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1.
J Oncol Pharm Pract ; 29(8): 2014-2022, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37680124

RESUMEN

OBJECTIVE: Available guidelines are ambiguous about safe handling monoclonal antibodies (MABs) and whether or not to use a Closed System Drug-Transfer Device (CSTD). In this article we want to describe a standardized working method on handling MABs in a clinical trial setting. DATA SOURCES: The current workflow at the clinical trial unit of the Ghent University Hospital was critically analyzed, after which an extensive literature review was performed using the National Institute for Occupational Safety and Health Working Group guidelines and the database PubMed (Keywords: monoclonal antibodies, closed system transfer devices, safety guidelines, safe handling, management, administration, (bio)compatibility, volume loss, contamination, clinical trial unit. Period: 2020-2022). DATA SUMMARY: Literature data are ambiguous. CSTDs can reduce cross-contamination and minimize exposure to potential hazardous drugs for healthcare professionals. However, in recent years more questions have been raised about their in-use compatibility and their impact on final product quality. This makes the debate on implementing CSTDs a hot topic in daily pharmacy practice and demands a holistic and standardized approach when deciding whether or not to use a CSTD when handling MABs. In a clinical trial setting, where safety data are frequently not available and the compatibility of CSTDs and investigational product is often unknown, this poses additional challenges that need to be taken into account. CONCLUSION: We developed a flowchart which standardizes the use of a CSTD when handling MABs. It allows other healthcare professionals and clinical trial sponsors to define and evaluate the necessary criteria when standardizing the position of a CSTD in their safe handling procedures.


Asunto(s)
Antineoplásicos , Exposición Profesional , Humanos , Preparaciones Farmacéuticas , Exposición Profesional/análisis , Anticuerpos Monoclonales/uso terapéutico , Diseño de Software , Equipos de Seguridad
2.
J Exp Psychol Appl ; 28(4): 794-815, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35389684

RESUMEN

When deciding whether to eat inside a restaurant or how many health protection items to purchase, individuals in the coronavirus disease (COVID-19) era tend to consider the infection risk of crowds of generalized others. With a field study and four experiments, the present study identifies associations between COVID-19 and friendship (e.g., thinking of a friend while reading COVID-19-related news, perceiving a friend as the source of infection, noting friends' presence during potential COVID-19 exposure) that decrease both infection risk perceptions and protective behaviors. The sense of safety that stems from psychological closeness of friends reduces perceived virus infection risks associated with third-party crowds. The distinction between psychological closeness and safety toward friends versus acquaintances widens with clear in-group/out-group boundaries, such that this friend-shield effect is especially pronounced among people whose group boundaries are well established. Limiting interactions to close friends and family members is a common protective measure to reduce COVID-19 transmission risk, but the study findings demonstrate that this practice also unintentionally creates other issues, in that people tend to perceive reduced health risks and engage in potentially hazardous health behaviors. By identifying this risk and encouraging more holistic responses, this research offers implications for individuals, health officials, and policymakers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Asunto(s)
COVID-19 , Amigos , Humanos , Amigos/psicología , Emociones , Equipos de Seguridad
3.
Ergonomics ; 65(10): 1410-1420, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35133239

RESUMEN

Several professions in industries, such as petroleum, manufacturing, construction, mining, and forestry require prolonged work tasks in awkward postures, increasing workers' risks for musculoskeletal pain and injury. Therefore, we developed and validated a rule-based model for classifying unilateral and bilateral kneeling and squatting based on 15 individuals wearing personal protective equipment and using three wireless triaxial accelerometers. The model provided both high sensitivity and specificity for classifying kneeling (0.98; 0.98) and squatting (0.96; 0.91). Hence, this model has the potential to contribute to increased knowledge of physical work demands and exposure thresholds in working populations with strict occupational safety regulations. Practitioner summary: Our results indicate that this rule-based model can be applied in a human-factors perspective enabling high-quality quantitative information in the classification of occupational kneeling and squatting, known risk factors for musculoskeletal pain, and sick leave. This study is adapted for working populations wearing personal protective equipment and aimed for long-term measurements in the workplace.


