Surfactant-enhanced solubilization and anaerobic biodegradation of 1,1,1-trichloro-2,2-bis(p-chlorophenyl)-ethane (DDT) in contaminated soil.

The hydrophobic pesticide 1,1,1-trichloro-2,2-bis(p-chlorophenyl)-ethane (DDT) is a persistent contaminant in soils and sediments, although it has long been known to be biodegradable under anaerobic conditions. Addition of a nonionic surfactant was evaluated as a means of enhancing the solubilization, potential bioavailability, and anaerobic biodegradability of DDT and its metabolites--1,1-dichloro-2,2-bis(p-chlorophenyl)-ethane (DDD) and 1,1-dichloro-2,2-bis(p-chlorophenyl)-ethylene (DDE)--in an aged contaminated soil. Approximately 12 mg surfactant/g soil was required before concentrations greater than the critical micelle concentration were observed in the liquid phase in soil microcosms.

The Safe Dates program: 1-year follow-up results.

Objectives: An earlier report described desirable 1-month follow-up effects of the Safe Dates program on psychological, physical, and sexual dating violence. Mediators of the program-behavior relationship also were identified. The present report describes the 1-year follow-up effects of the Safe Dates program.

The long-run effect of the Medicare Catastrophic Coverage Act.

This study examines the long-run effect of the 1988 Medicare Catastrophic Coverage Act (MCCA). Although most of the MCCA provisions were repealed after only one year, remaining in the law today are the provisions that directly affected the ability of married people to live in the community when their spouses were in a nursing home. We use longitudinal data from the National Long-Term Care Survey and exploit the differential effect of the MCCA on single and married people to test for changes in the probability of going to a nursing home, in wealth, and in the probability of living with others.

Water reclamation and unrestricted nonpotable reuse: a new tool in urban water management.

Growing urbanization accompanying growing population is increasing the demand for water supply in communities throughout the world. Water resources for many cities are already proving inadequate. Additional water resources are inherently more costly and are often not available because other communities and/or land owners have the water rights.

Breaking away: advocacy, education, and the relationship between Maternal and Child Health Professionals and the American Public Health Association.

Since its founding in 1921, the mission of the Maternal and Child Health (MCH) Section of the American Public Health Association (APHA) has been to develop innovative and creative approaches to addressing the health needs of mothers, children, and families. However, the growth and structure of APHA have impeded the capacity of MCH Section members to accomplish this mission. An independent organization would enhance the effectiveness of advocacy by MCH professionals and facilitate the dissemination of new strategies to address the needs of mothers and children.

School performance in a longitudinal cohort of children at risk of maltreatment.

Objective: Previous research has suggested that child maltreatment is associated with poor school performance. However, previous studies have largely been cross-sectional or, if longitudinal, have had small sample sizes, short follow-up periods, or have not adequately controlled for confounders. The objective of this study is to determine the relationship between child maltreatment and school performance in a cohort of children at risk of maltreatment and followed since birth.

Southeastern Title V program staff perceptions of state-level maternal and child health assessment skills.

Objectives: Since the publication of the Future of Public Health, a high priority has been placed on the development of the assessment capacity in public health programs.

Method: Key informant interviews were conducted by telephone with selected program personnel of state Maternal and Child Health and Children with Special Health Care Needs programs in ten southeastern states to determine perceived deficiencies in skills needed to carry out assessments.

Results: We found that professional staff perceived that several fundamental assessment skills were available in their units, including collecting secondary data, and creating interagency groups and frameworks for assessment.

Women's health in maternal and child health: time for a new tradition?

Objectives: The status quo in maternal and child health (MCH) focuses on obstetric health. An emerging alternative is to broaden the notion to reproductive health. An inclusive perspective encompasses women's health issues in MCH.

Comparing provider perceptions of access and utilization management in full-risk and no-risk Medicaid programs for adults with serious mental illness.

This article compares provider perceptions of access to services and utilization management (UM) procedures in two Medicaid programs in the same state: a full-risk capitated managed care (MC) program and a no-risk, fee-for-service (FFS) program. Survey data were obtained from 198 mental health clinicians and administrators. The only difference found between respondents in the FFS and MC sites was that outpatient providers in the MC site reported significantly lower levels of access to high-intensity services than did providers in the FFS site (p < .

Issues for academic health centers to consider before implementing a balanced-scorecard effort.

Because of changes in the health care environment, it is likely that strategic planning and management will become much more important to academic health centers (AHCs) than in the past. One approach to strategic planning and management that is gaining the considerable interest of health care organizations is the balanced scorecard. Based on a year's experience in examining this management tool, and on early implementation efforts, the authors critically evaluate the applicability of the balanced-scorecard approach at AHCs in relation to two fundamental questions: Does the decentralized nature of most AHCs mitigate the potential usefulness of the balanced-scorecard approach? Are the balanced scorecard's four perspectives (learning and growth, internal; customer; and financial) appropriate for AHCs, which are neither for-profit nor manufacturing organizations? The authors conclude that (1) the unique characteristics of AHCs may mitigate the full benefit of the balanced-scorecard approach, and (2) in cases where it is used, some key modifications must be made in the balanced-scorecard approach to account for those unique characteristics.

Risk of stillbirth from medications, illnesses and medical procedures.

Associations between stillbirth and 14 medical exposures during pregnancy were examined using deliveries in 1984 in 10 California counties. Cases (n = 332) were stillbirths and infant deaths within 24 h of birth. Randomly selected live births served as controls (n = 357) and were frequency matched by maternal age and county.

