Urban vegetable contamination - The role of adhering particles and their significance for human exposure

While urban-grown vegetables could help combat future food insecurity, the elevated levels of toxic metals in urban soils need to be met with measures that minimise transfer to crops. This study firstly examines soil/dust particle inclusion in leafy vegetables and its contribution to vegetable metals (As, Ba, Cd, Co, Cr, Cu, Ni, Pb, Sb, and Zn), using vegetable, soil and dust data from an open-field urban farm in southeastern Sweden. Titanium concentrations were used to assess soil/dust adherence. Results showed that vegetables contained 0.05-1.3 wt% of adhering particles (AP) even after washing. With 0.5 % AP, an adult with an average intake of vegetables could ingest approximately 100 mg of particles per day, highlighting leafy vegetables as a major route for soil/dust ingestion. The presence of adhering particles also significantly contributed to the vegetable concentrations of As (9-20 %), Co (17-20 %), Pb (25-29 %), and Cr (33-34 %). Secondly, data from an indoor experiment was used to characterise root metal uptake from 20 urban soils from Sweden, Denmark, Spain, the UK, and the Czech Republic. Combining particle adherence and root uptake data, vegetable metal concentrations were calculated for the 20 urban soils to represent hypothetical field scenarios for these. Subsequently, average daily doses were assessed for vegetable consumers (adults and 3-6 year old children), distinguishing between doses from adhering particles and root uptake. Risks were evaluated from hazard quotients (HQs; average daily doses/tolerable intakes). Lead was found to pose the greatest risk, where particle ingestion often resulted in HQs > 1 across all assessed scenarios. In summary, since washing was shown to remove only a portion of adhering metal-laden soil/dust particles from leafy vegetation, farmers and urban planners need to consider that measures to limit particle deposition are equally important as cultivating in uncontaminated soil.

ETDA as a legacy soil chelatant: a comparative study to a more environmentally sensitive alternative for metal removal by Pistia stratiotes L

The accuracy of environmental risk assessment depends upon selecting appropriate matrices to extract the most risk-relevant portion of contaminant(s) from the soil. Here, we applied the chelatants EDTA and tartaric acid to extract a metal-contaminated soil. Pistia stratiotes was applied as an indicator plant to measure accumulation from the metal-laden bulk solutions generated, in a hydroponic experiment lasting 15 days. Speciation modeling was used to elucidate key geo-chemical mechanisms impacting matrix and metal-specific uptake revealed by experimental work. The highest concentrations of soil-borne metals were extracted from soil by EDTA (7.4% for Cd), but their uptake and translocation to the plant were restricted due to the formation of stable metal complexes predominantly with DOC. Tartaric acid solubilized metals to a lesser extent (4.6% for Cd), but a higher proportion was plant available due to its presence mainly in the form of bivalent metal cations. The water extraction showed the lowest metal extraction (e.g., 3.9% for Cd), but the metal species behaved similarly to those extracted by tartaric acid. This study demonstrates that not all extractions are equal and that metal-specific speciation will impact accurate risk assessment in soil (water)-plant systems. In the case of EDTA, a deleterious impact on DOC leaching is an obvious drawback. As such, further work should now determine soil and not only metal-specific impacts of chelatants on the extraction of environmentally relevant portions of metal(loid)s.

Future food contaminants: An assessment of the plant uptake of Technology-critical elements versus traditional metal contaminants

Technology-critical elements (TCEs) include most rare earth elements (REEs), the platinum group elements (PGEs), and Ga, Ge, In, Nb, Ta, Te, and Tl. Despite increasing recognition of their prolific release into the environment, their soil to plant transfer remains largely unknown. This paper provides an approximation of the potential for plant uptake by calculating bioconcentration factors (BCFs), defined as the concentration in edible vegetable tissues relative to that in cultivation soil. Here data were obtained from an indoor cultivation experiment growing lettuce, chard, and carrot on 22 different European urban soils. Values of BCFs were determined from concentrations of TCEs in vegetable samples after digestion with concentrated HNO3, and from concentrations in soil determined after 1) Aqua Regia digestion and, 2) diluted (0.1 M) HNO3 leaching. For comparison, BCFs were also determined for 5 traditional metal contaminants (TMCs; As, Cd, Cu, Pb, and Zn). The main conclusions of the study were that: 1)BCF values for the REEs were consistently low in the studied vegetables;2)the BCFs for Ga and Nb were low as well;3) the BCFs for Tl were high relative to the other measured TCEs and the traditional metal contaminants; and 4) mean BCF values for the investigated TCEs were generally highest in chard and lowest in carrot. These findings provide initial evidence that there are likely to be real and present soil-plant transfer of TCEs, especially in the case of Tl. Improvements in analytical methods and detection limits will allow this to be further investigated in a wider variety of edible plants so that a risk profile may be developed.

