A scoping review of nursing education for firearm safety.

BACKGROUND: Firearm violence, whether intentional or accidental, affects families worldwide. Nurses often encounter firearm-related injury and death with little knowledge or preparation for dealing with firearm safety issues. OBJECTIVES: The aim was to locate published research on nurse education in firearm safety and examine the preparation of nurses to deal with issues of firearm safety as a deterrent toward decreasing violence. The review included nurse perceptions of barriers and facilitators related to firearm safety in clinical situations. DESIGN: A literature scoping review for article identification, examination, and reporting was structured on the extended form of Arksey and O'Malley's 5-step design framework. DATA SOURCES: Databases CINAHL, MEDLINE, Sociological Abstracts, PsychInfo, and ERIC were searched for articles in English language published between 2010 and 2021 that included nurses in the studies' samples. REVIEW METHODS: Searches were managed via Covidence®, a literature screening and data extraction tool. Two independent reviewers screened the articles retrieved from the databases by title, abstract, and full-text review. Data from selected articles were extracted onto a spreadsheet and critically appraised for eligibility. RESULTS: A search of healthcare databases resulted in identification of 645 articles, of which 15 met inclusion criteria. Seven of the 15 articles addressed nurse firearm safety preparation, and seven related to counseling firearm safety for suicide prevention. Main barriers included lack of standardized guidelines, inadequate knowledge, and discomfort discussing firearm safety with patients and families. CONCLUSIONS: The scoping review findings show a noticeable gap: nurse education addressing firearm safety is, for all purposes, non-existent. A need exists for evidence-based training within academic curricula and across acute and behavioral healthcare settings.

Health Impact Assessment of an oil drilling project in California.

OBJECTIVES: The Health Impact Assessment (HIA) was conducted to evaluate the potential community health implications of a proposed oil drilling and production project in Hermosa Beach, California. The HIA considered 17 determinants of health that fell under 6 major categories (i.e., air quality, water and soil quality, upset conditions, noise and light emissions, traffic, and community livability). MATERIAL AND METHODS: This paper attempts to address some of the gaps within the HIA practice by presenting the methodological approach and results of this transparent, comprehensive HIA; specifically, the evaluation matrix and decision-making framework that have been developed for this HIA and form the basis of the evaluation and allow for a clear conclusion to be reached in respect of any given health determinant (i.e., positive, negative, neutral). RESULTS: There is a number of aspects of the project that may positively influence health (e.g., increased education funding, ability to enhance green space), and at the same time there have been potential negative effects identified (e.g., odor, blowouts, property values). Except for upset conditions, the negative health outcomes have been largely nuisance-related (e.g., odor, aesthetics) without irreversible health impacts. The majority of the health determinants, that had been examined, have revealed that the project would have no substantial effect on the health of the community. CONCLUSIONS: Using the newly developed methodology and based on established mitigation measures and additional recommendations provided in the HIA, the authors have concluded that the project will have no substantial effect on community health. This approach and methodology will assist practitioners, stakeholders and decision-makers in advancing the HIA as a useful, reproducible, and informative tool.

Wind turbines and human health.

The association between wind turbines and health effects is highly debated. Some argue that reported health effects are related to wind turbine operation [electromagnetic fields (EMF), shadow flicker, audible noise, low-frequency noise, infrasound]. Others suggest that when turbines are sited correctly, effects are more likely attributable to a number of subjective variables that result in an annoyed/stressed state. In this review, we provide a bibliographic-like summary and analysis of the science around this issue specifically in terms of noise (including audible, low-frequency noise, and infrasound), EMF, and shadow flicker. Now there are roughly 60 scientific peer-reviewed articles on this issue. The available scientific evidence suggests that EMF, shadow flicker, low-frequency noise, and infrasound from wind turbines are not likely to affect human health; some studies have found that audible noise from wind turbines can be annoying to some. Annoyance may be associated with some self-reported health effects (e.g., sleep disturbance) especially at sound pressure levels >40 dB(A). Because environmental noise above certain levels is a recognized factor in a number of health issues, siting restrictions have been implemented in many jurisdictions to limit noise exposure. These setbacks should help alleviate annoyance from noise. Subjective variables (attitudes and expectations) are also linked to annoyance and have the potential to facilitate other health complaints via the nocebo effect. Therefore, it is possible that a segment of the population may remain annoyed (or report other health impacts) even when noise limits are enforced. Based on the findings and scientific merit of the available studies, the weight of evidence suggests that when sited properly, wind turbines are not related to adverse health. Stemming from this review, we provide a number of recommended best practices for wind turbine development in the context of human health.

Calcium primer: current controversies and common clinical questions.

