Mermel points out five variables in preventing the transmission of the virus to HCWs: the dynamics of disease transmission; the availability of personal protective equipment (PPE); compliance among HCWs in the use of PPE; cost of PPE; and immune status of HCWs.

He notes that in two studies, one already published and one recently presented at the Infectious Diseases Society of America Annual Meeting, researchers found no statistically significant reduction in influenza-like illness among HCWs wearing N95 respirators compared with surgical masks.

Mermel points out that there is tremendous variability in the bioaeorosols produced by influenza-infected patients. He suggests that the inability to easily identify those individuals who produce large amounts of bioaerosols (i.e., superspreaders) is “The Achilles’ heel of infection control” and he says, “Our limited understanding of such events leaves us vulnerable since we cannot predict which influenza-infected person is a superspreader.”

Mermel notes the paramount importance of source control (i.e., influenza-infected patients wearing surgical masks, as tolerated) to minimize risk of transmission to HCWs. Mermel also refers to the risk of HCW-to-HCW influenza transmission if influenza-infected HCWs work while ill.

As a physician, Mermel believes that, “Science will guide us as we care for patients infected with
H1N1 2009 but a lack of attention to our understanding of the transmission of human influenza has left us debating which procedures create influenza superspreading events, what is appropriate personal protective equipment, use of suboptimum engineered respirators that need fit testing and are poorly tolerated for prolonged use, and limited industrial capacity to meet our needs. For now, infection-control experts at each institution must weigh the variables noted to establish not only what is best, but what is realistic in reducing risk to their staff, their visitors, and their patients.”

Mermel is a past president of the Society for Healthcare Epidemiology of America.

Personal Choice Dining provides patients with an expanded menu as well as more personalized and efficient service. As part of the program, all patients are assigned a personal host or hostess who serves as their “food ambassador” during their hospital stay. Before each meal, they review possible meal options and helps patients make menu selections that comply with any dietary restrictions or doctor recommendations. After returning to the kitchen and personally preparing the patient tray, the host or hostess delivers the meal to the patient.

“This program offers patients at The Miriam Hospital with more mealtime choices and flexibility. It’s part of our commitment to make each patient’s stay as comfortable and enjoyable as possible,” says Ira Brandstein, CEC, director of the food and nutrition department at The Miriam Hospital.

The Miriam is the only hospital in Rhode Island offering Personal Choice Dining, a program developed by Sodexo Health Care, the hospital’s contractor for food services.

“Because each host and hostess is assigned between 30 and 40 patients, they are able to build relationships with these patients, and in turn, patients are more comfortable asking questions or expressing any concerns,” said Margarida McFarland, manager of the hospital’s Personal Choice Dining program. “It’s our goal that each host or hostess becomes an integral part of the patient care team and an asset to each inpatient unit.”

Patients now have their choice of featured entrees, which range from lemon dill sole to a Waldorf salad. They also have the option of selecting items from the hospital’s “All Times Favorites” list, featuring such comfort food staples as macaroni and cheese, chicken noodle soup and grilled cheese, which are available all day.

Fresh kosher meals now available
The Miriam Hospital is now also offering fresh kosher meals to patients upon request. Under the direction of Rose Forrest of Daniel Catering, the meals offered will be strictly glatt kosher and under Va’ad supervision.

Meals include such varied dishes as baked polenta with fresh homemade tomato sauce and mozzarella, chicken paprikash, eggplant parmesan and grilled chicken and kasha.

The Miriam Hospital also will be providing special kosher food in the cafeteria during Passover.

The SDBP is an international interdisciplinary academic organization whose members are developmental-behavioral pediatricians, neurodevelopmentalists, pediatric psychologists, nurse practitioners, child psychiatrists, academic generalists and trainees in these professions with a broad range of interests across the field of developmental-behavioral pediatrics.

“Dr. High has been an integral part of our department of pediatrics for more than 15 years,” said Robert B. Klein, MD, pediatrician-in-chief at Hasbro Children’s Hospital. “Her expertise and dedication to children with developmental and behavioral issues make her a natural choice to lead the Society of Developmental and Behavioral Pediatrics.”

High, of Providence, has been a member of the SDBP since 1988 and has served in various SDBP roles including member of the executive council; book review editor of the Journal of Developmental and Behavioral Pediatrics; delegate to the American Board of Pediatrics for maintenance of certification in pediatric subspecialties; chair of the Autism Special Interest Group; and liaison to the American Academy of Pediatrics section on developmental and behavioral pediatrics, among others.

