Background: Gastrointestinal conditions are common in hospitalized patients. Decreased mobility, dietary changes, medications and their underlying illness may alter patients’ bowel movements. It’s important for health care providers to be aware of patient’s bowel habits, especially for early identification of Clostridiodies difficile infection (CDI). Prior research has shown that patient modesty may be a barrier to discussing bowel habits with nurses and providers. This can lead to delay in diagnosis of CDI, lack of timely isolation and possible misclassification of community onset CDI cases as hospital onset (HO-CDI). Methods: A Bowel Habits Assessment Tool (BHAT) was developed to assist health care providers in learning skills to assess and document patient bowel habits accurately. The tool provides a structured approach to help clinicians gather relevant information, identify abnormalities, and promote effective communication with patients. The tool was developed by an infectious disease physician and modeled on existing tools utilized to take a sexual history. A team of infectious disease physicians, nurses and a gastroenterologist reviewed the tool and provided feedback. See Table 1. The tool was introduced as a pilot program at a 180 bed academically affiliated Veterans Affairs Hospital. Micro educational sessions were held to provide education about the importance of a bowel habit history, introduce the tool and teach its use in clinical care. The teaching sessions were led by an Infectious Disease physician and a nurse infection preventionist. An anonymous pre and post survey employing a 5-point Likert scale was administered to participants. All participation was voluntary. This project was reviewed and approved as a Quality Improvement by the VA Research Office, Eastern Colorado Health Care System. Results: Twenty nine healthcare personnel participated in the pilot. Participants included nurses (13), resident physicians (13), medical students (2) and nursing assistants (1). 59% of participants stated that they strongly agree with the statement “I am comfortable discussing patient’s bowel habits” on the pre-survey. (Question 1). This increased to 73% after the BHAT educational session. The mean difference between pre and post survey responses for question one was 0.45 (CI 0.08761 to 0.8089, p= 0.0167). All participants found the BHAT related to their work and useful, with 41% strongly agreeing and 52% somewhat agreeing that the BHAT was useful. See figure 1: Survey Responses. Conclusions: The effectiveness of a bowel habit assessment tool was demonstrated using a pre and post survey. BHAT improved clinicians comfort level discussing patient’s bowel habits.

Newcastle disease (ND) is a notifiable disease affecting chickens and other avian species caused by virulent strains of Avian paramyxovirus type 1 (APMV-1). While outbreaks of ND can have devastating consequences, avirulent strains of APMV-1 generally cause subclinical infections or mild disease. However, viruses can cause different levels of disease in different species and virulence can evolve following cross-species transmission events. This report describes the detection of three cases of avirulent APMV-1 infection in Great Britain (GB). Case 1 emerged from the ‘testing to exclude’ scheme in chickens in Shropshire while cases 2 and 3 were made directly from notifiable avian disease investigations in chicken broilers in Herefordshire and on premises in Wiltshire containing ducks and mixed species, respectively). Class II/genotype I.1.1 APMV-1 from case 1 shared 99.94% identity to the Queensland V4 strain of APMV-1. Class II/genotype II APMV-1 was detected from case 2 while the class II/genotype I.2 virus from case 3 aligned closely with strains isolated from Anseriformes. Exclusion of ND through rapid detection of avirulent APMV-1 is important where clinical signs caused by avirulent or virulent APMV-1s could be ambiguous. Understanding the diversity of APMV-1s circulating in GB is critical to understanding disease threat from these adaptable viruses.

ABSTRACT IMPACT: Understanding dietary patterns and nutrient intakes of the aging population may help address concerns and dietary guidelines regarding their nutritional needs. OBJECTIVES/GOALS: The objective of this study is to test the hypothesis that a healthy dietary pattern in the oldest old (aged 80 years and older) is related to greater compliance with dietary recommendations and better nutrient intake profiles. METHODS/STUDY POPULATION: We conducted a cross-sectional study of 122 participants aged 82 to 97 years old from the Geisinger Rural Aging Study (GRAS) cohort in rural Pennsylvania (n = 56 men and 66 women). The main outcome measures of the investigation were the daily nutrient intakes and food group intakes evaluated from the average of three 24-hour dietary recalls. The dietary patterns were determined by cluster analysis from 28 food groups. Diet quality and adherence to the Dietary Guidelines for Americans was assessed by the Healthy Eating Index (HEI)-2015 and the Dietary Screening Tool (DST). Recommended intakes were determined by the Recommended Dietary Allowances (RDAs) or Adequate Intakes (AIs). RESULTS/ANTICIPATED RESULTS: Less than 50% of participants met the dietary recommended intakes for vitamins D, E, K, B6, dietary fiber, zinc, potassium, and calcium. The more-nutrient-dense cluster was characterized by higher intakes of fruits and vegetables. The less-nutrient-dense cluster was characterized by higher intakes of foods including desserts and sweets. After adjusting for age, sex, and energy intake, participants in the more-nutrient-dense dietary pattern had a higher intake of vitamins A, D, K, C, fiber, and potassium (p < 0.05 for all). After adjusting for age and sex, participants in the more-nutrient-dense pattern had better diet quality assessed by the (HEI)-2015 (p < 0.001) and DST (p = 0.006). DISCUSSION/SIGNIFICANCE OF FINDINGS: Among the oldest old, many participants were found to have nutrient intakes lower than the recommended levels for fundamental nutrients suggesting that dietary guidance in addition to a dietary pattern more aligned with dietary guidelines may be beneficial for supporting healthy aging.

