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Notes: Abstract  The potential for risky sexual behaviors and adolescent unplanned pregnancy has become a main concern in the health care system for aborigines in eastern Taiwan. Using aboriginal nurses to provide information on sexual behaviors may have potential as a means of promoting healthy sexual practices among aborigines. This study explored aboriginal nurses' perceptions of facilitators and barriers for taking a sexual history. Several health centers in eastern Taiwan were randomly selected to recruit subjects in 2000. A self-report questionnaire was administered to 206 female nurses (age = 28.4, SD = 7.4) who worked in various clinical units. These aboriginal nurses perceive the major facilitators in taking a sexual history to be having attended a communication training course and experiencing a needle stick accident; they want to prevent themselves or colleagues from becoming infected. The major perceived barriers to taking sexual history result from patients' feeling embarrassed and not knowing how to answer the questions and patients' purposely concealing information. Decreasing these barriers and reinforcing facilitators about taking a sexual history is an important task for nursing education, and nurses can play an important role in promoting aborigines' sexual health and decreasing the prevalence of sexually transmitted diseases in this population.

Notes: Abstract  This descriptive-correlational study examined the Transtheoretical Model (TTM) of behavior change in relationship to the physical activity behavior of mothers receiving assistance from the Women, Infants, and Children program. A purposive sample (N = 30) of six women at each of the five stages of readiness for behavior change was used. Relationships between stage of behavior change (measured using the Stage of Exercise Adoption tool) and other TTM constructs were examined. The constructs and corresponding instruments included physical activity behavior (Seven-Day Physical Activity Recall), pros, cons, decisional balance (Exercise Benefits/Barriers Scale and two open-ended questions), self-efficacy (Self-efficacy for Exercise scale), and processes of behavior change (Processes of Exercise Adoption tool and the Social Support for Exercise scale). Significant relationships were found between stage of behavior change and two physical activity energy expenditure indices (rs = 0.71–0.73, p 〈 0.01), daily minutes of moderate to very hard physical activity (rs = 0.81, p 〈 0.01), pros (rs = 0.56, p 〈 0.01), cons (rs = −0.52, p 〈 0.05), decisional balance (rs = 0.56, p 〈 0.01), and self-efficacy (rs = 0.56, p 〈 0.01). Use of the 10 processes of change differed by stage of change. Pros to physical activity included a sense of accomplishment, increased strength, stress relief, and getting in shape after pregnancy. Cons included fatigue, childcare, and cold weather. Results support the TTM as relevant to WIC mothers and suggest strategies to increase physical activity in this population.

Notes: Abstract  The purpose of this pilot study was to gather information on Arab American adolescent tobacco use behavior. This information was used to modify the Project Toward No Tobacco Use cessation program so that it would reflect the cultural values of Arab American youths. Focus group interviews were conducted to collect qualitative data from 28 Arab American adolescents between the ages of 14 and 18 years. The number of participants in the focus groups ranged from three to eight; four sessions were conducted. A moderator, fluent in Arabic and English, facilitated the group's interactions. Each group addressed five interview questions. Discussions were audiotaped and transcribed with the expressed permission of study participants. Qualitative analysis consisted of careful reading of the transcripts and of the field notes for the purpose of identifying recurring themes around tobacco use. Those that emerged were Being Cool; Being able to “Nshar ma'a al shabab” (hang out with the guys); Present Orientation; Smoking feels good, tastes good, and keeps your mind off trouble; Availability and Accessibility of tobacco; and Barriers to Smoking Cessation Programs. The results of the focus group discussions provided valuable information about the tobacco use perceptions and behaviors of Arab American adolescents and the youths' need for a culturally relevant smoking cessation program.

Notes: Abstract  This article describes the outcomes at 1 year for a randomized clinical trial of Resources, Education and Care in the Home—Futures: a program to reduce infant mortality through home visits by a team of trained community residents led by a nurse. Low-income, inner-city pregnant women who self-identified as African American or Mexican American were recruited in two university prenatal clinics in Chicago. Because African Americans and Mexican Americans differed greatly at intake, we compared their outcomes at 12 months and then examined the effects of the intervention separately for these two groups. Participants were randomly assigned to the intervention or control group and were interviewed during the last trimester of pregnancy and at 2, 6, and 12 months after birth. The effects of the program varied by race/ethnicity. For African Americans, the program was associated with better maternal documentation of infant immunizations, more developmentally appropriate parenting expectations, and higher 12-month infant mental development scores. For Mexican Americans, the program had positive effects on maternal daily living skills and on the play materials subscale of the Home Observation for the Measurement of the Environment assessment. This study, along with previous research, suggests that home visits by a nurse-health advocate team can improve maternal and infant outcomes even for inner-city, low-income, minority families. Effective programs must be culturally sensitive, intensive, and adequately staffed and financed.

Notes: Abstract  Jane Elizabeth Hitchcock was one of many distinguished nursing leaders of the 19th and early 20th centuries who attended a women's college before enrolling in a nurse training school. Like many of her contemporaries with equally impeccable family credentials, Hitchcock was something of an enigma to her family for choosing nursing over teaching, the most common acceptable career for women of her social class. Hitchcock's endowment of character, according to contemporary Lavinia Dock, exemplified the best of her Puritan roots. Her contributions to the evolution of public health nursing and the integration of public health nursing content into curriculums of training schools rivaled the achievements in higher education of her famous father, grandfather, and brother but garnered no comparable recognition. Her life presents an interesting case for analysis of an independent woman, a characteristic shared by many pioneers in the early years of public health nursing: 1893 to 1920.

Notes: Abstract  Parish nursing is a model of nursing care that focuses on health promotion and disease prevention within a faith community. A descriptive study was conducted in the intermountain West to determine how faith communities form parish nursing programs and what their effect is. Thirteen congregations representing eight denominations with parish nurse/health ministries participated. Parish nurses, parish nurse coordinators from two medical centers, pastors, and hospital chaplains (n = 24) were interviewed and provided documents from their programs. Over time, congregations formed parish nursing/health ministries using strategies in a developmental process. The process involved significant support from the pastor, congregation members, and the parish nurses. Collaboration between faith communities and health organizations were successful using a limited domain approach to attain specific health goals. Parish nursing is making a contribution to integrating faith and health practices, promoting health, and increasing accessibility to health care and congregational activities. Conclusions and recommendations are included for future research, practice, and education.

Notes: Abstract  In Western cultures, adverse health effects resulting from providing care for impaired elders is well documented for family caregivers, but little is known about the health of Korean caregivers. This study examined the level of depression and physical health of 120 daughter and daughter-in-law caregivers who cared for cognitively or functionally impaired elderly in Korea. It was hypothesized that cultural factors would have a greater effect on caregivers' health outcomes than noncultural factors, but, contrary to this expectation, the effects of noncultural factors were found to outweigh those of cultural factors. Moreover, the caregivers in this study reported a relatively high level of depression, and more caregivers rated their own health as “poor” than did Western caregivers in previous studies.Family caregiving for the impaired elderly is stressful and negatively affects Korean caregivers' health outcomes regardless of societal values such as filial piety and familism regarding parent care in Korea. Culturally acceptable and sensible support programs may be useful in sustaining long-term care at home by Korean daughter and daughter-in-law caregivers. Further family caregiving studies in the Korean sociocultural context are recommended.

Notes: Abstract  The need to change the sedentary habits of many American adults is well recognized. Middle-aged women are an important target group for increased physical activity because of certain health risks such as osteoporosis. In the current study, 31 women between the ages of 30 and 60 from high- and low-income groups (high-income 〉$50,000; low-income 〈$50,000 per year) took part in a physical activity intervention. The goal was to increase walking activity to a minimum of 90 min per week. Each woman received 16 telephone calls over a 6-month period in which she was asked to reflect upon the benefits of walking, goal setting, restructuring plans, social support, exercise efficacy, relapse prevention, and maintenance. Content analysis revealed a number of themes emerging from intervention conversations. There were differences between races in walking location and walking partners. Furthermore, there were differences between income groups in beliefs about the benefits of walking and social support. Overall, the intervention appeared to provide a basis for women to develop a walking routine. The women were able to reflect upon their walking routine and attempts to begin a walking routine and to identify how each component of the intervention affected their individual daily routine.

Notes: Abstract  The purpose of this study was to describe the primary and secondary health promotion activities of a group of older adults living independently in a continuing care retirement community. Primary and secondary health promotion activities were described and compared among the young old (ages 65–80), the old (ages 81–85), and the old-old (ages 86–101). Model testing of the factors that influence participation in health-promoting activities was also completed. This descriptive study included 206 of 210 residents who participated in a single face-to-face interview. The majority of the participants were female (79%), white (99%), and cognitively intact. Those in the old-old age group were less likely than the old and young-old groups to have: (1) their stools checked for occult blood; (2) their skin checked for lesions; or (3) a recent mammogram, Pap test, or prostate exam. Model testing found that age, chronic illnesses, degree of physical and mental health, and cognitive status directly or indirectly influenced older adults' participation in primary and secondary health behaviors.

Notes: Abstract  Findings are presented from focus group data collected during a larger study describing factors that inhibit, support, and sustain women's abilities to leave and stay out of abusive relationships. A subset (n = 24) of the larger study sample (N = 40) participated in one of four focus groups. Participants had left or were currently in abusive intimate relationships. Women reported diverse experiences and were in various stages of abusive relationships. Ages ranged from 21 to 51; 67% were Caucasian, and 20% African American. Most women (71%) had at least a high school education and were employed (60%), but 83% reported annual incomes less than $20,000. NVIVO software facilitated content analysis of transcriptions. After initial synthesis of data, 20 women participated in one of two confirmatory focus groups. Four primary themes emerged from the content analysis: (1) Living an Unnatural Experience included maladaptive physical and emotional responses to chronic violence; (2) The Experience of Telling included multiple intrapersonal, interpersonal, and societal barriers to disclosure; (3) The Experience of Leaving included descriptions of acute and long-term experiences and difficulties; and (4) Reducing Barriers included participant ideas on ways to reduce barriers to assistance. Recommendations are made to improve community interventions and programs that will facilitate the choices and enhance the successes of women who have experienced domestic violence.

Notes: Abstract Three experiments were undertaken to investigate the influence of seed mixture on the establishment of a target grassland community on a site with high available phosphorus. In the first experiment autumn- and spring-sown commercial seed mixtures were compared with seed harvested from a nature reserve with respect to their ability to produce an inundation grassland community similar to that described by the British National Vegetation Classification (NVC) as Agrostis stolonifera–Alopecurus geniculatus grassland (MG13). In the second experiment the composition and sowing rate of a commercial seed mixture were altered to investigate whether these factors were significant in the establishment of a sward similar to MG13. Similarly, in the third experiment the composition of a commercial seed mixture designed to achieve an alternative community, Cynosurus cristatus–Caltha palustris grassland (NVC code MG8), was sown. The vegetation resulting from each of these treatments was monitored with permanent quadrats for a 3-year period, and the hydrological regime of each quadrat location was modeled and quantified. The results showed that seed mixture, timing of sowing, and seeding rate had an initial effect on the vegetation that established. However, by the third year of monitoring there were no significant differences between these treatments, and hydrological regime had become the most important factor in determining the distribution of species. The vegetation was less diverse than predicted from germination tests and decreased in diversity over the monitoring period. It is suggested that this may be a result of the hydrological regime being unsuitable for several of the sown species or due to the extremely high available phosphorus concentration in the soil. This study highlights the need to understand the soil and hydrological conditions of a site before choosing a target community and designing a seed mixture.

