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Interpersonal violence.

Interpersonal violence is unfortunately part of the social landscape for many American children. Physicians who care for children and adolescents may find it challenging to incorporate techniques to "screen and intervene" for violence. In order to guide these youth toward safety, the clinician must recognize the scope of the problem, understand the risk factors for violent injury, apply this knowledge to clinical practice, and either refer clients to or implement interventions on behalf of these youth. Unfortunately, despite an overall decrease in firearm mortality in the past few years, the prevalence and severity this problem in American adolescents remain high. Recent studies have further elucidated the demographic, behavioral, environmental, and psychosocial factors that may identify the high-risk patient. Other important work has concentrated on applying these risk factors in clinical settings. In addition, small but significant steps have been made toward educating physicians about their role in violence prevention. Finally, we have begun to scientifically evaluate interventions designed to keep youth from becoming part of a very grim statistic. This review focuses on the most recent advances that have been made toward addressing violence as a public health concern.

Adolescent↗

Environmental aspects of polymer additives.

The environmental behavior of stabilizers is not known for all chemicals which serve this purpose and further investigations will have to be done for a better understanding. From the investigations carried out on a few representative compounds, which are known to reach the environment, it can be shown that at the low concentrations at which such products appear in the environment even chemically inert substances such as hindered phenols or tin alkyl compounds are rapidly degraded and completely decomposed under the combined action of light, water, and microorganisms.

Butylated Hydroxytoluene↗

Fate of chemicals in plant-soil systems: comparison of laboratory test data with results of open air long-term experiments.

Three laboratory short-term test systems were used to determine volatilization rates, mineralization rates, and conversion rates of 14 14C-labeled chemicals in soils or soil-plant systems. The chemicals covered a wide range of water solubility, vapor pressure, chemical stability, and biodegradability. In order to compare the data obtained with the environmental behavior of the respective chemicals, data from an outdoor experimental setup which had been shown to give residue data within the range limits of field conditions were used. Volatilization rates, mineralization rates, and conversion rates obtained in the laboratory were correlated to those found under outdoor conditions. Based on these correlations, predictions of field residues were made. The predicted values for total field residues were comparable to those found experimentally with the exception of two chemicals. The prediction of residues of unchanged parent compounds in the field was less satisfactory. The reasons for differences observed are discussed.

Environmental Pollutants↗

Ecotoxicology of phenylphosphonothioates.

The phenylphosphonothioate insecticides EPN and leptophos, and several analogs, were evaluated with respect to their delayed neurotoxic effects in hens and their environmental behavior in a terrestrial-aquatic model ecosystem. Acute toxicity to insects was highly correlated with sigma sigma of the substituted phenyl group (regression coefficient r = -0.91) while acute toxicity to mammals was slightly less well correlated (regression coefficient r = -0.71), and neurotoxicity was poorly correlated with sigma sigma (regression coefficient r = -0.35). Both EPN and leptophos were markedly more persistent and bioaccumulative in the model ecosystem than parathion. Desbromoleptophos, a contaminant and metabolite of leptophos, was seen to be a highly stable and persistent terminal residue of leptophos.

Animals↗

Normative beliefs of health behavior professionals regarding the psychosocial and environmental factors that influence health behavior change related to smoking cessation, regular exercise, and weight loss.

