Work-related assault injuries among nurses.

Work-related violence is a major public health problem; however, there is a serious deficiency in the knowledge of risk factors for this problem. The purpose of this case-control study was to identify risk factors for work-related assault injuries among nurses. We used unconditional logistic regression to model the dependence of work-related assault injuries on each exposure of interest and the respective confounders. We found a decreased rate for the presence of security personnel (RR = 0.40; 95% CI = 0.19-0.82). We found increased rates for the following factors: the perception that administrators considered assault to be part of the job (RR = 8.14; 95% CI = 3.76-17.60); having received assault prevention training in the current workplace (RR = 4.64; 95% CI = 2.33-9.23); a high (>5) vs. low (<2) patient/personnel ratio (RR = 2.54; 95% CI = 1.13-5.70); working predominantly with patients with mental illness (RR = 3.5; 95% CI = 1.41-8.85); and working with patients who had more than 1- to 4-week and more than 4-week lengths of stay in the institution vs. <1 day (RR = 8.85; 95% CI = 1.58-49.52 and 4.25; 95% CI = 1.17-15.39, respectively).     

Environmental justice and statistical summaries of differences in exposure distributions

Recent regulatory action requires the assessment of environmental justice (equitable protection from the burdens of environmental hazards across sociodemographic subpopulations) in the siting of hazardous waste sites, and prioritization of environmental remediation efforts. Assessments of environmental justice require linking exposure, demographic, and health data. The geographic nature of the data makes the use of geographic information systems attractive for environmental justice assessments. Typical geographic assessments compare the composition of 'exposed' populations, while typical statistical assessments focus on differences in health outcomes between population subgroups, possibly adjusted for exposure. We outline an alternate approach based on summarized differences between exposure distributions within each population subgroup. We illustrate how such summaries provide a tool for site evaluation (e.g., defining exposure inequities resulting from locating a new potential hazard at any of a number of possible sites). In addition, we describe summaries, based on dose-response relationships, to describe risk differences imposed by the observed exposure differences. Reported toxic emissions from Allegheny County, Pennsylvania illustrate the approach.     

Caffeine consumption and menstrual function

The relation between caffeine intake and menstrual function was examined in 403 healthy premenopausal women who belonged to Kaiser Permanente Medical Care Program in 1990-1991. A telephone interview collected information about caffeinated beverage intake as well as other lifestyle, demographic, occupational, and environmental factors. Subjects collected daily urine samples and completed a daily diary for an average of five menstrual cycles. Metabolites of estrogen and progesterone were measured in the urine, each cycle was characterized as anovulatory or ovulatory, and a probable day of ovulation was selected when appropriate. Logistic regression and repeated measures analyses were performed on menstrual parameters. Women whose caffeine consumption was heavy (>300 mg of caffeine per day) had less than a third of the risk for long menses (> or =8 days) compared with women who did not consume caffeine (adjusted odds ratio = 0.30, 95% confidence interval 0.14-0.66).Those whose caffeine consumption was heavy also had a doubled risk for short cycle length (< or =24 days) (adjusted odds ratio = 2.00, 95% confidence interval 0.98-4.06); this association was also evident in those whose caffeine consumption was heavy who did not smoke (adjusted odds ratio = 2.11, 95% confidence interval 1.03-4.33). Caffeine intake was not strongly related to an increased risk for anovulation, short luteal phase (< or =10 days), long follicular phase (> or =24 days), long cycle (> or =36 days), or measures of within-woman cycle variability.     

Bone marrow and recombinant human bone morphogenetic protein-2 in osseous repair

Bone marrow stem cells and recombinant human bone morphogenetic protein-2 each has the capacity to repair osseous defects. Recombinant human bone morphogenetic proteins require the presence of progenitor cells to function. It is hypothesized that a composite graft of recombinant human bone morphogenetic protein-2 and marrow would be synergistic and could result in superior grafting to autogenous bone graft. Syngeneic Lewis rats with a 5-mm critical sized femoral defect were grafted with recombinant human bone morphogenetic protein-2 and marrow, recombinant human bone morphogenetic protein-2, marrow, syngeneic cancellous bone graft, or carrier alone (control). Serial radiographs (3, 6, 9, 12 weeks) and torque testing (12 weeks) were performed. Bone formation and union were determined. The recombinant human bone morphogenetic protein-2 and marrow composite grafts achieved 100% union at 6 weeks. Recombinant human bone morphogenetic protein alone achieved 80% union by week 12. Both groups yielded a higher union rate and superior mechanical properties than did either syngeneic bone graft (38%) or marrow (47%) alone. The superior performance of recombinant human bone morphogenetic protein-2 combined with bone marrow in comparison with each component alone strongly supports a biologic synergism. This experimentation shows the clinical importance of establishing operative site proximity for the osteoinductive factors and responding progenitor cells.     

