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At least 595 records · Page 33Linked to original sources
PubMed2006

A qualitative study to identify factors influencing COXIB prescribed by family physicians for musculoskeletal disorders.

INTRODUCTION: Cyclo-oxygenase-2 inhibiting (COXIB) anti-inflammatories have been the drug class prescribed for a large number of cases of musculoskeletal (MSK) disorders in Canada over the past 5 years. The Alberta Improvements for MSK Disorders (AIMS) initiative sought to better understand the COXIB prescribing situation by funding several studies. The objective of this qualitative study was to determine the factors underlying primary care physicians' medication prescribing behaviour during an office visit for an MSK disorder, with particular emphasis on the prescribing of COXIBs. METHODS: The target respondents were Alberta primary care physicians chosen from a stratified random sample to meet a wide range of characteristics. Individual, semi-structured interviews were used to assess decision pathways in four real cases chosen by the physician. A total of 19 interviews were conducted and analysed using an analytic inductive approach. RESULTS: Factors judged as being important to decision pathways in relation to COXIB prescribing for MSK disease included safety, patient characteristics, affordability to patients, availability of samples, drug company marketing practices, habit formation, time contstraints, previous clinical experience of doctors and/or patient with certain drugs and doctors' perception of absolute versus relative risk. Interpretation. Most physicians preferentially prescribed COXIBs subsequent to a complicated, multifactorial, but essentially patient-centred, decision-making process.

Alberta↗
PubMed1998

The transition to registered nurse: the experience of a group of New Zealand degree graduates.

Since 1991, entry to the nursing profession in New Zealand has primarily been through a three year degree programme. The purpose of this study was to explore the issues faced by a group of degree graduates in their first year of registered nurse practice and to identify if the degree outcomes (such as critical thinking, problem solving, reflection on practice, research, independent learning and using cultural safety knowledge) had mediated this transition process. Purposive sampling was used to invite five female graduates to take part in two focus groups, one held at 4 months and the other at 9 months after starting work. Qualitative data were collected using semi-structured questions and the taped interviews were analysed for themes. Five themes were identified: accepting responsibility, accepting their level of knowledge, becoming a team member, professional standards, and workplace conditions. Graduates were using their cultural safety knowledge but they perceived their knowledge of research was linked to further academic study. Their ability to critique their own practice was evident but they found it more difficult to challenge their colleagues' practice and the wider agency culture. Implications of the study are discussed in relation to nursing education and preceptor programmes and areas for further research are indicated.

Adaptation, Psychological↗
PubMed1992

First-trimester exposure to alprazolam.

OBJECTIVE: To assess prospectively pregnancy outcome associated with first-trimester exposure to alprazolam in order to monitor for early signals of potential drug-related risk to the fetus. METHODS: Reports of first-trimester exposure to alprazolam from patients, physicians, or pharmacists were registered. Information regarding drug exposure, risk factors, and pregnancy outcome was requested at 4.5 and 9 months after registration. RESULTS: From June 1982 through December 1990, 542 pregnancies had been registered. Follow-up data were obtained on 411 registrants. There were 13 live births with congenital anomalies, 263 live births with no congenital anomalies, 47 spontaneous fetal losses, and 88 elective abortions. CONCLUSIONS: No pattern of defects or excess of defects or spontaneous abortions was apparent. Although these findings may provide some reassurance in counseling women following inadvertent prenatal exposure, the cases represent a sample of insufficient size for reaching reliable and definitive conclusions about the safety of alprazolam for pregnant women and their developing fetuses. The cases accumulated in this report represent a sample of insufficient size to confirm or refute previous reports of specific congenital anomalies linked to exposure to benzodiazepines.

Abnormalities, Drug-Induced↗
PubMed1999

Laboratory evaluation of a protocol for personal sampling of airborne particles in welding and allied processes.

