Hypothalamic proopiomelanocortin (POMC) neurons, one of the major regulators of the HPA axis, immune functions, and energy homeostasis, are vulnerable to the adverse effects of fetal alcohol exposure (FAE). These effects are manifested in POMC neurons by a decrease in Pomc gene expression, a decrement in the levels of its derived peptide β-endorphin (β-EP) and a dysregulation of the stress response in the adult offspring. The HPA axis is a major neuroendocrine system with pivotal physiological functions and mode of regulation. This system has been shown to be perturbed by prenatal alcohol exposure. It has been demonstrated that the perturbation of the HPA axis by FAE is long-lasting and is linked to molecular, neurophysiological and behavioral changes in exposed individuals. Recently, we showed that the dysregulation of the POMC system function by FAE is induced by epigenetic mechanisms such as hypermethylation of POMC gene promoter and an alteration in histone marks in POMC neurons. This developmental programming of the POMC system by FAE altered the transcriptome in POMC neurons and induced a hyperresponse to stress in adulthood. These long-lasting epigenetic changes influenced subsequent generations via the male germline. We also demonstrated that the epigenetic programming of the POMC system by FAE was reversed in adulthood with the application of the inhibitors of DNA methylation or histone modifications. Thus, prenatal environmental influences such as alcohol exposure could epigenetically modulate POMC neuronal circuits and function to shape adult behavioral patterns. Identifying specific epigenetic factors in hypothalamic POMC neurons that are modulated by fetal alcohol and target Pomc gene could be potentially useful for the development of new therapeutic approaches to treat stress-related diseases in patients with Fetal Alcohol Spectrum Disorders.
A functional polymorphism (5-HTTLPR) in the promoter region of the serotonin transporter gene has been widely studied as a risk factor and moderator of treatment for a variety of psychopathologic conditions. To evaluate whether 5-HTTLPR moderates the effects of treatment to reduce heavy drinking, we studied 112 high-functioning European-American men who have sex with men (MSM). Subjects participated in a randomized clinical trial of naltrexone (NTX) and cognitive behavioral therapy (CBT) for problem drinking.
Subjects were treated for 12 weeks with 100 mg/day of oral NTX or placebo. All participants received medical management with adjusted Brief Behavioral Compliance Enhancement Treatment (BBCET) alone or in combination with Modified Behavioral Self-Control Therapy (MBSCT, an amalgam of motivational interviewing and CBT). Participants were genotyped for the tri-allelic 5-HTTLPR polymorphism (i.e., low-activity S′ or high-activity L′ alleles).
During treatment, the number of weekly heavy drinking days (HDD, defined as 5 or more standard drinks per day) was significantly lower in subjects with the L′L′ (N=26, p=0.015) or L′S′ (N=52, p=0.016) genotype than those with the S′S′ (N=34) genotype regardless of treatment type. There was a significant interaction of genotype with treatment: For subjects with the S′S′ genotype, the effects of MBSCT or NTX on HDD were significantly greater than the minimal intervention (i.e., BBCET or placebo, p=0.007 and p=0.049, respectively). In contrast, for subjects with one or two L′ alleles, the effects of the more intensive psychosocial treatment (MBSCT) or NTX did not significantly differ from BBCET or placebo.
These preliminary findings support the utility of the 5-HTTLPR polymorphism for personalizing treatment selection in problem drinkers.
pharmacogenetics; stress reactivity; psychotherapy; MSM; plasticity
In-depth interviews conducted separately with 13-year-olds with autism spectrum disorder (ASD), intellectual disability (ID), or typical development (TD) and their mothers investigated the experiences of victimization in the form of bullying. Coded constructs from the interviews were utilized to compare groups on the frequency, type, and impact of victimization. Youth with ASD were victimized more frequently than their ID or TD peers, and the groups differed with regard to the type of bullying and the impact it had, with ASD youth faring the worst. Higher internalizing problems and conflict in friendships were found to be significant predictors of victimization, according to both youth- and mother-reports. These predictors were found to be more salient than ASD status alone. Implications for practice are discussed.
Autism; Intellectual disability; Bullying; Adolescents; Friendship
Alcohol intoxication can increase inflammation and worsen injury, yet the mechanisms involved are not clear. We investigated whether acute alcohol intoxication elevates microvascular permeability, and investigated potential signaling mechanisms in endothelial cells that may be involved.
