bluuebunny/crossref_metadata_2025 huggingface dataset:
Heat Sources in a Biosafety Cabinet Compromise Experimental and User Protection
Authors: Held Kara F. , Thibeault Robert , Boudreau Jacqueline
Published: March 2019

Introduction:

Keeping a contamination free environment in the laboratory has commonly been achieved by one of two ways: a flame or a biosafety cabinet (BSC). However, it has been frequently observed that these two practices have been combined, where a heat source has been used within the BSC. As flames require flammable gasses and cause hot air to rise, it was hypothesized that these could lead to a loss of BSC containment, as BSCs rely on unidirectional downflow air.

Objectives:

The objective of this study was to determine whether BSCs can maintain containment when a heat source is operated within the work area.

Methods:

Several heat sources (Bunsen burner, High Heat Bunsen Burner, Spirit Lamp and Bacti-cinerator) were placed within two sizes of BSCs (4-foot and 6-foot), and smoke was used to visualize airflow disturbances, air cleanliness was measured by particle counting , and aerosol microbiological testing was conducted to ascertain containment. The risk of introducing a flammable gas into a BSC was also calculated.

Results:

Large flamed Bunsen burners were found to have the most detrimental effects on the ability of the BSC to maintain containment, especially in the center of the work area, while the smaller heat sources were more variable. Containment was completely lost in the 4-foot BSC, whereas the 6-foot BSC was capable of maintaining containment in only a few conditions. The BSC was also calculated to be able to maintain the required volume of flammable gas needed to operate the burners, not taking into consideration unintended leaks.

Conclusions:

Overall, it was determined that BSCs cannot operate safely and reliably while housing a heat source, as it could cause unexpected contamination of the work or the worker, or BSC ignition or explosion.
Bridging the Gaps Through Nurse-Led Nutrition Education to Underserved Children
Authors: Eanes Linda S. , Fuentes Lilia Azeneth , Bautista Beatriz , Salazar David , Garza Doreen
Published: March 2019

Although children residing in impoverished rural communities located along the Texas-Mexico border are at disproportionately high risk of unhealthy eating, limited resources may prevent devoting sufficient attention to school-based nutrition education. The purpose of this quasi-experimental study was to examine the teaching effectiveness of graduate nursing students on fourth-grade student learning about healthy eating. Purposive sampling was used to select 213 predominately Hispanic fourth-grade students enrolled in one of three low-socioeconomic status underserved elementary schools located in rural South Texas. Ten graduate nursing students implemented the Creating Healthy Eating Choices for Kids Nutrition Curriculum to approximately 40 fourth-graders per group who attended weekly 45- to 50-minute sessions for 6 weeks. The MyPlate standardized tests were administered before and following the intervention. Results showed a significant improvement in learning on all program modules for fourth-graders from each school ( p = .000). Results support the value of creating a strategic partnership between a university school of nursing and key community leaders as a feasible method of providing nutrition education for fourth-graders enrolled in schools with limited resources.
Ultrasound Evaluation for Incomplete Carpal Tunnel Release
Authors: Tulipan Jacob E. , Kachooei Amir Reza , Shearin Jonathan , Braun Yvonne , Wang Mark L. , Rivlin Michael
Published: March 2019

Background: Ultrasound can provide evaluation of the anatomy of the carpal tunnel in a convenient, noninvasive office setting. This study is intended to determine the accuracy and diagnostic performance of ultrasound, used by surgeons, for the evaluation of completeness of carpal tunnel release (CTR). Methods: Ten cadaver arms underwent randomized sectioning of 0%, 25%, 50%, 75%, or 100% of the transverse carpal ligament. Following a brief training session, a blinded observer used ultrasound to evaluate the percentage of the transverse carpal ligament release. The release amount was then confirmed with an open exposure of the transverse carpal ligament. Results: Cronbach α and Pearson correlation coefficients were 0.92 and 0.87, demonstrating excellent reliability and validity of the technique. Diagnostic performance including sensitivity, specificity, positive predictive value, and negative predictive value was 100%, 75%, 86%, and 100%, respectively, for the diagnosis of incomplete release of the transverse carpal ligament by a novice sonographer orthopedic surgeon. Conclusions: The ultrasound is a highly accurate tool for the diagnosis of incomplete transverse carpal ligament release and requires a minimal amount of training to use for this purpose. It provides a rapid means of diagnosing incomplete release of the transverse carpal ligament following CTR.
Longitudinal study of carotid artery bifurcation geometry using magnetic resonance angiography
Authors: Ngo Minh T , Kwak Hyo S , Ho Chung G , Koh Eun J
Published: March 2019

Background and purpose

Carotid artery geometry has been suggested as a risk factor for atherosclerotic carotid disease. Although normal aging and disease development can both lead to geometric changes in the arteries, the exact nature of this phenomenon remains elusive. The aim of our study was to investigate carotid artery geometric changes in a longitudinal study.