“The SDBP is a tremendous resource for clinicians treating children with developmental and behavioral issues,” High said. “The organization strives to provide clinicians with the tools they need to provide the highest level of care for patients and their families. The society promotes an understanding of social, educational, and cultural influences on children. I have been involved with the society for more than two decades and am proud to lead an extraordinary group of professionals who have clearly demonstrated their commitment to their patients and to research of evidence-based practices that improve child outcomes in this field.”

High is a member of the American Academy of Pediatrics (AAP) and serves as chair of its national committee on early childhood, adoption and dependent care;. In Rhode Island, she is on the executive committee of the state chapter of the AAP; is a member of the RI Department of Health Pregnancy Risk Assessment Monitoring System steering committee; the Birth Defects Advisory Council; the RI Department of Health Successful Start developmental screening and services workgroup; Reach Out and Read Rhode Island advisory board and the Rhode Island Kids Count board of directors.

Her clinical and research interests include infant behavioral issues such as colic; sleep problems and feeding problems; literacy promotion as part of well child care; autism and developmental disorders; and the interrelationship of medical and psychological problems in childhood. She sees patients as a member of interdisciplinary teams in the Children’s Neurodevelopment Center and the Partial Hospital Program at Hasbro Children’s Hospital and at the Brown Center for the Study of Children at Risk at Women and Infants’ Hospital.

The SDBP, formed in 1982, is an interdisciplinary professional organization with more than 700 members that promotes the developmental and behavioral health of all infants, children, adolescents and their families by advancing research, education, evidence-based clinical practice and advocacy.

According to experts at Bradley Hospital, it’s common for children to feel anxious about the unknown and they will look to their parents to provide support and comfort. “Children follow their parents’ cues, so if mom or dad seem stressed or are constantly talking about how worried they are, a child will pick up on that. But if parents cope well, their child will also cope better,” says Henry T. Sachs, MD, medical director at Bradley Hospital.

The key to helping children manage their anxiety is to address and acknowledge their fears without causing alarm or panic. “Reassure your child that everyone in the family is fine and that you will all work together to stay healthy. Being calm and confident will do wonders in helping a child feel safe and secure,” says Sachs.

He suggests parents proactively ask their children what they have heard about H1N1, which will indicate whether there are any rumors or misinformation that need to be addressed. Information and knowledge can help children feel a sense of control, so parents should also be prepared to provide some simple, age-appropriate facts about H1N1.

“Younger children will need equal amounts of fact and reassurance, but older kids and teens will likely have more specific questions or may need help separating fact from fiction,” Sachs says. “Although we want to shelter our children, it’s important to be honest and accurate about the situation.”

Sachs points out that these conversations also provide a good opportunity to remind children that good hygiene – particularly frequent hand-washing and covering coughs or sneezes – is the best way to stay healthy and avoid spreading disease, including H1N1.

Other ways parents can help ease their child’s H1N1 anxiety and help them stay healthy include:

• Make sure you are up to the date on the latest information on H1N1, including symptoms, vaccinations and how the disease spreads. The RI Department of Health website, http://www.health.ri.gov/, and www.flu.gov are good resources.
• Allow your children to express their feelings and let them know it is okay to be afraid or upset. Keep in mind that when children are uncertain about situations and feel frightened, they may need even more affection and attention.
• Even if the family’s normal routine is disrupted due to school or work closures, try and keep activities as consistent and normal as possible. Children are most comfortable when they can stick with their routines.
• Encourage healthy behaviors – such as eating well, getting a good night’s sleep, and playing outside – that can help children build a strong immune system.
• Remind your children not to share their food or drinks with others.
• Try to limit your child’s exposure to media coverage about the H1N1 virus.
• If your children are being vaccinated, remind them why this is important and how the vaccine will help keep them safe and healthy.
• Keep your children home when they are sick. They should remain out of school until they are free of fever for 24 hours without the use of a fever-reducing medication.

NOTE: Some information provided by the National Association of School Psychologists and the Centers for Disease Control and Prevention.

Shah has been an active member of the CCFA New England Chapter Advisory Committee for many years, serving as chair from 2004 to 2007. He is currently chair of the Board of Governors for the American College of Gastroenterology (ACG), was ACG Governor for Rhode Island from 2002 to 2006, and received the ACG’s Freshman Governor’s Award. Shah has also been named one of Rhode Island’s “Top Doctors” in gastroenterology by Rhode Island Monthly several times.

A clinical associate professor of medicine at The Warren Alpert Medical School of Brown University, Shah is actively involved in teaching medical students, residents and gastroenterology fellows. He has authored more than 90 articles, book chapters and abstracts, in addition to giving many presentations across the country on IBD. As a researcher, Shah has been involved with several multi-center clinical trials focusing on new therapies for IBD, is co-principal investigator for the Ocean State Crohn’s and Colitis Area Registry (OSCARR) and is collaborating to develop an IBD Center at Brown University.