PURPOSE: To examine the degree of consensus among health behavior change professionals regarding the personal and environmental factors they believe most strongly influence health behavior decisions related to smoking cessation, regular exercise, and weight loss. DESIGN: A factorial survey design was implemented. This method combines the positive elements from simple sample surveys and factorial experiment designs. A total of 44 independent psychosocial and environmental variables are used to randomly construct vignettes, or short stories, to collect dependent variable data. SUBJECTS: A probability sample of 311 health behavior change professionals was selected from the Society for Public Health Education, Inc., the Society of Behavioral Medicine, and faculty from the 1986 Harvard University Symposium on Health Promotion in the Work Place. MEASURES: Judgment ratings on the probability that the person described in each vignette would initiate the behavior in question. RESULTS: Multivariate analysis indicates that the multidimensional model explained approximately one half of the variance in the judgments across the three health behaviors (smoking cessation, R2 = .52; weight loss, R2 = .49; and regular exercise, R2 = .49). CONCLUSIONS: These data suggest a high degree of consensus among the sample regarding the personal and environmental factors that influence health behavior judgments. Here, the subjects perceive both behavioral intentions and self-efficacy as the most powerful determinants of judgments to initiate weight loss, regular exercise, and smoking cessation.

Attitude of Health Personnel↗

Invited review: sex ratio and rheumatic disease.

Human illnesses affect men and women differently. In some cases (diseases of sex organs, diseases resulting from X or Y chromosome mutations), reasons for sex discrepancy are obvious, but in other cases no reason is apparent. Explanations for sex discrepancy of illness occur at different biological levels: molecular (e.g., imprinting, X-inactivation), cellular (sex-specific receptor activity), organ (endocrine influences), whole organism (size, age), and environmental-behavioral, including intrauterine influences. Autoimmunity represents a prototypical class of illness that has high female-to-male (F/M) ratios. Although the F/M ratios in autoimmune diseases are usually attributed to the influence of estrogenic hormones, evidence demonstrates that the attributed ratios are imprecise and that definitions and classifications of autoimmune diseases vary, rendering at least part of the counting imprecise. In addition, many studies on sex discrepancy of human disease fail to distinguish between disease incidence and disease severity. In April 2001, the Institute of Medicine of the National Academy of Sciences published Exploring the Biological Contributions to Human Health: Does Sex Matter? (Wizemann T and Pardue M-L, editors). This minireview summarizes the section of that report that concerns autoimmune and infectious disease. Some thyroid, rheumatic, and hepatic autoimmune diseases have high F/M ratios, whereas others have low. Those that have high ratios occur primarily in young adulthood. Gonadal hormones, if they play a role, likely do so through a threshold or permissive mechanism. Examples of sex differences that could be caused by environmental exposure, X inactivation, imprinting, X or Y chromosome genetic modulators, and intrauterine influences are presented as alternate, theoretical, and largely unexplored explanations for sex differences of incidence. The epidemiology of autoimmune diseases (young, female) suggests that an explanation for sex discrepancy of these illnesses lies in differential exposure, vulnerable periods, or thresholds. Biologists have an opportunity to inform medical scientists about sex differences that explain different attack rates in specific diseases, and physicians offer biologists experiments of nature to test theories of sex.

Animals↗

Caring for patients with chronic heart failure: The trajectory model.

The purpose of this paper is to examine gaps in our understanding of the heart failure experience and describe the use of Trajectory of Chronic Illness Theory to bridge these gaps. New pharmacotherapeutic strategies have improved survival in heart failure, but research has consistently shown that clinical outcomes in these patients do not depend on physiologic variables alone. Psychological, behavioral, environmental, social and socioeconomic variables also contribute to a patient's ability to manage chronic illness. However, we have not yet identified the essential elements in helping patients engage in self-management and adhere to increasingly complex medical regimens. Theoretical models facilitate disciplinary integration, providing a comprehensive and cohesive foundation for building better science. The Trajectory of Chronic Illness Theory is particularly salient for heart failure because of its emphasis on patients' ability to manage a chronic illness. By using theory to explore gaps in our understanding of the heart failure experience, investigators may be able to develop more targeted interventions to help patients manage heart failure.

Adaptation, Psychological↗

Occurrence of dissolved PAHs in the Jinsha River (Panzhihua)--upper reaches of the Yangtze River, Southwest China.

