A model for worksite cancer prevention: integration of health protection and health promotion in the WellWorks Project

OBJECTIVES. To describe a theoretic approach and rationale for the integration of health protection and health promotion in worksite cancer prevention programs and to describe an intervention study designed to implement this integration. METHODS. Twenty-four worksites were recruited to participate in this randomized, controlled study. The theoretically based intervention model integrates health promotion and health protection through (1) joint worker-management participation in program planning and implementation, (2) consultation on worksite changes, and (3) educational programs targeting health behavior change. RESULTS. Although the primary purpose of this paper is to describe a theoretic approach to the integration of health promotion and health protection, preliminary results are also noted. In these predominantly manufacturing worksites, many workers faced the double jeopardy of exposures to occupational carcinogens and personal risks such as smoking or poor dietary habits. Production workers' job responsibilities frequently limited their full participation. Barriers to participation were identified early in the project, and strategies were developed to facilitate maximal worker involvement and worksite changes. CONCLUSIONS. Lifestyle changes such as smoking cessation or dietary changes may be more effectively promoted among blue collar audiences when programs also encourage management actions to reduce occupational exposures. Public health professionals trained in health promotion and health protection must work together to effectively address the health concerns of this population.     

BDNF, but not NT-3, promotes long-term survival of axotomized adult rat corticospinal neurons in vivo

Axotomy-induced death of corticospinal neurons (CSN) is prevented by intracotrical infusions of BDNF or NT-3 within the first week after axotomy. The present study examined whether this represents merely a delay of CSN death or whether BDNF and NT-3 can promote long-term survival of these neurons in vivo. The neurotrophins were infused for an initial period of 14 days to lesioned CSN which was followed by 28 days without treatment. BDNF was able to promote CSN survival for at least 42 days while NT-3 had no significant effect. These results suggest that initial BDNF treatment induces an endogamous mechanism that promotes survival of axotomized CSN without further exogenous neurotrophic factor supply. These findings may be important for the design of therapeutic strategies for motoneuron disease.     

Self-administration of cocaine analogs by rats

  Rationale: A novel scheme for the synthesis of cocaine analogs from vinylcarbenoid precursors has made available compounds that have a diverse range of affinities for the DA and 5-HT transporters. These compounds were used to explore the relationship between their biochemical properties and their reinforcing effects. Objectives: The objective was to assess the reinforcing efficacy of selected cocaine analogs and compare the results with their selectivity in binding to DA and 5-HT transporters. Methods: Rats were prepared with chronically indwelling intravenous cannulae and trained to self-administer cocaine on a progressive ratio (PR) schedule. A range of doses of seven cocaine analogs were substituted for cocaine in separate groups of animals. Results: The results demonstrate a wide range of reinforcing efficacies and potencies among the seven selected drugs. Four tropane analogs (WF-11, WF-23, WF-24, WF-55) were found to support self-administration behavior on a PR schedule while three did not (WF-31, WF-54 and WF-60). The DA/5-HT selectivity ratio was found to be a better predictor of self-administration behavior than affinity at the DA transporter alone. Conclusion: These data suggest that drugs with a higher affinity for the DA versus the 5-HT transporter are more likely to be self-administered. Received: 29 October 1998 / Final version: 5 February 1999     

Practice protocol for the examination of specimens removed from patients with carcinoma of the urinary bladder, ureter, renal pelvis, and urethra

This article details a practice protocol for the examination and reporting of specimens removed from patients with carcinoma of the urinary bladder, ureter, renal pelvis, or urethra. It was created by a multidisciplinary task force of pathologists and oncologists established by the Cancer Committee of the College of American Pathologists. Documentation for the protocol was obtained from the previously published protocol, the medical literature, personal experience, and consultation with colleagues. After creation and review by the task force, the protocol was sent to 1000 randomly selected practicing pathologists as a survey. Their comments and suggestions were addressed in the final version. The protocol was approved by the Board of Governors of the College of American Pathologists.     

Excretion of mutagens following chemotherapy

The mutagenic activity of urine was evaluated in children receiving single and multiple agent chemotherapy to determine the duration of carcinogenic risk to health care personnel and family contacts. Urine samples from 21 children were evaluated before and daily for 5 days after chemotherapy administration. Mutagenic activity, a sensitive though not specific indicator of carcinogenic risk, was assayed using mutant strains of Salmonella typhimurium (the "Ames test"). Validity of the assay was confirmed by demonstrating mutagenic activity in urine samples from 17 adult cigarette smokers but not from 21 adult nonsmokers (24/24 versus 0/37, p less than 0.001). None of the 21 children tested demonstrated mutagenic activity before chemotherapy administration. Following single agent dactinomycin, cyclophosphamide, daunorubicin, doxorubicin, methotrexate, or vincristine, mutagenic activity was demonstrated for 2 days (5/5 at 1 and 2 days and 0/5 at 3 days). Following multiple agent chemotherapy using two or three of the latter drugs on a single day, mutagenic activity was demonstrated for 4 or 5 days (16/16 at 1, 2, 3, and 4 days, and 4/16 at 5 days). Based on these observations with urine, and presumably other body fluids, precautions are recommended for 2 days following single agent and at least 5 days following multiple agent chemotherapy.     

Electronic data collection by trainee anaesthetists using palm top computers

The Royal College of Anaesthetist requires that trainees wishing to specialise in Anaesthesia register with the College and keep a logbook documenting their experience and training in clinical anaesthesia. There are a number of advantages if such logbooks are kept in an electronic format. For the first time in the United Kingdom, we have evaluated the usefulness in a district general hospital of introducing a computerized system of record keeping based on a portable palm top computer. This has enabled the careful analysis of the individual work load of each trainee in the department by means of a specific program designed to generate a comprehensive report after the information from each individual has been downloaded on to a standard desk top computer. We have found a number of interesting and unexpected results and have highlighted ways in which the system may be improved.