The official American guidelines for prevention of nosocomial pneumonia. U. S. Centers for Disease Control

The official German guidelines for prevention of nosocomial pneumonia were published by the Bundesgesundheitsamt, now called Robert-Koch-Institut, twelve years ago. The recently published official "guidelines for prevention of nosocomial pneumonia" of the Centers for Disease Control and Prevention (CDC) are categorized according to scientific evidence. The American guidelines are very detailed and differ in some aspects from the official German guidelines. The purpose of the present paper is to inform the German anaesthesiologist about the official CDC guidelines and to provide a renewed background for the prevention of nosocomial pneumonia.     

Vicia cytogenetic tests for environmental mutagens. A report of the U.S. Environmental Protection Agency Gene-Tox Program

Vicia root-tip mitotic and pollen mother-cell meiotic tests are two major kinds of cytogenetic tests for environmental mutagens. According to the present review, 81 of 85 earlier studies used mitotic tests to determine the frequencies of chromosome or chromatid aberrations and/or sister-chromatid exchange from root-tip meristematic cells; only 4 used meiotic tests to determine the frequencies of chromosome aberration from pollen mother cells. Treatment of root-tip meristem can be done by allowing the newly germinated roots to absorb the chemical mutagens from a water solution. Pollen mother cells can be treated by spraying the solution or pipetting the liquid over the flower buds. After an appropriate recovery time, the samples are fixed and stained, and the slides are prepared for metaphase or anaphase figures for scoring aberration frequencies. Slides for meiotic tests are prepared for metaphase I and/or Anaphase I stages for scoring chromosome aberration frequencies. Results of both cytogenetic tests should be expressed in terms of number of breaks per cell or per 100 cells. Test results of 76 chemicals from 32 classes in this review indicate that the Vicia root-tip mitotic test is reliable, efficient, and relatively inexpensive. These results also reveal that antibiotics are most frequently studied, followed by alkyl sulfones, pyrimidine, and purine derivatives. Of all the agents studied through root-tip mitotic tests, about 90% gave positive responses; antibiotics (phleomycin and bleomycin) had very high mutagenicity (less than 1 ppm gave positive response).     

Differing birth weight among infants of U.S.-born blacks, African-born blacks, and U.S.-born whites

Glomerular disease often accompanies a wide variety of liver diseases, including acute or chronic hepatitis. A striking association between hepatitis B virus and glomerulonephritis particularly membranous glomerulonephritis has been reported by various authors. It is not surprising, therefore, that hepatitis C virus (HCV) infection has been recently associated with the development of various types of glomerulonephritis. The principal type of glomerulonephritis associated with HCV infection is either cryoglobulinemic or non-cryoglobulinemic membranoproliferative glomerulonephritis. However, other types of glomerular lesions were seen in the clinical course of HCV infection. We report a rare case of a 20-year-old woman who developed rapidly progressive glomerulonephritis (RPGN) during the course of the active HCV infection. Whether this case represents a true association or a coincidental association is not known.     

Centers for Disease Control and Prevention partnerships with external behavioral and social scientists: Roles, extramural funding, and employment.

The Centers for Disease Control and Prevention (CDC) must have strong external partnerships with behavioral and social scientists to refine and carry out its research and programmatic mission. This article examines funding, employment, and other mechanisms used to develop and foster such partnerships. The authors describe in detail funding mechanisms (especially the often-used cooperative agreement and contracting mechanisms) and identify specific sources of information about funding opportunities. Furthermore, they describe several different long- and short-term employment mechanisms that can be used to link CDC staff and external behavioral scientists. Finally, external behavioral and social scientists can serve in important roles as members of CDC advisory committees, peer reviewers of funding applications, and consultants; examples of these opportunities are also provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral and social sciences at the Centers for Disease Control and Prevention: Critical disciplines for public health.

