Increasing Long-Term Care Employee Influenza Compliance Through an Educational Approach

Influenza (flu) is a highly contagious respiratory illness caused by several influenza viruses (Centers for Disease Control, 2019). The CDC estimates that there have been approximately 42.9 million flu incidents, 20.1 million flu medical visits, 647,000 flu related hospitalizations and 61,200 deaths from October 1, 2018 through May 4, 2019. Individuals who contract this illness may have symptoms varying from mild to severe. This project focused on the elderly population because these individuals fall into the high-risk category. Individuals 65 and older are more likely to experience flu-related complications, which could ultimately lead to hospitalizations and in some cases, death. It is noted that between 70 and 90 percent of all seasonal flu-related deaths typically occur in individuals 65 years and older (CDC, 2019). These astounding facts led to the PICO question: In rural community living center healthcare workers, how does incorporating educational interventions using evidence-based information on the purpose, risks, efficacy, and side effects of the influenza vaccine, compared to no educational intervention, influence the rate of healthcare professionals opting to have the influenza vaccine for the 2019-2020 influenza season. For this project, this author evaluated the educational interventions and the corresponding outcomes to evaluate the effectiveness of educational interventions with employees. This project focused on incorporating interventions with an overall goal to improve health outcomes for not only the employees but also the residents of the community living center. According to Terhaar and Sylvia (2014), “When the purpose of a data analysis is evaluation, the question (s) are expressed as aims and outcomes”. For this reason, the analysis question would be considered an evaluation (Terhaar & Sylvia, pg. 39. 2014). This project consisted of a four-week influenza campaign with pre and post questionnaires utilized to gauge an employee’s influenza knowledge as well as their reported likelihood of receiving the vaccination. The mean score for the post quiz increased by 8 points when re-administered post-education. Documented employees receiving the vaccination for the 2019-2020 flu season more than doubled with an increase of 25 seen post-education interventions

Effect of Preventive Primary Care Outreach on Health Related Quality of Life Among Older Adults at Risk of Functional Decline: Randomised Controlled Trial

Objective: To evaluate the impact of a provider initiated primary care outreach intervention compared with usual care among older adults at risk of functional decline. Design: Randomised controlled trial. Setting: Patients enrolled with 35 family physicians in five primary care networks in Hamilton, Ontario, Canada. Participants: Patients were eligible if they were 75 years of age or older and were not receiving home care services. Of 3166 potentially eligible patients, 2662 (84%) completed the validated postal questionnaire used to determine risk of functional decline. Of 1724 patients who met the risk criteria, 769 (45%) agreed to participate and 719 were randomised. Intervention: The 12 month intervention, provided by experienced home care nurses in 2004-6, consisted of a comprehensive initial assessment using the resident assessment instrument for home care; collaborative care planning with patients, their families, and family physicians; health promotion; and referral to community health and social support services. Main outcome measures: Quality adjusted life years (QALYs), use and costs of health and social services, functional status, self rated health, and mortality. Results: The mean difference in QALYs between intervention and control patients during the study period was not statistically significant (0.017, 95% confidence interval ?0.022 to 0.056; P=0.388). The mean difference in overall cost of prescription drugs and services between the intervention and control groups was not statistically significant, (-$C165 (£107; 118;$162), 95% confidence interval -$C16 545 to$$16 214; P=0.984). Changes over 12 months in functional status and self rated health were not significantly different between the intervention and control groups. Ten patients died in each group. Conclusions: The results of this study do not support adoption of this preventive primary care intervention for this target population of high risk older adults

Densification of polymer glass film under combined high pressure and shear flow revealed via scanning X-ray microscopy

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Effect of preventive primary care outreach on health related quality of life among older adults at risk of functional decline: randomised controlled trial

Objective To evaluate the impact of a provider initiated primary care outreach intervention compared with usual care among older adults at risk of functional decline

Semen quality in relation to biomarkers of pesticide exposure.

We previously reported reduced sperm concentration and motility in fertile men in a U.S. agrarian area (Columbia, MO) relative to men from U.S. urban centers (Minneapolis, MN; Los Angeles, CA; New York, NY). In the present study we address the hypothesis that pesticides currently used in agriculture in the Midwest contributed to these differences in semen quality. We selected men in whom all semen parameters (concentration, percentage sperm with normal morphology, and percentage motile sperm) were low (cases) and men in whom all semen parameters were within normal limits (controls) within Missouri and Minnesota (sample sizes of 50 and 36, respectively) and measured metabolites of eight current-use pesticides in urine samples provided at the time of semen collection. All pesticide analyses were conducted blind with respect to center and case-control status. Pesticide metabolite levels were elevated in Missouri cases, compared with controls, for the herbicides alachlor and atrazine and for the insecticide diazinon [2-isopropoxy-4-methyl-pyrimidinol (IMPY)]; for Wilcoxon rank test, p = 0.0007, 0.012, and 0.0004 for alachlor, atrazine, and IMPY, respectively. Men from Missouri with high levels of alachlor or IMPY were significantly more likely to be cases than were men with low levels [odds ratios (ORs) = 30.0 and 16.7 for alachlor and IMPY, respectively], as were men with atrazine levels higher than the limit of detection (OR = 11.3). The herbicides 2,4-D (2,4-dichlorophenoxyacetic acid) and metolachlor were also associated with poor semen quality in some analyses, whereas acetochlor levels were lower in cases than in controls (p = 0.04). No significant associations were seen for any pesticides within Minnesota, where levels of agricultural pesticides were low, or for the insect repellent DEET (N,N-diethyl-m-toluamide) or the malathion metabolite malathion dicarboxylic acid. These associations between current-use pesticides and reduced semen quality suggest that agricultural chemicals may have contributed to the reduction in semen quality in fertile men from mid-Missouri we reported previously