Crisis in our schools: survey of sanitation facilities in schools in Bloomsbury health district.

OBJECTIVE: To survey sanitation facilities in schools in Bloomsbury health district. DESIGN: Postal questionnaire. SETTING: Inner London health district. PARTICIPANTS: School nurses. RESULTS: 16 of 17 school nurses responded (37 of 41 schools). Fifteen schools did not have the minimum number of toilets and hand basins established in the Education (School Premises) Regulations 1981. In two schools toilets were kept locked for most of the day. In 10 schools toilet paper was not always available, and three of five secondary schools did not have disposal units for sanitary towels in the girls' toilet areas. In 18 of the schools the toilets were not kept adequately clean. CONCLUSIONS: These conditions raise serious questions about environmental health, with the potential for the spread of infectious diseases, and undermine attempts to teach children basic hygiene. Health professionals have an important role in assessing health and safety standards in schools and ensuring that necessary improvements are made.

Evaluation of Th series disequilibrium in Western Australian monazite.

Estimation of inhaled radiation doses associated with mineral sands processing is commonly performed by gross alpha-counting dust collected on air filters. The technique requires knowledge of the extent of disequilibrium in Th-bearing minerals. The daughters which can be expected to give rise to disequilibrium, viz. 228Ra and 220Rn (also designated thoron in the paper), were investigated in a typical Western Australia monazite. The thoron flux from a dry, "infinitely thick" layer of monazite was found to be 41 Bq m-2 s-1. The depth of monazite from which thoron is exhaled is limited to 40-50 mm, and within the first 10 mm is a linear function of bed thickness. The relative loss within the linear region is approximately 0.02% of the equilibrium concentration and progressively less for layers beyond 10 mm. The sample investigated gave no indication of disequilibrium involving 228Ra. The results indicate that secular equilibrium may be assumed when calculating 232Th daughter concentrations in monazite from the gross alpha activity. More extensive work on monazite samples from a number of sites will be necessary before this can be stated as a general conclusion applicable to all Western Australian monazite deposits.

Road safety and drink-driving: the knowledge and opinions of male and female adolescents.

This paper reports on a structured questionnaire survey of high school students from years 8, 9 and 10 and their knowledge and opinions on issues relating to general road safety and drink-driving. A representative sample of this larger group was then interviewed in more depth. The results are discussed in terms of previous surveys of adolescents' attitudes and knowledge on these issues and the educational questions that arise in the light of reported sex differences.

Bicycle safety in Australia.

An overview of bicycle safety strategies developed in Australia over the past decade, including information from the first community based bicycle injury survey. Evaluation of these strategies has important implications for the next generation of cyclists.

Obstetric practice. A decade under review.

As part of a prospective study concerning the cause of neonatal jaundice, information relating to obstetric practice over a 10 year period (1977 to 1987) in the New England area of Australia was collected. The data reveal certain trends over the decade and provide baseline data for obstetricians practising in a provincial setting.

Road safety. Perceptions of final-year secondary-school students.

Final-year high-school students were surveyed to assess their knowledge and opinions concerning various aspects of road trauma, in particular, its extent, its causes, its relationship to alcohol consumption and the possible solutions to the problem of drink-driving. When compared to the students who took part in a similar study conducted six years previously, it was found that the 1983 students knew more about road trauma in general, and its relationship to alcohol, and were more accepting of intrusive remedial measures such as random breath-testing and speed-humps. Recommendations are made which take into account the students' views on the matter of possible solutions to the problem.

Natural human interferon-gamma. Complete amino acid sequence and determination of sites of glycosylation.

Fresh human peripheral blood lymphocytes were induced with desacetylthymosin -alpha 1 and staphylococcal enterotoxin B. The induced gamma interferon (or IFN-gamma, immune interferon, type II interferon) was purified to homogeneity utilizing controlled-pore glass, concanavalin A-Sepharose, Bio-Gel P100, or Sephacryl S-200, and reversed phase high performance liquid chromatography. This procedure resulted in two active species with apparent Mr = 20,000 and 25,000 as judged by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Both species were found to have identical amino acid sequences with a pyroglutamate residue as NH2-terminus. In both cases six different COOH termini were found. They are, at least qualitatively, identical in both species. There are two possible Asn-X-Ser/Thr glycosylation sites. Both carry carbohydrates in the Mr = 25,000 species whereas in the Mr = 20,000 species only one site is glycosylated. This likely explains the difference in apparent molecular weight between the two species and the expected molecular weight based upon the amino acid sequence.

