Healthcare waste management: a case study from the National Health Service in Cornwall, United Kingdom.

This paper looks at steps taken towards the development of a 10-year strategy for the management of healthcare waste from the National Health Service (NHS) in Cornwall, United Kingdom. The major issues and challenges that affect the management of waste by the NHS, including its organisational structure and collection infrastructure, are outlined. The waste flows of the main acute medical site are detailed, using waste audits of domestic and clinical bags, redundant equipment, bulky waste, and special waste.

Temporal and geographic variation in United States motor neuron disease mortality, 1969-1998.

Objective: To describe temporal trends of motor neuron disease (MND) mortality in the United States. Variations in MND by demographic variables of sex, age, geography, and race/ethnicity were evaluated to assess the possible explanations for observed trends.

Methods: Multiple-cause mortality files from the National Center for Health Statistics for the years 1969 through 1998 were searched for all United States death records with codes corresponding to MND.

Relationship between post-traumatic stress disorder and pain in two American Indian tribes.

Objectives: To estimate the association of lifetime post-traumatic stress disorder (PTSD) and pain in American Indians, and determine if tribe, sex, cultural and psychosocial factors, or major depression influence the magnitude of this association.

Design: A cross-sectional probability sample survey completed between 1997 and 2000. A structured interview was conducted by trained, tribal members to gather information on demographic and cultural features, physical health status, psychiatric disorders, and functional status.

Efficient bunyavirus rescue from cloned cDNA.

Bunyaviruses are trisegmented, negative-sense RNA viruses. Previously, we described a rescue system to recover infectious Bunyamwera virus (genus Orthobunyavirus) entirely from cloned cDNA (Bridgen, A. and Elliott, R.

Increased prevalence of constipation and fecal soiling in a population of obese children.

To determine the prevalence of constipation and fecal soiling in obese children, we asked standardized questions during the initial visit to the obesity clinic. In 80 obese children, 23% met the criteria for constipation, and 15% reported fecal soiling. Constipation and soiling are more prevalent in obese children.

Communicating results to community residents: lessons from recent ATSDR health investigations.

As a public health agency within the US Department of Health and Human Services, the Agency for Toxic Substances and Disease Registry (ATSDR) is responsible for implementing the health-related provisions of the Superfund Act. Much of its work is carried out to address health concerns in communities near sources of environmental contamination, usually in consultation with other local, state, and federal agencies. Over the last decade, ATSDR has considered, supported or conducted health investigations in a variety of different communities across the country.

Clinical outcome of the altered cast impression procedure compared with use of a one-piece cast.

Statement Of The Problem: An altered cast impression procedure to improve the support of distal extension removable partial dentures is widely taught, but not often used in dental practice.

Purpose: The purpose of this study was to determine the efficacy of an altered cast compared to a one-piece cast with regard to base support, abutment health, and patient comfort over time.

Material And Methods: Seventy-two patients receiving a mandibular bilateral distal extension removable partial denture were assigned randomly for treatment using either a one-piece or an altered cast.

A bunyamwera virus minireplicon system in mosquito cells.

Artificial minigenomes are powerful tools for studying the replication and transcription of negative-strand RNA viruses. Bunyamwera virus (BUN; genus Orthobunyavirus, family Bunyaviridae) is an arbovirus that shows fundamental biological differences when replicating in mammalian versus mosquito cells. To study BUN RNA synthesis in mosquito cells, we developed a bacteriophage T7 RNA polymerase-based minireplicon system similar to that described previously for mammalian cells.

Antepartum dental radiography and infant low birth weight.

Context: Both high- and low-dose radiation exposures in women have been associated with low-birth-weight offspring. It is unclear if radiation affects the hypothalamus-pituitary-thyroid axis and thereby indirectly birth weight, or if the radiation directly affects the reproductive organs.

Objective: To investigate whether antepartum dental radiography is associated with low-birth-weight offspring.

A randomized controlled trial comparing mandibular local anesthesia techniques in children receiving nitrous oxide-oxygen sedation.

The aim of this study was to test the hypothesis that dental pain control using infiltration/intrapapillary injection was less effective than inferior alveolar block/long buccal infiltration anesthesia in children. A total of 101 healthy children, aged 5-8 years, who had no contraindication for local anesthetic and who needed a pulpotomy treatment and stainless steel crown placement in a lower primary molar were studied. A 2-group randomized blinded controlled design was employed comparing the 2 local anesthesia techniques using 2% lidocaine, 1:100,000 epinephrine.

Immune markers and ornithine decarboxylase activity among electric utility workers.

The effects of a 60-Hz magnetic field (MF) exposure on white blood cell ornithine decarboxylase (ODC) activity, natural killer (NK) cell activity, lymphocyte phenotypes, and differential cell counts were studied among 60 electric utility workers. Personal MF exposure monitoring over 3 consecutive workdays was followed by collection of a peripheral blood sample. There were no MF-related changes in NK activity or the number of circulating neutrophils, eosinophils, basophils, or T-lymphocytes (CD4, CD8, CD4:CD8 ratio).

