Tuesday Morning Research Articles

P-1848. Reduction of microbial burden on environmental floor samples through advanced photohydrolysis technology and its impact on Candida auris, fungi, and aerobic bacteria

Abstract Background The continued rise of antimicrobial resistance (AMR) and reduction of pharmacological options has created an urgent need for new treatments or countermeasures to combat the spread of multi-drug resistant organisms (MDROs). Focus on MDROs has become paramount with the rise of Candida auris (C. auris) infections that are associated with high mortality and AMR. Attention must be given to pathogen reservoirs such as the surfaces of floors, which have an underappreciated potential to transfer pathogens to hands from objects in contact with the floor. Mean CFUs of Aerobic Bacteria from Baseline to Post-Activation #4. Methods An experimental study to explore the impact of advanced photohydrolysis (AP) technology inside a high acuity hospital unit with active C. auris infections was performed from September 2023 to January 2024 and investigated the effect of the AP system on floor colony forming units (CFUs) of aerobic bacteria, fungi, and C. auris. Baseline pre-activation samples were compared to post-activation samples, which occurred every four weeks on Tuesday mornings prior to shift change and daily environmental services (EVS) cleaning. Mean CFUs of Fungi from Baseline to Post-Activation #4. Results Pairwise comparisons with a Bonferroni correction found median floor fungal CFUs achieved a statistically significant reduction of 99% (p=.011) from Baseline to Post-Activation #4. Aerobic bacteria decreased 98%; C. auris by 66% but did not achieve statistical significance. The mean CFUs on high-touch surfaces were reduced for aerobic bacteria by 82% and fungi by 99%. C. auris was reduced by 100% from Baseline to Post-Activation #3 (41 CFUs to 0 CFUs) but increased in Post-Activation #4 due to two positive sample locations in a patient room with an active C. auris infection. Although the locations were positive for C. auris, they both tested under 500 CFU/cm2, which is associated with a reduced level of infection risk from environmental bioburden. Mean CFUs of Candida Auris from Baseline to Post-Activation #4. Conclusion This study clearly demonstrates that despite intensive efforts by EVS, serious microbes remain on floors; however, application of the AP technology provided a continual and persistent decline in floor microbial burden all without the need for additional skilled labor or increases in cleaning and disinfection practices. A forthcoming study will analyze how these demonstrated environmental changes affected patient outcomes. Disclosures Kimberly Trosch, RN, BSN, ActivePure Technologies: Full time employee Amy Carenza, BBA, ActivePure Technologies: Full time employee Deborah Birx, MD, ActivePure Technologies: Advisor/Consultant

IMPLEMENTATION OF THE MUBASYAROH METHOD FOR THE ARABIC LANGUAGE CLASS PROGRAM IN INCREASING VOCABULARY AT THE ELEMENTARY SCHOOL OF THE FUTURE ISLAMIC SCHOOL PEKANBARU

Abstract The Mubasyarah method is an alternative to improve students' mastery or memorization of Arabic vocabulary. The deliberation method is also applied at the elementary school of the future Islamic School Pekanbaru in the Arabic class program every Tuesday morning. This study aims to determine the implementation of the deliberation method in Arabic language class programs for increasing vocabulary. The method used by researchers is a descriptive analysis method with a qualitative approach. The data collection techniques used are observation, interviews, and documentation. The results of the interviews show that the purpose of using the deliberation method in the language class program at the elementary school of the future Islamic school Pekanbaru is so that students can master and be motivated again to know simple Arabic vocabulary. In practice, the teacher prepares vocabulary related to the material, then reads the text followed by students repeatedly, and the teacher justifies that the students' pronunciation is still wrong. Evaluation of the Arabic class program with the Mubasyarah Method is carried out by giving individual students an assessment in the form of an oral test. Constraints in the Arabic language class program with the deliberation method that students feel are that they have difficulty memorizing the many, long, and difficult words. Meanwhile, the constraints felt by the teacher were that she felt difficulty maintaining order, consistent enthusiasm, and different backgrounds and EQs among students. Keywords: Language Program, Deliberation Method, Vocabulary.

