Microbial risk assessment for recreational use of the Chicago area waterway system.

A microbial risk assessment was conducted to estimate the human health risks from incidental contact recreational activities such as canoeing, boating and fishing in the Chicago Area Waterway System (CAWS) receiving secondary treated, but non-disinfected, effluent from three municipal water reclamation plants. Actual concentrations of the pathogens (pathogenic E. coli [estimated], Giardia, Cryptosporidium, adenovirus, norovirus, enteric virus) detected from the waterway field data collection at locations upstream and downstream of the effluent outfall during dry and wet weather conditions within the recreation season were included in the risk assessment. The results under the current treatment scheme with no disinfection indicated that the total expected gastrointestinal illness (GI) rate per 1000 incidental contact recreational exposure events during combined weather (dry and wet) conditions ranged from 0.10 to 2.78 in the CAWS, which is below the eight illnesses per 1000 swimmers considered tolerable by the United States Environmental Protection Agency. Wet weather conditions contribute to elevated pathogen load to the CAWS; therefore this study determined that disinfecting the effluents of three major WRPs that discharge to the CAWS would result in an extremely small reduction in the aggregate recreation season risk to incidental contact recreators.

Dry and wet weather microbial characterization of the Chicago area waterway system.

The Chicago Area Waterway System (CAWS) is a man-made channel, which serves the Chicago area for the drainage of urban storm water and the conveyance of secondary treated effluent from the Metropolitan Water Reclamation District of Greater Chicago's (District) North Side, Stickney and Calumet water reclamation plants (WRPs). A microbial characterization of the CAWS upstream and downstream of the WRPs and from the WRP outfall was initiated by collecting dry and wet weather samples and analyzing for indicators and pathogens. During dry weather, indicator bacteria (fecal coliform [FC], E. coli [EC], enterococci [EN]) were the most abundant microbial species detected in the CAWS compared to pathogens (Salmonella spp [SA], enteric viruses [EV], adenovirus [AV], norovirus [NV] and Giardia and Cryptosporidium). Pseudomonas aeruginosa [PA] levels in the outfall samples were either lower or equivalent to the CAWS. The wet weather samples had a higher frequency of detection of indicator bacteria and pathogens compared to dry weather samples. Overall, the concentrations of pathogens in the CAWS, representing the weather conditions experienced in a recreational year, were relatively low. The study concluded that the presence of pathogens in the CAWS downstream of the WRPs were due to secondary loading of the waterway under wet weather conditions from combined sewer overflows (CSOs) and other discharges.

Antibiotic resistant bacteria in wastewater processed by the Metropolitan Water Reclamation District of Greater Chicago system.

The Metropolitan Water Reclamation District of Greater Chicago (District) initiated a research study to determine the total numbers and percentages of antibiotic resistant fecal coliform (FC) bacteria in raw sewage (RS) entering and final effluents (FE) discharged from its seven Water Reclamation Plants (WRPs). The density of FC was determined on m-FC agar containing ampicillin (ampR-16 microg/ml), gentamycin (genR-8 microg/ml), tetracycline (tetR-8 microg/ml), or all three antibiotics. The study was primarily undertaken to determine whether secondary sewage treatment at the District WRPs adequately reduces the numbers and percentages of FC(ampR), FC(tetR), FC(genR), FC(amp/tet/genR) in the FE. The numbers of ampR, tetR, genR, and amp/tet/genR FC observed in RS ranged from 2.0 x 10(5) to 1.1 x 10(7), 9.5 x 10(4) to 2.2 x 10(6), 95 to 1.5 x 10(4) and 90 to 9.5 x 10(3) per 100 mL, respectively. Secondary sewage treatment without disinfection was shown to reduce the number of antibiotic resistant FC by two-three orders of magnitude. The numbers of FC(ampR), FC(tetR), FC(genR), and FC(amp/tet/genR) observed in non-disinfected FE ranged from 2.0 x 10(2) to 6.4 x 10(3), 2.2 x 10(2) to 4.1 x 10(3), 9 to <20 and 9 to <20 per 100 mL, respectively. The relative percentages of antibiotic resistant FC observed in FE followed the same trend observed in RS: FC(ampR) > FC(tetR) > FC(genR) > FC(amp/tet/genR). Only one FC(amp/tet/genR) bacteria was found in this study indicating that multiple-antibiotic resistant FC was virtually eliminated by secondary sewage treatment. The results of multivariate regression analysis showed that the percentages of antibiotic resistant FC in the FE from all seven District WRPs were lower than the percentages of these organisms in RS (p<0.01). These results support the conclusion that secondary sewage treatment in the District effectively reduces the number of antibiotic resistant FC and that the environments of the District's seven WRPs are not conducive to the propagation or survival of antibiotic resistant fecal coliform bacteria.

