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PubMed2000

Effects of pool-fencing ordinances and other factors on childhood drowning in Los Angeles County, 1990-1995.

OBJECTIVES: This study estimated the effects of local pool-fencing ordinances and other factors on the rate of childhood drowning in Los Angeles County, California. METHODS: Stage 1 was a retrospective dynamic cohort study of all drownings among children younger than 10 years that occurred in residential swimming pools in Los Angeles County between 1990 and 1995. Stage 2 was a matched case-control study that compared pools in which childhood drownings occurred (cases) with randomly selected pools in which drownings did not occur (controls). RESULTS: The drowning rate was relatively high among toddlers (aged 1-4 years), boys, and African Americans and in areas with a high density of residential swimming pools. Pool-fencing ordinances were not associated with a reduced overall rate of childhood drowning. CONCLUSIONS: Local ordinances enacted in Los Angeles County before 1996 do not appear to have been effective in reducing the rate of childhood drowning in residential pools. Possible reasons for this ineffectiveness are insufficient building codes for isolating pools from homes, inadequate enforcement of the ordinances, and inadequate operation or maintenance of fencing equipment by pool owners.

Age Distribution↗
PubMedDate not supplied

The case of the high-risk safety product.

After several days of meetings, J.F. Winchester, president of MDC Industries, felt no closer to a decision. MDC, a manufacturer of wall and ceiling panels, was considering whether to exercise an option to buy a new and safer wallboard technology. The product was being touted as revolutionary, but, Winchester wondered, could MDC afford to carry the flag? According to its inventor, Robert Goerner, Smoke-Safe would be a vast improvement over standard safety-rated wallboard. With almost the same flame-retardant properties, Smoke-Safe had the advantage of giving off almost no fumes or smoke in fire tests. And, Winchester knew, most fire-related deaths are from smoke, not flames. Indeed, the numbers were grimly persuasive: 82% of fire-related injuries involving standard panels were caused by smoke inhalation. What's more, Smoke-Safe would cost about the same to manufacture as MDC's current wallboard. But MDC had several other good options for spending the $5 million Goerner was asking; building plastics was only one of its profit centers. And the prospect of launching a campaign to change building codes in order to market Smoke-Safe, which could spark a fight with competitors, was daunting. Since its current wallboard gave MDC only 18% of the wallboard market, many industry insiders speculated whether MDC had the market clout to influence major cities to revise their codes. Six experts in marketing, law, and ethics advise MDC Industries on how it can balance ethical and business imperatives in making its decision.

Consumer Product Safety↗
PubMed1992

Atlanta's Grady renovating for the future.

Grady Memorial Hospital in Atlanta has opened a new emergency-care center, designed around a fast-track system. It's only part of a massive $318 million renovation affecting nearly every department in the public hospital. When the project is completed in 1995, it will allow Grady to meet building codes, increase its total number of beds to 1,024 and eliminate duplicative services.

Efficiency↗
PubMedDate not supplied

Project planning in the diagnostic imaging department.

Certain common steps in the planning process are necessary to ensure the success of any construction project in a diagnostic imaging department. Determining the need for the project, analyzing requirements for equipment, space and personnel, and budgeting for the project are necessary steps. They are followed by scheduling and designing the various aspects of the project. Engineering the construction phase and implementation with follow-up are the last steps. Determining whether a proposed project is necessary is the essential first step. Doing a cost-benefit analysis and determining if the return on the investment will be positive are important for a project's success. Good planning and communication with key staff members of the healthcare institution and the members of the design and construction team will help ensure successful implementation of any project. The role of the facility engineer is often critical in the early planning stages of a project to determine what utilities may be needed, any need for plumbing or electric work, power sources, building code requirements, the need for medical gasses and suction and so forth. Analysis of a potential project's equipment, space and personnel needs is also critical. Gathering the necessary information from various sources within the healthcare institution is essential. The steps for scheduling and designing an entire project should include finalizing the design and developing a schedule for its implementation. Keeping accurate minutes and documenting action items from all project meetings can serve to protect the budget. By following the steps outlined, budgeting time efficiently and delegating some tasks to others, the radiology administrator can continue to perform tasks involved in the day-to-day management of a radiology department.

Budgets↗
PubMed1989

Cost reductions from a smoking policy.

The health of its workforce is of paramount importance to a business. The loss of even one key person to heart and lung disease can have a detrimental effect on organizational efficiency. Provided strides similar to those made in the last five years continue, perhaps within the next five years major employers will have all work areas smoke free. In large cities considerable help in implementing a nonsmoking policy is available to employers. Individual companies need to consider the merits of each type of program and then decide which best fits the organization. Compared with a nonsmoker, the average employed smoker in the United States 1. Takes approximately 50% more sick leave 2. Uses the health care system at least 50% more 3. Suffers over twice the mortality rate during working years 4. Spends 6% of working hours smoking 5. Causes indoor work facilities to expend six times the capital and operating outlays to maintain air circulation rates that meet building code specifications 6. Imposes a much greater maintenance burden for cleaning, repairing, repainting and replacing furnishings and equipment 7. Imposes unnecessary costly liability on employers for damages sustained by co-workers who are forced to work in a smoky environment 8. Exacts a high price in employee morale because of the irritation and discomfort suffered by fellow workers.

Cost Control↗
PubMedDate not supplied

Biomaterials and biomechanics of oral and maxillofacial implants: current status and future developments.