Material and methods

We conducted a retrospective study of 114 subjects who underwent carotid contrast-enhanced magnetic resonance angiography at our clinic at baseline (2005 to 2007) and after 10 years. The right ( Rev#2–1) carotid arteries were segmented using semi-automated methods to obtain various measurements of carotid artery geometry. For each patient, these parameters were assessed at both time points, including bifurcation angle, internal carotid artery angle, vessel diameter, and circumference.

Results

The median age for the total patient population ( n = 114) at baseline was 59.06 ± 10.40 years. Mean time interval between baseline magnetic resonance angiography and magnetic resonance angiography after 10 years of these patients was 129.18 ± 7.77 months. For the whole group, there was a significant increase in the bifurcation angle ( p < 0.05) over a 10-year period. A significant increase was also noted in the diameter and circumference of the common carotid artery ( p < 0.05). However, the other vessel diameters and circumferences (bulb carotid, internal carotid) as well as the internal carotid angle did not significantly change ( p ≥ 0.05).

Conclusion

The diameter and circumference of the common carotid artery and bifurcation angle significantly increased over a decade of life.
(In)Animate Semiotics: Virtuality and Deleuzian Illusion(s) of Life
Authors: Roberts Spencer
Published: March 2019

It is well known that, despite his close engagement with cinema, Gilles Deleuze was less concerned with animated film, being somewhat dismissive of its capabilities. In recent years, however, a number of attempts have been made – most notably by William Schaffer, Thomas Lamarre and Dan Torre – to construct Deleuzian positions in animation theory. This article outlines some of these approaches, whilst engaging critically with Torre’s writings. In particular, it foregrounds Torre’s neglect of the post-structural, political dimension of Deleuzian thought through an examination of the concepts of faciality, the close-up, and relation as they occur in Deleuzian and Deleuzo-Guattarian philosophy. This is in part facilitated through a comparison of Stuart Blackton’s Humorous Phases of Funny Faces (1906) – a work directly addressed by Torre, and Emile Cohl’s Fantasmagorie (1908) – a work which he largely passes by. It is claimed here that, despite a number of apparent similarities, the animations of Cohl and Blackton express a radically divergent series of ontological commitments. Cohl offers the audience an experience of chaotic, mutable, relational complexity that revels in its incoherence, whilst Blackton presents a series of more straightforward set pieces, dwelling for the most part upon object-centric representational form. The tension between representation and becoming that occurs between these works is employed to facilitate a critical engagement with Torre’s process-cognitivism. It is suggested that Torre’s work, though exceptional in its pedagogic value, is likewise expressive of this tension, and that in its effort firstly to combine a series of process-philosophical and cognitivist ideas, and secondly to unpack the radical ideas of Deleuze through the more conservative philosophy of Nicholas Rescher, it runs the risk of falling back into a quasi-Kantian philosophy of generality and representation.
Have new map, will travel?
Authors: Castree Noel
Published: March 2019

Harriet Bulkeley identifies a persistent, and misconceived, framing of climate change as a ‘society–nature problem’ (Bulkeley H (2019). Navigating climate's human geographies: exploring the whereabouts of climate politics. Dialogues in Human Geography 9(1): 3–17). While I concur with her diagnosis, her implied cure begins with geographers volunteering to change their intellectual habits by responding to ‘good arguments’. I challenge this cognitivism and ask what sorts of material frameworks for inquiry will engender an embrace of the idea of ‘climate as condition’.
The absences in climate’s human geographies
Authors: Lovell Heather
Published: March 2019

This short commentary explores two absences in Bulkeley’s (2019) human geographies of climate change. First, the absence of other environment problems, signifying how in the debate about climate change our response often acts to crowd out other problems. Second, in considering the temporal boundaries of climate’s human geographies, the absence of the future, which is increasingly being brought into being by scenarios, visualizations and creative works.
A new vocabulary for cultural–economic geography?
Authors: Cook Ian
Published: March 2019

Ibert et al.’s (2019) article is a welcome stimulus to, and a refocusing on, what seem to us to be reasonably well-established problematics and debates. Its arguments seem familiar to us because of our work, since 2011, on the followthethings.com project. From this perspective, their remit for new cultural–economic geography research doesn’t seem cultural enough (what about cultural geography’s recent ‘turn’ towards creative practice?), the publications drawn upon seem unnecessarily traditional (what about geography’s ongoing ‘turn’ towards digital practice and ‘natively digital’ outputs?), and the research practices needed for the work that is outlined seem undeveloped (what can we learn about capitalism’s ‘dark’ places and strategies of association and dissociation from, among others, creative digital practice?). Digital outputs such as followthethings.com risk being bypassed by more traditional practices of academic review, and our insistence that it should ‘stand on its own’ without accompanying academic papers doesn’t, admittedly, help. So, in this response, we have chosen to engage with the anchor article’s main themes and arguments by sketching out our parallel world of ongoing research in which strategies and vocabularies of dissociation feature strongly. What we conclude is that both of our projects could be seen to be working towards the same goal: to assemble a new vocabulary that is better suited for the analysis of this area of cultural–economic geography. We’d like to collaborate on this with Ibert et al. ((2019) Geographies of dissociation: value creation, ‘dark’ places, and ‘missing’ links. Dialogues in Human Geography.) and anyone else who’s interested.
Positioning and ‘doing’ geographies of dissociation
Authors: Ibert Oliver , Hess Martin , Kleibert Jana , Müller Felix , Power Dominic
Published: March 2019

