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Understanding healthcare personnel’s (HCP) contact patterns are important to mitigate healthcare-associated infectious disease transmission. Little is known about how HCP contact patterns change over time or during outbreaks such as the COVID-19 pandemic.
Methods:
This study in a large United States healthcare system examined the social contact patterns of HCP via standardized social contact diaries. HCP were enrolled from October 2020 to June 2022. Participants completed monthly surveys of social contacts during a representative working day. In June 2022, participants completed a 2-day individual-level contact diary. Regression models estimated the association between contact rates and job type. We generated age-stratified contact matrices.
Results:
Three-hundred and sixty HCP enrolled, 157 completed one or more monthly contact diaries and 88 completed the intensive 2-day diary. In the monthly contact diaries, the median daily contacts were 15 (interquartile range (IQR) 8–20), this increased slightly during the study (slope-estimate 0.004, p-value 0.016). For individual-level contact diaries, 88 HCP reported 2,550 contacts over 2 days. HCP were 2.8 times more likely to contact other HCP (n = 1,592 contacts) than patients (n = 570 contacts). Rehabilitation/transport staff, diagnostic imaging technologists, doctors, nurses, mid-level, and laboratory personnel had higher contacts compared with the lowest contact group (Nursing aids). Contact matrices concentrated in working-age populations.
Conclusions:
HCP contacts concentrate in their work environment, primarily with other HCP. Their contacts remained stable over time even during large changes to societal contact patterns during the COVID-19 pandemic. This stability is critical for designing outbreak and pandemic responses.
Much ink has been spilled on the scientist–practitioner gap, that is, the apparent divide between knowledge published in academic peer-reviewed journals and the actual business practices employed in modern organizations. Most prior papers have advanced meaningful theories on why the gap exists, ranging from poor communication skills on the part of academics to paywalls and other obstacles preventing the public from accessing research in industrial-organizational psychology (I-O). However, very few papers on the scientist–practitioner gap have taken an empirical approach to better understand why the gap exists and what can be done about it. In our focal article, we specifically discuss the gap as it pertains to small businesses and present empirical data on the topic. Drawing from our experiences working with and in small businesses before entering a PhD program, we suggest that a primary reason for the existence of this gap is the differences between large and small businesses, and we advance two theory-driven reasons for why this is the case. Next, we compiled abstracts and practical implications sections from articles published in top I-O journals in the past 5 years, then we collected ratings and open-ended text responses from subject matter experts (i.e., small business owners and managers) in reaction to reading these sections. We close by recommending several potential perspectives, both for and against our arguments, that peer commentators can take in their responses to our focal article.
Pathogenic CACNA1A mutations can result in paroxysmal attacks of encephalopathy, hemiplegia and cerebral edema. We report two patients with CACNA1A-associated encephalopathy, hemiplegia and contralateral hemispheric cerebral edema treated successfully with intravenous magnesium sulfate and dexamethasone. One patient met the clinical criteria for familial hemiplegic migraine. There is a paucity of guidance in the literature on how to manage these patients. Despite some discrepancies in the treatment protocols in our two cases, they indicate that magnesium and dexamethasone could be part of the treatment algorithm for these patients. Further research to delineate appropriate dosing and duration of therapy is needed.
Plant names carry a significant amount of information without providing a lengthy description. This is an efficient shorthand for scientists and stakeholders to communicate about a plant, but only when the name is based on a common understanding. It is standard to think of each plant having just two names, a common name and a scientific name, yet both names can be a source of confusion. There are often many common names that refer to the same plant, or a single common name that refers to multiple different species, and some plants have no common name at all. Scientific names are based upon international standards; however, when the taxonomy is not agreed upon, two scientific names may be used to describe the same species. Weed scientists and practitioners can easily memorize multiple plant names and know that they refer to the same species, but when we consider global communication and far-reaching databases, it becomes very relevant to consider two sides of this shift: (1) a need for greater standardization (due to database management and risk of lost data from dropped cross-referencing); and (2) the loss of local heritage, which provides useful meaning through various common names. In addition, weed scientists can be resistant to changing names that they learned or frequently use. The developments in online databases and reclassification of plant taxonomy by phylogenetic relationships have changed the accessibility and role of the list of standardized plant names compiled by the Weed Science Society of America (WSSA). As part of an attempt to reconcile WSSA and USDA common names for weedy plants, the WSSA Standardized Plant Names Committee recently concluded an extensive review of the Composite List of Weeds common names and had small changes approved to about 10% of the list of more than 2,800 distinct species.
