Search

Mammalian orthoreovirus (MRV) infects many mammalian species including humans, bats, and domestic animals. To determine the prevalence of MRV in bats in the United States, we screened more than 900 bats of different species collected during 2015–2019 by a real‐time reverse‐transcription polymerase chain reaction assay; 4.4% bats tested MRV‐positive and 13 MRVs were isolated. Sequence and phylogenetic analysis revealed that these isolates belonged to four different strains/genotypes of viruses in Serotypes 1 or 2, which contain genes similar to those of MRVs detected in humans, bats, bovine, and deer. Further characterization showed that these four MRV strains replicated efficiently on human, canine, monkey, ferret, and swine cell lines. The 40/Bat/USA/2018 strain belonging to the Serotype 1 demonstrated the ability to infect and transmit in pigs without prior adaptation. Taken together, this is evidence for different genotypes and serotypes of MRVs circulating in US bats, which can be a mixing vessel of MRVs that may spread to other species, including humans, resulting in cross‐species infections. [ABSTRACT FROM AUTHOR]

PURPOSE People with cancer are at increased risk for severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) infection. ASCO's COVID-19 registry promotes systematic data collection across US oncology practices. METHODS Participating practices enter data on patients with SARS-CoV-2 infection in cancer treatment. In this analysis, we focus on all patients with hematologic or regional or metastatic solid tumor malignancies. Primary outcomes are 30- and 90-day mortality rates and change over time. RESULTS Thirty-eight practices provided data for 453 patients from April to October 2020. Sixty-two percent had regional or metastatic solid tumors. Median age was 64 years. Forty-three percent were current or previous cigarette users. Patients with B-cell malignancies age 61-70 years had twice mortality risk (hazard ratio 5 2.1 [95% CI, 1.3 to 3.3]) and those age. 70 years had 4.5 times mortality risk (95% CI, 1.8 to 11.1) compared with patients age#60 years. Association between survival and age was not significant in patients with metastatic solid tumors (P5 .12). Tobacco users had 30-day mortality estimate of 21% compared with 11% for never users (logrank P 5 .005). Patients diagnosed with SARS-CoV-2 before June 2020 had 30-day mortality rate of 20% (95% CI, 14% to 25%) compared with 13% (8% to 18%) for those diagnosed in or after June 2020 (P 5 .08). The 90-day mortality rate for pre-June patients was 28% (21% to 34%) compared with 21% (13% to 28%; P 5 .20). CONCLUSION Older patients with B-cell malignancies were at increased risk for death (unlike older patients with metastatic solid tumors), as were all patients with cancer who smoke tobacco. Diagnosis of SARS-CoV-2 later in 2020 was associated with more favorable 30- and 90-day mortality, likely related to more asymptomatic cases and improved clinical management. [ABSTRACT FROM AUTHOR]

Abstract: Given the recent increase in dust‐induced lung disease among U.S. coal miners and the respiratory hazards encountered across the U.S. mining industry, it is important to enhance an understanding of lung disease trends and the organizational contexts that precede these events. In addition to exploring overall trends reported to the Mine Safety and Health Administration (MSHA), the current study uses MSHA's enforcement database to examine whether or not compliance with health regulations resulted in fewer mine‐level counts of these diseases over time. The findings suggest that interstitial lung diseases were more prevalent in coal mines compared to other mining commodities, in Appalachian coal mines compared to the rest of the United States, and in underground compared to surface coal mines. Mines that followed a relevant subset of MSHA's health regulations were less likely to report a lung disease over time. The findings are discussed from a lung disease prevention strategy perspective. [ABSTRACT FROM AUTHOR]

We conducted e-mail surveys of organizations that had received forest management certification under the Forest Stewardship Council (FSC) in the United States and Sustainable Forestry Initiative (SFI) in the United States and Canada to determine if forest certification has changed forest management practices and if the changes are practically and statistically different between systems. The results indicate that forest certification prompted substantial changes in practices. On average, firms implemented 13-14 changes in forestry, environmental, social, and economic/system practices to obtain or maintain forest certification. Although there was no statistical difference between systems in the total number of changes, there were many differences in the implementation of specific forest practices, with FSC firms required to make more environmental/forest management changes and SFI firms required to make more economic/system changes. Forest managers believed that the benefits of forest certification were greater than the disadvantages. SFI managers rated the benefits of forest certification higher than FSC managers, but also rated the disadvantages higher. Most organizations felt certification accomplished their objectives and were likely to recertify, thus indicating their endorsement of the process. [ABSTRACT FROM AUTHOR]

