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1.
Am J Infect Control ; 2020 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-32035689

RESUMEN

BACKGROUND: In 2014, 56 US hospitals were designated as Ebola treatment centers (ETCs). ETCs had minimum augmented capability requirements for Ebola virus disease care, including for staffing and training. We sought to identify current ETC staffing challenges and frequency of staff retraining. METHODS: In May 2019, an electronic survey was distributed to representatives of the 56 ETCs. RESULTS: Sixty-six percent (37/56) of ETCs responded. Registered nurses comprised the majority of ETC staff. All responding units required orientation training (average = 15.21 hours) and all but one required retraining. Among the top challenges that ETCs reported to maintaining high-level isolation capabilities were staff training time, staff recruitment, staff retention, and training costs. DISCUSSION: Five years after ETC designation, units face staffing challenges. Research is lacking on the effective number of hours and optimal frequency of staff training. ETCs reported smaller staffing teams compared to our 2016 assessment, but team composition remains similar. As units continue to maintain capabilities with decreasing external support and attention, the need for retraining must be balanced with logistical constraints and competing demands for staff time. CONCLUSIONS: Our study shows that US preparedness capabilities are reduced. More research, support, and funding are needed to sustain the unique knowledge and proficiency acquired by ETC teams to ensure domestic preparedness for highly hazardous communicable diseases.

2.
Prev Sci ; 21(Suppl 1): 33-42, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29959716

RESUMEN

American Indians/Alaska Natives/Native Hawaiians (AI/AN/NHs) disproportionately experience higher rates of various health conditions. Developing culturally centered interventions targeting health conditions is a strategy to decrease the burden of health conditions among this population. This study analyzes characteristics from 21 studies currently funded under the Interventions for Health Promotion and Disease Prevention in Native American (NA) Populations program among investigators currently funded under this grant mechanism. Four broad challenges were revealed as critical to address when scientifically establishing culturally centered interventions for Native populations. These challenges were (a) their ability to harness culture-centered knowledge and perspectives from communities; (b) their utilization of Indigenous-based theories and knowledge systems with Western-based intervention paradigms and theories; (c) their use of Western-based methodologies; and (d) their cultural adaptation, if based on an evidence-based treatment. Findings revealed that qualitative methodologies and community-based participatory research (CBPR) approaches were very commonly used to finalize the development of interventions. Various Indigenous-based theories and knowledge systems and Western-based theories were used in the methodologies employed. Cultural adaptations were made that often used formative mixed qualitative and quantitative methods. Illustrative examples of strategies used and suggestions for future research are provided. Findings underscored the importance of CBPR methods to improve the efficacy of interventions for AI/AN/NH communities by integrating Indigenous-based theories and knowledge systems with Western science approaches to improve health.

3.
Prev Sci ; 21(Suppl 1): 54-64, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30397737

RESUMEN

Given the paucity of empirically based health promotion interventions designed by and for American Indian, Alaska Native, and Native Hawaiian (i.e., Native) communities, researchers and partnering communities have had to rely on the adaptation of evidence-based interventions (EBIs) designed for non-Native populations, a decidedly sub-optimal approach. Native communities have called for development of Indigenous health promotion programs in which their cultural worldviews and protocols are prioritized in the design, development, testing, and implementation. There is limited information regarding how Native communities and scholars have successfully collaborated to design and implement culturally based prevention efforts "from the ground up." Drawing on five diverse community-based Native health intervention studies, we describe strategies for designing and implementing culturally grounded models of health promotion developed in partnership with Native communities. Additionally, we highlight indigenist worldviews and protocols that undergird Native health interventions with an emphasis on the incorporation of (1) original instructions, (2) relational restoration, (3) narrative-[em]bodied transformation, and (4) indigenist community-based participatory research (ICBPR) processes. Finally, we demonstrate how culturally grounded interventions can improve population health when they prioritize local Indigenous knowledge and health-positive messages for individual to multi-level community interventions.

