Evaluation of a mass dispensing exercise in a Cities Readiness Initiative setting.

PURPOSE: The effectiveness of a point of dispensing (POD) used in a mass dispensing exercise was evaluated. METHODS: Public Health-Seattle & King County (PHSKC), in conjunction with the University of Washington, conducted a functional exercise of mass dispensing plans to test the effectiveness of a POD. Specifically, the organization and maintenance of patient flow, staffing model, signage, and dissemination of public information were evaluated. A data collection application using cellular telephones was used to record time and patient flow data to evaluate patient flow. Questionnaires distributed to staff and volunteer patients at the end of the exercise obtained feedback regarding the setup, organization, and operations of the POD. RESULTS: The POD was operational for approximately 68 minutes. The majority of POD staff reported feeling comfortable with their specific job tasks and duties within 15 minutes of opening the doors to the POD to the public. Staff questionnaires also revealed a high level of self-reported confidence in their ability and in the ability of their colleagues to perform the job-specific responsibilities required of them or respond to this hypothetical event. The majority of volunteer patients found the signs helpful and easy to follow and the check-in form easy to complete. Despite efforts to provide patients with oral and written information about the medications being dispensed, only 80% indicated that they knew how to take the medication, and only 73% reported understanding the medication instructions for all the individuals for whom they picked up medication. CONCLUSION: The majority of volunteer patients and staff who participated in a functional exercise of mass dispensing plans found the POD to be effective. Time-flow analysis provided preliminary estimates of the total amount of time needed to complete the dispensing process for each head of household.     

Improved myo-electric control system

A new family of myo-electric control equipment is described, with an example of its application to a forequarter amputee. Modular design, flexibility of function, reduced size and weight and improved packaging characterize this new equipment.     

Women's dietary intakes in the context of household food insecurity

A study of food insecurity and nutritional adequacy was conducted with a sample of 153 women in families receiving emergency food assistance in Toronto, Canada. Contemporaneous data on dietary intake and household food security over the past 30 d were available for 145 of the women. Analyses of these data revealed that women who reported hunger in their households during the past 30 d also reported systematically lower intakes of energy and a number of nutrients. The effect of household-level hunger on intake persisted even when other economic, socio-cultural, and behavioral influences on reported dietary intake were considered. Estimated prevalences of inadequacy in excess of 15% were noted for Vitamin A, folate, iron, and magnesium in this sample, suggesting that the low levels of intake associated with severe household food insecurity are in a range that could put women at risk of nutrient deficiencies.     

Sources of occupational stress among firefighter/EMTs and firefighter/paramedics and correlations with job-related outcomes

INTRODUCTION/OBJECTIVE: This paper reports the results of an initial effort to develop and test a measure of the various sources of job-related stress in firefighter and paramedic emergency service workers. METHODS: A 57-item paper and pencil measure of occupational stressors in firefighter/Emergency Medical Technicians (EMTs) and firefighter/paramedics was developed and administered by anonymous mail survey. RESULTS: More than 2,000 (50% rate of return) emergency service workers completed and returned the surveys. The responses of 1,730 firefighter/EMTs and 253 firefighter/paramedics were very similar in terms of the degree to which job stressors were bothersome. A factor analysis of replies yielded 14 statistically independent "Occupational Stressor" factors which together accounted for 66.3% of the instrument's variance. These Sources of Occupational Stress (SOOS) factor scale scores essentially did not correlate with a measure of the social desirability test-taking bias. Finally, SOOS factors were identified that correlated with job satisfaction and work-related morale of the respondents. Conflict with administration was the job stressor factor that most strongly correlated with reports of low job satisfaction and poor work morale in both study groups. CONCLUSION: The findings suggest that firefighter and paramedic job stress is very complicated and multi-faceted. Based on this preliminary investigation, the SOOS instrument appears to have adequate reliability and concurrent validity.     

Transsylvian selective amygdalohippocampectomy in children with hippocampal sclerosis: Seizure,intellectual and memory outcome

PurposeThis study investigates the efficacy of transylvian selective amygdalohippocampectomy (TS SAH) in children with medically intractable epilepsy due to unilateral hippocampal sclerosis. Post-surgical seizure control, intellectual and memory outcomes are examined.MethodThis study reports on pre- and post-surgical clinical data from 10 patients who underwent TS SAH between 2002 and 2010 after 24 months follow-up. Pre- and post-operative change in seizure frequency, AED use, intellect and memory are compared.ResultsAt 12 months and 24 months post-surgery, 9/10 (90%) and 7/8 (87.5%) patients respectively, were seizure free (Engel I). No patients were classed as Engel III or IV. No significant improvement or decline at a group level was found on measures of intellect or verbal or visual memory. One hundred per cent improved or remained within 1 SD of their pre-operatives score on verbal and perceptual reasoning learning and reasoning measures. Significant improvement was found post-operatively for both immediate and delayed facial memory.ConclusionOur findings of good post-surgical seizure control and favourable cognitive outcome provides evidence against previous findings that SAH in children may not be effective.     

Birth prevalence and characteristics of congenital toxoplasmosis in Sergipe,North‐east Brazil

Objectives To estimate, by neonatal screening, the birth prevalence of congenital toxoplasmosis among live‐born infants in Sergipe state, Brazil, and to investigate the clinical features of affected infants. Methods Dried blood spot specimens obtained from 15 204 neonates were assayed for the presence of anti‐T. gondii IgM antibodies. Duplicate retesting was done in infants with positive and borderline results. Confirmatory testing in peripheral blood samples consisted of testing for anti‐T. gondii IgG and IgM in infants and mothers. Those with possible congenital toxoplasmosis were evaluated and followed up to a median age of 20 months. Congenital infection was confirmed in the presence of persisting anti‐T. gondii IgG antibodies beyond 12 months of age. All infants with confirmed infection were treated with pyrimethamine, sulfadiazine and folinic acid for 1 year. Results Fifty‐three infants had detectable IgM in dried blood spot specimens. Confirmatory testing was reactive in 39/50, of which, 38 completed follow‐up. Six of 15 204 newborns were diagnosed with congenital toxoplasmosis, resulting in an estimated birth prevalence of four per 10 000 [CI 95% 1.4–8.0]. Four infants (67%) showed signs of congenital toxoplasmosis in their first year of life; three (75%) had retinochoroidal scars, and one had cerebral calcifications. Two infants remained asymptomatic until 20 months of age. Conclusions The birth prevalence of congenital toxoplasmosis is high in the Brazilian state of Sergipe, with most of the infants showing ocular lesions. Preventive measures are strongly warranted.