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Investigations into an outbreak of foodborne disease attempt to identify the source of illness as quickly as possible. Population-based reference values for food consumption can assist in investigation by providing comparison data for hypothesis generation and also strengthening the evidence associated with a food product through hypothesis testing. In 2014–2015 a national phone survey was conducted in Canada to collect data on food consumption patterns using a 3- or 7-day recall period. The resulting food consumption values over the two recall periods were compared. The majority of food products did not show a significant difference in the consumption over 3 days and 7 days. However, comparison of reference values from the 3-day recall period to data from an investigation into a Salmonella Infantis outbreak was shown to support the conclusion that chicken was the source of the outbreak whereas the reference values from a 7-day recall did not support this finding. Reference values from multiple recall periods can assist in the hypothesis generation and hypothesis testing phase of foodborne outbreak investigations.
Caregivers for patients undergoing hematopoietic cell transplantation (HCT) are susceptible to significant psychosocial distress. This cross-sectional study aimed to describe psychosocial support services offered and used by caregivers of pediatric primary immune deficiency (PID) during HCT at 35 hospitals across North America.
Caregivers of pediatric patients with PID were recruited by e-mail to participate in an anonymous 140-question survey instrument between April and May 2016 (N = 171).
Of those meeting inclusion criteria (53%), family counseling services were only offered to fewer than half of caregivers (42%). Of the survey participants not offered counseling services, the majority desired family counseling (70%) and sibling counseling (73%). That said, when offered counseling, utilization rates were low, with 22% of caregivers using family counseling and none using sibling counseling.
Significance of results
These results indicate the need to offer and tailor counseling services for families throughout the HCT process. Further research should focus on reducing barriers to utilization of counseling services such as offering bedside counseling services, online modalities, and/or financial assistance.
The West African Disaster Preparedness Initiative held a disaster preparedness tabletop exercise with representatives from the Economic Community of West African States (ECOWAS) in November 2015. The tabletop exercise was hosted by the Republic of Ghana’s National Disaster Management Organization and partners in Accra, Ghana.
ECOWAS Commission delegates and representatives from 10 member states were confronted with a series of simulated crises. Participants utilized existing national preparedness plans and web-based information technologies to research and communicate about internal disaster threats and those from neighboring countries. After each of the exercise’s three phases, facilitators distributed participant surveys.
A total of 106 individuals participated in the tabletop exercise. During the exercise, national teams utilizing well-developed disaster contingency plans and emergency operations center (EOC) standard operating procedures (SOPs) reached out to help less-prepared national teams. Key issues identified in the survey were language and cultural issues as barriers, effectiveness of disaster management agencies linked to heads of state, and the need for data sharing and real-time communication for situational awareness and multisector coordination.
This tabletop exercise helped improve and refine the ECOWAS regional and member states’ national SOPs that teams will employ to prepare for, respond to, and recover from future disasters. (Disaster Med Public Health Preparedness. 2019;13:400-404)
US Africa Command’s Disaster Preparedness Program (DPP), implemented by the Center for Disaster and Humanitarian Assistance Medicine, partnered with US Government agencies and international organizations to promote stability and security on the African continent by engaging with African Partner Nations’ (PN) civil and military authorities to improve disaster management capabilities. From 2008 to 2015, DPP conducted disaster preparedness and response programming with 17 PNs. DPP held a series of engagements with each, including workshops, strategic planning, developing preparedness and response plans, tabletop exercises, and prioritizing disaster management capability gaps identified through the engagements. DPP partners collected data for each PN to further capacity building efforts. Thus far, 9 countries have completed military pandemic plans, 10 have developed national pandemic influenza plans, 9 have developed military support to civil authorities plans, and 11 have developed disaster management strategic work plans. There have been 20 national exercises conducted since 2009. DPP was cited as key in implementation of Ebola response plans in PNs, facilitated development of disaster management agencies in DPP PNs, and trained nearly 800 individuals. DPP enhanced PNs’ ability to prepare and respond to crises, fostering relationships between international agencies, and improving civil-military coordination through both national and regional capacity building. (Disaster Med Public Health Preparedness. 2019;13:319–329)
