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PubMed1999

Disabling occupational morbidity in the United States. An alternative way of seeing the Bureau of Labor Statistics' data.

The United States Bureau of Labor Statistics' (BLS) annual survey of occupational injuries and illnesses (ASOII) is one of the most frequently utilized sources of data on national occupational morbidity. In 1992 the BLS introduced a new and expanded survey method that collects more detailed data on cases with days-away-from-work (DAW). However, to date, the BLS has not released any official publication that contains a comprehensive set of crosstabulated part-of-body (BP) and nature-of-injury (NOI) data. To improve the understanding of national DAW case morbidity estimates, the study presented here utilized a special data-call and data-reduction strategy to identify the leading ASOII BP-NOI combinations for DAW cases by frequency, incidence rate, and severity (median DAW) for 1994. The results indicated the significance of disability associated with discrete trauma (ie, resulting from instantaneous or sudden events) in the US workplace. While morbidity associated with back pain clearly continued as the most frequent type of disabling case, fractures at critical anatomical sites (eg, pelvic region, leg, shoulder) were responsible for the most lengthy disability absences from work in 1994. In some instances these findings were contrary to conclusions typically inferred from BLS publications.

Back Pain↗
PubMed2004

Survey of bandage lens use in North America, October-December 2002.

PURPOSE: The purpose of this work was to report the findings of a survey of current modes of bandage lens (BL) use by optometrists and ophthalmologists in Canada and the United States in 2002. METHODS: Two thousand voluntary surveys were sent to ophthalmic practitioners across the United States and Canada. The survey contained a questionnaire with 15 questions about the practitioner's background and BL-prescribing trends and views. It also contained a 10-patient list with parameters such as patient profile, BL type, and pharmaceutical use. RESULTS: Seventy-two percent of those opthalmic practitioners who returned surveys have prescribed soft contact lenses for therapeutic purposes. BLs are most often used for corneal wound healing and for managing postoperative complications. Pharmaceuticals are concomitantly administered in more than 81% of the patients treated with BLs. The most commonly prescribed pharmaceuticals are antibiotics (47.5% of patients) and antiinflammatory drugs (42% of patients). ACUVUE and Focus Night & Day lenses are the most popular choices for BLs. Most respondents (93%), regardless of whether they routinely prescribed BLs, would be interested in a BL that could deliver a topical pharmaceutical drug. CONCLUSIONS: The results from the survey indicated that BL use is prevalent across North America. The BL-prescribing habits of North American practitioners indicate that there is a strong interest and need for a drug-delivering therapeutic soft contact lens.

Contact Lenses, Hydrophilic↗
PubMed1997

Population density, automated external defibrillator use, and survival in rural cardiac arrest.

OBJECTIVE: To determine whether population density is an independent predictor of survival from out-of-hospital cardiac arrest managed by basic life support (BLS) services using automated external defibrillators (AEDs). METHODS: A retrospective, observational study in Kentucky of 34 BLS services covering 22 counties during the years 1992 to 1994 who used AEDs to treat patients who had out-of-hospital cardiac arrests. RESULTS: Of 311 patients who had out-of-hospital cardiac arrests, 110 (35%) were defibrillated, 46 (15%) were resuscitated to hospital admission, and 19 (6%) survived to hospital discharge. Univariate predictors for survival to hospital discharge were emergency medical services response interval (from call receipt to ambulance arrival) < 8 minutes, defibrillation by the AED, initial rhythm of ventricular fibrillation or ventricular tachycardia (VF/VT), and population density > 100/square mile (sq mi) for the BLS service area (p < 0.001). A forced logistic regression model of survival to hospital discharge, using these 4 factors plus the presence of a witnessed arrest or bystander CPR, demonstrated that population density > 100/sq mi was highly significant (OR 9.4, 95% CI: 1.7 to 51.4, p < 0.01). Stepwise logistic regression models with combinations of these 6 factors found that survival to hospital discharge was best predicted by an initial rhythm of VF/VT (p = 0.004) and population density > 100/sq mi (p = 0.011). CONCLUSIONS: Population density is strongly associated with survival from out-of-hospital cardiac arrest. BLS services within areas with population densities < or = 100/sq mi sustained little benefit from the addition of AEDs to their treatment of patients who had out-of-hospital cardiac arrests.

Aged↗
PubMed1994

Epidemiological and clinical investigations into big liver and spleen disease of broiler breeder hens.

