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A total of 38 long-term care facilities within a region participated in a 3-month quality improvement initiative focused on environmental cleaning and disinfection. Significant improvements in daily and discharge cleaning were observed during the project period. Further study of the sustainability and clinical impact of this type of initiative is warranted.
Previous research in clinical, community, and school settings has demonstrated positive outcomes for the Secret Agent Society (SAS) social skills training program. This is designed to help children on the autism spectrum become more aware of emotions in themselves and others and to ‘problem-solve’ complex social scenarios. Parents play a key role in the implementation of the SAS program, attending information and support sessions with other parents and providing supervision, rewards, and feedback as their children complete weekly ‘home mission’ assignments. Drawing on data from a school-based evaluation of the SAS program, we examined whether parents’ engagement with these elements of the intervention was linked to the quality of their children’s participation and performance. Sixty-eight 8–14-year-olds (M age = 10.7) with a diagnosis of autism participated in the program. The findings indicated that ratings of parental engagement were positively correlated with children’s competence in completing home missions and with the quality of their contribution during group teaching sessions. However, there was a less consistent relationship between parental engagement and measures of children’s social and emotional skill gains over the course of the program.
One in four cases of acute aortic syndrome are missed. This national survey examined Canadian Emergency physicians’ opinion on risk stratification, the need for a clinical decision aid to risk stratify patients, and the required sensitivity of such a tool.
We surveyed 1,556 members of the Canadian Association of Emergency Physicians. We used a modified Dillman technique with a prenotification email and up to three survey attempts using electronic mail. Physicians were asked 21 questions about demographics, importance of certain high-risk features, investigation options, threshold for investigation, and if a clinical decision tool is required
We had a response rate of 32%. Respondents were 66% male, and 49% practicing >10 years, with 59% in an academic teaching hospital. A total of 93% reported a need for a clinical decision aid to risk stratify for acute aortic syndrome. A total of 99.6% of physicians were pragmatic accepting a non-zero miss-rate, two-thirds accepting <1%, and the remaining accepting a higher miss-rate.
Our national survey determined that emergency physicians would use a highly sensitive clinical decision aid to determine which patients are at low, medium, or high-risk for acute aortic syndrome. The majority of clinicians have a low threshold (<1%) for investigating for acute aortic syndrome, but accept that a zero miss-rate is not feasible.
This descriptive paper aims to describe the design and implementation of a community engaged primary healthcare strategy in rural Australia, the Primary Healthcare Registered Nurse: Schools-Based strategy. This strategy seeks to address the health, education and social inequities confronting children and adolescents through community engaged service provision and nursing practice.
There have been increasing calls for primary healthcare approaches to address rural health inequities, including contextualised healthcare, enhanced healthcare access, community engagement in needs and solutions identification and local-level collaborations. However, rural healthcare can be poorly aligned to community contexts and needs and be firmly entrenched in health systems, marginalising community participation.
This strategy has been designed to enhance nursing service and practice responsiveness to the rural context, primary healthcare principles, and community experiences and expectations of healthcare. The strategy is underpinned by a cross-sector collaboration between a local health district, school education and a university department of rural health. A research framework is being developed to explore strategy impacts for service recipients, cross-sector systems, and the establishment and maintenance of a primary healthcare nursing workforce.
Although in the early stages of implementation, key learnings have been acquired and strategic, relationship, resource and workforce gains achieved.
In recent years, researchers have been working towards creating a standard conceptual framework of food parenting. To understand how parents’ reports correspond with the proposed model, the current study examined parents’ reports of their feeding behaviours in the context of a newly established framework of food parenting.
Cross-sectional, with a two-week follow-up for a subset of the sample. Participants completed a quantitative and qualitative survey to assess food parenting. The survey included items from common food parenting instruments to measure the constructs posited in the framework. Exploratory factor analyses were conducted to ascertain which items related most closely to one another and factors were mapped on to existing constructs.
Parents of children aged 2·5–7 years (n 496). Of these, 122 completed a two-week follow-up.
Analyses revealed eleven aspects of Structure (monitoring; distraction; family presence; meal/snack schedule; unstructured practices; healthy/unhealthy food availability; food preparation; healthy/unhealthy modelling; rules), ten aspects of Coercive Control (pressure to eat; using food to control emotions; food incentives to eat; food incentives to behave; non-food incentives to eat; restriction for health/weight; covert restriction; clean plate; harsh coercion) and seven aspects of Autonomy Promotion (praise; encouragement; nutrition education; child involvement; negotiation; responsive feeding; repeated offering). Content validity, assessed via parents’ open-ended explanations of their responses, was high, and test–retest reliability was moderate to high. Structure and Autonomy Promoting food parenting were highly positively correlated.
In general, parents’ responses provided support for the model, but suggested some amendments and refinements.
Commercial farmers have been using polyethylene plastic mulch since the 1950s. Despite the affordability and effectiveness of polyethylene mulch, the disposal process is financially and environmentally costly. Biodegradable plastic mulches, an ecologically sustainable alternative to polyethylene mulch films, were introduced in the 1980s. Biodegradable plastic mulches can be tilled into the soil or composted at the end of the season, reducing the labor and environmental costs associated with plastic removal and disposal. However, research results are mixed as to the effectiveness, degradability and ease-of-use of biodegradable plastic mulches. In 2008–2012, researchers, funded by a USDA Specialty Crop Research Initiative grant, conducted surveys and focus groups in three different agricultural regions of the USA to better understand the barriers and bridges to the adoption of biodegradable plastic mulches for specialty crop production systems. Data on the experiences and views of specialty crop growers, agricultural extension agents, agricultural input suppliers, mulch manufacturers and other stakeholders showed that the major adoption barriers were insufficient knowledge, high cost and unpredictable breakdown. The major bridges to adoption were reduced waste, environmental benefits and interest in further learning. These findings are discussed with reference to the classic innovation diffusion model, specifically work on the innovation–decision process and the attributes of innovations. The study results can be used to guide the activities of those involved in the design, development and promotion of biodegradable plastic mulches for US specialty crop production systems.
