Search

A study was conducted to characterize Streptomyces griseus strains emitting a toxin in indoor air and in indoor dust. An Andersen sampler and tryptic soy agar were utilized to collect actinomycetes while electrospray mass spectra were determined with a model API300 triple quadrupole mass spectrometer. Experimental results indicated that S. griseus isolates determined from dust and air in water-damaged buildings generated valinomycin.

Research was conducted to examine a new, sensitive, inexpensive and rapid bioassay for the detection of the emetic toxin of Bacillus cereus. The novel bioassay is based on the motility loss of boar spermatozoa upon 24 h of exposure to emetic B cereus strains extracts or contaminated food. Results indicate swollen mitochondria of the paralyzed spermatozoa but no epetion of cellular ATP or damage to plasma membrane integrity was observed.

Aims: The production of peptaibols, toxic secondary metabolites of Trichoderma, in the indoor environment is not well‐documented. Here, we investigated the toxicity of peptaibols in the guttation droplets and biomass of Trichoderma strains isolated from problematic buildings. Methods and Results: Seven indoor‐isolated strains of T. atroviride, T. trixiae, T. paraviridescens and T. citrinoviride were cultivated on malt extract agar, gypsum boards and paperboards. Their biomass extracts and guttation droplets were highly cytotoxic in resting and motile boar sperm cell assays and in inhibition of somatic cell proliferation assays. The toxins were identified with HPLC/ESI‐MS/MS as trichorzianines, trilongins, trichostrigocins and trichostrigocin‐like peptaibols. They exhibited toxicity profiles similar to the reference peptaibols alamethicin, trilongins, and trichorzianine TA IIIc purified from T. atroviride H1/226. Particular Trichoderma strains emitted the same peptaibols in both their biomasses and exudate droplets. The trilongin‐producing T. citrinoviride SJ40 strain grew at 37°C. Conclusions: To our knowledge, this is the first report of indoor‐isolated Trichoderma strains producing toxic peptaibols in their guttation droplets. Significance and Impact of the Study: This report proves that indoor isolates of Trichoderma release peptaibols in their guttation droplets. The presence of toxins in these types of exudates may serve as a mechanism of aerosol formation for nonvolatile toxins in the indoor air. [ABSTRACT FROM AUTHOR]

Presents a study to describe a bioassay in the detection of Bacillus cereus emetic toxin. Methodology used to conduct study; Indication of findings; Discussion on results.

It is controversial how useful bioassays are for identifying the in vivo toxicity of hazardous environmental exposures. In this study, fruiting bodies of forest mushrooms (n = 46), indoor mold colonies (n = 412), fungal secondary metabolites (n = 18), xenobiotic chemicals such as biocides and detergents (n = 6), and methanol extracts of indoor dusts from urban buildings (n = 26) were screened with two different bioactivity assays: boar sperm motility inhibition (BSMI) and inhibition of cell proliferation (ICP) tests. For the forest mushrooms, the toxicity testing result was positive for 100% of poisonous-classified species, 69% of non-edible-classified species, and 18% of edible-classified species. Colonies of 21 isolates of Ascomycota mold fungal species previously isolated from water-damaged buildings proved to be toxic in the tests. Out of the fungal metabolites and xenobiotic chemicals, 94% and 100% were toxic, respectively. Out of the indoor dusts from moldy-classified houses (n = 12) and from dry, mold-free houses (n = 14), 50% and 57% were toxic, respectively. The bioassay tests, however, could not differentiate the samples from indoor dusts of moldy-classified buildings from those from the mold-free buildings. Xenobiotic chemicals and indoor dusts were more toxic in the BSMI assay than in the ICP assay, whereas the opposite results were obtained with the Ascomycota mold colonies and fungal secondary metabolites. The tests recognized unknown methanol-soluble thermoresistant substances in indoor settled dusts. Toxic indoor dusts may indicate a harmful exposure, regardless of whether the toxicity is due to xenobiotic chemicals or microbial metabolites.

