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PubMed2005

Eye lens proteomics: from global approach to detailed information about phakinin and gamma E and F crystallin genes.

Exploration of the lenticular proteome poses a challenging and worthwhile undertaking as cataracts, the products of a disease phenotype elicited by this proteome, remains the leading cause of vision impairment worldwide. The complete ten day old lens proteome of Mus musculus C57BL/6J was resolved into 900 distinct spots by large gel carrier ampholyte based 2-DE. The predicted amino acid sequences of all 16 crystallins ubiquitous in mammals were corroborated by mass spectrometry (MS). In detailed individual spot analyses, the primary structure of the full murine C57BL/6J beaded filament component phakinin CP49 was sequenced by liquid chromatography/electrospray ionization-tandem MS and amended at two positions. This definitive polypeptide sequence was aligned to the mouse genome, thus identifying the entire C57BL/6J genomic coding region. Also, two murine C57/6J polypeptides, both previously classified as gamma F crystallin, were clearly distinguished by MS and electrophoretic mobility. Both were assigned to their respective genes, one of the polypeptides was reclassified as C57BL/6J gamma E crystallin. Building on these data and previous investigations an updated crystallin reference map was put forth and several non crystallin lenticular components were examined. These results represent the first part of a comprehensive investigation of the mouse lens proteome (http://www.mpiib-berlin.mpg.de/2D-PAGE) with emphasis on understanding genetic effects on proteins and disease development.

Amino Acid Sequence↗
PubMed1998

A pilot study of J95 in secondary care in Bosnia.

The Army's morbidity reporting system J95 was fashioned into a secondary care variant and a pilot study conducted in Multinational Division South West (MND SW) during Operation Resolute 2. Some codes were modified, in keeping with the concurrent primary care J95a amendment, which included separating 'Other Injury' event codes further into 'Sports Injuries' and 'Other Injuries'. The collection system encompassed both out-patient and in-patient data and appropriate disposal categories such as 'admit' and 'length of stay' were introduced. Participating units included the Hospital Squadron at Sipovo, the Hospital facility at Tomislavgrad and, via a liaison officer, UK admissions and referrals to the Force Hospital near Split. A four month period of compatible data was found. Over this period 1,410 personnel (42.2/1,000/month) first attended out-patients with 337 requiring subsequent attendances (10.1/1000/month) and there were 425 admissions (12.7/1,000/month) from an average force level of 8,340 personnel. Nearly half the patients seen (49%) had orthopaedic problems and this group provided over half of the admissions (54%) and the bed occupancy (53%). There was a sizeable out-patient work load for the physician (28%). The pilot study showed that a J95 surveillance mechanism in secondary care was possible and informative. It gave indications of the impact of morbidity on the medical services and could help shape medical manning for future operations. It would be possible to adopt such a system in both the peacetime setting and in an international operational setting--in keeping with its primary care partner. It is recommended that J95 secondary variant should be continued on operations.

Ambulatory Care↗
PubMed2003

Approval summary for zoledronic acid for treatment of multiple myeloma and cancer bone metastases.

PURPOSE: This article summarizes data submitted to the United States Food and Drug Administration for marketing approval of zoledronic acid (Zol; Novartis Pharmaceuticals, East Hanover, NJ), a bisphosphonate drug for treating patients with bone metastases. EXPERIMENTAL DESIGN: We review the chemistry, toxicology, pharmacology, and clinical study results submitted to support the supplemental New Drug Application for Zol for treatment of patients with bone metastases. Four- and 8-mg Zol doses were selected for Phase III trials based on bone resorption markers and clinical efficacy parameters. Patients with bone metastases were randomized in three Phase III studies (prostate cancer, solid tumors, and multiple myeloma or breast cancer) to receive 4 or 8 mg of Zol or to a control arm. The control was a placebo in the prostate cancer study and the other solid tumor study and was 90 mg of pamidronate (Pam) in the study of breast cancer and multiple myeloma. Studies were amended twice because of renal toxicity, initially to increase Zol infusion time from 5 to 15 min and later to decrease the dose in the Zol 8-mg arm to 4 mg. The efficacy end point was skeletal-related events (SREs), a composite end point consisting of pathologic fracture, radiation therapy to bone, changes in antineoplastic therapy for bone pain (prostate cancer only), surgery to bone, or spinal cord compression. This end point was analyzed either as the proportion of patients with SRE or time to first SRE. The breast cancer and myeloma study used a noninferiority statistical analysis methods to determine efficacy. RESULTS: In prostate cancer, both the proportions analysis and time-to-SRE analysis showed significantly less bone morbidity on Zol (4 mg) than placebo, but no significant difference between Zol (8 mg) and placebo in either analysis. In the solid tumor study, the time to SRE analysis but not the proportions analysis showed significantly less skeletal morbidity on Zol (4 mg) than placebo, and Zol (8 mg) was significantly better than placebo in both analyses. The breast cancer and myeloma study demonstrated noninferiority of Zol compared with Pam, with Zol retaining at least 49.3% of the Pam treatment effect previously demonstrated in placebo-controlled trials. Zol was approved on February 22, 2002, by the United States Food and Drug Administration for the "treatment of patients with multiple myeloma and documented bone metastases from solid tumors, in conjunction with standard antineoplastic therapy. Prostate cancer should have progressed after treatment with at least one hormonal therapy." The recommended dose and schedule is 4 mg of Zol infused over 15 min every 3-4 weeks. Increased Zol doses and shorter infusions are not recommended because of potential renal toxicity.

