factory A were, on the average, exposed to 5.4 GU (glycine units) per cubic millimetre in their breathing zones, and those studied in Factory B were exposed to enzyme activities about and below 1 GU/m³.Based on exposure measurements and medical examination of the exposed workers, a time-weighted hygienic limit value for subtilisins of 1 GU/m³ is proposed.     

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.     

A study of neurophysiological measurements and various function tests on workers occupationally exposed to vibration

Summary Seventy male air grinder operators and 72 age-matched control workers were examined. Both groups of workers worked in the warm climate (20°–33°C) of southern Taiwan. None of the workers had symptoms of white fingers. The investigation program comprised: (1) case history, (2) physical examination, (3) determination of maximal motor conduction velocity, proximal and distal sensory conduction velocity (NCV) of the median and ulnar nerves of the right upper extremity, (4) measurement of skin temperature, nail press test, pain threshold and vibratory sense threshold of the upper extremities, and (5) testing of the motor function. The dose-effect correlation between the NCV, various function tests and total operating time (TOT) was performed by multiple stepwise regression analyses. The regression analyses revealed a statistically significant correlation (dose/effect) between the six NCV, vibratory sense threshold, pain threshold and age, as well as TOT.     

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.

     

“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.     

Ultraviolet and volatility loss of herbicides

Herbicide 2,4-D formulated as a urea-type polymer was readily destroyed by long-wave uv (356-nm) irradiation, whereas conventional 2,4-D was more resistant. The opposite relationship was noted for polymeric and conventional formulations of dicamba. Polymerized 2,4-D was more resistant to thermal degradation (60°C) than non-polymerized formulations. Ultraviolet degradation of polymerized 2,4-D was eliminated by the incorporation of RYLEX-H and UVINUL D-50, industrial uv absorbers. Exposure of polymeric dicamba to 60°C heat, followed by trapping of the volatile component, indicated that 21 percent was lost by thermal degradation and 46.6 percent by volatilization. Comparable values for non-polymerized dicamba were 37.9 and 60.1 percent.     

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.     

Bromacil and diuron herbicides: Toxicity,uptake, and elimination in freshwater fish

Fathead minnows, 30 days old, were exposed to technical grade bromacil and diuron in flow-through tests to determine acute toxicity. LC₅₀ values for bromacil were 185, 183, 182 and 167 mg/L at 24, 48, 96, and 168 hr, respectively; and for diuron, 23.3, 19.9, 14.2, and 7.7 mg/L at 24, 48, 96, and 192 hr, respectively. Eggs, newly hatched fry, and juvenile fish were continuously exposed to lower concentrations of the herbicides for 64 days. Growth was significantly reduced (p 0.01) at the lowest bromacil exposure of 1.0 mg/L. Therefore, it was not possible to determine a no effect concentration. The no effect concentration for diuron was 33.4 g/L, while the lowest concentration which resulted in adverse effects was 78.0 g/L. Adverse effects at 78.0 g/L were an increased incidence of abnormal or dead fry immediately after hatch (p 0.01) and decreased survival throughout the exposure period (p 0.05). Neither herbicide accumulated significantly in fish tissue, as bioconcentration factors were <3.2 and 2.0 for bromacil and diuron, respectively. Rainbow trout (Salmo gairdneri) injected with radiolabeled bromacil or diuron eliminated over 90% of the radioactivity within 24 hr. Parent compound and metabolites were detected in the aquarium water in both cases. Metabolites of diuron recovered from the water included 3,4-dichloroaniline and several demethylated products.     

Identification of obstacles for chronic pain patients to return to work: evaluation of a questionnaire

The Obstacles to Return-to-Work Questionnaire (ORQ) was developed and evaluated. A total of 154 patients with chronic musculoskeletal pain and prolonged work disability participated in the study. Factor analyses reduced the ORQ to 55 items grouped into 9 subscales. The subscales were named Depression, Pain intensity, Difficulties at work return, Physical workload and harmfulness, Social support at work, Worry due to sick leave, Work satisfaction, Family situation and support, and Perceived prognosis of work return. The subscales showed satisfactory reliability. In order to determine predictive validity a discriminant analysis was conducted with sick leave 9 months after assessment as the outcome. This analysis indicated that the scales Perceived prognosis of work return, Social support at work, Physical workload and harmfulness, Depression, and Pain intensity could significantly predict sick leave and correctly classified 79% of the patients. The Multidimensional Pain Inventory and the Disability Rating Index could also significantly predict sick leave in this sample and correctly classified as many patients as the ORQ. However, these questionnaires do not include any work-oriented items and they had a lower specificity than the ORQ. This study suggests that patients' perceptions and beliefs about work and returning to work may be a significant hindrance for actual recovery.     

Fumigant contamination during large-scale food sampling for analysis

Incurred fumigants were determined from twenty-two food items before and after routine large-scale preparation of samples to see if these or similar kinds of chemicals were entering the samples during the preparation. This preparation includes making the samples table ready before compositing them for analysis. The following five fumigant residues were determined by gas chromatography (GC): carbon disulfide (CS₂), carbon tetrachloride (CCl₄), chloroform (CHCl₃), methyl chloroform (CH₃CCl₃), and tetrachloroethylene (or perchloroethylene, PCE). The number of residues determined from each sample ranged from none to four. The amounts determined varied significantly between the before and after portions from several samples. Four samples gained at least one new residue during the preparation. Six lost most of the residues determined from the original before portions, and 12 contained essentially the same residues before and after the preparation, although the amounts varied between the two portions. In samples where the variant residues were detected in both portions, five showed a tenfold or greater increase of CHCl₃ or CCl₄ and two showed a ten-fold or lesser decrease of CH₃CCl₃ or PCE in the after portions.     

