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At least 199 records · Page 11Linked to original sources
PubMed2005

Temporoparietal transcranial magnetic stimulation for auditory hallucinations: safety, efficacy and moderators in a fifty patient sample.

BACKGROUND: Auditory hallucinations are often resistant to treatment and can produce significant distress and behavioral difficulties. A preliminary report based on 24 patients with schizophrenia or schizoaffective disorder indicated greater improvement in auditory hallucinations following 1-hertz left temporoparietal repetitive transcranial magnetic stimulation (rTMS) compared to sham stimulation. Data from the full 50-subject sample incorporating 26 new patients are now presented to more comprehensively assess safety/tolerability, efficacy and moderators of this intervention. METHODS: Right-handed patients experiencing auditory hallucinations at least 5 times per day were randomly allocated to receive either rTMS or sham stimulation. A total of 132 minutes of rTMS was administered over 9 days at 90% motor threshold using a double-masked, sham-controlled, parallel design. RESULTS: Hallucination Change Score was more improved for rTMS relative to sham stimulation (p = .008) as was the Clinical Global Impressions Scale (p = .0004). Hallucination frequency was significantly decreased during rTMS relative to sham stimulation (p = .0014) and was a moderator of rTMS effects (p = .008). There was no evidence of neurocognitive impairment associated with rTMS. CONCLUSIONS: Left temporoparietal 1-hertz rTMS warrants further study as an intervention for auditory hallucinations. Data suggest that this intervention selectively alters neurobiological factors determining frequency of these hallucinations.

Adult↗
PubMed2001

The efficacy and safety of nutritional supplement use in a representative sample of adults in the North/South Ireland Food Consumption Survey.

OBJECTIVE: To describe the current use of nutritional supplements and their contribution to micronutrient intakes in a representative sample of Irish adults, to evaluate the impact of supplement use on the adequacy of micronutrient intakes and to assess the risk to supplement users of exceeding tolerable upper intake levels (UL). STUDY DESIGN AND SUBJECTS: Food intake data were collected in 1379 (662 male and 717 female) randomly selected Irish adults aged 18 to 64 years using a 7-day food diary. The current use of nutritional supplements was assessed using a self-administered questionnaire and respondents entered each supplement as it was consumed into the food diary. RESULTS: Twenty-three per cent of respondents regularly used nutritional supplements. Twice as many women used supplements as men. The intakes of micronutrients were significantly higher (P<0.001) in supplement users than in non-users. Micronutrient intakes from food sources were similar in male users and non-users of supplements, but were significantly higher (P<0.01) in female users, by 3 to 13%, for Fe, Mg, Mn, vitamins C and E and niacin than in non-users. The percentage of female users between 18 and 50 years who had mean Fe intakes below the average requirement (AR) (10 mg) decreased from 50 to 25 when the contribution from supplements was included. The use of supplements reduced the percentage of men who had mean intakes below the AR for Zn from 19 to 13, for riboflavin from 14 to 6 and for vitamin A from 20 to 5, and reduced the percentage of women with intakes below the AR for Ca from 23 to 16 and for riboflavin from 23 to 14. Twenty-one women out of 80 aged between 18 and 50 years, who consumed supplemental folate, achieved the intake of 600 microg recommended to prevent neural tube defects. Twenty-two per cent of the women who took iron and 15% of the women who took vitamin B6 in supplemental form had mean daily intakes that exceeded that UL for these nutrients. Supplement users did not exceed the UL for the other micronutrients. CONCLUSIONS: Supplementation appears to be beneficial in promoting adequate intakes of some micronutrients, particularly Fe and folate in women aged 18-50 years and vitamin A in men. There appears to be little risk to supplement users of experiencing adverse side effects due to excessive intakes of micronutrients.

Adolescent↗
PubMed1998

The safety of brachial artery puncture for arterial blood sampling.

