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At least 127 records · Page 7Linked to original sources
PubMed2000

Evaluation of the Agricultural Safety and Health Best Management Practices Manual.

The Agricultural Safety and Health Best Management Practices (ASHBMP) Manual was developed as an alternative intervention tool to help identify and correct farmwork hazards. A modified pretest-posttest control group experimental design was used to test the effectiveness of the manual with three intervention groups and a control. Testing consisted of conducting baseline and post-intervention audits on 150 farms in Pennsylvania. Significant differences were found among groups of farmers who were given the ASHBMP Manual and those who were not given the manual. The results of the data analysis also showed a positive significant difference among farmers who reduced their farm hazard levels through use of the ASHBMP Manual over farmers who received the Control (traditional safety fact sheets). The data supports the conclusion that the ASHBMP Manual is an effective tool for helping farmers reduce workplace hazards.

Agriculture↗
PubMedDate not supplied

Towards viable, useful and usable human factors design guidance.

This paper investigates the factors relevant to producing effective human factors design guidance, using the Engineering Data Compendium (EDC) as a research vehicle. A series of three exploratory experiments focusing on the factors that affect the usability, usefulness and viability of human factors handbooks was conducted. The results of these studies were interpreted in the context of the process by which the EDC was developed, leading to the following recommendations: (a) human factors guidance should be organized in a manner that is stepped in context; (b) human factors guidance should be based on an explicit requirements analysis; (c) the calibration of designers' perceptions of the cost of obtaining human factors information must be improved; (d) organizational policies must be changed to induce more effective information search behaviour.

Analysis of Variance↗
PubMed1998

The "Femassist": a new device for the treatment of female urinary incontinence.

Objective: This study was undertaken in order to determine if the "Femassist" device is a safe and effective treatment for women with the diagnosis of urinary incontinence.Methods: The Femassist is a medical-grade silicon dome-shaped device, worn over the urethra and held securely via suction and a commercially available adhesive lotion. Women with a chief complaint of urinary incontinence responding to local newspaper advertisements were screened for inclusion. Potential candidates underwent medical history, physical (including gynecologic) examination, Papanicolaou test, urine culture and cytology, and multichannel urodynamic testing (including abdominal leak-point pressure measurements). A total of 38 women with documented genuine stress urinary incontinence (GSUI) or mixed incontinence were ultimately recruited into the study and fitted with either the standard or petite-sized Femassist device, according to their individual anatomy. Subjects were assessed before and after 1 month's use. Subjective assessment included quality of life questionnaires, daily voiding and activity diaries, as well as ongoing patient comments retrieved through daily telephone contact with the study nurse. Objective assessment included blinded evaluation of bacteriuria and urinary infection rates and vulvar irritation and ulceration rates.Results: To date, of the 38 women who have completed the study, over 50% reported an improvement in their quality of life including comfort, convenience, and overall satisfaction. In total for all patients studied, the device was worn for a total of 886 days; 82% of these were dry days. Similar results were obtained for women with GSUI and mixed incontinence. Factors associated with successful experience with the device included degree of tissue estrogenization (either naturally or via a topical estrogen preparation), manual dexterity, and degree of motivation. One in five women reported vulvar irritation or urethral discomfort at some point; this was not correlated with percentage of dry days. There have been no reported significant increases in bacteriuria or urinary tract infection rates over patients' baseline experiences.Conclusion: Our preliminary study suggests that the Femassist device is a safe and effective method for the management of female urinary incontinence.

Journal Article↗
PubMed2002

Milia en plaque: a case report and review of the literature.

BACKGROUND: Milia en plaque (MEP) is an unusual entity with a distinctive clinicohistologic appearance. Optimal treatment is unestablished, particularly for MEP located on difficult anatomic areas. OBJECTIVE: To illustrate by a case report the clinical presentation and management of MEP. METHODS: A 35-year-old woman with numerous tiny cysts within an slightly erythematous base in unilateral periorbital distribution is described. Histology revealed epidermal cysts arranged within the entire dermis. RESULTS: Treatment with chemical exfoliating agents, manual extraction, and topical photodynamic therapy resulted in partial improvement. CONCLUSION: Dermatologists should become familiar with this peculiar condition, being significantly rare possibly because of underreporting or misdiagnosis. New treatment procedures must be tried to achieve a successful cosmetic result with minimal risks.

Adult↗
PubMed1999

Setting up a CLIA-certified laboratory in a student health services clinic.

Performing some laboratory tests on site at a student health service clinic may increase efficiency and cut costs for patients. However, with the passage of the Clinical Laboratory Improvement Amendments (CLIA) of 1988, many laboratories in physician offices and clinics have shut down because of increased regulatory requirements. The personnel in one SHS laboratory found that the guidelines proposed by CLIA help assure quality care and are not prohibitive. In this article, the process of applying for and receiving a CLIA certificate in the student health clinic setting is explored.

Ambulatory Care Facilities↗
PubMed1992

Tissue expansion in a patient with extensive nevus comedonicus.

