Hazardous Drug Wipe Sampling in Healthcare Facilities

Hazardous drugs are associated with causing acute and chronic side effects to healthcare workers that experience occupational exposures. Antineoplastic drugs are known to cause headaches, nausea, vomiting, hair loss, mutagenic activity, spontaneous abortions, infertility, and congenital malformations. Currently, there are no acceptable thresholds for exposures to this type of hazardous drugs. The use of as low as reasonably acceptable (ALARA) is used for exposures to these types of drugs. Occupational exposure risk should be evaluated within facilities where they are used. Performing hazardous drug wipe sampling in areas that are high risk for contamination can provide information to facilities on how to protect their employees

Hazardous Drug Exposure in Healthcare

Hazardous drug exposure in healthcare is a growing concern for the pharma industry and workers. Significant risks may be present including cancers for those handling and compounding various therapeutic agents. Workplace exposure standards do not exist for those employed in the pharma industry. Recommendations of safety have used the, ‘As Low as Reasonably Achievable’ (ALARA) principle to control exposures for pharmacists and others that handle hazardous substances. Steps should be taken to systematically eliminate and/or minimize exposures to workers through safer handling protocols, approved safety cabinets, negative pressure rooms, local exhaust ventilation, health surveillance, training and appropriate PPE

Beverage Sales and Drinking and Driving: The Role of On-Premise Drinking Places

Objective: The relationships between on-premise drinking places, beverage specific alcohol sales and drinking and driving were examined in a time series cross-sectional study of place-of-last-drink data from Perth, Western Australia. Method: At arrest, 2,411 drinking drivers reported their last location of consumption. Tabulated by 57 premises over 4 years, the rates at which individual premises were referenced as the place-of-last-drink were taken to reflect the relative distributions of numbers of drinking drivers coming from different premise types (hotels, taverns and nightclubs. The data were then statistically related to measures of premise types and characteristics and beverage specific alcohol sales. Results: Significant cross-sectional relationships were obtained between measures of premise types, alcohol sales and drinking and driving. Greatest numbers of drinking drivers came from taverns and from places selling greater amounts of beer and spirits. Significant longitudinal effects were obtained for sales of beer, proportions of high alcohol beer sold and sales of spirits. Conclusions: As a whole, the results suggest that, at least for Western Australia, outlets selling greater amounts of beer and spirits, and greater amounts of high alcohol beer, will produce larger numbers of drinking drivers. (J Stud. Alcohol 60: 47-53, 1999

Relationships between minimum alcohol pricing and crime during the partial privatization of a Canadian government alcohol monopoly

Objective: The purpose of this study was to estimate the independent effects of increases in minimum alcohol prices and densities of private liquor stores on crime outcomes in British Columbia, Canada, during a partial privatization of off-premise liquor sales. Method: A time-series cross-sectional panel study was conducted using mixed model regression analysis to explore associations between minimum alcohol prices, densities of liquor outlets, and crime outcomes across 89 local health areas of British Columbia between 2002 and 2010. Archival data on minimum alcohol prices, per capita alcohol outlet densities, and ecological demographic characteristics were related to measures of crimes against persons, alcohol-related traffic violations, and non–alcohol- related traffic violations. Analyses were adjusted for temporal and regional autocorrelation. Results: A 10% increase in provincial minimum alcohol prices was associated with an 18.81% (95% CI: ±17.99%, p < .05) reduction in alcohol-related traffic violations, a 9.17% (95% CI: ±5.95%, p < .01) reduction in crimes against persons, and a 9.39% (95% CI: ±3.80%, p < .001) reduction in total rates of crime outcomes examined. There was no significant association between minimum alcohol prices and non–alcohol-related traffic violations (p < .05). Densities of private liquor stores were not significantly associated with alcohol involved traffic violations or crimes against persons, though they were with non–alcohol-related traffic violations. Conclusions: Reductions in crime events associated with minimum-alcohol-price changes were more substantial and specific to alcohol-related events than the countervailing increases in densities of private liquor stores. The findings lend further support to the application of minimum alcohol prices for public health and safety objectives

