Measurements of airborne methylene diphenyl diisocyanate (MDI) concentration in the U.S. workplace.

This article summarizes a large body of industry air sampling data (8134 samples) in which airborne MDI concentrations were measured in a wide variety of manufacturing processes that use either polymeric MDI (PMDI) or monomeric (pure) MDI. Data were collected during the period 1984 through 1999. A total of 606 surveys were conducted for 251 companies at 317 facilities. The database includes 3583 personal (breathing zone) samples and 4551 area samples. Data demonstrate that workplace airborne MDI concentrations are extremely low in a majority of the manufacturing operations. Most (74.6%) of the airborne MDI concentrations measured in the personal samples were nondetectable, i.e., below the limits of quantification (LOQs). A variety of validated industrial hygiene sampling/analytical methods were used for data collection; most are modifications of OSHA Method 47. The LOQs for these methods ranged from 0.1-0.5 microg/sample. The very low vapor pressures of both monomeric MDI and PMDI largely explain the low airborne concentrations found in most operations. However, processes or applications in which the chemical is sprayed or heated may result in higher airborne concentrations and higher exposure potentials if appropriate control measures are not implemented. Data presented in this article will be a useful reference for employers in helping them to manage their health and safety program as it relates to respiratory protection during MDI/PMDI applications.

Motivational interviewing and pediatric health behavior interventions.

Motivational interviewing (MI) is an empirically supported intervention with a large evidentiary base in the adult behavioral medicine and addictions literature. In the last decade, a growing body of research has shown promise for the use of MI in health behavior change settings with pediatric populations. This article provides a description of MI and its differences from other pediatric counseling and medical management approaches. A review of outcome studies of health behavior change interventions using MI with pediatric populations (age 18 and younger) and parents is provided, and implications for clinical development, research, and training are discussed.

Health services use and growth patterns among older siblings of infants with prenatal drug exposure.

The health care use patterns, suspected maltreatment, and growth trajectories of siblings of infants with prenatal drug exposure were examined. Ninety-three siblings of drug-exposed infants were matched with patients from the same primary care clinic. The case patients were found to have significantly fewer health care contacts, more deficient immunizations, and more reports of suspected child maltreatment. Although they did not differ in birth weight, growth curve modeling found that case patients had lower weight gain trajectories. When drug-exposed infants are identified, nursing personnel are in a unique position to assist the siblings of those identified infants obtain needed medical care and services.

A brief form of the child abuse potential inventory: development and validation.

A brief version of the Child Abuse Potential Inventory (CAP) was developed using a development sample of N = 1,470, and cross-validated using an additional sample of N = 713. Items were selected to maximize (a) CAP variance accounted for; (b) prediction of future child protective services reports; (c) item invariance across gender, age, and ethnicity; (d) factor stability; and (e) readability and acceptability. On cross-validation, scores from the resulting 24-item risk scale demonstrated an internal consistency estimate of .89, a stable 7-factor structure, and substantial correlations with the CAP Abuse Risk score (r = .96). The CAP risk cutoff was predicted with 93% sensitivity and 93% specificity (area under the receiver operating characteristics curve = .98), and the Brief Child Abuse Potential Inventory (BCAP) and CAP demonstrated similar patterns of external correlates. The BCAP may be useful as a time-efficient screener for abuse risk.

Comprehensive services for mothers of drug-exposed infants: relations between program participation and subsequent child protective services reports.

It is unclear whether intensive services for women using drugs during pregnancy can reduce child maltreatment. Within-subjects, dose-response analyses can be conducted using Child Protective Services (CPS) reports. Dose of services received can indicate either engagement or higher need for services. Using data from an intensive intervention program for mothers of drug-exposed infants, the authors examined associations between CPS reports and (a) dose of services received and (b) a termination status variable combining dose of services received with duration of service involvement and progress on treatment plan goals. Cox regression revealed no association between dose of services and follow-up CPS reports. The termination status variable was strongly related to follow-up CPS reports, such that higher ratings were associated with significantly lower risk of re-report, even after controlling for baseline motivation. Findings suggest that program effects may be detectable using a treatment process-- based index that combines dose, duration, and quality of program involvement.

The impact of motivational interviewing on substance abuse treatment retention: a randomized control trial of women involved with child welfare.

Previous studies have supported the efficacy of Motivational Interviewing (MI) in increasing treatment engagement and retention among people with substance abuse disorders. However, few studies have assessed the impact of MI with coerced populations, particularly women referred to drug abuse treatment by child welfare due to prenatal drug use. Seventy-one such women who used drugs during pregnancy were randomly assigned to either receive three MI sessions or to watch two educational videos and participate in a home visit. Treatment retention group attendance and random urine analysis results were evaluated in these women during the first 8 weeks of treatment. No differences were found between the two conditions on these variables. Possible reasons for these negative findings are discussed, as are ideas for future research with coerced populations.