Factors influencing health care workers' willingness to respond to duty during infectious disease outbreaks and bioterrorist events: an integrative review

Background: Infectious disease emergencies are increasingly becoming part of the health care delivery landscape, having implications to not only individuals and the public, but also on those expected to respond to these emergencies. Health care workers (HCWs) are perhaps the most important asset in an infectious disease emergency, yet these individuals have their own barriers and facilitators to them being willing or able to respond. Aim: The purpose of this review was to identify factors affecting HCW willingness to respond (WTR) to duty during infectious disease outbreaks and/or bioterrorist events. Methods: An integrative literature review methodology was utilized to conduct a structured search of the literature including CINAHL, Medline, Embase, and PubMed databases using key terms and phrases. PRISMA guidelines were used to report the search outcomes and all eligible literature was screened with those included in the final review collated and appraised using a quality assessment tool. Results: A total of 149 papers were identified from the database search. Forty papers were relevant following screening, which highlighted facilitators of WTR to include: availability of personal protective equipment (PPE)/vaccine, level of training, professional ethics, family and personal safety, and worker support systems. A number of barriers were reported to prevent WTR for HCWs, such as: concern and perceived risk, interpersonal factors, job-level factors, and outbreak characteristics. Conclusions: By comprehensively identifying the facilitators and barriers to HCWs' WTR during infectious disease outbreaks and/or bioterrorist events, strategies can be identified and implemented to improve WTR and thus improve HCW and public safety. Keywords: bioterrorism; health care workers; infectious disease emergency; infectious disease outbreak; willingness to respond

On Care-fulness: Critical Creative Expressions of Care in a Feminist Theatre Research Project

In early 2020, as the first of many COVID lockdowns began across Australia, a collective of feminist and queer performance scholars and artists embarked on the research project Staging Australian Women’s Lives: Theatre, Feminism and Socially Engaged Art. Our aim was to document contributions of womxn theatre makers, while conducting a feminist analysis of strategies used to deal with gender inequality and oppression, on stage and off. While pivoting to the digital and the virtual, we recognised a need to support womxn theatre makers whose lives and livelihoods are thrown into further precarity by the pandemic. This paper speaks to our commitment to bringing together critical theory, arts practices and everyday life in ethical forms and encounters that make visible, recognise and express care for one another and for the work

Medial longitudinal arch development of school children : The College of Podiatry Annual Conference 2015: meeting abstracts

Background Foot structure is often classified into flat foot, neutral and high arch type based on the variability of the Medial Longitudinal Arch (MLA). To date, the literature provided contrasting evidence on the age when MLA development stabilises in children. The influence of footwear on MLA development is also unknown. Aim This study aims to (i) clarify whether the MLA is still changing in children from age 7 to 9 years old and (ii) explore the relationship between footwear usage and MLA development, using a longitudinal approach. Methods We evaluated the MLA of 111 healthy school children [age = 6.9 (0.3) years] using three parameters [arch index (AI), midfoot peak pressure (PP) and maximum force (MF: % of body weight)] extracted from dynamic foot loading measurements at baseline, 10-month and 22-month follow-up. Information on the type of footwear worn was collected using survey question. Linear mixed modelling was used to test for differences in the MLA over time. Results Insignificant changes in all MLA parameters were observed over time [AI: P = .15; PP: P = .84; MF: P = .91]. When gender was considered, the AI of boys decreased with age [P = .02]. Boys also displayed a flatter MLA than girls at age 6.9 years [AI: mean difference = 0.02 (0.01, 0.04); P = .02]. At baseline, subjects who wore close-toe shoes displayed the lowest MLA overall [AI/PP/MF: P < .05]. Subjects who used slippers when commencing footwear use experienced higher PP than those who wore sandals [mean difference = 31.60 (1.44, 61.75) kPa; post-hoc P = .04]. Discussion and conclusion Our findings suggested that the MLA of children remained stable from 7 to 9 years old, while gender and the type of footwear worn during childhood may influence MLA development. Clinicians may choose to commence therapy when a child presents with painful flexible flat foot at age 7 years, and may discourage younger children from wearing slippers when they commence using footwear

Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security

Things that fall over : Women's playwriting, poetics and the (anti-)musical

Abstract: This study explores the contradictions and ambivalences experienced by a working artist at a time when her age, her gender, and broader cultural shifts are all potential obstacles or liabilities to creative flourishing. It is the product of practice-led research into the creative process from the perspective of the female "late bloomer". In this phrase, I have in mind the mature-aged woman who is, in mid-life, suddenly seized with inspiration and fired with creative energy. At its heart is the question: If an Elizabeth Jolley were in our midst today, would we hear from her? The result is a full-length libretto and accompanying exegetical binoculars in the form of a Preface and an Afterword. The creative work, Things That Fall Over (TTFO) is conceived in two parts: a libretto and oratorio for performance. It begins as a play, but over three acts and into a coda, the work becomes something entirely other - an (anti-) musical. The work grew from a personal interest in the nexus between women, ageing and creative practice, via investigation into the oeuvre of two Australian artists, Elizabeth Jolley, author, first published at age 53, and Rosalie Gascoigne, sculptor, first exhibited at 58. A second strand of the research grew from a fascination for the stage musical, especially in its more alternative modes as in the hands of Stephen Sondheim, or in more provocative manifestations as witnessed in recent Tony Award winners Avenue Q and The Book of Mormon. Contextually, this research is conducted at a time when anecdotal evidence suggests that women’s work in the performing arts and in literature is being pushed to the margins after a late twentieth century Golden Age on page and stage. Using hybrid practice-led methodologies - bricolage, log-keeping - and working within queer and feminist paradigms, this study seeks to counter that push with a new work that is all-female, part-pantomime, part monstrous allegory. In illuminating the creative process of a mature-aged playwright it concludes that hybrid and interstitial forms still offer an inclusive and democratic space in which voices that may otherwise be muted will continue to be heard

