Effect of a No-Smoking Policy Aboard a U. S. Navy Aircraft Carrier

The purpose of this study was to assess the impact if a no-smoking policy aboard the Atlantic Fleet carrier USS THEODORE ROOSEVELT (CVN-71) on the crew\u27s smoking behavior and exposure to ETS, as well as crew attitudes regarding smoking policy. All crew members aboard ship were asked to participate in a baseline and post-intervention survey

Behavioral Effects of Tyrosine During Sustained Wakefulness

The fatigue and cognitive performance deficits associated with sleep loss and stress, like that experienced during sustained flight operations and nighttime flying, have motivated the search for effective nonpharmacological countermeasures. The behavioral effects of the potential countermeasure tyrosine, an amino-acid precursor to dopamine and norepinephrine, were examined during an episode of continuous nighttime work involving one night\u27s sleep loss. Volunteers performed nine iterations of a battery of cognitive and subjective tasks for approximately 13 h, beginning at 1930 and ending at 0820 the following morning. Subjects remained awake throughout the day on which the experiment began and were awake for approximately 24 h by the end of testing. Six hours after the start of the experiment, one-half of the subjects received 150 mg/kg tyrosine in a split dose while the other half received a cornstarch placebo in a double-blind procedure. The tracking-task performance of tyrosine subjects declined less during the night than that of placebo subjects. Tyrosine administration was also associated with nonsignificant trends toward reducing (a) lapses on a high-event-rate vigilance task, (b) subjective sleepiness, and (c) the intensities of several fatigue-related symptoms

Tyrosine as a Countermeasure to Performance Decrement During Sleep Loss

The fatigue and cognitive performance deficits associated with sleep loss and stress have motivated the search for effective nonpharmacological countermeasures. The purpose of the present study was to examine the potential behavioral effects of tyrosine, an amino-acid presursor to dopamine and norepinephrine, during an episode of continuous nighttime work involving one night of sleep loss

The Role of Gender in Nurse-Resident Interactions: A mixed-methods study

Background: Gender disparities continue to persist within the medical field. Adverse effects of gender bias are well documented, including among trainees in Emergency Medicine (EM). The extent to which gender bias affects interprofessional interactions is not well understood. Objectives: The study aimed to understand perceptions and experiences of gender bias in interactions between emergency medicine (EM) residents and emergency department (ED) nurses. Methods: This mixed-methods study involved eight key informant interviews and two focus groups, and an anonymous electronic survey administered to EM residents and nurses at two teaching hospitals. Quantitative analysis included descriptive statistics and between-group comparisons using Student t-tests and two-sample Wilcoxon rank-sum. Qualitative analysis used a inductive and thematic content analysis. Results: Most participants identified gender as an important factor in ED interprofessional relationships. Key themes emerging from qualitative data include differential treatment and communication styles based on gender. 134 individuals completed the survey: 104 nurses (29% response rate), 30 residents (53% response rate). Females more frequently reported experiencing interprofessional gender bias than males [mean 30.9 (95% CI 25.6-36.2) vs 17.6 (95%CI 10.3-24.9)]. Residents of both genders reported witnessing interprofessional gender bias more frequently than nurses [mean 58.7 (95%CI 48.6-68.7) vs 23.9 (95%CI 19.4-28.4)]. Residents, compared to nurses, more frequently felt gender bias affects job satisfaction (p=0.002) and patient care (p=0.001). These differences were largely driven by female residents’ responses. Conclusion/impact: Gender plays a significant role in shaping interprofessional interactions in the ED. Gender bias in interprofessional interactions contributes to workplace dissatisfaction, particularly for female residents. Initiatives to establish equitable relationships across the gender spectrum in EM are needed to address interprofessional gender bias.https://jdc.jefferson.edu/sexandgenderhealth/1033/thumbnail.jp

Targeted inhibition of mitochondrial Hsp90 suppresses localised and metastatic prostate cancer growth in a genetic mouse model of disease

