The Results of Water Fluoridation in Ireland

The visit of Dr. Trendley Dean to Dublin in the mid-1950s helped accelerate the decision to introduce water fluoridation as a public health measure in the prevention of caries in the Republic of Ireland. A challenge to the constitutional validity of the Health (Fluoridation of Water Supplies) Act 1960 failed and in 1964 the water supplies of Dublin city were fluoridated. Over the next seven to eight years all the major urban communities in the Republic of Ireland were fluoridated. Currently, 67 percent of the 3.5 million people in the country reside in fluoridated communities. Studies conducted over the last 20 years show that residents of fluoridated communities have better dental health than those in nonfluoridated communities—the mean dmft is lower in children and the number of natural teeth present in adults is higher.     

Terminal transverse limb defects and early chorionic villus sampling: Evaluation of 4,300 cases with completed follow-up

Data from 4,300 consecutive cases following prenatal diagnosis by transcervical (TC) CVS (n = (1,570) and transabdominal (TA) CVS (n = 2,370) were evaluated. In the follow-up study only infants examined by a physician were included. Gestational age varied between 8.5 and 11.6 weeks (mean 10.3 weeks) for TC-CVS and between 9.3 and 20 weeks (mean 12.3 weeks) for TA-CVS 98% of TC-CVS was performed at 9–10 weeks, 80.7% of TA-CVS procedures were carried out at 12–15 weeks. Selective termination took place in 97 cases of TC-CVS (6.1%) and in 72 cases of TA-CVS (2.6%). Another 8 Women had a termination for psychosocial reasons, resulting in 4,123 (1,469 TC, 2,645 TA) continuing pregnancies. The overall fetal loss rare <28 weeks was 5.4% (n = 80) for TC-CVS and 2.6% (n = 70) for TA-CVS. The overall incidence of congenital abnormalities after birth was 0.9%. Two terminal transversal limb defects were detected in the TC-CVS group (0.14%) against one (0.04%) in the TA-CVS group. © 1993 Wiley-Liss, Inc.     

Pelvic Pain Complicating LHRH Analogue Treatment of Fibroids

We present these 3 cases to alert others to the possibility of severe pain with rapid shrinkage of fibroids occurring during LHRH analogue treatment. We suggest management of such events should not be surgical except for vaginal excision of prolapsed fibroid polyps.     

Community nutrition education for people with coronary heart disease—who attends?

Abstract: A qualitative food-frequency questionnaire was administered by mail to a representative sample of 137 people previously diagnosed with possible or definite myocardial infarct. Seventy-eight per cent of subjects returned a completed questionnaire and were subsequently invited to attend local tastings of foods with the National Heart Foundation Tick of Approval. These tastings were organised and promoted with the active involvement of the local branch of the Australian Cardiac Association. The purpose of this study was to measure voluntary participation by people with coronary heart disease in community nutrition education and to identify any self-selection bias with respect to eating habits among the participants. A dietary risk score, which was the proportion of all food choices that were high in fat, was calculated from the data. Eighteen per cent of subjects who answered also participated in the food tastings; there was a statistically significant association between membership of the Australian Cardiac Association and being a participant. Participants had a significantly lower risk score (P < 0.01) after adjustment for age, sex and membership of the association. The results suggest that voluntary participation by people with heart disease in community nutrition education is low and that there is a self-selection bias, with those at highest dietary risk being least likely to attend. The use of existing community networks to recruit participants is also discussed.     

Brain plasticity following psychophysiological treatment in learning disabled/ADHD pre-adolescents.

This research investigated the effects of a psychophysiological treatment methodology on brain plasticity as reflected in event-related brain potential topographic mapping and morphology along with School-marks and Mangina-Test performance in three different groups of pre-adolescents at baseline and 8 months later: (a) Learning Disabled/ADHD pre-adolescents who were treated; (b) Non-treated Learning Disabled/ADHD pre-adolescents; (c) Normal controls. Results indicate that: (1) the Event-Related Brain Potentials topographic mapping was significantly modified in post-treatment condition for the treated Learning/Disabled/ADHD group as opposed to pre-treatment baseline (P < 0.001). This was mainly due to the enhanced pre-frontal and frontal N450 amplitudes along with higher P450 components over posterior regions in post-treatment condition (P < 0.001); (2) for group comparisons at baseline, no significant topographic mapping differences were found between the treated Learning Disabled/ADHD group and the non-treated Learning Disabled/ADHD control group (P > 0.05) and significant differences were present between the treated Leaning Disabled/ADHD and the normal control group (P < 0.001); (3) 8 months later, in post-treatment condition, group comparisons revealed significant topographic mapping differences between the treated Learning Disabled/ADHD group and the non-treated Learning Disabled/ADHD control group (P < 0.001) and none between the treated Learning Disabled/ADHD group and the normal control group (P > 0.05); (4) the topographic mapping of both components was similar at baseline and 8 months later in both control groups (P > 0.05); (5) at baseline, school-marks and Mangina-Test performance of treated Learning Disabled/ADHD were not significantly different than those of the non-treated Learning Disabled/ADHD (P > 0.05) and significantly lower than those of the normal control group (P < 0.001); (6) the treated Learning Disabled/ADHD group in post-treatment condition had significantly higher school-marks and Mangina-Test performance than those of non-treated Learning Disabled/ADHD controls (P < 0.001) and were similar to those of normal controls 8 months later (P > 0.05); (7) school-marks and Mangina-Test performance at baseline for non-treated Learning Disabled/ADHD controls were not modified 8 months later (P > 0.05) and normal controls maintained their high performance within the same time interval (P > 0.05). These findings provide evidence of the impact of the psychophysiological treatment methodology on brain plasticity and regulation as reflected in significantly improved neurophysiology of pre-frontal, frontal and posterior brain regions concomitantly with higher school-marks and neuropsychometric performance in the Mangina-Test.     

The narcissistically vulnerable system: A case study of the public mental hospital

The present paper introduces the concept of the narcissistically vulnerable system by suggesting that organizations may manifest some of the same pathological characteristics as narcissistic individuals. The public mental hospital was chosen as an example of such a system. Reasons for its vulnerability were suggested and specific defenses, employed at the system level, were discussed. Finally, remedies for the repair of the narcissistically vulnerable system were considered.     

Nursing involvement in euthanasia: how sound is the philosophical support?

Abstract  Preference utilitarians are concerned to maximize the autonomous choices of individuals; for this reason, they argue that nurses ought to advocate for those patients who desire assistance with ending their lives. This approach prompts us to consider, then, the moral validity of nursing involvement in measures intended to end the lives of patients. In this article, the terms of preference utilitarianism are set out and considered in order to determine whether this approach offers sufficient philosophical support for sanctioning a role for nursing in euthanasia. Ultimately, it is found that preference utilitarianism is lacking in this respect, as well as in its fitness for guiding nursing activity in general. In particular, it is found that nurses are required to exchange a handmaiden relationship with the medical profession for an equally undignified relationship with patients. If nursing involvement in measures intended to end the lives of patients is to find sufficient philosophical support, then we need to look elsewhere.