OBJECTIVES/GOALS: Harmful algal blooms (HABs) are increasing in both frequency and intensity due to climate change. HABs release the toxin microcystin-LR (MC-LR) which enters cells via organic anion-transporting polypeptides (OATPs). In this study, we sought to assess the ability of MC-LR to accumulate in trophoblasts, potentially disrupting placental functions. METHODS/STUDY POPULATION: Intracellular accumulation of MC-LR at exposure concentrations of 0.1, 1, and 10 µM over 6 hrs was evaluated in immortalized JAR placental cytotrophoblasts. Western blotting was used to evaluate protein-bound MC-LR accumulation in JAR cells. The function of OATP transporters in JAR cells was determined by pre-incubating cells with 10µM cyclosporin A, a general OATP inhibitor for 1 hr, and then incubated with 1µM OATP substrate fluorescein for up to 40 min. Fluorescence of fluorescein was measured at Ex/Em: 494nm/515nm by spectrophotometry. RESULTS/ANTICIPATED RESULTS: A concentration-dependent increase of MC-LR bound proteins in JAR cells was observed at 6 hrs with the greatest intracellular accumulation of MC-LR at 10µM. In the transporter experiments, a significant decrease of fluorescein uptake by up to 45% into JAR cells was observed following cyclosporin A inhibition of OATPs. These findings are consistent with the functional expression of OATP transporters in JAR placenta cells. Ongoing studies are evaluating whether the cyclosporin A-mediated inhibition of OATPs also inhibits the uptake of MC-LR. DISCUSSION/SIGNIFICANCE: Although MC-LR is well-known for its hepatotoxic and neurotoxic effects, there is growing interest in examining its potential adverse impacts on female reproductive health, particularly during pregnancy. Active uptake of MC-LR into the placenta could interfere with placental and fetal development.
This study describes the illness burden in the first year of life for children with single-ventricle heart disease, using the metric of days alive and out of hospital to characterize morbidity and mortality.
Methods:
This is a retrospective single-centre study of single-ventricle patients born between 2005 and 2021 who had their initial operation performed at our institution. Patient demographics, anatomical details, and hospitalizations were extracted from our institutional single-ventricle database. Days alive and out of hospital were calculated by subtracting the number of days hospitalized from number of days alive during the first year of life. A multivariable linear regression with stepwise variable selection was used to determine independent risk factors associated with fewer days alive and out of hospital.
Results:
In total, 437 patients were included. Overall median number of days alive and out of hospital in the first year of life for single-ventricle patients was 278 days (interquartile range 157–319 days). In a multivariable analysis, low birth weight (<2.5kg) (b = −37.55, p = 0.01), presence of a dominant right ventricle (b = −31.05, p = 0.01), moderate-severe dominant atrioventricular valve regurgitation at birth (b = −37.65, p < 0.05), index hybrid Norwood operation (b = −138.73, p < 0.01), or index heart transplant (b = −158.41, p < 0.01) were all independently associated with fewer days alive and out of hospital.
Conclusions:
Children with single-ventricle heart defects have significant illness burden in the first year of life. Identifying risk factors associated with fewer days alive and out of hospital may aid in counselling families regarding expectations and patient prognosis.
Infants with critical CHD have abnormal neurobehavior assessed by the Neonatal ICU Network Neurobehavioral Scales. This retrospective cohort study hypothesized associations between abnormal infant neurobehavior in the first month of life and later neurodevelopmental outcomes at 1−2 years of age. Associations between abnormal infant attention (orienting to and tracking stimuli) on the Neonatal ICU Network Neurobehavioral Scales and later motor, cognitive, and language neurodevelopmental outcomes on the Bayley Scales of Infant Development-III at follow-up were examined with descriptive statistics and univariable and multivariable regression. Multiple imputation was used to account for missing outcome data. 189 infants with critical CHD were included, and 69% had abnormal neurobehavioral attention scores. 58 (31%) returned as toddlers for neurodevelopmental follow-up, of which 23% had motor delay. Abnormal infant attention had high sensitivity (92%, 95% CI 60−100%) but low specificity (36%, 95% CI 23−52%) for later motor delay. Higher infant attention scores were associated with higher later motor scores in univariable analysis (coefficient 3.49, 95% CI 0.52,6.46, p = 0.025), but not in multivariable analyses. Neither cognitive nor language scores were associated with infant attention scores. Lower birth weight and male sex were significantly associated with lower motor scores in multivariable analysis (p = 0.048, 0.007). Although impaired infant attention is interdependent with other clinical and demographic risk factors, it may be a sensitive clinical marker of risk for later motor delay. In children with critical CHD, impaired infant attention may be capturing early signs of abnormal visual-motor neurodevelopment.
