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PubMed1998

Bone marrow composition and bone microarchitecture and turnover in blacks and whites.

We examined the relationship between bone histomorphometric variables versus marrow cellularity, marrow adiposity (among hemopoietic cells), and fatty degeneration (areas of only fat) of bone marrow in iliac crest bone samples from 98 normal black (n = 53) and white (n = 45) males and females. We found blacks to have greater marrow cellularity (p = 0.0001), less marrow adiposity (among hemopoietic cells, p = 0.0001), greater values for bone volume (p = 0.030), trabecular thickness (p = 0.002), and static bone turnover variables (osteoid volume, p = 0.001; osteoid surface, p = 0.001; osteoid thickness, p = 0.001; eroded surface, p = 0.0006) than whites. Marrow cellularity correlated positively with static bone turnover variables osteoid volume (r = 0.257, p = 0.011), osteoid surface (r = 0.265, p = 0.008), osteoid thickness (r = 0.217, p = 0.032), and eroded surface (r = 0.273, p = 0.007) when all 98 cases were analyzed together. These findings suggest that marrow cells may influence bone turnover. The extent of fatty degeneration, but not that of adipose tissue, increased with age in blacks (r = 0.476, p = 0.0003) and whites (r = 0.476, p = 0.001), as did bone loss. There was no racial difference in the extent of fatty degeneration. We conclude that the lesser extent of adiposity in blacks is a racial characteristic that is unaffected by aging, whereas fatty degeneration which may have partly occupied space vacated by bone loss, is an aging phenomenon, unrelated to race. Greater bone turnover in blacks may be expected to lead to more frequent renewal of fatigue-damaged bone, which together with sturdier bone structure may contribute to the lower fragility fracture rates in blacks.

Adult↗
PubMed1992

The effects of pharmaceutical firm enticements on physician prescribing patterns. There's no such thing as a free lunch.

We examined the impact on physician prescribing patterns of pharmaceutical firms offering all-expenses-paid trips to popular sunbelt vacation sites to attend symposia sponsored by a pharmaceutical company. The impact was assessed by tracking the pharmacy inventory usage reports for two drugs before and after the symposia. Both drugs were available only as intravenous preparations and could be used only on hospitalized patients. The usage patterns were tracked for 22 months preceding each symposium and for 17 months after each symposium. Ten physicians invited to each symposium were interviewed about the likelihood that such an enticement would affect their prescribing patterns. A significant increase in the prescribing pattern of both drugs occurred following the symposia. The usage of drug A increased from a mean of 81 +/- 44 units before the symposium to a mean of 272 +/- 117 after the symposium (p less than 0.001). The usage of drug B changed from 34 +/- 30 units before the symposium to 87 +/- 24 units (p less than 0.001) after the symposium. These changed prescribing patterns were also significantly different from the national usage patterns of the two drugs by hospitals with more than 500 beds and major medical centers over the same period of time. These alterations in prescribing patterns occurred even though the majority of physicians who attended the symposia believed that such enticements would not alter their prescribing patterns.

Conflict of Interest↗
PubMed2006

Spring break trips as a risk factor for heavy alcohol use among first-year college students.

OBJECTIVE: Many high school and college students are believed to use spring break vacation to travel to destinations with the intent of engaging in extreme party behaviors, including excessive alcohol use. However, the extent to which spring break travelers' behaviors are more risky than their typical behaviors remains unclear. METHOD: To assess the impact of spring break as a situational risk factor, we analyzed data collected from 176 first-year college students across 10 weeks using weekly telephone interviews. RESULTS: Using multilevel modeling, we found the following: (1) men, participants in fraternity/sorority organizations, students traveling on spring break trips, and those with higher fun-social alcohol expectancies drank more during the regular semester; (2) alcohol use did not increase during spring break week in general; however, (3) spring break travelers increased their alcohol use during spring break. CONCLUSIONS: Spring break trips are a risk factor for escalated alcohol use both during the academic semester and during spring break trips, suggesting that some students may seek out opportunities for excessive alcohol use. Results are discussed in terms of niche selection and prevention implications.

