Information sharing behaviors in text-based communication during emergency response.

Emergency response teams consist of highly experienced professionals who must effectively communicate to respond to crisis situations characterized by high levels of uncertainty and complexity. Although the existing literatures on team collaboration and information processing are well established, research examining team information sharing through text-based communication technology facing emergency situations is limited. With the increasing complex nature of emergency response situations, emergency response organizations are likely to introduce new technologies to address such events. In this paper, we examine text-based information sharing behaviors related to team situation awareness in a simulated fire-rescue operation of 62 teams. We elaborate on different types of information sharing behaviors and identify a typology and linguistic features as well as differences between high- and low-performing teams in the occurrence of team situational information sharing behaviors. We conclude by discussing implications for emergency response teams and implications for future research avenues.

A 3-Week, Low-Carbohydrate, High-Fat Diet Improves Multiple Serum Inflammatory Markers in Endurance-Trained Males.

ABSTRACT: Waldman, HS, Heatherly, AJ, Killen, LG, Hollingsworth, A, Koh, Y, and O'Neal, EK. A three-week, low-carbohydrate, high-fat diet improves multiple serum inflammatory markers in endurance-trained males. J Strength Cond Res 36(9): 2502-2508, 2022-This study examined the effects of a low-carbohydrate, high-fat diet (LCHF) on inflammatory marker responses in middle-aged endurance athletes. Eight male runners maintained their habitual mixed diet (HMD) in the first phase of the study before switching to a noncalorically restricted LCHF diet (∼70% of kcals from fat; carbohydrate <50 g) for 3 weeks. Subjects completed a 50-minute fixed pace treadmill running protocol in a hot environment, followed by a 5-km outdoor time trial. Fasting serum samples were collected immediately after exercise and heat stress restriction, and again 24 hours after the exercise/heat stressor. Thirty inflammation markers were assessed using the multiplex flow immunoassay technique. Seven markers (BAFF/TNFSF-13, sCD30/TNFRSF8, sCD163, Chitinase3-like1, gp130SIL-6Rß, sTNFR-1, and sTNFR-2) reached statistical significance ( p < 0.05) favoring LCHF before exercise, and sCD30/TNFRSF8 favored ( p < 0.05) LCHF before (HMD = 459 ± 111; LCHF = 296 ± 100) and after (HMD = 385 ± 104; LCHF = 285 ± 104 pg·ml -1 ) exercise. Although the current dietary intervention was short in duration, LCHF seems to offer some protection against multiple chronic inflammation markers for physically active men between ages 30 and 50 years.

Antimicrobial performance of two preoperative skin preparation solutions containing iodine and isopropyl alcohol.

BACKGROUND: Healthcare-associated infections (HAIs) are a persistent clinical challenge caused primarily by bacteria on the skin. Proper utilization of optimized antiseptic skin preparation solutions helps reduce the prevalence and impact of HAIs by decreasing patient skin microorganisms preoperatively. The purpose of this study was to evaluate the efficacy of 2 antimicrobial solutions containing iodine and isopropyl alcohol (IPA): Povidone iodine (PVP-I) with IPA (ie, PVP-I+IPA, PurPrep) and Iodine Povacrylex+IPA (DuraPrep). METHODS: The antimicrobial activity of the test solutions was evaluated in vitro by determinations of minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) against 1105 diverse microbial isolates and a time-kill assay to evaluate efficacy against 120 strains of Gram-positive and Gram-negative bacteria and yeasts. Peel tests were performed between skin samples treated with test solutions and representative drape/dressing materials to determine effects of test solutions on the biomechanical adhesion properties. Finally, an Institutional Review Board (IRB)-approved, randomized, controlled, single-center, partially blinded in vivo study was performed to assess the immediate and persistent antimicrobial activity of the test solutions on the abdomen and groin. RESULTS: Both PVP-I+IPA and Iodine Povacrylex+IPA solutions demonstrated broad-spectrum antimicrobial activity with MIC and MBC at less than 1% of the full-strength concentration of each product against a wide variety of microorganisms. In the time-kill tests, both solutions were able to successfully reduce all microbial populations by 99.99% (ie, 4 log10) at the contact times of 30 seconds, 2 minutes and 10 minutes. The 2 solutions showed relatively similar adhesion results when tested with 3 representative operating room materials. Both PVP-I+IPA and Iodine Povacrylex+IPA met the expected Food and Drug Administration (FDA) efficacy requirements at 10 minutes and 6 hours post-treatment for both anatomic sites (ie, groin, and abdomen) in the clinical study, with no safety issues or adverse events. CONCLUSIONS: Analysis of the in vitro antimicrobial activity, biomechanical adhesive strength, and in vivo efficacy of PVP-I+IPA demonstrated similar results compared to Iodine Povacrylex+IPA. Both products were efficacious at reducing or eliminating a wide range of clinically-relevant microorganisms in lab-based and clinical settings, supporting their use as antiseptic skin preparation solutions to reduce bacteria on the skin that can cause infection.

