The burden of emerging contaminants upon an Atlantic Ocean marine protected reserve adjacent to Camps Bay, Cape Town, South Africa.

The presence and levels of fifteen chemicals of emerging concerns, including five perfluorinated compounds (PFCs), two industrial chemicals, seven pharmaceuticals and one personal care product, were evaluated in biota, seawater and sediments obtained from near-shore coastal zone in Camps Bay, Cape Town, South Africa. Eight compounds were found in seawater, and between nine to twelve compounds were quantified in marine invertebrates, sediment and seaweed. Diclofenac was the prevalent pharmaceutical with a maximum concentration of 2.86 ng/L in seawater, ≥110.9 ng/g dry weight (dw) in sediments and ≥67.47 ng/g dw in marine biotas. Among PFCs, perfluoroheptanoic acid was predominant in seawater (0.21-0.46 ng/L). Accumulation of perfluorodecanoic acid (764 ng/g dw) as well as perfluorononanoic acid and perfluorooctanoic acid (504.52 and 597.04 ng/g dw, respectively) was highest in samples of seaweed. The environmental risk assessment carried out in this study showed that although individual pollutants pose a low acute and chronic risk, yet individual compounds each had a high bioaccumulation factor in diverse marine species, and their combination as a complex mixture in marine organisms might have adverse effects upon aquatic organisms. Data revealed that this Atlantic Ocean marine protected environment is affected by the presence of numerous and diverse emerging contaminants that could only have originated from sewage discharges. The complex mixture of persistent chemicals found bioaccumulating in marine organisms could bode ill for the propagation and survival of marine protected species, since many of these compounds are known toxicants.

Can't intubate, can't ventilate! A survey of knowledge and skills in a large teaching hospital.

BACKGROUND AND OBJECTIVE: The Difficult Airway Society protocol for the 'can't intubate, can't ventilate' scenario recommends the use of kink-resistant cannula cricothyroidotomy with transtracheal jet ventilation or surgical cricothyroidotomy. This survey aimed to assess the preparedness of anaesthetists and anaesthetic assistants for emergency tracheal access. METHODS: Ninety-seven anaesthetists and 63 assistants were asked the location of the two difficult airway trolleys. The anaesthetists were asked for their choice of emergency tracheal access. Those opting for cannula cricothyroidotomy with jet ventilation were asked to demonstrate cannulation of a mock trachea. After insertion of the airway cannula, the time required to attach the jet ventilator to the anaesthetic machine oxygen outlet and insufflate a dummy lung was recorded. The time to connect to a jet ventilator was also recorded for assistants. RESULTS: Five (5.2%) anaesthetists and 18 (28.6%) assistants knew the location of both airway trolleys. Sixty-one (62.9%) anaesthetists and one (1.6%) assistant did not know the location of either airway trolley. Thirty-six out of ninety-seven (37.1%) anaesthetists chose a method of tracheal access in keeping with Difficult Airway Society guidelines. Thirty-six out of ninety-seven (37.1%) anaesthetists opted for the jet ventilator, but 15 of these 36 (41.7%) could not locate the appropriate oxygen outlet on the anaesthetic machine. The median time [interquartile range (range)] to insufflate the dummy lung for the remaining 21 anaesthetists was 30 [23-32 (5.5-60)] s. CONCLUSION: There were widespread deficits in 'can't intubate, can't ventilate' knowledge and skills. All participants received a demonstration of equipment, were shown the location and given the opportunity to rehearse a 'can't intubate, can't ventilate' drill.

Obvious and not-so-obvious strategies to disseminate research.

The findings of health disparities research will have to be disseminated to a broad public in order to influence health outcomes. Some strategies for dissemination are obvious, and these generally work for ideas that are within the mainstream of current paradigms. However, ideas that challenge existing theories and assumptions may require different, and not-so-obvious, strategies. This article discusses the use of movies and site visits as two novel strategies for research dissemination.

Remembering the lizard: reconstructing sexuality in the rooms of narcotics anonymous.

The crack epidemic was devastating to poor American communities in part because of the destruction wrought by the system of exchanging sex for drugs, which was a key feature of the crack-use culture. Sex-for-drugs exchanges were often conducted under unsafe circumstances and were linked to the spread of AIDS and other STDs, as well as unplanned pregnancies. The existence of this alternative system of sexual relationships threatened the economic viability of established commercial sex work and undermined the status and power of women. Narcotics Anonymous (NA) meetings helped men and women recover from crack addiction through a well-described 12-step process. Described as the rooms, these time- and space-specific encounters helped people become sober in the context of neighborhoods that were centers of the drug trade. Because of the key role of sex in the crack culture, transformation of sexual relationships was essential to establishing and maintaining sobriety. The manner in which the rooms of NA influence the sexuality and lifeworld of addicted people is explored using Barker's theory of ecological psychology.

"Hey, mom, thanks!": use of focus groups in the development of place-specific materials for a community environmental action campaign.

We examined the relevance of five strategies to reduce the risk of exposure to environmental hazards for African-American and Hispanic children living in Northern Manhattan in New York City. Researchers conducting a community-wide intervention to increase awareness of environmental health hazards identified five strategies for keeping children healthy, preventing asthma, and promoting children's growth and development. These strategies were based on current scientific knowledge of environmental health and were tested and refined through a series of focus groups. The 14 focus groups were conducted with women of childbearing age living in the communities under study. The purpose of the focus groups was to test the relevancy of the five strategies and to obtain data to inform the intervention's social action campaign. Here authors discuss the process of identifying strategies for risk reduction and incorporating community residents' perceptions of risk into health risk messages. The authors argue that broader social and historical contexts are important in shaping community members' interpretations of risk and subsequent response to health education campaigns.

Awareness of environmental risks and protective actions among minority women in Northern Manhattan.

We report findings of a survey of 555 women 18-35 years of age living in Northern Manhattan in New York City. The survey was conducted by the Columbia Center for Children's Environmental Health (CCCEH) to learn what community women knew about environmental risks to health and what they did to protect themselves and their families, to validate the findings of focus groups held with community women, and to provide information for planning the Healthy Home, Healthy Child campaign sponsored by CCCEH. Survey findings showed that overall awareness of environmental risks to children's health was high, with more than 95% of respondents identifying lead, household pests, pesticides, environmental tobacco smoke, and drugs as harmful to health. Similarly, more than 95% of respondents reported taking one or more protective actions to reduce these risks, suggesting that these factors significantly concern women living in Northern Manhattan. The reported levels of specific protective actions to reduce these risks, however, varied greatly. In each area of risk the most frequently reported actions were effective ones, but many other important protective actions were rarely mentioned, suggesting that there was room for an educational campaign to teach women new ways to protect their families. Survey respondents and CCCEH scientists differed in the priorities they placed on the importance of key protective actions, confirming earlier focus group findings and suggesting the importance of incorporating community concerns into the planning of environmental campaigns.