bluuebunny/crossref_metadata_2025 huggingface dataset:
A survey of postgraduate education programmes and research interests of GPs in community trusts in an inner city area
Authors: Littlewood J. , Webb E. , Beer N. , Lazou E.
Published: September 2007

Following discussions with medical lecturers in a postgraduate centre, a questionnaire was sent to all the general practitioners (GPs) in three selected Community Trusts in an inner city area. Besides their qualifications and research interests, the GPs were asked for their views on continuing educa tion. The results showed that opportunities for col laborative education with other members of the primary care groups (PCGs) would be possible if it focused on research methods and 'Health of the Nation' targets. The results showed that up to 61 % of the GPs who responded had carried out research and had collaborated with nurses on the research projects. There was considerable variation across the Community Trusts in relation to the experi ence and interests of the GPs.

The formation of the PCGs and joint commis sioning offered an excellent opportunity for both collaborative educational opportunities and research. As the interests of the GPs is so diverse, some thought about consolidating and harnessing their interests and expertise in order to influence local and national research agendas may be of value.
Comparison of anthropometric characteristics between normotensive and hypertensive indi viduals among a population of Bengalee Hindu elderly men in Calcutta, India
Authors: Ghosh A. , Bose K. , Das Chaudhuri A.B.
Published: September 2007

A comparative investigation of 99 normotensive and 111 hypertensive Bengalee Hindu elderly men (aged 55 years and above) of Kalighat, South Cal cutta, India, was undertaken to study differences in levels of adiposity, body fat distribution and body composition between these two groups. Results revealed that there were significant differences between normotensive (NT) and hypertensive (HT) subjects in the mean values for weight (p < 0.05), body mass index (BMI, p < 0.01); waist (p < 0.001) and hip circumferences (p < 0.05); waist-hip ratio (WHR, p < 0.001), conicity index (CI, p < 0.01) and fat free mass (FFM, p < 0.001). Percentile dis tributions for all these variables and indices showed consistently higher values among the HT patients as compared with NT subjects. However, the frequen cy of obesity (BMI ≥25) was similar (NT = 6.1 %, HT = 11.7%) in both groups. Thus, these results indicated that there existed significant differences in central adiposity and FFM between NT and HT subjects although their level of obesity was simi lar. Hypertensive individuals have significantly enhanced levels of central body fat distribution.
Micronutrient intakes in a group of UK vegans and the contribution of self-selected dietary supplements
Authors: Lightowler H.J. , Davies G.J.
Published: September 2007

Micronutrient intakes and the contribution of self- selected dietary supplements were investigated in 26 vegans, comprising 17 non-supplement users (NSU) and nine supplement users (SU), consum ing their habitual diet. Micronutrient intakes were estimated using a four-day weighed record and the contribution of self-selected dietary supplements was assessed according to the manufacturers' decla rations on the packaging. Mean daily intakes from food sources were similar in NSU and SU. Dietary supplements significantly increased intakes of riboflavin (p<0.05), niacin (p<0.05), folate (p<0.01), vitamin A (p<0.05) and vitamin D (p<0.05). The mean daily contribution of dietary supplements ranged from 7-1640% of the refer ence nutrient intake (RNI). Intakes of vitamin B12 and selenium (Se) were below the appropriate lower reference nutrient intake (LRNI) in 80% and 65% of NSU respectively. After supplements, 33% of SU remained below the LRNI for vitamin B12 and 33% below the LRNI for Se. Some vegans who took supplements were not taking certain micronu trients in amounts sufficient to meet the RNIs but were taking a mix of micronutrients, some of which they needed and others which they did not need. Some vegans who did not take supplements had a potential need for the addition of supple ments to their diets. Advice on the appropriate usage of dietary supplements for those on a vegan diet is needed.
In the rationing of healthcare in indigent African populations, which services should come first?
Authors: Walker A.R.P. , Wadee A.A.
Published: September 2007

Governments, worldwide, have enormous difficul ties in affording adequate funds for healthcare and its maintenance. In developing populations, almost all of whom are indigent, the diverse health prob lems being faced with limited funds are insuffi ciently appreciated. Information is given, for both developed and developing populations, principally those in sub-Saharan Africa, regarding various countries' gross national product (GNP) per capi ta, the percentage of GNP devoted to health ser vices, and the allocation of health funds per capita. To illustrate the formidable health problems pre vailing, some data are given on the magnitudes of morbidity/mortality situations, both for communi cable and non-communicable diseases. Some examples are provided which exemplify opposing points of view regarding strongly contesting health claims for priorities in monetary support. Addi tionally, examples are given of some impoverished countries, which, despite highly adverse circum stances, have achieved enviable health statistics. In this respect it would be highly beneficial were the circumstances and means employed in these and similar contexts given wide publicity.
Is there a 'typical' consumer of obstetric services?
Authors: Tinson J.
Published: September 2007

