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PubMed1993

Dispositional traits as risk in problem drinking.

A trait-dispositional paradigm for conceptualizing personality provided the framework for investigating the relationship between personality dispositions and drinking problems. This approach was compared directly with personality research based on the Minnesota Multiphasic Personality Inventory (MMPI). A total of 241 subjects (192 men and 49 women) were tested at a mandatory Driving While Intoxicated (DWI) first-offender education program. Information was gathered from the Michigan Alcoholism Screening Test (MAST), Blood Alcohol Concentration (BAC) at time of arrest, and two personality tests--the MacAndrew Alcoholism Scale (MAC) and the Problem Drinker Trait List (PDTL). The psychometric properties of the PDTL were analyzed and compared with those of the MAC. In comparing the two personality tests in terms of their capacity to predict drinking problems over a wide range of drinking severity, the PDTL performed as well or better than the MAC, particularly for drinkers with low arrest BAC. Comparative analysis between the best predictor items of the MAC and of the PDTL revealed little relationship between the item domains. The predictive trait clusters of the PDTL for men were Emotionality/Depressiveness, Impulsivity, and Low Self-Confidence, whereas predictive clusters for women included Depressiveness, Overcontrol, and Alienation.

Adult↗
PubMed1996

Self-assessment of tuberculin skin test reactions by New York City firefighters: reliability and cost-effectiveness in an occupational health care setting.

OBJECTIVE: To determine whether self-assessment of purified protein derivative of tuberculin (PPD) skin test reactions, done using a simple two-choice approach, is an effective screening method for tuberculosis. DESIGN: Double-blind comparison between self-assessments and trained professional readings of PPD skin test reactions, done 72 hours after test administration. SETTING: The New York City Fire Department's Bureau of Health Services. PARTICIPANTS: 2011 New York City firefighters and fire officers were given PPD skin tests during a mandatory retraining course. Thirty-seven persons were excluded because of a history of a positive PPD skin test result or a bacille Calmette-Guérin vaccination. All others agreed to participate in testing and self-assessment done using simple written instructions. Self-assessment results were submitted just before trained professional readings were done. MEASUREMENTS: Self-assessments and trained professional readings of PPD skin test reactions. RESULTS: 1833 participants (91%) interpreted their test reactions as flat. Of these interpretations, 1824 (99.5%) matched the professional reading and 9 (0.5%) did not. One hundred seventy-eight participants (9%) interpreted their test reactions as not flat; 136 of these interpretations (76.4%) matched the professional reading and 42 (23.6%) did not (kappa = 0.828; lower 95% confidence limit = 0.790). The predictive value of a negative self-assessment reading was 99.5%, and the specificity was 97.7%. CONCLUSION: In this occupational health care setting, we follow (and recommend to others with similar populations) a tuberculin screening program based on self-assessment. Repeated tests with follow-up are required for all persons who do not report their results. All persons with self-assessments of "not flat" should return for readings by trained professionals, counseling, and treatment.

Adult↗
PubMed1991

Acute water intoxication as a complication of urine drug testing in the workplace.

Urine drug testing is now mandatory in many industries. We report the first case, to our knowledge, of an adverse consequence of drug testing in the workplace: acute water intoxication. We discuss normal water metabolism and the adverse effects of water loading and impaired renal function on free water clearance. We present a literature review of seven other cases of acute voluntary water intoxication in patients without chronic psychiatric or neurologic illness. For workers undergoing urine drug testing we conclude that risk factors for acute water intoxication include (1) intake of more than 1 L of water and (2) impaired urine dilution. In a recently drug-tested worker, symptoms of cerebral dysfunction should suggest the possibility of water intoxication.

Acute Disease↗
PubMed1990

[Drug treatment of epilepsy].

The presently preferred anticonvulsives in adults are carbamazepine and valproate. Before the age of 10 years valproate is a second-choice drug only, on account of its hepatotoxicity in patients of this age. Alternatives in generalized primary grand mal seizures are phenobarbital, possible also valproate and phenytoin; in petit mal seizures ethosuximide. At present, numerous substances are being tested for their suitability as anticonvulsives. Those at the most advanced stage of clinical testing are: gabapentine, lamotrigine, oxcarbazepine, progabide, vigabatrin. Among the adverse reactions, the hepatotoxicity of valproate is particularly topical, making comprehensive laboratory examinations mandatory; however, these tests have little prognostic value. During pregnancy the seizure frequency may change. In most patients, the blood levels of the anticonvulsives decrease, despite constant dosage. In the newborn vitamin K1 prophylaxis is mandatory to prevent bleeding. The use of anticonvulsives does not contraindicate nursing.

