A case–control study relating railroad worker mortality to diesel exhaust exposure using a threshold regression model

A case–control study of lung cancer mortality in U.S. railroad workers in jobs with and without diesel exhaust exposure is reanalyzed using a new threshold regression methodology. The study included 1256 workers who died of lung cancer and 2385 controls who died primarily of circulatory system diseases. Diesel exhaust exposure was assessed using railroad job history from the US Railroad Retirement Board and an industrial hygiene survey. Smoking habits were available from next-of-kin and potential asbestos exposure was assessed by job history review. The new analysis reassesses lung cancer mortality and examines circulatory system disease mortality. Jobs with regular exposure to diesel exhaust had a survival pattern characterized by an initial delay in mortality, followed by a rapid deterioration of health prior to death. The pattern is seen in subjects dying of lung cancer, circulatory system diseases, and other causes. The unique pattern is illustrated using a new type of Kaplan–Meier survival plot in which the time scale represents a measure of disease progression rather than calendar time. The disease progression scale accounts for a healthy-worker effect when describing the effects of cumulative exposures on mortality.     

黄芩甙护肤霜的研制和应用

介绍利用中草药黄芩提取物黄芩甙制成水包油型护肤霜,其各项理化指标符合QB/T1857—93标准。临床应用结果表明,该护肤霜对黄褐斑、色素沉着、痤疮、皮肤粗糙、干裂疗效显著。     

Mental disease postpartum and parent‐infant interaction—evaluation of videotaped sessions

In order to investigate the influence of maternal mental illness postpartum on mother‐infant and father‐infant interaction, infants of 14 mentally ill women admitted to hospital within 6 months after delivery were compared to infants of 22 women who had been somatically ill. Videotaped sessions when the infant was 10 months old revealed that mothers in the psychiatric sample showed less sensitivity in comparison to mothers in the somatic sample. When the infant was 2 years old, mothers in the psychiatric sample showed less positive affect and less link‐infant follow (stimulation dimension) as compared to the somatic mothers. However, there were no differences between fathers in the psychiatric sample and fathers in the somatic sample in any of the interaction variables. In the psychiatric sample, fathers showed more warmth as compared to mothers. In the somatic sample, fathers scored higher than mothers on autonomy but lower than mothers on link‐infant follow (stimulation dimension). A possible interpretation of our data was that the mental illness of the mothers may lead to a more active parenting role of the father in order to buffer the deficit in the mother‐infant relation. Copyright © 2001 John Wiley & Sons, Ltd.     

新型城镇化与经济转型:反思与借鉴

目前,我国已开始步入工业化中期阶段,城镇化也迈入了从传统城镇化向新型城镇化转变的关键时期。城镇化发展具有一般规律性,即阶段性、要素集聚与扩散以及经济发展水平决定规律。我国城镇化发展过程中伴随的是掠夺式扩张和线性发展模式,土地和政府助推了城镇化的粗放发展模式。因此,对我国现阶段新型城镇化过程进行反思,并借鉴国外城镇化的成功经验,创新城镇化发展战略与路径模式,对于推进我国现代化、实现富民强国具有重大现实意义。     

Heart Ed 101

Cardiovascular disease is the leading cause of death for men and women in the United States. Risk factors and health behaviors combine over time to contribute to the disease process. College communities provide a unique environment for health promotion, risk reduction, and primary intervention. Heart health should be an integral part of college health.     

College and University Compliance With a Required Meningococcal Vaccination Law

Objective: Maryland became the first state to pass a vaccination law requiring college and university students living on campus to obtain a meningococcal vaccination or to sign a waiver refusing vaccination because college students are at increased risk for disease. The authors sought to identify how Maryland colleges addressed the law and determine whether schools were in full compliance. Participants: The authors surveyed 32 college/university administrators via a self-administered questionnaire. Methods: The authors calculated vaccination and waiver rates and assessed compliance with the law overall and with specific law components. Results: Among 28 participating schools, annual vaccination rates and waiver rates among students during 2000-2004 ranged from 66%-76% and 12%-17%, respectively. Two (7%) schools were compliant with all components of the law. Conclusions: Mandatory vaccination laws do not ensure compliance at the college and university level. Mandatory reporting, increased education, and collaboration between colleges and universities and public health agencies are needed.     