Each user of the maternity services will have a dif ferent service experience. The experience will vary depending on the place of birth, type of antenatal care, delivery and postnatal support. However, to be effective service providers, the provision ought to be responsive to the needs of the consumers. This paper considers the development of the maternity services, reflecting on the current envi ronment in which the provision is delivered and attempts to characterise users of the provision to facilitate an understanding of consumer needs. This research considered primigravidae and multi parous users of the maternity provision and explored their access to information and their use of information with particular consideration of their referent groups. This study produced inter esting results, not least that both primigravidae and multiparous users are prepared to abdicate respon sibility for some aspects of their decision-making to medical professionals. Sub-categorisations of primigravida and multipara users and various socio-economic groups were also constructed.
Urinary tract infection in children: a review of its pathogenesis and risk factors
Authors: Twaij M.
Published: September 2007

Urinary tract infection (UTI) is one of the commonest bacterial infections seen in children, ranking second only to those of the respiratory tract. A steady flow of urine, complete emptying of the bladder and various host defences provide the principal means of protec tion. Urinary stasis, on the other hand, provides an opportunistic environment for bacterial multiplication; several other factors also contribute to UTI, such as urinary obstruction, vesico-ureteric reflux (VUR) and other urinary tract malformations. UTI, especially in the presence of VUR, may lead to scarring of the kid ney and progressive renal disease. It is vital, therefore, to diagnose such anomalies at an early stage, the over all aim being to identify those at high risk so that mea sures may be taken to prevent serious complications and preserve renal function. Those at low risk of UTI, however, should not be over investigated; this is in order to keep invasive procedures down to a mini mum. Whenever possible, the management of high risk cases is best discussed between paediatrician, microbiologist, radiologist, urologist and the general practitioner.
Dietary advice on cancer prevention: time for a change?
Authors: Hill M.J. , Davies G.J. , Davies G. Jill
Published: September 2007

Media coverage of recent dietary intervention stud ies has cast doubt on dietary advice for cancer pre vention. The studies cited focussed on colorectal adenoma initiation as opposed to progression. There is ample evidence that in the colorectum the factors controlling initiation of adenomas differ from those causing progression to cancer, and that it is the latter that are the most important. In the light of this it is argued that studies of adenoma ini tiation are irrelevant to the advice given for overall cancer prevention.
Historical perspectives on health Medicine 2000 years ago: the case of Qumran and other biblical sites
Authors: Moss G.A.
Published: September 2007

Since the eighteenth century, the dominance of orthodox or allopathic medicine in the West led to the branding of other forms of medicine as alterna tive. However, research shows a narrowing in the gap in popularity of the two methods and it is pos sible to envision a time when alternative medicine and mainstream medicine will work in tandem.

As the West completes a year of millennium cel ebrations and looks back to the events that shaped the founding of the first millennium two thousand years ago, it is appropriate to increase our under standing of the form medicine took at that time. Research on Qumran and other biblical sites shows that the therapies offered there were based on alter native therapies such as herbal medicine and hydrotherapy as well as conventional therapy such as surgery. The article shows that the twin reliance on alternative and orthodox methods emerging today, marks a return to a pattern of provision which prevailed at the time the first millennium was born.
Lessons to be learned: a case study approach Extramedullary plasmacytoma presenting as upper back pain
Authors: Ganesh M. , Sai Sankar N. , Jagannathan R.
Published: September 2007

Extramedullary plasmacytoma (EMP) is a rare soft tissue plasma cell tumour, usually presenting as a mass within the upper respiratory tract. It is most unusual for it to present in the posterior medi astinum as a primary solitary lesion. Discussed here is the case report of a patient who initially presented with musculoskeletal pain. Subsequent investiga tions, however, revealed the cause to be an EMP; diagnosis was made on finding aggregates of plasma cells on histological examination of the tissue speci men. The latter had been obtained by way of a com puterised tomography scan guided biopsy of the tumour. Bone marrow aspiration studies showed no evidence of multiple myelomatosis. There was sig nificant clinical improvement in response to radio therapy. It is possible that this might represent one of the first documented reports of a primary solitary EMP in the posterior mediastinum.
The distracted driver
Authors: Peters George A. , Peters Barbara J.
Published: September 2007

A serious health problem is developing from auto mobile collisions caused by distracted drivers. This is a result of the rapid proliferation of portable cel lular telephones and personal organisers used while driving, the development of more sophisticated entertainment systems and instrument panel con trols, the advent of navigation and television dis plays in vehicles and promises of sophisticated wireless email, FAX and Internet services in the vehicle.

Preoccupation with electronic gadgets may also degrade human driving performance. Many drivers however, sincerely believe they have the talent to do several things at the same time, such as hold and look at a cellular telephone in one hand and drive with a beverage container in the other hand whilst at the same time, exercise their personal skills. Obviously, they believe that they do not need two hands on the steering wheel and two eyes on the road.

