Feasibility of elementary school children’s use of hand gel and facemasks during influenza season

Please cite this paper as: Allison et al. (2010) Feasibility of elementary school children’s use of hand gel and facemasks during influenza season. Influenza and Other Respiratory Viruses 4(4), 223–229. Background The feasibility of non-pharmacologic interventions to prevent influenza’s spread in schools is not well known. Objectives To determine the acceptability of, adherence with, and barriers to the use of hand gel and facemasks in elementary schools. Patients and Methods Intervention: We provided hand gel and facemasks to 20 teachers and their students over 4 weeks. Gel use was promoted for the first 2 weeks; mask use was promoted for the second 2 weeks. Outcomes: Acceptability, adherence, and barriers were measured by teachers’ responses on weekly surveys. Mask use was also measured by observation. Results The weekly survey response rate ranged from 70% to 100%. Averaged over 2 weeks, 89% of teachers thought gel use was not disruptive (week 1 – 17/20, week 2 – 16/17), 95% would use gel next winter (week 1 – 19/20, week 2 – 16/17), and 97% would use gel in a pandemic (week 1 – 20/20, week 2 – 16/17). Averaged over 2 weeks, 39% thought mask use was not disruptive (week 1 – 6/17, week 2 – 6/14), 35% would use masks next winter (week 1 – 5/17, week 2 – 6/14), and 97% would use masks in a pandemic (week 1 – 16/17, week 2 – 14/14). About 70% estimated that their students used hand gel ≥4×/day for both weeks (week 1 – 14/20, week 2 – 13/17). Students’ mask use declined over time with 59% of teachers (10/17) estimating regular mask use during week 1 and 29% (4/14) during week 2. By observation, 30% of students wore masks in week 1, while 15% wore masks in week 2. Few barriers to gel use were identified; barriers to mask use were difficulty reading facial expressions and physical discomfort. Conclusions Hand gel use is a feasible strategy in elementary schools. Acceptability and adherence with facemasks was low, but some students and teachers did use facemasks for 2 weeks, and most teachers would use masks in their classroom in a pandemic.     

Very preterm birth is a risk factor for increased systolic blood pressure at a young adult age

Children born very prematurely who show intrauterine growth retardation (IUGR) are suggested to be at risk of developing high blood pressure as adults. Renal function may already be impaired by young adult age. To study whether very preterm birth affects blood pressure in young adults, we measured 24-h ambulatory blood pressure (Spacelabs™ 90207 device) and renin concentration in 50 very premature individuals (<32 weeks of gestation), either small (SGA) or appropriate (AGA) for gestational age (21 SGA, 29 AGA), and 30 full-term controls who all were aged 20 years at time of measurement. The mean (standard deviation) daytime systolic blood pressure in SGA and AGA prematurely born individuals, respectively, was 122.7 (8.7) and 123.1 (8.5) mmHg. These values were, respectively, 3.6 mmHg [95% confidence interval (CI) −0.9 to 8.0] and 4.2 mmHg (95% CI 0.4−8.0) higher than in controls [119.6 (7.6)]. Daytime diastolic blood pressure and nighttime blood pressure did not differ between groups. We conclude that individuals born very preterm have higher daytime systolic blood pressure and higher risk of hypertension at a young adult age.     

Impact of AAC Versus Verbal Modeling on Verbal Imitation,Picture Discrimination,and Related Speech: A Pilot Investigation

Delays in or lack of language development are a primary characteristic of autism. Thus, teachers, families and researchers face the challenge of determining which teaching strategies are most effective and efficient in addressing these communication deficits. This study attempts to add to the literature regarding this issue. A multi-treatment/multi-measure single-case design was used to compare the effects of the Picture Exchange Communication System (PECS) with a verbal modeling intervention on four communicative behaviors: (a) picture requests, (b) imitated verbalizations, (c) picture discrimination, and (d) any related speech for a 3 year old child with autism. Results indicated that the PECS training led to increases in picture requests and these results were maintained during the verbal modeling intervention phase. No change in imitated verbalizations was observed following either intervention. With respect to both picture discrimination and related speech, no significant results were achieved following PECS training or verbal modeling. However, during the verbal modeling phase the participant demonstrated a small increase in both picture discrimination and any related speech for both the PECS and verbal modeling item sets.     

