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The distribution and dynamics of atmospheric pollutants are spatiotemporally heterogeneous due to variability in emissions, transport, chemistry, and deposition. To understand these processes at high spatiotemporal resolution and their implications for air quality and personal exposure, we present custom, low-cost air quality monitors that measure concentrations of contaminants relevant to human health and climate, including gases (e.g., O3, NO, NO2, CO, CO2, CH4, and SO2) and size-resolved (0.3–10 µm) particulate matter. The devices transmit sensor data and location via cellular communications and are capable of providing concentration data down to second-level temporal resolution. We produce two models: one designed for stationary (or mobile platform) operation and a wearable, portable model for directly measuring personal exposure in the breathing zone. To address persistent problems with sensor drift and environmental sensitivities (e.g., relative humidity and temperature), we present the first online calibration system designed specifically for low-cost air quality sensors to calibrate zero and span concentrations at hourly to weekly intervals. Monitors are tested and validated in a number of environments across multiple outdoor and indoor sites in New Haven, CT; Baltimore, MD; and New York City. The evaluated pollutants (O3, NO2, NO, CO, CO2, and PM2.5) performed well against reference instrumentation (e.g., r=0.66–0.98) in urban field evaluations with fast e-folding response times (≤ 1 min), making them suitable for both large-scale network deployments and smaller-scale targeted experiments at a wide range of temporal resolutions. We also provide a discussion of best practices on monitor design, construction, systematic testing, and deployment.

OBJECTIVE--To determine if subclinical hepatotoxicity is associated with exposure to perchloroethylene at concentrations commonly experienced in the workplace, and whether surveillance with serum hepatic transaminase activity underestimates such effects. METHODS--Hepatic parenchymal echogenicity on ultrasonography and serum hepatic transaminase activity were compared in 29 community based dry cleaning operators exposed to perchloroethylene, and a control group of 29 non-exposed laundry workers. Perchloroethylene exposure was assessed by work history and air monitoring. RESULTS--Mean hepatic transaminase activities were minimally increased in dry cleaners compared with laundry workers. Increased alanine aminotransferase activities, between 1.0 and 1.5 times the normal limits, were found in five of 27 (19%) dry cleaners compared with one of 26 (4%) laundry workers. In contrast, diffuse parenchymal changes in echogenicity, as determined by hepatic ultrasonography, were increased nearly twofold in dry cleaners, occurring in 18 of 27 (67%) dry cleaners compared with 10 of 26 (39%) laundry workers (P < 0.05), and were most strongly associated with increased perchloroethylene exposure in older dry to dry or wet transfer operations (odds ratio 4.2, 95% confidence interval 1.1-15.3). Mean eight hour time weighted average perchloroethylene exposure for dry cleaners was 16 ppm, which is less than the permissible exposure limit of 100 ppm in the United States. CONCLUSIONS--It was concluded that mild to moderate hepatic parenchymal changes occur more frequently in workers exposed to perchloroethylene than in populations not exposed to chemical solvents, and that these effects are underestimated by serum hepatic transaminase activity.

THE PROBLEM IN A LARGE number of patients with alterations of consciousness and convulsive seizures there is difficulty in establishing the diagnosis of epilepsy because the seizures cannot be observed and the electroencephalogram is not sufficiently abnormal to warrant a probable diagnosis of paroxysmal disorder. The necessity of arriving at a diagnosis with reasonable certainty is particularly great in military neuropsychiatry. Army regulation requires confirmation of the history by a medical officer, who must witness a seizure or an abnormal electroencephalogram. Concerning such witnessing of a seizure, Roseman1pointed out how rarely a qualified observer has the opportunity to observe a convulsive seizure in the wards of a military hospital. As to the value of the electroencephalogram, Gibbs, Gibbs and Lennox2found that in a series of 730 adult epileptic patients the electroencephalogram gave little diagnostic aid in 47.1 per cent. This problem is of long standing, and

A brief test of adult intelligence designed for psychiatric examiners is reported. The test (Preliminary Test of Intelligence) consists of vocabulary, comprehension, similarities and differences, and arithmetic items and can be administered and scored in 5 to 15 minutes. Preliminary standardization data on 150 subjects ranging in age from 11 to 70 years show satisfactorily high correlations with the Wechsler-Bellevue Intelligence Scale. The test, together with complete instructions for administration, scoring and interpretation is included in the text. Tentative norms permit the classification of intelligence level in one of four categories: above average, average, below average and markedly below average. The I. Q. range within each category for the standardization group is reported.