This is a unique situation requiring intensive health promotion as distracted or 'offensive dri ving' may be habit forming and difficult to change, any significant design remedies will be slow to arrive and may be circumvented, and the regulato ry laws have proved difficult or impossible to enforce. This special need may require research to determine the most effective techniques for health promotion.
Personal exposure to benzene and the influence of attached and integral garages
Authors: Mann Hardip Singh , Crump Derrick , Brown Veronica
Published: September 2007

Benzene is an air pollutant that is a recognised human carcinogen. An air quality standard has been established for ambient air in the UK to reduce the popula tion's exposure. It has been estimated that about 70% of benzene emissions to air in the UK come from petrol vehicles.

A number of studies, including the Avon Longitudinal Study of Pregnancy and Childhood in the UK, have found that benzene concentrations in homes with attached or integral garages tend to be higher than in those without such garages. The present paper reviews these studies and reports a detailed investigation of five homes with either an attached or an integral garage.

Indoor and outdoor locations were monitored using diffusive sampling to determine the average benzene concentration over approximately 28 days each month for 18 consecutive months (June 1998-November 1999). For one of these homes, ten years of data had shown the indoor benzene concentration to be con sistently higher than outdoors. Personal exposure monitoring of one adult in this home showed that the benzene concentration in the main bedroom was a better predictor of personal exposure than the concentration outdoors.

In the homes where a car was regularly parked in the garage, 18-month aver age benzene concentrations of up to 101.3 μgm 3 were measured in the garage, which is more than six times the ambient air quality standard for benzene (16.25 μgm3 running annual average). Mean benzene values in all cars and most of the garages studied exceeded the benzene standard.

Mean benzene concentrations in the room above the garage ranged from 3.7 μgm3 in one home, where the car was rarely parked in the garage, to 39.9 μgm3 in another home where a car with high benzene emissions was parked in the garage for six of the 18 months monitored. The mean benzene concentration in the room above the garage in this latter home was nearly 2.5 times the ambient air standard.

The study demonstrates that there is a potential for people to have a higher exposure to benzene as a result of living in a home with an attached or integral garage. An understanding of routes of personal exposure is important to devel op effective policies to reduce risks to health.
Aspects of the history of nutrition since 1876
Authors: Dickerson John W. T.
Published: September 2007

Since 1876, developments in nutritional science have followed those in chemistry, physiology, biochem istry and medicine. The essential relationship between food and body energy has been elucidated. The aetiology of diseases long known in human his tory has been traced to deficiencies of specific nutri ents, the 'vitamins', required in very small amounts. These substances have been isolated, identified and synthesised. Research in infant malnutrition has led to the recognition that comparatively small changes in biochemical programming during growth and development may cause disease later in life. Dietary 'roughage' has been found to have significance in dis ease prevention and prospects for the very sick have been improved by the development of alternative feeds. Knowledge of the human genome promises exciting new advances for nutrition in relation to public health and clinical medicine.
An overview of biochemical markers in acute coronary syndromes
Authors: Olukoga A. , Donaldson D.
Published: September 2007

The cardiac troponins (cTns), cTnT and cTnI, are currently regarded as being the most useful diagnostic and prognostic biochemical mark ers of myocardial damage in patients with sus pected acute coronary syndromes (ACSs). In spite of the evidence-based nature of this observation, the uptake of serum cTn mea surement in routine clinical practice - in both the UK and elsewhere, is patchy; indeed, there still exists wide variability in the range of test ing and sampling strategies involving usage of the many existing cardiac markers. For evaluat ing suspected acute myocardial infarction (AMI) and other ACSs, international opinion favours either serum cTnT or cTnI (measured 12-24 h after admission to the emergency room) - together with a short-time window marker such as serum creatine kinase (CK) (measured on admission and perhaps again within the 12-24 h window). Translation of this strategy into universal clinical practice would require not only formulation of, but also strict adherence to, agreed clinical decision- making protocols which, in turn, would need to be backed by adequate funding.
Risk reduction for DDT toxicity and carcinogenesis through dietary modification
Authors: Jaga K. , Duvvi H.
Published: September 2007

Organochlorine pesticides, including dichlorodiphenyl- trichloroethane (DDT), are an environmental hazard due to their persistent nature and potential health effects. DDT and 1,1,dichloro-2,2,bis(p-chlorophenyl)ethylene (DDE) are lipid- soluble pesticides which accumulate in fatty tissues and are, therefore, more present in fat-containing foods such as meat, fish, milk, cheese and oil than in fruit, vegetables and grain. Sci entists have for some time been concerned about the human exposure to DDT and the potential risk of breast cancer due to its oestrogenic activity.

