PubMed HealthSearch

Biomedical subjects

T Howell

Publications and source records attributed to T Howell.

At least 19 recordsLinked to original sources

Residential exposure to chromium waste--urine biological monitoring in conjunction with environmental exposure monitoring.

To determine whether a population living on or adjacent to four sites of chromate production waste was measurably exposed to environmental chromium, spot samples of urine were collected along with wipe samples of household dust and lifestyle/activity interview data. Findings were compared to those from a control population in two communities with no significant chromium use or waste sites. Urine samples were collected and analyzed, employing measures to minimize background chromium contamination. The average Cr mass in dust was 3.7 times that in control houses. The mean creatinine-corrected urine Cr (Cr/c) level of the exposed subgroup residing in households in the 75th percentile of Cr mass in wipe samples was significantly greater than that of the control population. This subgroup was primarily located at a single exposure location. Using lifestyle/activity data, significantly elevated Cr/c urine levels were identified in other exposed subgroups defined by employment location and by outside play time. These data show an association between elevated exposure to chromium in household dust and elevated urine levels of chromium, consistent with residential exposure to chromate production waste. These data also suggest an association between chromium exposure and activities outside the home which are consistent with exposure to chromate production waste.

Adolescent

Geriatricians' attitudes toward assisting suicide of dementia patients.

OBJECTIVE: To identify geriatricians' attitudes toward assisting suicide of dementia patients, with particular reference to the case of Janet Adkins/Dr. Kevorkian. DESIGN: Mailed questionnaire survey. SETTING: Four distinct geographical regions of the US: Far West, Midwest, Southeast, and Northeast. PARTICIPANTS: All 1,381 ABIM-certified internist geriatricians in the four regions; 727 (52.6%) responded. MAIN OUTCOME MEASURES: Positive, negative, or unsure responses to questionnaire items; comparison of responses between geographical regions. RESULTS: Sixty-six percent of respondents felt that Dr. Kevorkian's assistance of Janet Adkins' suicide was not justifiable, while 14% stated it was morally justifiable. Twenty-nine percent felt Janet Adkins' decision to commit suicide was morally wrong, while 49% stated it was not morally wrong. If the responding geriatricians themselves were diagnosed as having a dementing illness, 41% would consider suicide a possible option; 39% would not consider suicide. Twenty-six percent favored easing restrictions on physician-assisted suicide of competent dementia patients, while 57% opposed this. If current restrictions were eased, 21% would consider assisting suicide of competent dementia patients, and 66% would not. Respondents' attitudes showed some significant (P less than or equal to 0.05) variations by geographical region. Where regional differences were observed, respondents in the Midwest tended to show more conservative attitudes toward physician-assisted suicide than those in the Far West and Northeast. CONCLUSIONS: Most responding geriatricians would not consider assisting suicide of dementia patients, and most oppose easing restrictions on physician-assisted suicide. Many, however, could accept the (unassisted) suicide of a competent dementia patient, and many would consider suicide themselves if stricken with dementia.

Attitude of Health Personnel

Microenvironmental analysis of residential exposure to chromium-laden wastes in and around New Jersey homes.

The purpose of this study was to identify the significant microenvironments that can lead to chromium exposure in Hudson County, New Jersey residential settings near or on soil contaminated with chromium waste. Measurements were made in indoor air, outdoor air, and house dust. Surface dust was found to be the best index of potential Cr exposure. The values of Cr in Hudson County household dust ranged from 3.25-320 ng/cm2 in wipe samples and 1.0-12 ng/cm2 in vacuum samples. Elevated Cr in household dust was found to be related to residential locations near large chromium waste sites, household cleaning habits, and house renovation activities. Outdoor Cr air levels were similar to those obtained in other urban areas at these seasons of the year, approximately 5-7 ng/m3. Comparisons with measurements of the Cr levels in urine found that the elevated Cr in dust was associated with elevated excretion of Cr. Site-specific Cr differences in household dust suggest different sources and routes of exposure. Within the total group of homes in the present study, Cr in household dust was the major influence on household exposure.

Air Pollutants

Occupational therapy in geriatric mental health.

Elderly persons with psychiatric disorders often experience a variety of functional deficits that affect their independence, safety, and activity level. The occupational therapist's role in addressing these needs is discussed, as are the possibilities for improvement of the elderly person's autonomy, safety, and integrity. Barriers to optimal service provision in the health care and social service systems as well as in occupational therapy are addressed.

Activities of Daily Living

Dangerous behavior in a demented patient. Preserving autonomy in a patient with diminished competence.

When a cognitively-impaired elderly man nearly caused a serious fire at home through his inappropriate use of a gas oven, the incident raised questions about his capacity to live alone. Although he clearly wanted to preserve his independence, the health care team felt obligated to assure his safety. The following discussion of dangerous behavior in a demented elderly man elicits and portrays these conflicting values, and highlights the physician's obligations in such ethically and legally complex situations.

Activities of Daily Living

Treatment of depression in cancer patients.

One hundred and fifty-two women undergoing mastectomy were randomly assigned to routine care or routine care plus monitoring by a specialist nurse. The nurse detected and referred 76% of her patients for psychiatric help. Only 15% of the routine care subjects that warranted help were referred. Twelve to eighteen months after surgery, morbid anxiety and depression were less common in the monitored (5% and 5%) than in the control (30% and 50%) group. This difference appeared to be due primarily to psychiatric treatment which included antidepressant medication, anxiolytic drugs, and supportive psychotherapy. Few affective disorders remitted without such treatment. In a further study, the effects of antidepressant medication plus cognitive therapy and cognitive therapy alone were compared. Both treatments alleviated depression in the short term but the improvement was sustained in the long term only in those given combined treatment.

Amitriptyline

Melanin distribution and sensitivity to group therapy.

Student participants in group therapy were hypothesized to improve on three dimensions of behavior as a result of therapy. It was further hypothesized that improvement would be related to participant eye color, with dark-eyed persons demonstrating greatest improvement and lighter-eyed individuals demonstrating lesser improvement. Differences were also expected from Ss by program. Ss were 35 male and female master's level students in clinical, counseling, and educational psychology programs, ranging in age from 23 to 39 years. Dependent measures were collected before and after therapy with the Vriend and Dyer Scale, an instrument yielding three factors: Self Defeating Behaviors, Fully Functioning Behaviors, and Personal Mastery Index. The design utilized a 3 (eye color) X 2 (program) two-way ANOVA, fixed effects model. Significant main effects were found for Fully Functioning Behaviors: by eye color (p less than .002) and by program (p less than .03). No interactions or other main effects were found.

Adult