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Background: Hospital-based providers' willingness to report to work during an influenza pandemic is a critical yet under-studied phenomenon. Witte's Extended Parallel Process Model (EPPM) has been shown to be useful for understanding adaptive behavior of public health workers to an unknown risk, and thus offers a framework for examining scenario-specific willingness to respond among hospital staff.Methods: We administered an anonymous online EPPM-based survey about attitudes/beliefs toward emergency response, to all 18,612 employees of the Johns Hopkins Hospital from January to March 2009. Surveys were completed by 3426 employees (18.4%), approximately one third of whom were health professionals.Results: Demographic and professional distribution of respondents was similar to all hospital staff. Overall, more than one-in-four (28%) hospital workers indicated they were not willing to respond to an influenza pandemic scenario if asked but not required to do so. Only an additional 10% were willing if required. One-third (32%) of participants reported they would be unwilling to respond in the event of a more severe pandemic influenza scenario. These response rates were consistent across different departments, and were one-third lower among nurses as compared with physicians. Respondents who were hesitant to agree to work additional hours when required were 17 times less likely to respond during a pandemic if asked. Sixty percent of the workers perceived their peers as likely to report to work in such an emergency, and were ten times more likely than others to do so themselves. Hospital employees with a perception of high efficacy had 5.8 times higher declared rates of willingness to respond to an influenza pandemic.Conclusions: Significant gaps exist in hospital workers' willingness to respond, and the EPPM is a useful framework to assess these gaps. Several attitudinal indicators can help to identify hospital employees unlikely to respond. The findings point to certain hospital-based communication and training strategies to boost employees' response willingness, including promoting pre-event plans for home-based dependents; ensuring adequate supplies of personal protective equipment, vaccines and antiviral drugs for all hospital employees; and establishing a subjective norm of awareness and preparedness. [ABSTRACT FROM AUTHOR]

Methanogens play an important role in the demethylation of arsenic. Soil amendments that inhibit methanogens can increase dimethylarsinic acid (DMA), which is responsible for straighthead disease in rice. A decrease in methanogenesis caused by silicate fertilizer may increase DMA concentration in paddy soils and rice grains; the relationship between these two factors and their impacts on DMA concentration remains unclear. We applied silicate fertilizer (2 Mg ha -1 ) to japonica and indica rice grown on arsenic-spiked soils and found a simultaneous reduction in methane emissions and pore-water DMA concentration, compared to no-silicate fertilization. Gene and transcript copies of mcrA and arsM, as well as dominant methanogens and arsenic-methylating microbes decreased significantly with silicate fertilization. However, the sulfate-reducing bacteria and the gene and transcript copies of dsrB did not change significantly in response to the application of silicate fertilizer to paddy soils. The abundance of arsenic methylating microbes was significantly and positively correlated with the abundance of methanogens, but not with the abundance of sulfate-reducing bacteria. Methylomonas and Methylobacter, which harbor the arsM gene, were suppressed under silicate fertilization, suggesting that they have the potential to methylate As and play a crucial role in reducing pore-water DMA in As-enriched flooded paddy soils. Increasing Fe concentration, soil pH, and Eh value decreased pore-water DMA concentration, while decreasing arsenite concentration, arsM and mcrA gene abundance decreased it. While silicate fertilization decreased arsenite and DMA concentrations in pore-water, it had no significant effect on rice DMA content, but significantly decreased arsenite content. Results reveal that methanogens and arsenic-methylating microbes have a synergistic relationship under silicate fertilization that facilitates a significant reduction in methane emissions and DMA concentration in As-enriched paddy soils., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Redox chemistry involving the quinone/phenol cycling of natural organic matter (NOM) is known to modulate microbial respiration. Complexation with metals or minerals can also affect NOM solubilization and stability. Inspired by these natural phenomena, a new soil amendment approach was suggested to effectively decrease methane emissions in flooded rice paddies. Structurally stable forms of NOM such as lignin and humic acids (HAs) were shown to decrease methane gas emissions in a vial experiment using different soil types and rice straw as a methanogenic substrate, and this inhibitory behavior was likely enhanced by ferric ion-NOM complexation. A mechanistic study using HAs revealed that complexation facilitated the slow release of the humic components. Interestingly, borohydride-based reduction, which transformed quinone moieties into phenols, caused the HAs to lose their inhibitory capacity, suggesting that the electron-accepting ability of HAs is vital for their inhibitory effect. In rice field tests, the humic-metal complexes were shown to successfully mitigate methane generation, while carbon dioxide emissions were relatively unchanged. Microbial community analysis of the rice fields by season revealed a decrease in specific cellulose-metabolizing and methanogenic genera associated with methane emissions. In contrast, the relative abundance of Thaumarchaeota and Actinomycetota, which are associated with NOM and recalcitrant organics, was higher in the presence of Fe-stabilized HAs. These microbial dynamics suggest that the slow release of humic components is effective in modulating the anoxic soil microbiome, possibly due to their electron-accepting ability. Given the simplicity, cost-effectiveness, and soil-friendly nature of complexation processes, Fe-stabilized NOM represents a promising approach for the mitigation of methane emissions from flooded rice paddies., Competing Interests: Declaration of competing interest The authors declare no competing financial interest., (Copyright © 2024. Published by Elsevier B.V.)