Using spatial-stream-network models and long-term data to understand and predict dynamics of faecal contamination in a mixed land-use catchment

An 11year dataset of concentrations of E. coli at 10 spatially-distributed sites in a mixed land-use catchment in NE Scotland (52km²) revealed that concentrations were not clearly associated with flow or season. The lack of a clear flow-concentration relationship may have been due to greater water fluxes from less-contaminated headwaters during high flows diluting downstream concentrations, the importance of persistent point sources of E. coli both anthropogenic and agricultural, and possibly the temporal resolution of the dataset. Point sources and year-round grazing of livestock probably obscured clear seasonality in concentrations. Multiple linear regression models identified potential for contamination by anthropogenic point sources as a significant predictor of long-term spatial patterns of low, average and high concentrations of E. coli. Neither arable nor pasture land was significant, even when accounting for hydrological connectivity with a topographic-index method. However, this may have reflected coarse-scale land-cover data inadequately representing "point sources" of agricultural contamination (e.g. direct defecation of livestock into the stream) and temporal changes in availability of E. coli from diffuse sources. Spatial-stream-network models (SSNMs) were applied in a novel context, and had value in making more robust catchment-scale predictions of concentrations of E. coli with estimates of uncertainty, and in enabling identification of potential "hot spots" of faecal contamination. Successfully managing faecal contamination of surface waters is vital for safeguarding public health. Our finding that concentrations of E. coli could not clearly be associated with flow or season may suggest that management strategies should not necessarily target only high flow events or summer when faecal contamination risk is often assumed to be greatest. Furthermore, we identified SSNMs as valuable tools for identifying possible "hot spots" of contamination which could be targeted for management, and for highlighting areas where additional monitoring could help better constrain predictions relating to faecal contamination.

Mobility and toxicity of heavy metal(loid)s arising from contaminated wood ash application to a pasture grassland soil

Heavy metal(loid) rich ash (≤10,000 mg kg^-1 total As, Cr, Cu and Zn) originating from the combustion of contaminated wood was subjected to several experimental procedures involving its incorporation into an upland pasture soil. Ash was added to soil that had been prior amended with local cattle manure, replicating practices employed at the farm scale. Metal(loid) concentrations were measured in soil pore water and ryegrass grown on soil/manure plus ash mixtures (0.1-3.0% vol. ash) in a pot experiment; toxicity evaluation was performed on the same pore water samples by means of a bacterial luminescence biosensor assay. Thereafter a sequential extraction procedure was carried out on selected soil, manure and ash mixtures to elucidate the geochemical association of ash derived metal(loid)s with soil constituents. Predictive modelling was applied to selected data from the pot experiment to determine the risk of transfer of As to meat and milk products in cattle grazing pasture amended with ash. The inclusion of manure to soils receiving ash reduced phyto-toxicity and increased ryegrass biomass yields, compared to soil with ash, but without manure. Elevated As and Cu concentrations in pore water and ryegrass tissue resulting from ash additions were reduced furthest by the inclusion of manure due to an increase in their geochemical association with organic matter. Zinc was the only measured metal(loid) to remain uniformly soluble and bioavailable regardless of the addition of ash and manure. Risk modelling on pot experimental data highlighted that an ash addition of >1% (vol.) to this pasture soil could result in As concentrations in milk and meat products exceeding acceptable limits. The results of this study therefore suggest that even singular low doses of ash applied to soil increase the risk of leaching of metal(loid)s and intensify the risk of As transfer in the food chain.

Assessing dietary exposure to cadmium in a metal recycling community in Vietnam: age and gender aspects

This study estimates the dietary exposure to cadmium (Cd), and associated potential health risks, for individuals living and working in a metal recycling community (n=132) in Vietnam in comparison to an agricultural (reference) community (n=130). Individual-level exposure to Cd was estimated through analysis of staple foodstuffs combined with information from a food frequency questionnaire. Individual-level exposure estimates were compared with published 'safe' doses to derive a Hazard Quotient (HQ) for each member of the study population. Looking at the populations as a whole, there were no significant differences in the diets of the two villages. However, significantly more rice was consumed by working age adults (18-60 years) in the recycling village compared to the reference village (p<0.001). Rice was the main staple food with individuals consuming 461±162g/d, followed by water spinach (103±51kg/d). Concentrations of Cd in the studied foodstuffs were elevated in the metal recycling village. Values of HQ exceeded unity for 87% of adult participants of the metal recycling community (39% had a HQ>3), while 20% of adult participants from the reference village had an HQ>1. We found an elevated health risk from dietary exposure to Cd in the metal recycling village compared to the reference community. WHO standard of 0.4mg Cd/kg rice may not be protective where people consume large amounts of rice/have relatively low body weight.

Urban geochemistry: research strategies to assist risk assessment and remediation of brownfield sites in urban areas

Urban geochemical maps of Wolverhampton and Nottingham, based on multielement analysis of surface soils, have shown distribution patterns of "total" metals concentrations relating to past and present industrial and domestic land use and transport systems. Several methods have been used to estimate the solubility and potential bioavailability of metals, their mineral forms and potential risks to urban population groups. These include sequential chemical extraction, soil pore water extraction and analysis, mineralogical analysis by scanning electron microscopy, source apportionment by lead isotope analysis and the development of models to predict metal uptake by homegrown vegetables to provide an estimate of risk from metal consumption and exposure. The results from these research strategies have been integrated with a geographical information system (GIS) to provide data for future land-use planning.

Prevalence of psychiatric disorders in youths across five sectors of care

OBJECTIVE

To examine the prevalence of psychiatric disorders among youths from the following five public sectors of care: alcohol and drug services (AD), child welfare (CW), juvenile justice (JJ), mental health (MH), and public school services for youths with serious emotional disturbance (SED) in San Diego, California.

METHOD

The Diagnostic Interview Schedule for Children was administered between October 1997 and January 1999 for 1,618 randomly selected youths aged 6-18 years who were active in at least one of the five sectors.