BACKGROUND: The molecular chaperone heat shock protein-90 (Hsp90) is a promising cancer drug target, but current Hsp90-based therapy has so far shown limited activity in the clinic. METHODS: We tested the efficacy of a novel mitochondrial-targeted, small-molecule Hsp90 inhibitor, Gamitrinib (GA mitochondrial matrix inhibitor), in the Transgenic Adenocarcinoma of the Mouse Prostate (TRAMP) model. The TRAMP mice receiving 3-week or 5-week systemic treatment with Gamitrinib were evaluated for localised or metastatic prostate cancer, prostatic intraepithelial neoplasia (PIN) or localised inflammation using magnetic resonance imaging, histology and immunohistochemistry. Treatment safety was assessed histologically in organs collected at the end of treatment. The effect of Gamitrinib on mitochondrial dysfunction was studied in RM1 cells isolated from TRAMP tumours. RESULTS: Systemic administration of Gamitrinib to TRAMP mice inhibited the formation of localised prostate tumours of neuroendocrine or adenocarcinoma origin, as well as metastatic prostate cancer to abdominal lymph nodes and liver. The Gamitrinib treatment had no effect on PIN or prostatic inflammation, and caused no significant animal weight loss or organ toxicity. Mechanistically, Gamitrinib triggered acute mitochondrial dysfunction in RM1 cells, with loss of organelle inner membrane potential and release of cytochrome-c in the cytosol. CONCLUSIONS: The Gamitrinib has pre-clinical activity and favourable tolerability in a genetic model of localised and metastatic prostate cancer in immunocompetent mice. Selective targeting of mitochondrial Hsp90 could provide novel molecular therapy for patients with advanced prostate cancer

Patient Safety in the Cardiac Operating Room: Human Factors and Teamwork: A Scientific Study from the American Heart Association

The cardiac surgical operating room (OR) is a complex environment in which highly trained subspecialists interact with each other using sophisticated equipment to care for patients with severe cardiac disease and significant comorbidities. Thousands of patient lives have been saved or significantly improved with the advent of modern cardiac surgery. Indeed, both mortality and morbidity for coronary artery bypass surgery have decreased during the past decade. Nonetheless, the highly skilled and dedicated personnel in cardiac ORs are human and will make errors. Refined techniques, advanced technologies, and enhanced coordination of care have led to significant improvements in cardiac surgery outcomes

Adverse Event Investigation and Risk Assessment

AbstractThis chapter describes a comprehensive approach to adverse event investigation and risk assessment, as well as the characteristics of an integrated system for patient safety and clinical risk management. Drawing on evidence from other industries and healthcare organizations across the globe, the author's report how such a system can be developed with the active involvement of policy-makers, healthcare managers, health professionals, and patients. Human factors and ergonomics provide the theoretical framework in which the guiding principles, methods, and tools are selected and applied to identify, analyze, and prevent risks related to unsafe care in any healthcare setting

Organizational Factors in Commercial Aviation Accidents 1990-2000

Recently several major transportation accidents have brought significant attention to the role of organizational factors in supporting safety within high-risk critical systems. However, little is essentially known about the types of organizational factors that contribute to these accidents, as there has yet to be a comprehensive analysis of these factors. This paper elaborates on the types of organizational factors that have contributed to pilot-error related aviation accidents in U.S. commercial aviation. Specifically, we analyzed 60 accidents with organizational cause factors from 1990-2000. Results from this analysis indicate that the type and frequency of organizational factors that contribute to accidents varies across type and size of aviation operations. However, the data also argue for a more thorough analysis of organizational factors during an investigation so that a clearer understanding of the actual contributing factors to an accident involving pilot error can be discerned

Investigation of a small centrifugal compressor with radial inflow diffuser

http://www.archive.org/details/investigationofs00shapU.S. Navy (U.S.N.) authors