The introduction of foods containing chemopreventive agents in the diet could inhibit the oestrogenic effects of DDT and the risk of developing cancer. Phytooestrogens are weak oestrogens found in certain plants such as soybean. They com pete with DDT for oestrogen receptors and inhibit the oestro genic effect of DDT on cultured human breast (MCF) cells. Curcumin, a spice widely used in Indian dishes, has and-car cinogenic and anti-inflammatory properties. It also inhibits the oestrogenic effects of DDT and is synergistic with phytooe strogens. Indole-3-carbinol, a compound naturally found in cru ciferous vegetables, stimulates oestrogen metabolism towards 2- hydroxyoestrone which reduces the oestrogenic response in MCF cells and the risk of breast cancer.

Since DDT is lipid soluble and accumulates in adipose tissue it could have a role in lipid metabolism. Would a low fat diet reduce DDT bioaccumulation? A reduction in calories can decrease oestrogen levels and possibly reduce the risk of breast cancer.

A dietary modification with the introduction of soy prod ucts, curcumin, cruciferous vegetables and low fat could be beneficial in reducing the risk of developing cancer and possi bly the effects of DDT.
Lessons to be learned: a case study approach 'Spontaneous' intraperitoneal bladder rupture in a psychiatric patient - with diagnostic difficulties
Authors: Jutley R.S. , Mason R.G.
Published: September 2007

The case described here is that of a 34-year-old woman with a psychiatric disorder who was referred to the local surgical receiving unit with abdominal pain and vomiting. She remained well and fully mobile but refused blood inves tigations until the day following admission. At that time the tests showed a picture of ac renal failure. With the development of increas ing abdominal tenderness and pyrexia she was persuaded to have a laparotomy which demon strated a small tear at the dome of the bladder.

Her deranged blood biochemistry returned to normal within 11 h following surgery. The important points demonstrated in this case study are the special clinical difficulties encountered in psychiatric patients, which may consequently lead to delay in diagnosis. This delay allowed significant peritoneal reabsorp tion of urea and creatinine, which masquerad ed as 'acute renal failure' on biochemical test ing. The case also highlights the use of procy clidine, commonly used in patients with psy chiatric disorders; urinary retention is a recog nised side effect of this drug - and it is possi ble that such retention together with a minor and hence easily overlooked episode of trau ma, may have contributed to the patient's con dition.
125 years of public health in the UK
Authors: Donaldson Liam J.
Published: September 2007

This paper examines four themes in public health theory and practice; all are important for the future and are illuminated by the last 125 years. First, while definitions of public health may be stable, the ratio nale of public health practice - 'why bother?' =has altered considerably over time. A second theme revolves around personal autonomy - can we compel individuals to take health promoting measures? Third, public health practice today pays attention as never before to the use of research-based evidence, helping to answer three questions: What are the problems? What are their causes? What are the solu tions ? The fourth theme is the changing character, locus and focus of public health. From being pre dominantly locally focused within Borough Councils, albeit operating within frameworks of national legis lation and one eye on global threats, it has become much more complex with emerging levels of action which encompass the neighbourhood, the strategic district, the region, nation state, Europe and finally the ever more pressing globalisation agenda as it affects the human condition.

Public health has been medically dominated for the last 125 years and this is now changing. Its ties with local government are being strengthened after a break of nearly 30 years. The focus of public health has recently been strongly on health services. This reached its apogee a few years ago but is also now rapidly changing. Looking back over the last 125 years can help us identify some of the mistakes to be avoided and opportunities to be seized at this time of change.
Professional territories and the fragmented landscape of elderly care
Authors: Hardey Michael , Payne Sheila , Powell Jackie , Hawker Sheila , Kerr Chris
Published: September 2007

This paper examines the problems and dilem mas involved in delivering care to older people. In particular it seeks to identify the processes that facilitate or hinder communication and collaboration between those involved in care that has to be both reliable and expeditious to ensure that high quality care is provided. To do this the paper draws on a recent international systematic review of the relevant research lit erature which is briefly described. A geo graphical analogy is employed to help map dif ferent organisational and professional territo ries of care. It will be argued that these territo ries have their own priorities, patterns of working and perceptions of older people. The paper concludes by considering a potential way to merge territorial interests by reconfig uring the map of care around the older per son.
Community pharmacists' experience of over-the-counter medicine misuse in Scotland
Authors: MacFadyen Lynn , Eadie Douglas , McGowan Tony
Published: September 2007

Over the last decade Britain has observed a trend towards the re-regulation of 'prescription only med icines' in favour of pharmacy status drugs. This move towards self-treatment to reduce pressures on general practitioner drug budgets and workloads has focused attention on the need for community phar macists to extend their patient education and screen ing roles. In response to these changes, this study was conducted to explore: the type of over-the- counter (OTC) medicine being misused in Scotland; pharmacists' professional attitudes and management of OTC misuse; and the training and support needs of pharmacists. A postal questionnaire was designed. This was informed by an earlier stage of qualitative research and the available literature. It was then piloted and administered to all 110 pharmacies in the study area. A 79% response rate was achieved. The research found that OTC misuse, particularly of cer tain analgesics, sleeping prescriptions, products con taining codeine or pseudoephedrine, caffeine, cough mixtures, and laxatives was common. The estimated mean number of patients suspected of misusing medicines in a typical week was 5.63. Pharmacies in urban areas were more likely than those in rural areas to report suspected misuse. The research identified a number of intervention strategies relating to: patient/pharmacist interaction; information provi sion ; removal of products from the point of sale; sharing of information with other local pharmacists; and referral to other members of the primary care team. Pharmacists expressed a need for support in managing OTC misuse and in organising 'early warn ing systems' to share information locally
Food hygiene training in the UK: time for a radical re-think?
Authors: MacAuslan E.
Published: September 2007