Antineoplastic Agents↗
PubMed2001

Agronomic measures of P, Q/I parameters and lysimeter-collectable P in subsurface soil horizons of a long-term slurry experiment.

Soils from a long-term slurry experiment established in 1970 at Hillsborough, Northern Ireland, were used in the experiment. The site has a clay loam soil overlying Silurian shale. Seven treatments were used with three replicate plots per treatment under the following manurial regimes: (1) mineral fertiliser supplying 200 kg N, 32 kg P and 160 kg K ha(-1) yr(-1); (2)-(4) pig slurry applied at 50, 100 or 200 m3 ha(-1) yr(-1); (5)-(7) cow slurry applied at 50, 100 or 200 m3 ha(-1) yr(-1). Agronomic measures of P determined on subsurface layers down to 90 cm were compared with sorption isotherm data and rates of desorption. Adsorption isotherms were fitted using a standard Langmuir model. Data were compared with soluble (molybdate-reactive) P levels in soil water collected at 35 and 90 cm using PTFE suction cup lysimeters. Agronomically available P was concentrated in the top 30 cm of soil in all treatments. The accumulation of P in surface layers of the plots was significantly greater in the pig slurry treatments compared to the cow slurry, reflecting the history of P amendments. Nevertheless, over a period of a year, molybdate-reactive phosphorus (MRP) concentrations in lysimeter collections was consistently higher at 35 cm depth in the highest cow slurry treatment (7) compared to the equivalent pig slurry treatment (4). Either the movement of soluble P down the profile is facilitated by the higher organic content of cow slurry or P movement is not directly related to P accumulation in the soils. In addition, it is hypothesised that P movement down the soil profile depends upon two separate mechanisms. First, a 'break' point above which the accumulated P in the surface horizons is less strongly held and therefore amenable to dissolution and movement down the profile. Second, a mechanism by which some solute P from the surface horizons can travel rapidly through horizons of low P status to greater depth in the soil, i.e., by preferential flow.

Adsorption↗
PubMed2005

High-mileage study of on-board diagnostic emissions.

The 1990 Clean Air Act amendments require the U.S. Environmental Protection Agency (EPA) to set guidelines for states to follow in designing and running vehicle inspection and maintenance (I/M) programs. Included in this charge was a requirement to implement an on-board diagnostic (OBD) test for both basic and enhanced I/M programs. This paper provides the results to date of an ongoing EPA study undertaken to assess the durability of the OBD system as vehicles age and as mileage is accrued. The primary results of this effort indicate the points described below. First, the majority of high-mileage vehicles tested had emission levels within their certification limits, and their malfunction indicator light (MIL) was not illuminated, indicating that the systems are capable of working throughout the life of a vehicle. Second, OBD provides better air quality benefits than an IM240 test (using the federal test procedure [FTP] as the benchmark comparison). This statement is based on greater emissions reductions from OBD-directed repairs than reductions associated with IM240-identified repairs. In general, the benefits of repairing the OBD fails were smaller, but the aggregate benefits were greater, indicating that OBD tests find both the high-emitting and a number of marginally high-emitting vehicles without false failures that can occur with any tailpipe test. Third, vehicles that truly had high-tailpipe emissions as confirmed by laboratory IM240 and FTP testing also had illuminated MILs at a statistically significant level. Last, field data from state programs have demonstrated MIL illumination rates comparable with those seen in this work, suggesting that the vehicles sampled in this study were representative of the larger fleet. Nonetheless, it is important to continue the testing of high-mileage OBD vehicles into the foreseeable future to ensure that the systems are operating correctly as the fleet ages and as changes in emission certification levels take effect.

