Women and work: highlights of NIOSH research

This report contains the observations of 9 women who received omeprazole for severe reflux disease during different stages of pregnancy. Four patients took omeprazole at the time of conception, and 3 of these patients continued omeprazole therapy without interruption until delivery. One patient discontinued therapy in the 8th week of pregnancy but had to take the drug again from the 28th week to delivery. The other 5 patients started therapy in weeks 24, 30, 33, 34 and 36 of pregnancy because of bleeding in 2 patients and unbearable H2 receptor refractory reflux symptoms in the other 3 patients. All patients were carefully monitored. In all cases omeprazole was well tolerated. No severe side effects were observed in any of the mothers or their newborns. No malfunctions or malformations were observed in the newborns. Follow-up of the children between 2 and 12 years showed normal development in all children. These data together with the data on 8 such pregnancies published by other authors suggest that omeprazole is safe when given during pregnancy at whatever phase.     

Discerning the future of early childhood intervention.

Examines the recent history of early childhood intervention efforts. Major views and principles that guided the formation of intervention programs in the 1960's and 1970's are considered: the deficit model, the focus on intelligence, the critical period formulation, and the overriding spirit of optimism. A major focus is the Head Start program and lessons learned from its development. Issues involved in evaluating intervention programs are discussed, including the nature of appropriate measures, timing, and persons to be assessed. Intensive and structured programs are compared with ones following a looser family-support approach. (63 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical research: any future?

Monochloramine has been suggested as an alternative disinfectant to chlorine to reduce levels of trihalomethanes in treated drinking water, but little is known of the toxicological properties and potential health implications of by-products specific to the chloramination process. Model aqueous fulvic acid solutions (200-400 mg C/liter), serving as surrogates for humic surface waters, were chloraminated over a range of molar Cl:C ratios from 1:40 to 1:2. The resulting by-products were extracted into diethyl ether at pH 2 and investigated with the Ames plate incorporation assay. Extractable mutagenicity increased with increasing chlorine and carbon dose up to about 30,000 revertants/liter at Cl:C ratios of 1:2. Mutagenicity was higher in Salmonella typhimurium strain TA100 than in strain TA98, and was decreased in the presence of S9, indicating that the mutagens formed were direct-acting and induced predominantly base-pair substitutions. Bovine serum albumin decreased slightly, and glutathione reduced greatly, the mutagenic activity detected in extracts. HPLC fractionation of the by-products indicated that most of the mutagenic activity was found in the earliest-eluting (most polar) fraction. The mutagenic by-products appeared to be qualitatively similar to 3-chloro-4-dichloromethyl-5-hydroxy-2-(5H)-furanone (MX) in their chromatographic behavior and responses to glutathione and bovine serum albumin, but were less readily detoxified by S9 than was MX.     

Summary and recommendations for future research

A novel triblock copolymer of epsilon-caprolactone (CL) and ethylene oxide (E), CL6E90CL6, intended for use in implantable drug-delivery systems, has been subjected to gamma irradiation, in the solid state and in aqueous solution, under different controlled environmental conditions, to assess its stability to a radiation sterilization process. When copolymer matrices were irradiated with doses of irradiation up to 72 kGy in the presence of oxygen, negligible changes were observed in the molar mass, molecular mobility (assessed by pulsed nuclear magnetic resonance spectroscopy) and thermal properties. However, irradiation of matrices in the absence of oxygen (anoxia) induced the formation of cross-links, as indicated by a reduction in the molecular mobility of the copolymer, but without affecting its molar mass and thermal properties. Gamma irradiation of aqueous solutions of CL6E90CL6 in the presence of oxygen induced random polymer chain scission, as evidenced by a reduction in the molar mass, and the formation of a distribution of copolymer chain lengths in solution. Nuclear magnetic resonance relaxation studies showed that irradiation of solutions of CL6E90CL6 at concentrations greater than 4% w/v under anoxic conditions with doses of 54 kGy produced polymer gels with a network structure. These differences in the effects of gamma irradiation on the physicochemical properties of CL6E90CL6 might be germane to the method selected for sterilization of the polymer before its use in implantable drug-delivery systems.     