Conscious rats received a 2.5 g/kg alcohol bolus via gastric catheters to produce acute intoxication. Microvascular leakage of intravenously administered FITC-albumin from the mesenteric microcirculation was assessed by intravital microscopy. Endothelial-specific mechanisms were studied using cultured endothelial cell monolayers. Transendothelial electrical resistance (TER) served as an index of barrier function, before and after treatment with alcohol or its metabolite acetaldehyde. Pharmacologic agents were used to test the roles of alcohol metabolism, oxidative stress, p38 mitogen-activated protein (MAP) kinase, myosin light chain kinase (MLCK), rho kinase (ROCK), and exchange protein activated by cAMP (Epac). VE-cadherin localization was investigated to assess junctional integrity. Rac1 and RhoA activation were assessed by ELISA assays.
Alcohol significantly increased FITC-albumin extravasation from the mesenteric microcirculation. Alcohol also significantly decreased TER and disrupted VE-cadherin organization at junctions. Acetaldehyde significantly decreased TER, but inhibition of ADH or application of a superoxide dismutase mimetic failed to prevent alcohol-induced decreases in TER. Inhibition of p38 MAP kinase, but not MLCK or ROCK, significantly attenuated the alcohol-induced barrier dysfunction. Alcohol rapidly decreased GTP-bound Rac1 but not RhoA during the drop in TER. Activation of Epac increased TER, but did not prevent alcohol from decreasing TER. However, activation of Epac after initiation of alcohol-induced barrier dysfunction quickly resolved TER to baseline levels.
Our results suggest that alcohol intoxication increases microvascular permeability to plasma proteins. The data also suggest the endothelial-specific mechanism involves the p38 MAP kinase, Rac1, and reorganization of VE-cadherin at junctions. Lastly, activation of Epac can quickly resolve alcohol-induced endothelial barrier dysfunction.
Ethanol; Ethanol Intoxication; Binge Drinking; Microvascular Permeability; Endothelium
To investigate the association between obesity and multiple sclerosis (MS) while accounting for established genetic and environmental risk factors.
Participants included members of Kaiser Permanente Medical Care Plan, Northern California Region (KPNC) (1,235 MS cases and 697 controls). Logistic regression models were used to estimate odds ratios (ORs) with 95% confidence intervals (95% CI). Body mass index (BMI) or body size was the primary predictor of each model. Both incident and prevalent MS cases were studied.
In analyses stratified by gender, being overweight at age 10 and 20 were associated with MS in females (p<0.01). Estimates trended in the same direction for males, but were not significant. BMI in 20’s demonstrated a linear relationship with MS (p-trend=9.60 × 10−4), and a twofold risk of MS for females with a BMI ≥ 30 kg/m2 was observed (OR = 2.15, 95% CI 1.18, 3.92). Significant associations between BMI in 20’s and MS in males were not observed. Multivariate modeling demonstrated that significant associations between BMI or body size with MS in females persisted after adjusting for history of infectious mononucleosis and genetic risk factors, including HLA-DRB1*15:01 and established non-HLA risk alleles.
Results show that childhood and adolescence obesity confer increased risk of MS in females beyond established heritable and environmental risk factors. Strong evidence for a dose-effect of BMI in 20’s and MS was observed. The magnitude of BMI association with MS is as large as other known MS risk factors.
multiple sclerosis; childhood; adolescence; genetics; risk factors in epidemiology
Altered functional connectivity in critical networks has been associated with chronic alcohol abuse. In turn, changes in connectivity in executive control networks may undermine the ability to control alcohol consumption. It was hypothesized that network connectivity would be reduced in individuals with problematic alcohol use (ALC) compared to controls and that diminished network connectivity would be associated with greater failure to control drinking.
Resting state functional magnetic resonance imaging was analyzed to identify fourteen previously identified intrinsic connectivity networks (ICNs) using a priori regions of interest in cases ranging from binge drinkers to those with severe alcohol use disorder, as well as control subjects. Analyses tested for differences in network connectivity strength between 255 ALC cases and 87 age- and gender-matched controls. Further, structural equation analysis, using 383 ALC cases, tested whether functional connectivity strength mediated the relationship between years of regular drinking and alcohol problems.