A Mediterranean-style eating pattern (MED-EP) may include moderate red meat intake. However, it is unknown if the pro-atherogenic metabolite trimethylamine N-oxide (TMAO) is affected by the amount of red meat consumed with a MED-EP. The results presented are from a secondary, retrospective objective of an investigator-blinded, randomised, crossover, controlled feeding trial (two 5-week interventions separated by a 4-week washout) to determine if a MED-EP with 200 g unprocessed lean red meat/week (MED-CONTROL) reduces circulating TMAO concentrations compared to a MED-EP with 500 g unprocessed lean red meat/week (MED-RED). Participants were seventy-seven women and twelve men (n 39 total) who were either overweight or obese (BMI: mean (30·5) (sem 0·3) kg/m2). Serum samples were obtained following an overnight fast both before (pre) and after (post) each intervention. Fasting serum TMAO, choline, carnitine and betaine concentrations were measured using a targeted liquid chromatography-MS. Data were analysed to assess if (a) TMAO and related metabolites differed by intervention and (b) if changes in TMAO were associated with changes in Framingham 10-year risk score. Serum TMAO was lower post-intervention following MED-CONTROL compared with MED-RED intervention (post-MED-CONTROL 3·1 (sem 0·2) µmv. post-MED-RED 5·0 (sem 0·5) µm, P < 0·001), and decreased following MED-CONTROL (pre- v. post-MED-CONTROL, P = 0·025). Exploratory analysis using mixed model ANCOVA identified a positive association between changes in TMAO and changes in homoeostatic model assessment of insulin resistance (P = 0·036). These results suggest that lower amounts of red meat intake lead to lower TMAO concentrations in the context of a MED-EP.
New Zealand has a strategy of eliminating SARS-CoV-2 that has resulted in a low incidence of reported coronavirus-19 disease (COVID-19). The aim of this study was to describe the spread of SARS-CoV-2 in New Zealand via a nationwide serosurvey of blood donors. Samples (n = 9806) were collected over a month-long period (3 December 2020–6 January 2021) from donors aged 16–88 years. The sample population was geographically spread, covering 16 of 20 district health board regions. A series of Spike-based immunoassays were utilised, and the serological testing algorithm was optimised for specificity given New Zealand is a low prevalence setting. Eighteen samples were seropositive for SARS-CoV-2 antibodies, six of which were retrospectively matched to previously confirmed COVID-19 cases. A further four were from donors that travelled to settings with a high risk of SARS-CoV-2 exposure, suggesting likely infection outside New Zealand. The remaining eight seropositive samples were from seven different district health regions for a true seroprevalence estimate, adjusted for test sensitivity and specificity, of 0.103% (95% confidence interval, 0.09–0.12%). The very low seroprevalence is consistent with limited undetected community transmission and provides robust, serological evidence to support New Zealand's successful elimination strategy for COVID-19.
Innovation Platforms (IPs) are seen as a promising vehicle to foster a paradigm shift in agricultural research for development (AR4D). By facilitating interaction, negotiation and collective action between farmers, researchers and other stakeholders, IPs can contribute to more integrated, systemic innovation that is essential for achieving agricultural development impacts. However, successful implementation of IPs requires institutional change within AR4D establishments. The objective of this paper is to reflect on the implementation and institutionalisation of IPs in present AR4D programmes. We use experiences from sub-Saharan Africa to demonstrate how the adoption and adaptation of IPs creates both opportunities and challenges that influence platform performance and impact. Niche-regime theory is used to understand challenges, and anticipate on how to deal with them. A key concern is whether IPs in AR4D challenge or reinforce existing technology-oriented agricultural innovation paradigms. For example, stakeholder representation, facilitation and institutional embedding determine to a large extent whether the IP can strengthen systemic capacity to innovate that can lead to real paradigm change, or are merely ‘old wine in new bottles’ and a continuation of ‘business as usual’. Institutional embedding of IPs and – more broadly – the transition from technology-oriented to system-oriented AR4D approaches requires structural changes in organisational mandates, incentives, procedures and funding, as well as investments in exchange of experiences, learning and capacity development.
Extreme impacts can result from extreme weather and climate events, but can also occur without extreme events. This chapter examines two broad categories of impacts on human and ecological systems, both of which are influenced by changes in climate, vulnerability, and exposure: first, the chapter primarily focuses on impacts that result from extreme weather and climate events, and second, it also considers extreme impacts that are triggered by less-than-extreme weather or climate events. These two categories of impacts are examined across sectors, systems, and regions. Extreme events can have positive as well as negative impacts on ecosystems and human activities.