The mission of the Centers for Disease Control and Prevention (CDC) is to promote health and quality of life by preventing and controlling disease, injury, and disability. Fifty years ago, CDC's efforts were focused on epidemiologic and laboratory studies of malaria, typhus, and plague. Today, CDC's activities cover a broad range of diseases and conditions, and a broader range of disciplines are required to address these diverse public health problems. The behavioral and social sciences have a critical role to play in helping the public understand risk group characteristics and the frequency, context, and determinants of risky behaviors and in developing, implementing, and assessing prevention programs. CDC is taking steps to foster an environment in which behavioral and social sciences can flourish and to integrate these sciences into all of CDC's prevention activities. Other articles in this section describe the breadth and nature of the contributions of behavioral and social sciences at CDC. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral scientists at the Centers for Disease Control and Prevention. Evolving and integrated roles

BACKGROUND: We assessed the diagnostic usefulness of endoscopic ultrasonography (EUS) for choledocholithiasis. METHODS: A prospective series of 155 patients with suspected choledocholithiasis all underwent EUS, conventional ultrasonography, CT, and ERCP. In 142 patients with a clear cholangiogram on ERCP, we analyzed the capability of EUS to image the extrahepatic bile duct and to identify choledocholithiasis, compared with ultrasonography and CT. RESULTS: No complications were encountered in performing EUS. In 51 patients, ERCP demonstrated bile duct stones, which were confirmed at endoscopic sphincterotomy or surgery. The extrahepatic bile duct was wholly displayed in 96% by EUS, in 60% by ultrasonography, and in 80% by CT. EUS (96%) was more sensitive than ultrasonography (63%) and CT (71%) for detecting choledocholithiasis (p < 0.001). Although ultrasonography and CT were poorly diagnostic for choledocholithiasis in patients with small stones or those with a nondilated common bile duct, EUS was able to accurately detect choledocholithiasis regardless of the size of stones or the diameter of the bile duct. The specificity of EUS (100%) was higher than those of ultrasonography (95%) and CT (97%). CONCLUSIONS: EUS, a safe imaging procedure, is more accurate than ultrasonography and CT and may be as accurate as ERCP for diagnosing choledocholithiasis.     

The L5178Y/tk+/- mouse lymphoma specific gene and chromosomal mutation assay a phase III report of the U.S. Environmental Protection Agency Gene-Tox Program

The L5178Y/tk+/- (-)3.7.2C mouse lymphoma assay (MLA) which detects mutations affecting the heterozygous thymidine kinase (tk) locus is capable of responding to chemicals acting as clastogens as well as point mutagens. Improvements in the assay to enhance detection of this spectrum of genetic events are summarized, and criteria for evaluating the data are defined. Using these criteria, the Phase III Work Group reviewed and evaluated literature containing MLA results published from 1976 through 1993. The data base included 602 chemicals of which 343 were evaluated as positive, 44 negative, 18 equivocal, 54 apparently inappropriate for evaluation in this test system with the published protocols, and 142 that were inadequately tested, and thus a definitive call could not be made. The overall performance of the assay is summarized by chemical class, and the outcome of testing 260 chemicals in the MLA is compared with Gene-Tox and National Toxicology Program evaluations of rodent carcinogenesis bioassay results for the same chemicals. Based on the Work Group's evaluation of published MLA data for chemicals that were considered adequately tested, it is concluded that for most chemicals the L5178Y/tk+/- mouse lymphoma assay is eminently well suited for genotoxicity testing and for predicting the potential for carcinogenicity.     

Resource Use and Environmental Emissions of U.S. Construction Sectors

Reducing the environmental effects of construction is a continuing professional and social concern to promote sustainable development. In this paper, we estimate the major commodity and service inputs, resource requirements, and environmental emissions and wastes for four major U.S. construction sectors as defined by the Department of Commerce: (1) highway, bridge, and other horizontal construction [0.6% of the 1992 U.S. gross domestic product (GDP)]; (2) industrial facilities and commercial and office buildings (1.5% of GDP); (3) residential one-unit buildings (1.9% of GDP); and (4) other construction (towers, water, sewer and irrigation systems, railroads, etc.) (2.4% of GDP). Our estimates include the entire supply chain of material, energy, and service suppliers for these sectors with the use of a detailed 1992 input-output model of the U.S. economy and publicly available environmental data. We find that in general, the four major U.S. construction sectors appear to use fewer resources and have lower rates of environmental emissions and wastes than their share of the GDP might suggest.     

Behavioral science activities at the Centers for Disease Control and Prevention: A selected overview of exemplary programs.