The age- and gender-matched analysis showed that ALC had significantly lower network connectivity strength than controls in the left executive control (LECN), basal ganglia (BG) and primary visual (PV) networks. For all ALC, LECN connectivity strength in negatively correlated with failed control and alcohol disorder severity. Edges connecting parietal regions with dorsolateral prefrontal, middle frontal and temporal regions within the LECN drove these relationships. A positive association between years of drinking and severity of alcohol problems was mediated by reduced executive control network connectivity.
This study reports relationships between network strength and problematic alcohol use, suggesting that chronic drinking negatively impacts brain connectivity, specifically in the left executive control network. Altered functional connectivity, related to chronic alcohol abuse, may contribute to the etiology of alcohol dependence and relapse.
alcohol dependence; executive control; functional connectivity; functional network; resting state
According to the Institute of Medicine, the local health department workforce is at the hub of the public health emergency preparedness system. A growing body of research has pointed to troubling attitudinal gaps among local health department workers, a vital response cohort, regarding willingness to respond to emergent infectious disease threats, ranging from naturally occurring pandemics to bioterrorism events. A summary of relevant literature on the empirical evidence, ethical norms, and legal standards applicable to the willingness of public health professionals to respond to an infectious disease emergency is presented. Recommendations are proposed for future work to be done to bring the relevant empirical, ethical, and legal considerations together to develop practical guidance for the local response to infectious disease emergencies.
Local health departments are the core of the public health emergency preparedness system. But a growing body of research has pointed to troubling attitudinal gaps among local health department workers regarding willingness to respond to emergent infectious disease threats, ranging from naturally occurring pandemics to bioterrorism events. Here the authors summarize relevant literature on the empirical evidence, ethical norms, and legal standards applicable to the willingness of public health professionals to respond to an infectious disease emergency. Recommendations are proposed for future work to develop practical guidance for the local response to such emergencies.
Previous articles in this series have provided funding information for federal civilian biodefense programs and programs focused on radiological and nuclear preparedness and consequence management. This year the authors have expanded the focus of the analysis to US federal funding for health security. This article provides proposed funding amounts for FY2015, estimated amounts for FY2014, and actual amounts for FY2010 through FY2013 in 5 domains critical to health security: biodefense programs, radiological and nuclear programs, chemical programs, pandemic influenza and emerging infectious disease programs, and multiple-hazard and preparedness programs.
Previous articles in this series have provided funding information for federal civilian biodefense programs and programs focused on radiological and nuclear preparedness and consequence management. This year the authors have expanded the focus of the analysis to US federal funding for health security, providing proposed funding amounts in 5 domains critical to health security: biodefense programs, radiological and nuclear programs, chemical programs, pandemic influenza and emerging infectious disease programs, and multiple-hazard and preparedness programs.
Children represent nearly a quarter of the US population, but their unique needs in chemical, biological, radiological, and nuclear (CBRN) emergencies may not be well understood by public health and emergency management personnel or even clinicians. Children are different from adults physically, developmentally, and socially. These characteristics have implications for providing care in CBRN disasters, making resulting illness in children challenging to prevent, identify, and treat. This article discusses these distinct physical, developmental, and social traits and characteristics of children in the context of the science behind exposure to, health effects from, and treatment for the threat agents potentially present in CBRN incidents.
The terrorist attacks of September 11 and the anthrax mailings a month later prompted a sweeping response by the federal government to improve the preparedness of the US to meet the potential threat posed by a terrorist using a biological agent. This response transcended traditional interagency boundaries, creating new opportunities while producing unique fiscal and leadership challenges. The National Interagency Confederation for Biological Research has made significant progress over the past 12 years because of its ability to adapt to the need for interagency cooperation and overcome many of these challenges. As construction of the National Interagency Biodefense Campus at Fort Detrick nears completion, the US has the capability to pursue a unique whole-of-government approach to the development of medical measures to counter the threat of bioterrorism. In addition to the high-level support of many in the federal government, the key success factors for this effort have been (1) a critical mass of leaders with the right leadership characteristics, (2) development of a compelling vision and accompanying narrative understood and articulated by all partnering organizations, and (3) recognition of the need for a partnership office to do the important communication and collaboration work in the organization to synchronize the information available to all the partners. The major barrier to interagency cooperative efforts of this kind is the inability to comingle funds from different appropriations.