Analisis Laju Emisi Gas Buang Karbon Monoksida (Qco) Pada Udara Ambient di Jalan Lintas Mendalo Darat Kabupaten Muaro Jambi

Carbon monoxide (CO) is a compound that has no smell, taste or color. The compound carbon monoxide (CO) originates from vehicle exhaust emissions from incomplete engine combustion, when exposed it will have an impact on disrupting the path of oxygen binding to hemoglobin in the blood. The Mendalo Darat road is one of the busiest roads in Jambi Province, so it is prone to traffic jams due ti the dense mobilization of motorized vehicles. This can result in a decrease in ambient air quality due to the concentration of carbon monoxide (CO) compounds. This study aims to determine the quality of ambient air in the parameters of carbon monoxide (CO) on the Mendalo Darat highway and the resulting emission rate. Based on the research results for 3 days, namely Sunday (Weekend), Monday, and Tuesday (Weekday), it shows that the highest density is on Tuesday morning which is 17,994 units. Meanwhile, the lowest vehicle volume was on Sunday afternoon point III with a vehicle volume of 6.576 units. The results showed that the highest carbon monoxide (Qco) emission rate on Sunday was at point I in the afternoon of 97.114 µg/m.s, at point II in the afternoon that was 52.665 µg/m.s, and point III in the afternoon wa 52.644 µg/m.s. on Monday, the highest emission rate of carbon monoxide (Qco) was at point I in the afternoon of 106.830 µg/m.s. followed by point II in the afternoon, which was 86.795 µg/m.s on Tuesday, and point III, which was 86.749 µg/m.s. on Tuesday, point I with the largest carbon monoxide (Qco) emission rate was 114.290 tn the morning, followed by point I, which was 109.601 in the afternoon

Assessment of Public Transport Footway Facilities Bogor District

Along with the increasing need for travel and the high dependence on motorized vehicles, the growth of existing transportation facilities and infrastructure is ultimately unable to accommodate these needs and leads to traffic jams, such as pollution, a decrease in the quality of life of the community and the level of road safety. Studies conducted at stations and Cibinong Terminal to analyze pedestrian characteristics and facilities. The research method used is direct observation and data collection in the field. From the results of the analysis in the direction of jl. Raya Bogor to Pabuaran with a vehicle volume of 2,160 per / hour on Monday afternoons at LOS B, the direction of Bogor to Jakarta with a vehicle volume of 13,390 on Tuesday and Saturday with peak hours in the afternoon, there is LOS E, and in the direction of Ciriung to Cikaret there is LOS B from morning to evening. The number of pedestrians is based on age with the direction of entering and exiting stations, stops and terminals, such as Cibinong Terminal with adult male pedestrians 16-40 years old, with the volume of pedestrians from and to the station. The density occurs on Monday afternoons. Tuesday morning, noon and evening, and Terminal on Wednesday morning. with the results of interviews of respondents who are at the productive age of 18-45 years, with high school / vocational school graduation with an income of 3-6 million and an expense of 1-2 million, the traveling characteristics of most respondents use station facilities, respondents are willing to walk 501-600 m, the level of facility in the respondent's station is quite satisfied, in the terminal the respondent is not satisfied, especially with the safety of pedestrians. Special satisfaction of Taxi / Ojek / delivery users and parking lots, respondents are quite satisfied, especially in the ease of finding a vehicle, the satisfaction of users of public transportation of respondents is quite satisfied, especially in the ease of finding a vehicle. The results of this study are the construction of pedestrian facilities and zebra crossing facilities.

Variations in the intended utilization of emergency care in case of gastrointestinal diseases