Behavioral research and surveillance activities are conducted across the Centers for Disease Control and Prevention (CDC). This article highlights activities in 4 program areas: violence against women, tuberculosis elimination, HIV prevention, and occupational health. The unique constraints and opportunities of each organization and program focus have shaped the way research has developed in each of these areas. Behavioral scientists also face many common challenges at CDC. Despite the difficulties of integrating behavioral research into an institution that historically has focused on biomedical and epidemiological research, behavioral scientists have made important contributions to public health. Many opportunities remain for psychologists to translate theory and operationalize constructs for use in solving important public health problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Holland in Iceland revisited: An emic approach to evaluating U.S. vocational interest models.

An emic approach was used to test the structural validity and applicability of Holland's (1997) RIASEC (Realistic, Investigative, Artistic, Social, Enterprising, Conventional) model in Iceland. Archival data from the development of the Icelandic Interest Inventory (Einarsdóttir & Rounds, 2007) were used in the present investigation. The data included an indigenous pool of occupations and work-task items representing Iceland's world of work that had been administered to a sample of 597 upper secondary school students. Multidimensional scaling analysis and property vector fitting using Prediger's (1981) work-task dimensions were applied to the item responses to test if the RIASEC model could be identified. The results indicated that a 4-dimensional solution better explains the interest space in Iceland than Holland's 2-dimensional RIASEC representation. The work-task dimension of People–Things and the Sex-Type and Prestige dimensions were located in the 1st and 2nd dimensions of the multidimensional scaling solution, but Data–Ideas, a dimension critical to the RIASEC model, was not. The 3rd and 4th dimensions did not correspond to any dimensions previously detected in structural studies in the United States and seem to be related to specific ecological, cultural, and political forces in Iceland. These results demonstrate the importance of selecting representative indigenous occupations and work tasks when evaluating the RIASEC model. The present study is an example of the next step in a comprehensive cross-cultural research program on vocational interests, an emic investigation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Medical care delivery at the 1996 Olympic Games. Centers for Disease Control and Prevention Olympics Surveillance Unit

CONTEXT: Mass gatherings like the 1996 Olympic Games require medical services for large populations assembled under unusual circumstances. OBJECTIVE: To examine delivery of medical services and to provide data for planning future events. DESIGN: Observational cohort study, with review of medical records at Olympics medical facilities. SETTING: One large multipurpose clinic and 128 medical aid stations operating at Olympics-sponsored sites in the vicinity of Atlanta, Ga. PARTICIPANTS: A total of 10715 patients, including 1804 athletes, 890 officials, 480 Olympic dignitaries, 3280 volunteers, 3482 spectators, and 779 others who received medical care from a physician at an Olympic medical station. MAIN OUTCOME MEASURES: Number of injuries and cases of heat-related illness among participant categories, medical use rates among participants with official Games credentials, and use rates per 10000 persons attending athletic competitions. RESULTS: Injuries, accounting for 35% of all medical visits, were more common among athletes (51.9% of their visits, P < .001) than among other groups. Injuries accounted for 31.4% of all other groups combined. Spectators and volunteers accounted for most (88.9%, P < .001) of the 1059 visits for heat-related illness. The rates for number of medical encounters treated by a physician were highest for athletes (16.2 per 100 persons, P < .001) and lowest for volunteers (2.0 per 100). Overall physician treatment rate was 4.2 per 10000 in attendance (range, 1.6-30.1 per 10000). A total of 432 patients were transferred to hospitals. CONCLUSIONS: Organizers used these data during the Games to monitor the health of participants and to redirect medical and other resources to areas of increased need. These data should be useful for planning medical services for future mass gatherings.     

Screening for birth defects: integrating laboratory evaluation, genetic counseling and clinical intervention

The search of inhibitors of the myrosinase enzyme and also enzymes able to transform the glucosinolates into non-toxic combinations has been carried out among the water extracts of the plants row. The inhibitor activity of the water extract of Arctostaphylos uva-ursi and its foresee acting outset-hydroquinone have been discovered. The direct dependence of the glucosinolates decompose degree from concentration of hydroquinone and quinone has been determined. The cultivation of Brassica napus cut seeds by quinone in correlation 1:100 (m:m) stopped the glucosinolates decomposition by endogenous myrosinase for 50%.     