Sport facilities represent extreme indoor environments due to intense cleaning and disinfection. The aim of this study was to describe the composition of the cultivated microbiota in dust samples collected in sport facilities during the COVID-19 pandemic. A dust sample is defined as the airborne dust sedimented on 0.02 m 2 within 28 d. The results show that the microbial viable counts in samples of airborne dust ( n = 9) collected from seven Finnish sport facilities during the pandemic contained a high proportion of pathogenic filamentous fungi and a low proportion of bacteria. The microbial viable counts were between 14 CFU and 189 CFU per dust sample. In seven samples from sport facilities, 20-85% of the microbial viable counts were fungi. Out of 123 fungal colonies, 47 colonies belonged to the potentially pathogenic sections of Aspergillus (Sections Fumigati , Nigri , and Flavi ). Representatives of each section were identified as Aspergillus fumigatus , A. flavus , A. niger and A. tubingensis. Six colonies belonged to the genus Paecilomyces. In six samples of dust, a high proportion (50-100%) of the total fungal viable counts consisted of these potentially pathogenic fungi. A total of 70 isolates were considered less likely to be pathogenic, and were identified as Aspergillus section Nidulantes , Chaetomium cochliodes and Penicillium sp. In the rural ( n = 2) and urban ( n = 7) control dust samples, the microbial viable counts were >2000 CFU and between 44 CFU and 215 CFU, respectively, and consisted mainly of bacteria. The low proportion of bacteria and the high proportion of stress tolerant, potentially pathogenic fungi in the dust samples from sport facilities may reflect the influence of disinfection on microbial communities.

Viable airborne pathogenic fungi represent a potential health hazard when exposing vulnerable persons in quantities exceeding their resilience. In this study, 284 indoor fungal isolates from a strain collection of indoor fungi were screened for pathogenic potential through the ability to grow in neutral pH at 37 °C and 30 °C. The isolates were collected from 20 locations including 14 problematic and 6 non-problematic ordinary buildings. Out of the screened isolates, 170 isolates were unable to grow at 37 °C, whereas 67 isolates growing at pH 7.2 at 37 °C were considered as potential opportunistic pathogens. Forty-seven isolates growing at 30 °C but not at 37 °C were considered as less likely pathogens. Out of these categories, 33 and 33 strains, respectively, were identified to the species level. The problematic buildings included known opportunistic pathogens: Aspergillus calidoustus , Trichoderma longibrachiatum , Rhizopus arrhizus and Paecilomyces variotii , as well as less likely pathogens: Aspergillus versicolor , Chaetomium cochliodes , Chaetomium globosum and Chaetomium rectangulare. Opportunistic pathogens such as Aspergillus flavus, Aspergillus fumigatus , Aspergillus niger and Aspergillus tubingensis and less likely pathogens such as Aspergillus westerdijkiae, Chaetomium globosum and Dichotomopilus finlandicus were isolated both from ordinary and from problematic buildings. Aspergillus was the dominant, most diverse genus found during screening for potentially pathogenic isolates in the indoor strain collection. Studies on Aspergillus niger and Aspergillus calidodoustus revealed that tolerance to cleaning chemicals may contribute to the adaptation of Aspergillus species to indoor environments.

The genus Chaetomium is a frequently occurring fungal taxon world-wide. Chaetomium and Chaetomium -like species occur in indoor environments, where they can degrade cellulose-based building materials, thereby causing structural damage. Furthermore, several species of this genus may also cause adverse effects on human health. The aims of this research were to identify Chaetomium and Chaetomium -like strains isolated from indoor environments in Hungary and Finland, two geographically distant regions of Europe with drier and wetter continental climates, respectively, and to study their morphological and physiological properties, as well as their extracellular enzyme activities, thereby comparing the Chaetomium and Chaetomium -like species isolated from these two different regions of Europe and their properties. Chaetomium and Chaetomium -like strains were isolated from flats and offices in Hungary, as well as from schools, flats, and offices in Finland. Fragments of the translation elongation factor 1α ( tef1α ), the second largest subunit of RNA polymerase II ( rpb2 ) and β-tubulin ( tub2 ) genes, as well as the internal transcribed spacer (ITS) region of the ribosomal RNA gene cluster were sequenced, and phylogenetic analysis of the sequences performed. Morphological examinations were performed by stereomicroscopy and scanning electron microscopy. Thirty-one Chaetomium sp. strains (15 from Hungary and 16 from Finland) were examined during the study. The most abundant species was Ch. globosum in both countries. In Hungary, 13 strains were identified as Ch. globosum , 1 as Ch. cochliodes, and 1 as Ch. interruptum . In Finland, 10 strains were Ch. globosum, 2 strains were Ch. cochliodes , 2 were Ch. rectangulare , and 2 isolates (SZMC 26527, SZMC 26529) proved to be representatives of a yet undescribed phylogenetic species from the closely related genus Dichotomopilus , which we formally describe here as the new species Dichotomopilus finlandicus . Growth of the isolates was examined at different temperatures (4, 15, 20, 25, 30, 37, 35, 40, and 45 °C), while their extracellular enzyme production was determined spectrophotometrically.