Adolescent↗
PubMed1985

Seasonal and circadian patterns of circulating prolactin during lactation and seasonal quiescence in the tammar, Macropus eugenii.

Prolactin was measured in peripheral plasma of female tammars once a week for 14 months and every 2 months it was measured in a subgroup of 7 tammars at hourly intervals for 28 h to determine short-term changes in concentration. During the course of the study 6 females gave birth in January/February and reared their young to weaning in October-November, while another 4 gave birth 1.5-3.0 months later and weaned their young in November-December. Concentrations of prolactin were less than 40 ng/ml in a non-lactating animal and for the first 140 days of lactation in the others. Between 140 and 180 days of lactation the concentrations of prolactin fluctuated between 10 and greater than 100 ng/ml and thereafter remained high until the young vacated the pouch for the last time at about 250 days. After pouch exit the concentrations declined to about 40 ng/ml even though lactation continued for a further 21-35 days. Although the short-term patterns of prolactin concentrations showed no consistent relationship between light-dark phases there was an increase in the magnitude and duration of peaks of plasma prolactin which correlated with the stage of lactation. Removal of pouch young aged between 203 and 242 days for 24 h resulted in a rapid decrease in plasma prolactin concentration which was reversed when the young was returned to the pouch, indicating that the high levels of prolactin in the second half of lactation may be maintained by the sucking stimulus of the pouch young. This period of lactation, therefore, may be equated with lactation in eutherians, but there appears to be no eutherian equivalent to early lactation in the tammar.

Animals↗
PubMed1999

Sex ratio bias in postpartum-conceived Norway rat litters is produced by embryonic loss in midpregnancy.

In rats, dams that conceive in their postpartum oestrus and then lose their firstborn litter bias the sex ratio of the litter toward females in utero. The present study identifies the source of litter sex ratio bias in these postpartum pregnant non-lactating dams. The female bias arises first through the postconception loss of embryos, and second, the loss occurs in midpregnancy between the attachment of the blastocyst to the uterine wall on day 5 and full metrial gland development on day 14. Some pregnancies were restricted to one uterine horn to see if this loss (and thus the opportunity for litter sex ratio biasing) was influenced by local factors operating within the uterine horn. Embryonic loss was more closely associated with the number of embryos implanting in a single horn than with the number implanting in the litter, demonstrating that local crowding within a horn is sufficient for the preferential loss of male embryos. This loss did not cause an obvious decrease in the size of the live-born litter because only those horns with a surfeit of embryos lost them. This process was the same in the right and left horns; both carried and lost the same numbers of embryos. A dam that conceives in her postpartum oestrus and then loses her suckling litter forgoes the implantation delay and uterine healing caused by lactation. Male embryos are less successful at implanting in a uterus only recently vacated by a previous litter.

Animals↗
PubMed2002

Sister chromatid exchange analysis and chromosoma aberration studies in interventional cardiology laboratory workers: one war follow up study.

Invasive cardiology laboratory workers are occupationally exposed to chronic ionizing radiation. It is known that ionizing radiation has a damaging effect on chromosomes. In present study. we investigated the frequency of sister chromatid exchange (SCE) and chromosomal aberrations in 11 invasive cardiology laboratory workers and 11 healthy controls. After a vacation period, we took blood samples for chromosome analysis in months 0, 4, 8 and 12 (last two month period was the nonradiation time). The SCE frequencies did not change significantly after exposure to ionizing radiation in any worker. Our study has revealed that non-specific structural chromosome aberrations such as gaps, isogaps, acentric chromosomes, chromatids and chromosome breakage could be in the 4th and 8th months after ionizing radiation exposure in the metaphase plaques. All abnormal chromosomal effects had disappeared by the end of the two month non-exposure period in each worker. In conclusion, the results suggest that SCE frequencies are not significantly affected in invasive cardiology laboratory workers who are exposed occupationally to ionizing radiation, although some degree of reversible chromosomal aberrations did appear.

