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PubMed1985

The neighborhood walk: sources of support in middle childhood.

This report documents children's perception of their involvement with self-development, family members, and members of the community and begins to test the relation between that network and aspects of social-emotional functioning during middle childhood. Support was conceptualized to include experiences of both relatedness to and autonomy from others. Three major types of reported support in this study using the Neighborhood Walk were considered: others as resources (e.g., persons in the peer, parent, and grandparent generation; pets), intrapersonal sources of support (e.g., hobbies; fantasies--structured and unstructured; skill development), and environmental sources of support (e.g., places to get off to by oneself; formally sponsored organizations with structured and unstructured activities; informal, unsponsored meeting places). One hundred sixty-eight children (72 7-year-olds and 96 10-year-olds), residing in nonmetropolitan and rural northern California and representing all but the lowest Hollingshead socioeconomic status, participated in this study. To assess their sources of support at home and in the neighborhood/community, each of these 168 children was taken on a Neighborhood Walk, and then several measures of social-emotional functioning were administered. Cross-sectional data form the empirical basis for a developmental perspective on sources of support, the structure of social-emotional functioning, and the relationship between sources of support and social-emotional functioning during middle childhood. The child's perception of support was found relevant to predicting the social-emotional functioning of children growing up in relatively secure and low-stress conditions in modern American society. Furthermore, a broad-based as opposed to a limited network and informal as opposed to formal sources of support were more predictive of social-emotional functioning. The empirical and theoretical relevance of considering middle childhood as a period of active development involving expansion and integration of social and affective phenomena was underscored by the results. First, it appears that the 7-year-olds have not yet developed the underlying response or habit clusters that characterize the 10-year-olds. Second, with respect to reported sources of support, 10-year-olds appear to have more elaborated sources of support than do 7-year-olds. Third, the findings confirm that developing a bridge to extended family and neighborhood resources is related to expressions of social-emotional functioning during middle childhood and that 10-year-olds appear to make effective use of more social support factors than do 7-year-olds.(ABSTRACT TRUNCATED AT 400 WORDS)

Adaptation, Psychological↗
PubMed1979

[Differential diagnosis of interstitial lung diseases].

It is reported on the different forms of the interstitial pulmonary diseases. Apart from the clinical examination the establishment of the professional and hobby anamnesis play an important part for the differential diagnosis. Allergologic and immunologic examination methods may contribute to the etiologic clarification. In unclear findings a bioptic ascertainment is necessary, though histologically not all cases are to be clarified. The author enters the most important clinical pictures and refers to the difficulties of the radiological differential diagnostics. Questions of therapy are briefly discussed.

Alveolitis, Extrinsic Allergic↗
PubMedDate not supplied

[The psychogenic death of Mr. J. A case report].

Numerous cases of psychogenic death have been cited throughout the world, as well by native peoples, inhabitants of concentration camps and prisoner of war camps. Psychogenic death is a generalized human extreme psychosomatic reaction. It is not specific to any culture or mentality. Psychogenic death refers to death triggered by psychic stimuli. The individual finds himself in a situation where external forces have lead to a restriction of his world and, in addition, is subjectively sensing of the inalterability of his situation. Decisive to the perception of the environment is the subjective emotional view of things which can greatly diverge reality. The physical state of these individuals is marked by total passivity. The psychic condition is characterized by regression, resignation, and apathy. The article described the psychic background and the physical process of a death by psychic phenomena. The case of a 37 year old patient with detailed anamnestic and clinical data is given. His hobby was taking photographs of natural scenery and animals. This had become vital for him, because he did not like his job. The patient suffered from a painful herniation of intervetebral disk. After the operation of the disk he still had backache. He thought that the operation had been unsuccessful. The following day the patient showed the symptoms of the psychogenic death and died within one day. The autopsy, histopathologic, and toxicologic examinations showed no indications to the cause of death.

Adult↗
PubMed1981

[Conception of the Klausenbach-Clinic for pre-geriatrics: Diagnostic, therapeutic and scientific aspects (author's transl)].

Risk-groups, cerebrovascular insufficiency without neurologic symptoms, transient ischemic attacks of the A. Carotis and/or A. Vertebralis, state after cerebral infarction. There are multidisciplinary possibilities for the consideration (internistic examination, neurologic-psychiatric examination with REM-phases patterns, permanent EEGs, power-spectrums, ultrasonic examinations, examination of the metabolism of the brain, psychologic examination with psychometric and psychopathometric procedures). There are various therapeutic employments, too (medical, psychologic-psychiatric therapy with brain-function-training, work-therapy (hobbies), and recreational activities, dietetic and physical therapy, health-talks, pension and social debates). By example of the health-talks there is shown what we mean with patient-adapted information. The scientific examinations concern retrospective studies of the anamnesis and psychometric investigations. Finally the patient-compliance is discussed.