The emissions of volatile organic compounds (VOCs) from building materials may significantly contribute to indoor air pollution, and VOCs have been associated with odor annoyance and adverse health effects. Wood materials together with coatings are commonly used indoors for furniture and large surfaces such as walls, floors, and ceilings. This leads to high surface-to-volume ratios, and therefore, these materials may participate remarkably to the VOC levels of indoor environment. We studied emissions of VOCs and carbonyl compounds from pinewood (Pinus sylvestris) boards of 10% and 16% moisture contents (MC) with three paints using small-scale test chambers (27 L). The emissions from uncoated pinewood and paints (on a glass substrate) were tested as references. The 28-day experiment showed that the VOC emissions from uncoated pinewood were lower from sample with 16% MC. Painted pinewood samples showed lower emissions compared to paints on glass substrate. Additionally, paints on 16% MC pinewood exhibited lower emissions than on drier 10% MC wood. The emissions from painted pinewood samples were dominated by paint-based compounds, but the share of wood-based compounds increased over time. However, we noticed differences between the paints, and wood-based emissions were clearly higher with the most permeable paint., (© 2021 The Authors. Indoor Air published by John Wiley & Sons Ltd.)

Occupants may complain about indoor air quality in closed spaces where the officially approved standard methods for indoor air quality risk assessment fail to reveal the cause of the problem. This study describes a rare genus not previously detected in Finnish buildings, Acrostalagmus , and its species A. luteoalbus as the major constituents of the mixed microbiota in the wet cork liner from an outdoor wall. Representatives of the genus were also present in the settled dust in offices where occupants suffered from symptoms related to the indoor air. One strain, POB8, was identified as A. luteoalbus by ITS sequencing. The strain produced the immunosuppressive and cytotoxic melinacidins II, III, and IV, as evidenced by mass spectrometry analysis. In addition, the classical toxigenic species indicating water damage, mycoparasitic Trichoderma, Aspergillus section Versicolores, Aspergillus section Circumdati, Aspergillus section Nigri , and Chaetomium spp., were detected in the wet outdoor wall and settled dust from the problematic rooms. The offices exhibited no visible signs of microbial growth, and the airborne load of microbial conidia was too low to explain the reported symptoms. In conclusion, we suggest the possible migration of microbial bioactive metabolites from the wet outdoor wall into indoor spaces as a plausible explanation for the reported complaints.

Background and Purpose: Elder abuse, neglect, and exploitation are under-detected and under-reported. The purpose of this qualitative study was to describe out-ofhospital emergency care providers' experiences of identifying elder abuse., Methods: Individual theme interviews were conducted with nine prehospital emergency care providers and three community paramedics in spring 2019. The transcribed data were analyzed using inductive content analysis., Results: Although the short duration of care contacts made the identification of elder abuse challenging, the emergency care providers detected indicators of physical, psychological and social abuse, unethical action, material exploitation, and self-neglect/self-abuse. The professionals based their observations on patient and family interviews, on clues in the home environment, on caregiving quality combined with the patient's medical history, and on physical signs, which were the easiest to identify., Implications for Practice: The identification of elder abuse may be improved by multiprofessional collaboration, by increased attention given to risk groups and common indicators of abuse, and by adoption or creation of screening tools to assist detection and reporting. Training on the detection of elder abuse should be included in nursing and social work curricula and in the continuing professional development of emergency care providers., (© Copyright 2021 Springer Publishing Company, LLC.)

