Ready or Not? Protecting the Public's Health in the Age of Bioterrorism, 2004

Examines ten key indicators to evaluate state preparedness to respond to bioterrorist attacks and other public health emergencies. Evaluates the federal government's role and performance, and offers recommendations for improving readiness

F as in Fat: How Obesity Policies Are Failing in America, 2004

Examines national and state obesity rates and government policies. Focuses on setting a baseline of current policies and programs, and offers a comprehensive look at their range and quality

F as in Fat: How Obesity Policies Are Failing in America, 2005

Examines national and state obesity rates and government policies. Challenges the research community to focus on major research questions to inform policy decisions, and policymakers to pursue actions to combat the obesity crisis

Establishing an evidenced-based dietetic model of care in haemodialysis using implementation science

To establish an evidence-based dietetics service in an in-centre haemodialysis unit utilising implementation science.The service was developed through the Knowledge-to-Action Framework. The steps of the Action Cycle were addressed through a literature review, identification of evidence-based guidelines, benchmarking and local staff engagement. The theoretical domains framework (TDF) was used to identify barriers/enablers, and behaviour change wheel to determine appropriate interventions. To monitor, evaluate outcomes and assess sustained knowledge use we employed multidisciplinary team engagement and database use. Audit data were collected at baseline, 6 and 12 months on nutrition assessment (Patient-Generated Subjective Global Assessment), intervention timeliness and alignment to dietetic workforce recommendations. Descriptive statistics, McNemar tests and a linear mixed model were applied.Barriers existed in the knowledge, skills, environmental context and resources TDF domains. Suitable interventions were identified with training on nutritional management of haemodialysis patients delivered to 148 nurses, and nutrition management recommendations summarised into local procedural resources. A database to prompt and monitor outcome measures was created and indicated that over 18 months post-service commencement, eligible patients received nutrition assessment at least 6-monthly, aligning with recommendations. Prevalence of malnutrition was 28% (n = 9/32) at baseline, 23% (n = 5/22) at 6 months and 20% (n = 4/20) at 12 months (P = 0.50).We demonstrated benefits to service development and implementation with implementation science providing a structured and methodical approach to translating guidelines into practice. Development of training, resources and prompts for outcome measures has supported the establishment of an evidence-based dietetics service in a haemodialysis unit

STR-997: INSTRUMENTATION AND LONG-TERM MONITORING OF AN INTEGRAL-ABUTMENT BRIDGE SUPERSTRUCTURE

Strain gauges were installed in the girders and deck of an integral abutment bridge to determine the behaviour of the superstructure to daily and seasonal thermal fluctuations. The two-span, 76 m-long bridge has no expansion joints; rather, the prestressed-concrete girders are cast directly into the abutments which are in turn supported by flexible pile foundations. Details of field instrumentation along with monitored data over a period of eight years are presented in this paper. Gauges measured the longitudinal strain in the girders and deck and were positioned at different elevations to provide a strain distribution across the superstructure depth. From the strain data, moments were computed at each of the installation locations. Data indicate that the superstructure responds to thermal fluctuations as expected with midspan moments smaller in magnitude when compared to the moments measured at the abutment and pier locations. Furthermore, data confirm that the level of sun exposure affects the thermally-induced moments measured in the girders

Estimativa quantitativa da resposta à clortetraciclina em um caso grave de disenteria por Balantidium coli

Feita uma tentativa de determinar a eficácia terapêutica da clortetraciclina em um caso grave de disenteria por Balantidium. Foram feitas várias estimativas da população de trofozoitos de Balantidium, a partir de fezes de 24 horas, antes e durante o tratamento de 4 dias com a droga. Houve uma redução marcante no número de parasitas eliminados durante o tratamento, associada a uma melhora clínica significativa nas condições da paciente.The therapeutic efficiency of chlortetracyclines for the treatment of Balantidial dysentery was tested in a Yanomama indian. Parasite counts were made on 24 hour samples of the patient's faeces, before treatment and on the third and fourth day of treatment. A marked reduction in parasite counts was seen during treatment associated with an improvement in the patient's condition

Computer processing support, volume 4

There are no author-identified significant results in this report

Liver transplant recipients’ experiences and perspectives of a telehealth-delivered lifestyle programme A qualitative study

Introduction Dietary modification and exercise are encouraged to address cardiometabolic risk factors after solid organ transplantation. However, the lived experience of attempting positive lifestyle changes for liver transplant recipients is not known. The aim of this study was to explore the experiences of liver transplant recipients and their perspectives of a 12-week telehealth lifestyle programme and assess the feasibility of this innovative health service. Methods Focus groups and one-on-one interviews were conducted with participants who had completed a 12-week, group-based, telehealth-delivered diet and exercise programme and thematic qualitative analysis was used to code and theme the data. Results In total, 19 liver transplant recipients participated in the study (25-68 years, median time since transplant 4.4 years, 63% male). Overarching themes included: (a) 'broad telehealth advantages' which highlighted that telehealth reduced the perceived burdens of face-to-face care; (b) 'impact of employment' which identified employment as a competing priority and appeared to effect involvement with the programme; (c) 'adapting Mediterranean eating pattern to meet individual needs' which identified the adaptability of the Mediterranean diet supported by sessions with the dietitian; (d) 'increasing exercise confidence' which recognised that a tailored approach facilitated confidence and acceptability of the exercise component of the programme. Discussion A telehealth lifestyle programme delivered by dietitians and exercise physiologists is an acceptable alternative to face-to-face care that can meet the needs of liver transplant recipients. There is a need to further innovate and broaden the scope of routine service delivery beyond face-to-face consultations