Take Care When Washing Work Clothes Used Around Pesticides

Pesticide applicators and handlers need to wear, at a minimum, the Personal Protective Equipment (PPE) specified on pesticide product labels. Most pesticide labels require a long-sleeved shirt and long pants. Proper laundering of work clothes that may be contaminated with pesticide residues is essential to reduce pesticide handlers’ short- and long-term exposure to pesticides and prevent the potential of residue cross-contamination onto other clothing

Evaluation of the Standards and Professional Learning Project 2003

In February 2003, the Victorian State Minister for Education and Training launched the ‘Standards and Professional Learning Project’ as the first major policy initiative of the new Institute. The brief of the project was: to develop professional teaching standards for full registration, and to support new teachers (who were mostly newly graduated teachers from tertiary teacher education programs) to move from provisional to full registration at the end of their first year of teaching. This involved designing and implementing evidence based assessment processes to show that the standards had been met. These assessments would provide guarantees of teacher quality to the public and to the teaching profession in Victoria

Pesticide Applications – Are you Prepared?

With the critical need for respirators and other personal protective equipment (PPE) for health care, there is a potential shortage of PPE, particularly N95 respirators, in the marketplace for agriculture and pesticide applications

An Examination of Opioid Prescribing Policy and Clinical Practice in the Context of the United States Opioid Crisis

Indiana University-Purdue University Indianapolis (IUPUI)In 2017, the United States government declared that the opioid epidemic was a public health emergency. Among responses to address the epidemic, the Centers for Disease Control and Prevention released a set of opioid prescribing guidelines for primary care clinicians. Since their release, federal agencies and experts have been interested and concerned about their application in policy and clinical practice. This dissertation examines how some of these federal recommendations were implemented in clinic practice and state law, as well as the effects of related prescribing laws. This dissertation includes three studies 1) a qualitative analysis of clinician and patient discussions about opioid-related risks, benefits, and treatment goals, 2) a policy surveillance study of state tapering laws and their consistency with the CDC guideline’s opioid tapering recommendations, and 3) an empirical study of the effects of morphine milligram equivalent daily dose laws and acute opioid prescribing laws on pain medication prescribing for patients with Medicaid. Overall, this dissertation attempts to understand the translation of national opioid prescribing guidelines into policy and their effects on healthcare delivery.2021-02-2

Implementing Handheld Computers as Tools for First-Grade Writers

All humans use objects in their environment as tools for actions. Some tools are more useful than others for certain people and populations. This paper describes how different first-graders used handheld computers as tools when writing. While all 17 children in the observed classroom were competent users of their handheld computers, their use of handhelds for pre-writing differed among the students. Some students’ thinking was clearly enhanced with the use of handhelds before writing. Other students showed writing competence without referring back to their pre-writing work on the handheld. No students were unable to operate their handhelds in the pre-writing process

Analgesic Management of Pain in Elite Athletes: A Systematic Review

Objective: To identify the prevalence, frequency of use, and effects of analgesic pain management strategies used in elite athletes. Design: Systematic literature review. Data Sources: Six databases: Ovid/Medline, SPORTDiscus, CINAHL, Embase, Cochrane Library, and Scopus. Eligibility Criteria for Selecting Studies: Empirical studies involving elite athletes and focused on the use or effects of medications used for pain or painful injury. Studies involving recreational sportspeople or those that undertake general exercise were excluded. Main Results: Of 70 articles found, the majority examined the frequency with which elite athletes use pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, anesthetics, and opioids. A smaller set of studies assessed the effect of medications on outcomes such as pain, function, and adverse effects. Oral NSAIDs are reported to be the most common medication, being used in some international sporting events by over 50% of athletes. Studies examining the effects of pain medications on elite athletes typically involved small samples and lacked control groups against which treated athletes were compared. Conclusions: Existing empirical research does not provide a sufficient body of evidence to guide athletes and healthcare professionals in making analgesic medication treatment decisions. Based on the relatively robust evidence regarding the widespread use of NSAIDs, clinicians and policymakers should carefully assess their current recommendations for NSAID use and adhere to a more unified consensus-based strategy for multidisciplinary pain management in elite athletes. In the future, we hope to see more rigorous, prospective studies of various pain management strategies in elite athletes, thus enabling a shift from consensus-based recommendations to evidence-based recommendations

