Bisphenol diglycidyl ethers and bisphenol A and their hydrolysis in drinking water

Epoxy coatings are commonly used to protect the interior (and exterior) surfaces of water mains and storage tanks and can be used on the interior surfaces of water pipes in homes, hospitals, hotels, and other buildings. Common major components of epoxies include bisphenols, such as bisphenol A (BPA) or bisphenol F (BPF), and their reactive prepolymers, bisphenol A diglycidyl ether (BADGE) and bisphenol F diglycidyl ether (BFDGE), respectively. There currently are health concerns about the safety of BPA and BPF due to known estrogenic effects. Determination of key bisphenol leachates, development of a hydrolysis model, and identification of stable hydrolysis products will aid in assessment of human bisphenol exposure through ingestion of drinking water. Liquid chromatography/mass spectrometry (LC/MS/MS) was used for quantitation of key analytes, and a pseudo-first order kinetic approach was used for modeling. In fill-and-dump studies on epoxy-coated pipe specimens, BADGE and a BPA-like compound were identified as leachates. The BADGE hydrolysis model predicts BADGE half-lives at pH 7 and 15, 25, 35, and 40 °C to be 11, 4.6, 2.0, and 1.4 days respectively; the BFDGE half-life was 5 days at pH 7 and 25 °C. The two identified BADGE hydrolysis products are BADGE-H2O and BADGE 2H2O, with BADGE 2H2O being the final end product under the conditions studied.

Preinjury Behavioral and Emotional Problems Among Pediatric Burn Patients

Standardized behavior rating scales have been used in the routine care of children during medical visits because they provide an objective, norm-based index for the child's behavioral functioning. The purpose of this study was to examine behavior problems among children (aged 2.5-18 years) with burn injuries using the Behavioral Assessment System for Children, a multi-informant system of standardized rating scales that assesses clinical and adaptive behavior areas. Parents and youth (ages 8-18) completed the Behavioral Assessment System for Children with reference to the pediatric patient's behavioral functioning before hospital admission for a burn injury. In total, data were collected on 94 children. Results suggested that a substantial portion of the sample endorsed significantly elevated levels of behavioral difficulties across a broad range of problem behaviors. On the basis of parent report, preschoolers exhibited concerns related to hyperactivity, anxiety, aggression, and attention problems, whereas school-aged children were reported to have these same concerns as well as depression and conduct problems. Twenty percent of our adolescent sample (ages 12-18 years) were described to be experiencing even more internalizing and externalizing behavior problems relative to the two groups of their younger counterparts. Boys were found to contribute to the cause of their burn injury significantly more often than girls. The strengths, limitations, and clinical implications of our findings are discussed.

Wheelchair-skill performance: Controlled comparison between people with hemiplegia and able-bodied people simulating hemiplegia

OBJECTIVE

To test the hypothesis that able-bodied people simulating hemiplegia (using the hemiplegic-propulsion pattern [1 arm and 1 leg]) have as much difficulty performing wheelchair skills as people with hemiplegia.

DESIGN

Single-blind, controlled comparison of 2 groups.

SETTING

Kinesiologic laboratory in a rehabilitation center.

PARTICIPANTS

Twenty wheelchair users with hemiplegia (HP group) (median age, 68y; 80% men) and 20 able-bodied participants (AB group) (median age, 67y; 75% men).

INTERVENTIONS

The participants in the AB group simulated hemiplegia and received a brief period of wheelchair skills training. Participants in both groups were asked to attempt the 50 skills of the Wheelchair Skills Test, version 2.4 (WST 2.4).

MAIN OUTCOME MEASURES

Total and subtotal percentage scores on the WST 2.4 and success rates for the 50 individual skills.

RESULTS

The mean percentage WST scores for the AB group were significantly greater than those for the HP group for the total WST scores ( P <.001), the indoor skill level ( P <.001), and the community skill level ( P <.001), but the advanced skill level scores were 0% for both groups. On the individual skills, the AB group had success rates at least 25% higher than the HP group for 13 (26%) of the skills. Both groups were generally successful (>/=75% success rate) on 21 skills (42%). Both groups experienced difficulties (</=50% success rate) on 13 skills (26%), notably those in which there was high rolling resistance (eg, incline ascent) or high balance demands (the wheelie skills).

