Covariates of alcohol consumption among career firefighters.

BACKGROUND: Little is known about rates of alcohol consumption in career firefighters. AIMS: To assess the quantity and frequency of alcohol consumption among career firefighters and the covariates that influence consumption levels. METHODS: A convenience sample of career firefighters completed an online, self-administered, health assessment survey. Hierarchical binary logistic regression assessed the ability of several covariates to predict binge drinking status. RESULTS: The majority of the sample (n = 160) consumed alcohol (89%), with approximately one-third (34%) having a drinking binge in the past 30 days. The regression model explained 13-18% of the variance in binge drinking status and correctly classified 71% of cases. Race (P < 0.05) and time of service (P < 0.01) were the only covariates that made a statistically significant contribution to the model. After controlling for other factors in the model, white respondents were ~4.5 times more likely to binge drink than non-white respondents (95% CI: 1.15-17.4). For each additional year of service, firefighters were 1.08 times less likely to binge drink (95% CI: 0.87-0.97). CONCLUSIONS: Drinking levels observed in this study exceed those of the general adult population, including college students. Thus, it appears that firefighters represent an at-risk drinking group. Further investigations addressing reasons for alcohol use and abuse among firefighters are warranted. This study and subsequent research will provide information necessary for the development and testing of tailored interventions aimed at reducing firefighter alcohol consumption.

Prevention of HPV-related oral cancer: assessing dentists' readiness.

OBJECTIVES: Epidemiological research indicates an association between the Human Papillomavirus (HPV) with a subset of oral cancers (OC). Dentists may play a role in primary prevention of HPV-related OC by discussing the HPV vaccine with patients. This study assessed dentists' readiness to discuss the HPV vaccine with female patients. STUDY DESIGN: Cross-sectional web-based survey. METHODS: A web-based survey based on the Transtheoretical Model was administered among Florida dentists (n = 210). RESULTS: The majority of participants (97%) fell into the precontemplation and contemplation stages of readiness to discuss the HPV vaccine with patients. Perceived role and liability were determined to be predictive of dentists in contemplation stage as opposed to those in precontemplation (P < 0.05). CONCLUSIONS: Findings suggest liability and perceived role as processes of change necessary to guide dentists to primary prevention of HPV-related OC despite high levels of knowledge. As public awareness of HPV-related OC increases, dentists may become more involved in primary prevention. Results of the current study may assist in developing intervention strategies for engaging dentists in discussing the HPV vaccine with patients.

Evaluation of the odour reduction potential of alternative cover materials at a commercial landfill.

The availability of virgin soils and traditional landfill covers are not only costly and increasingly becoming scarce, but they also reduce the storage capacity of landfill. The problem can be overcome by the utilisation of certain suitable waste streams as alternative landfill covers. The objective of this study was to assess the suitability of Construction & Demolition fines (C&D), Commercial & Industrial fines (C&I) and woodchip (WC) as potential landfill cover materials in terms of odour control. Background odour analysis was conducted to determine if any residual odour was emitted from the cover types. It was deemed negligible for the three materials. The odour reduction performance of each of the materials was also examined on an area of an active landfill site. A range of intermediate cover compositions were also studied to assess their performance. Odour emissions were sampled using a Jiang hood and analysed. Results indicate that the 200 mm deep combination layer of C&D and wood chip used on-site is adequate for odour abatement. The application of daily cover was found to result in effective reduction allowing for the background odour of woodchip.

Odour and ammonia emissions from intensive poultry units in Ireland.

Odour and ammonia emissions were measured from three broiler, two layer and two turkey houses in Ireland. The broiler units gave a large range of odour and ammonia emission rates depending on the age of the birds and the season. A considerable variation between the odour and ammonia emission rates was evident for the two layer units which may have been due to the different manure handling systems utilised in the houses. There was relatively little difference in the odour and ammonia emissions from the two turkey houses. As a precautionary principle, odour emission rates utilised in atmospheric dispersion models should use the maximum values for broilers and turkeys (1.22 and 10.5 ou(E) s(-1) bird(-1) respectively) and the mean value for the layers depending on the manure handling system used (0.47 or 1.35 ou(E) s(-1) bird(-1)).

Odour and ammonia emissions from intensive pig units in Ireland.