Nevus comedonicus is a rare developmental abnormality of the pilosebaceous apparatus that presents as an aggregation of dilated follicular orifices filled with pigmented keratinous material. Occurrence of extensive or giant lesions is even more rare. Indications for treatment include recurrent infections and cosmetic reasons. Therapeutic approaches include topical keratolytic agents, manual extraction of comedones, dermabrasion, and excision of smaller lesions. Increasing clinical experience with tissue expansion has suggested that it might be used effectively in the definitive treatment of an extensive nevus comedonicus previously considered too large to excise without the use of a skin graft, despite the potential risk of infection within the lesion during the course of expansion. We report the first patient with giant nevus comedonicus to be treated using tissue expansion. This patient demonstrates that prompt treatment of cellulitis and abscesses within the lesion will keep this process isolated from the adjacent expanders and will not compromise a planned excision and reconstruction.

Buttocks↗
PubMed1998

Validation of the self-report questionnaire DIP-Q in diagnosing DSM-IV personality disorders: a comparison of three psychiatric samples.

The DSM-IV section of the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q) was used to screen for personality disorders in 448 subjects from three clinical samples (general and forensic psychiatric patients and candidates for psychotherapy) and a sample of 139 healthy volunteers. Differences between the samples with regard to patterns of personality pathology in relation to concurrent Axis I disorders and sociodemographic variables were analysed. The prevalence of personality disorders according to DIP-Q was 14% among the healthy volunteers, compared to 59% in the general psychiatric sample, 68% in the forensic psychiatric sample and up to 90% among psychotherapy candidates. Moreover, from a dimensional perspective (i.e. the number of fulfilled Axis II criteria), all clinical groups differed significantly from the control group in all specified personality dimensions and clusters. Dimensional DIP-Q cluster scores also discriminated significantly between the three clinical samples. Unexpectedly, the odds ratio for an Axis II disorder was nearly five times higher among psychotherapy applicants than among general psychiatric patients, independent of concomitant Axis I disorders, gender or age. The strongest association between DIP-Q score and Axis I disorders was found for depressive disorders, which more than doubled the odds ratio for a personality disorder diagnosis. This association could result from high true comorbidity, but could also be due to the fact that a concomitant depressive state can increase self-reported personality difficulties. The high prevalence among psychotherapy candidates may to some extent reflect help-seeking exaggeration of problems. These are aspects to consider when using the DIP-Q, which overall appears to discriminate well between different samples.

Adolescent↗
PubMed1999

The accomplishments of Sir James Cantlie.

Sir James Cantlie succeeded in his diverse endeavours. A pioneer in first aid medicine in Britain, he wrote several important manuals on the topic. The interlude in Hong Kong set the stage for his role in Chinese history with his involvement with Sun Yat-Sen, the father of modern China, and in the establishment of the present Faculty of Medicine at the University of Hong Kong. The contact with tropical diseases sustained a career that included the founding of the current Royal Society of Tropical Medicine and Hygiene, and the extant Transactions of the Royal Society of Tropical Medicine and Hygiene. As a surgeon, he argued for a new concept of hepatic lobulation based on the vascular supply, and became recognized as the father of the surgical anatomy of the liver. The scope of Cantlie's achievements is rivalled by few physicians, and his legacy remains with us to this day.

China↗
PubMed1998

Field trial of a diagnostic axis for defense mechanisms for DSM-IV.

Following critiques that the DSM multiaxial system lacks psychodynamic information useful for treatment, an axis for defense mechanisms was developed for DSM-IV, including up to 7 individual defenses from a glossary of 27, and 3 predominant defense levels from a list of 7. We tested the feasibility, reliability, and discriminability of the proposed axis. Clinician and psychiatric resident volunteers were trained at two U.S. and one Norwegian sites. After conducting initial interviews on 107 patients, they rated the DSM-III-R and defense axes, as did a second blind rater. Median kappa reliabilities were .42 (individual defenses), and .47 (defense levels). A summary measure, Overall Defensive Functioning (ODF), had similar reliability to current GAF (IR .68 vs. .62), similar 1-month stability (.75 vs. .78), but greater 6-month stability (.51 vs. .17). Independent of Axis III, ODF had small to moderate associations with other Axes and symptoms. Our findings indicate that the defense axis is a feasible, acceptably reliable, and nonredundant addition to DSM-IV, which may prove useful for planning and conducting treatment.

Adult↗
PubMed1986

Early placebo response in anxious and depressed patients.

Specific subgroups of anxiety disorder patients (N = 130) and depression patients (N = 105), defined according to DSM-III criteria, were given 1 week of placebo treatment as part of ongoing clinical drug trials. Placebo responses and dropout rates were assessed at the end of the placebo trial period. The results indicate a comparable dropout rate between depression and anxiety disorder groups due to positive placebo response, negative placebo response, and "nonsymptomatic" reasons. In addition, male anxiety disorder patients dropped out at a significantly higher rate than male depression patients.

Adolescent↗
PubMed1984

The dexamethasone suppression test in schizophrenia.

