Between a rock and a healthy place.

The Federal Mine Safety and Health Act of 1977 consolidated all federal health and safety regulations of the mining industry-coal as well as noncoal mining-under a single mandate administered by the Mine Safety and Health Administration (MSHA). Today, the agency is striving to reduce the environmental health risks associated with mining.     

Atopic and non-atopic asthma in a farming and a general population

BACKGROUND: In a previous study inverse associations between asthma and exposure to fungal spores and endotoxins in atopic farmers and positive associations with the same factors in non-atopic farmers were documented. No external reference population had been included. We, therefore, compared this farming population with the general population from an adjacent region. METHODS: Random samples of a farming (n=2,106) and a rural (n=351) and urban (n=727) general population were selected. Atopy was assessed by serum IgE and asthma by questionnaires. RESULTS: The asthma prevalence was 4.0% among farmers, 5.7% in the rural, and 7.6% in the urban population. Atopy was similar (9-10%). Most asthmatics were not atopic, 67-75%. Farmers had asthma less often than the general population OR 0.52 (95% CI 0.36-0.75); both atopic (OR 0.33 (95% CI 0.15-0.69)) and non-atopic asthma (OR 0.60 (95% CI 0.39-0.93)). CONCLUSION: This may indicate a protective effect of the farm environment on asthma but a healthy worker effect may also play a role.     

Clinical death: a diagnosis and a testimony

The clinical death of a person is the death of the brain. There is a fairly general consensus in western medicine on the necessary criteria and the mode of proceeding for a correct diagnosis of "brain death". In a specific case, with a reasonable previous record of catastrophic brain damage and certain neurological exploratory signs, an expert practitioner is able to diagnose clinical death. Accepting that the diagnosis of death is an exercise of diagnostic judgement, in practical application, which cannot as such provide absolute certainty; we have to accept that, in spite of this uncertainty, we have to take sensible and prudent decisions. However, there are dissenting opinions that believe in the need for a higher degree of certainty before taking decisions. It is necessary to try to understand the concept of "brain death" in order to be able to take responsible decisions. This concept is a real "cultural construction", in which it is necessary to have knowledge about the scientific definition of death, how death can be diagnosed in practice, when it is possible to say that someone is clinically dead, and what is the degree of evidence carried by the diagnosis.     

Endometrial morphology during a normophasic and a triphasic regimen: a comparison

It is expected that cycle control during oral contraceptive regimens may be correlated with the pattern of gradual endometrial maturation. Therefore the objective of the present study was to investigate the endometrial histology during a normophasic and a triphasic preparation. Biopsies were obtained at different intervals in the second treatment cycle from 21 women taking a triphasic pill and from 21 women taking a normophasic pill. The morphology of the endometria during the two regimens was evaluated and compared, as well as with the normal cycle histology. The study showed an early progestational effect and a rather hypoplastic growth during the triphasic regimen. The normophasic preparation was characterised by a better development and a more balanced glandular growth in proportion to the stroma, imitating the normal physiological mucosal changes very closely. From these observations it is concluded that a more reliable cycle control may be achieved by the use of this normophasic oral contraceptive as compared with the triphasic pill.     

Smoke alarm ownership and installation: a comparison of a rural and a suburban community in Georgia

As part of a smoke alarm giveaway and installation program (The Get-Alarmed Campaign), a total of 454 households were surveyed in two counties in Georgia, one metropolitan and one nonmetropolitan. The targeted communities in these counties had a high prevalence of low-income and minority populations and thus were at high risk of house fire-related morbidity and mortality. The objectives of the program were to determine the prevalence of and predictors for installed, functioning smoke alarms, and to install at least one smoke alarm and/or smoke alarm batteries in 100% of participating homes in need. Characteristics associated with smoke alarm ownership included home ownership, having a higher income, and having a central heating source, factors which should be considered in targeting future intervention strategies. At onset, 159/454 households (35.0%) had no smoke alarms installed and 56/275 households with existing smoke alarms (20.4%) had none that were functional. Regardless of ownership status, a free smoke alarm was installed in the household of 93.8% of participants and new batteries were installed in existing smoke alarms for 31.7% of participants. This project illustrates the usefulness of a door-to-door campaign in increasing smoke alarm ownership in both a rural and a suburban community with a high concentration of residents at high risk of house fire-related morbidity and mortality.     

President Bush's vision for a healthy America: a record and a plan

During his first term in office, President Bush has been committed to improving the health of all Americans through a series of new programs and an increased level of funding for services to vulnerable populations. Recognizing the need for reform of the health care financing system, the President has put forward a comprehensive proposal that preserves the strengths of the U.S. systems while addressing its weaknesses. It is a system built on choice and incentives, not on government mandates and fiat.     

Winning loyalty with a vision and a corporate soul

This article provides insight and practical application for how to improve patient satisfaction and loyalty through a vision with a corporate soul. This article shows from actual experience that the chief executive officer must set the vision for the organization. The vision is key to an organization's ability to win loyalty. Without a vision to become great, an organization will never fulfill its potential to best serve its community. Essential to the vision is developing a corporate soul that embraces the intangibles of the human spirit of sensing the needs of others through meaning, purpose, empathy, caring, and sharing. Although recognizing that the tangibles of revenue, expenses, patient volume, and profit margin are necessary, addressing the intangibles is critical to long-term sustainability.     

一株野生型婴幼儿轮状病毒的分离鉴定与毒力测定

目的 从妇幼保健院腹泻患儿临床样本中分离鉴定一野生型人A组轮状病毒株,并对其毒力进行测试。 方法 采集水样粪便样品,应用A组轮状病毒特异性抗体采用点杂交(Dot blot)方法检测,感染vero细胞并用TRIzol法提取病毒RNA,SDS-PAGE电泳分析病毒RNA迁移型式,以轮状病毒VP7通用引物扩增特异性鉴定,体内毒力分析。 结果 Dot blot显示粪便中轮状病毒阳性,用通用引物PCR能扩增出轮状病毒特异条带,RNA电泳迁移型式为4:2:3:2。感染病毒株的vero细胞病变显著,实验鼠水样性腹泻严重,生长缓慢。 结论 分离获得的病毒株属野生型人A组轮状病毒,具有较强的感染性和致病性。