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Personal disaster and emergency support networks of rural older adults are described before and after participation in a disaster preparedness intervention, PrepWise.
At baseline, a total of 194 disaster support network members were identified by 27 older adults in a rural Midwest community. After the intervention, these participants identified 232 support network members. Multilevel logistic regression models were constructed to identify characteristics of the network members and social interactions associated with support providers at baseline as well as newly added support sources after the PrepWise intervention.
Member and interaction characteristics associated with being identified as emergency support sources at baseline were as follows: family, lived in close proximity, weekly or more frequent contact, and being someone whom participants shared concerns with, trusted, and exchanged emotional support with. After receiving PrepWise, participants on average identified 3 new sources of emergency support within their networks. Support sources added at follow-up tended to be nonfamily members and those participants trusted.
Enhancements in personal emergency support networks occurred after the intervention. Understanding characteristics of the network members and social interactions may assist in identifying additional emergency support sources. Larger studies investigating the impacts of enhanced support networks on disaster-related behaviors and outcomes will be beneficial. (Disaster Med Public Health Preparedness. 2017;11:110–119)
The active management of the experience of living with dementia appears to improve quality of life despite the lack of disease modification. However, research to date has been largely of modest scale and explanatory factors for improvements have been under-conceptualised. Thus, although promulgated through national strategies, the evidence base is relatively weak. This paper reports on a nation-wide study of the influence of the National Dementia Strategy for England in relation to Dementia Adviser and Peer Support Network services in 40 demonstration sites. The research aimed to identify ways in which the services contribute to the wellbeing and resilience of people with dementia and care partners. A mixed-methods research design collected data through: activity and outcome monitoring; organisational surveys; in-depth case studies, including qualitative interviews with people with dementia (N = 47) and care partners (N = 54), wellbeing and quality of life measures, and interviews with staff and other stakeholders (N = 82). Three themes are explored: addressing individual and community needs; promoting independence, control and choice; and getting a life back. Services promoted independence, control and choice, and consequently enabled people to re-narrate their lives as purposeful within their communities. Ways in which these are achieved resemble the public health model of lay health advisor and this research adds to the imperative to approach dementia as a key public health concern.
In the United States of America (USA), older adults in rural areas are at increased risk for adverse outcomes of disasters, partly due to medical needs, limited or long geographic distances from community resources, and less knowledge and motivation about preparedness steps. Older residents and ageing service providers in a rural community in the USA were interviewed regarding their perceptions about disasters and preparedness, and their reactions to the preparedness training programme using the concepts of the Extended Parallel Process Model. Participants generally indicated low motivation to engage in preparedness behaviours despite perceptions of personal risk and beliefs that preparedness behaviours were easy and could improve disaster outcomes. A theme of social relationships emerged from the data, with participants identifying social relationships as resources, barriers and motivators. People surrounding older adults can support or deter their preparedness behaviours, and sometimes elicit a desire to protect the wellbeing of others. Findings suggest two potential strategies to facilitate preparedness behaviours by moving beyond personal benefits: highlighting older adults' increased ability to protect the wellbeing of younger generations and their community by being prepared themselves, and engaging family, friends and neighbours in preparedness programmes to enhance the resilience of their social groups. Older adults in many cultures have a desire to contribute to their society. Novel and effective approaches to increase preparedness could target their social groups.
There is growing interest in brief contact interventions for self-harm
and suicide attempt.
To synthesise the evidence regarding the effectiveness of brief contact
interventions for reducing self-harm, suicide attempt and suicide.
A systematic review and random-effects meta-analyses were conducted of
randomised controlled trials using brief contact interventions (telephone
contacts; emergency or crisis cards; and postcard or letter contacts).
Several sensitivity analyses were conducted to examine study quality and
We found 14 eligible studies overall, of which 12 were amenable to
meta-analyses. For any subsequent episode of self-harm or suicide
attempt, there was a non-significant reduction in the overall pooled odds
ratio (OR) of 0.87 (95% CI 0.74–1.04, P = 0119) for
intervention compared with control. The number of repetitions per person
was significantly reduced in intervention v. control
(incidence rate ratio IRR = 066, 95% CI 0.54–0.80,
P<0001). There was no significant reduction in the
odds of suicide in intervention compared with control (OR = 0.58, 95% CI
A non-significant positive effect on repeated self-harm, suicide attempt
and suicide and a significant effect on the number of episodes of
repeated self-harm or suicide attempts per person (based on only three
studies) means that brief contact interventions cannot yet be recommended
for widespread clinical implementation. We recommend further assessment
of possible benefits in well-designed trials in clinical populations.