RESULTS

Fifty-four percent of the participants met criteria for at least one study disorder. Attention-deficit/hyperactivity disorder (ADHD) and disruptive behavior disorders (50%) were much more common than anxiety (10%) or mood (7%) disorders. Youths who were active in the MH and SED sectors were more likely than those not in these sectors to meet criteria for a disorder; youths in the CW sector were least likely.

CONCLUSIONS

Rates of psychiatric disorders, specifically ADHD and disruptive behavior disorders, are extremely high for youths in public sectors of care. Rates are generally higher in sectors designed to serve youths with psychiatric needs, but the prevalence of disorders was also high in sectors not specifically designed for this need (e.g., CW and JJ).

Prevalence of adolescent substance use disorders across five sectors of care

OBJECTIVE

To examine the prevalence of substance use disorders (SUDs) among adolescents who received services in one or more of the following public sectors of care: alcohol and drug (AD), juvenile justice (JJ), mental health (MH), public school-based services for youths with serious emotional disturbance (SED), and child welfare (CW), in relation to age, gender, and service sector affiliation.

METHODS

Participants included 1,036 adolescents aged 13 to 18 years, randomly sampled from all youths who were active in at least one of the above five sectors of care (N = 12,662) in San Diego County California. SUDs were assessed through structured diagnostic interviews conducted from October 1997 through January 1999.

RESULTS

SUDs were found for youths in all sectors of care, with lifetime rates of 82.6% in AD, 62.1% in JJ, 40.8% in MH, 23.6% in SED, and 19.2% in CW. Rates of SUDs were significantly higher among older youths and males. Sector differences held even when accounting for the effects of age and gender.

CONCLUSIONS

SUDs are highly prevalent among youths receiving care in the AD service sector as well as other sectors, particularly JJ and MH. These findings have implications for assessment, treatment, and service coordination for youths with SUDs in diverse sectors of public care.

Adolescent alcohol and drug abuse and health

PURPOSE

To examine the relationship of adolescent alcohol and drug use over a 5-year period to cumulative health problems in late adolescence and young adulthood.

METHODS

We prospectively examined self-reported health problems in a sample of adolescents, some of whom received treatment for substance use disorders and had consistently poor substance use outcomes (n = 38), some of whom received treatment for substance use disorders and had positive substance use outcomes (n = 30), and a low alcohol and drug use community comparison group (n = 48). Data regarding health-related problems of these adolescents (mean, 15.9 years; 83% Caucasian; 56.5% female) were collected at 2, 4, and 6 years following initial assessments.

RESULTS

Alcohol and/or drug involvement severe enough to warrant treatment during adolescence was associated with more cumulative health problems and severe health problems for girls and more cumulative health problems for boys. Protracted and continuous abuse of alcohol and drugs was associated with more cumulative and severe health problems for girls and more severe health problems for boys.

CONCLUSIONS

These results suggest that significant health problems and concerns are related to both brief and protracted alcohol and drug abuse during adolescence. Health problems will likely become even more evident as early-onset, chronic substance abusers continue to age.

Housing outcomes for homeless adults with mental illness: results from the second-round McKinney program

In the early 1990s the National Institute of Mental Health sponsored projects in four cities that served a total of 896 homeless mentally ill adults. Each project tested the effectiveness of different housing, support, and rehabilitative services in reducing homelessness. Most homeless individuals resided in community housing after the intervention. The proportion in community housing varied between sites. A 47.5 percent increase in community housing was found for those in active treatment conditions. At final follow-up, 78 percent of participants in community housing were stably housed. The findings indicate that effective strategies are available for serving homeless individuals with severe mental illness.

Recruitment and retention of homeless mentally ill participants in research

Are the unstable residential and personal lives of homeless mentally ill (HMI) individuals so difficult as to preclude their inclusion in rigorous, longitudinal research protocols? The continued presence of HMI individuals in U.S. society has prompted the mental health research community to reconsider the question of whether clinical trial and demonstration research protocols are feasible with this population. This article briefly examines the existing research literature on recruitment and retention rates in recent studies of this population and, in more detail, the specific strategies used by researchers to recruit and retain HMI individuals as research participants. In general, with sufficient resources and the persistent use of existing strategies for recruitment and retention, HMI individuals can be successfully studied over time. Finally, to demonstrate this potential, the recruitment and retention strategies of the San Diego McKinney Homeless Mentally Ill Demonstration Research Program are described.

Recruitment and retention of homeless mentally ill participants in research

Are the unstable residential and personal lives of homeless mentally ill (HMI) individuals so difficult as to preclude their inclusion in rigorous, longitudinal research protocols? The continued presence of HMI individuals in U.S. society has prompted the mental health research community to reconsider the question of whether clinical trial and demonstration research protocols are feasible with this population. This article briefly examines the existing research literature on recruitment and retention rates in recent studies of this population and, in more detail, the specific strategies used by researchers to recruit and retain HMI individuals as research participants. In general, with sufficient resources and the persistent use of existing strategies for recruitment and retention, HMI individuals can be successfully studied over time. Finally, to demonstrate this potential, the recruitment and retention strategies of the San Diego McKinney Homeless Mentally Ill Demonstration Research Program are described.

