A Case Study of the Risk and Crisis Communications Used in the 2008 Salmonella Outbreak

The Salmonella outbreak of 2008 was one of the largest foodborne illness outbreaks in the last 20 years. Tomatoes were initially pinpointed as the source of the outbreak, and the tomato industry suffered losses of $100 million in 2008. Eventually the FDA was able to trace the outbreak to imported jalapeño peppers, but this discovery was too late to recover losses for the tomato industry. The purpose of this study was to examine the risk and crisis communication efforts taken by public relations practitioners in the produce industry during the 2008 Salmonella outbreak to determine which efforts were successful and which were ineffective. This qualitative case study used the interviews of nine public relations practitioners in the tomato industry to collect the information needed to fully explore the research objectives of the study. The study found that all of the public relations practitioners attempted to communicate effectively with their audiences despite the negative nature of the 2008 Salmonella crisis. Additionally, the practitioners revealed their thoughts and perceptions about the outbreak, the media, and the communications used during the outbreak, which provided valuable insight into the communication efforts of an organization during a crisis

Regional Differences in South American Monsoon Precipitation Inferred from the Growth and Isotopic Composition of Tropical Trees

The authors present results on the relationship between tree-ring proxies and regional precipitation for several sites in tropical South America. The responsiveness of oxygen isotopes (δ18O) and seasonal growth as precipitation proxies was first validated by high-resolution sampling of a Tachigali myrmecophila from Manaus, Brazil (3.1°S, 60.0°W). Monthly growth of Tachigali spp. was significantly correlated with monthly precipitation. Intra-annual measurements of cellulose δ18O in Tachigali spp. were also significantly correlated with monthly precipitation at a lag of approximately one month. The annual ring widths of two tropical tree taxa, Cedrela odorata growing in the Amazon (12.6°S, 69.2°W) and Polylepis tarapacana growing in the Altiplano (22.0°S, 66.0°W), were validated using bomb-derived radiocarbon 14C. Estimated dates were within two to three years of bomb-inferred 14C dates, indicating that these species exhibit annual rings but uncertainties in our chronologies remain. A multiproxy record spanning 180 years from Cedrela spp. showed a significant negative relationship between cellulose δ18O and January precipitation. A 150-yr record obtained from Polylepis spp. also showed a significant negative relationship between δ18O and March precipitation, whereas annual ring width showed a significant positive correlation with December precipitation. These proxies were combined in a multivariate framework to reconstruct past precipitation, revealing a significant increase in monsoon precipitation at the Amazon site since 1890 and a significant decrease in monsoon precipitation at the Altiplano since 1880. Proxy time series also showed spatial and temporal coherence with precipitation variability due to El Niño forcing, suggesting that oxygen isotopes and ring widths in tropical trees may be important diagnostics for identifying regional differences in the response of the tropical hydrologic cycle to anthropogenic warming

Prescription drug monitoring program inquiry in psychiatric assessment: detection of high rates of opioid prescribing to a dual diagnosis population

OBJECTIVE: An epidemic of prescription drug abuse is disproportionately impacting the mentally ill. We examined the utility of a state prescription drug monitoring database for assessing recent controlled substance prescribing to patients presenting for dual diagnosis treatment. METHOD: In a community mental health center that provides integrated dual diagnosis care, we queried the Indiana Scheduled Prescription Electronic Collection and Tracking (INSPECT) system for all cases that were open as of August 2, 2011, and had been practitioner-diagnosed (per DSM-IV criteria) by January 2, 2012. INSPECT provided a record of controlled substance dispensations to each patient; diagnostic evaluation was conducted blind from prescription data compilation covering the prior 12 months. Demographic data, insurance status, and DSM-IV diagnoses were compiled from the clinic's electronic medical record. RESULTS: The sample (N = 201) was 51% female, 56% white, and two-thirds uninsured. Over 80% were dually diagnosed with substance use disorders and psychotic, mood, or anxiety disorders. Nicotine and alcohol disorders were identified in most, with about a third diagnosed with cannabis, cocaine, or opioid disorders. A majority of patients (n = 115) had been prescribed opioids in the prior year, with nearly 1 in 5 prescribed an opioid and benzodiazepine simultaneously. Patients were dispensed a mean of 4 opioid prescriptions and 213 opioid pills. More opioid prescriptions correlated with opioid dependence (OR = 1.08; 95% CI, 1.016-1.145), and more prescribers correlated with personality disorder diagnoses (OR = 1.112; 95% CI, 1.001-1.235). Higher rates and riskier patterns of controlled substance prescribing were identified in patients with Medicaid/Medicare insurance compared to uninsured patients. CONCLUSIONS: Prescription drug monitoring is a powerful tool for assessing addictions and high frequencies of patient exposures to prescribed opioids in a dual diagnosis clinic. Improved prevention and treatment strategies for addictions as facilitated by more research and clinical use of prescription drug monitoring in psychiatric care are warranted

Emergency Contraceptive (EC) Use in Indigent Populations

The indigent population in America is defined as persons who do not have the financial means to support themselves and are below the federal/state poverty line. According to the 2010 United States Census, 13.8% of Americans are living below the poverty line. Indigent populations often rely on the help of others to provide for their basic needs, whether the help of family and friends or government support. Indigent women are disproportionately affected by unwanted, unplanned pregnancies. It is a continuous cycle that plagues families, often causing poverty and an increased dependence on the welfare system. In Medicaid-eligible populations, many women have reported inconsistency in taking their normal birth control after having their first child which may result in another unplanned and/or unwanted pregnancy. This has led to a push for contraceptive education, both routine and emergency, to be integrated in as many places as possible, including schools, doctors’ offices, women’s clinics, and pharmacies