Notes: Abstract Introduced perennial grasses are one of the greatest constraints to prairie restoration. Herbicides suppress but do not eliminate introduced grasses, so we explored the interaction of herbicide with two additional controls: heavy clipping (to simulate grazing) and competition from native species. A 50-year-old stand of the introduced perennial grass Agropyron cristatum (crested wheatgrass) in the northern Great Plains was seeded with native grasses and treated with herbicide annually for 7 years in a factorial experiment. Clipping was applied as a subplot treatment in the final 3 years. Both herbicide and clipping significantly reduced the cover of A. cristatum, but clipping produced an immediate and consistent decrease, whereas herbicide control varied among years. The cover of A. cristatum decreased significantly with increasing cover of a seeded native grass, Bouteloua gracilis (blue grama), suggesting that both top-down (i.e., grazing) and bottom-up (i.e., resource competition) strategies can contribute to A. cristatum control. No treatment had any effect on the seed bank of A. cristatum. Even in the most effective control treatments, A. cristatum persisted at low amounts (approximately 5% cover) throughout the experiment. The cover of B. gracilis increased significantly with seed addition and herbicide, and, after 7 years, was similar to that in undisturbed prairie. The total cover of native species increased significantly with clipping and herbicide, and species richness was significantly higher in plots receiving herbicide. Clipping season had no effect on any variable. In summary, no method extirpated A. cristatum, but clipping reduced its cover by 90% and doubled the cover of native species. Extirpation might not be a realistic goal, but relatively simple management allowed coexistence of native species.

Notes: Abstract The reduction and fragmentation of forest habitats is expected to have profound effects on plant species diversity as a consequence of the decreased area and increased isolation of the remnant patches. To stop the ongoing process of forest fragmentation, much attention has been given recently to the restoration of forest habitat. The present study investigates restoration possibilities of recently established patches with respect to their geographical isolation. Because seed dispersal events over 100 m are considered to be of long distance, a threshold value of 100 m between recent and old woodland was chosen to define isolation. Total species richness, individual patch species richness, frequency distributions in species occurrences, and patch occupancy patterns of individual species were significantly different among isolated and nonisolated stands. In the short term no high species richness is to be expected in isolated stands. Establishing new forests adjacent to existing woodland ensures higher survival probabilities of existing populations. In the long term, however, the importance of long-distance seed dispersal should not be underestimated because most species showed occasional long-distance seed dispersal. A clear distinction should be made between populations colonizing adjacent patches and patches isolated from old woodland. The colonization of isolated stands may have important effects on the dynamics and diversity of forest networks, and more attention should be directed toward the genetic traits and viability of founding populations in isolated stands.

Notes: Abstract The effects of the earthworm Pontoscolex corethrurus (Muller) on the rate of mineralization of cattle dung-amended iron (Fe2+) ore mine wastes and its preference for partially decomposed leaf litter with contrasting chemical composition were studied in pot trials. The growth and survival rates of earthworms showed significant positive correlations with percent of organic matter. During 96 days of exposure, the earthworms significantly increased exchangeable Ca2+, Mg2+, PO43− and NH4-N. Iron ore mine wastes amended with 5–10% organic matter supported earthworm fauna better than mine wastes amended with 0–3% organic matter. The leaf litter preference shown by the earthworm was, in descending order, Phyllanthus reticulatus, Tamarindus indica, Anacardium occidentale, Casuarina equisetifolia, Acacia auriculiformis, and Eucalyptus camaldulensis. A significant positive correlation was observed between the survival and growth rates of earthworms and the nutrient contents of partially decomposed leaf litter. The first three plant species were significantly richer in nutrients, mainly organic carbon, calcium, phosphorus, and nitrogen, than the other two plant species. Acacia auriculiformis and E. camaldulensis litter were preferred less because of their high lignin and polyphenolic compounds, despite being rich in other macronutrients like nitrogen and phosphorus. It is concluded that the introduction of P. corethrurus to cattle dung-amended (5–10%) iron ore mine wastes or revegetation of the sites with P. reticulatus, T. indica, and A. occidentale plant species should be attempted before earthworm introduction. The litter from these species acts as a source of food for earthworms, thereby hastening the process of restoration of abandoned iron ore mines of Goa, India.

Notes: Abstract River and stream rehabilitation projects are increasing in number, but the success or failure of these projects has rarely been evaluated, and the extent to which buffers can restore riparian and stream function and species composition is not well understood. In New Zealand the widespread conversion of forest to agricultural land has caused degradation of streams and riparian ecosystems. We assessed nine riparian buffer zone schemes in North Island, New Zealand that had been fenced and planted (age range from 2 to 24 years) and compared them with unbuffered control reaches upstream or nearby. Macroinvertebrate community composition was our prime indicator of water and habitat quality and ecological functioning, but we also assessed a range of physical and water quality variables within the stream and in the riparian zone. Generally, streams within buffer zones showed rapid improvements in visual water clarity and channel stability, but nutrient and fecal contamination responses were variable. Significant changes in macroinvertebrate communities toward “clean water” or native forest communities did not occur at most of the study sites. Improvement in invertebrate communities appeared to be most strongly linked to decreases in water temperature, suggesting that restoration of in-stream communities would only be achieved after canopy closure, with long buffer lengths, and protection of headwater tributaries. Expectations of riparian restoration efforts should be tempered by (1) time scales and (2) spatial arrangement of planted reaches, either within a catchment or with consideration of their proximity to source areas of recolonists.

Notes: Abstract One of the greatest challenges for ecologists this century will be restoring forests on degraded tropical lands. This restoration will require understanding complex processes that shape successional pathways, including interactions between trees and other plants. Shrub species often quickly invade disturbed tropical lands, yet little is known about whether they facilitate or inhibit subsequent tree recruitment and growth. We examined how shrubs and other vegetation (e.g., vines, grasses, herbs) affect tree recruitment, survival, and growth during the first 6 years of forest succession in Kibale National Park, Uganda. The study was undertaken in two recently logged exotic softwood plantations. We studied the successional trajectories in two recently logged areas that varied in their initial densities of trees and shrubs. Analyses suggested tree seedling presence and density were not strongly related to shrub density or height during succession. Tree sapling presence and density were positively significantly related to shrub density and height. We found little response in the tree community to experimental shrub removal, and although removal of all nontree vegetation temporarily enhanced tree growth, the effect disappeared after 2 years. Some early-successional trees benefited from reduced competition, whereas some mid-successional trees benefited from the presence of other vegetation. Some specific tree species responded strongly to vegetation removal. We interpret our findings in light of designing manipulations promoting forest restoration for biodiversity conservation and conclude with four tentative guidelines: (1) manage at the species level, not the community level; (2) increase facilitation for seedlings, reduce competition for saplings; (3) be cautious of assumptions about plant interactions; and (4) be adaptable and creative with new strategies when manipulations fail.

Notes: Abstract Soil chemical properties and soil mesofauna composition were assessed at a forest site in northern Austria, where 20 years earlier an amelioration treatment had been performed. The site had been treated with limestone, a high P slag, and ammonium nitrate to replace the poorly growing pine (Pinus sylvestris) forest with a Norway spruce (Picea abies) stand. This treatment was at that time a common means for the amelioration of nutrient-poor forest soils with recalcitrant forest floor layers. After treatment, a dense cover of a nitrophilic stinging nettle (Urtica dioica) developed. Most likely, the site had been over-fertilized, and inadvertently, an experiment with extreme N enrichment had been conducted. The abundance of collembolans increased, and dominance structure shifted from Isotomiella minor, Lipothrix lubbocki, and Isotoma notabilis at fertilizer treatment to Friesea mirabilis, Isotomiella minor, and Sphaeridia pumilis in the control, but the abundance of soil mesofauna generally decreased in the fertilizer treatment. Fertilization reduced the mass of the litter layer from 7.6 to 2.4 kg/m2. The total carbon pool in the soil was reduced due to reduction of the litter layer. However, the content of soil organic matter in the upper mineral soil was significantly increased. A part of the applied and mineralized nitrogen had been lost from the soil, but N retention in the upper mineral soil was still considerable. Soil pH and the base saturation were sustainably increased. Carbon losses upon mineralization of the litter layer were not offset by the increase in C content of the mineral soil. Presently, the C pool in the soil of the fertilized treatment is lower than in the control. However, the overall nutrient enrichment of the soil may facilitate C sequestration in the fertilized site in the future.

Notes: Abstract Poor growth of Quercus robur L. (oak) trees has been reported on mine sites where overburden and subsoil have been used in the reinstatement of surface layers. This stunting has been attributed to a lack of macronutrients and to an adverse soil environment for root growth and mycorrhizal development. Growth, mineral nutrition, and ectomycorrhizal colonization of Q. robur seedlings were studied in an experiment carried out under controlled growing conditions in which mine spoil material was enriched with a leaf litter mulch. Enrichment of mine spoil material was found to produce a significant increase in growth and foliar N concentrations of oak seedlings. Inoculation with three taxa of ectomycorrhizal fungi did not benefit seedlings when mine spoil was the only substrate, possibly due to the poor physical properties of the unamended spoil and lack of nutrients. Inoculation with two taxa, Laccaria laccata and Hebeloma crustuliniforme, isolated from 3-year-old trees produced a significant stimulation of growth in the organically enriched treatment, which was believed to be due to greater uptake of mineralized N. However, Cortinarius anomalus isolated from fruit bodies associated with a 15-year-old tree did not increase biomass. The presence of organic matter was found to result in a significant stimulation of mycorrhizal infection by both inoculum and contaminant mycobionts. Recommendations are made for improving the establishment and growth of oak seedlings on reinstated sites.

Notes: Abstract Prairie restoration at the northern edge of the Great Plains can be frustrated by previously established non-native perennial grasses. We compared the emergence of a widely introduced grass, Agropyron cristatum, and a common native grass, Bouteloua gracilis, in a 4-year-old field experiment in which the Agropyron-dominated vegetation had either been left intact or treated annually with herbicide. This was done at two levels of water supply, reflecting conditions expected in wet and dry years, to examine the effects of among-year variability in precipitation. Water addition significantly increased the emergence of both surface-sown and buried (1 cm deep) seeds. Herbicide treatment of neighbors did not increase the emergence of experimentally added seeds. Emergence was much greater for buried (80%) than surface-sown seeds (20%). Significantly more Bouteloua than Agropyron germinated from experimentally buried seeds. Whereas only a single seedling of Bouteloua emerged from the existing seed bank, the mean density of Agropyron seedlings emerging from the seed bank was 930/m2 (range, 0 to 6,455/m2). Surprisingly, the emergence of Agropyron from the seed bank was not decreased by 4 years of herbicide treatment, possibly because herbicide may release Agropyron from intraspecific competition and allow increased seed production to compensate for decreased plant abundance. In summary, we found few differences between Agropyron and Bouteloua in spring and summer emergence at high or low water availability. The persistence of Agropyron stands despite repeated herbicide application may be partly due to increased seed production.

