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PubMed1983

Possible pubertal effect on therapeutic gains in an autistic girl.

A deaf, partially sighted, severely retarded autistic girl, 11 years, 6 months of age, received approximately 2 years of occupational therapy, where sensory integration procedures were employed to reduce self-stimulation. Videotaped time samples of the amount of stereotypies showed a consistent reduction from the time of starting therapy to an interruption for vacation and surgery for scoliosis 46 weeks later. On returning to therapy after a 9-week break, self-stimulation had greatly increased and did not return to the presurgery level during an additional 55 weeks of therapy, 30 of which followed the removal of a cast. Menarche occurred 1 week after removing the cast. Increased self-stimulation is linked to reduced inclination toward environmental interaction as well as to an interruption of intervention and possible pubertal effect. Brief reports on four other autistic adolescents who received similar therapy are consistent with the conjecture of frequent pubertal regression.

Adolescent↗
PubMed1992

Retaining occupational therapists in rehabilitation settings: influential factors.

The purpose of this study was to identify the factors considered by occupational therapists in their decision to leave or to remain at a present job. Fifty-five occupational therapists practicing in freestanding rehabilitation hospitals in the Philadelphia metropolitan area were surveyed regarding general satisfaction, rewarding and stressful aspects of their current job, and personal or professional reasons to consider leaving a job. The responses were grouped by the therapists' years of experience as a framework for drawing conclusions. The results show that years of experience affects what is important to therapists at their jobs; for example, therapists who have been working for 1 year value different aspects of their jobs than therapists who have been working for over 7 years. In general, the most rewarding aspect of an occupational therapist's job was seen to be patient care; the most stressful, paperwork. In deciding to leave a job, the occupational therapists surveyed most frequently rated the following items as highly important: salary, productivity expectations, professional growth opportunities, peer relationships with other occupational therapists, and vacation time.

Adult↗
PubMed1991

Determination of exposure to aflatoxins among Danish workers in animal-feed production through the analysis of aflatoxin B1 adducts to serum albumin.

Aflatoxin B1 is suspected as an etiologic factor in the increased risk for primary liver cancer among workers in animal-feed processing plants in Denmark. Aflatoxin bound to serum albumin was therefore measured for feed-processing workers. Blood samples were collected immediately after vacation and after four weeks of work, and aflatoxin was quantified by competitive enzyme-linked immunosorbant assay. Seven of 45 individuals with an estimated exposure of 64 ng aflatoxin B1.d-1.kg-1 body weight were positive. Three positive workers had been unloading a cargo with an aflatoxin B1 level of 26 micrograms.kg-1 raw material. The exposure level correlated well with the job titles. Dust samples collected at different sites showed considerable variation in the amount of aflatoxin B1 (nondetectable to 8 micrograms.kg-1 dust). The exposure to aflatoxin B1 may only partially explain the increased risk of liver cancer.

Adult↗
PubMed1991

Immunologic measurement of polycyclic aromatic hydrocarbon-albumin adducts in foundry workers and roofers.

Roofers and iron foundry workers with high exposure to polycyclic aromatic hydrocarbons (PAH) were monitored for levels of covalent PAH serum albumin adducts, quantitated in enzymatically digested samples by a sensitive competitive enzyme-linked immunosorbent assay. Albumin adducts were higher in the foundry workers (5.22 fmol/micrograms, 0.314 mmol/mol) than in the reference group (4.07 fmol/micrograms, 0.245 mmol/mol), but only of borderline significance probably due to the small sample size. In a subset of foundry workers, a significant difference in adduct levels was observed for samples collected immediately after vacation and after six weeks of workplace exposure. The roofers also showed higher levels of adducts (5.19 fmol/micrograms, 0.312 mmol/mol) than their reference group (3.28 fmol/micrograms, 0.197 mmol/mol). These results demonstrate the feasibility of PAH protein adduct measurement as a marker of human exposure to this class of chemicals.

Antibodies, Monoclonal↗
PubMed1983

Elimination of chromium in urine after stainless steel welding.

Nine retired (on an average of four years) stainless steel welders had higher (p less than 0.001) urinary chromium levels [mean 7 (range 3-13) mumol/mol of creatinine] than 21 nonexposed referents [mean less than or equal to 1.5 (range less than 0.6-7) mumol/mol of creatinine] but did not differ in this respect from 14 active welders studied at the end of a 31-d vacation (mean 9, range 4-17). This result shows the existence of a slow compartment for chromium in the body. Urinary chromium on time after the end of exposure was analyzed mathematically by use of an exponential two-compartment model. Good fits were obtained, showing the existence of a fast compartment in addition to the slow one. For four welders followed for 31 d, the biological half-time of the slow compartment ranged from 14 d to infinity. For 12 welders followed for 60 h, the fast compartment had a median half-time of 7 (range 4-35) h. For 19 welders there was a significant (p less than 0.01) correlation between chromium in air (total and soluble hexavalent) and urinary chromium (rs = 0.68 and 0.64). However, the variation of urinary chromium on chromium in air was considerable, especially at chromium air levels at or below the hygienic standards. Correction for urinary chromium levels on Monday morning did not decrease the variation.

