Asset Literacy Following Stroke: Implications for Disaster Resilience.

OBJECTIVE: The World Stroke Organization "1 in 6" campaign aims to raise awareness that 1 in 6 persons will experience a stroke during their lifetime. With aging populations and improved survival rates, an increased number of survivors live with functional limitations and require supportive care. This has important implications for implementing an all-of-society approach to disaster risk reduction. In this study, we explore the assets that stroke survivors and caregivers consider useful in supporting their capacity to manage routine activities and independent living and to respond to a disaster. METHODS: Transcripts from interviews with stroke survivors and caregivers were analyzed by use of content analysis. RESULTS: Assets were categorized into 4 classes: social, physical, energy, and personal characteristics and are presented as a household map. Emergent themes suggested that understanding how to mobilize assets is complicated yet essential for building resilience. Household resilience requires people have self-efficacy and motivation to move from awareness to action. The findings informed development of a conceptual model of asset literacy and household resilience following stroke. CONCLUSIONS: Interventions to enhance asset literacy can support an all-of-society approach to disaster risk reduction through awareness, empowerment, participation, innovation, and engagement. (Disaster Med Public Health Preparedness. 2018; 12: 312-320).

[An interprofessional simulation: an exploration of the experiences of nursing students.] / Une simulation interprofessionnelle : une exploration des expériences des étudiantes en sciences infirmières.

BACKGROUND: the literature suggests that simulation is an effective strategy to meet the learning needs of nursing students. Traditionally, simulation learning for nursing students takes place at nursing schools ; at a distance from the clinical setting, patients, and the interprofessional team. AIM: the objective of this pilot project is to explore the experiences of Francophone nursing students following their participation in an interprofessional simulation in a hospital setting during their third year clinical placements. METHOD: a case study using Yin's (2003) approach was used to explore this phenomenon through focus groups and individual interviews. RESULTS: thirteen people participated in three simulation sessions that each included two scenarios. Content analysis of the focus groups revealed four themes : 1) the need for a realistic, but safe environment ; 2) simulation helps to build self-confidence ; 3) simulation improves knowledge of the role of the nurse ; and 4) simulation improves knowledge of teamwork. Two themes emerged from individual interviews : 1) the knowledge and skills acquired during the simulation were retained over time ; and 2) perceptions of the effects on the quality and safety of patient care. CONCLUSION: the use of simulation could be effective for the development of knowledge of nursing role, teamwork, and self-confidence.

The htpAB operon of Legionella pneumophila cannot be deleted in the presence of the groE chaperonin operon of Escherichia coli.

HtpB, the chaperonin of the intracellular bacterial pathogen Legionella pneumophila , displays several virulence-related functions in vitro. To confirm HtpB's role in vivo, host infections with an htpB deletion mutant would be required. However, we previously reported that the htpAB operon (encoding co-chaperonin and chaperonin) is essential. We attempted here to delete htpAB in a L. pneumophila strain carrying the groE operon (encoding the Escherichia coli co-chaperonin and chaperonin). The groE operon was inserted into the chromosome of L. pneumophila Lp02, and then allelic replacement of htpAB with a gentamicin resistance cassette was attempted. Although numerous potential postallelic replacement transformants showed a correct selection phenotype, we still detected htpAB by PCR and full-size HtpB by immunoblot. Southern blot and PCR analysis indicated that the gentamicin resistance cassette had apparently integrated in a duplicated htpAB region. However, we showed by Southern blot that strain Lp02, and the Lp02 derivative carrying the groE operon, have only one copy of htpAB. These results confirmed that the htpAB operon cannot be deleted, not even in the presence of the groE operon, and suggested that attempts to delete htpAB under strong phenotypic selection result in aberrant genetic recombinations that could involve duplication of the htpAB locus.

Early identification of cognitive deficits: preclinical Alzheimer's disease and mild cognitive impairment.