Notes: Abstract The effect of increasing planting unit size and stabilizing sediment was examined for two seagrass planting methods at Carnac Island, Western Australia in 1993. The staple method (sprigs) was used to transplant Amphibolis griffithii (J. M. Black) den Hartog and the plug method was used to transplant A. griffithii and Posidonia sinuosa Cambridge and Kuo. Transplant size was varied by increasing the number of rhizomes incorporated into a staple and increasing the diameter of plugs. Planting units were transplanted into bare sand, back into the original donor seagrass bed, or into a meadow of Heterozostera tasmanica, which is an important colonizing species. Sprigs of A. griffithii were extracted from a monospecific meadow; tied into bundles of 1, 2, 5, and 10 rhizomes; and planted into unvegetated areas. Half the units were surrounded by plastic mesh and the remainder were unmeshed. All treatments were lost within 99 days after transplanting, and although larger bundles survived better than smaller ones, no significant differences could be attributed to the effects of mesh or sprig size. Plugs of P. sinuosa and A. griffithii were extracted from monospecific meadows using polyvinyl chloride pipe of three diameters, 5, 10, and 15 cm, and planted into unvegetated areas nearby. Half the units were surrounded by plastic mesh and the remainder were unmeshed. Posidonia sinuosa plugs were also placed within a meadow of H. tasmanica (Martens ex Aschers.) den Hartog. Only 60% of A. griffithii plug sizes survived 350 days after transplanting back into the donor bed; however, survival of transplants at unvegetated areas varied considerably, and analysis of variance indicated a significant two-way interaction between treatment and plug size. Transplants survived better when meshed (90% survived) and survival improved with increasing plug size. Posidonia sinuosa transplants survived poorly (no plugs survived beyond 220 days in bare or meshed treatments) regardless of size. Survival of 10- and 15-cm plugs was markedly better than the 5-cm plugs in vegetated areas, including the H. tasmanica meadow. The use of large seagrass plugs may be appropriate for transplantation in high-energy wave environments.

Notes: Abstract Dominance-diversity curves have been previously constructed for a range of ecosystems around the world to illustrate the dominance of particular species and show how their relative abundances compare between communities separated in time or space. We investigate the usefulness of dominance-diversity curves in rehabilitated areas to compare the floristic composition and abundance of “undisturbed” areas with disturbed areas, using bauxite mining rehabilitation in Western Australia as an example. Rehabilitated pits (11–13 years old) subjected to prescribed fire in autumn and spring were compared with unburned rehabilitated areas and the native jarrah (Eucalyptus marginata) forest. Dominance diversity curves were constructed by ranking the log of the species density values from highest to lowest. Species were categorized according to a variety of functional responses: life form (trees, shrubs, subshrubs, and annuals), fire response syndrome (seeder or resprouter), nitrogen fixing capability, and origin (native or adventive). Exponential functions showed extremely good fits for all sites (r2 = 0.939–0.995). Dominance diversity graphs showed that after burning of rehabilitated areas, sites exhibited a more similar dominance-diversity curve than before burning. This was emphasized in a classification (UPGMA) of the regression equations from the dominance-diversity curves that showed that sites burned in spring were more similar to the native forest than sites burned in autumn. There was no significant segregation of the nitrogen-fixing and species origin categories, although the life form and fire response groupings showed significant segregation along the dominance-diversity curve. Resprouters tended to be over-represented in the lower quartiles and under-represented in the upper quartiles of post-burn sites. It is suggested that using dominance-diversity curves in the monitoring of rehabilitated areas may be a useful approach because it provides an easily interpretable visual representation of both species richness and abundance relationships and may be further utilized to emphasize categories of plants that are over- or under-represented in rehabilitated areas. This will assist in the post-rehabilitation management of these sites.

Notes: Abstract The wave-exposed nature of much of the southwestern Australian coastline considerably reduces the protective influence of seagrasses, and sediment movement appears to be relatively unaffected by their presence. Present seagrass restoration efforts focus on the deployment of large mechanically transplanted “sods” of seagrass as a means of combating the negative effects of water motion on transplant survival. The aim of this study was to investigate the combined role of wave energy and transplant spacing on sediment movement and transplant survival to provide guidance for seagrass transplantation in areas of high wave energy. One hundred sixty sods (0.25 m2) of seagrass were mechanically extracted from a mixed meadow consisting of Amphibolis griffithii (Cymodoceaceae) and Posidonia coriacea (Posidoniaceae) and planted in a high wave energy site with the treatments configured as three replicates of 16 sods placed in 4 × 4–meter squares at distances of 0.5, 1.0, and 2.0 meters apart. An additional 16 single sods were planted randomly throughout the site. Monitoring was conducted at two monthly intervals and consisted of counting the number of sods surviving and measuring the shoot density of seagrass species within each surviving sod. Sediment height was monitored using a series of sediment plates and an electronic sediment level sensor. Sod spacing had no significant effect upon transplant survival, which remained above 90% for 4 months after transplantation and then declined with the onset of winter (June to August). After 14 months individual sod survival was between 9% and 40%. Initial shoot densities were 200 to 500 shoots/m2 and declined to less than 50 shoots/m2. Sediment fluctuations up to 35 cm were noted, occasionally taking place over a matter of hours, and storms during winter caused significantly increased sediment movement. This probably curtailed rhizome extension and prevented the expansion of the transplants. This study indicates that the ability of seagrasses to influence sediment would appear to vary with the prevailing hydrodynamic regime and that a reappraisal of the notion that all seagrass communities trap sediment is necessary.

Notes: The synthetic compound DX-9065a represents a low molecular weight, direct, competitive inhibitor of factor Xa (FXa) with a high affinity and selectivity for the enzyme. Under experimental conditions DX-9065a exerts strong anticoagulant actions in vitro and in vivo and is antithrombotically effective in various thrombosis models. It inhibits proliferation of vascular smooth muscle cells in cell culture systems as well as in in vivo models. As a small molecule inhibitor, DX-9065a inactivates both free and fibrin-bound FXa. By this mechanism it effectively affects the clot-associated procoagulant activity which might be responsible for the propagation of intravascular thrombi as well as for recurrent thrombosis and thrombotic reocclusion after lysis. Although DX-9065a is effective after oral administration, its oral bioavailability is relatively low and seems not to be sufficient for a long-term therapeutic use of the drug. However, first clinical trials in healthy volunteers and in patients with cardiovascular diseases demonstrated a predictable pharmacokinetic and pharmacodynamic behavior of DX-9065a after either intravenous bolus injection or constant infusion, as well as its high safety, especially a lower bleeding risk compared with other commonly used drugs. Further experimental studies and ongoing clinical trials will evaluate the inhibitory profile of the drug, its effectiveness and its possible superiority over other drug regimens in various cardiovascular indications.

Notes: Endothelins are powerful vasoconstrictor agents produced by endothelial cells and identified by Yanagisawa et al. in 1988. Two types of receptors for endothelins have been identified: ETA receptors are located on smooth muscle cells of the vascular wall and are responsible for endothelin-induced vasoconstriction while ET B receptors are located on endothelial cells and induce these cells to release NO and prostacyclin. Moreover, these peptides not only cause a potent and prolonged vasoconstriction but are also known to enhance cell proliferation and to stimulate extracellular matrix accumulation. High levels of plasma or tissue endothelins have been found in patients with heart failure, diabetes, stroke, primary pulmonary hypertension, liver cirrhosis and other diseases. Given these effects of endothelins, blocking their receptors might be a new way to reduce blood pressure and to treat other illnesses. Accordingly, many endothelin antagonists have been developed and evaluated in animals and humans. Enrasentan is a mixed ETA and ETB receptor antagonist with a higher affinity for ETA receptors, although it cannot be considered a selective antagonist. In an animal model of hypertension and cardiac hypertrophy the drug has reduced blood pressure, prevented cardiac hypertrophy and preserved myocardial function. In rats with hyperinsulinemia and hypertension enrasentan normalized blood pressure and prevented cardiac and renal damage. In rats with stroke the drug reduced the ischemic area in the brain. Enrasentan has been added to conventional treatment in patients with heart failure (NYHA Class 2-3) and no addictive effect of the drug has been observed. This is in contrast with results obtained in animal models and still has not been explained. In conclusion, many possible clinical applications can be suggested for this drug, but further studies are necessary to better evaluate its therapeutic efficacy.

Notes: Significant numbers of patients at risk for coronary heart disease (CHD) fail to reach National Cholesterol Education Program (NCEP)-designated low density lipoprotein cholesterol (LDL-C) goals in spite of the wide range of currently available treatments, including combination therapies. Ezetimibe, the first in a class of novel cholesterol absorption inhibitors, demonstrated lipid-lowering and antiatherosclerotic activity in experimental and clinical hypercholesterolemia. Studies in hypercholesterolemic dogs showed that ezetimibe coadministered with statins caused greater lipid-lowering effects compared to either drug alone. These effects were confirmed in clinical studies of patients with primary hypercholesterolemia where initiation of treatment with ezetimibe plus a statin, or addition of ezetimibe to ongoing statin therapy, produced significant incremental reductions in LDL-C, as well as incremental increases in high-density lipoprotein cholesterol (HDL-C) and reductions in triglyceride levels. Combination therapy also significantly increased the number of patients attaining LDL-C goal at the end of treatment, compared to statin monotherapy. In studies using simvastatin, atorvastatin, pravastatin, and lovastatin, addition of ezetimibe to low dose statin was as effective as a 2- to 3-fold upward titration of the corresponding statin dose. Ezetimibe-statin combination therapy provided similar improvements in patients with primary hypercholesterolemia, as well as with heterozygous and homozygous familial hypercholesterolemia. Ezetimibe monotherapy effectively reduced plasma campesterol and sitosterol in patients with homozygous sitosterolemia. Clinical studies showed that ezetimibe was well tolerated, with a safety profile comparable to placebo when administered as monotherapy and comparable to statin alone when coadministered with a statin. These data provide strong evidence that, through their complementary lipid-lowering mechanisms, ezetimibe coadministered with a statin offers an effective combination treatment option for patients with hypercholesterolemia, including those with genetically inherited disease.

Notes: FM-VP4 is a novel inhibitor of cholesterol absorption that has lipid lowering and body weight reducing properties. In vitro and in vivo studies were performed to investigate the lipid-lowering effects, mechanism of action, pharmacokinetics, and toxicity of FM-VP4. FM-VP4 decreased cholesterol accumulation in Caco-2 cells by approximately 50%; its activity appeared to be independent of pancreatic lipase, p-glycoprotein, or cholesterol incorporation in micelles. In animal studies, FM-VP4 was added to the diet or drinking water and the following results were obtained. In gerbils 2% FM-VP4 produced mean 56 and 53% reduction in total cholesterol (TC) after 4 and 8 weeks, respectively. This reduction was entirely due to the loss of the low-density lipoprotein (LDL) pool, which was reduced to undetectable levels at either time point. At 8 weeks, high-density lipoprotein (HDL) concentration had risen by a mean of 34% whereas total triglyceride (TG) concentrations had decreased by a mean of 60%. FM-VP4 also had a profound effect on body weight in these animals. At 8 weeks, the mean body weight was in the 4% FM-VP4 treatment group 25% lower than in the control group. No hepatic or renal toxicity was associated with these changes. In Apo E-deficient mice, after 4- and 8-week treatments FM-VP4 caused a significant decrease in both TC and TG concentrations compared to controls. After 12 weeks, the areas of atherosclerotic lesion involvement in the aortic roots were decreased by a mean of 80% in the 0.5, 1, and 2% FM-VP4 treatment groups compared to controls. Taken together, these results suggest that FM-VP4 is a potential new drug with lipid-lowering and weight loss potential, without apparent toxicity.

