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PubMed1984

Radon-222 in the gastrointestinal tract: a proposed modification of the ICRP Publication 30 model.

The New England states have a long involved history of radon in individual well water supplies. As a result of these previous findings on the abundance of radon, coupled with its potential health impact, the New England Radiological Health Committee (NERHC) formulated a technical working group in 1980 which was charged with evaluating the possibility of developing uniform concentration guidelines for radon in individual domestic water supplies. This working group determined that the current ICRP Publication 30 metabolic model for the gastrointestinal (GI) tract was inadequate to address the empirically observed rates of 222Rn removal from the body. A modification to the ICRP Publication 30 GI tract model is proposed which attempts to resolve these differences. Calculations are presented, using both the original and modified ICRP Publication 30 models, which indicate that individual potable water supplies containing 222Rn concentrations as high as 400,000 pCi/l. do not significantly increase the probability of stomach or intestinal cancer, as defined by the BEIR III risk estimates. Since this paper deals exclusively with the GI tract, no attempt is made to address the lung burden imposed by the contribution of radon released into the household air by aeration at the tap or other fixtures. Only when the contribution of the radon water source term to both the respiratory and ingestion pathways is evaluated as a whole can any meaningful standard for 222Rn in individual domestic water supplies be established.

Digestive System↗
PubMed2002

A process for evaluating adverse environmental impacts by cooling-water system entrainment at a California power plant.

A study to determine the effects of entrainment by the Diablo Canyon Power Plant (DCPP) was conducted between 1996 and 1999 as required under Section 316(b) of the Clean Water Act. The goal of this study was to present the U.S. Environmental Protection Agency (EPA) and Central Coast Regional Water Quality Control Board (CCRWQCB) with results that could be used to determine if any adverse environmental impacts (AEIs) were caused by the operation of the plant's cooling-water intake structure (CWIS). To this end we chose, under guidance of the CCRWQCB and their entrainment technical working group, a unique approach combining three different models for estimating power plant effects: fecundity hindcasting (FH), adult equivalent loss (AEL), and the empirical transport model (ETM). Comparisons of the results from these three approaches provided us a relative measure of confidence in our estimates of effects. A total of 14 target larval fish taxa were assessed as part of the DCPP 316(b). Example results are presented here for the kelp, gopher, and black-and-yellow (KGB) rockfish complex and clinid kelpfish. Estimates of larval entrainment losses for KGB rockfish were in close agreement (FH is approximately equals to 550 adult females per year, AEL is approximately equals to 1,000 adults [male and female] per year, and ETM = larval mortality as high as 5% which could be interpreted as ca. 2,600 1 kg adult fish). The similar results from the three models provided confidence in the estimated effects for this group. Due to lack of life history information needed to parameterize the FH and AEL models, effects on clinid kelpfish could only be assessed using the ETM model. Results from this model plus ancillary information about local populations of adult kelpfish suggest that the CWIS might be causing an AEI in the vicinity of DCPP.

Animals↗
PubMed2005

Hospital practice versus evidence-based obstetrics: categorizing practices for normal birth in an Egyptian teaching hospital.

BACKGROUND: Little is known of common normal labor hospital practices in Egypt or of their relationship to evidence-based obstetrics. This study documented facility-based practices for normal labor and delivery in Egypt for the first time by categorizing 44 practices observed in a busy obstetric teaching hospital according to the World Health Organization (WHO) Technical Working Group on Normal Birth classification of normal birth practices. METHODS: A multidisciplinary approach combined directly observing practices that were applied to individual laboring women and their newborns, observing ward activities, interviews, and focus groups. One hundred seventy-five normal births were observed in their entirety, over 28 days and nights, by medically trained observers using an observation checklist that documented 537 variables for each woman. Mothers were interviewed postpartum, and findings were shared with practitioners for their feedback. Observed practices were categorized according the 1999 WHO classification of 59 practices for normal birth, depending on their usefulness, effectiveness, or harmfulness. RESULTS: There was infrequent use of beneficial practices that should be encouraged and an unexpectedly high level of harmful practices that should be eliminated. Some beneficial practices were applied inappropriately, and practices of unproved benefit were also documented, some of which are potentially harmful to childbearing mothers and their babies. CONCLUSIONS: Hospital practices for normal labor were largely not in accordance with the WHO evidence-based classification of practices for normal birth. The findings are worrying, given the increasing proportion of hospital-based births in Egypt and the country's improved but relatively high maternal and neonatal mortality rates. Obstacles to following evidence-based protocols for normal labor require examination.

Adult↗
PubMed1999

Impact of DNA typing on standards and practice in the forensic community.