Type of maltreatment as a predictor of mental health service use for children in foster care

This study examined predictors of utilization of mental health services among children and adolescents in foster care. Of particular interest was whether the type of maltreatment was related to utilization of services. Subjects were 662 children ages 2-17 who were in foster care for at least 5 months. Service utilization, demographic, and behavioral data were collected through interviews with the subjects' caretakers. Type of maltreatment data were collected from Child Welfare case records. Fifty-six percent of the subjects had received mental health services. Children removed from their homes due to sexual and/or physical abuse were more likely to receive services than were those who were removed due to neglect and caretaker absence. Clinically significant behavior problems were associated with greater likelihood of receiving services, except for the sexually abused group who were very likely to receive services regardless of their behavior problem score. Sexually abused youth also received a higher number of outpatient visits than did neglected youth. In sum, youth who have experienced "active" types of maltreatment are more likely to receive mental health services than are those with "passive" types of maltreatment, even when the effect of severity of mental health problems is controlled.

Effects of substance abuse on housing stability of homeless mentally Ill persons in supported housing

OBJECTIVE

The study examined two-year housing outcomes of homeless mentally ill clients who took part in an experimental investigation of supported housing. The relationships between housing outcomes and client characteristics, such as gender, psychiatric diagnosis, and substance use, were of primary interest.

METHODS

A two-factor, longitudinal design was used. Homeless clients in San Diego County who were diagnosed as having chronic and severe mental illness were randomly assigned to four experimental conditions. Half of the clients were given better access to independent housing through Section 8 rent subsidy certificates. All clients received flexible case management, but half were provided more comprehensive case management services. The housing of each individual over a two-year period was classified in one of three categories: stable independent housing, stable housing in another setting in the community, or unstable housing.

RESULTS

Clients with access to Section 8 housing certificates were much more likely to achieve independent housing than clients without access to Section 8 certificates, but no differences emerged across the two different levels of case management. Housing stability was strongly mediated by several covariates, especially the presence of problems with drugs or alcohol.

CONCLUSIONS

Supported housing interventions can be very successful tools for stabilizing homeless mentally ill individuals in independent community settings. Advantages include the low level of restrictiveness of these settings and the preference of many clients for independent housing. However, the success of supported housing projects is likely to depend strongly on the specific characteristics of the population being served.

Childhood abuse as a precursor to homelessness for homeless women with severe mental illness

Previous studies of childhood abuse levels among homeless women have typically focused either on single homeless women or female heads of families; almost none have focused specifically on homeless women with severe mental illness. This study explores rates of childhood physical and sexual abuse among 120 homeless women with severe mental illness. Correlates of experiencing childhood abuse are considered, including mental health outcomes and when women first become homeless. The prevalence of childhood abuse in this sample of women was substantially higher than among homeless women in general. The experience of childhood abuse was related to increased suicidality, and resulted in symptoms of posttraumatic stress disorder for some women. Women who had suffered abuse were also much more likely to become homeless during childhood and it is suggested that this is an important precursor to homelessness for many homeless women with chronic and severe mental illness.

Peritraumatic dissociation and posttraumatic stress in male Vietnam theater veterans

OBJECTIVE

The aim of this study was to determine the reliability and validity of a proposed measure of peritraumatic dissociation and, as part of that effort, to determine the relationship between dissociative experiences during disturbing combat trauma and the subsequent development of posttraumatic stress disorder (PTSD).

METHOD

A total of 251 male Vietnam theater veterans from the Clinical Examination Component of the National Vietnam Veterans Readjustment Study were examined to determine the relationship of war zone stress exposure, retrospective reports of dissociation during the most disturbing combat trauma events, and general dissociative tendencies with PTSD case determination.

RESULTS

The total score on the Peritraumatic Dissociation Experiences Questionnaire--Rater Version was strongly associated with level of posttraumatic stress symptoms, level of stress exposure, and general dissociative tendencies and weakly associated with general psychopathology scales from the MMPI-2. Logistic regression analyses supported the incremental value of dissociation during trauma, over and above the contributions of level of war zone stress exposure and general dissociative tendencies, in accounting for PTSD case determination.

CONCLUSIONS

These results provide support for the reliability and validity of the Peritraumatic Dissociation Experiences Questionnaire--Rater Version and for a trauma-dissociation linkage hypothesis: the greater the dissociation during traumatic stress exposure, the greater the likelihood of meeting criteria for current PTSD.

Feed intake and apparent digestibility of hay-supplemented brassica diets for lambs

Animal performance on brassica diets often does not reflect laboratory estimates of the nutritive value of the herbage. Hay supplementation of brassica pastures should increase diet DM and fiber intake and dilute anti-quality factors. The optimal hay:brassica ratio needed to achieve desirable animal performance, however, has not been established. Effects of changing the hay:brassica ratio on feed and water intake, apparent digestibility of diets, thyroid status, and anemia were examined in five Dorset-cross wether spring lambs (initial BW 32.8 +/- 3.2 kg). The experimental design was a 5 x 5 Latin square with 21-d periods (7 d of adaptation, 6 d of intake measurement, and an 8-d digestion trial with jugular blood drawn on last day). Diets contained chopped grass hay and tyfon (turnip x Chinese cabbage hybrid) at five hay:tyfon ratios (DM basis): 100:0; 75:25; 50:50; 25:75; and 0:100. As the proportion of tyfon in the diet increased, there were linear increases (P < .05) in ad libitum DMI (922 to 1,359 g/d), total water intake (1.75 to 13.06 L/d), digestible DMI (401 to 952 g/d), and apparent digestibility of DM (55.9 to 86.3%), CP (52.9 to 84.5%), and neutral detergent solubles (57.2 to 88.5%). Hay plus tyfon diets exhibited negative associative effects for apparent digestibility of NDF, ADF, and cellulose. Plasma thyroxine and triiodothyronine, packed cell volume, red blood count, and hemoglobin concentration were not affected by diet. Tyfon influenced DMI and apparent digestibility of diets in a manner similar to that of a concentrate.