OBJECTIVE: This study was designed to determine the incidence of complications in a sample of 6,185 brachial artery punctures for arterial blood gas analysis. METHODS: The study sample was comprised of adult patients who had arterial blood gas analysis ordered in the course of their clinical evaluations in a multispecialty clinic and hospital affiliated with a university school of medicine. Subjects were entered prospectively at the time the procedure was done. RESULTS: The overall incidence of all complications was 2.0%. Immediate limb pain or parenthesias occurred in 1.1%, while the onset of symptoms was delayed up to 24 h in 0.9%. Hematoma formation occurred in only 0.06%. None of the complications was considered to be of major impact, in that none was associated with limb ischemia or other objective abnormalities. Only one subject required analgesic medication to control pain that ultimately subsided spontaneously without deficit. CONCLUSION: We believe that brachial artery puncture, when properly performed, is a safe and reliable alternative route for obtaining arterial blood for gas analysis.

Adolescent↗
PubMed1989

Endometrial sampling: analysis of 310 procedures performed by family physicians.

Endometrial sampling has become an accepted office procedure. Safety and clinical usefulness have been well established but not specifically studied in family practices. To address the safety and clinical usefulness of endometrial sampling, a chart review of 310 endometrial sampling procedures performed by practicing family physicians was undertaken. Cases were identified by billing records and chart auditing to assure complete recording of all procedures performed by study practitioners since the beginning of their practices. A prestudy survey revealed that 26% of rural family physicians and none of the urban family physicians in western New York were doing endometrial sampling. Practitioners were doing an average of 1.2 per month. Of the 310 procedures 14.5% were unsuccessful because of cervical stenosis or inadequate sample. There were no reported complications, and three cases of endometrial carcinoma were discovered. Endometrial sampling is safe and clinically useful when performed by family physicians.

Adolescent↗
PubMedDate not supplied

Complementary and alternative medicine in pediatric oncology.

Children with cancer and their families use complementary and alternative medicine (CAM) to reduce symptoms, cope with life-threatening illness, and improve overall well-being. Despite numerous published surveys on the use of CAM in pediatric oncology, few studies have tested CAM therapies for safety and efficacy. A growing body of literature in adult oncology provides evidence for the role of CAM to help manage symptoms and reduce distress. Translating this research to children requires studies with new models that address family roles and include measurement of outcomes relevant to children's developmental stages and unique responses. One of the limitations in pediatrics is the small samples available to single institutions. Conducting clinical trials through the cooperative group mechanism is one way of obtaining sufficient sample sizes to determine effectiveness and safety of CAM therapies. This article summarizes research to date and describes a beginning approach to measuring outcomes of supportive CAM therapies in children with cancer.

Affect↗
PubMed1997

Frequency and structure of precautionary behavior in the domains of hazard preparedness, crime prevention, vehicular safety, and health maintenance.

A sample of 831 adults were interviewed by researchers using a 72-item inventory about their precautionary behaviors and attitudes. Exploratory and confirmatory factor analyses conducted on random halves of the sample provided evidence of consistency and structure in precautionary behavior both within and across domains of concern. Hazard preparedness activities clustered into having basic supplies on hand, advance planning, and hazard alertness. Crime prevention acts organized according to person protection, neighborly cooperation, and professional guidance. Vehicular safety factored into auto care, responsible driving, and seat belt use. Health maintenance activities entailed healthy habits (diet and exercise), risk monitoring, and avoiding tobacco and alcohol. Higher order factor analyses evidenced intra-individual consistency in the use of Disciplined, Vigilant, and Proactive Behaviors across precautionary domains. At all levels, perceptions of the usefulness of precautionary measures were related strongly to the frequency of self-protective acts.

Adult↗
PubMed1996

SampLink: a new system for the collection of donor blood samples.

Increasing demands for screening tests on blood donors, which require a large number of undiluted samples, and the rising concern for the safety of the phlebotomists have led to the development of a new blood sampling system. The new device was evaluated during the collection of 60 blood units, and compared with 50 control units collected using the "cut and drip' method. The time required for both blood donation and donor samples collection, blood component quality, coagulation factors activation and haemolysis were studied. In addition, reports and recommendations of Magen David Adom phlebotomists were evaluated after collecting 75000 units using the new device. Donor sample collection with the new device was comparable and somewhat shorter than with the "cut and drip' method, while the blood unit collection time remained unchanged. There were no differences in plasma haemoglobin, factor VIII and platelet yields and morphology scores in blood units and donor samples collected by the two methods. There were no reported instances of needle-sticks among phlebotomists using either method. The new device was simple to operate, improved blood donor samples collection practice and enabled the collection of as many undiluted donor samples as required for routine testing. In addition, the use of vacuum tubes ensured sterility, safety and standardization of samples. The components provided were comparable in quality to those prepared from units collected by other methods.