Asunto(s)
Dolor Musculoesquelético , Enfermedades Profesionales , Exposición Profesional , Petróleo , Acelerometría , Humanos , Articulación de la Rodilla , Dolor Musculoesquelético/complicaciones , Dolor Musculoesquelético/prevención & control , Enfermedades Profesionales/etiología , Enfermedades Profesionales/prevención & control , Exposición Profesional/efectos adversos , Postura , Equipos de Seguridad , Factores de Riesgo
4.
Psychol Med ; 52(7): 1386-1392, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-32829730

RESUMEN

BACKGROUND: No studies have reported on how to relieve distress or relax in medical health workers while wearing medical protective equipment in coronavirus disease 2019 (COVID-19) pandemic. The study aimed to establish which relaxation technique, among six, is the most feasible in first-line medical health workers wearing medical protective equipment. METHODS: This was a two-step study collecting data with online surveys. Step 1: 15 first-line medical health workers were trained to use six different relaxation techniques and reported the two most feasible techniques while wearing medical protective equipment. Step 2: the most two feasible relaxation techniques revealed by step 1 were quantitatively tested in a sample of 65 medical health workers in terms of efficacy, no space limitation, no time limitation, no body position requirement, no environment limitation to be done, easiness to learn, simplicity, convenience, practicality, and acceptance. RESULTS: Kegel exercise and autogenic relaxation were the most feasible techniques according to step 1. In step 2, Kegel exercise outperformed autogenic relaxation on all the 10 dimensions among the 65 participants while wearing medical protective equipment (efficacy: 24 v. 15, no space limitation: 30 v. 4, no time limitation: 31 v. 4, no body position requirement: 26 v. 4, no environment limitation: 30 v. 11, easiness to learn: 28 v. 5, simplicity: 29 v. 7, convenience: 29 v. 4, practicality: 30 v. 14, acceptance: 32 v. 6). CONCLUSION: Kegel exercise seems a promising self-relaxation technique for first-line medical health workers while wearing medical protective equipment among COVID-19 pandemic.


Asunto(s)
COVID-19 , COVID-19/prevención & control , Personal de Salud , Humanos , Pandemias/prevención & control , Equipos de Seguridad , Terapia por Relajación
5.
PLoS One ; 16(3): e0249098, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33770110

RESUMEN

BACKGROUND: Nursing homes (NH) for the elderly have been particularly affected by the Covid-19 pandemic mainly due to their hosted vulnerable populations and poor outbreak preparedness. In Belgium, the medical humanitarian organization Médecins Sans Frontières (MSF) implemented a support project for NH including training on infection prevention and control (IPC), (re)-organization of care, and psychosocial support for NH staff. As psychosocial and mental health needs of NH residents in times of Covid-19 are poorly understood and addressed, this study aimed to better understand these needs and how staff could respond accordingly. METHODS: A qualitative study adopting thematic content analysis. Eight focus group discussions with direct caring staff and 56 in-depth interviews with residents were conducted in eight purposively and conveniently selected NHs in Brussels, Belgium, June 2020. RESULTS: NH residents experienced losses of freedom, social life, autonomy, and recreational activities that deprived them of their basic psychological needs. This had a massive impact on their mental well-being expressed in feeling depressed, anxious, and frustrated as well as decreased meaning and quality of life. Staff felt unprepared for the challenges posed by the pandemic; lacking guidelines, personal protective equipment and clarity around organization of care. They were confronted with professional and ethical dilemmas, feeling 'trapped' between IPC and the residents' wellbeing. They witnessed the detrimental effects of the measures imposed on their residents. CONCLUSION: This study revealed the insights of residents' and NH staff at the height of the early Covid-19 pandemic. Clearer outbreak plans, including psychosocial support, could have prevented the aggravated mental health conditions of both residents and staff. A holistic approach is needed in NHs in which tailor-made essential restrictive IPC measures are combined with psychosocial support measures to reduce the impact on residents' mental health impact and to enhance their quality of life.


Asunto(s)
COVID-19/patología , Personal de Enfermería/psicología , Calidad de Vida , Poblaciones Vulnerables/psicología , Anciano , Anciano de 80 o más Años , Ansiedad/etiología , COVID-19/virología , Depresión/etiología , Femenino , Grupos Focales , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Casas de Salud , Autonomía Personal , Equipos de Seguridad/provisión & distribución , Cuarentena , SARS-CoV-2
6.
Artículo en Inglés | MEDLINE | ID: mdl-32492955

