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Pilot Study on Risk Perceptions and Knowledge of Fentanyl Exposure Among New York State First Responders
- Eric Persaud, Charles R. Jennings
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- Journal:
- Disaster Medicine and Public Health Preparedness / Volume 14 / Issue 4 / August 2020
- Published online by Cambridge University Press:
- 01 October 2019, pp. 437-441
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Objectives:
The present opioid epidemic and abuse of fentanyl in the United States has led to an increased risk of exposure to first responders. Law enforcement, fire, and emergency medical services are receiving misinformation on fentanyl health and safety risks and this has led to miscommunication. Understanding the risk perceptions and knowledge of first responders regarding fentanyl can help identify training gaps.
Methods:A 15-item 6-point Likert scale online questionnaire was developed and distributed to firefighters, police officers, and emergency medical technicians, regarding perceptions of fentanyl exposure, and additional questions concerning knowledge. The online questionnaire was sent to 15 associations of national and New York State first responders with 3 associations acknowledging and distributing the survey.
Results:Of the 247 participants, 187 served New York State; 92 worked in law enforcement; and the other 95 worked in either fire, emergency medical service, or both. New York State first responders generally agreed with expert risk perceptions and knowledge of fentanyl exposure in the pilot study. Items pertaining to using hand sanitizer, selecting glove type, and dermal exposure to fentanyl had lower agreement with expert beliefs.
Conclusions:Risk perceptions and knowledge could be used to evaluate fentanyl response training among first responders.
Improving Emergency Preparedness among Children with Special Health Care Needs in a Pediatric Infant Disease Clinic
- Sukhshant Atti, Eric Persaud, James Salway, Ramon Gist, Patricia Roblin, Stephen Kohlhoff, Bonnie Arquilla
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- Journal:
- Prehospital and Disaster Medicine / Volume 34 / Issue s1 / May 2019
- Published online by Cambridge University Press:
- 06 May 2019, p. s139
- Print publication:
- May 2019
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Introduction:
Children with Special Health Care Needs (CSHCNs) are at an increased risk for physical, developmental, or emotional conditions, and require special services beyond what is typically required by children. Improving emergency preparedness amongst families with CSHCNs has been advocated by the Centers for Disease Control (CDC), Federal Emergency Management Agency (FEMA), and The American Academy of Pediatrics (AAP).
Aim:We evaluated the preparedness of children and family members, who are infected, or affected, by HIV illness and require daily medications.
Methods:A convenience sample was used to enroll patients and their parents at a pediatric infectious disease clinic. Surveys were used to assess baseline emergency preparedness. Patients were then given an educational intervention on improving personal preparedness. Participants were provided with emergency go-kit and educational materials. Follow up was completed in 30 days to re-assess preparedness by re-administering the initial survey with additional questions.
Results:Thirty-eight patients were enrolled and 10 were lost to follow up. Data from a total of 28 patients were used for study results analyses. Chi-squared testing was used for non-parametric variable analyses for an N < 30. Participants who designated an emergency meeting place outside of their home, post-intervention, were statistically significant-X2 (1) = 29.20, p-value <0.0001. Participants who completed an emergency information form, post-intervention, were statistically significant-X2 (1) = 13.69, p-value <0.0002. Participants who obtained an emergency kit of supplies for 3 days, post-intervention, were statistically significant-X2(1) = 8.92, p-value <0.0028. Participants who obtained a home first aid kit, post-intervention, were statistically significant-X2(1) = 12.16, p-value <0.0005. Five families obtained an emergency supply of medications, post-intervention-X2 (1) = 1.99, p-value = 0.1582. This result was not statistically significant.
Discussion:This study demonstrates that brief educational intervention has potential to improve the preparedness of CSHCNs, including those living with HIV illness.
