THE PROJECTED FINANCIAL SAVINGS IN DENTAL RESTORATIVE TREATMENT; THE RESULT OF CONSUMING FLUORIDATED WATER

The writers of this report provide readers with an interesting estimate of the savings that might accrue in a national dental health program when universal fluoridation of drinking water maintains.     

Survey nonresponse bias among young adults: the role of alcohol, tobacco, and drugs

The purpose of this study is to determine the role of alcohol, tobacco, and drug use as predictors of survey panel attrition among an occupational cohort of young adults in the U.S. military. Baseline data on substance use and sociodemographic factors were obtained from 2838 men and women through confidential, self-administered questionnaires while they attended Navy basic training or Officer Candidate School in 1998. Longitudinal follow-up using mailed self-administered questionnaires was begun in 2000. Multivariate logistic regression models were developed to estimate the odds of attrition in relation to baseline substance use. Results revealed that tobacco use was a significant predictor of attrition [Odds ratio (OR) = 1.63; 95% Confidence Interval (CI): 1.37, 1.95]. A significant interaction between level of education and drug use indicated that respondents with less than a college education who were also drug users were at elevated risk for attrition (OR = 2.39; 95% CI 1.09, 5.28). Other significant predictors of panel attrition were male gender and younger age. Alcohol use was not significantly associated with attrition. The findings suggest that tobacco users and drug users with less than a college education may be an important source of nonresponse bias in longitudinal surveys of employed young adults.     

Integrating qualitative research into occupational health: a case study among hospital workers

OBJECTIVE: We sought to better use qualitative approaches in occupational health research and integrate them with quantitative methods. METHODS: We systematically reviewed, selected, and adapted qualitative research methods as part of a multisite study of the predictors and outcomes of work-related musculoskeletal disorders among hospital workers in two large urban tertiary hospitals. RESULTS: The methods selected included participant observation; informal, open-ended, and semistructured interviews with individuals or small groups; and archival study. The nature of the work and social life of the hospitals and the foci of the study all favored using more participant observation methods in the case study than initially anticipated. CONCLUSIONS: Exploiting the full methodological spectrum of qualitative methods in occupational health is increasingly relevant. Although labor-intensive, these approaches may increase the yield of established quantitative approaches otherwise used in isolation.     

Olfactory influences on the human menstrual cycle

Two groups of women were compared for the timing of the onset of their menstrual cycle. One group was rubbed on the upper lip (directly beneath the nose) with a mixture of alcohol and underarm perspiration collected from a single female donor. The other group was rubbed with plain alcohol. The group which received the perspiration showed a significant shift in the timing of their menstrual cycles which conformed closely with the donor's monthly cycle. This is a preliminary study which supports the hypothesis that the time of menstrual onset may be modified by olfactory cues.     

Percutaneous management of bile duct strictures and injuries associated with laparoscopic cholecystectomy: a decade of experience

BACKGROUND: The 1990s were associated with a dramatic increase in bile duct injuries with the widespread use of laparoscopic cholecystectomy (LC). Interventional radiology has an integral role in diagnosing and managing these injuries. Definitive percutaneous management with balloon dilatation might be possible in select patients with intact biliary-enteric continuity, but longterm data are limited. STUDY DESIGN: Data were collected prospectively on 51 consecutive patients with major bile duct stricture or injury associated with LC, treated with percutaneous management, January 1, 1990, to December 31, 1999. Percutaneous transhepatic cholangiography and biliary catheter placement were followed by balloon dilatation and stenting. Outcomes were assessed with direct patient contact or hospital records. RESULTS: All patients completed treatment, and 50 (98%) were stent free at mean followup of 76 months. The success rate of percutaneous management was 58.8%, without need for subsequent intervention. Presenting symptoms, level of injury, and number of stents or dilatations did not predict outcomes. Percutaneous treatment was more likely to fail in patients stented for less than 4 months (p < 0.001). Operative repair at Hopkins before percutaneous management was predictive of a successful outcome (p < 0.05). Including subsequent operations or percutaneous management, successful outcomes were achieved in 98% of patients. CONCLUSIONS: Major bile duct injuries after LC remain a clinical challenge. Although surgical reconstruction is the treatment cornerstone, selected patients with biliary-enteric continuity can achieve successful long-term results with definitive percutaneous management. The combination of percutaneous management and surgical reconstruction results in successful outcomes in virtually all patients.     

Rationale and design of the National Program of Cancer Registries' breast, colon, and prostate cancer patterns of care study

Background: Investigators from the Centers for Disease Control and Prevention (CDC), National Program of Cancer Registries (NPCR), are collaborating with public health professionals from seven states and the District of Columbia to conduct the Patterns of Care study to assess the quality of cancer data and to determine whether stage-specific treatments are being carried out. Methods: To assess the quality and completeness of cancer care data in the United States, trained staff from the Patterns of Care study are abstracting medical records to obtain detailed clinical data on treatment, tumor characteristics, stage at diagnosis, and demographics of representative samples of patients diagnosed with breast, colon, and prostate cancer. Altogether staff from each of the eight participating cancer registries will abstract 500 cases of breast, prostate, and colon/rectum/anus cancer for the CONCORD study and an additional 150 cases of localized breast cancer, 100 cases of stage III colon cancer, and 100 cases of localized prostate cancer for the Patterns of Care study. Chi-square tests will be used to compare routine registry data with re-abstracted data. The investigators will use logistic regression techniques to describe the characteristics of patients with localized breast and prostate cancer and stage III colon cancer. Age, race, sex, type of insurance, and comorbidity will be examined as predictors of the use of those treatments that are consistent with consensus guidelines. The investigators plan to use data from the CONCORD study to determine whether treatment factors are the reason for the reported differences between relative survival rates in the United States and Europe. Conclusions Results from the methodology used in the Patterns of Care study will provide, for the first time, detailed information about the quality and completeness of stage and treatment data that are routinely collected by states participating in the NPCR. It will add significantly to our understanding of factors that determine receipt of treatment in compliance with established guidelines. As part of the CONCORD study, it will also examine differences in survival among cancer patients with breast, prostate, and colon/rectum/anus cancers in the United States and Europe.     

Phonological categorization of vowels: a mismatch negativity study

There is electrophysiological evidence that phonological categorization has occurred within 100-200 ms post stimulus onset for the syllables /tae/ and /dae/, which vary in voice onset time. Using a similar paradigm, this study investigated when phonological categorization occurred for the contrast between /I/ and /epsilon/, using synthesized speech tokens that differed in the frequency of the first formant. Here we show that phonological categorization of these tokens has not occurred 100-200 ms after stimulus onset. However, the presence of a late mismatch negativity (350 ms after stimulus onset) indicated that phonological categorization had taken place by this time.