Anticonvulsants↗
PubMed1990

Severe hepatitis caused by cyproterone acetate.

A case of severe acute hepatitis caused by cyproterone acetate in a 71 year old man with prostatic carcinoma is reported with a review of the literature on hepatic reactions to this drug. The association between the use of cyproterone acetate and liver abnormalities is poorly documented. This is the fourth published report of adverse hepatic reaction to cyproterone acetate and it substantiates other evidence that cyproterone acetate is potentially hepatotoxic. Monitoring of liver function tests should be mandatory in patients receiving high doses of cyproterone acetate; the drug should be withdrawn immediately if abnormal liver function tests are found.

Adenocarcinoma↗
PubMed1995

Attitudes toward urinalysis drug testing within a civilian pilot training program.

BACKGROUND: This descriptive-correlational study examined civilian student pilots' attitudes toward urinalysis (UA) drug testing and the pilots' opinions regarding effectiveness, adequacy, and fairness of the method as a deterrent for substance abuse among pilots. HYPOTHESIS: There will be significant differences among attitudes of professional aviation student pilots in mandatory and nonmandatory UA drug tested sections of a flight program when considering the pilots' flight hours, ages, gender, anxiety produced by UA drug testing, opinions on drug and alcohol abuse by pilots on the flight schedule, and their attitudes toward the testing process. METHODS: A Likert-scaled questionnaire was completed by the student pilots who were enrolled in mandatory and nonmandatory UA drug tested class sections within a large civilian aviation flight program. RESULTS: Pilots felt mandatory UA testing was less anxiety-producing (t = 2.25, p < 0.05) than the students in nonmandatory tested flight classes. The pilots in nonmandatory tested sections felt more strongly (t = 2.55, p < 0.01) that drug use existed among pilots on the flight schedule than mandatorily tested pilots. Significant intercorrelations (p < 0.05) emerged among the variables age, gender, flying hours, randomization of UA testing, and attitudes toward the UA testing process and its' effectiveness. CONCLUSIONS: Based on the results, mandatory UA drug testing appeared to decrease substance abuse among pilots on the flight schedule.

Adult↗
PubMed1993

College athletes and drug testing: attitudes and behaviors by gender and sport.

We surveyed varsity athletes at a Big East university to assess attitudes toward a mandatory drug education and testing program and examined whether there were differences in drug-related attitudes and behaviors based on gender or varsity sport. We found no statistically significant differences in personal drug use behaviors based on gender or team affiliation. Attitudes about drug use and knowledge of a teammate using drugs did show significant differences based on varsity sport. Tennis players were most likely to agree that drug use by college athletes is socially acceptable. Lacrosse players were most likely to know of atleast one teammate using drugs. Overall, attitudes towards the mandatory drug education and testing program were ambivalent. About half of our responding athletes believed drug testing was necessary and discouraged drug use. Only 17% believed that the program was an invasion of privacy.

Journal Article↗
PubMed2002

ECVAM's activities in validating alternative tests for skin corrosion and irritation.

ECVAM has funded and managed validation studies on in vitro tests for skin corrosion, resulting in the validities of four in vitro tests being endorsed by the ECVAM Scientific Advisory Committee: the rat skin transcutaneous electrical resistance (TER) assay, two tests based on the use of commercial reconstituted human skin equivalents, EPISKIN and EpiDerm, and another commercially-produced test, CORROSITEX. In the European Union (EU), a new test method on skin corrosion (B.40), incorporating the rat skin TER and human skin model assays, was included in Annex V of Directive 67/548/EEC in mid-2000, thereby making the use of in vitro alternatives for skin corrosion testing of chemicals mandatory in the EU. At the recommendation of its Skin Irritation Task Force, ECVAM has funded prevalidation studies on five in vitro tests for acute skin irritation: EpiDerm, EPISKIN, PREDISKIN, the pig-ear test, and the mouse-skin integrity function test (SIFT). However, none of the tests met the criteria (set by the Management Team for the studies) for inclusion in a large-scale formal validation study. Thus, to date, there are no validated in vitro tests for predicting the dermal irritancy of chemicals. Following further work on the EPISKIN, EpiDerm and SIFT test protocols and/or prediction models after the completion of the prevalidation studies, it appears that the modified tests could meet the performance criteria defined for progression to a validation study. This will now be assessed independently by the ECVAM Skin Irritation Task Force, with the objective of taking a decision before the end of 2002 on whether to conduct a formal validation study.