Research in biomaterials and biomechanics has fueled a large part of the significant revolution associated with osseointegrated implants. Additional key areas that may become even more important--such as guided tissue regeneration, growth factors, and tissue engineering--could not be included in this review because of space limitations. All of this work will no doubt continue unabated; indeed, it is probably even accelerating as more clinical applications are found for implant technology and related therapies. An excellent overall summary of oral biology and dental implants recently appeared in a dedicated issue of Advances in Dental Research. Many advances have been made in the understanding of events at the interface between bone and implants and in developing methods for controlling these events. However, several important questions still remain. What is the relationship between tissue structure, matrix composition, and biomechanical properties of the interface? Do surface modifications alter the interfacial tissue structure and composition and the rate at which it forms? If surface modifications change the initial interface structure and composition, are these changes retained? Do surface modifications enhance biomechanical properties of the interface? As current understanding of the bone-implant interface progresses, so will development of proactive implants that can help promote desired outcomes. However, in the midst of the excitement born out of this activity, it is necessary to remember that the needs of the patient must remain paramount. It is also worth noting another as-yet unsatisfied need. With all of the new developments, continuing education of clinicians in the expert use of all of these research advances is needed. For example, in the area of biomechanical treatment planning, there are still no well-accepted biomaterials/biomechanics "building codes" that can be passed on to clinicians. Also, there are no readily available treatment-planning tools that clinicians can use to explore "what-if" scenarios and other design calculations of the sort done in modern engineering. No doubt such approaches could be developed based on materials already in the literature, but unfortunately much of what is done now by clinicians remains empirical. A worthwhile task for the future is to find ways to more effectively deliver products of research into the hands of clinicians.

Biocompatible Materials↗
PubMed1987

Radon in homes. Council on Scientific Affairs.

Radon 222 and its radioactive decay products can enter buildings and, through inhalation, expose the inhabitants' pulmonary tissues to ionizing radiation. Studies of radon levels in the United States indicate that variations of 100-fold or greater exist among private dwellings. In one region, 55% of homes had levels exceeding 4 pCi/L (0.15 Bq/L), which is the guidance level recommended by the US Environmental Protection Agency. Ventilation and tightness of construction are important determinants of radon levels. In some instances, fans or heat exchangers can reduce excessive concentrations, but in others more elaborate remedial measures may be required. Physicians may obtain information about radon through Environmental Protection Agency regional offices and state radiation control programs. The risk of radiogenic cancer is believed to increase with exposure to ionizing radiation. According to some estimates, concentrations of radon decay products in US homes could be responsible for several thousand cases of lung cancer per year. Studies of radon levels in representative buildings and guidelines are needed to ensure safe, effective, and cost-effective countermeasures. Architects, contractors, designers, building code administrators, health physicists, and biomedical investigators can help with solutions.

Air Pollutants↗
PubMed1994

Indoor air quality medicolegal issues.

The regulatory and legal communities have begun only recently to address the medicolegal issues surrounding indoor air quality. No single governmental agency is responsible for indoor air quality issues. The focus of the federal government's indoor air quality programs is on the gathering and dissemination of information rather than on the regulation of indoor air pollution. State and local regulatory controls vary but may include antismoking ordinances, building codes, and contractor certification programs. Numerous lawsuits involving various parties and legal theories have been filed on the basis of illness allegedly related to indoor air quality. Further regulatory and legal review of indoor air problems will likely occur in the near future, particularly as a result of the characterization of environmental tobacco smoke as a class A carcinogen.

Air Pollution, Indoor↗
PubMed1997

Earthquakes: health outcomes and implications in Lebanon.

Earthquakes remain damaging to human life and property. Recent reports point out that there is 50% chance to have a damaging earthquake in the next 50 years in Lebanon. Major health outcomes of earthquakes include physical injuries, cardiovascular effects and psychological reactions. Physical injuries are correlated with entrapment, higher number of floors in buildings and behavior at time of impact. Cardiovascular effects of earthquakes are either immediate or delayed. Immediate cardiovascular effects are exemplified by increased coronary death while delayed effects are reflected by the increase in coronary risk factors such as serum triglycerides and heart rate. The severity of PTSD decreases as the distance from the epicenter of the earthquake increases. Preventive measures such as implementation of safety building codes, medical emergency readiness and public education should be carried out in areas threatened by earthquakes. Also special mental health programs should be executed following an earthquake.

Cardiovascular Diseases↗
PubMed1985

Building permanent memory codes: codification and repetition effects in word identification.

The studies presented in this article investigate the memory processes that underlie two phenomena in threshold identification: word superiority over pseudowords and the repetition effect (a prior presentation of an item facilitates later identification of that item). Codification (i.e., the development of a single memory code that can be triggered even by fragmented input information) explains the faster and more accurate identification of words than pseudowords. Our studies trace the development and retention of such codes for repeated pseudowords and examine the growth and loss of the repetition effect for both pseudowords and words. After approximately five prior occurrences, words and pseudowords are identified equally accurately in two types of threshold identification tasks, suggesting codification has been completed for pseudowords. Although the initial word advantage disappears, the accuracy of identification still increases with repetitions. The facilitation caused by repetition is not affected much by spacing within a session, but drops from one day to the next, and after a delay of one year has disappeared (new and old words were identified equally well). These results suggest an episodic basis for the repetition effect. Most important, after one year, performance is equal for old pseudowords and new and old words: all these levels are superior to that for new pseudowords, suggesting that the learned codes for pseudowords are as strong and permanent as the codes for words. A model of identification is presented in which feedback from codes and episodic images in memory facilitates letter processing. An instantiation of the model accounts for the major features of the data.

Attention↗