A new European/International Standard (ISOprEN 10882-1) on the sampling of airborne particulates generated during welding and allied processes has been proposed. The use of a number of samplers and sampling procedures is allowable within the defined protocol. The influence of these variables on welding fume exposures measured during welding and grinding of stainless and mild steel using the gas metal arc (GMA) and flux-cored arc (FCA) and GMA welding of aluminium has been examined. Results show that use of any of the samplers will not give significantly different measured exposures. The effect on exposure measurement of placing the samplers on either side of the head was variable; consequently, sampling position cannot be meaningfully defined. All samplers collected significant amounts of grinding dust. Therefore, gravimetric determination of welding fume exposure in atmospheres containing grinding dust will be inaccurate. The use of a new size selective sampler can, to some extent, be used to give a more accurate estimate of exposure. The reliability of fume analysis data of welding consumables has caused concern; and the reason for differences that existed between the material safety data sheet and the analysis of fume samples collected requires further investigation.

Air Pollutants↗
PubMed1994

An approach for estimating workplace exposure to o-toluidine, aniline, and nitrobenzene.

A comprehensive approach to estimating worker exposure to o-toluidine, aniline, and nitrobenzene using a combination of surface wipe, dermal badge, and air samples is described. Desorption of each sample was accomplished with ethanol followed by analyses using capillary gas chromatography with flame ionization detection. Analyte recovery was maximized when the gauze wipes and dermal badges were immediately desorbed in ethanol after sample collection. Sample collection of the airborne analytes was improved over previous solid sorbent samples by using a sampling train consisting of an acid-treated glass fiber filter in series with a large capacity silica gel tube (520/260 mg). The greatest recoveries of aniline and o-toluidine were from the acid-treated glass fiber filters and nitrobenzene from the large capacity silica gel sorbent tubes. The limit of detection for each analyte (1 micrograms) was approximately 10 times more sensitive than reported in previous National Institute for Occupational Safety and Health methods. Analyte recoveries for air samples were greatest under conditions of moderate relative humidity (53%), moderate sample volumes (< 50 L), and low flow rates (0.2 L/min). The overall relative standard deviation of the analytical method was 4.3%.

Air Pollutants, Occupational↗
PubMed2003

Survival of Escherichia coli O157:H7, Listeria monocytogenes 4b and Yersinia enterocolitica O3 in different yogurt and kefir combinations as prefermentation contaminant.

AIMS: To compare microbiological safety of yogurt, kefir and different combinations of yogurt and kefir samples by using three foodborne pathogenic strains (Escherichia coli O157:H7, Listeria monocytogenes 4b and Yersinia enterocolitica O3) as indicators. METHODS AND RESULTS: Fresh yogurt and kefir drinks were added to pasteurized milk at a 5% rate either separately or together, and then incubated at different temperatures (43 degrees C for yogurt and 30 degrees C for kefir), depending on appropriate growth temperature of their starter microflora. While traditional yogurt was found to be the least suppressive on the three pathogenic micro-organisms, samples obtained from two subsequent fermentation process (samples fermented at 43 degrees C for 3 h and at 30 degrees C for 21 h) were more suppressive than that of traditional kefir. There was no significant survival difference between E. coli O157:H7 and L. monocytogenes 4b in samples tested (P > 0.05), but Y. enterocolitica O3 was more susceptible than other two test strains (P < 0.05). CONCLUSIONS: The microbiological safety of the dairy product fermented at two consecutive periods was superior than that of traditional yogurt or kefir alone. SIGNIFICANCE AND IMPACT OF THE STUDY: These experiments may mimic what happens when yogurt and kefir starter micro-organisms are combined in a milk fermentation process with different time and temperature periods.

Animals↗
PubMed2002

Survey of waste comminglers' VOC exposures.