Frequent utilization of emergency care and overcrowded emergency departments (EDs) are highly relevant topics due to their harmful consequences for patients and staff. The present study examines variations of intended health care use in urgent and non-urgent cases among the general population. In a cross-sectional telephone survey, a sample of N = 1,204 adults residing in Hamburg, Germany, was randomly drawn. At the beginning of the survey, one of 24 different vignettes (case stories) describing symptoms of inflammatory gastrointestinal diseases were presented to the participants. The vignettes varied in sex (male/female), age (15, 49, 72 years), daytime (Tuesday morning, Tuesday evening), and urgency (low, high). Participants were asked in an open-ended question about their primal intended utilization if they or their children would be affected by such symptoms. Overall, about 14 % chose emergency facilities (ED, ambulance, emergency practice) despite presentation of non-urgent conditions (n = 602). Intended emergency care use varied considerably even if the degree of urgency was comparable. Adolescence, male sex, and symptoms occurring in the evening were associated with increased ED and ambulance use. Inappropriate utilization of ED and ambulance (analyses regarding utilization due to non-urgent problems) was more often observed among male respondents and those with a migration background (1st generation). Information campaigns focused on emergency care use and reorganisation of emergency care wards are possible interventions.

Regular Visitors

Regular Visitors Monica Ferrell (bio) inside every body is a blue wardrobe, and inside the wardrobe is an unremarkable lockbox, and inside Mila's was a picture of the man behind the counter at the café called Regular Visitors. His skin resembled a lamb's—that is, if you took a lamb and butchered it, then sheared it free of hair and massaged into it expensive toners and those moisturizers from Korea or Kiehl's that even the straight men among millennials seemed to wear. About as long ago as this man was old, she and her college friends used to play a game called Killed in the Initial Attack. There was nothing to the game beyond a mean-spirited hypothetical conjecture in which you imagined a scenario like the one from that movie Red Dawn, where America was being invaded by a foreign enemy. Who among them would go down first, stupidly wounded by the first tank, innocently stepping on the first grenade? Now Mila had a good answer for a game she no longer played. The man [End Page 5] behind the counter at Regular Visitors would. His teeth, presented in a smile each time he slid a coffee across the marble toward her, were guileless. "What will you have?" That's the way he took an order. It was so deferential, so Old World, especially in combination with the starched white apron he always wore, the half pencil he'd occasionally lift from the nook above his ear to jot down complex instructions on a little flip-top book of graph-lined paper, furrowing his fine forehead with the effort. He seemed to self-identify as a kind of writer; now and then she'd spotted him putting that poor mustard-colored notebook through its paces even when only she was around, and this one time when she rested a novel she was reading on the countertop as she poked in her wallet for her regular-visitor punch card, he'd twisted his long torso around to her side to read its title, sounding its words out with effort like a child. "Is this a good book?" She could see the bluish muscle working in his neck as he spoke. "He's Norwegian," she said, idiotically. Puckering his lips, the man on the other side of the counter put his hands to either side of the cover and studied it as though it were going to be on a test. "I've heard of him. Do you pronounce the K?" "Yes," she'd breathed. He nodded. "I thought so," he said, and grinned, a gymnast who'd stuck his landing. When her college friends used to play Killed in the Initial Attack, they'd rank Mila among the last to go, as she remembered, one of the final survivors. They said something about her spying—no, it was that she would turn double agent, using her sexual wiles to save herself with whichever side won. Mata Hari, they'd called her. It was vaguely dishonorable, the light they'd cast her in, tinged with a generalized racism made worse by the fact they clearly didn't know Mata Hari wasn't Indian, or even a real Asian at all. Odd to think how she had lost her wiles so thoroughly that she was now beneath the invaders' notice and could escape their bullets by simply not being seen. She had attained the fabled power of [End Page 6] cockroaches, she guessed, since like them she had become imperishable, a survivor who would persist through anything. ________ on tuesday mornings, Mila made breakfast for and dressed her five-year-old son and one-year-old daughter, then gathered them into coats, hats, gloves, and shoes and carried the littler one while holding hands with the bigger one down two flights of stairs. On her arms were threaded five bags: bag for Lily's daycare, bulging with diapers and wipes; bag for Jeet's school, heavy with lunch and snacks; bag with the breast pump, adapter, brick-sized ice pack, and bottles; her own work bag filled with books and papers; and her handbag. Sometimes Jeet would pretend to...

Public perceptions of urgency of severe cases of COVID-19 and inflammatory gastrointestinal disease.