Shah graduated magna cum laude with a bachelor’s degree in biochemistry from Brown University and received his medical degree from Harvard Medical School. He completed his residency in internal medicine and a fellowship in gastroenterology at Beth Israel Deaconess Medical Center in Boston. As part of his fellowship, Shah was awarded a Howard Hughes Postdoctoral Fellowship for Physicians.

A fellow of the American College of Gastroenterology, Shah is a member of the American Gastroenterology Association, American Medical Association, American Society for Gastrointestinal Endoscopy, Rhode Island Medical Society, and Rhode Island GI Society. He is a partner with Gastroenterology Associates, Inc. in Providence and currently resides in Sharon, MA.

Lifespan instituted the Excellence in Research Award in Judge Selya’s name in 1999 to honor the first Lifespan Board Chairman for his commitment to academic medicine. The award recognizes research excellence at the level of the independent investigator and serves to enhance the visibility and role of research within the Lifespan community.

A psychologist at The Miriam Hospital’s Weight Control and Diabetes Research Center and an assistant professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University, McCaffery was honored for her research on the relationship between genetics and behavioral factors in both cardiovascular disease and Type 2 diabetes.

“Dr. McCaffery is a rising star in the Lifespan research community who truly personifies the spirit of this award,” said Judge Selya. “She is obviously a skilled and effective researcher and teacher who has already accomplished much in her academic career. Her research contributions could someday play a major role in our battle against devastating illnesses like obesity, heart disease and diabetes that affect millions of Americans each year.”

Selya added, “We are extremely fortunate to have such a talented investigator on board who will continue to build our position as a major national research center.”

McCaffery’s most recent study, published in the American Journal of Clinical Nutrition, shed some light on the biological factors that may contribute to weight loss maintenance. According to her findings, people who have successfully maintained a significant weight loss may learn to respond differently to food cues than normal weight or obese individuals, leading researchers to believe that brain activity could influence behaviors – including food intake – that promote long-term weight control.

Earlier this year, McCaffery was lead author on a study that found genetic factors might predict depression in heart disease patients. Because the genes identified were related to the vascular system, the findings suggest that vascular health – which includes the body’s network of blood vessels, arteries and veins – may be a predictor of depression in individuals with heart disease.

McCaffery’s past research interests include twin and family studies, genetic and environmental associations between depression and smoking behavior, environmental contributions of socioeconomic status to health behaviors and cardiovascular disease, and specific variants in DNA that predict physiological responses to psychological stress.

A resident of West Greenwich, McCaffery received her undergraduate degree from Colgate University and her doctorate in clinical and health psychology from the University of Pittsburgh. She remained in Providence after serving as a clinical intern with the Brown Clinical Psychology Training Consortium, and has been a staff psychologist with The Miriam since 2001.
McCaffery is the author of nearly 40 peer-reviewed papers and has served as principal investigator and co-investigator on numerous grants from the National Institutes of Health. She serves on the editorial board of Psychosomatic Medicine and is a consulting reviewer for a number of top medical journals, including the American Journal of Cardiology, Archives of General Psychiatry, Journal of the American Medical Association, Annals of Behavioral Medicine and Circulation. McCaffery is also a member of the American Psychosomatic Society, American Psychological Association and The Obesity Society.

The grant will allow Quesenberry and investigators at Rhode Island Hospital to focus their research efforts on determining the true phenotype (what the cells actually looks like as a result of their interaction with their environment) of marrow stem cells and their fate as tissue. The researchers’ goal is to translate basic stem cell studies into clinical trials on tissue restoration or correction in patients with chronic obstructive lung disease and malignant blood diseases. Through the grant they will study how the phenotype information is transferred via microvesicles from injured tissue. They will then define the mechanisms by which the cells are differentiated.

Quesenberry, who is also a physician with the University Medicine Foundation, says, “The beauty of the COBRE grant is not only will it allow us to develop a stem cell research center at Rhode Island Hospital, but it will also help us to assemble a group of outstanding, talented investigators who excel in these areas.” He adds, “Those investigators can then serve as mentors to young, up-and-coming researchers, who we can recruit and then retain right here at this research center.” Their research will be conducted in a new 10,000 square foot lab in the Coro building, where Rhode Island Hospital has established other major research labs.