The response to the 2001 attacks transcended traditional interagency boundaries, creating new opportunities while producing unique fiscal and leadership challenges. The National Interagency Confederation for Biological Research has made significant progress over the past 12 years because of its ability to adapt to the need for interagency cooperation and overcome many of these challenges. Key success factors include a critical mass of leaders with the right leadership characteristics, a compelling vision and accompanying narrative understood and articulated by all partners, and a central office to synchronize the information available to all the partners. The major barrier has been the inability to comingle funds from different appropriations.
During the past decade, a number of journals have implemented dual-use policies in order to analyze whether the papers submitted for publication could raise concern because of the potential for misuse of their content. In this context, an analysis was performed on Latin American scientific journals to examine whether they apply formal written dual-use review policies and whether they inform their authors and reviewers about potentially sensitive issues in this area, as other international journals do. Peer-reviewed life sciences journals indexed in Latindex from Brazil, Mexico, Argentina, and Chile were analyzed. The Guide for Authors and the Instructions to Referees of 216 journals included in the Latindex catalogue (which means that they meet the best quality standards of the Latindex system) were screened for biosecurity-related information using the keywords biosecurity, biological weapons, and dual-use research of concern. Results showed that the screened publications had a total lack of dual-use review policies, even though some of them pointed out ethical behaviors to be followed related to authorship, plagiarism, simultaneous submission, research results misappropriation, ethical principles for medical research involving human subjects, guiding principles for the care and use of animals in research, research standard violations, and reviewer bias, among others.
A number of journals have implemented dual-use policies to analyze whether the papers submitted for publication could raise concern because of the potential for misuse of their content. Here the authors analyzed peer-reviewed life sciences journals from Brazil, Mexico, Argentina, and Chile to see whether they apply formal written dual-use review policies and whether they inform their authors and reviewers about potentially sensitive issues in this area. Results showed that none of the screened publications had dual-use review policies.
Both US foreign policy and global attention attest to the strategic, economic, and political importance of Asia. Yet, the region faces urgent challenges that must be addressed if it is to remain stable and prosperous. The densely populated countries of the Asia-Pacific are beleaguered by poverty, population displacement, decreasing access to potable water and adequate sanitation, and high rates of disease morbidity and mortality. New and reemerging diseases known to have originated in Asia over the past decades have spread globally by international trade, tourism, worker migration, and agricultural exportation. Unremitting naturally occurring and man-made disasters have strained Southeast Asia's already fragile disaster and public health response infrastructures and the essential services they provide (eg, surveillance, vaccination, maternal and child health, and mental health programs). Following disasters, governments often contract with the broader humanitarian community (eg, indigenous and international NGOs) and seek the assistance of militaries to provide essential services. Yet, their roles and capabilities in addressing acute and chronic health issues in the wake of complex disasters remain unclear. Current mechanisms of nation-state and outside organization interaction, including dissimilar operational platforms, may limit true partnership on behalf of the health security mission. Additionally, concerns regarding skill sets and the lack of standards-based training raise questions about the balance between developing internal response capabilities and professionalizing external, deployable resources. Both the mega-disasters that are forecast for the region and the global health security threats that are expected to emanate from them require an increased focus on improving the Asia-Pacific's emergency preparedness and response posture.
Asia faces urgent challenges that must be addressed if it is to remain stable and prosperous. These include poverty, population displacement, decreasing access to potable water and adequate sanitation, high rates of disease morbidity and mortality, new and reemerging diseases, and naturally occurring and man-made disasters. Following disasters, governments often contract with the broader humanitarian community and seek the assistance of militaries to provide essential services. Yet, their roles and capabilities in addressing acute and chronic health issues in the wake of complex disasters remain unclear. An increased focus is needed on improving the Asia-Pacific's emergency preparedness and response posture.
