Dietary intake of Americans reporting adherence to a low cholesterol diet (NHANES II).

We studied the dietary intake of persons age 18 and over participating in the 1976-80 National Health and Nutrition Examination Survey (NHANES II). We compared the diets of those on a "low cholesterol" diet (dieters, n = 296) with the diets of individuals not following a special diet (non-dieters, n = 10,052). Dietary intakes were assessed by 24-hour recall and food frequency reports and were adjusted for differences in age, sex, race, education, smoking, and socioeconomic status by multivariate statistical techniques. Dieters consumed 16 percent (99% confidence interval(-) -24, -9 fewer calories than non-dieters, and had decreased intake of saturated fat by 25 percent (-34, -15) and cholesterol by 21 percent (-32, -10). However, their intake of vitamin A, thiamine, riboflavin, niacin, calcium, and iron were not significantly different from non-dieters and their ascorbic acid intake was 18 percent (1, 36) higher. The nutrient density (nutrient/1000 kcal) among dieters was increased over non-dieters by 35 percent (-3, 72) for vitamin A, 35 percent (1, 70) for thiamine, 30 percent (-4, 65) for riboflavin, 27 percent (9, 44) for niacin, 60 percent (40, 80) for vitamin C, 14 percent for calcium (-5, 32), and 15 percent for iron (6,25). Compared with non-dieters, dieters consumed 27 percent (9, 45) more poultry and 39 percent (12, 66) more fish, but consumed 30 percent (-44, -16) less eggs and 15 percent (-24, -6) less meat.     

Contaminant levels in harbor seals from the northeastern United States

The concentrations of polychlorinated biphenyls (PCBs), organochlorine pesticides, polycyclic aromatic hydrocarbons (PAHs), polychlorinated dibenzofurans (PCDF), polychlorinated dibenzo-p-dioxins (PCDD), and mercury (Hg) were determined in blubber and liver tissues of harbor seals (Phoca vitulina) collected along the northeast coast of the U.S. Average PCB concentrations in seal blubber (sum of congeners) were 12.0 g/g (wet weight) with a range of 7.30 to 24.3 g/g in 1980 and 6.66 g/g (wet weight) with a range of 2.61 to 11.3 g/g in 1990–1992. Comparisons between blubber data from this study and previous work indicated that the concentration of PCBs along the northeast coast of the U.S. may have decreased over the past twenty years.The average p,p-DDE concentrations in seal blubber were 10.9 g/g (wet weight) in 1980 with a range of 6.95 to 21.9 g/g and 4.12 g/g (wet weight) with a range of 1.83 to 7.84 g/g in 1990–1992. Only trace amounts of PCDFs and PCDDs were found in a few blubber samples; levels in most tissues were below detection (3–5 pg/g) (wet weight). Trace amounts (<30 ng/g) of phenanthracene, anthracene, and alkylated MW-178 compounds were found in some seal samples; all other PAH compounds were below the detection level (5–15 ng/g).Toxic equivalents (TEQ) of selected coplanar and mono-ortho PCB congeners and relative toxic equivalents (RTE) (pg total TEQ/g total PCB) were calculated, using recently proposed dioxin toxic equivalent factors (Ahlborg et al. 1994). The TEQs ranged from 41 to 315, and the RTEs ranged from 2.25 to 16.3. The RTEs for seal blubber indicated that the present values were in the midrange of those reported in the literature. Toxic equivalents calculated on the basis of the concentrations of the coplanar PCBs, PCDDs, and PCDFs indicated that coplanar PCBs, rather than PCDDs and PCDFs, may pose a more important toxic threat to harbor seals.Mercury levels in liver tissue averaged 70.0 g/g (wet weight) and 44.1 g/g (wet weight) in the 1991 and 1980 samples, respectively, and are similar to those found in relatively polluted waters of the British Isles.     