Animal Testing Alternatives↗
PubMed2006

[Amyotrophic lateral sclerosis (ALS): evaluation of respiratory function].

Respiratory involvement is an almost constant feature of als, with a usually rapid progression leading to respiratory failure. These characteristics justify a close follow up, usually at three-month intervals. A systematic, careful clinical evaluation is essential to detect the subtle respiratory symptoms and signs related to respiratory muscle failure. Dyspnea and orthopnea are often late findings in patients with a usually severe functional impairment due to peripheral muscle weakness. Nocturnal respiratory events (obstructive sleep apnea syndrome and hypoventilation) are strongly suggested by daytime hypersomnolence and frequent morning headaches. Physical evaluation is essential to detect accessory muscle recruitment, supine abdominal paradox, and encumbrance of upper or lower airways. Vital capacity (VC) is the most classical lung function test. The major limitation of spirometry is its poor sensitivity to detect a moderate inspiratory muscle weakness. Supine VC may improve the detection of diaphragmatic involvement. Peak expiratory flow during cough (cough PEF) gives an overall evaluation of cough efficiency, values below 160 to 270 L/min suggesting poor airway clearance. Arterial blood gases are performed at first evaluation and subsequently in case of clinical signs, significant deterioration of lung function tests, or sleep desaturations. Hypercapnia is weakly related to lung function results in bulbar patients. A specific evaluation of respiratory muscle strength is mandatory, as these tests are both sensitive and highly prognostic. Possible discrepancies (particularly in bulbar patients) between Maximal inspiratory pressure (PImax) and sniff nasal inspiratory pressure (SNIP) justify to perform both measurements and to select the highest pressure. A maximal expiratory pressure (PEmax) below 45 cm H2O may indicate a compromised cough efficiency but the correlation with cough PEF may be poor. Screening nocturnal oxymetry is useful to detect sleep apneas and hypoventilation. Criteria defining significant desaturations remain however controversial. Suspicion of obstructive sleep apnea syndrome on clinical grounds or oxymetry findings should be confirmed by a conventional polysomnography.

Amyotrophic Lateral Sclerosis↗
PubMed2002

Named reporting and mandatory partner notification in New York State: the effect on consent for perinatal HIV testing.

The impact of the implementation of named reporting and mandatory partner notification on the percentage of patients not accepting prenatal human immunodeficiency virus (HIV) testing or deferring prenatal care has been examined in only a preliminary fashion. This retrospective, population-based cohort study of 5,007 patients admitted to a tertiary care labor-and-delivery unit in Central New York State between December 15, 1999, and March 14, 2001, is the first study to address the impact of named reporting and mandatory partner notification on prenatal HIV testing and prenatal care seeking. The percentage of patients who did not undergo prenatal HIV testing was significantly increased after the institution of named reporting and mandatory partner notification: 118/4,030 preimplementation, 59/966 postimplementation, with relative risk (RR) = 2.09 (1.54 < RR < 2.83). This remained significant after logistic regression controlled for confounding variables, with odds ratio (OR) = 1.5 (1.07 < OR < 2.10). The percentage of patients who did not receive prenatal care was significantly increased after the institution of named reporting and mandatory partner notification: 14/4,030 preimplementation, 18/966 postimplementation, with RR = 5.36 (2.68 < RR < 10.75). This remained significant after logistic regression controlled for confounding variables. OR = 3.77 (1.84 < OR < 7.72). There is a strong indication that the institution of named reporting and mandatory partner notification has significantly impacted the willingness of pregnant women to undergo HIV testing and prenatal care. Further analysis of the impact in perinatal populations is needed before the continued implementation of this controversial public policy initiative.

