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208 - Person-centred infection prevention and control during a pandemic: The Dementia Isolation Toolkit
- Andrea Iaboni, Hannah Quirt, Steven Stewart, Alisa Grigorovich, Claudia Barned, Kevin Rodrigues, Pia Kontos, Charlene Chu, Arlene Astell, Katia Engell, Colleen Maxwell, Julia Kirkham, Kathleen Bingham, Alastair Flint
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- Journal:
- International Psychogeriatrics / Volume 33 / Issue S1 / October 2021
- Published online by Cambridge University Press:
- 01 November 2021, p. 11
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Objectives:
People working in long-term care homes (LTCH) face ethical dilemmas about how to minimize the risk of spread of COVID-19, while also minimizing psychological hardship and other harms of infection control measures on residents. The Dementia Isolation Toolkit (www.dementiaisolationtoolkit.com; DIT) was developed to address the gap in ethical guidance for LTCH on how to safely and effectively isolate people with dementia while supporting the personhood and well-being of residents. In this presentation, we will present the DIT and report on the results of a survey of LTCH staff in Ontario, Canada on their experiences isolating residents in LTCH and the use of the DIT in supporting person-centred isolation care.
Methods:A link to an online survey was distributed to LTCH staff through provincial organizations and agencies as well as through social media and the DIT website. Inclusion criteria were LTCH staff working on-site at a LTCH since March 1, 2020, who had direct or indirect experience with the isolation/quarantine of LTCH residents. Results were summarized descriptively.
Results:A broad sample of LTCH staff (n=207) participated in the survey, most of whom had experienced an outbreak in their LTCH. Dementia (96%) was the most important barrier to implementation of infection control measures in LTCH, followed by staff distress about the effects of isolation on residents (61%). Important facilitators for isolation included delivery of 1:1 activities in the resident’s room (81%) and designating essential caregivers to provide support (67%), while inadequate staffing levels were reported as a barrier (55%). 65% of respondents indicated some familiarity with the DIT, and of those who had used the toolkit, 62% found it helpful in supporting isolation care, particularly in developing care plans and making and communicating decisions. Of those who had used the DIT, 48% found it fairly or very helpful at reducing their level of distress.
Conclusions:Isolation as an infection control and prevention (ICP) measure in LTCH environments can be harmful to residents and create moral distress in staff. ICP guidance and support of LTCH needs to address how to minimize these harms by providing dementia-specific guidance such as in the DIT.
Addressing personal protective equipment (PPE) decontamination: Methylene blue and light inactivates severe acute respiratory coronavirus virus 2 (SARS-CoV-2) on N95 respirators and medical masks with maintenance of integrity and fit
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- Thomas Sean Lendvay, James Chen, Brian H. Harcourt, Florine E. M. Scholte, Ying Ling Lin, F. Selcen Kilinc-Balci, Molly M. Lamb, Kamonthip Homdayjanakul, Yi Cui, Amy Price, Belinda Heyne, Jaya Sahni, Kareem B. Kabra, Yi-Chan Lin, David Evans, Christopher N. Mores, Ken Page, Larry F. Chu, Eric Haubruge, Etienne Thiry, Louisa F. Ludwig-Begall, Constance Wielick, Tanner Clark, Thor Wagner, Emily Timm, Thomas Gallagher, Peter Faris, Nicolas Macia, Cyrus J. Mackie, Sarah M. Simmons, Susan Reader, Rebecca Malott, Karen Hope, Jan M. Davies, Sarah R. Tritsch, Lorène Dams, Hans Nauwynck, Jean-Francois Willaert, Simon De Jaeger, Lei Liao, Mervin Zhao, Jan Laperre, Olivier Jolois, Sarah J. Smit, Alpa N. Patel, Mark Mayo, Rod Parker, Vanessa Molloy-Simard, Jean-Luc Lemyre, Steven Chu, John M. Conly, May C. Chu
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 43 / Issue 7 / July 2022
- Published online by Cambridge University Press:
- 21 May 2021, pp. 876-885
- Print publication:
- July 2022
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Objective:
The coronavirus disease 2019 (COVID-19) pandemic has resulted in shortages of personal protective equipment (PPE), underscoring the urgent need for simple, efficient, and inexpensive methods to decontaminate masks and respirators exposed to severe acute respiratory coronavirus virus 2 (SARS-CoV-2). We hypothesized that methylene blue (MB) photochemical treatment, which has various clinical applications, could decontaminate PPE contaminated with coronavirus.
Design:The 2 arms of the study included (1) PPE inoculation with coronaviruses followed by MB with light (MBL) decontamination treatment and (2) PPE treatment with MBL for 5 cycles of decontamination to determine maintenance of PPE performance.
Methods:MBL treatment was used to inactivate coronaviruses on 3 N95 filtering facepiece respirator (FFR) and 2 medical mask models. We inoculated FFR and medical mask materials with 3 coronaviruses, including SARS-CoV-2, and we treated them with 10 µM MB and exposed them to 50,000 lux of white light or 12,500 lux of red light for 30 minutes. In parallel, integrity was assessed after 5 cycles of decontamination using multiple US and international test methods, and the process was compared with the FDA-authorized vaporized hydrogen peroxide plus ozone (VHP+O3) decontamination method.
