Evaluation of the Test-mate ChE (cholinesterase) field kit in acute organophosphorus poisoning

STUDY OBJECTIVE: Measurement of acetylcholinesterase (AChE) is recommended in the management of organophosphorus poisoning, which results in 200,000 deaths worldwide annually. The Test-mate ChE 400 is a portable field kit designed for detecting occupational organophosphorus exposure that measures RBC AChE and plasma cholinesterase (PChE) within 4 minutes. We evaluate Test-mate against a reference laboratory test in patients with acute organophosphorus self-poisoning. METHODS: This was a cross-sectional comparison study of 14 patients with acute organophosphorus poisoning between May 2007 and June 2008. RBC AChE and PChE were measured in 96 and 91 samples, respectively, with the Test-mate ChE field kit and compared with a reference laboratory, using the limits of agreement method (Bland and Altman), κ statistics, and Spearman's correlation coefficients. RESULTS: There was good agreement between the Test-mate ChE and the reference laboratory for RBC AChE. The mean difference (Test-mate-reference) was -0.62 U/g hemoglobin, 95% limits of agreement -10.84 to 9.59 U/g hemoglobin. Good agreement was also observed between the categories of mild, moderate, and severe RBC AChE inhibition (weighted κ 0.85; 95% confidence interval [CI] 0.83 to 0.87). Measurement of PChE also showed good agreement, with a mean difference (Test-mate-reference) of +0.06 U/mL blood, 95% limits of agreement -0.41 to 0.53 U/mL blood. Spearman's correlation coefficients were 0.87 (95% CI 0.81 to 0.91) for RBC AChE and 0.76 (95% CI 0.66 to 0.84) for PChE. Analysis for within-subject correlation of subjects did not change the limits of agreement. CONCLUSION: The Test-mate ChE field kit reliably provides rapid measurement of RBC AChE in acute organophosphorus poisoning.

An evaluation of the role of green marketing and a firm's internal practices for environmental sustainability

The management of a firm's green operations is increasingly important for marketing strategists. The purpose of this study is to investigate the cross-influences of green marketing strategy and the key internal green functional areas in a firm. We use the antecedents of marketing strategy and identify relationships between green marketing strategy and key supporting internal environmental operations of firms with respect to (1) green suppliers, (2) environmental resource management, (3) green research and development, and (4) environmental manufacturing processes and procedures. The statistical techniques of parallel analysis, factor analysis and multiple regressions are used to analyze data collected from 332 firms. The results identify that among the four functional areas of firms adopting green marketing strategy. Two are more likely to influence green marketing strategy – supplier selection and research and development. Implications are discussed. The findings contribute to the theory of green marketing strategy. Future research is recommended.

Children impacted by parental substance abuse: an evaluation of the supporting kids and their environment program

The deleterious impact of parental substance abuse on child development and family functioning is well established. However, evaluations of interventions designed to ameliorate such impacts are very limited. This paper presents the results of a service evaluation using a pre-post design of the Supporting Kids And Their Environment (SKATE) program; a child-focused group program run by Glastonbury Community Services from 2006 to 2010 in the Geelong region of Victoria, Australia. The intervention was an 8-week psycho-educative model that used family-based techniques. Outcomes are reported for child behavior problems, assessed on the Child Behavior Checklist, and family functioning, assessed on the Family Support Scale. A total of 89 children and families within 13 intervention groups were recruited via adult Drug and Alcohol Services (Mean age = 10.4 years; SD = 2.4). Results suggest reductions in emotional and behavioral problems in children as well as improving family functioning with small to moderate effect sizes after children’s participation in the SKATE program compared to pre-test. These preliminary findings suggest that children whose parents are substance abusing are a high-risk group but they may benefit from targeted intervention programs that are well integrated with the adult drug treatment system. Such interventions warrant further development and evaluation.

A process evaluation of the Supermarket Healthy Eating for Life (SHELf) randomized controlled trial

BACKGROUND: Supermarket Healthy Eating for Life (SHELf) was a randomized controlled trial that operationalized a socioecological approach to population-level dietary behaviour change in a real-world supermarket setting. SHELf tested the impact of individual (skill-building), environmental (20 % price reductions), and combined (skill-building + 20 % price reductions) interventions on women's purchasing and consumption of fruits, vegetables, low-calorie carbonated beverages and water. This process evaluation investigated the reach, effectiveness, implementation, and maintenance of the SHELf interventions.

