PubMed Health⌕ Search

Biomedical subjects

L D Budnick

Publications and source records attributed to L D Budnick.

At least 19 recordsLinked to original sources
PubMed2001

Medical examinations and appeals for NJ public service workers.

The state of New Jersey has more than 200,000 employees in merit system jobs, who are covered by the Department of Personnel's formal hiring mechanism, including a medical examination and appeals process in which physicians play an important role. The State Medical Examiners Panel provides an innovative and practical approach to supply the Merit System Board with independent and objective findings and medical recommendations regarding the appeals. This article summarizes this process and discusses the structure, functions, and outcomes of the medical examiners Panel.

Coroners and Medical Examiners↗
PubMed1995

An evaluation of scheduled bright light and darkness on rotating shiftworkers: trial and limitations.

The effectiveness of a program of scheduled bright light and dark to alter the circadian pacemakers of rotating shiftworkers were evaluated. Thirteen industrial workers were exposed to scheduled bright light of 6,000-12,000 lux on at least half of their 12-hr night shifts for 3 months, as well as ambient light of 1,200-1,500 lux. All 10 workers evaluated with urinary melatonin levels had morning melatonin suppression on the night shift, and 50% had a statistically significant circadian change. Although a few significant changes were noted concerning reported sleep and alertness, most findings concerning self-perceived alertness and performance at work, and sleep patterns were mixed and inconsistent. The major complaint was increased difficulty adjusting to being off work after the night shift during the light phase. The alteration in urinary melatonin levels is the first objective demonstration that the bright light technology can alter the circadian pacemakers of workers in an industrial setting. At this worksite, a number of interventions to lessen the effects of rotating shiftwork are being evaluated. Criteria are proposed that should be considered in evaluating a worksite for the use of bright light technology.

Adult↗
PubMed1994

Sleep and alertness in a 12-hour rotating shift work environment.

Industrial workers on rotating shifts were evaluated for the effects of rotating shift work. Twenty-five (86%) of 29 workers in the study area who work 12-hour shifts in a scheduled 16-day rotation participated. The mean number of hours of sleep at home after working day shifts (5.6 hours) was less than after the first three night shifts (6.0, 6.4, and 6.6 hours, respectively). At work, the mean number of hours at reported peak alertness was greater during the night shift (6.1 hours) than the day shift (4.9 hours), but the perceived alertness levels were relatively lower on the night shift. Increased perceived difficulty working and decreased perceived productivity and safety were reported on the first night of the night shift. We demonstrate that workers on rotating shift work exhibit low alertness-related outcomes on both shifts. These workers have early shift work starting times that appear to disrupt sleep patterns on both day and night shifts. At this work site, a number of interventions to lessen the effects of rotating shift work are being evaluated.

Adult↗
PubMed1993

Human factors in occupational medicine.

Physicians should be knowledgeable of human factors (ergonomics) to address the workplace needs of their patients. Human factors is the discovery and application of principles concerning human capacities and capabilities to the design, evaluation, operation, and maintenance of the work system for the safe, effective, and satisfying use by people. Human factors encompasses a wide range of subjects that relate to the mutual interaction between the worker and the work system, which includes the following: the organization, the environment, and the workplace; the job and the tasks the worker performs; and the equipment and the tools used. The majority of work-related injuries and loss incidents have some contributory cause related to the interaction between the worker and the work system. The goal of human factors activities is to assess abnormal or excessive human stressors and minimize or eliminate the stress to improve performance and reliability and minimize error. Human factors is becoming an integral part of occupational medicine because it is increasingly important in the workplace. This overview of human factors emphasizes the current knowledge of prevention and intervention measures to enhance the functional quality of the workplace.

Ergonomics↗
PubMed1991

Diabetes mellitus--a newly described risk factor for infection from Salmonella enteritidis.

Infections due to Salmonella serotype enteritidis have increased markedly in the northeastern United States. Due to the potential severity of these infections, host risk factors for infection were determined in the largest nosocomial S. enteritidis outbreak to have occurred in the United States. In a case-control study, patients in a New York City hospital who developed infection after exposure to an S. enteritidis-contaminated meal were more likely to be medication-dependent diabetics than were those who did not develop infection (17/75 vs. 7/80, Mantel-Haenszel adjusted odds ratio = 3.1, 95% confidence interval = 1.1, 8.6). Proposed mechanisms for diabetes as a risk factor for infection include decreased gastric acidity in diabetic patients and an autonomic neuropathy of the small bowel that reduces intestinal motility and prolongs gastrointestinal transit time.

Aged↗
PubMed1990

An international outbreak of type E botulism due to uneviscerated fish.

In October and November 1987, eight cases of type E botulism occurred in New York City and Israel. All eight patients had eaten uneviscerated, salted, air-dried whitefish known as kapchunka. Clostridium botulinum was isolated from samples of fish, and trypsinized portions of kapchunka contained type E toxin despite levels of salt that were far in excess of those considered adequate for safety. As C. botulinum has been found in the viscera of fish from the Great Lakes, possible explanations for the outbreak include multiplication of C. botulinum and production of toxin during shipping or during processing before the fish reached inhibitory salt levels. However, there was no evidence of mishandling of the fish. More likely, the viscera provided a relatively low salt "protective" environment for organism multiplication and toxin production. A major public health campaign was initiated and regulations were passed prohibiting the processing, distribution, and sale of raw, uneviscerated, salt-cured fish products within New York City.

