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PubMed1993

State regulation of hospital water temperature.

OBJECTIVE: The purpose of this study was to determine current regulations and policies in the United States concerning maximal water temperatures in acute care hospitals. DESIGN: A standardized questionnaire administered by telephone to health department officials from 50 states and the District of Columbia. SETTING: State Health Departments in the 50 states and the District of Columbia. RESULTS: All states responded to the survey. Respondents from 39 states (77%) reported regulating maximum allowable hospital water temperature at a mean of 116 degrees F (median, 120 degrees F; mode 110 degrees F; range, 110 degrees F to 129 degrees F). Twelve states (23%) have no regulations for maximum water temperature. Of the 39 states regulating maximum water temperature, 30 (77%) routinely monitor hospital compliance. Nine states (23%) conduct inspections only in response to a complaint or incident. CONCLUSIONS: There is great variation among the states with respect to the existence, enforcement, and specific regulations controlling hospital water temperature. Risk-benefit and cost-effectiveness analyses would help to assess the risk of scald injuries at water temperatures that will inhibit microbial contamination.

Burns↗
PubMed2001

Melanin and blood concentration in human skin studied by multiple regression analysis: experiments.

Knowledge of the mechanism of human skin colour and measurement of melanin and blood concentration in human skin are needed in the medical and cosmetic fields. The absorbance spectrum from reflectance at the visible wavelength of human skin increases under several conditions such as a sunburn or scalding. The change of the absorbance spectrum from reflectance including the scattering effect does not correspond to the molar absorption spectrum of melanin and blood. The modified Beer-Lambert law is applied to the change in the absorbance spectrum from reflectance of human skin as the change in melanin and blood is assumed to be small. The concentration of melanin and blood was estimated from the absorbance spectrum reflectance of human skin using multiple regression analysis. Estimated concentrations were compared with the measured one in a phantom experiment and this method was applied to in vivo skin.

Biophysical Phenomena↗
PubMed1978

Effects of halothane on glucose metabolism after injury in the rat.

The effects of halothane anaesthesia on glucose metabolism have been investigated in rats after a non-lethal scald injury. Anaesthesia was induced about 70 min after injury. Glucose metabolism was studied at two stages: during and shortly after induction, and about 2 h after induction. Comparisons were made with conscious rats at the corresponding times after injury. All rats were in an ambient temperature of 30 degrees C. During and shortly after the induction of anaesthesia, halothane caused a rapid increase in plasma glucose concentration, which by 30 min had begun to return to the values in injured controls; thus glucose production and utilization were increased. Insulin concentrations were increased also. However, after 2 h exposure halothane had decreased glucose production and utilization, as determined with [5-3H]- and [U-14C]-glucose, increased plasma concentrations of insulin and decreased liver concentrations of glycogen, that is it had exacerbated well-known effects of injury in the rat, including insulin resistance. Hyperglycaemia was not increased.

Anesthesia, Inhalation↗
PubMed2003

Injury status and perspectives on developing community safety promotion in China.

The objective of this paper is to introduce the epidemiology of injuries in China, and then consider the development of safe communities in regard to injury prevention and safety promotion. The disease spectrum has changed in recent decades in the People's Republic of China. Both in cities and rural areas, injury has become the fifth leading cause of death. At least 800 000 people die from injury each year, and 50 million non-fatal injuries occur, of which 2.3 million lead to disability of varying degrees of severity. The average injury-related death rate in China from 1990 to 1997 was 66 per 100 000, which accounts for 11% of total deaths. The potential years of life lost (PYLL) of injury accounts for 24% of the total, and disability-adjusted life years (DALYs) account for 17%. Main injury causes of death, in descending order, are: suicide, traffic accident, drowning, falling, poisoning, homicide, burn and scald, and iatrogenic injury. Considering China's current injury status and its rapid societal change, injury prevention and safety promotion need to be strengthened further, and there is a special need for the development of Safe Communities programmes. The prevention of injuries through safety promotion has been increasingly focussed on over recent decades. The WHO Safe Community model is recognized as representing an effective and long-term approach to the prevention of injuries at a local level, and has been beneficially applied all over the world. A programme may cover several aspects of injury prevention and safety promotion simultaneously, or only include one or two aspects. In a Safe Community programme in China, children, the elderly, cyclists and their passengers, and farmers should be among the prioritized target populations. However, multi-focussed inter-sectoral programmes have been shown to have additional effects to distinct sectoral programmes.

Accident Prevention↗
PubMed1999

Lay beliefs about the preventability of major health conditions.