Blood Banks↗
PubMed1991

Health values, locus of control, and cues to action as predictors of adolescent safety belt use.

Pender's health promotion model was used as the conceptual framework for analyzing the relationship among health value, locus of control, and other cues influencing the use of a safety belt by adolescents. The sample consisted of 320 11th and 12th graders. A mandatory safety belt law had been in effect in the state for 11 months when it was repealed 6 months prior to this study. Data were collected by questionnaires. The theory was supported in part by study results. Adolescents reported higher safety belt use during the time the law was in effect, and those who learned to drive during that period reported higher safety belt use than those who learned to drive when no law was in effect. Parents'/friends' safety belt use and perceived benefits of safety belt use was positively correlated with adolescent's use. The number of perceived barriers was negatively correlated with safety belt use. Locus of control and health value were not significantly correlated with belt use. Based on these findings, there are educational and legislative opportunities for increasing adolescent safety belt use.

Adolescent↗
PubMed1997

Principles and practice of 'high risk' brain banking.

The storage of tissues obtained from patients with clinically documented and neuropathologically validated diseases of the central nervous system (CNS), and from well-chosen control cases, forms a valuable resource for present and future research needs. In particular, it facilitates immediate application of new investigative technology as this becomes available. To maximize their usefulness it is desirable to store tissues in a variety of different forms, including fixed and frozen samples. However, storage of infective dementias poses special problems (including risk to future users) since the infective agent may well survive long-term storage at -70 degrees C. Guidelines for optimal storage of such tissues should conform with safety, but should not be so prescriptive as to deter pathologists who do not have access to sophisticated brain banking resources. This article provides information about tissue storage from infective CNS diseases for pathologists who may require to retain frozen and other samples from such autopsies either occasionally or on a regular basis. Guidelines are offered for banking tissues from cases infected with human immunodeficiency virus (HIV), hepatitis viruses and prions. With detailed description of procedures for acquisition, storage and transparent of high-risk samples. Safety issues and protocols for response to accidental injury involving exposure to these agents are highlighted in this article.

Brain↗
PubMedDate not supplied

[Sampling plans and microbiological criteria as risk management options in recently developed food safety concerns].

In connection with the World Trade Organization SPS-Agreement new concepts for ensuring food safety have been discussed for some years now. Main topics have been quantitative risk analyses investigating relationships between microbial concentrations in foods and disease probabilities as well as the concept of food safety objectives developed by ICMSF. So far food safety demands have been defined as microbiological criteria. However, usually it is not transparent, whether sampling plans incorporated in such criteria are based on specific prescriptions with regard to decision reliability and tolerable food qualities. In addition, it is still to be discussed, which parts microbiological criteria can play in connection with new concepts of food risk management, for instance as an option to test whether food safety objectives are met or not. The performance of microbiological sampling plans, as visualized by operation characteristic curves, assumptions made in this context, and relationships between food safety objectives and microbiological criteria as well as implications for food safety issues are investigated in this paper.

Colony Count, Microbial↗
PubMed2005

A descriptive study of the perceptions of workplace violence and safety strategies of nurses working in level I trauma centers.

INTRODUCTION: Workplace violence is a significant occupational hazard in health care. As the largest group of employees in health care, nurses are particularly vulnerable to workplace violence, with those who work in emergency departments being especially at risk. The purpose of this research was to study the phenomenon of workplace violence by interviewing emergency nurses who had experienced violence while on duty. METHOD: A descriptive study approached the issue of workplace violence from the perspective of 8 registered nurses from 2 level I trauma centers who volunteered to be interviewed. Cross-case comparison of the interview responses was used to analyze the data from verbatim transcripts. RESULTS: Emergency nurses identified specific experiences of violence at work. Inadequate safety measures and vulnerability were the 2 themes that were consistently verbalized through out the interviews. IMPLICATIONS FOR NURSING PRACTICE: The emergency nurses who were interviewed discussed their experiences with patients, family members, and others who exhibited violent and aggressive behavior. They identified safety measures that they believed were inadequate and discussed their feelings of vulnerability because of violent incidents at work. Further research with larger samples could confirm specific safety problems in emergency departments that must be addressed to provide a safer workplace for emergency nurses, their colleagues, and their patients.