Results:Overall, MBL robustly and consistently inactivated all 3 coronaviruses with 99.8% to >99.9% virus inactivation across all FFRs and medical masks tested. FFR and medical mask integrity was maintained after 5 cycles of MBL treatment, whereas 1 FFR model failed after 5 cycles of VHP+O3.
Conclusions:MBL treatment decontaminated respirators and masks by inactivating 3 tested coronaviruses without compromising integrity through 5 cycles of decontamination. MBL decontamination is effective, is low cost, and does not require specialized equipment, making it applicable in low- to high-resource settings.
FOREWORD
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- By Steven Chu, Stanford University
- Marta García-Matos, Lluís Torner
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- Book:
- The Wonders of Light
- Published online:
- 05 July 2015
- Print publication:
- 18 June 2015, pp vi-viii
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Summary
We are visual beings, and qualities such as “insight” and “vision” describe our understanding well beyond sensory inputs. The ability to extend our sight beyond our eyes gives deeper meaning to the observation of Yogi Berra, the great American philosopher of the 20th century: “You see a lot by just watching.”
Visible light is a small sliver of a huge spectrum that includes radio waves with energies as low as 2 × 10-13 eV (48 Hz) used to communicate with submarines, to cosmic gamma rays with energies in excess of 300 GeV (7 × 1025 Hz). Maxwell's equations, written in 1862, predicted that radio waves, infrared radiation, and visible light are different forms of electromagnetic waves. In the ensuing 150 years, we discovered X-rays and gamma rays, and subsequently realized that these forms of energy are also part of the electromagnetic spectrum.
With the development of Quantum Mechanics in the 1920s, we discovered that the energy of these waves cannot be dialed down arbitrarily, but there exists a fundamental “graininess” to light: the photon. An electromagnetic wave of frequency ν is composed of particles of light with energy Emin = ℏν, where Planck's constant h is a universal constant of Nature. Light can display both particle and wave properties. Remarkably, Maxwell's equations predicted that photons with energies less than 10-13 eV to greater than 3 × 10+11 eV all move at the same speed in vacuum. This prediction, yet to be contradicted by experiment, is one of the wonders of light.
Marta García-Matos' and Lluís Torner's Wonders of Light presents a delightful smorgasbord that illustrates how light continues to redefine our daily lives. The chapter “Lighting” reminds us how artificial light liberated us from darkness (and boredom) and protected us from predators; rapidly advancing technology is allowing us to create light that mimics the changing hues of sunlight during the day.
Contributors
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- By Nalini Vadivelu, Christian J. Whitney, Raymond S. Sinatra, M. Khurram Ghori, Yu-Fan (Robert) Zhang, Raymond S. Sinatra, Joshua Wellington, Yuan-Yi Chia, Francis J. Keefe, Jon McCormack, Ian Power, John Butterworth, P. M. Lavand’homme, M. F. De Kock, Bradley Urie, Oscar A. de Leon-Casasola, Frederick M. Perkins, Larry F. Chu, David Clark, Martin S. Angst, Cynthia M. Welchek, Lisa Mastrangelo, Raymond S. Sinatra, Richard Martinez, Scott S. Reuben, Asokumar Buvanendran, Raymond S. Sinatra, Pamela E Macintyre, Julia Coldrey, Daniel B. Maalouf, Spencer S. Liu, Susan Dabu-Bondoc, Samantha A. Franco, Raymond S. Sinatra, James Benonis, Jennifer Fortney, David Hardman, Gavin Martin, Holly Evans, Karen C. Nielsen, Marcy S. Tucker, Stephen M. Klein, Benjamin Sherman, Ikay Enu, Raymond S. Sinatra, James W. Heitz, Eugene R. Viscusi, Jonathan S. Jahr, Kofi N. Donkor, Raymond S. Sinatra, Manzo Suzuki, Johan Raeder, Vegard Dahl, Stefan Erceg, Keun Sam Chung, Kok-Yuen Ho, Tong J. Gan, Dermot R. Fitzgibbon, Paul Willoughby, Brian E. Harrington, Joseph Marino, Tariq M. Malik, Raymond S. Sinatra, Giorgio Ivani, Valeria Mossetti, Simona Italiano, Thomas M. Halaszynski, Nousheh Saidi, Javier Lopez, Kate Miller, Ferne Braveman, Jaya L. Varadarajan, Steven J. Weisman, Sukanya Mitra, Raymond S. Sinatra, Theodore J. Saclarides, Knox H. Todd, James R. Miner, Chris Pasero, Nancy Eksterowicz, Margo McCaffery, Leslie N. Schechter, Amr E. Abouleish, Govindaraj Ranganathan, Tee Yong Tan, Stephan A. Schug, Marie N. Hanna, Spencer S. Liu, Christopher L. Wu, Craig T. Hartrick, Garen Manvelian, Christine Miaskowski, Brian Durkin, Peter S. A. Glass
- Edited by Raymond S. Sinatra, Oscar A. de Leon-Cassasola, University of Rochester Medical Center, New York, Eugene R. Viscusi, Brian Ginsberg
- Foreword by Henry McQuay
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- Book:
- Acute Pain Management
- Published online:
- 26 October 2009
- Print publication:
- 27 April 2009, pp vii-xii
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Poison Control Centers' Role in Glow Product-Related Outbreak Detection: Implications for Comprehensive Surveillance System
- Alvin F. Chu, Steven M. Marcus, Bruce Ruck
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- Journal:
- Prehospital and Disaster Medicine / Volume 24 / Issue 1 / February 2009
- Published online by Cambridge University Press:
- 28 June 2012, pp. 68-72
- Print publication:
- February 2009
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Introduction:
The development of syndromic surveillance systems to detect bioterrorist attacks and emerging infectious diseases has become an important and challenging goal to many governmental agencies and healthcare authorities. This study utilized the sharp increase of glow product-related calls to demonstrate the utility of poison ontrol data for early detection of potential outbreaks during the week of Halloween in 2007.