Beliefs about the extent to which health problems can be prevented reflect an understanding that preventive measures can reduce adverse health events and the level of control individuals perceive that they hold over the factors that affect their health. A population survey of 1659 people conducted in 1995 in south western Sydney, Australia, found that only child drownings, tooth decay, skin cancer, and burns and scalds were considered all or mostly preventable by more than 50% of the sample. The majority of respondents did not believe that heart attacks, cervical cancer, high blood pressure, serious road injury, lung cancer and asthma deaths were all or mostly preventable. Logistic regression analysis showed that people born in an English speaking country, those with more than 10 years of education and men were significantly more likely to recognize a number of key conditions as highly preventable. The findings suggest that, in spite of the range of prevention efforts in Australia to date, these are not matched by strong beliefs within the community that prevention is possible. Communication of the opportunities and methods for prevention needs to be improved, particularly among certain population groups. The findings also indicate a need to examine social and environmental factors which are potentially reducing confidence, and subsequently and adoption of preventive behaviours.

Adolescent↗
PubMed1979

Levels of exfoliatin antitoxin in pooled human serum globulin.

The potential value of human serum globulin for treatment of patients with the staphylococcal scalded-skin syndrome was determined by measuring the exfoliatin antitoxin content of globulin pools. Of 16 lots tested, only four had detectable antitoxin activity, and in these the levels were minimal. These findings suggest that pooled serum globulin is not a practical source of exfoliatin antitoxin.

Animals↗
PubMed1995

Antibiotics and the expression of staphylococcal virulence.

The last 25 years have witnessed a continuing interest in staphylococci as causes of human infection even though over 100 years have elapsed since their discovery. This has been due in part to the recognition of new disease entities such as scalded skin syndrome, toxic shock syndrome and various infections due to coagulase-negative staphylococci. Development of antimicrobial agents has not solved the problem of these infections partly because of their mediation by novel toxins and partly due to the emergence of multiple drug resistance. However study of the interaction between certain antibiotics and staphylococci in vitro and in vivo has provided new knowledge concerning the role of cell wall-associated and soluble virulence factors in the pathogenesis of staphylococcal disease.

Animals↗
PubMed2001

Health and safety in the catering industry.

There is evidence that the catering industry has high levels of work-related injury and disease. This study examined the incidence, nature and causes of work-related injury and disease among 315 catering students, at a large school of catering in the west of Ireland, over a 10 month academic year. A high incidence of accidents that caused injury was found. Cuts and lacerations, arising from accidents with knives, were the most common injuries seen, followed by burns and scalds from handling hot liquids. A significant level of work-related dermatitis was also recorded. Trainee chefs were identified as an occupational group with a high risk of occupational injury and disease. This group would benefit from vaccination against tetanus. Work-related injuries and disease generated a significant workload for the student health unit, which in itself is a good reason for catering establishments to make use of occupational health services. Health and safety procedures need to be audited and constantly reviewed at a local level. Further research is necessary to more accurately determine the incidence, nature and leading causes of work-related injury and disease in the catering industry in Ireland. This would help in the planning and implementation of an effective health and safety management system.

Accidents, Occupational↗
PubMed1996

Novel features of serine protease active sites and specificity pockets: sequence analysis and modelling studies of glutamate-specific endopeptidases and epidermolytic toxins.

With a view to obtaining a better understanding of the structural determinants of P1 glutamate specificity in glutamate-specific endopeptidases (GSEs), the active sites and specificity pockets of such enzymes from Bacillus licheniformis (gse-bl), Bacillus subtilis (mpr) and Staphylococcus aureus (v8 protease) were modelled. This approach was extended to the epidermolytic toxins (ETs), responsible for the staphylococcal scalded skin syndrome. We identify a canonical structure for the S1 subsite, composed of H213 and T190, both of which we predict to interact directly with the P1 glutamate. The possible importance of R30 (for gse-bl and mpr) and of the N-terminus (for gse-bl, mpr and v8 protease) was also examined. In the case of mpr, a G193C substitution is predicted to participate in a novel disulphide bridge which stabilizes C193 in such a way as to maintain the oxyanion hole. In v8, the loss or substitution of several important structural components around D102 of the catalytic triad probably explains its reduced catalytic efficiency in comparison with other GSEs. In the case of the epidermolytic toxins K216 may be important for the previously reported phospholipase C-like activity, since the model predicts that it may stabilize the negative charge on the phosphonyl group.

Algorithms↗
PubMed1997

Feather retention force in broilers ante-, peri-, and post-mortem as influenced by electrical and carbon dioxide stunning.

