Occupational health problems among workers handling Virginia tobacco

Summary The prevalence of green symptoms among 289 tobacco workers handling Virginia tobacco leaves was investigated. The frequency of these symptoms was high (53.29%). Urinary excretion rate of nicotine and cotinine increased significantly only among the subjects suffering from green symptoms.     

Sex education and related skills: A series of programs implemented with severely handicapped students

A series of programs to teach sex education and related skills to severely handicapped students is presented. The programs were implemented over a seven year period. Training was conducted in public school, home and community settings. The programs encompass skills in the areas of Bodily Distinctions, Reproduction and Birth Control Information, Family Life, Self Care and Social Manners and Interactions. The programs were data based and continuously have been revised and extended in response to student performance. The cooperation and support of the students' parents was considered crucial to program development and to facilitate the transfer of skills from the school to the home setting. Students who have received training in these sex education and related skill programs currently are using the skills in a variety of school, home and community settings.     

Sexuality,Fertility, and Danger: Twentieth-Century Images of Women with Cognitive Disabilities

Historically, women with cognitive disabilities in the United States have been portrayed as sexually and socially threatening, and in need of professional management and control. Expressions of concern over the sexual nature of this group are still present in medical, legal, and popular cultural discourse. This presentation considers five examples (four nonfiction and one fictional) where the sexual identities of women with cognitive disabilities received national scrutiny: the sterilization of Carrie Buck; the institutionalization of Deborah Kallikak the Glen Ridge sexual assault case; the sterilization of Cindy Wasiek; and the movie The Other Sister. These examples reveal that implicit cultural assumptions (modern fairy tales) about the sexuality and fertility of women with cognitive disabilities are embedded in United States history, and still very much in evidence today.     

Assertive/leveling communication and empathy in adolescent drug abuse prevention

This paper presents the feelings reported by 5th, 6th, 7th and 8th graders when role playing situations in which they wanted to say no to alcohol/drugs or to talk to a friend who was using. These role plays were part of SAY IT STRAIGHT (SIS) training, which was described in the preceding paper. Youngsters described themselves as feeling good and having high self-respect/esteem only when they said no in an assertive/leveling way. Only youngsters toward whom an assertive/leveling no was addressed described themselves as surprised/shocked and respectful of the person who was saying no. Finally, youngsters reported that the most effective way to convince a friend to quit using and/or get help was to express caring and friendship, and to touch the friend rather than being aggressive/blaming, irrelevant or super-reasonable. This feedback from youngsters opens conceptual issues relevant to some assertiveness training and drug abuse prevention programs.The authors thank Kevin Miller and Antoinette Bradley for their help on the project.This research was supported in part by the Oklahoma Department of Mental Health, Contract # N200073.     

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.     

Sentinel-Meldesystem in der Schweiz?

Zusammenfassung Sinn und Zweck der Einführung eines Sentinel- Meldesystems in der Schweiz werden dargestellt und das Vorgehen zu dessen Aufbau kurz geschildert.

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Enregistrement de données de morbidité par un réseau de médecins en Suisse

Résumé L'idée et le sens d'un système d'enregistrement de la morbidité par des Sentinelles en Suisse est décrit. Les préparatifs de mise sur pied d'un tel système sont en cours.

     

The demographic change campaign of the Bertelsmann Foundation

The article introduces the goals and strategies of the Bertelsmann Foundations Demographic Change Campaign. Each of the three modules of the campaign is presented. The module Communities and regions in demographic flux will help local decision-makers to cope with the challenges caused by the shrinking and aging of the population. The module Living and housing as a senior citizen develops and communicates concrete assistance for reaching decisions in this area. A long-term orientation and the sustainability of political action is the focus of the module Federation and states: prospective policy-making. Both here and in the area of local government appropriate indication instruments are put forward and concrete operational measures are developed. It shows that the complex interconnections created by demographic change demand clarity about the problems it raises and integrated strategies on various political levels, in order to realize the goal of a livable society 2050.

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.     