Disability and T2 MRI lesions: a 20-year follow-up of patients with relapse onset of multiple sclerosis.

Clinically isolated syndromes (CIS), such as optic neuritis, brainstem or spinal cord syndromes are frequently the first clinical presentations of multiple sclerosis. However, not all CIS patients develop multiple sclerosis and in those who do, disability is highly variable. In previous follow-up studies, brain lesions on T2-weighted MRI are associated with increased risk of multiple sclerosis and to an extent disability. We evaluated the longitudinal relationships between the MRI lesions and clinical course over a period of 20 years. CIS patients were recruited between 1984 and 1987 and previously followed up after 1, 5, 10 and 14 years. Of the 140 subjects who were initially recruited with a CIS for a baseline MRI study, we followed up 107 patients after a mean of 20.2 years (range 18-27.7). Multiple sclerosis was diagnosed as clinically definite on clinical grounds only and disability determined using the Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Functional Composite (MSFC) score. Clinically definite multiple sclerosis developed in 67 out of 107 (63%) overall: 60 out of 73 (82%) with abnormal and 7 out of 34 (21%) with normal baseline MRI. Multiple sclerosis was still relapsing-remitting in 39 (58%)--including 26 (39%) with a 'benign' course (EDSS < or = 3)--whilst 28 (42%) had developed secondary progression. T2 lesion volume at all time-points correlated moderately with 20-year EDSS (r(s) values 0.48 to 0.67; P < 0.001) and MSFC z-score [r(s) values (-0.50) to (-0.61); P < 0.001]. In those developing multiple sclerosis, a concurrent correlation of change in T2 lesion volume with change in EDSS was most evident in years 0-5 (r(s) = 0.69, P < 0.001). The estimated rate of lesion growth over 20 years was 0.80 cm3/year in those who retained a relapsing remitting multiple sclerosis course, and 2.89 cm3/year in those who developed secondary progressive multiple sclerosis, a difference of 2.09 cm3/year (95% CI: 0.77, 2.96; P < 0.001). This study extends previous follow-up of CIS patients and sheds new light on how the lesions evolve according to the natural history. Baseline MRI findings are predictive for development of clinically definite multiple sclerosis. Lesion volume and its change at earlier time points are correlated with disability after 20 years. Lesion volume increases for at least 20 years in relapse-onset multiple sclerosis and the rate of lesion growth is three times higher in those who develop secondary progressive than in those who remain relapsing remitting multiple sclerosis.

Effectiveness of combined sewer overflow treatment for dissolved oxygen improvement in the Chicago waterways.

An Use Attainability Analysis (UAA) has been initiated to evaluate what water-quality standards can be achieved in the Chicago Waterway System (CWS). There are nearly 200 combined sewer overflow (CSO) locations discharging to the CWS by gravity. Three CSO pumping stations also drain approximately 140 km2. Because of the dynamic nature of the CWS the DUFLOW model that is capable of simulating hydraulics and water-quality processes under unsteady-flow conditions was used to evaluate the effectiveness of water-quality improvement techniques identified by the UAA including CSO treatment. Several CSO treatment levels were applied at gravity flow CSOs to evaluate improvement in dissolved oxygen (DO). The results show that pollutant removal at CSOs improves DO to a certain degree, but it still was not sufficient to bring DO concentrations to 5 mg/L or higher for 90% of the time during wet weather at most locations on the CWS. Flow from the pumping stations results in substantial stress on DO since a huge amount of un-treated water with a high pollution load is discharged into the CWS in a short period of time at a certain location. The simulation results indicate that CSO treatment does not effectively improve DO during wet-weather periods on the CWS.