This article reviews the history of DNA-based human identification from its inception in 1985. Since the development of the technology, experts called for setting of standards and use of proficiency tests for quality assurance measures. The response of the National Institute of Standards and Technology to DNA forensic standards needs was catalyzed by the Technical Working Group on DNA Analysis Methods, sponsored by the Federal Bureau of Investigation with funding provided by the National Institute of Justice. Standard reference materials were developed for the original technologies used in DNA identification and for the newer polymerase chain reaction-based technologies. Adoption of recommended standards developed through the Federal Bureau of Investigation-commissioned DNA Advisory Board show the acceptance of National Institute of Standards and Technology standards for calibration of laboratory protocols. New technologies will require a process of validation and continued testing through the use of proficiency tests, such as those provided through the College of American Pathologists. Robotics and parallel processing of samples will lead to increased efficiency in DNA testing. The use of DNA data banks of convicted felons will increase dramatically with the the Federal Bureau of Investigation's national implementation of a computerized identification system known as the Combined DNA Index System. This system that will make major use of short, tandem, repeat genetic systems and will be the major driver of technology for the next 5 to 10 years. Finally, sample collection and training are of major concern for those who look at the long-term impact of DNA testing in forensic laboratories.

DNA↗
PubMed1991

Nursing practice in the next decade: the impact on nursing and pharmacy systems.

Nursing practice in the year 2000 will occur within more regulated health care systems, with a much higher focus on the cost and the quality of the service that is delivered. Patients will have more complex illnesses and treatment regimens that will require that nurses have appropriate levels of education, experience, and clinical specialization. The nursing work force will change in its nature, cost, and composition. Nurses will operate in flatter organizations and within productive multiprofessional and technical work groups that operate as flexible, self-directed teams. New clinical practice models will be operational, and they will be adapted to the unique work and environment of each patient care unit. Practice will be restructured to incorporate clinical and nonclinical support. Work redesign and restructured practice environments will be essential to meeting the requirements for the future. Patients with complicated illnesses will continue to move through hospital systems at high speeds. Treatment regimens will be extremely complex. The requirement will be to emphasize high-quality and affordable care, while minimizing errors and complications. Technology will provide new challenges, new excitement, new dilemmas, and new demands. The ethical dimensions of care will become ever more challenging. The pharmacological aspects of treatment will gain in prominence. Mutual respect and mutual support will be the hallmarks of the nursing and pharmacy interface in the year 2000.

Education, Nursing↗
PubMed1999

Graphical tools for RFLP measurement quality assurance: laboratory performance charts.

Forensic restriction fragment length polymorphism analyses typically provide two band size results at each genetic locus for each sample. In collaboration with the member laboratories of the Technical Working Group for DNA Analysis Methods, we have developed graphical techniques that compactly summarize even large numbers of such paired measurements. This paper provides a detailed description of the basic tool, a modified bivariate control chart for data from multiple samples and/or multiple loci. We demonstrate how various modifications and combinations of these "laboratory performance charts" can be used for quality control, quality assurance, and quality demonstration.

Computer Graphics↗
PubMed1999

TWGDAM validation of a nine-locus and a four-locus fluorescent STR multiplex system.

The Gene Print PowerPlex 1.1/Amelogenin and FFFL Fluorescent STR Systems have been validated following the recommendations presented by the Technical Working Group on DNA Analysis Methods (TWGDAM). The PowerPlex 1.1/Amelogenin System supports simultaneous amplification of eight short tandem repeat loci and the Amelogenin gender identification marker. The loci D16S539, D7S820, D13S317, and D5S818 are labeled with fluorescein (FL) while the loci CSF1PO, TP0X, TH01, vWA and Amelogenin are labeled with carboxy-tetramethylrhodamine (TMR). The FFFL Multiplex System is composed of the loci F13A01, FESFPS, F13B, and LPL, each labeled with fluorescein. We have observed no overlap of alleles across loci labeled with an individual fluorescent dye. Samples of each system were amplified and labeled in a single reaction, separated by electrophoresis through a denaturing polyacrylamide gel, and amplified alleles detected using a Hitachi FMBIO Fluorescent Scanner. Alterations from the standard amplification protocols in cycle number and annealing temperature generally produced excellent results. In experiments testing sensitivity as little as 0.2 ng of DNA template could be detected. As expected, different body fluids from the same individuals generated identical DNA profile results. Template DNA derived from blood-strains deposited on a variety of matrix supports displayed robust amplification except for material derived from deposits on wood and Japanese orchid leaves. Mixtures of DNA templates could be interpreted with the minor component present in as little as ten percent of the total sample. Monoplex and multiplex amplifications produced identical amplified allele patterns, indicating that STR multiplex systems save template and increase efficiency in the amplification procedure without loss of quality. Analyses of genotype frequencies in African-American, Caucasian-American and Hispanic-American populations using all twelve loci were used to determine matching probabilities smaller than 1 in 1.14 x 10(8) and 1 in 2658 for the PowerPlex 1.1 and the FFFL Multiplex Systems, respectively. The matching probability achieved with the two systems combined is smaller than 1 in 3.03 x 10(11). The independence of alleles within loci was generally demonstrated by applying the exact test to demonstrate Hardy-Weinberg Equilibrium. All of the studies performed indicate that the PowerPlex 1.1/Amelogenin and FFFL Multiplex Systems are powerful, robust, and reliable investigative tools that can be used in the analysis of forensic samples.

