A case-control study was conducted to assess personal and family medical history and the appearance of Alzheimer's disease. We compared 98 men with clinically diagnosed Alzheimer's disease and 162 controls, matched by sex, year of birth, and town of residence. Family history of dementia and personal history of depression were more frequent in patients. The number of cigarettes smoked was greater in cases.
public health preparedness ■ Abstract Threats to Americans' health-including chronic disease, emerging infectious disease, and bioterrorism-are present and growing, and the public health system is responsible for addressing these challenges. Public health systems in the United States are built on an infrastructure of workforce, information systems, and organizational capacity; in each of these areas, however, serious deficits have been well documented. Here we draw on two 2003 Institute of Medicine reports and present evidence for current threats and the weakness of our public health infrastructure. We describe major initiatives to systematically assess, invest in, rebuild, and evaluate workforce competency, information systems, and organizational capacity through public policy making, practical initiatives, and practice-oriented research. These initiatives are based on applied science and a shared federal-state approach to public accountability. We conclude that a newly strengthened public health infrastructure must be sustained in the future through a balancing of the values inherent in the federal system.
A cross sectional study of 101 construction painters was performed to investigate the relation between exposure to mixed organic solvents and changes in central nervous system function. Solvent exposure was estimated using questionnaire data to derive an exposure index (a measure of intensity of exposure) and to estimate the duration and frequency of exposure. Adverse effects on the central nervous system were assessed by self reported questionnaires and eight tests of a computer administered neurobehavioural evaluation system. Factor analysis of both measures of effect yielded factors both biologically plausible and in agreement with other empirical evidence. A consistent positive association was observed between most measures of exposure and the occurrence of neurotoxic symptoms, notably dizziness, nausea, fatigue, problems with arm strength, and feelings of getting "high" from chemicals at work. Associations with exposure were found with the neurobehavioural evaluation system tests of symbol digit substitution and digit span; however, no consistent pattern of effect on neurobehavioural function was observed. This pattern of the occurrence of neurotoxic symptoms without clear evidence of function deficit is consistent with the type 1 toxic central nervous system disorder as classified by the World Health Organisation.
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