Odour and ammonia emissions were measured at four intensive pig units in Ireland. Odour samples were collected on-site and analysed for odour concentration using an olfactometer. Ammonia concentrations in the exhaust ventilation air were measured using a portable sensor. The geomean odour emission rates over the four pig units were 17.2, 44.4, 4.3, 9.9 and 16.8 ou(E) s(-1) animal(-1) for dry sows, farrowing sows, first stage weaners, second stage weaners and finishers, respectively. The mean ammonia emission rates, measured at two of the units, were 12.1, 17.1, 1.4, 2.9 and 10.0 g d(-1) animal(-1) for dry sows, farrowing sows, first stage weaners, second stage weaners and finishers, respectively. In general, the odour and ammonia emission rates were comparable to those reported in literature, although some odour emission rate figures were noticeably lower for finishing pigs in this study. The variability in the data highlights the need for individual site assessment.

A dispersion modelling approach to determine the odour impact of intensive poultry production units in Ireland.

The use of atmospheric dispersion modelling has become more common for the determination of odour impacts from existing poultry production facilities and the assessment of setback distances for new facilities. Setback distances for broiler, layer and turkey units were determined using the atmospheric dispersion model ISCST3 and the Environmental Protection Agency (EPA, Ireland) recommended criterion (C(98,1-h)6.0 ou(E) m(-3)) and a new odour annoyance criterion (C(98,1-h) 9.7 ou(E) m(-3)) developed in this study. For a typical size unit in Ireland, maximum setback distances of 660, 665 and 1035 m were calculated for 40,000 broilers, 40,000 layers and 10,000 turkeys respectively at the current limit (C(98,1-h) 6.0 ou(E) m(-3)). However, if the suggested odour impact criterion (C(98,1-h) 9.7 ou(E) m(-3)) is implemented, the maximum setback distances decrease to 460, 500 and 785 m for broilers, layers and turkeys, respectively.

The influence of diet crude protein level on odour and ammonia emissions from finishing pig houses.

Feed trials were carried out to assess the influence of crude protein content in finishing pig diets on odour and ammonia emissions. Eight pigs (4 boars and 4 gilts), average initial weight 70.8 kg (s.e. 3.167) were housed in two pens that were isolated from the rest of a pig house at University College Dublin Research Farm, Newcastle, Dublin, Ireland. Four diets containing 130, 160, 190 and 220 g x kg(-1) crude protein were fed during six four-week feeding periods (one treatment per room). The first week of the feeding periods served to allow odour build up in the pens and as a dietary adjustment period. The pens had partially slatted floors that were cleaned and had all the manure removed after each four-week period. Odour and ammonia concentrations were measured on days 9, 14, 16, 21 and 23 of each trial period. Odour samples were collected in Nalophan bags and analysed for odour concentration using an ECOMA Yes/No olfactometer. The odour threshold concentration was calculated according to the response of the olfactometry panel members and was displayed in Ou(E)m(-3), which referred to the physiological response from the panel equivalent to that elicited by 40 ppbv(-1) n-butanol evaporated in 1 m(3) of neutral gas. Ammonia concentrations in the ventilation air were measured using Dräger tubes. The odour emission rates per animal for the 130, 160, 190 and 220 g x kg(-1) crude protein diets were 12.1, 13.2, 19.6 and 17.6 Ou(E)s(-1)animal(-1), respectively (P<0.01). The odour emission rate per livestock unit (500 kg) for the 130, 160, 190 and 220 g x kg(-1) crude protein diets were 77.6, 80.0, 115.8 and 102.9 Ou(E)s(-1)LU(-1), respectively (P<0.01). The ammonia emission rates per animal for the 130, 160, 190 and 220 g x kg(-1) crude protein diets were 3.11, 3.89, 5.89 and 8.27 g x d(-1)animal(-1), respectively (P0.05). Manipulation of dietary crude protein levels would appear to offer a low cost alternative, in relation to end-of-pipe treatments, for the abatement of odour and ammonia emissions from finishing pig houses.

A dispersion modelling approach to determining the odour impact of intensive pig production units in Ireland.

It is becoming more common now to use atmospheric dispersion models to predict where odour nuisance is likely to occur near pig units. An odour threshold concentration of 1 OuE m(-3) is the level at which an odour is detectable by 50% of screened panellists. A new odour annoyance criterion (C(98,1-h) (98%-ile, 1-h average odour concentration) < or = 4.3 OuE m(-3)) was developed in this study and compared to the Environmental Protection Agency (EPA) (Ireland) recommendation (C(98,1-h)< or = 6 OuE m(-3)) using the ISCST3 model with data from three meteorological stations. Abatement techniques such as exhaust vent modification, feed manipulation, and biofiltration were assessed. Based on current limits (C(98,1-h)< or = 6 OuE m(-3)) for existing facilities, predicted setback distances can be up to 780 m for a 1000-sow unit, depending on which meteorological data set is used. However, if using the suggested odour impact criterion in this research (C(98,1-h)< or = 4.3 OuE m(-3)), setback distances could reach a maximum of 1000 m. Biofilters on second stage weaning and finishing pig buildings offer the greatest single reduction (up to 650 m) in odour impact. When combined with feed manipulation and increased exhaust air velocity, the figure can be as high as 920 m. Due to the critical requirement for local meteorological data, it is recommended that a meteorological station be installed on large pig units to facilitate more accurate predictions. Site measurements of odour emissions should be made in each case because emissions are influenced by a range of local factors including feed, manure management, building design and operation.