Inspired by five commentaries on our forum article, in this response article we elaborate on three points related to geographies of dissociation, namely positioning dissociation, dealing with plurality and moving from agenda-setting to empirical research. In order to assess the validity of critique elaborated in the commentaries, we specify the contribution we seek to make. Geographies of dissociation aim to contribute to a strand of cultural economic geography that has become increasingly interested in the social construction of symbolic value but that still lacks a conceptual vocabulary for addressing the loopholes and missing links in these relational webs and their related geographies. We explain how geographies of dissociation build on pluralism without ignoring epistemological frictions. Furthermore, we discuss how geographies of dissociation might inspire political economic approaches and future empirical research.
Use of a subcutaneous ureteral bypass device for treatment of bilateral proximal ureteral injury in a 9-month-old cat
Authors: Sapora Joseph A , Hardie Robert J , Evans Natashia
Published: March 2019

Case summary

A 9-month-old male domestic longhair cat presented following iatrogenic ureteral trauma after an attempted laparoscopic ovariectomy. Prior to identifying that the cat was male, both ureters were transected approximately 4 mm from the renal pelves. Initial management involved a left-sided Boari flap neoureterocystostomy, cystonephropexy and right ureteronephrectomy. Thirty-six hours later, the cat developed uroabdomen due to leakage from the neoureterocystostomy site. At a tertiary referral institution, the ureter was reconstructed via end-to-end anastomosis and a left-sided subcutaneous ureteral bypass (SUB) device was placed in the event the anastomosis failed. Five weeks after SUB placement, the cat was dysuric and stranguric. A urine culture was negative and clinical signs were attributed to sterile cystitis secondary to device placement. Blood urea nitrogen (BUN) was 22 mg/dl and creatinine was 1.2 mg/dl. Contrast pyelography confirmed device patency, but no contrast was identified through the ureteral anastomosis. At 12 months, BUN and creatinine were 1.5 mg/dl and 25 mg/dl, respectively, and a subclinical urinary tract infection was identified ( Enterococcus faecalis). Antibiotic therapy was not prescribed in order to prevent multidrug resistance. At 42 months, BUN was 38 mg/dl and creatinine was 2.0 mg/dl. The cat had occasional and intermittent signs of pollakiuria and stranguria but was otherwise doing well.

Relevance and novel information

To our knowledge, this is the first case report to describe the use of a SUB device for management of traumatic proximal ureteral injury in a cat with one kidney. The case outcome provides valuable information about the direct effect of the SUB device and the presence of chronic Enterococcus species infection on long-term renal function.
How is Case Management Used with Substance Abuse Cases?
Authors: Kalina Christine M. , Haag Annette B. , Tourigian Robin , Wassel Mary Lou
Published: March 2019

Panel members come with expertise from a variety of case management arenas and have agreed to share their opinions and perspectives in response to specific questions or scenarios. Opinions and perspectives are those of the panel members, and do not necessarily represent the views of the AAOHN, the Editor, or the Publisher. We encourage readers to submit their questions or scenarios for the Panel. This month's Panel members include Christine M. Kalina, Annette B. Haag, Robin Tourigian, and Mary Lou Wassel.
Nurses' Perception of Their Work Environment, Health, and Well-Being
Authors: Geiger-Brown Jeanne , Trinkoff Alison M. , Nielsen Karen , Lirtmunlikaporn Sumalee , Brady Barbara , Vasquez Elias I.
Published: March 2019

The purpose of this analysis was to identify themes nurses expressed in open-ended comments at the end of a working conditions survey related to their work environment, health, and well-being. The nursing shortage, downsizing, and long working hours create challenges for nurses trying to deliver quality client care. In addition, nurses are experiencing high levels of physical injury in their work environments. Injuries on the job have led nurses to leave the workplace. Free form comments offered at the completion of a mailed survey of RNs were analyzed for content. Randomly selected nurses from two U.S. states were surveyed in 1999 and 2000 about their jobs with special reference to neck, shoulder, and back pain and disorders. Of the 1,428 respondents, 309 produced usable comments for this content analysis. Constant comparative analysis was used to identify themes present in these comments. The themes addressed in the nurses' comments included excessive work demands, injustice or unfairness, and nurses' personal solutions to their work environments. Based on the issues raised in the themes, recommendations are provided for improving retention while promoting nurses' health and well-being.
Cardiovascular Risks in Firefighters
Authors: Byczek Lance , Walton Surrey M. , Conrad Karen M. , Reichelt Paul A. , Samo Daniel G.
Published: March 2019

