The invasion of the lower respiratory tract by procedures and support measures such as fiberoptic bronchoscopy, endotracheal intubation, and mechanical ventilation generates respiratory aerosols. These aerosols have a potential for the transmission of tuberculosis and other infections. The follow-up of tuberculin skin test status among staff with exposure to this millieu was observed in hope of delineating whether a significant problem does exist. A questionnaire survey of tuberculin skin test status of graduating pulmonary fellows was performed. Graduating Infectious Disease Fellows formed the control group. Training programs situated in the top 25 cities for tuberculosis in 1983 were chosen if the Fellows spent a major proportion of their time in a large receiving/public hospital. The data returned were analyzed if the individual programs had both Pulmonary and Infectious Disease Fellows in training. Fourteen training programs supplied usable data over a 3-yr period. Seven of 62 (11%) of Pulmonary Fellows at risk converted their tuberculin skin test as opposed to one of 42 (2.4%) of Infectious Disease Fellows. This observation raises concern that more fastidious precautions are needed to isolate patients under these conditions of respiratory aerosol generation. The available armamentarium of nonrecirculated fresh air ventilation and ultraviolet light irradiation in addition to simply wearing face masks should be increasingly utilized. Further studies are warranted to substantiate the applicability of these measures to the current situation.

This study investigates the unique and common contributions of global selfconcept, academic self-concept, and need for academic competence to the variance in academic achievement of inner-city, black adolescents. Data on these variables were collected from 328 eighth grade students attending a New York City public junior high school. Results of commonality procedures indicate that academic self-concept and need for academic competence each accounted for significant proportions of criterion variance, whereas global selfconcept did not. In addition, explanations of variance in academic achievement were better for males than for females after the possible confounding effects of verbal ability had been partialled out. Directions for intervention strategies aimed at enhancing academic achievement are suggested for the two sexes.A notion that is central to a number of self-concept theories (Combs & Snygg, 1959;Hayakawa, 1963;Rogers, 1951;Snygg & Combs, 1949) is that global self-concept, an overall or general view of the self, is a critical factor in determining human behavior. Self-concept is seen as arising from the experience of self as object (James, 1892(James, /1961 and, as a global construct, consists in awareness of the totality of one's selfknowledge emanating from a history of interactions with others and evaluations of how one has coped with life (McCandless & Trotter, 1977). This core of data about one's attributes has been viewed as providing a self-theory that structures one's interface with the social world (Epstein, 1973) and as serving to direct the course of new experiences that elaborate the personal information base (Bannister & Agnew, 1977). In the frameworks of several theorists, the role of global self-concept in initiating and guiding behavior has been equated with motivation (e.g.,

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The decision to prescribe or withhold isoniazid (INH) preventive therapy for low-risk tuberculin reactors has been highly controversial, primarily due to isoniazid's possible hepatotoxic effects. Previous analyses have explored the INH decision only from the perspective of patient age, recognizing that the risks of INH-induced hepatotoxicity are age related. Decision analyses presented in this paper assess the impact of gender and ethnic group, as well as age, on the INH decision. Results for low-risk patients favor prescribing INH preventive therapy for all 20-yr-olds, all 35-yr-olds except black women, and no 50-yr-olds, projecting life expectancy benefits that range from 3 to 19 days. A comparison set of analyses performed for high-risk patients favors prescribing INH for all groups except 50-yr-old black women. These findings suggest that ethnicity, gender, and age should be considered when making the decision to prescribe or withhold INH preventive therapy.