Biofiltration of n-butyric acid for the control of odour.

Odour control from pig production facilities is a significant concern due to increased public awareness and the development of more stringent legislation to control production. Although many technologies exist, biofiltration is still the most attractive due to its low maintenance and operating costs. One of the key odour components, n-butyric acid, was selected for a laboratory scale biofilter study. It was examined as a sole carbon substrate in order to investigate the effectiveness of biofiltration in reducing n-butyric acid concentration under different operating conditions using a moist enriched woodchip medium. Three superficial gas velocities; 38.2, 76.4, and 114.6 m x h(-1) were tested for n-butyric acid concentrations ranging from 0.13 to 3.1 g [n-butyric acid] m(-3) [air]. For superficial gas velocities 38.2, 76.4, and 114.6 m x h(-1), maximum elimination capacities (100% removal) of 148, 113 and 34.4 g x m(3) x h(-1), respectively, were achieved. Upon investigation of effective bed height, true elimination capacities (100% removal) of 230, 233 and 103 g x m(-3) x h(-1), respectively, were achieved at these superficial gas velocities. Averaged pressure drops for superficial gas velocities 38.2, 76.4, and 114.6 m x h(-1) were 30, 78 and 120 Pa, respectively. It was concluded that biofiltration is a viable technology for the removal of n-butyric acid from waste exhaust air, but near 100% removal efficiency is required due to the low odour detection threshold for this gaseous compound.

Assessment of the influence of media particle size on the biofiltration of odorous exhaust ventilation air from a piggery facility.

Two pilot scale biofiltration systems were constructed and installed at the University College Dublin Research Farm, Lyons Estate. Experimental units consisting of two pens in a 12 pen pig house were sealed off from other pens. Air from each pen was extracted and treated separately in two biofiltration systems. Wood chips larger than 20 mm were selected as the medium for biofiltration system 1, whereas chips of between 10 and 16 mm were used in biofiltration system 2. The moisture content of the media was maintained at 69+/-4% (w.w.b.) using a load cell method. The volumetric loading rates ranged from 769 to 1847 m3 [gas] m(-1) [medium] h(-1) over a 63-day experimental period. Both biofilters reduced odour between 88% and 95%. Ammonia removal efficiencies ranged from 64% to 92% and 69% to 93%, for biofiltration systems 1 and 2, respectively. Sulphur-containing compounds were reduced between 9-66%, and -147-51% across biofiltration systems 1 and 2. The pH of the biofilters' leachate remained between 6 and 8. Pressure drop for biofilter 2 was 16 Pa greater than that of biofilter I at the maximum volumetric loading rate of 1847 m3 [gas] m(-3) [medium] h(-1). It is recommended that a wood chip media particle size greater than 20 mm be used for large scale operation of a biofiltration system on intensive pig production facilities to reduce the development of anaerobic zones and to minimize pressure drop on the system fans.

A comparison of the safety of cupfeedings and bottlefeedings in premature infants whose mothers intend to breastfeed.

OBJECTIVE: To compare the safety of cupfeeding, an alternative feeding method, to bottlefeeding, the current standard of artificial feeding in the United States, in preterm infants whose mothers intend to breastfeed. STUDY DESIGN: In a prospective, randomized crossover study, 56 infants or=34 weeks' corrected gestational age, the order of the first two non-breast oral feedings was randomized by coin toss to one cupfeeding and one bottlefeeding. Trained Neonatal Intensive Care Unit nurses provided the feedings. Heart rate, respiratory rate, and oxygen saturation were recorded at 1-minute intervals for 10 minutes before and during the feeding. Volume taken, time required to complete the feed, and any apnea, bradycardia, choking, or spitting episodes were recorded. RESULTS: Heart rate (p<0.0001) and respiratory rate (p<0.0001) increased and oxygen saturation decreased (p=0.0002) during both cup and bottlefeedings compared to pre-feeding baselines. The amount of change in these three parameters from baseline to feeding period was similar for both feeding methods. The fraction of O(2) saturation <90% during baseline compared to the study period was different between these two feeding methods (p=0.02). There was a 10-fold increase in desaturations <90% during bottlefeeds compared to no change during cupfeeds. When comparing cupfeeding periods to bottlefeeding periods, heart rates were higher (p=0.009) and oxygen saturations lower (p=0.02) during bottlefeeds. There were no differences between methods in respiratory rate, choking, spitting or apnea, and bradycardia. Volumes taken were lower (p=0.001) and duration of feeds longer (p=0.002) during cupfeedings. CONCLUSION: During cupfeedings, premature infants are more physiologically stable, with lower heart rates, higher oxygen saturations, and less desaturations, than during bottlefeedings. However, cupfed infants took less volume, over more time, than bottlefed for these initial feedings. Based on better physiologic stability and no difference in untoward effects, cupfeeding is at least as safe, if not safer, than bottlefeeding in this population. This study supports the use of cupfeeding as a safe alternative feeding method for premature infants learning to breastfeed.