Notes: The use of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, statins, has been shown to reduce major cardiovascular events in both primary and secondary prevention, and statins became one of the most widely prescribed classes of drugs throughout the world. Previously, statins have been well tolerated and have shown favorable safety profiles. However, the voluntary withdrawal of cerivastatin from the market because of a disproportionate number of reports of rhabdomyolysis-associated deaths drew attention to the pharmacokinetic profile of statins, which may possibly have been related to serious drug-drug interactions.Pitavastatin (NK-104, previously called itavastatin or nisvastatin, Kowa Company Ltd., Tokyo) is a novel, fully synthetic statin, which has a potent cholesterol-lowering action. The short-term and long-term lipid-modifying effects of pitavastatin have already been investigated in subjects with primary hypercholesterolemia, heterozygous familial hypercholesterolemia, hypertriglyceridemia, and type-2 diabetes mellitus accompanied by hyperlipidemia. Within the range of daily doses from 1 to 4 mg, the efficacy of pitavastatin as a lipid-lowering drug seems to be similar, or potentially superior, to that of atorvastatin.According to the results of pharmacokinetic studies, pitavastatin showed favorable and promising safety profile; it was only slightly metabolized by the cytochrome P450 (CYP) system, its lactone form had no inhibitory effects on the CYP3A4-mediated metabolism of concomitantly administered drugs; P-glycoprotein-mediated transport did not play a major role in its disposition, and pitavastatin did not inhibit P-glycoprotein activity.It could be concluded that pitavastatin could provide a new and potentially better thera-peutic choice for lipid-modifying therapy than do the currently available statins. The ef-ficacy and safety of higher dose treatment, as well as its long-term effects in the pre-vention of coronary artery disease, should be further investigated.

Notes: Lipoprotein lipase (LPL) is a rate-limiting enzyme that hydrolyzes circulating triglyceride-rich lipoproteins such as very low-density lipoproteins and chylomicrons. A decrease in LPL activity is associated with an increase in plasma triglycerides (TG) and a decrease in plasma high-density lipoprotein cholesterol (HDL-C). The increase in plasma TG and decrease in plasma HDL-C are risk factors for cardiovascular disease. Tsutsumi et al. hypothesized that elevating LPL activity would cause a reduction of plasma TG and an increase in plasma HDL-C, resulting in protection against the development of atherosclerosis. To test this hypothesis, Otsuka Pharmaceutical Factory, Inc. synthesized the LPL activator NO-1886.NO-1886 increased LPL mRNA and LPL activity in adipose tissue, myocardium and skeletal muscle, resulting in an elevation of postheparin plasma LPL activity and LPL mass in rats. NO-1886 also decreased plasma TG concentration and caused a concomitant rise in plasma HDL-C. Long-term administration of NO-1886 to rats and rabbits with experimental atherosclerosis inhibited the development of atherosclerotic lesions in coronary arteries and aortas. Multiple regression analysis suggested that the increase in plasma HDL-C and the decrease in plasma TG protect from atherosclerosis. The atherogenic lipid profile is changed to an antiatherogenic profile by increasing LPL activity, resulting in protection from atherosclerosis. Therefore, the LPL activator NO-1886 or other possible LPL activating agents are potentially beneficial for the treatment of hyper-triglyceridemia, hypo-HDL cholesterolemia, and protection from atherosclerosis.

Notes: Avasimibe is a novel orally bioavailable ACAT inhibitor, currently under clinical development (phase III trials). It was safe when administered to rats, dogs, and humans. In vitro studies in human macrophages demonstrated that avasimibe reduces foam cell formation not only by enhancing free cholesterol efflux, but also by inhibiting the uptake of modified LDL. The concentration-dependent reduction in cellular cholesteryl ester content in these cells was not accompanied by an increase in intracellular free cholesterol, which is in agreement with a good safety profile for avasimibe. In the liver, avasimibe caused a significant reduction in the secretion of apo B and apo B-containing lipoproteins into plasma. Avasimibe induced cholesterol 7α-hydroxylase and increased bile acid synthesis in cultured rat hepatocytes, and its administration to rats did not produce an increase in lithogenicity index of the bile. The hypolipidemic efficacy of the compound was demonstrated in cholesterol-fed as well as in non-cholesterol-fed animals. In these models, plasma cholesterol levels were reduced, mainly due to the decrease in the non-HDL cholesterol fraction. Clinical data are scarce, but in a study performed in 130 men and women with combined hyperlipidemia and hypoalphalipoproteinemia, avasimibe, 50–500 mg/day, significantly reduced plasma total triglyceride and VLDL-cholesterol. Although total cholesterol, LDL-cholesterol, and HDL-cholesterol were unchanged, it must be stressed that animal data suggest that avasimibe may have direct antiatherosclerotic activity in addition to its cholesterol-lowering effect. Avasimibe treatment can also contribute to increase plaque stability, as it reduces the accumulation of lipids in the arterial wall, inhibits macrophage infiltration into the media and reduces matrix metalloproteinase expression and activity. Moreover, avasimibe and statins have been shown to have synergistic effects, and the combination therapy may not only inhibit atherosclerotic lesion progression but also induce lesion regression, independently of changes in plasma cholesterol.

Notes: The Angiotensin I converting enzyme (ACE, EC 3.4.14.1, kininase II) and neutral endopeptidases (NEP, NEP 24.11) are mechanistically related metallopeptidases. They play a key role in the regulation of blood pressure, body fluid homeostasis and cell growth. Therefore, they are implicated in the pathogenesis of arterial hypertension, congestive heart failure, left ventricular remodeling after myocardial infarction and other cardiovascular diseases. Furthermore, since these two metallopeptidases possess some subsite and substrate similarities, as indicated by their interaction with certain mercaptoalkanoyl inhibitors, they are regarded as an important common target for pharmacological inhibition with a single drug. MDL 100,240 is a pro-drug that, upon conversion to MDL 100,173, acts as a potent dual inhibitor of ACE and NEP with a balanced activity on both enzymes. Only very limited pharmacokinetic studies with MDL 100,240 have been published. These studies used a high pressure liquid chromatography method with UV absorbance detection to quantify the drug. According to the studies in dogs the terminal t1/2 of MDL 100,173 was 35.7 h. The area under the curve for total MDL 100,173 was nearly 10-fold greater than the sum of the areas under the curve for MDL 100,240 and for unconjugated MDL 100,173. These results support the hypothesis that MDL 100,240 is hydrolyzed in plasma to the active thiol, MDL 100,173, which is rapidly conjugated with endogenous plasma thiols thus providing a pathway for elimination. Studies in vivo in experimental models of hypertension and congestive heart failure confirmed the vasodilatory and natriuretic effects of MDL, which appear to be independent of the degree of activation of the renin-angiotensin-aldosterone system. In addition, MDL 100,240 showed an impressive effectiveness both in preventing and in regressing hypertension-induced vascular remodeling and cardiac hypertrophy. Accordingly, MDL 100,240 is being developed for the treatment of cardiovascular diseases, including hypertension and congestive heart failure. If the promises of this novel therapeutic strategy are fulfilled, clinical trials are expected to demonstrate advantages of MDL 100,240 over pure ACE inhibitors.

Notes: Purpose In 2001, a survey of U.S. dental schools was conducted to determine the curricular structure, teaching philosophies, and techniques used in preclinical removable partial denture (RPD) courses and to also establish what newer educational techniques and materials are currently being used by U.S. dental schools.Materials and Methods The questionnaire was mailed to the chairpersons of the prosthodontic/restorative departments of 54 U.S. dental schools. Of these, 43 schools returned the completed survey, resulting in a response rate of 80%. The mean, median, and range of responses were computed where applicable.Results Results from this survey show that the mean student-to-faculty ratio in the preclinical RPD course was 12:1, with a median of 10:1 and a range of 6:1 to 27:1. The mean number of laboratory hours was 55, with a median of 50 and a range of 13.5 to 120. The mean number of lecture hours reported was 21, with a median of 20.5 and a range 10 to 60. The mean number of practical examinations was 2, with a median of 3 and a range of 0 to 8. The mean number of written examinations given was 2, with a median of 2 and a range of 1 to 6. Ninety-five percent of the schools have prosthodontists teaching this course. The mean number of months that this course is taught is 4.4 months, with a median of 4 and a range of 1.5 to 10. Fifty-five percent of the schools used the Hanau semiadjustable articulator. One hundred percent of the schools teach students to use a surveyor when designing an RPD, and 84% percent of the schools teach the Krol or the Kratochvil RPI design or a combination of the 2 designs.Conclusions Preclinical RPD educational programs vary from school to school, yet a large percentage of schools agree on certain topics. Only 19% of dental schools are incorporating new technologies, such as the use of the internet, in their preclinical RPD curriculum.

Notes: Purpose The purpose of this study was to compare recordings of mandibular movements obtained with a Denar mechanical pantograph to those obtained with a Denar computerized axiograph (Cadiax compact).Materials and Methods Pantographic recordings and computerized axiograms were collected on 10 subjects. All of the subjects had intact dentition and no clinical signs or symptoms of temporomandibular dysfunction. Tracings produced with the 2 instruments were compared using pantographic reproducibility indices (PRIs). Recordings with each instrument were repeated twice and assessed for consistency. Pearson's correlation coefficient was used to compare PRI scores obtained with the pantograph and the axiograph. Recordings with both instruments were repeated 2 weeks to 1 month later, and new PRI scores were calculated. Consistency between initial and second PRI scores for each instrument was assessed using a coefficient of stability.Results The coefficients of stability between the initial and second recordings were r = 0.91 for mechanical pantography and r =−0.06 for computerized axiography. Comparison of recordings made by mechanical pantography and computerized axiography at the initial and second recordings showed poor concordance, with coefficients of 0.23 and −0.11, respectively.Conclusions PRI scores recorded with the mechanical pantograph were consistent between the initial and second recordings. In contrast, recordings with the computerized axiograph appeared highly inconsistent across time. PRI scores calculated from the axiographs were significantly higher than PRI scores calculated from pantographic tracings for the same subject.

Notes: Organizing multiple and varied implant components in preparation for providing treatment for a patient with a complex implant prosthesis can be a challenge to even the most experienced practitioner. The many implant abutment component options available, especially when different sizes and types of abutments will be used in 1 arch, can create confusion for both dentist and assistant, hindering chairside efficiency. This article describes the fabrication and use of a custom chairside implant components organizer.

Notes: To maintain a harmonious craniofacial system, the dental practitioner must establish an appropriate occlusal vertical dimension (OVD). Several methods can be used to determine an appropriate OVD. The patient presenting with decreased OVD represents a particular challenge for the dental practitioner in fabricating conventional dentures. This clinical report describes the use of a diagnostic treatment prosthesis to evaluate the patient's ability to manage such an increase in vertical dimension and to reestablish an appropriate occlusal vertical dimension. The use of a diagnostic treatment prosthesis at a vertical dimension 5 mm greater than what the patient presented with was determined to not cause discomfort over a 2-month period. A conventional complete denture was fabricated based on the patient's ability to handle the increase during the trial period. This report reviews the literature on this topic and describes a clinical technique for reestablishing the OVD in edentulous patients.