Indigenous conversation and voice are increasingly heard in the research literature but there needs to be more dialogue in order for it to be a two-way conversation. This paper contributes to research that attempts to redress this situation by reporting on conversations with Aboriginal parents and caregivers of students enrolled in a public secondary school in a large New South Wales country town. The conversations were conducted over a three-year period (2005-7) by a team non-Indigenous researchers working in collaboration with Indigenous researchers. In this paper, we describe the various approaches we developed to establish conversations with Aboriginal parents and caregivers, and the various themes that emerged over the course of the study. We also assess how this type of research is located within and contributes to, the existing research literature. Finally, we discuss the importance of ongoing conversations with Aboriginal parents and caregivers, and how schools and systems can better respond to well-established policy goals of productive parent-school relationships.
Hospital-acquired Legionella pneumonia has a fatality rate of 28%, and the source is the water distribution system. Two prevention strategies have been advocated. One approach to prevention is clinical surveillance for disease without routine environmental monitoring. Another approach recommends environmental monitoring even in the absence of known cases of Legionella pneumonia. We determined the Legionella colonization status of water systems in hospitals to establish whether the results of environmental surveillance correlated with discovery of disease. None of these hospitals had previously experienced endemic hospital-acquired Legionella pneumonia.
Twenty US hospitals in 13 states.
Hospitals performed clinical and environmental surveillance for Legionella from 2000 through 2002. All specimens were shipped to the Special Pathogens Laboratory at the Veterans Affairs Pittsburgh Medical Center.
Legionella pneumophila and Legionella anisa were isolated from 14 (70%) of 20 hospital water systems. Of 676 environmental samples, 198 (29%) were positive for Legionella species. High-level colonization of the water system (30% or more of the distal outlets were positive for L. pneumophila) was demonstrated for 6 (43%) of the 14 hospitals with positive findings. L. pneumophila serogroup 1 was detected in 5 of these 6 hospitals, whereas 1 hospital was colonized with L. pneumophila serogroup 5. A total of 633 patients were evaluated for Legionella pneumonia from 12 (60%) of the 20 hospitals: 377 by urinary antigen testing and 577 by sputum culture. Hospital-acquired Legionella pneumonia was identified in 4 hospitals, all of which were hospitals with L. pneumophila serogroup 1 found in 30% or more of the distal outlets. No cases of disease due to other serogroups or species (L. anisa) were identified.
Environmental monitoring followed by clinical surveillance was successful in uncovering previously unrecognized cases of hospital-acquired Legionella pneumonia.
The physical properties of resonant leaky modes in periodically patterned layered materials are summarized. Representative examples of photonic device applications including filters, polarizers, wideband reflectors, tunable elements, and biosensors are discussed.
Studies have shown that parkinsonian signs are related to cognitive
function in aging. What remains unclear is whether this association is
stronger for some cognitive domains than it is for others, and precisely
how much variability in global and specific cognitive functions is
explained by the motor signs. We examined the associations between four
parkinsonian signs (gait, rigidity, bradykinesia, tremor) and five
cognitive domains (episodic memory, semantic memory, working memory,
perceptual speed, visuospatial ability) in a large cohort of older persons
who were free of Parkinson's disease and dementia and were
participating in the Rush Memory and Aging Project. In a series of
regression equations that controlled for age, sex, and education, higher
levels of three signs (gait, rigidity, and bradykinesia) were related to
lower levels of cognitive function, but they accounted for less than 5% of
the variance in most measures. The results did not change when the
presence of depressive symptoms, diabetes, and hypertension were added to
the models. The cross-sectional association between parkinsonian signs and
cognitive function did not vary substantially across specific cognitive
domains or specific cognitive tests. The results suggest that parkinsonian
signs have a modest, but statistically reliable, association with level of
cognitive function in old age. (JINS, 2005, 11,
Background. Little is known about the extent to which negative life events predict depressive symptoms in ethnically diverse groups or whether this relationship is proximal or enduring.
Method. The relationship between negative life events in adolescence and depressive symptoms in young adulthood was studied in a sample of over 1300 black and white female adolescents. Five domains of life events were assessed at age 16 years and depressive symptoms were measured at age 18 and again at age 21 years. Questions of interest included whether the association continued over time and whether there were specific domains of life events that predicted symptoms better than others.
Results. The total number of negative life events at time 1 predicted depressive symptoms at both time 2 and time 3. Interpersonal loss events and other adversities, however, predicted depressive symptoms only at time 2, whereas at time 3, only interpersonal trauma was a significant predictor. No ethnic differences were found, indicating that the relationship between life events and depressive symptoms appears to be similar for black and white adolescent girls.
Conclusions. The results suggest that negative life events and some specific type of stressors increase the likelihood of the onset of depression symptoms in future years, for both black and white girls. Early preventive efforts should be directed at adolescents who experience loss due to death of a significant other, traumatic events, and psychosocial adversities to forestall the development of depressive symptoms.
The Holocene portion of the Siple Dome (Antarctica) ice core was dated by interpreting the electrical, visual and chemical properties of the core. The data were interpreted manually and with a computer algorithm. The algorithm interpretation was adjusted to be consistent with atmospheric methane stratigraphic ties to the GISP2 (Greenland Ice Sheet Project 2) ice core, 10Be stratigraphic ties to the dendrochronology 14 C record and the dated volcanic stratigraphy. The algorithm interpretation is more consistent and better quantified than the tedious and subjective manual interpretation.