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Healthcare-associated infections (HAIs) are a significant burden on healthcare facilities. Universal gloving is a horizontal intervention to prevent transmission of pathogens that cause HAI. In this meta-analysis, we aimed to identify whether implementation of universal gloving is associated with decreased incidence of HAI in clinical settings.
A systematic literature search was conducted to find all relevant publications using search terms for universal gloving and HAIs. Pooled incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were calculated using random effects models. Heterogeneity was evaluated using the Woolf test and the I2 test.
In total, 8 studies were included. These studies were moderately to substantially heterogeneous (I2 = 59%) and had varied results. Stratified analyses showed a nonsignificant association between universal gloving and incidence of methicillin-resistant Staphylococcus aureus (MRSA; pooled IRR, 0.94; 95% CI, 0.79–1.11) and vancomycin-resistant enterococci (VRE; pooled IRR, 0.94; 95% CI, 0.69–1.28). Studies that implemented universal gloving alone showed a significant association with decreased incidence of HAI (IRR, 0.77; 95% CI, 0.67–0.89), but studies implementing universal gloving as part of intervention bundles showed no significant association with incidence of HAI (IRR, 0.95; 95% CI, 0.86–1.05).
Universal gloving may be associated with a small protective effect against HAI. Despite limited data, universal gloving may be considered in high-risk settings, such as pediatric intensive care units. Further research should be performed to determine the effects of universal gloving on a broader range of pathogens, including gram-negative pathogens.
Among low‐income homebuyers, a contract for deed (CFD) has been a widely used but risky and informal mechanism for purchasing a home or lot. This article examines a series of major consumer protections adopted by the Texas Legislature from 1995 to 2005 and whether this legislation shaped the behavior of sellers who historically relied on CFDs in Texas colonias. Tracking changes in the use of CFDs between 1990 and 2010, we show that developers responded to the legislative reforms by shifting away from CFDs and into other forms of seller financing. At the same time, developers have adopted a series of workarounds to the legislation (presumably legal), leaving low‐income buyers vulnerable to rapid repossession by the developer. In contrast, the impact of the legislation on low‐income residents selling their homes has been minimal. These consumer‐to‐consumer transactions remain highly informal, with ongoing reliance on the now illegal, unrecorded CFD.
Improvements in colorectal cancer (CRC) detection and treatment have led to greater numbers of CRC survivors, for whom there is limited evidence on which to provide dietary guidelines to improve survival outcomes. Higher intake of red and processed meat and lower intake of fibre are associated with greater risk of developing CRC, but there is limited evidence regarding associations with survival after CRC diagnosis. Among 3789 CRC cases in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, pre-diagnostic consumption of red meat, processed meat, poultry and dietary fibre was examined in relation to CRC-specific mortality (n 1008) and all-cause mortality (n 1262) using multivariable Cox regression models, adjusted for CRC risk factors. Pre-diagnostic red meat, processed meat or fibre intakes (defined as quartiles and continuous grams per day) were not associated with CRC-specific or all-cause mortality among CRC survivors; however, a marginal trend across quartiles of processed meat in relation to CRC mortality was detected (P 0·053). Pre-diagnostic poultry intake was inversely associated with all-cause mortality among women (hazard ratio (HR)/20 g/d 0·92; 95 % CI 0·84, 1·00), but not among men (HR 1·00; 95 % CI 0·91, 1·09) (Pfor heterogeneity=0·10). Pre-diagnostic intake of red meat or fibre is not associated with CRC survival in the EPIC cohort. There is suggestive evidence of an association between poultry intake and all-cause mortality among female CRC survivors and between processed meat intake and CRC-specific mortality; however, further research using post-diagnostic dietary data is required to confirm this relationship.
This study assessed childhood prospective memory, the memory for future intentions such as remembering to hand in homework by: (a) comparing 47 children in three age groups; (b) using both time- (i.e., CyberCruiser)*, and event-based (i.e., a card sorting task) prospective memory tosks; and (c) examining relationships between prospective and retrospective memory, and prospective memory and two tests of executive function (Stroop Colour-Word Interference Test [Stroop] and Tower of London [TOL]. Results indicated improvements with age, albeit not identical patterns of improvement, on both prospective- and retrospective-memory tasks and the TOL Furthermore, the TOL was significantly correlated with both measures of prospective memory. The different patterns of improvement with age on the prospective memory tasks suggest that it is not the type of task per se that matters so much as the complexity of the task. It is recommended that aspects of task demand be investigated further.