Notes: Purpose A survey of recently board-certified prosthodontists was conducted in 2001. The purpose of this survey was to identify trends that assisted candidates in attaining diplomate status.Materials and Methods A questionnaire was mailed to 176 diplomates who had become board certified between the years 1993 and 2001. Of these, 131 board-certified prosthodontists returned the completed survey, resulting in a response rate of 74%. The mean, median, and range of responses were computed when applicable.Results Results from this survey show that the mean number of years from completion of a postdoctoral program to achieving board certification was 6 years, with a median of 4 years and a range of 1 to 23 years. The mean number of years from the time of completion of a postdoctoral program to board eligibility was 2.3 years, with a median of 1 year and a range of 0 to 22 years. The mean number of years from board eligibility to board certification was 3.9 years, with a median of 3 years and a range of 0 to 17 years. The military was the most frequently reported employment status at the time the respondents took Parts 1–4 of the boards. A total of 54% of the diplomates reported that they challenged Part 1 separately, and then challenged Parts 2, 3, and 4 together; 79% of the diplomates were encouraged by their graduate program director/faculty to challenge the board; and 48% of the diplomates reported that their patients received free dental treatment.Conclusions Certain trends were observed regarding diplomates who succeeded in their efforts to challenge the board examination. The largest group who challenged the board certification examinations comprised members of the armed forces. Most prosthodontists challenged Part 1 before challenging the remaining 3 parts. In an effort to encourage more prosthodontists to challenge the board examination, numerous changes were made between 1992 and 1998; however, most of the diplomates did not take advantage of those changes.

Notes: Purpose The purpose of this article was to obtain dentists’ opinions via an Internet survey as to the prevalence, causes, and prevention of postcementation sensitivity and compare their responses with published data on the problem.Materials and Methods Information as to respondents opinions of postcementation sensitivity was obtained from an Internet survey asking about their experience and for a ranking of the importance of each of 15 factors.Results A total of 466 valid responses were received. The incidence of postcementation sensitivity was estimated to be less than 2% by more than 2/3 of the dentists. The factors considered “very important” in reducing sensitivity by more than 50% of the respondents were desiccation, luting agent, occlusion, provisional, and water spray.Conclusions Comparing respondents’ opinions with published clinical studies, the incidence of postcementation sensitivity appears to be underestimated. There is little published evidence to support the importance of antimicrobials, desensitizing, or bonding agents, although these are considered effective by some dentists. Many respondents consider luting agent to be an important variable.

Notes: A new implant analog system that improves the efficiency of the implant restoration's fabrication process is described. This 2-piece analog contains an outer plastic sleeve that is retained within the stone cast. The inner portion, a metal analog, can be easily removed and replaced within the plastic sleeve. Because the metal analog is removable, the time-consuming process of screwing and unscrewing the prosthesis- or abutment-retaining screws during laboratory procedures can be minimized. The prosthesis can remain secured to the analog during waxing, metal finishing, and porcelain buildup, yet is easily removed from the cast for inspection.

Notes: Purpose A new experimental resilient denture liner (MPDS-SL; Lai Laboratories, Burnsville, MN) and Molloplast-B (Buffalo Dental Manufacturing, Syosset, NY) were clinically evaluated for compliance and color change over a 1-year period.Materials and Methods In this crossover study, each of 20 patients had 2 dentures fabricated with long-term, silicone-based resilient liners, 1 denture with Molloplast-B and the other with MPDS-SL. Each denture was used for 6 months, during which time each patient kept a journal detailing his or her use and cleaning regimen. The 2 materials were assessed for compliance and color at the beginning of the study and again after 3 months and 6 months of use. Compliance was determined by applying a 3-lb force to the surface of the material following a square-wave pattern, using a closed-loop servohydraulic testing system. The force and position values were recorded using a storage oscilloscope. Compliance was measured at 3 locations on each denture and analyzed using data-acquisition software. Images of the dentures were captured using a zoom stereomicroscope with a charge-coupled video camera and image analysis software. The color was measured at 3 locations on each denture; RGB and L* a* b* were calculated.Results Compliance increased from baseline to 3 months and from 3 months to 6 months for almost all locations on both materials. Molloplast-B and MPDS-SL differed in average change in compliance at 6 months; the average change in compliance from baseline to 6 months was 453 (standard error, 46) for Molloplast-B and 284 (standard error, 46) for MPDS-SL (p= 0.019). For both materials, color changed significantly from baseline to 3 months and from baseline to 6 months (p 〈0.01). MPDS-SL changed significantly less than Molloplast-B from baseline to 6 months for R (p= 0.039), G (p= 0.037), B (p= 0.005), and L* (p= 0.042).Conclusion For both materials, compliance increased over 6 months of wear. The color change for MPDS-SL was considerably less significant than that for Molloplast-B.

Notes: Recent events have increased awareness of the risk posed by terrorist attacks. Bacillus anthracis has resurfaced in the 21st century as a deadly agent of bioterrorism because of its potential for causing massive civilian casualties. This analysis presents the results of a computer simulation of the dispersion of anthrax spores in a typical 50-story, high-rise building after an intentional release during a bioterrorist incident. The model simulates aerosol dispersion in the case of intensive, small-scale convection, which equalizes the concentration of anthrax spores over the building volume. The model can be used to predict the time interval required for spore dispersion throughout a building after a terrorist attack in a high-rise building. The analysis reveals that an aerosol release of even a relatively small volume of anthrax spores during a terrorist incident has the potential to quickly distribute concentrations that are infectious throughout the building.

Notes: Human health risk assessments use point values to develop risk estimates and thus impart a deterministic character to risk, which, by definition, is a probability phenomenon. The risk estimates are calculated based on individuals and then, using uncertainty factors (UFs), are extrapolated to the population that is characterized by variability. Regulatory agencies have recommended the quantification of the impact of variability in risk assessments through the application of probabilistic methods.In the present study, a framework that deals with the quantitative analysis of uncertainty (U) and variability (V) in target tissue dose in the population was developed by applying probabilistic analysis to physiologically-based toxicokinetic models. The mechanistic parameters that determine kinetics were described with probability density functions (PDFs). Since each PDF depicts the frequency of occurrence of all expected values of each parameter in the population, the combined effects of multiple sources of U/V were accounted for in the estimated distribution of tissue dose in the population, and a unified (adult and child) intraspecies toxicokinetic uncertainty factor UFH-TK was determined.The results show that the proposed framework accounts effectively for U/V in population toxicokinetics. The ratio of the 95th percentile to the 50th percentile of the annual average concentration of the chemical at the target tissue organ (i.e., the UFH-TK) varies with age. The ratio is equivalent to a unified intraspecies toxicokinetic UF, and it is one of the UFs by which the NOAEL can be divided to obtain the RfC/RfD. The 10-fold intraspecies UF is intended to account for uncertainty and variability in toxicokinetics (3.2×) and toxicodynamics (3.2×). This article deals exclusively with toxicokinetic component of UF.The framework provides an alternative to the default methodology and is advantageous in that the evaluation of toxicokinetic variability is based on the distribution of the effective target tissue dose, rather than applied dose. It allows for the replacement of the default adult and children intraspecies UF with toxicokinetic data-derived values and provides accurate chemical-specific estimates for their magnitude. It shows that proper application of probability and toxicokinetic theories can reduce uncertainties when establishing exposure limits for specific compounds and provide better assurance that established limits are adequately protective. It contributes to the development of a probabilistic noncancer risk assessment framework and will ultimately lead to the unification of cancer and noncancer risk assessment methodologies.

Notes: The treatment of uncertainties associated with modeling and risk assessment has recently attracted significant attention. The methodology and guidance for dealing with parameter uncertainty have been fairly well developed and quantitative tools such as Monte Carlo modeling are often recommended. However, the issue of model uncertainty is still rarely addressed in practical applications of risk assessment. The use of several alternative models to derive a range of model outputs or risks is one of a few available techniques. This article addresses the often-overlooked issue of what we call “modeler uncertainty,” i.e., difference in problem formulation, model implementation, and parameter selection originating from subjective interpretation of the problem at hand. This study uses results from the Fruit Working Group, which was created under the International Atomic Energy Agency (IAEA) BIOMASS program (BIOsphere Modeling and ASSessment). Model-model and model-data intercomparisons reviewed in this study were conducted by the working group for a total of three different scenarios. The greatest uncertainty was found to result from modelers' interpretation of scenarios and approximations made by modelers. In scenarios that were unclear for modelers, the initial differences in model predictions were as high as seven orders of magnitude. Only after several meetings and discussions about specific assumptions did the differences in predictions by various models merge. Our study shows that parameter uncertainty (as evaluated by a probabilistic Monte Carlo assessment) may have contributed over one order of magnitude to the overall modeling uncertainty. The final model predictions ranged between one and three orders of magnitude, depending on the specific scenario. This study illustrates the importance of problem formulation and implementation of an analytic-deliberative process in risk characterization.

Notes: This article presents the results of an analysis of the accident history data reported under section 112(r) of the Clean Air Act Amendments. These data provide a fairly complete record of the consequences of reportable accidental releases occurring during the time frame 1995–1999 in the U.S. chemical industry and covering 77 toxic and 63 flammable substances subject to the provisions of section 112(r). As such, these results are of fundamental interest to the affected communities, regulators, and insurers, as well as to owners and managers in the chemical industry. The results show the statistical associations between accident frequency and severity and a number of characteristics of reporting facilities, including their size, the hazardousness of the processes and chemicals inventoried, and the regulatory programs (in addition to section 112(r)) to which these facilities are subject. The results are interpreted in light of economic drivers of protective activity and regulatory priorities for monitoring and enforcement.

Notes: Unlike other waste streams, municipal solid waste (MSW) is collected manually, and MSW collection has recently been found to be among the highest-risk occupations in the United States. However, as for other occupational groups, actual total injury rates, including the great majority of injuries not compensated and those compensated by other insurance, are not known. In this article a predictive Bayesian method of assessing total injury rates from available information without computation is presented, and used to assess the actual numbers of musculoskeletal and dermal injuries requiring clinical care of MSW workers in Florida. Closed-form predictive Bayesian distributions that narrow progressively in response to information, representing both uncertainty and variability, are presented. Available information included workers' compensation (WC) data, worker population data, and safety records for one private and one public collection agency. Subjective input comprised epidemiological and medical judgment based on a review of 165 articles. The number of injuries was assessed at 3,146 annually in Florida, or 54 ± 18 injuries per 100 workers per year with 95% confidence. Further, WC data indicate that the injury rate is 50% higher for garbage collectors specifically, indicating a rate of approximately 80 per 100 workers. Results, though subject to uncertainty in worker numbers and classification and reporting bias, agreed closely with a survey of 251 MSW collectors, of whom 75% reported being injured (and 70% reported illness) within the past 12 months. The approach is recommended for assessment of total injury rates and, where sufficient information exists, for the more difficult assessment of occupational disease rates.

