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Nosocomial transmission of influenza is a major concern for infection control. We aimed to dissect transmission dynamics of influenza, including asymptomatic transmission events, in acute care.
Design:
Prospective surveillance study during 2 influenza seasons.
Setting:
Tertiary-care hospital.
Participants:
Volunteer sample of inpatients on medical wards and healthcare workers (HCWs).
Methods:
Participants provided daily illness diaries and nasal swabs for influenza A and B detection and whole-genome sequencing for phylogenetic analyses. Contacts between study participants were tracked. Secondary influenza attack rates were calculated based on spatial and temporal proximity and phylogenetic evidence for transmission.
Results:
In total, 152 HCWs and 542 inpatients were included; 16 HCWs (10.5%) and 19 inpatients (3.5%) tested positive for influenza on 109 study days. Study participants had symptoms of disease on most of the days they tested positive for influenza (83.1% and 91.9% for HCWs and inpatients, respectively). Also, 11(15.5%) of 71 influenza-positive swabs among HCWs and 3 (7.9%) of 38 influenza-positive swabs among inpatients were collected on days without symptoms; 2 (12.5%) of 16 HCWs and 2 (10.5%) of 19 inpatients remained fully asymptomatic. The secondary attack rate was low: we recorded 1 transmission event over 159 contact days (0.6%) that originated from a symptomatic case. No transmission event occurred in 61 monitored days of contacts with asymptomatic influenza-positive individuals.
Conclusions:
Influenza in acute care is common, and individuals regularly shed influenza virus without harboring symptoms. Nevertheless, both symptomatic and asymptomatic transmission events proved rare. We suggest that healthcare-associated influenza prevention strategies that are based on preseason vaccination and barrier precautions for symptomatic individuals seem to be effective.
In this chapter the major conservation issues bears face is reviewed and management actions that can address these conservation issues are highlighted. The future of bears across the world is bright for some species but dark for others. In some areas such as North America and in parts of Europe and Asia, bear populations have increased and stabilized because of increased management effort and increasing support for bears and their needs by the humans who share habitat with them. However, for most bear species, the future is uncertain. Andean bears continue to be threatened by habitat loss and human encroachment. In much of Asia outside Japan, Asiatic black bear, sloth bear, and sun bear populations are increasingly threatened by unmanaged excessive mortality combined with habitat loss to timber harvest, plantation agriculture, and human encroachment. The long-term future for polar bears is threatened by the unmanageable threat of climate change. Giant pandas are fragmented into small populations despite intense conservation efforts. Improving public and political support for bears is the most important need if we are to realize successful bear conservation and management.
To assess influenza symptoms, adherence to mask use recommendations, absenteesm and presenteeism in acute care healthcare workers (HCWs) during influenza epidemics.
Methods:
The TransFLUas influenza transmission study in acute healthcare prospectively followed HCWs prospectively over 2 consecutive influenza seasons. Symptom diaries asking for respiratory symptoms and adherence with mask use recommendations were recorded on a daily basis, and study participants provided midturbinate nasal swabs for influenza testing.
Results:
In total, 152 HCWs (65.8% nurses and 13.2% physicians) were included: 89.1% of study participants reported at least 1 influenza symptom during their study season and 77.8% suffered from respiratory symptoms. Also, 28.3% of HCW missed at least 1 working day during the study period: 82.6% of these days were missed because of symptoms of influenza illness. Of all participating HCWs, 67.9% worked with symptoms of influenza infection on 8.8% of study days. On 0.3% of study days, symptomatic HCWs were shedding influenza virus while at work. Among HCWs with respiratory symptoms, 74.1% adhered to the policy to wear a mask at work on 59.1% of days with respiratory symptoms.
Conclusions:
Respiratory disease is frequent among HCWs and imposes a significant economic burden on hospitals due to the number of working days lost. Presenteesm with respiratory illness, including influenza, is also frequent and poses a risk for patients and staff.