Economic losses from weather- and climate-related disasters have increased, but with large spatial and interannual variability (high confidence, based on high agreement, medium evidence). Global weather- and climate-related disaster losses reported over the last few decades reflect mainly monetized direct damages to assets, and are unequally distributed. Estimates of annual losses have ranged since 1980 from a few US$ billion to above 200 billion (in 2010 dollars), with the highest value for 2005 (the year of Hurricane Katrina). In the period 2000 to 2008, Asia experienced the highest number of weather- and climate-related disasters. The Americas suffered the most economic loss, accounting for the highest proportion (54.6%) of total loss, followed by Asia (27.5%) and Europe (15.9%). Africa accounted for only 0.6% of global economic losses. Loss estimates are lower bound estimates because many impacts, such as loss of human lives, cultural heritage, and ecosystem services, are difficult to value and monetize, and thus they are poorly reflected in estimates of losses. [4.5.1, 4.5.3.3, 4.5.4.1]
Maternal nutrition knowledge has frequently been identified as an important target for nutrition promotion interventions. The aim of the present study was to investigate whether maternal nutrition knowledge is more strongly associated with the mother's own diet or that of her child.
Design
Cross-sectional multivariate linear regression with interactions analyses of survey data.
Setting
Socio-economically disadvantaged neighbourhoods in Victoria, Australia.
Subjects
Five hundred and twenty-three mothers and their children who participated in the Resilience for Eating and Physical Activity Despite Inequality (READI) study, a cross-sectional survey study conducted in 2009 among women and their children residing in socio-economically disadvantaged neighbourhoods.
Results
In adjusted models, for three (vegetable, chocolate/lollies and soft drink consumption) out of the seven dietary outcomes assessed, there was a significant association between maternal nutrition knowledge and maternal diet, whereas for the children's diets none of the seven outcomes were associated with maternal nutrition knowledge. Statistical comparison of regression coefficients showed no difference between the maternal nutrition knowledge–maternal diet association and the maternal nutrition knowledge–child diet association.
Conclusions
Promoting maternal nutrition knowledge may represent an important avenue for improving diet in mothers from socio-economically disadvantaged neighbourhoods, but more information is needed on how and when this knowledge is translated to benefits for their children's diet.
Discussion of the Millennium Development Goal to improve maternal health (MDG5) is often pessimistic, yet some low-income countries are well under way to achieving this goal and have lowered maternal mortality. Egypt is one such case. Since 1992, maternal mortality has been reduced by 68%, and the absolute level of 55 per 100000 live births reported in 2008 is low by many standards, although it remains 5—10 times higher than those countries with the lowest mortality. This chapter addresses three questions:
□ Has maternal mortality in Egypt actually declined?
□ What else was happening at the same time?
□ What interventions and policies made these changes come about?
Has maternal mortality in Egypt actually declined?
Maternal mortality levels
Maternal mortality has declined in Egypt over the past 30 years (Table 19.1, Figure 19.1). Two comprehensive National Maternal Mortality Studies (NMMS) in 1992—93 and in 2000 showed a dramatic decline in the maternal mortality ratio (MMR) from 174 to 84 per 100000 live births. Although all methods are likely to miss some maternal deaths, the similar approach used in both of these studies means the degree of underestimation is probably similar. Subsequently, Egypt adopted a Maternal Mortality Surveillance System (MMSS) that has reported maternal mortality annually since 2002. Considerable effort seems to have gone into implementing the MMSS. For example, requests for free formula to feed infants whose mothers have died during delivery are collated centrally and checked against maternal deaths identified through the MMSS.
Mechanical devices implanted in the body present implications for
broad themes in religious thought and experience, including the nature and
destiny of the human person, the significance of a person's embodied
experience, including the experiences of pain and suffering, the
person's relationship to ultimate reality, the divine or the sacred,
and the vocation of medicine. Community-constituting convictions and
narratives inform the method and content of reasoning about such
conceptual questions as whether a moral line should be drawn between
therapeutic or enhancement interventions and/or between somatic and
neural/cognitive interventions. By attending to these broader
community-forming concepts, it is possible to identify three general
orienting themes in religious perspectives on incorporated mechanical
devices, which we shall designate as perspectives of
“appropriation,” “ambivalence,” and
“resistance.”
A substantial portion of the developed world's population is
increasingly dependent on machines to make their way in the everyday
world. For certain privileged groups, computers, cell phones, PDAs,
Blackberries, and IPODs, all permitting the faster processing of
information, are commonplace. In these populations, even exercise can be
automated as persons try to achieve good physical fitness by riding
stationary bikes, running on treadmills, and working out on cross-trainers
that send information about performance and heart rate.This essay is drawn from collaborative research conducted
under the auspices of the “Altering Nature: How Religious Traditions
Assess the New Biotechnologies” project at Rice University from 2002
to 2004 through the financial support of The Ford Foundation (Grant
#1010-1601). The paper is submitted with the permission and
acknowledgement of the project coordinators and The Ford Foundation. The
authors also acknowledge the research and editorial assistance of Dr.
Siobhan Baggot and Ms. Sarah Gehrke.
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