Twelve U.S. universities performing hazardous waste solvent commingling operations were surveyed for waste handler exposures to 45 U.S. Environmental Protection Agency (EPA)-designated volatile organic compounds (VOCs). Personal exposures (n = 33) and area concentrations (n = 30) were determined using gas chromatography/ mass spectrometry (GC/MS) analysis of passively collected samples. Air monitoring data were used to determine the veracity of laboratory-generated reports of waste container contents. Participants completed a questionnaire concerning the use of personal protective equipment, ventilation, and other appropriate safety equipment for their specific commingling operation. Follow-up telephone interviews were conducted to elucidate safeguards in place. Results showed that personal exposures exceeded area concentrations in 70% of operations. For the contaminant concentrations reported, 17% of personal samples exceeded Occupational Safety & Health Administration (OSHA) time-weighted average or ceiling limit values. Methylene chloride was a frequently seen airborne contaminant not listed on drum inventory sheets. When airborne constituents were compared with container content tags, 44% of the chemicals detected in air were omitted from the waste tags. This study concluded that the most frequently necessary safeguard is respiratory protection, preferably a supplied-air-type. The use of local exhaust ventilation systems rather than dilution or natural systems and facility operation in a totally explosion-safe manner are also recommended.

Data Collection↗
PubMed1997

Fine needle trucut biopsy of focal liver lesions: a new technique.

A series of 77 ultrasound guided biopsies were performed in 72 patients with an ultrasonographically diagnosed focal liver lesion using a new semiautomated biopsy gun (Temno Biopty Gun) with a 21 G trucut needle. The rate of insufficient sampling was very low (1.5%), and more precise identification of malignant as well as benign lesions was possible when compared with the results of other fine-needle techniques available in the literature. No higher complication rate was noted. Our results show a sensitivity of 88%, a specificity of 100%, and an overall accuracy of 91% in identifying malignancy. Therefore we conclude that fine-needle trucut biopsy is a safe and accurate procedure combining the safety of the fine needle with the better sample quality of a large-bore needle biopsy technique.

Adolescent↗
PubMed1997

The pitfalls of field trials in fish vaccinology.

Field trials are essential for accurately assessing the worth of a vaccine under actual conditions of use. Compared with the laboratory, the dynamics of the host, pathogen, and environment in a production setting can produce both subtle and dramatic differences on the performance of the vaccine and the immune response. Because of this, field trials are conducted by manufacturers in vaccine development and are required by many national regulatory agencies to evaluate safety and/or efficacy before granting vaccine licenses. Aquaculture producers, veterinarians and fish health professionals can use field trials to analyse the cost-benefit of a vaccination programme for a facility, or to compare competitive products. Vaccine field trials are more than merely using the products in the field. Small efficacy effects can result in considerable cost reductions to the fish farmer. Proper field trial design, conduct and analysis is critical to detecting these effects. However, field trials are also fraught with many pitfalls that can result in failure or misleading conclusions. The discussion regarding possible pitfalls of vaccine field trials in aquaculture is divided into two parts: 1) the art and 2) the science of successful field trials. The art of successful field trials involves dealing with the "people" aspect which is necessary for initial and continuing compliance. Meticulous planning is essential, including a written protocol to which everyone agrees by signature. The bottom line to the art of field trials is anticipation and discussion of all possible eventualities together with constant communication with the farmer and site supervisor. The science of successful fields trials involves anticipating and realizing the logistical and statistical difficulties in design and implementation. Problems often encountered are: lack of stated quantifiable purpose; low power of the test due to inherent small sample size, large variation and small margin of effect; lack of estimate for anticipated results in controls and unpredictable challenges; non-blinding design with bias and unequal treatment; one or few measures of outcome; lack of redundancy in sites selected; poor statistical design and analysis with violation of assumptions; herd effects; inability to assess long-term effects through several production cycles; and manufacturer/producer expense.

Animals↗
PubMed2004

The new car assessment program: does it predict the relative safety of vehicles in actual crashes?