Notes: Statistical fatigue life of a ductile alloy specimen is traditionally divided into three stages, namely, crack nucleation, small crack growth, and large crack growth. Crack nucleation and small crack growth show a wide variation and hence a big spread on cycles versus crack length graph. Relatively, large crack growth shows a lesser variation. Therefore, different models are fitted to the different stages of the fatigue evolution process, thus treating different stages as different phenomena. With these independent models, it is impossible to predict one phenomenon based on the information available about the other phenomenon. Experimentally, it is easier to carry out crack length measurements of large cracks compared to nucleating cracks and small cracks. Thus, it is easier to collect statistical data for large crack growth compared to the painstaking effort it would take to collect statistical data for crack nucleation and small crack growth. This article presents a fracture mechanics-based stochastic model of fatigue crack growth in ductile alloys that are commonly encountered in mechanical structures and machine components. The model has been validated by Ray (1998) for crack propagation by various statistical fatigue data. Based on the model, this article proposes a technique to predict statistical information of fatigue crack nucleation and small crack growth properties that uses the statistical properties of large crack growth under constant amplitude stress excitation. The statistical properties of large crack growth under constant amplitude stress excitation can be obtained via experiments.

Notes: An occupational risk assessment for manganese (Mn) was performed based on benchmark dose analysis of data from two epidemiological studies providing dose-response information regarding the potential neurological effects of exposure to airborne Mn below the current Occupational Safety and Health Administration (OSHA) Permissible Exposure Level (PEL) of 5 mg Mn/m3. Based on a review of the scientific evidence regarding the toxicity of Mn, it was determined that the most appropriate measure of exposure to airborne Mn for the subclinical effects measured in these studies is recent (rather than historical or cumulative) concentration of Mn in respirable (rather than total) particulate. For each of the studies analyzed, the individual exposure and response data from the original study had been made available by the investigators. From these two studies benchmark concentrations calculated for eight endpoints ranged from 0.09 to 0.27 mg Mn/m3. From our evaluation of these results, and considering the fact that the subtle, subclinical effects represented by the neurological endpoints tested in these studies do not represent material impairment, we believe an appropriate occupational exposure guideline for manganese would be in the range of 0.1 to 0.3 mg Mn/m3, based on the respirable particulate fraction only, and expressed as an 8-hour time-weighted average.

Notes: The Safe Drinking Water Act Amendments of 1996 required U.S. utilities to report on drinking water quality to their customers annually, beginning in fall 1999, on the assumption that such reports would alert them to quality problems and perhaps mobilize pressure for improvement. A random sample of New Jersey customers read alternative versions of a water quality report, in an experiment on reactions to water quality information under U.S. Environmental Protection Agency (USEPA) rules. Experiment design was 2 × 3 + 1: two versions each—one with, one without, a violation of a health standard—of a report that was (1) Qualitative (without water quality numbers, thus not meeting USEPA rules); (2) Basic, with minimal information meeting the rules; or (3) Extended, adding reading aids and utility performance information; plus a control instrument without any hypothetical report. Results of ANOVA suggest the reports will have less effect than hoped or feared. These manipulations were successful: people reading the Qualitative versions were less likely to say that the report gave the amounts of substances found in the water, and those reading Violation versions were more likely to report a violation of a health standard. The main differences in responses to the report involved the judged adequacy of the information, and to a lesser extent responses on a Concern scale (constructed from measures of concern, judged risk, clean-up intentions, distrust of utility information, and doubt that the utility was doing all it could to improve water quality). Overall judgments of water quality and utility performance did not change, either relative to the controls or in before versus after responses. Qualitative reports performed worse than others, confirming the decision to have utilities report actual contaminant levels. Extended reports did only slightly better than the Basic versions on these measures. Many respondents had trouble identifying the presence or absence of substance amounts or violations, despite their seeming obviousness (e.g., in a “bottom line” summary on the front page of each report), suggesting many were not processing this information carefully. However, the pattern of responses for those who accurately identified the presence or absence of substance amounts or violations did not differ substantially from that for the group as a whole. Generic risk beliefs (serious local environmental problems; lack of control over risks to one's health) dominated demographic variables, attitudes toward utility water quality or trustworthiness, and the content and format of water quality reports in influencing concern about drinking water quality. Previous empirical and theoretical evidence for lack of change in public risk attitudes due to one-time or infrequent communications—e.g., role of personal experience, perseverance of prior trust or distrust—seems to be confirmed for annual water quality reports.

Notes: Polluted soils have become a public health problem. While population exposure to soil pollutants is generally quantified using multimedia models, their estimations have not been validated, and studies that attempted to do so are scarce. The objective of the SOLEX study was to compare the predictions of pyrene exposure levels (converted into 1 hydroxypyrene) computed by several models with the results of urinary 1-hydropyrene (1-HOP) assays among 110 employees working at three sites polluted during their past use as manufactured gas plants. Four models were used: AERIS (Canada), CalTOX (California, USA), CLEA (UK), and HESP (The Netherlands). Three occupational exposure scenarios—with office, mixed, and outdoor workers—were constructed, based upon job activities during two measurement campaigns, one in winter and one in summer. The exposure levels estimated by the four models could differ markedly (from 7 up to 80 times) according to the exposure scenario. Also, the predominant exposure routes differed according to the model (direct soil ingestion for HESP and CalTOX, inhalation for AERIS, and dermal absorption for CLEA). The predictions of CalTOX are consistent with the 1-HOP measurements for all the scenarios. For HESP, the consistency is observed for the scenarios, office and mixed, for which the pyrene level in the soil is low. AERIS and CLEA yield results that are systematically above the 1-HOP measurements. This study confirms that validation of the models is crucial and points out to the need to proceed to assess components of the models that are the most influential using appropriate statistical analysis in combination with true field data.

Notes: The wide-scale use of methyl tertiary butyl ether (MTBE) in gasoline has resulted in substantial public controversy and action to ban or control its use due to perceived impacts on water quality. Because oxygenates are still required under federal law, considerable research has focused on ethanol as a substitute for MTBE. In this article, we summarize the currently available literature on the air and water quality risks and benefits of MTBE versus ethanol as alternative fuel oxygenates. We find that MTBE-fuel blends are likely to have substantial air quality benefits; ethanol-fuel blends appear to offer similar benefits, but these may be at least partially negated because of ethanol's propensity to increase emissions and ambient concentrations of some air contaminants. Releases of gasoline containing either MTBE or ethanol could have an impact on some drinking water sources, although the impacts associated with MTBE tend to relate to aesthetics (i.e., taste and odor), whereas the impacts associated with ethanol generally relate to health risk (i.e., greater exposure to gasoline constituents such as benzene). It is likely that these water quality impacts will be outweighed by the air quality benefits associated with MTBE and perhaps ethanol use, which affect a much larger population. A lack of data on environmental exposures and associated health impacts hinders the completion of a comprehensive quantitative risk-benefit analysis, and the available air and water quality data should be evaluated in a broader risk-management context, which considers the potential life-cycle impacts, costs, and feasibility associated with alternative fuel oxygenates.

Notes: A sample of 3,201 Danes was subjected to personal interviews in which they were asked to state their preferences for risk-reducing health care interventions based on information on absolute risk reduction (ARR) and relative risk reduction (RRR). The aim of the study was to measure the relative weighting of different types of risk information under various circumstances. The effect of presenting questions, and of explicitly formulating RRR, was analyzed. A preference for increases in RRR was demonstrated. There was a stronger inclination to choose the intervention that offered the highest RRR if RRR was explicitly stated. Individuals with more than 10 years of schooling also demonstrated a preference for increased ARR, but only when facing individually framed choices. In a social choice context, preferences for RRR remained intact, but the magnitude of ARR had no impact on choices. Results imply that social framing may induce a propensity to prefer interventions that target high-risk populations. Those respondents who had received ≤10 years of schooling demonstrated preferences for RRR but not ARR, and no impact of social framing was observed.

Notes: The relationship between trust and risk perception was investigated, within and across four European countries (Sweden, Spain, United Kingdom, and France). Survey data were collected in 1996; total number of respondents was approximately 1,000 (United Kingdom and Spain), 1,350 (France), and 2,050 (Sweden). Trust was a significant predictor of perceived risk within countries, but the strength of the relationship varied from weak (Spain and France) to moderate (United Kingdom and Sweden). General trust was also a significant source of variation in perceived risk among countries, but much of the variation in perceived risk remained unexplained. Correlations between trust and risk perception also varied depending on the type of risk (i.e., nuclear risks were more influenced by trust) and trust measure (i.e., general trust explained perceived risk better than specific trust). It is concluded that trust may be an element in models explaining risk perception, but it is not as powerful as often argued in the risk perception literature.

Notes: Despite many claims for and against the use of risk comparisons in risk communication, few empirical studies have explored their effect. Only one study, published by Roth et al. in this journal in 1990, has tested the 1988 predictions by Covello et al. as to the public's relative preferences for 14 kinds of risk comparisons as they might be used by a factory manager to explain risks of his ethylene oxide plant. That study found no correlations between the Covello predictions and seven different measures of “acceptability” of Covello's examples of each type of comparison. However, two critics of the Roth study, as well as its own authors, suggested that a scenario involving local risks, a conflict-ridden situation, and a plant manager unknown to the townspeople might better evoke Covello-like preferences than the distant, calm, friends-involving scenario used by Roth. The research reported here replicated the Roth study using the same scenario, risk comparison examples, and evaluation measures, and added a second scenario intended to replicate the conditions suggested by critics. Over 200 New Jersey residents answered the study questionnaire. The replication scenario reproduced Roth's results, and the conflict scenario also evoked no rankings correlated with Covello's predictions. Furthermore, neither agreement nor disagreement with five statements representing “conflict”—respondents' reports that the industrial-plant scenario made them angry, they lived near industry, they were concerned about industrial risks, people in their home town were angry about industrial pollution, and they worried “frequently” about long-term effects of pollution—correlated with Covello's predictions. Over half of all ratings ascribed to the comparisons in aggregate were positive, and most detailed comments offered by respondents also were positive, despite many criticisms and suggestions for their improvement. The wide variability in individuals' rankings also undermines the notion of any single ranking of preferred comparisons. These findings have implications for use of risk comparisons, but also reveal the inaccuracy of the field's assumptions about public reaction to industrial risk information, including risk comparison.

Notes: The effect of specification of the target on risk evaluation was examined. A whole set of hazards, covering most of the domains, were considered: common individual hazards, outdoor activities, medical care, public transportation, energy production, pollutants, sex, deviance, and addictions. Three human targets were introduced: personal health risk (including personal risk of death), health risk for people in the country, and health risk for people in the world. The basic design was a between-subjects design. The first hypothesis was that risk judgments made in the “world” condition should be higher than risk judgments made in the “country” condition, and risk judgments made in this condition should be higher than risk judgments made in the “personal” condition. This is what was observed. The second hypothesis was that the target effect should differ as a function of the kind of hazards considered. This also is what was observed. In two domains— pollutants, and deviance, sex, and addictions—the target effect was important. It corresponded to about one-tenth of the response scale. In the four remaining domains, the target effect was unimportant or absent.

