Hand-Hygiene Mitigation Strategies Against Global Disease Spreading through the Air Transportation Network

The risk for a global transmission of flu-type viruses is strengthened by the physical contact between humans and accelerated through individual mobility patterns. The Air Transportation System plays a critical role in such transmissions because it is responsible for fast and long-range human travel, while its building components—the airports—are crowded, confined areas with usually poor hygiene. Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) consider hand hygiene as the most efficient and cost-effective way to limit disease propagation. Results from clinical studies reveal the effect of hand washing on individual transmissibility of infectious diseases. However, its potential as a mitigation strategy against the global risk for a pandemic has not been fully explored. Here, we use epidemiological modeling and data-driven simulations to elucidate the role of individual engagement with hand hygiene inside airports in conjunction with human travel on the global spread of epidemics. We find that, by increasing travelers engagement with hand hygiene at all airports, a potential pandemic can be inhibited by 24% to 69%. In addition, we identify 10 airports at the core of a cost-optimal deployment of the hand-washing mitigation strategy. Increasing hand-washing rate at only those 10 influential locations, the risk of a pandemic could potentially drop by up to 37%. Our results provide evidence for the effectiveness of hand hygiene in airports on the global spread of infections that could shape the way public-health policy is implemented with respect to the overall objective of mitigating potential population health crises.     

The Influence of the Human Rights to Water and Sanitation Normative Content in Measuring the Level of Service

Human Rights to Water and Sanitation (HRWS) have been consolidated as relevant frameworks to measure different levels of services. It is essential to move forward with specific initiatives that interpret the content of these human rights and operationalize them through specific metrics. However, some critical issues emerge in attempting this. Different approaches are proposed in this article to tackle this challenge: (1) utilizing a participatory technique to discuss the relative importance of the normative criteria to define water and sanitation services, (2) defining a short list of key indicators to measure the different dimensions of HRWS, and (3) assessing the impact of different weighting systems in the constructing an aggregated index, which has been proposed as a useful tool to monitor water, sanitation, and hygiene (WASH) from a rights perspective. Two municipalities (in Mozambique and Nicaragua) were selected as initial case studies. The results suggest that there is a common understanding among the experts about prioritization of the HRWS criteria. Differences in the relative importance given to the HRWS criteria can be explained due to the particularities of the local context. Further, the research suggests that expert opinions may be partially conditioned by targets and indicators proposed at the international level. Although the influence of weighting techniques on aggregated measures and their utilization in the decision-making process are limited, this methodology has a great potential for adapting specific WASH metrics to different regional, national, and/or local contexts taking into account the HRWS normative content.     

Living with Dementia: Lay Definitions of Alzheimer's Disease among African American Caregivers and Sufferers

While the medical world aggressively pursues scientific knowledge about Alzheimer's disease, sufferers and caregivers live with this ailment, not as patients, but as people going about their lives, needing and providing care. This article reports explanations of Alzheimer's from the perspectives of African American family caregivers and sufferers. Data were collected from thirty‐six families using participant observation and focus group interviews. Although caregivers sought and used medical expertise, their explanations of Alzheimer's were not only nonmedical, but not necessarily explanations of illness per se. Alzheimer's was presented instead as a way of being, predominantly characterized by views of the sufferer as childlike and by issues of continuity/discontinuity, though some saw Alzheimer's as part of a larger picture.     