The epidemiological and clinical features of big liver and spleen disease (BLS) in flocks on two broiler breeder farms were investigated by serology and gross pathology. The most common necropsy findings on farm 1 were splenomegaly and hepatomegaly, with kidney enlargement in some birds. In one flock (farm 1), a decline in egg production began at 40 weeks of age and lasted for 9 weeks. Seroconversion to BLS antigen was first detected at 45 weeks (3.1% of birds) and increased to 72% at 50 weeks, which coincided with clinical recovery in the flock. Antigen was detected before antibody at 44 weeks and persisted at low incidence (< 15%). Farm egg production statistics and serology indicated that the disease affected all flocks on the farm. In three of eight flocks, seroconversion was detected in birds before peak production. The birds in the remaining sheds did not seroconvert or become sick until after peak production. On the second farm, sampling began within a flock already experiencing BLS. Clinical signs and pathology were similar to those seen in flocks on farm 1. However, the lesions that were seen in the pancreas in 15% of birds have not been reported previously. BLS antibody was detected in 78%, and circulating antigen in 14%, of sick birds.

Animals↗
PubMed1994

Cardiopulmonary resuscitation. Paper 1: A survey of undergraduate training in UK medical schools.

This paper presents the results of a UK national survey of Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) training for undergraduate medical students. In all responding medical schools, undergraduates are taught BLS at least once during their course but the assessment and refresher aspects of BLS training are not uniformly covered. There are inconsistencies in ACLS teaching, with some schools providing formal courses, some teaching specific techniques and others providing no ACLS teaching. Most interestingly, of those completing the questionnaire, only 52% considered present undergraduate training adequate to enable junior house officers to provide an effective resuscitation service. We recommend that all aspects of BLS and ACLS training for medical undergraduates be improved and standardized throughout the UK.

Cardiopulmonary Resuscitation↗
PubMed1986

A Periodontitis Severity Index.

A Periodontitis Severity Index (PSI) was developed and then tested in a population of 154 patients attending the University of Mississippi School of Dentistry screening clinic. Patients were grouped by age decade. The premises of the PSI follow: (1) Periodontitis is diagnosed on the concurrence of clinically apparent marginal inflammation and vertical loss of supporting periodontium (the severity of the associated clinical inflammation does not seem to be related to the severity of the tissue loss) and (2) a Schei ruler is used to determine from the radiograph the percentage of bone loss for a tooth surface. For each patient, a 0 to 1 Clinical Inflammation Score (CIS) was determined at the mesial and distal of every tooth. A CIS of 0 reflected no demonstrable clinical inflammation, whereas a CIS of 1 meant that clinical inflammation could be detected. A modified Schei ruler was used to determine the percentage of bone loss at each interproximal site. A Bone Loss Score (BLS) was calculated on a 0 to 10 whole number continuum. A BLS of 0 meant no bone loss, 1 = up to 10%, etc., up to BLS 10 = 90 to 100% loss. The PSI was then calculated for each mesial and distal surface. PSI = BLS X CIS. The PSI could be 0 if either no bone loss could be determined or the gingiva was healthy. In the presence of marginal inflammation, the PSI value was directly proportional to the percentage of bone loss. Mean PSI values were calculated for each age group. The PSI tended to increase with age. The PSI offers several advantages.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2005

[Evaluation of a self-efficacy-based basic life support program for high-risk patients' family caregivers].

PURPOSE: The purpose of this study was to evaluate a Self-efficacy-based Basic Life Support (SEBLS) program for high-risk patients' family caregivers on cardiac arrest. The SEBLS program was constructed on the basis of Bandura's self-efficacy resources as well as the International Liaison Committee on Resuscitation's "2000 Guidelines for CPR and ECC". METHOD: The effect of the SEBLS program on emergency response self-efficacy and emergency response behavior such as BLS (Basic Life Support) knowledge and BLS skill performance was measured by a simulated control group pretest-posttest design. Study subjects were38 high-risk patients' family caregivers (20 experimental subjects and 18 control subjects) whose family patients were admitted to a general hospital in Incheon, Korea. RESULT: 1. Emergency response self-efficacy was significantly higher in the experimental subjects who participated in the SEBLS program than in the control subjects. (t=8.3102, p=0.0001). 2. For emergency response behavior, BLS knowledge (t=5.6941, p=0.0001) and BLS skill performance (t=27.8281, p=0.0001) was significantly higher in experimental subjects than in control subjects. CONCLUSION: A SEBLS program can increase emergency response self-efficacy and emergency response behavior, and could be an effective intervention for high-risk patient's family caregivers. Long-term additional studies are needed to determine the lasting effects of the program.

