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The Fort McMurray Demonstration Project in social marketing: health- and safety-related behaviour among oil sands workers.

This is the first round in a series of surveys conducted in Fort McMurray as part of the Fort McMurray Demonstration Project in social marketing. This component of the survey was intended to focus on the most prominent group of employed workers in the community and to compare their patterns of response with the community as a whole. Respondents to the survey were overwhelmingly male (96%), married (72.9%) and living in households of two to five persons (87.9%). They were predominantly aged 30-44 (55%) and graduates of high school (53.5%). Younger male workers (below age 30) were more likely to have a high school diploma (78.3%) or some additional technical or vocational training (21.7% compared to 12.5% overall) and to be unmarried or separated. Attitudes toward safety-related behaviours were stronger than for respondents from the community as a whole. Approximately 70-100% of all age groups and both sexes showed strong agreement with attitudes involving child car seats and the unacceptability of drinking and driving. These attitudes include strong advocacy of vigorous enforcement of occupational health and safety standards. However, they showed a variability similar to the community as a whole in behaviour at home compared to work, generally reporting more consistent use of personal protection on the job than in their own homes, particularly hearing protection. Even so, they were much less likely to perform stretching and warm-up exercises prior to exertion than community residents in general. The potential may exist to transfer the technology and attitudes from workplace health and safety to community safety. One possible strategy to accomplish this is to involve workers in this industry directly in community initiatives. This strategy may be generalizable to any community in which there are major employers who place a heavy emphasis on risk control and occupational health and safety.

Adult↗

Nuclear-cytoplasmic interactions affect in utero developmental capacity, phenotype, and cellular metabolism of bovine nuclear transfer fetuses.

We generated a clone of bovine somatic cell nuclear transfer embryos using oocyte pools from defined maternal sources to study nuclear-cytoplasmic interactions. Nucleocytoplasmic hybrids were reconstructed with Bos taurus (Brown Swiss) granulosa cells and oocytes that contained B. taurus A (Simmental), B. taurus B (Simmental), or Bos indicus (Dwarf Zebu) cytoplasm. Another set of embryos was reconstructed with randomly selected Brown Swiss (B. taurus R) oocytes. Embryo transfer resulted in nine (12.5%), nine (13.8%), three (50%), and 11 (16.7%) Day 80 fetuses, of which eight (11.1%), three (4.6%), three (50%), and 10 (15.2%) were viable, respectively. The proportion of viable fetuses was affected by cytoplasm (likelihood ratio test, P < 0.02) and was higher for embryos with B. indicus cytoplasm than for the B. taurus A (P < 0.05) and B (P < 0.01) groups. Furthermore, the proportion of surviving Day 80 fetuses was reduced for B. taurus B as compared with B. taurus A and B. taurus R cytoplasm (P < 0.05 and P < 0.02). Body weight of nucleocytoplasmic hybrid fetuses was not significantly different from Brown Swiss control fetuses produced by artificial insemination (AI), but fetuses reconstructed with random cytoplasts of the same breed as the nuclear donor exhibited overgrowth (P < 0.01) and a higher coefficient of variation in weight. Furthermore, body weight, crown rump length, thorax circumference (P < 0.05), and femur length (P < 0.01) of fetuses with B. taurus A cytoplasm differed from fetuses with B. taurus R cytoplasms. Fetal skin, heart, and liver cells with B. indicus cytoplasm showed a greater increase in number per time period (P < 0.001) and oxygen consumption rate per cell (skin and liver, P < 0.001; heart, P < 0.08) in comparison with their counterparts with B. taurus A cytoplasm. These data point to complex oocyte cytoplasm-dependent epigenetic modifications and/or nuclear DNA-mitochondrial DNA interactions with relevance to nuclear transfer and other reproductive technologies such as ooplasmic transfer in human assisted reproduction.

Animals↗

Using the Ottawa Model of Research Use to implement a skin care program.

Addressing skin care issues requires a systematic and comprehensive approach. We used the pragmatic Ottawa Model of Research Use to guide the implementation of clinical practice guidelines in a surgical program of a tertiary care hospital. Assessments were made of existing clinical practice guidelines, the practice environment, and the potential adopters. With this information, we tailored strategies to address the barriers and to implement the guidelines. A formative evaluation demonstrated positive results.

Diffusion of Innovation↗

Advancing biomedical engineering in developing nations: Project HOPE and the potential impact of nongovernmental organizations.

Nongovernmental organizations (NGOs) have played a major role in the diffusion of biomedical engineering training to developing nations. This paper reviews the roles and unique attributes of NGOs in biomedical engineering training programs. The activities of one leading NGO in this field, Project HOPE, are discussed with examples drawn from around the world. Future challenges to biomedical engineering in the developing world, and the potential of NGOs to provide a response to these needs, are considered.