Training food handlers in the hospitality industry has been recommended by various organisations as a means of improving food handling practices and thus the safety of food for consumers. It is nearly 20 years since the first examinations for basic level food hygiene certificates were made available to food handlers in the UK. Since then lit tle has changed in the syllabuses and in the way the ques tions are worded. However, the range of languages spoken by food handlers working in the UK has increased sub stantially since more employers are recruiting those who speak English as a second language. Training can be an unwelcome expense for managers where there is a high turnover of employees, especially amongst those for whom English is not a first language. To improve practical imple mentation of food hygiene theory it is time to develop a radical strategy concerning the way training is targeted and delivered in the UK, and perhaps Europe.
Work-related stress: a brief review
Authors: Holmes S.
Published: September 2007

Work-related stress is a serious and growing problem in the UK and as such, is regarded as a significant health and safety issue. It is vital that this issue is addressed and that action is taken to address the problems that this may create both for individuals and the organisations in which individuals work.

This paper reviews the concept of work-related stress showing how its deleterious impact may exert both direct and indirect effects on the workforce thus affecting both individual and organisational effective ness. It also shows how individual and organisational factors may contribute to the development of occupa tional stress. However, since not all the stress which affects people at work is caused by the workplace, the home/work interface is also considered. The paper concludes by considering how work-related stress may be managed.
The perceived benefits of singing
Authors: Clift S.M. , Hancox G.
Published: September 2007

Two exploratory studies are reported on the perceived benefits associated with active participation in choral singing. In the first study, 84 members of a uni versity college choral society completed a brief questionnaire that asked whether they had benefited personally from their involvement in the choir and whether there were ways in which participation could benefit their health. A large majority of respondents agreed they had benefited socially (87%) and emotionally (75%), with 58% agreeing they had benefited in some physical way, and 49% spiritually. A content analysis of written comments served to elaborate the ways in which choir members felt they had benefited. Common themes expressed were: meeting new people, feeling more positive, increased control over breathing, feeling more alert and feeling spiritually uplifted. With respect to health benefits, 84% of participants gave answers, the main themes of which related to improved lung function and breathing, improved mood and stress reduction. In the second study, 91 members of the choir complet ed a structured questionnaire consisting of 32 statements about singing reflecting the ideas expressed in the first study. Over 40% of respondents strongly agreed that 'singing helps to make my mood more positive', 'singing is a moving experience for me sometimes', 'singing makes me feel a lot hap pier' and 'singing is good for my soul'. A principal components analysis fol lowed by Oblimin rotation identified six dimensions of benefit associated with singing These were labelled as: benefits for well-being and relaxation, benefits for breathing and posture, social benefits, spiritual benefits, emotion al benefits, and benefits for heart and immune system. Cronbach alpha coef ficients were satisfactory for all components except the third, social benefits, due primarily to the small number of items loading on this component. Women were significantly more likely to experience benefits for well-being and relaxation, younger people were more likely to report social benefits, and those professing religious beliefs were more likely to experience spiritual ben efits. The present studies have a number of limitations, but they provide a useful foundation for future larger scale surveys, more sophisticated qualita tive studies, and experimental investigations of the impact of singing on psy cho-physiological functioning.
The effect of domestic air treatment equipment on the concentration of radon-222 daughters in a sealed room
Authors: Miles J.C.H. , Davies B.L. , Algar R.A. , Cliff K.D.
Published: September 2007

REDUCTION OF the ventilation rate in houses in the interests of energy conservation can lead to a build-up of radon-222 in room air. This results in irradiation of the lungs by the radioactive daughters of radon. An electrostatic precipitator has been used to remove radon daughters from the atmosphere of a sealed room. It is shown that this can reduce the dose to the bronchial epithelium by an order of magnitude, and effectively counter the effects even of extremely low ventilation rates.
Referral and decision-making process for psychiatric treatment in the Yoruba community of Nigeria
Authors: Daramola S.O.
Published: September 2007

FIFTY YORUBA male patients were interviewed in the psychiatric out patient clinic at the Ife University Teaching Hospitals Complex Ile-Ife, Nigeria.