Influence of environmental zinc on the association between environmental and biological measures of lead in children.

Exposure to lead, a common environmental contaminant found at hazardous waste sites, has been associated with adverse health effects to humans. Zinc, a nutritionally essential metal, may influence both the absorption and the toxicity of lead. The purpose of this study was to determine if zinc levels present in the environment affect the association between environmental lead measured in two small communities in the northeastern United States and biological measurements of lead in the residents of these communities.

Melatonin metabolite excretion among cellular telephone users.

Purpose: The relationship between cellular telephone use and excretion of the melatonin metabolite 6-hydroxymelatonin sulfate (6-OHMS) was evaluated in two populations of male electric utility workers (Study 1, n=149; Study 2, n=77).

Materials And Methods: Participants collected urine samples and recorded cellular telephone use over 3 consecutive workdays. Personal 60-Hz magnetic field (MF) and ambient light exposures were characterized on the same days using EMDEX II meters.

Vaginal hydrolytic enzymes, immunoglobulin A against Gardnerella vaginalis toxin, and risk of early preterm birth among women in preterm labor with bacterial vaginosis or intermediate flora.

Objective: The purpose of this study was to determine whether the microbial hydrolytic enzymes, sialidase and prolidase, and immunoglobulin A against the Gardnerella vaginalis cytolysin (anti-Gvh IgA) increase the risk for early preterm birth (< or =34 weeks of gestation) among women with bacterial vaginosis or intermediate flora.

Study Design: Two hundred eighteen afebrile women in preterm labor with intact membranes had a vaginal Gram stain performed, and sialidase, prolidase, and anti-Gvh IgA concentrations were determined.

Results: Women with bacterial vaginosis or intermediate flora had significantly higher sialidase and prolidase concentrations than women with normal flora.

Combined optical and atropine penalization for the treatment of strabismic and anisometropic amblyopia.

Introduction: The treatment of amblyopia by occlusion of the fellow eye is beset by problems related to compliance, stigmatization, and regression of visual acuity (VA). Atropine or optical penalization has been used as an alternative treatment for amblyopia and might be synergistic as a combination therapy. Combined optical and atropine penalization treatment (COAT) was therefore assessed in patients with anisometropic and strabismic amblyopia.

Relationship between amyloid beta protein and melatonin metabolite in a study of electric utility workers.

This study assessed the relationship between occupational magnetic field exposure, the urinary melatonin metabolite 6-hydroxymelatonin sulfate (6-OHMS), and concentrations of blood-borne soluble amyloid beta (A beta), a protein associated with the hallmark lesions of Alzheimer's disease (AD). Blood and urine samples were obtained from male electric utility workers (n = 60) to quantify two lengths of the protein in plasma, A beta (amino acids 1-40) and A beta (1-42), and the urinary concentrations of 6-OHMS. Average A beta levels were positively associated with categories of magnetic field exposure, but this relationship was weak and did not achieve statistical significance.

Prevalence, predictors, and outcomes of early adherence after starting or changing antiretroviral therapy.

The objectives of this research were to assess prevalence and predictors of early antiretroviral therapy adherence using multiple indicators and to estimate effects of early adherence on subsequent HIV viral load and CD4+ lymphocyte responses. Study subjects were adults with HIV infection referred to an antiretroviral therapy-monitoring clinic for initiation or change in therapy between March 1998 and June 1999. The design was a prospective observational cohort involving baseline interview followed by 30 days of electronic adherence monitoring (MEMS), 30-day interview, and follow-up viral load at 1, 3, and 6 months.

Occupational exposure to magnetic fields in case-referent studies of neurodegenerative diseases.

Objectives: Case-referent studies of Alzheimer's disease, amyotrophic lateral sclerosis, and Parkinson's disease were conducted to explore the relationship between these neurodegenerative diseases and occupational exposure to magnetic fields. Three methods of exposure assessment were used for the comparison, and the consistency of findings between these approaches was evaluated.

Methods: Separate case-referent sets were formed from among recorded deaths of males in the state of Colorado for the years 1987 through 1996.

Effects of exposure to low levels of environmental cadmium on renal biomarkers.

We conducted a study among residents of a small community contaminated with heavy metals from a defunct zinc smelter and residents from a comparison community to determine whether biologic measures of cadmium exposure were associated with biomarkers of early kidney damage. Creatinine-adjusted urinary cadmium levels did not differ between the smelter and comparison communities; thus we combined individuals from both communities (n = 361) for further analyses. The overall mean urinary cadmium level was low, 0.

Prevalence estimates for MS in the United States and evidence of an increasing trend for women.

The purpose of this study was to provide current age-, sex-, and region-specific MS prevalence estimates and to identify trends using the National Health Interview Survey. The overall prevalence estimate was 85/100,000 population, or approximately 211,000 (+/-20,000) persons. A 50% increase was observed in the number of women reporting MS for 1991 through 1994 vs 1982 through 1986.