Headquarters managers and Regional staff in the U.S. Environmental Protection Agency’s hazardous and solid waste programs were surveyed to determine priorities for technical information and guidance among EPA Regional staff, state hazardous waste management staff, EPA contractors, and the regulated community. The survey also examined delivery systems effective for EPA Regional staff. The fifteen highest ranked technical needs for RCRA, Superfund, and UST reflect a pervasive interest in hazardous waste remediation. Top priority technical needs focus on establishing cleanup levels, subsurface fate and transport, field monitoring and quality assurance, remedy selection, and most importantly, which remedies work and which do not in specific situations. Technical needs of non- EPA audiences are quite similar to those for EPA field staff. Preferences for technology transfer delivery systems are generally for conventional distribution methods (such as print materials and workshops) rather than electronic or video media. Regional staff report serious problems in utilizing technology transfer because of time constraints, insufficient knowledge of available products, insufficient travel funds, and limited access to and training on computers. 相似文献
Objectives: In this study, we sought to accomplish the following objectives: to (1) calculate the percentage of children considered appropriately restrained across 8 criteria of increasing restrictiveness; (2) examine agreement between age- and size-based appropriateness criteria; (3) assess for changes in the percentage of children considered appropriately restrained by the 8 criteria between 2011 (shortly after updates to U.S. guidelines) and 2015.Methods: Data from 2 cross-sectional surveys of 928 parents of children younger than 12 years old (n = 591 in 2011, n = 337 in 2015) were analyzed in 2017. Child age, weight, and height were measured at an emergency department visit and used to determine whether the parent-reported child passenger restraint was considered appropriate according to 8 criteria. Age-based criteria were derived from Michigan law and U.S. guidelines. Weight, height, and size-based criteria were derived from typical restraints available in the United States in 2007 and 2011. The percentage appropriate restraint use was calculated for each criterion. The kappa statistic was used to measure agreement between criteria. Change in appropriateness from 2011 to 2015 was assessed with chi-square statistics.Results: Percentage appropriate restraint use varied from a low of 19% for higher weight limits in 2011 to a high of 91% for Michigan law in 2015. Agreement between criteria was slight to moderate. The lowest kappa was for Michigan law and higher weight limits in 2011 (κ = 0.06) and highest for U.S. guidelines and lower weight limits in 2011 (κ = 0.60). Percentage appropriate restraint use was higher in 2015 than 2011 for the following criteria: U.S. guidelines (74 vs. 58%, P < .001), lower weight (57 vs. 47%, P = .005), higher weight (25 vs. 19%, P = .03), greater height (39 vs. 26%, P < .001), and greater size (42 vs. 30%, P = .001).Conclusions: The percentage of children considered to be using an appropriate restraint varied substantially across criteria. Aligning the definition of appropriate restraint use with current U.S. guidelines would increase consistency in reporting results from studies of child passenger safety in the United States. Potential explanations for the increased percentage of children considered appropriately restrained between 2011 and 2015 include adoption of the updated U.S. guidelines and the use of child passenger restraints with higher weight and height limits. 相似文献
Objective: This study evaluated the effectiveness of a series of 1-year multifaceted school-based programs aimed at increasing booster seat use among urban children 4–7 years of age in economically disadvantaged areas.
Methods: During 4 consecutive school years, 2011–2015, the Give Kids a Boost (GKB) program was implemented in a total of 8 schools with similar demographics in Dallas County. Observational surveys were conducted at project schools before project implementation (P0), 1–4 weeks after the completion of project implementation (P1), and 4–5 months later (P2). Changes in booster seat use for the 3 time periods were compared for the 8 project and 14 comparison schools that received no intervention using a nonrandomized trial process.
The intervention included (1) train-the-trainer sessions with teachers and parents; (2) presentations about booster seat safety; (3) tailored communication to parents; (4) distribution of fact sheets/resources; (5) walk-around education; and (6) booster seat inspections.
