Creating a Culture of Courage: A Behavioral Health Study of Resilience and Response to Traumatic Events for Firefighters

Firefighters experience a variety of challenging situations and traumatic events while performing necessary job duties as public servants, which can create behavioral health concerns and even suicide ideation. The purpose of this study is to recognize how individual resilience relates to lived experiences for firefighters who may need next-level behavioral healthcare, which in turn, will identify higher “at risk” firefighters with suicide ideation who need increased mental and emotional care outside of peer interventions. The fundamental question centers on what role does individual resilience, as well as formal and informal resources of behavioral health support, play in mitigating the impact of traumatic events? This study utilized qualitative research, specifically Interpretive Phenomenological Analysis, to identify how firefighters make meaning of resilience as it relates to lived experiences associated as a firefighter. Through direct observation interviews, analysis of the recorded data, descriptive, linguistic, and conceptual coding associations, and data-driven results, firefighters will provide the essence of their experiences in relation to individual resilience, post-traumatic stress symptoms, and suicide ideation while filling gaps in already conducted research within the fire service. Six themes emerged that will foster cultural change for firefighter behavioral health initiatives such as a tiered support plan, educative initiatives, intentional leadership actions, communicative resources, normalizing the symptomatic response as much as the event, and the need for a caring community for firefighters. Limitations of research design entail time constraints for a longitudinal study

Economic Model Predictive Control for Variable Refrigerant Systems

Variable refrigerant (VRF) systems are in a unique position to be combined with economic model predictive control (MPC) in order to reap significant benefits. In buildings with a variable utility price, it is feasible to use the building mass to shift a portion of the building heating, ventilation, and air conditioning (HVAC) load from the high priced (peak) period to the low priced (off-peak) period. It is also feasible for further savings to be visualized through a reduction of the monthly demand charge. By employing the building mass as an element to store thermal energy, one can see a significant reduction in utility costs. The MPC algorithm can accomplish this by using the building mass to store and release heat at the appropriate time to reduce HVAC usage during the peak utility price periods. This is accomplished through MPC of the indoor air temperature within the acceptable temperature set point limits. With proper, linear models, a linear programming (LP) algorithm can be employed to perform the economic optimization over the future time horizon. Savings in commercial buildings estimate HVAC cost savings from --% to --% annually

Habitat Utilization of Blackfin Tuna, Thunnus atlanticus, in the North-Central Gulf of Mexico

Short-duration (9.5–, 18-, and 28.5-day) deployments of pop-up satellite archival tags (PSATs) on blackfin tuna, Thunnus atlanticus Lesson 1831, were used to evaluate the applicability of external electronic tags on small tunas. Ten tunas (71.1-86.4 cm FL) were tagged in the northern Gulf of Mexico in April 2012 after being caught on typical recreational fishing gear. PSATs recorded point measurements of temperature, pressure (depth), and light level every 90 s (n = 2 tags, deployment duration 9.5 days), 180 s (n = 4, duration 19 days), or 270 s (n = 4, duration 28.5 days). Nine fish survived for their respective full deployment periods; one fish died after only 5 h following release. Depths ranged from 0–217 m with a mean of 28 m (SD = 8.38 m) and temperatures ranged from 13.9–32.9 °C with a mean of 23.8 °C (SD = 1.3 °C) for all nine archived records. The nine blackfin spent 90 % of their time in depths from 0–57 m and 89 % of their time in temperatures from 21.9–26.6 °C. Over 87 % of the movements in the water column, either ascending or descending, were less than 12 m differences in depth between sequential short-duration data sampling. With appropriate concern regarding the matching of fish and PSAT sizes, these results suggest that external tags with fishery-independent reporting capabilities are an available option for smaller tuna species

Identification and characterisation of enteroaggregative Escherichia coli subtypes associated with human disease

Enteroaggregative E. coli (EAEC) are a major cause of diarrhoea worldwide. Due to their heterogeneity and carriage in healthy individuals, identification of diagnostic virulence markers for pathogenic strains has been difficult. In this study, we have determined phenotypic and genotypic differences between EAEC strains of sequence types (STs) epidemiologically associated with asymptomatic carriage (ST31) and diarrhoeal disease (ST40). ST40 strains demonstrated significantly enhanced intestinal adherence, biofilm formation, and pro-inflammatory interleukin-8 secretion compared with ST31 isolates. This was independent of whether strains were derived from diarrhoea patients or healthy controls. Whole genome sequencing revealed differences in putative virulence genes encoding aggregative adherence fimbriae, E. coli common pilus, flagellin and EAEC heat-stable enterotoxin 1. Our results indicate that ST40 strains have a higher intrinsic potential of human pathogenesis due to a specific combination of virulence-related factors which promote host cell colonization and inflammation. These findings may contribute to the development of genotypic and/or phenotypic markers for EAEC strains of high virulence

Dimensões ecológicas do controle e gerenciamento de doenças transmitidas por vetores

The paper explores the ecological dimension of vector-borne diseases in order to clarify the role of "ecological thinking" in the development and implementation of vector control activities. It traces some anthropogenic factors in research, and reviews a systems ecology of dengue and Chagas disease. Vector-borne diseases are essentially ecological problems that span biophysical, social, and economic environments. The paper views the ecological dimension as a unifying element that can provide direction in research, with a holistic perspective important for all participants/stakeholders involved