CONCLUSIONS

Both people with hemiplegia and able-bodied people who are simulating hemiplegia experience similar difficulties when performing some wheelchair skills. This suggests that there are difficulties inherent in these tasks, a finding that holds promise for solutions based on new techniques and technologies.

An assessment of burn prevention knowledge in a high burn-risk environment: restaurants

Our facility has seen an increase in the number of cases of children burned in restaurants. Fieldwork has revealed many unsafe serving practices in restaurants in our tristate area. The current research targets what appears to be an underexamined burn-risk environment, restaurants, to examine server knowledge about burn prevention and burn care with customers. Participants included 71 local restaurant servers and 53 servers from various restaurants who were recruited from undergraduate courses. All participants completed a brief demographic form as well as a Burn Knowledge Questionnaire. It was found that server knowledge was low (ie, less than 50% accuracy). Yet, most servers reported that they felt customer burn safety was important enough to change the way that they serve. Additionally, it was found that length of time employed as a server was a significant predictor of servers' burn knowledge (ie, more years serving associated with higher knowledge). Finally, individual items were examined to identify potential targets for developing prevention programs.

Use of a token reinforcement system to promote appropriate behavior at a pediatric burn summer camp

Child behavior management can be an important concern in conducting summer camps for pediatric burn patients, because many of these patients have a history of significant behavioral difficulties. To be efficient, a flexible camp-wide behavior management system, such as a token economy, would be ideal. In this article we discuss the concept and principles of a token reinforcement system and outline how this intervention was applied to our pediatric burn summer camp across 2 consecutive years. We also provide a description of modifications made for the second camp, based on counselor ratings of and our experience with the token system during the first camp. Results from counselor assessments indicated that after using the token system, counselors' perceptions of its utility (eg, effective in decreasing problem behavior in campers, useful in making behavior management easier) increased significantly across both years.

Changing patterns of severe craniomaxillofacial trauma in Auckland over eight years

BACKGROUND

This study was performed to review the changing pattern of incidence of severe craniomaxillofacial (CMF) trauma in Auckland over 8 years (1989-1997) and to audit the involvement of the regional plastic surgery service.

METHODS

A review of prospectively collected admission data of patients admitted to the Auckland Hospital Department of Critical Care Medicine (DCCM) with severe CMF trauma during 1997. A comparison is made with similar data from 1989. Injury severity was defined using the Injury Severity Score (ISS).

RESULTS

Twenty-six patients with severe CMF trauma were admitted to Auckland Hospital DCCM in 1997. Their average ISS was 35. Eighty per cent had a significant head injury. Sixty-two per cent had injuries due to road traffic accidents (RTA) and 42% had positive blood alcohol levels, including 37% of the RTA victims. Twenty-three per cent had their surgical care provided by the regional plastic surgery service. In 1989, 55 patients were admitted to DCCM with severe CMF trauma. The average ISS was 36. Ninety-five per cent had a significant head injury. Seventy-three per cent had injuries due to RTA and 55% had positive blood alcohol, including 60% of the RTA group.

CONCLUSIONS

Patients with severe CMF trauma make up a significant proportion of trauma admissions to DCCM and have a high incidence of life-threatening injuries. A multidisciplinary approach is essential. The nature and severity of these injuries has not changed over the last decade. There has been a clear decrease in the incidence of these injuries. This seems to be due to a profound decrease in the rate of RTA associated with alcohol intoxication.

Phoenix date palm injuries: a review of injuries from the Phoenix date palm treated at the Starship Children's Hospital

BACKGROUND

The purpose of this study was to review patients treated for penetrating Phoenix date palm injuries. Documentation of the clinical behaviour of these injuries was sought as they have different clinical outcomes to other foreign body injuries.

METHODS

Data was collected via a retrospective review of patient files and imaging studies of all patients with foreign body injury admitted to the Orthopaedic Service of Starship Children's Hospital between 1992 and 1997.

