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Despite lessons learned from the recent Ebola epidemic, attempts to survey and determine non-health care worker, industry-specific needs to address highly infectious diseases have been minimal. The aircraft rescue and fire fighting (ARFF) industry is often overlooked in highly infectious disease training and education, even though it is critical to their field due to elevated occupational exposure risk during their operations.
Supervisors perceived Frontline respondents to be more willing and comfortable to encounter potential highly infectious disease scenarios than the Frontline indicated. More than one-third of respondents incorrectly marked transmission routes of viral hemorrhagic fevers. There were discrepancies in self-reports on the existence of highly infectious disease orientation and skills demonstration, employee resources, and personal protective equipment policies, with a range of 7.5%-24.0% more Supervisors than Frontline respondents marking activities as conducted.
There are deficits in highly infectious disease knowledge, skills, and abilities among ARFF members that must be addressed to enhance member safety, health, and well-being. (Disaster Med Public Health Preparedness. 2018;12:675-679)
The acoustic impedance of the subglacial material beneath 7.2 km profiles on four ice streams in Antarctica has been measured using a seismic technique. The ice streams span a wide range of dynamic conditions with flow rates of 35–464 m a–1. The acoustic impedance indicates that poorly lithified or dilated sedimentary material is ubiquitous beneath these ice streams. Meanacoustic impedance across each profile correlates well with basal shear stress and the slipperiness of the bed, indicating that acoustic impedance is a good diagnostic not only for the porosity of the subglacial material, but also for its dynamic state (deforming or non-deforming). Beneath two of the ice streams, lodged (non-deforming) and dilated (deforming) sediment coexist but their distribution is not obviously controlled by basal topography or ice thickness. Their distribution may be controlled by complex material properties or the deformation history. Beneath Rutford Ice Stream, lodged and dilated sediment coexist and are distributed in broad bands several kilometres wide, whileon Talutis Inlet there is considerable variability over much shorter distances; this may reflect differences in the mechanism of drainage beneath the ice streams. The material beneath the slow-moving Carlson Inlet is probably lodged but unlithified sediment; this is consistent with the hypothesis that Carlson Inlet was once a fast-flowing ice stream but is now in a stagnant phase, which could possibly be revivedby raised basal water content. The entire bed beneath fast-flowing Evans Ice Stream is dilated sediment.
The aims of the present study were to provide nationally representative data on fruit and vegetable consumption in Vietnam, and to assess the accuracy of the reported numbers of ‘standard servings’ consumed. Data analysed were from a multi-stage stratified cluster survey of 14 706 participants (46·5 % males, response proportion 64·1 %) aged 25−64 years in Vietnam. Measurements were made in accordance with the WHO STEPwise approach to surveillance of non-communicable diseases (STEPS) protocols. Approximately 80 % of Vietnamese people reported having less than five servings of fruit and vegetables daily in a typical week. Fruit and vegetable intake reported in ‘standard serving’ sizes was positively correlated with levels of education completed and household income (P<0·001 for trend). The correlations between summary values for each province reflect some known demographic, geographical and climatic characteristics of the country. For example, provinces at higher latitude had higher mean servings of vegetables (r 0·90), and provinces with higher proportions of urban population had higher mean servings of fruit (r 0·40). In conclusion, about eight in ten Vietnamese people aged 25–64 years did not meet WHO recommendations for daily consumption of at least five servings of fruit and vegetables. On the basis of the consistency of the data collected with other estimates and with physical and demographic characteristics of the country, the WHO STEPS instrument has construct validity for measuring fruit and vegetable intake, but with two issues identified. The issues were seasonal variation in reporting and a limitation on the usefulness of the information for associative analyses.
To describe current Ebola treatment center (ETC) locations, their capacity to care for Ebola virus disease patients, and infection control infrastructure features.
A 19-question survey was distributed electronically in April 2015. Responses were collected via email by June 2015 and analyzed in an electronic spreadsheet.
The survey was sent to and completed by site representatives of each ETC.
The survey was sent to all 55 ETCs; 47 (85%) responded.
Of the 47 responding ETCs, there are 84 isolation beds available for adults and 91 for children; of these pediatric beds, 35 (38%) are in children’s hospitals. In total, the simultaneous capacity of the 47 reporting ETCs is 121 beds. On the basis of the current US census, there are 0.38 beds per million population. Most ETCs have negative pressure isolation rooms, anterooms, and a process for category A waste sterilization, although only 11 facilities (23%) have the capability to sterilize infectious waste on site.
Facilities developed ETCs on the basis of Centers for Disease Control and Prevention guidance, but specific capabilities are not mandated at this present time. Owing to the complex and costly nature of Ebola virus disease treatment and variability in capabilities from facility to facility, in conjunction with the lack of regulations, nationwide capacity in specialized facilities is limited. Further assessments should determine whether ETCs can adapt to safely manage other highly infectious disease threats.