The article offers information on Students' Cloud Observations On-Line (S'COOL) project of the U.S. National Aeronautics & Space Administration (NASA). It notes that S'COOL program, integrated to problem-based learning (PBL) activity, renders a simple and effective way to educators in adding an authentic science into their teaching practice. It implies that through the program, students are able to employ skills used by research scientists like peer training, data collection, and analysis.

The article discusses the Crosswalks Intervention, a U.S. Department of Education-funded program which created a faculty development strategy aimed at making early childhood preservice programs more culturally and linguistically diverse. The author notes that as the U.S. becomes more ethnically and culturally diverse faculty training programs need to ensure that educators can work effectively with children from different cultures and backgrounds. Evidence-based practices were used to create the educational content of the Crosswalks Intervention and the evaluation tools used to assess the program's effectiveness. Participants in the program reported a significant change in their cultural knowledge and their ability to incorporate it into their educational practice.

Abstract: Introduction: The restricted workspace present in low-seam coal mines forces workers to adopt awkward working postures (kneeling and stooping), which place high physical demands on the knee and lower back. Method: This article provides an analysis of injury claims for eight mining companies operating low-seam coal mines during calendar years 1996-2008. All cost data were normalized using data on the cost of medical care (MPI) as provided by the U.S. Bureau of Labor Statistics. Results: Results of the analysis indicate that the knee was the body part that led in terms of claim cost ($4.2 million), followed by injuries to the lower back ($2.7 million). While the average cost per injury for these body parts was $13,100 and $14,400, respectively (close to the average cost of an injury overall), the high frequency of these injuries resulted in their pre-eminence in terms of cost. Analysis of data from individual mining companies suggest that knee and lower back injuries were a consistent problem across companies, as these injuries were each among the top five most costly part of body for seven out of eight companies studied. Application/Impact: Results of this investigation suggest that efforts to reduce the frequency of knee and low back injuries in low-seam mines have the potential to create substantial cost savings. [Copyright &y& Elsevier]

This article documents the impact that federal spectrum oversight has had on U.S. radio operators since 1995. It outlines the positions and activities of stakeholders and interest groups in the commercial and government sectors, as well as U.S. federal oversight bodies' responses to these activities. For more than a decade, U.S. radio operators, wireless industry experts, scientists, and economists have criticized the government's overregulation of the radio spectrum. The difficult spectrum acquisition process and inefficient allocation inhibits technological innovation and economic growth. To support their claim, they point to the unlicensed bands of spectrum, which have substantially lower regulatory barriers for entry into the wireless market, and which have demonstrated far more dramatic growth in recent years. To spur similar growth in the other bands, commercial-sector reform proponents support decentralized, open-market controls that leave only radio interference and unfair competition under government regulation.

Focuses on forest certification of state and university lands in North Carolina. Certification standards and processes; Management impacts; Audit results.

Evaluates the role of advanced practice nurses (APN) in community settings and in providing health care needs of residents in the U.S. Characteristics of APN; Role of APN in pharmacotherapeutics; Analysis of the effectiveness of the APN practice.

