Digital biosurveillance for zoonotic disease detection in kenya

Infectious disease surveillance is crucial for early detection and situational awareness of disease outbreaks. Digital biosurveillance monitors large volumes of open-source data to flag potential health threats. This study investigates the potential of digital surveillance in the detection of the top five priority zoonotic diseases in Kenya: Rift Valley fever (RVF), anthrax, rabies, brucellosis, and trypanosomiasis. Open-source disease events reported between August 2016 and October 2020 were collected and key event-specific information was extracted using a newly developed disease event taxonomy. A total of 424 disease reports encompassing 55 unique events belonging to anthrax (43.6%), RVF (34.6%), and rabies (21.8%) were identified. Most events were first reported by news media (78.2%) followed by international health organizations (16.4%). News media reported the events 4.1 (±4.7) days faster than the official reports. There was a positive association between official reporting and RVF events (odds ratio (OR) 195.5, 95% confidence interval (CI); 24.01–4756.43, p p = 0.030). This study highlights the usefulness of local news in the detection of potentially neglected zoonotic disease events and the importance of digital biosurveillance in resource-limited settings

Recertification and Reentry to Practice for Nurse Anesthetists: Determining Core Competencies and Evaluating Performance via High-Fidelity Simulation Technology

Introduction The National Board of Certification and Recertification for Nurse Anesthetistsaddressed a barrier to return to practice of uncertified practitioners by replacing required direct patient care experiences with high-fidelity simulation. Objectives The aims of this study were to: (a) validate a set of clinical activities for their relevance to reentry and determine if they could be replicated using simulation, (b) evaluate the content validity of an existing simulation scenario containing the proposed clinical activities and determine its substitutability for a clinical practicum, and (c) evaluate the validity of two methods to assess simulation performance. Methods A modified Delphi method incorporating an autonomous, anonymous, three-round online survey process using three unique expert certified registered nurse anesthetists groups was used to address each study aim. Results Twenty-seven clinical activities gained consensus as necessary to be assessed in the simulation. All 14 survey questions used to determine simulation content validity exceeded the minimum content validity index (CVI) value of 0.78, with a mean CVI of 0.99. The global rating scale CVI and the competency checklist CVI were 0.83 and 1.0, respectively. Conclusion The findings add to the existing literature supporting the utility of simulation for high-stakes provider assessment and certification

Measurement and Validation of Bidirectional Reflectance of Space Shuttle and Space Station Materials for Computerized Lighting Models

Task illumination has a major impact on human performance: What a person can perceive in his environment significantly affects his ability to perform tasks, especially in space's harsh environment. Training for lighting conditions in space has long depended on physical models and simulations to emulate the effect of lighting, but such tests are expensive and time-consuming. To evaluate lighting conditions not easily simulated on Earth, personnel at NASA Johnson Space Center's (JSC) Graphics Research and Analysis Facility (GRAF) have been developing computerized simulations of various illumination conditions using the ray-tracing program, Radiance, developed by Greg Ward at Lawrence Berkeley Laboratory. Because these computer simulations are only as accurate as the data used, accurate information about the reflectance properties of materials and light distributions is needed. JSC's Lighting Environment Test Facility (LETF) personnel gathered material reflectance properties for a large number of paints, metals, and cloths used in the Space Shuttle and Space Station programs, and processed these data into reflectance parameters needed for the computer simulations. They also gathered lamp distribution data for most of the light sources used, and validated the ability to accurately simulate lighting levels by comparing predictions with measurements for several ground-based tests. The result of this study is a database of material reflectance properties for a wide variety of materials, and lighting information for most of the standard light sources used in the Shuttle/Station programs. The combination of the Radiance program and GRAF's graphics capability form a validated computerized lighting simulation capability for NASA

Improving Receipt and Preventive Care Delivery for Adolescents and Young Adults: Initial Lessons from Top-Performing States

Purpose Provisions of the Patient Protection and Affordable Care Act (ACA) of 2010 hold promise for improving access to and receipt of preventive services for adolescents and young adults (AYAs). The Title V Block Grant transformation also includes a focus on improving adolescent preventive care. This brief report describes and discusses an inquiry of promising strategies for improving access and preventive care delivery identified in selected high-performing states. Methods Two data sources were used to identify top-performing states in insurance enrollment and preventive care delivery: National Survey of Children's Health for adolescents (ages 12-17 years) and Behavioral Risk Factors Surveillance System for young adults (ages 18-25 years). Interviews were conducted with key stakeholders to identify promising strategies related to increasing AYAs' insurance enrollment and receipt of preventive services. Results Seven top-performing states were selected: California, Colorado, Illinois, Iowa, Oregon, Vermont, and Texas; 27 stakeholders completed interviews. Four strategies were identified regarding insurance enrollment: use of partnerships; special populations outreach; leveraging laws and resources; and youth engagement. Four strategies were identified regarding quality preventive care: expand provider capacity to serve AYAs; adopt medical home policies; establish quality improvement projects; and enhance consumer awareness of well-visit. States focused more on adolescents than young adults and on increasing health insurance enrollment than the provision of preventive services. Conclusions This commentary identifies strategies and recommends areas for future action, as Title V programs and their partners focus on improving healthcare for AYAs as ACA implementation and the Title V transformation continues

Herbivore Effects on Productivity Vary by Guild: Cattle Increase Mean Productivity While Wildlife Reduce Variability