Fifty years of applied population-based prevention research at the Centers for Disease Control and Prevention

Infantile regurgitation is a frequently occurring problem. Throughout the world, anxious parents are imploring physicians to eliminate their infant's regurgitation. General practitioners, pediatricians and pediatric gastroenterologists strive to alleviate infantile regurgitation and its related parental stress. In this paper we define the scope of the problem and analyze the optimal, cost-efficient management approach to simple regurgitation in infants. The intent of this paper is to disseminate this information to practicing physicians and other health care professionals in an attempt to minimize the impact of this annoying problem of infancy and to eliminate confusion and expensive diagnostic tests and use of sub-optimal treatment modalities. Parental reassurance and dietary management by feeding thickened formula are important components in managing regurgitation in infants while maintaining optimal nutritional intake for adequate growth and development.     

The spatial relationship between infant mortality and birth defect rates in a U.S. city

The spatial patterns of infant mortality and birth defect rates in the Des Moines, Iowa, urban region are described as a contoured surface based on the punctual kriging of address-matched vital statistics records from The Iowa Department of Public Health. Areas defined as having high rates are shown to be sensitive to the size of the spatial filtering units. There is no correlation between infant mortality and birth defect rates in the region. The significance of areas with high rates is determined by a Monte Carlo simulation procedure. One area of high infant mortality is found in the region, which contrasts with many smaller areas with high birth defect rates in the region. The observed birth defect rate pattern is consistent with the hypothesis that each birth was equally likely to result in a birth defect, while the infant mortality pattern is unlikely to be the result of such an equal likelihood process.     

The public health approach to youth violence and child maltreatment prevention at the Centers for Disease Control and Prevention.

Millions of people in the United States suffer the consequences of violence, including physical injuries, psychological trauma, and death. Solutions to violence have traditionally been reactive. Through the lens of the public health perspective, the Centers for Disease Control and Prevention (CDC) views violence as predictable based on various contributing factors, and thus as preventable. Within CDC, the Division of Violence Prevention (DVP) leads efforts to prevent injury, death, and disability, and to reduce the suffering and medical costs caused by violence. DVP employs a multidisciplinary, public health approach to identify factors associated with violence, and to develop, evaluate, and disseminate preventive interventions. Psychology is one discipline that has contributed to our approach. The authors present a series of violence prevention initiatives funded by the CDC that are framed within a public health perspective, with attention to the contributions of psychology to youth violence and child maltreatment prevention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Deep dyslexia and the right hemisphere hypothesis: Evidence from the U.S.A. and the U.S.S.R.

Discusses the theory that asserts that the residual reading abilities seen in deep dyslexia entirely reflect the operation of an intact right hemisphere reading system rather than a partially disabled left hemisphere reading system. Evidence from an experiment with normal Ss in a report by the present author and colleagues (1983) is presented, which suggests that the right hemisphere contains no lexical entries for abbreviations that can be accessed by visual presentation. Data are presented from studies by K. E. Patterson (1980; see also PA, Vols 63:12203 and 64:10691) on 2 male deep dyslexic's understanding of printed abbreviations, along with observations of a young female deep dyslexic who was tested on understanding of abbreviations and on letter-naming abilities. Considerable sparing of the ability to obtain semantic information from printed abbreviations was evidenced in all 3 Ss. This contrast suggests that the current right hemisphere account of the residual reading abilities seen in deep dyslexia is not a sufficient one and should be modified. (French abstract) (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Control of workers' compensation claims and costs in the U.S. Army

The Army Medical Department has been implementing initiatives to reduce workers' compensation claims and costs since 1983. After years of an upward trend, reductions in both costs and claims were reported for 1995 and 1996. To assess efforts at managing workers' medical care and compensation in the Army, we reviewed Department of Defense and Department of the Army documents and studied data on claims and costs. We found several programs that were launched to control claims and associated costs. None of these programs adequately addressed the absence of real-time financial incentives for reducing compensation costs, a lack of acceptable workers' compensation data collection and data management systems, and a lack of emphasis on medical case management. To sustain this trend of decreased costs and claims, the Army must focus on (1) incentives, (2) data management systems, and (3) a comprehensive plan for medically managing workers' compensation claims and costs.