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[The effects of spatial information for cognitive distance in an architectural space].

The present study investigated the effects of the spatial information for cognitive distance in an architectural space. One hundred undergraduate students participated in the experiment, and they were divided into two groups. The control group (CG) was given the pictures of both ends of the routes, and the experimental group (EG) was given some scenes of the routes in addition to the ends. The subjects have used the building used for the experiment for more than 2 years, and they estimated each walk of the 10 routes in the building. Each of those routes (50 m-144 m) is longer than the standard route (34 m). Before estimating the distance, the pictures were given on display through World Wide Web with questionnaires. The ratio method was used to obtain the cognitive distance data. As a result, the cognitive distance data of both groups showed similar distribution, and the cognitive distance data of EG were longer than those of CG in all routes. However, the effects of the number of the pictures were varied. These results suggested that not only the amount of the spatial information (i.e., chair, pillar, garbage box) but also the subjects' cognitive processing of the information affected the cognitive distance.

Cognition↗

Man and polar bear in Svalbard: a solvable ecological conflict?

The objective of this study is twofold. First, it is to assess the nature and magnitude of the polar bear-human conflict with respect to injuries to man and bear. Second, a major concern has been to minimize injurious interactions in order to safeguard the people who live and work in the Arctic, and, at the same time, secure the future of the polar bear in one of the last relatively unspoiled habitats on earth for big carnivores. From 1971 to 1995, approximately 80 bears were involved in serious bear-human interactions. Of these, 77 bears were killed and 3 escaped after having injured people. During the same period, 10 people were injured, 4 of them fatally, in 7 separate interactions, each involving a single bear. None of the victims carried an appropriate firearm. The circumstances leading up to the confrontations give strong reasons for supposing that the majority of the attacks were predatory in nature. Seven of the injured, including the four who were killed, sustained bites to the head and neck. Correct use of firearms could probably have prevented all the fatalities. However, the keeping and use of firearms caused two accidental deaths in the same period. We conclude that alertness, the absence of attractants (food, garbage), and appropriate bear repellents to secure field camps are important items in preventing conflicts and should always be available. However, as a last but indispensable resort, a firearm (rifle or shotgun) carried by an experienced user is the only safe precaution for avoiding injuries in polar bear country. Killing a bear on the rare occasions when humans are in danger presents no threat to the bear population. With regard to physical injury to people, the problem is a minor one. Bears have a dual impact on everyday life in the Svalbard settlements. While there is some anxiety related to the presence of bears, the polar bear is a source of breathtaking adventure highly valued by both residents and visitors.

Adult↗

Waste not--want not.

The waste budget rarely gets the attention it requires. After all, c'mon it's garbage. We produce it and it costs money to get rid of it. There's nothing we can do about it. Sound familiar? We feel as if we have a handle on it when we negotiate to receive the lowest bid, but our efforts can not stop there. Do we really know what we-re getting for our money? Do we really need everything that is being suggested by the hauler? Are we investigating every avenue that involves waste or are we wasting valuable dollars? With the ever increasing need to find savings, let's look for in in our waste. The following overview of current waste issues is Part One of a guide for the review of practices and potential opportunities. The second part will appear next month.

Cost Control↗

Disposal of hazardous pharmaceuticals.

The literature contains very little information regarding the disposal of pharmaceuticals. This article examines this topic from the viewpoint of hospital pharmacists. Environmental, safety and legal factors are discussed. Of the three most common disposal methods available (i.e. sewer, landfill, and incineration), incineration is the preferred method of destruction. If this method is unavailable, discriminate disposal via the sewer or garbage (landfill) systems is acceptable. Special disposal precautions are discussed for biologicals (autoclaving and then incineration), antineoplastics (incineration or neutralization before disposal via sewer or landfill systems), and radiopharmaceuticals (disposal according to the recommendations of the Atomic Energy Control Board).

Antineoplastic Agents↗

Wellness and prevention: educating the family and contacts.