Monolayer barriers, which are usually known as evapotranspiration (ET) covers, have long been used as alternative final cover systems in waste landfills. Coal bottom ash was evaluated as a good alternative to soil in landfill ET cover systems to increase the bottom ash (BA) recycling ratio in the past. In a previous study, applying BA promoted plant growth characteristics and improved the soil physicochemical properties, particularly the soil organic carbon (SOC) content. In this study, we investigated the effect of BA on the SOC increase by examining the chemical and physical characteristics of ET cover systems, and we compared BA mixed and pure soils. We collected two types of soil from the landfill cover, namely, BA mixed soil (BA 35% + soil 65%) and soil alone (100%), for treatments during the 5th year after installation. Bottom ash mixed soil has four times more SOC than the pure soil at the surface soil layer, but the SOC contents significantly decreased with the soil depth in BA mixed soil, and no differences were found between BA mixed soil and pure soil below a 25 cm soil depth. In addition, there was no significant difference in the chemical composition of the SOC according to a 13 C NMR. However, the allophane contents were significantly higher in BA mixed soil than pure soil, which physically protects the material from organic matter decomposition. Conclusively, the higher allophane content originating from BA might act as the primary factor in the high accumulation of soil organic carbon in the BA mixed soil layer by retarding the organic matter decomposition., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

With the increase in iron/steel production, the higher volume of by-products (slag) generated necessitates its efficient recycling. Because the Linz-Donawitz (LD) slag is rich in silicon (Si) and other fertilizer components, we aim to evaluate the impact of the LD slag amendment on soil quality (by measuring soil physicochemical and biological properties), plant nutrient uptake, and strengthens correlations between nutrient uptake and soil bacterial communities. We used 16 S rRNA illumine sequencing to study soil bacterial community and APIZYM assay to study soil enzymes involved in C, N, and P cycling. The LD slag was applied at 2 Mg ha -1 to Japonica and Indica rice cultivated under flooded conditions. The LD slag amendment significantly improved soil pH, plant photosynthesis, soil nutrient availability, and the crop yield, irrespective of cultivars. It significantly increased N, P, and Si uptake of rice straw. The slag amendment enhanced soil microbial biomass, soil enzyme activities and enriched certain bacterial taxa featuring copiotrophic lifestyles and having the potential role for ecosystem services provided to the benefit of the plant. The study evidenced that the short-term LD slag amendment in rice cropping systems is useful to improve soil physicochemical and biological status, and the crop yield.