Adult↗
PubMed2004

Moderating effects of psychological job strain on the relationship between working hours and health: an examination of white-collar workers employed by a Japanese manufacturing company.

The effects of working hours on health were examined taking psychological job strain into account. White-collar workers employed at the main office of a Japanese manufacturing company provided data for analysis done in 1997. The eligible subjects were 286 workers aged 20-39. Causal relationships between working hours, health, and psychological job strain were examined by covariance structure analyses. The main findings were as follows: Not only working hours but also sleeping hours and vacations affected the workers' effort to deal with work as a work-related hour factor. Decision authority and skill discretion of Karasek's psychological job strain items significantly constituted a discretion in the work factor, and this factor moderated the effects of the work-related hour factor on health. The effects of psychological job strain, especially discretion, must always be taken into account in examinations of working hours and health.

Adult↗
PubMed2003

[Factors related to the mental health of workers dispatched to foreign countries].

The purpose of this study was to elucidate factors related to mental health standards of workers dispatched to foreign countries. The subjects were 317 male employees of an electronics company aged between 30 and 49 yr who were first dispatched to North America, Southeast Asia, or Western Europe without movement between the actual locations. A questionnaire survey was conducted on these subjects. Items of investigation consisted of 12 General Health Questionnaire (GHQ) items (indices of mental health standards), 4 baseline characteristics (age, assignment period, areas, and types of work), and 37 other items such as sociocultural factors, medical-sanitary factors, work factors, daily lifestyle factors, social support factors, and environmental factors. Multiple regression analysis was performed on the GHQ scores as criterion variables and baseline characteristics and various factors as explanatory variables. As a result, the following factors were correlated with GHQ scores in workers dispatched to foreign countries: inconvenience caused by different manners and customs (beta = 0.256) among sociocultural factors: inability to understand doctor's instructions (beta = 0.129) among medical-sanitary factors: bad relationships with local superiors (beta = 0.229) and the frequency of paid vacation in a year (beta = -0.129) among work factors: taking exercise less than once in a week (beta = 0.141) and smoking habit (beta = 0.136) among daily lifestyle factors, and lack of communication with the family (beta = 0.177), lack of persons to consult with (beta = 0.138), being dispatched alone (beta = 0.119), and lack of cultural exchange with the local community (beta = 0.117) among social support factors. Since social support factors accounted for 4 of the 10 items related to GHQ scores, personal relationships may be important for mental health in workers dispatched to foreign countries.

Adult↗
PubMed1997

Lack of deafness in Crigler-Najjar syndrome type 1: a patient survey.

We performed a questionnaire survey about 42 patients with Crigler-Najjar syndrome type 1 who were currently alive. Information was obtained on their age, sex, birth weight, gestation, parental consanguinity, other family members affected, age of onset of jaundice, neonatal and postneonatal bilirubin values, neonatal and postneonatal therapy, problems faced with phototherapy, liver transplantation, current growth status, current neurologic status, and the status of hearing. Patients were between 2 months and 21 years of age. There were 18 males and 24 females. Thirty-nine patients had been born at full term gestation and 3 had been preterm. Jaundice was noted on postnatal day 1 in 34%, between days 2 and 4 in 55%, and after day 11 of life in 11% of patients. In the neonatal period bilirubin values (mean +/- SD) were typically 19.8 +/- 4.5 mg/dL. Eighty-six percent of patients had neonatal peak bilirubin values of >20 mg/dL. Parental consanguinity was present in 44% and a history of Gilbert's disease in one parent was present in 10% of patients. Causes of exacerbations of jaundice reported were respiratory infections, febrile illnesses, vaccinations, fasting, surgery, emotional stress, and noncompliance with treatment. Neonatal therapy consisted of exchange transfusion in 28%, phototherapy in 79%, phenobarbitone in 20%, and cholestyramine, albumin, infusions, and plasmapheresis in one case each. The mainstay of postneonatal therapy was home phototherapy for 10 to 16 hours, primarily at night during sleep, using blue lights or a combination of blue and fluorescent lights. Some patients used innovatively designed phototherapy units. Problems reported with phototherapy were decreased effectiveness with age, poor compliance, restriction of activity and play, inability to travel or take vacations, irritation from eye shades, difficulty keeping eye protection on, difficulties in temperature maintenance, tanning of the skin, embarrassment from the need to be nearly nude during phototherapy, and difficulty in procuring phototherapy lamps. Other therapies that had been tried included oral agar, albumin infusions, antioxidants, acupuncture, bilirubin oxidase, calcium infusions, clofibrate, cruciferous vegetables, cholestyramine, chlorpromazine, flumecinol, plasmapheresis, tin mesoporphyrin, ursodeoxycholic acid, and urinary alkalinization. Fifteen children had undergone liver transplantation (5 auxiliary and 10 orthotopic). All 42 patients are reportedly of normal height and weight. Neurodevelopmental status is said to be normal in 77% of patients. Two patients have kernicterus, 4 have cerebellar symptoms, and 1 each has developmental delay, mild intention tremor, and mild speech delay. Hearing was reported to be normal in 94% of patients. The 2 children with hearing loss have conductive loss from otitis media. With home phototherapy prolonged, survival free of neurologic deficits is possible in Crigler-Najjar syndrome type 1, but there are many problems associated with phototherapy. Avoiding exacerbations of jaundice is an important aspect of management. Liver transplantation offers the prospect of cure but its risk versus benefit ratio is undetermined. Hearing loss was absent in the patients surveyed despite prolonged exposure to high bilirubin levels, which suggests that bilirubin may not be as ototoxic as is commonly believed.