Historically, the healing arts have been devoted to curing those already sick. Only in recent decades has disease prevention by vaccination, quarantine, regulation of food, water and drugs, proper garbage and water disposal and health education become procedures utilized by the medical and allied health practitioners. Today, maintenance of wellness is the novel but desirable role to be undertaken by health professionals. To do this, doctors and allied health personnel must become conversant with information from many scientific and social disciplines, must become skillful communicators and teachers, and must be personal examples of wellness. This role - especially of education and communication - must be carried out not only with clients but also with the family and contacts of patients.

Health Education↗

A survey of houseflies in bangkok and neighboring provinces.

A survey of flies in Bangkok and neighboring province revelaed that among 8,675 flies collected there were 10 genera and 18 species of flies, eg. Musca domestica, M. bezzii, M. conducens, M. nebulo, Chrysomyia megacephala, C. rufifacies, Phaenicia sericata, P. cuprina, Sarcophaga ruficornis, S. peregrina, S. orchidae, S. albiceps, Megaselia scalaris, Lispe orientalis, Anaclysta flexa, Morellia hortensia, Hemipyrellia ligurriens and Orthellia coeruleifrons. Musca mostly bred in low-protein content media, eg., garbage piles of vegetable and rice, and was predominant in the morning while Chrysomyia and Phaenicia mostly bred in high-protein content media, eg., animal carcasses, and were predominant in the afternoon. Female flies were bigger than male and they were more predominant than males in or around breeding places. The density of flies was correlated with the relative humidity but not with rainfall or temperature. The density of flies was correlated with the occurrence of gastrointestinal diseases. Some cases of myiasis have been reported from Thailand.

Animals↗

[Medical care and environmental hygiene in Mexico City from the 16th through the 18th century].

This paper deals with public health in Mexico City from the 16th to the 18th century. The first part is about sickness and epidemics; the origin of a very high concerned with death rate at that time; general and private hospitals foundations, and about the role of the Church, Medical Board and the Viceroy in Health Care and Preventive Medicine. Medical care was efficient in these aspects. The second part deals with public services concerning public health as a clean environment and streets and collecting garbage, problems that caused sickness according to the ideas of those days. A clear environment was good until the second half of the 18th century. The paper is divided as follows: introduction; sickness and epidemics; medical care; actions against epidemics; public services, and final commentary.

Delivery of Health Care↗

[The incidence of Culicidae in an urban area of Ciudad de La Habana during 1995].

In the present paper it is made an analysis of the incidence of culicides in the municipality of Marianao, Havana City, during 1995, after following the requirements of the National Program for the Eradication of Aedes aegypti. 6 species of mosquitoes were found in the municipality, with a predominance of the Culex quinquefasciatus and Aedes mediovittatus species. 4 focuses of Aedes aegypti were detected during this period. It was found that the groups of deposits preferred by the culicides for their breeding in this municipality were other deposits, low tanks, artificial deposits and larva traps. The People's Councils 4 and 5 (Libertad and Pogolotti) had the highest number of focuses (967 and 1,240, respectively, and therefore, they need more attention. It is analyzed the influence of the deficiencies of the public services, such as the collection of solid, wastes (garbage) and the existence of leakages and sewing overflows, on the proliferation of mosquitoes in the municipality.

Animals↗

[Changes in the kidneys in patients with successive findings of Mycobacterium xenopi and Mycobacterium fortuitum in the urine--report of 16 cases]].

