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Sink drainage systems are not amenable to standard methods of cleaning and disinfection. Disinfectants applied as a foam might enhance efficacy of drain decontamination due to greater persistence and increased penetration into sites harboring microorganisms.
To examine the efficacy and persistence of foam-based products in reducing sink drain colonization with gram-negative bacilli.
During a 5-month period, different methods for sink drain disinfection in patient rooms were evaluated in a hospital and its affiliated long-term care facility. We compared the efficacy of a single treatment with 4 different foam products in reducing the burden of gram-negative bacilli in the sink drain to a depth of 2.4 cm (1 inch) below the strainer. For the most effective product, the effectiveness of foam versus liquid-pouring applications, and the effectiveness of repeated foam treatments were evaluated.
A foam product containing 3.13% hydrogen peroxide and 0.05% peracetic acid was significantly more effective than the other 3 foam products. In comparison to pouring the hydrogen peroxide and peracetic acid disinfectant, the foam application resulted in significantly reduced recovery of gram-negative bacilli on days 1, 2, and 3 after treatment with a return to baseline by day 7. With repeated treatments every 3 days, a progressive decrease in the bacterial load recovered from sink drains was achieved.
An easy-to-use foaming application of a hydrogen peroxide- and peracetic acid-based disinfectant suppressed sink-drain colonization for at least 3 days. Intermittent application of the foaming disinfectant could potentially reduce the risk for dissemination of pathogens from sink drains.
In a crossover trial, a gown designed to increase skin coverage at the hands and wrists significantly reduced contamination of personnel during personal protective equipment (PPE) removal, and education on donning and doffing technique further reduced contamination. Simple modifications of PPE and education can reduce contamination during PPE removal.
C band backscatter parameters contain information about the upper snowpack/firn in the dry snow zone. The wide incidence angle diversity of the Advanced Scatterometer (ASCAT) gives unprecedented characterisation of backscatter anisotropy, revealing the backscatter response to climatic forcing. The A (isotropic component) and M2 (bi-sinusoidal azimuth anisotropy) parameters are investigated here, in conjunction with data from atmospheric and snowpack models, to identify the backscatter response to surface forcing parameters (wind speed and persistence, precipitation, surface temperature, density and grain size). The long-term mean A parameter is successfully recreated with a regression using these drivers, indicating strong links between the A parameter and precipitation on long timescales. While the ASCAT time series is too short to determine which factors drive observed trends, factors influencing the seasonal and short timescale variability are revealed. On these timescales, A strongly responds to the propagation of surface temperature cycles/anomalies downward through the firn, via direct modulation of the dielectric constant. The influence of precipitation on A is small at shorter timescales. The M2 parameter is controlled by wind speed and persistence, through modification of monodirectionally-aligned surface roughness. This variability indicates that throughout much of coastal Antarctica, a microwave ‘snapshot’ is generally not representative of longer-term conditions.
In this commentary we focus on individual differences in proposed mechanisms underlying arousal-based enhancement of prioritized stimuli. We discuss the potential of genotyping studies for examining effects of noradrenergic processes on stimulus prioritization in humans and stress the importance of potential individual differences in the activity of specific receptor subtypes in hotspot processes proposed by the GANE model.
Decontamination of gloves before removal could reduce the risk for contamination of hands of personnel caring for patients with Clostridium difficile infection. We demonstrated that a novel sporicidal formulation of ethanol rapidly reduced C. difficile spores on gloved hands without adverse odor, respiratory irritation, or staining of clothing.
Infect. Control Hosp. Epidemiol. 2016;37(3):337–339
Background: A definitive diagnosis of multiple sclerosis (MS), as distinct from a clinically isolated syndrome, requires one of two conditions: a second clinical attack or particular magnetic resonance imaging (MRI) findings as defined by the McDonald criteria. MRI is also important after a diagnosis is made as a means of monitoring subclinical disease activity. While a standardized protocol for diagnostic and follow-up MRI has been developed by the Consortium of Multiple Sclerosis Centres, acceptance and implementation in Canada have been suboptimal. Methods: To improve diagnosis, monitoring, and management of a clinically isolated syndrome and MS, a Canadian expert panel created consensus recommendations about the appropriate application of the 2010 McDonald criteria in routine practice, strategies to improve adherence to the standardized Consortium of Multiple Sclerosis Centres MRI protocol, and methods for ensuring effective communication among health care practitioners, in particular referring physicians, neurologists, and radiologists. Results: This article presents eight consensus statements developed by the expert panel, along with the rationale underlying the recommendations and commentaries on how to prioritize resource use within the Canadian healthcare system. Conclusions: The expert panel calls on neurologists and radiologists in Canada to incorporate the McDonald criteria, the Consortium of Multiple Sclerosis Centres MRI protocol, and other guidance given in this consensus presentation into their practices. By improving communication and general awareness of best practices for MRI use in MS diagnosis and monitoring, we can improve patient care across Canada by providing timely diagnosis, informed management decisions, and better continuity of care.