4.
Air Med J ; 38(5): 359-365, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31578975

RESUMEN

INTRODUCTION: Aeromedical evacuation (AE) is a challenging process, further complicated when a patient has a highly hazardous communicable disease (HHCD). We conducted a review of the literature to evaluate the processes and procedures utilized for safe AE high-level containment transport (AE-HLCT) of patients with HHCDs. METHODS: A literature search was performed in PubMed/MEDLINE (from 1966 through January 2019). Authors screened abstracts for inclusion criteria and full articles were reviewed if the abstract was deemed to contain information related to the aim. RESULTS: Our search criteria yielded 14 publications and were separated based upon publication dates, with the natural break point being the beginning of the 2013-2016 Ebola virus disease epidemic. Best practices and recommendations from identified articles are subdivided into pre-flight preparations, inflight operations, and post-flight procedures. CONCLUSIONS: Limited peer-reviewed literature exists on AE-HLCT, including important aspects related to healthcare worker fatigue, alertness, shift scheduling, and clinical care performance. This hinders the sharing of best practices to inform evacuations and equip teams for future outbreaks. Despite the successful use of different aircraft and technologies, the unique nature of the mission opens the opportunity for greater coordination and development of consensus standards for AE-HLCT operations.

5.
Faraday Discuss ; 220(0): 45-57, 2019 Dec 02.
Artículo en Inglés | MEDLINE | ID: mdl-31524899

RESUMEN

Transfer hydrogenation of acetophenone from formic acid/triethylamine mixtures catalysed by the Ikariya-Noyori complex [(mesitylene)RuCl(R,R)-(TsDPEN)] has been investigated using simultaneous high-resolution FlowNMR and FlowUV-Vis spectroscopies coupled with on-line sampling head-space mass spectrometry and chiral high-performance liquid chromatography using an integrated, fully automated recirculating flow setup. In line with previous observations, the combined results show a gradual switch from formic acid dehydrogenation to hydrogen transfer mediated by the same Ru-hydride complex, and point to a Ru-formate species as the major catalyst intermediate. Hydrogen bonding in the formic acid/triethylamine mixture emerges as a sensitive 1H NMR probe for the transfer hydrogenation activity of the system and can be used to locate optimum reaction conditions.

6.
Bioorg Med Chem Lett ; 29(16): 2354-2357, 2019 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-31196712

RESUMEN

A series of fluorogenic heterocyclic azides were prepared and assessed as reductase substrates across a selection of Gram-negative and Gram-positive microorganisms. The majority of these azides showed similar activity profiles to nitroreductase substrates. Microorganisms that do not produce hydrogen sulfide reduced the azides, indicating reductase activity was not linked to hydrogen sulfide production.

8.
Int J Offender Ther Comp Criminol ; 63(13): 2356-2377, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31081394

RESUMEN

As prostitution is widely condemned as a form of criminality in China, there is a need to examine how Buddhism functions not as a form of therapy for the purposes of rehabilitating or deterring prostitution but as a force that encourages participation in prostitution. In this work, we argue that rural-urban migrant sex workers who are Buddhists appropriate the religion's teachings of compassion, mindfulness, and karma to find a renewed sense of meaning and purpose in their livelihoods. We illustrate how Buddhism allows sex workers to cultivate the affective labor required for the purposes of servicing male clients in conjunction with finding positive purpose in their lives. In doing so, their bodies gain affirmative value in the form of helping their heterosexual male clients address deficits in their masculinities.

9.
Front Chem ; 7: 255, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31119120

RESUMEN

A long wavelength TCF-based fluorescent probe (TCF-ALP) was developed for the detection of alkaline phosphatase (ALP). ALP-mediated hydrolysis of the phosphate group of TCF-ALP resulted in a significant fluorescence "turn on" (58-fold), which was accompanied by a colorimetric response from yellow to purple. TCF-ALP was cell-permeable, which allowed it to be used to image ALP in HeLa cells. Upon addition of bone morphogenic protein 2, TCF-ALP proved capable of imaging endogenously stimulated ALP in myogenic murine C2C12 cells. Overall, TCF-ALP offers promise as an effective fluorescent/colorimetric probe for evaluating phosphatase activity in clinical assays or live cell systems.