INTRODUCTION: Environmental or MOTT (mycobacteria other than tubercle bacilli) mycobacteria are found in both living environment and most of the food we consume. These mycobacteria can induce a disease in humans, although they rarely do. There are a few reports of urogenital infections caused by these bacteria. This is a report of 16 patients with successive findings of Mycobacterium xenopi and Mycobacterium fortuitum in the urine. MATERIAL AND METHODS: In patients suspected for a specific disease of the urogenital tract 7-10 morning urine samples were sent for a bacteriological analysis before initiating any therapy. The samples were treated by 2% NaOH, neutralized by 1% HCl and cultivated on four UIT media with penicillin and acid additives. The cultivated media were incubated at 37C and followed for a potential growth for up to three months. Growth-exhibiting cultures were submitted to a further cultural and biochemical investigation, applying antituberculotic sensitivity tests and a biological probe when needed. The study included 6,468 patients. Finding of mycobacteria was registered in 180 (2.78%) patients. Of them, 164 had Mycobacterium tuberculosis while 16 patients had successive urine culture findings of MOTT bacilli: Mycobacterium xenopi--14 patients or Mycobacterium fortuitum--2 patients. RESULTS: Of 180 patients with positive bacteriologic urine finding, 164 (91.11%) had Mycobacterium tuberculosis and 16 (8.89%) had MOTT bacilli. Of the latter 16 patients, Mycobacterium xenopi was found in 14. They were all females aged 14-64 yrs. MOTT bacilli were secreted in certain time intervals, ranging from a month to nine years. The bacteria were registered successively, at the frequency rate of 6-53 times. Even 5 of 14 patients worked at the Institute for Lung Diseases as either a nurse, laboratory technician, cleaning lady or an officer at the bacteriologic material admission unit. The evidence of patho-anatomic renal changes was obtained from 11 of 14 patients, including a deformed pelvic system of the kidney, a dilated pelvis of the kidney, papillary ulceration, cystic formations, calcification, hydronephrosis and the presence of concrements. Cystic lesions were the most common ones, registered in 7/14 patients. Regarding functional disorders, haematuria, leukocytes in the sediment, proteinuria and renal colics were most frequently registered. Two patients with successive findings of Mycobacterium fortuitum were presented with neither significant patho-anatomic nor functional renal disorders. DISCUSSION: The following conclusions have emerged from the comparative analysis of the findings: the most common source of Mycobacterium tuberculosis is an infected person. The disease is transmitted by a droplet infection. Smear positive patients infect 50-63% of their family members. The renal disease induced by these bacteria is hematogenous in origin and is always associated with a former extrarenal infection. The infection is bilateral, but always manifested in one of the kidneys only. The symptoms of the infection appear in diverse combinations. The most common is a combination of dysuria and albuminuria, while 20% of patients are asymptomatic. The most effective diagnostic procedures are bacteriologic urine test for mycobacteria and intravenous pyelography. A combined antituberculotic 6-9-month treatment is usually effective. Regarding environmental mycobacteria (MOTT), their host is still obscure. The external environment contains them in abundance, but they are not transmitted from one person to another. The MOTT bacteria's habitat can be earth, water, waste waters, garbage, plant material, sphagnum of the swamp vegetation. They colonize the water-pipe systems in towns and are found in the biofilm which coats the water pipes. Water chlorination does not affect their development. They are also found in country yards, animal farms, raw milk and butter, fruit and vegetables. They are also registered in the house dust, in art

Adolescent↗

Evaluation of groundwater pollution potential of sewage-irrigated vegetable growing areas of the eastern fringe of Calcutta city.

In recent years recycling in agriculture is a common method of disposal or utilisation of waste. However, recycling of wastes may cause contamination of groundwater by toxic elements like heavy metals, cationic and anionic contaminants and pathogens. Groundwater of shallow and deep tubewells was collected during 1991 to 1997 from raw sewage effluent irrigated garbage farming areas on the eastern fringe of Calcutta city. In general raw sewage effluents, sludges and sewage-irrigated soils contain very high amounts of cations, anions, organics and heavy metals. It is found that most of the groundwater contained undesirable pH, total dissolved solids, total hardness, calcium, magnesium, phenolic compounds, iron and manganese and the observed values or concentrations were much above the maximum desirable limits specified by World Health Organisation (WHO) and Bureau of Indian Standards (BIS) for use as drinking water. Groundwater of that area may be used for irrigation. Dispersion by leaching of the metals, cationic and anionic contaminants from irrigated soil and from settled bottom sludge in unlined sewage channels are the principal causes of groundwater contamination. Some management plans have been suggested to control further deterioration of groundwater quality.

Agriculture↗

Clinical capital equipment acquisition: decision-making at the executive level.