16 priority polycyclic aromatic hydrocarbons (PAHs) were determined in water samples from the Jinsha River (Panzhihua part), Southwest China. Total dissolved PAH concentrations varied from 21.89 microg l(-1) to 382.8 microg l(-1). It was found that the concentration of PAHs decreased along the flow direction due to the higher density distribution of coal chemical industry in the upstream of our study rivers. The pollution levels in our study area are significantly higher than previously reported values in other waters both in China and other countries. The predominance of benzo[k]fluoranthene and indeno[1,2,3-cd]pyrene was clearly observed in all water samples. On average these two compounds accounted for 98.3% of the total dissolved PAH concentration in water. The results showed the positive correlations among total dissolved PAHs, benzo[k]fluoranthene and indeno[1,2,3-cd]pyrene, which suggested that these two predominant PAHs have similar source and environmental behaviors in our study area. When compared with the survey results of organic micropollutants two decades ago, it was found that hydrocarbon pollution both predominated and even increased with the development of coal chemical industry in this area during the past 20 years. The results therefore provide important information on the current contamination status of a key industrial city in China, and points to the need for urgent action to investigate the relationship between the PAH composition and concentration in water from the Jinsha River and the wastewater discharge from coal chemical industry, and to identify the source, transport pathway and fate of PAHs in the area. It should then be necessary to adopt appropriate and instant measures to control the pollution around this area.

Chemical Industry↗

The contribution of predisposing and situational risk factors to serious fall injuries.

OBJECTIVES: The objectives were to identify situational risk factors associated with suffering a serious fall injury and to determine whether, and to what extent, predisposing and situational risk factors contributed independently to risk of suffering a serious fall injury. DESIGN: Nested cohort study. SETTING: General community. PARTICIPANTS: 568 members of a representative sample of community-living persons 72 years of age or older who fell during a median follow-up of 36 months. MEASUREMENTS: Candidate predisposing factors, identified during a baseline face-to-face home assessment, were the demographic, cognitive, medical, and physical performance measures associated with an increased risk of serious injury among fallers in a previous analysis of the cohort. Acute host, behavioral, and environmental factors present at the time of the participants' first reported fall constituted potential situational risk factors. The primary outcome was occurrence of a serious fall injury, defined as a fracture, joint dislocation, or head injury resulting in loss of consciousness and hospitalization, during the first fall recorded during follow-up. RESULTS: Sixty-nine subjects (12%) suffered a serious injury during their first reported fall. No acute host factor was associated with increased risk of injury. The environmental and activity factors associated independently with serious injury in multivariate analysis included falling on stairs (adjusted relative risk 2.0; 95% confidence intervals 1.1-3.5), during displacing activity (1.8; 1.0-3.0), and from at least body height (2.1; 1.0-4.7). The independent predisposing factors included female gender (2.1; 1.0-4.4), low body mass index (1.8; 1.2-2.9), and cognitive impairment (2.8; 1.7-4.7). Although 12% of first falls resulted in a serious injury overall, this percentage ranged from 0% to 36% as the number of predisposing risk factors increased from zero to three and from 5% to 40% as the number of situational risk factors increased from zero to three. Further, for any given number of predisposing risk factors, the percentage of fallers suffering a serious injury increased with the number of situational risk factors. CONCLUSIONS: Several environmental and behavioral factors contributed to the risk of serious fall injury; this contribution was independent of the effect of chronic predisposing risk factors. Preventive programs that address both predisposing and situational risk factors may result in the greatest injury reduction. These findings support previously recommended multicomponent intervention programs that combine medical, rehabilitative, and environmental components.

Accidental Falls↗

Fractionation and characterization of sludge bacterial extracellular polymers by FT-IR, 13C-NMR, 1H-NMR.