10.
Nurs Clin North Am ; 54(2): 169-180, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31027659

RESUMEN

The 2014 to 2016 Ebola outbreak response resulted in many lessons learned about biocontainment patient care, leading to enhanced domestic capabilities for highly infectious and hazardous communicable diseases. However, additional opportunities for improvement remain. The article identifies and describes key considerations and challenges for laboratory analysis, clinical management, transportation, and personnel management during the care of patients infected with Ebola or other special pathogens. Dedication to maintaining preparedness enables biocontainment patient care teams to perform at the highest levels of safety and confidence.


Asunto(s)
Contención de Riesgos Biológicos/normas , Brotes de Enfermedades/prevención & control , Guías como Asunto , Fiebre Hemorrágica Ebola/diagnóstico , Fiebre Hemorrágica Ebola/terapia , Medidas de Seguridad/normas , África Occidental , Humanos , Estados Unidos
12.
Am J Epidemiol ; 188(3): 527-536, 2019 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-30668648

RESUMEN

Although respiratory symptoms, including wheezing, are common in preterm-born subjects, the natural history of the wheezing phenotypes and the influence of early-life factors and characteristics on phenotypes are unclear. Participants from the Millennium Cohort Study who were born between 2000 and 2002 were studied at 9 months and at 3, 5, 7, and 11 years. We used data-driven methods to define wheezing phenotypes in preterm-born children and investigated whether the association of early-life factors and characteristics with wheezing phenotypes was similar between preterm- and term-born children. A total of 1,049/1,502 (70%) preterm-born children and 12,307/17,063 (72%) term-born children had recent wheeze data for 3 or 4 time points. Recent wheeze was more common at all time points in the preterm-born group than in term-born group. Four wheezing phenotypes were defined for both groups: no/infrequent, early, persistent, and late. Early-life factors and characteristics, especially antenatal maternal smoking, atopy, and male sex, were associated with increased rates for all phenotypes in both groups, and breastfeeding was protective in both groups, except late wheeze in the preterm group. Preterm-born children had similar phenotypes to term-born children. Although early-life factors and characteristics were similarly associated with the wheezing phenotypes in both groups, the preterm-born group had higher rates of early and persistent wheeze. However, a large proportion of preterm-born children had early wheeze that resolved with time.


Asunto(s)
Exposición Materna/efectos adversos , Nacimiento Prematuro/fisiopatología , Efectos Tardíos de la Exposición Prenatal/fisiopatología , Ruidos Respiratorios/fisiopatología , Nacimiento a Término/fisiología , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Fenotipo , Embarazo , Efectos Tardíos de la Exposición Prenatal/etiología , Factores de Riesgo
13.
J Child Adolesc Psychiatr Nurs ; 32(1): 16-23, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30637880

RESUMEN

OBJECTIVE(S): The purpose of this paper is to report study findings related to themes of stress and coping strategies experienced by non-reservation-based Native American adolescents as expressed by their written stories. DESIGN: A qualitative descriptive narrative approach was used to capture written stories of stress. ANALYSIS: Key concepts and themes were identified by using the consensual qualitative research (CQR) approach from the participant's stories of stress. RESULTS: Written stories of stress were collected and analyzed from a convenience sample of 179 Native American adolescent's ages 13-18-years old. Five major themes related to experiences of stress emerged from the stories including (a) relationships, (b) responsibilities, (c) socioeconomic status, (d) negative coping strategies, and (e) positive coping through Native-Reliance. CONCLUSION: The findings reveal the importance of understanding the types and response to stress experienced by Native American adolescents.