RESUMEN

The purpose of this study was to compare the patterns of skill actions executed during Taekwondo competitions when wearing and not wearing an electronic protector. To achieve this purpose, 110 matches from two university-level Taekwondo championships were taped and analyzed. The performance skills were composed of 18 detailed skills and grouped into five categories by considering kicks to the target area (chest or head/face). The data were organized in the form of a contingency table that demonstrated the relationship between grouping factors (skills, protectors, win-lose, and weight division). A log-linear analysis was carried out to investigate the effect of the grouping factors (IVs) on the skills (DV) using SPSS Statistics. The results obtained in the present study can be summarized as follows. First, the overall proportion of "points" called by the judge for the general protector (32.3%) was approximately 3.4 times that for the electronic protector (9.5%). Second, for the electronic protector, the proportions of kicks to the chest area were in the following order: Roundhouse kick (R-Kick) (44.7%), Pushing kick (P-kick) (19.3%), Turn kick (T-kick) (8.7%), and Double roundhouse kick (DR-kick) (7.6%). For the general protector, the order differed slightly, with T-kick and P-kick switched around with different proportions. Third, the proportion of kicks to the head/face was higher for the electronic protector (19.8%) than for the general protector (10.4%), and this difference was even more distinct when the light (-68kg) (33.5% (electronic) vs. 6.5% (general)) and heavy (+85kg) (1.4% (electronic) vs. 13.3% (general)) weight divisions were compared. Finally, the match status (win/lose) had no significant effect on the pattern of playing actions for both the protectors. The result from this study suggests that skill frequency of linear simple movement for activating electrical protector's sensor is increased, while the one of rotational complex movement is decreased gradually. Additionally, headgear without sensors, such as for a hit movement to the face/head part, represent characteristics of increased attack skills to the facial area; these scores are provided through subjective judgement, and consequently changes in performance skills can occur.


Asunto(s)
Artes Marciales , Equipos de Seguridad , Fenómenos Biomecánicos , Electrónica , Cabeza , Movimiento
7.
Encephale ; 46(3S): S99-S106, 2020 Jun.
Artículo en Francés | MEDLINE | ID: mdl-32405083

RESUMEN

COVID-19 is a multi-organ disease due to an infection with the SARS-CoV2 virus. It has become a pandemic in early 2020. The disease appears less devastating in children and adolescents. However, stress, quarantine and eventually mourning have major impacts on development. It is difficult to describe what this pandemic implies for a child psychiatrist, other than by giving a first-hand account. I propose to go through the main ethical questions that have arisen; to describe how my hospital team has reorganized itself to meet the new demands and questions, in particular by opening a unit dedicated to people with autism and challenging behaviors affected by COVID-19; and to address, in a context of national discussion, how the discipline has sought to understand the conditions of a certain well-being during quarantine. Finally, I will try to conclude with more speculative reflections on re-opening.


Asunto(s)
Psiquiatría del Adolescente , Actitud del Personal de Salud , Trastorno Autístico/terapia , Betacoronavirus , Psiquiatría Infantil , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Psiquiatría , Adolescente , Conducta del Adolescente , Psiquiatría del Adolescente/ética , Trastorno Autístico/complicaciones , Trastorno Autístico/psicología , COVID-19 , Niño , Conducta Infantil , Psiquiatría Infantil/ética , Control de Enfermedades Transmisibles/métodos , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/psicología , Infecciones por Coronavirus/transmisión , Infección Hospitalaria/complicaciones , Infección Hospitalaria/psicología , Infección Hospitalaria/terapia , Exposición a Riesgos Ambientales , Francia , Accesibilidad a los Servicios de Salud , Reestructuración Hospitalaria , Unidades Hospitalarias/organización & administración , Humanos , Control de Infecciones/métodos , Servicios de Salud Mental/ética , Servicios de Salud Mental/organización & administración , Trastornos del Olfato/etiología , Trastornos del Olfato/psicología , Pandemias/prevención & control , Aceptación de la Atención de Salud , Grupo de Atención al Paciente , Aislamiento de Pacientes/psicología , Ludoterapia , Neumonía Viral/complicaciones , Neumonía Viral/prevención & control , Neumonía Viral/psicología , Neumonía Viral/transmisión , Práctica Profesional/ética , Equipos de Seguridad , Factores de Riesgo , SARS-CoV-2 , Estrés Psicológico/etiología
8.
J Pharm Sci ; 109(1): 761-768, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31376374

RESUMEN

Closed system transfer devices (CSTD) are a supplemental engineering control designed to reduce occupational exposure of hazardous drugs and are currently implemented in accordance with evolving regulations. Owing to the novelty and complexity of these devices and their importance in clinical in-use testing, here we evaluated FDA-approved CSTD, assessing product quality through stability indicating assays to determine any drug product incompatibilities. Six devices were used in a simulated compounding and administration of a late-phase IgG1 antibody-drug conjugate (ADC) and the resulting samples were analyzed for visible and subvisible particle counts by light obscuration and micro-flow imaging, physical stability by size exclusion chromatography, and biological activities by relative potency. Potential challenges included improper fit of CSTD components, loss of product to void volume, and material incompatibility. Results showed compatibility of the ADC with the 6 CSTD evaluated. One CSTD introduced subvisible particles into the ADC during compounding that were identified through morphological assessment as silicone oil. This study highlights the importance of clinical in use testing with new devices and proposes strategies to mitigate the risk of drug product incompatibility with CSTD.


