Errors That Occur from Using an Inappropriate Thermal Buffer When Monitoring the Storage Conditions of Temperature Sensitive Products: Size and Material DO Matter

Common practice in the monitoring of cold chain conditions for temperature sensitive products is to employ a physical thermal buffer into which the temperature probe is inserted. This buffer may be a bottle of glycol or other liquid, a container of glass beads, aluminum block or nearly any other media the user feels appropriate. The purpose of the buffer is to simulate the experience of the stored product rather than the air temperature. Obviously, this mission will not be accomplished to the extent that the physical buffer is not matched to the thermal properties of the stored product and its container. Cold chain managers are faced with a complex problem if they attempt to take this issue into account. Furthermore, a match is not possible with a single physical buffer when the cold storage unit contains different products or size containers. This paper quantifies the results of this mismatch from various factors and suggests possible solutions to this dilemma.   Type: Original Researc

Improving Vaccine Safety by Using an Algorithmic Model as a Replacement for a Physical Thermal Buffer

Conventional practice in vaccine storage is to insert a temperature probe into a bottle of glycol, or another equivalent thermal buffer medium, to simulate the temperature experience of the stored vaccine, rather than just the air temperature.  Such a thermal buffer is intended to reduce false alarms so that the drug manager will know with higher confidence that a temperature alert is an event requiring action. While necessary and appropriate to correctly monitor the storage conditions, it is a practice that is messy, inconvenient, and costly, and can result in reports that diverge from the actual experience of the stored inventory.  This paper explores the use of a mathematical algorithm to reproduce the behavior of a physical thermal buffer medium. The paper describes the algorithm and reports the degree to which it accurately simulates the experience of a 20-ml glycol container. The algorithm is shown to be highly predictive of the temperatures measured inside a container containing glycol

Harvesting Empowerment

IMPACT. 1: 52 clients served over 12 months. -- 2. Exposure to healthy foods including eggplant, squash, tomatoes, peppers, lettuce, greens, cucumbers, beets, and strawberries -- 3. Skill groups in healthy eating, managing boredom, social participation, defining health, and exercise.COMMUNITY PARTNERS: Redmond House of Southeast, Inc. is a therapeutic transitional home for men with severe and persistent mental illness.PRIMARY CONTACT: Maggie Rusnack, Kim Zwissler ([email protected] )Harvesting Empowerment is designed to facilitate healthy habits in men with mental illness through participation in a vegetable garde

Exploring Medical Student Experiences of Trauma in the Emergency Department: Opportunities for Trauma-informed Medical Education

PURPOSE: During the third-year emergency medicine (EM) clerkship, medical students are immersed in traumatic incidents with their patients and clinical teams. Trauma-informed medical education (TIME) applies trauma-informed care (TIC) principles to help students manage trauma. We aimed to qualitatively describe the extent to which students perceived the six TIME domains as they navigated critical incidents during their EM clerkship. METHODS: We employed a constructivist, modified grounded theory approach to explore medical students\u27 experiences. We used the critical incident technique to elicit narratives to better understand the six TIME domains as they naturally appear in the clerkship. Participants were asked to describe a traumatic incident they experienced during the clerkship, followed by the clerkship\u27s role in helping them manage the incident. Using the framework method, transcripts were analyzed 1) deductively by matching transcript excerpts to relevant TIME domains and 2) inductively by generating de novo themes to capture factors that affected students\u27 handling of trauma during critical incidents. RESULTS: Twelve participants were enrolled and interviewed in July 2022. Safety was the most frequently described TIME domain, whereas Gender, Cultural, and Historical issues and Peer Support were discussed least. Inductive analysis revealed themes that hindered or supported their ability to manage traumatic experiences, which were grouped into three categories: 1) student interactions with the learning environment: complex social determinants of health, inequalities in care, and overt discrimination; 2) student interactions with patients: ethically ambiguous care, witnessing acute patient presentations, and reactivation of past trauma; and 3) student interactions with supervisors: power dynamics, invalidation of contributions, role-modeling, and student empowerment. CONCLUSION: The six TIME domains are represented in students\u27 perceptions of immediate, stressful critical incidents during their EM clerkship, with Safety being the most commonly described; however, the degree to which these domains are supported in students\u27 experiences of the EM clerkship differ, and instances of inadequately experienced domains may contribute to student distress. Understanding the EM clerkship through the specific lens of students\u27 experiences of trauma may be an effective strategy to guide curricular changes that promote a supportive learning environment for students in the emergency department

Intolerance of Uncertainty and Attitudes Towards Persons Living with Disabilities in Medical Students: Is There a Correlation?

INTRODUCTION: Patients living with a disability experience an illness trajectory that may be uncertain. While navigating clinical uncertainty has been well-researched, health professionals\u27 intolerance of uncertainty for patients living with disabilities has yet to be explored. We examined the relationship between medical students\u27 intolerance of uncertainty with their attitudes towards people living with disabilities to better inform curricular efforts. METHODS: We employed a survey-based design consisting of the Intolerance of Uncertainty Scale (IUS) and Disability Attitudes in Healthcare (DAHC) Scale to medical students upon completion of core clerkships (end of third-year of training). Data were de-identified. Mean DAHC and IUS scores were compared with published values RESULTS: Response rate was 97% (268/275 students). Mean IUS score did not differ from previously cited medical student scores, but mean DAHC score was significantly higher than previously cited scores. We observed a statistically-significant relationship between IUS and DAHC scores. Students with greater intolerance of uncertainty had lower scores for disability attitudes [ CONCLUSION: We identified a weak negative correlation between IUS and DAHC scores in medical students. Further research is needed to clarify findings and identify best practices that equip trainees with skills to care for patients with uncertain illness trajectories and patients living with disabilities

Lifestyle impact and the biology of the human scrotum

The possession of a scrotum to contain the male gonads is a characteristic feature of almost all mammals, and appears to have evolved to allow the testes and epididymis to be exposed to a temperature a few degrees below that of core body temperature. Analysis of cryptorchid patients, and those with varicocele suggest that mild scrotal warming can be detrimental to sperm production, partly by effects on the stem cell population, and partly by effects on later stages of spermatogenesis and sperm maturation. Recent studies on the effects of clothing and lifestyle emphasize that these can also lead to chronically elevated scrotal temperatures. In particular, the wearing of nappies by infants is a cause for concern in this regard. Together all of the evidence indirectly supports the view that lifestyle factors in addition to other genetic and environmental influences could be contributing to the secular trend in declining male reproductive parameters. The challenge will be to provide relevant and targeted experimental results to support or refute the currently circumstantial evidence.Richard Ivel