The effectiveness of demonstration in training office ergonomics

This study, an extension of research reported by Cameron (1997), examines the effectiveness of a demonstration in training clerical workers in office ergonomics principles. The effectiveness was evaluated based on 4 factors: (1) reaction to training; (2) ergonomic knowledge; (3) work-related body-part discomfort (WBPD); and (4) directly observed workstation modifications. Office personnel at the University were trained in office ergonomics with Cameron’s PC-3-D-ME instructional materials. PC-3- D-ME is an instructional approach that addresses both intrinsic factors (work technique) and extrinsic factors (workstation adjustment). Half of the participants received Cameron’s PC-3-D-ME training literature in the form of a booklet. The other half received this literature and a demonstration. This study serves as an independent replication of Cameron’s study. Despite a small sample size (N = 38), the use of less powerful, non-parametric tests, and only a six week period between pre- and post-instruction data collection, results of the current study revealed that both groups of participants reacted positively to the training, displayed a significant increase in ergonomic knowledge, made a significant number of modifications to their workstations, and experienced significant decreases in discomfort severity, hifrequency, and duration in the back of the neck. Furthermore, participants in the literature-demonstration group made significantly more modifications to their workstations and experienced decreased discomfort of a greater magnitude than participants in the literature only group. This evidence indicates that while benefits can be seen after administration of office ergonomics training via literature alone, adding a demonstration that incorporates more sensory modalities and gives participants the opportunity to observe a model, practice, and ask and answer questions could lead to a greater number of workstation modifications and ultimately a greater reduction in the number of injuries experienced by training participants. Therefore, although providing a demonstration as part of office ergonomics training requires employers to make an additional investment, the return on investment can be seen in a greater reduction in the severity, frequency, and duration of injuries

Changes in Mindfulness, Well-Being, and Sleep Quality in College Students Through Taijiquan Courses: A Cohort Control Study

Objectives: This study sought to determine whether participants in taijiquan classes would report increases in mindfulness greater than that of a comparison group, and whether changes in mindfulness were associated with improvements in mood, perceived stress, self-regulatory self-efficacy, and sleep quality. Design: The study design was quasi-experimental with repeated measures. Settings/location: The study was set in a midsized public university. Subjects: Students aged 18–48 years old enrolled in 15-week courses of either taijiquan (n = 76) or special recreation (control group, n = 132). Intervention: Chen-style taijiquan classes were offered 2 times per week for 50 minutes each time. Outcome measures: Self-report of mindfulness (Five Facet Mindfulness Questionnaire), mood (Four Dimensional Mood Scale), perceived stress (Perceived Stress Scale), self-regulatory self-efficacy (Self-regulatory Self-Efficacy Scale), and sleep quality (Pittsburgh Sleep Quality Index). Results: Increases in total mindfulness scores occurred only in the taijiquan group, not in the control group. All well-being variables showed a pattern of improvement in the taijiquan group, with either stability or decline over time in the control group. Increases in mindfulness were significantly correlated with improvements on all wellbeing measures and with sleep quality. Conclusions: Relative to a recreation control group, taijiquan classes for college students are associated with increased mindfulness and improved sleep quality, mood, and perceived stress, but not self-regulatory selfefficacy. Randomized control design studies are needed to substantiate the causal role of taijiquan exercise in the development of mindfulness and associated improvements in well-being

A Tool to Cost Environmental Health Services in North Carolina Local Health Departments