Notes: Dissemination of risk information is ubiquitous in contemporary society. We explore how individuals react in everyday life to health-risk information, based on what they report in personal interviews. Health-risk information was without exception recognized as unstable and inconsistent. This conformity, however, did not extend to the narratives regarding how health-risk information should be handled. Two opposite positions (ideal-typical strategies) are presented. Either you tend to process and evaluate new information or you tend to ignore it as a whole. Our attempt to reveal the underlying rationality in these two very different approaches involved the exploration of three different avenues of interpretation and brings together two scientific paradigms—economics and sociology—that provide the framework for our analysis. First, we suggest that a greater long-term experience of explicit choice implies that this kind of action becomes more natural and less resource consuming, whereas a reliance on habits in daily life—a natural adjustment to a lack of resources—makes it is more costly to bother about new information. Second, with fewer resources in the short run, fewer opportunities to mitigate bad outcomes, and greater exposure to social and material risks, one is less likely to devote resources to deal with health-risk information. Third, there are several possible links between a low propensity to take account of risk information and a high relative importance of genuine uncertainty in one's life. These theoretical perspectives provide a viable set of hypotheses regarding mechanisms that may contribute to social differences in the response to health-risk information.

Notes: European directives require that all veterinary medicines be assessed to determine the harmful effects that their use may have on the environment. Fundamental to this assessment is the calculation of the predicted environmental concentration (PEC), which is dependent on the type of drug, its associated treatment characteristics, and the route by which residues enter the environment. Deterministic models for the calculation of the PEC have previously been presented. In this article, the inclusion of variability and uncertainty within such models is introduced. In particular, models for the calculation of the PEC for residues excreted directly onto pasture by grazing animals are considered and comparison of deterministic and stochastic results suggest that uncertainty and variability cannot be ignored.

Notes: In risk assessment, no observed exposure level (NOAEL) and benchmark dose (BMD) are usually derived either from epidemiological studies in humans or from animal experiments. In many in vitro studies, concentration-effect/response curves have been analyzed using different mathematical models finalized to the identification of EC50. In the present article, we propose a model to fit dose-response curves in vitro. The BMD approach has been used to compare the cell viability (MTT assay) of different rat (C6 and PC12, glial and neuronal, respectively) and human cell lines (D384 and SK-N-MC, glial and neuronal, respectively) after 24-hour exposure to the following neurotoxic substances: manganese chloride (MnCl2), methyl-mercury (Me-Hg), and the enantiomers of styrene oxide (SO). For all rat and human cell lines, the potency of the examined compounds was: MnCl2 〈 S-SO 〈 R-SO 〈 Me-Hg. A preliminary comparison with in vivo toxicity data for these substances gave rise to consistent results. Whereas a reasonable agreement between in vitro and in vivo data has been found for Mn and styrene oxide, a wide scatter of LOAEL has been reported for Me-Hg and these appear to be either much higher or lower than the BMD for the MTT assay we observed invitro.

Notes: This article examines the role of climatic and hydrological variability in assessing the cumulative risk of flood events in Poland over a T-year period. In a broad sense flood-risk estimation combines a frequency analysis of extreme hydrological phenomena with an evaluation of flood-induced damages. The damage from floods depends on the critical values of the river discharges. The probabilistic flood analysis usually includes an estimation of the expected annual probability of the critical discharge Qcr being exceeded and the equivalent long-term risk of it being exceeded over the next T years. If, however, the process is nonstationary, the T-year risk of flood damage may depend importantly on the variation of hydrological processes. As a possible explanation for the variations observed in snowmelt-induced floods in Polish rivers, this article investigates the possible impact of the North Atlantic Oscillation (NAO) on surface air temperature T and precipitation P. The spatial distribution of the correlation coefficients between NAO and T, as well as NAO and P, show very significant differences in the NAO impact on meteorological variables in various parts of Europe. To assess the implications of NAO variations on spring flood discharges, a simple model of Snow Cover Water Equivalent (SCWE) was applied to selected Polish river catchments. The conclusion of this analysis is that the yearly maximum of SCWE values significantly decreases with increasing NAO. This leads to a temporal redistribution of winter and spring runoff. The question of spring flood characteristics being stationary or nonstationary may therefore be linked with stochastic properties of the NAO index time series.

Notes: We examine the opportunities for using catastrophe-linked securities (or equivalent forms of nondebt contingent capital) to reduce the total costs of funding infrastructure projects in emerging economies. Our objective is to elaborate on methods to reduce the necessity for unanticipated (emergency) project funding immediately after a natural disaster. We also place the existing explanations of sovereign-level contingent capital into a catastrophic risk management framework. In doing so, we address the following questions. (1) Why might catastrophe-linked securities be useful to a sovereign nation, over and above their usefulness for insurers and reinsurers? (2) Why are such financial instruments ideally suited for protecting infrastructure projects in emerging economies, under third-party sponsorship, from low-probability, high-consequence events that occur as a result of natural disasters? (3) How can the willingness to pay of a sovereign government in an emerging economy (or its external project sponsor), who values timely completion of infrastructure projects, for such instruments be calculated? To supplement our treatment of these questions, we use a multilayer spreadsheet-based model (in Microsoft Excel format) to calculate the overall cost reductions possible through the judicious use of catastrophe-based financial tools. We also report on numerical comparative statics on the value of contingent-capital financing to avoid project disruption based on varying costs of capital, probability and consequences of disasters, the feasibility of strategies for mid-stage project abandonment, and the timing of capital commitments to the infrastructure investment. We use these results to identify high-priority applications of catastrophe-linked securities so that maximal protection can be realized if the total number of catastrophe instruments is initially limited. The article concludes with potential extensions to our model and opportunities for future research.

Notes: Risk perceptions have, to a great extent, been studied exclusively as individual cognitive mechanisms in which individuals collect, process, and form perceptions as atomized units unconnected to a social system. These individual-level theories do not, however, help explain how perception of risk may vary between communities or within a single community. One alternative approach is based on a network theory of contagion. This approach, emerging largely from organizational and community social network studies, suggests that it is the relational aspects of individuals and the resulting networks and self-organizing systems that influence individual perceptions and build “groups or communities of like-minded” individuals. These social units, it is argued, behave as attitude, knowledge, or behavioral structures. The study reported in this article tests one aspect of this theoretical perspective. The central hypothesis proposes the existence of risk perception networks—relational groupings of individuals who share, and perhaps create, similar risk perceptions. To test this idea, data were collected from individuals involved in a community environmental conflict over a hazardous waste site cleanup. The statistical analysis used a matrix of relational social linkages to compare with a matrix of individual risk perceptions. The analysis confirmed the hypothesis suggesting that social linkages in communities may play an important role in focusing risk perceptions.

Notes: We adopted a comparative approach to evaluate and extend a generic methodology to analyze the different sets of beliefs held about chemical hazards in the workplace. Our study mapped existing knowledge structures about the risks associated with the use of perchloroethylene and rosin-based solder flux in differing workplaces. “Influence diagrams” were used to represent beliefs held by chemical experts; “user models” were developed from data elicited from open-ended interviews with the workplace users of the chemicals. The juxtaposition of expert and user understandings of chemical risks enabled us to identify knowledge gaps and misunderstandings and to reinforce appropriate sets of safety beliefs and behavior relevant to chemical risk communications. By designing safety information to be more relevant to the workplace context of users, we believe that employers and employees may gain improved knowledge about chemical hazards in the workplace, such that better chemical risk management, self-protection, and informed decision making develop over time.

Notes: Seven driving attitude scales representing driving behaviors and beliefs about driving were created and initially validated using 257 undergraduate students (168 females, 89 males) in Study 1. However, the Speeding Attitude Scale (SAS) accounted for most of the strength of the intercorrelations among these scales and discriminant classification analyses showed that SAS dominated the other scales as a sufficient explanation for having speeding tickets. Study 2, using 180 students (75 males, 105 females), replicated findings regarding the significant but low correlation between SAS and speeding tickets, and was significantly correlated with Zuckerman's Sensation Seeking Scale (SSS). Replication also showed that males had higher SAS scores and more speeding tickets. Accidents were typically a function of sex, increasing age, and variables related to recent accident history. Objective sources of speeding attitude confirmation may enhance the future validity of the SAS. Potential interventions for being a safe passenger and attitudinal control in the training of young drivers were discussed.

Notes: The prospect of industrial accidents motivated the U.S. Congress to require in the Clean Air Act of 1990 that manufacturing facilities develop Risk Management Plans (RMP) to submit to the U.S. Environmental Protection Agency (USEPA) by July 1999. Industry worried that the requirement to communicate to the public a “worst-case scenario” would arouse unnecessary and counterproductive fears among industry neighbors. We report here the results of focus groups and surveys with such neighbors, focusing particularly upon their reactions to messages about a hypothetical worst-case scenario and management of these risks by industry, government, and other parties. Our findings confirmed our hypotheses that citizens would be skeptical of the competence and trustworthiness of these managers and that this stance would color their views of industrial-facility accident risks. People with job ties to industry or who saw industrial benefits to the community as exceeding its risks had more positive views of industrial risks, but still expressed great concern about the risk and doubt about accident management. Notwithstanding these reactions, overall respondents welcomed this and other related information, which they wanted their local industries to supply. Respondents were not more reassured by additional text describing management of accidents by government and industry. However, respondents did react very positively to the concept of community oversight to review plant safety. Claims about the firm's moral obligation or financial self-interest in preventing accidents were also received positively. Further research on innovative communication and management of accident risks is warranted by these results, even before recent terrorist attacks made this topic more salient.

Notes: Enabling people to make an informed choice on whether to change consumption behavior is ultimately the objective of any fish consumption advisory. This will occur only if people are aware of the advisory, know and understand the advisory information, and believe the information to be true. Interactive, meaningful communication and the opportunity to participate in the process to develop and review advisories are key to achieving these attributes. A case study was undertaken in a community in Alberta, Canada (where an existing advisory was under consideration for review) to determine public awareness, knowledge, compliance, communication effectiveness, information needs, and desire for involvement related to the advisory. The information obtained from this case study was used to develop 14 guiding principles as a foundation for the incorporation of public participation and risk communication into the process of developing and reviewing fish consumption advisories.

Notes: The impacts of fish consumption advisories on recreational and subsistence fishing, particularly in fresh waters, have been examined extensively. By contrast, little attention has focused on organized recreational fishing, such as from party and charter boats, and particularly for salt water fish. We interviewed 93 New Jersey boat captains to determine their knowledge about fish consumption advisories, and whether, in their opinion, clients knew of fish consumption advisories, and whether they thought advisories had an effect on recreational fishing and their businesses. Advisories were ranked by captains as a moderate influence on the success of their business, less so than number of fish caught, strength of the economy, overfishing by commercial boats, and management regulations. Only one boat captain had not heard warnings about eating fish, but what captains said they had heard was mixed in its accuracy and completeness. Clients expect captains to know about fish, and about half of boat captains said clients had asked about the safety of eating fish. Captains who felt advisories were affecting their businesses tended to fish for species without high levels of mercury (except for bluefish) or PCBs, the primary contaminants of concern for state advisories and federal advice. However, these captains worked closer to areas (e.g., Raritan Bay complex and New York Harbor) subject to advisories than did other captains, and were more prone to say that management regulations (e.g., fish size, creel limits, seasons) and marketing and advertising by the industry or state were strong influences on the success of their seasons. Comparing captains who thought advisories had some or great effect (60%) versus those reporting “no effect” (40%), there was no difference in the mean percentage of trips targeting high mercury species such as swordfish and shark. Many captains said they would or might post advisories, but 42% of the boat captains said they would not post consumption warnings if the state provided them. The significant portion (at least 15%) of saltwater fishing supported by these businesses suggests that these captains are an important conduit for future risk communication.

