bluuebunny/crossref_metadata_2025 huggingface dataset:
Avidity of Tetanus and Hib antibodies after childhood acute lymphoblastic leukaemia – implications for vaccination strategies
Authors: Ek Torben , Mellander Lotta , Hahn‐Zoric Mirjana , Abrahamsson Jonas
Published: August 2010

Aim: To investigate the possible relationship between serum levels and avidities of antibodies against tetanus toxoid (TT) and Haemophilus influenzae type b (Hib) in children that were vaccinated after treatment for childhood acute lymphoblastic leukaemia (ALL). Methods: The study groups were 31 paediatric patients with ALL and 18 healthy controls. All subjects were vaccinated with TT and a protein conjugated Hib vaccine. Antibody levels were analysed at three time points: At diagnosis of ALL, after cessation of treatment before vaccination and three weeks after vaccination. Avidity was measured twice, with a thiocyanate elution assay, at diagnosis of ALL and three weeks after vaccination. Results: There was a correlation between level and avidity of tetanus antibodies after vaccination (rs=0.59, P<0.001). In the standard‐risk and intermediate‐risk ALL groups, all patients responded with protective levels of tetanus antibodies with normal avidity. In the high‐risk ALL group 7/9 patients had subprotective levels of tetanus antibodies after vaccination and concomitantly the lowest avidity, implying poor protection against tetanus. No patients were found with low levels and low avidity of anti‐Hib IgG, and 29/31 patients had full protection after a single dose of conjugated Hib‐vaccine.

Conclusion: The vaccination strategy after childhood ALL must be different for low‐risk and high‐risk ALL groups, since the high‐risk group fail to elicit a recall response to tetanus.
Reducing discomfort while measuring crown–heel length in neonates
Authors: Pereira‐Da‐Silva Luis , Bergmans Kim I. M. , Van Kerkhoven Lieke A. S. , Leal Frederico , Virella Daniel , Videira‐Amaral João M.
Published: August 2010

Aim: To assess the degree of discomfort caused by length measurement in neonates, performed with one or both lower limbs extended, on the first and second day after birth, with either one or both lower limbs extended. Methods: Healthy full‐term neonates were systematically sampled during the months of February and March 2004. Crown–heel length was measured, using a 1‐mm precision neonatometer, at approximately 8 h and 32 h after birth, with one and both lower limbs extended. The Neonatal Facial Coding System was used to assess discomfort during measurements. Data were analysed by parametric and non‐parametric tests as appropriate. Results: Whatever the measurement technique, discomfort scores are significantly higher during the length measurement than at baseline. Whenever length measurements are performed, discomfort scores are significantly higher when extending both lower limbs rather than one lower limb (p<0.006). The measured length is greater with one lower limb extended; however, the difference decreases over time, being 0.19 cm (95% CI 0.1–0.3; p<0.001) at approximately 32 h of age. No significant differences in length were found between measurements at approximately 8 or 32 h, regardless of the technique used. The best correlation between length measurements with one or both lower limbs extended was observed at approximately 32 h after birth (r=0.98).

Conclusion
: Measuring crown–heel length is a distressful procedure for the neonate. Measurements with one lower limb extended result in less discomfort than when both lower limbs are extended, without decreasing the accuracy.
Influenza in children
Authors: Heikkinen Terho
Published: August 2010

Excess mortality associated with annual influenza epidemics is highest among persons over 65 y of age, and therefore influenza is often regarded as an illness of the elderly population. Ample evidence indicates, however, that the burden of influenza is also substantial in children, and that children have a central role in the spread of influenza in the community during epidemics. Vaccination of children against influenza could bring about substantial health benefits not only to children themselves but also to persons in other age groups.

Conclusion: General awareness about the total impact of influenza in children should be increased among both healthcare personnel and the parents of children. More widespread vaccination of children should be considered to decrease the burden of influenza on children and wider society.
The use of scoring systems in patients with haematological malignancy
Authors: Hughes Derralynn A.
Published: August 2010

Hughes D.A. The use of scoring systems in patients with haematological malignancy. Acta Pædiatr 2006;00:00–00. Stockholm. ISSN 0803‐XXXX

The utility of predictive systems in patients with haematological malignancy stems both from the heterogeneity of disease presentation and from the inherent disadvantages of therapy. There is an acute morbidity and mortality associated with chemotherapy and bone marrow transplantation, a need for long term follow‐up, the possibility of treatment failure and the issue of cost. In general, the value of a scoring system is in its ability to quantify disease burden, classify patient subgroups and predict disease course. Successful scoring systems are disease‐specific, have been validated in an independent population and are useful in different countries, centres and individuals. There should be good discrimination of poorly responsive and optimally responsive populations and a high rate of prediction of the disease course for individual patients. Optimal utility should be provided by a few variables which are independent, highly predictive and easy to obtain. Other considerations include economic evaluation and adaptation for population changes over time.