Stunning and slaughter trials were conducted to evaluate the influence of stunning method (electrical 50 V alternating current, CO2 gas: 0 to 40% for 90 s or 40 to 60% for 30 s) on feather retention force (FRF) in commercial broilers. Feathers from the pectoral, sternal, and femoral feather tracts were sampled with a force gauge before stunning (ante-mortem) and contralaterally either after stunning (peri-mortem from 0.5 to 4 min) or after stunning and bleeding (post-mortem from 2 to 6 min). Prior to stunning, ante-mortem FRF values varied among assigned stunning methods only for the pectoral (7%) feather tract. After stunning, peri-mortem FRF values were higher only for the sternal tract (11% for 40 to 60% CO2 for 30 s); whereas after stunning and bleeding, post-mortem FRF values were lower than ante- or peri-mortem only for the sternal tract (10% lower for 40 to 60% CO2 for 30 s). Peri- and post-mortem FRF values did not differ among stunning methods for the pectoral and femoral feather tracts. Small changes in FRF values occurred from ante-mortem to peri-mortem (-1 to +12%), and from ante-mortem to post-mortem (-2 to +8%) across stunning methods. A significant increase was determined for only the pectoral tract (7%) from ante- to peri-mortem across stunning methods. Electrically stunned broilers that were not bled gained weight in excess of the 36 feathers removed (0.16%), apparently due to body surface water pickup during the brine-stunning process, whereas CO2-stunned broilers lost weight due to excretion of cloacal contents (-0.31 to -0.98%). The change in body weight among stunning methods was significant (P < 0.0233). Peri- and post-mortem FRF, in addition to bleed-out body weight loss, were not substantially influenced by electrical or CO2 stunning methods, and, therefore, carcass defeathering efficiency may not differ after scalding.

Animals↗
PubMed1998

Influence of time off feed on broiler viscera weight, diameter, and shear.

The influence of time off feed on broiler viscera weight, intestinal diameter, and shear was studied by subjecting market-age male broilers (42, 44, or 48 d) to incremental feed withdrawal periods (0, 6, 12, 18, or 24 h). Body weight was determined prior to feed withdrawal and at the time of processing. After slaughter, scalding, and defeathering, the abdominal cavity was opened. Diameter and shear of the proventriculus-ventriculus junction, jejunum, and ileum segments were measured, as were gallbladder length and width. Thoracic and abdominal viscera, liver, and ventriculus weights were determined, and liver surface color was measured. Percentage body weight loss increased with longer feed withdrawal periods, as viscera, liver, and ventriculus weights decreased. Gallbladder length increased with time off feed, whereas its width did not change. Diameter of the proventriculus-ventriculus junction, jejunum, and ileum decreased with longer feed withdrawal periods. Shear values for the proventriculus-ventriculus junction, jejunum, and ileum were not influenced by time off feed. Positive correlations (P < 0.05 and r > 0.4) between viscera weight and intestinal diameter were detected. Correlations between all measured parameters and shear values were not significant. Liver color measurements indicated that longer feed withdrawal periods resulted in significant linear decreases in L* (lightness), +a* (redness), and +b* (yellowness). Longer feed withdrawal periods decreased viscera weight and intestinal diameter, which would lower the potential for cutting the intestine during automated evisceration. However, the resulting greater gallbladder length (5 mm) would increase the possibility of bile contamination during evisceration.

Animal Feed↗
PubMed2000

Physical, chemical, and microbiological changes in the crop of broiler chickens subjected to incremental feed withdrawal.

Trials were conducted to determine the effect of feed withdrawal on the weight, pH, native bacterial flora, and Salmonella typhimurium persistence in crops of broilers. Six-week-old broilers were provided medicated or unmedicated feed and were subjected to feed withdrawal for 0 to 24 h in transportation crates or on litter. After feed withdrawal, broilers were stunned, bled, scalded, and picked. Crops were aseptically removed and weighed. Crops were then blended in 20 mL distilled water, and pH values of the suspensions were measured. Aerobic bacteria, Enterobacteriaceae, S. typhimurium, and lactic acid bacteria in the suspension were enumerated on appropriate bacteriological media. Feed withdrawal produced significant decreases in the crop weights. Crop pH increased by 1.0 unit within 6 h of feed withdrawal. Enterobacteriaceae and S. typhimurium populations generally decreased during the first 12 h of feed withdrawal and remained unchanged or increased during the final 12 h of the 24-h feed withdrawal period. The number of lactic acid bacteria recovered from the crop usually decreased as the duration of feed withdrawal increased. Changes in crop weights, pH, native microflora, or the recovery of S. typhimurium from the crop were similar in broilers subjected to feed withdrawal on litter or in crates and in broilers provided medicated or unmedicated feed before initiating feed withdrawal. Findings indicate that a decrease in the number of lactic acid producing bacteria in the crop and an increase in crop pH may be related to the reduction of anti-Enterobacteriaceae activity in the crop during extended feed withdrawal.