METHODS: RE-AIM provided a conceptual framework to examine the processes underlying the impact of the interventions using data from participant surveys and objective sales data collected at baseline, post-intervention (3 months) and 6-months post-intervention. Fisher's exact, χ (2) and t-tests assessed differences in quantitative survey responses among groups. Adjusted linear regression examined the impact of self-reported intervention dose on food purchasing and consumption outcomes. Thematic analysis identified key themes within qualitative survey responses.

RESULTS: Reach of the SHELf interventions to disadvantaged groups, and beyond study participants themselves, was moderate. Just over one-third of intervention participants indicated that the interventions were effective in changing the way they bought, cooked or consumed food (p < 0.001 compared to control), with no differences among intervention groups. Improvements in purchasing and consumption outcomes were greatest among those who received a higher intervention dose. Most notably, participants who said they accessed price reductions on fruits and vegetables purchased (519 g/week) and consumed (0.5 servings/day) more vegetables. The majority of participants said they accessed (82 %) and appreciated discounts on fruits and vegetables, while there was limited use (40 %) and appreciation of discounts on low-calorie carbonated beverages and water. Overall reported satisfaction with, use, and impact of the skill-building resources was moderate. Maintenance of newly acquired behaviours was limited, with less than half of participants making changes or using study-provided resources during the 6-month post-intervention period.

CONCLUSIONS: SHELf's reach and perceived effectiveness were moderate. The interventions were more effective among those reporting greater engagement with them (an implementation-related construct). Maintenance of newly acquired behaviours proved challenging.

Evaluation of the mechanical performance of short concrete column confined with CFRP and GFRP

Concrete has been successfully used to build strong and economic structures. However severe environmental exposures slowly deteriorate concrete strength until complete failure reducing its designed service life. Fiber Reinforced Polymer “FRP” has been recently introduced in the construction industry to strengthen and retrofitting several structural elements including columns. In this research two types of FRP have been used to wrap concrete column in order to increase its capacity; these are Carbon Fiber Reinforced Polymer “CFRP” and Glass Fiber Reinforced Polymer “GFRP”. Twelve short concrete columns have been wrapped with one and two FRP layers including CFRP and GFRP to evaluate their mechanical performance. Mechanical testing has shown that, in general, concrete columns wrapped with FRP produced higher modulus of elasticity compared to the control sample. Results showed that one layer of CFRP have 85.8% increases where as one layer of GFRP showed an increase of 64.5%. Furthermore, two layers of CFRP and GFRP showed 112.5% and 77.2% increase respectively.

Evaluation of the Counterweight Programme for obesity management in primary care: a starting point for continuous improvement

Background Evaluation for obesity management in primary care is limited, and successful outcomes are from intensive clinical trials in hospital settings.

Aim To determine to what extent measures of success seen in intensive clinical trials can be achieved in routine primary care. Primary outcome measures were weight change and percentage of patients achieving ≤5% loss at 12 and 24 months.

Design of study Prospective evaluation of a new continuous improvement model for weight management in primary care.

Setting Primary care, UK.

Method Primary care practice nurses from 65 UK general practices delivered interventions to 1906 patients with body mass index (BMI) ≥30 kg/m2 or ≥28 kg/m2 with obesity-related comorbidities.

Results Mean baseline weight was 101.2 kg (BMI 37.1 kg/m2); 25% of patients had BMI ≥40 kg/m2 and 74% had ≥1 major obesity-related comorbidity. At final data capture 1419 patients were in the programme for ≥12 months, and 825 for ≥24 months. Mean weight change in those who attended and had data at 12 months (n = 642) was −3.0 kg (95% CI = −3.5 to −2.4 kg) and at 24 months (n = 357) was −2.3 kg (95% CI = −3.2 to −1.4 kg). Among attenders at specific time-points, 30.7% had maintained weight loss of ≥5% at 12 months, and 31.9% at 24 months. A total of 761 (54%) of all 1419 patients who had been enrolled in the programme for >12 months provided data at or beyond 12 months.

Conclusion This intervention achieves and maintains clinically valuable weight loss within routine primary care.