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Seeing a voice: Rudolph Koenig's instruments for studying vowel sounds.

The human voice was one of the more elusive acoustical phenomena to study in the 19th century and therefore a crucial test of Hermann von Helmholtz's new theory of sound. This article describes the origins of instruments used to study vowel sounds: synthesizers for production, resonators for detection, and manometric flames for visual display. Instrument maker Rudolph Koenig played a leading role in transforming Helmholtz's ideas into apparatus. In particular, he was the first to make the human voice visible for research and teaching. Koenig's work reveals the rich context of science, craft traditions, experiment, demonstration culture, and commerce in his Paris workshop.

Equipment Design↗

Current challenges in tobacco control.

Tobacco is the world's biggest preventable killer, but the circumstances of its history, the power and influence of its commerce and the nature of addiction make it a very difficult public health issue. Determinants of smoking are both individual and environmental. Genetics and environment influence to varying degrees all of the steps in a smoker's career. Persistence of use, degree of addiction to nicotine and difficulty in stopping are influenced by inherited traits and nicotine susceptibility, whereas the social environment and the individual's cognitions are the key factors in starting smoking and successfully stopping smoking. The tools available to tobacco control include influencing the social and cultural norms concerning tobacco; legislative and regulatory measures to protect the population and to limit tobacco industry marketing tactics, now encapsulated in the Framework Convention on Tobacco Control; and programmes to enhance the chance of not starting and successfully stopping. Strategies for tobacco control must work at both societal and individual levels, and directions are being taken that include genetic, pharmacological, behavioural, socio-cultural and international approaches.

Algorithms↗

Atrazine sorption-desorption hysteresis by sugarcane mulch residue.

Sorption and desorption kinetics are essential components for modeling the movement and retention of applied agricultural chemicals in soils and the fraction of chemicals susceptible to runoff. In this study, we investigated the retention characteristics of sugarcane (Saccharum spp. hybrid) mulch residue for atrazine (2-chloro-4-ethylamino-6-isopropylamino-1,3,5-triazine) based on studies of sorption-desorption kinetics. A sorption kinetic batch method was used to quantify retention of the mulch residue for a wide range of atrazine concentrations and reaction times. Desorption was performed following 504 h of sorption using successive dilutions, followed by methanol extraction. Atrazine retention by the mulch residue was well described using a linear model where the partitioning coefficient (K(d)) increased with reaction time from 10.40 to 23.4 cm3 g(-1) after 2 and 504 h, respectively. Values for mulch residue K(d) were an order of magnitude higher than those found for Commerce silt loam (fine-silty, mixed, superactive, nonacid, thermic Fluvaquentic Endoaquepts) where the sugarcane crop was grown. A kinetic multireaction model was successful in describing sorption behavior with reaction time. The model was equally successful in describing observed hysteretic atrazine behavior during desorption for all input concentrations. The model was concentration independent where one set of model parameters, which was derived from all batch results, was valid for the entire atrazine concentration range. Average atrazine recovery following six successive desorption steps were 63.67 +/- 4.38% of the amount adsorbed. Moreover, a hysteresis coefficient based on the difference in the area between sorption and desorption isotherms was capable of quantifying hysteresis of desorption isotherms.

Adsorption↗

Communication and interoperability for serial comparison in continuous health care--the new challenges.

The evolution of information technology and of telematics and increasing efforts to establish an electronic health record stimulate the development and introduction of new concepts in health care. However, compared to other application areas, e.g., tourism, banking, commerce etc. the use of information technology in health care is still of limited success. In hospitals as well in ambulatory medicine (General Practitioner systems) computers are often only used for administrative purposes. Fully operational Hospital Information Systems (HIS) are rare and often island solutions. The situation is somewhat better for department systems (DIS), e.g., where image analysis, processing of biochemical data or of biosignals is in the clinical focus. Even before we have solved the various problems in health care data processing and management within the "conventional" care institutions new challenges are coming up with concepts of telemedicine for assisted and non-assisted home care for patients with chronic diseases or people at high risk. The major challenges for provision of tele-monitoring and alarming services are improvement of communication and interoperability of devices and care providers. A major obstacle in achieving such goals are lack of standards for devices as well for procedures and a lack of databases with information on "normal" variability of many medical parameters to be monitored by serial comparison in continuous medical care. Some of these aspects will be discussed in more detail.

Biosensing Techniques↗

[New study on the history of anesthesiology--(11) three Japanese doctors who observed William TG Morton's ether anesthesia at the Gross Clinic in 1860].