Animals↗
PubMed2000

Physical, chemical, and microbiological changes in the ceca of broiler chickens subjected to incremental feed withdrawal.

Trials were conducted to determine the effect of feed withdrawal on the weight, pH, native bacterial flora, and the persistence of Salmonella typhimurium in the ceca of market-age broilers. Broilers were provided medicated or unmedicated feed and then were subjected to feed withdrawal for 0 to 24 h in transportation crates or on litter. After feed withdrawal, broilers were stunned, bled, scalded, and picked. One cecum from each bird was aseptically removed and weighed. The cecum was then blended in 20 mL of distilled water, and the pH of the blended suspension was measured. The number of total aerobes, Enterobacteriaceae, S. typhimurium, and lactic acid bacteria in the suspension were enumerated on the appropriate bacteriological media. Results indicated that up to 24 h of feed withdrawal produced no significant change in cecal weight and that cecal pH varied by up to 0.3 units during feed withdrawal. There were significant increases in the population of Enterobacteriaceae during feed withdrawal in Trials 2 and 3, and there was a significant increase in the population of cecal aerobes in Trial 3. Feed withdrawal produced significant decreases in the population of lactic acid bacteria in all trials, but no significant change in the population of S. typhimurium occurred during feed withdrawal. There were no significant differences in cecal weight, pH, native bacteria populations, or S. typhimurium populations between broilers that were subjected to feed withdrawal on litter or in crates. Findings indicate that feed withdrawal does not always effectively evacuate the contents of the ceca and that the ceca of broilers subjected to feed withdrawal can remain a source of foodborne bacterial pathogens.

Animal Feed↗
PubMed2000

The relationship of raw broiler breast meat color and pH to cooked meat color and pH.

Three replicate trials were conducted to determine the influence of raw breast meat color and pH on subsequent cooked meat color and pH. In each trial, approximately 50 breast fillets were obtained from a commercial processing plant based on being either normal, lighter than normal, or darker than normal. Color (L* = lightness, a* = redness, and b* = yellowness) of each fillet was determined in triplicate on the underside surface of the fillet (to avoid scalding effects), and the pH was determined on a tissue sample removed from the posterior portion of each fillet. Fillets were then cooked in steam at 98 C for 20 min and cooled to room temperature, and a second sample was removed from the posterior section for cooked meat pH. Cooked meat color was measured on an exposed surface, to avoid cooking-related discoloration. The data were subjected to linear regression analysis to determine the relationship between raw and cooked values. Results indicated a significant linear relationship between raw and cooked values for each color parameter as well as pH. Model R2 values were 0.43, 0.40, 0.64, and 0.78 for L*, a*, b*, and pH, respectively. There were also significant linear relationships between raw meat L* and raw muscle pH (R2 = 0.59) as well as cooked meat L* and raw meat pH (R2 = 0.36). These results indicate that raw breast meat color and pH affect cooked breast meat color and pH but that cooking reduces the degree of color variation. Moreover, cooked meat lightness is more closely associated with raw breast meat pH than with cooked meat pH.

Analysis of Variance↗
PubMed2003

Effects of electrical stunning frequency and voltage combinations on the presence of engorged blood vessels in goose liver.

The purpose of this study was to investigate the influence of nine electrical stunning methods using various frequency and voltage combinations on the occurrence of engorged blood vessels in goose liver. Two hundred seventy Gourmaud geese (liver-type line SI 14) were slaughtered at 12 wk of age, in groups of 90 at three different times. Thirty birds each were subjected to one of the nine stunning methods. Neck cutting was performed immediately after stunning. The duration of exsanguination was 11 min. After completion of bleeding, the birds were scalded, defeathered manually, and kept refrigerated. At 1 d postmortem, the carcasses were eviscerated and cut up. From the slaughterhouse, the livers chilled in ice were transported to the cannery where they were weighed and graded at 2 d postmortem and were further processed. All of the veins and capillaries full of blood were removed from livers, because their presence was a hazard to product quality by causing discoloration of the canned liver, and the percentage of liver weight loss was then determined. The loss in liver weight due to removal of engorged blood vessels was reduced (P < 0.05) at 350 Hz, 70 to 90 V, and 80 to 85 mA when compared to the results obtained with any other stunning method tested. It was concluded that the use of high-frequency currents for electrical stunning of liver geese might have considerable commercial advantages.