Conclusion: Experience gained from the use of staging and scoring systems in haematology provides useful insights into their potential use in Fabry disease and other lysosomal storage diseases. Such systems may help to predict whom to treat, when to treat and what response is likely to be achieved.
Surgery in disabled children: General gastroenterological aspects
Authors: Ceriati Emanuela , De Peppo Francesco , Ciprandi Guido , Marchetti Paola , Silveri Massimiliano , Rivosecchi Massimo
Published: August 2010

Cerebral palsy (CP) is a non‐progressive but not unchanging disorder of movement and/or posture, due to an insult to or anomaly of the developing brain. Gastrointestinal surgery can play a role in the treatment of pathologies frequently associated with a condition of neurological impairment such as gastro‐oesophageal reflux disease (antireflux procedure), feeding difficulties (percutaneous endoscopic gastrostomy/jejunostomy) and swallowing difficulties (ligation of salivary gland ducts). Gastro‐oesophageal reflux occurs in up to 70–75% of children with cerebral palsy. Children with gastro‐oesophageal reflux disease (GERD) may present with feeding difficulties, recurrent vomiting and recurrent chest infection associated with poor growth and nutrition, reactive airway disease particularly nocturnal asthma, choking attacks, anaemia, and wheezing. Nutritional deprivation in children with cerebral palsy is the summation of several factors which result in reduced intake. Percutaneous endoscopic gastrostomy (PEG) has radically changed the handling of children with nutritional problems who, before the introduction of this procedure, were force fed parenterally or enterally, by nasogastric tube, conventional surgical gastrostomy or central venous access. In children with CP, PEG is the preferred technique for long‐term enteral feeding. Swallowing dysfunction is the main cause of drooling in cerebral palsy, and medical treatment is often inefficient. Surgical treatment involves neurectomy, translocation of the salivary duct, salivary gland resection or salivary duct (parotid and submandibular) ligation. 

Conclusion: This review focuses on the role of surgery in managing gastrointestinal aspects in children with CP and, in particular, surgical experience at our department with fundoplication, PEG placement and ligation of salivary ducts.
Ethical issues in neonatal intensive care and physicians’ practices: A European perspective
Authors: Cuttini Marina , Casotto Veronica , Orzalesi Marcello ,   THE EURONIC STUDY GROUP
Published: August 2010

An international project (EURONIC) was carried out to explore the end‐of‐life decision‐making process in a large, representative sample of neonatal intensive care units (NICUs) in eight western European countries: France, Germany, Great Britain, Italy, Luxembourg, the Netherlands, Spain and Sweden. Structured questionnaires were used to record data on NICU organization and policies, and to survey staff views and practices regarding ethical decision‐making. One hundred and twenty‐two NICUs were recruited by census or random sampling (response rate 86%); 1235 physicians and 3115 nurses completed the staff questionnaire (response rates 89 and 85%, respectively). This paper focuses on the physicians’ answers. In all countries but Italy, most physicians reported having been involved at least once in setting limits to intensive care because of a baby's incurable condition and/or poor neurological prognosis. Adopted strategies varied between countries. Practices such as the continuation of current treatment without intensifying it and the withholding of emergency manoeuvres appeared widespread. In contrast, the frequency of doctors reporting withdrawal of mechanical ventilation was highest in the Netherlands (93%), Sweden (91%) and the Great Britain (88%), intermediate in France and Germany, and lowest in Spain and Italy (34 and 21%, respectively).

Conclusion: Ethically problematic clinical cases are approached differently in the various countries. The findings of this study may provide an opportunity for physicians to review their practices critically, in light of how other colleagues proceed, and foster an open discussion about these difficult issues.
Moderately elevated body mass index is associated with metabolic variables and cardiovascular risk factors in Swedish children
Authors: Larsson Christel , Hernell Olle , Lind Torbjörn
Published: August 2010

Aim:  To evaluate associations between anthropometrics and metabolic variables as well as cardiovascular risk factors among children.

Methods:  Subjects were recruited from a cohort of 274 healthy children in Umeå, Sweden. Anthropometric measures, blood pressure and venous blood samples were collected at age 10 years and simultaneously from parents.

Results:  Altogether 144 children (53%), 142 mothers and 123 fathers participated. The prevalence of overweight and obesity among the children was 18 and 2%, respectively. Overweight children (above age‐ and sex‐specific cut offs corresponding adult BMI ≥ 25 kg/m2), compared to normal weight children, had significantly higher BMI already during infancy and higher S‐insulin and Homeostatic Model Assessment (HOMA) index at 10 years. The children’s BMI was positively associated with waist (boys’ r = 0.67, girls’ r = 0.81), hip (r = 0.68), waist/hip ratio (girls’ r = 0.37), waist/height ratio (boys’ r = 0.59, girls’ r = 0.80), sagittal abdominal diameter (r = 0.75), S‐insulin (r = 0.45), HOMA index (r = 0.49), systolic blood pressure (r = 0.24), mothers’ BMI (girls’ r = 0.42) and mothers’ waist (girls’ r = 0.42).

