Homelessness and housing stress among police detainees: results from the DUMA program

This research reaffirms the need for intensive accommodation support services to complement criminal justice responses to crime and those who have contact with the criminal justice system. Foreword It is generally accepted that a person’s living situation, in particular their experience of homelessness and housing stress, can have both long-lasting and wide-ranging consequences. For criminal justice practitioners, the task of limiting homelessness and preventing crime remain key policy priorities in need of ongoing and integrated research. This paper provides a much needed examination of homelessness and housing stress among Australia’s criminal justice population. Using data from the AIC’s Drug Use Monitoring in Australia program, this study examines the prevalence and nature of homelessness among a sample of police detainees. It is the first of its kind to examine a broader range of homelessness experiences and the reasons why some offenders have few choices but to ‘sleep rough’ or seek accommodation support. Importantly, the authors estimate that 22 percent of the detainee population is homeless or experiencing housing stress in some form; much higher than has been previously estimated. This research reaffirms the need for intensive accommodation support services to complement criminal justice responses to crime and those who have contact with the criminal justice system

Quantifying bacterial transfer from patients to staff during burns dressing and bed changes : implications for infection control

Routine nursing activities such as dressing/bed changes increase bacterial dispersal from burns patients, potentially contaminating healthcare workers (HCW) carrying out these tasks. HCW thus become vectors for transmission of nosocomial infection between patients. The suspected relationship between %total body surface area (%TBSA) of burn and levels of bacterial release has never been fully established. Bacterial contamination of HCW was assessed by contact plate samples (n = 20) from initially sterile gowns worn by the HCW during burns patient dressing/bed changes. Analysis of 24 gowns was undertaken and examined for relationships between %TBSA, time taken for activity, and contamination received by the HCW. Relationships between size of burn and levels of HCW contamination, and time taken for the dressing/bed change and levels of HCW contamination were best described by exponential models. Burn size correlated more strongly (R2 = 0.82, p < 0.001) than time taken (R2 = 0.52, p < 0.001), with levels of contamination received by the HCW. Contamination doubled with every 6–9% TBSA increase in burn size. Burn size was used to create a model to predict bacterial contamination received by a HCW carrying out bed/dressing changes. This may help with the creation of burn-specific guidelines on protective clothing worn by HCW caring for burns patients

Clinical studies of the high-intensity narrow-spectrum light environmental decontamination system (HINS-light EDS), for continuous disinfection in the burn unit inpatient and outpatient settings

Infections are the leading cause of morbidity and mortality in burn patients and prevention of contamination from exogenous sources including the hospital environment is becoming increasingly emphasised. The High-Intensity Narrow-Spectrum light Environmental Decontamination System (HINS-light EDS) is bactericidal yet safe for humans, allowing continuous disinfection of the environment surrounding burn patients. Environmental samples were collected from inpatient isolation rooms and the outpatient clinic in the burn unit, and comparisons were then made between the bacterial contamination levels observed with and without use of the HINS-light EDS. Over 1000 samples were taken. Inpatient studies, with sampling carried out at 0800 h, demonstrated a significant reduction in the average number of bacterial colonies following HINS-light EDS use of between 27% and 75%, (p<0.05). There was more variation when samples were taken at times of increased activity in the room. Outpatient studies during clinics demonstrated a 61% efficacy in the reduction of bacterial contamination on surfaces throughout the room during the course of a clinic (p=0.02). The results demonstrate that use of the HINS-light EDS allows efficacious bacterial reductions over and above that achieved by standard cleaning and infection control measures in both inpatient and outpatient settings in the burn unit

Structuring as an Aid to Performance in Base-Rate Problems

41 pagesFour groups of college students were each given two base-rate problems. Three of the groups were given an aid with the first problem: (a) An instruction to list factors or aspects that were relevant to solving the problem, (b) a fill-in-the-blank algorithm that provided the correct solution, or (c) a seven-page tutorial that explained base-rate problems and showed how to solve them using a 2 x 2 table. No aid was provided for the second problem. The control group replicated previous findings in disregarding the base-rate information. The "list factors" group showed no improvement over the control group. The algorithm group showed distinctly better performance for the first problem but were the same as the control group for the second problem. The tutorial group did best: 42% of answers to the first problem and 31% of answers to the second problem were within+ .10 of the correct answer. An error analysis identified a conceptual weakness in the tutorial; a high rate of arithmetic errors was also found. College students appear to lack the knowledge needed to solve base-rate problems but they can be taught this knowledge relatively easily

Airborne bacterial dispersal during and after dressing and bed changes on burns patients