The interviews revealed that 38% of the psychiatric patients referred for treatment were by friends of the patients, followed by the general hospital 12 % and neighbours 10%. Whereas, decisions were made by the patient's nearest relative such as the father, 11 %, the mother, 16%; the eldest brother of the patients made 20% of all the decisions.
The control of the heavy metals health hazard in the reclamation of wastewater sludge as agricultural fertilizer
Authors: Diamant B.Z.
Published: September 2007

WASTEWATER SLUDGE production is esti mated at 33 tons, dry weight, per year per 1,000 people living in sewered areas. About a quarter of this sludge is disposed of by means of application to cropland. This disposal means has an important fertilizing advantage due to the high nitrogen content in the sludge — but also a serious disadvantage caused by the presence of poisonous heavy metals in the same sludge, that affect plants, animals, man and water resources. Out of the 14 most common heavy metals in sludge, that include — aluminium, antimony, arsenic, chromium, iron, lead, manganese, mercury and selenium, as well as cadmium, copper, molybdenum, nickel and zinc — the last five are the most hazardous, in particular the cadmium. Most heavy metals are essential in the metabolism processes, but are poison ous in excess quantities. Heavy metals tend to accumu late in leaves, rather than in the fruit of plants — and in the liver and kidneys of animals feeding on the infected plants. Plants absorb heavy metals only in a soluble form. High content clay soils, maintained in high pH values tend to reduce this solubility. Other control means include adequate selection of the raised crops (preferably non-edible plants), adjusting the sludge application rates to the nitrogen demand of the plants, reducing the heavy metals content in the sludge by pre-treating the relevant industrial wastes and regular monitoring and sampling of the heavy metals concent rations in the sludge, soil and plants.
Socio-economic implications of Chronic Pyogenic Osteomyelitis in a developing community
Authors: Ogunjumo D.O.
Published: September 2007

THE SOCIAL implications, and the magnitude of the economic burden caused by chronic osteomyelitis have been studied from fifty-six patients encountered in the Teaching Hospital of the University of Ife, Ile-Ife, Nigeria, between November 1976 and December 1977. The disease may become a social stigma because of the unpleasant odour of the discharge from the sinuses. Amputation, which is sometimes the last resort in the treatment of this disease, was rejected by patients for whom it was suggested because of its socio-economic and socio-cultural problems.

The major sources of financial loss to the patients, and or to the health services included prolonged use of expensive antibiotics, maintenance during the usual long hospitalisation, the cost of surgical operations which often have to be repeated, expenses incurred in arranging for blood donors since free and willing donors are now scarce in this society, and the transport fares to and from the hospital during the repeated visits for the necessarily prolonged period of follow-ups. Besides, there is a waste of valuable manpower time since patients invariably lose time from work, and/or school.
Studies in Dietary Intake and Extreme Food Consumption
Authors: Coomes Trevor J. , Sherlock John C. , Walters Ben
Published: September 2007

METHODS USED to estimate dietary intakes are described and their relative merits are discussed in the context of intakes of heavy metals. In deriving the distribution of high levels of consumption of some foodstuffs a constant relationship has been found between the average consumption, and a measure of the highest consumption. The relationship holds good for a wide range of foods and for data collected using a variety of methods.
The Rheumatologist and the Spa
Authors: Cosh J.A.
Published: September 2007

THERE ARE many thousands of people in Britain with inadequately treated rheumatic disorders, ranging from minor complaints to serious and disabling forms of arthritis. The widespread public interest in treatment methods other than drugs suggests that spa treatment should be revived. It could be as successful in Britain as it is elsewhere in relieving pain and disability and in promoting health. The role of a thermal spa in the treatment of rheumatic disorders is described, and a plea is made for a return to these methods in the public interest.
Epidemiology of Road Traffic Accidents in Zaria, Nigeria
Authors: Aganga A.O. , Umoh J.U.
Published: September 2007

A STUDY of Road Traffic Accident (RTA) was carried out in Zaria for the period of eight (8) years, from 1972 to 1979. Data was collected from the Motor Traffic Division (MTD), of the Nigeria Police Force, Zaria, Medical Records Office and Casualty Ward of Ahmadu Bello University (A.B.U.) Teaching Hospital, Zaria. It was found that there were more RTA on Tuesdays (16.10%) and Wednesdays (16.63%) than Fridays (11.52%) and Saturdays (11.87%). More cases of RTA were witnessed in the months of September (9.48%) and October (11.20%) than in February (6.82%) and June (2.82%). Reckless ness and negligence of drivers (23.58%) was found to be mostly responsible for the cause of RTA while intoxication (0.59%) was found to be the least cause. Private car drivers played more role in RTA in Zaria than any of the other participants like taxi drivers, bus drivers and motor cyclists. More males were involved in the accidents than females. Four years (1975-78) analy sis of RTAs revealed that there were six (6) cases of RTAs in Zaria everyday, and two (2) persons were injured or maimed everyday in Zaria.