The effective utilization of slag-based Silicon fertilizer (silicate fertilizer) in agriculture to improve crop productivity and to mitigate environmental consequences turns it into a high value added product in sustainable agriculture. Despite the integral role of soil microbiome in agricultural production and virtually all ecosystem processes, our understanding of the microbial role in ecosystem functions and agricultural productivity in response to the silicate fertilizer amendment is, however, elusive. In this study, using 16S rRNA gene and ITS amplicon illumina sequencing and a functional gene microarray, i.e., GeoChip 5, we report for the first time the responses of soil microbes and their functions to the silicate fertilizer amendment in two different geographic races of Oryza sativa var. Japonica (Japonica rice) and var. Indica (Indica rice). The silicate fertilizer significantly increased soil pH, photosynthesis rate, nutrient (i.e., C, Si, Fe, P) availability and crop productivity, but decreased N availability and CH 4 and N 2 O emissions. Moreover, the silicate fertilizer application significantly altered soil bacterial and fungal community composition and increased abundance of functional genes involved in labile C degradation, C and N fixation, phosphorus utilization, CH 4 oxidation, and metal detoxification, whereas those involve in CH 4 production and denitrification were decreased. The changes in the taxonomic and functional structure of microbial communities by the silicate fertilizer were mostly regulated by soil pH, plant photosynthesis, and nutrient availability. This study provides novel insights into our understanding of microbial functional processes in response to the silicate fertilizer amendment in rice cropping systems and has important implications for sustainable rice production., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The threat of a catastrophic public health emergency causing life-threatening illness or injury on a massive scale has prompted extensive federal, state, and local preparedness efforts. Modeling studies suggest that an influenza pandemic similar to that of 1918 would require ICU and mechanical ventilation capacity that is significantly greater than what is available. Several groups have published recommendations for allocating life-support measures during a public health emergency. Because there are multiple ethically permissible approaches to allocating scarce life-sustaining resources and because the public will bear the consequences of these decisions, knowledge of public perspectives and moral points of reference on these issues is critical. Here we describe a critical care disaster resource allocation framework developed following a statewide community engagement process in Maryland. It is intended to assist hospitals and public health agencies in their independent and coordinated response to an officially declared catastrophic health emergency in which demand for mechanical ventilators exceeds the capabilities of all surge response efforts and in which there has been an executive order to implement scarce resource allocation procedures. The framework, built on a basic scoring system with modifications for specific considerations, also creates an opportunity for the legal community to review existing laws and liability protections in light of a specific disaster response process., (Copyright © 2018. Published by Elsevier Inc.)

Over the past decades, with increasing steel manufacturing, the huge amount of by-products (slags) generated need to be reused in an efficient way not only to reduce landfill slag sites but also for sustainable and eco-friendly agriculture. Our preliminary laboratory study revealed that compared to blast furnace slag, electric arc furnace slag and ladle furnace slag, the Linz-Donawitz converter (LD) slag markedly decreased CH 4 production rate and increased microbial activity. In the greenhouse experiment, the LD slag amendment (2.0 Mg ha -1 ) significantly (p < 0.05) increased grain yield by 10.3-15.2%, reduced CH 4 emissions by 17.8-24.0%, and decreased inorganic As concentrations in grain by 18.3-19.6%, compared to the unamended control. The increase in yield is attributed to the increased photosynthetic rates and increased availability of nutrients to the rice plant. Whereas, the decrease in CH 4 emissions could be due to the higher Fe availability in the slag amended soil, which acted as an alternate electron acceptor, thereby, suppressed CH 4 emissions. The more Fe-plaque formation which could adsorb more As and the competitive inhibition of As uptake with higher availability of Si could be the reason for the decrease in As uptake by rice cultivated with LD slag amendment., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: During a catastrophe, health-care providers may face difficult questions regarding who will receive limited life-saving resources. The ethical principles that should guide decision-making have been considered by expert panels but have not been well explored with the public or front-line clinicians. The objective of this study was to characterize the public's values regarding how scarce mechanical ventilators should be allocated during an influenza pandemic, with the ultimate goal of informing a statewide scare resource allocation framework., Methods: Adopting deliberative democracy practices, we conducted 15 half-day community engagement forums with the general public and health-related professionals. Small group discussions of six potential guiding ethical principles were led by trained facilitators. The forums consisted exclusively of either members of the general public or health-related or disaster response professionals and were convened in a variety of meeting places across the state of Maryland. Primary data sources were predeliberation and postdeliberation surveys and the notes from small group deliberations compiled by trained note takers., Results: Three hundred twenty-four individuals participated in 15 forums. Participants indicated a preference for prioritizing short-term and long-term survival, but they indicated that these should not be the only factors driving decision-making during a crisis. Qualitative analysis identified 10 major themes that emerged. Many, but not all, themes were consistent with previously issued recommendations. The most important difference related to withholding vs withdrawing ventilator support., Conclusions: The values expressed by the public and front-line clinicians sometimes diverge from expert guidance in important ways. Awareness of these differences should inform policy making., (Copyright © 2017. Published by Elsevier Inc.)

