Acid soil indicators in forest soils of the Cherry River Watershed, West Virginia

Declining forest health has been observed during the past several decades in several areas of the eastern USA, and some of this decline is attributed to acid deposition. Decreases in soil pH and increases in soil acidity are indicators of potential impacts on tree growth due to acid inputs and Al toxicity. The Cherry River watershed, which lies within the Monongahela National Forest in West Virginia, has some of the highest rates of acid deposition in Appalachia. East and West areas within the watershed, which showed differences in precipitation, stream chemistry, and vegetation composition, were compared to evaluate soil acidity conditions and to assess their degree of risk on tree growth. Thirty-one soil pits in the West area and 36 pits in the East area were dug and described, and soil samples from each horizon were analyzed for chemical parameters. In A horizons, East area soils averaged 3.7 pH with 9.4 cmol(c) kg(-1) of acidity compared to pH 4.0 and 6.2 cmol(c) kg(-1) of acidity in West area soils. Extractable cations (Ca, Mg, and Al) were significantly higher in the A, transition, and upper B horizons of East versus West soils. However, even with differences in cation concentrations, Ca/Al molar ratios were similar for East and West soils. For both sites using the Ca/Al ratio, a 50% risk of impaired tree growth was found for A horizons, while a 75% risk was found for deeper horizons. Low concentrations of base cations and high extractable Al in these soils translate into a high degree of risk for forest regeneration and tree growth after conventional tree harvesting.

Birth plans and health facility based delivery in rural Uganda

OBJECTIVES

To evaluate whether the completion of birth plans is associated with delivery in a health facility and the perceptual causes of birth plan completion and health facility based delivery were explored according to a well-tested health behaviour theory.

DESIGN

A community survey.

SETTING

Rakai and Luwero districts.

SUBJECTS

A total of 415 (202 in Rakai and 213 in Luwero district) respondents were randomly selected and interviewed using a mixed survey questionnaire composed of open and close-ended questions.

MAIN OUTCOME MEASURES

Health facility based delivery.

RESULTS

The results demonstrate a statistically significant relationship between the completion of birth plans and delivery in a health facility (OR = 1.86, 95% CI =1.1, 3.1). The fear of consequences of delivering at home was found to be an important driving force in promoting the completion of birth plans, thereby indirectly influencing the likelihood of delivery in a health facility.

CONCLUSION

Given the empirical evidence presented here, this study suggests that birth plans are an important tool in improving the rate of health facility based deliveries and thus essential in the fight against maternal mortality in Uganda. It is further recommended that campaigns market the use of birth plans as a way to reduce uncertainty and manage fear and the unknown about pregnancy.

An investigation of the psychological characteristics of stalkers: empathy, problem-solving, attachment and borderline personality features

This study examined the psychological characteristics of a sample of self-reported stalkers in comparison with a control group, on measures of empathy, problem-solving skills, attachment, and borderline personality features. Stalkers were identified by their endorsement of specific behavioral items, consistent with a widely adopted definition of stalking, denoting behaviors that: (a) are repeatedly directed toward an identified target; (b) are intrusive and unwanted; and (c) evoke fear in the victim. Stalkers scored significantly higher than controls on measures of insecure attachment and borderline personality features, suggesting that the stalking group demonstrates a general pattern of inadequate interpersonal attachment, has limited abilities to form and maintain appropriate relationships, is emotionally labile and unstable, and experiences ambivalence regarding their interpersonal relationships. Treatment implications are discussed herein.

Hyaluronidase and its substrate hyaluronan: biochemistry, biological activities and therapeutic uses

This is an overview of the biochemistry, biological function and therapeutic uses of hyaluronidase and its substrate, hyaluronate. We focus on the role of hyaluronate and its receptor CD44 in cell-cell and cell-matrix adhesion and cell activation as well as on the putative role of hyaluronate and hyaluronidase in morphogenesis. Variants of CD44 and their putative role in tumor metastasis are also included. Other topics that are discussed are the chemical and enzymatic nature of hyaluronidase, i.e. the mode of substrate degradation, pharmacodynamical and pharmacokinetic aspects of this enzyme and its role as spreading factor. Purification methods, possible contaminations and techniques of activity determinations are mentioned as well as the physiological role of hyaluronidase and tumor-associated alterations in serum and tissue enzyme levels. As far as therapeutic applications are concerned, we discuss uses of hyaluronidase in ophthalmology and regional anesthesia as well as pain management in osteoarthritis using hyaluronate.

[Clinical pharmacology and possible applications of hyaluronidase with reference to Hylase "Dessau"]

Hyaluronidase is employed therapeutically since many years. The various detectable effects of hyaluronidase are referred to the action of this enzyme. Hyaluronidase depolymerises the mucopolysaccharide hyaluronic acid, a component of the mucoprotein ground substance or tissue cement. Hyaluronidase thereby increases in tissues the membrane permeability, reduces the viscosity and renders the tissues more readily permeable to injected fluids (spreading effect). The effects of hyaluronidase enables this enzyme to be used therapeutically to increase the speed of absorption and to diminish discomfort due to subcutaneous or intramuscular injection of fluid, to promote resorption of excess fluids and extravasated blood in the tissues and to increase the effectiveness of local anaesthesia. Hyaluronidase is widely used in many fields, i.e. in orthopaedia, surgery, ophthalmology, internal medicine, oncology, dermatology, gynaecology, etc. The following paper deals with the therapeutic uses of hyaluronidases and allows a review of the current and up to date status of the literature.

