Efficacy of flow restrictors in limiting access of liquid medications by young children.

OBJECTIVE: To assess whether adding flow restrictors (FRs) to liquid medicine bottles can provide additional protection against unsupervised medication ingestions by young children, even when the child-resistant closure is not fully secured. STUDY DESIGN: In April and May 2012, we conducted a block randomized trial with a convenience sample of 110 3- and 4-year-old children from 5 local preschools. Participants attempted to remove test liquid from an uncapped bottle with an FR and a control bottle without an FR (with either no cap or an incompletely closed cap). RESULTS: All but 1 (96%; 25 of 26) of the open control bottles and 82% (68 of 83) of the incompletely closed control bottles were emptied within 2 minutes. Only 6% (7 of 110) of the bottles with FRs were emptied during the 10-minute testing period, none before 6 minutes. Overall, children removed less liquid from the bottles with FRs than from the open or incompletely closed control bottles without FRs (both P < .001). All children assigned open control bottles and 90% of those assigned incompletely closed control bottles removed ≥ 25 mL of liquid. In contrast, 11% of children removed ≥ 25 mL of liquid from uncapped bottles with FRs. Older children (aged 54-59 months) were more successful than younger children at removing ≥ 25 mL of liquid (P = .002) from bottles with FRs. CONCLUSION: Our findings suggest that adding FRs to liquid medicine bottles limits the accessibility of their contents to young children and could complement the safety provided by current child-resistant packaging.

Workplace safety: a meta-analysis of the roles of person and situation factors.

Recent conceptual and methodological advances in behavioral safety research afford an opportunity to integrate past and recent research findings. Building on theoretical models of worker performance and work climate, this study quantitatively integrates the safety literature by meta-analytically examining person- and situation-based antecedents of safety performance behaviors and safety outcomes (i.e., accidents and injuries). As anticipated, safety knowledge and safety motivation were most strongly related to safety performance behaviors, closely followed by psychological safety climate and group safety climate. With regard to accidents and injuries, however, group safety climate had the strongest association. In addition, tests of a meta-analytic path model provided support for the theoretical model that guided this overall investigation. The implications of these findings for advancing the study and management of workplace safety are discussed.

On the role of positive and negative affectivity in job performance: a meta-analytic investigation.

Although interest regarding the role of dispositional affect in job behaviors has surged in recent years, the true magnitude of affectivity's influence remains unknown. To address this issue, the authors conducted a qualitative and quantitative review of the relationships between positive and negative affectivity (PA and NA, respectively) and various performance dimensions. A series of meta-analyses based on 57 primary studies indicated that PA and NA predicted task performance in the hypothesized directions and that the relationships were strongest for subjectively rated versus objectively rated performance. In addition, PA was related to organizational citizenship behaviors but not withdrawal behaviors, and NA was related to organizational citizenship behaviors, withdrawal behaviors, counterproductive work behaviors, and occupational injury. Mediational analyses revealed that affect operated through different mechanisms in influencing the various performance dimensions. Regression analyses documented that PA and NA uniquely predicted task performance but that extraversion and neuroticism did not, when the four were considered simultaneously. Discussion focuses on the theoretical and practical implications of these findings. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Arthroscopic debridement of the osteoarthritic knee combined with hyaluronic acid (Orthovisc) treatment: a case series and review of the literature.