Capital investment in the United States health care industry is one of the components of the system that has historically fueled cost increases and complicated the quality/cost/access conundrum. This article is concerned with capital development focused on clinical equipment acquisition in acute care hospitals. The research findings suggest that decision-makers are abandoning two approaches to decision-making known as Quantitative Decision-Making and Mixed Scanning in favor of two models known as Rational Decision-Making and Political Decision-Making. While this is the case, a method of decision-making known as Idea Sets (developed and labeled by James March as Garbage Can Decision-Making) is the most widely used approach. Equipment acquisition criteria used by the decision-makers are shifting away from concerns of enhancing existing clinical programs and/or adding new clinical programs. Acquisition criteria are shifting toward procuring equipment which will decrease institutional expense, improve organizational efficiency, and galvanize operational effectiveness. In addition to the technical findings of the research, further insights about ourselves and our colleagues are gleaned. Accordingly, we understand more completely the human dynamics surrounding decisions and thus are able to dialogue more richly about issues. Meaningful dialogue such as this will have the dual benefit of advancing teamwork and facilitating decision-making.

Capital Expenditures↗

[Knowledge, opinions, and practices regarding Aedes aegypti].

The active participation of the community is indispensable for reducing Aedes aegypti mosquito populations so causes leading to their growth, actions taken, effects on the health and the people in charge of controlling such mosquitoes are all dealt with in this paper. 210 persons were interviewed from June 25 to 27, 1997. The causes of the growth of the mosquito population were: excessive garbage (59%), dirty waters (58%), open water reservoirs (50%) and lack of fumigation (21%). 40% of interviewed people did not know that these vectors can breed even in clean waters. They mentioned some effects on the health due to the mosquito bites. 51% said that mosquitoes should be jointly controlled by the State and the community but 35% believed that the State should be the sole responsible for this task. These opinions may determine that steps are not properly taken to avoid proliferation of vector and that the activities of the anti-vector program are not really understood since they do not meet the expectations.

Adult↗

[Self-impalement after thoracic stab wound. An unusual method of suicide in psychotic symptomatology].

A 35 year-old male was found dead within a vast collection of garbage in his parent's house with 13 stab wounds of the thorax. 6 years before death he had suffered from a severe cerebral trauma with intracranial hemorrhage, after which an organic psychosis had ensued. At autopsy besides the stab wounds measuring 1-3.5 cm in length and partly exhibiting a so-called "fish-tail" formation a piece of wood was detected, having penetrated the fourth intercostal space along the sternal border and lacerated the pericardium, right pulmonary hilum and the pleura parietalis at the paravertebral line between the eight and ninth rib. There the leading part of the tool had apparently broken and bent to the left in a nearly 90 degrees angle, thus penetrating the left pleural cavity with a slight laceration of the lower lobe of the lung. From the forensic pathologist's point of view this case of multiple stabbing and additional impalement was at least remarkable and at first sight might have raised a suspicion of homicide due to the extent of the rib penetrations and especially the intrusion of the wooden device, which had been pushed by substantial force into an already existing wound. The police presupposed a suicide based on the personal history and situation at the site, where no traces suggesting an activity of somebody else could be ascertained. Reconstruction of the case and resulting differential diagnostic considerations are to be discussed.

Adult↗

[Hypersensitivity pneumonitis in Mexico City].

OBJECTIVE: To investigate the association between the urban area of origin of patients and the prevalence of hypersensitivity pneumonitis (HP), induced by avian antigens. MATERIAL AND METHODS: A case-control study was conducted in 1999 at the National Institute of Respiratory Diseases (NIRD). Cases were 109 consecutive HP patients and controls were 184 patients: 39 with idiopathic pulmonary fibrosis (IPF), 63 with pulmonary tuberculosis (PTB), and 82 with asthma. Mexico City and surrounding counties (SC) were divided into 5 geographical areas: 1) Downtown; 2) North-East (NE); 3) South-East (SE); 4) North-West (NW) and 5) South-West (SW). Statistical analysis consisted of calculation of disease prevalence by urban area; associations were assessed with odds ratios and 95% confidence intervals. Multivariate analysis with multiple logistic regression was performed to adjust for age, gender and socioeconomic level. RESULTS: Eighty HP cases were located in the NE southernmost and SE northernmost areas of Mexico City (48 and 32, respectively) (OR = 3.86; 95% CI 2.17-6.96). Thirty-six controls with asthma came from the SW area, (where NIRD is located) (p < 0.05), and four from SC. Controls with PTB and IPF were scattered throughout the study area. CONCLUSIONS: The NE southernmost and SE northernmost areas were associated with HP. The cause of HP may not be geographical; a garbage dump used to be located in this area, suggesting that exposure to organic particles might contribute to the development of HP in susceptible individuals.