Introduction: The cost of providing a basic set of public health services necessary not been well-described. Recent work suggests public health practitioners are unlikely to have the empirically-based financing information necessary to make informed decisions regarding practice. The purpose of this paper is to describe the development of a costing tool used to collect primary data on the number of services provided, staff employed, and costs incurred for two types of mandated environmental health services: food and lodging inspections and onsite water services. Methods: The tool was iteratively reviewed, revised, and piloted with local health department (LHD) environmental health and finance managers. LHDs (n=15) received technical support to estimate costs for fiscal year 2012. Results: The tool contained the following sections: Agency/Respondent Information, Service Counts, Direct Labor Costs, Direct Non-Labor Costs, and Indirect/Overhead Costs. The time required to complete the tool ranged from 2 to 12 hours (median = 4). Implications: LHDs typically did not track costs by program area, nor did they acknowledge indirect costs or costs absorbed by the county. Nonetheless, this costing tool is one of the first to estimate costs associated with environmental health programs at the LHD level and has important implications for practitioners and researchers, particularly when these limitations are recognized

Sensitivity of estuaries to compound flooding.

Fluvial and surge-tide extremes can occur synchronously resulting in compound flooding in estuaries, greatly intensifying the hazard. This flood risk has the potential to increase in the future as the frequency, phasing and/or intensity of these drivers change. Improved understanding of how extreme fluvial discharge and surge-tides interact will help inform future flood mitigation methodology. In this paper, therefore, we resolve for the first time intra-estuary sensitivities to fluvial and surge-tide extremes, for two contrasting UK estuaries (Humber and Dyfi). Model simulations at hyper-spatial resolution (< 50 m) using a 2D hydrodynamic model predicted compound flooding hazards based on: (1) present-day extreme events (worst on record); (2) present-day extreme events with shifted timings of the drivers to maximise flooding; and (3) modified drivers representing projected climate change. We found that in a small estuary with short-duration, high-intensity fluvial inputs (Dyfi), flood extent is sensitive to the relative timing of the fluvial and surge-tide drivers. In contrast, the relative timing of these drivers did not affect flooding in a larger estuary with a slower fluvial response to rainfall (Humber). In the Humber, extreme fluvial inputs during a compound hazard actually reduced maximum water depths in the outer estuary, compared with a surge-tide-only event. Projected future changes in these drivers by 2100 will increase compound flooding hazards: simulated sea-level rise scenarios predicted substantial and widespread flooding in both estuaries. However, projected increases in surge-tide behaved differently to sea-level rise of the same magnitude, resulting in a greater seawater influx and more flooding. Increased fluvial volumes were the weakest driver of estuarine flooding. In this paper we show how these interactions are complex and how the hydrodynamics vary considerably between different estuaries and sites within estuaries, making it difficult to generalise, use probabilistic or use 1D approaches for assessing compound flooding hazards. Hence, we contribute new knowledge and methods for catchment-to-coast impact modelling used for flood mitigation strategies

Degradation and Uptake of Benzene in Laboratory Phytoremediation Studies

In Whole-Plant Laboratory Studies, Hybrid Poplar Trees Were Shown to Impact a Variety of Fate and Transport Mechanisms for Benzene. Laboratory Experiments Investigated the Distribution of the Contaminant in the Plant Tissues, Degradation in the Soil Profile, and Volatilization from Both the Soil and Leaf Tissues. a New Testing System Was Developed that Allowed for Rapid Testing that is More Field-Representative Than Earlier Studies. Whole Plants Were Utilized in a Reactor Design that Included Both a Saturated and a Vadose Zone. the Continuous Feed Reactors Were Supplied with a Steady Influent Benzene Stream to Mimic Plume Conditions. the Presence of the Poplar Trees Enhanced the Degradation Rate of the Benzene, and Dramatically Decreased the Effluent Mass of Benzene. Benzene Was Also Volatilized from the Leaf Tissues, Providing Evidence to the Extent of Plant Enhanced Volatilization that Has Not Been Previously Documented. the Observed Degradation and Removal Pathways Were a Result of Active/live Trees. Reactors with Killed Controls Did Not Exhibit the Removal Seen in the Live Tree Replicates. the Soil Profile Maintained Higher Degradation Rates with the Trees Present. Causes for the Higher Degradation Rates Appeared to Be Larger Microbial Populations of Benzene Degraders and Preferable Redox Conditions in the Presence of the Poplars. These Results Combined with Previous Hydroponic and Related Field Scale Studies to Provide Evidence that Phytoremediation Has Potential for Effective, Efficient, and Environmentally Friendly Application at Benzene Contaminated Sites, and Potentially Other Contaminated Sites with Biodegradable Organics or VOCs

