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The aim of this review was to summarize current evidence from the United States on the effectiveness of practices and interventions for preventing, recognizing, and controlling occupationally acquired infectious diseases in Emergency Medical Service (EMS) clinicians.
Report and Methods:
PubMed, Embase, CINAHL, and SCOPUS were searched from January 1, 2006 through March 15, 2022 for studies in the United States that involved EMS clinicians and firefighters, reported on one or more workplace practices or interventions that prevented or controlled infectious diseases, and included outcome measures. Eleven (11) observational studies reported on infection prevention and control (IPC) practices providing evidence that hand hygiene, standard precautions, mandatory vaccine policies, and on-site vaccine clinics are effective. Less frequent handwashing (survey-weight adjusted odds ratio [OR] 4.20; 95% confidence interval [CI], 1.02 to 17.27) and less frequent hand hygiene after glove use (survey-weight adjusted OR 10.51; 95% CI, 2.54 to 43.45) were positively correlated with nasal colonization of Methicillin-resistant Staphylococcus aureus (MRSA). Lack of personal protective equipment (PPE) or PPE breach were correlated with higher severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seropositivity (unadjusted risk ratio [RR] 4.2; 95% CI, 1.03 to 17.22). Workers were more likely to be vaccinated against influenza if their employer offered the vaccine (unadjusted OR 3.3; 95% CI, 1.3 to 8.3). Active, targeted education modules for H1N1 influenza were effective at increasing vaccination rates and the success of on-site vaccine clinics.
Evidence from the United States exists on the effectiveness of IPC practices in EMS clinicians, including hand hygiene, standard precautions, mandatory vaccine policies, and vaccine clinics. More research is needed on the effectiveness of PPE and vaccine acceptance.
Seven species of cornulitids, one unidentified tubicolous shell, and the problematic bryozoan Lagenosypho Spandel, 1898 are here described from the Katian of Baltica. Three new species—Cornulites lindae new species, Cornulites meidlai new species, and Conchicolites kroegeri new species—are described. The unidentified tubicolous organism has punctate shell structure and setae-like structures that can best be affiliated with lophophorates. The Hirmuse fauna indicates that the diversity and number of cornulitids in the Ordovician of Baltica has been underestimated and it is likely that the Baltic cornulitid fauna was as diverse and abundant as the fauna of Laurentia. Clay mud-bottom environments supported the highest cornulitid diversity in the Late Ordovician of Baltica. The occurrence of intermediate forms indicates that some tentaculitid characters, e.g., regular annulation and a nearly straight shell, which were thought to be apomorphies of free-living tentaculitids, were actually inherited from ancestral cornulitids. The cornulitid fauna of the Late Ordovician of Laurentia somewhat resembles the cornulitid fauna of the Late Ordovician of Baltica, but there are fewer common faunal elements between Gondwana and Baltica.
History bears witness to the cataclysmic effect on society of inventions of new media for the transmission of information among persons. The development of writing and later the development of printing are examples.
The “Gutenberg Revolution” served as a touchstone for western intellectuals during much of the second half of the twentieth century, especially during the decades of the Cold War. The standard account, popularized by scholars such as Marshall McLuhan, tells a familiar march-of-progress narrative, in which the invention of printing happily launched western Europe into an era of intellectual, political, religious, and economic achievement. Scholars of European and global premodernity, however, never accepted the oversimplifications of this potted history, and chafed both at its assumptions about the unequivocally positive effects of the new medium and especially at all it incuriously projects onto earlier centuries, which in popular and learned accounts have been obliged, once again, to represent the darkness before the dawn of modernity.
Today we inhabit a world of temporal mirroring: for the past three decades we have been immersed in another revolution “of new media for the transmission of information” on an effectively global scale, like a vast cultural experiment taking place in real time. This unprecedentedly rapid new revolution demands a reassessment of the pieties and prejudices associated with the information-technology revolution of the late fifteenth and sixteenth centuries by seeking a deeper awareness of the counter-currents characteristic of such moments of dramatic cultural change, including “the cataclysmic effect on society” of the new order.
The 1990s digital revolution was thought to generate, as the print revolution and its contemporary, the Protestant Reformation, is still often claimed to have generated, the unqualified good of more readers with access to vastly wider ranges of reading material. The unmediated reading of scripture, for example, finds its parallel in the immediate access to digital information. Paeans to the digital revolution still ring with the unqualified confidence of John Foxe’s praise of the printing press in Acts and Monuments, whereby “knowledge groweth, judgement increaseth, bookes are dispersed … stories be opened, times compared, truth decerned, falsehode detected.”
The optimism of the first phase of the digital revolution was not wholly unfounded.