Bioburden on Imaging Lead Apparel and Infection Control Measures.

PURPOSE: To explore the level of bioburden and the effectiveness of the manufacturers' recommended cleaning methods on lead apparel in a radiology department. METHODS: A 2-phase experiment at a level II trauma center during a 2-year period assessed the level of bioburden on radiology lead apparel. Adenosine triphosphate swabs and a luminometer were used to measure cleanliness of high-touch areas. Cleanliness was measured before and after 3 cleaning methods were used: cleaning with a mild detergent and water; cleaning with a mild detergent, water, and then a disinfectant; and scrubbing with cleaning wipes. RESULTS: Average bioburden levels exceeded facility thresholds for all areas and types of lead apparel examined. All tested cleaning methods significantly reduced bioburden. DISCUSSION: Monthly cleaning of lead apparel provides improved cleanliness when compared with quarterly cleaning. Daily cleaning of lead apparel that will be used in a sterile environment is recommended. Future research might include examining other patient care and ancillary equipment found in the imaging department for potential bioburden and surveying technologists to examine practices for routine removal of bioburden from equipment. CONCLUSION: Health care professionals must be aware of the potential bioburden on clinical equipment and maintain an effective cleaning practice and schedule to reduce the possibility of spreading infection.

Effects of a 3-week High-Fat-Low-Carbohydrate Diet on Lipid and Glucose Profiles in Experienced, Middle-age Male Runners.

This study examined glucose and lipid marker responses following a 3-week, ad libitum low-carbohydrate-high-fat diet (LCHF; ~70% kcals from fat, <50 g/day of net carbohydrates) versus the habitual mixed macronutrient diet (HMD) of eight middle-age, trained male runners (40 ± 10 years; V̇O2peak = 49 ± 4 mL·kg-1·min-1). Blood was drawn at 0600 from an antecubital vein after an overnight fast under conditions of no exercise/heat stress (NEXH; 48 h of restriction from intense exercise) or 24-h after exercise/heat stress (EXH; 60 min run in hot conditions plus 5-km time trial) for both dietary conditions. Glucose improvement during LCHF approached but did not reach statistical significance (p = 0.07). Pre-exercise triacylglycerol did not differ between treatments but decreased > 20 mg/dL (p < 0.05) for both treatments from NEXH to EXH (HMD = 42 ± 16; LCHF = 35 ± 21 mg/dL). Main effects for diet were exhibited for HDL-C during NEXH and EXH (HMD = 48 ± 10 and 50 ± 11; LCHF = 57 ± 13 and 60 ± 13 mg/dL), and LDL-C also increased (p = 0.02) by ~20 mg/dL for LCHF at both collection points resulting in ~30 mg/dL greater total cholesterol for LCHF before and 24-h after exercise (p < 0.05). A 3-week, ad libitum LCHF did not elicit significant negative cardiovascular disease risk in male runners 30-50 years of age with healthy pre-intervention lipid and glucose marker status.

The Implementation of a Cultural Change Toolkit to Reduce Nursing Burnout and Mitigate Nurse Turnover in the Emergency Department.

PROBLEM: Nursing burnout and high levels of nursing turnover contribute to negative work environments, diminished patient care, and increased health care costs. There is a gap in literature regarding cost-effective, easily implemented interventions to address burnout and turnover. The purpose of this project was to determine if the implementation of evidence-based interventions would improve the perception of the practice environment, decrease the levels of nursing burnout, and decrease the voluntary nurse turnover rate in the emergency department. METHODS: The Cultural Change Toolkit was developed based on current recommendations in literature and implemented within an emergency department in southeast Texas. The toolkit included specific interventions related to meaningful recognition, shared decision making, and increased leadership involvement and support. Nursing burnout and anticipated turnover were measured using the Anticipated Turnover Scale and the Oldenburg Burnout Inventory both before and after implementation of the project. Participants (n = 30) included nursing staff employed in the emergency department. RESULTS: There was a reduction in both the anticipated turnover (mean anticipated turnover score, preimplementattion = 3.133, postimplementation = 2.989) and burnout scores among nursing staff (mean burnout score, preimplementation = 4.808, postimplementation = 4.463). The reduction in overall burnout scores were statistically significant following a paired t-test analysis (P = 0.004). There were no resignations among nursing staff throughout the project period. DISCUSSION: Nursing burnout and turnover are frequently discussed topics. The results support the use of cost-effective interventions outlined in the Cultural Change Toolkit to address nursing turnover and burnout.

Effects of Ad libitum Low-Carbohydrate High-Fat Dieting in Middle-Age Male Runners.