Benzene Toxicity and Removal in Laboratory Phytoremediation Studies

Hybrid Poplar Cuttings Were Shown to Impact the Fate and Transport of Subsurface Benzene, While Toxicity to the Poplars Was Not Observed. Laboratory Experiments Investigated the Toxicity Response of Poplar Cuttings to Benzene Exposure, Contaminant Distribution in Plant Tissues, Contaminant Degradation in the Soil Profile, and Contaminant Volatilization from the Soil and Plant Tissues. Two Separate Studies Were Conducted to Evaluate These Parameters. the First Study Examined the Toxicity of Benzene to Hybrid Poplar Cuttings in Batch Reactors. Poplar Cuttings Were Exposed to Various Concentrations of Benzene Contaminated Water in Two Different Types of Soil. Transpiration Rates Were Measured as an Indicator of Acute Toxicity. No Acute Toxicity Was Noted for Dose Concentrations Up to 1,000 Ppm. the Second Study Evaluated Benzene Fate and Transport. Live Poplar Cuttings and Excised Controls Were Planted in Flow-Through Reactors and Supplied with an Influent Benzene Stream to Mimic Plume Conditions. the Presence of Live Poplar Cuttings Enhanced Benzene Degradation and Decreased the Effluent Mass of Benzene. a Small Amount of Benzene Was Also Volatilized from the Plant Tissues, Providing Evidence of Plant-Enhanced Volatilization. Causes for the Higher Degradation Rates Appeared to Be Greater Microbial Populations of Benzene Degraders and a More Oxygenrich Environment. the Higher Redox Potential Observed May Be an Artifact of the Laboratory Reactor Design. the Results Obtained in This Research Combined with Previous Studies Provide Evidence that Phytoremediation Has the Potential for Effective, Efficient, and Environmentally Friendly Application at Sites Highly Contaminated with Benzene and Potentially for Other Sites Contaminated with Biodegradable Organics or Volatile Organic Compounds

Para-cresol production by Clostridium difficile affects microbial diversity and membrane integrity of Gram-negative bacteria

Clostridium difficile is a Gram-positive spore-forming anaerobe and a major cause of antibiotic-associated diarrhoea. Disruption of the commensal microbiota, such as through treatment with broad-spectrum antibiotics, is a critical precursor for colonisation by C. difficile and subsequent disease. Furthermore, failure of the gut microbiota to recover colonisation resistance can result in recurrence of infection. An unusual characteristic of C. difficile among gut bacteria is its ability to produce the bacteriostatic compound para-cresol (p-cresol) through fermentation of tyrosine. Here, we demonstrate that the ability of C. difficile to produce p-cresol in vitro provides a competitive advantage over gut bacteria including Escherichia coli, Klebsiella oxytoca and Bacteroides thetaiotaomicron. Metabolic profiling of competitive co-cultures revealed that acetate, alanine, butyrate, isobutyrate, p-cresol and p-hydroxyphenylacetate were the main metabolites responsible for differentiating the parent strain C. difficile (630Δerm) from a defined mutant deficient in p-cresol production. Moreover, we show that the p-cresol mutant displays a fitness defect in a mouse relapse model of C. difficile infection (CDI). Analysis of the microbiome from this mouse model of CDI demonstrates that colonisation by the p-cresol mutant results in a distinctly altered intestinal microbiota, and metabolic profile, with a greater representation of Gammaproteobacteria, including the Pseudomonales and Enterobacteriales. We demonstrate that Gammaproteobacteria are susceptible to exogenous p-cresol in vitro and that there is a clear divide between bacterial Phyla and their susceptibility to p-cresol. In general, Gram-negative species were relatively sensitive to p-cresol, whereas Gram-positive species were more tolerant. This study demonstrates that production of p-cresol by C. difficile has an effect on the viability of intestinal bacteria as well as the major metabolites produced in vitro. These observations are upheld in a mouse model of CDI, in which p-cresol production affects the biodiversity of gut microbiota and faecal metabolite profiles, suggesting that p-cresol production contributes to C. difficile survival and pathogenesis.Peer reviewedFinal Published versio