Aged↗
PubMed1984

[Aeromonas hydrophila septicemia: 3 cases, 1 with mediastinitis].

Three cases of Aeromonas hydrophila septicaemia are reported. The first case concerned a 51 years old patient suffering from drowning who had previously been in good health and who died after a few days of refractory hypoxaemia. The second case was an 8 years old child with trisomy 21 operated for a congenital cardiac defect. The portal of entry was a catheter and the septicaemia was complicated by A. hydrophila mediastinitis, a complication which has not been described previously. The third case was a 75 years old man with no previous medical history, whose hobby was gardening. He developed septicaemia after a flu-like illness. A. hydrophila is a mobile Gram negative bacillus whose natural habitat is water. It appears to be an exceptional and temporary contaminant of the human G I tract. Clinical infection is rare and usually focal: gastroenteritis, infection of soft tissues after trauma in aquatic surroundings. In 60 out of 82 cases there was a documented deficiency in the patient's immune defenses. A digestive portal of entry was suspected in 63 cases but only rarely proved. In one of our cases the portal of entry was septic thrombophlebitis induced by an indwelling catheter; this complication has not previously been reported. The clinical picture of A. hydrophila septicaemia is characterised by the relative high incidence of Echtyma gangrenosum. The lethal outcome in 50 p. 100 of cases is often related to the patient's general condition. The sensitivity of the three cultures isolated was tested against third generation cephalosporins: they were effective in each occasion.

Aeromonas↗
PubMedDate not supplied

[Allergic contact dermatitis caused by plants].

The proliferation of house and garden plants, some of them highly sensitizing, produced by the general improvement of the standard of living, is causing an increase in the number of cases of contact dermatitis from plants with both irritative and allergic mechanisms. During the past 12 years, we have studied 43 cases of allergic eczema caused by plant contact as primary sensitization which supposes 2.4% of the patients with allergic contact dermatitis attended in our Services. The majority of patients were women (65%) as opposed to 35% men while the ages varied from 12 to 70 years with an average of 44.5. Below the age of 25 there were only 3 cases (6.9%) 12, 18 and 20 years respectively. In the clinical study, as well as the profession, secondary activities and hobbies were also evaluated. Through localization of lesions, an attempt was made to determine how the patient came in to contact with the different plants. The diagnosis was confirmed by the use of epicutaneous tests, as recommended by the ICDRG (3). Some plants in a natural state were used but etheral extracts were preferred. In cases of photo-dermatitis, photo-patch-tests were carried out using standard photo-sensitizers and suspected plants. The plants found to be responsible were: Allium (garlic) in 11 cases, Frullania in 8, Primula (primrose) in 8. Compositae (composites) in 6, Pinus (pine) in 3, Umbelliferae (umbellifers) in 3, Philodendron (philodendron) in 1, Pelagonium (pelargonium) in 1, Citrus (citrus) in 1 and Chlorophora (iroko) in 1. The frequency of reactions to garlic and primrose is particularly interesting and their characteristics will be the object of a later study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1976

Preliminary studies on the kinetics of utilization of acetate by bacterioplankton in Mikołajskie Lake.

The kinetics of the utilization of acetate by bacterioplankton in natural waters was measured according to a modification of the method of Wright and Hobbie (1965, 1966) which enabled investigations in natural conditions in the open. A number of measurements made with this method allowed the determination of the natural concentration of the substrate in lake water and potential maximal rate and time of utilization of the substrate by bacterioplankton. Measurements were made in different zones and at various depths in Mikołajskie Lake in July, August and Septemper of 1974.

Acetates↗
PubMed1984

Mortality, morbidity, and life satisfaction in the very old dialysis patient.

The average age of dialysis patients is rapidly increasing. In our present program, 20-25% of all patients are 70 yrs or older. We performed survival analysis of all 157 patients 70 yrs and above (mean age 75 yrs) and evaluated risk factors associated with dialysis survival using the Cox proportional hazards model. Morbidity, biochemical status, clinical results and life satisfaction were evaluated in a prevalence study of all 53 in-center and 26 home dialysis patients. In the survival analysis, we found improved survival since January 1, 1976, indicating improvement in dialysis technique up until that time. The 1, 3, and 5 yr survival were 78%, 47%, and 22% respectively. Only arteriosclerotic heart disease and year of entry were significant risk factors; advancing age over age 70 and in-center dialysis were only of marginal importance. The home patients had fewer dialysis symptoms than in-center patients. Almost all patients lived at home. Five patients (6%) were in nursing homes. Most patients were very satisfied with their lives, regarded their health as better than other 70 year old persons, spent time outdoors, participated in church activities, had active hobbies, enjoyed life very much, and scored high on the Karnofsky activity scale. We conclude older patients are excellent dialysis candidates and it is wrong not to consider them for dialysis.

