Validation and Application of Models to Predict Facemask Influenza Contamination in Healthcare Settings

Facemasks are part of the hierarchy of interventions used to reduce the transmission of respiratory pathogens by providing a barrier. Two types of facemasks used by healthcare workers are N95 filtering facepiece respirators (FFRs) and surgical masks (SMs). These can become contaminated with respiratory pathogens during use, thus serving as potential sources for transmission. However, because of the lack of field studies, the hazard associated with pathogen‐exposed facemasks is unknown. A mathematical model was used to calculate the potential influenza contamination of facemasks from aerosol sources in various exposure scenarios. The aerosol model was validated with data from previous laboratory studies using facemasks mounted on headforms in a simulated healthcare room. The model was then used to estimate facemask contamination levels in three scenarios generated with input parameters from the literature. A second model estimated facemask contamination from a cough. It was determined that contamination levels from a single cough (≈19 viruses) were much less than likely levels from aerosols (4,473 viruses on FFRs and 3,476 viruses on SMs). For aerosol contamination, a range of input values from the literature resulted in wide variation in estimated facemask contamination levels (13–202,549 viruses), depending on the values selected. Overall, these models and estimates for facemask contamination levels can be used to inform infection control practice and research related to the development of better facemasks, to characterize airborne contamination levels, and to assist in assessment of risk from reaerosolization and fomite transfer because of handling and reuse of contaminated facemasks.     

Responsible Gambling: General Principles and Minimal Requirements

Many international jurisdictions have introduced responsible gambling programs. These programs intend to minimize negative consequences of excessive gambling, but vary considerably in their aims, focus, and content. Many responsible gambling programs lack a conceptual framework and, in the absence of empirical data, their components are based only on general considerations and impressions. This paper outlines the consensus viewpoint of an international group of researchers suggesting fundamental responsible gambling principles, roles of key stakeholders, and minimal requirements that stakeholders can use to frame and inform responsible gambling programs across jurisdictions. Such a framework does not purport to offer value statements regarding the legal status of gambling or its expansion. Rather, it proposes gambling-related initiatives aimed at government, industry, and individuals to promote responsible gambling and consumer protection. This paper argues that there is a set of basic principles and minimal requirements that should form the basis for every responsible gambling program.     

Romantic partners, friends, friends with benefits, and casual acquaintances as sexual partners

The purpose of this study was to provide a detailed examination of sexual behavior with different types of partners. A sample of 163 young adults reported on their light nongenital, heavy nongenital, and genital sexual activity with romantic partners, friends, and casual acquaintances. They described their sexual activity with "friends with benefits," as well as with friends in general. Young adults were most likely to engage in sexual behavior with romantic partners, but sexual behavior also often occurred with some type of nonromantic partner. More young adults engaged in some form of sexual behavior with casual acquaintances than with friends with benefits. The frequencies of sexual behavior, however, were greater with friends with benefits than with friends or casual acquaintances. Interview and questionnaire data revealed that friends with benefits were typically friends, but not necessarily. Nonsexual activities were also less common with friends with benefits than other friends. Taken together, the findings illustrate the value of differentiating among different types of nonromantic partners and different levels of sexual behavior.     

Romantic Partners,Friends, Friends with Benefits,and Casual Acquaintances as Sexual Partners

The purpose of this study was to provide a detailed examination of sexual behavior with different types of partners. A sample of 163 young adults reported on their light nongenital, heavy nongenital, and genital sexual activity with romantic partners, friends, and casual acquaintances. They described their sexual activity with “friends with benefits,” as well as with friends in general. Young adults were most likely to engage in sexual behavior with romantic partners, but sexual behavior also often occurred with some type of nonromantic partner. More young adults engaged in some form of sexual behavior with casual acquaintances than with friends with benefits. The frequencies of sexual behavior, however, were greater with friends with benefits than with friends or casual acquaintances. Interview and questionnaire data revealed that friends with benefits were typically friends, but not necessarily. Nonsexual activities were also less common with friends with benefits than other friends. Taken together, the findings illustrate the value of differentiating among different types of nonromantic partners and different levels of sexual behavior.     

Accurate probabilities for the sign test

Limitations in currently available methods for producing significance probabilities for the sign test are discussed. Two simple modifications to the continuity corrected normal approximation are derived and presented in a simple form. These modifications are shown to markedly reduce the relative error in approximating exact probabilities. The relative simplicity of these modifications and the importance of accurate p values suggest that one or both modifications could be useful improvements.     

Whose Wishes and Feelings? Children's Autonomy and Parental Influence in Family Court Enquiries

The importance of the child’s right to be heard and fortheir wishes and feelings to be taken notice of is now acceptedacross a broad professional and research terrain. Increasingly,children are being treated as active participants in the processesand decisions that affect them. In cases of divorce and separation,especially where parental relationships are conflicted, theaccepted wisdom in the UK for many years has been for childrento be protected rather than empowered. More recently, practitioners,policy makers and researchers have looked for ways to involvechildren, although the ‘welfare’ of the child hasremained paramount. In this context, the question of how toensure that wishes and feelings expressed are those that authenticallybelong to the child, rather than to their parent, sibling orother, has achieved a new significance. This article presentsfindings from recent research to illustrate how the tensionbetween protection and empowerment is being played out in thisaspect of welfare report enquiries carried out by CAFCASS (Childrenand Family Court Advisory and Support Service) private law practitioners.     

The epistemology of “addictive disease”: Gambling as predicament

This research examines the relative perception of gambling as a disease in the context of drug use/abuse, and other excessive behavior patterns, for example, workaholism. A sample of 144 adults provided subjective perceptions of disease status of 80 representative items drawn from the literature. A subset of these items represented the class of addictive diseases. These items were subjected to principal components analysis to reveal the presence of clusters or constellations of perceptually similar entities. Gambling was perceived to beless of a predicament (i.e., a potentially dangerous situation; Shaffer, 1987) than substance abuse or substance dependence, particularly if the substance was illicit, such as cocaine or heroin. Gambling was not perceived to be characterized by the underlying construct of dependence, a dimension associated with the abuse of illicit substances. Another analysis revealed that when gambling and substance abuse and dependence were perceived against ause of substances background, licit and illicit, gambling was more likely perceived as a permissible activity than a predicament which might lead to abuse and/or dependence. This same result characterizes the perceptions of alcohol use, cocaine use, chemical use, and heroin use. While individuals may recognize the potential danger of drug abuse, illicit drug use per se is not perceived to lead to drug abuse, dependence, or addiction as often portrayed by the government and media. Against a background of excessive behaviors, for example, workaholism, gambling emerged as more similar to these behaviors than abuse or use. The implications of these findings are discussed. The clinical implications of an epistemology of addictive disease were also discussed.Preparation of this article was supported, in part, by a contract (#2322905893) from the Massachusetts Department of Public Health.Special thanks are extended to Thomas Cummings, Sharon Stein and Norman Zinberg for their helpful comments on earlier drafts of this article.