Kontrola, tehnologija i mehanizam djelovanja izloženosti prašini i plinovima na plućnu funkciju

In an earlier investigation, a major temporary effect on the lung function was determined, with a spirometer, in stevedoors on a ro-ro-ship exposed to diesel exhausts from trucks during a work shift. In the present study all the trucks used aboard were equipped with especially designed micro-filters mounted on the exhaust pipes. When the filter was in use, no significant effect on the lung function was measured. The removal of the particulate fraction of the exhausts by filtering modified, or possibly eliminated, the effect observed earlier. In designing an indicator of the biological effects of diesel exhausts the particle fraction should be taken into consideration.U prijašnjem istraživanju nađen je značajan prolazni učinak ispušnih plinova kamiona na plućnu funkciju radnika za vrijeme smjene. U sadašnjem istraživanju svi kamioni imali su specijalne mikro filtre pričvršćene na ispušne cijevi. Pri upotrebi filtara nije primijećeno značajno djelovanje ispušnih plinova na plućnu funkciju. Uklanjanje određenog dijela plinova promijenilo je ili sasvim eliminiralo djelovanje koje je prije primijećeno. Stoga bi pri stvaranju indikatora za biološko djelovanje osobitu pažnju trebalo obratiti na tu frakciju ispušnih plinova dizel-goriva

Samvariation med brottsdata, demografiska och ekonomiska data.

Rapporten presenterar ett sätt att söka riskfaktorer för arbetsskador och trafik-skador i historiskt material. Korrelations- och regressionsanalyser har utförts med tidsserier av anmälda fall av arbetsskador och trafikskador, som beroende variabler; skadevariablerna. Oberoende variabler har varit tidsserier av observationer, som kan antas vara korrelerade med skadevariablerna; prediktorvariablerna. Resultaten visar att arbetsskador och trafikskador är korrelerade med tillgreppsbrott, bedrägeri och narkotikabrottslighet. Arbetsolyckor samvarierar med invandring. Alla skadetyper samvarierar med alkoholbruket i samhället (mätt som antal anmälda rattfylleribrott). Arbetsolyckor, arbetssjukdomar och trafikdödade samvarierar med utomhustemperaturen. Resultaten pekar ut ett antal samband för vidare undersökningar av möjliga orsakssamband. Metoden bör kunna användas för undersökningar med andra prediktorvariabler än de hittills studerade

Custodian for elderly with memory impairment in Sweden – a study of 260 physicians’ statements to the court

BACKGROUND: In the modern world with new family structures, international migration and increased life expectancy, there is a growing need for legal ways of assisting elderly with impaired mental capacity to decide about their life and assets. There are few studies about the physician’s role when a court appoints proxies for vulnerable elderly. Many doctors do not know how to assess mental capacity, and most lawyers and judges know little about medicine. METHODS: Applications for a custodian sent to the Stockholm Chief Guardian’ Office in Sweden were used. Physician’s statements to the court for elderly with memory impairment were selected and 260 statements were scrutinized with regard to formal quality, the narrative content and the physician who wrote it. RESULTS: The quality of the statements varied from one sentence to excellent. Most statements were written by senior family practitioners or geriatricians. Seventeen % of the statements were handwritten and had more formal shortcomings than machine/computer written statements. The majority of patients needed massive help with daily life and economy. Median age was 84 years of age. MMSE score was given in 20% of the cases and varied from 6–27.A diagnosis of dementia was established in 57%. At the time of application, at least 48% were in a hospital or nursing home and at least 27% were in their private home. Only 5% were living with a spouse or a child. In 53% of the cases, the doctor knew the patient, but in 40% of the cases, the identity of the patient was not confirmed. The physician found that 54% were unable to understand the idea of getting a custodian, but out of those very vulnerable elderly, 20% had signed consent and 57% were considered able to be heard in court. CONCLUSIONS: There is a large variation in the quality of physicians’ statements to the court concerning the mental capacity of elderly patients with cognitive impairment. Many statements have serious short-comings, and the system is not safe. There is a strong need for guide-lines, and additional training for all professionals involved

Factors associated with medication adherence in older patients: A systematic review

OBJECTIVE: Medication adherence is a major challenge in the treatment of older patients; however, they are under‐represented in research. We undertook a systematic review focused on older patients to assess the reasons underlying non‐adherence in this population. METHODS: We searched multiple electronic databases for studies reporting reasons for non‐adherence to medication regimens in patients aged 75 years and over. Our results were not limited to specific diseases, health‐care settings, or geographical locations. The quality of eligible studies was assessed using the Newcastle‐Ottawa Scale. A narrative synthesis of findings was performed. RESULTS: A total of 25 publications were included, all of which were in community settings. Frequent medication review and knowledge regarding the purpose of the medication were positively associated with adherence. Factors associated with poor adherence were multimorbidity, cognitive impairment, complex regimens with multiple prescribing physicians, and problems with drug storage or formulation. CONCLUSION: These findings suggest that interventions to improve adherence could focus on medication review aimed at simplifying regimens and educating patients about their treatment. Groups with poor adherence that may benefit most from such a model include patients with multiple comorbidities and cognitive impairment