Bone densitometry should be included in the evaluation of candidates for lung transplantation.

Bone loss and fractures are common complications of heart and liver transplantation, and are likely related to high-dose immunosuppressive therapy. We have previously demonstrated that many patients with end-stage lung disease already have osteoporosis and may be at even greater risk for fracture after lung transplantation. The purpose of this study is to determine the incidence of fracture in lung transplant recipients on osteoporosis prevention regimens, the relationship of fracture to pretransplant bone mineral density, and the impact of fracture on quality of life after lung transplantation. Twenty-one lung transplant candidates were prospectively evaluated with spine radiographs and bone mineral densitometry. Bone density was expressed as T scores, the number of standard deviations from the mean bone density of a young normal population of the same gender. Of 21 patients, 8 (38%) fractured during the first year. The mean pretransplant lumbar spine T score was significantly lower in the fracture patients (P = .03). Four of the 7 surviving fracture patients and 1 of the 10 patients who survived without fracture believed that chronic pain diminished their quality of life (X2 = 4.408; P = .04). These findings suggest that bone mineral density should be routinely included in the evaluation of lung transplant candidates. Patients with extremely low bone density or osteoporotic fracture should be counseled about the increased risk of fracture after transplantation.

Gestational age assessment.

A six-pound infant may be 33 weeks, 43 weeks, or term, each with a different set of medical and developmental needs, requiring different nursing care. Gestational age determination is important for anticipating each infant's medical risks, preventing complications, distinguishing the infant's developmental capabilities in feeding, sleep, and interactive behaviors with the parents, and establishing the infant's nursing care needs on a timely basis. This article reviews the history of gestational age assessment, gestational age classifications and associated risks, and the accuracy of current tools and provides instruction for performing a gestational age assessment.

Bronchoesophageal fistula and transient megaesophagus in a dog.

Bronchoesophageal fistula and megaesophagus were diagnosed in a dog. Within 2 days after surgical correction of the bronchoesophageal fistula, peristalsis in the thoracic portion of the esophagus returned to normal and the esophagus resumed its normal size. The cause of the fistula was attributed to damage from a foreign body. The cause of the transient megaesophagus likely was related to the bronchoesophageal fistula.

Heterogeneity of renin substrate in human plasma: effect of pregnancy and oral contraceptives.

PIP: The electrophoretic mobility of renin substrate in human plasma was determined by electrophoresis of the plasma on a cylinder of polyacrylamide gel, followed by slicing the gel, incubation of each slice with human renin, EDTA, and BAL in saline, and determination of the angiotensin formed by radioimmunoassay. With this modified technique 5, and possibly 8, electrophoretically dissimilar renin substrates have been found in human plasma. Significant variations in the patterns of renin substrates in the blood plasma of pregnant women and of those taking oral contraceptives were shown. In normal plasma from male or female subjects there was a single large peak of renin substrate with a mobility slightly less than that of albumin, and there were a series of very small peaks of renin substrate with lesser mobilities than the major peak. Increasing the sample size and prolonging the period of incubation with renin made the smaller peaks more apparent. In women using oral contraceptives, a distinctly different pattern of renin substrates was found. Early smaller peaks were increased. The major peak was sometimes increased also. Pregnancy produced a strikingly different pattern of renin substrates. There was an increase in all slow-moving peaks and their bases ran together without a return to the baseline. The absence of peaks when renin was omitted indicated that they were renin substrates. In 2 of 4 patients having cirrhosis of the liver with ascites, the amount of major substrate peak was greatly diminished and minor peaks were somewhat reduced. In 3 bilaterally nephrectomized patients, the major peak was not increased and the pattern of minor peaks was normal.^ieng