Sludge bacterial extracellular (BEP) polymers exhibit a strong affinity with metals in addition to their role in the bioflocculation of activated sludge. It is of utmost importance in elucidating the chemical characterization of sludge BEP prior to a better understanding of its environmental behavior. Sludge BEP extracted from activated sludge was characterized by FT-IR, 1H-NMR, and 13C-NMR and fractionated into 6 fractions (hydrophilic acid, base, and neutral; and hydrophobic acid, base, and neutral). The results indicated that sludge BEP contained more polysaccharides but fewer amino acids or proteinaceous materials compared to dissolved organic matter (DOM) derived from sludge. No aromatic substance was found in sludge BEP as indicated by NMR. Sludge BEP was dominated by hydrophilic fractions, accounting for 65% of total DOC of sludge BEP and hydrophilic neutral constituted about 58% of the hydrophilic fraction. The chemical fraction and characterization indicated that sludge BEP might exhibit a higher capability in enhancing the transport of the associated contaminants through porous media than that of sludge DOM.

Bacteria↗

Environmental chemistry of phosphonates.

Phosphonates are anthropogenic complexing agents containing one or more C-PO(OH)(2) groups. They are used in numerous technical and industrial applications as chelating agents and scale inhibitors. Phosphonates have properties that differentiate them from other chelating agents and that greatly affect their environmental behavior. Phosphonates have a very strong interaction with surfaces, which results in a significant removal in technical and natural systems. Due to this strong adsorption, little or no remobilization of metals is expected. No biodegradation of phosphonates during water treatment is observed but photodegradation of the Fe(III)-complexes is rapid. Aminopolyphosphonates are also rapidly oxidized in the presence of Mn(II) and oxygen and stable breakdown products are formed that have been detected in wastewater. The lack of information about phosphonates in the environment is linked to analytical problems of their determination at trace concentrations in natural waters. Further method development is urgently needed in this area, including speciation of these compounds. With the current knowledge on speciation, we can conclude that phosphonates are mainly present as Ca and Mg-complexes in natural waters and therefore do not affect metal speciation or transport.

Adsorption↗

Subcritical water extraction to evaluate desorption behavior of organic pesticides in soil.

We evaluated the feasibility of extracting organic pesticides in soil using a hot-water percolation apparatus at 105 degrees C and 120 kPa pressure. Efficiency of the method was assessed by extracting six selected pesticides (acetochlor, atrazine, diazinon, carbendazim, imidacloprid, and isoproturon) from previously equilibrated soil at 13.6-65.8 mg/kg concentration range. Studies were performed on brown forest soil with clay alluviation (Luvisol). The method developed was compared to the traditional batch equilibrium method in terms of desorbed amount of pesticides from soil and extraction time. Pesticides in the liquid phase from the batch sorption experiment and in the effluent from the hot-water percolation were quantified by high-performance liquid chromatography with UV detection. The results of the percolation experiment are in close correlation with those of the conventional soil testing method. Desorbed quantities by hot-water percolation were 85% acetochlor, 62% atrazine, 65% carbendazim, 44% diazinon, 95% imidacloprid, and 84% isoproturon, whereas using batch equilibrium method 101, 66, 64, 37, 81, and 90% were desorbed, expressed as the percentage of the adsorbed amount of pesticide on soil following equilibration. The average time for hot-water extraction was 3.45 min, in contrast to the 16 h time consumption of the traditional batch method. The effect of temperature on stability of selected compounds was also evaluated using pesticide-spiked sand without soil. Recoveries of analytes ranged between 84.6 and 91.1% with reproducibility of 7.9-10.2%, except for diazinon, for which recovery was 59.4% with 14.4% relative standard deviation since decomposition occurred at elevated temperature. The percolation process has been described by a first-order kinetic equation. The parameters calculated from the equation provide an opportunity to estimate the amount of compound available for desorption, the rate of desorption processes in the studied soil-pesticide-water system, and modeling the leaching process to obtain additional information on the environmental behavior of the examined pesticide.

Atrazine↗

Distribution and migration of 95Zr in a tea plant/soil system.