Stent characteristics for preservation of patency of the arterial duct—experimental evaluation
- Eric Rosenthal, Shakeel A. Qureshi, A. Hussein Tabatabaie, Deo Persaud, Ashok P. Kakadekar, Edward J. Baker, Michael Tynan
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- Journal:
- Cardiology in the Young / Volume 5 / Issue 4 / October 1995
- Published online by Cambridge University Press:
- 19 August 2008, pp. 331-337
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In neonates with duct-dependent congenital heart defects, a reliable non-pharmacological, non-surgical method of maintaining flow through the arterial duct may simplify the management. Stent implantation into the arterial duct has been proposed as such a method. In order to evaluate the technical difficulties which may accompany clinical application, stent implantation into the arterial duct was attempted in 32 newborn lambs aged two to nine days (mean 4.2±1.4) weighing 2.4–7.3 kg (mean 4.6±1.0). Four different types of stent were implanted and the ease of implantation and outcomes were assessed. Stent implantation was technically successful in 28 of the 32 lambs (88%). Of these, 11 lambs died shortly after stent implantation with patent ducts, five lambs had early occlusion of the duct and 12 lambs were entered into a long-term study. The Gianturco-Roubin stent was too rigid and too long to enable successful implantation. The Palmaz-Schatz stent was poorly radio-opaque and was difficult to place accurately. When the aortic orifice was not completely covered, the duct occluded within a few days of implantation. The articulation gap also allowed duct tissue to prolapse into the middle of the stent. The Medinvent and Tower stents were simpler to position due to their superior radio-opacity. The Tower stent had an additional advantage in being a single strand stent which could be easily retrieved if misplaced.
The transfer of 15N from urea to lysine in the human infant
- D. Joe Millward, Terrance Forrester, Eric Ah-Sing, Nana Yeboah, Neil Gibson, Asha Badaloo, M. Boyne, M. Reade, C. Persaud, Alan Jackson
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- Journal:
- British Journal of Nutrition / Volume 83 / Issue 5 / May 2000
- Published online by Cambridge University Press:
- 09 March 2007, pp. 505-512
- Print publication:
- May 2000
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To explore the nutritional significance of urea hydrolysis for human subjects, male infants being treated for severe undernutrition were given oral doses of 10 mg [15N15N]urea every 3 h for 36 h, on admission, during rapid growth and after repletion with either moderate or generous intakes of protein. Urea hydrolysis was calculated from the 15N enrichment of urinary urea, and where possible, lysine, alanine, glycine and histidine were isolated from urine by preparative ion-exchange chromatography for measurement of 15N enrichment. Sufficient N was obtained for 15N enrichment of lysine to be measured on fifteen occasions from six children. Urea hydrolysis accounted for half of all urea production with 130 (sd 85) mg N/kg hydrolysed per d, most of which appeared to be utilized in synthetic pathways. Of the samples analysed successfully, nine samples of lysine were enriched with 15N (mean atom percent excess 0·0102, range 0·0017–0·0208) with relative enrichment ratios with respect to lysine of 1·63 (range 0·18–3·15), 1·96 (range 0·7–3·73) and 0·9 (range 0·4–1·8) for glycine, alanine and histidine respectively. Enriched samples were identified at each treatment phase and 68 % of the variation in lysine enrichment was explained by the variation in urea enrichment with 54 % explained by the overall rate of delivery of 15N to the lower gastrointestinal tract. The results indicate a minimum of 4·7 mg lysine per kg body weight made available by de novo synthesis with the more likely value an order of magnitude higher. Thus, urea hydrolysis can improve the quality of the dietary protein supply by enabling an increased supply of lysine and other indispensable amino acids.To explore the nutritional significance of urea hydrolysis for human subjects, male infants being treated for severe undernutrition were given oral doses of 10 mg [15N15N]urea every 3 h for 36 h, on admission, during rapid growth and after repletion with either moderate or generous intakes of protein. Urea hydrolysis was calculated from the 15N enrichment of urinary urea, and where possible, lysine, alanine, glycine and histidine were isolated from urine by preparative ion-exchange