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To determine the effect of mandatory and nonmandatory influenza vaccination policies on vaccination rates and symptomatic absenteeism among healthcare personnel (HCP).
Retrospective observational cohort study.
This study took place at 3 university medical centers with mandatory influenza vaccination policies and 4 Veterans Affairs (VA) healthcare systems with nonmandatory influenza vaccination policies.
The study included 2,304 outpatient HCP at mandatory vaccination sites and 1,759 outpatient HCP at nonmandatory vaccination sites.
To determine the incidence and duration of absenteeism in outpatient settings, HCP participating in the Respiratory Protection Effectiveness Clinical Trial at both mandatory and nonmandatory vaccination sites over 3 viral respiratory illness (VRI) seasons (2012–2015) reported their influenza vaccination status and symptomatic days absent from work weekly throughout a 12-week period during the peak VRI season each year. The adjusted effects of vaccination and other modulating factors on absenteeism rates were estimated using multivariable regression models.
The proportion of participants who received influenza vaccination was lower each year at nonmandatory than at mandatory vaccination sites (odds ratio [OR], 0.09; 95% confidence interval [CI], 0.07–0.11). Among HCP who reported at least 1 sick day, vaccinated HCP had lower symptomatic days absent compared to unvaccinated HCP (OR for 2012–2013 and 2013–2014, 0.82; 95% CI, 0.72–0.93; OR for 2014–2015, 0.81; 95% CI, 0.69–0.95).
These data suggest that mandatory HCP influenza vaccination policies increase influenza vaccination rates and that HCP symptomatic absenteeism diminishes as rates of influenza vaccination increase. These findings should be considered in formulating HCP influenza vaccination policies.
Recent studies have highlighted the threat that climate change poses to species, as areas of climatic suitability contract or shift across the landscape. North American Neotropical long-distant migrant bird species present a unique problem compared to sedentary species because climate change may differ significantly across their breeding and wintering grounds. Studying the potential future distributions of these birds is challenging on many levels, including the fact that our understanding of the wintering grounds of these species is quite poor. To address this issue, we analyse available eBird data during the winter season in the Western Hemisphere in an effort to further promote and direct citizen science efforts to focus on areas that are climatically undersampled. We used Mobility-Oriented Parity (MOP) to understand the areas where climates are most dissimilar from climates sampled by existing eBird checklists, creating a map that ranks the western hemisphere at a 10 km resolution for climatic sampling during the winter season. We found that parts of Mexico and Central America, areas of Colombia, almost the entire Amazon Basin, coastal Peru and Chile, and northern Argentina are climatically undersampled. As a test case, we then used the map of survey priorities to simulate additional sampling in Colombia and recalculated the rankings. Guiding additional sampling with the priorities reduced climate dissimilarities between sampled and unsampled grid cells more than when additional sampling expanded in proportion to current sampling efforts or based on geographic undersampling. Analyses of sampling coverage in environmental space, such as this, will be a useful tool for targeting monitoring effort for bird species.
Avian diet selection is hypothesized to be sensitive to seasonal changes in breeding status, but few tests exist for frugivorous tropical birds. Frugivorous birds provide an interesting test case because fruits are relatively deficient in minerals critical for reproduction. Here, we quantify annual patterns of fruit availability and diet for two frugivorous hornbill (Bucerotidae) species over a 5.5-y period to test for patterns of diet selection. Data from the lowland tropical rain forest of the Dja Reserve, Cameroon, are used to generate two nutritional indices. One index estimates the nutrient concentration of the diet chosen by Ceratogymna atrata and Bycanistes albotibialis on a monthly basis using 3165 feeding observations combined with fruit pulp sample data. The second index is an estimate of nutrient concentration of a non-selective or neutral diet across the study area based on tree fruiting phenology, vegetation survey and fruit-pulp sample data. Fifty-nine fruit pulp samples representing 40 species were analysed for 16 nutrient categories to contribute to both indices. Pulp samples accounted for approximately 75% of the observed diets. The results support expected patterns of nutrient selection. The two hornbill species selected a diet rich in calcium during the early breeding season (significantly so for B. albotibialis in July and August). Through the brooding and fledging periods, they switched from a calcium-rich diet to one rich in iron and caloric content as well as supplemental protein in the form of invertebrates. Calcium, the calcium to phosphorus ratio and fat concentration were the strongest predictors of breeding success (significant for calcium and Ca:P for B. albotibialis in June). We conclude that hornbills actively select fruit based on nutritional concentration and mineral concentration and that the indices developed here are useful for assessing frugivore diet over time.