OBJECTIVE: An evaluation of safety and efficacy of high molecular weight hyaluronan (HA) delivered at the time of arthroscopic debridement of the osteoarthritic knee. METHODS: Thirty consecutive patients who met inclusion and exclusion criteria underwent arthroscopic debridement by a single surgeon and concomitant delivery of 6 ml/90 mg HA (Orthovisc). These patients were evaluated preoperatively, at 6 weeks, 3 and 6 months post-operatively. Evaluations consisted of WOMAC pain score, SF-36 Physical Component Summary (PCS) score and complications. RESULTS: No complications occurred during this study. Pre-op average WOMAC pain score was 6.8 +/- 3.5 (n = 30) with a reduction to 3.4 +/- 3.1 at 6 weeks (n = 27). Final average WOMAC pain score improved to 3.2 +/- 3.8 at six months (n = 23). No patients had deterioration of the WOMAC pain score. Mean pre-operative SF-36 PCS score was 39.0 +/- 10.4 with SF-36 PCS score of the bottom 25th percentile at 29.9 (n = 30). Post procedure and HA delivery, mean PCS score at 6 weeks improved to 43.7 +/- 8.0 with the bottom 25th percentile at 37.5 (n = 27). At 6 months, mean PCS score was 48.0 +/- 9.8 with the bottom 25th percentile improved to 45.8 (n = 23). CONCLUSION: The results show that concomitant delivery of high molecular weight hyaluronan (Orthovisc--6 ml/90 mg) is safe when given at the time of arthroscopic debridement of the osteoarthritic knee. By delivering HA (Orthovisc) at the time of the arthroscopic debridement, there may be a decreased risk of joint infection and/or injection site pain. Furthermore, the combination of both procedures show efficacy in reducing WOMAC pain scores and improving SF-36 PCS scores over a six month period.

Occupational exposure to static and time-varying gradient magnetic fields in MR units.

PURPOSE: To assess exposure of MR staff to static and time-varying gradient magnetic fields by direct measurement and questionnaire and to compare these to the action values and exposure limits stated in published guidance. MATERIALS AND METHODS: Instantaneous and time-averaged exposure to static magnetic fields were measured on clinical and research MR scanners. A questionnaire was sent to 100 clinical MR centers to estimate the average static field exposure. Instantaneous measurements of the time-varying magnetic field were conducted on a 1.5 T conventional and a 0.6 T open-bore MR system. RESULTS: The 24-hour time-averaged static field exposure was measured to be 1.8 +/- 1 mT and the questionnaire produced a 24-hour time-average of 2.3 mT. The maximum static field strength recorded during patient set up was 554 mT. Time-varying gradient field exposure was found to exceed the action values up to 30 cm from the bore entrance or magnet rim. CONCLUSION: The time-varying gradient field exposure limit is the only limit to be exceeded. The time-averaged static field exposure to staff was found to be 100 times lower than the recommended guidelines.

Simulating public health response to a severe acute respiratory syndrome (SARS) event: a comprehensive and systematic approach to designing, implementing, and evaluating a tabletop exercise.

In response to recent public health threats and disasters, greater emphasis has been placed on the use of exercises and drills to improve individual performance and enhance capacity of the public health workforce. However, despite the increased application of these exercises, rigorous research regarding their appropriate development and relative effectiveness in improving public health preparedness is limited. The present study attempted to fill this void by presenting a detailed account of a comprehensive and integrated approach to developing, implementing, and evaluating a tabletop exercise designed to enhance emergency preparedness and response of public health workers. Following a comprehensive training systems model, a tabletop exercise was developed to simulate worker recognition and response to a Severe Acute Respiratory Syndrome event among public health workers in Arkansas. Forty-nine individuals participated in the tabletop exercise, including public health workers and their external partners. Results demonstrated the effectiveness of this tabletop exercise in increasing participants' competency-related knowledge and skills. The flexibility afforded by creating a standardized competency-based process can extend to other state and local health departments and provides evidence of the reciprocal relationship between research and practice needed to advance the areas of emergency preparedness training and workforce development initiatives in public health.

The big five personality traits and individual job performance growth trajectories in maintenance and transitional job stages.

This study extends the literature on personality and job performance through the use of random coefficient modeling to test the validity of the Big Five personality traits in predicting overall sales performance and sales performance trajectories--or systematic patterns of performance growth--in 2 samples of pharmaceutical sales representatives at maintenance and transitional job stages (K. R. Murphy, 1989). In the maintenance sample, conscientiousness and extraversion were positively associated with between-person differences in total sales, whereas only conscientiousness predicted performance growth. In the transitional sample, agreeableness and openness to experience predicted overall performance differences and performance trends. All effects remained significant with job tenure statistically controlled. Possible explanations for these findings are offered, and theoretical and practical implications of findings are discussed.