Dimensions of self-serving misrepresentation in forensic assessment.

I conducted an exploratory principal components analysis of 15 scales that evaluate a variety of possible self-serving biases using assessment data from 101 general forensic clients. Three distinct factors emerged, representing exaggeration of psychiatric symptoms versus exaggeration of personal adjustment, exaggeration of virtue, and exaggeration of physical health difficulties. Confirmatory factor analysis supported the findings. The surprising fact that none of the scales contained a significant number of items representing the affirmation or exaggeration of positive mental health adjustment precluded the possibility of finding a specific factor in that area. The factor structure was similar to previous results based on personal injury evaluations alone, suggesting that this 3-factor categorization of self-serving misrepresentation has some degree of generality, at least in forensic settings.

Effects of altering spectral cues in infancy on horizontal and vertical sound localization by adult ferrets.

We investigated the behavioral consequences of removing the pinna and concha of the external ear bilaterally in infancy on the sound localization ability of adult ferrets. Altering spectral cues in this manner has previously been shown to disrupt the development of the neural representation of auditory space in the superior colliculus. Using broadband noise stimuli, we tested pinnae-removed ferrets and normal ferrets in three sound localization tasks. In each case, we found that both groups of animals performed significantly better when longer duration noise bursts were used. In a relative localization task, we measured the acuity with which the ferrets could discriminate between two speakers in the horizontal plane. The speakers were placed symmetrically either around the anterior midline or around a position 45 degrees lateral to the midline. In this task, the pinnae-removed ferrets achieved very similar scores to the normal ferrets. By contrast, in another relative localization task that measured localization ability in the midsagittal plane, pinnae-removed ferrets performed less well than normals. In an absolute localization task, 12 speakers were spaced at 30 degrees intervals in the horizontal plane at the level of the ferrets' ears. Overall, the pinnae-removed ferrets also performed poorly in this task compared with normal ferrets: they made significantly fewer correct responses, larger localization errors and more front-back errors. Both normal and pinnae-removed animals showed an improvement in performance with practice, although the pattern of improvement differed for each group. The largest improvements in localization accuracy were achieved by the pinnae-removed ferrets, particularly at the frontal positions, and their performance eventually approached that of the normal animals. Nevertheless, some intergroup differences were still present. In particular, the pinnae-removed ferrets continued to make significantly more front-back errors than the normals. These deficits can be attributed to differences in the spectral localization cues available to the animals. Acoustical measurements showed that, compared with normal animals, the head-related transfer functions in the horizontal plane were largely ambiguous around the interaural axis and also contained fewer location-dependent features in the midsagittal plane.

Development and validation of the multidimensional health profile, part I: Psychosocial functioning.

This article describes the development and preliminary validation of the Multidimensional Health Profile, Part I: Psychosocial Functioning (MHP-P), a self-report screening instrument for use in mental health and primary care settings. The MHP-P assesses mental health, life stress, coping skills, and social resources. In Study 1, retest reliability, validity, social desirability response bias, and factor structure were examined in a national sample of men and women (N = 673). In Study 2, the effect of time frame on the retest reliability of the mental health scales was examined in a sample of male and female college students (N = 147). A national sample of men and women (N = 2,411) provided data for additional confirmatory factor analyses and norm development in Study 3.

Scientific status of the concept of continuing emotional propensity for sexually aberrant acts.

Continuing emotional propensity for sexually aberrant acts and similar concepts have a central role in the prosecution of sex offenders. This article examines the theoretical and scientific viability of such concepts, focusing on child molestation. It is shown that neither theoretical nor scientific underpinnings exist, although there is broad clinical agreement on the existence in some offenders of "something more" than just a pattern of continuing behavior. Both the DSM-IV and addiction models of sex offending capture this viewpoint, and it is suggested that clinical/forensic assessment for the presence of a continuing emotional propensity rely on these sources until a scientific foundation can be laid.