BackgroundThere is evidence that perceived urgency of medical complaints is associated with emergency care utilization. Patients’ perception of urgency can differ from physicians’ assessment. This study explored public perceptions of urgency of severe cases of COVID-19 and inflammatory gastrointestinal disease and analyzed variations in perceptions of urgency by characteristics of the afflicted person in the vignettes and sociodemographic characteristics of respondents.MethodsVignettes with severe symptoms of either inflammatory gastrointestinal disease or COVID-19 with comparable urgency of treatment were used in a telephone survey in Germany (N = 1,207). Besides disease, the vignettes varied in terms of sex, age (child, middle-aged person, old person) and daytime (Tuesday morning, Tuesday evening). Respondents were asked to rate the urgency of the reported symptoms with four items. A sum scale was computed. Variations in perceptions of urgency according to vignette characteristics and sociodemographic characteristics of the respondents (sex, age, educational level, migration background, children (yes/no) and personal affliction) were analyzed using a linear regression model.ResultsIn terms of vignette characteristics, multivariate analysis showed a lower estimated urgency for males, as well as for the middle-aged and aged persons, compared to the child vignettes, and for COVID-19, compared to inflammatory gastrointestinal disease. Regarding the characteristics of the respondents, estimated urgency increased with age and was lower among respondents, who were previously affected by the symptoms themselves.ConclusionAlthough urgency in the vignettes was comparable, variations in estimated urgency by age and sex of the afflicted person and the described disease as well as age and personal affliction of the respondents were identified. This could result in an inadequate health care service utilization. Therefore, variations in public perceptions of urgency should be considered in the planning of public campaigns on adequate health care services utilization.

First weeks at Nursery School. Young Child Observations in a Montessori Nursery by Florence Daligault, with Commentary by Simonetta Adamo and Trudy Klauber

ABSTRACT My Young Child Observation took place in a nursery whose 26 children were grouped in three sections according to age. The Nursery followed the Montessori method and the teacher, Catherine, was supported by Marie-Laure, the teaching assistant. The classroom was large, with a patio where the children could do gardening. There were many small, individual tables, some of which were put together to create small islands. Learning materials and toys were on trays kept on the shelves which lined the walls of the room. The observations took place on Tuesday morning between 9 and 10 am. The extracts presented below cover the period from the first week of the new school year until the Autumn Half Term holiday at the beginning of November.

HAK PERDATA MASYARAKAT DESA KAYU DUJUNG DALAM PENYELESAIAN PEMECAHAN SERTIFIKAT TANAH KANTOR BADAN PERTANAHAN NASIONAL SINTANG

Earth is god’s gift of earth. The Land is a vital for human being as sources of human welfare, life and happiness. The rupiah rose to Rp.9,310/9,329 per dollar in the Jakarta interbank spot market on Tuesday morning as investors bought the local unit. It creates a wide range of needs both in individual and in group, both for offices or institutions, provide fertility in the economic needs of food and clothing. People should live in land and building. Therefor, land ownership is important aspect as means to create an ownership of land certificate. the legality of land ownership is necessary in the light of a valid evidence. The only way to prove land ownership of every society is using land certificate. This study is designed in the form of juridical sociological approach. The nature of this study is a descriptive analysis that describes thoroughly the systematic objects of the subject matter. A deed of land issued by the National lands Agency (BPN).Keywords: civil rights, Land certificates

"Particulars as to the Proposed Interment of Charles Dickens at Rochester"

Dickens left an injunction in his will that he be buried "in an inexpensive, unostentatious and strictly private manner." This article, by analysis of previously unremarked contemporary newspaper reports and related documents, records the attempts of his grieving family and friends to address this requirement by considering burial sites in or near Rochester, and their ultimate decision to satisfy a perceived need for public commemoration. Events are traced from Dickens's death at Gad's Hill by Rochester on the evening of Thursday 9 June 1870 to his burial in the early morning of Tuesday 14 June at Westminster Abbey.

