An assessment of worker exposure to respirable dust and crystalline silica in workshops fabricating engineered stone.

There is a significant silicosis risk for workers fabricating engineered stone (ES) products containing crystalline silica. The aims of this study by SafeWork NSW were to: (i) assess current worker exposure to respirable dust (RD) and respirable crystalline silica (RCS) following a 5-y awareness and compliance program of inspections in ES workshops and (ii) to identify improvements in work practices from the available evidence base to further reduce exposures. One hundred and twenty-three personal full shift samples taken on as many workers and 34 static samples across 27 workshops fabricating ES were included in the final assessment. The exposure assessment was conducted using Casella Higgins-Dewell cyclones (Casella TSI) placed in the breathing zone of workers attached to SKC Air Check XR 5000 or SKC Chek TOUCH sampling pumps. Sample filters were sent to an ISO (2017) 17025:2017 accredited laboratory for gravimetric analysis for RD and X-Ray Diffraction (XRD) analysis to determine the amount of deposited RCS i.e. alpha-quartz and cristobalite. All workshops used wet methods of fabrication. The geometric mean (GM) of the pooled result for respirable dust (RD) was 0.09 mg/m3 TWA-8 h and 0.034 mg/m3 TWA-8 h for RCS. The highest exposed workers with a GM RCS of 0.062 mg/m3 TWA-8 h were those using pneumatic hand tools for cutting or grinding combined with polishing tasks. Workers operating semiautomated routers and edge polishers had the lowest GM RCS exposures of 0.022 mg/m3 TWA-8 h and 0.018 mg/m3 TWA-8 h respectively. Although ES workers remain exposed to RCS above the workplace exposure limit (WEL) of 0.05 mg/m 3 TWA-8 h, these results point to a very substantial reduction in exposures compared to poorly controlled dry methods of fabrication. Therefore, the wearing of respiratory protection by workers remains necessary until further control measures are more widely adopted across the entire industry e.g. reduction in the crystalline silica content of ES.

Impact of Automated Notifications on Prescription Abandonment.

BACKGROUND: Prescription abandonment impacts patients' quality of life and disease progression. In addition, prescription abandonment can increase total healthcare costs. OBJECTIVE: This study compared effects of automated telephone calls (ATC), automated text messages (ATM), and control on prescription abandonment rates with Medicare defined Star Rated medications. The secondary objective compared prescription abandonment rates between age groups (18-64 versus ≥ 65 years) within each arm. METHODS: This was a retrospective observational analysis from a regional division of a large community-based pharmacy chain. Star Rated medication prescriptions consisting of hydroxymethylglutaryl-coenzyme A reductase inhibitors, renin-angiotensin system antagonists, and non-insulin type 2 diabetes mellitus medications were included. Prescriptions for patients who activated or deactivated automated notification enrollment during the study period were excluded. RESULTS: A total of 31,056, 33,278, and 20,299 prescriptions were included in the analysis of ATC, ATM, and control arms, respectively. Prescription abandonment occurred on 726 (2.3%) prescriptions within ATC arm, 864 (2.6%) prescriptions within ATM arm, and 513 (2.5%) prescriptions within control arm (p = 0.099). Prescription abandonment occurred on 390 (2.6%) prescriptions for 18-64 and 336 (2.1%) prescriptions for 65 years or older within the ATC arm (p = 0.002). Prescription abandonment occurred on 251 (2.9%) prescriptions for 18-64 and 262 (2.3%) prescriptions for 65 years or older within the control arm (p = 0.006). CONCLUSION: No difference in rates of prescription abandonment existed between each automated notification arm on Star Rated medications. ATC notifications decreased rates of prescription abandonment when utilized by patients 65 years or older.

Pain assessment and management strategies for elderly patients.

Home healthcare nurses play a critical role in pain assessment and management in elderly patients. People 65 years of age and older are the largest consumers of prescription and nonprescription pain medications in the United States and are at increased risk for adverse reactions and inadequate pain management. This article seeks to explore strategies to assist hospice and home healthcare nurses in assessing and managing elderly patients' pain. The goal is to provide tools to assist nurses in streamlining elderly patient care and improving quality of life while decreasing mortality and morbidity for this patient population.

Time-frequency and time-scale analyses for structural health monitoring.

Signal processing is one of the most important elements of structural health monitoring. This paper documents applications of time-variant analysis for damage detection. Two main approaches, the time-frequency and the time-scale analyses are discussed. The discussion is illustrated by application examples relevant to damage detection.