Reported indoor air quality (IAQ) complaints are common even in relatively new or renovated school buildings in Finland. However, detecting the causes for complaints with commonly used indoor air measurements is difficult. This study presents data on perceived and measured IAQ in six comprehensive school buildings in Finland. The aim of this study was to discover the possible differences of perceived and measured IAQ between schools with reported IAQ complaints and schools without reported IAQ complaints. The initial categorisation of schools with ('problematic schools') and without ('comparison schools') complaints was ensured via a validated indoor climate survey and a recently developed online questionnaire, which were completed by 186 teachers and 1268 students from the six schools. IAQ measurements of physical parameters, gaseous pollutants, particulate matter and bioaerosols were conducted in four problematic school buildings (26 classrooms) and two comparison school buildings (12 classrooms). Using air sampling as well as exhaust air filters and classroom settled dust to detect the presence of elevated concentrations of airborne cultivable microbes and pathogenic, toxigenic and mycoparasitic Trichoderma strains were the most indicative methods in distinguishing problematic schools from comparison schools. Other IAQ-related measurements did not detect clear differences between problematic and comparison schools, as the concentration levels were very low. The results indicate that the complaints reported by occupants could have been related to excess moisture or mould problems that had not been found or repaired. Ventilation pressure condition investigations and simultaneous exhaust and supply air filter dust culture should be addressed precisely in future studies., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The diversity of Chaetomium- like isolates in buildings in Finland is poorly documented. This paper describes a set of methods for rapid diversity tracking of 42 indoor Chaetomium -like isolates. These isolates were categorized based on their fluorescence emission, ascomatal hair morphology, responses in three bioassays and resistance/sensitivity to the wetting agent Genapol X-080. Thirty-nine toxigenic isolates were identified [ Ch. globosum ( n = 35), Ch. cochliodes ( n = 2) and Ch. rectangulare ( n = 2)]. These isolates were identified down to the species level by tef1α gene sequencing. The major toxic substances in the ethanol extracts of the Ch. globosum and Ch. cochliodes strains were chaetoglobosin, chaetoviridin A and C, chaetomugilin D and chaetomin, identified based on HPLC-UV and mass spectrometry data (MS and MS/MS). Ethanol extracts from pure Ch. globosum cultures exhibited a toxicological profile in the boar sperm motility inhibition assay (BSMI), sperm membrane integrity damage assay (SMID) and inhibition of cell proliferation (ICP) assay, similar to that exhibited by pure chaetoglobosin A. Overall, differences in fluorescence, morphology, toxicity profile, mycotoxin production and sensitivity to chemicals were consistent with those in tef1α sequencing results for species identification. The results indicate the presence of Ch. cochliodes and Ch. rectangulare in Finnish buildings, representing a new finding.

The occurrence and toxin production of the opportunistic pathogen Aspergillus calidoustus in Finnish buildings is not well documented in the literature. We tracked and identified four A. calidoustus colonies cultivated from indoor settled dusts and revealed the biological activities of crude biomass extracts. The toxic substances were identified as 6-epi-ophiobolin K, ophiobolin K, and ophiobolin G by high-performance liquid chromatography-mass spectrometry (HPLC-MS) based on chromatographic and mass spectrometry data (MS and MS/MS) on the crude extract of A. calidoustus strain MH34. A total of 29 fungal colonies collected from settled dust in an office room reported for indoor-air-related illnesses were screened for toxins that inhibited boar sperm motility in the BSMI (boar sperm motility inhibiting) assay and cell proliferation in the ICP (inhibition of cell proliferation) assays with PK-15 cells. Out of the 27 colonies tested as toxic, 12 colonies exhibiting conidiophores representative of the genera Chaetomium , Penicillium , and Paecilomyces were excluded from the study, while 13 colonies exhibited Aspergillus-like conidiophores. Biomass suspensions of these colonies were divided into two categories: Category 1 colonies (n = 4), toxic in the BSMI assay and the ICP assays, emitted blue fluorescence and grew at 37 °C; Category 2 colonies (n = 9), only toxic in the ICP assay, emitted orange fluorescence and exhibited limited or no growth at 37 °C. Colonies in Category 1 were pure-cultured, and the strains were named as MH4, MH21, MH34, MH36. Strain MH34 was identified as A. calidoustus by the internal transcribed spacer (ITS) sequences. Ethanol-soluble dry substances extracted from the biomass of the pure cultures exhibited a toxicological profile in the BSMI assay, SMID (sperm membrane integrity damage) assay, and ICP assay similar to that exhibited by pure ophiobolin A. Overall, the viable conidia of A. calidoustus in indoor settled dusts deserve attention when potentially hazardous mold species are monitored., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the result.