Adolescent↗
PubMed2001

Access to orthopedic care for children with medicaid versus private insurance in California.

OBJECTIVE: To compare the availability of timely orthopedic care to a child with a fractured arm insured by Medi-Cal (California state Medicaid) and by private insurance. STUDY DESIGN: Fifty randomly chosen offices of orthopedic surgeons were telephoned with the following scenario: "My 10-year-old son broke his arm last week during a vacation" followed by a request for an appointment that week. Each office was called twice with an identical script except for insurance status: once with Medi-Cal and once with private insurance. RESULTS: All 50 offices offered an appointment to see the child with private insurance within 7 days. Only 1 of the same 50 offices offered an appointment to see the child with Medi-Cal within 7 days. Of the offices that would not see a child with Medi-Cal, 87% were unable to recommend an orthopedic office that accepted Medi-Cal. CONCLUSIONS: Timely access to orthopedic care was available in 100% of offices polled to a child with private insurance versus in 2% of offices to a child with Medi-Cal. This is a significant difference. Lack of timely orthopedic care may result in poor outcome, ie, if a fracture is not properly aligned in the first few weeks, a permanent deformity may result. Although causation cannot be established from this study, we suspect that Medi-Cal reimbursement rates below the cost of office overhead may be of significance. Although federal guidelines require that payments must be sufficient to enlist enough providers so that services to Medi-Cal recipients are available to the same extent as those available to the general population, this study finds that that children with Medi-Cal insurance have significantly less access to timely orthopedic care.

Appointments and Schedules↗
PubMed2001

UV doses of Americans.

The UV doses of Americans were never measured, but are needed for assessing the risks of UV-related health effects. We calculated these doses using a novel approach. The Environmental Protection Agency's (EPA) National Human Activity Pattern Survey (NHAPS) recorded the activity profiles of 9386 Americans over 24 months to assess their exposure to environmental pollutants, one of which is UV radiation. NHAPS used randomized telephone interviews to get their previous day's minute-by-minute activities. From NHAPS we extracted only the outdoor-daylight data of the northern and southern indoor workers (95%), stratifying by season, sex and age (0-21, 22-40, 41-59 and 60+ years) to find the average time Americans spend outdoors. Knowing the total daylight time and that while outdoors Americans are exposed to about 30% of the available solar UV (on a horizontal plane), we calculated their percent ambients. The average American's percent ambients are 2.6 and 2.5% for northern and southern females, respectively, and 3.5 and 3.6% for northern and southern males, respectively. Men over 40 years of age have the highest ambients (4%). From their ambients we calculated their annual doses using seasonal averages of UV measurements taken daily for over 2 years by EPA Brewer spectrophotometers located in four quadrants of the United States: Atlanta, GA; Boston, MA; Bozeman, MT and Riverside, CA. The average erythemal UV doses of Americans are about 25,000 J/m2/year, 22,000 for females and 28,000 for males, or 33,000 J/m2/year including a conservative continental U.S. vacation (7800 J/m2). Thus, we can now assess the risks of UV-related health effects for Americans.