Exposure to prenatal hypoxia in rats leads to intrauterine growth restriction (IUGR), decreases fetal cardiomyocyte proliferation and increases the risk to develop cardiovascular diseases (CVD) later in life. The tumor necrosis factor-related weak inducer of apoptosis (TWEAK) induces cardiomyocyte proliferation through activation of the fibroblast growth factor-inducible molecule 14 (Fn-14) receptor. The TWEAK/Fn-14 pathway becomes quiescent shortly after birth, however, it becomes upregulated with CVD; suggesting that it could be a link between the increased susceptibility to CVD in pregnancies complicated by hypoxia/IUGR. We hypothesized that offspring exposed to prenatal hypoxia will exhibit reduced cardiomyocyte proliferation due to reduced Fn-14 expression and that the TWEAK/Fn-14 pathway will be expressed in those adult offspring. We exposed pregnant Sprague Dawley rats to control (21% oxygen) or hypoxic (11% oxygen) conditions from gestational days 15 to 21. Ventricular cardiomyocytes were isolated from male and female, control and hypoxic offspring at postnatal day 1. Proliferation was assessed in the presence or absence of r-TWEAK (72 h, 100 ng/ml). Prenatal hypoxia was not associated with differences in Fn-14 protein expression in either male or female offspring. Cardiomyocytes from prenatal hypoxic male, but not female, offspring had decreased proliferation compared with controls. Addition of r-TWEAK increased cardiomyocyte proliferation in all offspring. In adult offspring of all groups, the TWEAK/Fn-14 pathway was not detectable. Cardiomyocyte proliferation was reduced in only male offspring exposed to prenatal hypoxia but this was not due to changes in the Fn-14 pathway. Studies addressing other pathways associated with CVD and prenatal hypoxia are needed.
We present radiocarbon (14C) in tree rings from Mexico City and a reconstruction of fossil CO2 concentrations for the last five decades, as part of a research program to understand the 14C dynamics in this complex urban area. Background values were established by 14C concentrations in tree rings from a nearby clean area. Agreement between background and NH-zone 2 values indicate Taxodium mucronatum is a good biomonitor for annual atmospheric 14C variations. Values for the urban tree rings were significantly lower than background values, indicating a 14C depletion from fossil CO2 emissions. There is an increasing trend of fossil CO2 between 1960 and 1990, in agreement with the population growth and the increasing demand for fossil fuels in Mexico City. Between 1990 and 2000, there is an apparent decrease in fossil CO2 concentration, increasing again after 2000. The decrease in 2000, despite being of the same magnitude as the overall uncertainty, may reflect environmental policies that improved the energy efficiency and reduced CO2 emissions in the area. The increase in fossil CO2 concentration between 2000 and 2010 may be attributable to the significant growth of motor vehicle usage in Mexico City, which made transportation the main energy-demanding and -emitting sector.
To explore the trends in infection control peer-reviewed journals, mainstream media, and blogs written by infection control professionals
Narrative and scoping reviews
Narrative and scoping reviews were performed to identify trending infection prevention and control topics from international journals, national news websites, newspapers, and so-called grey literature throughout 2015. Data were analyzed using word frequencies, and results are displayed in word clouds.
For 2015, our search identified 6 news websites with a total of published 116 articles, 71 articles from selected newspapers, and 214 publications from infection control websites. In total, 1,059 journal articles were initially identified; 98 articles were anonymous and thus were excluded, leaving 961 articles in the reviews. The terms ‘superbug’ and ‘antibiotics’ were most commonly used in titles of news websites and newspapers, whereas the terms ‘infection’ and ‘prevention’ were most commonly used in infection control websites or blogs. The word frequency differences among the 4 selected journals reflected their respective specialties.
In infection prevention and control, the integration of a range of mediums is necessary to best serve public interests. Whether the aim is advocacy, general health information dissemination, or warnings of imminent risk, health researchers have access to multiple forums with different strengths through which to influence public risk perceptions and responses.
