Reviews

Lisa Tyler. Writing and Healing: Toward an Informed Practice. (Charles M. Anderson and Marian M. MacCurdy, eds., 2000). Fran Claggett. Revisioning Writers\u27 Talk: Gender and Culture in Acts of Composing. (Mary Ann Cain, 1995). Bruce Novak. Tomorrow\u27s Children: A Blueprint for Partnership Education in the 21st Century. (Riane Eisler, 2000). Neal Lerner. Stories from the Center: Connecting Narrative and Theory in the Writing Center. (Lynn Craigue Briggs and Meg Woolbright, eds., 2000)

Differences in Hospital Managers’, Unit Managers’, and Health Care Workers’ Perceptions of the Safety Climate for Respiratory Protection

This article compares hospital managers’ (HM), unit managers’ (UM), and health care workers’ (HCW) perceptions of respiratory protection safety climate in acute care hospitals. The article is based on survey responses from 215 HMs, 245 UMs, and 1,105 HCWs employed by 98 acute care hospitals in six states. Ten survey questions assessed five of the key dimensions of safety climate commonly identified in the literature: managerial commitment to safety, management feedback on safety procedures, coworkers’ safety norms, worker involvement, and worker safety training. Clinically and statistically significant differences were found across the three respondent types. HCWs had less positive perceptions of management commitment, worker involvement, and safety training aspects of safety climate than HMs and UMs. UMs had more positive perceptions of management’s supervision of HCWs’ respiratory protection practices. Implications for practice improvements indicate the need for frontline HCWs’ inclusion in efforts to reduce safety climate barriers and better support effective respiratory protection programs and daily health protection practices

Population pharmacokinetics of meropenem administered as a prolonged infusion in children with cystic fibrosis

OBJECTIVES: Meropenem is frequently used to treat pulmonary exacerbations in children with cystic fibrosis (CF) in the USA. Prolonged-infusion meropenem improves the time that free drug concentrations remain above the MIC (fT> MIC) in adults, but data in CF children are sparse. We describe the population pharmacokinetics, tolerability and treatment burden of prolonged-infusion meropenem in CF children. METHODS: Thirty children aged 6-17 years with a pulmonary exacerbation received 40 mg/kg meropenem every 8 h; each dose was administered as a 3 h infusion. Pharmacokinetics were determined using population methods in Pmetrics. Monte Carlo simulation was employed to compare 0.5 with 3 h infusions to estimate the probability of pharmacodynamic target attainment (PTA) at 40% fT> MIC. NCT#01429259. RESULTS: A two-compartment model fitted the data best with clearance and volume predicted by body weight. Clearance and volume of the central compartment were 0.41 ± 0.23 L/h/kg and 0.30 ± 0.17 L/kg, respectively. Half-life was 1.11 ± 0.38 h. At MICs of 1, 2 and 4 mg/L, PTAs for the 0.5 h infusion were 87.6%, 70.1% and 35.4%, respectively. The prolonged infusion increased PTAs to >99% for these MICs and achieved 82.8% at 8 mg/L. Of the 30 children, 18 (60%) completed treatment with prolonged infusion; 5 did so at home without any reported burden. Nine patients were changed to a 0.5 h infusion when discharged home. CONCLUSIONS: In these CF children, meropenem clearance was greater compared with published values from non-CF children. Prolonged infusion provided an exposure benefit against pathogens with MICs ≥1 mg/L, was well tolerated and was feasible to administer in the hospital and home settings, the latter depending on perception and family schedule

Young men’s views towards the barriers and facilitators of internet-based Chlamydia trachomatis screening: a qualitative study

Background: There is a growing number of Internet-based approaches that offer young people screening for sexually transmitted infections. Objective: This paper explores young men’s views towards the barriers and facilitators of implementing an Internet-based screening approach. The study sought to consider ways in which the proposed intervention would reach and engage men across ages and socioeconomic backgrounds. Methods: This qualitative study included 15 focus groups with 60 heterosexual young men (aged 16-24 years) across central Scotland, drawn across age and socioeconomic backgrounds. Focus groups began by obtaining postcode data to allocate participants to a high/low deprivation category. Focus group discussions involved exploration of men’s knowledge of chlamydia, use of technology, and views toward Internet-based screening. Men were shown sample screening invitation letters, test kits, and existing screening websites to facilitate discussions. Transcripts from audio recordings were analyzed with "Framework Analysis". Results: Men’s Internet and technology use was heterogeneous in terms of individual practices, with greater use among older men (aged 20-24 years) than teenagers and some deprivation-related differences in use. We detail three themes related to barriers to successful implementation: acceptability, confidentiality and privacy concerns, and language, style, and content. These themes identify ways Internet-based screening approaches may fail to engage some men, such as by raising anxiety and failing to convey confidentiality. Men wanted screening websites to frame screening as a serious issue, rather than using humorous images and text. Participants were encouraged to reach a consensus within their groups on their broad design and style preferences for a screening website; this led to a set of common preferences that they believed were likely to engage men across age and deprivation groups and lead to greater screening uptake. Conclusions: The Internet provides opportunities for re-evaluating how we deliver sexual health promotion and engage young men in screening. Interventions using such technology should focus on uptake by age and socioeconomic background. Young people should be engaged as coproducers of intervention materials and websites to ensure messages and content are framed appropriately within a fast-changing environment. Doing so may go some way to addressing the overall lower levels of testing and screening among men compared with women