Conclusion:  Children at 10 years of age with moderately elevated BMI had higher levels of some metabolic variables and cardiovascular risk factors than did normal weight children, and there was a correlation between BMI and some metabolic variables as well as cardiovascular risk factors.
EFFECT OF COMBINED UNDERWATER PROCESSING AND MILD PRECUT HEAT TREATMENT ON THE SENSORY QUALITY AND STORAGE OF FRESH‐CUT CANTALOUPE MELON
Authors: BETT‐GARBER KAREN L. , WATSON MICHAEL A. , LEA JEANNE M. , CHAMPAGNE ELAINE T. , LAMIKANRA OLUSOLA
Published: August 2010

Improvement of storage quality of fresh‐cut cantaloupe using a combination precut heat treatment and a modified underwater cutting treatment was determined. Eating quality was evaluated using descriptive sensory analysis, and fruit integrity was measured with respiration, cell leakage and product weight loss. Treatments included (1) control (no treatment); (2) making the first longitudinal cut underwater; (3) mild precut heat treatment in a water bath at 60C for 60 min; and (4) combination of precut heat treatment and the underwater cutting methods. Precut heating and processing underwater resulted in more intense fruity/melon flavor compared to conventional processed fresh‐cut fruit. Reduced electrolyte leakage and enhanced membrane integrity were observed in all three experimental treatments, as evidenced by lower conductivity measurements. The underwater cut and combined treatments significantly reduced respiration during fresh‐cut storage, reflecting less physical stress and membrane damage. Weight loss was not significantly affected by any treatment during fresh‐cut storage.

PRACTICAL APPLICATIONS

There is a steady increase in the consumption of fresh‐cut produce. To enhance the storage quality of fresh‐cut cantaloupe melon, two minimal processing techniques were examined separately and combined. The methods are mild heat treatment of the whole melon at 60C for 60 min then cooling to 4C for 24 h, cutting the cantaloupe in half and removing the seeds while submerged in a calcium chloride and water solution, and the combination of the two treatments. These methods are simple and can be utilized by small or large processors to maintain sensory quality and fruit integrity during storage.
Structural Characterization and Pharmacodynamic Effects of an Orally Active 11β‐Hydroxysteroid Dehydrogenase Type 1 Inhibitor
Authors: Hale Clarence , Véniant Murielle , Wang Zhulun , Chen Michelle , McCormick Jocelyn , Cupples Rod , Hickman Dean , Min Xiaoshan , Sudom Athena , Xu Haoda , Matsumoto Guy , Fotsch Christopher , St. Jean David J. , Wang Minghan
Published: August 2010

11β‐Hydroxysteroid dehydrogenase type 1 regulates glucocorticoid action and inhibition of this enzyme is a viable therapeutic strategy for the treatment of type 2 diabetes and the metabolic syndrome. Here, we report a potent and selective 11β‐hydroxysteroid dehydrogenase type 1 inhibitor with a binding mode elucidated from the co‐crystal structure with the human 11β‐hydroxysteroid dehydrogenase type 1. The inhibitor is bound to the steroid‐binding pocket making contacts with the catalytic center and the solvent channel. The inhibitor binding is facilitated by two direct hydrogen bond interactions involving Tyrosine183 of the catalytic motif Tyr‐X‐X‐X‐Lys and Alanine172. In addition, the inhibitor makes many hydrophobic interactions with both the enzyme and the co‐factor nicotinamide adenine dinucleotide phosphate (reduced). In lean C57BL/6 mice, the compound inhibited both the in vivo and ex vivo 11β‐hydroxysteroid dehydrogenase type 1 activities in a dose‐dependent manner. The inhibitory effects correlate with the plasma compound concentrations, suggesting that there is a clear pharmacokinetic and pharmacodynamic relationship. Moreover, at the same doses used in the pharmacokinetic/pharmacodynamic studies, the inhibitor did not cause the activation of the hypothalamic–pituitary–adrenal axis in an acute mouse model, suggesting that this compound exhibits biological effects with minimal risk of activating the hypothalamic–pituitary–adrenal axis.
CAESARISM AND THE AMERICAN PRESIDENCY
Authors: Zentner Scot J.
Published: August 2010

Since the New Deal, the American presidency has been the focal point of demands made upon the central government by all segments of society. Franklin Roosevelt's successors have found themselves in the difficult position of living up to his progressive example. They have found it difficult to serve the multitude of interests in American society through a government naturally bound by a scarcity of resources. As a result, according to some scholars, a successful presidency is now less likely. Contemporary presidents, however, have shown themselves to be unable or unwilling to confront directly the transformation of the presidency effected by FDR. In this article, I investigate the nature of that transformation by comparing the presidencies of Roosevelt and Abraham Lincoln. Through this comparison, we see the distinctiveness of what I call the “Caesarean” leadership style adopted by Roosevelt and advocated by his progressive forebears.
A Review Of Pulpotomy Therapy In The Primary Dentition
Authors: Mekertichian Kareen
Published: August 2010

Pulp therapy for primary teeth and the options for management remains a controversial and often confusing topic. The choice of pulpotomy medicaments, regimes and clinical techniques have sometimes been empirically based and vary considerably between different parts of the world. This paper will present an overview of the dental and clinical parameters useful in assessing pulpotomy therapy in primary teeth as well as a brief summary of the more commonly utilised pulpotomy medicaments available.
Prevalence, Prognosis, and Therapeutic Implications of Unrecognized Left Ventricular Systolic Dysfunction in Patients With Anemia and Chronic Kidney Disease
Authors: Bhatti Sabha , Hakeem Abdul , Dillie Kathryn S. , Cook Jeffery R. , Chang Su Min
Published: August 2010