Limited cardiovascular risk data are available for firefighters. This cross sectional study of data collected during annual physical examinations described the prevalence of cardiovascular risk factors among firefighters (N = 200) and examined relationships between body mass index (BMI) and other cardiovascular risk factors. Evidence based guidelines were used to determine prevalence of cardiovascular risk factors and Framingham risk scoring was used to estimate probability of coronary heart disease (CHD). Firefighters ranged in age from 22 to 64 with a mean of 41. The prevalence of obesity, elevated total cholesterol, and elevated blood pressure in firefighters exceeded Healthy People 2010 targets. In addition, their prevalence of obesity, low high density lipoprotein (HDL), high low density lipoprotein (LDL), and high total cholesterol levels was higher relative to the general population. Elevated body mass index (BMI) values had positive significant (p ≤ .01) associations with elevated blood pressures, triglycerides, and glucose levels, and a negative significant (p < .05) association with lower HDL cholesterol levels. Fire department worksite health and fitness policies and programs should proactively target firefighters’ cardiovascular risks. Future firefighter related intervention research will benefit from considering not only the individual determinants of cardiovascular disease, but also the ecological framework that includes the influences of workplace and external environmental factors.
Garment Workers in California: Health Outcomes of the Asian Immigrant Women Workers Clinic
Authors: Burgel Barbara J. , Lashuay Nan , Israel Leslie , Harrison Robert
Published: March 2019

In this cross sectional descriptive study, the demographics, risk factors, and health outcomes of a volunteer, symptomatic sample of monolingual Cantonese garment workers in the Oakland, California Chinatown area are documented. Methods included a questionnaire and clinical examination and treatment at the Asian Immigrant Women Workers Clinic, a free clinic providing culturally focused occupational health consultation and treatment for painful musculoskeletal disorders. Because garment work involves highly repetitious, sustained awkward postures, focused education on stretching and ergonomics also was provided. Results from the first 100 clients revealed a highly symptomatic sample, with an average age of 48.7 years. Sixty-six percent rated their health status as fair or poor. Sixteen percent of the sample had nerve entrapments, and 99% had a diagnosed strain or sprain of the spine or upper extremities. This population did not file workers' compensation claims because of a lack of knowledge and a fear of reprisal. This study documented the barriers to seeking care for this low wage, immigrant population.
Impact of Converting to Powder-Free Gloves: Decreasing the Symptoms of Latex Exposure in Operating Room Personnel
Authors: Korniewicz Denise M. , Chookaew Nantiya , Brown Jeanine , Bookhamer Nichol , Mudd Kim , Bollinger Mary Elizabeth
Published: March 2019

This study examined health care worker satisfaction with the use of non-powdered natural rubber latex (NRL) surgical gloves to determine the impact of non-powdered NRL gloves on the NRL sensitization of operating room personnel. The study used a 1-year longitudinal design to obtain recall information from employees about their NRL exposure. Additionally, a survey was completed by participants related to their satisfaction with non-powdered NRL gloves. Informed consent was obtained from 103 employees. After conversion to an operating room using non-powdered NRL, there was a significant decrease in reported symptoms with NRL exposure (42% pre- and 29% post-conversion, Fisher's exact, two-tailed, p = .0001). This study demonstrated that the conversion to non-powdered low-protein NRL gloves resulted in decreased symptoms because of NRL exposure.
Environmental Health and Nursing: Piloting a Technology-Enhanced Distance Learning Module
Authors: Olson Debra , Stedman-Smith Maggie , Fredrickson Ann
Published: March 2019

The results of a pilot study evaluating a technology-enhanced distance learning module to impart environmental health core concepts to nurses are presented in this article. The internet-based module was developed for continuing professional education and imparts principles of adult education through interactive features including simulated clinical vignettes, an environmental justice case study, and hyperlinks to websites related to environmental protection and health regulation. Mean gains between pre- and post-tests; participant identification of adult learning principles as advanced by Knowles, Holton, and Swanson (1998); and satisfaction were measured among participating RNs (N = 34). A 6% mean gain in learning occurred between pre- and post-tests (95% CI .51 to 1.37, p < .0001). No significant differences in learning occurred for those who prefer face-to-face instruction and those who tend to procrastinate. Ninety-four percent of respondents indicated they were satisfied or very satisfied with the module. A strong association was found between recognition of adult learning principles as enhancing the assimilation of knowledge and competencies of environmental health and high satisfaction with the module. Distance learning via the Internet shows promise as a format to promote environmental health education for nurses.
Injuries and Assaults in a Long-Term Psychiatric Care Facility: An Epidemiologic Study
Authors: Myers Douglas , Kriebel David , Karasek Robert , Punnett Laura , Wegman David
Published: March 2019