Effect of instructions to simulate a back injury on torque reproducibility in an isometric lumbar extension task

The purpose of this study was to investigate the differences in test-retest reliability between maximal and simulated back injury efforts in an isometric lumbar extension task and to test the hypothesis that voluntary attempts to simulate a back injury would yield less consistent torque production than maximal efforts. Twenty subjects were asked to undergo lumbar extensor testing at seven different positions in a lumbar extension machine. Each subject was tested twice in a maximal effort condition and twice with instructions to simulate a back injury. The order of the conditions was counterbalanced across subjects so that half of the subjects performed the maximal effort tests first and half performed the simulated effort first. Results indicated high test-retest correlations at all angles in both conditions. There were no differences in test-retest reliability between effort conditions. Therapist ratings of consistency did not differ between conditions and therapists could not discriminate between conditions on the basis of effort consistency. In the simulated condition subjects produced reliable, submaximal torque plots consistent with previous data indicating similar reliability at submaximal levels. It was concluded that use of test-retest torque consistency as a measure of sincerity of effort is premature and may be misleading.     

“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.     

Lifestyle patterns concerning sports and physical activity,and perceptions of health

SummaryObjectives To explore the perceptions of health and physical activity, and the associations between these two areas from a theoretical lifestyle perspective.Methods Data was collected by means of a self-administered questionnaire, among 3019 adults attending centres for preventive medicine in France. Correspondence analysis examined the significance of the relationships between perceptions of health and perceptions of sports and physical activity.Results Four pricipal types of subjects emerged from the factor analyses expressing four different lifestyle patterns. Non physically active lifestyle: a feeling of not being healthy, Physically active lifestyle, pleasure/leisure-oriented, Necessarily physically active lifestyle, regardless of health, Physically active lifestyle aimed at stress relief.Conclusions The sociological approach helps tackle sports and physical activity as behaviour patterns but also and especially as a health orientation connected with the socio-economical climate. This approach also gives sports practice back its meaningful cultural dimension.

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ZusammenfassungFragestellung Wie werden Gesundheit und körperliche Aktivitäten und Sport wahrgenommen? Welche Zusammenhänge bestehen zwischen den beiden Parametern in Hinblick auf den Lebensstil?Methoden Die Rohdaten wurden mit Hilfe eines selbst zu beantwortenden Fragebogens gesammelt. Die 3019 Studienteilnehmer sind ausschliesslich Erwachsene, die in einem französischen Vorsorgezentrum während einer freiwilligen Beratungsstunde angesprochen wurden. Der Schwerpunkt der anschliessenden Faktorenanalyse lag in der Suche nach Korrelationen zwischen der Wahrnehmung der Gesundheit und den Eindrücken, die die sportlichen Aktivitäten hinterliessen.Ergebnisse Diese Analyse ermöglicht es, vier Antwortprofile herauszuarbeiten, die letztlich vier verschiedenen Lebensstilen entsprechen: inaktiv, allgemeines Unwohlsein, das sich im klinischen Bereich niederschlägt, aktiv, auf Lustempfindungen orientiert, passiv, fatalistisch, ohne Interesse an Gesundheit, aber gesellschaftsorientiert, aktiv, gesundheitsbewusst, auf Stressabbau orientier.Schlussfolgerungen Aus soziologischer Sicht kann somit die Ausübung körperlicher Aktivitäten einerseits als reines Verhaltensmuster gedeutet werden, andererseits aber auch als gesundheitsorientierte Handlung, eng verknüpft mit den sozioökonomischen Verhältnissen. Sprot an sich erhält somit seine Bedeutung als kulturelle Dimension wieder.

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RésuméObjectifs Etudier les perceptions de la santé et de l'activité physique et sportive, ainsi que les relations entre les deux dans la perspective théorique du style de vie.Méthodes Des données ont été recueillies par questionnaire auto-administré auprès de 3019 adultes consultant un centre de médecine préventive français. Une analyse factorielle des correspondances a permis d'étudier les relations d'affinités entre les perceptions de la santé et celles de l'activité physique et sportive.Résultats Quatre profils de réponses se distinguent par cette analyse factorielle qui font émerger quatre styles de vie: physiquement inactif, le sentiment de ne pas être en bonne santé, physiquement actif, orienté vers le plaisir et les loisirs, physiquement actif au travail sans attention pour la santé et physiquement actif pour lutter contre le stress.Conclusions L'approche sociologique permet d'aborder la pratique physique et sportive, comme un comportement mais aussi et surtout comme une orientation de santé, en relation avec les conditions socio-économiques. Elle redonne ainsi à la pratique sportive sa dimension culturelle signifiante.

     

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.     

Number-Between g-Type Statistical Quality Control Charts for Monitoring Adverse Events

Alternate Shewhart-type statistical control charts, called g and h charts, are developed and evaluated for monitoring the number of cases between hospital-acquired infections and other adverse events, such as heart surgery complications, catheter-related infections, surgical site infections, contaminated needle sticks, and other iatrically induced outcomes. These new charts, based on inverse sampling from geometric and negative binomial distributions, are simple to use and can exhibit significantly greater detection power over conventional binomial-based approaches, particularly for infrequent events and low defect rates. A companion article illustrates several interesting properties of these charts and design modifications that significantly can improve their statistical properties, operating characteristics, and sensitivity.