Air Pollution↗
PubMedDate not supplied

Modification to the AOAC Sporicidal Activity of Disinfectants Test (Method 966.04): collaborative study.

In an effort to improve AOAC Method 966.04, the Sporicidal Activity of Disinfectants Test, selected modifications to the procedure were evaluated in a collaborative study. Method 966.04 is used to generate efficacy data to support the product registration of sporicides and sterilants. The method is a carrier-based test that provides a qualitative measure of product efficacy against spores of Bacillus subtilis and Clostridium sporogenes. The use of garden soil extract and the lack of standard procedures for the enumeration of spores and neutralization of the test chemicals have been considered problematic for many years. The proposed modifications were limited to the B. subtilis and hard surface carrier (porcelain penicylinder) components of the method. The study included the evaluation of a replacement for soil extract nutrient broth and an establishment of a minimum spore titer per carrier, both considered crucial for the improvement and utilization of the method. Additionally, an alternative hard surface material and a neutralization confirmation procedure were evaluated. To determine the equivalence of the proposed alternatives to the standard method, 3 medium/carrier combinations, (1) soil extract nutrient broth/porcelain carrier (current method), (2) nutrient agar amended with 5 microg/mL manganese sulfate/porcelain carrier, and (3) nutrient agar amended with 5 microg/mL manganese sulfate/stainless steel carrier were analyzed for carrier counts, HCI resistance, efficacy, quantitative efficacy, and spore wash-off. The test chemicals used in the study represent 3 chemical classes and are commercially available antimicrobial liquid products: sodium hypochlorite (bleach), glutaraldehyde, and a combination of peracetic acid and hydrogen peroxide. Four laboratories participated in the study. The results of the spore titer per carrier, HCI resistance, efficacy, and wash-off studies demonstrate that amended nutrient agar in conjunction with the porcelain is comparable to the current method, soil extract nutrient broth/porcelain. The nutrient agar method is simple, inexpensive, reproducible, and provides an ample supply of high quality spores. Due to the current use of porcelain carriers for testing C. sporogenes, it is advisable to retain the use of porcelain carriers until stainless steel can be evaluated as a replacement carrier material for Clostridium. The evaluation of stainless steel for Clostridium has been initiated by the Study Director. Study Director recommendations for First Action revisions are provided in a modified method.

Bacillus subtilis↗
PubMed1988

Income Tax (Amendment) Act 1988 (No. 1 of 1988), 21 January 1988.

This Singapore Act does the following, among other things: 1) authorizes the deduction from income taxes of the delivery and hospitalization expenses incurred with respect to the birth of a legitimate fourth child, up to $3000; 2) authorizes a deduction of payments made to a person's or that person's parent's retirement fund, up to $6000; 3) grants a rebate of $20,000 against tax payable to a person who has a third legitimate child, spread over up to five years, with an additional rebate against tax payable of 15% of her income for a married woman electing to be charged in her own name; and 4) sets deductions from taxable income at $750 for the first, second, and third child; and $300 for the fourth and fifth child, if born before 1 August 1973. In addition to these deductions, a married woman electing to be charged in her own name and having achieved certain educational qualifications is authorized to deduct 5% of her earned income for her first child up to $10,000, 10% for her second child up to $10,000, and 15% for her third child up to $10,000. For a fourth child born after 1 January 1987, she may deduct $750 and 15% of her earned income up to $10,000. In a message to Singapore citizens to mark the new year, the Prime Minister of Singapore urged citizens not to use lunar signs to plan the birth of their children. He stated, "Have your babies any year, including the snake year." See International Herald Tribune, 10 February 1989.

Asia↗
PubMed2004

Factors related to the attraction of flies at a biosolids composting facility (Bariloche, Argentina).