Adult↗
PubMed2000

Molecular genetics of the Bare lymphocyte syndrome.

Major Histocompatibility Complex class II (MHC-II) molecules play a pivotal role in the adaptive immune system because they direct the development, activation and homeostasis of CD4+ T helper cells. Hereditary defects leading to the absence of MHC-II expression result in a severe autosomal recessive immunodeficiency disease called the Bare Lymphocyte Syndrome (BLS), also referred to as MHC-II deficiency. The genetic lesions responsible for BLS do not lie within the MHC-II locus itself, but reside instead in genes encoding transcription factors controlling MHC-II expression. Mutations in four different MHC-II regulatory genes are known to lead to BLS. These genes encode CIITA, RFXANK, RFX5 and RFXAP. CIITA (Class II Transactivator) is a transcriptional coactivator that functions as a master control factor dictating the cell type specificity, induction and level of MHC-II expression. RFXANK, RFX5 and RFXAP are the three subunits of RFX (regulatory factor X), a DNA-binding complex that binds to a conserved cis-acting sequence, the X box, present in the promoters of all MHC-II genes. Elucidation of the molecular defects underlying BLS has led to major advances in our understanding of the mechanisms regulating expression of MHC-II genes.

Animals↗
PubMed2003

Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) and Fas apoptosis in Burkitt's lymphomas with loss of multiple pro-apoptotic proteins.

BACKGROUND AND OBJECTIVES: Normal B-cells in the germinal center (GC) may be exposed to both tumor necrosis factor-related apoptosis inducing ligand (TRAIL) and Fas-L. Whether abrogation of TRAIL apoptosis is a feature in the genesis of B cell lymphomas of GC-phenotype is not known. We assessed the integrity of the TRAIL pathway in Fas-resistant and Fas-sensitive Burkitt s lymphomas (BLs). DESIGN AND METHODS: Expression of TRAIL receptors was determined by flow cytometry and Western blots. The extent of apoptosis following exposure to TRAIL was measured by annexin-V/propidium iodide dual staining. The integrity of the Fas and TRAIL apoptotic pathways was determined by Western blotting to assess cleavage of downstream caspases. Western blot analyses were used to determine the expression of pro- and anti-apoptotic proteins and the profile of expression was correlated with response to TRAIL and CH11. RESULTS: Our results demonstrate that BL expresses both functional and decoy TRAIL receptors. BLs with a functional Fas pathway retained sensitivity to TRAIL: Frequent and compound loss of expression of pro-apoptotic proteins can be identified in BLs resistant to Fas. However, loss of Bax, Bak and Bcl-Xs did not compromise sensitivity to TRAIL: INTERPRETATION AND CONCLUSIONS: Our results indicate that BLs frequently retain sensitivity to the TRAIL pathway. These results underscore the utility of TRAIL-based therapeutic strategies in the treatment of those B-cell lymphomas that may have compromised expression of several pro-apoptotic proteins.

Apoptosis↗
PubMed2004

In vivo tissue characterization using magnetic techniques.

Among the few non-invasive methods to quantify liver iron deposits, magnetic resonance imaging (MRI) and biomagnetic liver susceptometry (BLS) have been considered the best to evaluate iron overload in the body. This diagnosis is necessary for patients who regularly receive red blood cells transfusion and that have a genetic disorder known as hemochromatosis. In this work, we present the evaluation of the clinical usefulness of MRI and BLS of hepatic tissue to quantify iron deposits in non-transfused and transfused patients. Liver iron evaluation by MRI and BLS were performed in a group of 48 patients. The MRI images weighted in T2 were acquired using multi-slice single-spin-echo (SSE) and single-slice multi-spin-echo (MSE), conducted on a 1.5 T whole body scanner. BLS measurements were performed using an ac superconducting susceptometer based on SQUID. Typically MRI is able to evaluate iron overload in liver as high as 30 mg/g(dry tissue) when using MRI scanners provided with specially designed pulse sequences. For higher iron concentrations susceptibility measurement works better than MRI to evaluate higher iron overloads in the liver, because in this case there is saturation of MRI signal.