Recommendations aimed at enhancing road safety are highlighted.
Micro-Technology — its impact on engineering and environmental health
Authors: Booker G.A.
Published: September 2007

It is both appropriate and opportune in a congress programme whose theme is 'the place of Public Works in National Recovery' and following a plenry session on Information Technology, to examine the ways in which micro-technology is affecting the general field of en vironmental health. This paper covers the impact which new technology is having on public health engineering with particular reference to the water services industry, and discusses the likely effects over the next few years on organisations and employees in the industry at national through to local levels. The work of a number of committees which are currently operating within the industry is examined to see the ways in which the problems of harnessing micro-technology are being dealt with and the consequential implications for in dustrial relations and manpower. The conclusion is drawn that the industry needs to develop a co-ordin ated overall strategy in order to benefit fully from the rapid developments which are taking place.
Food poisoning and fish
Authors: Hobbs G.
Published: September 2007

FOOD POISONING caused by the consumption of fishery products is reviewed. More detailed descriptions are given of those types with some special or unique association with fish such as botulism, Vibrio para haemolyticus and scombrotoxin poisoning.
Some social and anthropometric predictors of energy intake by residents in homes for the elderly
Authors: Auckland J.N. , Smith A.G. , Hunt C.
Published: September 2007

An equation is presented which attempts to predict food energy intake in groups of elderly people in local authority homes, from a knowledge of six factors viz: sex, marital status, bodyweight, ideal bodyweight, height and home size. About 41 % of total variation in energy intake was accounted for by the six variables. Energy intake was not significantly influenced by age or by home per se.
Assessment of Health Needs of Black Agricultural Workers in Mid-Delta of Mississippi, U.S.A.*
Authors: Ademola Omishakin M.
Published: September 2007

THE REPORT described in this paper aimed at defining the health needs and identifying some of the medical and social problems of a group of agricultural workers residing in the Mid-Delta of Mis sissippi, U.S.A. One hundred and seventy (170) black households were randomly selected and the heads of such households were interviewed by means of ques tionnaire. The findings with regard to housing facilities and practices in the houses showed that good ventila tion was lacking in many homes, indoor pollution existed in more than half of the houses and the occupants concept of environmental hygiene in relation to health and disease was poor. Fifty one per cent of the men interviewed did not associate indiscriminate de faecation or improper sewage disposal with any health hazard.

The respondents' knowledge of health hazards associated with pesticides is very poor especially with regard to the disposal of pesticide containers. 56.8 per cent of the men did not associate indiscriminate or improper disposal of pesticides containers with any health hazard, 13.5 per cent claimed there were health hazards whilst the remaining 29.7 per cent did not know.

In conclusion, this study has revealed some of the needs of agricultural workers in Leflore county. These include good housing conditions, improved health care delivery system and better knowledge of the harmful effects on health of some respondents' habits and practices. Such goals can only be attained through health education, better medical coverage and involve ment of the community in health care delivery at the local level.
A Pattern for the Establishment of a Unit for the Dental Treatment of the Handicapped Patient in the Community Based on Such a Unit in Hertfordshire
Authors: O'Donnell D.
Published: September 2007

In 1978 the Hertfordshire Area Health Authority converted a ground floor dental surgery with the specific aim of providing a comprehensive dental service to the handicapped in the Community. This article describes the criteria used in the design and location of the unit and, briefly, how an efficient patient flow is achieved.

The routine dental treatment of the handicapped patient has always posed problems real and artificial for the dental surgeon.

Problems can be simply classified into:

(1) Medical.

(2) Management from the patient's point of view, including access to surgery, dental chair, and transportation.

(3) Management from the Dental Surgeon's point of view.

(4) Economics.

(5) Time, which is closely related to economics.

The Community Dental Service is responsible, as part of its duties, for the provision of dental care for both physically and mentally handicapped children and adults living in the Community. In 1978 the Hertford shire Area Health Authority decided that dental facilities for these children and adults were inadequate and began work on the conversion of a ground floor dental surgery to cope with their special needs. The following criteria were considered to be basic essen tials :

Situation of Unit

(1) The site of the surgery would have to be centrally located in the county with good road and public transport access.

(2) As some patients would be treated under general anaesthetic on a day-care basis good access to a nearby General Hospital would be essential in case of emergency and possible utilization of in-patient facilities.

(3) The unit must be on the ground floor with adequate access for wheelchairs.

The standard wheelchair is 42 inches long, 25 inches wide, 36 inches high (handles to floor) and 20 inches high from seat to floor. Hence to turn a wheelchair through 360 degrees needs 54 inches clearance.

Using figures for an average adult, the average reach of such an adult in a wheelchair is 60 inches vertically, 30 inches long and 48 inches diagonally from the floor.