The composting process is used to treat biosolids from the Wastewater Treatment Plant of Bariloche (NW Patagonia, Argentina). Since 1998, an odourless, innocuous and stable organic amendment has been produced at the Biosolids Composting Plant of Bariloche. However, volatile compounds produced during this process, attract different vectors, mainly insects belonging to the Order Diptera, particularly in summer. To evaluate factors associated with the attraction of Diptera to composting windrows, volatile compounds, wind velocity, ambient and windrow temperatures were measured and their relationships with the taxa of flies found were determined. Sampling was conducted several months on newly formed windrows during 3 weeks of the thermophilic composting period. Composite samples from each windrow were taken on the first day of each sampling week, from November 1999 to March 2000 to analyze volatile compounds using an 'electronic nose'. Windrow and ambient temperatures and wind velocity were recorded on three consecutive days of each week, from January to March 2000; also the capture of flies was performed in this period. A weekly mean value was calculated for each environmental variable. Canonical Correspondence Analysis was employed to determine relationships between taxa of flies and the studied factors. The electronic nose discriminated among odours emitted, differentiating windrows by the bulking agent employed and by week of the thermophilic composting period. Ambient temperatures increased slightly during the sampling weeks; the highest values of wind velocity were registered during the second sampling week while windrow temperatures were sustained approximately 60 degrees C. Canonical Correspondence Analysis showed that attraction of flies to composting windrows was related to minimum and maximum ambient temperatures and volatile compounds for Muscina stabulans, Fannia sp. and Acaliptratae and to wind velocity for Ophyra sp., Sarcophaga sp., Cochliomyia macellaria and Phaenicia sericata.

Animals↗
PubMed1997

Stalkers and other obsessional types: a review and forensic psychological typology of those who stalk.

Stalking, an age-old phenomenon, was discussed in the ancient writings of Hippocrates, researched extensively in the early 20th century by French psychiatrist G.G. de Clerambault, given notoriety with the tragic death of former Beatle John Lennon, and viewed as 'Fatal Attraction' in local theaters across the world. Stalking is unique as the repetitive, harassing, long-term course of conduct and behaviour reflects the internal dynamics of the stalker's motivating mental disorder. Furthermore, the investigation of stalking is difficult. The numerous and progressive acts, comprising the intentional course of conduct, require a continuity of purpose: harassment designed to control the victim. A multi-disciplinary approach, utilizing law enforcement, legal, medical and mental health professionals, is necessary to effectively eradicate this encroaching behaviour. In 1990, the first Anti-Stalking legislation was passed in California, USA. In just 6 years, all 50 states have followed suit. Public awareness has encouraged federal legislation to stop stalking behaviour as a course of conduct crime and to give victims a measure of protection. This research paper overviews periodicals, law review articles, studies and projects of law enforcement, legal counsel, medical professionals, forensic mental health professionals, forensic examiners and criminologists since 1992. The study of stalkers and stalking behaviour is a work in progress. As questions are answered, statutes are amended and diagnoses are distinguished, it becomes a stepping stone to the future understanding of the pervasive stalking phenomenon facing our culture and society today.

Journal Article↗
PubMed2006

International control of alcohol: alternative paths forward.

Alcohol was the first psychoactive substance to be subject to international control, but these agreements between colonial powers have long since fallen away. In the wake of the entry into force of the Framework Convention on Tobacco Control (FCTC), paths forward for international control of alcohol are considered. The choices embedded in the FCTC are discussed, and the justifications for a parallel convention for alcohol considered. An alternative would be scheduling alcohol under one or more of the international drug conventions, most probably the 1971 convention, although the convention would have to be amended to allow use outside 'medical and scientific purposes' and without a prescription regime. In considering potential contents of an alcohol convention, it is noted that both the FCTC and the drug conventions are concerned at least as much with domestic markets as with international trade.

Alcohol Drinking↗
PubMed2006

Field demonstration of reduction of lead availability in soil and cabbage (Brassica Chinensis L.) contaminated by mining tailings using phosphorus fertilizers.

A field demonstration of reduction of lead availability in a soil and cabbage (Brassica Chinensis L.) contaminated by mining tailings, located in Shaoxing, China was carried out to evaluate the effects of applications of phosphorus fertilizers on Pb fractionation and Pb phyto-availability in the soil. It was found that the addition of all three P fertilizers including single super phosphate (SSP), phosphate rock (PR), and calcium magnesium phosphate (CMP) significantly decreased the percentage of water-soluble and exchangeable (WE) soil Pb and then reduced the uptake of Pb, Cd, and Zn by the cabbage compared to the control (CK). The results showed that the level of 300 g P/m(2) soil was the most cost-effective application rate of P fertilizers for reducing Pb availability at the first stage of remediation, and that at this P level, the effect of WE fraction of Pb in the soil decreased by three phosphorus fertilizers followed the order: CMP (79%)>SSP (41%)>PR (23%); Effectiveness on the reduction of Pb uptake by cabbage was in the order: CMP (53%)>SSP (41%)>PR (30%). Therefore our field trial demonstrated that it was effective and feasible to reduce Pb availability in soil and cabbage contaminated by mining tailings using P fertilizers in China and PR would be a most cost-effective amendment.