DNA Fingerprinting↗
PubMed2001

TWGDAM validation of the AmpFlSTR Profiler Plus and AmpFlSTR COfiler STR multiplex systems using capillary electrophoresis.

Prior to forensic implementation, a profiling system requires validation following the recommendations presented by the Technical Working Group on DNA Analysis Methods (TWGDAM). In this work two such systems, AmpFlSTR Profiler Plus and AmpFfSTR COfiler have been validated according to the guidelines provided by TWGDAM. Profiler Plus and COfiler simultaneously amplify nine and six STR loci respectively; both also amplify a portion of the amelogenin gene. Performance of the two STR multiplex systems under conditions set forth by TWGDAM was robust and reproducible, indicating that these systems are suitable for use in forensic analysis. Additionally, specific sections of the TWGDAM validation guidelines are especially valuable in terms of familiarizing users with particular limitations of the systems prior to taking on casework.

Amelogenin↗
PubMed2002

TWGDAM validation of AmpFlSTR PCR amplification kits for forensic DNA casework.

Laboratory procedures used in short tandem repeat (STR) analysis were subjected to various scenarios that assessed reliability and identified potential limitations. These validation studies were designed as recommended by the Technical Working Group on DNA Analysis Methods (TWGDAM) and the DNA Advisory Board (DAB) (17,18). Various DNA samples were amplified by the polymerase chain reaction (PCR) using AmpFlSTR PCR Amplification Kits (i.e., AmpFlSTR Green I, Profiler, Profiler Plus, and COfiler kits), detected with ABI Prism instrumentation, and analyzed using GeneScan and Genotyper software. Data acquired in these studies reinforced an existing body of knowledge and expertise regarding application and interpretation of STR typing in the forensic science community. Consistent STR genotypes were detected in various body tissues and fluids. Inter-laboratory comparisons produced concordant genotype results. Quantitative interpretational aids for DNA mixtures were characterized. Ability of the typing systems to type potentially compromised samples reliably was evaluated. Nonprobative case evidentiary DNA was successfully amplified, genotyped, and interpreted. Potential limitations or cautionary factors in the interpretation of minimal fluorescence intensity were demonstrated. Differential amplification between loci was observed when PCR was inhibited; preferential amplification typically was not. Single AmpFlSTR locus amplification did not offer consistent benefit over AmpFlSTR multiplexing, even in cases of DNA degradation or PCR inhibition. During rigorous evaluation, AmpFlSTR PCR Amplification Kits reproducibly yielded sensitive and locus-specific results, as required in routine forensic analyses.

DNA↗
PubMed1992

Evaluation of four deoxyribonucleic acid (DNA) extraction protocols for DNA yield and variation in restriction fragment length polymorphism (RFLP) sizes under varying gel conditions.

This study originated from discussions and recommendations of the Technical Working Group on DNA Analysis Methods (TWGDAM). Four bloodstain deoxyribonucleic acid (DNA) extraction protocols and five semen stain DNA extraction protocols were evaluated. Nine laboratories participated in the extraction of DNA from 20 bloodstains and 20 semen stains using each protocol. All blood and semen stains originated from a single donor and were prepared under uniform conditions to permit the direct comparison of DNA yields and restriction fragment lengths. The extracted DNA from approximately 600 bloodstains and 700 semen stains was quantified by yield gel analysis and a slot blot hybridization technique. The extracted DNA was digested and restriction fragment length polymorphism (RFLP) patterns were generated using three single-locus probes. The RFLP sizing data produced from the blood and semen stains were evaluated with respect to (1) DNA extraction method, (2) gel length, (3) agarose type, (4) presence or absence of ethidium bromide in the gel, and (5) fragment sizes obtained from DNA isolated directly from the donor's liquid blood. This study demonstrates conclusively that high-molecular-weight DNA can be isolated using either organic or nonorganic DNA extraction protocols and that the resulting RFLP sizes are highly reproducible regardless of gel length, agarose type, or presence/absence of ethidium bromide.