MANAJEMEN PENGEMBANGAN BUDAYA ORGANISASI BERBASIS IHSAN DI MAS AL-HIKMAH TEBING TINGGI

Madrasah Aliyah Private Tebing Tinggi is very unique with the development of its ihsan-based organizational culture, where the head of MAS Al-Hikmah Tebing Tinggi often communicates the vision and mission of the madrasa with the slogan of excellence and dignity. The values built by teachers and students are also displayed on a daily basis, starting from the cleanliness of the environment, carrying out the midday and asar prayers in congregation. So this is why the researchers chose the location at the Private Madrasah Aliyah Tebing Tinggi. Problem Formulation. How to develop an organizational culture based on Ihsan MAS Al-Hikmah Tebing Tinggi. What is the strategy for developing an organizational culture based on Ihsan MAS Al-Hikmah Tebing Tinggi. Place and time of research. This research was conducted at the Tebing Tinggi Private Madrasah Aliyah. Central Padanghulu District, Tebing Tinggi City. Research time is from 09 to 11 January 2022. Type of Research Research method is a way of doing something by using the mind carefully to achieve the objectives of the research. The method used by the author is a qualitative approach. Qualitative method is a method based on philosophy, postpositivism. Findings. The development of an Ihsan-Based Organizational Culture at MAS Al-Hikmah Tebing Tinggi is: The development of an organizational culture based on the Ihsan Aliyah Private Madrasah of Tebing Tinggi is developed and applied every day in learning and outside of learning, students continue to be fostered by teachers and senior students so that they are good in knowledge, attitudes and worship . Every Tuesday and Thursday morning students must line up in the field to listen to lectures. Ihsan-Based Organizational Culture Development Strategy at MAS Al-Hikmah Tebing Tinggi. Efforts made by school/madrasah principals in the early stages are preparing for cultural development in schools/madrasahs. In some cases in schools/madrasah the principal can use several steps. Based on an interview with the deputy head of the madrasa regarding the development of an ihsan-based organizational culture at the Madrasah Aliyah Swasta Tebing Tinggi, he explained as follows: The head of the madrasa conveyed the vision and mission of the madrasah.

The History of Things in Ralf Andtbacka'sWunderkammer

The History of Things in Ralf Andtbacka's<i>Wunderkammer</i>

Intended healthcare utilisation in cases of severe COVID-19 and inflammatory gastrointestinal disease: results of a population survey with vignettes

ObjectivesTo examine variations in intended healthcare utilisation in severe cases of COVID-19 and inflammatory gastrointestinal disease (IGD).DesignRepresentative cross-sectional telephone survey.Setting and participants1207 randomly drawn adults of the city of Hamburg,...

Improving Mental Health Support, Career Transitions and Access to Health Care for Surgical Residents

To increase access to mental health support, assist with career transitions, and improve access to health care. Retrospective survey data. General surgery residency program. Surgical residents. We developed three programs to address the issues above. The "Fifth Tuesday of the Month" program allows residents to take time off during the first Tuesday morning of any month with five Tuesdays. The Physician Wellness Collaborative provides confidential, affordable, and easy-to-access counseling resources for residents. Residents are automatically signed up for a session to establish care. The Peer Resident Mentorship Program matches a fourth-year resident with a first-year resident based on personal and professional interests to help ease the transition and improve career satisfaction. All programs were associated with improvement in related outcome measures on our institution's annual program evaluation survey. At our institution, we introduced three simple and accessible programs aimed at increasing access to mental health support, assisting with career transitions, and improving work-life balance. These programs have improved related outcomes in our residents and can be easily implemented at any program.