The prevalence and outcomes of unrecognized left ventricular dysfunction (ULVSD) in patients with anemia and chronic kidney disease (CKD) is not known. The authors determined whether anemia (hemoglobin <13 g/L) and CKD (glomerular filtration rate <60 mL/min) are risk factors for ULVSD (ejection fraction <35%, no known heart failure [HF]) and to determine its impact on clinical outcomes. A total of 1358 patients without history of HF undergoing gated myocardial perfusion single photon emission computed tomography for evaluation of suspected coronary artery disease were followed for a mean of 2.15±0.8 years. End points were death and heart failure hospitalization (HFH). Patients were divided into 4 groups (I: no anemia/no CKD, n=752; II: CKD/no anemia, n=285; III: anemia/no CKD, n=153; IV: anemia+CKD, n=168). Compared with group I, LVSD was significantly more common in group IV (11.3% vs 4%; P=.0009). Death and HFH were significantly higher in group IV compared with group I (death rate for group I: 3.5% per year vs group IV: 12% per year; P<.0001) (HFH rate for group I: 1.5% per year vs group IV: 8% per year, P<.0001). Among patients with ejection fraction <35%, presence of anemia+CKD was associated with a relative risk of 2.48 (95% confidence interval, 1.13–5.4; P=.02) for death compared with group I. Among patients with ULVSD, only 65% were taking angiotensin enzyme inhibitors/angiotensin receptor blockers and β‐blockers. ULVSD was almost 3 times more common in patients with anemia+CKD compared with those without and was associated with a significantly higher risk of death and HFH. It may therefore be beneficial to screen patients with anemia and CKD for ULVSD, since early therapy may improve outcomes. Congest Heart Fail. 2010;16:271–277. © 2010 Wiley Periodicals, Inc.
SERUM LIPIDS AND OTHER CORONARY RISK FACTORS IN SYDNEY BLOOD DONORS: A COMPARISON WITH OTHER AUSTRALIAN SUBJECTS
Authors: Brennan Peter J. , Simpson Judy M. , McGilchrist Clyde A. , Blacket Ralph B.
Published: August 2010

The distribution of body weight, body weight index, serum cholesterol, serum triglycerides, serum urate and systolic blood pressure are given for 600 male and 400 female Sydney blood donors, aged 20 to 49. The mean values rise with age but to different degrees and at different rates for each sex. The prevalence of high values of two or more variables also rises with age. Comparisons with findings in other Australian surveys show the high levels of risk factors for coronary disease in all the Australian populations so far studied and reported.
ACCESS TO A QUEENSLAND COMMUNITY HEALTH SERVICES CENTRE THROUGH COMMUNITY CARETAKERS
Authors: Raymer Vera
Published: August 2010

When persons needing health and welfare services do not know about available resources, their access to such services depends in part upon the people they have contact with in the community being knowledgeable and making appropriate referrals. Groups of community “caretakers” were surveyed to find their level of awareness of a community health services centre in their city. Most respondents were aware of the community health services centre but did not have a clear understanding of its objectives and functions. The community caretakers thought the centre could increase their knowledge of its functions by more personal contact by staff members with individuals and professional groups in the community and through increased press publicity, the issuing of brochures, cards and pamphlets.
CARDIOVASCULAR DISEASE AND CANCER MORTALITY IN AUSTRALIA, BY OCCUPATION, IN RELATION TO DRINKING, SMOKING AND EATING
Authors: McMichael A. J. , Hartshorne J. M.
Published: August 2010

The evidence that alcoholic drinks, tobacco smoking, and aspects of diet contribute to various cardio vascular diseases and cancers is now substantial. Cause‐specific death rates have been calculated here for fourteen Australian male occupational groups, for 1968–76, at ages 30–64. Strong positive correlations occur between presumptive alcohol consumption (liver cirrhosis) and upper alimentary tract cancers and cerebrovascular disease (stroke); between tobacco (lung cancer) and upper alimentary tract cancers and ischaemic heart disease; between low socioeconomic status (SES) (for example labourers, miners, hotel workers, storemen and waterside workers) and stomach cancer; and between high SES status (for example doctors, administrators, executives and lawyers) and colon cancer. The aetiological significance of these findings is discussed.
FROM WAITING LIST TO NURSING HOME BED ‐ AN UNLIKELY MOVE?
Authors: Howe Anne L.
Published: August 2010

This paper reports and assesses the results from studies of the waiting lists of private nursing homes, the waiting lists of deficit‐funded homes and people who were registered with one of the voluntary organisations conducting several of these nursing homes. The theme of the studies is expressed in the title of this paper.
COMPARISON OF MERCURY IN HAIR WITH FISH EATING HABITS OF CHILDREN IN AUCKLAND
Authors: Kjellstrom T. E. , Reeves Robyn L. , Mitchell J. W.
Published: August 2010

The mercury concentrations of hair samples from groups of Auckland schoolchildren increased with increasing fish consumption and decreased with increasing age. Polynesian children had higher mean levels than Europeans. Ninety‐five percent of values for 14–15 year old children were in the range 0.27‐5.30 μg Hg/g (Polynesian) and 0.09‐4.10 μg Hg/g (European).