Adolescent↗
PubMed1990

[Cardiopulmonary resuscitation in Switzerland: time to act!].

Cardiovascular related deaths still represent about 50% of all demises despite their decreasing incidence in the United States and in Switzerland. About two thirds of these deaths are due to ischemic heart disease in which half of the patients die outside hospital, the majority of them two hours after the first symptoms. Moreover, sudden death is the first symptom of coronary artery disease in 25% of cases. In this country few of these persons receive adequate basic life support (BLS) at the scene because a coordinated plan to teach BLS to the citizen does not yet exist in Switzerland. With the aid of specialized medical societies, the Swiss Red Cross and affiliated organizations, it is proposed to elaborate a plan to teach BLS to the general public in Switzerland on the basis of the future European guidelines for BLS.

Death, Sudden↗
PubMed1989

Pharmacists' attitudes toward and use of cardiopulmonary resuscitation training received in pharmacy school.

Recent graduates of a pharmacy school were surveyed to determine their attitudes toward and use of cardiopulmonary resuscitation (CPR) and basic life support (BLS) training received as part of their pharmacy school instruction. Questionnaires were mailed to 215 pharmacists who had completed the mandatory CPR-BLS training; only those who had practiced pharmacy for at least 6 of the previous 12 months were asked to respond. Usable questionnaires were received from 187 of the pharmacists surveyed. Of the respondents, 134 (72%) believed that the CPR-BLS program should continue to be mandatory for graduation; 131 (70%) believed their training to be of value in their current practices, and 174 (93%) believed it would be of value in the future. Nine (5%) of the pharmacists had actually performed CPR since their graduation. Pharmacists practicing in small and large hospitals were more likely to participate in CPR than pharmacists in medium-sized hospitals, and such participation was associated with the presence of decentralized and clinical pharmacy services. Recent pharmacy graduates who had received mandatory CPR-BLS training in school had positive attitudes about the value of this training in their professional practices.

Attitude of Health Personnel↗
PubMedDate not supplied

The identification of an 18,000-molecular-weight antigen specific to big liver and spleen disease.

Big liver and spleen (BLS) disease is an infectious syndrome of broiler breeders that has been serologically diagnosed worldwide with the agar gel immunodiffusion test. Liver homogenate from an affected broiler breeder was used as the antigen source in this study. This paper reports the identification, from liver, of a soluble basic protein antigen (molecular weight 18,000) that is specific to BLS disease. The antigen was partially purified from soluble extract of liver using a two-step fractionation procedure comprising Sephacryl S200 gel filtration and carboxymethyl (CM) cellulose cation exchange. After cation exchange, the partially purified (CM) antigen contained approximately 12 proteins. Immunoblotting was used to identify the single BLS disease-specific antigen. In addition, a polyclonal rabbit antiserum raised to the CM antigen was found to be monospecific to the 18,000-molecular-weight antigen by immunoblotting on the CM antigen. This serum was also of use in specifically detecting intracellular BLS disease antigen in frozen cryostat sections by indirect immunofluorescence.

Animals↗
PubMed1995

How to evaluate an emergency medical dispatch system: a Belgian perspective.

In order to evaluate the local emergency medical dispatch centre, 4601 calls were analysed. Information was obtained from the tape recordings of the dispatch centre and standardized reports from the basic life support (BLS) teams, advanced life support (ALS) teams and the emergency departments of all receiving hospitals in the study area. The need for prehospital ALS care was assessed 'post hoc', based on the clinical findings at the scene and in the emergency department. The accuracy of the medical dispatch was evaluated by comparing the level of care actually sent with the real medical needs of the patient. The 4601 medical problems reported led to 4446 interventions: a BLS team only in 82% (n = 3627), an ALS team and BLS team simultaneously in 14% (n = 623), and a BLS team followed somewhat later by an ALS team in 4% (n = 196). In the 633 cases judged 'post hoc' to require prehospital ALS care, an ALS team was not sent in 260 (41%) or sent with some delay in 112 (18%). Of the 819 interventions of the ALS teams, 446 (54%) dealt with cases not requiring that level of care. With regard to the role of the dispatchers in the mismatches between the medical needs of the patients and the level of care sent, underestimation and overestimation of the severity of the emergency by the dispatchers was found in 31% and 22% cases respectively.

Belgium↗
PubMed1985

Binocular luminance summation in infants. A test for stereopsis?