Identifying Network Representation Issues with the Network Trip Robustness

The purpose of this study was to evaluate the effects of road-network representation on the application of the Network Robustness Index (NRI), using the Chittenden County Regional Transportation Model. The results are expected to improve the requirements for how a road network must be represented for an effective application of the NRI. This work was performed under Year 2 of UVM Transportation Research Center (TRC) Signature Project 1H \u2013 Network Robustness Index: A Comprehensive Spatial-Based Measure for Transportation Infrastructure Management. Funding for this work comes from the USDOT through the University Transportation Center (UTC) at the University of Vermont

Cave deposits as a sedimentary trap for the Marine Isotope Stage 3 environmental record: The case study of Pod Hradem, Czech Republic

Pod Hradem Cave, located in the Moravian Karst, Czech Republic, offers an excellent opportunity for environmental reconstructions of Marine Isotope Stage 3 (MIS 3) in Central Europe due to its detailed sedimentary record dated 50,000 to 28,000 cal BP. Identifying the natural environments of the Middle to Upper Palaeolithic (MUP) transition is necessary to understand the settlement strategies and related behaviour of both Neanderthals and Anatomically Modern Humans, both of whom may have occupied the region at the same time. A multidisciplinary excavation was carried out between 2011 and 2016. Detailed analyses of the sediments, vertebrate microfauna, pollen and charcoal revealed minor but observable fluctuations in climate, with little change in the surrounding vegetation. The Pod Hradem palaeoenvironmental dataset is complex, but generally reflects a predominantly glacial climate with a range of vegetation types and habitats during the Late Pleistocene, followed by the warmer and more humid Holocene. The MUP transition as recorded in Pod Hradem Cave was a glacial environment interrupted by two relatively warmer periods. Central Europe experienced extreme climate fluctuations during MIS3, as recorded from different sedimentary archives, but it seems that the Pod Hradem Cave environment may have acted as a buffer zone, ameliorating those extremes, and providing a suitable refuge for both bears seeking winter hibernation dens and occasionally visiting humans.Thisproject was funded from the SoMoPro programme. Research leading tothese results has received a financial contribution from the EuropeanCommunity within the Seventh Framework Programme (FP/2007–2013) under Grant Agreement No. 229603. The research was alsoco-financed by the South Moravian Region and the Department ofAnthropology & Department of Geological Sciences (departmentalfunding - Masaryk University) and the internal programme of theInstitute of Geology CAS in Prague No. RVO 67985831

A Phase 1a/1b Clinical Trial Design to Assess Safety, Acceptability, Pharmacokinetics and Tolerability of Intranasal Q-Griffithsin for COVID-19 Prophylaxis

Background: The COVID-19 pandemic remains an ongoing threat to global public health. Q-Griffithsin (Q-GRFT) is a lectin that has demonstrated potent broad-spectrum inhibitory activity in preclinical studies in models of Nipah virus and the beta coronaviruses SARS-CoV, MERS-CoV, and SARS-CoV-2. Methods: Here, we propose a clinical trial design to test the safety, pharmacokinetics (PK), and tolerability of intranasally administered Q-GRFT for the prevention of SARS-CoV-2 infection as a prophylaxis strategy. The initial Phase 1a study will assess the safety and PK of a single dose of intranasally administered Q-GRFT. If found safe, the safety, PK, and tolerability of multiple doses of intranasal Q-GRFT will be assessed in a Phase 1b study. Group 1 participants will receive 3 mg of intranasal Q-GRFT (200 μL/nostril) once daily for 7 days. If this dose is tolerated, participants will be enrolled in Group 2 to receive 3 mg twice daily for 7 days. Secondary endpoints of the study will be user perceptions, acceptability, and the impact of product use on participants’ olfactory sensation and quality of life. Discussion: Results from this study will support further development of Q-GRFT as a prophylactic against respiratory viral infections in future clinical trials