Only 3 children of 415 studied had hair mercury concentration above 6 μg/g, which corresponds to the WHO maximum tolerable weekly mercury intake. In view of the known high levels of mercury in certain locally consumed fish, the data are reassuring. Owing to the uncertainty of toxic levels for sensitive groups, such as the foetus of pregnant women, further studies of mercury exposure and toxicity are needed.
THE AUTOMATION OF OCCUPATIONAL MEDICAL SURVEILLANCE
Authors: Mathews John A.
Published: August 2010

A number of companies have introduced systems of automated medical surveillance in the past few years. The computer blocks of information which they store can be used to carry out prospective concurrent epidemiological monitoring or to perform case control studies where a hazard is suspected. This paper reviews the various systems in operation, distils from them the principles of a sound system and discusses recent developments in Australia.
SEASONAL VARIATION OF MORTALITY IN QUEENSLAND
Authors: Scragg Robert
Published: August 2010

Queensland mortality shows a seasonal, age‐dependent variation in cardio‐vascular and respiratory diseases, although not in malignant neoplasms. The hypotheses previously put forward to explain the winter increases in respiratory disease and cardiovascular disease are discussed and a new hypothesis is considered, that the winter rise in cardiovascular disease is due to decreased exposure to ultraviolet radiation. It is concluded that the relative importance of the factors which may be causing the seasonal variations in disease, will have to be determined by analytical studies of individuals.
HEALTH‐RELATED ASPECTS OF LIFESTYLE IN GENERAL HOSPITAL PATIENTS
Authors: Oldenburg B. , MacMahon S.W.
Published: August 2010

Health‐related aspects of lifestyle were surveyed in a random sample of adult inpatients from a general hospital in Sydney. The results were compared with the results of the National Heart Foundation of Australia 1980 Risk Factor Prevalence Study. The results suggest that the lifestyle of male hospital patients in this sample was similar to that of males in the community; the most prevalent lifestyle risk factors being smoking, obesity and heavy alcohol consumption. The lifestyle of female patients was different from that of females in the community; high risk lifestyles were more prevalent in the hospital group. The difference was most pronounced in women under the age of 40, in whom smoking, obesity, heavy alcohol consumption and frequent use of analgesics were 2–3 times more common in hospital patients than in the community sample. Hospitals need to consider more closely the specific health promotion and educational needs of their own patient populations.
DIETARY INTAKE IN A GROUP OF INSTITUTIONALISED ELDERLY AND THE EFFECT OF A FIBRE SUPPLEMENTATION PROGRAMME ON NUTRIENT INTAKE AND WEIGHT GAIN
Authors: Baghurst K.I. , Hope A.K. , Down E.C.
Published: August 2010

As part of a long‐term study of the effects of a dietary fibre supplementation programme on bowel function in a group of institutionalised elderly, various aspects of nutritional status were assessed before, and three, six and twelve months after introducing a fibre supplementation programme.

Mean dietary intakes were satisfactory throughout the programme, although some individuals had intakes well below recommended levels for certain nutrients. The fibre supplementation programme not only improved bowel function, but also improved the nutrient density of the diet. Despite a slight increase in total energy intake, supplementation did not increase mean body weights in the group. Trace element status was not adversely affected by the supplementation programme.
THE WEIGHT OF KNOWLEDGE: TEACHERS AND STUDENTS AND DOCTORS AND PATIENTS
Authors: Underwood Peter , Owen Alan
Published: August 2010

This paper examines one particular problem in medical education: the rapid accumulation of technical medical knowledge. It is suggested that this development contributes significantly to several major deficiencies in training for clinical practice: it encourages a passive learning model, it helps to undervalue consultation skills and it inappropriately increases the student's anxiety in “not knowing all the facts.” In addition, the emphasis on technical knowledge helps to narrow the focus of attention to technical details at the expense of essential information on the patient's relationships and environment. Knowledge will continue to accumulate; a number of suggestions are made to ameliorate some of the harmful effects of this accumulation on teaching and learning in medical school. They include more emphasis on the process of the consultation and on problem‐solving skills learned experientially rather than mastery of facts. A further recommendation is made to re‐evaluate what is the essential knowledge base so that greater weight is given to information about the patient's relationships, attitudes and beliefs. The paper concludes with an assessment of the major institutional constraints standing in the way of the educational reforms outlined and suggests some ways these could be overcome.
OCCUPATIONAL MORTALITY IN NEW ZEALAND MALES 1974–78
Authors: Pearce Neil E. , Howard J. Kcir
Published: August 2010

Occupational mortality among New Zealand males aged 15–64 is examined for the period 1974–78. Age‐standardised mortality rates are presented for each of 6 occupational orders and 79 occupational groups and the rates for major disease groupings are presented for those occupational groups with significantly elevated relative risks. The findings are generally in line with those of the Office of Population Censuses and Surveys for England and Wales and a number of associations which have been found in British studies and were also present in the New Zealand data are discussed. Errors in death registration data, together with its limited nature, hamper this type of study. In addition, problems of selection into, and survival in, occupations and confounding by extrinisic factors such as smoking, diet and general lifestyle further complicate the picture. These problems are discussed in relation to the New Zealand context and it is shown that they can be minimised, but not eliminated, by standardising the data for social class. It is concluded that, although the findings of such routine analyses are rarely new, they may reinforce previous knowledge, thus allowing the assessment in New Zealand of occupations which have demonstrated high mortality in overseas studies.
HALFWAY TO WHERE? A HALFWAY HOUSE FOR EMPLOYED ALCOHOLICS
Authors: Stanhope John M. , Gehlhaar Patricia , Florio Tony
Published: August 2010

A halfway house for abstinent alcohol dependants who were employable but lacked social supports was opened in 1973. Experience of the sobriety and employment status of residents up to March 1981 is reviewed.