Editorial

Editorial Christina Larocco Earlier this year, I unintentionally let my vote-by-mail registration lapse, and so I found myself at Overbrook High School, my local polling place, early on a Tuesday morning. Understandably nicknamed "the castle on the hill," the school looms large over Lancaster Avenue amid (then as now) an assortment of stalwart single-family homes and commercial establishments. In the end, I was happy to have voted in person. The polling place was a model of efficiency, and the school itself is quite marvelous: if the architecture and design are resolutely early twentieth-century, the hallway murals tell a longer story of Black history through the rest of the twentieth century and into the twenty-first. Established to alleviate overcrowding at West Philadelphia's separate high schools for girls and boys, Overbrook High School opened in September of 1926. Unlike the established schools, which merged the same year Overbrook High opened, the new school was coeducational from the start. With a projected cost of over $2 million and capacity for 4,000 students, the school skimped nowhere. Designed in the English Gothic Revival style by Irwin T. Catharine, architect of the Philadelphia Board of Education, the building used some 4.5 million bricks and 2,000 tons of steel. The walls of the large, airy rooms were 20 percent windows, and a giant, oil-burning furnace replaced coal stoves. Like many of Catharine's [End Page 185] other designs, Overbrook High reflected the national trend toward specialized interior spaces. Described upon its opening as a "castle-like … educational fortress," Overbook High's design also reflected the new subjects combined under its roof: it was the first and only high school in the city to include all subjects, from the industrial to the academic.1 Overbrook High began its life as the model of a modern school, well-regarded in the city and its environs. In the late 1980s and early 1990s, it was put on the national map—in one case literally, in the other figuratively. In 1986, it was added to the National Register of Historic Places (NRHP), which the federal government uses to identify aspects of the built environment that are particularly significant—and thus particularly worthy of preservation. Despite this national recognition, in other parts of the country Overbrook High remains best-known as the alma mater of Wilt Chamberlain and Will Smith—"West Philadelphia born and raised" like his alter ego, the fictionalized version of himself he played on The Fresh Prince of Bel-Air. The theme song describes the show's premise: playing basketball with friends, Will unintentionally provokes members of a local gang. Fearing for his safety, Will's mother sends him to live with his wealthy aunt, uncle, and cousins in the Bel Air section of Los Angeles. The proximity of these developments (the school's appearance on the NRHP and its affiliation with an influential, nationally aired sitcom) illustrates something of the past of Philadelphia's built environment—and perhaps of its future. As I sit here typing this piece, just blocks from Overbrook High, home and office still, in late 2021, sometimes collapsed together, a work crew hammers away at the vacant house next door to mine. It's been that way since before I moved in, two years ago now. When it's completed, it will probably resemble the other rehabbed houses across the city, with the subway tile backsplashes and exposed-brick staircases that populate Zillow listings. On neighborhood blogs popular among middle-class, largely White West Philadelphians in their thirties and forties, exhortations abound not to cross Fifty-Second Street when it comes to real estate. I posit no causality, of course, but these exhortations reflect the fact that those of us in this age cohort grew up with the Fresh Prince of Bel-Air vision of Overbrook and adjacent neighborhoods, after White flight and disinvestment affected the infrastructure and livability of cities across the [End Page 186] country. Certainly some members of this generation see the appeal of the area, with its quiet, residential streets and iconic landmarks, like the high school. Whoever moves into the vacant house will probably have more in common...

Induction of parturition in a large number of pregnant dairy goats and its benefits as a management tool in a commercial scale goat operation

At LFB USA, Inc., transgenic goats are utilized for the production of recombinant human protein therapeutics in their milk through the rPRO™ Technology platform. This retrospective analysis and report describes the results of induced parturition and its use as a management tool in this large herd of dairy goats. Over a three-year period, 342 does received pronuclear microinjected (MI) embryos transferred into the oviductal lumen via midline laparotomy (day 1). To initiate the induction process, does were given intramuscular injections (IM) of 10 mg each of prostaglandin (Lutalyse®) and dexamethasone to induce parturition on days 144–148 of pregnancy. Mean and Standard Deviation (±SD) time to parturition was 36.7 (±6.5) hours. Does were given these injections at 4pm on Sundays with an expected kidding time of late Monday into Tuesday morning. Of the 342 does, 333 or 97% had kidded by 3pm the following Tuesday, and 313 or 91% kidded in the 18 h between 9pm Monday and 3pm on Tuesday or between 29 and 47 h post induction. By the end of Tuesday, most kids had received colostrum and were transferred to the nursery. The incidences of kid mortality and retained placenta were 2.5% and 1.5%, respectively, clearly achieving a priority at this commercial operation for generating a high percentage of live kids (97.5%) of marked value being produced. The use of induced parturition allowed this large dairy operation to designate two 9-h time blocks in which to concentrate parturition times within the herd. This facilitated strategic scheduling to optimize availability of staff, in order to assist with parturition, separate kids from the dam at birth, and ensure adequate and prompt feeding of colostrum. Predicting the time of kidding in this way can serve as an effective management tool, especially to help reduce kid mortality and prevent disease spread by restricting suckling of colostrum.