In January of 1860 the Tokugawa Shogunate dispatched a group of Japanese mission headed by Masaoki Niimi, the first ambassador, to Washington D.C. to exchange ratification of Japan-United States treaty of commerce and amity. On May 22nd the ratification was approved. They left Washington D.C. to move to Baltimore and Philadelphia to visit various sites and institutions. The Niagara sailed from New York with the Japanese mission on board on June 30th. In Philadelphia three Japanese medical doctors visited Jefferson Medical College to observe an operation of lithotomy by Dr Samuel D Gross, professor of surgery. Ether was given by Dr William TG Morton, the man that had succeeded in the public demonstration of ether anesthesia at Massachusetts General Hospital in Boston on October 16, 1846. The doctors might have brought new information on ether anesthesia to Japan, but they only left few traces of providing the information to medical professionals in Japan.

Anesthesia, Inhalation↗

Extended possibilities of pharmaceuticals delivery to patients using dematerialized prescriptions.

This paper considers the requirement for e-commerce enabled delivery of pharmaceutical prescriptions. First, currently available solutions are critically reviewed and an ideal solution is specified and then the concept of the proposed solution--Dematerialized Prescription (DP), is outlined. Next, the information flows required to enable such a service are considered. The paper then considers a number of possible services which could be made available with DP to deliver medicals to patients. Finally, a proposed solution, which enables physician to fill dematerialized prescriptions online using inexpensive mobile Internet devices is presented in detail, the advantages of such a model are summarized and future research directions are suggested.

Drug Prescriptions↗

[Differences of perceived health and lifestyle by occupational groups in the Italian ISTAT (Central Statistic Institute) health survey].

BACKGROUND: Little is known about the distribution by occupation of chronic illness, disability, morbidity, and lifestyles which put health at risk. OBJECTIVES: To provide a map of the social inequalities in various dimensions of health and lifestyle by social class and for specific occupational groups. To formulate a hypothesis about the mechanisms which generate these inequalities. METHODS: Prevalence rate ratios and prevalence odds ratios of perceived health, chronic illness, disability, absenteeism, trauma, smoking, and obesity calculated with data from the 1999-2000 Italian ISTAT (Central Statistics Institute) health survey; the study population includes adults (aged over 18 years) employed, or searching for a job, or withdrawn from the workforce. RESULTS: Among workers in manual unskilled labour, construction and agriculture are noted for worse health and more unhealthy lifestyles than average. For example, perceived bad health is more widespread among agricultural labourers (OR = 1.63), masons and construction machine operators (OR = 1.75), transport drivers (OR = 1.40), male caretakers, custodians, janitors and domestic help (OR = 1.46), electro-technicians (OR = 1.44), leatherworkers and shoemakers (OR = 3.58), miners and quarrymen (OR = 2.60), earthenware and stone workers (OR = 2.14), garment and furnishings workers (OR = 1.86); in female workers excess risk for perceived bad health was present among agricultural labourers (OR = 2.08), caretakers, custodians, janitors and domestic helpers (OR = 1.49), waitresses, cooks and bartenders, (OR = 1.44), and textile workers (OR = 1.67). Smoking was more widespread among chemical workers (OR = 1.41), and in miners and quarrymen (OR = 1.30). An excess risk of smoking of 20-25% was evident in spinners, weavers and finishers; masons, (and) builders; waiters, cooks and bartenders; garment and furnishings workers; porters and warehouse workers. The risk was 10% higher among foundry workers and forgers, plumbers, carpenters and welders, and transport drivers. Among women the propensity to smoke was higher among waitresses, cooks and bartenders (OR = 1.37), cleaners, commerce and service workers (OR = 1.22). Other occupational groups with an increased smoking prevalence, where women were less represented, included: chemical workers (OR = 2.25), butchers (OR = 1.97), postwomen (OR = 1.58), plastics workers (OR = 1.56), shippers (OR = 1.37). CONCLUSIONS: It can be hypothesized on the one hand that there are factors and mechanisms common to the various occupational groups belonging to the same social class; on the other, there are factors and mechanisms specific to certain occupational categories. The latter can generate specific health subcultures. A greater integration between qualitative and quantitative research is recommended, which would yield better explanations of the observed inequalities.

Adult↗

[Study of the relationship among work and demographic characteristics, sickness absence and occupational mobility].