After a mean period of follow‐up of 25 months, 58 per cent were sober and 62 per cent were employed. Control data are lacking to establish what contribution the house made to therapeutic success. Stricter admission criteria are suggested, since demand for places exceeds supply and some subgroups of the clientele did poorly. Younger patients with current or recent employment did well. Neurotic and personality disordered patients are not suitable for this program.
THE DEVELOPMENT OF A NEW ZEALAND TWIN REGISTER
Authors: Findlay John , Kjellstrom Tord , Veale Arthur
Published: August 2010

Large‐scale twin registers have been used in several countries for epidemiological studies of chronic diseases. They make possible an analysis of the health effects of environmental factors while genetic factors are controlled.

A twin register comprising all live nuptial non‐Maori twins born in 1926 to 1935 in New Zealand was developed. The total number of multiple births was 2765 (with 2750 twin births) giving a multiple birth ratio of 1.1 per cent of live births. About one third each of the twin pairs were mixed‐sex, male and female pairs. After a multi‐stage record search process 1998 pairs had been traced to an address or a death record and an additional 580 pairs had one twin traced. The neonatal mortality rate for the twins was about 8 per cent, much higher than the 2.4 per cent reported for all births in 1930.

The current addresses of the twins were searched in electoral rolls and a total of 1428 pairs where both are alive have been located. It is planned to collect base‐line environmental exposure data with an internationally agreed questionnaire and to follow‐up the mortality of the twins in the future.
REPLACING THE CLOCKWORK MODEL OF MEDICINE
Authors: Underwood Peter , Owen Alan , Winkler Robin
Published: August 2010

The medical task itself needs to be examined and re‐defined so that medicine can become but one of several social responses required to raise health status. Dominant now is a clockwork model which defines illness in terms of specific causes located inside the individual. In contrast, social medicine has been the poor relation, despite strong evidence that past and present mortality patterns are strongly influenced by key social factors. The major forces working for or against a social model of medicine are outlined. The paper concludes with a summary of some of the questions to which a resurgent social medicine might address itself.
DECLINE IN PRIMARY TOOTH DECAY IN NEW ZEALAND
Authors: Colquhoun John
Published: August 2010

Data collected in New Zealand over a 50‐year period suggest that the general decline in decay of primary teeth in 5‐year‐olds started well before the introduction of fluoridation. Some correlations and possible causative factors are discussed.
PARENTAL PERCEPTIONS OF MEASLES
Authors: Blaze‐Temple Debra , Binns Colin W. , Boldy Duncan P.
Published: August 2010

Australia has recently decided to undertake an eradication programme for indigenous measles. A 90 to 95 per cent coverage rate will be needed to prevent epidemics in urban areas. The reasons for non‐compliance must be understood if this goal is to be reached by voluntary participation. This study used household interviews to assess the measles immunisation status of 506 children age 0 to 10 years and the attitudes/knowledge of 312 parents in selected areas of Perth. No statistical associations were found between measles immunisation compliance and child's age, parental ethnicity, child order, family size, parental level of education or parental ignorance level. However, lower family income, high parental apathy level and high parental fear level were found to be associated with measles immunisation non‐compliance.
HEALTH STATUS AND HEALTH CARE IN RURAL AUSTRALIA: A CASE STUDY
Authors: Humphreys J.S. , Weinand H.C.
Published: August 2010

Knowledge of the health status of, and patterns of health care service utilization by rural Australian communities, is scant. This deficiency limits attempts to formulate policies designed to bring about efficient, effective and equitable delivery of health care services. This article reports the results of a health interview survey conducted in the Wimmera region of Victoria during spring 1984. The results demonstrate not only that patterns of morbidity in rural areas differ from the Australian average, but also that the health status of rural dwellers is worse than that of most Australians. Evidence suggests that while accessibility is not the most significant determinant of utilization of health care services, distance from services does affect propensity to use them.
PREDICTORS OF A SUCCESSFUL LOCAL GOVERNMENT PUBLIC IMMUNISATION PROGRAM IN WESTERN SYDNEY
Authors: Bazeley Patricia
Published: August 2010

The public immunisation programs of 14 local government councils in Sydney's Western Region were examined to determine those variables which might predict an effective program.