(95)Zr is a primary radionuclide in the radioactive liquid efflux from a pressurized water reactor and one of the main radionuclides released after nuclear accidents. The fission yield of (95)Zr is as high as 6.2%, however, its environmental behavior has not been well documented. An experiment was conducted to evaluate the accumulation and distribution of (95)Zr in a tea plant/soil system. (95)Zr was accumulated primarily in the trunk of tea plants after being taken up from the soil. The radioactivity concentration of (95)Zr in the trunk increased slowly with time, then it reached a dynamic equilibrium 14 days after application. The radioactivity concentration of (95)Zr in the other parts of the tea plant was very low; only slighter greater than the detection limit. The results indicated that (95)Zr was not readily translocated in the tea plant. About 98.9% of applied (95)Zr was found to concentrate in the upper 5 cm layer after being sprayed onto the soil surface. The results indicated that (95)Zr could not readily move downwards with percolating water due to strong adsorption to surface soil.

Environmental Monitoring↗

Dynamics of 95Zr in the rice/water/soil system.

In order to get a better understanding of the environmental behavior of 95Zr and to generate fundamental data for evaluation of its ecological risk, an experiment was conducted to study 95Zr dynamics in a simulated rice/water/soil system. The results showed that the concentration of 95Zr in surface water decreased rapidly with time due to precipitation, adsorption to soil and uptake by rice, and most of 95Zr in soil was found concentrated in the surface layer (0-8 cm from surface). The 95Zr could not readily move downwards with percolating water and remained in surface soil. The 95Zr taken up from surface water and surface soil mainly concentrated in roots and lower parts of stem. The concentration of 95Zr in upper part of stem and leaves were relatively lower, which were only slightly greater than the detection limit. The 95Zr concentration in tassel was near the detection limit. The dynamics of 95Zr concentrations in rice, water and soil can be described with exponential function.

Environmental Monitoring↗

Polybrominated diphenyl ethers (PBDEs), polybrominated dibenzo-p-dioxins/dibenzofurans (PBDD/Fs) and monobromo-polychlorinated dibenzo-p-dioxins/dibenzofurans (MoBPXDD/Fs) in the atmosphere and bulk deposition in Kyoto, Japan.

Polybrominated diphenyl ethers (PBDEs), polybrominated dibenzo-p-dioxins/dibenzofurans (PBDD/Fs) and monobromo-polychlorinated dibenzo-p-dioxins/dibenzofurans (MoBPXDD/Fs) in atmosphere, bulk atmospheric deposition and soil in Kyoto, which is an urban city in Japan, were measured. Decabromodiphenyl ether (D(10)BDE, BDE-209) was detected in relatively high concentrations compared to other PBDE congeners in most samples. Similar results, in which D(10)BDE was predominantly detected, were reported in other studies in Japan. However, these homologue profiles differ from those of studies conducted in North America. The partitioning of semivolatile organic compounds between atmospheric gas phase and particulate-associated phase is an important factor in their environmental behavior. In this study, atmospheric particulate phase fraction (f(P)) of the brominated compounds increased with increasing bromine number, and f(P) was higher in samples collected in winter than in those collected in summer. Moreover, f(P) of PBDFs and MoBPXDFs was higher than that of PCDFs with the same halogen number. These results agree well with expectations from the vapor pressure of the brominated compounds and PCDD/Fs. Among the brominated compounds in the atmosphere, the level of MoBPXDD/Fs correlates positively with that of PCDD/Fs. This relationship has been previously observed in waste incineration samples. These results suggest that one of the sources of MoBPXDD/Fs in the atmosphere is incineration byproduct. The level of PBDD/Fs seems to correlate positively with that of PBDEs. This relationship suggest that the PBDD/Fs in the atmosphere relate to PBDEs, which is an impurity of PBDE products, or formed by the manufacture or combustion of plastics containing PBDEs.

Air Pollutants↗

India-US case-control study of age-related cataracts. India-US Case-Control Study Group.