Nurse prescribing of medicines in Western European and Anglo-Saxon countries: a systematic review of the literature

<p>Abstract</p> <p>Background</p> <p>A growing number of countries are introducing some form of nurse prescribing. However, international reviews concerning nurse prescribing are scarce and lack a systematic and theoretical approach. The aim of this review was twofold: firstly, to gain insight into the scientific and professional literature describing the extent to and the ways in which nurse prescribing has been realised or is being introduced in Western European and Anglo-Saxon countries; secondly, to identify possible mechanisms underlying the introduction and organisation of nurse prescribing on the basis of Abbott's theory on the division of professional labor.</p> <p>Methods</p> <p>A comprehensive search of six literature databases and seven websites was performed without any limitation as to date of publication, language or country. Additionally, experts in the field of nurse prescribing were consulted. A three stage inclusion process, consisting of initial sifting, more detailed selection and checking full-text publications, was performed independently by pairs of reviewers. Data were synthesized using narrative and tabular methods.</p> <p>Results</p> <p>One hundred and twenty-four publications met the inclusion criteria. So far, seven Western European and Anglo-Saxon countries have implemented nurse prescribing of medicines, viz., Australia, Canada, Ireland, New Zealand, Sweden, the UK and the USA. The Netherlands and Spain are in the process of introducing nurse prescribing. A diversity of external and internal forces has led to the introduction of nurse prescribing internationally. The legal, educational and organizational conditions under which nurses prescribe medicines vary considerably between countries; from situations where nurses prescribe independently to situations in which prescribing by nurses is only allowed under strict conditions and supervision of physicians.</p> <p>Conclusions</p> <p>Differences between countries are reflected in the jurisdictional settlements between the nursing and medical professions concerning prescribing. In some countries, nurses share (full) jurisdiction with the medical profession, whereas in other countries nurses prescribe in a subordinate position. In most countries the jurisdiction over prescribing remains predominantly with the medical profession. There seems to be a mechanism linking the jurisdictional settlements between professions with the forces that led to the introduction of nurse prescribing. Forces focussing on efficiency appear to lead to more extensive prescribing rights.</p

Izlučivanje i raspodjela žive u štakora, antidoti za živu i učinci primjene žive na nesivost i plodnost u kokoši

The results of investigations of the distribution and excretion of organic and inorganic mercury compounds in albino rats and white leghorn hens conducted over a period of ten years are surveyed. The storage of mercury in eggs as well as its effects on the egg-lay-frequency and hatchability of the layed eggs have also been studied. All investigated mercury compounds were labelled with the radioactive mercury isotope 203Hg and the mercury level was measured with a scintillation technique. Since antidotes used in the treatment of mercury poisoning influence not only the excretion of mercury, but also its distribution in the body, the effects of nine antidotes on the metabolism of different mercury compounds were also investigated. The results of the survey are presented graphically.Prikazani su rezultati desetogodišnjeg istraživanja raspodjele i izlučivanja organskih i anorganskih spojeva žive na albino-štakorima i leghorn-kokošima, lstraživano je i odlaganje žive u jajima nesilica, učinci na nesivost i oplođenost jaja. Živini spojevi obilježavani su radioaktivnim izotopom 203Hg, a živa mjerena scintilacijskom tehnikom. Budući da antidoti što se primjenjuju pri otrovanju živom utječu ne samo na izlučivanje već i na raspodjelu žive u organizmu, izneseni su i rezultati učinaka devet antidota na prijetvor pojedinih živinih spojeva u organizmu pokusnih životinja

Corrosion protection of steel ships - Localized high strain failures of protective coating

The advances of corrosion protection over the last decade has been considerable due to mutual efforts of ship owners, TSCF, IMO, IACS, research institutes and paint manufacturers. Now there are well-described corrosion protection systems that give 15 years of surface protection without much maintenance work. However, there are deterioration mechanisms that are not understood. Further research efforts are needed and new understanding should be turned into procedures for implementation. Tankers and bulk carriers are designed for about 25 years. In trans-ocean trade these ships may make as few as 300-1000 voyages in the lifetime. The loading and discharge cycle ballast-cargo-ballast causes high local stresses in some bracket corners and cutouts. During the ocean voyages wave loads causes high stresses in the same spots. When stresses are superimposed the yield point of the material is frequently reached and there will be local yielding in many such places. In the paper it is shown that the steel sustains high strain better than the aged coating. Spots at risk are not systematically identified today despite the very high probability of localized failure of the coating. Once the coating has failed locally corrosion starts and accelerated crack propagation takes place in the steel for the wave-induced stresses. The paper gives a state of the art description concerning corrosion protection systems and focuses on the localized strain induced coating failures, some methods under development. In order to avoid localized cracks in the coating due to high strain followed by corrosion one should identify spots with very high strain, give the local geometry of the steel below the vulnerable coating a perfect shape for the benefit of a sustainable coating