On March 17, 2020, a member of a Skagit County, Washington, choir informed Skagit County Public Health (SCPH) that several members of the 122-member choir had become ill. Three persons, two from ...Skagit County and one from another area, had test results positive for SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). Another 25 persons had compatible symptoms. SCPH obtained the choir's member list and began an investigation on March 18. Among 61 persons who attended a March 10 choir practice at which one person was known to be symptomatic, 53 cases were identified, including 33 confirmed and 20 probable cases (secondary attack rates of 53.3% among confirmed cases and 86.7% among all cases). Three of the 53 persons who became ill were hospitalized (5.7%), and two died (3.7%). The 2.5-hour singing practice provided several opportunities for droplet and fomite transmission, including members sitting close to one another, sharing snacks, and stacking chairs at the end of the practice. The act of singing, itself, might have contributed to transmission through emission of aerosols, which is affected by loudness of vocalization (1). Certain persons, known as superemitters, who release more aerosol particles during speech than do their peers, might have contributed to this and previously reported COVID-19 superspreading events (2-5). These data demonstrate the high transmissibility of SARS-CoV-2 and the possibility of superemitters contributing to broad transmission in certain unique activities and circumstances. It is recommended that persons avoid face-to-face contact with others, not gather in groups, avoid crowded places, maintain physical distancing of at least 6 feet to reduce transmission, and wear cloth face coverings in public settings where other social distancing measures are difficult to maintain.
Rural older adults are at risk of readmissions and medication-related problems after hospital discharge.
This study aimed to compare 30-day hospital readmissions between participants and ...nonparticipants and describe medication therapy problems (MTPs) and barriers to care, self-management, and social needs among participants.
The Michigan Region VII Area Agency on Aging (AAA) Community Care Transition Initiative (CCTI) for rural older adults after hospitalization.
Eligible AAA CCTI participants were identified by an AAA community health worker (CHW) trained as a pharmacy technician. Eligibility criteria were Medicare insurance; diagnoses at risk of readmission; length of stay, acuity of admission, comorbidities, and emergency department visits score more than 4; and discharge to home from January 2018 to December 2019. The AAA CCTI included a CHW home visit, telehealth pharmacist comprehensive medication review (CMR), and follow-up for up to 1 year.
A retrospective cohort study examined the primary outcomes of 30-day hospital readmissions and MTPs, categorized by the Pharmacy Quality Alliance MTP Framework. Primary care provider (PCP) visit completion, barriers to self-management, health, and social needs were collected. Descriptive statistics, Mann-Whitney U, and chi-square analyses were used.
Of 825 eligible discharges, 477 (57.8%) enrolled in the AAA CCTI; differences in 30-day readmissions between participants and nonparticipants were not statistically significant (11.5% vs. 16.1%, P = 0.07). More than one-third of participants (34.6%) completed their PCP visit within 7 days. MTPs were identified in 76.1% of the pharmacist visits (mean MTP 2.1 SD 1.4). Adherence (38.2%) and safety-related (32.0%) MTPs were common. Physical health and financial issues were barriers to self-management.
AAA CCTI participants did not have lower hospital readmission rates. The AAA CCTI identified and addressed barriers to self-management and MTPs in participants after the care transition home. Community-based, patient-centered strategies to improve medication use and meet rural adults' health and social needs after care transitions are warranted.
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•Inorganic elements modify the thermogravimetric combustion profile influencing R50 index.•GS index (R50) provides insight into structural changes describing biochar stability.•GS ...index (R50) and ageing tests link structural changes and permanency in soils.
Carbon stability is an important parameter to measure prior to the application of biochar to soil and in the past few years, several methods have been developed to measure it. The carbon sequestration potential (CO2 reduction) for biochar can be estimated by the recalcitrance index (R50 index). This study investigates further refinement of the R50 index as a measure of carbon stability. The following key findings were observed: 1) prior washing of the biochar in water before measurement of the R50 index influences the measure of char stability determined, particularly for biochar containing high levels of water leachable inorganic materials; 2) a new subscale is proposed to interpret the understanding of the biochar stability changes as a function of pyrolysis temperature defined as “gained stability” and 3) a strong correlation (R=0.97) was observed between the R50 index and the accelerated ageing test when their function is linearised, providing a better understanding of the carbon stability evaluation.
Air curtains are well established to be effective for preventing ingress of flying insects and for preventing mixing of different temperature environments. However, the ability of an air curtain to ...improve indoor air quality by preventing infiltration of fine airborne particulate matter (PM25) has been less thoroughly studied. This study seeks to use physical equipment in a semi-controlled environment to simulate real-world conditions and validate the effectiveness of air curtains for this use case. The results indicate a significant reduction of about 54% in the rate of particulate infiltration through a doorway with an air curtain operating compared to no air curtain.
In the aftermath of the 2011 England riots, the then Prime Minister David Cameron referred to a ‘small number of families as the source of a large number of problems in society’ (Cameron, 2011). Soon ...after, the Troubled Families Programme was set up by the government to ‘turn around’ 120,000 troubled families. Despite government rhetoric focusing on ‘neighbours from hell’ (ibid.) the initial estimate of the number of troubled families did not include any indicators of problematic behaviours, such as crime or anti-social behaviour. Instead, a measure previously used by government to classify families with multiple social and economic disadvantages was used (Social Exclusion Task Force, 2007a). This article revisits the research behind the initial identification of the 120,000 troubled families and explores more widely the overlap between families with multiple social and economic disadvantage and their engagement in problematic behaviours. Our reanalysis of the original research data reveals that although families experiencing multiple social and economic disadvantage were at an increased risk of displaying problematic behaviour, only a small minority did so.
