A Stochastic Assessment of the Public Health Risks of the Use of Macrolide Antibiotics in Food Animals

Campylobacteriosis is an important food-borne illness with more than a million U.S. cases annually. Antibiotic treatment is usually not required. However, erythromycin, a macrolide antibiotic, is recommended for the treatment of severe cases. Therefore, it is considered a critically important antibiotic and given special attention as to the risk that food animal use will lead to resistant infections and compromised human treatment. To assess this risk, we used a retrospective approach; estimating the number of campylobacteriosis cases caused by specific meat consumption utilizing the preventable fraction. We then determined the number of cases with macrolide resistance Campylobacter spp. based on a linear model relating the resistance fraction to on-farm macrolide use. In this article, we considered the uncertainties in the parameter estimates, utilized a more elaborate model of resistance development and separated C. coli and C. jejuni . There are no published data for the probability of compromised treatment outcome due to macrolide resistance. Therefore, our estimates of compromised treatment outcome were based on data for fluoroquinolone-resistant infections. The conservative results show the human health risks are extremely low. For example, the predicted risk of suboptimal human treatment of infection with C. coli from swine is only 1 in 82 million; with a 95% chance it could be as high as 1 in 49 million. Risks from C. jejuni in poultry or beef are even less. Reduced antibiotic use can adversely impact animal health. These low human risks should be weighed against the alternative risks.     

The after-effects of a prolonged period of day-sleep on subjective sleep quality

The effects of day-sleep on the quality ofsleep are not restricted to the night-work period itself. Effects can be measured during night-sleep in the period following night-work. A study on these after-effects, using a self-report instrument to measure sleep quality, is described. A total of N=7O operators wcrc observed over five consecutive undisturbed nights after a working period of seven morning shifts (N= 35) and after a working period of seven night-shifts (N= 35). The quality of sleep during the third night after the night-shift period was still significantly worse than the third night after the rnorning-shift period. No differential (after-)effects were observed with respect to differences in sleep duration.     

THE RATE OF CONVERGENCE IN THE NORMAL APPROXIMATION FOR THE WILCOXON R-ESTIMATOR

We exploit the fact that the Wilcoxon score R-estimator of the slope in a linear regression model minimises Gini's mean difference of the residuals to obtain a Berry-Esseen rate of convergence result for the Wilcoxon R-estimator.     

Advocacy and ombudswork for children: implications of the Israeli experience

Israel's establishment of what is to be the first in a network of child advocacy councils is discussed in relation to child advocacy efforts in the United States. The work and structure of the Jerusalem Children's Council and its Ombudsman for Children is described. It is suggested that Israel's experience in establishing a well-functioning local child advocacy council provides a model for implementing the recommendation of the Joint Commission on the Mental Health of Children to establish a network of local child advocacy councils in the United States.     

Ideology and Social Movements: The Contributions of Habermas*

Theorists of social movements have not developed a sufficiently complex perspective of the role that ideology has in the dynamics of social movements. This essay demonstrates that Habermas’theory of the autonomy of normative structures is useful to explain the independent role of ideology in determining the direction taken by social movements. Habermas’emphasis on the interrelationship between cultural traditions, consensus formation, epistemologies, and differentiated rationalization processes furnishes an alternative to the instrumentalist and ahistorical assumptions that often characterize theorists’treatment of ideology in social movements. Empirical examples from studies of social movements are utilized to demonstrate the usefulness of Habermas’approach.     

EBV. Managing the physiological and psychosocial implications of the Epstein-Barr virus

EBV has both physiological and psychological implications. Few medical/nursing interventions are available to alleviate the physical stressors and fatigue. The primary nursing intervention, therefore, becomes one of providing emotional support and psychosocial interventions. Providing measures to ensure adequate sleep will assist the patient in more positive feelings about self. Although causation and diagnosis of this syndrome may be debated in the medical literature, the nursing role is to provide support and guidance for these patients. Longitudinal studies could be done to facilitate the understanding of the long-term effects of EBV and the outcome measures of mental health interventions.     

The Effect of Risk Beliefs on Property Values: A Case Study of a Hazardous Waste Site1

Health risk beliefs of homeowners near a landfill site were assessed in a survey and compared to expert judgments of the health risks of living near the site. A bimodal distribution of health risk beliefs suggested sharp disagreement between the experts and at least some of the residents. Correlates of high risk beliefs included perception of odor from the site, exposure to media coverage of the problem, having children living at home, age (younger respondents more concerned), and gender (females more concerned). An aggregated neighborhood health risk belief predicted reductions in home prices even after controlling for home physical characteristics, such as size and other disamenities such as proximity to a freeway. In the 4100 homes near the site, the estimated depression in property values was estimated to total about $40.2 million before the site was closed and to be about $19.7 million after closure. Implications of these results for community conflict and for benefit-cost analysis of hazard site remediation are discussed.