Pharmacist's whistleblower claim for wrongful termination is rejected

Most pharmacists are “at will” employees, meaning that without an employment contract stating to the contrary, they can be discharged at the employer's will for any or no reason. Many state laws contain an exception to the “discharge at will” doctrine, providing that an employee may not be discharged from employment for refusing to participate in an illegal act or for reporting illegal acts by the employer. This provision encourages “whistleblowers” to report and put an end to illegal conduct they detect. A Mississippi pharmacist recently attempted to assert the whistleblower provision following her discharge from employment. The plaintiff, who had been designated as the pharmacy's Pharmacist-in-Charge (PIC), had what the court called a “rocky” relationship with the pharmacy owners. She thought that the owners “infringed on her authority as the PIC.” She wanted “full reign” over a pharmacy technician and the relief pharmacist, and she felt that she had not been given this needed authority. The event that led to termination of the plaintiff's employment occurred on the Saturday of a Labor Day weekend. At the end of that day, the relief pharmacist processed a verbal order for four diazepam tablets for a patient. On Tuesday morning, the plaintiff opened the pharmacy and discovered a new prescription for a larger quantity of the drug, with the notation to “take four tablets out” of the quantity dispensed. The prescription was dated with Tuesday's date. The plaintiff concluded that the relief pharmacist had unlawfully dispensed the four diazepam tablets on Saturday. She reported this allegedly illegal act to the pharmacy owners. The report apparently led to a series of “heated” discussions over a period of days, eventually resulting in the plaintiff being fired. The plaintiff's wrongful discharge lawsuit against her former employer was dismissed, and from the dismissal the pharmacist appealed. The court evaluated the evidence, which was somewhat contradictory. The court concluded that the relief pharmacist had received a verbal authorization to dispense a Schedule IV controlled substance, and that verbal prescriptions are allowed for these medications. The plaintiff contended that the prescription was not lawful because the prescription had not been “reduced promptly to writing,” as is required by law. In support of this argument, the plaintiff cited the delay between the Saturday when the order was received and the Tuesday date on the written prescription. The court noted that the word “promptly” is not defined in the relevant laws. The court examined the purpose of controlled substance regulations, concluding that they are “designed to ensure that the doctor examines the patient before delivering the prescription and to ensure that there is a legitimate medical reason for delivering the prescription.” The court ruled that the plaintiff had failed to provide any evidence “that a delay of such duration is a crime.” Dismissal of the plaintiff's wrongful discharge lawsuit was affirmed. All pharmacists, and particularly those designated as a pharmacy's PIC, have a significant responsibility to ensure that violations of pharmacy laws are avoided. When regulatory violations occur, they must be reported to appropriate pharmacy authorities. Whistleblower laws in many states protect a reporting pharmacist from retaliation based on the submission of such a report. Whistleblower laws apply when a clear violation of regulatory requirements has occurred or is reasonably suspected to have occurred. Unique interpretations of the law that support allegations of minor regulatory violations cannot be used as a smokescreen to avoid the consequences of major disagreements with management. The diversion of controlled substances is a very serious matter. Any activity related to controlled substance diversion must be reported to and taken seriously by management. Disagreements over the definition of a word like “promptly” may lead to interesting discussions, but it is unlikely that a clear violation of regulatory requirements will be identified by these discussions.

The heartbeat of the city.