Background: White blood cells on endocervical Gram stain and vaginal wet mount are frequently used to predict chlamydial and gonococcal infections. Previous studies provide conflicting evidence for the clinical utility of these tests.Goal: To evaluate the clinical utility of measuring white blood cells on vaginal wet mount and endocervical Gram stain for the prediction of chlamydial infection and gonorrhea.Study Design: Women undergoing pelvic examinations at 10 county health department family planning and sexually transmitted disease clinics were tested for chlamydial infection by ligase chain reaction assay (n = 4550) and for gonorrhea by culture (n = 4402). Vaginal wet mount and endocervical Gram stains were performed in county laboratories at the time of examination.Results: The prevalences of chlamydial infection and gonorrhea were 8.8% and 3.2%, respectively. For detection of chlamydial or gonococcal infection, the likelihood ratio was 2.85 (95% CI, 2.10-3.87) for > 30 white blood cells on vaginal wet mount and 2.91 (95% CI, 2.07-4.09) for > 30 white blood cells on endocervical Gram stain. Similar results were seen for individual diagnoses either of chlamydial infection or of gonorrhea.Conclusion: Vaginal wet mount and endocervical Gram stain white blood cells are useful for the presumptive diagnosis of chlamydial infection or gonorrhea only in settings with a relatively high prevalence of infection or when other predictors can increase the likelihood of infection. [ABSTRACT FROM AUTHOR]

In 1972 the United States Supreme Court in Furman V. Georgia found that the death penalty as it was then being applied was cruel and unusual punishment in violation of the Eighth and Fourteenth Amendments of the United States Constitution. Furman provided few constitutional guidelines, but states reinacted their death penalty statutes. In 1976 the Court began to receive appeals from death sentences imposed under the reinacted statutes. In its decisions the Court began to establish guidelines. It found the death penalty was not per se cruel and unusual punishment. Before the death penalty can be imposed the court must take into consideration any mitigating circumstances and the case must be reviewed by the state supreme court. A mandatory death sentence is unconstitutional. Other issues including proportionality, due process and finality of judgment will be examined in the next segment of this study. [ABSTRACT FROM AUTHOR]

The article reports the status of the plan to implement the use of geographic coordinates in library research systems in the U.S. According to the author, the idea of using geographic coordinates in library research was first presented during the American Library Association 1994 Conference and since then, extensive research has been conducted to determine its utility to authority records for places in libraries. An overview on the two types of coordinates and its application to authority records in libraries is also discussed.

The author discusses the benefits of patient navigation in cancer treatment in the U.S. She states that patient navigation, which include social workers, aims to remove financial and social barriers to cancer treatment. She notes that patient navigation was the main focus of the American Cancer Society Inc. and the Commission on Cancer of the American College of Surgeons in 2009. She also mentions that nurses should be the navigators for cancer treatment despite the nurse shortage.

The article presents the responses of several U.S. oncology nurses when asked how they support caregivers of patients receiving outpatient transplantation. Susan Moore of Vanderbilt University Medical Center mentions that her hospital conducts twice-monthly caregivers class. Deborah Dydyk of Nebraska Medical Center details her hospital's outpatient transplant program. Martha Lassiter of Duke University explains how the college's Adult Stem Cell Transplant Program conducts its weekly support group for caregivers.

Human rabies is an acute, progressive encephalomyelitis that is nearly always fatal once symptoms begin. Several measures have been implemented to prevent human rabies in the United States, including vaccination of targeted domesticated and wild animals, avoidance of behaviors that might precipitate an exposure (e.g., provoking high-risk animals), awareness of the types of animal contact that require postexposure prophylaxis (PEP), and use of proper personal protective equipment when handling animals or laboratory specimens. PEP is widely available in the United States and highly effective if administered after an exposure occurs. A small subset of persons has a higher level of risk for being exposed to rabies virus than does the general U.S. population; these persons are recommended to receive preexposure prophylaxis (PrEP), a series of human rabies vaccine doses administered before an exposure occurs, in addition to PEP after an exposure. PrEP does not eliminate the need for PEP; however, it does simplify the rabies PEP schedule (i.e., eliminates the need for rabies immunoglobulin and decreases the number of vaccine doses required for PEP). As rabies epidemiology has evolved and vaccine safety and efficacy have improved, Advisory Committee on Immunization Practices (ACIP) recommendations to prevent human rabies have changed. During September 2019-November 2021, the ACIP Rabies Work Group considered updates to the 2008 ACIP recommendations by evaluating newly published data, reviewing frequently asked questions, and identifying barriers to adherence to previous ACIP rabies vaccination recommendations. Topics were presented and discussed during six ACIP meetings. The following modifications to PrEP are summarized in this report: 1) redefined risk categories; 2) fewer vaccine doses in the primary vaccination schedule; 3) flexible options for ensuring long-term protection, or immunogenicity; 4) less frequent or no antibody titer checks for some risk groups; 5) a new minimum rabies antibody titer (0.5 international units [IUs]) per mL); and 6) clinical guidance, including for ensuring effective vaccination of certain special populations., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Susan M. Moore reports directorship (until September 2020) of the not-for-profit Kansas State University rabies laboratory, which performs rabies serology testing; presidency of Compass Rabies Consulting, LLC, during September 2020–January 2022, and in that role, receipt of consulting fees for advice on rabies serology testing, interpretation, and quality assurance; and since January 2022, affiliation with the University of Missouri to build a not-for-profit One Health Laboratory that will include rabies serology testing. No other potential conflicts of interest were disclosed.