Adolescent↗
PubMed2001

Suppression of UVB-induced cutaneous erythema by a previous UVB exposure.

People who vacation in sunny places are exposed to the sun on multiple occasions at least on a daily basis. The clinical assessment of sun exposure is erythema in the first 48 h after exposure and pigmentation at times greater than 3-5 days. The purpose of this investigations was to determine the extent to which consecutive erythemogenic exposures result in additive erythema responses. Studies were conducted in which volunteers were first exposed to a graded series of fluences of UVB radiation and then on subsequent days (1-3 days) the same sites along with the surrounding unexposed skin were challenged with varying fluences of UVB radiation. The erythema reactions were assessed clinically and were objectively documented with diffuse reflectance spectroscopy. The sites that received two exposures always showed a reduced erythema response compared to a single erythemogenic exposure. The suppression of erythema was more pronounced when the second exposure was given 48 h after the first. The erythema suppression was maximal when the first exposure was at 1.3 minimum erythema dose (MED). The pigment response to the first exposure was completely suppressed for fluences less than 1.5 MED. We thus provide evidence for a decoupling of the classical sequence of erythema-pigmentation response. We also show that the erythema induced by a second exposure may be substantially suppressed by an earlier exposure, and that this cannot be due to melanin photoprotection or due to substantial thickening of the stratum corneum. We propose that the cause may be some diffusible element of yet unknown origin.

Adult↗
PubMed2001

UV doses of American children and adolescents.

The ultraviolet (UV) doses of American young adults were never measured, but are needed for assessing UV-related health risks. These doses were calculated using a novel approach. The National Human Activity Pattern Survey recorded the daily minute-by-minute activities of about 2000 young adults (0-19 years) over the course of 2 years to assess their exposure to environmental pollutants. From that survey, only the outdoor daylight data of northern and southern girls and boys were extracted and stratified by season and age to find the time American children (0-5 and 6-12 years) and adolescents (13-19 years) spend outside. They spend about 10% of the day outdoors, but only get about 30% of the available terrestrial UV radiation (on a horizontal plane). American children have about the same percent personal ambients as adults (3.1%), 2.8% for girls and 3.4% for boys. Adolescents have the lowest personal ambients (2.6%), 2.1% for girls and 3.1% for boys. To get their UV doses, their percent ambients are multiplied by the total available terrestrial UV. Excluding vacation, the erythemally weighted UV doses for American children are 25 kJ/m2/year, 23 for girls and 28 for boys. Adolescents get the lowest UV exposure of any group, 21 kJ/m2/year, 18 for girls and 24 for boys. Young adult northern girls get 18 kJ/m2/year and boys get 21 kJ/m2/year, whereas southern girls get 24 kJ/m2/year and boys get 31 kJ/m2/year. The youngest children (0-5 years) get slightly higher summer doses. Thus, we can now assess the UV-related health risks for American children and adolescents.

Adolescent↗
PubMedDate not supplied

UV doses worldwide.