Human activity is organised around daily and weekly cycles, which should, in turn, dominate all types of social interactions, such as transactions, communications, gatherings and so on. Yet, despite their strategic importance for policing and security, cyclical weekly patterns in crime and road incidents have been unexplored at the city and neighbourhood level. Here we construct a novel method to capture the weekly trace, or "heartbeat" of events and use geotagged data capturing the time and location of more than 200,000 violent crimes and nearly one million crashes in Mexico City. On aggregate, our findings show that the heartbeats of crime and crashes follow a similar pattern. We observe valleys during the night and peaks in the evening, where the intensity during a peak is 7.5 times the intensity of valleys in terms of crime and 12.3 times in terms of road accidents. Although distinct types of events, crimes and crashes reach their respective intensity peak on Friday night and valley on Tuesday morning, the result of a hyper-synchronised society. Next, heartbeats are computed for city neighbourhood 'tiles', a division of space within the city based on the distance to Metro and other public transport stations. We find that heartbeats are spatially heterogeneous with some diffusion, so that nearby tiles have similar heartbeats. Tiles are then clustered based on the shape of their heartbeat, e.g., tiles within groups suffer peaks and valleys of crime or crashes at similar times during the week. The clusters found are similar to those based on economic activities. This enables us to anticipate temporal traces of crime and crashes based on local amenities.

COVID-19 survivor experiencing long-term symptoms

COVID-19 survivor experiencing long-term symptoms

Editors' Page

Editors' Page Stephanie G'schwind and Donald Revell A year into the pandemic we each continue to find our own ways of understanding and grappling with the nature of isolation, seeking self-care and coping strategies in these Groundhog Days of staying in, staying safe, staying sane. Many of us are, not surprisingly, finding comfort and companionship in reading. Among the joys of literature is connecting with characters, with stories, and recognizing ourselves—thinking, Yes, I have felt that too or I thought I was the only one … And in those moments we feel, for better or worse, seen, known, perhaps even understood. So in this issue's stories and essays, we hope you discover such moments, in which you see yourself, maybe someone else, and find that, though you may be isolated, you are indeed not alone. We are delighted to feature Holly Goddard Jones's "Antipodes," a fabulist story set amid environmental crisis and postpartum depression, in which a mother's obsession with a sinkhole and fears for her family threaten to overwhelm her. In Tim Erwin's "The Sparks Fly Upward," a man tries desperately to reconcile with his wife but manages only to get in his own way after an illconceived money-making scheme goes awry. A college student, home for the summer and living with her disintegrating family, takes on a lonely copyediting job and seeks solace in a relationship with an older co-worker in Kim Magowan and Michelle Ross's co-written "Twenty-Three Safety Manuals." And in Kathryn Harlan's "Endangered Animals," a young woman accompanies her former girlfriend on a cross-country road trip, anticipating a move that may end their friendship. Molly Rogers's essay "House of Secrets" explores the nature of photography, anxiety, and the secrets our families keep from us, the secrets we keep from them. In "A Shared Stillness," Monica Macansantos considers the possibilities for connection and healing through tango, drawing on her family's trauma and her own grief. And in "Monsters," David Franke returns to his tornado-prone Iowa childhood and observes the unraveling of his parents' marriage. We welcome you to the spring issue—come, join us. You'll be in good company. stephanie g’schwind [End Page 1] ________ There comes a tender shock of recognition when reading the opening line of Maria Zoccola's "At the Downtown Kroger"—"i pray in parking lots"—a recognition not only of shared circumstance but of the courage and humility required to avow as much and then to go forward into the day, into the poem. Every Tuesday morning, just as the designated "Seniors' Shopping Hour" is about to begin, I pull into our supermarket's parking lot, adjust my masks (one for safety and one on top of that with a floral pattern to seem less severe), say a quick prayer, and then go inside for the week's groceries. In this vexed and precarious springtime of 2021, the second spring of the pandemic, all of our public spaces have become little chapels of daring, of wariness, and of faith. We are, it seems to me, newly medieval, steering our shopping carts through allegory, looking to the left and to the right upon our neighbors with both caution and compassion. It's not surprising, then, that the poems appearing in this issue all resound in several worlds at once: worlds of fact, worlds of emblem, worlds of vague but vital anticipation. The skills required to navigate such worlds, as Mary Ann Samyn beautifully proposes, "include humor and patience." As a rule, the springtime is a season of exaltation and refreshing carelessness. Yet this spring, we must take care to exercise patience—with ourselves, with our neighbors of every persuasion, and with our struggling planet—in a spirit of humor and with our allegorical smiles intact. The poems we've gathered here will, I truly believe, help us all to do just that. donald revell [End Page 2] Copyright © 2021 Center for Literary Publishing