Infect. Control Hosp. Epidemiol. 2016;37(3):313–318
Influenza A (H1N1) pdm09 became the predominant circulating strain in the United States during the 2013–2014 influenza season. Little is known about the epidemiology of severe influenza during this season.
A retrospective cohort study of severely ill patients with influenza infection in intensive care units in 33 US hospitals from September 1, 2013, through April 1, 2014, was conducted to determine risk factors for mortality present on intensive care unit admission and to describe patient characteristics, spectrum of disease, management, and outcomes.
A total of 444 adults and 63 children were admitted to an intensive care unit in a study hospital; 93 adults (20.9%) and 4 children (6.3%) died. By logistic regression analysis, the following factors were significantly associated with mortality among adult patients: older age (>65 years, odds ratio, 3.1 [95% CI, 1.4–6.9], P=.006 and 50–64 years, 2.5 [1.3–4.9], P=.007; reference age 18–49 years), male sex (1.9 [1.1–3.3], P=.031), history of malignant tumor with chemotherapy administered within the prior 6 months (12.1 [3.9–37.0], P<.001), and a higher Sequential Organ Failure Assessment score (for each increase by 1 in score, 1.3 [1.2–1.4], P<.001).
Risk factors for death among US patients with severe influenza during the 2013–2014 season, when influenza A (H1N1) pdm09 was the predominant circulating strain type, shifted in the first postpandemic season in which it predominated toward those of a more typical epidemic influenza season.
Infect. Control Hosp. Epidemiol. 2015;36(11):1251–1260
There are no evidence-based treatments for severe and enduring anorexia nervosa (SE-AN). This study evaluated the relative efficacy of cognitive behavioral therapy (CBT-AN) and specialist supportive clinical management (SSCM) for adults with SE-AN.
Sixty-three participants with a diagnosis of AN, who had at least a 7-year illness history, were treated in a multi-site randomized controlled trial (RCT). During 30 out-patient visits spread over 8 months, they received either CBT-AN or SSCM, both modified for SE-AN. Participants were assessed at baseline, end of treatment (EOT), and at 6- and 12-month post-treatment follow-ups. The main outcome measures were quality of life, mood disorder symptoms and social adjustment. Weight, eating disorder (ED) psychopathology, motivation for change and health-care burden were secondary outcomes.
Thirty-one participants were randomized to CBT-AN and 32 to SSCM with a retention rate of 85% achieved at the end of the study. At EOT and follow-up, both groups showed significant improvement. There were no differences between treatment groups at EOT. At the 6-month follow-up, CBT-AN participants had higher scores on the Weissman Social Adjustment Scale (WSAS; p = 0.038) and at 12 months they had lower Eating Disorder Examination (EDE) global scores (p = 0.004) and higher readiness for recovery (p = 0.013) compared to SSCM.
Patients with SE-AN can make meaningful improvements with both therapies. Both treatments were acceptable and high retention rates at follow-up were achieved. Between-group differences at follow-up were consistent with the nature of the treatments given.
A comparative study of chemical and textural properties for materials obtained by three different methods of dealumination of alumina-rich parent Ca-A zeolite showed that the method using ammonium hexafluorosilicate (AFS) resulted in the most interesting developments of mesoporous materials, with much higher void volumes and cation exchange properties than obtained by acid leaching or hydrothermal treatment. AFS treatment on both the Na and Ca forms of zeolite A resulted in materials with 12 nm sized mesopores, whereas smaller mesopores of about 4 nm were obtained when using the higher Si/Al ratio parent zeolite Na-X. Pore size distribution profiles obtained for these new materials are fairly narrow, indicating homogeneous mesopore sized solids.
The electrical and piezoresistive properties of in-situ doped PECVD silicon films deposited on oxided silicon wafers have been investigated. One series of films was deposited in the so-called microcrystalline state at 450°C. The other set of samples was deposited in the amorphous state at 320°C and subjected to rapid thermal annealing. Structural properties (grain size, texture, residual stress) were evaluated experimentally through TEM and grazing angle X ray diffraction and related to the measured gauge factor. A maximum longitudinal gauge factor of 28 is measured in the case of advantageously textured microcrystalline material, the magnitude of the gauge factor decreasing sharply for randomly oriented material. For the amorphous deposited and subsequently annealed material, the longitudinal gauge factor is in the range 22–27 depending on dopant concentration. These experimental features are compared to the results of a theoretical approach of piezoresistance in polysilicon. We derive various expressions of the gauge factor according to the assumptions of either constant stress or constant strain within the aggregate. In the case of untextured films, analytical Voigt-Reuss-Hill averages for the elements of piezoresistive and elastoresistive tensors lead to greatly simplified expressions. Theoretical estimates are shown to be in reasonable agreement with the experimental measurements. This confirms the great potential of PECVD microcrystalline and polycrystalline silicon for strain gauges.