Asunto(s)
Composición de Medicamentos/instrumentación , Inmunoconjugados/química , Inmunoglobulina G/química , Exposición Profesional/prevención & control , Equipos de Seguridad , Línea Celular Tumoral , Supervivencia Celular/efectos de los fármacos , Estabilidad de Medicamentos , Humanos , Inmunoconjugados/administración & dosificación , Inmunoconjugados/toxicidad , Inmunoglobulina G/administración & dosificación , Inmunoglobulina G/toxicidad , Ensayo de Materiales , Exposición Profesional/efectos adversos , Agregado de Proteínas , Estabilidad Proteica
9.
Breastfeed Med ; 14(8): 603-608, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31314578

RESUMEN

Objective: To determine the possible relationship between pain experienced by mothers with breastfeeding and musculoskeletal impairment commonly seen in physiotherapy practice. Evidence-based principles of the evaluation and treatment of musculoskeletal impairment used in physiotherapy practice were applied and adapted to manage pain experienced by mothers with breastfeeding. Subjects and Methods: This report describes 11 mothers referred to a breastfeeding clinic for pain with breastfeeding. Mothers were initially assessed by a physician and a nurse clinician, both International Board-Certified Lactation Consultants, to rule out causes of breast or nipple pain. When the cause remained unexplained, it was deemed musculoskeletal, and mothers were referred to a physiotherapist for assessment and treatment with manual orthopedic therapy and mobilization of the myofascial system. Results: The physiotherapist's objective musculoskeletal assessment and mothers' impression showed an improvement in the overall clinical picture after the first appointment in most mothers. Pain was resolved or alleviated by 80% in five mothers after 1-3 weekly treatments. The most useful therapeutic approach was to make afflicted mothers aware of their posture to maintain spinal alignment and avoid shear posture (lateral displacement of the trunk). Shear posture is a consequence of sitting leaning to one side. This posture is exacerbated by thoracic rotation and flexion, for example, when turning the trunk and bending over the baby while giving the breast. Conclusion: Treating musculoskeletal impairment referred pain to the breast or nipple with physiotherapy practices used in a nonbreastfeeding clientele can help alleviate or resolve pain with breastfeeding.


Asunto(s)
Lactancia Materna/efectos adversos , Madres , Dolor Musculoesquelético/terapia , Manejo del Dolor/métodos , Postura , Enfermedades de la Mama/terapia , Femenino , Humanos , Manipulaciones Musculoesqueléticas , Dolor Musculoesquelético/etiología , Pezones , Fisioterapeutas , Equipos de Seguridad
10.
J Agromedicine ; 24(4): 381-390, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31256715

RESUMEN

Background: Falls overboard are the most frequent cause of death in the Northeast lobster fishing industry. National Institute for Occupational Safety and Health (NIOSH) surveillance indicates every victim of a fall overboard who has been found was not wearing a lifejacket. Preliminary research conducted in Maine and Massachusetts indicates lifejacket use is relatively uncommon among lobstermen due to barriers such as comfort, practicality, and social norms.Methods: This study highlights an initiative to: (1) trial various lifejacket designs with lobstermen; (2) identify the most popular designs; and (3) identify other features that could encourage use of lifejackets. In 2017, nine designs were trialed with lobstermen in Maine and Massachusetts during the winter and summer fishing seasons. Participants were recruited dockside, and lifejackets were randomly assigned. Participants completed surveys at 1 week and 4 weeks to assess positive and negative design features and to understand the importance of survival technology that can be used in conjunction with lifejackets.Results: 181 lobstermen in Maine and Massachusetts agreed to participate. Recruitment rates were 90.5%, while the survey completion rate was 88.4%. Survey results identified no clear preference for a specific lifejacket design; however, the ability to choose from many options appeared to be an important factor.Conclusion: Previous studies have indicated that lifejacket preferences are fisheries specific. In the Northeast lobster fishery, however, individual preferences varied. Our research demonstrates that a range of devices covering different buoyancies, wear type, and retrieval systems should be made more available to lobstermen.