In a study of 20 inpatients who met DSM-III criteria for schizophrenia, there was a high incidence of depressed mood (N = 14), DSM-III melancholia (N = 6) and dexamethasone nonsuppression (N = 7). This incidence of positive DSTs (serum cortisol greater than 5 micrograms/dl at 3:30 or 10:00) was significantly higher than the expected rate based on a literature review (35% vs. 4%, p less than .001). A positive DST did not result in all cases in antidepressant pharmacotherapy, nor did a negative result preclude such treatment. Hence, clinicians in the study did not "treat the DST" in the absence of clinical evidence of depression. This study is consistent with others reporting a significant proportion of depressed schizophrenics. However, some studies have claimed no differences in response to dexamethasone between nondepressed and schizophrenic patients. These findings do not support a biological basis for the RDC differentiation of primary and secondary depression and challenge the DSM-III concept of schizophrenia as excluding the diagnosis of major depression. Viewed from a different perspective, the data may support recent reports casting doubt on the specificity of the DST.

Adult↗
PubMed1994

Liquid disinfecting and sterilizing reprocessors used for flexible endoscopes.

In this issue, we evaluate three liquid disinfecting flexible endoscope reprocessors that can be used with a user-supplied liquid chemical germicide (LCG), primarily for high-level disinfection (HLD). Applying most of the same criteria and test methods, we also evaluated a fourth unit, presented separately, that is marketed as a liquid sterilizing reprocessor and must be used with manufacturer-supplied, single-use containers of LCG. Although the sterilizing unit can be used for rigid endoscopes, surgical instruments, and endoscopic accessories, we evaluated its application to the reprocessing of only flexible endoscopes. Our ratings are based on the following: (1) basic performance, such as compatibility with several different types of endoscopes and LCGs, inclusion of all essential reprocessing phases, and exposure of all endoscope surfaces to the LCG and rinse water; (2) safety, such as ensuring that essential reprocessing phases cannot be skipped or omitted, that personnel exposure to LCG vapors is minimized, and that the reprocessor is unlikely to contaminate the endoscope during reprocessing; and (3) human factors design, such as ease of use and installation. We did not perform microbiological testing to confirm HLD or sterilization by any of the evaluated reprocessors because, with a suitably clean endoscope that is in good condition, no evidence indicates that the LCGs used would not be effective on the surfaces that they contact; also, the results would be unique to the two flexible endoscopes that we used for our testing. We rated all four reprocessors Conditionally Acceptable. The units are Acceptable on the condition that users understand that they cannot be used to process the elevator cable channel of side-viewing duodenoscopes; additional conditions apply only to the liquid disinfecting units. However, if the conditions are met, all four units reduce the likelihood of using a contaminated endoscope on a patient and reduce personnel exposure to the LCG. Selection of a unit will be based on the needs and preferences of the individual healthcare facility. Our ratings also assume that these units will be used according to the manufacturers' instructions and the endoscope's operator's manual. Note that, although the evaluated liquid disinfecting units provide detergent-flushing, post-detergent water-rinse, and post-detergent water-rinse-removal phases, manual cleaning of endoscopes before automatic reprocessing is essential, regardless of which reprocessor is used.(ABSTRACT TRUNCATED AT 400 WORDS)

Consumer Behavior↗
PubMedDate not supplied

Incisional hernia: a review.

BACKGROUND: Otherwise known as post operative ventral hernia, incisional hernia is a common complication following abdominal surgery and is a significant cause of morbidity. This review examines incisional hernia from its historical perspective to the present. METHOD: A Literature review of the topic was carried out using manual library search of journal articles on the topic published both locally and internationally. The search also made use of intemet material from Pubmed and Medline on relevant parts of the topic. All relevant articles from the reference lists of these papers were also studied. RESULT: Incisional hernia is a common complication of abdominal surgery. Its incidence is about 1% following primary healing and increasing to about 11% with postoperative wound infection. The most consistent causative factor is wound infection and the incidence may rise to 30% after abdominal wound dehiscenece and resuture. It may be difficult to repair and a wide range of surgical procedures have been developed for such repair. The repair may be direct suture or prosthetic mesh using the open or laparoscopic technique. Prosthetic mesh has revolutionized the repair of incisional hernias. Laparoscopic repair, which was introduced in the 1990's, has been adjudged feasible, safe and as effective as the open methods of repair. Recurrence rates of up to 49% with direct suture repair have been reported. Open and laparoscopic mesh repair have recurrent rates of 0-10% and 0-9% respectively. CONCLUSION: Despite improved surgical techniques and the use of prosthetic mesh incisional herniation remains a major problem for the general surgeon.

Hernia, Abdominal↗
PubMed2001

Final FDA inspection manual.

For some time now, the only publicly available compliance programme guidance manual on medical device inspections and administrative and enforcement activities has been a draft document. On 7 February 2001, a final guidance document was issued. This article discusses this document and its importance to non-US medical device manufacturers preparing for FDA facility inspections.

Equipment and Supplies↗