Wild herbivores and livestock share the majority of rangelands worldwide, yet few controlled experiments have addressed their individual, additive, and interactive impacts on ecosystem function. While ungulate herbivores generally reduce standing biomass, their effects on aboveground net primary production (ANPP) can vary by spatial and temporal context, intensity of herbivory, and herbivore identity and species richness. Some evidence indicates that moderate levels of herbivory can stimulate aboveground productivity, but few studies have explicitly tested the relationships among herbivore identity, grazing intensity, and ANPP. We used a long- term exclosure experiment to examine the effects of three groups of wild and domestic ungulate herbivores (megaherbivores, mesoherbivore wildlife, and cattle) on herbaceous productivity in an African savanna. Using both field measurements (productivity cages) and satellite imagery, we measured the effects of different herbivore guilds, separately and in different combinations, on herbaceous productivity across both space and time. Results from both productivity cage measurements and satellite normalized difference vegetation index (NDVI) demonstrated a positive relationship between mean productivity and total ungulate herbivore pressure, driven in particular by the presence of cattle. In contrast, we found that variation in herbaceous productivity across space and time was driven by the presence of wild herbivores (primarily mesoherbivore wildlife), which significantly reduced heterogeneity in ANPP and NDVI across both space and time. Our results indicate that replacing wildlife with cattle (at moderate densities) could lead to similarly productive but more heterogeneous herbaceous plant communities in rangelands

Increased Mood Disorder Symptoms, Perceived Stress, and Alcohol Use Among College Students During the COVID-19 Pandemic

The COVID-19 pandemic caused significant disruption during the spring of 2020. Many college students were told to leave campus at spring break and to complete the semester remotely. This study evaluates effects of this disruption on student well-being. Measures of psychological symptoms, perceived stress, and alcohol use during the pandemic were completed by 148 students in spring 2020 and 352 students in fall 2020 at a university in the southeastern U.S. Results from both cohorts were compared to 240 students who completed the same measures in the fall 2019 semester. Participants in spring 2020 reported more mood disorder symptoms, perceived stress, and alcohol use than did pre-pandemic participants and worry about COVID-19 was negatively associated with well-being. By fall 2020 symptoms had largely returned to pre-pandemic levels. In general, White students reported a greater effect of the pandemic on well-being than did African American students. Young adults appear to be less vulnerable to the most serious medical complications associated with COVID-19, but nonetheless experience psychological effects from the pandemic. Universities and practitioners who work with college students can help young adults manage their symptoms and avoid behaviors like risky alcohol use when confronted with stressors such as the COVID-19 pandemic

Demographic Predictors of the Perceived Likelihood of Hiring a Health Care Advocate

Background and Significance: The field of health care advocacy developed in response to the growing complexity of the health care system. A Health Care Advocate (HCA) is a trained professional who can help patients navigate the health care system. In the present study we investigated the effects of social support, number of people with whom individuals reside, gender, age, income, and race on the perceived likelihood of hiring an HCA for oneself. Method: Nine hundred and eighty-seven adults (Mage = 45.48 years, SD = 17.33 years, 55.4% female) were randomly selected and asked to complete a questionnaire. To explore the relationships of the perceived likelihood of hiring an HCA, path-analytic models using full-information maximum likelihood (FIML) estimation were tested, using Stata 12.1. Results: The model fit well statistically, ? 2 (5, N = 987) = 8.50, p = 0.131, and descriptively, CFI = 0.999, RMSEA = 0.027, pclose = 0.891, CD = 0.205. Conclusion: Overall, the model accounted for 4.30% of the variance in Hire HCA. More research is needed to better understand the role of an HCA in our complex and everchanging health care system

Estimates of Victim Surface Area and Associated Extraction Force for Partial Entrapment in Grain

A prediction model for estimating extraction forces on entrapped victims was enhanced and modernized in 2018 from the original 1985 model. The prediction model was divided into two conditions based on the victim‘s relative position to the grain surface. The first condition was when the victim is completely below the grain surface. The second condition was when the victim‘s shoulders are above the grain surface; this condition is the focus of this research. A variable in the prediction model that changes with the depth of entrapment is the surface area of the victim. A sample of 60 male models was used to approximate the human surface area at optimal discrete positions selected based on visually identifiable anthropometric landmarks. The surface area estimates for those 60 partially entrapped male models ranged from 0.0716 to 2.7296 m2. Extraction forces for twelve partially entrapped male body types with various combinations of stature and body mass index were calculated. The extraction forces were calculated for conditions when the victim‘s arms were raised (above the grain) and lowered (in the grain). Results from the prediction model showed that surface area contributed less to the partial extraction force for short underweight bodies than for tall extremely obese bodies. At the lower landmarks, i.e., medial malleolus (MM) and knee crease (KN), surface area did not contribute noticeably to the partial extraction force. The contribution of surface area was not noticeable until the victim was buried up to the crotch (landmark CR).This article is published as Schwab, Charles V., Lauren E. Schwab, and Pamela J. Schwab. "Estimates of Victim Surface Area and Associated Extraction Force for Partial Entrapment in Grain." Journal of Agricultural Safety and Health 27, no. 1 (2021): 53-68. doi: https://doi.org/10.13031/jash.14230. © 2021 ASABE. This work is licensed under a Creative Commons Attribution NonCommercial-NoDerivatives 4.0 International License (https://creative commons.org/licenses/by-nc-nd/4.0/)