Endotoxin exposure-response in a fiberglass manufacturing facility

Peak expiratory flow (PEF) and workplace exposure to endotoxin, phenolic resin, and formaldehyde were measured to investigate asthma symptoms and medication use among employees in a fiberglass wool manufacturing plant. Self-recorded PEF was obtained from 37 workers, for a total of 181 days off work and 187 days at work with concurrent personal exposure monitoring. Pre- and post-shift spirometry were obtained on at least 2 days. The 8 hr time-weighted average personal exposure ranges were endotoxin, 0.4–759 ng/m³; phenolic resin, 5.7–327 μg/m³; and formaldehyde, 1.2–265 μg/m³. Amplitude percent mean peak flow was associated with years since starting regular work in the highest endotoxin exposure area, although current assignment in that area was associated with reduced amplitude—evidence for a healthy worker effect. Exposure-response was analyzed by regression of lung function change on exposure using generalized estimating equations with robust variance estimates. Endotoxin exposure above 4 ng/m³ (8 hr time-weighted average) was associated with a decline in lung function across the work shift, and with drops in lung function 16–20 hr after exposure. Phenolic resin exposure was not consistently associated with decrements, and formaldehyde was not associated with decrements in lung function. © 1996 Wiley-Liss, Inc.     

Bulimia nervosa: A population-based study of purgers versus nonpurgers

There has been recent interest in the possibility of dividing bulimia nervosa into two subtypes based on the method of weight prevention utilized by the individual. In an attempt to see if such a division is justified, this study compared 54 purging bulimics with 69 nonpurging bulimics ascertained from a population-based register of Virginia female twins. A bulimic was defined as a “purger” if she engaged in vomiting or laxative abuse. These two groups were examined on a variety of demographic, weight, and personality measures after controlling for the presence of obesity. No significant differences were found between the two groups on any of the variables examined. © 1993 by John Wiley & Sons, Inc.     

Use of the MMPI in predicting psychotherapeutic persistence in groups of male and female outpatients

Attempted to predict therapeutic persistence, as measured by the total number of sessions attended, with the MMPI. High persisters were defined as patients who attended six or more sessions, while low persisters were patients who attended fewer than six sessions. Ss were 360 (180 high persisting, 180 low persisting) female outpatients and 204 (102 high persisting, 102 low persisting) male outpatients. All groups were divided into equal halves in order to allow for cross-validation of three separate discriminant functions: One for males, one for females, and one for the entire sample (male + female). Cross-validation revealed that only the discriminant function for males achieved a classification accuracy (60%) greater than chance expectations. A series of biserial correlations indicated that male persisters tended to be less defensive while experiencing greater distress and that female persisters tended to be more introverted and less impulsive relative to their respective low-persisting counterparts.     

A Heideggerian hermeneutic study of the practice of critical care nurses

This study provides a Heideggerian analysis of the practice of eight critical care nurses who work in an Australian intensive care unit Specifically, it describes two themes that emerged from a larger study on expert critical care nursing practice These themes are referred to as 'balancing' and 'being busy' Each theme emerged with several foci The theme 'balancing' is concerned with the ability of the nurse to manage simultaneously the paradoxical relationship between the technology of the intensive care unit and the processes of care 'Being busy' was a theme that recognized the technical nature of critical care nursing The paper concludes with a discussion of the relevant Heideggerian philosophical concepts     

An assessment of methacholine inhalation tests in elderly asthmatics

We have assessed the feasibility and value of measuring nonspecific bronchial responsiveness to methacholine in investigation of asthma in the elderly. Results from duplicated tests in 20 subjects aged 65-82 years were expressed as dose provoking a 20% decrement in 1 second forced expiratory volume (PD20.FEV1) or peak expiratory flow (PD20.PEF). Repeatability for PD20.FEV1 was satisfactory but less good than in younger subjects, 95% confidence limits being 0.39-2.57 and 0.52-1.91, respectively, x initial PD20. For PD20.PEF, confidence limits were wider (0.26-3.91 x initial PD20) but multiple PEF measurements were better tolerated than those of FEV1, which commonly caused fatigue and dizziness. PD20.FEV1 and PD20.PEF correlated closely (r = 0.95, P less than 0.0001) and both predicted bronchodilatation following a 6-week course of inhaled corticosteroid and beta agonist. This was not predicted by the response to a single dose of beta agonist. We conclude that measurement of bronchial responsiveness is feasible and clinically valuable in elderly subjects.