Adult↗
PubMed1990

Ciprofloxacin-resistant methicillin-resistant Staphylococcus aureus in New York health care facilities, 1988. The New York MRSA Study Group.

The emergence in 1988 of ciprofloxacin-resistant methicillin-resistant Staphylococcus aureus (MRSA) in New York City was studied in nine hospitals and eight nursing homes. Of the 43 hospitalized patients studied, 21 were admitted from home, while nine of the 12 nursing home patients were transferred from a hospital. Twenty-four of the 55 patients had been treated previously with ciprofloxacin, and 26 had an identifiable risk factor for a nosocomial infection. MRSA was a contributing factor in at least five of the 21 deaths. MRSA resistance to ciprofloxacin was detected within three months of the drug's commercial availability, apparently emerged independently at a number of the health care facilities, and has become widespread. If such resistance is found in a health care facility, ciprofloxacin may not be useful as a first line antibiotic.

Adult↗
PubMed1986

Outbreak of cryptosporidiosis in a day-care center.

An outbreak of diarrhea due to infection with Cryptosporidium occurred in a day-care center. During a period of 2 months, 23 of 53 (43%) children attending the day-care center and 15 of 104 (14%) household contacts had diarrhea. Cryptosporidium oocysts were identified in 13 of 20 (65%) symptomatic children tested compared with three of 27 (11%) asymptomatic children (chi 2 = 12.56, P less than .001). Enteropathogenic bacteria, enteroviruses, rotavirus, and other protozoan parasites were ruled out as the cause of the diarrhea. A history of diarrhea in household contacts was associated with excretion of Cryptosporidium oocysts by the children. Human-to-human transmission of the infection was suggested by the epidemiology.

Child Day Care Centers↗
PubMed1986

Hemolytic-uremic syndrome--an outbreak in Sacramento, California.

Between July and November 1982, 14 cases of the hemolytic-uremic syndrome occurred in the Sacramento, California, metropolitan area; 9 of the 14 patients lived within a 7.5-mile radius in northeast Sacramento, 10 were female, 12 were white non-Hispanic and 13 were children with a mean age of 3.6 years. Of the 14 patients, 13 were admitted to hospital; 7 required peritoneal dialysis. The 14th child, a 3-month-old white female infant, was found dead in her crib and had renal histopathologic findings consistent with the hemolytic-uremic syndrome. Of the 13 nonfatal cases, 12 patients had diarrhea before being admitted to hospital. A case-control study involving 11 cases and 22 controls did not show any significant differences in exposure to a variety of possible risk factors including restaurants, specific foods and water supply. Stool specimens were negative for enteric bacterial pathogens by culture and for viruses by tissue culture assay, suckling mouse inoculation and immune electron microscopy; no serologic evidence was found for infection due to enteroviruses, respiratory viruses or arenaviruses. Two of four children tested, however, showed serologic evidence of infection by Vero-cytotoxin-producing Escherichia coli. These 14 cases represent one of the largest reported outbreaks of the hemolytic-uremic syndrome in the United States.

Adult↗
PubMed1985

The probability of dying of injuries by the year 2000.

Life tables in which the probability of dying of injuries in the United States from 1985 to 1999 are determined may be useful for clinicians in counseling persons concerning the risk of fatal injuries. Overall, more than 1% of persons aged 10 to 34 years in 1985 probably will die of injuries by the year 2000. For white males aged 5 to 29 years in 1985, white females aged 5 to 19 years in 1985, and black males aged 5 to 24 years in 1985, over half of all the estimated deaths during the next 15 years will be probably due to injuries.

Actuarial Analysis↗
PubMed1985

Bathtub-related drownings in the United States, 1979-81.

We analyzed National Center for Health Statistics data on drownings in bathtubs and Consumer Product Safety Commission data on bathtub-related injuries for the years 1979-80 and 1979-81, respectively. Seven hundred ten persons drowned in bathtubs in 1979 and 1980, for a crude mortality rate of 1.6 per million persons per year. Although there was an excess of deaths in the spring, there was no important seasonal trend. Mortality rates in the Pacific and Mountain states were higher than in other states. Persons at the extremes of age were at greatest risk of death, with mortality rates of 5-6 per million per year. Black males aged 20-64 years had substantially elevated mortality rates compared to White males. The prevalence of personal risk indicators varied with age, with a frequent history of being left unattended among children less than 5 years old, a frequent history of seizures among persons 5-39 years old, a frequent history of alcohol or drug use among persons 40-59 years old, and frequent evidence of having fallen among those at least 60 years old. Bathtubs are potentially dangerous, and the prevention of drownings in them can be approached through a combination of passive and active strategies.

Adolescent↗