Household endotoxin reduction in the Louisa Environmental Intervention Project for rural childhood asthma

Endotoxin exacerbates asthma. We designed the Louisa Environmental Intervention Project (LEIP) and assessed its effectiveness in reducing household endotoxin and improving asthma symptoms in rural Iowa children. Asthmatic school children (N = 104 from 89 homes) of Louisa and Keokuk counties in Iowa (aged 5-14 years) were recruited and block-randomized to receive extensive (education + professional cleaning) or educational interventions. Environmental sampling collection and respiratory survey administration were done at baseline and during three follow-up visits. Mixed-model analyses were used to assess the effect of the intervention on endotoxin levels and asthma symptoms in the main analysis and of endotoxin reduction on asthma symptoms in exploratory analysis. In the extensive intervention group, dust endotoxin load was significantly reduced in post-intervention visits. The extensive compared with the educational intervention was associated with significantly decreased dust endotoxin load in farm homes and less frequent nighttime asthma symptoms. In exploratory analysis, dust endotoxin load reduction from baseline was associated with lower total asthma symptoms score (Odds ratio: 0.52, 95% confidence interval: 0.29-0.92). In conclusion, the LEIP intervention reduced household dust endotoxin and improved asthma symptoms. However, endotoxin reductions were not sustained post-intervention by residents.     

Measles, polio and tetanus toxoid antibody levels in Gambian children aged 3 to 4 years following routine vaccination

A nation-wide cross-sectional survey of 816 children 3-4 years old was carried out in The Gambia between September 1990 and July 1991 to assess the seroprevalence of antibodies against 3 diseases included in the expanded programme on immunization: measles, poliomyelitis and tetanus. Among 689 children whose records were available, 94.5% were fully immunized. Measles vaccine was administered to 97% of the children and 91% of these had detectable antibodies at the time of the survey. Antibodies against type 1 and type 3 polioviruses, after up to 6 doses of oral polio vaccine, were present in 88.1% and 89.3% of the children respectively. Ninety-seven percent of the children who had received 4 doses of diphtheria-pertussis-tetanus vaccine (DPT) and 91% of those who received 3 doses had detectable tetanus toxoid antibodies at the age of 3-4 years. This study shows that serological responses to EPI vaccines given in infancy persist at very satisfactory levels throughout early childhood.     

Employees’ witnessed presence in changing organisations

In recent years, governments, businesses and other organisations have increasingly been forced to attempt to survive by reorganising themselves fundamentally. Although this happens at present on a large scale, it is not unprecedented. In fact, most organisations have had to change their working practises at some time for some reason—for example, when the competition catches up or when technology threatens to make production obsolete. The usual strategy is to fire part of the staff and to redistribute tasks. This tends to put a heavy burden on staff. They have to search for other jobs or attempt re-skilling. Those remaining may face substantial changes in their relations to their managers, who will require changes … ‘or else’. The study reported in the paper focuses on people’s reactions to this approach. Some employees accept and leave. Others become aware of an opportunity to damage their company. Others again see a way to resist and change the way the managers behave and thereby turn around the company and maintain or increase the number of jobs. The study focuses on two questions. The first is how one should model or describe the behaviour of people in the third category, i.e. those wishing to contribute. It does not seem useful to follow one’s first hunch, i.e. to search for quantifiable patterns. People’s behaviour will always be contextualised as a reaction to what managers do. This suggests the use of qualitative methods. The second question is whether the concept of presence may clarify the behaviour and identify ways for employees to contribute positively to changes in their organisations. An obstacle to answering the second question is that qualitative methods focus on people’s experiences in some context, and on the emergence of their behaviour, but do not necessarily lead to suggestions on how to behave with what effect. It is attempted to answer the second question and thereby the first question with the aim of identifying what people may do who are not immediately fired or made redundant when fundamental organisational changes are introduced. Data have been collected from four companies that decided to initiate such changes in 2003–2004.     

Effects of oral 5-hydroxy-tryptophan on energy intake and macronutrient selection in non-insulin dependent diabetic patients

Hospital-based occupational tuberculosis (TB) control programs have four basic components: rapid detection of TB disease in presenting patients; use of environmental controls, including personal respiratory protection; periodic tuberculin skin testing; and administration of prophylactic antibiotic therapy to newly infected employees. This article assesses which component is the most important in reducing TB disease risk among health care workers. A quantitative framework for estimating disease risk is developed, and two important results are described. First, the rapid identification of TB disease in presenting patients is the most important element in the overall program. Second, once TB disease has been identified, the use of highly efficient environmental controls (which include respiratory protection) becomes the most important element; these controls are especially important for procedures such as bronchoscopy and autopsy, which can aerosolize large numbers of viable Mycobacterium tuberculosis bacilli.     

Further considerations on alcohol intake and coronary risk factors in a Rome working population group: HDL-cholesterol

A study on the relationships between habitual alcohol consumption and the main coronary risk factors was carried out in 520 consecutive high-risk men examined during an annual rescreening of a working population group within the Rome Project of Coronary Heart Disease Prevention. Alcohol intake was determined by means of a semiquantitative questionnaire. The mean daily wine intake was about 0.5 liter, the consumption of other alcoholic beverages being negligible. No statistically significant correlations were found between average daily wine consumption and the main coronary risk factors, while a strongly positive correlation (p less than 0.001) was observed with plasma HDL-cholesterol levels. Also differences in HDL-cholesterol between occasional drinkers and moderate drinkers were statistically significant. No differences were observed in total cholesterol and triglycerides. The findings suggest that habitual moderate amounts of alcohol may increase HDL-cholesterol between occasional drinkers and moderate drinkers were statistically significant. No differences were observed in total cholesterol and triglycerides. The findings suggest that habitual moderate amounts of alcohol may increase HDL-cholesterol levels.     