Aggression↗
PubMedDate not supplied

Exposure of miners to diesel exhaust particulates in underground nonmetal mines.

A study was initiated to examine worker exposures in seven underground nonmetal mines and to examine the precision of the National Institute for Occupational Safety and Health (NIOSH) 5040 sampling and analytical method for diesel exhaust that has recently been adopted for compliance monitoring by the Mine Safety and Health Administration (MSHA). Approximately 1000 air samples using cyclones were taken on workers and in areas throughout the mines. Results indicated that worker exposures were consistently above the MSHA final limit of 160 micrograms/m3 (time-weighted average; TWA) for total carbon as determined by the NIOSH 5040 method and greater than the proposed American Conference of Governmental Industrial Hygienists TLV limit of 20 micrograms/m3 (TWA) for elemental carbon. A number of difficulties were documented when sampling for diesel exhaust using organic carbon: high and variable blank values from filters, a high variability (+/- 20%) from duplicate punches from the same sampling filter, a consistent positive interference (+26%) when open-faced monitors were sampled side-by-side with cyclones, poor correlation (r 2 = 0.38) to elemental carbon levels, and an interference from limestone that could not be adequately corrected by acid-washing of filters. The sampling and analytical precision (relative standard deviation) was approximately 11% for elemental carbon, 17% for organic carbon, and 11% for total carbon. An hypothesis is presented and supported with data that gaseous organic carbon constituents of diesel exhaust adsorb onto not only the submicron elemental carbon particles found in diesel exhaust, but also mining ore dusts. Such mining dusts are mostly nonrespirable and should not be considered equivalent to submicron diesel particulates in their potential for adverse pulmonary effects. It is recommended that size-selective sampling be employed, rather than open-faced monitoring, when using the NIOSH 5040 method.

Adult↗
PubMedDate not supplied

Statistical methods for establishing equivalency of a sampling device to the OSHA standard.

Occupational Safety and Health Administration (OSHA) regulations allow the use of an alternative sampling device for exposure monitoring provided the device has been demonstrated to be equivalent to the standard device. For example, the OSHA standard allows the use of an alternate cotton dust sampler that is equivalent to the Lumsden-Lynch vertical elutriator (VE); also, OSHA defines the accuracy of the monitoring device for measuring airborne chemicals such as benzene and sulfur dioxide. Typically, the OSHA criterion is that 90% of the readings of the sampling device should be within +/- 25% of the readings obtained by the standard device or within +/- 25% of the actual airborne chemical concentration. This article proposes two statistical tests for establishing that an alternative measuring device of airborne chemicals or dust is equivalent to the OSHA standard. The statistical tests are illustrated using an example.

Air Pollutants, Occupational↗
PubMed2002

Total dust, respirable dust, and microflora toxin concentrations in Colorado corn storage facilities.

To aid in the process of characterizing corn dust exposures on farms and in elevators in northeastern Colorado, several parameters were examined. Total dust and respirable dust samples were collected and evaluated. Potentially dangerous dust components evaluated were respirable silica, endotoxin, and mycotoxin levels. Many of the total dust samples (58%) would have exceeded 8-hour time-weighted average (TWA) had sampling been conducted for 8 hours; on farms the operation takes between two and four hours. The same statement may be made for respirable dust samples collected for this project. Nearly 33 percent of the respirable dust samples collected would have exceeded the Occupational Safety and Health Administration (OSHA) TWA had sampling been conducted over an 8-hour period. Respirable silica standards were exceeded at 25 percent of the sampling locations. Presence of mycotoxins at all sites was confirmed by the use of ELISA kits. The most significant finding of this study was high levels of endotoxin at several of the sampling sites. Eighty-five percent of the sampling locations had endotoxin levels above 500 EU/m3. One location, Farm 4, had endotoxin levels of above 1.7 million EU/m3.