Animals↗
PubMed2003

Effects of high frequency electrical stunning and decapitation on early rigor development and meat quality of broiler breast meat.

Three independent trials were conducted to determine the effects of high frequency electrical stunning followed by decapitation on broiler breast meat rigor development and meat quality. All birds were stunned and half of the birds were killed using a conventional unilateral neck cut, half were killed by decapitation, and both groups were allowed to bleed for 90 s prior to scalding and picking. New York dressed carcasses were chilled in a static ice-water bath for 90 min and held at 2 degrees C prior to deboning. Breast fillets were removed from the carcasses at 2, 4, and 24 h postmortem. From the right breast fillet, R-values and pH were determined at time of deboning. The left fillet was wrapped in plastic and held for 24 h at 2 degrees C prior to determining lightness (L*), redness (a*), yellowness (b*), cook yield, and Allo-Kramer shear. Deboning time affected raw meat pH, R-value, cook loss, and shear value but had no effect on color. The breast meat from the decapitated birds had significantly higher pH values at 2 and 24 h postmortem than the conventionally killed birds. Other than for the effect on breast meat pH, decapitation had no effect on rigor development, R-value, meat color, or meat quality as measured by cooked-meat yield and Allo-Kramer shear.

Adenine Nucleotides↗
PubMed2006

Incidence of pectoralis major turkey muscles with light and dark color in a Portuguese slaughterhouse.

Turkey meat and processed products are very popular in Portugal. However, no studies have been made to assess turkey meat quality. The main objective of this study was to evaluate the quality of turkey breast meat in a Portuguese slaughterhouse, differentiating it to obtain better industrial management, performance, and consumer contentment. Nine hundred and seventy-seven male turkeys (from 16 to 20 wk old) from different flocks (BUT 9 and BIG 6) were evaluated to assess meat quality. Turkeys were slaughtered on different days, electrically stunned (225 V/3 s), and scalded in a vertical water bath at 81 degrees C/5 min. On the slaughter line, the pH and temperature were measured on the pectoralis muscle 15 min postmortem. The carcasses were fast-cooled in a tunnel (-2 degrees C/2 m.s(-1)/90% RH) for 2 h and kept in a refrigeration chamber (0 degree C/85% RH) until deboning (approximately 24 h postmortem). Color and pH 24 h postmortem (pH(24)) were measured on the pectoralis major muscle after carcass deboning. Pectoralis major muscles were selected according to criteria used by Barbut (1996) and drip loss, cooking loss, and total pigments analysis were performed on 67 different sliced meat samples. Muscles classified by pH decline rate, called rapid glycolytic, did not present final quality characteristics that could relate them with pale, soft, and exudative- (PSE) like meat, because there was no relationship between pH 15 h postmortem and lightness (L*), drip loss, or cooking loss. The differences, founded on physicochemical characteristics within pectoralis major muscles, allowed us to establish a criteria of turkey meat quality for dark and PSE-like meat, with L* < or = 44 and pH(24) > or = 5.8 and L* > or = 50 and pH(24) < 5.8, respectively. Based on criteria, the studied population presented 8.1% of carcasses with PSE-like muscles and 12.1% with dark muscles. The association of pH(24) and L* as criteria classification can be useful to classify turkey meat quality.

Abattoirs↗
PubMed1995

Serial casting of the lower extremity to correct contractures during the acute phase of burn care.

Severe contractures that develop early following a burn may not improve with splinting and exercise treatment. An alternative treatment is serial casting, which has been used to promote increased range of motion, to facilitate patient compliance with positioning, and to prevent the patient from scratching the burned area. This case report describes the use of serial casting for resolution of ankle plantar-flexion contractures that occurred in the acute phase of burn injury. The child described in this case report sustained a 49% total body surface area scald burn and developed contractures within 1 week after injury. The contractures, which were not corrected with thermoplastic splints, improved with casting from 45 degrees of plantar flexion to neutral dorsiflexion over 2 months with biweekly cast changes. The patient had multiple skin grafts and progressed in functional activities. Serial casting is a conservative and effective modality in correcting contractures resulting from burns. Further documentation of the efficacy of this treatment approach is necessary to support its use in burn care throughout various stages of healing.

Acute Disease↗