Biodegradation, Environmental↗
PubMedDate not supplied

A model for strategic leadership.

Boards can exercise strategic leadership, but to do so well, they must change their concept of governance. Most of what is traditionally accepted in the boardroom is not conducive to excellence in strategic leadership and, in fact, actually impedes it. First, trustees must be able to escape the clutter that interferes with a continual emphasis on strategic issues. This calls for a far more incisive way to withdraw responsibility from administrative tissues in favor of control by policy. Second, trustees must understand that strategic leadership is a matter of how the board approaches its job, not a mechanical annual tussle with setting long-range goals. Third, trustees must structure their annual plans around updating their long-range intentions--chiefly concerning mission issues and priorities--and restating them in amended ends policies. Finally, trustees must realize that strategic leadership--hence, good governance--is not so much about budgets, personnel practices, construction projects or medical staff bylaws as it is about public policy, purpose, values and the vision that shapes institutional destiny.

Canada↗
PubMed1994

Legal limitations in primary health care nursing practice in South Africa (Part 1).

In this, the first of two articles, legal limitations in the practice of the primary health care nurse in the Republic of South Africa, having direct implications for the achievement of the goal 'health for all by the year 2000', are discussed. The questions which had to be answered by means of research relate to the nature and scope of the limitations as well as to how these limitations should be addressed in order to facilitate the practice of the primary health care nurse. A content analysis was done and recommendations formulated to amend and/or clarify certain health legislation. It is recommended that an empirical investigation be done to verify the results.

Delivery of Health Care↗
PubMed2004

Marijuana odor perception: studies modeled from probable cause cases.

The 4th Amendment of the United States Constitution protects American citizens against unreasonable search and seizure without probable cause. Although law enforcement officials routinely rely solely on the sense of smell to justify probable cause when entering vehicles and dwellings to search for illicit drugs, the accuracy of their perception in this regard has rarely been questioned and, to our knowledge, never tested. In this paper, we present data from two empirical studies based upon actual legal cases in which the odor of marijuana was used as probable cause for search. In the first, we simulated a situation in which, during a routine traffic stop, the odor of packaged marijuana located in the trunk of an automobile was said to be detected through the driver's window. In the second, we investigated a report that marijuana odor was discernable from a considerable distance from the chimney effluence of diesel exhaust emanating from an illicit California grow room. Our findings suggest that the odor of marijuana was not reliably discernable by persons with an excellent sense of smell in either case. These studies are the first to examine the ability of humans to detect marijuana in simulated real-life situations encountered by law enforcement officials, and are particularly relevant to the issue of probable cause.

Adult↗
PubMed2006

A rapid mutant screening technique for detection of technetium [Tc(VII)] reduction-deficient mutants of Shewanella oneidensis MR-1.

Microbial metal reduction forms the basis of alternate bioremediation strategies for reductive precipitation and immobilization of toxic metals such as the radionuclide technetium [Tc(VII)]. A rapid mutant screening technique was developed to identify Shewanella oneidensis MR-1 respiratory mutants unable to reduce Tc(VII) as anaerobic electron acceptor. The Tc(VII) reduction-deficient (Tcr) mutant screening technique was based on the observation that wild-type S. oneidensis produced a black Tc(IV) precipitate on its colony surface during growth on Tc(VII)-amended agar, while colonies arising from mutagenized cells did not. Tcr mutants unable to produce the black precipitate were subsequently tested for anaerobic growth on an array of three electron donors and 13 alternate electron acceptors. The Tcr mutants displayed a broad spectrum of anaerobic growth deficiencies, including several that were unable to reduce Tc(VII) with hydrogen or lactate as electron donor, yet retained the ability to reduce Tc(VII) with formate. This report describes the development of a novel Tcr mutant screening technique and its application to identify the first set of Tcr mutants in a metal-reducing member of the genus Shewanella.