The Ebola outbreak demonstrated the need for improved disaster response throughout West Africa. The West Africa Disaster Preparedness Initiative was a training and assessment effort led by US Africa Command and partners to strengthen capacities among 12 West African partner nations (PNs).
Series of 3-week training sessions with representatives from each PN were held from 13 July through 20 November 2015 at the Kofi Annan International Peacekeeping Training Centre in Accra, Ghana. A team conducted Disaster Management Capabilities Assessments (DMCAs) for each PN, including a review of key data, a survey for leaders, and in-person interviews of key informants.
All 12 PNs generated a national Ebola Preparedness and Response Plan and Emergency Operations Center standard operating procedures. DMCA metrics were generated for each PN. Top performers included Ghana, with a plan rated good/excellent, and Benin and Burkina Faso, which both achieved a satisfactory rating for their plans. More than 800 people from 12 nations were trained.
PNs have improved disaster management capabilities and awareness of their strengths and weaknesses. The Economic Community of West African States has increased its lead role in this and future planned initiatives. (Disaster Med Public Health Preparedness. 2017;11:431–438)
The Republic of Senegal Disaster Preparedness and Response Exercise was held from June 2-6, 2014, in Dakar, Senegal. The goal was to assist in familiarizing roles and responsibilities within 3 existing plans and to update the National Disaster Management Strategic Work Plan.
There were 60 participants in the exercise, which was driven by a series of evolving disaster scenarios. During the separate Disaster Management Strategic Work Plan review, participants refined a list of projects, including specific tasks to provide a “road map” for completing each project, project timelines, and estimated resource requirements. Project staff administered a survey to conference participants.
A total of 86% of respondents had improved knowledge of Senegal disaster plans as a result of the exercise. A total of 89% of respondents had a better understanding of their ministry’s role in disaster response, and 92% had a better understanding of the role of the military during a pandemic. Participants also generated ideas for disaster management system improvement in Senegal through a formal “gap analysis.”
Participants were in strong agreement that the exercise helped them to better understand the contents of their disaster response plans, build relationships across ministerial lines, and effectively enhance future disaster response efforts. (Disaster Med Public Health Preparedness. 2017;11:183–189)
We present preliminary results from a programme designed to produce deep images of radio source fields drawn from the Parkes 2700 MHz and Molongolo 408 MHz catalogues using the charge-coupled-device (CCD) camera system built at the Institute of Astronomy, Cambridge. The programme is directed at a search both for faint extensions and nebulosity around radio QSOs and BL Lac objects and for faint objects in otherwise empty radio source fields; a detailed examination of the morphology of selected radio galaxies is also included.
Fr Arthur Gabriel Hebert SSM is perhaps best known for his role in the Parish Communion Movement (PCM), a predominantly Church of England based offshoot of the wider liturgical reform movement of the early and mid-twentieth century. The PCM made the case for Holy Communion to be the main act of Sunday morning worship, rather than the then more widely used Matins service.
Today Hebert's name is most often associated with liturgical reform, and the systematic theology which underpinned his work has fallen largely into obscurity. This paper explores the theology that informed Hebert's liturgical arguments, drawing out his understanding of a faith that transcends denominational and stylistic differences, and makes the case that Hebert's theology has much to contribute to present-day ecumenical and missional dialogue.
Ridgway’s Hawk Buteo ridgwayi is a Critically Endangered forest raptor endemic to the island of Hispaniola in the Caribbean. The species is currently limited to a small area on the north-east coast of the island, with fewer than 110 pairs remaining. From 2005 to 2009 we studied its breeding ecology, finding that Ridgway’s Hawks have a clutch size (2.0 ± 0.4 eggs) similar to other tropical raptors and island Buteo species. Fledging rate of 0.64 fledglings per active nest (fledgling nest-1) with pairs raising a single brood per year was also similar to that of other tropical Buteo species. Nest success was 40% (n = 151), with the majority of nest failures caused by human disturbance. The two significant predictors of nest success and fledging rate were related to human persecution: nest height and territory disturbance index. Pairs were able to tolerate human activity in their territory if there was no direct disturbance to the immediate nest area. Conservation planning for Ridgway’s Hawk must focus on community awareness programmes targeting local user groups within Los Haitises National Park regarding the uniqueness and endangered status of the hawk, and effective protection of the remaining karst forest in Los Haitises.