In response to the 2014-2015 Ebola virus disease outbreak in West Africa, Johns Hopkins Medicine created a biocontainment unit to care for patients infected with Ebola virus and other high-consequence pathogens. The unit team examined published literature and guidelines, visited two existing U.S. biocontainment units, and contacted national and international experts to inform the design of the physical structure and patient care activities of the unit. The resulting four-bed unit allows for unidirectional flow of providers and materials and has ample space for donning and doffing personal protective equipment. The air-handling system allows treatment of diseases spread by contact, droplet, or airborne routes of transmission. An onsite laboratory and an autoclave waste management system minimize the transport of infectious materials out of the unit. The unit is staffed by self-selected nurses, providers, and support staff with pediatric and adult capabilities. A telecommunications system allows other providers and family members to interact with patients and staff remotely. A full-time nurse educator is responsible for staff training, including quarterly exercises and competency assessment in the donning and doffing of personal protective equipment. The creation of the Johns Hopkins Biocontainment Unit required the highest level of multidisciplinary collaboration. When not used for clinical care and training, the unit will be a site for research and innovation in highly infectious diseases. The lessons learned from the design process can inform a new research agenda focused on the care of patients in a biocontainment environment.

Rye (Secale cerealis) has been widely cultivated to improve soil quality in temperate paddies. However, its biomass incorporation can significantly increase greenhouse gas emissions, particularly the emission of methane (CH4), during rice cultivation. The chemical composition and productivity of cover crop biomass may vary at different growing stages. Therefore, nutrient productivity and CH4 production potential might be controlled by selecting the optimum harvesting stage. To investigate the effect of rye harvesting stage on nutrient productivity and CH4 production potential, rye was harvested at different growing stages, from the flowering stage to the maturing stage, for seven weeks. The chemical composition and biomass productivity of rye were investigated. CH4 production was measured by laboratory incubation, and CH4 production potential was estimated to determine the real impact on CH4 dynamics in rice soils. Rye biomass increased with plant maturation, but nutrient productivities such as N (nitrogen), P2O5, and K2O were maximized at the flowering stage. The contents of cellulose and lignin increased significantly as plants matured, but the total N, labile organic carbon (C), and hot and cold water-extractable organic C clearly decreased. Soils were mixed with 0.3% (wt wt(-1) on dry weight) air-dried biomass and incubated to measure the maximum CH4 productivity at 30 °C under flooded conditions. Maximum CH4 productivity was significantly correlated with increasing labile organic C and protein content, but it was negatively correlated with total organic C, cellulose, and lignin content. CH4 production potentials were significantly increased up to the pre-maturing stage (220 DAS) and remained unchanged thereafter. As a result, CH4 production potential per N productivity was the lowest at the late flowering stage (198-205 DAS), which could be the best harvesting stage as well as the most promising stage for increasing nutrient production and decreasing GHG emissions in temperate mono-rice paddy soils., (Copyright © 2015 Elsevier B.V. All rights reserved.)

We describe an academic/faith partnership approach for enhancing the capacity of communities to resist or rebound from the impact of terrorism and other mass casualty events. Representatives of several academic health centers (AHCs) collaborated with leaders of urban Christian-, Jewish-, and Muslim faith-based organizations (FBOs) to design, deliver, and preliminarily evaluate a train-the-trainer approach to enhancing individual competencies in the provision of psychological first aid and in disaster planning for their respective communities. Evidence of partner commitment to, and full participation in, project implementation responsibilities confirmed the feasibility of the overall AHC/FBO collaborative model, and individual post-training, self-report data on perceived effectiveness of the program indicated that the majority of community trainees evaluated the interventions as having significantly increased their: (a) knowledge of disaster mental health concepts; (b) skills (self-efficacy) as providers of psychological first aid and bereavement support services, and (c) (with somewhat less confidence because of module brevity) capabilities of leading disaster preparedness planning efforts within their communities. Notwithstanding the limitations of such early-phase research in ensuring internal and external validity of the interventions, the findings, particularly when combined with those of earlier and subsequent work, support the rationale for continuing to refine this participatory approach to fostering community disaster mental health resilience, and to promoting the translational impact of the model. An especially important (recent) example of the latter is the formal recognition by local and state health departments of program-trained lay volunteers as a vital resource in the continuum of government assets for public health emergency preparedness planning and response.