Importance: Management of cardiovascular disease (CVD) risk in socioeconomically vulnerable patients is suboptimal; better risk factor control could improve CVD outcomes., Objective: To evaluate the impact of a clinical decision support system (CDSS) targeting CVD risk in community health centers (CHCs)., Design, Setting, and Participants: This cluster randomized clinical trial included 70 CHC clinics randomized to an intervention group (42 clinics; 8 organizations) or a control group that received no intervention (28 clinics; 7 organizations) from September 20, 2018, to March 15, 2020. Randomization was by CHC organization accounting for organization size. Patients aged 40 to 75 years with (1) diabetes or atherosclerotic CVD and at least 1 uncontrolled major risk factor for CVD or (2) total reversible CVD risk of at least 10% were the population targeted by the CDSS intervention., Interventions: A point-of-care CDSS displaying real-time CVD risk factor control data and personalized, prioritized evidence-based care recommendations., Main Outcomes and Measures: One-year change in total CVD risk and reversible CVD risk (ie, the reduction in 10-year CVD risk that was considered achievable if 6 key risk factors reached evidence-based levels of control)., Results: Among the 18 578 eligible patients (9490 [51.1%] women; mean [SD] age, 58.7 [8.8] years), patients seen in control clinics (n = 7419) had higher mean (SD) baseline CVD risk (16.6% [12.8%]) than patients seen in intervention clinics (n = 11 159) (15.6% [12.3%]; P < .001); baseline reversible CVD risk was similarly higher among patients seen in control clinics. The CDSS was used at 19.8% of 91 988 eligible intervention clinic encounters. No population-level reduction in CVD risk was seen in patients in control or intervention clinics; mean reversible risk improved significantly more among patients in control (-0.1% [95% CI, -0.3% to -0.02%]) than intervention clinics (0.4% [95% CI, 0.3% to 0.5%]; P < .001). However, when the CDSS was used, both risk measures decreased more among patients with high baseline risk in intervention than control clinics; notably, mean reversible risk decreased by an absolute 4.4% (95% CI, -5.2% to -3.7%) among patients in intervention clinics compared with 2.7% (95% CI, -3.4% to -1.9%) among patients in control clinics (P = .001)., Conclusions and Relevance: The CDSS had low use rates and failed to improve CVD risk in the overall population but appeared to have a benefit on CVD risk when it was consistently used for patients with high baseline risk treated in CHCs. Despite some limitations, these results provide preliminary evidence that this technology has the potential to improve clinical care in socioeconomically vulnerable patients with high CVD risk., Trial Registration: ClinicalTrials.gov Identifier: NCT03001713.

During emergencies, areas with higher social vulnerability experience an increased risk for negative health outcomes. However, research has not extrapolated this concept to understand how the workers who respond to these areas may be affected. Researchers from the National Institute for Occupational Safety and Health (NIOSH) merged approximately 160,000 emergency response calls received from three fire departments during the COVID-19 pandemic with the CDC's publicly available Social Vulnerability Index (SVI) to examine the utility of SVI as a leading indicator of occupational health and safety risks. Multiple regressions, binomial logit models, and relative weights analyses were used to answer the research questions. Researchers found that higher social vulnerability on household composition, minority/language, and housing/transportation increase the risk of first responders' exposure to SARS-CoV-2. Higher socioeconomic, household, and minority vulnerability were significantly associated with response calls that required emergency treatment and transport in comparison to fire-related or other calls that are also managed by fire departments. These results have implications for more strategic emergency response planning during the COVID-19 pandemic, as well as improving Total Worker Health ® and future of work initiatives at the worker and workplace levels within the fire service industry.

