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.

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.

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.

Facilities and diagnostic criteria in sexually transmitted disease clinics in England and Wales.

A study was conducted to collect information from consultants about the facilities and diagnostic criteria used in clinics for sexually transmitted diseases in England and Wales. Most of the information was obtained by personal interview with a response rate of 92%. Half the clinics were open for 10 hours or less a week, the mean length of time for all clinics was 14 1/2 hours a week. Eighty per cent of clinics had a full or part-time contact-tracing service. All the clinics had microscopical and serological services and almost all (99%) had cultural facilities. The policy concerning the most efficient use of these facilities is discussed.