UV radiation affects human health. Human exposure to UV radiation causes a few beneficial health effects like vitamin D3 formation but it causes many detrimental health effects: sunburn, ocular damage, photoaging, immune suppression, DNA damage and skin cancer. In countries with fair-skinned populations, skin cancer is the most diagnosed of all cancers. In the United States in 2002, there were over one million new skin cancer cases. That means one out of every 285 people got skin cancer. Skin cancer of fair-skinned individuals is increasing at an alarming rate (4-6% per year) around the world and has now reached so-called "pandemic" proportions. Thus, it is important to know what UV doses people around the world get throughout their lives. This review covers how the outdoor UV doses are weighted for different biological effects, the most commonly used measuring devices for terrestrial and personal UV doses, the natural and other effects on terrestrial and personal UV doses, the time people spend outside, their ambient exposures and the terrestrial and personal UV doses of adult outdoor and indoor workers as well as children and adolescents around the world. Overall, outdoor-working adults get about 10%, while indoor-working adults and children get about 3% (2-4%) of the total available annual UV (on a horizontal plane). People's UV doses increase with increasing altitude and decreasing latitude; most indoor-working adult Europeans get 10,000-20,000 J/m2 per year, Americans get 20,000-30,000 J/m2 per year and Australians are estimated to get 20,000-50,000 J/m2 per year (excluding vacation, which can increase the dose by 30% or more).

Erythema↗
PubMedDate not supplied

[Sleep patterns of first-year nursing students].

This exploratory and descriptive study aimed at describing sleep patterns of first-year university students at the beginning of their course. The study was conducted at Campinas State University, Brazil. Data were collected in two points of time using Pittsburgh Sleep Quality Index. Results showed that students report sleep of better quality and increased length during vacations, when they kept sleep habits in conformity to chronotype. After classes started a greater number of subjects reported poor sleep quality and daytime lack of enthusiasm. Those changes could be due to the submission of subjects to schedules imposed by the university or to the irregularity of sleep habits assumed. Possible relationship between those sleep-changes and academic performance stresses the importance of ongoing studies on this issue.

Adult↗
PubMed2000

[Ecoepidemiology of urban schistosomiasis in Itamaracá Island, Pernambuco, Brazil].

INTRODUCTION: In 1988, 22 autochthonous cases from accidental exposure were registered in Forte Orange beach, Itamaracá Island, Pernambuco, Brazil. All cases occurred in middle-to-upper class individuals who were vacationing in the island. After the cases were identified, the major objective was to find breeding sites of schistosomiasis vectors and correlate the biological factors with the environmental conditions. METHODS: The environmental characteristics of the beach before human occupation were obtained from several documents. Also, a one-year malacological survey was conducted with monthly collection of mollusks, and the determination of their infectivity rates. RESULTS/CONCLUSIONS: The malacological survey was able to identify 20 breeding sites of Biomphalaria glabrata and 28 capture station were set up. Snails were collected and examined each month throughout a whole year. The results show a seasonal variation in the mollusk population density associated with infection rates and types of breeding sites. The importance of this new epidemiological profile of schistosomiasis in the State of Pernambuco relies on the fact that it can be related with the drastic human interference on the environment. Ecological, environmental, and demographic factors as well as the epidemiological characteristics of the disease have social and economic repercussions.

Animals↗
PubMed2002

[Noise-induced hearing loss and high blood pressure among city bus drivers].

OBJECTIVE: To estimate the prevalence of occupational noise-induced hearing loss and arterial hypertension among city bus drivers. METHODS: A cross-sectional study was carried out on a probability random sample of 108 city bus drivers taken out of a total of 1,529 estimated professionals in the city of Campinas, Brazil, in 1991. Drivers were interviewed using questionnaires on job history, shift work and vacation schedules and underwent clinical and laboratory examinations including measures of blood pressure, pure-tone audiometry, speech audiometry, and anthropometric data analysis after an informed consent was obtained. RESULTS: The prevalence of noise-induced hearing loss was 32.7%. According to Merluzzi's classification, 91.2% (31 cases) were classified as first and second-degree losses and the most affected frequencies were 6 kHz in 61.3%, and 4 kHz in 38.7%. There were no differences in the laterality of the first affected ear. The prevalence of arterial hypertension was 13.2% (PAD > or =90 mmHg; PAS > or =140 mmHg). CONCLUSIONS: The risk of noise-induced hearing loss was greater for drivers in job for more than 6 years, after controlling for age-related hearing loss. An odds ratio of 19.25 was found for those aged 45 or more (1.59<OR<386.75; p<0.01).

Adult↗