Neurological Dysfunction in Coeliac Disease and Non-Coeliac Gluten Sensitivity

OBJECTIVES: Non-coeliac gluten sensitivity (NCGS) refers to patients with primarily gastrointestinal symptoms without enteropathy that symptomatically benefi t from gluten-free diet (GFD). Little is known about its pathophysiology, propensity to neurological manifestations, and if these differ from patients with coeliac disease (CD). We investigated the clinical and immunological characteristics of patients presenting with neurological manifestations with CD and those with NCGS. METHODS: We compared clinical, neurophysiological, and imaging data of patients with CD and NCGS presenting with neurological dysfunction assessed and followed up regularly over a period of 20 years. RESULTS: Out of 700 patients, 562 were included. Exclusion criteria included no bowel biopsy to confi rm CD, no HLA type available, and failure to adhere to GFD. All patients presented with neurological dysfunction and had circulating anti-gliadin antibodies. Out of 562 patients, 228 (41%) had evidence of enteropathy (Group 1, CD) and 334 (59%) did not (Group 2, NCGS). The most common neurological manifestations were cerebellar ataxia, peripheral neuropathy, and encephalopathy. There was a greater proportion of patients with encephalopathy in Group 1 and with a greater proportion of neuropathy in Group 2. The severity of ataxia did not differ between the two groups. Patients in Group 1 had more severe neuropathy. All patients from both groups responded to gluten-free diet. Anti-tissue transglutaminase (TG2) antibodies were found in 91% of patients in Group 1 and in 29% of patients in Group 2. Comparison between those patients in Group 2 with HLA-DQ2/DQ8 and those without as well as those with positive TG2 compared with those with negative TG2 antibodies identifi ed no differences within these subgroups. Serological positivity for TG6 antibodies was similar in the two groups (67 and 60%). CONCLUSIONS: The neurological manifestations of CD and NCGS are similar and equally responsive to a GFD suggestive of common pathophysiological mechanisms

Growing Environmental Activists: Developing Environmental Agency and Engagement Through Children’s Fiction.

We explore how story has the potential to encourage environmental engagement and a sense of agency provided that critical discussion takes place. We illuminate this with reference to the philosophies of John Macmurray on personal agency and social relations; of John Dewey on the primacy of experience for philosophy; and of Paul Ricoeur on hermeneutics, dialogue, dialectics and narrative. We view the use of fiction for environmental understanding as hermeneutic, a form of conceptualising place which interprets experience and perception. The four writers for young people discussed are Ernest Thompson Seton, Kenneth Grahame, Michelle Paver and Philip Pullman. We develop the concept of critical dialogue, and link this to Crick's demand for active democratic citizenship. We illustrate the educational potential for environmental discussions based on literature leading to deeper understanding of place and environment, encouraging the belief in young people that they can be and become agents for change. We develop from Zimbardo the key concept of heroic resister to encourage young people to overcome peer pressure. We conclude with a call to develop a greater awareness of the potential of fiction for learning, and for writers to produce more focused stories engaging with environmental responsibility and activism

Cardiovascular Variability, Sociodemographics, and Biomarkers of Disease: The MIDUS Study

Introduction: Like heart rate, blood pressure (BP) is not steady but varies over intervals as long as months to as short as consecutive cardiac cycles. This blood pressure variability (BPV) consists of regularly occurring oscillations as well as less well-organized changes and typically is computed as the standard deviation of multiple clinic visit-to-visit (VVV-BP) measures or from 24-h ambulatory BP recordings (ABPV). BP also varies on a beat-to-beat basis, quantified by methods that parse variation into discrete bins, e.g., low frequency (0.04–0.15 Hz, LF). However, beat-to-beat BPV requires continuous recordings that are not easily acquired. As a result, we know little about the relationship between LF-BPV and basic sociodemographic characteristics such as age, sex, and race and clinical conditions. Methods: We computed LF-BPV during an 11-min resting period in 2,118 participants in the Midlife in the US (MIDUS) study. Results: LF-BPV was negatively associated with age, greater in men than women, and unrelated to race or socioeconomic status. It was greater in participants with hypertension but unrelated to hyperlipidemia, hypertriglyceridemia, diabetes, elevated CRP, or obesity. LF-diastolic BPV (DBPV), but not-systolic BPV (SBPV), was negatively correlated with IL-6 and s-ICAM and positively correlated with urinary epinephrine and cortisol. Finally, LF-DBPV was negatively associated with mortality, an effect was rendered nonsignificant by adjustment by age but not other sociodemographic characteristics. Discussion: These findings, the first from a large, national sample, suggest that LF-BPV differs significantly from VVV-BP and ABPV. Confirming its relationship to sociodemographic risk factors and clinical outcomes requires further study with large and representative samples

‘Everyone can imagine their own Gellert’: the democratic artist and ‘inclusion’ in primary and nursery classrooms

What do artists do when they work in schools? Can teachers do the same? These were the questions at the heart of our recent research, investigating the work of 12 artists working in primary and secondary schools in England. Funded by Creativity, Culture and Education as a ‘legacy’ project of Creative Partnerships (2003–2011) our intention was to develop a theorisation of artists’ practice that could inform the work that teachers do. In this paper, we report on a key aspect of the Signature Pedagogies project (www.signaturepedagogies.org.uk) the way in which artists approached the issue of inclusion. Through an examination of the work of three story-makers in primary and nursery schools, documented through observation, film and interview, we show that the democratic participatory practices they adopted were based on a fundamental belief that: every child was capable of having ideas; every child could contribute meaningfully to discussions; and every child was integral to a collective ‘performance’. We conclude that these artists’ democratic orientations may well be difficult for teachers to adopt in the current moment, but that this artistic work in schools may still provide a welcome relief for all involved, as well as maintaining an exemplar of alternative pedagogical practice that might be expanded in a changed policy environment