Preparedness for bioterrorism is based on communication between people in organizations who are educated and trained in several disciplines, including law enforcement, health, and science. Various backgrounds, cultures, and vocabularies generate difficulties in understanding and interpretating terms and concepts, which may impair communication. This is especially true in emergency situations, in which the need for clarity and consistency is vital. The EU project AniBioThreat initiated methods and made a rough estimate of the terms and concepts that are crucial for an incident, and a pilot database with key terms and definitions has been constructed. Analysis of collected terms and sources has shown that many of the participating organizations use various international standards in their area of expertise. The same term often represents different concepts in the standards from different sectors, or, alternatively, different terms were used to represent the same or similar concepts. The use of conflicting terminology can be problematic for decision makers and communicators in planning and prevention or when handling an incident. Since the CBRN area has roots in multiple disciplines, each with its own evolving terminology, it may not be realistic to achieve unequivocal communication through a standardized vocabulary and joint definitions for words from common language. We suggest that a communication strategy should include awareness of alternative definitions and ontologies and the ability to talk and write without relying on the implicit knowledge underlying specialized jargon. Consequently, cross-disciplinary communication skills should be part of training of personnel in the CBRN field. In addition, a searchable repository of terms and definitions from relevant organizations and authorities would be a valuable addition to existing glossaries for improving awareness concerning bioterrorism prevention planning.
Preparedness for the decontamination of affected environments, premises, facilities, and products is one prerequisite for an immediate response to an animal disease outbreak. Various information sources provide recommendations on how to proceed in an outbreak situation to eliminate biological contaminants and to stop the spread of the disease. In order to facilitate the identification of the right decontamination strategy, we present an overview of relevant references for a collection of pathogenic agents. The choice of pathogens is based on a survey of lists containing highly pathogenic agents and/or biological agents considered to be potential vehicles for deliberate contamination of food, feed, or farm animals. European legislation and guidelines from national and international institutions were screened to find decontamination protocols for each of the agents. Identified recommendations were evaluated with regard to their area of application, which could be facilities and equipment, wastes, food, and other animal products. The requirements of a disinfectant for large-scale incidents were gathered, and important characteristics (eg, inactivating spectrum, temperature range, toxicity to environment) of the main recommended disinfectants were summarized to assist in the choice of a suitable and efficient approach in a crisis situation induced by a specific high-risk animal or zoonotic pathogen. The literature search revealed numerous relevant recommendations but also legal gaps for certain diseases, such as Q fever or brucellosis, and legal difficulties for the use of recommended disinfectants. A lack of information about effective disinfectants was identified for some agents.
Botulism is a neuroparalytic disease that can occur in all warm-blooded animals, birds, and fishes. The disease in animals is mainly caused by toxins produced by Clostridium botulinum strains belonging to group III, although outbreaks due to toxins produced by group I and II organisms have been recognized. Group III strains are capable of producing botulinum toxins of type C, D, and C/D and D/C mosaic variants. Definitive diagnosis of animal botulism is made by combining clinical findings with laboratory investigations. Detection of toxins in clinical specimens and feed is the gold standard for laboratory diagnosis. Since toxins may be degraded by organisms contained in the gastrointestinal tract or may be present at levels below the detection limit, the recovery of C. botulinum from sick animal specimens is consistent for laboratory confirmation. In this article we report the development and in-house validation of a new multiplex real-time PCR for detecting and typing the neurotoxin genes found in C. botulinum group III organisms. Validation procedures have been carried out according to ISO 16140, using strains and samples recovered from cases of animal botulism in Italy and France.
Since 2001, the United States government has spent substantial resources on preparing the nation against a bioterrorist attack. Earlier articles in this series have analyzed civilian biodefense funding by the federal government for fiscal years (FY) 2001 through proposed funding for FY2013. This article updates those figures with budgeted amounts for FY2014, specifically analyzing the budgets and allocations for biodefense at the Departments of Health and Human Services, Defense, Homeland Security, Agriculture, Commerce, Veterans Affairs, and State; the Environmental Protection Agency; and the National Science Foundation. This article also includes an updated assessment of the proportion of biodefense funding provided for programs that address multiple scientific, public health, healthcare, national security, and international security issues in addition to biodefense. The FY2014 federal budget for civilian biodefense totals $6.69 billion. Of that total, $5.86 billion (88%) is budgeted for programs that have both biodefense and nonbiodefense goals and applications, and $835 million (12%) is budgeted for programs that have objectives solely related to biodefense.