In a hospital-based case-control study of 1441 patients with age-related cataracts and 549 controls, we studied associations between types of cataract--nuclear, cortical, posterior subcapsular, and mixed--and a number of physiologic, behavioral, environmental, and biochemical variables. Using polychotomous logistic regression analysis, we found an increased risk of cataract with lower educational achievement (all types of cataract), decreased cloud cover at place of residence (all types), use of aspirin less than once a month (posterior subcapsular and mixed), diets low in selected nutrients (posterior subcapsular, nuclear, and mixed), higher blood pressure (nuclear and mixed), lower body mass index (nuclear and mixed), use of cheaper cooking fuels (cortical, nuclear, and mixed), and lower levels of an antioxidant index based on red blood cell levels of glutathione peroxidase and glucose-6-phosphate dehydrogenase and plasma levels of ascorbic acid and vitamin E (posterior subcapsular and mixed). All risks cited were significantly different from those for the other cataract types, a finding that emphasizes the need to investigate the epidemiology of specific types of cataract.

Adult↗

Environmental distribution of acetochlor, atrazine, chlorpyrifos, and propisochlor under field conditions.

The environmental behavior, movement, distribution, persistence, and runoff by rainfall of the pesticides acetochlor, atrazine, chlorpyrifos, and propisochlor were studied under field conditions during a five-month period at normal weather conditions. The pesticide concentrations in soil depths of 0-5 and 5-20 cm, and in sediment and runoff water samples (collected from an artificial reservoir built in the lower part of the experimental plot) were measured every second week and following every runoff event. The contamination of a stream running across the lowest part of the plot was also monitored. The weather conditions were also recorded at the experimental site. The pesticide residues were quantified by a capillary gas chromatograph equipped with a nitrogen phosphorus selective detector (GC-NPD). There was a consistent decrease in pesticide residues in the 0-5 cm soil layer with time after spaying. At 140 days after treatment only atrazine and chlorpyrifos were present; acetochlor and propisochlor were not detected in this soil layer. Atrazine and chlorpyrifos in the soil at a depth of 5-20 cm were detectable during the whole experimental interval, whereas acetochlor and propisochlor concentrations were below the limit of detection. Pesticide losses by the surface runoff process and the contamination of the stream were closely related to the time of rainfall elapsed after treatment and amount of rain at the experimental plots. Losses were primarily dependent on surface rainfall volume and intensity. The maximum detected residues of atrazine and acetochlor in stream water were 1 order of magnitude higher than the maximum residue limit specified by the European Union (EU) for environmental and drinking water (0.1 microg/L for individual compounds and 0.5 microg/L for total pesticides). Chlorpyrifos and propisochlor were not detected in this matrix.

Atrazine↗

Exposure patterns of perfluorooctane sulfonate in aquatic invertebrates from the Western Scheldt estuary and the southern North Sea.

Over the past decades little research has been conducted on the environmental behavior and effects of fluorinated organochemicals (FOCs). Recently it has been reported that perfluorooctane sulfonic acid (PFOS) is occurring worldwide. Little is known about the PFOS levels in organisms originating from the southern North Sea and the Western Scheldt estuary. In this study, we determined, for the first time, the PFOS-exposure levels in Crangon crangon, Carcinus maenas, and Asterias rubens from these ecosystems. Concentrations on a wet-weight basis in soft tissues of shrimp, crab, and starfish ranged from 19 to 520 ng/g, from 24 to 877 ng/g, and from 9 to 176 ng/g, respectively. These results show the existence of a PFOS pollution gradient in organisms along the Western Scheldt estuary, with the highest concentrations near Antwerp. The range of PFOS levels in shrimp and crab are slightly higher in coastal regions compared with sampling sites in open water. This study shows widespread distribution of PFOS in the Belgian and Dutch marine and estuarine environment at rather high concentrations.

Alkanesulfonic Acids↗