Cultural Differences in Residential Child and Youth Care: Analyzing Perspectives

In many Western-European countries, clients from ethnic minority groups form an increasingly large proportion of the client population of child and youth care centers. This development raises the question of how to respond to cultural differences between professionals and clients. In this article we discuss the concepts clinical reality, world view, and acculturation to provide a theoretical framework for studying the influence of cultural differences on the care and support process. We focus on Moroccan youth in Dutch residential youth care centers and present a case from our study to illustrate the theoretical issues raised.     

Assessing Capacity and Measuring Performance in Maternal and Child Health

Objectives: To understand the similarities, differences, and relationships between three tools for performance and capacity assessment currently available for Maternal and Child Health (MCH) programs and for state and local health agencies. Methods: Three tools for performance and capacity assessment currently available for Maternal and Child Health (MCH) programs and for state and local health agencies, the Title V MCH Block Grant Performance and Outcome Measures (Title V 24), CAST-5, and the National Public Health Performance Standards Program (NPHPSP) were compared using two metrics, a conceptual model of the public health system, and a set of attributes related to the use of the instruments. Results: Both CAST-5 and the NPHPSP are focused on the capacity and key processes (10 Essential Public Health Services) of the public health system, although CAST-5 is intended for capacity assessment and the NPHPSP is intended for performance measurement. The Title V 24 tool is also intended for performance measurement; however, its focus is on the outputs and outcomes of the health system. The Title V 24 tool is the only one of the three that is mandatory, and the only one whose results at the current time can be used to compare across entities. In addition, both the Title V 24 and the NPHPSP include explicit standards, while CAST-5 does not specify explicit standards against which to compare findings. Conclusions: While there are various tools available to MCH practitioners for capacity assessment and performance measurement, knowing how the tools relate to each other, and their defining characteristics, should lead to more effective and productive use.     

Load on the low back of teachers in nursery schools

In order to evaluate the load on the low back of teachers in nursery schools, basic activity, working posture, child-lifting, and desk-lifting were analyzed for eight nursery teachers using video recording. The trunk inclination angle (TIA) was also measured continuously during full workshifts for 20 nursery teachers using an inclination monitor. The nursery teachers in the 0–1 (year) age class more often adopted low working postures, sitting on the floor and kneeling, while teachers in the 4–5 age class more frequently adopted high working postures, standing and sitting on a chair. The mean of TIA among all subjects was 20°. The time spent at a TIA of more than 20° represented 43% of the workshift. The mean and time distribution of TIA did not differ between the age classes. The frequency of trunk-lifting from severe bending forward (TIA > 45°) was 86 times/hour on average. The frequency of trunk-lifting was highest in the 0–1 age class. The number of times of child-lifting was 46 in the 0–1 age class, while it was 1 in the 4–5 age class.     

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.     

Backgroud and introduction

The proceedings of the 1974 conference, Child Care Training for a Changing World, sponsored by the Department of Child Development and Child Care, School of Health Related Professions, University of Pittsburgh, will be presented in three parts. The first part will delineate the background of the conference, by describing the events that led to its implementation and presenting results of a preliminary study done to assess the structure and status of current educational programs. The second part will summarize the key speeches presented at the Conference. The third part will present a summary of the proceedings, highlighting signposts for the future as articulated by a review of the overall transactions of the conference.Child Care Training for a Changing World received partial support from: National Institute of Mental Health Grant ST 21MH 12725; Education Professions Development Act Early Childhood Project Grant OEG-0-70-1833; the Guinevere S. Chambers Memorial Fund; and the Maurice Falk Medical Fund.     

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.     

Differences in Finger Length Ratios Between Self-Identified “Butch” and “Femme” Lesbians

There is indirect evidence that heightened exposure to early androgen may increase the probability that a girl will develop a homosexual orientation in adulthood. One such putative marker of early androgen exposure is the ratio of the length of the index finger (2D) to the ring finger (4D), which is smaller in male humans than in females, and is smaller in lesbians than in heterosexual women. Yet there is also evidence that women may have different sexual orientations at different times in their lives, which suggests that other influences on female sexual orientation, presumably social, are at work as well. We surveyed individuals from a gay pride street fair and found that lesbians who identified themselves as butch had a significantly smaller 2D:4D than did those who identified themselves as femme. We conclude that increased early androgen exposure plays a role in only some cases of female homosexuality, and that the sexual orientation of femme lesbians is unlikely to have been influenced by early androgens.     