RESULTS

Of 250 patients admitted with foreign body injuries, 21 cases were identified as caused by the Phoenix date palm. The age range was 5 to 12 years. There was a median delay of 43 days between the time of injury and presentation to hospital. An average of 1.3 operations were performed on each patient. Ultrasound was used in 12 cases, foreign body was identified in 10 patients--a sensitivity of 83%. Intraoperative ultrasound was also found to be beneficial in three of these cases.

CONCLUSIONS

Phoenix date palm injuries often have a protracted course. The initial diagnosis and treatment of such injuries is often delayed. Fracturing and fragmentation of the barbs may occur and multiple surgical procedures may be required to remove all of the foreign material. The Phoenix date palm barbs may cause a severe tissue reaction with sterile granulomatous synovitis and bony pseudotumour formation. A high level of suspicion on history taking and surgical exploration is needed. Total synovectomy for delayed joint or tendon sheath involvement may be required when fragmentation has occurred. Ultrasound has higher sensitivity for detection of thorn foreign bodies than magnetic resonance imaging.

Measuring binge eating in adolescents: adolescent and parent versions of the questionnaire of eating and weight patterns

OBJECTIVE

This study investigated the psychometric properties of an adolescent version of the Questionnaire of Eating and Weight Patterns (QEWP-A).

METHOD

Male and female adolescents between 10-18 years completed the QEWP-A and measures of depression and eating attitudes. Height and weight were also measured. Parents completed a parental version (QEWP-P) that was referenced to their children. Adolescent and parent responses to the QEWP were independently categorized into no diagnosis (ND), nonclinical binge eating (NCB), and binge eating disorder (BED) groups.

RESULTS

Adolescent and parental agreement over the diagnostic categories was as follows: 81.6% for ND, 15.5% for NCB, and 25% for BED with an overall kappa of. 19. Adolescents with BED had significantly higher levels of depression than the other two groups with NCB being higher than ND. For eating attitudes, BED adolescents were more deviant than the other two groups who did not differ from one another.

DISCUSSION

The QEWP-A displayed adequate concurrent validity. The low overall agreement between adolescents and their parents was influenced by high and low base rates in the NCB and BED categories, respectively. This lack of agreement is consistent with other behavioral problems such as depression. The data suggest that parental perceptions of eating problems approximate those of their children when no problem is present. However, parents are not as likely to be aware of eating difficulties when they actually exist.

The Adolescent Behavior Checklist: development and initial psychometric properties of a self-report measure for adolescents with ADHD

Developed and provided initial psychometric properties on an adolescent, self-report questionnaire for attention deficit hyperactivity disorder (ADHD). The Adolescent Behavior Checklist (ABC) consists of 44 items that measure ADHD core symptoms and associated difficulties (e.g., conduct problems, academic problems, and social deficits). A total of 909 adolescents between the ages of 11 and 17 served as the standardization sample. Results indicated that the ABC was internally consistent. Principal components analysis revealed six factors for the ABC: Conduct Problems, Impulsivity/Hyperactivity, Poor Work Habits, Inattention, Emotional Lability, and Social Problems. Significant gender and race differences were obtained for some ABC factor scores, and initial standardization data were established based on this information. Initial convergent and divergent validity of the ABC was supported by the correlations obtained between factor scores and the subscale scores on the Child Behavior Checklist and Youth Self-Report. Using an additional sample of 81 adolescents, the stability of ABC scores across a 2-week interval was found to be satisfactory. Initial evidence for discriminant validity was established by comparing ABC scores for a sample of adolescents diagnosed with ADHD to the normative sample.

Circulating nucleated red blood cells following splenectomy in a patient with congenital dyserythropoietic anemia

A 24-year-old white female with a 10-year history of juvenile rheumatoid arthritis and splenomegaly developed numerous circulating nucleated red blood cells (NRBC) following splenectomy for chronic abdominal pain. Subsequent evaluation revealed the presence of a congenital dyserythropoietic anemia (CDA) with atypical features. Circulating NRBCs have been reported following splenectomy in three other cases of CDA, each of which had atypical features and did not fit into the customary classification of types I-IV. Follow-up of our patient at 4 years revealed no untoward consequences of persistent NRBCs in her circulation.