The creation and integration of the high tech operatory

Dentistry is in the early stages of a major technological transformation. For the most part, however, computers and many of the other technological tools dentists use to gather or display clinical information, including intraoral cameras, digital radiography, and multimedia systems, have been less productive then they could be. This paper examines several offices where this technology is currently in use to provide working models of how integrated technology can be implemented into operatories to make them more flexible, productive, and resourceful environments for clinicians, and assist the clinician in creating a corresponding improvement in patient care.

MRI efficacy and effectiveness research: who needs it and who pays for it?

Health care reform has made quality efficacy research in MRI important to an increasing number of audiences. Historically, the deficit of quality outcomes research in MRI was due to difficulties in study design, lack of funding, disincentives for researches and funding sources, and poor coordination. These issues would be best addressed by the formation of an MRI implementation group that would coordinate funding, planning, and dissemination of the outcomes research efforts.

Acute and subchronic toxicity of 1,1-dichloro-1-fluoroethane (HCFC-141b)

The acute and subchronic toxicity of 1,1-dichloro-1-fluoroethane (HCFC-141b), a CFC alternative, was evaluated in several acute and subchronic studies to assist in establishing proper handling guides. Data from acute toxicity studies in rats and rabbits demonstrated that HCFC-141b has very low acute toxicity. HCFC-141b was not a skin irritant, but was a mild eye irritant, in rabbits and was not a skin sensitizer in guinea pigs. Skin application of HCFC-141b to rabbits at 2000 mg/kg body weight produced no adverse effects. Oral administration at 5000 mg/kg body weight did not cause any deaths or clinical signs of toxicity in rats. The 4-hr LC50 for HCFC-141b was about 62,000 ppm in rats. Repeated exposures of rats for 6 hr/day, 5 days/wk for up to 90 days at concentrations of 2000, 8000 or 20,000 ppm did not result in significant adverse effects. Minor, but dose-dependent, reductions in body weight were observed in male and female rats during the 90-day study. Decreased responsiveness was also observed in rats but only at 20,000 ppm. An increase in serum cholesterol or triglycerides was observed in male and female rats at 20,000 ppm, and in males at 8000 ppm. No specific organ pathology was noted in these subchronic inhalation studies. The no-observable-adverse-effect level (NOAEL) from these studies was 8000 ppm. Results from other studies demonstrate that HCFC-141b was not neurotoxic in rats. As with trichlorofluoroethane (CFC-11), a cardiac sensitization response to an intravenous epinephrine challenge occurred in dogs with HCFC-141b at 5000 ppm and higher concentrations in experimental screening studies.

MR equipment acquisition parameters

Arguably, MR is the most costly and sophisticated diagnostic imaging equipment in wide use today. Since its inception in the mid 1980s, much has been written regarding the purchase criteria for this million-dollar-plus capital investment--most of it pitting one technological advantage against another. Expectedly, the lion's share of this information was directed at radiologists. Today, it is universally accepted that, as far as the MR purchase decision is concerned, the "buck stops" at increasingly higher administrative levels in the healthcare organization. However, it has been our experience that the most satisfactory MRI acquisitions are not made strictly in the executive conference room. They encompass teams of buying influences from the various areas of the hospital that will be impacted by the MRI system. Knowing that institutions have utilization differences, different patient demographics, varying reimbursement agreements and other pertinent areas of definition, this article does not offer a cookie cutter checklist for an MRI purchase. Instead, it profiles the true-life decision-making processes undertaken by four MRI customers. The article's objective is to provide the reader with an understanding of various approaches to the same process from which the reader can glean ideas relevant to his or her own situation.

Athlete age and sports physical examination findings

BACKGROUND

Interscholastic and intercollegiate athletes commonly visit physician offices to have sports participation examinations (PPEs). Few data exist, however, to help determine the age range for which such examinations are reasonable. The purpose of this study was to determine the percentage of athletes with significant findings on sports PPEs among junior high school, high school, and college-age athletes.

METHODS

Analyses were made of 937 consecutive PPEs that were performed by primary care physicians using a standardized form. Subjects were interscholastic athletes of junior high, high school, and college age. Significant findings were defined as those that resulted in any recommendation, ie, change in management, by the examining physician.

RESULTS

The incidence of significant findings was 3.4% for the junior high school athletes, 15.4% for high school athletes, and 33.9% for college athletes (P < .001). The overall percentage of athletes disqualified from participating in any sport, which was 1.7%, did not differ significantly across age levels.

CONCLUSIONS

In this sample, college and high school athletes were much more likely than junior high school athletes to have significant findings on sports. PPEs. These data cast uncertainty on the necessity of annual PPEs to screen athletes of junior high school age.

The Psychosocial Assessment of Patients Discharged from Accident and Emergency Departments after Deliberate Self-Poisoning

One-third of accident and emergency (A & E) patients who deliberately take an overdose are not admitted to hospital, and this proportion is increasing. We conducted an audit of 300 case records of such patients from two different district health authorities in London. We found that only 4% of patients were assessed in the manner recommended by the Department of Health and 10% had no psychosocial assessment whatsoever. We recommend specific training, an assessment form, regular audit, and communication with the general practitioner.