Incidence of childhood brain and other non-haematopoietic neoplasms near nuclear sites in Scotland, 1975-94

OBJECTIVES: To examine the risk of cancers other than leukaemia and non- Hodgkin's lymphoma in children resident in the vicinity of nuclear sites in Scotland. METHODS: The study dataset comprised registrations of cancer other than leukaemia and non-Hodgkin's lymphoma diagnosed in children aged under 15 in the period 1975-94. These were validated for completeness and accuracy and analysed in two groups: (a) tumours of the central nervous system and (b) other malignant tumours (excluding leukaemia and non-Hodgkin's lymphoma). Around each nuclear site observed cases (O) were enumerated and expected numbers (E) calculated with adjustment for age, sex, deprivation, and an urban-rural category. Stone's maximum likelihood ratio test (MLR) was used to determine whether there was any evidence of increased risk of these neoplasms among children living within 25 km of one of the nuclear sites investigated. The significance level of each MLR statistic was estimated by simulation. RESULTS: More tumours of the central nervous system were observed than expected within 25 km of Dounreay (O/E = 1.14), Hunterston (1.14), and Rosyth (1.22). These results were based on 2, 26, and 136 observed cases, respectively. The unconditional MLR was significant only for Rosyth (p = 0.006). The conditional application of the MLR test for Rosyth was not significant (p = 0.771). For the group of other malignant neoplasms, the unconditional MLR test was not significant for any of the seven sites. CONCLUSIONS: There was no evidence for generally increased risk of either tumours of the central nervous system or other malignant tumours in children living near nuclear sites. The significant excess of tumours of the central nervous system around Rosyth is likely to be due to the high incidence of these tumours in east central Scotland. Further investigations in this area are warranted.

 

     

Balancing the equation: The significance of professional and lay perceptions in the promotion of cervical screening amongst minority ethnic women

Studies of minority ethnic women and cancer screening have, in the past, suffered from many theoretical and methodological weaknesses. In addition, no attempts have been made to study the complexity of the issue involved in the intercultural context, or the possible contribution of women's experiences to low uptake rates. In order to further our understanding of the issues, an alternative approach, participatory action research (PAR), was adopted to identify factors that might have contributed to the persistently low participation of minority ethnic women in the cervical screening programme, and address them collaboratively. This paper presents the key findings of the ‘problem identification' phase of the project. Using mainly the focus-group method, it explores both smear takers' and minority ethnic women's perceptions and experiences of cervical screening. Data suggest that there was a divergence in perceptions held by these groups regarding cervical screening, which contributed to negative experiences for both groups. There is also clear evidence of dysfunctional clinical communication arising from these differing perceptions. Opportunistic screening at post-natal examination adopted by many general practices appeared to have perpetuated the perceptions that the majority of minority ethnic women held about the purpose of the smear test. Compounded by language differences, the majority of women who had undergone smear testing understood neither the purpose of screening programme nor the procedure of the test. This has clear implications for promoting regular uptake, and more importantly for informed consent and choice.     

Effects of imipramine treatment of separation-induced social disorders in rhesus monkeys.

Two groups of young rhesus monkeys were subjected to repetitive peer separations, a procedure that has been shown to produce depressivelike reactions in infant monkeys. Midway through the procedure one group was treated with the antidepressant imipramine hydrochloride, the other with a saline placebo. In comparison with placebo treatment, the imipramine treatment yielded significant behavioral improvement in a form and with a time course similar to that seen when the drug is given clinically to human depressives. We discuss the implications of the findings.     

Congenital pulmonary atresia with ventricular septal defect: angiographic and surgical correlates

Of 181 patients with severe congenital pulmonary atresia and ventricular septal defect or "type IV truncus" (an obsolete term), all but 11% had true central pulmonary arteries. These arteries were demonstrable by large serial biplane angiograms using multiple selective injections into collateral vessels, frequent photographic subtraction, and occasional pulmonary vein-wedge angiograms. These techniques are extremely important for accurate diagnosis and in planning corrective or palliative surgery, which was done in 77% of patients with pulmonary arteries.     

Paths and pacemakers: innovation diffusion networks in multihospital systems and alliances

This article examines the role of multihospital systems and alliances as "innovation carriers." Drawing upon studies of interpersonal and interorganizational communications networks, the authors suggest how membership in a system or alliance, as well as network characteristics, affects innovation practices in general acute care hospitals.     

Capture your market share. Healthcare's largest growth area requires strategic facilities planning

The outpatient consumer has more choices than ever before. Hospital's delivery systems must be optimized to remain competitive and survive financially.