Independent variables included the demographic characteristics of the populations being served, as well as relevant aspects of each council's clinic program and administrative input. The dependent variables were three indices of immunisation reflecting the proportion of the 0–5 population reached by the public immunisation service. One variable, the amount of staff time spent on administration, was best able to explain the variance in public clinic immunisation rates across the local government areas. Components of effective staff time were examined and the results are discussed in relation to the planning and promotion of public immunisation programs.
PUBLIC AND PRIVATE IMMUNISATION SERVICES: A COMPARISON OF COSTS
Authors: Bazeley Patricia
Published: August 2010

Cost inputs to infant immunisation programs were identified for both the public and private health systems, based on data from the fourteen local government areas which made up the Western Metropolitan Health Region in Sydney. New South Wales. The public health approach is shown to be significantly less costly than private immunisation services. The costs of the latter, however, are largely hidden within the national health bill, while the costs of the former are spread across all three levels of government. Total public sector costs of immunisation could be decreased, but only with increased input at the local government level. Thus, under present distribution and funding arrangements in NSW, covert fostering of the less cost efficient private immunisation services is likely to continue.
INDICATORS OF SOCIAL CLASS ‐ RELATIONSHIP BETWEEN PRESTIGE OF OCCUPATION AND SUBURB OF RESIDENCE
Authors: Quine Susan , Lancaster Paul A.L.
Published: August 2010

The difficulty of measuring social class is well known. Two indicators of social class, prestige of occupation and prestige of suburb of residence, are considered here. Australian prestige scales which measure these indicators are discussed. Comparisons between the original scales and the recently updated versions indicate that in the Australian community there is general community agreement on the prestige of occupations and of suburbs which has changed little over two decades. However, there is only a weak association between the prestige of the occupation in which a person is employed and the prestige of the suburb in which that person resides. This raises queries concerning the validity of using prestige of suburb as an indicator of social class, and highlights the fact that when conducting research one indicator of social class cannot simply be substituted for another. The implications for investigation of health‐related issues are discussed.
ACCURACY OF DEATH CERTIFICATES AND MORTALITY STATISTICS IN VICTORIAN TESTIS CANCER DEATHS 1950–1977
Authors: Stone Janey M. , Cruickshank Deborah G. , Sandeman Thomas F.
Published: August 2010

426 death certificates relating to testicular cancer in Victoria, from 1950 to 1977, were examined for inaccuracies in cause of death narrative and coding for cause of death statistics. The narrative was inaccurate in major diagnosis in 33 certificates (21 false positives and 12 false negatives) and 17 accurately written certificates were mis‐coded (12 false positives and 5 false negatives). Review of the pathological terms used revealed 10 lymphomas incorrectly ascribed to germ cell malignancy. The term “seminoma” seems to have been employed as a generic term for testis tumour, only 50 per cent of the tumours so designated being confirmed as seminoma. It is concluded that although Victorian figures relating to mortality from testis cancer are reasonably accurate (for 337 cases for which relevant records were available the detection rate was 95%, the confirmation rate 96% and concordance 91%), little reliance can be placed on the recorded pathological sub‐type.
The Fruitful Years
Authors: Smyth George W.
Published: August 2010

At the summer meeting of the New York State Bar Association, held at Saranac Inn, there was a challenging discussion of the problems of family and children's courts. The following article presents extracts from Judge Smyth's leading address.
Community Drive Credited In Juvenile Court Bill Victory
Authors: EDSTROM EVE
Published: August 2010

The entire Juvenile Court, Council, Foundation, Journal and the great body of men and women working with children in trouble throughout the country, congratulate Judge Orman Ketcham of the Washington, D. C. Juvenile Court, in the fine victory won in Congress granting another judge to that court and relieving much of the overload.

It was a great effort at Washington and therefore the Journal is printing a series of stories, some from the Washington Post, copy of the bill passed and a speech by Judge Ketcham, all of which comprise the Washington story.
Responsibility of Bar To Juvenile Offender
Authors: RIEDERER HENRY A.
Published: August 2010

“It is true that at the present time the lawyer does not hold that position with the people that he held fifty years ago, but the reason is not, in my opinion, lack of opportunity. It is because, instead of holding a position of independence between the wealthy and the people, prepared to curb the excesses of either, the able lawyers have to a great extent allowed themselves to become an adjunet of the great corporations and have neglected their obligations to use their powers for the protection of the people.”
A PROMISING METHOD FOR PROBLEM PREVENTION—PARENT EDUCATION IN SMALL GROUPS
Authors: CROW MAXINE S.
Published: August 2010

The Child Welfare League of America held its Southwest Regional Conference on April 21 to April 24, 1968. One of the Institutes held at the Conference dealt with parent group education as a new dimension in social work. Following are two papers presented at the Conference concerning this new concept which is designed to prevent problems by raising the level of family living.
High School Equivalency Programs: A Method of Rehabilitating Suburban School Drop‐Outs
Authors: Rulo Joseph H.
Published: August 2010

In a five‐year period, 825 delinquent school drop‐outs received their high school equivalency certificates from the Missouri State Department of Education. 37% of those receiving certificates enrolled in college full or part‐time. 55% found jobs, enrolled in training programs, or entered the armed services. Only 3% were re‐referred to the Court for additional services. These are the amazing results of a high school equivalency program staffed by volunteers and operated by the St. Louis County Juvenile Court from February, 1969, to 1974.
Some Facts About the Sniffing Phenomenon
Authors: Byars George H.
Published: August 2010

Only within the last several years has validated research been seriously undertaken in this area. The findings of these recent studies, though scientifically meaningful, only relate directly to the laboratory test subjects actually used, which have been mostly dogs, cats, mice, and rats. It appears that these new findings are still only theoretically relevant to the solvent sniffing phenomenon in humans, and further research is called for in order to show these findings to be significant to humans.