Problem-solving and coping skills deficits have been shown in adolescents who experience suicide-related behaviours, including suicidal ideation. Little evidence exists about effective interventions for this population. We undertook a pilot study of an Internet-based CBT programme that included problem-solving skills training to investigate its impact on skills deficits. The study employed a pre-test/post-test design. Outcomes of interest were negative problem orientation, emotion- and task-focused coping, and adolescents’ perception of helpfulness of the intervention. Participants, recruited via the school wellbeing team, were assessed at baseline, at weekly intervention sessions and immediately post-intervention. Twenty-one adolescents completed the intervention. Over the course of the intervention, negative problem-solving orientation improved and students relied less on emotion-focused coping strategies. Because there was no control group, we cannot be certain that the changes seen between baseline and post-intervention can be attributed to the intervention. Adolescents rated the problem-solving and cognitive restructuring modules as particularly helpful. Interventions that include enhancement of problem-solving skills, as well as cognitive restructuring to address adolescents’ appraisal of problems and their ability to solve them appear promising for adolescents with suicidal ideation. Further investigation is warranted.
The 2013 Infection Prevention and Control (IP&C) Guideline for Cystic Fibrosis (CF) was commissioned by the CF Foundation as an update of the 2003 Infection Control Guideline for CF. During the past decade, new knowledge and new challenges provided the following rationale to develop updated IP&C strategies for this unique population:
1. The need to integrate relevant recommendations from evidence-based guidelines published since 2003 into IP&C practices for CF. These included guidelines from the Centers for Disease Control and Prevention (CDC)/Healthcare Infection Control Practices Advisory Committee (HICPAC), the World Health Organization (WHO), and key professional societies, including the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). During the past decade, new evidence has led to a renewed emphasis on source containment of potential pathogens and the role played by the contaminated healthcare environment in the transmission of infectious agents. Furthermore, an increased understanding of the importance of the application of implementation science, monitoring adherence, and feedback principles has been shown to increase the effectiveness of IP&C guideline recommendations.
2. Experience with emerging pathogens in the non-CF population has expanded our understanding of droplet transmission of respiratory pathogens and can inform IP&C strategies for CF. These pathogens include severe acute respiratory syndrome coronavirus and the 2009 influenza A H1N1. Lessons learned about preventing transmission of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant gram-negative pathogens in non-CF patient populations also can inform IP&C strategies for CF.
1/f noise in semiconductor devices and circuits provides important information regarding quality of the interface as well as the transport mechanism. In 1D and 2D channel materials, 1/f noise also provides information on stability under ambient conditions, including effects of contaminants adsorbed on the surface. In addition, noise levels are important in evaluating suitability of the device for analog and digital applications. In this work, we have fabricated back-gated field-effect transistors (FETs) using various thicknesses of mechanically exfoliated MoS2 flakes (bilayer and 15 layer flakes) and studied the 1/f noise under ambient conditions. The on-current of the devices scales with the number of layers. The Hooge parameters inferred from the measured noise amplitudes and calculated carrier densities are comparable to prior reports on devices such as CNTs and graphene FETs, even when measured under ambient conditions. The effect of channel and contacts on both the conductance and noise can be inferred from bias-dependent current and noise measurements.
Adults from South Auckland, New Zealand who required acute admission to hospital were followed from admission to discharge. After adjusting for demographic factors, diagnosis, chronicity, severity, consultant psychiatrist and involuntary admission, the length of stay for those from more deprived areas was significantly longer by 7 days than for those from less deprived areas. Information on socio-economic deprivation should be used in discharge planning and in optimising access to community care. Research is needed on group-level factors that may affect recovery from mental disorders.