Anaerobiosis↗
PubMed1998

Rapid Consumption of Low Concentrations of Methyl Bromide by Soil Bacteria

A dynamic dilution system for producing low mixing ratios of methyl bromide (MeBr) and a sensitive analytical technique were used to study the uptake of MeBr by various soils. MeBr was removed within minutes from vials incubated with soils and ~10 parts per billion by volume of MeBr. Killed controls did not consume MeBr, and a mixture of the broad-spectrum antibiotics chloramphenicol and tetracycline inhibited MeBr uptake by 98%, indicating that all of the uptake of MeBr was biological and by bacteria. Temperature optima for MeBr uptake suggested a biological sink, yet soil moisture and temperature optima varied for different soils, implying that MeBr consumption activity by soil bacteria is diverse. The eucaryotic antibiotic cycloheximide had no effect on MeBr uptake, indicating that soil fungi were not involved in MeBr removal. MeBr consumption did not occur anaerobically. A dynamic flowthrough vial system was used to incubate soils at MeBr mixing ratios as low as those found in the remote atmosphere (5 to 15 parts per trillion by volume [pptv]). Soils consumed MeBr at all mixing ratios tested. Temperate forest and grassy lawn soils consumed MeBr most rapidly (rate constant [k] = 0.5 min-1), yet sandy temperate, boreal, and tropical forest soils also readily consumed MeBr. Amendments of CH4 up to 5% had no effect on MeBr uptake even at CH4:MeBr ratios of 10(7), and depth profiles of MeBr and CH4 consumption exhibited very different vertical rate optima, suggesting that methanotrophic bacteria, like those presently in culture, do not utilize MeBr when it is at atmospheric mixing ratios. Data acquired with gas flux chambers in the field demonstrated the very rapid in situ consumption of MeBr by soils. Uptake of MeBr at mixing ratios found in the remote atmosphere occurs via aerobic bacterial activity, displays first-order kinetics at mixing ratios from 5 pptv to ~1 part per million per volume, and is rapid enough to account for 25% of the global annual loss of atmospheric MeBr.

Journal Article↗
PubMed1992

Maternal and paternal nitrogen investment in Blattella germanica (L.) (Dictyoptera; Blattellidae).

The investment of nitrogenous materials by female and male German cockroaches Blattella germanica (L.) into their progeny was examined. Adult females maintained on dog food invested 34% of their dry mass and 26% of their nitrogen into an oothecae during their first gonadotrophic cycle. Females maintained on a low- (5%) protein diet and injected simultaneously with [3H]leucine and [14C]hypoxanthine incorporated less [3H]leucine-derived radiolabel in their oothecae than those on a dog food diet (25% crude protein). Females on the low-protein diet incorporated more [14C]hypoxanthine-derived material (primarily as [14C]urates) into their oothecae than they retained in their bodies. Stored [14C]urates were metabolized more readily by females on the low-protein diet. Oothecae obtained from females provided with an [15N]urate-amended diet contained at least four 15N-enriched amino acids, which supports the hypothesis that urates are utilized as a nitrogen resource in these insects. Dietary effects on paternal investment were also found to be significant. Females fed a low-protein diet and their oothecae contained 63% of the radiolabel made available to them at mating when paired with males injected simultaneously with [3H]leucine and [14C]hypoxanthine, whereas dog-food-fed females and their oothecae contained only 17% of the total radiolabel made available to them at mating.

Animals↗
PubMed2001

Legal regulations on occupational health system in Poland.

Occupational health care has a long tradition in Poland. It has evolved from the industrial health care system established in the post-war period to a modern system defined in the Occupational Health Services Act of 1997. When the process of political and economic transformation began in Poland in 1989, the reforms of the workers' health care became inevitable. The process of introducing and implementing new legal regulations comprised three phases: 1. Introduction of amendments to the Polish Labor Code, according to which employers are now committed to provide their workers with occupational health services (OHS) appropriate to given working conditions. 2. Incorporation into the 1991 Health Care Institutions Act the provisions which allow for the establishment of alternative non-public structures responsible for the health care of the working population. 3. Adoption of the Occupational Health Services Act in 1997, the most important law providing grounds for establishing a most comprehensive system of occupational health services. The Occupational Health Services Act introduces, for the first time, the concept of the OHS system that encompasses the whole working population. The Act outlines a broad range of OHS competences; defines individual tasks; and provides the up-to-date definition of the OHS structure with its two organizational levels, consisting of primary and regional occupational health centers. In addition, the Act specifies the sources of finance for the accomplishment of the defined tasks. Pursuant to the provisions of the Act, OHS units co-operate with employers and employees, bodies supervising working conditions and other organizations involved in occupational health that become their partners in activities aimed at protecting and promoting health of workers. In order to further develop the workers' health care system its constant adaptation to changing conditions is absolutely necessary through: developing modern training for specialists in the field of occupational medicine; establishing an efficient system for controlling the quality of services provided by the occupational health care centers; and implementing more effective forms of health protection and promotion at workplace, especially for those self-employed.

Facility Regulation and Control↗