Factors in recruitment and employment of allied health students: preliminary findings

The efforts of a group of participants in the Coalition for Allied Health Leadership program to assess how and why allied health students became interested in their professions and students' plans for future employment are described. Results of a survey administered to 29 physical therapist assistant (PTA) and 54 communication disorders (CD) students revealed that most of the students first learned about their professions through personal experience. Almost half of the PTA students decided to pursue their career after working in another career, and most of the CD students made the decision during high school or in college. The most important factors in students' decisions to enter the professions were a desire to help others and the nature of the work. CD students preferred private practice, whereas the most desired employment setting for PTA students was an outpatient clinical facility. For both groups, the three most important factors influencing where they wish to live and work were job availability, access to medical care, and proximity to family and loved ones. Although half of the CD students hailed from small towns and rural areas, less than one third intended to work in these areas. Implications of survey findings are discussed.     

Cancer in Korean war navy technicians: mortality survey after 40 years

This study reports on over 40 years of mortality follow-up of 40,581 Navy veterans of the Korean War with potential exposure to high-intensity radar. The cohort death rates were compared with mortality rates for White US men using standardized mortality ratios, and the death rates for men in occupations considered a priori to have high radar exposure were compared with the rates for men in low-exposure occupations using Poisson regression. Deaths from all diseases and all cancers were significantly below expectation overall and for the 20,021 sailors with high radar exposure potential. There was no evidence of increased brain cancer in the entire cohort (standardized mortality ratio (SMR) = 0.9, 95% confidence interval (CI): 0.7, 1.1) or in high-exposure occupations (SMR = 0.7, 95% CI: 0.5, 1.0). Testicular cancer deaths also occurred less frequently than expected in the entire cohort and high-exposure occupations. Death rates for several smoking-related diseases were significantly lower in the high-exposure occupations. Nonlymphocytic leukemia was significantly elevated among men in high-exposure occupations but in only one of the three high-exposure occupations, namely, electronics technicians in aviation squadrons (SMR = 2.2, 95% CI: 1.3, 3.7). Radar exposure had little effect on mortality in this cohort of US Navy veterans.     

Timing of pubertal maturation and heterosexual behavior among Hong Kong Chinese adolescents

This study presents a cross-sectional examination of the independent contribution of pubertal maturation timing to heterosexual activity among Chinese adolescents. A standardized self-administered questionnaire was designed to obtain information on a spectrum of physical heterosexual behaviors from dating to sexual intercourse, age at first nocturnal ejaculation in boys, age at menarche in girls, and several psychosocial variables that might be associated with sexual behavior in adolescents. A total of 4,116 students aged from 14 to 18 years (2,175 boys and 1,941 girls) were recruited in the Youth Sexuality Survey of the Hong Kong Family Planning Association in 1996–97. When groups were defined as early, average, and late maturers, among boys, early maturers were youngest to report dating and to have sexual intercourse, followed by average and late maturers. Among girls, late maturers were slower to date and have sexual intercourse, but early maturers showed no difference from average maturers. Age of maturation was significantly lower for those reporting all heterosexual behaviors for both sexes. Our findings illustrate culture's moderation of the expression of biological differences.     

From research to application: the development of an antenatal psychosocial health assessment tool

OBJECTIVE: To describe the development of an assessment tool for antenatal psychosocial risk factors associated with poor postpartum outcomes. METHODS: A survey of Ontario family physicians established a need for an antenatal psychosocial health assessment (ALPHA) form. A critical literature review identified important antenatal factors for inclusion on the form. Focus groups of obstetrical care providers indicated acceptance of the provider-completed ALPHA; their feedback led to the development of a self-report ALPHA. Satisfaction, yield and reliability of the self-report and provider-completed ALPHA forms were studied and found to be comparable. RESULTS: Physicians and patients reported good satisfaction and usefulness of the ALPHA form in identifying antenatal psychosocial risk factors. The provider ALPHA was further tested in clinical practice. ALPHA endorsement was obtained from physicians, nurses and midwives. CONCLUSION: A program planning process, which included multidisciplinary involvement, evaluation and endorsement by professional organizations, aided the development, refinement and application of the ALPHA forms as primary care tools. ALPHA topic headings are incorporated into the official 2000 Ontario Antenatal Record and the ALPHA adopted for use on Prince Edward Island.     

Laboratory investigation of an E. coli O157:H7 outbreak associated with swimming in Battle Ground Lake,Vancouver, Washington

Escherichia coli O157:H7 has been associated with a number of waterborne outbreaks, but it has never been recovered from an implicated environment. This paper reports on an August 1999 outbreak of E. coli O157:H7 associated with swimming in Battle Ground Lake in Clark Country, Washington. E. coli O157:H7 was isolated from duck feces, as well as from two water samples. The authors used pulsed-field gel electrophoresis to compare these isolates with patient isolates for genetic homology. All the isolates yielded the same restriction fragment patterns. In addition, using polymerase chain reaction, the authors found patient isolates and environmental isolates to have the same virulence factors (Stx, eaeA, and hly).     

