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Biomedical subjects

Thomas J Keefe

Publications and source records attributed to Thomas J Keefe.

14 recordsLinked to original sources
PubMed2006

Sex differences in mortality after traumatic brain injury, Colorado 1994-1998.

PRIMARY OBJECTIVE: The purpose of this study was to assess the relationship between sex and traumatic brain injury (TBI) mortality. METHODS AND PROCEDURES: A total of 20,465 persons with TBI were identified from a Colorado population-based surveillance system for 1994-1998. Case fatality ratios were calculated to identify sex differences for selected risk factors. Unconditional logistic regression was used to determine the relationship between TBI mortality and sex controlling for risk factors. MAIN OUTCOMES AND RESULTS: Adjusting for age, race, metropolitan residence and penetrating injury, the estimated odds of TBI mortality for males compared to females was 1.21 (95% CI 1.10, 1.34) for pre-hospital fatalities and 1.19 (95% CI 1.05, 1.37) for hospital fatalities. CONCLUSION: Results indicate differences in TBI mortality comparing males and females. Future studies are warranted to identify if behaviour and physiological responses are associated with TBI outcomes among males and females.

Adolescent↗
PubMed2006

Training methods and association with worker injury on Colorado dairies: a survey.

The goals of this study were to define the current methods for training entry-level workers on Colorado dairies, to measure the relationship of training methods to the incidence of work-related injuries on those operations, and to characterize the nature and cause of injuries reported by participating workers. Seventy-two workers from 15 dairies from Weld, Morgan, Larimer and Yuma counties volunteered to be interviewed privately in the language of their choice. Training methods were classified by content (task training versus safety training), method of delivery (on-the-job verbal instruction, on-the-job demonstration, on-the-job supervision, classroom- based, and / or reading materials); and instructor (supervisor and/or co-worker). The majority (84.7%) of interviewed workers were Mexican-born, Spanish-speaking males. Most workers reported the training to be a combination of verbal instruction, demonstration and supervision. Twenty-nine of 72 (40.3%) of all participants suffered at least one work-related injury in the 12 months prior to the interview. Entry-level safety training had no protective effect (P = 0.463) on the reported incidence of injury in dairy workers in the previous year. However, workers that received task-related training were four times less likely to suffer a work-related injury (P = 0.008). Training conducted by a co-worker also had a significant protective effect against work-related injuries (P = 0.028). Dairy workers identified direct contact with livestock or machinery as the main cause for work-related injuries, and most injuries occurred while medicating sick cows and milking.

Accidents, Occupational↗
PubMed2005

Combining in-school and community-based media efforts: reducing marijuana and alcohol uptake among younger adolescents.

This study tests the impact of an in-school mediated communication campaign based on social marketing principles, in combination with a participatory, community-based media effort, on marijuana, alcohol and tobacco uptake among middle-school students. Eight media treatment and eight control communities throughout the US were randomly assigned to condition. Within both media treatment and media control communities, one school received a research-based prevention curriculum and one school did not, resulting in a crossed, split-plot design. Four waves of longitudinal data were collected over 2 years in each school and were analyzed using generalized linear mixed models to account for clustering effects. Youth in intervention communities (N = 4,216) showed fewer users at final post-test for marijuana [odds ratio (OR) = 0.50, P = 0.019], alcohol (OR = 0.40, P = 0.009) and cigarettes (OR = 0.49, P = 0.039), one-tailed. Growth trajectory results were significant for marijuana (P = 0.040), marginal for alcohol (P = 0.051) and non-significant for cigarettes (P = 0.114). Results suggest that an appropriately designed in-school and community-based media effort can reduce youth substance uptake. Effectiveness does not depend on the presence of an in-school prevention curriculum.

Adolescent↗
PubMed2005

Using community readiness key informant assessments in a randomized group prevention trial: impact of a participatory community-media intervention.