Problems in families of male Vietnam veterans with posttraumatic stress disorder

Interviews were conducted with a nationally representative sample of 1,200 male Vietnam veterans and the spouses or co-resident partners of 376 of these veterans. The veteran interview contained questions to determine the presence of posttraumatic stress disorder (PTSD) and items tapping family and marital adjustment, parenting problems, and violence. The spouse or partner (S/P) interview assessed the S/P's view of these items, as well as her view of her own mental health, drug, and alcohol problems and behavioral problems of school-aged children living at home. Compared with families of male veterans without current PTSD, families of male veterans with current PTSD showed markedly elevated levels of severe and diffuse problems in marital and family adjustment, in parenting skills, and in violent behavior. Clinical implications of these findings are discussed.

Problems in families of male Vietnam veterans with posttraumatic stress disorder

Interviews were conducted with a nationally representative sample of 1,200 male Vietnam veterans and the spouses or co-resident partners of 376 of these veterans. The veteran interview contained questions to determine the presence of posttraumatic stress disorder (PTSD) and items tapping family and marital adjustment, parenting problems, and violence. The spouse or partner (S/P) interview assessed the S/P's view of these items, as well as her view of her own mental health, drug, and alcohol problems and behavioral problems of school-aged children living at home. Compared with families of male veterans without current PTSD, families of male veterans with current PTSD showed markedly elevated levels of severe and diffuse problems in marital and family adjustment, in parenting skills, and in violent behavior. Clinical implications of these findings are discussed.

Responses to Depression Scale items among Mexican-Americans and non-Hispanic whites

This study examined two possible patterns of ethnic differences in responses to Center for Epidemiologic Studies Depression scale items: isolated differences in relatively disparate items and consistent differences in conceptually related items. Data were from randomly selected household residents (4,222 Mexican-Americans, 1,063 non-Hispanic Whites). The most common symptoms reflected lack of positive affect; least common were crying, feelings of failure, and feeling disliked. Mexican-Americans were more likely than non-Hispanic Whites to report symptoms that reflect lack of positive affect, which suggests possible limitations on this dimension's cross-cultural validity. U.S.-born Mexican-Americans reported more somatic and negative affect symptoms than did the Mexican-born, which suggests an overall immigration difference in depressed mood.

Influence of nutritional restriction during late gestation on production measures and passive immunity in beef cattle

A 2-yr study was conducted to examine the effects of nutritional restriction of beef cows during the last 90 d of gestation on neonatal immunity and production. Cows were fed corn silage, soybean meal diets; dietary treatments consisted of 1) control (CO), 100% of the NRC (1984) requirements for protein and energy, or 2) restricted (RS), 57% of the NRC requirements for energy and protein. All cows received adequate amounts of this diet postpartum. Each year, 26 Angus cows were grouped by age and weight:height ratio (WT:HT) and allotted randomly to treatments. Calves born to dams within each nutritional treatment group were allotted to one of two colostral treatments: 1) colostrum from their dam, or 2) colostrum from a cow from the other nutritional treatment group. Calves from restricted dams had higher cortisol (33.8 vs 26.1 ng/ml) and lower triiodothyronine (T3) (3.82 vs 4.01 ng/ml) concentrations (P less than .05). Maternal nutrition did not affect either colostrum immunoglobulin G (IgG) concentration (43.0 vs 39.5 mg/ml for RS and CO, respectively) or the calves' serum IgG concentration (19.06 vs 20.17 mg/ml IgG at 24 h for RS and CO, respectively). Yet, calves fed colostrum from restricted cows tended to have lower serum IgG concentration (17.2 vs 22.0 mg/ml IgG at 24 h).

Influence of glucocorticoid on macromolecular absorption and passive immunity in neonatal lambs

The relationship of serum cortisol to immunoglobulin absorption and gut closure in cesarean-derived neonatal lambs was evaluated in two trials. In trial 1, 21 lambs were obtained on d 136 to 138 of gestation, and in trial 2, 17 lambs were obtained on d 140 to 142 of gestation. At birth, lambs were assigned randomly to four treatments: 1) control (CO), 1 ml saline/kg BW every 4 h; 2) a drug to lower cortisol (LC), 5 mg metyrapone/kg BW every 4 h; 3) single-peak cortisol (SP), 10 IU ACTH/kg BW at 0 h; or 4) elevated cortisol (HC), 5 mg cortisol/kg BW every 4 h in trial 1 or 10 IU ACTH/kg BW every 4 h in trial 2. The treatment period was 24 and 48 h after delivery for trial 1 and 2, respectively. Lambs were fed pooled bovine colostrum every 4 h for 48 h after birth at 2 and 3.5% BW for trial 1 and 2, respectively. Compared with CO, HC increased serum cortisol, LC decreased serum cortisol and SP elevated serum cortisol concentrations through at least 8 h for both trials. In trial 1, HC and SP lambs exhibited elevated serum IgG, IgM and IgA concentrations by 20 h compared with CO. However, no difference in serum immunoglobulin concentration was observed at 36 h among CO, HC and SP. Conversely, LC had the lowest immunoglobulin concentration at 36 and 48 h, and precocious closure to immunoglobulin absorption had occurred by 20 h (P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Psychiatric disorder in male veterans and nonveterans

Prevalences of Diagnostic Interview Schedule/DSM-III psychiatric disorders for male veterans and nonveterans from four war eras were estimated using data from over 7500 male community respondents interviewed by the Epidemiologic Catchment Area program at five geographic areas across the country. Veterans serving after Vietnam (Post-Vietnam era) had greater lifetime and 6-month prevalences of psychiatric disorder than their nonveteran counterparts, whereas the reverse tended to be the case for the Vietnam, Korean, and World War II war eras. Comparisons across war eras revealed a trend for more psychiatric disorder, especially substance abuse, in younger veterans and nonveterans than in older respondents.