BACKGROUND: The problem of sick absences from work is correlated to a series of organizational, social and psychological factors which interact with risk factors typical of the work performed, and thus determine how frequently absences occur. The correlation between morbidity and work is of interest in itself for studying the processes of occupational mobility. OBJECTIVES: To examine, using data from administrative sources, the association of sick absence with individual and workplace factors, as well as the relationship between illness and career mobility. METHODS: Employee sick absence data registered at INPS (National Institute of Social Insurance) in the period 1992-95 were studied using a sample of 124,686 subjects. RESULTS: The probability of being absent from work due to illness did not appear to be affected by sex or age. The sectors more at risk for sick absences were the service sector, business and commerce. Inequalities were noted in illness rates to the disadvantage of those who had received redundancy payments in the previous years. New hirings and upward mobility were associated with a lower occurrence of illness. A higher probability of illness was observed in those who had lost their jobs and in those who had changed from full-time to part-time work. CONCLUSIONS: It is likely that formal regulations and practices in use within INPS vary according to the different economic activities. Therefore this source allows investigation of illness only in activities with homogeneous regulatory aspects. The results confirm a link between unstable work situations and illness and between illness and career advancement.

Adult↗

[Use of pension records for occupational health surveillance: example of record-linkage with hospital discharge records to study the association between work and the incidence of leukaemias, lung and bladder cancer, and miscarriage].

BACKGROUND: Epidemiologic surveillance of occupational health based on routinely collected data allows groups of workers to be studied, whose type of work (e.g. small enterprises, self-employed workers, artisans) makes it difficult to use a traditional cohort study design. OBJECTIVE: To evaluate the validity of a study design based on the record-linkage between hospital discharge records and INPS social security records (National Institute for Social Security), in order to investigate the association between past employment in an economic sector and occurrence of diseases with a low fraction attributable to occupation and a high frequency in the population, where it is too costly to perform retrospective interviews to gather data from each recruited subject. METHODS: A case-control study design was used in which hospital discharge records from 1995 in the Piedmont Region represented the source of subjects enrolled. Four series of cases were identified: males aged 40-75 years, with first hospital admission for leukaemia, lung or bladder cancer; and women aged 18-39 years, admitted for miscarriage. The controls were a random sample of patients admitted in the same year and matched by sex and age. The exposure variable was the prevalent economic sector in the occupational history of the subjects enrolled, as inferred from INPS social security records. RESULTS: No economic sector examined showed a significant excess of incidence of bladder cancer or leukaemia. There was a significant excess of lung cancer in subjects with longest employment in the building industry, in metal working, and in the "foundries, heat pressing, forging, and rolling mills" sector. A significant excess of miscarriages was present only in women working in commerce. DISCUSSION: The results demonstrated overall a low consistency compared with those obtained via other surveillance systems of occupational morbidity and mortality, as well as by means of analytical studies. The results appear more plausible for the sectors characterized by a low number of job tasks, or by a more homogenous exposure to risk factors among workers in different jobs. Among the limitations of this study the lack of a complete occupational history, the absence of information on potential confounders like smoking and alcohol consumption, and the probable non-differential misclassification of the longest held job need to be stressed

Abortion, Spontaneous↗

What is eHealth?: a systematic review of published definitions.

CONTEXT: The term eHealth is widely used by many individuals, academic institutions, professional bodies and funding organisations. It has become an accepted neologism despite the lack of an agreed-upon clear or precise definition. We believe that communication among the many individuals and organisations that use the term could be improved by comprehensive data about the range of meanings encompassed by the term. OBJECTIVE: To report the results of a systematic review of published, suggested or proposed definitions of eHealth. DATA SOURCES: Using hte search query string 'eHealth' OR 'e-Health' OR 'electronic health', we searched the following databases: Medline and Premedline (1996-June 2004), EMBASE (1980-May 2004), International Pharmaceutical Abstracts (1970-May 2004), Web of Science (all years), Information Sciences Abstracts (1996-May 2004), Library Information Sciences Abstracts (1969-May 2004), and Wilson Business Abstracts (1982-March 2004), In addition, we searched dictionaries and an Internet search engine. STUDY SELECTION: We included any source published in either print format or on the Internet, available in English, and containing text that defines or attempts to define eHealth in explicit terms. Two of us independently reviewed titles and abstracts of citations identified in the bibliographic databases and Internet search, reaching consensus on relevance by discussion. DATA EXTRACTION: We retrieved relevant reports, articles, references, letters and websites containing definitions of eHealth. Two of us qualitatively analysed the definitions and coded them for content, emerging themes, patterns and novel ideas. DATA SYNTHESIS: The 51 unique definitions that we retrieved showed a wide range of themes, but no clear consensus about the meaning of the term eHealth. We identified two universal themes (health and technology) and six less general (commerce, activities, stakeholders, outcomes, place, and perspectives). CONCLUSIONS: The widespread use of the term eHealth suggests that it is an important concept, and that there is a tacit understanding of its meaning. This compendium of proposed definitions may improve communication among the many individuals and organisations that use the term.