Therefore for wheel chair manoeuverability a hall way would have to be at least 60 inches wide in order to allow two way traffic, and doors would have to be 30 inches wide to allow adequate access 1-3.
The Influence of Socioeconomic Status on Health-Related Knowledge and Habits of Middle-aged Males
Authors: Auckland J.N. , Easter Helen , Hunt C.
Published: September 2007

INFORMATION concerning health-related know ledge and habits was obtained by means of question naire from fifty men aged between 40 and 55 years. Twenty-five were categorised as 'working class' and twenty-five as 'middle class'. Mean knowledge score was significantly higher in middle class subjects and this superiority was even more marked in middle class men whose parents were also middle class. However this difference in knowledge between classes is not associ ated with any class difference in health-related habits, although there was a significant positive correlation between knowledge score and habit score within the middle class sample.
Evaluation of the Scottish Health Education Group's 1981-1982 Environmental Health Campaign
Authors: Leathar D.S. , Hastings G.B.
Published: September 2007

THIS PAPER describes the evaluation of a Scottish environmental health campaign comprising two display stickers promoting food hygiene in food outlet estab lishments. One sticker was designed for customers, the other for staff. They were assessed by interviewing three separate quota samples of butchers, grocers and hotels/restaurants in Strathclyde Region, using a fully structured questionnaire in face-to-face personal inter views.

The results indicated that the material was very well received in all groups, especially among butchers, and for the staff sticker. However, some misinterpretations were made of the campaign's objectives, and problems in awareness and distribution occurred. The reasons for this and the implications are discussed.
Methodological Considerations in Smoking Research with Children and Adolescents
Authors: Newman Belinda , Gillies Pam
Published: September 2007

THIS PAPER critically assesses the most popular methodological approach used to obtain data on the prevalence of smoking amongst children and adoles ments. It suggests that questionnaires are unlikely to enlarge further the body of knowledge on this topic and that an alternative approach, interviewing, is needed to improve our understanding of the problem. A diversity of research approaches should inform more successful preventive interventions.
Consumer Views of Self-care: Promise or Panacea
Authors: Green Kathy
Published: September 2007

This paper presents data on people's perceptions of the value of self health care. The author reviews the argu ments supporting and opposing self-care and reports results of a survey addressing some of those arguments. It is concluded that people perceive self-care as a posi tive influence on their personal health and as a positive direction for the community.
Group Testing and its Effectiveness in Learning Selected Nursing Concepts
Authors: Durrant Laurice K. , Pierson Geraldine , Allen Eleanor M.
Published: September 2007

THE PURPOSE of this study was to investigate the effectiveness of an instructional method, the group testing approach, as a teaching/learning strategy. The group testing approach allows students, placed in groups of three, to discuss among themselves answers to test questions before answering them on an individual basis.

This approach was compared to the individual testing approach (conventional) with respect to short-term and long-term retention respectively on mid-term and final examinations. Subjects for the study consisted of 50 freshman nursing students enrolled in a Medical-Surgical nursing course. A teaching module dealing with the Care of a Client with Neurological Dysfunction was selected for the study. This same module was divided in Part I and Part II with specific behavioural objectives developed for each part. A pre-test was administered. Following the teaching of Part I, group testing (experimental method) as a formative evaluation test, was administered to all 50 students. Following the teaching of Part II individual testing (conventional method) as a formative evaluation test, was administered to all 50 students. Mid-term and final examinations covered the total neurological module along with other modules studied. Subscores for only Part I and Part II of the neurological module were considered for the study.

The t-test for dependent samples was used to test hypotheses comparing 1. Pre-test with mid-term and pre- test with final; 2. Short-term retention experimental with short-term retention conventional and long-term retention experimental with long-term retention conventional.

The t-test for independent samples was used to test hypotheses comparing the performance, on mid-term and final, of the three ability groups within the total sample (upper with middle, upper with lower, and lower with middle). An attitude test was also administered.

The major findings of this study were the following: 1) Pre-test compared with mid-term and final showed a significant difference at the .05 level of significance with better performance on mid-term and final. 2) Comparison between ability groups (upper, middle, lower) showed no significant difference. 3) Comparison between the experi mental and conventional methods showed a significant difference at the .05 level of significance with better performance both in short-term and long-term retention for the experimental method.

On the attitude test evaluating the group testing method the majority of the students were in favour of this strategy irrespective of ability groups.

More research is needed in this area using a random sample with experimental and control groups. Also students with wider range of ability may be more appropriate subjects for a replicated study.

This method of testing as expressed repeatedly in the attitude questionnaire is less threatening and promotes the idea of collaboration which is an attitude to be nurtured in the practice of nursing.
Prediction of Energy Intakes of Residents in Homes for the Elderly
Authors: Auckland John N. , Thomas Paul , Hunt Clive
Published: September 2007

AN EQUATION to predict intake in institutionalised elderly, derived from data collected in W. Yorkshire, was tested in two homes for the elderly in Shropshire by comparing observed with predicted intakes. On average, observed and predicted intakes differed by only about 2%, although there were substantial individual discrepancies.

Observed intakes of iron, folate, and vitamins A and D were below recommended intakes for these nutrients.