For several years now, headlines around the world have been trumpeting the cognitive control advantages enjoyed by bilinguals. As the story goes, a lifetime of experience selecting between two competing languages leads to improvements in control that generalize beyond the domain of language. It even protects the brain from the untoward effects of aging.
There has been a long history of herd health and production management programmes in many dairy industries around the world, but evidence for the efficacy of such programmes is limited. In response to a perceived decline in fertility of dairy cows, a herd reproductive management programme (InCalf) was introduced in New Zealand in 2007. This programme uses a management cycle approach that includes an assessment of the current herd status, identification of areas for improvement, development of a plan, implementation of this plan and finally a review process. The programme uses facilitators who work with farmers either in a one-to-one manner or in a formalised group setting that involves a series of meetings over a 12-month period (the farmer action group). The hypothesis that involvement in a reproductive management programme would improve herd reproductive performance was tested using a herd-level controlled randomised study (the National Herd Fertility Study) involving herds in four geographic regions of New Zealand over 2 years. Within each region, herds were ranked on the basis of the 6-week in-calf rate (i.e. the proportion of the herd pregnant in the first 6 weeks of the seasonal breeding programme) in the year preceding commencement of the study and then randomly assigned to be involved in a farmer action group or left as untreated controls. The key outcome variable of the study was the 6-week in-calf rate. Pregnancy diagnosis was undertaken at 12 weeks after the start of the seasonal breeding programme, which allowed determination of conception dates and hence calculation of the 6-week in-calf rate. Additional measurements including heifer live weight and body condition score (pre-calving and pre-mating) were undertaken to test whether treatment resulted in measurable changes in some of the key determinants of herd reproductive performance. Involvement in the farmer action group of InCalf resulted in a 2 percentage point increase in the 6-week in-calf rate (P=0.05). The following additional observations were made in herds involved in the farmer action group relative to control herds: heifers had live weight closer to target; the pre-mating body condition score of cows was higher; and oestrous detection rates were higher. It was concluded that involvement in this herd reproductive management programme improved reproductive outcomes in this New Zealand study. However, to achieve substantial improvements in herd reproductive performance at the regional or national level a greater response to the programme and a high uptake of such programmes is required, as well as use of other industry-level tools such as genetic management programmes.
The 2011 investigations of the Caves Branch Archaeological Survey at the large and recently documented Maya site of Tipan Chen Uitz resulted in the discovery of the site's first monument with a glyphic inscription. Prior to this discovery, the site's glyphic corpus was limited to a small collection of texts rendered on fragmentary ceramics. In this paper, we describe these sherds as well as the monument (Monument 1), report on their archaeological contexts, provide an epigraphic analysis of the texts, and consider these written sources relative to our growing understanding of Tipan and its place in the ancient political landscape. The discovery of Monument 1 is important, for it stands to contribute to sociopolitical reconstructions in this part of the central Maya Lowlands and has significant implications for the possible presence of other, as yet undiscovered, Late Classic period (A.D. 550-830) monuments at Tipan.
Patterns of social organization and mating systems have been shown to be functions of ecological factors such as resource allocation and breeding density. In some species, particularly birds, social organization and genetic mating systems differ with molecular studies providing evidence of extra-pair young frequently occurring within broods of socially monogamous species. Here we examine the social and genetic mating system of an ecologically little-known forest raptor endemic to the island of Hispaniola in the Caribbean. From 2005–2009, our field observations of over 60 breeding pairs verified a social mating system of monogamy for the species. During the same time period, we collected blood samples (n = 146 birds, 48 nests) and used microsatellite profiles from 10 loci to estimate genetic relatedness among nestlings in a brood and assign putative fathers. We found no evidence of extra-pair paternity in 41 broods. We had one instance where a social male was not assigned as the putative father, however, the confidence level of this assignment was not significant since the genotypes of the social and assigned males were very similar. Our results support our hypothesis that genetic monogamy would be exhibited by Ridgway's hawk, an island-endemic tropical raptor.