The case is presented of an 8-year-old boy who was referred for psycho-educational assessment because of difficulties with writing. The article provides an example of the way in which a case unfolds as further assessment data become available, and describes a number of challenging aspects of the assessment process. In this case, dilemmas arose when test results were inconsistent at different time points, and when the results were inconsistent with clinical observations. The case report illustrates the ways in which practitioners can collaborate to make sense of such discrepancies, with each contributing a slightly different perspective or set of skills that, in combination, assist to better understand a child's difficulties.
Phyto-oestrogens have been associated with a decreased risk for osteoporosis, but results from intervention and observational studies in Western countries have been inconsistent. In the present study, we investigated the association between habitual phyto-oestrogen intake and broadband ultrasound attenuation (BUA) of the calcanaeum as a marker of bone density. We collected 7 d records of diet, medical history and demographic and anthropometric data from participants (aged 45–75 years) in the European Prospective Investigation into Cancer-Norfolk study. Phyto-oestrogen (biochanin A, daidzein, formononetin; genistein, glycitein; matairesinol; secoisolariciresinol; enterolactone; equol) intake was determined using a newly developed food composition database. Bone density was assessed using BUA of the calcanaeum. Associations between bone density and phyto-oestrogen intake were investigated in 2580 postmenopausal women who were not on hormone replacement therapy and 4973 men. Median intake of total phyto-oestrogens was 876 (interquartile range 412) μg/d in postmenopausal women and 1212 (interquartile range 604) μg/d in men. The non-soya isoflavones formononetin and biochanin A were marginally significant or significantly associated with BUA in postmenopausal women (β = 1·2; P < 0·1) and men (β = 1·2; P < 0·05), respectively; enterolignans and equol were positively associated with bone density in postmenopausal women, but this association became non-significant when dietary Ca was added to the model. In the lowest quintile of Ca intake, soya isoflavones were positively associated with bone density in postmenopausal women (β = 1·4; P < 0·1). The present results therefore suggest that non-soya isoflavones are associated with bone density independent of Ca, whereas the association with soya or soya isoflavones is affected by dietary Ca.
To assess the feasibility of combining short-term and long-term dietary assessment instruments as new concept for improving usual dietary intake assessment on the individual level.
Feasibility study of completing three 24 h dietary recalls (24-HDR) and a self-administered food propensity questionnaire (FPQ). The 24-HDR was conducted by monthly telephone interviews, using EPIC-SOFT software. The FPQ was completely standardized across cohorts and offered either as a web-based tool or in paper format.
Random sample derived from five ongoing European cohort studies (EPIC-San Sebastian, EPIC-Florence, EPIC-Potsdam, Estonia Genome Center (EGC) and Norwegian Women and Cancer study (NOWAC)).
A total of 400 participants.
Overall, the total participation rate for the present study was 65·3 % (n 261). On average, completion of the 24-HDR was highest for the first 24-HDR (63·0 %) and decreased slightly for the second (60·3 %) and third 24-HDR (56·3 %). The proportions of selecting the web-based FPQ varied among the study centres, with the highest in EGC (92·9 %) and NOWAC (70·0 %) and the lowest in EPIC-San Sebastian (25·5 %) and EPIC-Potsdam (33·9 %). Web users rarely requested support and were younger and more highly educated than those who completed the paper format.
The present study supports the feasibility of a combined application of three 24-HDR and an FPQ in culturally different populations. The varying acceptance of the web-based instrument across populations requires a flexible application of assessment instruments.
To examine the risk of CHD in relation to alcohol intake from three different instruments.