14.
Forensic Sci Med Pathol ; 15(1): 31-40, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30402743

RESUMEN

In the United States of America, Medical Examiners and Coroners (ME/Cs) investigate approximately 20% of all deaths. Unexpected deaths, such as those occurring due to a deceased person under investigation for a highly infectious disease, are likely to fall under ME/C jurisdiction, thereby placing the ME/C and other morgue personnel at increased risk of contracting an occupationally acquired infection. This survey of U.S. ME/Cs' capabilities to address highly infectious decedents aimed to determine opportunities for improvement at ME/C facilities serving a state or metropolitan area. Data for this study was gathered via an electronic survey. Of the 177 electronic surveys that were distributed, the overall response rate was N = 108 (61%), with 99 of those 108 respondents completing all the questions within the survey. At least one ME/C responded from 47 of 50 states, and the District of Columbia. Select results were: less than half of respondents (44%) stated that their office had been involved in handling a suspected or confirmed highly infectious remains case and responses indicated medical examiners. Additionally, ME/C altered their personal protective equipment based on suspected versus confirmed highly infectious remains rather than taking an all-hazards approach. Standard operating procedures or guidelines should be updated to take an all-hazards approach, best-practices on handling highly infectious remains could be integrated into a standardized education, and evidence-based information on appropriate personal protective equipment selection could be incorporated into a widely disseminated learning module for addressing suspected or confirmed highly infectious remains, as those areas were revealed to be currently lacking.


Asunto(s)
Médicos Forenses/estadística & datos numéricos , Transmisión de Enfermedad Infecciosa/prevención & control , Control de Infecciones/estadística & datos numéricos , Enfermedades Profesionales/prevención & control , Autopsia , Restos Mortales , Contención de Riesgos Biológicos/estadística & datos numéricos , Humanos , Control de Infecciones/normas , Morgue , Equipo de Protección Personal/estadística & datos numéricos , Competencia Profesional , Administración de la Seguridad/estadística & datos numéricos , Encuestas y Cuestionarios , Estados Unidos
15.
Health Promot J Austr ; 29(3): 236-242, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30511488

RESUMEN

ISSUE ADDRESSED: Improving the health of men is a national policy priority. The Men's Shed program is one health promoting initiative that seeks to improve the health and wellbeing of men. This study assessed Men's Shed members' perceptions of the health and wellbeing benefits of Men's Shed activity in a large regional Queensland Men's Shed. METHODS: Data were collected via a self-administered questionnaire from 147 and three group interviews with 17 shedders. Wilcoxon signed-rank test was used to determine differences in shedders perceived health and wellbeing measures retrospectively just before joining the Men's Shed and currently. Thematic analysis was used to analyse qualitative data. RESULTS: There was no change in overall self-assessed health of shedders before and after joining the Men's Shed. Shedders expanded their social networks, and experienced less felt need for social interaction. Shedders' level of satisfaction with feeling part of the community and life as a whole increased. Health and wellbeing benefits of Men's Shed included fellowship, sense of belonging, access to equipment, and learning new and sharing their own skills. CONCLUSIONS: The Men's Shed appeared to provide social health and wellbeing benefits to its members, and an environment for quality social interaction. The Men's Shed is seen as a place for and about members - men. SO WHAT?: Men's Shed may have a unique role in supporting the social health and wellbeing of men beyond that already available from other community groups by providing an environment for the fellowship of men and activities of interest in an unstructured way.


Asunto(s)
Actitud Frente a la Salud , Promoción de la Salud/métodos , Estado de Salud , Salud del Hombre , Apoyo Social , Adulto , Anciano , Anciano de 80 o más Años , Servicios de Salud Comunitaria , Humanos , Relaciones Interpersonales , Masculino , Persona de Mediana Edad , Queensland , Estudios Retrospectivos , Red Social , Encuestas y Cuestionarios
16.
PLoS One ; 13(11): e0207619, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30458053