The objectives of this study were to document the high rates of acute injuries and physical assaults among nurses and certified nursing assistants working in long-term psychiatric care facilities and to identify risk factors for assaults and injuries to inform prevention strategies. A mixed-design cohort study was conducted. Acute injury and physical assault data were obtained from administrative records. Using staff rosters and schedule records, incidence rates were calculated by job title, gender, shift, and floor. Rates were also reported by severity, body part, type, and nature. Targeted interviews with staff members provided measures of physical lifting and resident combativeness. Injury rates were calculated by degree of lifting and assault rates were calculated by degree of resident combativeness. Overall rates of injuries (55.6 per 100 person-years) and assaults (67.3 per 100 person-years) were substantially higher than expected. Predictably, injuries were associated with resident lifting and assaults were associated with contact with combative residents. A higher risk of assault was found among women and higher risks of injury and assault were observed among full-time employees compared to per diem or pool agency workers. In addition, weekend shifts were found to have a higher rate of injuries and a lower rate of assaults than weekday shifts. In similar longterm care facilities with psychiatric populations, efforts should be made to reduce lifting and avoid circumstances that agitate residents. Work organization factors should be taken into consideration when developing interventions.
Cost-Effectiveness Analysis of a Worksite Clinic: Is it Worth the Cost?
Authors: Chenoweth David H. , Garrett Judy
Published: March 2019

This study assessed the cost-effectiveness of a worksite clinic. In-house clinic operational costs were compared to off-site (i.e., community) health care costs during a 1-year time frame. Community cost norms were extracted from statewide databases and adjusted to local costs. Lost productivity costs were based on survey feedback from current clinic users, which included their estimated time away from work if they had to seek health care off-site, average hourly wages, and the number of actual treatments rendered by the on-site staff. Combined off-site costs of $224,461 (health care) and $113,883 (lost productivity) were nearly twice as high as actual on-site operational costs ($171,332). Overall, it appears the organization's worksite clinic provides employee health care services 2 to 3 times more cost-effectively than do off-site health care services.
Relationship between Job Dissatisfaction and Physical and Psychological Health among Filipino Immigrants
Authors: Strasser Patricia B. , de Castro A. B. , Gee Gilbert C. , Takeuchi David
Published: March 2019

This study investigated the relationship between job dissatisfaction and psychological and physical health among Filipino immigrants in the United States. Cross-sectional data from the Filipino American Community Epidemiological Study were analyzed for 1,381 Filipino immigrants. The primary independent variable of interest was job dissatisfaction. Linear and negative binomial regression analyses were conducted to determine separate associations between job dissatisfaction and the outcomes of psychological distress and physical health conditions, respectively. Job dissatisfaction was positively associated with both psychological distress (β = 0.32, p < .001) and physical health conditions (β = 0.42, p < .001), controlling for sociodemographic variables such as age, gender, education, income, and job category. This community-based study demonstrated that job dissatisfaction has implications for health and well-being among an understudied, immigrant group of workers. Findings also suggest that job-related experiences should be considered when examining disparate health for immigrant, minority populations.
How Can Case Managers Incorporate Health Promotion into Their Practices?
Authors: Kalina Christine M. , Haag Annette B. , Brown Norman DePaul
Published: March 2019

The panel approach provides a forum for sharing ideas, viewpoints, and perspectives. Panel members come with expertise from a variety of case management arenas and have agreed to share their opinions and perspectives in response to specific questions or scenarios. Opinions and perspectives are those of the panel members, and do not necessarily represent the views of AAOHN, the Editor, or the Publisher. We encourage readers to submit their questions or scenarios for the panel. This month's panel members include Christine M. Kalina, Annette B. Haag, and Norman DePaul Brown.
Weight Gain among Women during Smoking Cessation
Authors: Chaney Susan E. , Sheriff Susan
Published: March 2019

Cigarette smoking continues to be the leading preventable cause of chronic illness in the United States. A high percentage of smokers attempt to quit each year; however, smoking cessation success rates are low. Adding an exercise program to traditional therapies can increase smoking cessation rates among women. An experimental design was used to test two hypotheses. The first was that women who engage in a multifaceted approach to smoking cessation that includes a structured exercise program, nicotine replacement therapy (NRT), and weekly counseling sessions will experience less weight gain during an 8-week smoking cessation program and at the 4-month follow-up session than women who engage in NRT and weekly counseling sessions alone. The second was that women who engage in a structured exercise program with NRT and weekly counseling sessions will have higher smoking cessation rates at the end of the 8-week smoking cessation program and at the 4-month follow-up session than women who engage in NRT and weekly counseling sessions alone.
Domestic Violence Screening and Treatment in the Workplace
Authors: Felblinger Dianne M. , Gates Donna
Published: March 2019

The purpose of this study was to survey occupational health nurses about their perceived ability to screen for and treat domestic violence in the workplace. Occupational health nurses providing direct care or case management anonymously responded to the mailed Occupational Health Nurses' Survey on Screening for Domestic Violence in the Workplace. Findings indicate that occupational health nurses consider domestic violence screening and treatment to be components of their nursing role, but do not believe they have adequate training to competently care for workers who have experienced domestic violence. The occupational health nurses also did not believe policies existed in their workplace to assist them in treating these workers. Findings from this study can be used as the foundation for domestic violence education, policy development, and intervention research.
If Case Management Services are Outsourced, What Should Be Included in the Service Agreement?
Authors: Brown Norman DePaul , Sliski Susan Katz
Published: March 2019