The future of HPV testing in clinical laboratories and applied virology research

BACKGROUND: Human papillomaviruses (HPV) are now considered etiologic agents of cancer of the uterine cervix. Adjunctive diagnostic procedures for the detection of HPV infection could increase the sensitivity of primary and secondary screening of cervical cancer. HPV testing could also improve the specificity of screening programs resulting in avoidance of overtreatment and saving of costs for confirmatory procedures. OBJECTIVES: To review the rationale of HPV testing in genital diseases and the potential applications of HPV DNA detection methods for clinical and epidemiological purposes. RESULTS: Progression of HPV infection is associated with the persistence of HPV infection, involvement of high-risk HPV types, high HPV viral load in specimens, integration of viral DNA and possibly the presence of cofactors. The design of HPV diagnostic tests will need to take into account these parameters of disease progression. HPV DNA detection techniques based on signal-amplification are standardized, commercially available and detect several high-risk HPV types. They increase the sensitivity of screening for high-grade and low-grade lesions. Although they may yield false-negative results in the presence of significant HPV-related disease, new test formats could resolve this weakness. Amplification techniques are ideal instruments for epidemiologic purposes since they minimize misclassification of HPV infection status and allow for the detection of low viral burden infections. They are currently not readily applicable to diagnostic laboratories. CONCLUSIONS: Before recommending HPV testing, prospective trials of untreated LSIL with HPV testing as well as the determination of the efficacy and cost-effectiveness of novel HPV tests, need to be completed.     

NIOSH research initiatives to prevent back injuries to nursing assistants, aides, and orderlies in nursing homes

Over the past 100 years, advances in nutrition, modern medicine, public health, and a multitude of public health improvements have increased the life expectancy of U.S. residents. The fact that Americans are living longer has resulted in extensive growth in our elderly population and a rapid employment growth that delivered about 2 million new jobs between 1980 and 1989 in the health care workforce. The Bureau of Labor Statistics Injury and Illness Data for nursing homes rose from 10.7 to 18.6 injuries or illnesses per 100 full-time workers between 1980 and 1992. The injury and illness rates among nursing home workers are partly due to the physical stress of providing round-the-clock assistance with the basic activities of daily living, such as getting in and out of a bed or chair, as well as bathing and toileting. The National Institute for Occupational Safety and Health (NIOSH) is conducting a series of research studies to identify strategies to reduce the risk of musculoskeletal injuries to workers in nursing homes. NIOSH has funded two laboratory evaluations of resident transferring methods and one field study in an actual nursing home. The purpose of this paper is to describe the key findings from past NIOSH research initiatives and to present an overview of future research.     

The future of risk factor research in understanding the etiology of eating disorders

This article explores whether particular risk factors are best seen as precursors or as symptoms. Psychological, cultural, family, developmental, and biological risk domains that may be important in the etiology of eating disorders are briefly reviewed. We describe a 4-year prospective study assessing a wide range of risk factors for development of eating disorders in a large school-based sample of adolescents. For subjects who were relatively asymptomatic, a personality or temperamental characteristic of negative affect/esteem measured at study entrance was the only significant predictor of later risk score for both girls and boys. The significant comorbidity demonstrated in a separate group that had high risk for eating disorders suggests that negative affectivity may be a vulnerability factor for overall psychopathology rather than a predisposition specifically for eating disorders. Following subjects through the young-adult years and later may further clarify the range of influences affecting disordered eating. Primary prevention and early intervention programs in the schools are also recommended.     

The future of play therapy: Elevating credibility through play therapy research.