Adult↗

Occupational hazards of municipal solid waste workers.

The removal of municipal solid waste is a job associated with a variety of physical, chemical, and biological hazards. Municipal solid waste workers (MSWWs) have a risk of fatal occupational injuries that is much higher than for the general workforce. Among this group of workers, non-fatal injuries are mainly musculoskeletal. Other common injuries are fractures, ocular trauma, and bites, and diseases include skin and gastrointestinal disorders. Workers at municipal solid waste incinerators are exposed to a variety of concerning substances, such as heavy metals, respirable quartz dust, dioxins, furans, and mutagens. Workers can be protected by using safety procedures on and around garbage trucks and with personal protective equipment. The burden of morbidity due to occupational exposure to bioaerosols and carcinogens among MSWWs is unknown.

Accidents, Occupational↗

[Effect of polycyclic aromatic hydrocarbons on the immune system].

Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous compounds in our environment. They are formed during incomplete burning of coal, oil, gas, wood, garbage or other organic substances such as tobacco and charbroiled meat. PAHs enter the environment mostly as releases to air from volcanoes, forest fires, residential wood and coal burning and exhaust from automobiles and trucks. There are more than 100 different PAHs. Some of them have danger toxic properties including mutagenic and carcinogenic potential. Since 1993 PAHs are classified as the compounds which can cause immunosuppression. They reduce the body resistance against infection and cancer diseases. Immunosuppressive, carcinogenic and hypersensitivity effects of some PAHs representatives were described well in experimental studies. On the other hand, only sporadic information about immunological changes after long-term occupational exposure to PAHs were found from existing human epidemiological database. In addition, these studies usually did not cover the complex immunological profile represented by cellular and humoral activity.

Air Pollutants↗

[Urbanization and dengue ecology].

Demographic changes occurring in underdeveloped countries due to intense rural-urban migration since the 1960s have resulted in overcrowded cities with multiple deficiencies, particularly in housing and basic sanitation. Some 20% of the population in large and medium-sized cities live in slums or under similar conditions. Lack of regular water supply and public garbage collection foster the proliferation of potential breeding sites for Aedes aegypti (the main mosquito vector for dengue), including precarious reservoirs for potable water and disposable recipients which accumulate water, like used cans and plastic and glass bottles. Modern industries also produce large volumes of disposable materials. Propagation of the dengue virus and the spread of dengue vectors are favored by the high intensity, frequency, and speed of private and public transportation. Such factors can help explain the re-emergence of dengue, the most important arbovirus in the world today, affecting thousands of people each year.

Aedes↗

[A case of cephalic tetanus presenting with opisthotonus].

We report a case of cephalic tetanus presenting with opisthotonus. A 49-year-old man was admitted because of repeated convulsions. The patient was a garbage truck driver known to be alcoholic, who fell down to suffer an injury of the left face two days before the onset of convulsion. Intravenous administration of diazepam and phenytoin partially relieved the convulsions. Anti-tetanus human immuno-globulin was also administered despite absence of typical clinical sign. Six hours later, however, the patient became unable to open the mouth, i.e. lockjaw developed, and the diagnosis of tetanus was made. Additional anti-tetanus human immunoglobulin of 3,000 units and 4,500 units on the next day rapidly relieved the lockjaw, convulsion, and general muscle rigidity without sequalae. The patient showed transient bilateral facial palsy and rotatory nystagmus during the course. Cephalic tetaus is characterized by a history of an injury of the head and a short latency before developing generalized tonic convulsion or opisthotonus. While a typical case presents with lockjaw, our case presented with opisthotonus, presumably because of early systemic lymphatic spreading of tetanus toxin. Early diagnosis and treatment is important to prevent generalized convulsions which are more frequent and sometimes lethal in cephalic tetanus than the common form.

Facial Injuries↗