Basal Cell Carcinoma Arising in a Cleft Lip Repair Scar

BACKGROUND: A case of basal cell carcinoma (BCC) developing in the repair scar of a cleft lip is presented. OBJECTIVE: Primary BCCs arising in surgical scars are very rare and no known reported cases exist of a BCC developing in a surgically repaired cleft lip scar. METHODS: A 69-year-old white man presented with a 5 mm primary BCC on his upper lip at the site of his cleft lip repair scar. The diagnosis was made by a tangential biopsy that showed an ulcerated BCC. RESULTS: Review of the medical literature indicates that a scar may be an independent risk factor for developing BCC. CONCLUSION: BCC may rarely arise in a cleft lip repair scar.     

Independent effects of residual renal function and dialysis adequacy on dietary micronutrient intakes in patients receiving continuous ambulatory peritoneal dialysis

BACKGROUND: Dialysis patients are at risk of vitamin and mineral deficiencies, not only because of losses during chronic hemodialysis or peritoneal dialysis but also because of low intakes. OBJECTIVE: The objective was to determine the importance of urea clearance (calculated as K(t)/V) and residual renal function (RRF) in predicting micronutrient intakes in a large cohort of patients receiving continuous ambulatory peritoneal dialysis (CAPD). DESIGN: We conducted a survey of dietary intakes in 242 CAPD patients and divided them into 3 groups according to their weekly urea clearance and RRF: WD group (n = 84), a urea clearance >/= 1.7 and a glomerular filtration rate (GFR) >/= 1 mL x min(-1) x 1.73 m(-2); DD group (n = 71), a urea clearance >/= 1.7 and a GFR < 1 mL x min(-1) x 1.73 m(-2); and ID group (n = 87), a urea clearance < 1.7. RESULTS: Most of the patients had intakes of water-soluble vitamins and minerals that were lower than the recommended dietary allowance; most intakes were significantly higher in the WD group than in the DD and ID groups, except those of niacin and calcium. After age, sex, body weight, and the presence of diabetes were controlled for, total weekly urea clearance and the GFR (but not peritoneal dialysis urea clearance) were significantly associated with intakes of vitamins A and C, the B vitamins, and minerals (calcium, phosphate, iron, and zinc). Low intakes of vitamins and minerals with low RRF and urea clearance were the result of reduced overall food intakes, except for thiamine, vitamin B-6, and folic acid, which were deficient in the diet. CONCLUSIONS: Supplementation with most water-soluble vitamins and minerals, including iron and zinc, should be considered in CAPD patients, especially those with low RRF and low urea clearance. The optimal dose needs to be determined.     

Effect of breaking bad news on patients' perceptions of doctors

The breaking of bad news is a routine but difficult task for many health professionals. There are numerous anecdotes of insensitive practice but the subject has attracted little systematic research. We therefore interviewed 106 patients with advanced cancer (from an original sample of 195) to assess their perceptions of the doctors involved in their care. Aspects of the 'breaking bad news' event were recorded during discussion of the illness history and were subsequently rated. Participants were also asked to nominate doctors under the headings 'most helpful' and 'less helpful', and completed standardized psychological screening questionnaires. In 94 of the 106 cases the bad news had been given by a doctor, usually a surgeon. Of the 13 doctors categorized as 'most helpful' when breaking bad news, 8 were general practitioners; of the 7 categorized as 'less helpful' all were surgeons. 69% of patients were neutral or positive about the bad-news consultation, but 20% were negative and 6% very negative. Doctors in surgical specialties were significantly more likely to be rated poorly than non-surgical specialists or general practitioners. Surgeons were the group of doctors most likely to break bad news, but non-surgical doctors were rated more positively in performance of the task. This finding has implications for training.