In this annual update and analysis of federal biodefense spending, formerly called “Billions for Biodefense,” the authors report the budgeted levels of spending for FY2014. The article analyzes the budgets and allocations for biodefense at the Departments of Health and Human Services, Defense, Homeland Security, Agriculture, Commerce, Veterans Affairs, and State; the Environmental Protection Agency; and the National Science Foundation. It also includes an updated assessment of the proportion of biodefense funding provided for programs that address multiple scientific, public health, healthcare, national security, and international security issues in addition to biodefense.
During a public health crisis, public health agencies engage in a variety of public communication efforts to inform the population, encourage the adoption of preventive behaviors, and limit the impact of adverse events. Given the importance of communication to the public in public health emergency preparedness, it is critical to examine the extent to which this field of study has received attention from the scientific community. We conducted a systematic literature review to describe current research in the area of communication to the public in public health emergency preparedness, focusing on the association between sociodemographic and behavioral factors and communication as well as preparedness outcomes. Articles were searched in PubMed and Embase and reviewed by 2 independent reviewers. A total of 131 articles were included for final review. Fifty-three percent of the articles were empirical, of which 74% were population-based studies, and 26% used information environment analysis techniques. None had an experimental study design. Population-based studies were rarely supported by theoretical models and mostly relied on a cross-sectional study design. Consistent results were reported on the association between population socioeconomic factors and public health emergency preparedness communication and preparedness outcomes. Our findings show the need for empirical research to determine what type of communication messages can be effective in achieving preparedness outcomes across various population groups. They suggest that a real-time analysis of the information environment is valuable in knowing what is being communicated to the public and could be used for course correction of public health messages during a crisis.
During a public health crisis, agencies engage in a variety of communication efforts to inform the public, encourage the adoption of preventive behaviors, and limit the impact of adverse events. The authors conducted a systematic literature review to examine the extent to which this field of study has received attention from the scientific community. They describe current research in the area of communication to the public in public health emergency preparedness, focusing on the association between sociodemographic and behavioral factors and communication as well as preparedness outcomes. Their findings show the need for empirical research to determine what type of communication messages can be effective in achieving preparedness outcomes across various population groups.
With the growing recognition of the critical role that risk communication plays in a public health emergency, a number of articles have provided prescriptive best practices to enhance such communication. However, little empirical research has examined perceptions of the quality of communication, the impact of uncertainty on changing communication, use of information sources, and trust in specific government spokespersons. Similarly, although there is significant conceptual focus on trust and communication as important in vaccination intent and acceptance, little research has explored these relationships empirically. We conducted an online survey in late January 2010 with a nationally representative sample (N=2,079) that included Hispanic and African American oversamples. The completion rate was 56%. We found that public health officials were the most trusted spokespersons, with President Obama being the most highly trusted elected official. Demographic variables, including race, accounted for 21% of the variance in trust of the president. Perceptions of the quality of communication were high, including significant understanding of uncertainty and appreciation for officials' openness about evolving information. Other factors that contributed to vaccination acceptance were quality of communication, closely following the news, and confidence in the vaccine because of a role model effect of the Obama daughters' immunizations; these factors significantly increased trust in government actions. Because the challenges of communication often vary over the course of a pandemic, there is a consistent need to pay close attention to both communication content and delivery and prepare public health officials at all levels to be effective communicators.
Clear and consistent communication by public health and government spokespersons about vaccination during the 2009 H1N1 pandemic was important to the public's trust in government actions and increased the likelihood that people sought the vaccine. Public health officials were the most trusted spokespersons, with President Obama indicated as the most highly trusted elected official. Other factors that contributed to vaccination acceptance were the quality of the communication, closely following the news, and confidence in the vaccine because of a role model effect when President Obama had his daughters immunized.
Over the past decade, community engagement has become a central tenet of US federal doctrine on public health emergency preparedness. Little is known, however, about how the vision of a ready, aware, and involved populace has translated into local practice, or which conditions thus far have advanced community involvement in what is typically considered the province of government authorities and emergency professionals. In 2011-12, to help close that knowledge gap, investigators carried out semistructured qualitative interviews with practitioners (N=25) from 7 local health departments about which conditions have advanced or inhibited community engagement in public health emergency preparedness. Among the organizational factors identified as enabling local health departments' involvement of community residents and groups in emergency preparedness were a supportive agency leadership and culture, sufficient staffing and programmatic funding, interested and willing partners, and external triggers such as federal grants and disaster experiences that spotlighted the importance of community relationships to effective response. Facing budget and staff cuts, local health departments feel increasingly constrained in efforts to build trusted and lasting preparedness ties with community partners. At the same time, some progress in preparedness partnerships may be possible in the context of agency leadership, culture, and climate that affirms the value of collaboration with the community.
