DYNAMICS OF CHANGE OF REQUIREMENTS OF STANDARDS TO DURABILITY OF WOOD-SHAVING PLATES: REASONS AND CONSEQUENCE

Drevesno – chip plates are widely used in production of case furniture. The volume of their production constantly grows in Russia. If in 2013 it has been made 7270, then in 2017 – 8370, in 2018 – 9789, in 2019 – 9986 thousand m3 of plates. However, one of the main shortcomings of plates of the plates released by the industry is their low durability. It especially concerns one of the main strength performances of plates – ultimate strength at bend. So, in comparison with requirements of GOST 10632-77 durability of plates at bend of the most widespread thickness (13-20 mm) in accordance with GOST 10632-89 has decreased on 9 and 21, in accordance with GOST 10632-2007 on 21 and 29, and by current GOST 10632-2014 – by 38 and 43% depending on brand of plates. Decrease in durability at stretching perpendicular to plate face less noticeable. One of the main reasons of such decrease, use in technology of plates of low-toxic carboamidoformaldehyde (KFS) pitches the content of free formaldehyde in which generally is makes about 0,15%. It is known, than more free formaldehyde is in pitch of subjects bond quality of wood and wood-base materials, with use of this pitch, above. However such big decrease in durability of plates for furniture makers is big shortcoming. It is necessary to change approaches to designing of furniture from such plates. Manufacturers of plates, using low requirements of the present standard, sometimes manipulate due to decrease in density of plates that results in friability of plates, problem of fastening of plates in furniture designs. The purpose of our work was studying of dynamics of decrease in durability of plates according to requirements of standards, since 1977 till present, establishment of the reasons and possible consequences from such decrease.

1576. Re-Evaluation of cefepime or piperacillin-tazobactam to Decrease Use of Carbapenems in ESBL-Producing Enterobacterales BloodStream Infections (REDUCE-BSI)

Background The ideal therapy for treatment of bloodstream infections (BSI) due to ESBL-producing organisms is widely debated. Although prior studies have demonstrated efficacy of non-carbapenems (CBPNs) for ESBL infections, results from the MERINO study group found increased mortality associated with piperacillin/tazobactam (PT) when compared with meropenem for treatment of ESBL BSI. The goal of this study was to investigate patient outcomes associated with the use of CBPN-sparing therapies (PT and cefepime (CEF)) for ESBL BSI. The primary outcome was in-hospital mortality between non-CBPN (PT and CEF) and CBPN groups. Secondary outcomes included clinical cure, microbiologic cure, infection recurrence, and development of resistance. Methods This was a retrospective observational study of patients admitted to the hospital from May 2016 - May 2019 with a positive blood culture for an ESBL-producing organism. Patients receiving meropenem, ertapenem, PT, or CEF were included. Patients were excluded if < 18 years old, receiving antibiotics for < 24 hours, treated for a polymicrobial BSI, or receiving concomitant antibiotic therapy for another gram-negative (non-ESBL) infection. Results One hundred and fourteen patients were analyzed; 74 (65%) patients received CBPN therapy compared with 40 (35%) patients that received a non-CBPN (CEF N=30, PT N=10). There were no statistically significant differences in baseline characteristics between groups. The overall in-hospital mortality rate was 6% (N=7). Eight percent of patients (N=6) in the CBPN arm died compared to 3% (N=1) of patients in the non-CBPN arm, P = 0.42. No difference in mortality was detected between groups when evaluating subgroups with Pitt bacteremia score ≥4 (N=25), requiring ICU admission (N=50), non-genitourinary source (N=50), or by causative organism (N=76 E. coli; N=38 Klebsiella spp.). There was no difference between groups for secondary outcomes. Conclusion CEF and PT are reasonable options for the treatment of ESBL BSI and did not result in increased mortality or decreased clinical efficacy when compared to CBPNs in this cohort. Disclosures All Authors: No reported disclosures

Characteristics of Knowledge Translation Theories, Models and Frameworks for Health Technology Reassessment: Expert Perspectives Through a Qualitative Exploration