chromatography for measurement of 15N enrichment. Sufficient N was obtained for 15N enrichment of lysine to be measured on fifteen occasions from six children. Urea hydrolysis accounted for half of all urea production with 130 (sd 85) mg N/kg hydrolysed per d, most of which appeared to be utilized in synthetic pathways. Of the samples analysed successfully, nine samples of lysine were enriched with 15N (mean atom percent excess 0·0102, range 0·0017–0·0208) with relative enrichment ratios with respect to lysine of 1·63 (range 0·18–3·15), 1·96 (range 0·7–3·73) and 0·9 (range 0·4–1·8) for glycine, alanine and histidine respectively. Enriched samples were identified at each treatment phase and 68 % of the variation in lysine enrichment was explained by the variation in urea enrichment with 54 % explained by the overall rate of delivery of 15N to the lower gastrointestinal tract. The results indicate a minimum of 4·7 mg lysine per kg body weight made available by de novo synthesis with the more likely value an order of magnitude higher. Thus, urea hydrolysis can improve the quality of the dietary protein supply by enabling an increased supply of lysine and other indispensable amino acids.To explore the nutritional significance of urea hydrolysis for human subjects, male infants being treated for severe undernutrition were given oral doses of 10 mg [15N15N]urea every 3 h for 36 h, on admission, during rapid growth and after repletion with either moderate or generous intakes of protein. Urea hydrolysis was calculated from the 15N enrichment of urinary urea, and where possible, lysine, alanine, glycine and histidine were isolated from urine by preparative ion-exchange chromatography for measurement of 15N enrichment. Sufficient N was obtained for 15N enrichment of lysine to be measured on fifteen occasions from six children. Urea hydrolysis accounted for half of all urea production with 130 (sd 85) mg N/kg hydrolysed per d, most of which appeared to be utilized in synthetic pathways. Of the samples analysed successfully, nine samples of lysine were enriched with 15N (mean atom percent excess 0·0102, range 0·0017–0·0208) with relative enrichment ratios with respect to lysine of 1·63 (range 0·18–3·15), 1·96 (range 0·7–3·73) and 0·9 (range 0·4–1·8) for glycine, alanine and histidine respectively. Enriched samples were identified at each treatment phase and 68 % of the variation in lysine enrichment was explained by the variation in urea enrichment with 54 % explained by the overall rate of delivery of 15N to the lower gastrointestinal tract. The results indicate a minimum of 4·7 mg lysine per kg body weight made available by de novo synthesis with the more likely value an order of magnitude higher. Thus, urea hydrolysis can improve the quality of the dietary protein supply by enabling an increased supply of lysine and other indispensable amino acids.To explore the nutritional significance of urea hydrolysis for human subjects, male infants being treated for severe undernutrition were given oral doses of 10 mg [15N15N]urea every 3 h for 36 h, on admission, during rapid growth and after repletion with either moderate or generous intakes of protein. Urea hydrolysis was calculated from the 15N enrichment of urinary urea, and where possible, lysine, alanine, glycine and histidine were isolated from urine by preparative ion-exchange chromatography for measurement of 15N enrichment. Sufficient N was obtained for 15N enrichment of lysine to be measured on fifteen occasions from six children. Urea hydrolysis accounted for half of all urea production with 130 (sd 85) mg N/kg hydrolysed per d, most of which appeared to be utilized in synthetic pathways. Of the samples analysed successfully, nine samples of lysine were enriched with 15N (mean atom percent excess 0·0102, range 0·0017–0·0208) with relative enrichment ratios with respect to lysine of 1·63 (range 0·18–3·15), 1·96 (range 0·7–3·73) and 0·9 (range 0·4–1·8) for glycine, alanine and histidine respectively. Enriched samples were identified at each treatment phase and 68 % of the variation in lysine enrichment was explained by the variation in urea enrichment with 54 % explained by the overall rate of delivery of 15N to the lower gastrointestinal tract. The results indicate a minimum of 4·7 mg lysine per kg body weight made available by de novo synthesis with the more likely value an order of magnitude higher. Thus, urea hydrolysis can improve the quality of the dietary protein supply by enabling an increased supply of lysine and other indispensable amino acids.