Purpose
Previous research on time trends of young people’s mental health in Britain has produced conflicting findings: evidence for deterioration in mental health during the late 20th century ...followed by stability and slight improvement during the early 21st century is contrasted with evidence showing continued deterioration. The present study adds to the evidence base by assessing time trends in means, variances, and both low and high psychological distress scores covering a similar period.
Methods
GHQ-12 (Likert scale) was regressed on time (adjusting for age) using a sample of young people aged 16–24 between 1991 and 2008 from the British Household Panel Study. Change in variance was assessed using Levene’s homogeneity of variance test across 9-year intervals. Polarisation was assessed by a comparison of the prevalence of scores ≥1 standard deviation and ≥1.5 standard deviations above and below the pooled mean.
Results
There was a small but significant increase in mean GHQ-12 among young women (
b
0.048; 95% CI 0.016, 0.080) only. Variance increased significantly (
p
< 0.05) across 9-year intervals in seven out of nine comparisons for women and in six out of nine comparisons for men. There were significant increases in low (OR: 1.19; 95% CI 1.05, 1.35), high (OR: 1.27; 95% CI 1.13, 1.42), and very high scores (OR: 1.42; 95% CI 1.23, 1.64) for young women, and increases in low (OR: 1.39; 95% CI 1.21, 1.59) and very low (OR: 1.53; 95% CI 1.21, 1.92) scores for young men.
Conclusions
The evidence suggests a polarisation of the psychological distress of young women in Britain between 1991 and 2008.
BackgroundSocial exclusion of the elderly is a key policy focus but evidence on the processes linking health and social exclusion is hampered by the variety of ways that health is used in social ...exclusion research. We investigated longitudinal associations between health and social exclusion using an analytical framework that did not conflate them.MethodsData employed in this study came from 4 waves of Understanding Society, the UK Household Longitudinal Study 2009–2013. The sample comprised all adults who took part in all 4 waves, were 65 years or more in Wave 3, and had complete data on our variables of interest for each analysis. We used linear regression to model the relationship between Wave 2/3 social exclusion and Wave1–2 health transitions (N=4312) and logistic regression to model the relationship between Wave2/3 social exclusion and Wave 4 health states, conditional on Wave 3 health (N=4244).ResultsThere was a dose–response relationship between poor health in Waves 1 and 2 and later social exclusion. Use of a car, mobile phone and the internet moderated the association between poor health and social exclusion. Given the health status in Wave 3, those who were more socially excluded had poorer outcomes on each of the three domains of health in Wave 4.ConclusionsUse of the internet and technology protected older adults in poor health from social exclusion. Age-friendly hardware and software design might have public health benefits.
Drawing on data collected from two longitudinal Cohort Studies following the lives of over 20,000 individuals born in the United Kingdom 12 years apart in 1958 and 1970, respectively, this paper ...examines antecedents and outcomes of educational and occupational aspirations of young men and women, covering the transition from dependent childhood into independent adulthood. Two analytical models, a Social Reproduction Model and a Developmental-Contextual Model are tested to assess the processes by which family background and the wider socio-historical context influence work and family related careers. The findings demonstrate the persistent role of gender, social origin and individual agency processes as well as the influence of a changing socio-historical context on career development. Results are interpreted with regard to biographical agency processes linking individual lives with social contexts across the life course.
Social exclusion is a dynamic multi-dimensional process that is interactive in nature. The complex interplay between domains, whereby each domain can act as a determinant, indicator and/or outcome of ...social exclusion, hinders understanding of the process and the mechanisms through which social exclusion exists. This article highlights the need to disentangle these pathways and move beyond descriptive accounts of social exclusion, presenting a new working framework that allows direct hypothesis testing of these between-domain relationships. Whilst this working framework can be applied to any population, this article focuses on older adults. Life events that can drive social exclusion such as bereavement and changes in health are more likely to occur in later life, and occur more frequently, increasing the risk of social exclusion for this population. Rooted in the new working framework, this article presents the construction of later life social exclusion measures for use with Understanding Society – the United Kingdom Household Longitudinal Study. The validity of these measures are considered by examining the characteristics of those aged 65 years and over who score the highest, and therefore experience the greatest level of exclusion. This new working framework and developed social exclusion measures provide a platform from which to explore the complex relationships between domains of social exclusion and ultimately provide a clearer understanding of this intricate multi-dimensional process.
Economic thinking is widely used now across most areas of government activity, though there is not much research on what professional economists do. This paper, therefore, develops and reports on a ...survey of over 500 members of the UK Government Economic Service, which we use to shed light on the activities and thinking of practitioners. We find, inter alia, that professional economics can be seen as drawing on at least four distinct economic paradigms, that the uses of economics vary significantly between areas of government and that whilst significant use of research can be made, this is not necessarily a defining aspect of professional practice.
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