Public support is usually a precondition for the adoption and successful implementation of costly policies. We argue that such support is easier to achieve with policy-packages that incorporate primary and ancillary measures. We specifically distinguish command-and-control and market-based measures as primary measures and argue that the former will usually garner more public support than the latter given the low-visibility tendency of costs associated with command-and-control measures. Nevertheless, if included in a policy-package, ancillary measures are likely to increase public support by reducing negative effects of primary measures. Based on a choice experiment with a representative sample of 2,034 Swiss citizens, we assessed these arguments with respect to political efforts to reduce vehicle emissions. The empirical analysis supported the argument that policy-packaging affects public support positively, particularly generating more support when ancillary measures are added. Lastly, we ultimately observe that command-and-control measures obtain more public support than market-based instruments.
The NASA/DLR Stratospheric Observatory for Infrared Astronomy (SOFIA), a 2.5-meter infrared telescope on board a Boeing 747-SP, will conduct 0.3 - 1,600 μm photometric, spectroscopic, and imaging observations from altitudes as high as 45,000 ft., where the average atmospheric transmission is greater than 80 percent. SOFIA's first light cameras and spectrometers, as well as future generations of instruments, will make important contributions to the characterization of the physical properties of exoplanets. Our analysis shows that optical and near-infrared photometric and spectrophotometric follow-up observations during planetary transits and eclipses will be feasible with SOFIA's instrumentation, in particular the HIPO-FLITECAM optical/NIR instruments. The airborne-based platform has unique advantages in comparison to ground- and space-based observatories in this field of research which we will outline here. Furthermore we will present two exemplary science cases, that will be conducted in SOFIA's cycle 1.
Contemporary social theory considers the growth of risk to be a distinguishing feature of modernity (e.g. Beck 1992; Giddens 1991; Luhmann 1993). The broad agreement among social scientists ceases where they explain the emergence and diffusion of risk as a comprehensive management tool. We can roughly distinguish between an explanatory strategy that conceptualises risk as a substantive event, and one that understands risk as an organising concept.
Becks' Risk Society (1992) is the primary example of a substantive notion of risk. In his theory, Beck identified two, tightly interrelated triggers for the increasing concern with risk. When risks capture the unintended, often disastrous consequences of modern, industrial production and technology, these (technological) failures attract attention where social institutions fail to cope with the effects of technological progress (Beck 1992). Hence, risk signals a rising societal vulnerability and a growing friction between technology, risk management and societal institutions. Thus, ‘risk’ indicates a loss of technological and societal control.
Contrary to this view, authors like Ericson et al. (2000), Luhmann (1993 and 1998) or Power (2004) suggest that risk is a concept for managing future developments. It is not institutional vulnerability that risk flags, but rather the expanding control it provides. And there is an in-built growth mechanism. To escape the inevitable contingencies of the future, these authors suggest, it should not be opted for certainty and security, but ‘the solution … is based on the acceptance and elaboration of the problem, on the multiplication and specification of the risks’ (Luhmann 1993: 76).
The freedom of movement of persons is one of the core tenets of the European Union. Immigration however is often seen as a cause for concern amongst native workers, as rising labour supply may threaten jobs and create downward pressure on wages. National politicians are increasingly under pressure to guard against it — in times of recession particularly. Despite this, there is evidence that highly-skilled migrant labour has the potential to raise competitiveness significantly and in theory this may feed into productivity. In this paper, we explore first the composition of inward migration to the EU and within the EU, concentrating specifically on the role of the highly-skilled and the extent to which migrants are overqualified within their jobs. We then analyse whether migrant workers affect productivity at the sectoral level. We find under-utilisation of skilled foreign labour and there is little evidence in general to suggest that migrants have raised productivity which may in part be attributable to over-qualification. However, we find robust evidence that migrants — particularly highly-skilled migrants — play a positive role in productivity developments in industries which are classified as ‘skill intensive’.