In the European Prospective Investigation into Cancer in Norfolk study, weekly alcohol intake was estimated from a single question in a mail-in health and lifestyle questionnaire (HLQ), a semi-quantitative FFQ, and a 7 d diet diary (7DD). Information on smoking status, physical activity, disease history, social class and medication use was reported in the HLQ. Height, weight, blood pressure and blood lipids were measured at a health check-up. The average length of follow-up was 11 years. The association between alcohol intake and incident fatal and non-fatal CHD in a nested case–control sample was calculated using logistic regression.
A total of 2151 cases of incident fatal and non-fatal CHD and 5354 controls.
The Spearman correlation values between the 7DD, FFQ and HLQ alcohol estimates ranged from r = 0·70 to 0·82 (P < 0·0001 for all r values). Alcohol intake from all instruments was inversely associated with the risk of CHD in age- and multivariate-adjusted models. The relationships between the risk of CHD and alcohol intake from the 7DD, HLQ or FFQ were not significantly different from each other (P >0·10). A marginal difference between men and women was detected for the risk of CHD in relation to HLQ alcohol intake (P = 0·065).
In conclusion, while the instruments were not uniform in their assessment of alcohol intake levels, the 7DD, HLQ and FFQ yielded similar inverse associations between alcohol intake and risk of CHD.
The seventh annual Teaching and Learning Conference (TLC) was held in Philadelphia, Pennsylvania, from February 5 to 7, 2010, with 224 attendees onsite. The theme for the meeting was “Advancing Excellence in Teaching Political Science.” Using the working-group model, the TLC track format encourages in-depth discussion and debate on research dealing with the scholarship of teaching and learning.
This study aimed to assess planning ability in adults with traumatic brain injury (TBI) using a 4-disk version of the Tower of London (TOL). Thirty three individuals with TBI were compared with equivalent numbers of matched controls. Overall, the TOL4 was shown to be sensitive to the effects of brain injury, with the TBI group performing significantly more poorly on this version of the planning test than the matched controls. More specifically, group differences were found to be related to the complexity of the planning problems, particularly among a TBI subgroup with localised prefrontal damage. Results of the study provide support for the adverse effects of TBI on planning ability, and the important role of the prefrontal cortex in planning.
Heather Carmichael Olson, Division of Child Psychiatry University of Washington School of Medicine Seattle, WA USA,
Nancy C. Winters, Department of Child and Adolescent Psychiatry Oregon Health and Science University USA,
Sally L. Davidson Ward, Division of Pediatric Pulmonology Children's Hospital Los Angeles USA,
Matthew Hodes, Imperial College London St Mary's Campus Norfolk Place London W2 1PGUK
Peter Tyrer, Imperial College of Science, Technology and Medicine, London,Kenneth R. Silk, University of Michigan, Ann Arbor
This chapter includes separate sections on treatment for feeding and sleeping disorders. These are disorders that truly do apply to the youngest of patients in child psychiatry, though some eating disorders such as rumination as well as some sleep disorders, such as limit setting sleep disorder and perhaps night terrors can extend into late childhood and perhaps, in rare instances, to adolescence. These are disorders for which behavioural treatments, particularly behavioural treatments such as reinforcement, punishment and graduated extinction, often play key roles in intervention. In both of these groups of disorders, parent training and education are important interventions. While medications can be used in both these disorders, they are certainly not the mainstay of treatment, and because of the young age of the patient population, are rarely used except for a very short time. As in much of child psychiatry, there remains a paucity of methodologically sound trials of the various treatments, though there are randomized controlled studies for both of these conditions that support primarily a behavioural approach.
This chapter includes separate sections on treatment for feeding and sleeping disorders. These are two common, yet complex topics important in child psychiatry as the field applies to infants and young children (American Psychiatric Association, 2000; Anders & Eiben, 1997; Linscheid, 2004; Manikam & Perman, 2000; Mindell, 1999; World Health Organization, 1993).
To examine the associations of adiposity, dietary restraint and other personal characteristics with energy reporting quality.
Secondary analysis of 230 women and 158 men from the 1997/98 Ontario Food Survey.
Energy reporting quality was estimated by ratios of energy intake (EI) to both basal metabolic rate (BMR) and total energy expenditure (TEE). Multivariate regression analyses were conducted to examine energy reporting quality between two dietary recalls and in relation to body mass index (BMI) with adjustment for potential confounders. Energy reporting quality was explored across categories of age, BMI, income, education, dieting status and food insecurity through analysis of variance (ANOVA).