Examination of near-wall hemodynamic parameters in the renal bridging stent of various stent graft configurations for repairing visceral branched aortic aneurysms

ObjectiveThis study examined the flow behavior of four stent graft configurations for endovascular repair of complex aneurysms of the descending aorta.MethodsComputational fluid dynamics models with transient boundary conditions and rigid wall simplifying assumptions were developed and used with four distinct geometries to compare various near-wall hemodynamic parameters.ResultsGraphic plots for time-averaged wall shear stress, oscillating shear index, and relative residence time were presented and compared among the four stent graft configurations of interest.ConclusionsAbrupt 90° and 180° changes in stent geometry (particularly in the side branches) cause a high momentum change and thus increased flow separation and mixing, which has significant implications in blood flow characteristics near the wall. By comparison, longer bridging stents provide more gradual changes in momentum, thus allowing blood flow to develop before reaching the target vessel.Clinical RelevanceRenal vessel patency is a well-known but rarely talked about challenge with complex aneurysm repair. Many factors need to be optimized to ensure branch vessel patency in aneurysms of the visceral segment, including bridging stent compliance transition, bridging stent material selection and design, and main body graft alignment. One topic that has not been discussed much is the flow characteristics entering the branch. Here we propose a technique to evaluate device configurations and their associated flows for their ability to maintain branch vessel patency

An Analysis of Primary Care Clinician Communication About Risk, Benefits, and Goals Related to Chronic Opioid Therapy

Background. Safe opioid prescribing and effective pain care are particularly important issues in the United States, where decades of widespread opioid prescribing have contributed to high rates of opioid use disorder. Because of the importance of clinician-patient communication in effective pain care and recent initiatives to curb rising opioid overdose deaths, this study sought to understand how clinicians and patients communicate about the risks, benefits, and goals of opioid therapy during primary care visits. Methods. We recruited clinicians and patients from six primary care clinics across three health systems in the Midwest United States. We audio-recorded 30 unique patients currently receiving opioids for chronic noncancer pain from 12 clinicians. We systematically analyzed transcribed, clinic visits to identify emergent themes. Results. Twenty of the 30 patient participants were females. Several patients had multiple pain diagnoses, with the most common diagnoses being osteoarthritis (n = 10), spondylosis (n = 6), and low back pain (n = 5). We identified five themes: 1) communication about individual-level and population-level risks, 2) communication about policies or clinical guidelines related to opioids, 3) communication about the limited effectiveness of opioids for chronic pain conditions, 4) communication about nonopioid therapies for chronic pain, and 5) communication about the goal of the opioid tapering. Conclusions. Clinicians discuss opioid-related risks in varying ways during patient visits, which may differentially affect patient experiences. Our findings may inform the development and use of more standardized approaches to discussing opioids during primary care visits

Identification and characterization of an irreversible inhibitor of CDK2

Irreversible inhibitors that modify cysteine or lysine residues within a protein kinase ATP binding site offer, through their distinctive mode of action, an alternative to ATP-competitive agents. 4-((6-(Cyclohexylmethoxy)- 9H-purin-2-yl)amino)benzenesulfonamide (NU6102) is a potent and selective ATP-competitive inhibitor of CDK2 in which the sulfonamide moiety is positioned close to a pair of lysine residues. Guided by the CDK2/NU6102 structure, we designed 6-(cyclohexylmethoxy)-N-(4-(vinylsulfonyl)phenyl)-9H-purin-2-amine (NU6300), which binds covalently to CDK2 as shown by a co-complex crystal structure. Acute incubation with NU6300 produced a durable inhibition of Rb phosphorylation in SKUT-1B cells, consistent with it acting as an irreversible CDK2 inhibitor. NU6300 is the first covalent CDK2 inhibitor to be described, and illustrates the potential of vinyl sulfones for the design of more potent and selective compounds