Model‐based linear clustering

The authors propose a profile likelihood approach to linear clustering which explores potential linear clusters in a data set. For each linear cluster, an errors‐in‐variables model is assumed. The optimization of the derived profile likelihood can be achieved by an EM algorithm. Its asymptotic properties and its relationships with several existing clustering methods are discussed. Methods to determine the number of components in a data set are adapted to this linear clustering setting. Several simulated and real data sets are analyzed for comparison and illustration purposes. The Canadian Journal of Statistics 38: 716–737; 2010 © 2010 Statistical Society of Canada     

From Prowar Soldier to Antiwar Activist: Change and Continuity in the Narratives of Political Conversion among Iraq War Veterans

This study examines conversion narratives of Iraq War military veterans who have become antiwar political activists. I examine how antiwar veterans construct and emplot prewar, wartime, and postwar narrative periods to shape and reclaim their moral identities as patriots fighting for a just cause, and how through a communal antiwar story they work to both challenge and reappropriate the rhetorical framework they associate with justifications for the invasion of Iraq. The study draws on in‐depth interviews with forty members of Iraq Veterans Against the War (IVAW). In sum, the research describes how veterans engage with dominant narratives, shape new moral identities, and transition from soldiers to political activists.     

Preparedness of representatives for people with dementia in a self-directed program

ABSTRACT

Representatives enact their role as decision-making partners across the intersection of participant direction (PD) and dementia care. Self-rated preparedness for key dimensions of the role endorsed by a panel of experts in PD and dementia was assessed by telephone survey of 30 representatives of persons with dementia in a PD program. The sample (daughters 60%; Black 50%; rural 70%) was diverse in length of time in the role and additional responsibilities. They represented participants with moderate to advanced dementia and ≥ two additional chronic illnesses. Overall preparedness scores were in the pretty well to very well prepared range, with variation across dimensions and between individuals. Preparedness varied according to what has to be done day-to-day in dynamic or unpredictable situations, gauging decisional capacity, anticipating changing needs, ensuring safety, supporting a dementia-capable care team and negotiation. Stress was related to having a safety net of capable back-up supports and dementia care literacy. Areas of strength, individual variation and particular challenges along the trajectory of representing can guide development of support counselor interventions to provide representatives with tailored training and resources as they enable the benefits of PD for persons with dementia.     

Online programs as tools to improve parenting: A meta-analytic review

Background

A number of parenting programs, aimed at improving parenting competencies, have recently been adapted or designed with the use of online technologies. Although web-based services have been claimed to hold promise for parent support, a meta-analytic review of online parenting interventions is lacking.

Method

A systematic review was undertaken of studies (n = 19), published between 2000 and 2010, that describe parenting programs of which the primary components were delivered online. Seven programs were adaptations of traditional, mostly evidence-based, parenting interventions, using the unique opportunities of internet technology. Twelve studies (with in total 54 outcomes, N_tot parents = 1615 and N_tot children = 740) were included in a meta-analysis.

Results

The meta-analysis showed a statistically significant medium effect across parents outcomes (ES = 0.67; se = 0.25) and child outcomes (ES = 0.42; se = 0.15).

Conclusions

The results of this review show that web-based parenting programs with new technologies offer opportunities for sharing social support, consulting professionals and training parental competencies. The meta-analytic results show that guided and self-guided online interventions can make a significant positive contribution for parents and children. The relation with other meta-analyses in the domains of parent education and web-based interventions is discussed.     

Sleep Quality and Body Mass Index in College Students: The Role of Sleep Disturbances

Abstract

Objective: Obesity and its comorbidities have emerged as a leading public health concern. The aim of this study was to explore the relationship between body mass index (BMI) and sleep patterns, including duration and disturbances. Methods: A convenience sample of 515 college students completed an online survey consisting of the Pittsburgh Sleep Quality Index (PSQI), and self-reported height and weight to calculate BMI. Univariate and multivariate logistic regression analyses were performed using components of the PSQI as predictors of overweight (BMI ≥ 25). Results: One-third of the participants had BMI ≥ 25, and 51% were poor-quality sleepers (PSQI > 5). Controlling for age and sex, only sleep disturbances were associated with overweight (odds ratio = 1.66, 95% confidence interval [1.08, 2.57]). Conclusions: Sleep disturbances, rather than sleep duration, predicted overweight among young adults; this is consistent with the most recent evidence in the literature. These findings support expanding the scope of wellness programs to promote healthy sleep among students.