Biomedical Engineering↗

The role of appropriate medical technology procurement and user maintenance instructions in developing countries.

Reports bear witness that a significant proportion of all healthcare equipment in developing countries is not in use. There are many and varied reasons this, including inappropriateness or a lack of basic maintenance. This report addresses these issues, including guidelines for procurement staff and end-users and a bibliography. Examples of the considerations involved are given in the specialties of therapy oxygenation, laboratory tests and solar-powered equipment.

Biomedical Engineering↗

New technology continues to invade healthcare. What are the strategic implications/outcomes?

Healthcare technology continues to advance and be implemented in healthcare organizations. Nurse executives must strategically evaluate the effectiveness of each proposed system or device using a strategic planning process. Clinical information systems, computer-chip-based clinical monitoring devices, advanced Web-based applications with remote, wireless communication devices, clinical decision support software--all compete for capital and registered nurse salary dollars. The concept of clinical transformation is developed with new models of care delivery being supported by technology rather than driving care delivery. Senior nursing leadership's role in clinical transformation and healthcare technology implementation is developed. Proposed standards, expert group action, business and consumer groups, and legislation are reviewed as strategic drivers in the development of an electronic health record and healthcare technology. A matrix of advancing technology and strategic decision-making parameters are outlined.

Delivery of Health Care↗

Trends and patterns of cancer mortality in European countries.

This study aims at documenting differentials in the cancer mortality profile of European countries during the recent process of intense geo-political transformations. The World Health Organization Regional Office for Europe provided information on cancer mortality and several covariates for each country. In contrast with the European Union and Nordic countries, Central and Eastern Europe presented higher current levels and increasing trend of cancer mortality. Age-standardized rates for overall cancer mortality increased at an annual average of 2.43% in Central and Eastern European countries during the period from 1980 to 2001, while the European Union, Nordic countries and Switzerland underwent an average decrease of 7.27% per year. Trends in cancer death rates were associated with indices of welfare and socio-economic status at the country level: gross national product, health expenditure, unemployment, food intake, smoking habits and air pollution. Concurrent with this observation, we registered an extended gap in standings for these figures between richer and poorer European countries. These observations suggest that part of cancer mortality in Central and Eastern Europe could be prevented with current technology and health promotion. The drop of rates in Nordic and Western European countries indicates a progress in cancer control that, regrettably, does not hold for the whole Continent.

Adolescent↗

Caregiving and care receiving among a technologically dependent heart failure population.

This descriptive study investigated health-related quality of life (HRQOL) and caregiving/care receiving among 20 end stage heart failure patients receiving community-based inotropic infusions and among their 18 family caregivers. The analysis revealed that care recipients perceived considerable impairment from their disease process and poor HRQOL despite the use of inotropic infusions. Perceived powerlessness was identified as a predictor of the recipients' mental health status, while caregiver esteem adversely affected recipient HRQOL. Although insufficient preparation to care and caregiving tasks significantly contributed to the negative aspects of care provision. the esteem and mental health of the caregiver significantly enhanced HRQOL among caregivers.

Aged↗

Skeletal myoblast for cell therapy.

After a decade of experimental work, skeletal myoblast transplantation has now entered the clinical arena as a potentially new means of improving the function of the failing heart. Because of the apparent lack of connections between the engrafted myoblasts and the host cardiomyocytes, it is likely that the functional benefits of myogenic cell transplantation are more related to limitation of adverse post-infarction remodelling and/or paracrine effects on recipient tissue rather than to a synchronous contribution of the graft to systolic pump function. As the initial clinical studies have primarily documented the feasibility of the procedure, it is now critical to assess whether the functional benefits observed in the laboratory setting translate into meaningful improvements in cardiac contractility and ultimate patient outcomes. Only randomised trials will allow us to satisfactorily address efficacy. These trials should also clarify the potentially pro-arrhythmic risk of myoblast engraftment, which might be related to the heterogeneous electrical properties between donor and recipient cells. In parallel, additional experimental studies are still warranted to address some key issues including the means of optimising post-transplantation myoblast survival, the development of less invasive cell transfer delivery technologies, the role of myoblast transplantation in non-ischemic heart failure settings and the comparative effects of skeletal myoblasts compared with other potential forms of cell therapy such as bone marrow-derived and embryonic stem cells.

Animals↗

Cross-industry benchmarking: is it applicable to the operating room?

The use of benchmarking has been growing in nonmedical industries. This concept is being increasingly applied to medicine as the industry strives to improve quality and improve financial performance. Benchmarks can be either internal (set by the institution) or external (use other's performance as a goal). In some industries, benchmarking has crossed industry lines to identify breakthroughs in thinking. In this article, we examine whether the airline industry can be used as a source of external process benchmarking for the operating room.

Aviation↗