Acculturation and the probability of use of health services by Mexican Americans

How does level of acculturation affect the probability that Mexican Americans use general health, mental health, and human social services? We studied this question using data from a general population sample of Mexican Americans (N = 1,055). Data were elicited in face-to-face interviews. After controlling for sociodemographic and economic factors, health status, and insurance coverage, Mexican Americans who were less acculturated had significantly lower probabilities of an outpatient medical visit for physical health problems and of a visit to a mental health specialist or human service provider for emotional problems. The less acculturated with good perceived general health were especially unlikely to receive outpatient medical care. Having Medicaid coverage was associated with a larger increase in the probability of an inpatient medical admission for the more acculturated than for the less acculturated. Other individual characteristics had generally similar effects on use of medical and mental health services for both the more and the less acculturated Mexican Americans.

Anxiety disorders among Mexican Americans and non-Hispanic whites in Los Angeles

This report from the Los Angeles site of the NIMH Epidemiologic Catchment Area study reveals significant ethnic and national origin differences in lifetime prevalence rates for three out of six specific, DSM-III-defined anxiety disorders. In the case of simple phobia, United States-born Mexican Americans report higher rates than native non-Hispanic whites or immigrant Mexican Americans, the latter two groups having similar rates. Mexican Americans born in the United States had higher rates of agoraphobia than immigrant Mexican Americans, and non-Hispanic whites reported higher lifetime rates of generalized anxiety disorder compared with both immigrant and native Mexican Americans. Neither ethnic nor national origin differences in lifetime prevalence rates were found for panic disorder, social phobia, and obsessive-compulsive disorder. Selective migration is postulated as a potential factor influencing prevalence differences between native and immigrant Mexican Americans.

Distribution of major mental disorders in an US metropolis

This paper reviews the evolution of psychiatric nosologies in North America and the major epidemiological surveys of Mental Disorders culminating with the recently completed National Institute of Mental Health Epidemiologic Catchment Area project (NIMH-ECA). The NIMH-ECA examined the prevalence of diagnosable (DSM III) Mental disorders in 5 U.S. communities utilizing a highly structured diagnostic interview, the Diagnostic Interview Schedule (DIS). Data from the Los Angeles ECA, one of five study sites are presented with particular emphasis on cross-cultural comparison (Mexican Americans versus Non Hispanic Whites). Overall, there were only a few cross-cultural differences in prevalence of specific diagnoses. Mexico-born Mexican Americans showed a lower prevalence for most disorders examined than their U.S. born counterparts, and a subgroup of Mexican-American women (those over the age of 40) showed higher rates of phobic and dysthymic disorders as well as a greater number of functional somatic symptoms than other groups.

Factors affecting the probability of use of general and medical health and social/community services for Mexican Americans and non-Hispanic whites

Are individual characteristics associated with use of general and mental health and human service sectors similar for Mexican Americans (MAs) and non-Hispanic whites (NHWs)? We addressed this question using data from the Los Angeles site of the NIMH Epidemiologic Catchment Area Program. A random sample of the general population of two mental health catchment areas was interviewed in 1983-1984. With four exceptions, individual variation in sociodemographic factors, insurance coverage, and health status had similar effects on the probability of use of the general and mental health and human service sector for both NHWs and MAs. Recent psychiatric disorder was associated with greater use of general medical providers for mental health care for both NHWs and MAs, but significantly more so for NHWs. Female NHWs were more likely to use the human service sector (e.g., social service agencies) than male NHWs, but gender had no effect on this type of use for MAs. Higher job status was associated with greater use of outpatient general medical services, but significantly more so for NHWs than MAs. By contrast, having private health insurance was associated with a greater increase in use of outpatient general medical services for MAs than for NHWs.

Depressive symptomatology in northern Mexico adults

A cross-sectional field survey of 991 people in Tijuana, Mexico, a border city experiencing unbridled population growth, was designed to measure levels of depressive symptoms and identify correlates using the Center for Epidemiological Studies Depression measure (CES-D). Bivariate and multivariate analyses of the data indicate that similar variables are highly associated with depressive symptoms in the US and Mexico: low socioeconomic status, female gender, disrupted marital status, unemployment, and poor health. Risk-for-caseness is 19.1 per cent for males and 33.0 per cent for females.