Aged↗
PubMed1984

Faculty approaches to combating professional burnout.

The peculiar stresses of the dental educator make him or her a prime candidate for burnout and at the same time offer rather special protection against this phenomenon. The dental teacher, especially the clinical teacher, is required to spend virtually all of his time in intimate contact with students, whom he instructs, and with patients in the clinic, for whom he has responsibility. In addition, this same dental educator will probably have some kind of private practice. He will also be required, if he expects to advance in academic rank, to do research, to be cognizant of the latest developments in his field, to publish, to give presentations to his peers and to the community. This adds up to a lot that is expected of one person. Many people have expectations of him, many people crowd in on him with their demands. The situation sounds ideal for burnout. Yet, I believe that if the dental educator does what is expected, if he laces this diet of teaching and patient contact with research and library work, if he sets aside time (you may ask where he is to find it) for contemplation, for good works in the community, for hobbies, for reading, for cultural activities, then in fact the chance of burnout seems lower. And finally, if the dental educator pursues the possibilities that exist for leaves, for time away, for refreshment of his career by new contacts, new ideas, new ways of doing things, and new commitments, he will push away and hold at bay the dangers of burnout.

Adaptation, Psychological↗
PubMed1983

Hearing levels in U.S. Army engineers.

An 18-item questionnaire on otoaudiological and noise-exposure history was completed by over 900 U.S. Army engineers, of whom reference and current audiograms were collected on 209 Ss who reported no obvious ear or hearing problems and did not participate in non-military noise-hazardous hobbies or activities. Subgroups of 6 military occupation specialties were studied separately; differences among these were unremarkable in age, length of military service, and job-related noise exposure, in current HTLs and in hearing losses re reference audiogram prior to appreciable military noise exposure. Mean current HTLs were better 3, 4 and 6 kc/s by about 23, 34, and 24 db (L + L ears) than a comparably-aged group of 450 men working in industry (Glorig et al, 1957). These results augur well for the current Army hearing conservation program.

Adult↗
PubMed1982

[Personal and psychosocial problems in mastectomy for breast cancer and the possibility of adjustment].

Parts of the results of single interviews of 34 patients with carcinoma of the breast are reported. A team of physician, psychologist, and the patients themselves worked out the interviews. These were then coded and analyzed. 10 patients said that they had found it especially difficult to overcome the problems caused by their illness due to the loss of their jobs because of bureaucratic reasons. 5 patients got into financial troubles. The patients tried to get back to their previous jobs, hobbies, social contacts and holiday habits as soon as possible. In all cases the illness caused a more anxious observation of bodily sensations. 19 patients felt the loss of the breast as a heavy diminution of their female identity. These reactions were strongly influenced by the reactions of their male partners and the loss of their jobs. The loss of the breast and the awareness of the disease partly negatively, partly positively changed the emotional state and family life and in many cases caused a change of sexual behaviour. Overprotection and questions regarding the patients' health were generally felt to be stressful. 17 patients tried to avoid obtaining complete information on the disease. They were afraid of contradictory views presented by the mass media or by fellow patients they met in waiting rooms, in convalescent sanatoriums, or in self-help groups. Although, still aware of their disease, 23 patient regained a fully satisfying life-style, 3 were ambivalent. The most important factors in overcoming the problems were family, friends, and the patients' own ability to adapt. The psychosocial care was entirely insufficient, although the patients showed a great readiness to cooperate.

Adaptation, Psychological↗
PubMed1981

[Allergic alveolitis as a result of mold on the bedroom wall].

A 23-year-old woman patient became seriously ill with the typical signs and symptoms of allergic alveolitis and with deep hypoxemia during exercise. A broad spectrum of positive precipitating antibodies was found in the serum, mainly against Penicillium casei and Aureobasidium pullulans. Although she was intensively questioned on hobbies and on possible antigens at home and at work, it was only possible to trace an antigen source after a controlled antigen free period away from home in another environment and after a controlled reexposure experiment at home: it proved to be a patch of mould of 0.5 m2 on the bedroom wall. The filaments and the spores of the fungi of the mould were shown directly by microscope. Precipitating antibodies were also present against these fungi. After several antigen-free months (the patient moved into a dry and sunny new apartment) the threatening respiratory failure (severe hypoxemia during exercise) disappeared completely together with the clinical signs and symptoms. Thus, mould on bedroom walls may constitute a threat and should be considered in cases of allergic alveolitis of apparently unknown origin.