Asunto(s)
Accidentes de Trabajo/prevención & control , Salud Laboral/estadística & datos numéricos , Traumatismos Ocupacionales/prevención & control , Equipos de Seguridad/estadística & datos numéricos , Adulto , Animales , Femenino , Explotaciones Pesqueras/estadística & datos numéricos , Humanos , Maine/epidemiología , Masculino , Massachusetts/epidemiología , Persona de Mediana Edad , Nephropidae/crecimiento & desarrollo , Traumatismos Ocupacionales/epidemiología , Adulto Joven
11.
Invest Ophthalmol Vis Sci ; 60(1): 147-153, 2019 01 02.
Artículo en Inglés | MEDLINE | ID: mdl-30629728

RESUMEN

Purpose: We assess the safety and effectiveness of intranasal neurostimulation to promote tear production via the nasolacrimal pathway in subjects with dry eye disease. Methods: A multicenter, randomized, controlled, double-masked pilot study was conducted in adults with dry eye diagnosis and at least one eye with corneal fluorescein staining ≥2 in at least one region or a sum of all regions ≥5 (National Eye Institute grading), basal Schirmer test score ≤10 mm, a cotton-swab stimulated Schirmer score ≥7 mm higher, and an Ocular Surface Disease Index score ≥23. Subjects were randomized to receive active intranasal neurostimulation or sham control intranasal stimulation 4 to 8 times per day. Assessments were scheduled before (unstimulated) and during (stimulated) device application at days 0, 7, 14, 30, and 90. The primary effectiveness endpoint was stimulation-induced change in Schirmer test (with anesthesia) score. Primary safety measure was incidence of device-related adverse events (AEs). Results: Fifty-eight subjects were randomized at nine sites in Australia and New Zealand; 56 completed the 90-day study. Stimulation-induced change in Schirmer score was significantly greater with active intranasal (mean ± SEM, 9.0 ± 2.0) than sham control intranasal stimulation (0.4 ± 0.6; P < 0.001) at day 90. Similar results were observed at days 0, 7, 14, and 30 (P < 0.001). No serious device-related AEs were observed. Mild nosebleed, the most common device-related AE, was reported in five (16.7%) subjects. Conclusions: Intranasal neurostimulation was effective in inducing acute tear production after 90 days of use and generally was well tolerated in subjects with dry eye disease.


Asunto(s)
Síndromes de Ojo Seco/terapia , Mucosa Nasal/inervación , Lágrimas/fisiología , Estimulación Eléctrica Transcutánea del Nervio/métodos , Adulto , Anciano , Método Doble Ciego , Síndromes de Ojo Seco/metabolismo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estudios Prospectivos , Equipos de Seguridad , Microscopía con Lámpara de Hendidura , Estimulación Eléctrica Transcutánea del Nervio/efectos adversos
12.
Phytopathology ; 109(4): 582-592, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30418089

RESUMEN

Citrus Huanglongbing (HLB), also known as greening, is a destructive disease caused by the fastidious, phloem-colonizing bacteria Candidatus Liberibacter spp.; 'Ca. Liberibacter asiaticus' (Las) is the most prevalent of the species causing HLB. The Asian citrus psyllid (ACP, Diaphorina citri) transmits Las. HLB is threatening citrus production worldwide, and there is no cure for infected trees. Management strategies targeting diseased trees at different stages of colonization by Las are needed for sustainable citrus production in HLB-endemic regions. We evaluated the effect of the combinations of plant defense elicitors, nitrogen (N) fertilizer, and compost on mildly diseased trees. We tested thermotherapy on severely diseased trees and assessed tree protectors to prevent feeding by ACP, thus preventing Las from being transmitted to new plantings that replaced HLB-moribund trees. After four applications over two consecutive growing seasons we found that the combination of compost, urea, and plant defense elicitors ß-aminobutyric acid, plus ascorbic acid and potassium phosphite with or without salicylic acid, slowed down the progression of HLB and reduced disease severity by approximately 18%, compared with the untreated control. Our data showed no decline in fruit yield, indeed treatment resulted in a higher yield compared with the untreated control. Thermotherapy treatment (55°C for 2 min) exhibited a suppressive effect on growth of Las and progress of HLB in severely diseased trees for 2 to 3 months after treatment. The tree protectors prevented feeding by ACP, and therefore young replant trees remained healthy and free from infection by Las over the 2-year duration of the experiment. Taken together, these results may contribute to a basis for developing a targeted approach to control HLB based on stage of host colonization, application of plant defense elicitors, N fertilizer, compost, thermotherapy, and tree protectors. There is potential to implement these strategies in conjunction with other disease control measures to contribute to sustainable citrus production in HLB-endemic regions.


