Architectural interventions to mitigate the spread of SARS-CoV-2 in emergency departments.

INTRODUCTION: Emergency departments (EDs) are a critical entry gate for infectious agents into hospitals. In this interdisciplinary study, we explore how infection prevention and control (IPC) architectural interventions mitigate the spread of emerging respiratory pathogens using the example of SARS-CoV-2 in a prototypical ED. METHODS: Using an agent-based approach, we integrated data on patients' and healthcare workers' (HCWs) routines and the architectural characteristics of key ED areas. We estimated the number of transmissions in the ED by modelling the interactions between and among patients and HCWs. Architectural interventions were guided towards the gradual separation of pathogen carriers, compliance with a minimum interpersonal distance, and deconcentrating airborne pathogens (higher air exchange rates (AERs)). Interventions were epidemiologically evaluated for their mitigation effects on diverse endpoints. RESULTS: Simulation results indicated that higher AERs in the ED (compared with baseline) may provide a moderate level of infection mitigation (incidence rate ratio (IRR) of 0.95 (95% confidence interval (CI) 0.93-0.98)) while the overall burden decreased more when rooms in examination areas were separated (IRR of 0.78 (95% CI 0.76-0.81)) or when the size of the ED base was increased (IRR of 0.79 (95% CI 0.78-0.81)). The reduction in SARS-CoV-2-associated nosocomial transmissions was largest when architectural interventions were combined (IRR of 0.61 (95% CI 0.59-0.63)). CONCLUSIONS: These modelling results highlight the importance of IPC architectural interventions; they can be devised independently of profound knowledge of an emerging pathogen, focusing on technical, constructive, and functional components. These results may inform public health decision-makers and hospital architects on how IPC architectural interventions can be optimally used in healthcare premises.

Identification of feeding and nutrition problems in young children with neuromotor involvement: a self-assessment.

The purpose of this article is to provide information needed to identify feeding and nutrition problems in children from birth to twenty-four months. Oral-motor and self-feeding skill development should be viewed within the framework of overall development and changing nutrition needs. Neuromotor dysfunction affects feeding and nutrition through changes in muscle tone, reflexes and the response to sensory stimulation. Nutrient compromises, including delays in texture progression, decreased fluid intake, and problems associated with self-feeding and food selection must be considered when assessing the nutrition/feeding needs of children. Successful completion of the self-assessment can be used to check the reader's basic understanding of the subject.

Perceived task complexity and reaction time on a single trial and a series of trials.

The time required to begin movement toward a panel of lights and switches of two different complexity levels was investigated in both a between-subjects and within-subjects design. In the between-subjects design, the mean RT on the subjects' first trial was longer to the more complex task, supporting the memory-drum theory of Henry and Rogers (1960). In the within-subjects design, a significant complexity x order x blocks interaction showed that the subjects receiving the less complex task first responded differently than subjects receiving the more complex task first. Implications for experimental design in investigations of task complexity are discussed.

Eye and head movements in peripheral vision: nature of compensatory eye movements.

Simultaneous recordings of both eye and head movements in response to a peripheral signal indicated that the backward compensatory eye movement was initiated during the constant velocity of the head rotation. This compensatory movement began before the eyes had actually reached the peripheral signal.