Adult↗
PubMed1982

Physician life-style management: a selective for first-year medical students.

A two-week selective is offered to medical students at the end of their first medical school year on physician life-style management. The primary objective of the selective is to enhance the quality of physician life-planning and to prevent physician disability. The course focuses on various aspects of physicians' life-styles, including practice management, health maintenance, marriage and the family, and physician disability and exposes students to actual physician practices and nonprofessional aspects of physician life-styles, for example, home life, hobbies, and civic involvement. The selective received high ratings from the students participating in the course and is believed to be helpful in the socialization of medical students into satisfying physician life roles.

Curriculum↗
PubMedDate not supplied

Blood lead levels in San Diego policemen.

Blood lead levels were measured by atomic absorption spectrophotometry in 86 San Diego policemen to see if they would reflect the known high atmospheric lead levels in San Diego. The mean blood lead for the entire group was 27.0 microgram per dl, a level very similar to that found in the general population of other cities. Work exposure to heavy traffic, area of residence, work shift and smoking did not significantly influence blood lead. Thus, an ambient atmospheric lead load ranging from 2 to 5 microgram per cubic m does not demonstrably cause higher blood lead levels in persons exposed to such air. Surprisingly, the youngest group, 21 to 25 years, had the highest mean (32.2 microgram per dl) while the oldest, 46 to 55 years, had the lowest mean (20.9 microgram per dl), a difference statistically highly significant. However, length of work as a policeman per se did not influence blood lead levels. Exposure to other known high-risk factors (hobbies, ceramics, old dwellings) was associated with higher levels (mean 30.6 microgram per dl).

Adult↗
PubMed1995

Blood lead levels in children aged 24 to 36 months in Vancouver.

OBJECTIVES: To determine the blood lead levels in children and to identify risk factors for elevated levels. DESIGN: Cross-sectional study. SETTING: Vancouver. PARTICIPANTS: Random sample of children aged 24 to 36 months, born and still resident in Vancouver. The sample was stratified proportionally by the median annual family income in the census tract where each family resided. OUTCOME MEASURES: Blood lead levels and risk factors for elevated blood lead levels, determined from a questionnaire administered to parents. RESULTS: Of the children in the sample, 42% (178/422) were ineligible or could not be located. Of the remaining children, 73% (177/244) participated and adequate blood specimens were obtained from 172. The mean blood lead level was 0.29 mumol/L (standard deviation 0.13 mumol/L). (A blood lead level of 1 mumol/L is equivalent to 20.7 micrograms/dL.) The lowest level was 0.06 mumol/L, and the highest was 0.85 mumol/L. Of children with adequate samples, 8.1% (14/172) had blood lead levels of 0.48 mumol/L or higher, and 0.6% (1/172) had a level higher than 0.72 mumol/L. The logarithms of the levels were normally distributed, with a geometric mean (GM) of 0.26 mumol/L (geometric standard deviation 1.56). Of approximately 70 possible predictors of blood lead levels analysed, those that showed a statistically significant association (p < 0.05) with increased blood lead levels were soldering performed in the home as part of an electronics hobby (GM blood lead level 0.34 mumol/L, 95% confidence interval [CI] 0.27 to 0.39 mumol/L), aboriginal heritage (GM blood lead level 0.33 mumol/L, 95% CI 0.28 to 0.39 mumol/L), dwelling built before 1921 (GM blood lead level 0.32 mumol/L, 95% CI 0.28 to 0.37 mumol/L), age of water service connection to dwelling (predicted blood lead level 0.00087 mumol/L [95% CI 0.00005 to 0.00169 mumol/L] higher per year since service connection) and decreased stature (predicted blood lead level 0.018 mumol/L [95% CI 0.0353 to 0.0015 mumol/L] higher for every standard deviation below the age-specific mean height). CONCLUSIONS: This study found much lower blood lead levels in children than those found in previous Canadian studies. The authors believe that this result is not an artefact due to differences in population sampling or methods of collection of blood specimens. The study showed no clear risk factors for elevated blood lead levels: although a few factors had a statistically significant association with increased blood lead levels, the differences in levels were small and unimportant.

Age Factors↗
PubMedDate not supplied

Identification of lead and other elements in ceramic glazes and housewares by 109Cd-induced X-ray fluorescence emission spectrometry.