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.     

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.     

Toxicity of mercury,copper, nickel,lead, and cobalt to embryos and larvae of zebrafish,Brachydanio rerio

The toxicity of mercury (HgCl₂), copper (CuCl₂: 5 H₂O), nickel (NiSO₄: 6 H₂O), lead (Pb(CH₃COO)₂: 3 H₂O) and cobalt (CoCl₂: 6 H₂O) was studied under standardized conditions in embryos and larvae of the zebrafish,Brachydanio rerio. Exposures were started at the blastula stage (2–4 h after spawning) and the effects on hatching and survival were monitored daily for 16 days. Copper and nickel were more specific inhibitors of hatching than cobalt, lead, and mercury. Nominal no effect concentrations determined from the dose-response relationships (ZEPs, Zero Equivalent Points) for effect on hatching time were 0.05 g Cu/L, 10 g Hg/L, 20 g Pb/L, 40 g Ni/L and 3,840 g Co/L, and those for effect on survival time were 0.25 g Cu/L, 1.2 g Hg/L, 30 g Pb/L, 80 g Ni/L, and 60 g Co/L. The no effect concentrations for Ni, Hg and Pb are consistent with previously reported MATC values for sensitive species of fish. The no effect concentrations for copper are 1–2 orders of magnitude lower than previously reported values. The major reason for the latter discrepancy was considered to be the absence of organics that can complex copper ions in the reconstituted water that we used, which had a hardness of 100 mg/L (as CaCO₃) and a pH of 7.5–7.7. Unexposed controls were started with embryos from different parental zebrafishes and the parental-caused variability in early embryo mortality, median hatching time and median survival time were estimated.     

State mental hospitals and their host communities: the origins of hostile public reactions

This article examines the hostile public reactions of a community that, through a state policy to consolidate all long-term behavioral health services, was to become the site of the state's only mental hospital. A telephone survey conducted in the host community (n=800) and a matched community (n=800) was used to test whether the origins of hostility toward consolidation were related to the public's negative attitudes toward mental illness and homelessness or to the beliefs about the discharge and supervisory behavior of the hospital. The host community was not found to have more negative views of mental illness, although it did have significantly more negative views about the homeless. Disapproval of consolidation was unrelated to negative views of mental illness or homelessness but was strongly related to the expected bad behavior of the hospital. These results suggest that the best way to improve relations between hospitals and their host communities is for hospitals to behave like good neighbors.     

Chronic toxicity and bioaccumulation of 2,5,2′,5′- and 3,4,3′,4′-tetrachlorobiphenyl and Aroclor® 1242 in the amphipodHyalella azteca

The addition of 100 (g/L of Aroclor^® 1242 (A1242) or 2,5,2,5-tetrachlorobiphenyl (TeCB) during 10 week chronic toxicity tests withHyalella azteca resulted in complete mortality. There were no effects on survival, growth, or reproduction after addition of 30 g/L. Toxic effects were observed at tissue levels of between 30 and 180 g/g on a wet weight basis, and tissue levels appear to be a better indicator of toxicity than levels in water. No toxic effects were observed after additions of up to 2,700 g/L of the coplanar congener 3,4,3,4-TeCB.H. azteca has the ability to avoid accumulating in excess of 140 g/g 3,4,3,4-TeCB. The amount taken up was proportional to the amount added in water up to 100 g/L, but was constant at higher additions, possibly accounting for its relatively low toxicity. The low toxicity of the coplanar congener, as compared to the non-coplanar 2,5,2,5-TeCB, is in direct contrast to the high toxicity of coplanar PCB congeners to mammals and may be associated with slower rates of aromatic hydrocarbon metabolism in amphipods. Polychlorinated biphenyl levels measured in amphipods from Lake Ontario are approximately 100-fold below levels associated with toxicity inH. azteca, but are above levels which, through biomagnification up the food chain, lead to salmonid residues in excess of 2 g/g, a tolerance limit for human consumption.