The healing energy of love.

That love promotes health surprises few people, yet the scientific study of love and physical health is in its infancy. Because love has many facets and is manifested in many ways, as described here, it was banned from Western science, which insisted on observable and simple independent variables. This article presents data indicating the salutary effects of love on physical health. These data are from several areas-psychology, sociology, medicine, epidemiology, and healing-and together form a foundation for understanding and enhancing love and its effects. Three processes are formulated to explain the health-promoting effects of love: psychophysiologic, psychophysical, and psychosocial/behavioral. Love is described as an energy by virtue of its capacity to produce effects.

A guide for planning community-oriented health care: the health sector resource allocation model.

The objective of this study was to demonstrate the value of a planning model for the design and evaluation of community health services. The health status of Washtenaw County, Michigan was modeled. Data were obtained from the Michigan Department of Public Health, Medstat Systems, and the medical literature for 32 diseases or conditions, representing approximately 85% of causes of death and 56% of medical payments (excluding medication costs). An expanded life-table approach was used for 16 age-and sex-matched cohorts exposed to a disease attack rate, access-to-care rate, case fatality rate, morbidity, and costs. Rates can be modified to reflect changes due to treatment, secular trends, or prevention programs. Two alternative delivery methods were considered to show the potential impact of reducing cardiovascular deaths (worksite initiative), or increasing utilization of services (lay health promotion) on county health status and costs over time. Deaths, bed days, and annual medical payments were the main outcome measurements. Cardiovascular and cancer conditions are and will be the primary causes of death in this population. The most important causes of bed days are musculoskeletal conditions, chronic obstructive pulmonary disease, accidents, strokes, and depression. The major health-care payments are for angina pectoris and/or other cardiac conditions, musculoskeletal conditions, accidents, prenatal care, and/or childbirth, and depression. The two alternative scenarios illustrate how reductions in mortality are not necessarily equated with similar improvements in morbidity or costs. This model presents an overview of the current and projected health status of a community. With such a planning tool, a community can better understand the impact of potential prevention or intervention programs, and help design its health-care system within the constraints of available resources.

A smoking cessation incentive program for chemical employees: design and evaluation.

Worksite smoking cessation intervention programs have become increasingly popular, although program evaluations are often unavailable. In 1984, the Texas Operations of Dow Chemical USA offered a Smoking Cessation Incentive Program (SCIP) to its employees. SCIP was a highly publicized, upbeat program that had the active support of management and union. Altogether, 7,516 employees (95.4% of all employees) were surveyed about their smoking habits; 28.3% identified themselves as smokers. A total of 1,113 employees voluntarily enrolled in SCIP from March 1, 1984, through March 1, 1985. Smoking cessation methods included a buddy program, nicotine-containing chewing gum, American Lung Association self-help material and group clinics, and incentive prizes. SCIP registrants, compared to employees identified as smokers in a pre-program survey who did not participate in SCIP, were significantly (P less than .01) more often females, whites, administrators, professionals, heavier smokers, and smokers who had tried to quit at least two times prior to SCIP. There were 326 (29.3%) SCIP participants who quit smoking for at least one month during SCIP. A total of 265 (23.8%) succeeded at quitting for at least six months and remained ex-smokers at the end of the program. Logistic regression analysis showed administrators had significantly higher six-month or more rates of quitting than did professionals, craftsmen, operators or clerical workers.(ABSTRACT TRUNCATED AT 250 WORDS)

An epidemiologic investigation of forced expiratory volume at 1 second and respiratory symptoms among employees of a toluene diisocyanate production plant.

Pulmonary function tests were done and compared to current and past potential exposure levels of toluene diisocyanate (TDI) for 57 TDI manufacturing workers and 89 workers not exposed to TDI or other known respiratory hazards. The average TDI plant experience was 4.1 years (standard deviation = 2.8). Routine industrial hygiene measurements have shown TDI exposure below a time-weighted average of 0.005 parts per million and a short-term exposure level of 0.02 parts per million. A certified industrial hygienist ranked department and job classification by level of potential exposure to TDI (none, low, moderate, and high). A questionnaire was administered to determine the prevalence of respiratory symptoms and smoking habits. Using backward regression analysis, cumulative pack-years of cigarette smoking and prevalence of lower respiratory symptoms were statistically significant predictors of a standardized forced expiratory volume at 1 second observed v expected difference; however, TDI exposure, whether classified as current, highest career level, cumulative, or cumulative highest-to-date, was not associated with a decline in forced expiratory volume.

Validation of work histories obtained from interviews.

There have been few attempts to assess the validity of occupational histories obtained from interviews. A nested case-control study of lung cancer conducted in 1985 among a cohort of 19,608 male workers at a Texas chemical production facility provided such an opportunity. Telephone interviews were attempted with 308 lung cancer patients and 588 matched controls or their next of kin in order to gather information on tobacco use, diet, places of residence, and occupations. Interview data from 734 respondents (143 subjects and 591 next of kin) were then compared with the records of work area assignments maintained by the company and with exposure profiles developed by an industrial hygienist. Respondents recalled 48.4 per cent of all documented work area assignments, but only 2.6 per cent of the chemical agents judged as likely exposures. Recall of usual work area assignment was 70.8 per cent. Among the factors found to have most influenced recall were the number and durations of assignments, a subjective assessment of the quality of the interview, and the relationship of the interview respondent to the subject. The elapsed time from job assignment to interview was also found to affect recall of the longest assignment of the subject.