BACKGROUND: Federal motor vehicle safety standards are based on crash test dummy analyses that estimate the relative risk of traumatic brain injury (TBI) and severe thoracic injury (STI) by quantifying head (Head Injury Criterion [HIC]) and chest (Chest Gravity Score [CGS]) acceleration. The New Car Assessment Program (NCAP) combines these probabilities to yield the vehicle's five-star rating. The validity of the NCAP system as it relates to an actual motor vehicle crash (MVC) remains undetermined. We therefore sought to determine whether HIC and CGS accurately predict TBI and STI in actual crashes, and compared the NCAP five-star rating system to the rates of TBI and/or STI in actual MVCs. METHODS: We analyzed frontal crashes with restrained drivers from the 1994 to 1998 National Automotive Sampling System. The relationship of HIC and CGS to the probabilities of TBI and STI derived from crash tests were respectively compared with the HIC-TBI and CGS-STI risk relationships observed in actual crashes while controlling for covariates. Receiver operating characteristic curves determined the sensitivity and specificity of HIC and CGS as predictors of TBI and STI, respectively. Estimates of the likelihood of TBI and/or STI (in actual MVCs) were compared with the expected probabilities of TBI and STI (determined by crash test analysis), as they relate to NCAP ratings. RESULTS: The crash tests overestimate TBI likelihood at HIC scores >800 and underestimate it at scores <500. STI likelihood is overestimated when CGS exceeds 40 g. Receiver operating characteristic curves demonstrated poor sensitivity and specificity of HIC and CGS in predicting injury. The actual MVC injury probability estimates did not vary between vehicles of different NCAP rating. CONCLUSION: HIC and CGS are poor predictors of TBI and STI in actual MVCs. The NCAP five-star rating system is unable to differentiate vehicles of varying crashworthiness in actual MVCs. More sensitive parameters need to be developed and incorporated into vehicle crash safety testing to provide consumers and automotive manufacturers with useful tools with which to measure vehicle safety.

Accident Prevention↗
PubMed2006

A survey of sun protection policy and education in secondary schools.

BACKGROUND: The Centers for Disease Control and Prevention (CDC) issued recommendations for school programs to reduce skin cancer. OBJECTIVE: Personnel at US secondary schools were surveyed to describe sun protection policy and education before the CDC recommendations. METHODS: School principals or other personnel at 484 secondary schools in 27 cities responded to a telephone survey in January and February 2002 (response rate = 31%). RESULTS: A sun protection policy was reported at 10% of the schools, but sun protection education occurred at nearly all schools (96%). Policies were more prevalent in regions with high ultraviolet radiation (P < .0001), but education was not. Many personnel were willing to adopt a policy (41%) and interested in obtaining a sun safety curriculum (96%). LIMITATIONS: Self-report measures, nonresponse, and new schools not in the sampling frame. CONCLUSION: Sun protection was a low policy priority for US schools. Sun safety education was prevalent, but written materials were used infrequently. A substantial proportion of school personnel were receptive to the CDC's advice.

Adolescent↗
PubMed1993

Risk factors for delayed immunization in a random sample of 1163 children from Oregon and Washington.

Despite extensive study of vaccine safety and decades of effort to immunize infants and toddlers, little is known about the comprehensiveness of vaccine coverage in US children younger than 2 years of age. Provider and parent data from a population-based sample of 1163 children from two states were analyzed to assess coverage rates at three ages and to evaluate characteristics of children and their families that predict failure to immunize on schedule. Overall, 78% of the children had received their first dose of diphtheria and tetanus toxoids with pertussis vaccine (DTP) and their first dose of oral poliovirus (OPV) by 92 days of age. Similarly, 77% had received their third dose of DTP and their second dose of OPV by their first birthday. However, by their second birthday only 60% had received the full series of four doses of DTP, three doses of OPV, and one dose of the measles, mumps, and rubella vaccines. When considered singly, several variables including child birth order, family income, maternal education, and marital status significantly predicted failure to immunize on schedule. In multivariate logistic models, only birth order and maternal education consistently predicted vaccine status at each of the three ages. Compared with first-born children, those who were later-born were 1.7 times more likely to be incompletely immunized at 2 years of age (95% confidence interval: 1.2, 2.3). Children of more educated mothers were significantly less likely to be underimmunized at all ages.(ABSTRACT TRUNCATED AT 250 WORDS)

Birth Order↗
PubMed2005

A national study of neighborhood safety, outdoor play, television viewing, and obesity in preschool children.

