Occupational Exposures Of Healthcare Workers To Pertussis Within A Large Pediatric Care Network: A Retrospective Study

Background Infection control policies have a significant impact on the risk for disease transmission in healthcare settings, and adherence to guidelines dictates their effectiveness. Healthcare worker (HCW) exposure to communicable diseases can occur when guidelines have not been consistently implemented, placing the HCW at risk for infection with subsequent transmission to patients and co-workers. Respiratory pathogens are a common source of healthcare-associated infection, especially in pediatric settings and pertussis has emerged as a particularly important agent that is associated with an increasing number of both community and healthcare-associated outbreaks despite the availability of an effective vaccine. Adults, including HCWs, are at high risk to be key reservoirs for transmission. We therefore aimed to describe the epidemiology and prevalence of HCW exposures to pertussis and related infection control measures in place for their prevention. Methods Data were collected as part of a retrospective cross-sectional study of occupational exposures of HCWs to four pathogens (pertussis, tuberculosis, meningococcus and varicella) at a large quaternary pediatric care network from January 1st, 2002 to July 18th, 2011. We reviewed occupational health and infection control records for all reported cases of pertussis to measure the frequency of potential and confirmed exposures, the associated index case and HCW characteristics, and subsequent occupational health interventions. We reviewed electronic health record data to identify all laboratory-confirmed pertussis cases during the study period and measure the frequency of potential missed exposures to pertussis. Results During the study period, there were 219 index cases of pertussis identified from occupational health records associated with 1193 confirmed employee exposures. 322 exposures (27%) occurred despite documentation of infection control precautions being in place for the patient. Of the 448 laboratory-confirm pertussis cases identified through the EHR, 50%(N=224) were not investigated, indicating potential missed HCW exposures. The majority of uninvestigated cases were patients from ambulatory sites. Conclusions Pertussis results in a significant number of occupational exposures among HCWs. The true magnitude of exposures may be even greater than measured and thus many exposed HCWs may not receive appropriate interventions to prevent infection and subsequent transmission to co-workers and vulnerable patients. Interventions are needed to improve identification and reporting of pertussis as well as consistent implementation of infection control practices to prevent exposure

Walls Inhibit Chaotic Mixing

We report on experiments of chaotic mixing in a closed vessel, in which a highly viscous fluid is stirred by a moving rod. We analyze quantitatively how the concentration field of a low-diffusivity dye relaxes towards homogeneity, and we observe a slow algebraic decay of the inhomogeneity, at odds with the exponential decay predicted by most previous studies. Visual observations reveal the dominant role of the vessel wall, which strongly influences the concentration field in the entire domain and causes the anomalous scaling. A simplified 1D model supports our experimental results. Quantitative analysis of the concentration pattern leads to scalings for the distributions and the variance of the concentration field consistent with experimental and numerical results.Comment: 4 pages, 3 figure

How Does Varsity Girls' Soccer Support the Mission Statement of A High School in Eastern Pennsylvania?

Recently enforced federal education laws that provide money in return for academic progress and improvement began a significant movement of increasing school accountability within every community across the United States. Since the passing of No Child Left Behind in 2001, school stakeholders have been bound to executing educational reformations to raise the achievement rates of their student populations. Public school leaders have created comprehensive strategies in response to the pressures faced from federally created accountability systems. Public school officials have used many strategies to better communicate to community members and school district stakeholders the types of achievement that take place within their school. The redevelopment of school district mission statements across the United States is one such strategy that has been well documented over the course of the last fifteen years. The mission statement of a school district is a valuable tool used to openly communicate to all stakeholders what students will achieve upon graduation. The mission statement encompasses all school sponsored curricular and co-curricular student activities. This study examines the current components included within a mission statement from an Eastern Pennsylvania school district. The specific current components included within the mission statement are defined as 21st century learning skills and this study determines if a specific co-curricular activity supports or does not support the current mission statement. According to the Glossary of Education Reform, co-curricular activity is any activity that complements what students are learning in school (2014). This is a case study that takes an ethnographic approach to explore the awareness and assessment of the current components included within the school mission statement through questionnaires, focus groups, and individual interviews. Student athletes of a specific co-curricular activity, their parents/guardians, and their coaches are involved in the questionnaire, focus group and individual interview processes.Ed.D., Educational Leadership and Management -- Drexel University, 201