Methods:A review was conducted of the electronic records of exposures reported to the New Jersey Poison Information and Education System NJPIES) Poison Control Hotline from 2002 through 2007 with generic code number 0201027 (glow products) set by the American Association of Poison Control Centers (AAPCC). Key information such as age, gender, time of the call, exposure reason, clinical effects, and medical outcomes along with telephone number, zip code, and county location were used in the analyses to determine the extent of the outbreak.
Results:Analyses included a total of 139 glow product-related calls during the week of Halloween in 2007 with a single-day high of 59 calls on Halloween Day. More than 90% of the glow product exposures were in children 1–10 years of age. The glow product-related calls on Halloween Day increased from 14 calls in 2002 to 59 calls in 2007, a 321% increase during a six-year period.
Conclusions:Poison control centers in the United States are equipped with a unique and uniform input data collection system—the National Poison Data System—that provides an important data source in the development of a comprehensive surveillance system for early outbreak detection.
Measurements of the interaction of wave groups with shorter wind-generated waves
- Jacob S. Chu, Steven R. Long, O. M. Phillips
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- Journal:
- Journal of Fluid Mechanics / Volume 245 / December 1992
- Published online by Cambridge University Press:
- 26 April 2006, pp. 191-210
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Fields of statistically steady wind-generated waves produced in the NASA-Wallops wind wave facility, were perturbed by the injection of groups of longer waves with various slopes, mechanically generated at the upwind end of the tank. The time histories of the surface displacements were measured at four fetches in ensembles consisting of 100 realizations of each set of experimental conditions, the data being stored and analysed digitally. The overall interaction was found to have four distinct phases. (i) When the longer waves overtake the pre-existing wind-generated waves, during the first half of the group where successive crests are increasing in amplitude, vigorous wave breaking near the crests reduces the energy density and $\overline{\zeta^2}$ in the wind waves while straining by the orbital velocities of the group reduces their wavelengths near the crests; the ‘significant slope’ $2\pi(\overline{\zeta^2})^{\frac{1}{2}}/\lambda $ at the crests is found to be very nearly constant and equal to the initial, undisturbed value. After the maximum wave of the group has passed, breaking appears to virtually cease but the earlier energy loss results in suppression of the short waves. The overall suppression by a group of waves is significantly less than that measured by Mitsuyasu (1966) and Phillips & Banner (1974) in a continuous train of waves whose slope is equal to the maximum in the group. A simple description of this phase of the interaction, involving constant significant slope of the breaking waves over the leading half of the group and conservation of action thereafter, gives suppression ratios close to those measured. (ii) Once the group has passed, the surface is much smoother and the waves begin to regenerate under the continued influence of the wind but at rates considerably slower than those suggested by Plant's formula, using the averaged value of u*. This is qualitatively consistent with a locally reduced surface stress as the wind blows from rougher water well behind the group to the smoother surface immediately behind it. (iii) The regeneration is interrupted by the arrival of a wave energy front moving down the tank, across which the energy density rises abruptly to values up to six times greater than in the undisturbed field. At the same time, the dominant frequencies just behind the wave energy front are lower than in the initial field, and the significant slope $(\overline{\zeta^2})^{\frac{1}{2}} \sigma^2/g $ is, within experimental uncertainty, again identical to that in the initial field. The front was found to propagate notably faster than the appropriate group velocity (g/2σ) and it is suggested that this is the combined result of dispersion, nonlinearity and wind amplification, together with wind-induced drift in the tank. Finally, (iv) the energy density gradually subsides and the dominant wave frequency increases as the wind waves relax towards their undisturbed state, the relaxation seeming to be essentially complete when energy packets arriving at a point have originated at the upwind end of the tank, rather than at the wave energy front.