The authors conducted interviews with practitioners from 7 local health departments about which conditions have advanced or inhibited community engagement in public health emergency preparedness. Among the organizational factors identified as enabling local health departments' involvement of the community in emergency preparedness were a supportive agency leadership and culture, sufficient staffing and programmatic funding, interested and willing partners, and external triggers, such as federal grants and disaster experiences that spotlighted the importance of community relationships. Facing budget and staff cuts, local health departments feel increasingly constrained in efforts to build trusted and lasting preparedness ties with community partners.
In late 2010, the National Biodefense Analysis and Countermeasures Center (NBACC) implemented a Personnel Reliability Program (PRP) with the goal of enabling active participation by its staff to drive and improve the biosafety and biosecurity culture at the organization. A philosophical keystone for accomplishment of NBACC's scientific mission is simultaneous excellence in operations and outreach. Its personnel reliability program builds on this approach to: (1) enable and support a culture of responsibility based on human performance principles, (2) maintain compliance with regulations, and (3) address the risk associated with the insider threat. Recently, the Code of Federal Regulations (CFR) governing use and possession of biological select agents and toxins (BSAT) was amended to require a pre-access suitability assessment and ongoing evaluation for staff accessing Tier 1 BSAT. These 2 new requirements are in addition to the already required Federal Bureau of Investigation (FBI) Security Risk Assessment (SRA). Two years prior to the release of these guidelines, NBACC developed its PRP to supplement the SRA requirement as a means to empower personnel and foster an operational environment where any and all work with BSAT is conducted in a safe, secure, and reliable manner.
The National Biodefense Analysis and Countermeasures Center (NBACC) implemented a personnel reliability program to enable its staff to participate in improving the biosafety and biosecurity culture at the organization. The personnel reliability program enables and supports a culture of responsibility based on human performance principles, maintains compliance with regulations, and addresses the risk associated with the insider threat.
The goal of this study was to investigate the willingness of Medical Reserve Corps (MRC) volunteers to participate in public health emergency–related activities by assessing their attitudes and beliefs. MRC volunteers responded to an online survey organized around the Extended Parallel Process Model (EPPM). Respondents reported agreement with attitude/belief statements representing perceived threat, perceived efficacy, and personal/organizational preparedness in 4 scenarios: a weather-related disaster, a pandemic influenza emergency, a radiological (“dirty bomb”) emergency, and an inhalational anthrax bioterrorism emergency. Logistic regression analyses were used to evaluate predictors of volunteer response willingness. In 2 response contexts (if asked and regardless of severity), self-reported willingness to respond was higher among those with a high perceived self-efficacy than among those with low perceived self-efficacy. Analyses of the association between attitude/belief statements and the EPPM profiles indicated that, under all 4 scenarios and with few exceptions, those with a perceived high threat/high efficacy EPPM profile had statistically higher odds of agreement with the attitude/belief statements than those with a perceived low threat/low efficacy EPPM profile. The radiological emergency consistently received the lowest agreement rates for the attitude/belief statements and response willingness across scenarios. The findings suggest that enrollment with an MRC unit is not automatically predictive of willingness to respond in these types of scenarios. While MRC volunteers' self-reported willingness to respond was found to differ across scenarios and among different attitude and belief statements, the identification of self-efficacy as the primary predictor of willingness to respond regardless of severity and if asked highlights the critical role of efficacy in an organized volunteer response context.
This study investigated the willingness of Medical Reserve Corps (MRC) volunteers to participate in public health emergency–related activities by assessing their attitudes and beliefs. MRC volunteers responded to an online survey and reported agreement with attitude/belief statements in 4 scenarios: a weather-related disaster, a pandemic influenza emergency, a radiological (“dirty bomb”) emergency, and an inhalational anthrax bioterrorism emergency. The volunteers' willingness to respond was found to differ across scenarios and among different attitude/belief statements, with self-efficacy being the primary predictor of willingness to respond.