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Recent Recommendations (recent + recommendation)
Selected AbstractsCombined exposures to anti-androgenic chemicals: steps towards cumulative risk assessmentINTERNATIONAL JOURNAL OF ANDROLOGY, Issue 2 2010A. Kortenkamp Summary There is widespread exposure to anti-androgens, a group of chemicals able to disrupt androgen action in foetal life, with irreversible de-masculinizing consequences. Substances of concern include certain phthalates, pesticides and chemicals used in cosmetics and personal care products. Although people come into contact with several anti-androgens, chemicals risk assessment normally does not take account of the effects of combined exposures. However, a disregard for combination effects may lead to underestimations of risks and for this reason, we have assessed the feasibility of conducting cumulative risk assessment, where the focus is on considering the effects of exposure to multiple chemicals, via multiple routes and pathways. Following recent recommendations by the US National Research Council, we have, for the first time, included phthalates and other anti-androgenic chemicals, a total of 15 substances. On the basis of exposure estimates for the individual chemicals and reference doses for anti-androgenicity, we have used the hazard index approach. We show that the cumulative risks from anti-androgen exposures exceed acceptable levels for people on the upper end of exposure levels. The value obtained for median exposures to the 15 substances can be judged tolerable. However, significant knowledge gaps exist that prevent us from arriving at definitive conclusions. Of greatest concern is an absence of appropriate in vivo toxicity data about large numbers of in vitro androgen receptor antagonists. Knowledge about the effect profiles of these chemicals will lead to higher risk estimates. Our analysis suggests that risk reductions can be achieved by limiting exposures to the plasticizer diethyl hexyl phthalate, the cosmetic ingredients butyl- and propyl paraben, the pesticides vinclozolin, prochloraz and procymidone and bisphenol A. [source] Aspiration syndromes: 10 clinical pearls every physician should knowINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 5 2007H. S. Paintal Summary Aspiration syndromes are clinically and pathologically classified into three sets of disorders: (i) large airway mechanical obstruction caused by foreign bodies; (ii) aspiration pneumonitis; and (iii) aspiration pneumonia. In this article, we discuss the common clinical presentations, risk factors, radiographic features and methods of management of these disorders. We highlight recent recommendations and controversies surrounding the prevention of aspiration pneumonia in the critically ill patient. Finally, we review ethical dilemmas surrounding feeding and aspiration risk concerns in debilitated and demented patients. [source] Police officers' use of emotional language during child sexual abuse investigationsJOURNAL OF INVESTIGATIVE PSYCHOLOGY AND OFFENDER PROFILING, Issue 1 2006Gavin Oxburgh Abstract This paper examined the use of emotional language by police officers that interview child victims as well as suspects during sexual offence investigations. It was hypothesised that officers who interviewed child victims prior to questioning suspects would use more emotional utterances during interviews with the suspect than those who had not interviewed the child victims. In addition, it was also hypothesised that the number of emotional utterances used would vary as a function of the gender of the interviewer and the type of offence (e.g. intra or extrafamilial abuse). Thirty-four interview transcripts of investigative interviews with alleged sex offenders were analysed and, contrary to the hypothesis, the results revealed a significant effect of prior acquaintance with the victim, in that a greater number of negative emotional utterances (e.g. contempt, disgust and anger) were used by interviewers who had not previously interviewed the victim. There were no significant effects with regard to gender of the interviewer or the type of offence (e.g. extra, or intrafamilial abuse) and the study found that, despite recent recommendations, the majority of police officers had not received specialist investigative interviewing specific to sex offenders. Copyright © 2006 John Wiley & Sons, Ltd. [source] The Canadian Prehospital Evidence-based Protocols Project: Knowledge Translation in Emergency Medical Services CareACADEMIC EMERGENCY MEDICINE, Issue 7 2009Jan L. Jensen ACP Abstract Objectives:, The principles of evidence-based medicine are applicable to all areas and professionals in health care. The care provided by paramedics in the prehospital setting is no exception. The Prehospital Evidence-based Protocols Project Online (PEP) is a repository of appraised research evidence that is applicable to interventions performed in the prehospital setting and is openly available online. This article describes the history, current status, and potential future of the project. Methods:, The primary objective of the PEP is to catalog and grade emergency medical services (EMS) studies with a level of evidence (LOE). Subsequently, each prehospital intervention is assigned a class of recommendation (COR) based on all the appraised articles on that intervention, in an effort to organize the evidence so it may be put into practice efficiently. An LOE is assigned to each article by the section editor, based on the study rigor and applicability to EMS. The section editor committee consists of EMS physicians and paramedics from across Canada, and two from Ireland and a paramedic coordinator. The evidence evaluation cycle is continuous; as the section editors send back appraisals, the coordinator updates the database and sends out another article for review. Results:, The database currently has 182 individual interventions organized under 103 protocols, with 933 citations. Conclusions:, This project directly meets recent recommendations to improve EMS by using evidence to support interventions and incorporating it into protocols. Organizing and grading the evidence allows medical directors and paramedics to incorporate research findings into their daily practice. As such, this project demonstrates how knowledge translation can be conducted in EMS. [source] A parent as a vector of Salmonella brandenburg nosocomial infection in a neonatal intensive care unitCLINICAL MICROBIOLOGY AND INFECTION, Issue 6 2003G.-L. Cartolano A newborn baby was admitted to the Neonatal Intensive Care Unit (NICU) of St Germain en Laye Hospital (France) because of premature birth. On day 12, he contracted gastroenteritis due to Salmonella brandenbourg. The salmonellosis led to a septic shock syndrome with a brief cardiopulmonary arrest. He was treated with intravenous ceftriaxone and gentamicin, and the evolution was favorable. Microbiological investigations revealed that the mother was the vector for this nosocomial infection. S. brandenbourg was isolated from the feces of the baby, despite recent recommendations on managing stool specimens from patients hospitalized for more than three days: according to these recommendations, these stools should be processed for viruses and Clostridium difficile toxin only. [source] | ||||||||||