With the projected dramatic increase in the number of people who will be diagnosed with Alzheimer's disease (AD) in the coming years, interest is growing in identifying and treating adults at high risk for developing the disorder. Recent research suggests that individuals who will go on to receive a diagnosis of AD exhibit deficits in cognitive performance years beforehand. Those with mild cognitive impairment (MCI), for example, have characteristic cognitive deficits, such as memory loss, and convert to a diagnosis of AD at a faster rate than cognitively healthy controls. MCI has thus become a focus of research because it may help identify high-risk individuals for whom prophylactic treatments designed to slow the progress toward AD can be prescribed. After describing the diagnostic criteria and dementia outcomes associated with MCI, this article discusses several challenges to the study of cognitive impairment before the diagnosis of AD.

Common ground for the control of multidrug-resistant Salmonella in ground beef.

A strategy to combat multidrug-resistant (MDR) Salmonella in ground beef is urgently needed. A national multi-disciplinary meeting reviewed the epidemiology of MDR Salmonella infection and contamination in humans, animals, and retail meat. In spite of a recent overall decrease in human MDR Salmonella isolates, certain types, such as Salmonella enterica serotype Newport multidrug-resistant-AmpC strain and Salmonella enterica serotype Typhimurium definitive type (DT) 104, have persisted, and several recent large outbreaks of human infection have occurred. Key agencies that contribute to a safe ground beef supply were represented at the meeting and contributed to the discussion of possible control strategies from the farm to the table. Several of the control strategies suggested are unpopular to some, including restricting the use of antimicrobial agents in food animals, designation of multidrug-resistant Salmonella as an adulterant in ground beef, and improving the mechanisms for product trace-back investigations. Nevertheless, enhanced farm-based animal infection control, judicious veterinary and human antibiotic use, regulatory controls, and consumer practices will lead to important industry, veterinary, and public health outcomes.

The prevalence and correlates of nonaffective psychosis in the National Comorbidity Survey Replication (NCS-R).

BACKGROUND: To estimate the prevalence and correlates of clinician-diagnosed DSM-IV nonaffective psychosis (NAP) in a national household survey. METHODS: Data came from the United States National Comorbidity Survey Replication (NCS-R). A screen for NAP was followed by blinded sub-sample clinical reappraisal interviews. Logistic regression was used to impute clinical diagnoses to respondents who were not re-interviewed. The method of Multiple Imputation (MI) was used to estimate prevalence and correlates. RESULTS: Clinician-diagnosed NAP was well predicted by the screen (area under the curve [AUC] = .80). The MI prevalence estimate of NAP (standard error in parentheses) is 5.0 (2.6) per 1000 population lifetime and 3.0 (2.2) per 1000 past 12 months. The vast majority (79.4%) of lifetime and 12-month (63.7%) cases met criteria for other DSM-IV hierarchy-free disorders. Fifty-eight percent of 12-month cases were in treatment, most in the mental health specialty sector. CONCLUSIONS: The screen for NAP in the NCS-R greatly improved on previous epidemiological surveys in reducing false positives, but coding of open-ended screening scale responses was still needed to achieve accurate prediction. The lower prevalence estimate than in total-population incidence studies raises concerns that systematic nonresponse bias causes downward bias in survey prevalence estimates of NAP.

Parents' decision-making preferences in pediatric oncology: the relationship to health care involvement and complementary therapy use.

This study investigated how parents' preferred level of control in treatment decision-making is related to their personal health care involvement and to their decision to use complementary therapies (CTs) for their child. One hundred-eighteen parents of pediatric oncology patients completed an anonymous CT survey. The Krantz Health Opinion Survey (KHOS) was used to determine parents' preferred involvement in personal health care, and the Control Preferences Scale for Pediatrics (CPS-P) measured preferred role in pediatric treatment decision-making. Unlike previous studies of adult cancer patients, most parents preferred active or collaborative decision-making. The KHOS and CPS-P were significantly correlated, indicating that parents' preferred role in children's treatment decisions was related to their own personal health care involvement. Forty-six percent of parents used CTs for their child, and 33% began using a new CT after diagnosis. The hypothesized relationship between CT use and parents' own health care involvement was partially supported. Preference for control in decision-making was not associated with CT use. These findings provide validation for the newly developed CPS-P and indicate that parents' decisions to use CT for their child are related in part to individual health care preferences.