Asunto(s)
Citrus , Hemípteros , Calor , Inmunidad de la Planta , Equipos de Seguridad , Rhizobiaceae , Animales , Citrus/microbiología , Citrus/parasitología , Fertilizantes , Calor/uso terapéutico , Enfermedades de las Plantas , Inmunidad de la Planta/efectos de los fármacos , Equipos de Seguridad/microbiología , Equipos de Seguridad/parasitología , Rhizobiaceae/crecimiento & desarrollo , Rhizobiaceae/efectos de la radiación , Árboles
13.
J Agric Saf Health ; 23(4): 281-295, 2017 Nov 20.
Artículo en Inglés | MEDLINE | ID: mdl-29140645

RESUMEN

Power take-off (PTO) is a common method of transferring power from a tractor to a towed piece of machinery. The PTO is also a well-documented cause of severe and often permanent disabling injuries to farm operators. The physical conditions that cause entanglements are not well established. Several studies have explored the parameters of PTO entanglements as materials have been drawn across a rotating PTO knuckle to test for entanglement probability. The objective of this study was to determine probability of entanglement when materials are dropped vertically onto a PTO knuckle spinning at 540 rpm. A total of 360 randomized trials were conducted with ten replications for each of the six positions (center of yoke, edge of yoke rotating downward, edge of yoke rotating upward, center of cross, edge of cross rotating downward, and edge of cross rotating upward) and six different materials (woven cotton athletic shoe lace, cotton workboot lace, leather workboot lace, cotton twine, denim strip, and Tyvek strip). Not a single entanglement was recorded. Dramatic high-speed video imagery authenticated the material's motion and path as it interacted with the rotating PTO knuckle.


Asunto(s)
Accidentes de Trabajo/psicología , Agricultura , Equipos de Seguridad , Diseño de Equipo , Granjas , Probabilidad
14.
Surg Oncol ; 26(3): 242-251, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28807243

RESUMEN

BACKGROUND: During hyperthermic intraperitoneal chemotherapy (HIPEC), caregivers are exposed by different routes to cytotoxic drugs. This review proposes an overview of the safety of HIPEC by assessing existing data on protection procedures, biological and non-biological samples. Based on these data, relevant good practices, eventual irrelevant overprotection procedures and missing data to implement adapted protections are highlighted. MATERIALS AND METHODS: Data were extracted from a systematic review of literature from 1980 till 2016: number and type of surgical procedure, healthcare professionals present, protective equipment, samples, pre-analytical method and analytical method. RESULTS AND DISCUSSION: Only 55 HIPEC procedures have been evaluated. The majority of antineoplastic drugs used have all required characteristics to penetrate the organism and are recognized as very dangerous. Moreover, a great heterogeneity in protective equipment used, either individual or collective is observed. Environmental contamination occurs during HIPEC, especially for all surfaces in the operating room. Compounds penetration into caregivers lungs cannot be excluded. Priority remains to prove professionals contamination by focusing on biological samples. Biological material is rarely sampled or samples are not necessarily adapted. CONCLUSION: Repeated blood tests should be preferred using appropriate sampling schedules and validated sensitive analytical methods. Furthermore, there is a great need of new biological indicators to monitor caregivers exposure. During hyperthermic intraperitoneal chemotherapy (HIPEC), healthcare workers are exposed by different routes to cytotoxic drugs. There are currently few available occupational exposure data and environmental monitoring and biomonitoring must be improved in order to ensure optimal protection against antineoplastic drugs.


Asunto(s)
Citotoxinas/toxicidad , Personal de Salud , Hipertermia Inducida/efectos adversos , Exposición Profesional/efectos adversos , Monitoreo del Ambiente , Humanos , Exposición Profesional/análisis , Salud Laboral , Equipos de Seguridad , Gestión de Riesgos , Administración de la Seguridad , Manejo de Especímenes
15.
Lab Anim ; 51(6): 647-651, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28650259

