Problem: Nurses are potentially exposed to hazardous drugs (HDs) in their practice. HD exposure is associated with adverse outcomes (reproductive problems, learning disabilities in offspring of nurses exposed during pregnancy, and cancer occurrence). Safe handling precautions (safety equipment and personal protective equipment, [PPE]) minimize exposure to HDs and decrease the potential for adverse outcomes. Despite existing OSHA recommendations, adherence to precautions is below recommendations. The purpose of this study was to examine relationships among factors affecting nurses’ use of HD safe handling precautions, to identify factors that promote or interfere with HD precaution use, and to determine nurse managers’ perspectives on use of safe handling precautions. This study used a conceptual model which proposes that both individual and organizational factors influence precaution use. Methods: A cross-sectional, correlational design was used. Nurses (N = 165; 46% response rate) from oncology centers across the US who reported handling chemotherapy completed a mailed survey. Instruments measured HD precaution use, knowledge, self efficacy, barriers, perceived risk, conflict of interest, interpersonal influences and workplace safety climate. Hierarchical regression was used. Twenty managers of nurses handling chemotherapy were interviewed. Results: Nurses were experienced in oncology (M = 15.8 ± 7.6) yrs, well-educated (62.5% ≥BSN), certified in oncology nursing (85%), worked in outpatient settings (69%), and on average treated 6.8 ± 5.2 patients per day. Chemotherapy exposure knowledge was high (M = 10.9, ± 1, 0-12 scale); as was self efficacy for using PPE (M = 20.8 ± 3, 7-24 scale), and perceived risk (M = 3.14 ± .6, 0-4 scale). Total precaution use during HD administration and disposal was low (M = 1.9, SD = 1.1, 0= never to 5 = 100%). Nurse characteristics did not predict HD precaution use. In the final model (R2 = .29, F (2, 155) = 24.6, p < .000), fewer patients per day, fewer barriers and better workplace safety climate were independent predictors of higher precaution use. Conclusions: Results emphasize the importance of organizational influence on nurses’ HD safe handling precaution use and suggest fostering a positive workplace safety climate and reducing barriers as interventions.

<p> With the increasing use of technology in the workplace, many jobs are becoming more sedentary. The purpose of this study was to establish a quantitative baseline measure of occupational physical activity (OPA) in active and sedentary workers. Two activity trackers (Fitbit Charge HR&trade; and Hexoskin) were used to assess activity measures (step count, heart rate and energy expenditure) among workers during their work shift. The first objective of the study was to assess the agreement between two types of accelerometer-based activity trackers as measures of OPA. The second objective of this study was to assess differences in measures of OPA among workers in physically active and sedentary work environments. There was a statistically significant difference in measures of total step counts between the two devices. When comparing active and sedentary workers there were also statistically significant differences in measures of step counts, mean percent heart rate increase, maximum heart rate range and energy expenditure. Conclusion: The Fitbit Charge HR&trade; and Hexoskin had significant differences in measures of step counts and heart rate. When comparing active and sedentary workers, there were significant differences in measures of step counts, mean heart rate, maximum heart rate range required by job, and energy expenditure. The results of the present study provide quantitative evidence that active workers require greater physiologic demands than sedentary workers.</p>

This series of studies examined the role of neutrophils and their proteases in Kepone/carbon tetrachloride (CD-CCl4) induced hepatotoxicity leading to mortality. The data demonstrate that neutrophils have an involvement in the hepatotoxicity induced by CD-CCl4, but are not causally linked to mortality. Neutropenia induced in female Sprague-Dawley rats maintained on a 10-ppm Kepone diet for 15 days prior to CCl4 (0.1 ml/kg, IP) reduced the hepatotoxicity by approximately 50%, but did not protect against lethality. A temporal examination of the infiltration of neutrophils demonstrated that neutrophils infiltrate in response to damage with the numbers of neutrophils infiltrating at the same rate regardless of the level of hepatotoxicity and/or mortality. The data also demonstrate that the CD-CCl4 interaction causes a reduction in acute phase proteins. In an attempt to substantiate the importance of the acute phase protein. depletion in the CD-CCl4 interaction, galactosamine (175 mg/kg, IP) was used to reduce the acute phase proteins. The galactosamine (175 mg/kg, IP) did not affect the hepatotoxicity of CCl 4 (0.3 ml/kg or 0.5 ml/kg, IP) in the order of magnitude as the CD diet. Turpentine, a general inducer of the acute phase response, administered 24 hours prior to the CCl4 is protective against both the hepatotoxicity and lethality associated with the CD-CCl4 nteraction. Although turpentine was protective, administering specific acute phase proteins did not demonstrate the same profound protection. [special characters omitted]-1-acid glycoprotein and [special characters omitted]-1-antitrypsin did not significantly reduce the hepatotoxicity and had no effect on the mortality. The combined data substantiates that neutrophils play a role in the interaction, but they are not solely responsible for the observed increases in hepatotoxicity or mortality.