Notes: This article begins with a review of the regulation of chemicals in Sweden over the past 30 years, focusing particularly on the 1997 Government Environmental Quality Bill, which called for a toxic-free society by the year 2020. The second part of the article analyzes why Sweden has taken this route. The third and final section discusses Sweden's present role in formulating present EU chemical regulation, such as the recent EU Chemical White Paper, and hypothesizes future impacts of Swedish chemical regulations on the EU itself.

Notes: In 2001, the U.S. Environmental Protection Agency derived a reference dose (RfD) for methylmercury, which is a daily intake that is likely to be without appreciable risk of deleterious effects during a lifetime. This derivation used a series of benchmark dose (BMD) analyses provided by a National Research Council (NRC) panel convened to assess the health effects of methylmercury. Analyses were performed for a number of endpoints from three large longitudinal cohort studies of the neuropsychological consequences of in utero exposure to methylmercury: the Faroe Islands, Seychelles Islands, and New Zealand studies. Adverse effects were identified in the Faroe Islands and New Zealand studies, but not in the Seychelles Islands. The NRC also performed an integrative analysis of all three studies. The EPA applied a total uncertainty factor (UF) of 10 for intrahuman toxicokinetic and toxicodynamic variability and uncertainty. Dose conversion from cord blood mercury concentrations to maternal methylmercury intake was performed using a one-compartment model. Derivation of potential RfDs from a number of endpoints from the Faroe Islands study converged on 0.1 μg/kg/day, as did the integrative analysis of all three studies. EPA identified several areas for which further information or analyses is needed. Perhaps the most immediately relevant is the ratio of cord:maternal blood mercury concentration, as well as the variability around this ratio. EPA assumed in its dose conversion that the ratio was 1.0; however, available data suggest it is perhaps 1.5–2.0. Verification of a deviation from unity presumably would be translated directly into comparable reduction in the RfD. Other areas that EPA identified as significant areas requiring further attention are cardiovascular consequences of methylmercury exposure and delayed neurotoxicity during aging as a result of previous developmental or adult exposure.

Notes: Risk estimates for food-borne infection will usually depend heavily on numbers of microorganisms present on the food at the time of consumption. As these data are seldom available directly, attention has turned to predictive microbiology as a means of inferring exposure at consumption. Codex guidelines recommend that microbiological risk assessment should explicitly consider the dynamics of microbiological growth, survival, and death in foods. This article describes predictive models and resources for modeling microbial growth in foods, and their utility and limitations in food safety risk assessment. We also aim to identify tools, data, and knowledge sources, and to provide an understanding of the microbial ecology of foods so that users can recognize model limits, avoid modeling unrealistic scenarios, and thus be able to appreciate the levels of confidence they can have in the outputs of predictive microbiology models. The microbial ecology of foods is complex. Developing reliable risk assessments involving microbial growth in foods will require the skills of both microbial ecologists and mathematical modelers. Simplifying assumptions will need to be made, but because of the potential for apparently small errors in growth rate to translate into very large errors in the estimate of risk, the validity of those assumptions should be carefully assessed. Quantitative estimates of absolute microbial risk within narrow confidence intervals do not yet appear to be possible. Nevertheless, the expression of microbial ecology knowledge in “predictive microbiology” models does allow decision support using the tools of risk assessment.

Notes: Background. Helicobacter pylori induces inflammation of gastric mucosa regulated by several interleukins. This study examined associations between anti-Helicobacter pylori immunoglobulin G antibody seropositivity and functional polymorphisms of interleukin-8 T-251 A and interleukin-10 T-819C.Materials and Methods. The subjects were 454 health check-up examinees (126 males and 328 females) without a history of cancer, aged 35–85 years, residing in Nagoya, Japan. After written informed consent was obtained individually, residual blood was anonymously applied for anti-Helicobacter pylori immunoglobulin G antibody testing and genotyping by the polymerase chain reaction with confronting two-pair primers.Results. The genotype frequency of interleukin-8 T-251 A was 52.2% for TT, 39.5% for TA, and 8.3% for AA, and that of interleukin-10 T-819C was 49.5% for TT, 39.9% for TC and 10.6% for CC. Although the differences in the positive rates among the genotypes were not marked, 115 individuals with interleukin-8–251TT (low expression genotype) and interleukin-10–819TT (high expression genotype) had a higher rate (63.5%) than the others (52.0%). Relative to the combination of interleukin-8–251TT and interleukin-10–819TT, the sex-age-adjusted odds ratio for those with the other combinations was 0.62 (95% confidence interval, 0.39–0.98). The adjusted odds ratio among 65 current smokers was 0.13 (0.03–0.61).Conclusions. The observed association suggests that individuals with interleukin-8–251TT and interleukin-10–819TT, a combination presumably causing mild inflammation, have a higher probability of the continuing Helicobacter pylori infection, especially among current smokers.

Notes: Abstract:  The changing trends in the diagnosis and management of women with invasive breast cancer have prompted an examination of the need for routine axillary lymph node dissection (ALND) in women with a clinically negative axilla. The objective of this study was to examine the value of information from an ALND in guiding the selection of adjuvant systemic therapy for women with clinically node-negative breast cancer. Between January 1996 and June 2000, 447 clinically node-negative women underwent an ALND as part of their treatment for invasive breast cancer at Westmead Hospital. Three categories of risk of recurrence were devised, based on the primary tumor characteristics alone, without information from an ALND. Recommendations for adjuvant systemic therapy with and without information from an ALND were compared, and the frequency of change was calculated. Overall, 12% of women had their treatment recommendation altered by their pathologic nodal status based on the model treatment algorithm. For women in the low-risk category (pathologic tumor size ≤10 mm, grade 1, lymphovascular invasion [LVI] negative, and estrogen receptor [ER] positive), 17% of those less than 50 years old and 14% of those 50–69 years old would have a shift in their treatment recommendations based on the pathologic nodal status. In addition, 13% of the women less than 50 years old and 10% of those 50–69 years old were recommended for more intensive chemotherapy on the basis of four or more involved nodes. For women in the high-risk category (pathologic tumor size greater than 20 mm or greater than 10 mm associated with any unfavorable prognostic factor [grade 3, LVI, or negative ER]), 19% of those less than 50 years old and 18% of those 50–69 years old were recommended for more intensive chemotherapy. Information from ALND did not alter the treatment recommendation for women ≥70 years old, as they were not recommended chemotherapy in the model algorithm. If women ≥70 years old who were node positive and had an ER-negative tumor were recommended chemotherapy, 14% in the high-risk category would have had their treatment recommendation altered as a result of the information from ALND. The continued utilization of ALND is appropriate in women less than 70 years old in the high-risk category. In other patients less than 70 years old, the pathologic nodal status is of value in guiding the selection of women for adjuvant systemic therapy. For women ≥70 years old, information from an ALND adds little to the selection of patients for adjuvant systemic therapy. However, in selected patients ≥70 years old who are classified as high risk on the basis of unfavorable primary tumor features, and are potential candidates for chemotherapy, an ALND would be appropriate. 

Notes: Abstract:  Breast sarcomas account for about 1% of all malignant breast cancers. Leiomyosarcoma (LMS), one of the rarest, was first described 20 years ago, and yet few published reports exist. A case of primary LMS in a 25-year-old woman is presented and is only the 18th well-documented case in the literature. The clinical presentation, diagnosis, therapy, and pathologic features are reviewed.

Notes: Abstract:  A prospective study was carried out on 143 consecutive patients with palpable lumps larger than 2 cm in size which were clinically suspicious of carcinoma. One hundred and five lumps proved to be malignant and 38 were benign. Of the 105 patients with malignancy, confirmation was made in 95 by fine-needle aspiration cytology (FNAC) with a sensitivity of 90.4% and 100 by core biopsy with a sensitivity of 95.2%. The sensitivity of core biopsies increased with the number of cores taken (one core, 76.2%; two cores, 80.9%, three cores, 89.2%; four cores, 95.2%). The combined sensitivity of FNAC and core biopsies was 100%, and so are complementary in the accurate diagnosis of breast cancer. Patients presenting to the breast clinic with a solid suspicious breast lump larger than 2 cm can benefit from FNAC and a minimum of four core biopsies to improve diagnosis. 

Notes: Abstract:  Cat-scratch disease of the breast has been previously reported. This report describes a very unusual case of cat-scratch disease of the breast caused by Bartonella quintana in which the clinical and radiographic presentation mimicked that of inflammatory breast cancer.

Notes: Abstract:  A sentinel node biopsy done at the time of initial tumor resection allows for a one-stage surgical procedure. In addition, sentinel node identification may be impaired when done after a previous tumor excision. This study evaluates the sentinel node biopsy in patients with nonpalpable breast cancer and assesses whether a sentinel node biopsy for mammographically suspect breast lesions is justified when preoperative needle biopsy is inconclusive for invasive malignancy. A sentinel node biopsy was done in 67 patients with nonpalpable breast lesions after injection of radioactive tracer (intraparenchymal in 35 and subdermal in 32) and blue dye (para-areolar). A preoperative core needle biopsy was positive for malignancy in 42 patients. Thirteen patients had positive cytology or ductal carcinoma in situ (DCIS). In 12 patients the needle biopsy was nondiagnostic, but the lesions remained highly suggestive of malignancy on mammography. Sentinel node biopsy was successful in 64 patients (96%). In these, the sentinel node was both radioactive and blue in 58 patients (91%). Only 4 of 13 patients with positive cytology or DCIS on preoperative needle biopsy and only 5 of 12 patients without a preoperative diagnosis had an invasive cancer after resection. Sentinel nodes were positive for nodal metastases in 9 of 49 patients (18%) with a successful sentinel node biopsy for invasive malignancy. None of the eight patients with DCIS had nodal metastases. The sentinel node procedure avoids the potential morbidity of an axillary dissection in more than 80% of patients with nonpalpable breast cancer. A sentinel node biopsy for mammographically detected suspect breast lesions is not justified without a preoperative histologic diagnosis of invasive breast cancer. 

Notes: Abstract:  Seroma formation is a frequently occurring complication in patients operated on because of breast cancer. This complication can be the cause of flap necrosis, can lead to infection, and can prolong the hospital stay. It can also cause a delay in chemotherapy and radiotherapy. In order to prevent seroma formation, various methods such as external compression dressings, immobilization of the arm, sclerotherapy, and suction drainage have been used, without much success. In animal models and some clinical studies, it has been stated that fibrin glue reduces seroma formation, and these statements generated high expectations. For this reason, a prospective study was planned to test this in patients who underwent modified radical mastectomy (MRM) because of breast cancer. Of the 54 patients studied, 27 patients had fibrin glue (4 ml) applied to wound surfaces and under the flap (study group); the remaining 27 patients were the control group. Daily drainage volumes, total amount of drainage, drain removal time, and seroma formation were recorded and compared between the two groups. The first-day drainage was significantly lower in the study group (p 〈 0.05, Student's t-test). There were no significant differences in daily drainage volumes, drain removal time, seroma formation frequency, and the number of seromas between the two groups (p 〉 0.05). In conclusion; fibrin glue application had no significant benefit on axillary lymphatic drainage, drain removal time, or seroma formation.