The procoagulant potential of environmental particles (PM10)

Background and Aims: Epidemiology studies have shown that cardiovascular (CV) disease is primarily responsible for the mortality associated with increased pulmonary environmental particle (PM₁₀) exposure. The mechanisms involved in PM₁₀ mediated CV effects are unknown although changes in plasma viscosity and in the homoeostasis of blood coagulation have been implicated. It was hypothesised that PM₁₀ exposure would result in an inflammatory response and enhance the activation of the extrinsic coagulation mechanisms in pulmonary and vascular cells in culture.     

Detecting small-area similarities in the epidemiology of childhood acute lymphoblastic leukemia and diabetes mellitus, type 1: a Bayesian approach

Childhood acute lymphoblastic leukemia and diabetes mellitus, type 1, have common epidemiologic and etiologic features, including correlated international incidence and associations with infections. The authors examined whether the diseases' similar large-scale distributions are reflected in small geographic areas while also examining the influence of sociodemographic characteristics. Details of 299 children (0-14 years) with acute lymphoblastic leukemia and 1,551 children with diabetes diagnosed between 1986 and 1998 were extracted from two registers in Yorkshire, United Kingdom. Standardized incidence ratios across 532 electoral wards were compared using Poisson regression, confirming significant associations between population mixing and the geographic heterogeneity of both conditions. Bayesian methods analysis of spatial correlation between diseases by modeling a bivariate outcome based on their standardized incidence ratios was applied; spatial and heterogeneity components were included within a hierarchical random effects model. A positive correlation between diseases of 0.33 (95% credible interval: -0.20, 0.74) was observed, and this was reduced after control for population mixing (r = 0.18), population density (r = 0.14), and deprivation (r = 0.06). The Bayesian approach showed a modest but nonsignificant joint spatial correlation between diseases, only partially suggesting that the risk of both was associated within some electoral wards. With Bayesian methodology, population mixing remained significantly associated with both diseases. The links between diabetes and acute lymphoblastic leukemia observed for large regions are weaker for small areas. More powerful replications are needed for confirmation of these findings.     

Unraveling smoking ties: how tobacco use is embedded in couple interactions

The purpose of this research was to explore couple interactions related to tobacco use prior to pregnancy, as part of a larger grounded theory project focused on couple interactions related to tobacco use. Interviews with 28 women who quit or reduced smoking for pregnancy and their partners were conducted. Analysis of retrospective accounts of pre-index pregnancy interactions resulted in the identification of tobacco-related routines related to: (a) regulation of smoking; (b) practices related to the acquisition, use and handling of tobacco; (c) communication about tobacco use; and (d) responding to slips and lapses. Variations in the enactment of routines were captured in three tobacco-related interaction patterns: (a) disengaged; (b) conflictual; and (c) accommodating. Findings provide insights into the role tobacco plays in relationships and resistance to behavior change.     

All masquerading as aul

Of 597 cases of acute leukaemia in adults (>16 years) seen at St. Bartholomew's Hospital, London, between May 1973 and January 1982, 412 were diagnosed as AML, 103 as ALL and 58 as Philadelphia chromosome positive blast crisis of CML (13 presenting as acute leukaemia and 45 having a prior chronic phase). The remaining 24 cases were considered to be acute undifferentiated leukaemia. Twenty-one of the latter were investigated using a panel of immunological markers at diagnosis and/or retrospectively using frozen cell suspensions. Eighteen out of 21 were shown to have a predominantly ‘lymphoid’ phenotype which comprised 12 cases of common ALL (two of whom were Ph¹ positive), three cases of null-ALL, one case with a probable early thymic phenotype, and two cases with a monoclonal B lymphoblast phenotype. One ‘common ALL’ and one ‘null-ALL’ had a significant proportion of pre-B (cytoplasmic μ chain⁺) cells. One other case reacted with anti-myeloid sera. Leukaemic blasts from two patients were unreactive with all markers tested. No cases of glycophorin positive erythroleukaemia or anti-platelet (glycoprotein I) positive leukaemia were detected.

These observations suggest that the overwhelming majority of acute leukaemias have an identifiable affiliation to the lymphoid or myeloid lineages and that patients diagnosed haematologically as ‘AUL’ might benefit by therapy appropriate for their leukaemic cell type.     

Gender-specific 5-HT1A receptor changes in BrdU nuclear labeling patterns in neonatal dentate gyrus

The actions of 5-HT1A receptors on cell proliferation in the rat neonatal dentate gyrus are unknown. We injected a 5-HT1A receptor agonist (ipsapirone) or antagonist (Way 100635) 1 h before injections of BrdU in neonates of both genders between days 2-4, a peak time of dentate gyrus granule cell proliferation. The BrdU immunoreactive (IR) nuclei in the granule cell layer and subgranular zone were examined after 2 weeks. The BrdU-IR nuclear staining patterns were classified as being either diffuse (homogenous dark BrdU-staining throughout the nucleus) or punctate (multiple distinct small stained spots within the nucleus). Most BrdU-labeled nuclei with a diffuse pattern were seen in the subgranular zone while the punctate pattern nuclei were seen within the granular cell layer of the dentate gyrus. 5-HT1A antagonist showed no overall change in absolute number or pattern of labeled nuclei compared to control animals. After a 5-HT1A agonist, there was also no differences in the total number of BrdU-IR nuclei (punctate and diffuse pattern). However, in both genders, the proportion of the BrdU-labeled nuclei showing a punctate compared to diffuse pattern increased: 33% in females and 18% in males. In females, the 5-HT1A receptor agonist increased the number of nuclei showing a punctate pattern by 41%, while in males the 5-HT1A receptor agonist decreased the number of nuclei showing a diffuse pattern by 29%. These results indicate gender-specific 5-HT1A receptor action on the state of nuclear DNA in the cells of the dentate gyrus, without increasing the total number of BrdU-labeled nuclei.     

Three Hundred Sixty Degree Feedback: program implementation in a local health department.

Three Hundred Sixty Degree Feedback systems, while popular in business, have been less commonly implemented in local public health agencies. At the same time, they are effective methods of improving employee morale, work performance, organizational culture, and attainment of desired organizational outcomes. These systems can be purchased "off-the-shelf," or custom applications can be developed for a better fit with unique organizational needs. We describe the City of Milwaukee Health Department's successful experience customizing and implementing a 360-degree feedback system in the context of its ongoing total quality improvement efforts.