Employee Influenza Immunization: Education and a Directive to Increase Immunization Rates

Purpose: The aim of this quality improvement project was to improve the influenza vaccination rate of health care workers at an ambulatory care center to meet the national benchmark of 90%. Background: Influenza is a communicable disease that affects over 130,000 people causing 7,000 deaths (CDC, 2017b). Over the last 3 years the influenza immunization rates at the facility of interest have been on a downward trend despite multiple interventions, resulting in 43% last season. A directive was published at the beginning of the 2017-2018 influenza season mandating each employee to either get a vaccine or decline in writing. This directive resulted in a formal grievance filed by the union causing a delay in enforcement. Methods: An intense effort to improve the immunization rate was undertaken in collaboration with the Occupational Health employees. Staff were educated with a script that would be utilized for employees who declined the influenza immunization. Employees who were not immunized by week 1 of the project were tracked by the Occupational Health team for directive adherence and provide face-to-face communication to encourage immunization. Results: At the end of the influenza season the health care immunization rate increased to 86% (n = 883) Conclusion: Having a one-on-one interaction with individuals who had not made an immunization decision provided the opportunity for education and administration of the immunization if desired. With increased compliance, documentation, and education the project obtained overall success despite unexpected challenges

Effect of Dairy Beef Quality Assurance Training on Dairy Worker Knowledge and Welfare-Related Practices

A study was conducted to determine whether on-farm dairy beef quality assurance (BQA) training affected dairy worker knowledge of BQA and welfare-related practices. Dairy personnel who participated in the BQA training were administered an exam before and after the training to gauge the amount of knowledge gained. The average exam score was 21.0 points higher after the training, increasing from 54.4 to 75.4. Improvement in dairy worker knowledge suggests that BQA training programs have the potential to positively influence the dairy industry through the education of dairy owners and workers on BQA and welfare-related practices

Methodological heterogeneity biases physical activity metrics derived from the Actigraph GT3X in multiple sclerosis: A rapid review and comparative study

BACKGROUND Physical activity (PA) is reduced in persons with multiple sclerosis (MS), though it is known to aid in symptom and fatigue management. Methods for measuring PA are diverse and the impact of this heterogeneity on study outcomes is unclear. We aimed to clarify this impact by comparing common methods for deriving PA metrics in MS populations. METHODS First, a rapid review of existing literature identified methods for calculating PA in studies which used the Actigraph GT3X in populations with MS. We then compared methods in a prospective study on 42 persons with MS [EDSS 4.5 (3.5-6)] during a voluntary course of inpatient neurorehabilitation. Mixed-effects linear regression identified methodological factors which influenced PA measurements. Non-parametric hypothesis tests, correlations, and agreement statistics assessed overall and pairwise differences between methods. RESULTS In the rapid review, searches identified 421 unique records. Sixty-nine records representing 51 eligible studies exhibited substantial heterogeneity in methodology and reporting practices. In a subsequent comparative study, multiple methods for deriving six PA metrics (step count, activity counts, total time in PA, sedentary time, time in light PA, time in moderate to vigorous PA), were identified and directly compared. All metrics were sensitive to methodological factors such as the selected preprocessing filter, data source (vertical vs. vector magnitude counts), and cutpoint. Additionally, sedentary time was sensitive to wear time definitions. Pairwise correlation and agreement between methods varied from weak (minimum correlation: 0.15, minimum agreement: 0.03) to perfect (maximum correlation: 1.00, maximum agreement: 1.00). Methodological factors biased both point estimates of PA and correlations between PA and clinical assessments. CONCLUSIONS Methodological heterogeneity of existing literature is high, and this heterogeneity may confound studies which use the Actigraph GT3X. Step counts were highly sensitive to the filter used to process raw accelerometer data. Sedentary time was particularly sensitive to methodology, and we recommend using total time in PA instead. Several, though not all, methods for deriving light PA and moderate to vigorous PA yielded nearly identical results. PA metrics based on vertical axis counts tended to outperform those based on vector magnitude counts. Additional research is needed to establish the relative validity of existing methods

Non-equivalent, but still valid: Establishing the construct validity of a consumer fitness tracker in persons with multiple sclerosis

Tools for monitoring daily physical activity (PA) are desired by persons with multiple sclerosis (MS). However, current research-grade options are not suitable for longitudinal, independent use due to their cost and user experience. Our objective was to assess the validity of step counts and PA intensity metrics derived from the Fitbit Inspire HR, a consumer-grade PA tracker, in 45 persons with MS (Median age: 46, IQR: 40-51) undergoing inpatient rehabilitation. The population had moderate mobility impairment (Median EDSS 4.0, Range 2.0-6.5). We assessed the validity of Fitbit-derived PA metrics (Step count, total time in PA, time in moderate to vigorous PA (MVPA)) during scripted tasks and free-living activity at three levels of data aggregation (minute, daily, and average PA). Criterion validity was assessed though agreement with manual counts and multiple methods for deriving PA metrics via the Actigraph GT3X. Convergent and known-groups validity were assessed via relationships with reference standards and related clinical measures. Fitbit-derived step count and time in PA, but not time in MVPA, exhibited excellent agreement with reference measures during scripted tasks. During free-living activity, step count and time in PA correlated moderately to strongly with reference measures, but agreement varied across metrics, data aggregation levels, and disease severity strata. Time in MVPA weakly agreed with reference measures. However, Fitbit-derived metrics were often as different from reference measures as reference measures were from each other. Fitbit-derived metrics consistently exhibited similar or stronger evidence of construct validity than reference standards. Fitbit-derived PA metrics are not equivalent to existing reference standards. However, they exhibit evidence of construct validity. Consumer-grade fitness trackers such as the Fitbit Inspire HR may therefore be suitable as a PA tracking tool for persons with mild or moderate MS

