Changes in bone turnover following gonadotropin-releasing hormone (GnRH) agonist administration and estrogen treatment in cynomolgus monkeys: a short-term model for evaluation of antiresorptive therapy.

In this study we determine the early time course of estrogen deficiency-induced bone loss in the cynomolgus monkey and examine the potential of this method for evaluating antiresorptive therapies. In two groups of animals, estrogen deficiency was induced by the administration of a gonadotropin-releasing hormone agonist (GnRHa) and bone turnover was measured using biochemical markers. Two weeks after receiving GnRHa, serum estradiol decreased to below the detection limit in most animals and remained there through 6 months or until estrogen replacement started (months 4-6). Relative to untreated animals, urinary deoxypyridinoline (dPyr), as well as C- and N-telopeptides of type I collagen, were significantly elevated 4 weeks after receiving GnRHa. Serum osteocalcin increased in GnRHa-treated animals as early as week 4 and the level was significantly higher than in untreated control animals from weeks 8-24. Estradiol treatment returned all measures of bone turnover to control levels within 2 weeks. The use of biochemical markers as surrogates of bone turnover and loss was validated by measurement of bone mineral density (BMD), which showed a significant reduction at 6 months in estrogen-deficient animals. However, lumbar BMD in animals that received GnRHa and estradiol was similar to that in animals that had not received GnRHa. In conclusion, a monthly depot injection of GnRHa resulted in increased bone turnover due to estrogen deficiency, as early as 4 weeks after treatment. Estrogen administration returned bone turnover to control levels in 2 weeks. This method represents a valid model for evaluating antiresorptive agents in the short term in a nonhuman primate. Furthermore, the data suggest that changes in biochemical markers in response to antiresorptive therapy in humans may be detectable at much earlier timepoints than commonly used.

Development of a women's wellness center in Almaty, Kazakhstan.

Twelve Women's Wellness Centers were established by American International Health Alliance (AIHA) partnerships in the New Independent States of the former Soviet Union. The services offered by these centers focused on health promotion, disease prevention, and other health and social issues that affect women's health. The innovations in the model include patient-centered care that emphasizes patient choice and the introduction of the role of the nurse educator.

The effect of high-efficiency and standard vacuum-cleaners on mite, cat and dog allergen levels and clinical progress.

The major triggers for allergic asthma are exposure to allergens of the house dust mite, Dermatophagoides pteronyssinus, and of pets. Unfortunately studies of techniques designed to reduce house dust mite and pet allergens have had mixed results. However, new so-called 'improved' products continue to appear on the market and require subjective evaluation. The homes of 60 house dust mite-allergic patients were studied to compare the effects of high-efficiency and standard vacuum-cleaners on allergen concentration. Der p 1 (house dust mite), Fel d 1 (cat) and Can f 1 (dog) allergens were measured in four separate locations in each home. Clinical analysis was by lung function, bronchodilator usage and histamine challenge techniques. There was a significant reduction in Fel d 1 (ng/m2) in dust samples from the living-room carpet (p = 0.046), bedroom carpet (p = 0.003) and mattress (p = 0.013) and living-room sofa (p = 0.005) after 12 months of using the high-efficiency cleaners, but only in the mattress sample using the standard cleaners (p = 0.014). Can f 1 (ng/g dust) was reduced in the mattress sample after using the high-efficiency vacuum-cleaners (p = 0.028), but not at other sites. Der p 1 levels were not significantly changed over this period. Clinically, patients in the high-efficiency group showed improvements in peak expiratory flow rate (PEFR) (p = 0.004), FEV1 (p = 0.026) and bronchodilator usage (p = 0.005) after 12 months. When the cat-sensitive patients were analyzed separately, improvements in histamine PC20 (p = 0.039) were also seen. Reducing Fel d 1 concentrations, in the absence of any change in Der p 1 concentrations, can produce significant improvements in the lung function of atopic, asthmatic patients. This effect was primarily achieved in those patients with cat sensitivity, but who did not possess a cat themselves.

Homicide against women in the workplace.

OBJECTIVES: To examine the nature and magnitude of violence against women in the workplace. METHOD: Data from the National Traumatic Occupational Fatalities surveillance system were analyzed for the 13-year period, 1980 to 1992. Employment information was coded from industry and occupation narratives taken from the death certificates. Rates were calculated using annual average employment data published by the Bureau of Labor Statistics. RESULTS: From 1980 to 1992, 2,001 women and 7,935 men were victims of work-related homicides, for rates of 0.32 and 1.01 per 100,000 female and male workers, respectively. The majority of female homicide victims were employed in two industries-retail trade (46%) and services (22%). The highest risk industry was grocery stores (1.74 per 100,000 workers), followed by eating and drinking establishments, hotels and motels, and justice and public order. CONCLUSIONS: The findings presented here are consistent with previous research indicating that homicide is the leading cause of occupational injury death for women, but that women are at lower risk than their male counterparts. Homicide played a major role in sales and service, sectors that have increased over the last several decades and in which future growth is predicted. Feasible and effective prevention strategies to reduce the risk of work-related homicides must be developed and implemented.

Workplace homicide: industries and occupations at high risk.

Homicide is to blame for 20 workplace deaths each week. Although no single intervention strategy will be appropriate in all situations, the author points out that interventions cannot be designed without knowledge of the demographic characteristics of victims and the distribution of workplace violence across industries and occupations. Such data are presented by gender, age, race, geographic distribution, method of homicide, and industry and occupation.

Occupational injury mortality rates in the United States: changes from 1980 to 1989.