Background: Health Technology Reassessment (HTR) is a process that systematically assesses technologies that are currently used in the health care system. The process results in four outputs: increase use or decrease use, no change, or de-adoption of a technology. Implementation of these outputs remains a challenge. The Knowledge Translation (KT) field enables knowledge into practice. KT could help with implementation of HTR outputs. This study sought to identify which characteristics of KT theories, models, and frameworks (TMFs) could be useful, specifically for decrease use or de-adoption of a technology.Methods: A qualitative descriptive approach was used to ascertain the perspectives of international KT and HTR experts on the characteristics of KT TMFs for decrease use or de-adoption of a technology. One-to-one semi-structured interviews were conducted from September to December 2019. Interviews were audio recorded and transcribed verbatim. Themes and sub-themes were deduced from the data through framework analysis using five distinctive steps: familiarization, identifying an analytic framework, indexing, charting, mapping and interpretation. Themes and sub-themes were also mapped to existing KT TMFs.Results: Thirteen individuals from Canada, United States, United Kingdom, Australia, Germany, Spain, and Sweden participated in the study. Three themes emerged that illustrated the ideal traits of a KT TMF: principles that were foundational for HTR, levers of change, and steps for knowledge to action. Principles included evidence-based, high usability, patient-centered, and ability to apply to the micro, meso, macro levels. Levers of change were characterized as positive, neutral, or negative influences for changing behaviour for HTR. Steps for knowledge to action included: build the case for HTR, adapt research knowledge, assess context, select, tailor and implement interventions, and assess impact. Of the KT TMFs that were mapped, the Consolidated Framework for Implementation Research had most of the characteristics, except ability to apply to micro, meso, macro levels. Conclusions: Application of KT TMFs to HTR has not been clearly understood. Characteristics that need to be considered within a KT TMF for implementing HTR outputs have been identified. Consideration of these characteristics within KT TMFs may guide users undertaking HTR projects.

How increased atmospheric carbon dioxide and ‘The Law of the Minimum’ are contributing to environmental obesity

Justus von Liebig observed that one could greatly increase agricultural yields by adding relatively small quantities of nitrogen (N), phosphorus (P) and potassium (K) to soils. This finding led to the most recent agricultural revolution. But because most plants and microbes can be non-homeostatic with respect to their biomass elemental composition, adding nutrients can lead to disproportional increases in some macro-elements in organisms, while micronutrient content decreases. Increased CO2 in the atmosphere is an important driver of climate change, but it is also an important driver of changing biomass content and ecosystem stoichiometry. Increased CO2 has contributed to excess carbon in biomass and ecosystems, a state which could be contributing to changes in metabolism which I liken to metabolic diseases and ‘environmental obesity’. Here I defined environmental obesity as excess C accumulation relative to other elements in the environment. A warming climate is certainly motivation enough for humans to do whatever is necessary to decrease use of fossil fuels. However, increased carbon has detrimental health outcomes through effects on our food in natural and agricultural systems and suggests that CO2 is not ‘just an environmental problem’, but also a human health problem.

Informational Videos About Alcohol Use: Feasibility and Acceptability

Background: An estimated 15.1 million adults ages 18 years and older are classified with an alcohol use disorder, which includes 9.8 million men and 5.3 million women. A brief intervention is indicated for those identified to be at risk because of alcohol use. Objective: To determine the feasibility and acceptability of informational videos about alcohol use. Design: This feasibility study provided participants with the opportunity to choose one of two videos, Alcohol and the Brain or Rethinking Drinking. An online survey was administered to all study participants to identify alcohol-related risk, readiness to decrease use, and knowledge pertaining to alcohol use. Results: The two videos provided in this study were feasibly delivered in an on-line format to 129 adults, including 115 males and 5 females identified to be at risk. Knowledge scores increased only slightly. There were mixed results for the readiness scores. Conclusions: Future research should examine the efficacy of these two alcohol brief interventions on alcohol-related outcomes.

Overcoming Innumeracy and the Use of Heuristics When Communicating Science

Science communication is difficult because, rather than understanding and using important, often numeric, information, lay people and experts alike resort to superficial heuristic processing of information. This chapter examines heuristic processing with respect to the power of experience, the affect heuristic, and framing effects along with their interactions with innumeracy. Recommendations are made for how to improve science communication to decrease use of heuristic processing and improve use of numeric information in risk perceptions and decision making. Based on existing evidence, science communicators should carefully identify communication goals and then choose evidence-based strategies to meet them. Evidence-based strategies include providing numeric information (as opposed to not providing it), reducing cognitive effort, increasing affective meaning, and drawing attention to key information.