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occupational health risk assessment

BACKGROUND Fetal alcohol spectrum disorders (FASD) are prevalent neurodevelopmental conditions. Significant barriers prevent family access to FASD-informed care. To improve accessibility, a scalable mobile health intervention for caregivers of children with FASD is under development. The app, called Families Moving Forward (FMF) Connect, is derived from the FMF Program, a parenting intervention tailored for FASD. FMF Connect has 5 components: Learning Modules, Family Forum, Library, Notebook, and Dashboard. OBJECTIVE This study assesses the feasibility of FMF Connect intervention prototypes. This includes examining app usage data and evaluating user experience to guide further refinements. METHODS Two rounds of beta-testing were conducted as part of a systematic approach to the development and evaluation of FMF Connect: (1) an iOS prototype was tested with 20 caregivers of children (aged 3-17 years) with FASD and 17 providers for the first round (April-May 2019) and (2) iOS and Android prototypes were tested with 25 caregivers and 1 provider for the second round (November-December 2019). After each 6-week trial, focus groups or individual interviews were completed. Usage analytics and thematic analysis were used to address feasibility objectives. RESULTS Across beta-test trials, 84% (38/45) of caregivers and 94% (17/18) of providers installed the FMF Connect app. Technological issues were tracked in real time with updates to address problems and expand app functionalities. On use days, caregivers averaged 20 minutes using the app; most of the time was spent watching videos in Learning Modules. Caregiver engagement with the Learning Modules varied across 5 usage pattern tiers. Overall, 67% (30/45) of caregivers posted at least once in the Family Forum. Interviews were completed by 26 caregivers and 16 providers. App evaluations generally did not differ according to usage pattern tier or demographic characteristics. Globally, app users were very positive, with 2.5 times more positive- than negative-coded segments across participants. Positive evaluations emphasized the benefits of accessible information and practical utility of the app. Informational and video content were described as especially valuable to caregivers. A number of affective and social benefits of the app were identified, aligning well with the caregivers’ stated motivators for app use. Negative evaluations of user experience generally emphasized technical and navigational aspects. Refinements were made on the basis of feedback during the first beta test, which were positively received during the second round. Participants offered many valuable recommendations for continuing app refinement, which is useful in improving user experience. CONCLUSIONS The results demonstrate that the FMF Connect intervention is acceptable and feasible for caregivers raising children with FASD. They will guide subsequent app refinement before large-scale randomized testing. This study used a systematic, user-centered design approach for app development and evaluation. The approach used here may illustrate a model that can broadly inform the development of mobile health and digital parenting interventions.

This study investigated aerosolized viable bacteria in a university research laboratory during operation of an acoustic-assisted flow cytometer for antimicrobial susceptibility testing by sampling room air before, during and after flow cytometer use. The aim was to assess the risk associated with use of an acoustic-assisted flow cytometer analyzing unfixed bacterial suspensions. Air sampling in a nearby clinical laboratory was conducted during the same period to provide context for the existing background of microorganisms that would be detected in the air. The three species of bacteria undergoing analysis by flow cytometer in the research laboratory were Klebsiella pneumoniae, Burkholderia thailandensis and Streptococcus pneumoniae. None of these was detected from multiple 1000 L air samples acquired in the research laboratory environment. The main cultured bacteria in both locations were skin commensal and environmental bacteria, presumed to have been disturbed or dispersed in laboratory air by personnel movements during routine laboratory activities. The concentrations of bacteria detected in research laboratory air samples were reduced after interventional cleaning measures were introduced and were lower than those in the diagnostic clinical microbiology laboratory. We conclude that our flow cytometric analyses of unfixed suspensions of K. pneumoniae, B. thailandensis and S. pneumoniae do not pose a risk to cytometer operators or other personnel in the laboratory but caution against extrapolation of our results to other bacteria and/or different flow cytometric experimental procedures.

Apoptosis has long been recognised by two hallmarks of the end stage of nuclear breakdown: collapse of the chromatin and oligonucleosomal cleavage of the DNA. Control of initial nuclear events, such as high molecular weight (HMW) DNA and specific nuclear matrix cleavage, and their relationship to the cytoplasmic steps of cell death has not been elucidated. Examination of the relationship between events in the cell death path is limited by the stochastic nature of the process in all known models, which forces investigators to deal with mixed populations, combined with the tight temporal relationship of events in single cells. To determine whether a mitochondria-based signal could be responsible for the initial nuclear events of apoptosis, the timecourse of cell death in both primary rat thymocytes treated with dexamethasone or VM-26 (teniposide) and human Jurkat T cells treated with anti-Fas was first established using several cytoplasmic and nuclear criteria of cell death. Initial nuclear events were characterised at the single cell level at early time points in the apoptotic response by staining of the chromatin, immunofluorescence labelling of nuclear matrix and in situ detection of DNA breaks by TUNEL. Reorganisation of the matrix attachment region (MAR)-binding protein SATB1 was uniquely detected prior to chromatin collapse but after the appearance of initial DNA breaks. Early reorganisation of a portion of SATB1 was followed by increasing DNA cleavage, the reorganisation of the internal nuclear matrix, represented by NuMA, coincident with chromatin collapse and maximal DNA breaks. Peripheral nuclear proteins, represented by lamin B, lamin B receptor (LBR) and PI2, were not affected until after chromatin collapse, if at all. SATB1 reorganisation and initial DNA breaks were then compared with mitochondrial function detected in live Jurkat cells by uptake of DiOC6(3), using flow cytometry and cell sorting to isolate those cells with normal mitochondrial membrane potential, normal size and intact plasma membrane from the mixed population of anti-Fas treated Jurkats. At the single cell level, changes in nuclear morphology, initial DNA cleavage and early reorganisation of SATB1 were detected in a minority of the "apparently normal" cells that displayed a normal mitochondrial membrane potential. Specific cleavage of SATB1 in these cells was detected by Western blotting and accumulation of single strand breaks demonstrated as well, using two-dimensional electrophoresis of DNA. (Abstract shortened by UMI.)