Radioisotope x-ray fluorescence spectrometry was investigated as a potential screening method for Pb and other elements in housewares. Thirty-six commercial houseware items and 87 ceramic test tiles (85 fired with hobby glazes and 2 blank bisques) were examined qualitatively for the presence of Pb by using 109Cd-induced L x-ray fluorescence emission spectrometry. For the housewares, the technique provided fast, nondestructive analysis of areas with about 10 cm diameters (general regions) to about 4 mm diameters (isolated design regions). Pb was found in 25 of 28 ceramicware items, in all 8 other housewares, and in all the test-tile glazes above the limit of detection of 1 count per second (cps) for Pb L beta x-rays. For housewares, Pb identification did not always correspond to Pb leachability. For 68 test-tile glazes labeled as containing Pb (39 of which were also labeled 'dinnerware safe' or 'safe for food containers'), count rates ranged from 290 to 730 cps, whereas for the other 17 glazes labeled (with one exception) 'non-toxic,' much lower count rates (5-61 cps) were obtained. Other elements found in the housewares or test glazes were As, Au, Ca, Co, Cr, Cu, Fe, Mn, Nb, Ni, Rb, Sr, Y, Zn, and Zr.

Cadmium Radioisotopes↗
PubMed1995

[Care for patients with Pick's disease--by using their preserved procedural memory].

Pick's disease are more often complicated than Alzheimer's disease by behavioral disturbances such as social misconduct and stereotypy, that are troublesome and clinically difficult to manage. The purpose of this study was to investigate the possibility of improvement in care for patients with Pick's disease by using their presumably preserved procedural memory. Four inpatients and two outpatients with Pick's disease were studied. Case 1: A 54-year-old right-handed retired clerk presented with a 3-year history of increasing restlessness, word-finding difficulty and impaired comprehension of nominal terms. He was forced to retire from his work because of his social misconduct and incommunicability. On admission he wandered about the ward irritably, did not enter into any conversation, and destroyed all keys in the ward by putting a pencil into keyholes. Neuroradiological examination revealed circumscribed bilateral frontotemporal atrophy which was more marked on the left side. However, he has become more adaptive to the life in the ward and his expression has become peaceful since he began to play othello games with other patients and his doctors. Case 2: A 71-year-old right-handed housewife had progressively altered in her personality and behavior over 4 years. She was restless and showed striking palilalia with marked right frontotemporal atrophy when initially evaluated 2 years after her initial symptoms. Subsequently, her verbal output decreased. She ate large amounts of food and her overweight became a serious problem in her care at home. On admission she wandered about the ward irritably, ate meals of other patients, and put on a quilt on their head. However, these troublesome behavior disappeared when she was bent on knitting that was her former hobby. Case 3: A 63-year-old right handed physician presented with a 5-year history of increasing word-finding difficulty and impaired comprehension of nominal terms. His conversation was limited to continuous repetition of a few phrases. He wandered into several hospitals around his house in fixed order every day. On examination, he was mildly disinhibited and distractible with circumscribed bilateral frontotemporal atrophy which was more marked on the left side. Wandering away from home overnight necessitated admission to the hospital. In the ward he wandered about and tried to open each door restlessly and irritably. However, he has become calm and his expression has become peaceful since he was conducted to measure blood pressures of his nurses. Case 4: A 65-year-old right-handed retired office worker.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1995

Childhood lead poisoning.

Lead poisoning has been referred to as the most important environmental health hazard for children in New England. Medical professionals are in a unique position to perform a number of interventions that could make a lasting impact. First, physicians and nurses, particularly in the areas of pediatrics and family medicine, can provide anticipatory guidance to all families with young children. Lead poisoning, in contrast to long held beliefs, is an affliction that affects all socioeconomic groups. Parents should thus be informed regarding sources of lead, including occupational and hobby sources, and basic nutritional and abatement information should be provided. Second, health care workers should encourage lead screening in appropriately aged children at recommended intervals based on known risk factors. Once a blood lead concentration greater than 20[symbol: see text]g/dl has been obtained in a child, treatment or referral to an established lead clinic should be undertaken in a timely fashion. For children with low or moderate lead levels, many pediatricians or family physicians prefer to supervise their patients' treatment, including chelation therapy. For children with higher levels or in instances when the health care professional elects to refer, there are several lead clinics throughout New England whose clinicians are experienced in the treatment of childhood lead poisoning. Finally the medical profession needs to publicly recognize, as child advocates, that lead poisoning is one of the most common pediatric health problems in the United States and that it is entirely preventable. Fortunately, after many years and much hard work, Rhode Island finally has laws that start to deal with the lead problem in an appropriately aggressive fashion.(ABSTRACT TRUNCATED AT 250 WORDS)

Chelation Therapy↗