A new look at how reading was practised and represented in England from the seventh century to the beginnings of the print era, finding many kinships between reading cultures across the medieval longue durée.
In Fiji, Ghana, Jamaica, and the Maldives, the tourism sector is an important source of economic wealth. For example, in the Maldives tourism accounts for around a quarter of total GDP and is a main source of employment (Meierkord, 2018: 5). Similarly, the role of tourism as one of Jamaica's main industries has been stated in Deuber (2014: 29), and Hundt, Zipp and Huber (2015: 691) also mention that tourism is one of the key industries and employment sectors in Fiji. While many of these destinations use traditional channels of advertising such as print magazines, a considerable amount of advertising is carried out online via social media.
BACKGROUND: IGTS is a rare phenomenon of paradoxical germ cell tumor (GCT) growth during or following treatment despite normalization of tumor markers. We sought to evaluate the frequency, clinical characteristics and outcome of IGTS in patients in 21 North-American and Australian institutions. METHODS: Patients with IGTS diagnosed from 2000-2017 were retrospectively evaluated. RESULTS: Out of 739 GCT diagnoses, IGTS was identified in 33 patients (4.5%). IGTS occurred in 9/191 (4.7%) mixed-malignant GCTs, 4/22 (18.2%) immature teratomas (ITs), 3/472 (0.6%) germinomas/germinomas with mature teratoma, and in 17 secreting non-biopsied tumours. Median age at GCT diagnosis was 10.9 years (range 1.8-19.4). Male gender (84%) and pineal location (88%) predominated. Of 27 patients with elevated markers, median serum AFP and Beta-HCG were 70 ng/mL (range 9.2-932) and 44 IU/L (range 4.2-493), respectively. IGTS occurred at a median time of 2 months (range 0.5-32) from diagnosis, during chemotherapy in 85%, radiation in 3%, and after treatment completion in 12%. Surgical resection was attempted in all, leading to gross total resection in 76%. Most patients (79%) resumed GCT chemotherapy/radiation after surgery. At a median follow-up of 5.3 years (range 0.3-12), all but 2 patients are alive (1 succumbed to progressive disease, 1 to malignant transformation of GCT). CONCLUSION: IGTS occurred in less than 5% of patients with GCT and most commonly after initiation of chemotherapy. IGTS was more common in patients with IT-only on biopsy than with mixed-malignant GCT. Surgical resection is a principal treatment modality. Survival outcomes for patients who developed IGTS are favourable.
The Zika virus was largely unknown to many health care systems before the outbreak of 2015. The unique public health threat posed by the Zika virus and the evolving understanding of its pathology required continuous communication between a health care delivery system and a local public health department. By leveraging an existing relationship, NYC Health+Hospitals worked closely with New York City Department of Health and Mental Hygiene to ensure that Zika-related processes and procedures within NYC Health+Hospitals facilities aligned with the most current Zika virus guidance. Support given by the public health department included prenatal clinical and laboratory support and the sharing of data on NYC Health+Hospitals Zika virus screening and testing rates, thus enabling this health care delivery system to make informed decisions and practices. The close coordination, collaboration, and communication between the health care delivery system and the local public health department examined in this article demonstrate the importance of working together to combat a complex public health emergency and how this relationship can serve as a guide for other jurisdictions to optimize collaboration between external partners during major outbreaks, emerging threats, and disasters that affect public health. (Disaster Med Public Health Preparedness. 2018;12:689-691)
Limited continuity of care, poor communication between healthcare providers, and ineffective self-management are barriers to recovery as seniors transition back to the community following an Emergency Department (ED) visit or hospitalization. The intensive geriatric service worker (IGSW) role is a new service developed in southern Ontario, Canada to address gaps for seniors transitioning home from acute care to prevent rehospitalization and premature institutionalization through the provision of intensive support and follow-up to ensure adherence to care plans, facilitate communication with care providers, and promote self-management. This study describes the IGSW role and provides preliminary evidence of its impact on clients, caregivers and the broader health system.
This mixed methods evaluation included a chart audit of all clients served, tracking of the achievement of goals for IGSW involvement, and interviews with clients and caregivers and other key informants.
During the study period, 632 clients were served. Rates of goal achievement ranged from 25%–87% and in cases where achieved, the extent of IGSW involvement mostly exceeded recommendations. IGSWs were credited with improving adherence with treatment recommendations, increasing awareness and use of community services, and improving self-management, which potentially reduced ED visits and hospitalizations and delayed institutionalization.
The IGSW role has the potential to improve supports for seniors and facilitate more appropriate use of health system resources, and represents a promising mechanism for improving the integration and coordination of care across health sectors.