Identification of target genes for wild type and truncated HMGA2 in mesenchymal stem-like cells

Background The HMGA2 gene, coding for an architectural transcription factor involved in mesenchymal embryogenesis, is frequently deranged by translocation and/or amplification in mesenchymal tumours, generally leading to over-expression of shortened transcripts and a truncated protein. Methods To identify pathways that are affected by sarcoma-associated variants of HMGA2, we have over-expressed wild type and truncated HMGA2 protein in an immortalized mesenchymal stem-like cell (MSC) line, and investigated the localisation of these proteins and their effects on differentiation and gene expression patterns. Results Over-expression of both transgenes blocked adipogenic differentiation of these cells, and microarray analysis revealed clear changes in gene expression patterns, more pronounced for the truncated protein. Most of the genes that showed altered expression in the HMGA2-overexpressing cells fell into the group of NF-κB-target genes, suggesting a central role for HMGA2 in this pathway. Of particular interest was the pronounced up-regulation of SSX1, already implicated in mesenchymal oncogenesis and stem cell functions, only in cells expressing the truncated protein. Furthermore, over-expression of both HMGA2 forms was associated with a strong repression of the epithelial marker CD24, consistent with the reported low level of CD24 in cancer stem cells. Conclusions We conclude that the c-terminal part of HMGA2 has important functions at least in mesenchymal cells, and the changes in gene expression resulting from overexpressing a protein lacking this domain may add to the malignant potential of sarcomas

Transglutaminase activation in neurodegenerative diseases

The following review examines the role of calcium in promoting the in vitro and in vivo activation of transglutaminases in neurodegenerative disorders. Diseases such as Alzheimer's disease, Parkinson's disease and Huntington's disease exhibit increased transglutaminase activity and rises in intracellular calcium concentrations, which may be related. The aberrant activation of transglutaminase by calcium is thought to give rise to a variety of pathological moieties in these diseases, and the inhibition has been shown to have therapeutic benefit in animal and cellular models of neurodegeneration. Given the potential clinical relevance of transglutaminase inhibitors, we have also reviewed the recent development of such compounds

Review article: Direct-acting antivirals for the treatment of HCV during pregnancy and lactation: implications for maternal dosing, foetal exposure, and safety for mother and child

BACKGROUND: With the global efforts to eradicate hepatitis C virus (HCV), treatment during pregnancy is becoming a priority for research as this, and maternal cure should reduce vertical transmission. However, as information on the efficacy and safety of direct-acting antivirals (DAAs) in pregnancy is generally lacking, treatment of HCV infection during pregnancy is not currently recommended. AIM: To provide an overview of current knowledge regarding maternal exposure, placental handling and safety of DAAs during pregnancy and lactation METHODS: A literature search was performed focusing on the effect of pregnancy on maternal exposure to DAAs, the placental handling of DAAs, the safety of DAAs for mother and child during pregnancy and the safety of DAAs during lactation. RESULTS: Exposure to all DAAs studied is likely to be altered during pregnancy, mostly related to pregnancy-induced effects on drug absorption and metabolism. Although animal studies show that most DAAs are reported to cross the placenta and transfer into breast milk, most DAA combinations show a favourable safety profile. Because of the rapid viral decline after treatment initiation, and to avoid the critical period of organogenesis, treatment may be started at the end of the second trimester or early third trimester. CONCLUSIONS: Treatment of HCV infection during pregnancy is realistic, as DAAs are highly effective and treatment duration is relatively short. There is an urgent need to study DAAs during pregnancy and lactation to contribute to the goal of HCV elimination

Relic furniture in Victorian America

Ames, Kenneth L.This paper examines America's nineteenth-century fascination with relic furniture. It attempts to identify the motivating forces behind this fascination, and to determine what Victorian American values and desires were reflected by the relic objects created during this time. ☐ Research focused on nineteenth-century diaries, letters, magazine articles, and other documents containing references to relic objects of the period. In an attempt to understand the psychological forces underlying the potency of relic objects, modern psychological analyses of the importance of myth, religion, place, and memory were also explored. ☐ In the minds of Victorian Americans, relics -- imbued with potency associated with past people, places, and events -- survived as tangible proof of people and events that played vital roles in America's history. The relic objects they created and preserved provided nineteenth-century Americans with material evidence of their country's origins, and helped them confirm their own place within America's historical context.M.A.University of Delaware, Winterthur Program in Early American Cultur