Autoradiography↗
PubMed1997

Summary of validation studies from twenty-six forensic laboratories in the United States and Canada on the use of the AmpliType PM PCR amplification and typing kit.

A cooperative study was undertaken to collect and summarize the results of validation studies from forensic laboratories in the United States and Canada on the use of the AmpliType PM PCR amplification and typing kit for genetic typing of forensic biological evidence. This report compiles data from 26 laboratories on: 1) reproducibility studies on DNA extracted from various samples, 2) genetic typing of DNA extracted from a variety of biological samples on various substrates, 3) the effects of exogenous chemicals, materials, and environmental factors on test results, 4) sensitivity studies to determine the least detectable amount of extracted genomic DNA that can be reliably typed, 5) analysis of mixtures containing two sources of genomic DNA, 6) cross-hybridization with DNA extracted from various nonhuman species, and 7) evaluation of assay performance on parallel studies with other genetic typing systems on proficiency test panels, mock cases, and adjudicated/nonprobative casework. Equivalent results were obtained by each laboratory that supplied data, demonstrating the reliability and consistency of the test. Overall, it can be concluded from this study that the AmpliType PM PCR amplification and typing kit meets the guidelines of the Technical Working Group on DNA Analysis Methods (TWGDAM) and there is general scientific acceptability of this kit for forensic DNA testing.

Canada↗
PubMed1997

Validation studies for the genetic typing of the D1S80 locus for implementation into forensic casework.

A series of validation experiments were designed to evaluate, according to the Technical Working Group on DNA Analysis Methods (TWGDAM) guidelines, the analysis of the D1S80 locus for casework implementation. Approximately 400 samples from three different populations (Minnesota Caucasian, Minnesota African Americans, and Minnesota Native Americans) were typed to determine allele frequencies. Simulated forensic type specimens (blood, saliva, hair and semen, or vaginal secretions) were typed to demonstrate that deoxyribonucleic acid (DNA) extracted from various tissues of an individual yield the same D1S80 type. Dilution studies were performed and it was determined that a wide range of input DNA (0.5 ng to 40.0 ng) will consistently yield typeable results. The evaluation of DNA from various animals showed that the D1S80 locus is specific to human DNA within the limits of the parameters tested. The reproducibility of the system was tested by duplicate analysis of approximately 200 population samples. Duplicate samples were analyzed on both horizontal and vertical gel systems. In addition, simulated forensic specimens were analyzed by two independent laboratories: the Minnesota Forensic Science Laboratory (MFSL) and the Roche Biomedical Laboratories (RBL). All analyses, including extraction, quantitation, amplification and typing, were performed independently. All typing results for both laboratories were in agreement. By the analysis of mixtures from various simulated casework type mixtures, it was demonstrated that the D1S80 typing system is suitable for analyzing mixtures. In addition to the simulated casework, evidentiary samples from several adjudicated cases previously analyzed by restriction fragment length polymorphism (RFLP) analysis and/or DQA1 were typed at the D1S80 locus. The D1S80 results were consistent with previous RFLP and/or DQA1 results regarding inclusions/exclusions.

Alleles↗
PubMed1997

[Optimal world-wide obstetrical care; a WHO report].

'Safe motherhood; care in normal birth: a practical guide' is a document produced by an international technical working group of the World Health Organization. This report addresses issues of care during normal birth irrespective of country or region. Routine interventions and non-interventions in the physiological processes of pregnancy and labour are analysed and assessed for their scientific validity. Scientific foundation of obstetric practice is considered an important step towards worldwide demystification of obstetric practice, which now often relies on authority, culture and habit. For risk assessment, the cornerstone of the Dutch system of obstetric care, an evidence-based strategy is imperative. This requires scientific training in schools of midwifery.

Delivery of Health Care↗
PubMed1998

Interlaboratory comparison of autoradiographic DNA profiling measurements: precision and concordance.