AIDS Serodiagnosis↗
PubMed2006

Needlestick injuries and other occupational exposures to body fluids amongst employees and medical students of a German university: incidence and follow-up.

The aim of this study was to obtain data concerning the incidence, reporting and follow-up of occupational exposure to blood or other body fluids (OEB). A questionnaire was distributed to employees and medical students (N=787) and official reports of OEB during the year 2003 (N=203) and their consequent follow-up (N=100) were evaluated. The percentages of needlestick injuries were 29.5% for students and 22.5% for employees. Incidence rates per 1000 employee days were 0.61 for needlestick injuries or sharp object injuries and 0.27 for mucocutaneous exposure to body fluids. The mean rate of underreporting was approximately 45%. Contrary to expectations, only 4.3% of nurses and 3.9% of doctors officially reported an OEB in 2003. The number of persons who did not attend for a serological test increased during the follow-up period. Considering all documented test results, 35 out of 100 affected persons were lost to follow-up due to default of appearance. As a consequence, the employer should provide safety devices and enforce didactical interventions with practical training and incident reporting. Periodical occupational health medicals, including serological testing, should be mandatory for all employees, including medical students and student nurses. To increase compliance after OEB, a short follow-up period using improved laboratory tests requires further discussion.

Follow-Up Studies↗
PubMed2004

[Exercise ECG].

Exercise ECG testing is the most widely used method for detecting myocardial ischaemia, but the test is also applied in numerous other settings. The method requires close attention to technical details and application of appropriate test protocols. Attention to absolute and relative contraindications and criteria for test abortion is mandatory. In addition to the ECG, work capacity, heart rate and blood pressure responses are also important diagnostic and prognostic markers. Interpretation of the test results depends on the setting; knowledge of potential confounders is important. The diagnostic and prognostic value of the test is population-dependent. Exercise ECG testing is most valuable as a diagnostic tool for myocardial ischaemia when pretest disease probability is high.

Contraindications↗
PubMedDate not supplied

Proficiency testing in cytology laboratories in Ontario, Canada: a decade of experience. I. Introduction and description of the testing model.

There are few formally documented proficiency testing programs for cytology laboratories, and those that have been documented are not entirely comparable in format. The first of three papers documenting a mandatory universal proficiency testing program for cytology laboratories in the Province of Ontario, Canada, presents data on the structure and function of the participating laboratories (including a comparison of the data for 1974 and 1980) and on the organization of the testing model (including selection of terminology, construction and use of the survey and assessment of responses). In 1980, of the 463 medical laboratories in Ontario, 91 of 222 hospital laboratories and 65 of 216 nonhospital laboratories were licensed in cytology. In that year, the 156 cytology laboratories processed 1.48 million cytology specimens, 92% of which were gynecologic. Hospital laboratories processed 87.5% of the nongynecologic cytology specimens and 30% of the gynecologic cytology specimens. These proportions have been virtually constant for several years. Between 1974 and 1980, there was a trend in Ontario to fewer laboratories processing less than 5,000 cytology specimens per annum. Subsequent papers in this series describe the results of the initial surveys in this program and a precision study to evaluate the consistency of reporting by individual laboratories.

Cytological Techniques↗
PubMed2004

Gentronix.

Gentronix is an innovative biotechnology company with the aim of providing cell-based assays and systems to ease or remove some of the current bottlenecks in preclinical drug discovery and development. Gentronix's first product, GreenScreen trade mark GC, is a combined genotoxicity and cytotoxicity test designed for high-throughput screening of new pharmaceutical lead compounds, giving drug development scientists a cost-effective preview of the battery of mandatory regulatory genotoxicity tests. Future products based on the company's extensive intellectual property rights portfolio will combine the company's expertise in cellular biosensor systems with novel optical detection technology to deliver a range of products for other applications within drug discovery, as well as industrial and environmental monitoring of toxic chemicals.

Biosensing Techniques↗
PubMed1999

[Voluntary testing procedures of farm animal housing equipment according to the Animal Welfare Act of 1998].