Goal-relevant dimensions of hypochondriacal tendencies and their relation to symptom manifestation and psychological distress.

A national sample of 60 male and 61 female adults completed a telephone interview that included measures of hypochondriacal tendencies, psychological distress, and symptom manifestation. They also provided cognitive evaluations for their most important health goal on scales measuring self-efficacy, value, planning, self-reward, self-criticism, self-monitoring, social comparison, and positive and negative goal-based arousal. Health goal cognition significantly predicted hypochondriacal tendencies measured 15 to 30 days after the goal assessment, even after controlling for chronic illness diagnosis. Correlations between goal cognition and hypochondriacal tendencies differed from those observed for psychological distress, and no significant correlations emerged with symptom manifestation. Results support a motivational account of hypochondriacal tendencies and extend previous goals research.

Use of biographical and case history data in the assessment of malingering during examination for disability.

This study examine the relationship of biographical and case history data thought to be associated with malingering to known indices of malingering based on MMPI and sentence-completion test data. Subjects were 65 patients who had undergone formal psychiatric evaluations in connection with ongoing litigation over injury-related disability. Biographical/case history data were reduced to six factors, which were correlated with six MMPI and five sentence completion test variables. Of the 66 correlations, 24 were significant, supporting the relevance of biographical and case history data in assessing malingering under these circumstances.

The use of subtle items in detecting deception.

When subjects attempt to fake psychopathology on the MMPI, scores on subtle subscales tend to be lower than those of nonfaking subjects. Our study hypothesized that this paradox comes about because the subtle subscales have no predictive validity, but their face validity for psychopathology is the opposite of the keyed direction for psychopathology. Subjects who attempt to fake psychopathology do so on the basis of item content and thus achieve lower rather than higher scores. Three groups of 80 undergraduates took the MMPI under regular, faking-good, or faking-bad instructions. As expected, faking-bad subjects scored significantly lower than regular subjects on the 100 most subtle items, and this was due to their responses to those. 73 of the items whose face validity was misleading. The results are consistent with other work showing valid uses of subtle items in detecting deception.

The maintenance of weight loss after behavioral treatment. A review.

This article reviews the recent empirical literature on the behavioral treatment of obesity in an attempt to delineate those variables that are most closely related to the posttreatment maintenance of weight loss. Such variables were found to fall into three general categories: adherence to treatment and use of behavioral skills, posttreatment vigilance regarding both weight fluctuation and the skills learned in therapy, and intraindividual physical and emotional factors. An attempt is made to develop a rational understanding of these findings, which appear to be consistent with Kanfer's self-regulation model of self-control. Implications for treatment and future research are discussed.

Retraining social and adaptive living skills in severely head injured adults.

To assess the effectiveness of an intensive, multidisciplinary rehabilitation program upon social and adaptive living skills, and to study the relationship of cognitive functioning to those skills, 10 severely head-injured adults who were treated in the program were matched with 10 waiting-list control subjects. The mean improvement shown by the treated subjects in social and adaptive living skills were all in the expected direction and all greater than the mean changes of control subjects, though not significantly so. Cognitive changes showed no consistent patterns. A striking bimodal distribution in the results for social and adaptive living skills suggests that future researchers should consider employing single-subject methodology coupled with a knowledge of the patterns and events that occur during each individual's recovery sequence.

Skill training with alcoholics: a clinical extension.

The present study attempted to replicate and extend a behavioral skill training package developed by Chaney, O'Leary, & Marlatt (1978) to a group of alcoholics of higher socio-economic status than the population originally studied. Subjects receiving the skill training package, which consisted of behavioral rehearsal of coping responses generated for potential relapse-precipitating events, were compared to a control group which received no additional treatment and to a discussion control group which discussed the potential relapse-precipitating events without rehearsing specific responses. All subjects received the assigned treatment as an adjunct to a standard inpatient treatment program. Unlike the results of the Chaney et al. study, which found the skill training package to be superior to both control groups, the present study found that both the skill training and discussion groups were superior to the no-treatment control group, and did not differ from each other.