Anecdotally, there are frequent reports that peer-facilitated initiatives can be successfully used in employment services. However, in Australia, there is little information about how to effectively deliver peer support. In this paper, we discuss how peer-based interventions might be used to supplement formal return-to-work services and contribute to positive job-seeking outcomes. We illustrate the potential of vocational peer support using a real situation involving a young adult who successfully returned to work soon after sustaining a traumatic injury. Future research should explore the inclusion of various peer support structures and formats as a component of other employment services, to help people with long-term conditions and disabilities achieve a range of vocational outcomes and to guide practice in this area.

This article examines the legacy of lynchings on contemporary whites' views of blacks as criminal threats. To this end, it draws on prior literature on racial animus to demonstrate the sustained influence of lynching on contemporary America. We hypothesize that one long-standing legacy of lynchings is its influence in shaping views about blacks as criminals and, in particular, as a group that poses a criminal threat to whites. In addition, we hypothesize that this effect will be greater among whites who live in areas in America where socioeconomic disadvantage and political conservatism are greater. Results of multilevel analyses of lynching and survey data on whites' views toward blacks support the hypotheses. In turn, they underscore the salience of understanding historical forces, including the legacy of lynchings that influence contemporary views of blacks, criminals, and punishment policies.

Post-injury return to work (RTW) is an important rehabilitation outcome regardless of injury type. With Spinal Cord Injury (SCI), the odds of successful RTW are lower than for the general population of work-injured. Australians living with a SCI have a higher RTW rate than many other developed countries, including the United States. Important influences on relatively higher post-injury RTW rates in the Australian context include its universal disability care policy, Australia's suite of no-fault accident insurance systems that allow for multi-faceted rehabilitation services to be provided to eligible individuals in addition to appropriate rewards for rehabilitation service providers. A combination of these systemic factors is important when delivering comprehensive rehabilitation services to those with catastrophic injuries, such as SCI. The empirical evidence on drivers of successful RTW post SCI is, however, limited in comparison to the evidence on interventions for enhanced coping following SCI. Future studies could consider the relative merits of specific RTW interventions with SCI contrasting policy and capitation systems as well as utilising study designs that take into account pre-morbid work participation and secondary health conditions.

Difficulties can arise in correctly diagnosing clients who present with mood and anxiety disturbances. Unless a detailed history is taken and a comprehensive interview performed, errors of diagnosis are likely to occur which may result in aversive consequences. To illustrate this likelihood, two cases of persons exhibiting anxiety and mood disturbance are briefly reported. The first case involved a prior diagnosis of psychogenic disorder (Mood Disorder). However, further investigation of the client's symptoms revealed that the anxiety and depression were secondary and caused by an underlying organic disorder. The second case involved a prior diagnosis of a physically based disorder presenting with anxiety and depression (Multiple Sclerosis). However, further investigation of the client's symptoms revealed that the somatic symptoms were secondary and the mood and anxiety disturbance were primary symptoms. A model is presented as a guide to better understand the diagnostic process, comments upon the need for a detailed history and interview are offered, and problems arising from incorrect diagnoses are discussed.

Tausug (ISO code tsg) is an Austronesian language spoken on the island of Jolo in the southwestern Philippines. It is also found on other nearby islands in the southwestern part of the Philippines and in parts of Sabah, Malaysia, where it is called Suluk. The population of the Tausug in the Philippines is estimated at 900,000 (Gordon 2005) and the year 2000 population estimate of the Suluk in Sabah, Malaysia, is 150,000. The following description is based on the variety spoken on Jolo. ‘The North Wind and the Sun’ text was translated from English into Tausug by Irene Hassan. Previous studies of Tausug phonology include Asmah (1978, 1983) and Hassan, Ashley & Ashley (1994). David Lao, age 62 at the time of the recording, born in Jolo, Philippines, was the reader for the Tausug words in this article. Due to difficult access into the language area, all audio recordings were obtained by Skype transmission.

First identified in 2009 as the site with the lowest precipitable water vapour (PWV) and best terahertz transmission on Earth, “Ridge A” is located approximately 150 km south of Dome A, Antarctica. We use three years of data from the Microwave Humidity Sensor (MHS) on the NOAA-18 satellite and recent ground-based measurements from Ridge A to probe the PWV variations and stability over the high Antarctic plateau.

While the summit of the Antarctic Plateau has long been expected to harbor the best ground-based sites for terahertz (THz) frequency astronomical investigations, it is only recently that direct observations of exceptional THz atmospheric transmission and stability have been obtained. These observations, in combination with recent technological advancements in astronomical instrumentation and autonomous field platforms, make the recognition and realization of terahertz observatories on the high plateau feasible and timely. Here, we will explore the context of terahertz astronomy in the era of Herschel, and the crucial role that observatories on the Antarctic Plateau can play. We explore the important scientific questions to which observations from this unique environment may be most productively applied. We examine the importance and complementarity of Antarctic THz astronomy in the light of contemporary facilities such as ALMA, CCAT, SOFIA and (U)LDB ballooning. Finally, building from the roots of THz facilities in Antarctica to present efforts, we broadly highlight future facilities that will exploit the unique advantages of the Polar Plateau and provide a meaningful, lasting astrophysical legacy.

This study investigated fatigue and anger in people with SCI. Participants were 27 adults with SCI living in the community (males = 26, females = 1; mean age = 50 years, SD = 9.47 years) and a comparison group of 27 other adults without SCI. Data about their experience of fatigue and anger were collected using the Chalder Fatigue Scale and the Profile of Mood States. Kruskal-Wallis ANOVA by ranks and chi-square analyses were used to determine whether the SCI participants had elevated levels of fatigue and anger than the typical or noninjured community group. Persons with SCI reported significantly elevated fatigue and elevated levels of anger than typical others. These findings are discussed with reference to adjustment following SCI, and interpreted in light of the Stress Appraisal and Coping Model (SAC) of adjustment following SCI.