Degrading 2-ethylhexyl-containing PVC floorings (eg DEHP-PVC floorings) and adhesives emit 2-ethylhexanol (2-EH) in the indoor air. The danger of flooring degradation comes from exposing occupants to harmful phthalates plasticisers (eg DEHP), but not from 2-EH as such. Since the EU banned the use of phthalates in sensitive applications, the market is shifting to use DEHP-free and alternative types of plasticisers in PVC products. However, data on emissions from DEHP-free PVC floorings are scarce. This study aimed at assessing the surface and bulk emissions of two DEHP-free PVC floorings over three years. The floorings were glued on the screed layer of concrete casts at 75%, 85%, and 95% RH. The volatile organic compounds (VOCs) were actively sampled using FLEC (surface emissions) and micro-chamber/thermal extractor (µ-CTE, bulk emissions) onto Tenax TA adsorbents and analyzed with TD-GC-MS. 2-EH, C9-alcohols, and total volatile organic compound (TVOC) emissions are reported. Emissions at 75% and 85% RH were similar. As expected, the highest emissions occurred at 95% RH. 2-EH emissions originated from the adhesive. Because the two DEHP-free floorings tested emitted C9-alcohols at all tested RH, it makes the detection of flooring degradation harder, particularly if the adhesive used does not emit 2-EH., (© 2019 The Authors. Indoor Air published by John Wiley & Sons Ltd.)

The emergency department is a workplace where the staff regularly encounter new challenges and factors that can cause fear. The aim of this study was to describe coping with work-related fear among emergency department staff. The study explains the current coping methods of emergency department staff and the requirement for support as well as the availability of support. A coping model for work-related fear was also developed and will be presented. The study was conducted using a survey developed specifically for this study, which included the Brief COPE Inventory. The study was conducted in 16 hospitals (N = 544) among the doctors, nurses, practical nurses, and orderlies of the emergency departments. The results were analysed using statistical methods such as frequencies, cross-tabulation, principal component analysis and binary logistic regression analysis. All values of p < 0.05 were considered statistically significant. The results showed that nearly all of the emergency department personnel had experienced work-related fear. Most of the respondents to the survey would have wanted more support, professional help, preventive action and more resources for the emergency department. The emergency department staff had used several coping methods to cope with fear. The most commonly used coping methods were problem-focused coping and social support. Based on the results of the study, it is possible to increase the availability of coping methods and further develop the existing coping methods., (© 2019 Nordic College of Caring Science.)

Fusaricidins and related LI-F compounds are effective bactericides and fungicides. Recently, we have found that they are highly toxic to mammalian cells. Here, we studied the effect of fusaricidin-type compounds (FTCs) on the membranes of mammalian cells. Ethanol extracts from Paenibacillus polymyxa strains, RS10 and I/Sim, were fractionated and analyzed by HPLC and mass spectrometry. The effects of FTCs on mitochondrial functions and integrity were studied by standard methods: measurements of swelling, membrane potential (ΔΨ m ), respiration rate, cytochrome c release, and pore sizes. Superoxide flashes were registered by 3,7-dihydro-2-methyl-6-(4-methoxyphenyl)imidazol[1,2-a]pyrazine-3-one (MCLA). Plasma membrane permeability was assessed by propidium iodide (PI) staining and ATP release. FTCs caused the permeabilization of the inner mitochondria membrane (IMM) to ions and low-molecular-weight (~750 Da) solutes. The permeabilization did not depend on the permeability transition pore (mPTP) but was strongly dependent on ΔΨ m . Fusaricidins A plus B, LI-F05a, and LI-F05b-LI-F07b permeabilized IMM with comparable efficiency. They created pores and affected mitochondrial functions and integrity similarly to mPTP opening. They permeabilized the sperm cell plasma membrane to ATP and PI. Thus, the formation of pores in polarized membranes underlays the toxicity of FTCs to mammals. Besides, FTCs appeared to be superior reference compounds for mPTP studies., Competing Interests: The authors declare no conflict of interest.