A ICAL MEDICAL diagnosis of Adolf Hitler is presented: giant cell arteritis—temporal arteritis. It is based on findings of attacks of temporal headaches, tenderness of the temporal and supraorbital regions, an enlarged temporal artery, visual loss in the right eye, low-grade fever, weight loss, normochromic anemia, and an elevated erythrocyte sedimentation rate. The likelihood of this diagnosis and its relationship to Hitler's cardiological, gastrointestinal, hepatic, dermatological, ophthalmological, and neurological symptoms is discussed. In 1975, I embarked on a psychiatric and medical study of Hitler. During the course of this study, I acquainted myself with the numerous biographical works; examined thousands of references in the National Archives of Washington, DC, Germany, and Austria; and interviewed persons who knew Hitler. The result of this study will be presented in a forthcoming book to be published by Oxford University Press Inc, New York, NY. In this article, I am concerned exclusively with a

The authors survey the ethical problems confronting psychiatry today. They state that with rare exceptions psychiatric intervention can be morally justified only with the potential patient's informed consent. Within this framework, they discuss the fact that today nonpsychiatrists, particularly ethicists, lawyers, legislators, and social scientists, as well as psychiatrists are concerned about medical ethics, specifically regarding the right to be treated, the right not to be treated, the civil rights of psychiatric patients, the ethics of behavior control, the problem of conflicts of interest in therapeutic goals, privacy and confidentiality, the ethics of human experimentation, policy decisions, and psychiatry's relationship to the changing moral value structure of U.S. society.

1. The hypothesis that social mobility is related to psychoneurosis and schizophrenia was tested as part of a large study on social class and psychiatric disorders in the metropolitan New Haven community. 2. Methods in studying the social mobility of 25 psychoneurotics and 25 schizophrenics divided between social classes III and V and a number of control subjects are described. 3. These psychoneurotics and schizophrenics are more mobile than the control subjects. 4. There is a discrepancy between achieved and aspired mobility in the psychiatric patients. 5. The implications of the above findings for phenomenology, etiology, and treatment of psychoneurosis and schizophrenia are discussed.

To explain illness adequately and sensitively is not an easy matter. To tell patients brusquely just the name of their illness, or to lecture to them pedantically may be as bad as to tell them nothing, and only slightly better than to lie to them. To inform patients, to clarify their ideas, to interpret their apprehensions, requires the ability to listen with empathy and to appraise the patient's capacity to understand and “take it.” It requires patience and proper timing—as opposed to a rigid technique—and sticking with one's patients for better and for worse. It demands maturity and control of one's own emotions as a physician. This may be much harder for the physician than the traditional authoritative approach of protecting the patient from the truth. The gifted physician will use the newer techniques intuitively. Most others will have to learn through practice and precept. I believe that these principles and attitudes can be taught today quite well by sensitivity training in groups and, less economically, in an individual preceptorship. The “soft” approach can be effectively combined with the hard approach of a computerized information-gathering technique. I am convinced that the new “hard” and “soft” techniques will enable us to practice better medicine and help us to approximate Nathaniel Hawthorne's ideal of a good physician.

Social and cultural factors pertaining to neuroses and psychosomatic illnesses were reviewed. An attempt was made to define terms and to suggest which of a large number of possibilities might be relevant variables in the mental health equation. Cultural, sub-cultural, and small and large group systems were selected. It was concluded, on the basis of present knowledge, that there is probably a significant amount of cultural invariance i.e., the same basic syndromes occur in widely different settings but are modified by them in form and course. Subcultural variables contribute more to variance than culture. Some forms of behavior disorders such as drug addiction, alcoholism, and the sociopathies are strongly influenced by the sub-cultural system. Small group systems, particularly the family, are major sources of variance in questions of both psychologic and somatic disease. Prevention and treatment will benefit from a more comprehensive framework than we have had heretofore. An emerging general systems theory would seem to fit this need. It was suggested that today's professional role allocations for treatment and research of psychosomatic and psychoneurotic disorders are artificial and that new professional roles must be created if we are to achieve our ultimate goals.