Background: Personal protective equipment (PPE) are stockpiled across the nation to offset supply depletion during public health emergencies. Stockpiled PPE inventories vary across the United States by type, model, quantity, and the conditions in which they are stored. Over the past decade, federal, state, and local stockpile managers have had concerns for the viability of aging PPE., Methods: To understand factors that may affect stockpiled PPE, we explored the breadth of stockpile storage conditions and respirator and surgical gown inventories through collaboration with the national PPE community, qualitative observations collected at 10 different US stockpiles, and by compiling stockpile PPE inventories and climate data from a convenience sample of US stockpiles., Results: The aggregated inventory from 20 stockpiles is reported, accounting for approximately 53 million respirators. Most respirators (69% or 35.8 million) have been stored between 5 and 10 years. Upon visiting 10 stockpile facilities, we report on the storage conditions observed and summarize the storage environment data collected., Conclusions: This is the first study to identify common PPE types, inventories, and storage conditions across federal, state, and local government stockpile facilities as well as health care organization-managed caches. These findings will be leveraged to guide the development of sampling protocols for air-purifying respirators and surgical gowns in US stockpiles to understand the performance viability after long-term storage., (Copyright © 2020 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

The quality of hospice care remains highly variable in the U.S. Patients, providers, and health care systems lack a comprehensive method of measuring the quality of care provided by an individual hospice. Partners HealthCare sought to assess hospice quality based on objective and quantitative criteria obtained directly from hospices and through public reporting. Here, we describe the process of creating and administering this assessment and the initial creation of a collaborative network with high-quality hospices. A multidisciplinary advisory council developed criteria and a scoring system, focusing on organizational information (e.g., nursing turnover), clinical care quality indicators (e.g., visit hours before death), and training (e.g., medical director certification) and satisfaction (e.g., patient and family surveys). All Medicare-certified hospices in good standing in Massachusetts were eligible to participate in a request for information (RFI) process. We blinded data before scoring and invited hospices scoring above the 15th percentile to join the initial collaborative. Of 72 eligible hospices, most (53%) responded to the RFI, and 32% (n = 23) submitted completed surveys. Hospices could receive up to 23.75 points, and scores ranged from 2.25 to 19.5. The median score was 13.62 (interquartile range 10.5-16.75). For hospices scoring above the 15th percentile (n = 19), scores ranged from 10.0 to 19.5 (median 14). The hospice RFI process is one health care system's attempt to evaluate hospice quality. Further research will determine whether the scoring system proves to be a sensitive, specific, and reproducible measure of hospice quality, and whether the collaborative can foster quality improvement over time., (Copyright © 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.)

Given the recent increase in dust-induced lung disease among U.S. coal miners and the respiratory hazards encountered across the U.S. mining industry, it is important to enhance an understanding of lung disease trends and the organizational contexts that precede these events. In addition to exploring overall trends reported to the Mine Safety and Health Administration (MSHA), the current study uses MSHA's enforcement database to examine whether or not compliance with health regulations resulted in fewer mine-level counts of these diseases over time. The findings suggest that interstitial lung diseases were more prevalent in coal mines compared to other mining commodities, in Appalachian coal mines compared to the rest of the United States, and in underground compared to surface coal mines. Mines that followed a relevant subset of MSHA's health regulations were less likely to report a lung disease over time. The findings are discussed from a lung disease prevention strategy perspective., (© 2018 Society for Risk Analysis.)