Background: Not much research has been conducted on emergency patients' and family members' experiences of encountering care providers and receiving care in nonconveyance situations. This knowledge is required to develop the quality and safety of emergency care., Aim: The aim of the study was to describe patients' and family members' experiences concerning encounters with emergency care providers and the patient's care in nonconveyance situations., Methods: The study is a descriptive, cross-sectional survey carried out using quantitative methods. Statistical data were analysed using SPSS Statistics for Windows. The responses to an open question were analysed using inductive content analysis., Results: Patients and family members found that emergency care providers had acted in a professional and friendly manner. They would have expected more psychological support. Family members were less satisfied with the emergency care than patients, especially as regards psychological support and the amount of time given to the patient., Conclusions: Emergency care providers should take the whole family's situation into consideration and seek to promote the family's coping by providing comprehensible counselling and support., (© 2018 Nordic College of Caring Science.)

A novel, objective, and rapid computed motility inhibition (CMI) assay was developed to identify and assess sublethal injury in toxin-exposed boar spermatozoa and compared with a subjective visual motility inhibition (VMI) assay. The CMI values were calculated from digital micrographic videos using a custom MATLAB ® script by contrasting the motility index values of each experiment with those of the background and control experiments. Following a comparison of the CMI and VMI assays results, it was determined that their agreement depended on the shape of the dose-response curve. Toxins that exhibited a steep slope were indicative of good agreement between the assays. Those depicted by a gentle decline in the slope of the dose-response curve, the CMI assay were shown to be two times more sensitive than the VMI assay. The CMI assay was highly sensitive to the inhibition of mitochondrial function and glucose transport activity by sublethal doses of toxins and to disruption of cellular cation homeostasis by carrier ionophoric toxins, when compared to the cytotoxicity and lethal toxicity assays (i.e., that evaluated the inhibition of cell proliferation in somatic cell lines (FL, PK-15, and MNA cells)) and disruption to spermatozoa membrane integrity. The CMI assay recognized subtle sublethal toxicity changes in metabolism, manifested as a decrease in boar spermatozoa motility. Thus, it was feasible to effectively compare the objectively-measured numerical values for motility inhibition using the CMI assay against those reflecting lethal damage in the spermatozoa cells and somatic cell lines using a cytotoxicity assay.

Making nonconveyance decisions can be demanding for care providers in prehospital emergency services. Studies have found homecare instructions and counseling of patients and family members partly insufficient. A descriptive cross-sectional design was applied for this pilot study to explore emergency patients' and family members' experiences of nonconveyance situations and counseling. Data were collected by questionnaires from acutely ill patients (n = 97) treated on-site and not transported to hospital and from their family members (n = 72) in 2015-2016. Responses to quantified statements were analyzed statistically, whereas responses to open questions were analyzed using qualitative inductive content analysis. Patients and family members had mostly received verbal home care instructions. Just more than 10% of patients found the instructions insufficient for their coping at home. Male patients were slightly more satisfied with counseling than female patients. One-fifth of female patients but only 6% of male patients were dissatisfied with nonconveyance decisions. In family members, the proportion of dissatisfied respondents was 14%. Older patients were more often dissatisfied than younger patients. Although the majority of the respondents were satisfied with the emergency medical services in general, patients suggested that home care instructions, staff competence, and availability of ambulances should be improved and resources and attention given to patients' opinions increased. Family members proposed more careful assessment of conveyance needs, increased resources, and attention given to the patient. The results highlight the importance of developing a more family-centered approach to emergency care.