Factors Influencing Emergency Contraception Use in Indigent Populations

Introduction: Indigent women are disproportionately affected by unwanted, unplanned pregnancies. Studies previously identified lack of knowledge about emergency contraception (EC) as a major deterrent from use. This study was performed to address three potential barriers to the use of EC in indigent populations: culture and religion, patient education, and cost. For the entirety of this study, EC refers to levonorgestrel (LNG). Objectives: To determine the impact of culture and religion, patient education, and cost on EC use in the indigent population. Methods: This study was a cross-sectional observational study to explore and investigate relationships between indigent populations and the use of EC. To be included in the study, participants had to be: at least 14 years old, female, and have an annual household income below the federal poverty line (FPL). Those excluded were less than 14 years old, male, and reported an annual household income above the FPL. A questionnaire consisting of 31 survey questions were utilized to assess the endpoints of the study. The study utilized both paper and electronic forms of the survey. Participants signed informed consent to enable them participate in the study. Out of 319 participants, 59 met all inclusion criteria and were used in statistical analyses. Results:Based on Kruskal-Wallis results, religious groups’ acceptance of EC influenced indigent women’s decision to use it (p=0.016). Level of education also influenced women’s understanding of EC as an abortifacient and knowledge of when LNG is effective. Spearman rho revealed correlations between participants’ willingness to pay for EC or routine birth control and knowing that EC was an option (coefficient 0.391; p-value 0.005). There was also a correlation between the cost of EC and ultimate use (coefficient -0.603; p-value Conclusion: Our research found that religious groups’ acceptance of EC use and knowledge about how LNG works does affect the decision to use EC. Neither cultural identification nor cost of EC appears to have a significant impact on the final decision to use

Outcomes of a randomized controlled trial assessing a smartphone Application to reduce unmet needs among people diagnosed with CancEr (ACE)

© 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. Background: Smartphone technology represents an opportunity to deliver practical solutions for people affected by cancer at a scale that was previously unimaginable, such as information, appointment monitoring, and improved access to cancer support services. This study aimed to determine whether a smartphone application (app) reduced the unmet needs among people newly diagnosed with cancer. Methods: A single blind, multisite randomized controlled trial to determine the impact of an app-based, 4-month intervention. Newly diagnosed cancer patients were approached at three health service treatment clinics. Results: Eighty-two people were randomized (intervention; n = 43 and control; n = 39), average age was 59.5 years (SD: 12.9); 71% female; 67% married or in a de facto relationship. At baseline, there were no differences in participants’ characteristics between the groups. No significant effects, in reducing unmet needs, were demonstrated at the end of intervention (4-month) or 12-month follow-up. Overall, 94% used the app in weeks 1-4, which decreased to 41% in weeks 13-16. Mean app use time per participant: Cancer Information, 6.9 (SD: 18.9) minutes; Appointment Schedule, 5.1 (SD: 9.6) minutes; Cancer Services 1.5 minutes (SD: 6.8); Hospital Navigation, 1.4 (SD: 2.8) minutes. Conclusions: Despite consumer involvement in the design of this smartphone technology, the app did not reduce unmet needs. This may have been due to the study being underpowered. To contribute to a meaningful understanding and improved implementation of smartphone technology to support people affected by cancer, practical considerations, such as recruitment issues and access to, and confidence with, apps, need to be considered. Australian New Zealand Clinical Trials Registration (ACTRN) Trial Registration: 12616001251415; WEF 7/9/2016

Social Enterprise Evaluation : Implications for Tourism Development

The evaluation of social enterprise projects has focused mainly on devising effective performance measurement methods and processes to justify the investment of resources and time committed to such activities. With increasing demands for accountability, effectiveness, evidence of return on investment and value-added results, evaluation activities have been driven by imperatives of objectivity in assessments and the development of tools that monetize the social outcomes and impacts of social enterprise projects. These traditional approaches to evaluation have also been widely adapted in tourism based social enterprises that seek to attain goals of poverty alleviation, empowerment of local communities, and improved livelihoods for those marginalized from mainstream tourism economic activities. This chapter argues that traditional approaches to evaluation may be limited in supporting social entrepreneurship projects with development objectives of empowerment and societal change. It is proposed that social enterprise projects involving community participation may be better positioned to achieve their developmental objectives by incorporating more of the principles of Participatory Evaluation (PE) and Empowerment Evaluation (EE) in the quest to harness the economic prowess of tourism for human development

Towards evaluation criteria in participatory flood risk management

Flood risk consists of complex and dynamic problems, whose management calls for innovative ways of engaging with a wide range of local stakeholders, many of whom lack the technical expertise to engage with traditional flood risk management practices. Participatory approaches offer potential for involving these stakeholders in decision-making, yet limited advice is available to users in choosing which techniques to employ and what they might expect them to deliver. Assessing the effectiveness of participatory approaches in local flood risk management is a critical step towards better understanding how community resilience is built. This paper presents a framework for evaluating participatory approaches to flood risk management that covers four evaluation elements (context, process, substantive and social outcomes). Practical success criteria are provided for evaluation, with references indicating where further advice and guidance can be sought. Criteria are tailored to the requirements of flood risk management, and aim to be sufficiently flexible for the framework to be easily transferable