To test the hypothesis that cognitive impairment in older adults is associated with all-cause mortality risk and the risk increases when the degree of cognitive impairment augments; and then, if this association is confirmed, to report the population-attributable fraction (PAF) of mortality due to cognitive impairment.
A representative random community sample of individuals aged over 55 was interviewed, and 4557 subjects remaining alive at the end of the first year of follow-up were included in the analysis. Instruments used in the assessment included the Mini-Mental Status Examination (MMSE), the History and Aetiology Schedule (HAS) and the Geriatric Mental State (GMS)-AGECAT. For the standardised degree of cognitive impairment Perneczky et al's MMSE criteria were applied. Mortality information was obtained from the official population registry. Multivariate Cox proportional hazard models were used to test the association between MMSE degrees of cognitive impairment and mortality risk. We also estimated the PAF of mortality due to specific MMSE stages.
Cognitive impairment was associated with mortality risk, the risk increasing in parallel with the degree of cognitive impairment (Hazard ratio, HR: 1.18 in the ‘mild’ degree of impairment; HR: 1.29 in the ‘moderate’ degree; and HR: 2.08 in the ‘severe’ degree). The PAF of mortality due to severe cognitive impairment was 3.49%.
A gradient of increased mortality-risk associated with severity of cognitive impairment was observed. The results support the claim that routine assessment of cognitive function in older adults should be considered in clinical practice.
Two of the problems that currently affect a large proportion of university students are high levels of anxiety and stress experienced in different situations, which are particularly high during the first years of their degree and during exam periods. The present study aims to investigate whether mindfulness training can bring about significant changes in the manifestations of depression, anxiety, and stress of students when compared to another group undergoing a physical activity program and a control group. The sample consisted of 125 students from the Bachelor of Education Program. The measuring instrument used was the Abbreviated Scale of Depression, Anxiety and Stress (DASS-21). The results indicate that the effects of reducing the identified variables were higher for the mindfulness group than for the physical education group and for the control group F(2) = 5.91, p = .004, η2 = .106. The total scores for all variables related to the mindfulness group decreased significantly, including an important stress reduction t(29) = 2.95, p = .006, d = .667. Mindfulness exercises and some individual relaxing exercises involving Physical Education could help to reduce manifestations of stress and anxiety caused by exams in students.
SCFA resulting from the microbial fermentation of carbohydrates have been linked to increased glucagon-like peptide-1 (GLP-1) secretion from the gastrointestinal tract in cell and animal models; however, there is little direct evidence in human subjects to confirm this. The present study was designed to investigate whether endogenous plasma GLP-1 concentrations increase following acute consumption of 48 g dietary fibre (as resistant starch (RS) from high-amylose maize type 2 RS (HAM-RS2)) compared with a matched placebo. A total of thirty healthy males participated in the present randomised cross-over study where HAM-RS2 or placebo was consumed as part of standardised breakfast and lunch meals. Changes to GLP-1, glucose, insulin and C-peptide were assessed half hourly for 7 h. Following the breakfast meal, plasma GLP-1 concentrations were lower with HAM-RS2 compared with the placebo (P =0·025). However, there was no significant difference between the supplements following the lunch meal. Plasma insulin concentrations were significantly lower following the lunch meal (P =0·034) with HAM-RS2 than with the placebo, but were not different after breakfast. Plasma glucose and C-peptide concentrations did not differ at any point. These results suggest that increased dietary fibre intake, in the form of HAM-RS2, does not acutely increase endogenous GLP-1 concentrations in human subjects. Further fibre feeding studies are required to determine whether GLP-1 concentrations may increase following longer-term consumption.
Empirical evidence of the efficacy and effectiveness of psychosocial family intervention and of the specificity of its effects on the course of schizophrenia is limited. The aim was to study the efficacy and effectiveness of psychosocial family intervention with regard to clinical and social functioning and family burden after controlling for compliance and several prognostic factors.
A 2-year randomized controlled trial with blind assessments. Fifty patients with DSM-IV schizophrenia and persistent positive symptoms and/or previous clinical relapse were allocated to psychosocial family intervention, individual counselling and standard treatment versus individual counselling and standard treatment.
Family intervention was associated with fewer clinical relapses, hospitalizations and major incidents, and an improvement in positive and negative symptoms, social role performance, social relations, employment and family burden. The reduction in hospitalizations in the family intervention group was significantly greater than that observed in the group of patients who refused to participate but this was not the case for the control group. The effects of family intervention were independent of compliance and prognostic factors.
Family intervention is effective in severe schizophrenia independently of compliance and prognostic factors.