Core beliefs in anorexic and bulimic women

There is research evidence to suggest the presence of dysfunctional cognitions in anorexia nervosa and bulimia nervosa that are not related to food, weight, or shape. These maladaptive cognitions have not been addressed by the conventional cognitive behavioral models of etiology or therapy. This study aimed to assess the impact of unhealthy core beliefs on eating disorders and their symptoms. Twenty restricting anorexics, 10 bulimic anorexics, 27 bulimics, and 23 normal controls completed Young's Schema Questionnaire. Eating behaviors and attitudes were also measured. The results indicate that both anorexic and bulimic women had significantly higher levels of unhealthy core beliefs than comparison women, but the clinical groups only differed on one individual core belief (entitlement). However, there were different patterns of association between core beliefs and eating psychopathology in anorexic and bulimic women. It is suggested that future clinical practice should incorporate core beliefs as a potential element in the assessment and treatment of eating disorders.     

A Review of the Diagnostic Methods Reported in the Journal of Autism and Developmental Disorders

This review summarizes subject selection and diagnostic procedures documented in the Journal of Autism and Developmental Disorders. One hundred forty-two empirical articles published between February 1993 and April 1997 were examined. Reviewers independently evaluated articles using a coding instrument developed by the authors. Results indicated that a majority of researchers reported the use of one or more standard diagnostic criteria in classifying their subjects. However, numerous studies did not report the methods by which the diagnostic criteria were quantified or applied. Additionally, there was a lack of clear specification of inclusion and exclusion criteria for comorbid disorders. Improving the documentation of diagnostic practices in research on autism will benefit researchers and practitioners.     

Health locus of control and self-efficacy beliefs in a healthy elderly sample

BACKGROUND. The elderly are the fastest growing segment of the population, and this will place additional burdens on the healthcare system. It is therefore valuable to study the elderly who have reached their later years relatively free of disease and in good health. METHODS. Health locus of control, self-efficacy beliefs, and lifestyle behaviors were studied in a sample of 57 healthy elderly subjects. Subjects completed the Multidimensional Health Locus of Control Scale, Self-Efficacy Scale, and Healthstyle Self-Test for Seniors. RESULTS. Most of the subjects were characterized by an internal health locus of control belief (91.2%), high generalized self-efficacy (57.9%), and good health behaviors. As hypothesized, positive relationships were found among these variables. DISCUSSION. Individuals with an internal health locus of control and high generalized self-efficacy are more likely to benefit from a health education program than those with an external locus of control and low self-efficacy. Health educators can better serve their clients by evaluating these parameters when developing programs.     

Evaluation of poly(styrene-4-sulfonate) as a preventive agent for conception and sexually transmitted diseases

A commercial preparation of a sodium polystyrene sulfonate (designated as N-PSS; its molecular weight is 500000 daltons) was tested as an inhibitor of sperm function and as a preventive agent for conception and the transmission of sexually transmitted diseases. The polymer is an irreversible inhibitor of hyaluronidase and acrosin; its IC50 values are 5.7 microg/mL and 0.5 microg/mL, for hyaluronidase and acrosin, respectively. N-PSS is also a stimulus of human sperm acrosomal loss. It produces maximal acrosomal loss at 2.5 microg/mL. Contraception in rabbits is nearly complete when rabbit spermatozoa are pretreated with 0.5 mg/mL of N-PSS before artificial insemination; however, N-PSS does not immobilize spermatozoa at concentrations as high as 50 mg/mL. N-PSS has broad spectrum antiviral and antibacterial activities. Infection by human immunodeficiency virus and herpes simplex virus are inhibited by N-PSS; 3-log reductions are produced by 7 microg/mL and 3 microg/mL, respectively. N-PSS is active against Chlamydia trachomatis and Neisseria gonorrhoeae. At 1 mg/mL, N-PSS inhibits chlamydial infectivity by more than 90%. N-PSS produces a 3-log reduction in gonococcal growth at 15 microg/mL. In contrast, N-PSS (5 mg/mL) does not affect the growth of Lactobacillus (normal component of the vaginal flora). N-PSS can be classified as a noncytotoxic contraceptive antimicrobial agent. These properties justify bringing a polystyrene sulfonate into clinical trials for its evaluation as a preventive agent for conception and several sexually transmitted diseases.