Objectives: The aim of this study was to characterize the public health emergency perceptions and willingness to respond (WTR) of hospital-based pediatric staff and to use these findings to propose a methodology for developing an institution-specific training package to improve response willingness., Methods: A prospective anonymous web-based survey was conducted at the Johns Hopkins Hospital, including the 180-bed Johns Hopkins Children's Center, between January and March 2009. In this survey, participants' attitudes/beliefs regarding emergency response to a pandemic influenza and a radiological dispersal device (RDD or "dirty bomb") event were assessed., Results: Of the 1,620 eligible pediatric staff 246 replies (15.2 percent response rate) were received, compared with an overall staff response rate of 18.4 percent. Characteristics of respondent demographics and professions were similar to those of overall hospital staff. Self-reported WTR was greater for a pandemic influenza than for an RDD event if required (84.6 percent vs 75.1 percent), and if asked, but not required (74.4 percent vs 64.5 percent). The majority of pediatric staff were not confident in their safety at work (pandemic influenza: 51.8 percent and RDD: 76.6 percent), were far less likely to respond if personal protective equipment was unavailable (pandemic influenza: 33.5 percent and RDD: 21.6percent), and wanted furtherpre-event preparation and training (pandemic influenza: 89.6 percent and RDD: 82.6 percent). The following six distinct perceived attitudes / beliefs were identified as having institution-specific high impact on response willingness: colleague response, skill mastery, safety getting to work, safety at work, ability to perform duties, and individual response efficacy., Conclusions: Children represent a uniquely vulnerable population in public health emergencies, and pediatric hospital staff accordingly represent a vital subset of responders distinguished by specialized education, training, clinical skills, and disaster competencies. Even though the majority of pediatric hospital staff report WTR, nearly 15 percent for a pandemic influenza emergency and 25 percent for an RDD event would not respond if required. Other institutions can apply the methodology used here to identify particularly influential response willingness modifiers for pediatric care providers. These insights can inform customized preparedness training for pediatric healthcare workers, through identification of high-impact attitudes/beliefs, and training initiatives focused on addressing these modifiers.

Introduction: Terrorist use of a radiological dispersal device (RDD, or "dirty bomb"), which combines a conventional explosive device with radiological materials, is among the National Planning Scenarios of the United States government. Understanding employee willingness to respond is critical for planning experts. Previous research has demonstrated that perception of threat and efficacy is key in the assessing willingness to respond to a RDD event., Methods: An anonymous online survey was used to evaluate the willingness of hospital employees to respond to a RDD event. Agreement with a series of belief statements was assessed, following a methodology validated in previous work. The survey was available online to all 18,612 employees of the Johns Hopkins Hospital from January to March 2009., Results: Surveys were completed by 3426 employees (18.4%), whose demographic distribution was similar to overall hospital staff. 39% of hospital workers were not willing to respond to a RDD scenario if asked but not required to do so. Only 11% more were willing if required. Workers who were hesitant to agree to work additional hours when required were 20 times less likely to report during a RDD emergency. Respondents who perceived their peers as likely to report to work in a RDD emergency were 17 times more likely to respond during a RDD event if asked. Only 27.9% of the hospital employees with a perception of low efficacy declared willingness to respond to a severe RDD event. Perception of threat had little impact on willingness to respond among hospital workers., Conclusions: Radiological scenarios such as RDDs are among the most dreaded emergency events yet studied. Several attitudinal indicators can help to identify hospital employees unlikely to respond. These risk-perception modifiers must then be addressed through training to enable effective hospital response to a RDD event.

Clergy and laity have been a traditional source of support for people striving to cope with everyday tragedies, but not all faith leaders have the specialized knowledge required for the challenges of mental health ministry in the aftermath of widespread trauma and mass casualty events. On the other hand, some mental health professionals have acquired high levels of expertise in the field of disaster mental health but, because of their limited numbers, cannot be of direct help to large numbers of disaster survivors when such events are broad in scale. The authors have addressed the problem of scalability of post-disaster crisis mental health services by establishing an academic/faith partnershipforpsychological first aid training. The curriculum was piloted with 500 members of the faith community in Baltimore City and other areas of Maryland. The training program is seen as a prototype of specialized first-responder training that can be built upon to enhance and extend the roles of spiritual communities in public health emergencies, and thereby augment the continuum of deployable resources available to local and state health departments.

Health care reform has posed special challenges for departments of psychiatry in academic medical centers. This report describes one department's strategic responses to a marketplace with high penetration by managed care and provides examples of the kinds of faculty concerns that can arise when major departmental reorganizations are attempted. The department's successful adaptation to a radically altered professional environment is attributed to the following five initiatives: vertical integration and diversification of clinical programs, service line management, outcomes measurement, regional network development, and institutional managed care partnerships Although the authors did not design their adaptive efforts as a research study, they offer objective data to support their conclusion that the viability of their overall clinical enterprise has been sustained despite an external environment inhospitable to academic psychiatry.