PURPOSE: This study examined the effects of a 3-wk ad libitum, low-carbohydrate (<50 g·d) high-fat (~70% of calories) (LCHF) diet on markers of endurance performance in middle-age, recreationally competitive male runners. METHODS: All subjects (n = 8) after their normal high-carbohydrate (HC) diet had anthropometric measures assessed and completed five 10-min running bouts at multiple individual race paces in the heat while physiological variables, metabolic variables, and perceptual responses were recorded. After 20 min of rest, participants completed a 5-km time trial on a road course. Subjects then consumed an LCHF diet for 3 wk and returned for repeat testing. RESULTS: Body mass and seven-site skinfold thickness sum decreased by approximately 2.5 kg (P < 0.01) and 13 mm (P < 0.05) after LCHF diet. Rectal temperature was higher after the first 10 min of exercise (37.7°C ± 0.3°C vs 37.3°C ± 0.2°C) in the HC diet but did not differ at any other time with LCHF diet. Heart rate and perceptual measures did not display any consistent differences between treatments excluding thirst sensation for LCHF diet. RER and carbohydrate oxidation declined significantly, whereas fat oxidation increased after LCHF diet for every pace (P < 0.01). There was no significant difference (P = 0.25) in a 5-km time trial performance, but LCHF diet (23.45 ± 2.25 min) displayed a trend of improved performance versus HC (23.92 ± 2.57 min). CONCLUSION: Improved body composition and fat oxidation from LCHF diet potentially negate expected performance decrement from reduced carbohydrate use late in exercise for nonelite runners. An acute decrease in training capacity is expected; however, if performance improvement is not exhibited after 3 wk, diet cessation is suggested for negative responders.

Efficacy of surgical hand scrub products based on chlorhexidine is largely overestimated without neutralizing agents in the sampling fluid.

BACKGROUND: Surgical hand antiseptics often contain chlorhexidine gluconate (CHG). There are doubts that the full effect measured for these products might only be achieved after sampling because of a lack of valid neutralizing agents (NAs) in the sampling fluid. METHODS: We measured the efficacy of Avagard CHG and Hibiclens for 11 applications over 5 days according to the manufacturers' instructions. NAs were added to the sampling fluid and the dilution fluid (group 1) or to only the dilution fluid (group 2). In a third group, NAs were added to the dilution fluid only, and cream was applied after the final scrub on days 1 to 4. Neutralization was validated according to American Society for Testing and Materials International standard 1054 using Staphylococcus epidermidis. RESULTS: When NAs were not added to the sampling fluid, both products were very effective, with a mean log(10) reduction in flora of 3.32 ± 0.53 for Avagard and 3.68 ± 0.52 for Hibiclens on day 5. When NAs were included in the sampling fluid, however, the immediate efficacy was significantly lower, at 2.75 ± 0.55 and 3.14 ± 0.50, respectively. A lack of NAs in the sampling fluid resulted in overestimation of efficacy by a factor of between 0.3 and 1.1 log(10). CONCLUSION: Efficacy studies carried out without NAs in the sampling fluid for products with CHG should be critically assessed.

Reducing risk factors for childhood obesity: the Tommie Smith Youth Athletic Initiative.

This study has sought to determine if the Tommie Smith Youth Athletic Initiative (TSYAI) intervention could decrease the risk factors for childhood obesity among children 5 to 10 years of age. The TSYAI intervention is a 14-week after-school intervention for students in Grades K-5 that was started during the spring of 2008. It serves 63 children in a predominantly African American elementary school. The intervention consists of supervised after-school sessions 3 days per week. These sessions include 2 days of physical activity (flexibility, resistance, and track-and-field training) and 1 day of 45 min of nutrition education modules based on the Transtheoretical Model of behavior change followed by 45 min of group physical activity. Ninety-two percent of the participants are African American and 60% are overweight or obese (>85th percentile BMI for age and gender). The findings indicate that the TSYAI intervention significantly improves the participant's cardiovascular fitness, body composition, and dietary habits.

Comprehensive bactericidal activity of an ethanol-based hand gel in 15 seconds.

BACKGROUND: Some studies indicate that the commonly recommended 30 s application time for the post contamination treatment of hands may not be necessary as the same effect may be achieved with some formulations in a shorter application time such as 15 s. METHOD: We evaluated the bactericidal activity of an ethanol-based hand gel (Sterillium Comfort Gel) within 15 s in a time-kill-test against 11 Gram-positive, 16 Gram-negative bacteria and 11 emerging bacterial pathogens. Each strain was evaluated in quadruplicate. RESULTS: The hand gel (85% ethanol, w/w) was found to reduce all 11 Gram-positive and all 16 Gram-negative bacteria by more than 5 log10 steps within 15 s, not only against the ATCC test strains but also against corresponding clinical isolates. In addition, a log10 reduction > 5 was observed against all tested emerging bacterial pathogens. CONCLUSION: The ethanol-based hand gel was found to have a broad spectrum of bactericidal activity in only 15 s which includes the most common species causing nosocomial infections and the relevant emerging pathogens. Future research will hopefully help to find out if a shorter application time for the post contamination treatment of hands provides more benefits or more risks.