Knowledge of the expected uncertainty in restriction fragment length polymorphism (RFLP) measurements is required for confident exchange of such data among different laboratories. The total measurement uncertainty among all Technical Working Group for DNA Analysis Methods laboratories has previously been characterized and found to be acceptably small. Casework cell line control measurements provided by six Royal Canadian Mounted Police (RCMP) and 30 U.S. commercial, local, state, and Federal forensic laboratories enable quantitative determination of the within-laboratory precision and among-laboratory concordance components of measurement uncertainty typical of both sets of laboratories. Measurement precision is the same in the two countries for DNA fragments of size 1000 base pairs (bp) to 10,000 bp. However, the measurement concordance among the RCMP laboratories is clearly superior to that within the U.S. forensic community. This result is attributable to the use of a single analytical protocol in all RCMP laboratories. Concordance among U.S. laboratories cannot be improved through simple mathematical adjustments. Community-wide efforts focused on improved concordance may be the most efficient mechanism for further reduction of among-laboratory RFLP measurement uncertainty, should the resources required to fully evaluate potential cross-jurisdictional matches become burdensome as the number of RFLP profiles on record increases.

Autoradiography↗
PubMed1998

TWGDAM validation of the AmpFISTR blue PCR amplification kit for forensic casework analysis.

Studies were performed as recommended by the Technical Working Group on DNA Analysis Methods (TWGDAM) committee to validate the AmpFISTR Blue PCR Amplification Kit for forensic casework applications. The kit coamplifies the tetranucleotide short tandem repeat (STR) loci D3S1358, vWA, and FGA. The dye-labeled amplification products were electrophoresed and detected directly using the ABI PRISM 377 DNA Sequencer or the 310 Genetic Analyzer. CEPH family studies demonstrated Mendelian inheritance of these loci and probability of identity values from population studies were 1/4,830 (African-American), 1/5,479 (U.S. Caucasian), and 1/3,443 (U.S. West Coast Hispanic). In all studies examining different body tissues and fluids, the expected genotypes were observed. Studies to determine and test the PCR reagent components and thermal cycling parameters demonstrated specificity, sensitivity, and balance over a wide range of conditions. Reliable results were obtained from DNA quantities as low as 0.25 ng. A variety of environmental studies were performed, as forensic samples are often exposed to different environmental conditions and substances which may degrade DNA or inhibit the amplification process. Highly degraded samples demonstrated that FGA was the first locus to become undetectable, followed by vWA, and then D3S1358; this is the expected pattern according to locus size. In studies of PCR inhibition, the pattern in which the loci became undetectable was different; FGA was the first locus to become undetectable, followed by D3S1358, and then vWA. Single versus multiple locus amplifications revealed no benefit to single locus analysis, even in cases of degradation or inhibition. The occurrence of preferential amplification was very rare, particularly in noncompromised, unmixed samples. Artifact peaks were not observed in any instance. Mixture studies confirmed the ability to detect mixed DNA samples and included the characterization of stutter and peak height ratios; the limit of detection was 1:10 for 1 ng total genomic DNA and 1:30 for 5 ng. DNA extracted from nonprobative case evidence was successfully amplified and genotyped. All such studies indicate that the AmpFISTR Blue PCR Amplification Kit will reproducibly yield specific and sensitive results.

Animals↗
PubMed1990

Technical workshop report: Working Group II: agricultural occupational health and safety services for farmers and ranchers.

This work group felt that there is compelling evidence that effective occupational health services are essential to improve the serious occupational safety and health problems in agriculture. Program initiatives may be stimulated by federal and state governments, but development and implementation must involve the grassroots farm community and local resources. Other countries (Sweden, Finland, Canada) are far ahead of the United States in this area and serve as examples. Developing services should be comprehensive and should include clinical, technical, and educational efforts. Marketing programs to the public must include grassroots involvement. Surveillance and program evaluation are essential in any new program efforts. Funding such programs must be shared by federal, state, local, and private resources. Regulatory options should be a minimal part of such a program, but mandatory rollover protective devices and mandatory reporting seems to be one feasible regulatory option.

Accidents, Occupational↗
PubMed1990

Technical workshop report: Working Group I: Occupational health and safety strategies for agriculture.

The six workshops in this subgroup--Injuries, Respiratory Diseases, Acute Chemical Toxicity, Cancer, and Health Surveillance--competently outlined the principal health and safety issues in agriculture, documenting the increased and unacceptable morbidity and mortality in farmers and their families. It became evident that although research knowledge is just now unfolding, sufficient data exist to permit comprehensive program planning for research and prevention. It is necessary that farmers and their families be considered an occupational grouping and that specific programs aimed at ongoing risk assessment and early diagnosis are important. At the same time, a more broadly based approach to rural family life enhancement is essential, including the following: 1) education; 2) prevention; 3) family life enhancement; and 4) research. Because of the scope and nature of the problem, program development should include a multidisciplinary approach that involves the local community, state government, university (professional) resources, farm/organizations, and industry.

Agricultural Workers' Diseases↗