Lifetime prevalence of specific psychiatric disorders among Mexican Americans and non-Hispanic whites in Los Angeles

The lifetime prevalence of specific DSM-III-defined psychiatric disorders among 1243 Mexican-American and 1309 non-Hispanic white residents of two Los Angeles communities is reported from the Los Angeles site of the Epidemiologic Catchment Area (ECA) research study. Results from household interviews in response to the National Institute of Mental Health Diagnostic Interview Schedule revealed overall rates of disorders for the total Los Angeles sample and ethnic subsamples that were similar to rates reported from the initial three ECA sites. Non-Hispanic whites reported far more drug abuse/dependence and more major depressive episodes than Mexican Americans. Young non-Hispanic white women reported high rates of major depressive episodes and drug abuse/dependence. Alcohol abuse/dependence is highly prevalent among Mexican-American and non-Hispanic white men of any age. Mexican-American women infrequently abuse or become dependent on drugs or alcohol at any age. Dysthymia, panic disorder, and phobia are somewhat more prevalent among Mexican-American women over 40 years of age compared with both non-Hispanic white women over and Mexican-American women under 40 years of age. Antisocial personality is predominantly a disorder of young men of both ethnic groups.

Six-month prevalence of specific psychiatric disorders among Mexican Americans and non-Hispanic whites in Los Angeles

The current prevalence of DSM-III psychiatric disorders was assessed using the Diagnostic Interview Schedule (DIS) as part of a Los Angeles household population survey. The Los Angeles prevalence estimates were compared with sex- and age-adjusted estimates from four other US field sites, all of which were part of the Epidemiologic Catchment Area (ECA) program. Overall, few significant differences in household population rates were found between Los Angeles and the other ECA sites. Within the Los Angeles household sample, the current prevalence of disorder among Mexican Americans was compared with that among non-Hispanic whites. Non-Hispanic whites had higher rates of drug abuse/dependence than Mexican Americans; the rates among non-Hispanic whites in Los Angeles were also higher than those found at other ECA sites. Mexican Americans displayed higher rates of severe cognitive impairment, a finding that likely reflects ethnic and educational bias in the measurement of cognitive impairment. Another ethnic difference was found only for one specific age and sex group: Mexican-American women 40 years of age or older had strikingly high rates of phobia.

Utilization of health and mental health services by Los Angeles Mexican Americans and non-Hispanic whites

Utilization of general medical and mental health services by respondents in the Los Angeles Epidemiologic Catchment Area (ECA) site was compared with that in three ECA sites studied previously (New Haven, Conn, Baltimore, and St Louis). Within the Los Angeles sample, Mexican-American patterns of utilization were compared with those for non-Hispanic whites. Los Angeles respondents were less likely than those at other ECA sites to make ambulatory health care visits and to be hospitalized for physical or mental health reasons. Mexican Americans were less likely than non-Hispanic whites to report ambulatory health care but were as likely to have been hospitalized. Six percent of Los Angeles respondents reported a recent mental-health-care visit as compared with 6% to 7% of respondents at the other ECA sites. However, among respondents with Diagnostic Interview Schedule DSM-III disorders diagnosed within the six months prior to the interview, a lower proportion made a mental health visit in Los Angeles (14%) compared with the other sites (16% to 20%). Of those who made a mental-health-care visit, Los Angeles respondents with a recently diagnosed disorder were more likely than comparable respondents at the other ECA sites to visit a mental health specialist rather than a general medical care provider. Mexican Americans with a recently diagnosed mental disorder were only half as likely as non-Hispanic whites (11% vs 22%, respectively) to have made a mental health visit. However, when Mexican Americans with Diagnostic Interview Schedule/DSM-III did make a mental health visit, they were as likely as non-Hispanic whites to see a mental health specialist.

Which Mexican-Americans underutilize health services?

Data collected from the Los Angeles site of the National Institute of Mental Health Epidemiologic Catchment Area Program were used to examine the utilization of health services in a community population. Mexican-Americans, especially the less acculturated, had significantly lower rates of use of outpatient, but not inpatient, care than non-Hispanic whites. Differences were greater for mental than physical health care. Less acculturated Mexican-Americans made very little use of either mental health specialists or the human services sector (e.g., religious leaders). Among those with a recent psychiatric disorder, non-Hispanic whites were seven times more likely to use outpatient mental health services than the less acculturated Mexican-Americans.

Somatization in the community: relationship to disability and use of services

We tested the hypotheses that an abridged somatization construct that we had developed would be associated with use of health services, preferential use of medical over mental health services, and an index of disability. These hypotheses were tested using structured interview data from 3,132 randomly selected community respondents. We found that: respondents meeting criteria for somatization reported a heavier use of health services than non-somatizers; of those respondents meeting criteria for a psychiatric diagnosis, somatizers preferentially used medical over mental health services whereas non-somatizers reported the opposite trend; and somatizers were more likely than non-somatizers to report recent sick leave or restricted activity.

Psychiatric diagnoses of medical service users: evidence from the Epidemiologic Catchment Area Program

Based on data from the five sites of the National Institute of Mental Health-sponsored Epidemiologic Catchment Area (ECA) Program, this paper examines the prevalence of psychiatric disorder among recent medical service users versus nonusers, with a particular focus on affective disorders, substance abuse/dependence, and phobias. The rate of current Diagnostic Interview Schedule (DIS) disorders among medical users in all five ECA sites is 21.7 per cent (slightly higher than general population rates) versus 16.7 per cent among nonusers; there is generally no difference between users and nonusers with past DIS diagnoses. Affective disorders were among the most common mental disorders of medical service users, especially among females, with little variation between sites: females: users: 6.9 per cent to 9.3 per cent, nonusers: 3.4 per cent to 6.4 per cent, and males: users: 3.3 per cent to 6.5 per cent, nonusers: 1.2 per cent to 4.1 per cent. Rates of phobias among persons using medical services are also higher than among nonusers. Substance abuse disorders are at least as common among persons who use medical services (8 per cent to 14 per cent of male users) as among those who do not (9 per cent to 11 per cent of male nonusers). The high rates of affective disorders among women and of substance abuse among male medical service users underscore the need to increase the ability of general medical practitioners to recognize and manage or refer these conditions.