Invasive Haemophilus influenzae Disease in Adults ≥65 Years, United States, 2011.

BackgroundSince the introduction of the Haemophilus influenzae serotype b vaccine, H influenzae epidemiology has shifted. In the United States, the largest burden of disease is now in adults aged ≥65 years. However, few data exist on risk factors for disease severity and outcome in this age group.MethodsA retrospective case-series review of invasive H influenzae infections in patients aged ≥65 years was conducted for hospitalized cases reported to Active Bacterial Core surveillance in 2011.ResultsThere were 299 hospitalized cases included in the analysis. The majority of cases were caused by nontypeable H influenzae, and the overall case fatality ratio (CFR) was 19.5%. Three or more underlying conditions were present in 63% of cases; 94% of cases had at least 1. Patients with chronic heart conditions (congestive heart failure, coronary artery disease, and/or atrial fibrillation) (odds ratio [OR], 3.27; 95% confidence interval [CI], 1.65-6.46), patients from private residences (OR, 8.75; 95% CI, 2.13-35.95), and patients who were not resuscitate status (OR, 2.72; 95% CI, 1.31-5.66) were more likely to be admitted to the intensive care unit (ICU). Intensive care unit admission (OR, 3.75; 95% CI, 1.71-8.22) and do not resuscitate status (OR, 12.94; 95% CI, 4.84-34.55) were significantly associated with death.ConclusionsWithin this age group, burden of disease and CFR both increased significantly as age increased. Using ICU admission as a proxy for disease severity, our findings suggest several conditions increased risk of disease severity and patients with severe disease were more likely to die. Further research is needed to determine the most effective approach to prevent H influenzae disease and mortality in older adults

Meningococcal Disease in Patients With Human Immunodeficiency Virus Infection: A Review of Cases Reported Through Active Surveillance in the United States, 2000-2008.

BackgroundAlthough human immunodeficiency virus (HIV) infection is an established risk factor for several bacterial infections, the association between HIV infection and meningococcal disease remains unclear.MethodsExpanded chart reviews were completed on persons with meningococcal disease and HIV infection reported from 2000 through 2008 from 9 US sites participating in an active population-based surveillance system for meningococcal disease. The incidence of meningococcal disease among patients meeting Centers for Disease Control and Prevention acquired immune deficiency syndrome (AIDS) surveillance criteria was estimated using data from the National HIV Surveillance System for the participating sites.ResultsThirty-three cases of meningococcal disease in individuals with HIV infection were reported from participating sites, representing 2.0% of all reported meningococcal disease cases. Most (75.8%) persons with HIV infection were adult males aged 25 to 64 years old. Among all meningococcal disease cases aged 25 to 64 years old, case fatality ratios were similar among HIV-infected and HIV-uninfected persons (13.3% vs 10.6%; P = .6). The cumulative, mean incidence of meningococcal disease among patients aged 25 to 64 years old with HIV infection ever classified as AIDS was 3.5 cases per 100000 person years (95% confidence interval [CI], 2.1-5.6), compared with 0.3 cases per 100000 person years (95% CI, 0.3-0.3) for persons of the same age group not reported to have AIDS (relative risk = 12.9; 95% CI, 7.9-20.9).ConclusionsIndividuals with HIV infection meeting the AIDS surveillance case definition have a higher incidence of meningococcal disease compared with the general adult population