The association between the GKB intervention and proper booster seat use was determined initially using univariate analysis. The association was also estimated using a generalized linear mixed model predicting a binomial outcome (booster seat use) for those aged 4 to 7 years, adjusted for child-level variables (age, sex, race/ethnicity) and car-level variables (vehicle type). The model incorporated the effects of clustering by site and by collection date to account for the possibility of repeated sampling.
Results: In the 8 project schools, booster seat use for children 4–7 years of age increased an average of 20.9 percentage points between P0 and P1 (P0 = 4.8%, P1 = 25.7%; odds ratio [OR] = 6.9; 95% confidence interval [CI], 5.5, 8.7; P < .001) and remained at that level in the P2 time period (P2 = 25.7%; P < .001, for P0 vs. P2) in the univariate analysis. The 14 comparison schools had minimal change in booster seat use. The multivariable model showed that children at the project schools were significantly more likely to be properly restrained in a booster seat after the intervention (OR = 2.7; 95% CI, 2.2, 3.3) compared to the P0 time period and compared to the comparison schools.
Conclusion: Despite study limitations, the GKB program was positively associated with an increase in proper booster seat use for children 4–7 years of age in school settings among diverse populations in economically disadvantaged areas. These increases persisted into the following school year in a majority of the project schools. The GKB model may be a replicable strategy to increase booster seat use among school-age children in similar urban settings. 相似文献
The aim of this study was to compare assessments made by Finnish- and Swedish-speaking workers in Finland about the safety climate in their companies, because an earlier study showed that the accident frequency of Swedish-speaking workers was one third lower than that of Finnish-speaking workers. 148 Finnish-speaking and 138 Swedish-speaking workers from 14 small and medium-sized companies participated in this study. They filled out a Finnish safety climate questionnaire, the reliability of which was above the acceptable level. There were no differences between the language groups in the total variables of safety climate and safety action. Based on the differences in single items, we interpreted that Swedish-speaking workers stressed collective safety more, whereas Finnish-speaking workers put more emphasis on their personal responsibility for safety. 相似文献
Urban ecosystems are often sources of nonpoint source (NPS) nitrogen (N) pollution to aquatic ecosystems. However, N export from urban watersheds is highly variable. Examples of densely urbanized watersheds are not well studied, and these may have comparatively low export rates. Commonly used metrics of landscape heterogeneity may obscure our ability to discern relationships among landscape characteristics that can explain these lower export rates. We expected that differences not often captured by these metrics in the relative cover of vegetation, structures, and impervious surfaces would better explain observed variation in N export. We examined these relationships during storms in residential watersheds. Contrary to expectations, land cover did not directly predict variation in N or water export. Instead, N export was strongly linked to drainage infrastructure density. Our research highlights the role of fine‐scaled landscape attributes, mainly infrastructure, in explaining patterns of N export from densely urbanized watersheds. Changes to hydrologic flow paths by infrastructure explained more variation in N export than land cover. Our findings support further development of landscape ecological models of urban N export that focus on hydrologic modification by infrastructure rather than traditional landscape measures such as land use, as indicators for evaluating patterns of NPS nitrogen pollution in densely urbanized watersheds. 相似文献
With improvements in early diagnosis and management of genetic diseases, more women with genetic disorders are reaching reproductive age and becoming pregnant. While pregnancy can have a significant impact on a woman's health when there is an underlying genetic disorder, there can also be fetal effects, including embryopathy, fetal growth restriction, and brain injury. Some maternal genetic disorders are associated with adverse perinatal outcomes, including a high risk of perinatal loss and preterm birth. In this article, we review several maternal genetic disorders associated with fetal risk that are important for clinicians and patients to understand and manage appropriately. These include phenylalanine hydroxylase (PAH) deficiency and other inborn errors of metabolism, tuberous sclerosis complex, myotonic dystrophy, cystic fibrosis, Turner syndrome, sickle cell disease, and connective tissue disorders. 相似文献