We use the case of the Eurasian lynx Lynx lynx in the Alps to discuss how to implement existing directives and recommendations, as well as how to integrate biological concepts, into practical conservation and wildlife management. Since 1995 the occurrence of lynx in the Alpine countries has been monitored and reported by the Status and Conservation of the Alpine Lynx Population expert group. Both the area of occupancy and the estimated number of individuals increased from 1995–1999 to 2000–2004. The estimated number of lynx is 120–150 across the Alps and the area of occupancy 27,800 km2, in six distinct sub-areas. In the highly fragmented Alpine habitat lynx populations expand slowly, even in situations of high local density and when suitable habitat is available. Thus, almost 40 years after the first reintroduction, < 20% of the Alps have been recolonized by lynx. In addition to biological and ecological factors, the persistent disagreements about the return of the lynx between conservationists and other land-users, including livestock breeders and hunters, and the political fragmentation of the Alps (with different regional priorities and large carnivore policies), has prevented the creation of a consensus regarding pan-Alpine conservation goals for the lynx and the implementation of conservation measures such as translocations and reintroductions. We discuss possible approaches in the light of new guidelines for population level management plans for large carnivores recently developed on behalf of the European Commission.
In this guide we briefly explain what an Interdisciplinary Lively Application Project (referred to hereafter as an ILAP) is, how ILAPs are developed and executed, and what considerations and strategies arise when developing and using ILAPs. While there are many perspectives and elements to consider, we include only the essentials here and leave the rest of the material for future articles.
An ILAP is a process that generates a product that drives a student learning experience. ILAPs are student group projects that are jointly authored by a faculty member from the Mathematical Sciences Department and a faculty member from a partner department. ILAPs can be used in the mathematics classroom, in the partner classroom, or in both to let students work on mathematical concepts within the context of another discipline. ILAPs help connect the curricula by taking applications and current methods from a using department and connecting them with the concepts and techniques in the mathematics curriculum. They also can be used to reach forward to preview ideas from applications that wait downstream or backward to connect current mathematical topics with ideas from applications that already have been studied.
ILAPs provide students with practice in the interdisciplinary threads of modeling in scenarios more realistic than those usually presented within the mathematics curriculum. Students engage in reasoning (within an applied context) and problem solving, use technology as a tool to enable analysis of complex situations, connect and integrate ideas from different curricula, engage in teamwork in problem solving, and learn how to communicate methods, conclusions, and recommendations.
The impact of hysterectomy without oophorectomy and with no malignant purpose on body composition and postmenopausal weight gain was tested in 184 Viennese females aged between 47 and 57 years (mean 52·9). Hysterectomized women were significantly heavier than those who experienced a spontaneous menopause (controls). The amount of fat tissue, especially in the abdominal region, was significantly higher in hysterectomized women. Furthermore, they were reported to have experienced a significantly higher weight gain since menopause (9·1 versus 6·0 kg). No significant differences in bone mass were found. Psychological stress factors and hormonal changes following hysterectomy are discussed as possible causes of these differences.
The objective of this study was to evaluate growth and seed production of giant foxtail under different N sources (NO3 and NH4) and N fertilizer application rates. Nitrate and NH4 fertilizers plus nitrification inhibitor were applied at 56, 112, and 225 kg N ha−1 under field conditions, and in the greenhouse four N rates (1, 5, 10, and 25 mM N) were applied in three NO3: NH4 ratios (100 : 0, 50 : 50, 0 : 100). Growth of giant foxtail was affected by N rates under both greenhouse and field conditions. In 1993, abundant rainfall in May and June allowed a rapid and earlier uptake of N by giant foxtail, resulting in larger plants with greater N accumulation and higher numbers of heads and seeds than in 1994. Total dry weight increased with increasing N rates; however, seed production reached a maximum at approximately 150 kg N ha−1. Nitrogen translocation efficiency decreased with increasing N rates. Giant foxtail did not show any preference to N form; however, seed production was reduced when the high N rate was applied as NH4 compared to NO3. These results suggest that NH4 fertilizer applications with a long-term nitrification inhibitor could reduce the seed production of giant foxtail and its contribution to the soil seedbank for subsequent growing seasons.
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