Specific effects and biofeedback versus biofeedback-assisted self-regulation training.

In any field, clear and logical conceptualizations are the basis of accurate models----correct research design----correct results----correct conclusions----advancement in the field. Faulty conceptualizations----faulty models----faulty research design----faulty results----faulty conclusions----confusion. In analyzing the conceptualizations of "biofeedback" as expressed by John Furedy (1987) in, "Specific versus Placebo Effects in Biofeedback Training: A Critical Lay Perspective," we focus on two issues: Does biofeedback have a treatment effect? Is biofeedback necessary for the training effect? In discussing issue (1) we describe the multiple meanings of "biofeedback" and raise the fundamental question: Is biofeedback a treatment? We argue that faulty conceptualizations of clinical biofeedback (1) assume that the treatment in clinical biofeedback is "biofeedback" with specific effects, (2) assume that the scientific basis of biofeedback is dependent upon demonstrations of these specific effects through double-blind design that distinguish "specific" from "placebo effects," and (3) trivialize clinical research by attempting to determine the usefulness of biofeedback information--usefulness that is already understood logically by professionals and consumers and demonstrated by clinical studies in the laboratory and in the clinic. We further argue that accurate conceptualizations of clinical biofeedback (1) identify self-regulation skills as the treatment with specific effects of physiological change and symptom reduction, and (2) describe the use of information from biofeedback instruments as scientific verification of self-regulation skills. Finally, the scientific basis of clinical biofeedback is based on (1) evidence from experimental and clinical control studies that have demonstrated the effectiveness of self-regulation skills for symptom alleviation, and (2) the use of biofeedback instruments to verify the acquisition of self-regulatory skills, thus fulfilling the scientific dictum of verifiability.

Nested case-control study of lung cancer among chemical workers.

A recent cohort mortality study of 19,608 male employees of a major Texas chemical production facility had suggested that they might be at higher risk of lung cancer compared with the male population of the United States or Texas but not with the male population of the five-county area in which they reside. An occupational exposure was a possible explanation for this pattern, and a nested case-control study was undertaken of the 308 lung cancer deaths observed between 1940 and 1981. Two control groups, one a decedent and the other a "living" series, were individually matched to cases one-for-one. Interviews were conducted with subjects or their next of kin to collect information on smoking and other potential confounders. These data were combined with employee work history records and industrial hygiene data to form the basis of the analyses. Traditional stratification methods and conditional logistic regression were employed to examine for effect modification and to control confounding. Statistically significant, positive and negative associations were found for assignment to several work areas within the facility. Suggestive associations were observed for exposure to sulfur dioxide and heat. These and additional associations are discussed relative to evidence from other studies.

Mortality among a large cohort of chemical manufacturing employees.

Cause-specific mortality was surveyed among 19,608 male employees with 1 or more years of service between 1940 and 1980 at the Texas Operations of Dow Chemical U.S.A. Vital status was ascertained through 1980 for 97.3% of the cohort members, and death certificates were obtained for 96.4% of the 3,444 decedents. Mortality risks were found to vary, depending upon which of 3 population groups (United States, Texas, and local counties) was used for comparison, although significantly fewer than expected deaths from all causes was a common finding due to significant deficits in diabetes, diseases of the circulatory system, and cirrhosis of the liver. Significantly more deaths were from ill-defined conditions and cancers of unspecified sites. Lung cancer was significantly elevated in comparisons with the incidences in the United States and Texas, but not in comparison with those in the local counties. The influence of age at hire, period of hire, duration of employment, interval since entry into cohort, employment status, and two measures of social class--educational level and job category--were explored with the use of the Mantel-Haenszel method as adapted for a cohort study. Findings from these analyses are discussed in relation to the observations of other investigators and in the context of the possible impact of these findings on future studies of this work force.

A case-control study of renal cancer mortality at a Texas chemical plant.

An in-plant case-control study of 26 renal cancer deaths was conducted to determine whether an occupational exposure may be related to an apparent increase in mortality from this disease observed among a sample of employees at a multiple process chemical production facility. None was found that explained the excess. Elevated odds ratios were identified for employment in the cell maintenance area of chlorine production and with those presumptive exposures considered to occur in this job, asbestos and caustic, but not chlorine. While an association between renal cancer and asbestos has been previously reported, an association with caustic, per se, is not consistent with prior observations made by others. Diminished risk estimates were observed for employment in magnesium production and for exposures in this process to sulfur dioxide and heat. Both the increased and decreased risks, while statistically significant, are based on small numbers of exposed subjects and may be spurious owing to the problem of multiple comparisons.

Case-control study of brain tumor deaths among employees at a chemical manufacturing plant.

Recent studies have reported an increased risk of death from primary intracranial neoplasms among employees in the petrochemical industry. One of them, a NIOSH/OSHA county-based case-control study, suggested a twofold risk for having ever been employed at the Texas Division of Dow Chemical U.S.A. Using the case-control approach, we compared 24 brain tumor cases among employees at this large, diverse chemical plant in Texas with two sets of age-, race-, and sex-matched controls to determine if a risk could be associated with job assignment in a particular process area, with presumptive exposure to a major process chemical, or with a number of other occupationally related and unrelated variables. Results implicated no specific area or chemical. The only significant findings were an elevated odds for being hired prior to 1950 and a negative correlation with employment greater than 10 years. Further, preliminary calculations of expected deaths from primary intracranial neoplasms among the employee cohort suggested there was no excessive risk.