RESUMEN

In situ analysis of biomarkers is essential for clinical diagnosis and research purposes. The increasing need to understand the molecular signature of pathologies has led to the blooming of ultrasensitive and multiplexable techniques that combine in situ hybridization (ISH) and immunohistochemistry or immunocytochemistry (IHC or ICC). Most protocols are tailored to formalin-fixed paraffin embedded (FFPE) tissue sections. However, methods to perform such assays on non-adherent cell samples, such as patient blood-derived PBMCs, rare tumor samples, effusions or other body fluids, dissociated or sorted cells, are limited. Typically, a laboratory would need to invest a significant amount of time and resources to establish one such assay. Here, we describe a method that combines ultrasensitive RNAscope-ISH with ICC on cytospin cell preparations. This method allows automated, sensitive, multiplex ISH-ICC on small numbers of non-adherent cells. We provide guidelines for both chromogenic and fluorescent ISH/ICC combinations that can be performed either in fully automated or in manual settings. By using a CD8+ T cells in vitro stimulation paradigm, we demonstrate that this protocol is sensitive enough to detect subtle differences in gene expression and compares well to commonly used methods such as RT-qPCR and flow cytometry with the added benefit of visualization at the cellular level.


Asunto(s)
Linfocitos T CD8-positivos/citología , Células Dendríticas/citología , ARN/análisis , Animales , Linfocitos T CD8-positivos/química , Células Cultivadas , Células Dendríticas/química , Citometría de Flujo , Humanos , Inmunohistoquímica , Hibridación in Situ/métodos , Ratones , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
17.
JMIR Mhealth Uhealth ; 6(11): e199, 2018 Nov 28.
Artículo en Inglés | MEDLINE | ID: mdl-30487115

RESUMEN

BACKGROUND: Skin cancer is the most prevalent and most preventable cancer in Australia. Despite Australia's long-running public health campaigns, young Australian adults continue to report high levels of ultraviolet radiation (UVR) exposure and frequent sunburns. Young people are now increasingly turning away from traditional media, such as newspapers and TV, favoring Web-based streaming, which is challenging the health care sector to develop new ways to reach this group with targeted, personalized health promotion messages. Advances in technology have enabled delivery of time- and context-relevant health interventions. OBJECTIVE: The primary aim of this randomized controlled trial was to test the effect of UVR feedback from a smartphone app or a UVR dosimeter feedback device on sun protection habits, sun exposure behaviors, sunburn, and physical activity levels in young adults. METHODS: Young adults aged 18-35 years (n=124) were recruited from Queensland, Australia, between September 2015 and April 2016, via social or traditional media campaigns and outreach activities in the local community. Participants were randomized into 3 groups for a 4-week intervention: (1) no intervention control group; (2) UVR monitor group, who were asked to wear a UVR dosimeter feedback device set to their skin type; and (3) a SunSmart app group, who were asked to download and use the SunSmart phone app. Data were self-assessed through Web-based surveys at baseline and 1 week and 3 months postintervention. RESULTS: Complete data were available for 86.2% (107/124) of participants (control group, n=36; UVR monitor group, n=36; and SunSmart app group, n=35). Intervention uptake in the UVR monitor group was high, with 94% (34/36) of participants using the device all or some of the time when outdoors. All SunSmart app group participants downloaded the app on their smartphone. There was no significant difference in the change in the sun protection habits (SPH) index (main outcome measure) across the 3 groups. However, compared with the control group, a significantly greater proportion of the participants in the UVR monitor group reduced their time unprotected and exposed to UVR on weekends during the intervention compared with the baseline (odds ratio [OR]: 2.706, 95% CI 1.047-6.992, P=.04). This significant effect was sustained with greater reductions observed up to 3 months postintervention (OR: 3.130, 95% CI 1.196-8.190, P=.02). There were no significant differences between the groups in weekday sun exposure, sunscreen use, sunburn, suntan, or physical activity. CONCLUSIONS: Using technology such as apps and personal UVR monitoring devices may improve some sun exposure behaviors among young adults, but as the SPH index did not increase in this study, further research is required to achieve consistent uptake of sun protection in young people. TRIAL REGISTRATION: The Australian and New Zealand Clinical Trials register ACTRN12615001296527; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368458 (Archived by WebCite at http://www.webcitation.org/731somROx).