Journal Article↗

Mobile phone related-hazards and subjective hearing and vision symptoms in the Saudi population.

OBJECTIVES: Over the past decade utilization of mobile phones has dramatically increased. They are now an essential part of business, commerce, and communication, however, their use may lead to health problems. Therefore, the present study was designed to investigate a link between the use of mobile phones and hearing and vision symptoms in the Saudi population and also to contribute to the increase in social awareness of health problems associated with the use of these devices. MATERIALS AND METHODS: A total of 873 (57.04% of males and 39.86% of females) subjects using mobile phones were invited to participate in the presented study. A structured questionnaire was distributed among them to collect a detailed medical history. The Chi-square test was employed to observe the relationship between duration of calls and hearing and vision complaints. RESULTS: The present study showed an association between the use of mobile phones and hearing and vision complaints. About 34.59% of problems were related with impaired hearing, ear ache and/or warmth on the ear, and 5.04% of complaints with the decreased and/or blurred vision. CONCLUSIONS: It is concluded that the use of mobile phone is a health risk factor, and thus it is suggested that excessive use of mobile phones should be avoided and social awareness increased through health promotion activities, such as group discussions or public presentations and via electronic and printed media sources.

Adolescent↗

Vermont hospital's web site focuses on valuable healthcare information.

Brattleboro Memorial Hospital's web site celebrates a century of caring in the region of Brattleboro, Vt. The web site, bmhvt.org, is loaded with information, including a local links page that enables site visitors to hook up with the Brattleboro Chamber of Commerce, the Area Health Education Council, Lifeline Personal Response Service, and more.

Hospitals, Community↗

Tobacco use in Kerala: findings from three recent studies.

BACKGROUND: We reviewed the literature on tobacco use in Kerala and present data from three recently conducted unpublished studies. METHODS: Three cross-sectional studies were conducted; a community-based study of 1,298 individuals aged 15 years and above (mean age 37.4 years, men 630), a school-based study of 1,323 boys (mean age 14.7 years), and a college-based study of 1,254 male students (mean age 18.2 years). Information on tobacco use and sociodemographic variables was collected using pre-tested, structured interview schedules and questionnaires. RESULTS: In the community study, 72% of men and 6% of women had ever used tobacco. Compared to men with > 12 years of schooling, those with < 5 years of schooling were 7 times more likely to smoke (OR 7, CI 3.2-15.6). The age at initiation of smoking was 19 years among those < 25 years of age compared to 25.5 years among ever smokers > 44 years. In the school study, the age at initiation among boys aged < or = 1 3 years was 10.7 years compared with 13.2 years among > or = 16-year-old boys. Boys whose fathers and friends used tobacco were 2 times and 2.9 times more likely to use tobacco (OR 2.0, CI 1.3-3.1 and OR 2.9, CI 1.6-5.1), respectively, compared with their counterparts. In the college study, 29% of the commerce students used tobacco compared with 5.3% of polytechnic students (p < 0.001). CONCLUSION: Survey data suggest that the age at initiation of tobacco use appears to be falling. A series of cross-sectional studies with larger sample sizes of the youth is required to confirm this impression. Tobacco use habits of fathers and peers are significant influences on youth smoking. There is a need to focus on particular types of colleges as these appear to have high-risk tobacco use environments.

Adolescent↗

Food offerings in Marshfield area businesses: a survey conducted in collaboration with the healthy lifestyles--Marshfield Area Coalition.