Mechanical Characterization and Micromechanical Modeling of Woven Carbon/Copper Composites

The present investigation examines the in-plane mechanical behavior of a particular woven metal matrix composite (MMC); 8-harness (8H) satin carbon/copper (C/Cu). This is accomplished via mechanical testing as well as micromechanical modeling. While the literature is replete with experimental and modeling efforts for woven and braided polymer matrix composites, little work has been done on woven and braided MMC's. Thus, the development and understanding of woven MMC's is at an early stage. 8H satin C/Cu owes its existence to the high thermal conductivity of copper and low density and thermal expansion of carbon fibers. It is a candidate material for high heat flux applications, such as space power radiator panels. The experimental portion of this investigation consists of monotonic and cyclic tension, compression, and Iosipescu shear tests, as well as combined tension-compression tests. Tests were performed on composite specimens with three copper matrix alloy types: pure Cu, Cu-0.5 weight percent Ti (Cu-Ti), and Cu-0.7 weight percent Cr (Cu-Cr). The small alloying additions are present to promote fiber/matrix interfacial bonding. The analytical modeling effort utilizes an approach in which a local micromechanical model is embedded in a global micromechanical model. This approach differs from previously developed analytical models for woven composites in that a true repeating unit cell is analyzed. However, unlike finite element modeling of woven composites, the geometry is sufficiently idealized to allow efficient geometric discretization and efficient execution

Seroprevalence of simian immunodeficiency virus in wild and captive born Sykes' monkeys (Cercopithecus mitis) in Kenya

BACKGROUND: The Sykes' monkey and related forms (Cercopithecus mitis) make up an abundant, widespread and morphologically diverse species complex in eastern Africa that naturally harbors a distinct simian immunodeficiency virus (SIVsyk). We carried out a retrospective serological survey of SIV infection from both wild and captive Sykes' monkeys from Kenya. We compared two commercially available, cross-reactive ELISA tests using HIV antigens with a novel SIVsyk antigen-specific Western blot assay and analyzed the data by origin, subspecies, age and sex. RESULTS: The SIVsyk antigen-specific Western blot assay detected more serum samples as positive than either of the cross-reactive ELISA assays. Using this assay, we found that seroprevalence is higher than previously reported, but extremely variable in wild populations (from 0.0 to 90.9%). Females were infected more often than males in both wild and captive populations. Seropositive infants were common. However, no seropositive juveniles were identified. CONCLUSION: We have developed a specific and sensitive Western blot assay for anti-SIVsyk antibody detection. Sykes' monkeys are commonly infected with SIVsyk, but with extremely variable prevalence in the wild. Higher infection prevalence in females suggests predominantly sexual transmission. High infection prevalence in infants, but none in juveniles, suggests maternal antibodies, but little or no vertical transmission

Cost-effectiveness of continuous glucose monitoring and intensive insulin therapy for type 1 diabetes

<p>Abstract</p> <p>Background</p> <p>Our objective was to determine the cost-effectiveness of Continuous Glucose Monitoring (CGM) technology with intensive insulin therapy compared to self-monitoring of blood glucose (SMBG) in adults with type 1 diabetes in the United States.</p> <p>Methods</p> <p>A Markov cohort analysis was used to model the long-term disease progression of 12 different diabetes disease states, using a cycle length of 1 year with a 33-year time horizon. The analysis uses a societal perspective to model a population with a 20-year history of diabetes with mean age of 40. Costs are expressed in $US 2007, effectiveness in quality-adjusted life years (QALYs). Parameter estimates and their ranges were derived from the literature. Utility estimates were drawn from the EQ-5D catalogue. Probabilities were derived from the Diabetes Control and Complications Trial (DCCT), the United Kingdom Prospective Diabetes Study (UKPDS), and the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Costs and QALYs were discounted at 3$23,552, resulting in an ICER of approximately $45,033/QALY. For a willingness-to-pay (WTP) of$100,000/QALY, CGM with intensive insulin therapy was cost-effective in 70% of the Monte Carlo simulations.</p> <p>Conclusions</p> <p>CGM with intensive insulin therapy appears to be cost-effective relative to SMBG and other societal health interventions.</p

Identification and characterisation of enteroaggregative Escherichia coli subtypes associated with human disease

Enteroaggregative E. coli (EAEC) are a major cause of diarrhoea worldwide. Due to their heterogeneity and carriage in healthy individuals, identification of diagnostic virulence markers for pathogenic strains has been difficult. In this study, we have determined phenotypic and genotypic differences between EAEC strains of sequence types (STs) epidemiologically associated with asymptomatic carriage (ST31) and diarrhoeal disease (ST40). ST40 strains demonstrated significantly enhanced intestinal adherence, biofilm formation, and pro-inflammatory interleukin-8 secretion compared with ST31 isolates. This was independent of whether strains were derived from diarrhoea patients or healthy controls. Whole genome sequencing revealed differences in putative virulence genes encoding aggregative adherence fimbriae, E. coli common pilus, flagellin and EAEC heat-stable enterotoxin 1. Our results indicate that ST40 strains have a higher intrinsic potential of human pathogenesis due to a specific combination of virulence-related factors which promote host cell colonization and inflammation. These findings may contribute to the development of genotypic and/or phenotypic markers for EAEC strains of high virulence