Polymerization occurring during fluorocarbon plasma treatment as a potential
method for pore sealing was investigated. CHF3 was used as a
reactant gas to expedite the rate of polymerization due to the presence of
hydrogen and the low C/F ratio. The reactor pressure was varied from 30mTorr
to 90mTorr to change the number of neutrals that act as the polymerizing
species. The films were exposed to the plasma for times of 1min, 3min, and 5
min to observe the penetration depth of neutrals and the thickness of
modified layer as a function of time. Dielectric constants were measured
before and after plasma treatment. The film morphology was investigated by
scanning electron microscopy before and after plasma treatment and a
featureless surface morphology was observed at 90mTorr on a 56% porosity
film. After plasma treatment, the average pore neck size decreases which may
help reduce metal precursor penetration during metallization.
Education is about learning. But it is not always about teaching. Nor is it always held in formal educational settings. Here we present an example from Mua Island in Torres Strait, where cultural knowledge was recently communicated and passed down to the younger generation through community participation rather than through formal educational institutions. The role that community research and ceremonies play in customary learning is here brought out through recent commemoration of the legendary hero Goba on Mua Island.
The effects of non-fried and fried virgin olive and sunflower oils on rat liver microsomal compositional features have been investigated. In addition, plasma antioxidants (α-tocopherol and ubiquinone 9) were investigated as well as the possible oxidative modifications suffered by virgin olive and sunflower oils during the frying process. The frying process decreased the content of α-tocopherol and phenolics in the oils and increased total polar materials. Sunflower oil was affected to a greater extent than olive oil. In rats, the intake of fried oil led to higher levels of lipid peroxidation and a lower concentration of plasma antioxidants. Microsomal fatty acid and antioxidant profiles were also altered. It seems that a strong relationship exists between the loss of antioxidants and the production of toxic compounds in the oils after frying and the extent of the peroxidative events in microsomes, which were also different depending on the fat source. The highly unsaturated sunflower oil was less resistant to the oxidative stress produced by frying and led to a higher degree of lipid peroxidation in liver microsomes in vivo than virgin olive oil.
In this study the effects of changes in extracellular magnesium ([Mg2+]o) and calcium ([Ca2+]o) concentrations on basal and on nerve-mediated and acetylcholine (ACh)-evoked in vitro amylase release and calcium mobilization were investigated in rat parotid gland tissue. In the presence of a normal (2.56 mM) [Ca2+]o, both zero (0 mM) and an elevated (10 mM) [Mg2+]o significantly attenuated basal and ACh-evoked amylase release compared to the response obtained in normal (1.1 mM) [Mg2+]o. During electrical field stimulation (EFS) of parotid tissues, only elevated [Mg2+]o reduced amylase release. In a Ca2+-free medium, both basal and ACh-evoked amylase output were markedly reduced compared to the responses obtained under similar conditions in normal [Ca2+]o. Again, the ACh-induced amylase release in a Ca2+-free solution was larger in normal [Mg2+]o than when the [Mg2+]o was either zero or was elevated to 10 mM. Perturbation of [Mg2+]o had no significant effect on basal intracellular free calcium concentration ([Ca2+]i) in parotid acinar cells loaded with the fluorescent Ca2+ indicator fura-2. Both zero Mg2+ and an elevated [Mg2+]o significantly reduced the ACh-induced rise in the peak and the plateau phase of the Ca2+ transient that was seen in normal [Mg2+]o. In parotid acinar cells loaded with the fluorescent Mg2+ indicator magfura-2, ACh elicited a gradual decrease in intracellular free Mg2+ concentration ([Mg2+]i) to below the basal level. The results indicate that both hypo- and hypermagnesaemia may reduce both basal and ACh-evoked amylase secretion from the salivary gland. As far as the ACh-evoked response is concerned, the effect may be exerted by a decrease in cellular Ca2+ transport. Experimental Physiology (2002) 87.3, 321-326.
The aim of the present study was to investigate in human subjects whether or not the ingestion of two liquid meals that differed only in their fatty acid composition (due to the addition of olive oil (group O) or sunflowerseed oil (group S) as the source of dietary fat) would lead to differences in the pancreatic enzyme activities secreted into the duodenum. The experiments were performed in eighteen cholecystectomized subjects who, during the 30d period immediately before surgery, modified their habitual diets in such a way that their fat composition would reflect, as far as possible, that of the experimental meals. Lipase (EC 220.127.116.11), colipase, amylase (EC 18.104.22.168), chymotrypsin (EC 22.214.171.124) and trypsin (EC 126.96.36.199) activities were measured in duodenal contents aspirated before and after the ingestion of the test meals. The plasma levels of secretin and cholecystokinin (CCK) were also examined. Duodenal enzyme activities were similar in resting conditions. No significant differences were revealed in postprandial enzyme activities, except for lipase activity, which was higher in group O, probably in relation to the greater plasma CCK concentrations observed in this group. In the absence of enzyme output data, we should not exclude the possibility that the type of dietary fat will affect human pancreatic enzyme secretion to a greater extent than is evident from the present study, for instance through a flow-mediated effect, as we previously observed in dogs.