Background: Effective healthcare for people with multiple chronic conditions (MCC) is a US priority, but the inherent complexity makes both research and delivery of care particularly challenging. As part of AHRQ Multiple Chronic Conditions Research Network (MCCRN) efforts, the Network developed a conceptual model to guide research in this area., Objective: To synthesize methodological and topical issues relevant to MCC patient care into a framework that can improve the delivery of care and advance future research about caring for patients with MCC., Methods: The Network synthesized essential constructs for MCC research identified from roundtable discussion, input from expert advisors, and previously published models., Results: The AHRQ MCCRN conceptual model defines complexity as the gap between patient needs and healthcare services, taking into account both the multiple considerations that affect the needs of MCC patients, as well as the contextual factors that influence service delivery. The model reframes processes and outcomes to include not only clinical care quality and experience, but also patient health, well being, and quality of life. The single-condition paradigm for treating needs one-by-one falls apart and highlights the need for care systems to address dynamic patient needs., Conclusions: Defining complexity in terms of the misalignment between patient needs and services offers new insights in how to research and develop solutions to patient care needs.

This study examines stress transmitted to anatomic landmarks of the knee (patella, combined patella tendon and tibial tubercle) while in static kneeling postures without kneepads and while wearing two kneepads commonly worn in the mining industry. Ten subjects (7 male, 3 female) simulated postures utilized in low-seam mines: kneeling in full flexion; kneeling at 90° of knee flexion; and kneeling on one knee while in one of three kneepad states (no kneepads, non-articulated kneepads, and articulated kneepads). For each posture, peak and mean pressure on the anatomic landmarks of the knee were obtained. The majority of the pressure was found to be transmitted to the knee via the combined patellar tendon and tibial tubercle rather than through the patella. While the kneepads tested decreased the maximum pressure experienced at the combined patellar tendon and tibial tubercle, peak pressures of greater than 25 psi were still experienced over structures commonly injured in mining (e.g. bursa sac - bursitis/Miner's Knee). The major conclusion of this study is that novel kneepad designs that redistribute the stresses at the knee across a greater surface area and to other regions of the leg away from key structures of the knee are needed., (Published by Elsevier Ltd.)

Introduction: The objective of this study was to evaluate the circumstances leading to fall from equipment injuries in the mining industry., Method: The 2006 and 2007 Mine Safety and Health Administration annual injury databases were utilized for this study whereby the injury narrative, nature of injury, body part injured, mine type, age at injury, and days lost were evaluated for each injury., Results: The majority of injuries occurred at surface mining facilities (approximately 60%) with fractures and sprains/strains being the most common injuries occurring to the major joints of the body. Nearly 50% of injuries occurred during ingress/egress, predominantely during egress, and approximately 25% of injuries occurred during maintenance tasks. The majority of injuries occurred in relation to large trucks, wheel loaders, dozers, and conveyors/belts. The severity of injury was independent of age and the median days lost was seven days; however, there was a large range in severity., Impact on Industry: From the data obtained in this study, several different research areas have been identified for future work, which include balance and stability control when descending ladders and equipment design for maintenance tasks.

Adverse effects of cancer therapies may occur more than three decades after drug administration. Continued vigilance in postmarketing use of oncology agents is necessary to accurately track adverse effects, update prescribing information, and alert healthcare providers in a timely manner. This article will define the processes involved in regulatory approval of oncology agents and discuss selected oncology drugs, labeling changes, and the role of oncology nurses in postmarketing surveillance by reviewing journal articles, governmental agency Web sites, federal regulatory documents, and pharmaceutical prescribing information. Oncology nurses administer and monitor cancer therapies in outpatient and inpatient settings and routinely assess patients for side effects of therapy; therefore, maintaining awareness of short- and long-term adverse effects after drug approval is important to patient safety. Nursing leadership should initiate, maintain, and manage an incident reporting system to effectively respond to changing needs. In addition, publication of case reports and articles on the emergence and management of postmarketing, treatment-related side effects in peer-reviewed nursing and medical journals may improve patient care and outcomes.

Oncology nurses and ancillary support personnel who work in oncology settings are at risk for exposure to antineoplastic drugs in their workplaces. A review of the literature reveals issues of environmental contamination and personal exposure. Although the United States has no formal regulations regarding hazardous drugs, including cytotoxic agents, guidelines have been published and are readily available to improve workplace safety. Oncology healthcare workers must be aware of the serious nature of antineoplastic drug exposure and the avenues available to initiate a simple, highly effective, problem-solving process called SOLVE to make medical workplaces safer.