Agriculture↗
PubMed2004

Urban adolescents' exposure to community violence: the role of support, school safety, and social constraints in a school-based sample of boys and girls.

This study examined recent exposure to violence in the community and in other settings, protective factors, and current psychological functioning among 349 young adolescents from 9 urban middle schools. The majority (76%) of adolescents reported witnessing or being victimized by at least 1 violent event in the prior 6 months. Nearly half of adolescents who had talked about their experience of a violent event reported feeling constrained from sharing their thoughts or feelings because of others' reactions. After controlling for daily hassles, more exposure to violence was associated with more self-reported posttraumatic stress disorder (PTSD) and depressive symptoms. Exposure to violence was not a significant predictor of teachers' ratings of adaptive functioning or internalizing symptoms. Support from specific individuals, perceived school safety, and lower constraints for discussing violence showed protective effects in the relation between exposure to violence and specific dimensions of psychological functioning. The implications of this research for school-based interventions are discussed.

Adolescent↗
PubMed1991

Single-center comparison of results of 1000 prenatal diagnoses with chorionic villus sampling and 1000 diagnoses with amniocentesis.

Large multicenter studies have confirmed the safety and accuracy of chorionic villus sampling as a prenatal genetic diagnostic procedure, but there have been few single-center evaluations. We report our experience with 1000 consecutive chorionic villus sampling procedures compared with 1000 consecutive amniocentesis procedures during the same period. The procedures were performed by the same genetic counselors, sonographers, obstetricians, and laboratory personnel. Indications for referral, demographic characteristics of patients, numbers of attempts per patient, fetal loss rates, laboratory results, and evaluation of accuracy are included. Analysis of all data suggests that chorionic villus sampling is a safe and accurate alternative to amniocentesis in our community-based teaching hospital.

Adult↗
PubMed1994

Failure to follow safety instructions: faulty communication or risky decisions.

The faulty communication versus risky decision hypotheses of failure to follow safety instructions were explored in a laboratory experiment. Four groups of 10 male college students differing in tool-using experience and safety orientation were asked to perform work sample activities with an electric chain saw. Safety orientation was provided by classroom lecture content. Dependent variables were compliance with safety warnings contained in the chain saw operating instructions and recognition of those instructions in a posttrial test. Understanding of instructions was verified by posttrial interview. Overall group compliance with the test safety instructions was 55.6%. Compliance for the group experienced with chain saws was 41.25%; for the inexperienced group it was 70%. An ANOVA showed both tool experience and safety orientation to be significant in influencing compliance. Instruction recognition was 87.5% overall with no difference between groups. Interviews revealed that the groups made an assessment of subjective risk dependent on their individual experience and safety orientation and acted accordingly.

Adult↗
PubMed1995

Diagnostic value of fine-needle puncture of the gallbladder: side effects, safety, and prognostic value.

Bile sampling without the risk of contamination by pancreatic and duodenal secretions and avoiding unpredictable influences of general anesthesia during biliary surgery on biliary analytics are feasible with percutaneous puncture of the gallbladder. In 207 patients with gallstones, gallbladder puncture was performed under local anesthesia with a 22-gauge spinal needle under continuous real-time ultrasound guidance. Bile samples were investigated for biliary lipids and nucleation time. Complete aspiration of gallbladder bile could be achieved in all patients without complications such as bleeding, bile leak, or inflammation. Of these patients, 11.6% reported mild abdominal problems, 3.4% required analgetics, and in 1.0% biliary colics were observed. Elective cholecystectomy was performed in 1 patient. Of the bile samples, 10.1% were contaminated with bactobilia. Biliary lipids, cholesterol saturation index (CSI), total lipid concentration (TLC), and bacteriological contamination were independent of gallstone number, whereas patients with solitary gallbladder stones exhibited a significantly longer nucleation time (NT) in comparison with those with multiple stones. In patients with gallstones, fine-needle puncture of the gallbladder represents an important diagnostic procedure and can be performed within minutes without major side effects if performed by an experienced sonographer.

Adult↗