The role of water in the oxidation process of extra virgin olive oils

Different emulsifying techniques were used to study the influence of water on the oxidative degradation of extra virgin olive oil. The emulsions of water/extra virgin olive oil, oxidized with O₂, UV radiation, and Air, were prepared by dispersing water under different conditions. Oil oxidation, monitored by measuring the PV and polyphenolic content, was greater for emulsions obtained with low dispersing power. A linear model was used to correlate the PV and the polyphenolic content with dispersing energy. An important result was that the dispersed water exerted a positive antioxidant effect on the oil.     

Novel surfactant-based adsorbent material for groundwater remediation

Many surfactants aggregate spontaneously in aqueous media to form small spherical structures called micelles. Among the numerous technical applications it is known that micelles have the ability to dissolve in their hydrophobic part significant amounts of water-insoluble organic compounds. In this study we investigated through UV-vis spectroscopy the micellar solubilization of 2,4,5-trichlorophenol (Tcp), an intermediate product of the microbial degradation of the broad-leaf herbicide 2,4,5-trichlorophenoxyacetic (2,4,5-T). Our results show that in the presence of the anionic surfactant sodium dodecylsulfate SDS the water solubility of Tcp increases six-fold whereas with cationic CTAB and nonionic Triton-X 100 the partition of chlorinated compound is not efficient. After the excess amount of the pollutant solubilized in SDS-micelles has been precipitated with CaCl2 the remaining fraction of Tcp has been successfully reduced within the toxicological limit for drinkable water through a cocurrent multistage operation. Finally, potential use in the decontamination of wastewater or soils of the new adsorbent material has been compared with the most commonly used activated carbon and silica gel.     

Transplantation of islets of Langerhans in patients with insulin-requiring diabetes mellitus undergoing orthotopic liver transplantation--the Miami experience

Most patients with cirrhosis of the liver have detectable insulin resistance. In 60-80% of patients with cirrhosis, impaired glucose tolerance can be uncovered; approximately 20% of these patients eventually develop overt diabetes. Theoretically, insulin resistance and glucose intolerance could be improved or reversed by orthotopic liver transplantation alone or in association with a simultaneous transplant of pancreatic islet cells from the same donor. To investigate these possibilities we initiated a pilot study of simultaneous liver and pancreatic islet cell transplantation in seven patients with diabetes and liver cirrhosis. Donor bone marrow cells were also infused to enhance the acceptance of the grafts. Seven patients who received only orthotopic liver transplantation and donor bone marrow cells were used as historical controls. The preliminary results of this pilot trial suggest that islet cell transplantation in conjunction with orthotopic liver transplantation improves glucose metabolism in patients with liver cirrhosis in association with reduced insulin requirements and HbA1c levels. These results were evident in spite of pre- and post-transplant basal C-peptide levels that were unchanged. Further evaluation of the effects of orthotopic liver transplantation with or without islet cell transplantation will require a randomized prospective trial including accurate metabolic evaluation with the euglycemic insulin clamp technique.     

Effects of different dietary intake of essential fatty acids on C20∶3ω6 and C20∶4ω6 serum levels in human adults

Four diets which differed in fatty acid composition were provided for five months each to a group of 24 healthy nun volunteers. The diets contained 54% carbohydrates, 16% proteins and 30% lipids. One-third of the lipid part remained unchanged during the whole study, and two-thirds were modified during each period. For this latter portion, one of the following dietary fats was used: sunflower oil, peanut oil, low erucic acid rapeseed (LEAR) oil or milk fats. This procedure allowed an evaluation of the effects of various amounts of dietary linoleic acid (C18∶2ω6) and alpha-linolenic acid (C18∶3ω3) on the serum level of their metabolites. A diet providing a large amount of linoleic acid (14% of the total caloric intake) resulted in low levels of dihomo-gamma-linolenic acid (C20∶3ω6) and arachidonic acid (C20∶4ω6) in serum phospholipids and cholesteryl esters. A diet providing a small amount of linoleic acid (0.6% to 1.3% of the total caloric intake) induced high levels of ω6 fatty acid derivatives. Intermediate serum levels of C20∶3ω6 and C20∶4ω6 were found with a linoleic acid supply of about 6.5% of the total caloric intake. Serum levels of ω6 metabolites were not different after two diets providing a similar supply of C18∶2ω6 (4.5% to 6.5% of the total caloric intake), although in one of them the supply of C18∶3ω3 was higher (1.5% for LEAR oil versus 0.13% for peanut oil). Under our experimental conditions (healthy human adults fed on a normo-caloric diet with 30% lipids), we tried to determine PUFA (linoleic and linolenic acid) allowances which should be recommended for adults. The aim of the study was to obtain a hypocholesterolemic or normocholesterolemic effect while keeping normal 20∶3ω6 and 20∶4ω6 serum levels which would evidence a normal linoleic acid metabolism. The amounts recommended are: linoleic acid 5 to 6% of the total calories; alpha-linolenic acid 0.5 to 1% of the total calories.