Birth weight, and use of oxytocin and analgesic agents in labour in relation to neonatal jaundice.

A prospective study of 1977 babies, delivered in two district hospitals in the Northern Tablelands area of New South Wales, revealed a highly significant relationship between neonatal jaundice and birth weight in all cases of neonatal jaundice (P = 0.0001). The use of oxytocin was associated with a significant increase in the incidence of jaundice (all cases, P = 0.003; severely jaundiced babies, P = 0.05). This effect was related to the total dose of oxytocin used (P = 0.003 for all cases; P = 0.056 for severely jaundiced babies), but not to its rate of administration. No significant difference was apparent whether oxytocin was administered to initiate or to accelerate labour. The suggestion that oxytocin use is associated with delivery of immature babies is refuted. The use of analgesic agents during labour was not associated with an increased incidence of neonatal jaundice.

Morbidity associated with pelvic inflammatory disease.

To identify the long-term sequelae and morbidity associated with acute pelvic inflammatory disease (PID) patients with acute PID and matched controls were interviewed at five-monthly intervals for about 21 months after entry into the study. In some instances morbidity among the patients was increased, particularly at five months after admission to hospital. Significantly more patients than controls had visited hospital as outpatients, been admitted to hospital and undergone abdominal operations, and had to alter their normal daily routine and take time off work. The cumulative rates for all of these, except for time off work, were significantly higher in the patients than in the controls. Differences between the two groups both at early and later interviews and cumulatively were evident in the incidence of abdominal pain (other than menstrual pain), change in menstruation (longer and more painful), and pain during sexual intercourse, which persisted in one-fifth of patients after the initial acute episode.

Biliary-type pain as a manifestation of genital tract infection: the Curtis-Fitz-Hugh syndrome.

Ten patients with biliary-type pain, in whom investigations of the biliary tract were negative, are reported. All the patients were sexually active premenopausal women and all had evidence of infection with chlamydia trachomatis. Five patients submitted to laparoscopy had fibrinous adhesions between the anterior surface of the liver and the parietal peritoneum (perihepatitis). All 10 patients were diagnosed as suffering from the Curtis-Fitz-Hugh syndrome caused by Chlamydia trachomatis. The clinical similarities between the Curtis-Fitz-Hugh syndrome (right upper quadrant abdominal pain, perihepatitis and genital tract infection) and acute biliary disease are emphasized and the diagnostic implications discussed.

Levels and temporal trends of trace element concentrations in vertebral bone.

An X-ray fluorescence analysis study of iron, zinc, rubidium, strontium, and lead in ashed vertebral column whole bone samples of 51 sudden death victims in Western Australia gave median values of 893, 213, 25, 108, and 25 ppm, respectively. Highly significant concentration-age Spearman correlations were observed for iron-age (rs = 0.45, P less than .004), Zn-age (0.43, P less than .006), and lead-age (0.63, P less than .001), the mean per annum rates of increase being 26, 0.4, and 0.8 ppm, respectively, and marked concentration-concentration correlations were found for iron-lead (0.44, P less than .003) and strontium (0.30, P less than .06). The median zinc concentrations for the male and female subsets are 216 and 205 ppm, respectively; the corresponding values for strontium are 100 and 120 ppm.

Current approaches to the diagnosis, treatment, and reporting of trichomoniasis and candidosis.

The current approach to the management of trichomoniasis and candidosis in sexually transmitted disease (STD) clinics in England and Wales is described. Microscopy alone was used in the diagnosis of trichomoniasis in 44% of clinics and of candidosis in 35% of clinics. Oral metronidazole was used for the treatment of trichomoniasis in women in 92% of clinics. Vaginal pessaries containing nystatin or clotrimazole were routinely used to treat candidosis in 95% of clinics. Male sexual contacts of female patients with candidosis and trichomoniasis were invited to attend for examination in 88% of clinics. Physicians in 81% of clinics prescribed treatment on epidemiological grounds for male contacts of female patients with trichomoniasis. A more uniform approach to the diagnostic categories used for the quarterly returns for cases treated epidemiologically is recommended.