This study examines the role of key informant community readiness assessments in a randomized group trial testing the impact of a participatory community-media intervention (which was also complemented by in-school efforts). These assessments were used to help match communities in random assignment, as a source of formative data about the community, as the basis for a coalition-building workshop, and as an evaluation tool, with a follow-up set of surveys approximately 2 years after the baseline survey. Results of the nested, random effects analysis indicated that the intervention influenced community knowledge of efforts and (at marginally significant levels) improved prevention leadership quality and community climate supportive of prevention efforts. There was evidence that the professional affiliation of informants in some cases had an effect on their assessments, which could be controlled in the analysis. The authors conclude that key informant community readiness assessments can usefully serve to supplement aggregated measures of individual attitudes and behavior (reported elsewhere for this study) in evaluating community-based interventions.

Community Participation↗
PubMed2004

Effects of meloxicam on severity of lameness and other clinical signs of osteoarthritis in dogs.

OBJECTIVE: To evaluate effects of meloxicam on severity of lameness and other clinical signs in dogs with osteoarthritis (OA). DESIGN: Randomized, controlled, multicenter clinical trial. ANIMALS: 217 client-owned dogs with clinical and radiographic signs of OA. PROCEDURE: Dogs were randomly assigned to be treated with meloxicam (n = 105; 0.2 mg/kg [0.09 mg/lb], SC, once on day 1, then 0.1 mg/kg [0.045 mg/lb], PO, q 24 h, for 13 days) or a placebo (n = 112). A general clinical score was assigned by investigators on days 1 (ie, prior to initiation of treatment), 8, and 15 on the basis of severity of lameness, extent of weight bearing, and severity of signs during palpation of the affected joint. Owners and investigators provided overall evaluations on days 8 and 15. RESULTS: Dogs treated with meloxicam had significantly greater improvements in general clinical scores, compared with baseline scores, on days 8 and 15 than did dogs treated with placebo. On days 8 and 15, percentages of dogs treated with meloxicam in which owners and investigators considered treatment to be successful were significantly higher than percentages of control dogs in which treatment was considered to be successful. No abnormalities in hematologic and serum biochemical test results were detected. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that compared with administration of a placebo, administration of meloxicam for 14 days significantly improved the clinical condition of dogs with OA without causing adverse effects.

Administration, Oral↗
PubMed2004

Effectiveness of the HomeSafe Pilot Program in reducing injury rates among residential construction workers, 1994-1998.

BACKGROUND: The construction industry typically has one of the highest fatal and non-fatal injury rates compared with other industries. Residential construction workers are at particular risk of injury (work is in remote sites with small crews, there are often many subcontractors, and they have limited access to safety programs). Difficulty accessing information specific to this group has made research more challenging, therefore, there are few studies. This study evaluated the effectiveness of the HomeSafe Pilot Program, a safety education and training program designed to reduce injuries among residential construction workers. METHODS: Researchers evaluated whether overall and severe injury incidence rates declined during the intervention period. Data were analyzed using incidence rates and Poisson regression to control for the effect of antecedent secular trend. RESULTS: Injury incidence rates declined significantly following HomeSafe; however, this effect was not statistically significant once temporal variation was controlled. CONCLUSIONS: The decline in injury rates following HomeSafe cannot be attributed solely to HomeSafe, however, programmatic and methodologic limitations contributed to the inconclusive results. Further research into the hazards faced by residential construction workers is needed. Am. J. Ind. Med. 45:210-217, 2004.

Accidents, Occupational↗
PubMed2004

Immune markers and ornithine decarboxylase activity among electric utility workers.

The effects of a 60-Hz magnetic field (MF) exposure on white blood cell ornithine decarboxylase (ODC) activity, natural killer (NK) cell activity, lymphocyte phenotypes, and differential cell counts were studied among 60 electric utility workers. Personal MF exposure monitoring over 3 consecutive workdays was followed by collection of a peripheral blood sample. There were no MF-related changes in NK activity or the number of circulating neutrophils, eosinophils, basophils, or T-lymphocytes (CD4, CD8, CD4:CD8 ratio). MF exposure intensity was associated with decreased ODC activity (P<0.01) and lower NK cell counts (P=0.04). Melatonin production, which stimulates the immune system, was quantified on the night preceding immune marker determinations. Exposure-related reductions in ODC activity, NK and B cells, and monocytes were strongest among workers with reduced melatonin production. The biological significance or long-term health consequences associated with these changes are not known.

Adult↗
PubMed2003

Factor analysis of minimum-inhibitory concentrations for Escherichia coli isolated from feedlot cattle to model relationships among antimicrobial-resistance outcomes.

