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Using the example of surveys conducted by the American College of Emergency Physicians (ACEP) regarding the management of Ebola cases in the United States, we aimed to demonstrate how survey-based information networks can provide timely data to inform best practices in responding to public health emergencies.
ACEP conducted 3 surveys among its members in October to November 2014 to assess the state of Ebola preparedness in emergency departments. We analyzed the surveys to illustrate the types of information that can be gleaned from such surveys. We analyzed qualitative data through theme extraction and collected quantitative results through cross-tabulations and logistic regression examining associations between outcomes and potential contributing factors.
In the first survey, most respondents perceived their hospital as being reasonably prepared for Ebola. The second survey revealed significant associations between a hospital’s preparedness and its perceived ability to admit Ebola patients. The third survey identified 3 hospital characteristics that were significantly and independently associated with perceived ability to admit Ebola patients: large size, previous Ebola screening experience, and physician- and nurse-led hospital preparedness.
Professional associations can use their member networks to collect timely survey data to inform best practices during and immediately after public health emergencies. (Disaster Med Public Health Preparedness. 2016;10:681–690)
A monolithic fuel design based on U–Mo alloy has been selected as the fuel type for conversion of United States’ high-performance research reactors (USHPRRs) from highly enriched uranium (HEU) to low-enriched uranium (LEU). In this fuel design, a thin layer of zirconium is used to eliminate the direct interaction between the U–Mo fuel meat and the aluminum-alloy cladding during irradiation. The co-rolling process used to bond the Zr barrier layer to the U–Mo foil during fabrication alters the microstructure of both the U–10Mo fuel meat and the U–Mo/Zr interface. This work studied the effects of post-rolling annealing treatment on the microstructure of the co-rolled U–Mo fuel meat and the U–Mo/Zr interaction layer. The U–Mo/Zr interaction-layer thickness increased with the annealing temperature with an Arrhenius constant for growth of 184kJ/mole, consistent with a previous diffusion-couple study. The phases in the U–Mo/Zr interaction layer produced by co-rolling, however, differ from those reported in the previous diffusion-couple study.
To assess the knowledge, attitudes, and practices of infection control among staff in a residential care facility for children and young adults with neurologic and neurodevelopmental conditions.
Residential care facility (facility A).
Facility A staff (N = 200).
We distributed a survey to staff at facility A. We classified staff with direct care responsibilities as clinical (ie, physicians, nurses, and therapists) or nonclinical (ie, habilitation assistants, volunteers, and teachers) and used X2 tests to measure differences between staff agreement to questions.
Of 248 surveys distributed, 200 (81%) were completed; median respondent age was 36 years; 85% were female; and 151 were direct care staff (50 clinical, 101 nonclinical). Among direct care staff respondents, 86% agreed they could identify residents with respiratory symptoms, 70% stayed home from work when ill with respiratory infection, 64% agreed that facility administration encouraged them to stay home when ill with respiratory infection, and 72% reported that ill residents with respiratory infections were separated from well residents. Clinical and nonclinical staff differed in agreement about using waterless hand gel as a substitute for handwashing (96% vs 78%; P = .005) and whether handwashing was done after touching residents (92% vs 75%; P = .04).
Respondents' knowledge, attitudes, and practices regarding infection control could be improved, especially among nonclinical staff. Facilities caring for children and young adults with neurologic and neurodevelopmental conditions should encourage adherence to infection control best practices among all staff having direct contact with residents.
Studies were carried out on conscious female non-pregnant (NP) and pregnant (P; third-trimester) dogs (n 16; eight animals per group) to define the role of the liver in mixed meal disposition with arteriovenous difference and tracer techniques. Hepatic and hindlimb substrate disposal was assessed for 390 min during and after an intragastric mixed meal infusion labelled with [14C]glucose. The P dogs exhibited postprandial hyperglycaemia compared with NP dogs (area under the curve (AUC; change from basal over 390 min) of arterial plasma glucose: 86 680 (sem 12 140) and 187 990 (sem 33 990) mg/l in NP and P dogs, respectively; P < 0·05). Plasma insulin concentrations did not differ significantly between the groups (AUC: 88 230 (sem 16 314) and 69 750 (sem 19 512) pmol/l in NP and P dogs, respectively). Net hepatic glucose uptake totalled 3691 (sem 508) v. 5081 (sem 1145) mg/100 g liver in NP and P dogs, respectively (P = 0·38). The AUC of glucose oxidation by the gut and hindlimb were not different in NP and P dogs, but hepatic glucose oxidation (84 (sem 13) v. 206 (sem 30) mg/100 g liver) and glycogen synthesis (0·4 (sem 0·5) v. 26 (sem 0·7) g/100 g liver) were greater in P dogs (P < 0·05). The proportion of hepatic glycogen deposited via the direct pathway did not differ between the groups. Hindlimb glucose uptake and skeletal muscle glycogen synthesis was similar between the groups, although final glycogen concentrations were higher in NP dogs (9·6 (sem 0·6) v. 70 (sem 0·6) mg/g muscle; P < 0·05). Thus, hepatic glucose oxidation and glycogen storage were augmented in late pregnancy. Enhanced hepatic glycogen storage following a meal probably facilitates the maintenance of an adequate glucose supply to maternal and fetal tissues during the post-absorptive period.
A history of exposure to harsh physical discipline has been linked to
negative outcomes for children, ranging from conduct disorder to
depression and low self-esteem. The present study extends this work into
adolescence, and examines the relationship of lifetime histories of harsh
discipline to adolescents' internalizing and externalizing symptoms
and to their developing capacities for establishing autonomy and
relatedness in family interactions. Adolescent and parent reports of harsh
discipline, independently coded observations of conflictual interactions,
and adolescent reports of symptoms were obtained for 141 adolescents at
age 16. Both parents' use of harsh discipline was related to greater
adolescent depression and externalizing behavior, even when these effects
were examined over and above the effects of other parenting measures known
to account for these symptoms. Adolescents exposed to harsh discipline
from mothers were also less likely to appear warm and engaged during an
interaction task with their mothers. It is suggested that a history of
harsh discipline is associated not only with social and emotional
functioning, but also with the developmental task of autonomy and
relatedness.This study and its write-up
were supported by grants from the National Institute of Mental Health
(R01-MH44934 and R01-MH58066).
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