To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Bathing intensive care unit (ICU) patients with 2% chlorhexidine gluconate (CHG)–impregnated cloths decreases the risk of healthcare-associated bacteremia and multidrug-resistant organism transmission. Hospitals employ different methods of CHG bathing, and few studies have evaluated whether those methods yield comparable results.
To determine whether 3 different CHG skin cleansing methods yield similar residual CHG concentrations and bacterial densities on skin.
Prospective, randomized 2-center study with blinded assessment.
PARTICIPANTS AND SETTING
Healthcare personnel in surgical ICUs at 2 tertiary-care teaching hospitals in Chicago, Illinois, and Boston, Massachusetts, from July 2015 to January 2016.
Cleansing skin of one forearm with no-rinse 2% CHG-impregnated polyester cloth (method A) versus 4% CHG liquid cleansing with rinsing on the contralateral arm, applied with either non–antiseptic-impregnated cellulose/polyester cloth (method B) or cotton washcloth dampened with sterile water (method C).
In total, 63 participants (126 forearms) received method A on 1 forearm (n=63). On the contralateral forearm, 33 participants received method B and 30 participants received method C. Immediately and 6 hours after cleansing, method A yielded the highest residual CHG concentrations (2500 µg/mL and 1250 µg/mL, respectively) and lowest bacterial densities compared to methods B or C (P<.001).
In healthy volunteers, cleansing with 2% CHG-impregnated cloths yielded higher residual CHG concentrations and lower bacterial densities than cleansing with 4% CHG liquid applied with either of 2 different cloth types and followed by rinsing. The relevance of these differences to clinical outcomes remains to be determined.
To examine the use of vitamin D supplements during infancy among the participants in an international infant feeding trial.
Information about vitamin D supplementation was collected through a validated FFQ at the age of 2 weeks and monthly between the ages of 1 month and 6 months.
Infants (n 2159) with a biological family member affected by type 1 diabetes and with increased human leucocyte antigen-conferred susceptibility to type 1 diabetes from twelve European countries, the USA, Canada and Australia.
Daily use of vitamin D supplements was common during the first 6 months of life in Northern and Central Europe (>80 % of the infants), with somewhat lower rates observed in Southern Europe (>60 %). In Canada, vitamin D supplementation was more common among exclusively breast-fed than other infants (e.g. 71 % v. 44 % at 6 months of age). Less than 2 % of infants in the USA and Australia received any vitamin D supplementation. Higher gestational age, older maternal age and longer maternal education were study-wide associated with greater use of vitamin D supplements.
Most of the infants received vitamin D supplements during the first 6 months of life in the European countries, whereas in Canada only half and in the USA and Australia very few were given supplementation.
The purpose of this study is to describe the post-treatment goals of colorectal cancer (CRC) survivors. We sought to determine whether goals were a salient concept during the period immediately following treatment, and whether a goal-setting intervention might be feasible and acceptable to these patients.
Semi-structured qualitative interviews were administered to a convenience sample of 41 CRC patients who were 0–24 months post-treatment. Topics discussed included expectations and goals for future health, cancer prevention awareness, health-promoting behavior-change goals, and post-treatment cancer issues. Content analysis was used to explore emergent themes.
Overall, participants’ health-related goals were: being healthy, getting back to normal, and not having a cancer recurrence. Most of the CRC survivors reported being proactive with their health by maintaining healthy behaviors or making healthy behavior changes, or had goals to change their behavior. All respondents had plans to maintain follow-up care and regular screening appointments. Some patients were managing treatment side effects or non-cancer issues that limited their functional abilities. Many respondents were satisfied with the care they received, and felt it was now their responsibility to do their part in taking care of themselves.
Significance of results:
CRC survivors talk about goals, and many of them are either making or have an interest in making health behavior changes. Self-management support could be an appropriate strategy to assist patients with achieving their health goals post-treatment. Patients may need help addressing lingering treatment side effects or non-cancer issues. Healthcare providers should consider assessing patients’ goals to help patients resolve post-treatment issues and promote healthy behaviors.
The direct sale of emission allowances by auction is an emerging characteristic of cap-and-trade programs. This study is motivated by the observation that all of the major implementations of cap-and-trade regulations for the control of air pollution have started with a generous allocation of allowances relative to recent emissions history, a situation we refer to as a “loose cap.” Typically more stringent reductions are achieved in subsequent years of a program. We use an experimental setting to investigate the effects of a loose cap environment on a variety of auction types. We find that all auction formats studied are efficient in allocating emission allowances, but auction revenues tend to be lower relative to competitive benchmarks when the cap is loose. Regardless of whether the cap is tight or loose, the different auction formats tend to yield comparable revenues toward the end of a series of auctions. However, aggressive bidding behavior in initial discriminatory auctions yields higher revenues than in the other auction formats, a difference that disappears as bidders learn to adjust their bids closer to the cut-off that separates winning and losing bids.
The initial phase of a trial of cognitive–behavioural therapy (CBT) for acutely ill patients with schizophrenia of recent onset showed that it speeded recovery.
To test the hypothesis that CBT in addition to treatment as usual (TAU) during the first or second acute episode of schizophrenia will confer clinical benefit over a follow-up period.
This was an 18-month follow-up of a multicentre prospective trial of CBT or supportive counselling administered as an adjunct to TAU, compared with TAU alone, for patients hospitalised for an acute episode of schizophrenia of recent onset. Primary outcomes were total and positive symptom scales, time to relapse and re-hospitalisation.