Factor analysis was used to assess relationships in the minimum-inhibitory concentration among 17 antimicrobials tested on isolates of Escherichia coli isolated from 360 faecal samples obtained from feedlot cattle. Six factors were extracted using maximum-likelihood factor analysis. The factors were interpretable antimicrobial groupings based on class of antimicrobial and previously described associations. New-generation cephalosporins, older-generation beta-lactams, fluoroquinolones and aminoglycosides grouped separately as classes of antimicrobials on four of the six factors. One of the remaining factors was a grouping of antimicrobials that had been identified as being related in previous feedlot studies. The last factor was a grouping of three of the five antimicrobials that comprise the antimicrobials found in penta-resistant strains of Salmonella Typhimurium. The factor analysis described patterns in the MIC data that would not have been apparent if only antimicrobial-resistance data categorized as susceptible-resistance had been analysed.

Animals↗
PubMed2003

Short-term repeatability of measurements of antimicrobial susceptibility of Escherichia coli isolated from feces of feedlot cattle.

Short-term stability of measurements of antimicrobial susceptibility of Escherichia coli isolated from feces of feedlot cattle is important in developing monitoring and surveillance programs. Frequent evaluations (i.e., daily) are resource intensive and in some situations may be impractical for long-term sampling protocols. Consequently, a point-in-time measurement will need to be used to represent conditions in the perisampling period. In this study, 30 fecal samples were collected from each of 6 cattle pens on a commercial cattle feedlot on 2 occasions separated by 48 hours. Escherichia coli was isolated from single and pooled samples. The isolates were tested for antimicrobial susceptibility against a panel of 17 antimicrobials. Resistance to 5 antimicrobials (ampicillin, nalidixic acid, streptomycin, sulfamethoxazole, and tetracycline) was detected in single and pooled samples from both sampling periods (days 1 and 3). The prevalence of isolates resistant to these 5 antimicrobials was 2% or higher in all treatment combinations except for pools obtained from day 3 samples. Lower levels of resistance to 6 more antimicrobials were detected inconsistently across the single and pooled samples. Logistic models constructed for the antimicrobials to which the E. coli isolates were most commonly resistant demonstrated that there were no significant differences between periods (P > 0.10) and between single and pooled samples (P > 0.20). The distribution of the number of antimicrobials to which isolates were resistant was consistent for the single samples across periods, but there appeared to be a lower prevalence of any resistance in day 1 pooled samples. A larger number of resistant phenotypes were detected in the single samples than in the pooled samples, and resistant phenotypes with prevalence of less than 2% were detected inconsistently across periods and single and pooled samples. Resistance to individual antimicrobials was consistent by all measures when the prevalence was at least 2%. Inconsistent results were obtained for antimicrobials to which resistance rarely occurred. The apparent inconsistencies do not appear to be related to external factors but rather to sampling intensity. Short-term stability is a plausible assumption under sampling strategies that are designed to detect specific levels of prevalence. However, when resistance levels fall below these levels, there will likely be fluctuations in the presence or absence of rare resistant phenotypes and in their prevalence and central tendency measures.

Animals↗
PubMed2003

Management commitment to safety and health in residential construction: HomeSafe spending trends 1991-1999.

The support of good management is fundamental to the success of any safety and health program. Residential construction is a high-risk industry requiring significant commitment by management to impact day-to-day safety and health challenges. Investigators have evaluated management practices and spending trends in a cohort of 228 residential homebuilders in the Denver metro area of Colorado. Findings suggest that companies significantly increased dollars allocated to support safety and health practices between 1991 and 1999. In addition, the HomeSafe Pilot Program has positively impacted financial commitments of partner companies. Resource allocations were significantly greater for specific expense categories when comparing pre to post HomeSafe intervention. This paper presents data on the use of written safety and health programs, safety committees, and workers compensation premium cost containment certification, as well as allocations to safety incentive programs (SIP), personal protective equipment (PPE), other safety equipment (OSE), and safety training (ST).

Accidents, Occupational↗
PubMed2002

Comparison of sampling techniques for measuring the antimicrobial susceptibility of enteric Escherichia coli recovered from feedlot cattle.