Surveying older people from minority ethnic groups: an evaluation of a primary care sampling method for UK African-Caribbean elders

There are substantial logistical difficulties in conducting community surveys of minority ethnic group populations. Primary care lists have been identified as an important potential resource but the representativeness of samples derived through this method has received little evaluation. In a community survey of psychiatric morbidity, African-Caribbean people aged 55-75 were identified by practice staff from registration lists for seven primary care teams in south London. The sensitivity of the process was evaluated by contacting a random sample of people whose ethnicity was not known. Participants aged 65-75 (n = 174) were also compared to a similarly aged group sampled through household enumeration (n = 34) with respect to demographic factors, risk factors for vascular disease, depression and cognitive function. For those with correct addresses, the identified group was estimated to include 72% of the potentially eligible population. Only 8% of contacted people were found not to be eligible in terms of ethnicity. Compared to the household enumeration sample, the primary care sample had marginally higher socio-economic status but was similar with respect to all other measured characteristics. Primary care list sampling with staff-assigned ethnicity therefore appeared highly specific, reasonably sensitive, and did not seem to introduce substantial bias for this population.     

Ruptured pericallosal aneurysm causing hemorrhage along the fornix

We present a 57 year-old man with a pericallosal aneurysm causing parenchymal hemorrhage in the preseptal region of the frontal lobe with extension into the fornix. We briefly discuss the literature pertaining to ruptured pericallosal aneurysms and their bleeding patterns.     

Pediatric meralgia paresthetica

Meralgia paresthetica is a focal peripheral neuropathy involving the lateral femoral cutaneous nerve and is rarely observed in pediatric practice. Previous reports have highlighted its occurrence within the context of a regional bony malignancy. We present here three patients less than 18 years of age with idiopathic meralgia paresthetica.     

The distribution of Mini-Mental State Examination scores in an older UK African-Caribbean population compared to MRC CFA study norms

OBJECTIVE: to describe normative data for the Mini-Mental State Examination (MMSE) in a UK African-Caribbean population and compare these with norms for white UK-born elders. DESIGN: a comparison of MMSE data from two cross-sectional surveys. METHOD: the MMSE had been administered to a community UK African-Caribbean population and scores were compared to norms from the Medical Research Council Cognitive Function and Ageing Study (CFAS). MMSE data were analysed for 248 African-Caribbean participants aged 55-75 and 5379 CFAS participants aged 65-74, without visual or auditory problems. Distributions of scores were tabulated and error rates for individual items compared. RESULTS: Median MMSE scores were 25 (interquartile range 22-27) for the whole African-Caribbean sample, 24 (22-27) for those aged 65-75 in the African-Caribbean sample, and 27 (25-29) for CFAS. Differences in error rates were specific to particular items: naming the season, serial seven subtraction, phrase repetition, three-stage command, and copying intersecting pentagons. These differences persisted when both samples were restricted to those with statutory duration of education, who were literate and who had worked in non-manual occupations. Normative data are displayed for MMSE scores in both groups. CONCLUSION: different distributions of MMSE scores between UK African-Caribbean and Caucasian groups can be principally explained by cultural bias in certain items. If the MMSE is to be administered to older African-Caribbean people, specific normative data should be referred to or else a culturally modified version of the instrument should be used.     

Dietary docosahexaenoic acid levels influence the outcome of arabinosylcytosine chemotherapy in L1210 leukemic mice

The purpose of this study was to investigate whether dietary supplementation with the n-3 fatty acid docosahexaenoic acid (DHA) in combination with arabinosylcytosine (AraC) chemotherapy could prolong the life expectancy of mice bearing L1210 leukemia. The four control diets included rodent chow, a diet containing 5% of a blended oil mimicking the fatty acid composition of rodent chow, and diets containing 5% or 10% fat with safflower oil as the main oil source. The two DHA-supplemented diets provided 1.5% or 3.5% DHA and 5% or 10% total fat, respectively. After tumor cell inoculation, mice were treated with AraC for 10 days. Mice fed the 5% safflower oil diet (30.1 -/+ 4.1 days), but not those fed the 10% safflower oil diet, survived longer than the chow-fed animals (22.1 -/+ 3.1 days, P = 0.05). The 1.5%-/+ DHA diet (average intake 1.8 g DHA/kg/day) was associated with a longer life span (33.3 -/+ 3.4 days, P < 0.01 vs. chow-fed) and no incidence of death due to drug toxicity. Further increasing DHA intake (4.5 g DHA/kg/day) resulted in shortened survival time (26.5 -/+ 2.0 days), increased circulating tumor cell burden, and lowered red blood cell concentrations. These data suggest that a modest level of dietary DHA or linoleic acid supplementation may improve the antineoplastic efficacy of AraC. However, overconsumption of DHA reverses the beneficial effect of DHA intake on drug sensitivity.