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S Fisher

Publications and source records attributed to S Fisher.

347 records · Page 20Linked to original sources
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The transfer of safety training in work organizations: a systems perspective to continuous learning.

The effectiveness of safety and health programs can be evaluated from a "transfer" perspective, which evaluates the effectiveness of training in individual programs, and from a "systems" perspective that contends that a safety training program cannot be isolated from the organizational system of which it is a part. This chapter explores the effectiveness of training from a systems perspective and includes recommendations for improving safety and health training.

Accidents, Occupational↗
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Patient drug attributions and postmarketing surveillance.

Although studies have shown that patients can distinguish probable adverse drug reactions (ADRs) from adverse clinical events (ACEs) caused by other factors, it is not known whether these attribution judgments add any independent validity to other accepted methods of identifying ADRs, such as physician assessments or epidemiologic data. Data from 2487 patients receiving fluoxetine and 815 receiving trazodone were used to see whether such information was redundant when added to standard statistical analysis directed toward detecting ADRs. Relative risk values for 14 trazodone or fluoxetine ADRs were selected because each was significantly identified by an innovative postmarketing surveillance system. In one analysis, all patient reports were used to compute relative risk; in the other, only reports attributed by patients to the study drug were included. Results indicate that taking into account patient attribution judgments results in a consistent, albeit modest, increase in the discriminatory power of this monitoring method.

Adverse Drug Reaction Reporting Systems↗
PubMedDate not supplied

The relationship of the postcoital test and semen characteristics to pregnancy rates in 200 presumed fertile couples.

OBJECTIVE: To evaluate the postcoital test (PCT) and semen analysis (SA) in the prediction of pregnancy in 200 potentially fertile couples. METHODS: 200 couples without risk for infertility were prospectively followed for 1 year. Couples were attempting pregnancy for 12 menstrual cycles. In the first three cycles, the women underwent monthly PCTs and collected daily urines while the men provided bimonthly semen analyses. For the next nine cycles, the couples were monitored for pregnancy. The PCT included hours post-coitus, amount of mucus, spinnbarkeit, number of motile sperm, and percent of motile sperm. Since multiple PCTs and SAs were available for each couple, values were averaged to provide one mean value per couple. The Wilcoxon ranked sum test was used to detect differences in PCT and SA. RESULTS: Pregnancy occurred in 163/200 couples (82%) in 12 cycles. Mean sperm count per high-power field (p = 0.01) and mean number of highly motile sperm (p = 0.03) were higher among women in whom pregnancy occurred. Amount of mucus and spinnbarkeit were similar between women who became pregnant and those who did not. Semen concentration, motile sperm count, and percent motile sperm were significantly higher among men whose partner conceived (P < .02). Only 93 couples (47%) had PCTs that were correctly timed. CONCLUSIONS: Measures predictive of pregnancy included vigorously moving sperm per high-power field, sperm concentration, motile sperm count, and percent motility. Mucus characteristics were not predictive of pregnancy. Additionally, a high number of sperm seen in the PCT correlated with a high number of motile sperm in the SA. These results support the use of the PCT for initial evaluation of the infertile couple.

Adult↗
PubMedDate not supplied

Whole-abdomen radiation therapy as salvage treatment for epithelial ovarian carcinoma.

PURPOSE: This study aimed to evaluate the efficacy and safety of whole-abdomen radiation therapy as salvage treatment in patients with ovarian cancer. PATIENTS AND METHODS: Twenty-seven patients who failed aggressive cytoreductive surgery followed by multiple-drug platinum-based chemotherapy were found to have recurrent epithelial carcinoma of the ovary and were treated with whole-abdomen radiation as salvage therapy. Dosage fractions were planned at 100 to 150 cGy daily to 3000 to 3500 cGy, followed by a pelvic boost at 150 to 180 cGy daily. All patients completed the planned treatment. The average treatment program required 53.5 days (range, 42-71 days). RESULTS: Survival rates at years 1 through 5 were 66%, 48%, 26%, 15%, and 15%, respectively. Residual disease at initiation of radiation correlated strongly with length of survival. The patients with microscopic disease survived an average of 63 months (range, 30-111 months). Patients with disease larger than 2 cm survived an average of 9 months (range, 5-17 months). Toxicity was seen in all patients. Eight patients experienced grade 3 or 4 toxicity, primarily white blood cell count and gastrointestinal toxicity. There were no deaths related to toxicity. DISCUSSION: This experience strongly suggests that whole-abdomen radiation is a viable salvage option, especially for patients with microscopic retroperitoneal disease or small-volume macroscopic disease.

Abdomen↗