OBJECTIVE: To evaluate the effectiveness of various sampling techniques for determining antimicrobial resistance patterns in Escherichia coli isolated from feces of feedlot cattle. SAMPLE POPULATION: Fecal samples obtained from 328 beef steers and 6 feedlot pens in which the cattle resided. PROCEDURE: Single fecal samples were collected from the rectum of each steer and from floors of pens in which the cattle resided. Fecal material from each single sample was combined into pools containing 5 and 10 samples. Five isolates of Escherichia coli from each single sample and each pooled sample were tested for susceptibility to 17 antimicrobials. RESULTS: Patterns of antimicrobial resistance for fecal samples obtained from the rectum of cattle did not differ from fecal samples obtained from pen floors. Resistance patterns from pooled samples differed from patterns observed for single fecal samples. Little pen-to-pen variation in resistance prevalence was observed. Clustering of resistance phenotypes within samples was detected. CONCLUSIONS AND CLINICAL RELEVANCE: Studies of antimicrobial resistance in feedlot cattle can rely on fecal samples obtained from pen floors, thus avoiding the cost and effort of obtaining fecal samples from the rectum of cattle. Pooled fecal samples yielded resistance patterns that were consistent with those of single fecal samples when the prevalence of resistance to an antimicrobial was > 2%. Pooling may be a practical altemative when investigating patterns of resistance that are not rare. Apparent clustering of resistance phenotypes within samples argues for examining fewer isolates per fecal sample and more fecal samples per pen.

Animals↗
PubMed2002

Multiple-center study of reduced-concentration triamcinolone topical solution for the treatment of dogs with known or suspected allergic pruritus.

OBJECTIVE: To determine the efficacy of triamcinolone acetonide topical solution (TTS) in dogs for use in reduction of clinical signs of pruritic inflammatory skin diseases of a known or suspected allergic basis and to evaluate adverse effects associated with TTS administration. ANIMALS: 103 pruritic adult dogs with known or suspected allergic skin disease. PROCEDURE: Dogs were treated for 4 weeks with TTS or with vehicle solution (control dogs) in a multiple-center study. Clinical signs were scored by owners and by examining veterinarians before and after treatment. Blood samples obtained before and after treatment were subjected to routine hematologic and serum biochemical analyses. RESULTS: Treatment success, as defined by an improvement of at least 2 of 6 grades in overall clinical score, was evident in 35 of 52 (67%) TTS-treated dogs (mean improvement, 1.98) and 12 of 51 (24%) control dogs (mean improvement, 0.29). For several criteria, TTS was significantly more effective than vehicle in reducing clinical signs. Minor alterations in hematologic determinations in TTS-treated dogs were limited to slightly lower total leukocyte, lymphocyte, and eosinophil counts after treatment. Minor adverse effects were reported by owners in 6 of 52 (12%) TTS-treated and 9 of 51 (18%) control dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Triamcinolone used as a spray solution at a concentration approximately one-sixth the concentration of triamcinolone topical preparations currently available for veterinary use is effective for short-term alleviation of allergic pruritus in dogs. Adverse effects are few and mild and, thus, do not preclude prolonged treatment with the solution.

Administration, Topical↗
PubMedDate not supplied

Construction work practices and conditions improved after 2-years' participation in the HomeSafe pilot program.

This study reevaluated changes in job-site safety audit scores for a cohort of residential construction workers that had protracted exposure to the HomeSafe pilot program for 2(1/2) years. The investigation was a repeated measure of a cohort study underway in the six-county metro area of Denver, Colo. The larger study was a longitudinal, quasi-experimental design with a cohort of residential construction workers within the HomeSafe strategic partnership between Occupational Safety and Health Administration Region VIII and the Home Builders Association of Metropolitan Denver (HBA). Audits were conducted on residential construction sites. Study subjects were construction workers employed by partner or control companies within the study. Repeated measures of 41 companies showed significant improvement (p=.01) in audit scores, increasing from 71.8 to 76.8 after 2(1/2) years in the program. HomeSafe companies out-performed controls (p=.01) for both the retest group and previously unaudited HomeSafe companies. Prolonged exposure in the HomeSafe pilot program resulted in improved audit scores for companies within the program for at least 2 years.

Accidents, Occupational↗