From the ANOVA, energy reporting quality was associated with BMI group, age category and weight loss for men and women, as well as with education among women (P < 0.05). The multivariate regression analyses indicated that energy reporting quality was positively associated with education and inversely associated with obesity and dieting. No associations were observed in relation to food insecurity or income (P>0.05). EI:BMR and EI:TEE on the first and second 24-hour recalls were positively related (P < 0.0001 for men and women). A higher proportion of variance in energy reporting quality was explained for women than for men (R2 = 0.19 and 0.14, respectively).
Studies of diet and adiposity are probably hindered to some extent by BMI-related variation in energy reporting quality. Methods to address this issue are urgently needed if population surveys will continue to serve as the primary source of dietary intake data.
Value-based marketing is shaping cattle production; however, market signals differ dramatically depending on carcass quality. This study applies a two-stage coefficients of separate determination procedure to four regional fed cattle datasets sorted by grid value and by carcass quality attributes. Weight is the strongest signal sent when higher valued cattle and better quality cattle are sold on a grid. Quality characteristics send stronger signals when lower valued cattle and poorer quality cattle are sold on a grid. Producers of lower quality cattle can potentially gain $52 to $149 per head by improving quality and $113 to $150 per head by adding weight.
Objective: To describe the progression of patients with mild or moderate Alzheimer's disease (AD) to a severe stage using the Standardized Mini-Mental State Examination (SMMSE). Methods: A cohort of 206 patients was stratified according to their baseline SMMSE scores: mild (19–24) and moderate (10–18). Proportional hazards analyses were used to determine the hazard of switching into a severe stage, defined as SMMSE score < 10. Results: Among patients at the mild stage, 25% reached the severe stage within 2.6 years, and in the moderate group within 1.5 years. Patients with hallucinations at the mild stage experienced more rapid decline. The previous rate of decline was also found to be an important predictor. At the moderate stage, key predictors were lower SMMSE score and longer time since onset. Conclusions: Current SMMSE scores with other clinical details can be used to advise patients and caregivers about the expected progression of AD.
Electroencephalogram (EEG) alpha power has been
demonstrated to be inversely related to mental activity
and has subsequently been used as an indirect measure of
brain activation. The thalamus has been proposed as an
important site for modulation of rhythmic alpha activity.
Studies in animals have suggested that cortical alpha rhythms
are correlated with alpha rhythms in the thalamus. However,
little empirical evidence exists for this relation in humans.
In the current study, resting EEG and a fluorodeoxyglucose
positron emission tomography scan were measured during
the same experimental session. Over a 30-min period, average
EEG alpha power across 28 electrodes from 27 participants
was robustly inversely correlated with glucose metabolic
activity in the thalamus. These data provide the first
evidence for a relation between alpha EEG power and thalamic
activity in humans.
The availability of childcare is an important factor in enabling motherhood to be combined with paid employment. This article uses evidence from the fifth sweep of the National Child Development Study to analyse the use of childcare by a cohort of employed women who were aged 33 in 1991. There is a heavy reliance on informal care by women in partnerships and also by lone mothers. Formal care is most heavily used by women whose youngest child is under five, especially if the woman works full-time. Reported costs of childcare represent nearly a quarter of net weekly earnings for mothers with a child under five. Formal childcare is shown to play an important role in facilitating women's full-time employment. Full-time employment is the route by which women achieve financial independence from their partner. It also increases the likelihood of contributing to an occupational pension which, in turn, has implications for financial independence in later life. However, the majority of women in this cohort do not take the full-time route. For these women, low earnings potential and part-time working make paid childcare uneconomic and reinforces both their role as minor financial contributors within the family and their lack of pension provision in later life.
Young males with alcohol-related offending behaviours were recruited into a research study. In a Young Offenders' Institution, pre-release offenders were allocated to a behavioural Alcohol Education Course (AEC) or a non-intervention control group. At follow-up, dependent variable differences were observed between the two groups. Results are discussed in the context of policy and practice.
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