In this study, I have attempted to compile the most current materials and research data concerning the causes and effects of the inhalation of solvent vapors. I have also attempted to draw a composite picture of the person who inhales, both in terms of his cultural background or lifestyle and his psychological makeup.

It would like to emphasize, at this point, that this paper is neither a statistical, nor medically explicit analysis of the current studies in the literature. This paper does, however, borrow heavily from both of those disciplines while presenting the solvent sniffing phenomenon from a sociological and social work perspective.
Policies, Politics and Positions
Authors: Hart Judith
Published: August 2010

SUMMARY British representation at international conferences is usually a matter of a carefully prepared brief worked out by, and presented by, an interdepartmental team of officials, perhaps headed for the first few days by a Minister who delivers the formal plenary speech. It is possible, however, for a determined Minister to play an active role and to bring ‘the position’ more into line with his policy if he insists on taking part in the preparation of the position papers and is present at the conference in the last week when the line may be modified in the light of the changing situation A ministerial committee for development matters could also improve the process.

RESUMEN Políticas, Politíca y Posiciones

La posición británica en las conferencias internacionales es normalmente producto de un documento preparado cuidadosamente por un equipo inter‐departamental de funcionarios, que además la presentan, posiblemente dirigidos durante los primeros días por un Ministro que pronuncia el discurso formal en la sesión plenaria. Sin embargo, para un Ministro decidido es posible desempeñar un papel activo y hacer ‘la posición’ más acorde con su propia politica si insiste en tomar parte en la preparación de los documentos y está además presente en la última semana de la conferencia; donde la linea puede modificarse a la luz de los cambios en la situación. Un Comité Ministerial sobre asuntos del desarrollo también podria mejorar el proceso.

RESUME Politiques, affaires publiques et positions

La participation britannique aux conférences internationales tourne d'habitude autour d'un dossier, soigneusement constitué, et présenté, par une équipe interministérielle. Il arrive,des fois, qu'un ministre assiste à titre de dirigeant aux premiers jours de la conférence, et prononce le discours plénier. Or un ministre vigoureux peut virer “la situation” vers ses propres attitudes en s'associent activement à la rédaction des prises de position et en assistant aux dernières séances, lorsque les tendances actuelles pourraient se modifer en fonction de la nouvelle situation. Une comité ministérielle, pour le développement pourrait également effectuer des a méliorations de procédure.
National Water Management: The Central Planning Impetus
Authors: Vincent Linden
Published: August 2010

SUMMARY A national water administration must ensure that water is available where it is needed at the least financial and environmental cost: thus planning capability is more important than operational efficiency. The development of the administration is influenced both by the role water plays in a society and the politics of a society, as these determine, respectively, how, and to what extent, central government becomes involved. Integrated planning and management capability appear to develop best as governments become involved in some degree of regional planning and thus create the necessary vertical and horizontal liaisons between state, ministers and local government.

RESUME Organisation du Service dex Eaux: l'Impact du Plan Central

Une administration nationale de l'eau doit s'assurer que ce produit existe là ou il est nécessaire, à un coût financier et environnemental minimum : une telle capacité de planification est plus importante qu'une efficacité opérationnelle. Le développement d'une telle administration est influencé à la fois par le rôle que prend l'eau dans une société et dans sa politique, parce que ces deux facteurs déterminent respectivement comment et dans quelle mesure le gouvernement central y est impliqué. La capacité de planification et d'organisation intégrées semble se développer mieux lorsque les gouvernements deviennent dans une certaine mesure, concernés par la planification régionale et donc crée les liaisons verticales et horizontales nécessaires entre l'Etat, les ministres et le gouvernement local.

RESUMEN Administración Nacional de las Aguas : el Empuje Planificador Central

Una administración nacional del agua debe asegurar que el agua esté disponible donde se necesita al menor costo financiero y ambiental : así la capacidad de planificación es más importante que la eficiencia operativa. El desarrollo de la administración es influido tanto por el papel del agua en una sociedad como por el proceso político de la sociedad, en tanto éstos determinan respectivamente cómo y en qué medida se ve envuelto el gobierno central. La planificación integrada y la capacidad de gestión parecen desarrollarse mejor cuando los gobiernos se ven envueltos en algun grado de planificación regional y crean por tanto los lazos verticales y horizontales necesarios entre el estado, los ministros y el gobierno local
Planning Techniques: Physical Indicators in Tanzania
Authors: Thomas Ian
Published: August 2010

SUMMARY Following an introductory discussion of levels of infant mortality in Tanzania, some indices developed in research and planning work with reference to the provision of health facilities in Iringa Region before and after villagization are presented.

RESUME Les Techniques de Planification: Les Indicateurs Physiques en Tanzanie

Faisant suite à une discussion introductoire sur les chiffres de la mortalité infantile en Tanzanie on nous expose quelques indices développés au cours de travaux de recherche et de planification, tout en se référant au pourvoiement des services de santé avant et après la villagisation dans la région d'Iringa.

RESUMEN Técnicas de Planificación : Indicadores Físicos en Tanzania

Luego de una discusión introductoria de los niveles de mortalidad infantil en Tanzania se presentan algunos índices desarrollados en el trabajo de investigación y planificación respecto de la provisión de servicios de salud en la Región de Iringa antes y después de la ‘aldeización’.