Before its broad application in practice, housing equipment should be tested, in particular with regard to animal welfare. The differing positions of the German Federal Council (Bundesrat) and the German Federal Parliament (Bundestag), whether such testing should be mandatory or voluntary, have been conciliated in the amended animal welfare act by empowering the Federal Ministry of Food, Agriculture and Fisheries (BML) to fix official standards for voluntary testing procedures by regulation. On request of the BML, a report as scientific basis for a draft regulation is currently prepared by the scientific animal welfare committee of the German Agricultural Society (DLG). The scientific animal welfare committee has been appointed by the DLG in order to provide support in the effort to strengthen animal welfare aspects in the DLG-utility testing procedure of housing equipment, which is in place since 1953. The committee elaborates standards concerning testing methods, assessment criteria and the necessary size of investigations. As required, the scientific animal welfare committee may support the DLG-testing bodies in the implementation of the animal welfare part of the testing procedure. It will, moreover, be involved in the welfare assessment based on the testing results. The amendments of the already established testing procedure will help to fulfill the general requirements on an acceptable animal welfare testing procedure. While keeping in mind that there are certain limits in what can be achieved by a voluntary testing procedure, the enhanced consideration of animal welfare aspects within the DLG-utility testing procedure has the advantage to be relatively unbureaucratic and in line with EU legislation, and is, therefore, an appropriate tool for a contibrution to improved animal welfare in livestock housing.

Agriculture↗
PubMedDate not supplied

Using self-studies to meet JCAHO requirements.

Using self-studies to provide mandatory information for hospital employees is both cost effective and time effective. Time invested in writing and distributing these programs is well worth it provided learning is verified through testing. Records of mandatory information can be kept either by hand on education cards or by computer. Periodic updates of material keep the self-study process fresh and interesting for participants and educators alike.

Disaster Planning↗
PubMed1984

Malignant intra-abdominal testis. A case report.

A case of malignant change within an intra-abdominal testis is reported. The development in a Black man of a malignant testicular lesion with a mixed cellular picture on histological examination, the absence of serum tumour markers in the presence of a seminoma and the presence of local invasive spread--all uncommon features of testicular tumours--in combination make this a rare case. Orchiopexy does not reduce the risk of malignant change and in the postpubertal patient does not influence spermatogenesis. Orchiectomy is therefore advised for all maldescended testes and should be considered mandatory for all intra-abdominal testes.

Adult↗
PubMed1996

Pertussis serological potency test as an alternatively to the intracerebral mouse protection test.

The current potency test for pertussis vaccines, the intracerebral protection test (MPT), is still the only mandatory laboratory model available. This test, however, is a valid, but inhumane and imprecise test and therefore a good candidate for replacement. Recently we have developed the Pertussis Serological Potency Test (PSPT) as an alternative for the MPT. The PSPT is based on in vitro assessment of the humoral immune response against the whole range of surface -antigens of B. pertussis in mice after immunisation with Whole Cell Vaccine (WCV). We have demonstrated a relationship between the mean pertussis antibody concentration at the day of challenge and the proportion of surviving mice at each vaccine dose in the MPT (R = 0.91). The PSPT is a model in which mice (20-24 g) are immunised i.p. with graded doses of vaccine and bled after four weeks. Sera are titrated in a whole cell ELISA and potency based on the vaccine dose-dependent antibody response is estimated by means of a parallel line analysis. In an in-house validation study 13 WCVs were tested in the PSPT and MPT. Homogeneity of both tests was proven by means of the chi-square test; potencies were significantly similar (p = 0.95). Compared to the MPT, the PSPT is more reproducible as is indicated by its smaller 95% confidence intervals. Moreover, by using the PSPT the animal distress can be reduced to an acceptable level and the PSPT also results in a reduction of more than 25% in use of mice. Additional experiments showed that estimation of WCV-potency in the PSPT based on specific antibody responses against protective antigens (PT, FHA, 69- and 92-kDa OMPS) was not possible or did not correlate with protection in MPT. Sera obtained from the PSPT showed a correlation between pertussis antibody levels and complement-mediated killing by pertussis antibodies in in vitro assays. In conclusion, the PSPT is a promising substitute for the MPT though further validation and additional studies on functional validity should finally warrant replacement of the MPT by this serological model.

Animal Testing Alternatives↗