Adult↗
PubMed2006

Unusual forms of immature sporulating Coccidioides immitis diagnosed by fine-needle aspiration biopsy.

Coccidioidomycosis is an endemic infection acquired by inhalation of the spores (arthroconidia) of the thermally dimorphic fungus, Coccidioides immitis. The arthroconidia transform into spherical cells called mature spherules in the lung. Immature spherules and other atypical forms of immature C immitis have rarely been found in vivo. We report on a case that presented unusual forms of immature sporulating C immitis in a fine-needle aspiration specimen. A 36-year-old Chinese woman, living in New Jersey for the past 10 years, presented with fever, night sweats, hemoptysis, and an abnormal chest radiograph approximately 9 months after a brief vacation trip to the Grand Canyon in Arizona. She was treated with antibiotics for 4 weeks without improvement. Subsequent chest computed tomography showed a 3-cm cavitary lesion in the right lower lobe of the lung. Fine-needle aspiration biopsy revealed diverse morphologic forms of a fungus that was confirmed by culture as immature sporulating C immitis.

Adult↗
PubMed1975

Respiratory tract disease from thermosetting resins. Study of an outbreak in rubber tire workers.

An outbreak of upper and lower respiratory tract inflammatory disease and conjunctivitis among synthetic rubber tire workers occurred. The outbreak began after the introduction of a new thermosetting resin, containing resorcinol and a trimere of methylene aminoacetronitrile, into the rubber tire carcass stock formulation. Two hundred ten workers were affected. Characteristically, symptoms improved during periods of sick leave or vacation, recurring upon the workers' return to the plant. Chest radiograms disclosed pneumonic infiltrates in about one fourth of the cases. Pulmonary function studies detected abnormal airways dynamics as well as abnormal diffusing capacity in more than one third of the workers tested. Lung biopsy showed evidence of focal interstitial fibrosis and peribronchiolar and perivascular chronic inflammatory reaction. The illness was ascribed to volatile products released during the manufacture of synthetic rubber tires. The exact chemical nature of these products is unknown.

Adult↗
PubMedDate not supplied

Cutaneous larva migrans: case report with current recommendations for treatment.

Cutaneous larva migrans is a common skin pathology that occurs in people who have recently visited tropical or subtropical climates. Given the ubiquity of this condition, the podiatric physician may encounter cutaneous larva migrans during clinical practice and should be cognizant of the presenting signs and typical patient history given in these cases. We describe the case of a 62-year-old man who presented with a pruritic, erythematous, serpiginous lesion on the dorsum of his left foot after having vacationed in Florida for several weeks. The patient was treated successfully with oral thiabendazole, 500 mg after meals 4 times daily for 5 days.

Animals↗
PubMed1990

Management of complex pedal cutaneous larva migrans.

Although cutaneous larva migrans is more commonly seen in the southeastern US and tropical regions of the world, patients with such parasitic involvement may present in other non-endemic areas for various reasons, particularly travelers returning from tropical vacations. Awareness of the clinical presentation and symptomatology of cutaneous larva migrans is important for all physicians, including those practicing in northern climates, for prompt recognition and effective treatment of the disease. Furthermore, cutaneous larva migrans should be of particular interest to podiatrists, because the infestation commonly involves the feet, and a patient may initially present for treatment of secondary manifestations, ie, dermatitis, pruritus, or infection, as in this case report.

Adult↗
PubMed1999

Botfly infestation (myiasis) masquerading as furunculosis.

With air travel so prevalent, diseases endemic to certain regions may appear anywhere. The botfly (Dermatobia hominis) is not native to North America. We describe a case of a young boy and his father who presented with furunculosis secondary to infestation with the botfly. The infected patients live in South Florida and had been vacationing in Central America. Standard surgical treatment as well as multiple native remedies are described.

Adult↗
PubMed1991

Benefits plans focus on flexibility. Hospitals increase choices for employees as emphasis moves from recruitment to retention.

As hospitals turn their attention from employee recruitment to employee retention, flexible benefits plans are becoming increasingly popular as a means of meeting workers' preference for choice when it comes to issues such as healthcare coverage, insurance and vacation days. At the same time, such programs can help hospitals hold down their long-term costs.

Employee Incentive Plans↗
PubMed1991

The project shift: a form of participative management and staffing.

