Effect of milling and preparation method on the physical properties and quality of moin-moin (steamed paste).

Moin-moin is steamed cowpea paste native to Nigeria. This product is classified as a protein/starch gel with the dominate portion of the gel network consisting of cowpea starch. Moin-moin was prepared from starting materials (cowpea meal and cowpea flour) and compared to moin-moin prepared from dry, whole, undecorticated cowpea seeds. Texture profile measurements showed that moin-moin made from cowpea flour (small particle size) formed a firmer structure when compared to moin-moin made from either cowpea meal or whole, dry cowpea seeds. Starting materials with smaller particle sizes and longer cooking times produced stickier moin-moin. The cowpea solids to water ratio was shown to affect the firmness of moin-moin, where a 3.75:1 ratio of solids to water produced a firmer product than other concentrations. Generally, color was unaffected across treatment regimens as identified by an expert sensory panel, although instrumental color measurements showed significant differences for hue angle and chroma. This study demonstrated that the particle size of this food ingredient contributes significantly to its functionality in food formulations.

Prioritizing back injury risk in hospital employees: application and comparison of different injury rates.

To identify high risk areas for back injury in a large teaching hospital, we calculated standard injury rates and newly developed composite statistics for nursing and non-nursing work groups. Data were extracted from the hospital's workers' compensation database. The hospital-wide total injury rate was 4.6 reports per 100 full-time equivalents (FTE); Compensation Case Rate, 1.4 cases per 100 FTE; Compensation Severity Rate, 76 days lost per 100 FTE; and the Cost Rate, $3742 per 100 FTE. The Total Injury Reports Rate for nursing varied from 14.2 per 100 FTE for Intensive Care Unit (ICU) Nursing to 3.8 per 100 FTE for Pediatric Nursing. Non-nursing areas also demonstrated increased rates for back injury. Individual statistical rates ranked areas differently in risk, whereas composite statistical measures consistently ranked ICU Nursing, Buildings and Grounds, and Orthopedics/Neurological Nursing as the top three. Patient handling was the precipitating event in the majority of nursing back injuries, indicating the need for ergonomic intervention. The use of combined statistical measures provided a more integrative measure for describing and following back injury risk over time.

Methods of prioritizing and measuring occupational health risks utilizing hospital back injury data. Development of composite comparative statistics.

The employee health service of a Boston hospital wanted a method to prioritize the risk of occupational injury or illness among its employees as the first step in developing a comprehensive ergonomics program. Data from the safety office and workers' compensation third-party administrator (TPA) was combined with hospital payroll data to create rates that compared all work areas based on the common denominator of 100 full-time equivalents (FTE). Rates for four different aspects of injury experience were calculated: incidence of total reported injuries, incidence of serious injuries, level of severity of injuries, and cost. The use of these simple rates alone was inadequate to accurately prioritize risk. Because most work areas ranked differently from one rate scale to the next, it was unclear which, if any, single rate most accurately defined risk. Composite statistics that combined all of the rates were needed. The Composite Risk Indicator (CRI), the Average Relative Risk (ARR), and the Justified Average Relative Risk (JARR) were developed and examined for their utility. The JARR emerged as the best choice in this setting because it captured all available information about injury or illness experience and provided a meaningful single indicator of risk that could be followed over time.

Furosemide overdose and maximal allowable weight standards.

Adherence to the Maximal Allowable Weight (MAW) standards established by regulation can be difficult for many active duty personnel. We have discovered some members of this group utilizing the potentially dangerous rapid weight loss methods that are commonly seen in patients with bulimia and anorexia nervosa. Two cases of furosemide (Lasix) overdose in active duty members are presented in an effort to enlighten military clinicians concerning this hazardous practice in our patient population. Furosemide overdose related to a scheduled or mandatory weight measurement has not been previously reported.

Care of the central venous catheterization site: the use of a transparent polyurethane film.

Studies of care of patients with central venous catheters report a 3-7% incidence of catheter-induced sepsis when sterile gauze and tape are used as an occlusive dressing. The technique requires that the dressing be changed three times each week for catheterization site inspection. From June 1979 to September 1980, a noncomparative evaluation of a transparent, self-adhesive, polyurethane dressing which is permeable to water vapor but not bacteria was performed. This dressing was used for the care of 100 consecutive patients with central venous catheters. Dressing life averaged 5.3 days with silicone rubber catheters and 4.3 days for polyvinyl chloride catheters. One patient developed catheter induced sepsis (incidence 1%). This dressing material: (1) is acceptable for use as a dressing of central venous catheters; (2) continuously permits inspection of the insertion sites; (3) decreases nursing hours; (4) provides a comfortable dressing which secures the catheter to the patient; and (5) is durable even when exposed to high humidity therapy devices, or when possible permits the patient to take showers.

Daily dressing change effects on skin flora beneath subclavian catheter dressings during total parenteral nutrition.

Septicemia is a persistent problem during total parenteral nutrition (TPN). The skin around the catheter insertion site is one possible source of this infection. In previous studies we showed mechanical cleansing of the skin was more important than the ointment applied; however, alternate day dressing changes did not completely eradicate all skin organisms. The present study was designated to examine the effects of daily dressing changes on the skin flora beneath the subclavian dressing. Fifteen patients receiving TPN were studied for a minimum of 11 days each. The dressing was changed daily and the catheter site cultured immediately. The area was then scrubbed with polyvinylpovidine-iodine, an antibiotic ointment was placed on the catheter insertion site, and a new dressing applied. There were no positive skin or blood cultures in this group during a total study period of 242 patient-days. The control group consisted of 23 patients receiving identical subclavian catheter care but on an alternative rather than daily basis. In the control group there was a 3.5% incidence of positive skin cultures in 530 patient-days. Daily dressing changes eliminated all skin organisms beneath the subclavian dressing during TPN and would be useful in patients who are at high risk for septic complications.