Risk of Fetal Mortality After Exposure to Listeria monocytogenes Based on Dose-Response Data from Pregnant Guinea Pigs and Primates

One‐third of the annual cases of listeriosis in the United States occur during pregnancy and can lead to miscarriage or stillbirth, premature delivery, or infection of the newborn. Previous risk assessments completed by the Food and Drug Administration/the Food Safety Inspection Service of the U.S. Department of Agriculture/the Centers for Disease Control and Prevention (FDA/USDA/CDC)^{( 1 )} and Food and Agricultural Organization/the World Health Organization (FAO/WHO)^{( 2 )} were based on dose‐response data from mice. Recent animal studies using nonhuman primates^{( 3 , 4 )} and guinea pigs^{( 5 )} have both estimated LD₅₀s of approximately 10⁷ Listeria monocytogenes colony forming units (cfu). The FAO/WHO^{( 2 )} estimated a human LD₅₀ of 1.9 × 10⁶ cfu based on data from a pregnant woman consuming contaminated soft cheese. We reevaluated risk based on dose‐response curves from pregnant rhesus monkeys and guinea pigs. Using standard risk assessment methodology including hazard identification, exposure assessment, hazard characterization, and risk characterization, risk was calculated based on the new dose‐response information. To compare models, we looked at mortality rate per serving at predicted doses ranging from 10^?4 to 10¹² L. monocytogenes cfu. Based on a serving of 10⁶ L. monocytogenes cfu, the primate model predicts a death rate of 5.9 × 10^?1 compared to the FDA/USDA/CDC (fig. IV‐12)^{( 1 )} predicted rate of 1.3 × 10^?7. Based on the guinea pig and primate models, the mortality rate calculated by the FDA/USDA/CDC^{( 1 )} is underestimated for this susceptible population.     

SPC—making it work for the gas transportation business

Transco is the main provider of gas transportation to domestic and commercial customers in mainland Britain. Gas arrives in Britain at a steady rate but is consumed with a distinct diurnal pattern. The safe and timely movement of gas from arrival at the beach in various places in Britain to delivery at burners is the main driver for System Operations. The movement of gas is meticulously controlled and monitored resulting in a mass of information on pressure, flow and temperature. Gas is stored temporarily in various storage vessels and is moved around the pipes and in and out of storage as demand dictates. Demand is mostly dictated by the weather and is therefore subject to much variation. Transco and its predecessors have been transporting gas for over 50 years and are very successful as judged by their excellent safety record and the continual delivery of gas. Nevertheless, the company wished to improve itself and make further use of the many measurements collected. SPC is ideal for improving communication and understanding through increased visibility of data. All companies have special issues to face when they implement SPC, and this paper describes the way these were dealt with in System Operations and the lessons learnt along the way. The first part describes how performance measures were chosen for investigation. It includes a novel use of correlation between output and day-to-day conditions, which was successfully turned into a measure to check the uncheckable. The second part is about the issues involved with early application of SPC when features of the system are still unexplained. SPC has helped enhance understanding of the complex transportation process, encouraged team work, improved performance and provided an objective means of decision making.     

Finding common cause in quality: confronting the physician engagement challenge

Although it's difficult to achieve, physicians can be engaged and supportive of quality improvement efforts, if the activity is presented and managed effectively.     

Career Coaching: Practice,Training, Professional,and Ethical Issues

The authors address the practice, training, professional, and ethical issues of career coaching and propose recommendations regarding the professional organization, training, certification, code of ethics, research, and multicultural issues related to the field.     

Connecting Parliament to the Public via the Internet

A number of scholars have argued that the Internet could strengthen representative democracy. This article presents two case studies of online consultations run on behalf of the UK Parliament and tests a series of hypotheses about online public deliberation. One consultation involved women survivors of domestic violence; the other was linked to the examination by a Parliamentary Committee of the draft Communications Bill. The article concludes by suggesting that the success of online parliamentary consultations is dependent upon two groups of actors, parliamentarians and citizens, each of which must acquire new types of communication skills and develop new practices of operating.     

Presenting features in adult victims of satanist ritual abuse

This paper begins with a brief account of the author's own introduction to the subject of satanist ritual abuse (SRA). This is followed by clinical data concerning five adult victims of SRA, brought up within multi-generational Satanic cults. Clinical features are described, some of which are common to those seen in victims of other forms of child sexual abuse (CSA). Others appear to be more specific to SRA victims. The pattern of disclosure is described briefly but details of the content are not included. Professional scepticism about SRA is discussed and attention drawn to the similarity of these cases with those reported in the US literature. The conclusion emphasizes the importance of considering the possibility of SRA in patients presenting with these symptoms.     

Financial responsibility for children following divorce and remarriage

In this article the phenomena of the declining financial status of children following the divorce of their parents are explored. Two cultural beliefs are proposed as particularly relevant for understanding why some parents do not provide financially for their children following divorce: the belief that the nuclear family form is the only one that is normal and natural, and the belief that an individual's rights are of supreme importance. The consequences of these beliefs for the financial support of children are discussed, and suggestions for addressing the situation are presented.Marilyn Coleman and Lawrence Ganong received their doctorates from the University of Missouri-Columbia. Their research interests include divorce and remarriage issues, belief systems about family life, and sex roles in couples and families. They may both be reached at 31 Stanley Hall, University of Missouri, Columbia, MO 65211.