OBJECTIVE: To test the hypothesis that preschool children have a higher prevalence of obesity, spend less time playing outdoors, and spend more time watching television (TV) when they live in neighborhoods that their mothers perceive as unsafe. METHODS: In a cross-sectional survey in 20 large US cities, mothers reported the average daily time of outdoor play and TV viewing for their 3-year-old children, and the children's BMI was measured. Maternal perception of neighborhood safety was assessed with the Neighborhood Environment for Children Rating Scales; the scale score was used to divide children into tertiles of neighborhood safety. RESULTS: Of the 3141 children studied, 35% lived in households with incomes below the US poverty threshold. After adjustment for sociodemographic factors (household income and mothers' education, race/ethnicity, age, and marital status), obesity prevalence (BMI > or =95th percentile) did not differ in children from the least safe to the safest neighborhood safety tertile (18% vs 17% vs 20%) or in weekday (160 vs 151 vs 156 minutes/day) or weekend (233 vs 222 vs 222 minutes/day) outdoor play time. Children who lived in neighborhoods that were perceived by their mothers as the least safe watched more TV (201 vs 182 vs 185 minutes/day) and were more likely to watch >2 hours/day (66% vs 60% vs 62%). TV viewing and outdoor play minutes were not significantly correlated to each other or to BMI. CONCLUSIONS: In a national sample of preschool children, mothers' perception of neighborhood safety was related to their children's TV viewing time but not to their outdoor play time or risk for obesity.

Attitude↗
PubMedDate not supplied

Health behaviors of undergraduate African American nursing students.

Health experts describe lifestyle as one of the most important factors influencing health. Adolescents and young adults have been identified as a population that engages in high-risk behaviors. The purposes of this study were to determine the health behaviors of undergraduate African American nursing students and compare the results to findings from studies of other college students. A convenience sample of 214 undergraduate African American nursing students participated in the study. The Health Style: A Self-Test, a Likert-type scale consisting of six behaviors, was used for data collection. Descriptive statistics and analysis of variance were used to analyze the data. Over 80% of the sample had excellent scores for cigarette smoking, alcohol and drug use, and safety behaviors. Over 60% had good scores for nutrition and stress control behaviors. Fifty-one percent of the sample had low scores for exercise and fitness behaviors indicating they are taking unnecessary risk with their health. Compared to other findings, these findings were consistent in all areas except alcohol and drug use. Early identification of at-risk behaviors among nursing students can contribute to the development and implementation of programs by faculty that foster healthy lifestyle behaviors throughout the life span.

Adult↗
PubMed1993

Amniocentesis and chorionic villus sampling.

Amniocentesis and chorionic villus sampling have been shown through prospective, multicenter trials to be safe and effective methods of prenatal diagnosis; accordingly, a knowledge of these tests is important for those physicians who care for women during their childbearing years. We review the indications, techniques, safety, accuracy, and efficacy of amniocentesis and chorionic villus sampling and compare the advantages and disadvantages of each diagnostic test. This review should enable physicians to provide appropriate counseling and information to women at increased risk for fetal abnormalities detectable by either of these procedures.

Adult↗
PubMed2005

Antineoplastic agent workplace contamination study: the Alberta Cancer Board Pharmacy perspective.