Chemical Mechanical Polish (CMP) is one of the key technologies for the development of modern high performance integrated circuits. The requirements for the CMP uniformity get extremely demanding in order to meet the litho requirements for 32nm technology node and beyond. In this paper, two kinds of orders related to the stressor films that affect the CMP uniformity are revealed. The first is the stressor films deposition order according to the CMP polish rate of each stressor film. The second is the stress gradients order that formed inside the films sitting on top of the stressors. Through the optimization of the order, we show successfully removal of couple hundreds angstroms stressor step heights within 300mm wafer range. The method developed here can also find applications in microelectromechanical systems and 3D integration circuits.
Heterogeneous nucleation and crystal growth on protein substrates are critical steps in biological hard tissue formation. Self assembled monolayers can be derivatized with various organic functional groups to mimic the “nucleation proteins” for induction of mineral growth. Studies of nucleation and growth on SAMs can provide a better understanding of biomineralization and can also form the basis of a superior thin film deposition process. We demonstrate that micron-scale, electron and ion beam, lithographic techniques can be used to pattern SAMs with functional organic groups that either inhibit or promote mineral deposition. Patterned films of iron oxyhydroxide were deposited on the areas patterned with nucleation sites. Studies of the deposition kinetic of these films show that the surface indeed induces heterogeneous nucleation and that film formation does not occur via absorption of polymers or colloidal material formed homogeneously in solution. The nucleus interfacial free energy was calculated to be 88 mJ/m2 on a SAM surface composed entirely of sulfonate groups.
There is a great need to develop methods to regulate cellular growth in order to enhance or prevent cell proliferation as needed, to either improve health or prevent disease. In this work we evaluated the adhesion, survival and growth of bone marrow stromal cells on the surface of several new ion beam engineered nano-crystals of ceramic hard coatings such as zirconium, titanium, tantalum and cerium oxides. Cell adhesion and growth on the ceramic coatings were compared to adhesion and growth on a nano-crystalline silver coating which is known to possess antibacterial properties. The initial results of a study to determine the effect of nanocrystalline titanium and silver coating on staphylococcus aureus biofilm growth is also discussed.
The meeting of the Working Group on Active B-type Stars consisted of a business meeting followed by a scientific meeting containing invited and contributed talks. The titles of the talks and their presenters are listed below. We plan to publish a series of articles containing summaries of these talks in Issue No. 39 of the Be Star Newsletter.
To describe an infection control network (the Duke Infection Control Outreach Network [DICON]) and its impact on nosocomial infection rates in community hospitals.
Prospective cohort study of rates of nosocomial infections and exposures of employees to bloodborne pathogens in hospitals during the first 3 years of their affiliation with DICON. Attributable cost and mortality estimates were obtained from published studies.
Twelve community hospitals in North Carolina and Virginia.
During the first 3 years of hospital affiliation with DICON, annual rates of nosocomial bloodstream infections at study hospitals decreased by 23% (P = .009). Annual rates of nosocomial infection and colonization due to methicillin-resistant Staphylococcus aureus decreased by 22% (P = .002), and rates of ventilator-associated pneumonia decreased by 40% (P = .001). Rates of exposure of employees to bloodborne pathogens decreased by 18% (P = .003).
The establishment of an infection control network within a group of community hospitals was associated with substantial decreases in nosocomial infection rates. Standard surveillance methods, frequent data analysis and feedback, and interventions based on guidelines and protocols from the Centers for Disease Control and Prevention were the principal strategies used to achieve these reductions. In addition to lessening the adverse clinical outcomes due to nosocomial infections, these reductions substantially decreased the economic burden of infection: the decline in nosocomial bloodstream infections and ventilator-associated pneumonia alone yielded potential savings of $578,307 to $2,195,954 per year at the study hospitals.
To identify the etiologic agent and risk factors associated with a hospital ward outbreak of gastroenteritis.
A regional referral hospital in upstate South Carolina.
We reviewed patient charts, surveyed staff, and tested stool from acutely ill persons. A case was defined as diarrhea and vomiting in a staff member or patient from January 5 to 13, 1996.
The initial case occurred on January 5 in a staff nurse who subsequently was hospitalized on the ward and visited by many staff colleagues. The staff were at a significantly greater risk for gastroenteritis than were patients (28/89 [31%] vs 10/91 [11%]; relative risk [RR], 2.9; 95% confidence interval [CI95], 1.5-5.5). All 10 case-patients had been exposed to case-nurses (assigned nurses who were primary caretakers), and eight had documented exposure to case-nurses 1 to 2 days before their illness. Patients exposed to case-nurses had a significantly increased risk of illness (8/57 [14%] vs 0/32; RR, >4.5; CI95, undefined). Neither staff nor patients had significantly increased risk from food, water, ice, or exposure to case-patients. Electron microscopy identified small round-structured viruses (SRSVs) in nine of nine stool samples.
This nosocomial outbreak of gastroenteritis was likely caused by SRSVs introduced by a staff member and spread via person-to-person transmission from and among staff. The potential for spread of SRSV-associated gastroenteritis from and among staff should be considered in developing strategies to prevent similar outbreaks in hospital settings
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