The Boric Acid Powder Treatment of Vulvovaginal Candidiasis

Abstract

This double blind comparison of fourteen daily intravaginal gelatin capsules containing 600 mg of boric acid powder versus identical capsules containing 100,000 units of nystatin diluted to volume with cornstarch found vulvovaginal candidiasis albicans cure rates for boric acid to be 92% seven to ten days after treatment and 72% at thirty days, whereas the nystatin cure rates were 64% at seven to ten days and 53% at thirty days. Speed of alleviation of signs and sumptoms was similar with both drugs. There were no untoward side effects, and cervical cytology was not affected. In vitro studies found boric acid to be fungistatic and its effectiveness to be unrelated to pH. Blood boron analyses indicated little absorption from the vagina and a half life of less than 12 hours. A 30% follow-up of 2,030 nonstudy patients revealed wet mount and symptom cure rates of 93% within two weeks and 88% within four weeks. Patient acceptance was better than with “messy” vaginal creams, and self-made boric acid powder capsules are inexpensive, 31¢ for fourteen, compared with costly, commonly prescribed medication.     

Results of a Heart Disease Risk-Factor Screening Among Traditional College Students

Abstract

Biological, behavioral, and psychosocial contributions to the gender gap in coronary heart disease (CHD) are discussed. Although CHD is the Number 1 cause of death for both sexes in the industrialized world, CHD mortality rates between these countries are larger than those between men and women, suggesting that biological factors are not the sole influences on the gender gap in CHD. Traditional coronary risk factors cannot explain the rapid increase in CHD mortality among middle-aged men in many of the newly independent states of eastern Europe. However, eastern European men score higher on stress-related psychosocial coronary risk factors (eg, social isolation, vital exhaustion) than men living in the West. Comparisons between the sexes also reveal gender differences in psychosocial and behavioral coronary risk factors, including excessive alcohol consumption and smoking, favoring women. Overall, it appears that men's coping with stressful events may be less adaptive physiologically, behaviorally, and emotionally, contributing to their increased risk for CHD.     

Does Self-Neglect Occur Among Older Adults With Dementia When Unsupervised in Assisted Living? An Exploratory,Observational Study

The phenomenon of older adults with dementia who develop behavioral expressions when they are unsupervised in assisted living residences is understudied. This qualitative study aimed to bridge this gap in the literature by focusing on 12 residents in various stages of dementia. Grounded Theory was followed to guide data collection and analysis. Data were collected in two special care units of an assisted living residence for 10 months. Participant observation was the primary data collection strategy. Semistructured interviews with staff and managers and review of clinical records augmented the observation data. While unsupervised, residents exhibited a wide spectrum of negative emotional states, behavioral expressions, functional difficulties, wayfinding difficulties, serious hygiene problems, and safety risks. More than half of the identified incidents represented self-neglectful behaviors. The study highlights the need for enhanced supervision and targeted interventions for residents with dementia who are susceptible to self-neglect.     

Weighing the Success of a National Alzheimer's Disease Service Demonstration

Summary

As the need for long-term care services within the United States has grown dramatically, Congress has consistently deflected the primary responsibility for such care to state governments, local organizations, and, ultimately, the family. This paper examines the impact of the Alzheimer's Disease Demonstration Grants to States (ADDGS) program, a small federally funded initiative within the context of this trend. Although the demonstration can be deemed a huge success relative to the goals of creating new services for an underserved target population, questions are raised about the merits of the program relative to the exploding need for an effective network of long-term care services.