STUDY OBJECTIVE: To investigate the feasibility of routine monitoring for workplace antineoplastic agent contamination in the Alberta Cancer Board (ACB) pharmacy practice environment. SETTING: The ACB in the Canadian province of Alberta, which includes two public tertiary centres and 17 associated community satellite sites based around the province in existing hospitals. METHODS: Obtained organizational support and input prior to launching the feasibility study (Phase I). Samples were analysed for a common cytotoxic agent - cyclophosphamide. Surfaces chosen were within the biological safety cabinets, workplace counter tops and on external surfaces of vials provided by manufacturers. Blank samples and known contaminated controls were included in Phase I to reconfirm the methodology in a previously published study. Feasibility aspects of logistics and financial expenses were examined. A second phase (Phase II) was completed to test other areas of the pharmacy and vials, with blank samples included to reconfirm previously mentioned methodology. RESULTS: The results determined that the samples tested were below acceptable detection limits with the exception of the known contaminated sample (Phase I) and exterior surfaces of vials (Phase II). CONCLUSION: This project has increased staff awareness of the sources for antineoplastic agent workplace contamination. Some practice changes were instituted during the project itself. Logistics and expenses were realistic for routine monitoring to be adopted.

Alberta↗
PubMed2005

Laboratory safety during assisted reproduction in patients with blood-borne viruses.

For couples where one or both partners are infected with human immunodeficiency virus or hepatitis C, the doors to receiving fertility care are opening as a result of better antiviral medication, better long-term prognosis and consequent changes in attitude. In line with this, fertility centres electing to treat couples with blood-borne viral (BBV) infection need to re-examine their policies and procedures to ensure the safety of their staff and both non-infected and infected patients during assisted reproduction treatments. At a time when the European Tissue Directive aims to introduce quality standards for assisted reproduction throughout Europe, we highlight the risks involved when treating patients with known BBV infections and argue that safety cannot be met with any certainty unless samples from such patients are handled within a separate high security laboratory or laboratory area, technically adapted to ensure minimal cross-contamination risk to uninfected gametes and embryos.

Blood-Borne Pathogens↗
PubMedDate not supplied

Environmental and occupational health hazards associated with the presence of asbestos in brake linings and pads (1900 to present): a "state-of-the-art" review.

Throughout the history of automobile development, chrysotile asbestos has been an essential component of vehicle brake linings and pads. Acceptable alternatives were not fully developed until the 1980s, and these were installed in vehicles produced over the past decade. This article presents a "state-of-the-art" analysis of what was known over time about the potential environmental and occupational health hazards associated with the presence of chrysotile asbestos in brake linings and pads. As part of this analysis, the evolution of automobile brakes and brake friction materials, beginning with the early 1900s, is described. Initial concerns regarding exposures to asbestos among workers involved in the manufacture of friction products were raised as early as 1930. Between 1930 and 1959, eight studies were conducted for which friction product manufacturing workers were part of the population assessed. These studies provided evidence of asbestosis among highly exposed workers, but provided little information on the magnitude of exposure. The U.S. Public Health Service proposed the first occupational guideline for asbestos exposure in 1938. The causal relationship between asbestos exposure and lung cancer was confirmed in 1955 in asbestos textile workers in the United Kingdom, and later, in 1960, in South Africa, mesothelioma was attributed to asbestos exposure to even relatively low airborne concentrations of crocidolite. Between 1960 and 1974, five epidemiology studies of friction product manufacturing workers were conducted. During this same time period, the initial studies of brake lining wear (dust or debris) emissions were conducted showing that automobile braking was not a substantial contributor of asbestos fibers greater than 5 microm in length to ambient air. The first exposure surveys, as well as preliminary health effects studies, for brake mechanics were also conducted during this period. In 1971, the Occupational Safety and Health Administration promulgated the first national standards for workplace exposure to asbestos. During the post-1974 time period, most of the information on exposure of brake mechanics to airborne asbestos during brake repair was gathered, primarily from a series of sampling surveys conducted by the National Institute of Occupational Safety and Health in the United States. These surveys indicated that the time-weighted average asbestos

Air Pollutants, Occupational↗