There were significant advantages for CBT and supportive counselling over TAU alone on symptom measures at 18 months but no group difference was seen for relapse or re-hospitalisation. There was a significant centre–treatment interaction, reflecting centre differences in the effect of introducing either treatment, but not in the comparison of CBT and supportive counselling. Medication dosage and compliance did not explain group differences.
Adjunctive psychological treatments can have a beneficial longterm effect on symptom reduction.
The extent to which cognitive behaviour therapy can be used with children is unclear. In meta analyses older children and teenagers seem to derive greater benefit than young children. This may be because the cognitive immaturity of young children means that they cannot manage the cognitive demands of cognitive behaviour therapy. This paper seeks to establish how well children aged 7-8 and aged 10-11 can complete a task requiring them to distinguish between thoughts and behaviours (based on Greenberger & Padesky, 1995). Half of the children were provided with a visual cue and half were not. The effects of age, the visual cue, and verbal IQ on performance were examined. Seventy-two children were randomized to the cue and no-cue condition and individually tested during school time. Both age groups performed well and there was a significant difference between older and younger children, with the older children performing better. Visual cues did not aid performance. Verbal IQ was significantly associated with performance in the younger but not the older children. The implications of these results for the delivery of cognitive behaviour therapy with children and future research are discussed.
To test the effectiveness of added CBT in accelerating remission from acute psychotic symptoms in early schizophrenia.
A 5-week CBT programme plus routine care was compared with supportive counselling plus routine care and routine care alone in a multi-centre trial randomising 315 people with DSM–IV schizophrenia and related disorders in their first (83%) or second acute admission. Outcome assessments were blinded.
Linear regression over 70 days showed predicted trends towards faster improvement in the CBT group. Uncorrected univariate comparisons showed significant benefits at 4 but not 6 weeks for CBTv. routine care alone on Positive and Negative Syndrome Scale total and positive sub-scale scores and delusion score and benefits v. supportive counselling for auditory hallucinations score.
CBT shows transient advantages over routine care alone or supportive counselling in speeding remission from acute symptoms in early schizophrenia.
In March 1997 APT published two reviews of the use of benzodiazepines, buspirone, beta-blocking drugs and antidepressants in the treatment of anxiety disorders (Cowen, 1997; Tyrer, 1997). These were followed by a paper on the practical pharmacotherapy of anxiety (Nutt & Bell, 1997). The present review was originally prompted for several reasons. A number of large-scale investigations of the use of antidepressants in anxiety disorders have been completed since those papers were published. Indeed, several antidepressant drugs have since been licensed to treat anxiety disorders, and more applications are being considered. El-Khayat & Baldwin (1998) found that the prescription of antipsychotic drugs for anxiety disorders was widespread, but concluded there was no methodologically sound evidence to support their prescription. They suggested that this use of antipsychotic drugs reflected the fears of practitioners about the risks associated with benzodiazepines. There is no reason why the prescription of antidepressant drugs should arouse such fears, and it seemed timely to produce an up-to-date review of their efficacy in the treatment of anxiety disorders. This view was reinforced while this manuscript was in preparation, when the Committee on Safety of Medicines issued a statement in December 2000 that restricted the indications for the prescription of thioridazine because of concerns about rare but serious cardiotoxicity; thioridazine was no longer to be indicated for the treatment of anxiety or psychomotor agitation.
Pual E. Kolenbrander, Oral Infection and Immunity Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA,
Roxanna N. Andersen, Oral Infection and Immunity Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA,
Karen M. Kazmerzak, Oral Infection and Immunity Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA,
Robert J. Palmer, Oral Infection and Immunity Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA
Certain molecules on the surfaces of human oral bacteria can be recognized by cognate surface components of genetically distinct cells, which bind to form networks of cell–cell interactions. When these interactions occur in suspension, they are called coaggregations (Kolenbrander, 1988). When the interaction occurs between suspended or planktonic cells and already adherent cells, it is called coadhesion (Bos et al., 1994). Coadhesion may involve the accretion of an already formed coaggregate onto a biofilm, which is an assemblage of living cells on a substratum, or onto a virgin surface.
Coaggregation among human oral bacteria was first described 30 years ago (Gibbons & Nygaard, 1970). Coaggregation is measured by several methods, including visual inspection of clumps or coaggregates after mixing dense suspensions of two cell types (Gibbons & Nygaard, 1970), turbidometric measurement of supernatant after slowspeed centrifugation to pellet the coaggregates (McIntire et al., 1978), filtration through specific pore size to separate single cells from coaggregates (Lancy et al., 1980), distribution of radiolabelled cells of one cell type in coaggregates and supernatant after slow-speed centrifugation (Kolenbrander & Andersen, 1986) and binding of a radiolabelled cell type to partner cells immobilized on a nitrocellulose membrane (Lamont & Rosan, 1990). Coaggregations may be unimodal or bimodal (Kolenbrander, 1997). Unimodal coaggregations involve protease-sensitive molecules on the cell surface of one of the partners recognizing their cognate receptors (protease-insensitive) on the other partner's cell surface. Bimodal coaggregations involve more than one of the unimodal mechanisms. For example, one partner expresses both an adhesin and a non-cognate receptor. Its partner expresses the respective cognates for the adhesin and receptor.
Email your librarian or administrator to recommend adding this to your organisation's collection.