The use of calcium supplements has recently come under fire because of studies purportedly showing a relationship to cardiovascular events. Although the conclusions made sensational headlines in the popular press, numerous editorials and convincing scientific evidence to the contrary went unnoticed. This controversy and others, such as the relationship of proton-pump inhibitors and osteoporosis, caffeine consumption and the risk of calciuria, and the effects of loop diuretics on fracture risk, are common clinical queries of both primary care physicians and subspecialists. The purpose of this article, therefore, is to provide a concise review of select literature pertinent to current clinical practice and to provide no-nonsense recommendations for common clinical dilemmas regarding calcium supplementation.

Intramuscular VEGF activates an SDF1-dependent progenitor cell cascade and an SDF1-independent muscle paracrine cascade for cardiac repair.

The skeletal muscle is endowed with an impressive ability to regenerate after injury, and this ability is coupled to paracrine production of many trophic factors possessing cardiovascular benefits. Taking advantage of this humoral capacity of the muscle, we recently demonstrated an extracardiac therapeutic regimen based on intramuscular delivery of VEGF-A(165) for repair of the failing hamster heart. This distal organ repair mechanism activates production from the injected hamstring of many trophic factors, among which stromal-derived factor-1 (SDF1) prominently mobilized multi-lineage progenitor cells expressing CXCR4 and their recruitment to the heart. The mobilized bone marrow progenitor cells express the cardiac transcription factors myocyte enhancer factor 2c and GATA4 and several major trophic factors, most notably IGF1 and VEGF. SDF1 blockade abrogated myocardial recruitment of CXCR4(+) and c-kit(+) progenitor cells with an insignificant effect on the hematopoietic progenitor lineage. The knockdown of cardiac progenitor cells led to deprivation of myocardial trophic factors, resulting in compromised cardiomyogenesis and angiogenesis. However, the VEGF-injected hamstring continued to synthesize cardioprotective factors, contributing to moderate myocardial tissue viability and function even in the presence of SDF1 blockade. These findings thus uncover two distinct but synergistic cardiac therapeutic mechanisms activated by intramuscular VEGF. Whereas the SDF1/CXCR4 axis activates the progenitor cell cascade and its trophic support of cardiomyogenesis intramuscularly, VEGF amplifies the skeletal muscle paracrine cascade capable of directly promoting myocardial survival independent of SDF1. Given that recent clinical trials of cardiac repair based on the use of marrow-mobilizing agents have been disappointing, the proposed dual therapeutic modality warrants further investigation.

Risk perception, risk communication, and stakeholder involvement for biosolids management and research.

An individual's perception of risk develops from his or her values, beliefs, and experiences. Social scientists have identified factors that affect perceptions of risk, such as whether the risk is knowable (uncertainty), voluntary (can the individual control exposure?), and equitable (how fairly is the risk distributed?). There are measurable differences in how technical experts and citizen stakeholders define and assess risk. Citizen knowledge and technical expertise are both relevant to assessing risk; thus, the 2002 National Research Council panel on biosolids recommended stakeholder involvement in biosolids risk assessments. A survey in 2002 identified some of the factors that influence an individual's perception of the risks involved in a neighbor's use of biosolids. Risk communication was developed to address the gap between experts and the public in knowledge of technical topics. Biosolids management and research may benefit from applications of current risk communication theory that emphasizes (i) two-way communications (dialogue); (ii) that the public has useful knowledge and concerns that need to be acknowledged; and (iii) that what may matter most is the credibility of the purveyor of information and the levels of trustworthiness, fairness, and respect that he or she (or the organization) demonstrates, which can require cultural change. Initial experiences in applying the dialogue and cultural change stages of risk communication theory--as well as consensus-building and joint fact-finding--to biosolids research suggest that future research outcomes can be made more useful to decision-makers and more credible to the broader public. Sharing control of the research process with diverse stakeholders can make research more focused, relevant, and widely understood.

Noise exposure and hearing conservation practices in an industry with high incidence of workers' compensation claims for hearing loss.

BACKGROUND: Washington State has experienced a striking increase in workers' compensation claims for hearing loss. METHODS: This cross-sectional study examined noise exposures and hearing conservation practices in one industry with a high rate of hearing loss claims. We evaluated 10 representative foundries with personal noise dosimetry, management interviews, employee interviews, and existing audiometry. RESULTS: Noise levels routinely exceeded 85 dBA. All companies were out of compliance with hearing conservation regulations. Most employees with important findings on audiograms were not aware of their findings. There was a significant positive correlation between management-interview scores and worksite-average employee-interview scores (r = 0.70, P = 0.02). CONCLUSIONS: Companies where more effort is put into hearing conservation program activities can achieve a greater positive impact on employee awareness. However, there were broad deficiencies even in the better programs in this sample, suggesting that workers in this industry probably face a continuing substantial risk of occupational hearing loss.