High quality SrS and SrS:Ce thin films were deposited from Sr(thd)2, Ce(thd)4 and H2S via a low pressure MOCVD process. Film characteristics were found to be insensitive to the presence of the cerium dopant in the concentration range investigated. Depositions were carried out for a wide temperature range (250–550° C). Deposition rates were found to be relatively insensitive for the temperature range investigated. The films produced were found to be highly crystalline at all temperatures investigated. Deposited material showed texturing as a function of substrate material and temperature. FWHM of the <111> reflections were found to have a 2Θ values of 0.15–0.18 deg. for all temperatures. RBS and AES shows stoichiometric 1:1 SrS with less than 2% carbon and oxygen contaminates. ERD indicates the films to have 1 – 2.5% hydrogen. Films doped with 0.019 – 0.043 atom – 250 volts.
Electrical conductivity of three simulated nuclear waste glass melts was measured over a wide range of temperatures, using a high-accuracy, calibration-free, coaxial-cylinders technique. Glass chemistries representing both low-activity and high-level wastes at Hanford and Savannah River sites were used. The temperature dependence of the conductivity of these glasses was presented. The conductivity values measured at 1150°C were compared to the conductivity values predicted from first-order mixture model.
The objective of this study is to optimize the storage system with respect to thermal constraints. Due to a large number of 3D calculations, a simple temperature model based on an Design Of Experiment method has been developed. The most significant parameters have been exhibited by an extensive parametric study. A satisfactory agreement is observed between polynomial model and 3D approach.
To quantify the prevalence of cerebral palsy (CP) in British Columbia within a four-year birth cohort.
The study was a population-based record linkage study of a birth cohort of British Columbian children born between April 1, 1991 and March 31, 1995. Cases were identified by the presence of International Classification of Diseases, Version 9 (ICD-9) diagnostic code “343” recorded at three years of age or older or by having the ICD-9 diagnostic code “343” recorded prior to the third birthday with two confirmatory diagnoses within the first three years of life through a record search of the BC Medical Services Plan billing files for the fiscal years 1991 to 1995.
This research has provided an estimate of the prevalence of CP in the four-year birth cohort 1991 to 1995 in British Columbia. An aggregate prevalence rate of CP was measured as 2.68 per 1000 live births, and a congenital rate was measured at 2.57 for the same population. Birth weight and gestational age demonstrated a significant relationship with the development of CP. This study should lend credence to the establishment of a CP register in British Columbia.
Alternative mating tactics are found in many species, and may have important implications for population genetics and speciation. The existence of such alternative mating tactics is well-documented in the three-spined stickleback Gasterosteus aculeatus, and sneaking and egg-stealing may occur in a significant proportion of matings under natural conditions. Sneaking can impose high costs on territorial males, both in terms of reduced reproductive output and caring for unrelated offspring. We ask whether territorial males adjust their behaviour in response to the risk of sneaking. In a field study of three-spined sticklebacks on the Isle of Arran, Scotland, territorial males were presented with glass bottles containing either a male, a female or neither, to address whether territorial males were more aggressive to other males in the presence of a female, and whether territorial males courted females less in the presence of another male. Behavioural observations showed that territorial males did not behave more aggressively towards rival males in the presence of a female, but did reduce their rate of courtship towards females in the presence of rival males. We conclude that territorial males adopt behavioural strategies that may reduce their risk of reproductive parasitism.
The presence of specific steroid receptors in neurons and evidence of steroid binding provide a basis for understanding the direct effects of steroids on neuronal function. Yet many key actions of gonadal steroids may be transmitted through multisynaptic pathways, in which only a subset of the participants are directly steroid-sensitive. The exploration of steroid actions on multisynaptic neuronal systems is nonetheless important but has been complicated by the lack of experimental techniques for monitoring activity changes across brain areas. In recent years, scientists have recognized that Fos, the protein product of the c-fos immediate early gene, is expressed in neurons that are stimulated. Immunocytochemical staining of Fos following specific stimuli has proved valuable for assessing neuronal activity (Morgan and Curran 1989; Sagar et al. 1988), and the results of studies using this approach will be presented here.
Specifically, the studies summarized in this chapter examined certain effects of gonadal steroids on neuronal activity as assessed by Fos staining. Two principal lines of investigation will be discussed. The first is the role of estrogen and progesterone in the luteinizing hormone–releasing hormone (LHRH) neuron activation that drives the preovulatory LH surge. The second is the role of progesterone in modifying neuronal activation by excitatory amino acids in brain systems other than the LHRH neurons. The latter studies point to the global effects that gonadal steroid hormones can have on neuronal function distinct from their actions on the regulation of reproductive function.
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