The difference in pupil diameter between monocular and binocular viewing conditions has been found to be significantly different in human infants at an age of onset that is positively correlated with the age of onset for stereopsis. We attempted to use this information on binocular luminance summation (BLS) to devise a simple objective test using a direct ophthalmoscope in a modified two-part swinging-flashlight test. We evaluated 67 subjects with varying degrees of known heterotropia ranging in age from 16 hours to 20 years in an effort to determine a threshold measure of stereo-acuity or degree of heterotropia at which the test result might reproducibly change. We found BLS to be normally absent until about 4 months of age. All subjects older than 4 months manifested summation regardless of the extent of heterotropia, thus making our test unusable. We conclude that BLS is more than an ipsilateral consensual pupillary response, and we concur with others that these visual pathways must undergo maturation beyond the time of birth.

Adolescent↗
PubMed1996

Fatal and nonfatal injuries related to violence in Washington workplaces, 1992.

This study describes injuries related to assaults and violence that occurred in Washington State workplaces in 1992. Nonfatal injuries are emphasized. High-risk industries and occupations are described. Fatalities caused by work-related violence were identified using the 1992 U.S. Department of Labor Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries. Nonfatal injuries were identified using the BLS Annual Survey of Occupational Injuries and Illnesses and the Washington State workers' compensation system. Thirteen occupational fatalities resulted from assaults or violent acts in 1992. BLS data identified 784 nonfatal injuries that resulted in one or more day off work; workers' compensation data identified 2,395 claims. Industries experiencing the highest claim rates were Social Services (148 per 10,000) and Health Services (106 per 10,000). Nonfatal violent injuries were common and appeared to have different risk factors than fatal injuries. Industries in which injuries occurred were often predictable and suggested specific strategies for prevention efforts.

Absenteeism↗
PubMed1995

Establishment size and risk of occupational injury.

For many years, the annual survey of occupational injuries and illnesses by the Federal Bureau of Labor Statistics (BLS) has consistently reported, without explanation, that injury rates in the smaller establishments (< 50 employees) are substantially lower than those for midsize establishments (100-499 employees). Also during those years, a remarkable increase has been reported in the injury rate in large companies, following the imposition of stiff fines for failure to keep required injury records. The rate patterns are identical for Michigan and the country in general. We investigated possible causes for lower injury rates in small establishments since such rates are inconsistent with reports of higher fatality rates in small establishments in the mining, construction, manufacturing, and transportation industries and higher, or at least comparable, injury rates for small establishments in the mining industry. They are also inconsistent with increased turnover and decreased availability of occupational safety services in small companies. Moreover, injury severity, as measured by missed worktime, is greater for workers in small establishments. We investigated the possibility that interactions of workforce or injury characteristics with establishment size could explain the rate differences. We also reviewed the available literature to see whether differences in labor turnover rates could explain the BLS findings. Graphical and statistical analyses of the 1988 CPS Annual Demographic File, a sample of employed persons in the U.S. workforce, failed to identify any associations between workforce characteristics and enterprise size that would explain the lower rates. Similarly, graphical and statistical analyses of all Michigan workers incurring a compensable injury in 1986 failed to indicate any associations between injury characteristics and establishment size that would explain the lower rates. The potential role of labor turnover on the injury rate was analyzed from data in the literature on turnover rate by establishment size and risk of injury by time on the job. None of these analyses explains the lower injury rates reported for small establishments. This leaves underreporting of injuries from small establishments as a substantial possibility. If small establishments were subject to the same injury incidence rates as midsize establishments, then the 1986 survey for Michigan may have missed as many as 54,000 injuries (and far more nationally). We suggest that BLS undertake methodological studies to validate the completeness of reporting from small establishments.

Absenteeism↗
PubMed1994

Further delineation of the Beemer-Langer syndrome using concordance rates in affected sibs.

Six familial cases of the Beemer-Langer syndrome (BLS) were analyzed to further elucidate the spectrum and frequency of anomalies observed in this disorder. Preaxial polydactyly was found in 3/6 affected sibs, and, therefore, its frequency previously may have been underestimated. Some patients, described as infants affected with the Majewski syndrome (MS) or "atypical" short rib-polydactyly conditions, may indeed have BLS. A high frequency of brain defects (16/26) and cleft tongue, oral frenula, and/or natal teeth (13/29) widens the list of typical findings in this syndrome. The specific type of tibial defect seems to be the most important discrimination of the MS and the BLS.

Brain↗