The panel approach provides a forum for sharing ideas, viewpoints, and perspectives. Panel members come with expertise from a variety of case management arenas and have agreed to share their opinions and perspectives in response to specific questions or scenarios. Opinions and perspectives are those of the panel members, and do not necessarily represent the views of AAOHN, the Editor, or the Publisher. We encourage readers to submit their questions or scenarios for the panel. This month's panel members include Norman DePaul Brown and Susan Katz Sliski.
The Potential Toxicity of Artificial Sweeteners
Authors: Whitehouse Christina R. , Boullata Joseph , McCauley Linda A.
Published: March 2019

Since their discovery, the safety of artificial sweeteners has been controversial. Artificial sweeteners provide the sweetness of sugar without the calories. As public health attention has turned to reversing the obesity epidemic in the United States, more individuals of all ages are choosing to use these products. These choices may be beneficial for those who cannot tolerate sugar in their diets (e.g., diabetics). However, scientists disagree about the relationships between sweeteners and lymphomas, leukemias, cancers of the bladder and brain, chronic fatigue syndrome, Parkinson's disease, Alzheimer's disease, multiple sclerosis, autism, and systemic lupus. Recently these substances have received increased attention due to their effects on glucose regulation. Occupational health nurses need accurate and timely information to counsel individuals regarding the use of these substances. This article provides an overview of types of artificial sweeteners, sweetener history, chemical structure, biological fate, physiological effects, published animal and human studies, and current standards and regulations.
Business Traveler Fitness
Authors: Tompkins Olga S.
Published: March 2019

Occupational and environmental health nurses can counsel employees who travel about remaining healthy and fit on the road.
Development and Evaluation of a Women's Health Support System at a Japanese Company
Authors: Ariyoshi Hiromi
Published: March 2019

This research was designed to evaluate a work environment in which all female employees can work safely and comfortably by developing a health support system for women in the workplace. With consent from management, the occupational health nurse invited an OB/GYN physician, contracted from outside the company, to act as a specialist adviser. Because health-related concerns unique to women are sometimes difficult to differentiate from mental health issues, a health management system was developed to ensure that the psychological health of workers is promoted and maintained. After development of this system, case studies were reviewed and evaluated for menstrual disorders, perinatal health management, and menopausal disorders. Intraoffice cooperation and support were garnered from the Personnel Department, the Sexual Harassment Measures Committee, the industrial physician, and the Health and Safety Committee. In addition, through the review of the case studies, the roles for care on every level were clarified. The number of female employees who opted for early retirement due to menstrual disorders, miscarriage, or menopausal disorders was also reduced. It is believed that as a result of this study, a health management system for health-related concerns unique to women and based on mental health care measures in the workplace was developed and supportive measures were practiced. In the future, it will be important to continue to comprehensively view and create a work environment in which all female staff members can work safely and comfortably.
Strategies and Tools to Reduce Workplace Violence
Authors: Gallant-Roman Mary A.
Published: March 2019

The U.S. health care system is in the beginning of a crisis that can barely be comprehended. If projections are accurate, the demand for nurses will increase 40% and a 400,000-hour full-time equivalent registered nurse shortfall will occur by 2020. Not only are nurses leaving the field, but fewer candidates are entering. The reasons are unclear, but research has shown that nursing is a dangerous occupation—four times more dangerous than most other occupations. Protection from an unsafe workplace is guaranteed under Occupational Safety and Health Administration regulations, and many national and international groups call for zero tolerance of workplace violence. Health care worksites must develop specific plans to minimize and prevent workplace violence. Additional research is necessary to determine which methods are most effective. This article examines the necessary components of a workplace violence prevention program.
When a Coworker Completes Suicide
Authors: Lynn Cynthia W.
Published: March 2019

The suicide death of a coworker is considered a psychiatric emergency for nurse managers and coworkers left to process the feelings associated with this type of grief. The occupational health nurse can assist nurse managers and coworkers in the grieving process. It is critical for the occupational health nurse to understand the psychological, social, and emotional implications for coworkers (suicide survivors) left to grieve the loss. Appropriate support and guidance immediately following the suicide death of a coworker will assist individuals through the normal grieving process and avoid suppressed emotions that may lead to personal and departmental dysfunction.
Working through a Migraine
Authors: Weiss Marjorie D. , Bernards Penny , Price Steven J.
Published: March 2019

The financial and personal impact of migraines in the workplace is substantial. Effective management of workplace migraines includes screening, prevention, and effective treatment. Worksite screeners are available to detect the burden of undiagnosed migraine in the workplace. Decreasing the personal and financial impact of migraines in the workplace requires a variety of strategies predicated on collaborative efforts among workers, occupational health nurses, other providers, and management.
Sustaining a Healthy Work Force in the 21st Century—A Model for Collaborating Through Reciprocation
Authors: Strasser Patricia B. , Thomason Diane L. , Lagowski Lisa R.
Published: March 2019