18.
Nature ; 563(7731): 393-396, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30356212

RESUMEN

Large mammals that live in arid and/or desert environments can cope with seasonal and local variations in rainfall, food and climate1 by moving long distances, often without reliable water or food en route. The capacity of an animal for this long-distance travel is substantially dependent on the rate of energy utilization and thus heat production during locomotion-the cost of transport2-4. The terrestrial cost of transport is much higher than for flying (7.5 times) and swimming (20 times)4. Terrestrial migrants are usually large1-3 with anatomical specializations for economical locomotion5-9, because the cost of transport reduces with increasing size and limb length5-7. Here we used GPS-tracking collars10 with movement and environmental sensors to show that blue wildebeest (Connochaetes taurinus, 220 kg) that live in a hot arid environment in Northern Botswana walked up to 80 km over five days without drinking. They predominantly travelled during the day and locomotion appeared to be unaffected by temperature and humidity, although some behavioural thermoregulation was apparent. We measured power and efficiency of work production (mechanical work and heat production) during cyclic contractions of intact muscle biopsies from the forelimb flexor carpi ulnaris of wildebeest and domestic cows (Bos taurus, 760 kg), a comparable but relatively sedentary ruminant. The energetic costs of isometric contraction (activation and force generation) in wildebeest and cows were similar to published values for smaller mammals. Wildebeest muscle was substantially more efficient (62.6%) than the same muscle from much larger cows (41.8%) and comparable measurements that were obtained from smaller mammals (mouse (34%)11 and rabbit (27%)). We used the direct energetic measurements on intact muscle fibres to model the contribution of high working efficiency of wildebeest muscle to minimizing thermoregulatory challenges during their long migrations under hot arid conditions.


Asunto(s)
Antílopes/fisiología , Regulación de la Temperatura Corporal/fisiología , Clima Desértico , Metabolismo Energético/fisiología , Calor , Locomoción/fisiología , Músculo Esquelético/fisiología , Aclimatación/fisiología , Sistemas de Identificación Animal , Migración Animal/fisiología , Animales , Antílopes/anatomía & histología , Tamaño Corporal , Botswana , Bovinos , Ingestión de Líquidos , Femenino , Sistemas de Información Geográfica , Humedad , Contracción Isométrica , Ratones , Conejos , Conducta Sedentaria , Agua/análisis
19.
Inorg Chem ; 57(21): 13749-13760, 2018 Nov 05.
Artículo en Inglés | MEDLINE | ID: mdl-30303005

RESUMEN

The major product of the reaction between Ru(IMe4)2(PPh3)2H2 (1; IMe4 = 1,3,4,5-tetramethylimidazol-2-ylidene) and P(C6F5)3 (PCF) is the five-coordinate complex Ru(IMe4)2(PF2{C6F5})(C6F5)H (2), which is formed via a complex series of C-F/P-C bond cleavage and P-F bond formation steps. In contrast, hydrodefluorination of all six ortho C-F bonds in PCF occurs with Ru(PPh3)4H2 to afford Ru(PPh3)3HF (3). NaBArF4 abstracted the fluoride ligand in 3 to give [Ru({η6-C6H5}PPh2)(PPh3)2H][BArF4], while B2pin2 reacted with 3 in C6D6 to yield a mixture of [Ru({η6-C6D6)(PPh3)2H]+ and Ru(PPh3)4H2. The treatment of 3 with HBpin (5 equiv) and HSiR3 (R = Et, Ph; 2 equiv) afforded Ru(PPh3)3(σ-HBpin)H2 and Ru(PPh3)3(SiR3)3H3, respectively. No stable substitution products were generated when 3 was reacted with Me3SiX (X = CF3, C6F5).

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