Senator Jack Reed commented on the hospital’s grant. “Rhode Island Hospital is nationally renowned for pioneering efforts in stem cell research. This federal award will allow the hospital to expand and enhance existing research initiatives and help attract more talented researchers and promising young scientists to the state,” said Reed, a member of the Appropriations subcommittee, which oversees federal funding for NIH programs. Reed wrote a letter in support of Rhode Island Hospital’s application earlier this spring.
Congressman Jim Langevin also said, “I have long believed that stem cell research will help change the direction of medicine for the better,” said Langevin. “I congratulate Dr. Quesenberry and the entire Rhode Island Hospital research community for securing this prestigious award. Grants such as this will drive both scientific innovation and economic development in our state. I look forward to following this study and learning about its outcomes.”
The work in the stem cell research center will also include general stem cell biology. An experienced group of scientists will be mentoring three promising young investigators, and potentially more in three specific studies. Quesenberry, who also holds the Paul Calabresi, MD, professorship in oncology and is director of the division of Hematology/Oncology at The Warren Alpert Medical School of Brown University, comments further, “This grant holds real promise for expanding our understanding of stem cell biology. We appreciate the support of the National Center for Research Resources.”

Peter Snyder, PhD, Lifespan’s vice president of research, says, “A grant of this magnitude is especially welcome during these difficult economic times and is a definite boon for the research sector of our state. Dr. Quesenberry is already a renowned scientist, and this grant will undoubtedly result in breakthroughs that will have a direct impact on the care of patients who will benefit from advances in tissue restoration. I know we all look forward to that day.”

“We’re committed to maintaining and honoring the Jewish heritage and history of The Miriam Hospital,” said Arthur J. Sampson, executive director of The Miriam Hospital. “Rabbi Hodgetts brings a wealth of experience, knowledge and passion to our team and will be a valuable resource, not only to our staff, but also to the community that we serve.”

As a member of the Rhode Island Board of Rabbis, Hodgetts works with other rabbis in the Providence community to ensure that Jewish patients at The Miriam Hospital receive optimal spiritual care. She is also available as a Jewish resource for other chaplains and chaplaincy students as part of The Miriam’s relationship with the Chaplaincy Center in Providence.

“I am honored to be a part of a topnotch hospital with such strong Jewish roots that understands the essential role of spiritual care in medicine,” said Hodgetts. “I look forward to working alongside staff who are very energized and committed to providing quality care to patients, and for whom work is not just a job, but in many cases a calling.”

A graduate of Cornell University, Hodgetts received her MBA from Harvard Business School and spent many years in the field of organizational behavior and human resource management. In May 2009, Hodgetts received her ordination as rabbi from Hebrew College Rabbinical School. She completed several chaplaincy and rabbinic internships at organizations throughout New England, including Beth Israel Deaconess Medical Center in Boston. She currently resides in Chestnut Hill, MA.

Most children with flu have required no medications at discharge. Very young patients, those with underlying medical conditions and those living in homes with family members who are pregnant or have underlying conditions have been prescribed “Tamiflu” in accordance with national guidelines. “Tamiflu” is a prescription medicine that acts on the flu virus to lessen the duration of illness. It should not be confused with the non-prescription brand name medicine “Theraflu” that is available for purchase. In addition, some preparations of Theraflu have high doses of acetaminophen and may be unsuitable for children.

Tamiflu:
• Prescription medication
• Lessens severity and duration of flu symptoms
• Only effective when given within 24-48 hours of the onset of flu symptoms

Theraflu:
PLEASE consult your pediatrician before giving your child Theraflu as many preparations of Theraflu have high doses of acetaminophen and may be unsuitable for children.

• Over-the-counter medication
• May reduce fever or ease body aches and nasal congestion, similar to other over-the-counter products
• Does NOT lessen severity and duration of flu symptoms

Hurvitz joined The Miriam Hospital Board of Trustees in 1974, serving as both a trustee and an officer, in addition to numerous committee assignments during his tenure. Upon completion of his term as trustee in 2004, he joined The Miriam Hospital Foundation Board, where he co-chaired The Campaign for the Next Generation. The campaign, the largest in the hospital’s history, raised more than $30 million to support the construction of the Victor and Gussie Baxt Building – a patient and surgical services center housing ten state-of-the-art operating rooms, a 25,000 square-foot radiology suite and 36 private patient rooms.

“Arthur Hurvitz has been a mentor for so many of us who volunteer at The Miriam. He leads by example in establishing the highest standards for quality and philanthropy,” said Edward D. Feldstein, chair of The Miriam Hospital Board of Trustees.

“Because of Arthur, we have an outstanding new building and are recognized nationally as a leader providing the highest quality of hospital care among academic medical facilities,” Feldstein added. “We are proud of Arthur for all he has done, and we thank him for permitting us to honor him as The Miriam Person of the Year.”

Hurvitz and his wife, Joyce – both strong supporters of nursing education at The Miriam – also established the Hurvitz Nursing Scholarship Fund, which has provided ongoing education for the hospital’s award-winning Magnet nurses.