North Colorado Medical Center is a 326 bed primary and tertiary care medical center serving northeastern Colorado and southwestern Nebraska. The pharmacy department provides 24-hour-a-day clinical and distributive services to both inpatients and outpatients with a staff of 1 clinical pharmacy coordinator, 10 pharmacists (excluding pharmacy manager), and 11 technicians. Rather than rely on one assistant manager, the pharmacy manager involves all interested staff pharmacists in various administrative, clinical, and distributive projects. These project (P) shifts are scheduled 8-hour shifts with minimal or no drug distribution duties. This staffing system and form of participative management has been used since 1983 and has been successful in achieving three objectives: it provides assistance to the manager in achieving certain departmental objectives; it provides job variety and professional growth/satisfaction for staff pharmacists; and it provides flexible and readily available source of pharmacists to meet personal leave days (vacation, illness, time off) needs.

Colorado↗
PubMedDate not supplied

Is Germany a model for managers?

Most American managers have a hard time making sense of Germany. The country has a fraction of the resources and less than one-third the population of the United States. Labor costs are substantially higher, paid vacations are at least three times as long, and strong unions are deeply involved at all levels of business, from the local plant to the corporate boardroom. Yet German companies manage to produce internationally competitive products in key manufacturing sectors, making Germany the greatest competitive threat to the United States after Japan. The seemingly paradoxical nature of the German economy typically evokes one of two diametrically opposed responses. The first is to celebrate the German economy as a "model" worth emulating--indeed, as the answer to declining U.S. competitiveness. The alternative, more skeptical response is to question Germany's staying power in a new, more competitive global economy. According to Kirsten Wever and Christopher Allen, the problem with both points of view is that they miss the forest for the trees. Observers are so preoccupied with praising--or blaming--individual components of the German economy that they fail to see the dynamic logic that ties these components together into a coherent system. In their review of recent research on the German business system, Wever and Allen argue that managers can learn an important lesson from Germany. In the global economy, competition isn't just between companies but between entire socioeconomic systems. Germany's ability to design a cohesive economic and social system that adapts continuously to changing requirements goes a long way toward explaining that country's competitive success.

Administrative Personnel↗
PubMed1993

The effect of the federal Family and Medical Leave Act upon employee benefits.

FMLA will substantially influence the administration of employee benefits. The plan sponsor, trustees, plan administrator and collective bargaining parties must make a number of policy decisions. These include employer reporting and contribution procedures, settlement of eligibility questions, delinquency procedures, coordination with COBRA, substitution of vacation and sick leave rights and procedures, restrictions on participants working during leave, procedures for the non-forfeiture of accrued benefits and restoration of benefits. After the policy decisions are made and the procedures are established, the proper notices and caveats must be communicated to plan participants, and the plan must update the SPD. Each of the policy decisions, administrative procedures and participant communications must be carefully thought out before implementation. Plan sponsors, trustees and plan administrators should seek the help, advice and assistance of the plan's professional advisers.

Employment↗
PubMed1996

Payoff's worth the price in UR/discharge merger.

Combining discharge and utilization review functions eliminates duplication of effort in chart review and assessing patient needs. Cross trained staff can better cover for each other on sick days and vacation. Increased efficiencies led to reduction in staffing needs.

Efficiency, Organizational↗
PubMed1996

Remote access to neurosurgical ICU physiological data using the World Wide Web.

There is a significant demand by physicians and clinical researchers for remote access to continuously acquired physiological patient data. Until recently such access was technically unfeasible. However, with the recent development of Internet-based World Wide Web (WWW) client/server applications and underlying communication protocols, there is now a real possibility for the development of cost-effective, platform independent solutions to this problem. We have devised a way using existing WWW tools and minimal startup costs to provide access to current as well as previously acquired physiological patient data. Physicians and clinical researchers can obtain access to these data through personal computers located in the office, at home or even through portable computers while traveling to conferences or while on vacation.

Computer Communication Networks↗
PubMedDate not supplied

Case study. Does this company need a union?

No doubt about it, the top managers in this fictitious case study agree, Wellington Associates is a great place to work. Analysts at the high-tech consulting firm enjoy some of the best pay in the industry. And their benefits are extensive: flextime, liberal educational opportunities, comprehensive medical and dental coverage, generous vacation leave, and even on-site day care. So it came as something of a shock to CEO Jane Wellington and her top executives when HR chief Elvin Cusack started out the weekly senior-management meeting by declaring that the United Office Workers Union had begun organizing the support staff. Turns out, Cusack explained, that the company looks very different from the support staff's point of view. Although their starting salaries are indeed competitive, raises average a mere 2% to 3%, and promotions to professional ranks are rare. Medical and dental coverage take a greater chunk out of clerical pay than out of the larger professional salaries, and the cost of the day care center is pretty much out of reach for the support staff. Flextime is impractical for workers who need to be in the office to answer phones and to file papers. Worse, the support staff is expected to accommodate the analysts' flexible schedules; if an analyst decides to work late to finish a project, the secretary has to stay as well. What to do? Suggestions ranged from "fire 'em" to "say nothing before calling in legal counsel." Five commentators examine Wellington's options and its legal obligations.

Employee Grievances↗