ΔNp63 transcriptionally regulates ATM to control p53 Serine-15 phosphorylation

Background: Delta Np63 alpha is an epithelial progenitor cell marker that maintains epidermal stem cell self-renewal capacity. Previous studies revealed that UV-damage induced p53 phosphorylation is confined to Delta Np63 alpha-positive cells in the basal layer of human epithelium. Results: We now report that phosphorylation of the p53 tumour suppressor is positively regulated by Delta Np63 alpha in immortalised human keratinocytes. Delta Np63 alpha depletion by RNAi reduces steady-state ATM mRNA and protein levels, and attenuates p53 Serine-15 phosphorylation. Conversely, ectopic expression of Delta Np63 alpha in p63-null tumour cells stimulates ATM transcription and p53 Serine-15 phosphorylation. We show that ATM is a direct Delta Np63 alpha transcriptional target and that the Delta Np63 alpha response element localizes to the ATM promoter CCAAT sequence. Structure-function analysis revealed that the Delta Np63-specific TA2 transactivation domain mediates ATM transcription in coordination with the DNA binding and SAM domains. Conclusions: Germline p63 point mutations are associated with a range of ectodermal developmental disorders, and targeted p63 deletion in the skin causes premature ageing. The Delta Np63 alpha-ATM-p53 damage-response pathway may therefore function in epithelial development, carcinogenesis and the ageing processes

Alternatives to Pretrial Detention:Pre Global Best Practice Catalog

This Global Best Practice Catalog of Alternatives to Pretrial Detention was completed by students of the Master of Arts Degree Program in International Crime and Justice at John Jay College of Criminal Justice as part of their capstone course, in collaboration with the US State Department\u27s Diplomacy Lab program. This catalog is intended to cover best practices in reducing pretrial detention (either before it occurs or while it is occurring) across the globe, including laws, policies and programs. It does not include Oceania or very detailed information on North America. Each entry meets 5 of 8 criteria below, as decided by the students: 1. It respects human rights 2. It is affordable for the country\u27s budget 3. It is available to the majority of accused 4. It is definable: we know how the best practice works in context 5. It ensures public safety: no further crime or victimization occurs upon release from detention 6. It is verifiable: more than one source attests to it (it is not a recommendation - it really exists) 7. It is sustainable - it really works and it can self-subsist 8. It should not result in profits for private entities, beyond reasonable salaries Each entry includes: Title of the Practice Listing of the class best practice criteria that it meets (5 out of 8) Paragraph description of the practice, to include -how long it’s been in practice -what the main components of the best practice are -scope: local or national -who it affects -costs if available (how it’s funded) -who’s in charge of it (e.g. NGO/organizational structure) -any independent evaluations? -results -whether it has been exported elsewhere (used in another country) Links Bibliography Associated files are a series of case studies where student teams apply global best practice to selected countries. (El Salvador, Uruguay, Bangladesh, Ghana, Liberia and Macedonia.

The Grizzly, September 13, 2007

Ursinus Implements Swipe, Message Systems for Better Student Safety on Campus • Strassburger Goes to Dubai • Why Don\u27t You Escape Velocity? • Residence Life Sponsors Alcohol Education Program for Freshmen • Beyond the Condom: Guide to Safe Sex • Faculty Spotlight: Yoshitomo Yamashita • Wismer Hall: Too Hard to Handle? • Ursinus Recycling 101 • Opinions: Should We Lower the Drinking Age?; On Patriot Day • Rank \u27em • UC Volleyball Spikes to Success • Men\u27s Soccer Stumbles in Home Openerhttps://digitalcommons.ursinus.edu/grizzlynews/1742/thumbnail.jp

Polytraumatized patient lower extremity nonunion development: Raw data

In this article we report data collected to evaluate the pathomechanistic effect of acute anaerobic metabolism in the polytraumatized patient and its subsequent effect on fracture nonunion; see "Base Deficit ≥6 within 24 Hours of Injury is a Risk Factor for Fracture Nonunion in the Polytraumatized Patient" (Sardesai et al., 2021) [1]. Data was collected on patients age ≥16 with an Injury Severity Score (ISS) >16 that presented between 2013-2018 who sustained a fracture of the tibia or femur distal to the femoral neck. Patients presenting to our institution greater than 24 hours post-injury and those with less than three months follow-up were excluded. Medical charts were reviewed to collect patient demographic information and known nonunion risk-factors, including smoking, alcohol use, and diabetes. In addition, detailed injury characteristics to quantify injury magnitude including ISS, Glasgow Coma Scale (GCS) at admission, and ICU length of stay were recorded. ISS values were obtained from our institutional trauma database where they are entered by individuals trained in ISS calculations. Associated fracture-related features including fracture location, soft-tissue injury (open vs. closed fracture), vascular injury, and compartment syndrome were recorded. Finally, vital signs, base deficit (BD), and blood transfusions over 24 hours from admission were recorded. We routinely measure BD and less consistently measure serum lactate in trauma patients at the time of presentation or during resuscitation. BD values are automatically produced by our laboratory with any arterial blood gas order, and we recorded BD values from the medical record. Clinical notes and radiographs were reviewed to confirm fracture union versus nonunion and assess for deep infection at the fracture site. Patients were categorized as having a deep infection if they were treated operatively for the infection prior to fracture healing or classification as a nonunion. Nonunion was defined by failure of progressive healing on sequential radiographs and/or surgical treatment for nonunion repair at least six months post-injury