PURPOSE: To survey Marshfield area businesses to determine the types of foods currently available to employees at the workplace and the potential need for nutrition information to facilitate the ordering of healthy food options at workplaces. METHODS: A 2-page self-administered questionnaire was mailed to all businesses registered with the Marshfield Area of Chamber of Commerce. Questionnaires were mailed a second time to non-responders to improve the response rate. The questionnaire included items about foods available to employees at the workplace, cooking and eating facilities available to employees, and reasons for food choices made. Data were entered into an Excel spreadsheet, verified against the hard copies and transferred to SPSS for analysis. RESULTS: Completed questionnaires were returned by 249 businesses (41.1% participation). The reported number of minutes that most employees take for their lunch ranged from 0 to 60 (median = 30). Eighty-one percent of businesses (n = 184) reported that most employees take 30 or more minutes for their lunch. Respondents were asked to list the most common menu items purchased for consumption on-site. One hundred fifteen respondents listed sandwiches (46.2%), 101 listed pizza (40.6%), 30 listed salad (12.0%), and 17 listed various sweets (6.8%). Employees were thought to be less likely than managers to select foods lower in calories if the foods are more expensive. DISCUSSION: There is great potential to improve the health of employees through the provision of nutrition information to businesses. The survey employed in the current study can be used again in the future to track changes after implementation of worksite initiatives through the Business and Industry Committee of the Healthy Lifestyles--Marshfield Area Coalition.

Chi-Square Distribution↗

Managing nutritional programmes in developing countries.

Improving community nutrition in developing countries requires a detailed epidemiological picture of the prevalent nutritional problems in different regions and age groups. This makes it possible to identify priorities, sensitize policy-makers, establish political commitment and design appropriate community programmes for income generation and education for the best use of food resources. Experiences acquired from community-based nutritional programmes show that ownership of a programme by the community and using a tailor-made approach are essential factors in the successful implementation of programmes. A multifaceted approach is needed, involving a range of sectors-agriculture, commerce, education and health--and commitment at all levels from government to communities and individuals.

Communication↗

The Progressive Era.

The American College of Dentists was founded in 1920 for the purpose of encouraging young dentists to continue study and to apply science to their practices. This ideal emerged in the Progressive Era, which lasted roughly from 1895 to 1920. The animating spirit of this period was that the human condition could be improved and that the way to achieve this was through science and the use of experts working together. The Progressive Era saw inventions, such as automobiles and airplanes, telephone and radio, that required mass production and brought people together. It also spawned many political and legislative innovations that we now take for granted. Among these are the Food and Drug Administration, the Department of Commerce, and the Federal Trade Commission. Workers' compensation and other social protections were introduced, as were city commissions; the income tax; women's suffrage; and initiative, referendum, and recall. Medicine, for the first time, became an effective way to treat disease as it developed a scientific foundation.

History, 19th Century↗

[Registry of the Italian Institute for Occupational Prevention and Safety of local productive units: methodology and structure].

The Italian Institute for Occupational Prevention and Safety (ISPESL) carried out a register of enterprises operating in industry, services and agriculture sector to provide information on their location, economical activity and occupational data. This database has been built merging administrative files from the National Institute of Social Security (INPS) and the Computer Science Society of Italian Chambers of Commerce (InfoCamere). Enterprises have been classified by economic sector - in accordance with ISTAT (National Statistics Institute) "Ateco91" classification--and by accuracy level of the record linkage. In details, three different subsystems have been set up: (A) enterprises satisfying linkage; (B) enterprises in InfoCamere file not linked with INPS file; (C) enterprises in INPS file not linked with InfoCamere file. In the whole, 6.026.676 factories have been collected, of which 1.188.784 in group A, 4.543.091 in group B and 294.801 in group C. Establishing a database of information on industries may be useful to improve preventive programs and to plan health care surveillance systems.

Academies and Institutes↗

Are we preparing health services administration students to respond to bioterrorism and mass casualty management?

Bioterrorism/natural disaster events add significant specialized demands and disrupt normal operation of the health system, often for an indefinite period of time. Health administration leaders should be educationally prepared for and informed about these potential events, but few receive this knowledge via their academic preparation in health administration. This study examined the existence of coverage of bioterrorism topics in health administration curricula and characteristics of bioterrorism coverage in current health administration programs through a self-completed survey among AUPHA graduate and undergraduate program members. Of the total survey respondents, only 32% of programs have current coverage of bioterrorism. The main reasons for nothavingbioterrorism coverage were not having enough resources; not having enough time to develop course/materials; and not thinking it is necessary to add these courses/materials. To prepare better and to inform future health administrators regarding major disruptive circumstances, advocacy and documentation are important to develop and implement bioterrorism awareness. Possibly, suggested minimum curricular requirements, content, and mechanisms for inclusion can be developed in the near future. Health administration educators should address the new reality and demonstrate that their graduates can function and lead in crises and situations disruptive to normal commerce.

Administrative Personnel↗