RESUMEN

Maintaining appropriate acoustic conditions for animal welfare and data collection are crucial in biomedical research facilities. Negative impacts of disruptive sound are known and can include auditory damage, immune function changes, and behavioral alterations. One type of disruptive sound occurring in research facilities is that of fire alarms. To ameliorate this problem, many facilities have incorporated the use of low-frequency fire alarms that emit tones outside the rodent audible range. The impact of these devices has been assumed to be negligible. However, this has yet to be evaluated with controlled behavioral experiments. Thus, our objective was to investigate the impact of low-frequency fire alarm exposure on locomotor behavior in the open field, a test sensitive to acoustic stimuli disruption. Male mice were randomized to three alarm exposure groups (No-Alarm; Alarm-During; and Alarm-After) and placed in individual photobeam-activated locomotor chambers. The Alarm-During group displayed significantly reduced horizontal locomotion, with a trend towards reduced vertical locomotion. These data suggest that a low-frequency brief alarm tone can temporarily disrupt movement, a valuable insight should an alarm be deployed. Further, findings support close collaboration between researchers and institutional facility staff to ensure appropriate acoustic conditions are maintained, whenever possible, for research animals.


Asunto(s)
Percepción Auditiva , Incendios , Locomoción , Ratones/fisiología , Equipos de Seguridad , Estimulación Acústica , Animales , Masculino , Ratones Endogámicos C57BL , Distribución Aleatoria
17.
PLoS One ; 12(2): e0171624, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28158283

RESUMEN

Zinc delivery from a nipple shield delivery system (NSDS), a novel platform for administering medicines to infants during breastfeeding, was characterised using a breastfeeding simulation apparatus. In this study, human milk at flow rates and pressures physiologically representative of breastfeeding passed through the NSDS loaded with zinc-containing rapidly disintegrating tablets, resulting in release of zinc into the milk. Inductively coupled plasma optical emission spectrometry was used to detect the zinc released, using a method that does not require prior digestion of the samples and that could be applied in other zinc analysis studies in breast milk. Four different types of zinc-containing tablets with equal zinc load but varying excipient compositions were tested in the NSDS in vitro. Zinc release measured over 20 minutes ranged from 32-51% of the loaded dose. Total zinc release for sets tablets of the same composition but differing hardness were not significantly different from one another with P = 0.3598 and P = 0.1270 for two tested pairs using unpaired t tests with Welch's correction. By the same test total zinc release from two sets of tablets having similar hardness but differing composition were also not significantly significant with P = 0.2634. Future zinc tablet composition and formulation optimisation could lead to zinc supplements and therapeutics with faster drug release, which could be administered with the NSDS during breastfeeding. The use of the NSDS to deliver zinc could then lead to treatment and prevention of some of the leading causes of child mortality, including diarrheal disease and pneumonia.


Asunto(s)
Lactancia Materna , Pezones , Equipos de Seguridad , Comprimidos/administración & dosificación , Zinc/administración & dosificación , Sistemas de Liberación de Medicamentos/métodos , Humanos , Comprimidos/química , Zinc/química
18.
J Trauma Acute Care Surg ; 82(1): 196-206, jan. 2017.
Artículo en Inglés | BIGG | ID: biblio-966135

RESUMEN

"BACKGROUND: Fall-related injuries among the elderly (age 65 and older) are the cause of nearly 750,000 hospitalizations and 25,000 deaths per year in the United States, yet prevention research is lagging. Using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, the Eastern Association for the Surgery of Trauma produced this practice management guideline to answer the following injury prevention-related population, intervention, comparator, outcomes (PICO) questions:PICO 1: Should bone mineral-enhancing agents be used to prevent fall-related injuries in the elderly?PICO 2: Should hip protectors be used to prevent fall-related injuries in the elderly?PICO 3: Should exercise programs be used to prevent fall-related injuries in the elderly?PICO 4: Should physical environment modifications be used to prevent fall-related injuries in the elderly?PICO 5: Should risk factor screening be used to prevent fall-related injuries in the elderly?PICO 6: Should multiple interventions tailored to the population or individual be used to prevent fall-related injuries in the elderly? METHODS: A comprehensive search and review of all the available literature was performed. We used the GRADE methodology to assess the breadth and quality of the data specific to our PICO questions. RESULTS: We reviewed 50 articles that met our inclusion and exclusion criteria as they applied to our PICO questions. CONCLUSION: Given the data constraints, we offer the following suggestions and recommendations:PICO 1: We conditionally recommend vitamin D and calcium supplementation for frail elderly individuals.PICO 2: We conditionally recommend hip protectors for frail elderly individuals, in the appropriate environment.PICO 3: We conditionally recommend evidence-based exercise programs for frail elderly individuals.PICO 4: We conditionally recommend physical environment modification for frail elderly people.PICO 5: We conditionally recommend frailty screening for the elderly.PICO 6: We strongly recommend risk stratification with targeted comprehensive risk-reduction strategies tailored to particular high-risk groups. LEVEL OF EVIDENCE: Systematic review, level III"