The aim of this dissertation was to develop, demonstrate and evaluate a tendon adaptation model (TAM), which predicts the relative tendon damage incurred by wrist muscles during repetitive wrist motion. This research was divided into three major goals. The first goal was to adapt the muscle model of Loren and Lieber (1995) with an optimization routine in order to predict muscle forces during dynamic motions. The muscle model was combined with the cumulative strain model of Goldstein (1981) and the tendon healing and damage models of Wren, Beaupre and Carter (1998) and Liao and Belkoff (1993) respectively. TAM predicts the amount of tendon adaptation given job/worker specific force, repetition, duration, and anthropometry and wrist posture. Individual components and the entire model were subjected to benchmark tasks to demonstrate how TAM produces muscle forces, tendon strains and damages for a given task. Results showed that the TAM reproduced results found in animal studies. The second goal was to demonstrate the model's capabilities. The first of three experiments was designed to collect maximal contractions at the wrist to determine the maximal strength (PST) of five wrist muscles. The second experiment was designed to evaluate the muscle model under dynamic situations. TAM predicted muscle stimulation patterns were compared to those recorded from subject electromyograms. Predicted stimulation patterns synchronized well with electromyograms but did not match as well in amplitude. The third experiment was designed to collect necessary data over the course of one hour while subjects performed a repetitive wrist flexion task to determine tendon strain parameters K1, K2 and α. The results suggest that subjects change their kinematic and kinetic profiles over the course of an hour to minimize the effects of fatigue and damage. The third goal was to perform a sensitivity analysis on the model by varying the estimated parameters and subject specific measurements. The muscle model was found to be sensitive to the parameter PST. The cumulative strain model was hardly sensitive to the parameter K1 while changes in the parameter α were found to have little effect on ending damage levels for simulations lasting approximately 1 hour.

No description available.

Reflexive and voluntary performance in four test batteries was examined in 12 able-bodied and 12 disabled (6 spinal cord injured, 6 with cerebral palsy) subjects. The batteries, administered pre and post to 4 weeks of training, consisted of tests for patellar tendon tap reflex, phasic vibratory response, knee extension isometric strength, reaction time, and speed of movement. Training involved 120 patellar tendon taps per session, 3 sessions per week. The training patellar taps were paired with an auditory tone; one half of the subjects were trained with a loud (100 db) auditory tone, the remaining were trained with a soft (50 db) auditory tone. No significant difference was observed for reflexive agonist and antagonist EMG amplitude and reflexive peak force during the training or posttraining sessions. The expected habituation of reflexive response was not observed, but the impact force to elicit a maximum reflexive response increased across sessions. These findings suggest that the muscle spindles became less responsive with repeated sessions, but this decreased responsiveness was masked by the increased impact force. Pre to posttraining increases were observed in: tendon tap reflex long motor time and long reflex time; phasic vibratory response; maximum isometric knee extension strength; and velocity of movement in both groups. Posttraining changes in reflexive and voluntary responses were likely due to increased Ia afferent presynaptic inhibition and a more efficient muscle contraction. Auditory effects on reflexive and voluntary responses were mainly limited to a shortening of reaction premotor time especially in the disabled group. The loud tone increased the agonist EMG during the strength test, without a concurrent increase in maximum strength. Between group differences, with regard to spinal and supraspinal influences during the reflex profile, indicated that the gain in reflexive response was greater for the disabled subjects under spinal conditions, and greater for the able-bodied subjects under supraspinal conditions. Another finding revealed greater absolute antagonist reflexive responses, and greater relative antagonist voluntary responses of the disabled group compared to the able-bodied group under all conditions. Adaptations across training sessions and descriptive differences between groups provide insight into future research and rehabilitation strategies.

The focus of this dissertation was to determine whether the values of "Familism", "Religion", and "Personalization of Interpersonal Relations" of Puerto Ricans were related to individuals' participation in their work place health promotion programs. The study was conducted in six private corporations located in the Western New England area which had work place health promotion programs on-site. The sample population of the study consisted of 84 Puerto Ricans working at these organizations. This exploratory study did not deal with hypothesis testing. It set the basis for the formulation of hypothesis to be tested in future research endeavors. The instrument used in this study consisted of a (Likert-Type Scale) questionnaire, in English and Spanish versions, that combined demographic information and the three value clusters of familism, religion and interpersonal relations that were researched. The collected data were submitted to analysis using Statistical Packages for Social Sciences (SPSS). Results indicated that this Puerto Rican population was very young, with 98% falling between 18-to-45-years old. There were 40 females and 43 males, one case missing. The levels of education were low, with 66% having high school or less education; and 66% worked in manufacturing. Overall, there were no gender-based differences in the responses to the questions about values. All participants agreed that their health promotion program did not include activities for the family, and all thought it should do so. In addition, participants agreed that activities were not culturally sensitive, and all thought they should be, including the availability of written materials in Spanish. Responses to questions about religion and interpersonal relations, also showed a disapproval of the health promotion program, since it failed to pay attention to these values in the planning of activities; therefore, negatively influencing the participation of the subjects in the programs. This study was significant because it looked at cultural values as one of the underlying reasons for the lack of participation of Puerto Ricans in health promotion programs. Health promotion programs designers must be culturally sensitive when designing activities for Puerto Ricans, as well as for other special populations. Recommendations for health promotion program planners are offered as first-step solutions to the low participation problem.

The purpose of this study was to decrease the risk of Carpal Tunnel Syndrome (CTS) during keyboard entry tasks through a combination of training, self-monitoring, feedback, goal-setting and reinforcement. A multiple baseline across subjects was used to assess subjects' posture and hand-wrist positions as they entered text on a keyboard. Following baseline data subjects received training and self-monitored either posture or hand-wrist positions. Later feedback, goal-setting, and reinforcement were given on both behaviors in a staggered fashion. The results indicate dramatic increases in both the percentage of posture items performed correctly and the percentage of time hand-wrist positions were at neutral for all subjects. Implications of the results are discussed.

No description available.

No description available.