Ventilation system design and operation may significantly affect indoor air quality (IAQ). The aims of this case study were to investigate the functionality of a supply air fan-assisted hybrid ventilation system in a newly built school building with reported IAQ problems and to determine the effects of ventilation improvement on measured and perceived IAQ. The ventilation system function was researched simultaneously with IAQ measurements, with an analysis of total volatile organic compounds (TVOC), single volatile organic compounds (VOCs), and indoor mycobiota, and with questionnaires about perceived IAQ. At the baseline, an operational error of the ventilation system was found, which prevented the air from coming into the classrooms, except for short periods of high carbon dioxide (CO₂) concentrations. After the ventilation operation was improved, a significant change in indoor mycobiota was found; the dominant, opportunistic human pathogenic species Trichoderma citrinoviride found in settled dust in the classroom before the improvement was no longer detected. In addition, the concentrations of CO₂, TVOC, and some single VOCs, especially toluene and decamethylcyclopentasiloxane, decreased. The analysis of the questionnaire results indicated that the perceptions of unpleasant odors and stuffy air decreased, although a statistically significant improvement in perceived IAQ was not observed. The results provided evidence that the properly controlled hybrid ventilation system operating in mechanical supply mode provided adequate ventilation and was effective in decreasing the concentrations of some indoor-generated pollutants. With simple ventilation adjustments, microbiological exposure from building structures might be prevented.

Acutely ill patients are often treated on site instead of being transported to hospital, so wide-ranging professional competence is required from staff. The aim of this study was to describe and produce new information about out-of-hospital emergency care providers' competence, skills and willingness to engage in self-development activities, and to uncover challenges experienced by care providers in the midst of changing work practices. A quantitative questionnaire was sent to out-of-hospital emergency care providers (N = 142, response rate 53%) of one Finnish hospital district. Data were analysed using spss for Windows 22 software. Almost all respondents found their work interesting and their ability to work independently sufficient. The majority found the work meaningful. Almost 20% felt that work was dominated by constant rush, and 40%, more than half of 25-year-olds but <10% of over 45-years-olds, found the work physically straining. The majority indicated that they had a sufficient theoretical-practical basis to perform their regular duties, and more than one-third felt that they had sufficient skills to deal with multiple patient or disaster situations. Over 20% stated that they were unsure about performing new or infrequent procedures. A number of factors experienced as challenging were revealed. The results provide a basis for improving care providers' initial and further training., (© 2017 Nordic College of Caring Science.)

This case study investigates the effects of ventilation intervention on measured and perceived indoor air quality (IAQ) in a repaired school where occupants reported IAQ problems. Occupants' symptoms were suspected to be related to the impurities leaked indoors through the building envelope. The study's aim was to determine whether a positive pressure of 5-7 Pa prevents the infiltration of harmful chemical and microbiological agents from structures, thus decreasing symptoms and discomfort. Ventilation intervention was conducted in a building section comprising 12 classrooms and was completed with IAQ measurements and occupants' questionnaires. After intervention, the concentration of total volatile organic compounds (TVOC) and fine particulate matter (PM 2.5 ) decreased, and occupants' negative perceptions became more moderate compared to those for other parts of the building. The indoor mycobiota differed in species composition from the outdoor mycobiota, and changed remarkably with the intervention, indicating that some species may have emanated from an indoor source before the intervention., Competing Interests: The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Aims and Objectives: To describe fear, the threats causing fear and the occurrence of fear among emergency department nursing staff and physicians., Background: The emergency department is a challenging workplace where the staff is often confronted by factors that cause fear., Design: A cross-sectional study., Methods: A survey was conducted in 16 hospitals (n = 544). Nurses, practical nurses, orderlies and physicians from those hospitals participated in the survey. The survey questionnaire was based on the analysis of interviews of 30 nurses from one university hospital and one central hospital. The results of the interviews were analysed using the inductive content analysis method. The analysis of the survey was performed using statistical methods, such as frequencies, cross-tabulation and principal component analysis., Results: The results showed that nearly all of the emergency department personnel had experienced work-related fear. Generally, the fear had been momentary. According to the survey results, fear was most often caused by medication errors, the resuscitation of a child, a catastrophic accident, urgent or violent situations or patients armed with weapons. Threats that caused fear included insecurity, danger in the work environment, threat of loss of one's health and threat of the consequences of one's mistakes and actions., Conclusion: The staff of emergency departments often encountered factors or situations that caused fear. The main threats causing fear that were raised by the respondents were insecurity and danger in the work environment., Relevance to Clinical Practice: The data obtained from this study can be utilised in identifying and describing work-related fear and threats of fear among emergency department nursing staff and physicians. Based on the information herein, it will be possible to develop methods to prevent situations that cause fear in emergency departments., (© 2016 John Wiley & Sons Ltd.)