Macroscopic Fabric Analysis, the systematic study and description of ceramic fabrics with the aid of a handlens and other simple equipment, has grown in importance along with systematic archaeological survey. Microscopic Fabric Analysis, or ceramic petrology, is better known, but more expensive and time-consuming. Using examples drawn from Sphakia Survey material, the authors show that Macroscopic Fabric Analysis of large pottery collections with a high proportion of coarse ware sherds, when combined with targeted microscopic analysis, provides detailed, reliable information on crucial topics such as chronology, in this case from FN/EM I–Turkish; function (cooking, transport, storage, and beehives); and regional interaction. The authors also discuss issues connected with publication, including the use of electronic publications such as the Sphakia Survey website, and the rigorous comparison of individual fabrics, and they make a case for adopting standard ceramic terminology.
We investigated the gastrointestinal handling and post-absorptive metabolic handling of [1,1,1-13C]tripalmitin and [1-13C]glycocholate during recovery from severe childhood malnutrition. Eight children were studied on three occasions: at admission (phase 1), during rapid catch-up growth (phase 2) and when weight-for-height had reached 90 % of the reference (phase 3). Breath samples were obtained over a 24 h period and stools were collected over 3 d following the administration of each tracer. At admission, the lipid content of stool expressed as a percentage of ingested lipid was 6 (range 0.7–28.9) but less variation was shown between children at phase 2 (3.3 (range 0.9–4.1)) and phase 3 (1.4 (range 0.4–2.5)). The excretion of 13C in stool varied markedly between children at admission (11.1 (SD 5.4) % administered dose) and during rehabilitation (phase 2, 15.4 (sd 16.5) % administered dose; phase 3, 6.2 (sd 10.2) % administered dose). About 5 % of the absorbed label was recovered on breath at each stage (% absorbed dose; phase 1, 5.1 (sd 6.0); phase 2, 5.2 (sd 3.1); phase 3, 6.4 (sd 6.6)). None of the children exhibited significant bile salt malabsorption as a consequence of small intestinal overgrowth. Of the 13C measured in stool, more label was recovered in fatty acids than triacylglycerols during each of the three phases and this was interpreted to reflect a failure to absorb the products of digestion. The results show that not all the children had problems associated with the digestion and absorption of 13C-labelled tripalmitin in severe malnutrition and during recovery, which was not reflected in gross lipid balance across the gastrointestinal tract. Absorbed lipid was more likely to be deposited as adipose tissue than to satisfy the immediate needs for energy.
Emergency anaesthesia for the compromised fetus encompasses anaesthesia for both acute fetal distress and the chronically hypoxic fetus. Fetal distress, a poorly defined term, is still used by clinicians today. Parer and Livingston defined fetal distress as “progressive fetal asphyxia, that if not corrected or circumvented, will result in decompensation of the physiologic responses (primarily redistribution of blood flow to preserve oxygenation of vital organs) and cause permanent central nervous system and other organ damage or death.” More recently the term “non-reassuring fetal status” has been adopted as a better descriptor than fetal distress.
Thirty codependent cocaine and alcohol users were
compared with age-, education-, race-, and sex-matched
cocaine abusers (N = 30) and normals (N
= 30) using an extended Halstead-Reitan Neuropsychological
Test Battery to determine whether cocaine abusers with
alcohol dependence were more cognitively impaired than
singly addicted cocaine abusers. Tests were grouped and
analyzed according to 8 major ability areas. Participants
who abused both cocaine and alcohol did not differ from
normals on the majority of test measures. An unexpected
but consistent finding was the poorer performance of the
cocaine sample relative to cocaine and alcohol abusers
on measures of complex psychomotor and simple motor functioning
(ps < .001). Pure cocaine abusers, but not
abusers of both cocaine and alcohol, also performed more
poorly than normals on a measure of global neuropsychological
functioning (p < .01). These results are consistent
with previous reports of generally mild cognitive dysfunction
in cocaine abusers. The findings also suggest that cocaine
and alcohol abusers of relatively young ages may be less
cognitively impaired than demographically comparable cocaine
abusers. Evidence from studies of vascular functioning
in abusers of cocaine and alcohol alone and in combination
is discussed as possible explanation for these findings.
(JINS, 1999, 5, 10–19.)