Hepatitis E virus seroprevalence in children living in rural Ghana.

Large outbreaks of hepatitis E virus have been reported in warm climates with poor sanitation although it exists in endemic form in these areas too. This oro-fecally transmitted infection has been described mainly in adults with very little data from children. This study looked at seroprevalence in children resident in a rural district in Ghana with very little pipe-borne water supply.

Early detection of cervical cancer among Native American women: a qualitative supplement to a quantitative study.

The North Carolina Native American Cervical Cancer Prevention Project was a 5-year (1989-1995) National Cancer Institute-funded, community-based, early detection of cervical cancer intervention implemented among two Native American tribes in North Carolina: the eastern band of the Cherokee Indians and the Lumbee. The initial quantitative analysis of the intervention showed modest effects and found that the intervention had different effects in the two communities. Due to the equivocal findings, a retrospective qualitative study was conducted.

Potential for bias in estimating human fecundability parameters: a comparison of statistical models.

Fecundability studies, where couples attempting pregnancy subject to 'failure' (conception) one time in each menstrual cycle, present a natural discrete failure-time scenario. Because the biologic capacity to conceive varies among couples in the population, a complication arises in choosing a method of analysis, related to the fact that the maximum follow-up time can vary from study to study, and follow-up time could potentially have different effects on parameters based on different approaches to modelling. Traditional development in fertility studies has been based on an implicit assumption that binary outcomes for different menstrual cycles are mutually independent.

ECG changes after rabbit coronavirus infection.

This study examines the electrocardiographic (ECG) changes following rabbit coronavirus (RbCV) infection. We have shown that infection with RbCV results in the development of myocarditis and congestive heart failure and that some survivors of RbCV infection go on to develop dilated cardiomyopathy in the chronic phase. Serial ECGs were recorded on 31 RbCV-infected rabbits.

A new assay for albumin and hemoglobin adducts of 1,2- and 1,4-benzoquinones.

A new method has been developed to detect mono-S-substituted cysteinyl adducts of 1,2- and 1,4-benzoquinone (BQ) in hemoglobin (Hb) and albumin (Alb). After reacting the protein with trifluoroacetic anhydride and methanesulfonic acid, the resulting isomers of O,O',S-tris-trifluoroacetyl-hydroquinone and -catechol are extracted and detected by gas-chromatography-mass spectrometry in the negative-ion chemical ionization mode. The limit of detection of the assay is about 20 pmol adduct/g protein.

Collaboration to improve community health: trends and alternative models.

Background: Many health care organizations have begun to pursue collaborative approaches for addressing community-level health issues. To understand how these community health alliances develop and operate, a descriptive study was conducted within a nationally selected group of 60 local communities and supplemented by detailed case studies in 8 communities.

Alliance Models: A broad array of organizations were found to participate in community health alliances.

Relationship between the Maternal Social Support Index and the Parenting Stress Index in mothers of very-low-birthweight children now age 7.

Two measures, the Maternal Social Support Index and the Parenting Stress Index were used to assess parents' stress and social support among mothers of 7-yr-old children born at very low birthweight. The MSSI Total scores did not significantly correlate with the PSI Total Child, Total Parent, or Total Stress Indices, although they were significant, but modestly correlated with scores on the Parent subscale of Social Isolation. The relationship between parental stress and maternal social support requires continued investigation.

Seroprevalence of viral hepatitis in Tanzanian adults.

In a cross-sectional study in Dar es Salaam, Tanzania, we determined the seroprevalence of markers for hepatitis A, B, C and E viruses and examined associated risk markers. Among 403 healthy adults, the seroprevalence of antibodies to hepatitis A virus was 99.0% (95% confidence interval: 97.

US health journal editors' opinions and policies on research in race, ethnicity, and health.

Health research on race and ethnicity has been criticized for lacking rigor in conceptualization, terminology, and analysis. Scientific journals' editorial processes help determine research quality. This survey assessed editors' awareness of current debates, attitudes toward recent recommendations, and involvement in developing editorial policies.

The health insurance puzzle: a new approach to assessing patient coverage preferences.

Previous studies of preferences for health insurance benefits have required individuals to make a series of complex and repetitive decisions, and have assumed that all insured benefits are desirable. This study reports the development and testing of a simple, innovative instrument to measure preferences for health insurance benefits. The newly developed instrument (Puzzle) is designed to allow subjects to select health benefits in a way that underscores the trade-offs dictated by budgets and costs.

The Authoritative Parenting Index: predicting health risk behaviors among children and adolescents.

Public health research demonstrates increasing interest in mobilizing parental influence to prevent health risk behaviors among children and adolescents. This research focuses on authoritative parenting, which previous studies suggest can prevent health risk behaviors among youth. To evaluate the reliability and validity of a new survey measure of authoritative parenting, data from studies of (1) substance use in a sample of 1,236 fourth- and sixth-grade students; (2) weapon carrying and interpersonal violence in a sample of 1,490 ninth- and tenth-grade students, and (3) anger, alienation, and conflict resolution in a sample of 224 seventh- and eighth-grade students were analyzed.

High birthweights among infants of north African immigrants in Belgium.

Objectives: This study examined birthweights of North African immigrants in Belgium.

Methods: Analyses focused on Belgian single live birth certificates from 1981 to 1988.

Results: Low-birthweight (< 2500 g) rates were 3.