Perceived self-other differences in life events and mental health among Mexicans and Americans

The social context of reported stressful life events was examined as a determinant of psychiatric symptoms in four cultural groups: Anglo-Americans (n = 132), Mexican-Americans (n = 108), Mexicans in El Paso (n = 90), and Mexican nationals (n = 133). The perceived difference between life events experienced by the self and spouse or by the self and significant others constituted preliminary operational definitions of the social context of life events. Ten Psychiatric Epidemiology Research Interview (PERI) psychiatric symptom scales as well as a suicidal tendency scale and a hopelessness index constituted the measures of the dependent variables. The potential predictive value of the social contextual measures of life-event stress for mental health variables was generally supported by the findings. Results indicated a rank ordering of predicted effects, with Mexican nationals most susceptible to the psychological effects of the social context of life events and Anglo-Americans least susceptible.

The NIMH Epidemiologic Catchment Area program. Historical context, major objectives, and study population characteristics

The National Institute of Mental Health multisite Epidemiologic Catchment Area (ECA) program is described in the context of four previous psychiatric epidemiologic surveys that included a combined total of 4,000 subjects from Stirling County, the Baltimore Morbidity Study, Midtown Manhattan, and the New Haven third-wave survey. The ECA program is distinguished by its sample size of at least 3,500 subjects per site (about 20,000 total); the focus on Diagnostic Interview Schedule--defined DSM-III mental disorders; the one-year reinterview-based longitudinal design to obtain incidence and service use data; the linkage of epidemiologic and health service use data; and the replication of design and method in multiple sites. Demographic characteristics of community and sample populations are provided for New Haven, Conn, Baltimore, and St Louis.

The Spanish Diagnostic Interview Schedule. Reliability and comparison with clinical diagnoses

The National Institute of Mental Health Diagnostic Interview Schedule (DIS) was translated into Spanish. The reliability of the Spanish instrument, its equivalence to the English version, and its agreement with clinical diagnoses were examined in a study of 90 bilingual (English-and Spanish-speaking) and 61 monolingual (Spanish-speaking only) patients from a community mental health center. The study design involved two independent DIS administrations and one independent clinical evaluation of each subject.

Development of the Spanish-language version of the National Institute of Mental Health Diagnostic Interview Schedule

The use of the National Institute of Mental Health Diagnostic Interview Schedule (DIS) to elicit DSM-III-defined mental disorders among Hispanic respondents in the Los Angeles site of the Epidemiologic Catchment Area project required development of a Spanish translation of the instrument that would be understood readily by persons of Mexican, Puerto Rican, and Cuban origin. The translation was carried out using back translation, bilingual test respondents, a bilingual translation staff, an extensive committee of experienced bilingual clinicians as translation consultants, and revision following clinical evaluation. A study of its reliability and comparison with clinical diagnoses obtained with Spanish-speaking psychiatric outpatients indicated satisfactory equivalence of the Spanish DIS to the English version. Early international use of the Spanish DIS promises new data on the cross-cultural validity and prevalence rates of DSM-III-diagnosed disorders.

Post-traumatic stress disorder in Hispanic Vietnam veterans. Clinical phenomenology and sociocultural characteristics

The complex symptomatology of Hispanic Vietnam veterans receiving treatment for post-traumatic stress disorders (PTSD) was explored with the National Institute of Mental Health Diagnostic Interview Schedule, a structured diagnostic interview that yields current and lifetime operational diagnoses (e.g., DSM-III). Social networks and level of acculturation of these veterans were also examined and compared to those of a "control" group and a sample of veterans with DSM-III schizophrenic disorder (both samples included only Hispanic veterans from the Vietnam and post-Vietnam eras). All subjects reported heavy combat stress and met DSM-III criteria for PTSD. Most were very symptomatic and had significant social impairment. PTSD was rarely seen as a discrete entity but appeared instead mixed with symptom clusters cutting across various DSM-III diagnoses. Social networks of PTSD veterans were intermediate in size, frequency of contact with network members, and network density to those of the comparison groups. A distinctive feature of the PTSD group was the high proportion of negative relationships with close family members, especially spouses. "Highly" symptomatic PTSD veterans reported significantly smaller networks, fewer contacts outside the close family circle, and more negative emotionality directed toward family members than "minimally" symptomatic veterans. While all Hispanic groups studied were not significantly different in level of acculturation, PTSD veterans appeared more alienated from their cultural heritage than the other groups. The severe and polymorphous psychopathology found among these veterans suggests that "rap" groups alone may not constitute an adequate therapeutic approach and that more formal psychiatric therapies should be additionally considered in the management of Vietnam-linked PTSD.

Life event classifications and the event-illness relationship

Several theoretically important and distinct categories of life change are found in most life event scales. These categories can be organized in terms of at least three dimensions: the person's control over the event, the desirability of the event, and whether or not the independent variable of the event is confounded with the dependent variable of illness. It is important to separate conceptually and, to the extent possible, to distinguish empirically among events according to these dimensions, because several different models of the event-illness relationship are implied when events from several categories are combined. A secondary analysis of recently published data shows that the kinds of events associated with illness are undesirable events within the subject's control. It may not be necessary to consider these dimensions in predicting illness, but the prevention and understanding of illness are furthered by their consideration.