It is acknowledged that activities such as dressing changes and bed sheet changes are high-risk events; creating surges in levels of airborne bacteria. Burns patients are particularly high dispersers of pathogens; due to their large, often contaminated, wound areas. Prevention of nosocomial cross-contamination is therefore one of the major challenges faced by the burns team. In order to assess the contribution of airborne spread of bacteria, air samples were taken repeatedly throughout and following these events, to quantify levels of airborne bacteria. Air samples were taken at 3-min intervals before, during and after a dressing and bed change on a burns patient using a sieve impaction method. Following incubation, bacterial colonies were enumerated to calculate bacterial colony forming units per m3 (cfu/m3) at each time point. Statistical analysis was performed, whereby the period before the high-risk event took place acted as a control period. The periods during and after the dressing and bed sheet changes were examined for significant differences in airborne bacterial levels relative to the control period. The study was carried out four times, on three patients with burns between 35% total burn surface area (TBSA) and 51% TBSA. There were significant increases in airborne bacteria levels, regardless of whether the dressing change or bed sheet change took place first. Of particular note, is the finding that significantly high levels (up to 2614 cfu/m3) of airborne bacteria were shown to persist for up to approximately 1 h after these activities ended. This is the most accurate picture to date of the rapidly changing levels of airborne bacteria within the room of a burns patient undergoing a dressing change and bed change. The novel demonstration of a significant increase in the airborne bacterial load during these events has implications for infection control on burns units. Furthermore, as these increased levels remained for approximately 1 h afterwards, persons entering the room both during and after such events may act as vectors of transmission of infection. It is suggested that appropriate personal protective equipment should be worn by anyone entering the room, and that rooms should be quarantined for a period of time following these events

Categorical Confidence

29 pagesPeople tend to be inadequately sensitive to the extent of their own knowledge. This insensitivity typically emerges as overconfidence. That is, people's assessments of the probability of having answered questions correctly are typically too high compared to the portion of questions they get right. Few debiasing procedures have proven effective against this problem. Those that have worked seem to be directive in character. Rather than improving subjects' feeling for how much they know, such procedures may have suggested to subjects how their probability assessments should be changed. These successful manipulations include giving feedback and requiring subjects to provide reasons contradicting their chosen answers. The present study attempted to improve the appropriateness of confidence with a nondirective method. Subjects were asked to sort items into a specified number of piles according to their confidence in the correctness of their answers. Subsequently, they assigned a number to each pile expressing the probability that each item in the pile was correct. It emphasizes confidence assessment over fact assessment; it forces the comparison of knowledge levels for different questions, it deemphasizes the need to produce numbers; it gives different hints as to the fineness of the discrimination that assessors can make. This procedure differed from its predecessors in many respects; nonetheless, performance here was indistinguishable from that observed elsewhere. Although some small pockets of improvement were noted, confidence was largely resistant to this manipulation. Such robustness is discouraging for the developer of elicitation procedures, encouraging for the student of judgmental processes

The Associations of Cancer’s Financial Stress on the Patient-Caregiver Dyad’s Sleep and Psychological Well-Being

https://openworks.mdanderson.org/sumexp23/1037/thumbnail.jp

ALMA 1.3 Millimeter Map of the HD 95086 System

Planets and minor bodies such as asteroids, Kuiper-belt objects and comets are integral components of a planetary system. Interactions among them leave clues about the formation process of a planetary system. The signature of such interactions is most prominent through observations of its debris disk at millimeter wavelengths where emission is dominated by the population of large grains that stay close to their parent bodies. Here we present ALMA 1.3 mm observations of HD 95086, a young early-type star that hosts a directly imaged giant planet b and a massive debris disk with both asteroid- and Kuiper-belt analogs. The location of the Kuiper-belt analog is resolved for the first time. The system can be depicted as a broad ($\Delta R/R \sim$0.84), inclined (30\arcdeg$\pm$3\arcdeg) ring with millimeter emission peaked at 200$\pm$6 au from the star. The 1.3 mm disk emission is consistent with a broad disk with sharp boundaries from 106$\pm$6 to 320$\pm$20 au with a surface density distribution described by a power law with an index of --0.5$\pm$0.2. Our deep ALMA map also reveals a bright source located near the edge of the ring, whose brightness at 1.3 mm and potential spectral energy distribution are consistent with it being a luminous star-forming galaxy at high redshift. We set constraints on the orbital properties of planet b assuming co-planarity with the observed disk.Comment: accepted for publication in A

Cardiovascular risk factors associated with polymyalgia rheumatica and giant cell arteritis in a prospective cohort: EPIC-Norfolk Study.

OBJECTIVES: PMR and GCA are associated with increased risk of vascular disease. However, it remains unclear whether this relationship is causal or reflects a common underlying propensity. The aim of this study was to identify whether known cardiovascular risk factors increase the risk of PMR and GCA. METHODS: Clinical records were examined using key word searches to identify cases of PMR and GCA, applying current classification criteria in a population-based cohort. Associations between cardiovascular risk factors and incident PMR and GCA were analysed using Cox proportional hazards. RESULTS: In 315 022 person years of follow-up, there were 395 incident diagnoses of PMR and 118 incident diagnoses of GCA that met the clinical definition. Raised diastolic blood pressure (>90 mmHg) at baseline/recruitment was associated with subsequent incident PMR [hazard ratio=1.35 (95% CI 1.01, 1.80) P=0.045], and ever-smoking was associated with incident GCA [hazard ratio=2.01 (95% CI 1.26, 3.20) P=0.003]. Estimates were similar when the analysis was restricted to individuals whose diagnoses satisfied the current classification criteria sets. CONCLUSION: PMR and GCA shares common risk factors with vascular disease onset, suggesting a common underlying propensity. This may indicate a potential for disease prevention strategies through modifying cardiovascular risk