Occupational health nurses are positioned to restore and maintain worker health, well-being, and safety, thereby increasing productivity. A model of practice is needed that provides a comprehensive worker-environment perspective. A model that incorporates reciprocation and collaboration increases workers' engagement in their own health action plan. It empowers workers and provides a broader multidimensional perspective on factors affecting or influencing their health. The Reciprocation Model has been designed using the nursing process; it incorporates reciprocation and collaboration to assist occupational health nurses improve or maintain worker health and safety, as well as achieve corporate goals of reducing on-the-job lost time and increasing productivity.
Part II. Returning to Work following Bariatric Surgery
Authors: Dugan Susan
Published: March 2019

Recovery from bariatric surgery is a slow process requiring lifestyle change that extends to the workplace.
Safety Certification—A Path to Job Security and Personal Growth
Authors: Strasser Patricia B. , Budde Sarah R.
Published: March 2019

In 2005, the American Board for Occupational Health Nurses, Inc. introduced a new credential in safety management for certified occupational health nurses. To date, 11 nurses have attained this credential and several of those have advanced to the Certified Safety Professional designation. This article discusses the certification process and its benefits. It also discusses problems in the application process observed by the administrators, and offers suggestions to prepare for the examination. Nurses who have attained the Safety Manager credential were surveyed for advice to those considering certification.
Worksite Wellness
Authors: Berryman Phyllis , Lukes Eileen , Fritsch Michelle A. , Montpellier Julie , Kussman Cyra
Published: March 2019

A 7-month intervention was undertaken to determine the impact of education and coaching on lifestyle choices and lipid values among employees with hyperlipemia. Four classes over 2 months at the worksite during work time and two telephone interventions were provided with pre, mid, and post data collection. Total cholesterol and low-density lipoprotein values improved during the intervention. Positive lifestyle changes were made involving exercise and diet. Appropriate physician visits and continuous health care increased. Lipid-based interventions at the worksite can elicit positive changes in lifestyle, appropriate health care use, and improved lipid values.
Workplace Incivility, Bullying, and Mobbing
Authors: Wachs Joy
Published: March 2019

Incivility, bullying, and mobbing at the workplace negatively impact the company and the work force.
Measles, Mumps, Rubella, and Varicella Immunization Status of First Responders—A Policy Proposal
Authors: Nord Dana Drew , Childre Frances
Published: March 2019

The responsibility of occupational health nursing often extends to the communities that workers serve. This is especially true for first responders (i.e., firefighters, paramedics, and emergency medical technicians) and their measles, mumps, rubella, and varicella status.
Using Aspirin to Prevent Cardiovascular Disease in Adults
Authors: Chalupka Stephanie
Published: March 2019

New recommendations provide more age- and sex-specific guidance for using aspirin to prevent myocardial infarction or stroke.
A Biopsychosocial Perspective on the Management of Work-Related Musculoskeletal Disorders
Authors: Noonan Joanna , Wagner Shannon L.
Published: March 2019

This article provides an overview of current literature about workplace-related musculoskeletal disorders from a biopsychosocial perspective. The authors conclude that disability management and early intervention efforts can only be meaningful within the context of targeted interventions, including mechanisms for psychosocial screening. In addition, they suggest that return to work should be considered an integral, rather than superficial, contribution to the rehabilitative process.
Role of Imaging in Breast Cancer Detection
Authors: Giurescu Marina E. , Hu Tilina , Obembe Olufolajimi
Published: March 2019

This article reviews the role of imaging (i.e., mammography, ultrasound, magnetic resonance imaging) in breast cancer detection. Screening and diagnostic indications are outlined for each modality. New mammography screening guidelines are discussed, and risk factors for breast cancer are included.
Feedback Actigraphy and Sleep among Long-Haul Truck Drivers
Authors: Heaton Karen L. , Rayens Mary Kay
Published: March 2019

This pilot intervention study evaluated the effect of feedback actigraphy on sleep and sleep-related variables in a group of long-haul truck drivers. Visual feedback from actigraphs provided cues to the truck drivers, alerting them to their accumulated sleep times. Exposure to the cues was hypothesized to lead truck drivers to modify their behavior and result in improvement in sleep and sleep-related variables. It was predicted that exposure to feedback actigraphy would be associated with more sleep (quantity), better sleep (quality), a more positive attitude toward sleep, less subjective sleepiness, and increased control over sleep behavior by the sample.
Sleep Deprivation and Psychomotor Performance among Night-Shift Nurses
Authors: Johnson Arlene L. , Brown Kathleen , Weaver Michael T.
Published: March 2019

This study examined how sleep deprivation influenced psychomotor performance of nurses who worked the night shift. Psychomotor performance was measured with the d2 Test of Attention, which quantifies attention, concentration, processing speed, and quality of performance. A sample of 289 licensed nurses was tested with the instrument. Fifty-six percent of the sample was sleep deprived. Mean psychomotor performance scores (26.6 for men and 11.4 for women) were above the normative means (44.4 for men and 41.03 for women). A significant ( p < .0001) inverse relationship was found between psychomotor performance and hours of sleep. Nurses reported more hours of sleep on a general self-report sleep item than in a sleep diary.
Bisphenol A—A Precautionary Approach
Authors: Chalupka Stephanie
Published: March 2019