Changes in occupational injury mortality rates over the 1980s were examined through analysis of the National Traumatic Occupational Fatalities surveillance system. The US occupational injury mortality rate decreased 37% over the decade, with decreases seen in nearly every demographic and employment sector. Greater declines were among men, Blacks, and younger workers, as well as among agricultural, trade, and service workers. Electrocutions, machine-related incidents, and homicides showed the greatest decreases. Changes in occupational mortality rates by demography, industry, and cause of death indicate the areas in which the most progress has been made and those that are prime targets for prevention efforts.

Workplace-related homicide among health care workers in the United States, 1980 through 1990.

OBJECTIVE: To improve understanding of the epidemiology of fatal violence directed toward physicians and other health care workers (HCWs) in health care settings. DESIGN: Analyses of data for 1980 through 1990 from the National Traumatic Occupational Fatalities surveillance system. MAIN OUTCOME MEASURES: Overall occurrence of occupational injury deaths and occurrence of workplace-related homicides among HCWs. RESULTS: From 1980 through 1990, a total of 522 HCWs died from injuries sustained while working. The most common causes of death were motor vehicle crashes (122 [23.4%]), homicide (106 [20.3%]), and suicide (88 [16.9%]). Firearms were used in the greatest number (78 [73.6%]) of workplace-related homicides among HCWs. CONCLUSIONS: These findings highlight the need for strengthened surveillance and more accurate estimates of the risks of workplace-related violent injury for HCWs in the United States.

Occupational injury deaths among females. The US experience for the decade 1980 to 1989.

From 1980 through 1989, females accounted for 44% of the total employed population. Thus, occupational safety and health issues specific to the experience of women merit consideration. Research has demonstrated that the occupational fatality experience of females is not adequately described by the group of all workers. The leading cause of death for all workers is motor vehicle incidents, while the leading cause of occupational injury death of females is homicide. The National Institute for Occupational Safety and Health (NIOSH) has compiled a decade of data on the fatal occupational injury experience of US workers, providing a sufficient number of female cases to allow separate analyses. Over the decade, 3821 females died as a result of injuries sustained at work, with an average annual fatality rate of 0.82/100,000 female workers. Among industries, retail trade and services accounted for nearly half of all occupational injury deaths to females. The detailed occupations with the highest rates of work-related injury death were airplane pilots and navigators, drivers of heavy trucks, construction laborers, and police and detectives. Information on the causes of work-related injury death by occupation is fundamental to the prevention of these deaths. The causes of death in the highest-risk occupations included aircraft crashes, motor vehicle collisions, pedestrians struck by motor vehicles, and homicides by firearms. These data provide a foundation for the prevention of occupational injury deaths among females in the United States.

Industries and occupations at high risk for work-related homicide.

Homicide is the third leading cause of injury death in the workplace. The death certificate-based National Traumatic Occupational Fatalities surveillance system and estimates of annual employment were used to calculate average annual rates of work-related homicide for detailed industries and occupations for the nation for 1980 to 1989. Workers in the taxicab industry had the highest rate of work-related homicide (26.9 per 100,000 workers). High rates were also identified for workers providing public and private security, and in a number of retail trade and service industries. For many high-risk industries, the risk was excessive for male workers only. Differences between rates for black and nonblack workers varied across industries and occupations. Immediate efforts to protect workers, and long-term efforts to describe and study work-related homicide thoroughly and to evaluate interventions are needed.

Elderly persons with mental retardation: an exceptional population with special needs.

The passage of recent legislation has ensured special service provisions for a previously overlooked population, elderly persons with mental retardation. This article presents a broad overview of current research studies on this topic and focuses on identification of the population, residential options, and service needs of elderly persons with mental retardation. Similarities and differences between older persons with developmental disabilities and the non-retarded elderly, and service need requirements of this particular population are also included. Finally, the importance of developing collaborative services of developmental disability agencies and aging services is discussed as well as recommendations for future research needs.

Homicide in the workplace: the U.S. experience, 1980-1988.

1. Homicide was the third leading cause of occupational injury death in the United States from 1980 to 1988. 2. Of all occupational injury deaths to females from 1980 to 1988, 40% were homicides. 3. The highest age specific rates of occupational homicide were found among workers 65 years and older (2.04 per 100,000 workers). 4. Protection of workers will require the collaborative work of public health and safety professionals, including occupational health nurses, as well as law enforcement, engineering, and architecture professionals and behavioral scientists.

Capillary column gas chromatography with nitrogen-phosphorus detection for determination of nitrogen- and phosphorus-containing pesticides in finished drinking waters: collaborative study.

A joint U.S. Environmental Protection Agency/AOAC interlaboratory method validation study was conducted on EPA Method 507, Determination of Nitrogen- and Phosphorus-Containing Pesticides in Finished Drinking Water by Gas Chromatography with a Nitrogen-Phosphorus Detector, to determine the mean recovery and precision for analyses of 45 nitrogen- or phosphorus-containing pesticides in reagent water and finished drinking waters. The study design was based on Youden's nonreplicate plan for collaborative tests of analytical methods. The waters were spiked with 45 nitrogen- or phosphorus-containing pesticides at 6 concentration levels, prepared as 3 Youden pairs. Ten volunteer laboratories extracted the spiked test waters with methylene chloride, performed a solvent exchange with methyl tert-butyl ether, and analyzed an aliquot of each extract by gas chromatography using a nitrogen-phosphorus detector. Results were analyzed using an EPA computer program, which measured recovery and precision for each of the 45 pesticides and compared the performance of the method between water types. Method 507 was judged acceptable for all analytes tested except merphos, which thermally decomposed in the injection port of the gas chromatograph. Five compounds (carboxin, disulfoton, metolachlor, pronamide, and simazine) exhibited statistically significant matrix effects for the finished drinking water. The method has been adopted official first action by AOAC.