Elevating credibility in play therapy through research has been a difficult task. This difficulty is represented well in the Myth of Sisyphus (wherein Sisyphus is cursed with the mandate of rolling a large boulder up a hill, only to have it roll back down every time he approaches the top of the hill). Play therapy, in some form, has been in mental health clinics, clinician’s offices, and in journals for more than a century—yet empirical research on play therapy has consistently lagged behind practice. Also, we have several decades of research supporting the use of play therapy in addressing many common childhood problems, yet there is little recognition of play therapy as an “empirically supported treatment.” To stretch the Myth of Sisyphus just a bit, if we are to see the effort to develop empirical support for play therapy as our task, we need to look carefully at who is pushing the boulder, what strategies are being used to get the boulder up the hill, and how we will we know when we’ve reached the top of the hill. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

人工干预对妇科腹腔镜术后患者肠功能恢复的影响

目的:观察不同人工干预方法对妇科腹腔镜手术后患者肠道功能恢复的影响.方法:随机观察90例患者,分为三组,每组30人,年龄从20岁至66岁.对照组30例患者,年龄20岁至66岁,观察组①采用开塞露20ml于术后第二天9时入肛,观察组②对无肠道损伤者采用酚酞片2片手术后第二天9时口服,观察组③采用新斯的明0.5mg于手术后第二天9时肌注.结果:经人工干预后,观察组患者不同程度缩短了排气、排便的时间.结论:人工干预对妇科腹腔镜术后患者肠功能恢复有很好的促进作用.     

The future of psychotherapy integration: Closing the gap between research and practice.

Over the past several decades, the field of psychotherapy has become more receptive to the idea of integration. For the most part, efforts have been made to find commonalities and complementarities across different theoretical orientations. When the Society for the Exploration of Psychotherapy Integration (SEPI) was formed in 1983, its stated goals were for the integration of different approaches to therapy, but also for the integration of research and practice. This article comments on the long-standing gap between practice and research, and offers ways in which this gap may be closed. Moreover, in light of increasing demands for accountability, it is maintained that empirical pragmatism needs to be the integrative theme of the 21st century. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of personal variables on work-related low-back disorders and implications for future research

Work-related low-back disorders (LBDs) continue to be one of the single largest sources of compensation costs. The relative contributions of personal, workplace, organizational, and environmental variables to the development and severity of LBDs are not completely understood. The inclusion of personal variables in epidemiologic studies of LBDs has been inconsistent, and different authors have different opinions concerning the importance of such variables. Personal variables either known or suspected to influence outcomes are discussed to elucidate the importance of these variables with respect to understanding LBDs and conducting epidemiological studies in industry. The authors suggest that age, gender, injury history, relative strength, smoking, and psychosocial variables be studied further, and that height, weight, pathologies, genetic factors, maximum oxygen uptake, and absolute strength are unlikely to produce significant effects in industrial populations.     

The future of testing: A research agenda for cognitive psychology and psychometrics.

Discusses social and educational demands of the present and future and examines current research in cognitive and developmental psychology that can influence the development of new psychometric methodology. Research on the diagnosis of performance regularities at different levels of learning and development should contribute to assessment measures that provide information useful for instructional decision and guidance. Investigation of the structure and cognitive processes of highly competent performers in various knowledge domains is beginning to suggest techniques for assessing the attainment of increasingly complex levels of skill and understanding. Research on information processing models of aptitude measures and self-monitoring skills is providing an understanding of the abilities for learning tested by intelligence and aptitude tests. Understanding of how these abilities are acquired is a prerequisite to facilitating their acquisition. It is concluded that these advances in the study of cognition should contribute to redressing social concerns about testing and assessment in education. (59 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The safer choices project: methodological issues in school-based health promotion intervention research

Randomized trials of school-based health promotion programs present unique design and analytical issues not widely discussed in the research literature. This article describes the Safer Choices study--a school-based program for prevention of HIV, other sexually transmitted diseases, and pregnancy--to illustrate critical methodological issues involved in large-scale, school-based intervention trials, particularly those evaluating interventions with a school-wide focus. The issues presented are: 1) comparability of the intervention and control groups even when few units are randomized; 2) factors that affect the decision to use a cohort or cross-sectional design; and 3) appropriate analysis strategy when the unit of randomization and intervention is at the school level, but observations are at the student level.