CDC research found detectable levels of bisphenol A (BPA) in samples from 93% of individuals 6 years and older.
Radiofrequency Catheter Ablation for Atrial Fibrillation
Authors: Chalupka Andrew N.
Published: March 2019

Radiofrequency catheter ablation can lead to improvements in morbidity and mortality rates and quality of life for individuals with atrial fibrillation.
Bullying in the Workplace—A Qualitative Study of Newly Licensed Registered Nurses
Authors: Simons Shellie R. , Mawn Barbara
Published: March 2019

Bullying in the workplace is associated with negative job satisfaction and retention. It has also been found to have adverse effects on the health of employees. Using a qualitative descriptive design, this study examined the stories of bullying among nurses based on actual or witnessed experiences. One hundred eighty-four newly licensed U.S. nurses responded to an open-ended question on a survey about bullying mailed to their homes. Four major themes emerged that related to varying types of bullying behaviors, perceived causes of bullying, and the impact of bullying behaviors. The themes included structural bullying; nurses “eating their young”; being out of the clique; and leaving the job. Bullying is experienced firsthand and secondhand by nurses, and particularly by vulnerable, newly graduated nurses. Workplace bullying must be explored fully to develop effective strategies to eliminate it.
Seeking Balance
Authors: Litchfield Sheila M.
Published: March 2019

This column is intended to offer a mini break from stress, and to be a gentle reminder to seek balance daily to ensure the nurse will be effective when needed.
Thai Nursing Students' Knowledge and Health Beliefs about AIDS and the Use of Universal Precautions
Authors: Earl Catherine E.
Published: March 2019

This study examined Thai nursing students' knowledge and health beliefs about the use of universal precautions to prevent infections, particularly HIV. After providing informed consent, 26 nursing students participated in the study. The students responded to a questionnaire with four sections: demographics, education, knowledge about universal precautions and transmission of HIV, and health beliefs. Students had substantial knowledge about the transmission of HIV; however, they were not confident in the use of universal precautions to prevent transmission. This research will assist occupational health nurses in hospitals and educational institutions develop programs to enhance skills and attitudes to prevent HIV infection.
Vaccine Cold Chain
Authors: Rogers Bonnie , Dennison Kim , Adepoju Nikki , Dowd Shelia , Uedoi Kenneth
Published: March 2019

The Centers for Disease Control and Prevention reports that professionals in clinic settings may not be adequately storing and handling vaccine, leading to insufficient immunity of vaccinated individuals. This article provides information about proper cold chain storage and handling of vaccine and offers resources to begin, or reinforce, proper procedures in the occupational health unit to secure an effective immunization program.
The Stealth Expatriate
Authors: Tompkins Olga
Published: March 2019

Global business practices have created a new category of worker, the stealth expatriate. Tax, immigration, and political risks exist for corporations that do not track this type of worker. Critical implications exist for occupational health nurses in the areas of travel health, fitness for duty, and emergency response.
Social Media
Authors: Lukes Christine A.
Published: March 2019

Various social media sites, including Facebook, have become part of everyday life. They are used by individuals of all ages and are even favored by companies and organizations as a promotional mechanism. Professional organizations, including the American Association of Occupational Health Nurses, Inc., would be remiss to overlook the potential of social media.
Why Breastfeeding Matters to Occupational Health Nurses and Employers
Authors: Rietz Melissa Foster , McCullagh Marjorie C.
Published: March 2019

Women with children are the fastest growing segment of the U.S. work force. Employers must comply with the 2010 Patient Protection and Affordable Care Act, requiring them to provide acceptable facilities for breastfeeding employees. This article discusses resources for examining the economic costs and benefits of becoming a breastfeeding-friendly organization, current legislation affecting breastfeeding women in the workplace, resources related to breastfeeding, and recommendations for initiating and managing a workplace lactation program. Research demonstrating the effects of lactation programs on health care and employee replacement costs (i.e., recruiting, hiring, and training staff) is reviewed. Implementation issues are discussed, including providing breastfeeding women with sufficient time, adequate space, and support from employers and coworkers. The role of occupational health nurses in initiating and coordinating workplace lactation programs is also discussed.
Preventing Bedbug Infestation
Authors: Chalupka Stephanie
Published: March 2019

Bedbugs are increasingly encountered in hotels, motels, office buildings, movie theaters, and modes of transport—anywhere the turnover of occupants is constant.
Giving and Receiving—A Time for All Things
Authors: Litchfield Sheila M.
Published: March 2019

Life can change in an instant, leaving you wondering what lesson is to be learned. My recent accident curtailed a frenetic schedule and forced an uninvited reprioritization of activities. However, I am finding some special moments that otherwise might have gone unseen or not happened at all. This article is a personal exploration of the frustrations and rewards of time necessarily spent recuperating.