Asunto(s)
Humanos , Masculino , Femenino , Anciano , Accidentes por Caídas , Accidentes por Caídas/prevención & control , Accidentes Domésticos/prevención & control , Equipos de Seguridad , Accidentes Domésticos , Evaluación Geriátrica , Factores de Riesgo , Planificación Ambiental , Conservadores de la Densidad Ósea , Conservadores de la Densidad Ósea/uso terapéutico , Terapia por Ejercicio
19.
Int J Occup Environ Health ; 23(2): 128-142, 2017 04.
Artículo en Inglés | MEDLINE | ID: mdl-29460694

RESUMEN

Background Cr(VI) is a suspected human carcinogen formed as a by-product of stainless steel welding. Nano-alumina and nano-titania coating of electrodes reduced the welding fume levels. Objective To investigate the effect of nano-coating of welding electrodes on Cr(VI) formation rate (Cr(VI) FR) from a shielded metal arc welding process. Methods The core welding wires were coated with nano-alumina and nano-titania using the sol-gel dip coating technique. Bead-on plate welds were deposited on SS 316 LN plates kept inside a fume test chamber. Cr(VI) analysis was done using an atomic absorption spectrometer (AAS). Results A reduction of 40% and 76%, respectively, in the Cr(VI) FR was observed from nano-alumina and nano-titania coated electrodes. Increase in the fume level decreased the Cr(VI) FR. Discussion Increase in fume levels blocked the UV radiation responsible for the formation of ozone thereby preventing the formation of Cr(VI).


Asunto(s)
Contaminantes Ocupacionales del Aire/análisis , Contaminación del Aire Interior/prevención & control , Cromo/análisis , Nanoestructuras/química , Exposición Profesional/prevención & control , Soldadura , Óxido de Aluminio/química , Electrodos/estadística & datos numéricos , Equipos de Seguridad/estadística & datos numéricos , Espectrofotometría Atómica , Acero Inoxidable , Titanio/química
20.
Seton Hall Law Rev ; 46(3): 813-82, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27066611

RESUMEN

The plight of immigrant workers in the United States has captured significant scholarly attention in recent years. Despite the prevalence of discourses regarding this population, one set of issues has received relatively little attention: immigrant workers' exposure to unhealthy and unsafe working conditions, and their corresponding susceptibility to workplace injuries and illnesses. Researchers have consistently found that immigrant workers suffer disproportionately from occupational injuries and fatalities, even when controlling for industry and occupation. Why, then, are foreign-born workers at greater risk for workplace injuries and fatalities, when compared with their native-born counterparts? This Article seeks to develop answers to that question with the aid of empirical research and to build upon a growing interdisciplinary literature. This Article presents findings from a qualitative research study designed to explore the factors that shape occupational risks for immigrants. The study, conducted over several months in 2014, centered on in-depth interviews of eighty-four immigrant day laborers seeking employment in different parts of Northern Virginia. The workers' responses present a complex picture of the immigrant worker experience, reflecting persistent dangers alongside powerful expressions of worker dignity: while the Virginia day laborers continue to encounter significant occupational risks, many comfortably asserted their rights, complicating standard narratives of immigrant worker subordination and vulnerability. The results of the study also point to ongoing economic insecurities, and regulatory failures relating to the provision of training, use of protective equipment, and oversight of smaller worksites. The findings also signal the need for a more holistic approach to workplace regulation that concomitantly examines a range of workplace concerns, including wage violations, hostile work environments, and health and safety risks. Finally, the day laborers' experiences reveal that worker centers are well positioned to insulate immigrant workers from workplace risks, by promoting transparency and accountability in the employer-employee relationship.


Asunto(s)
Emigrantes e Inmigrantes/legislación & jurisprudencia , Empleo/legislación & jurisprudencia , Salud Laboral/legislación & jurisprudencia , Personeidad , Seguridad , Migrantes/legislación & jurisprudencia , Lugar de Trabajo/legislación & jurisprudencia , Accidentes de Trabajo/mortalidad , América Central/etnología , Documentación , Hispánicos o Latinos , Humanos , Entrevistas como Asunto/métodos , Enfermedades Profesionales/mortalidad , Exposición Profesional/efectos adversos , Traumatismos Ocupacionales/mortalidad , Equipos de Seguridad , Factores de Riesgo , Factores Socioeconómicos , Encuestas y Cuestionarios , Estados Unidos , Virginia
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