Poly(2-hydroxyethyl methacrylate) Hydrogels Doped with Gold Nanoparticles for Surface-Enhanced Raman Spectroscopy

Poly(2-hydroxyethyl methacrylate) hydrogels doped with gold nanoparticles (Au-PHEMA) were prepared via photochemically and thermally induced phase separation polymerization of aqueous formulations containing 2-hydroxyethyl methacrylate (HEMA), a cross-linker, an initiator, and either KAuCl4 or (CH3)2SAuCl. In photopolymerizations, 2,2-dimethoxy-2-phenylacetophenone (DPAP) served as the photoinitiator of polymerization of HEMA but also appeared to play a role in the reduction of Au(III) to Au(0). For thermal polymerizations, potassium persulfate (K2S2O8) was used to initiate polymerization of HEMA, and it appeared that the resulting PHEMA was responsible for the reduction of Au(III) to Au(0). The Au-PHEMA hydrogels exhibited the morphology based on a network of polymer droplets and interconnected pores characteristic of PHEMA formed via polymerization-induced phase separation, with only minor differences in the sizes of the polymer droplets and mechanical properties. The application of Au-PHEMA as a platform for surface-enhanced Raman scattering was demonstrated using an 80 ppb solution of 4-ethynylbenzaldehyde as an analyte.</p

A Novel Antimicrobial Hydrogel for the Management of Periodontal Diseases

Objectives: This study aimed to synthesise a drug-delivery system based on a porous polymer hydrogel, with antimicrobial properties against Porphyromonas gingivalis and potential to be used in tissue regeneration. Material and methods: 2-Hydroxyethyl methacrylate monomers were polymerised using thermal and photoactivation in the presence of silver nitrate (AgNO3) and/or chlorhexidine digluconate. Poly-2-hydroxyethyl methacrylate (pHEMA) hydrogels containing silver nanoparticles (AgNPs) and/or 0.12% chlorhexidine (CHX) were produced and characterised using cryo-SEM and confocal microscopy. Hydrogel degradation and leaching of AgNP were tested for 1.5 months. The antimicrobial properties were tested against P. gingivalis using broth culture system and disk diffusion tests. Results: Our methodology manufactured porous polymeric hydrogels doped with AgNPs and CHX. Hydrogels showed a successful delivery of CHX and sustainable release of AgNPs in a steady hydrogel degradation rate determined based on the weight loss of samples. Hydrogels with AgNPs or CHX had a significant antimicrobial effect against P. gingivalis, with CHX-hydrogels exhibiting a stronger effect than AgNP-hydrogels in the short-term assessment. AgNP-CHX hydrogels showed a compounded antimicrobial effect, whereas control hydrogels containing neither AgNPs nor CHX had no influence on bacterial growth (P < .05). Conclusions: The dual-cured pHEMA hydrogel loaded with antimicrobial agents proved to be an efficient drug-delivery system against periodontopathogens, with the potential to be used as a scaffold for tissue regeneration

Poly(2-Hydroxyethyl Methacrylate) Sponges Doped with Ag Nanoparticles as Antibacterial Agents

Poly(2-hydroxyethyl methacrylate) sponges doped with silver nanoparticles (Ag NP-PHEMA) were prepared by irradiation of aqueous solutions containing 2-hydroxyethyl methacrylate (HEMA) and silver nitrate in the presence of a cross-linking agent and a photoinitiator. The Ag NP-PHEMA sponges had polymer droplet morphology with interconnected pores, characteristic of PHEMA sponges prepared by polymerization-induced phase separation. The Ag NP-PHEMA sponges were yellow-brown, whereas PHEMA sponges were white. For formation of Ag NP-PHEMA, the size of the polymer droplets was larger and the rate of polymerization was increased compared to PHEMA sponges formed under similar conditions but in the absence of silver nitrate. Mechanical strength, as indicated by compression testing, was similar for Ag NP-PHEMA and PHEMA sponges. Nanoparticles slowly leached out of Ag NP-PHEMA sponges, exerting antibacterial activity against Escherichia coli (Gram-negative) and Staphylococcus aureus (Gram-positive) bacteria. Notably, Ag NPs that leached were nontoxic to human corneal epithelial (HCE-T) cells.</p