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Batrachochytrium dendrobatidis (Bd) is a pathogenic chytrid fungus that is particularly lethal for amphibians. Bd can extirpate amphibian populations within a few weeks and remain in water in the absence of amphibian hosts. Most efforts to determine Bd presence and quantity in the field have focused on sampling hosts, but these data do not give us a direct reflection of the amount of Bd in the water, which are useful for parameterizing disease models, and are not effective when hosts are absent or difficult to sample. Current methods for screening Bd presence and quantity in water are time, resource, and money intensive. Here, we developed a streamlined method for detecting Bd in water with low turbidity (e.g., water samples from laboratory experiments and relatively clear pond water from a natural lentic system). We centrifuged water samples with known amounts of Bd to form a pellet and extracted the DNA from that pellet. This method was highly effective and the resulting concentrations across all tested treatments presented a highly linear relationship with the expected values. While the experimentally derived values were lower than the inoculation doses, the values were highly correlated and a conversion factor allows us to extrapolate the actual Bd concentration. This centrifuge-based method is effective, repeatable, and would greatly expand the domain of tractable questions to be explored in the field of Bd ecology. Importantly, this method increases equity in the field, because it is time- and cost-efficient and requires few resources.
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STUDY OBJECTIVE: The aim of this study was to evaluate the clinical and operational effectiveness of US federal government guidance (Primary Response Incident Scene Management [PRISM]) for the initial response phase to chemical incidents. METHODS: The study was performed as a large-scale exercise (Operation DOWNPOUR). Volunteers were dosed with a chemical warfare agent simulant to quantify the efficacy of different iterations of dry, ladder pipe system, or technical decontamination. RESULTS: The most effective process was a triple combination of dry, ladder pipe system, and technical decontamination, which attained an average decontamination efficiency of approximately 100% on exposed hair and skin sites. Both wet decontamination processes (ladder pipe system and technical decontamination, alone or in combination with dry decontamination) were also effective (decontamination efficiency >96%). In compliant individuals, dry decontamination was effective (decontamination efficiency approximately 99%), but noncompliance (tentatively attributed to suboptimal communication) resulted in significantly reduced efficacy (decontamination efficiency approximately 70%). At-risk volunteers (because of chronic illness, disability, or language barrier) were 3 to 8 times slower than ambulatory casualties in undergoing dry and ladder pipe system decontamination, a consequence of which may be a reduction in the overall rate at which casualties can be processed. CONCLUSION: The PRISM incident response protocols are fit for purpose for ambulatory casualties. However, a more effective communication strategy is required for first responders (particularly when guiding dry decontamination). There is a clear need to develop more appropriate decontamination procedures for at-risk casualties.
Assuntos
Vazamento de Resíduos Químicos , Descontaminação , Planejamento em Desastres/organização & administração , Socorristas/educação , Incidentes com Feridos em Massa , Substâncias para a Guerra Química , Descontaminação/métodos , Guias como Assunto , HumanosRESUMO
BACKGROUND: Australia's first programme dedicated to promulgating the teaching nursing home model - Teaching and Research Aged Care Services (TRACS) -- is overviewed and key findings from its national evaluation are presented. RESULTS: These findings are discussed in relation to the four pillars of the TRACS programme: partnerships between aged care providers and education providers, student education, workforce education and research. The multiple positive outcomes achieved by TRACS partnerships within a very small time frame of 3 years are presented, together with lessons arising from the experiences of 16 TRACS projects.
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BACKGROUND: The Student Education and Participation Program that has evolved at Helping Hand Aged Care over the past decade is based on ongoing research and evaluation, and a highly innovative example of the teaching nursing home model has emerged. METHODS: Drawing on that body of work and findings from the national evaluation of Australia's TRACS (Teaching and Research Aged Care Services) programme (2012-2015) an analysis of the model is presented. RESULTS AND CONCLUSIONS: Lessons learned about the challenges faced, enabling factors, the benefits generated and outcomes achieved are presented.
Assuntos
Lesões Encefálicas/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Lesões Encefálicas/diagnóstico , Causalidade , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Rhode Island/epidemiologia , Índice de Gravidade de Doença , Adulto JovemRESUMO
OBJECTIVES: Unmarried women with disabilities may be a particularly vulnerable group for underutilization of repeat mammography screening. Our goal was to compare the breast cancer screening experiences of unmarried women with disabilities (WWD) versus women with no disabilities (WND), and determine whether these experiences are associated with adherence to repeat screening. METHODS: We conducted a matched cohort study of 93 WWD and 93 WND to compare mammography experiences by disability status, examine rates of repeat mammography by disability status, and identify factors that are associated with repeat mammography. RESULTS: WWD were less likely to be on-schedule than WND in univariable (54.8% vs. 71.0%; relative risk, 0.77; 95% confidence limits, 0.61, 0.97), but not multivariable, analyses. In multivariable analyses, there was a significant interaction between disability status and positive experiences as the reasons for returning to the same mammography facility. Among WND, repeat screening ranged from 59% to 86%, depending on the number of positive experiences endorsed (range, 1-5). In contrast, among WWD, screening rates were only 37% among those who did not report any positive experiences and increased to a maximum of 60% regardless of whether women endorsed one to four or all five positive experiences. Severity and type of disability were not associated with repeat screening. CONCLUSION: WWD may be less likely than WND to remain on-schedule for mammography. WWD who do not report any positive experiences as reasons for returning to a mammography facility may be at particularly high risk of underutilization of screening.