bluuebunny/crossref_metadata_2025_split huggingface dataset:
Why Healthcare Workers Don't Wash Their Hands: A Behavioral Explanation
Authors: Whitby Michael , McLaws Mary-Louise , Ross Michael W. 
Published: May 2006

Objective.To elucidate behavioral determinants of handwashing among nurses.Design.Statistical modeling using the Theory of Planned Behavior and relevant components to handwashing behavior by nurses that were derived from focus-group discussions and literature review.Setting.The community and 3 tertiary care hospitals.Participants.Children aged 9-10 years, mothers, and nurses.Results.Responses from 754 nurses were analyzed using backward linear regression for handwashing intention. We reasoned that handwashing results in 2 distinct behavioral practices—inherent handwashing and elective handwashing—with our model explaining 64% and 76%, respectively, of the variance in behavioral intention. Translation of community handwashing behavior to healthcare settings is the predominant driver of all handwashing, both inherent (weightedβ= 2.92) and elective (weightedβ= 4.1). Intended elective in-hospital handwashing behavior is further significantly predicted by nurses' beliefs in the benefits of the activity (weightedβ= 3.12), peer pressure of senior physicians (weightedβ= 3.0) and administrators (weightedβ= 2.2), and role modeling (weightedβ= 3.0) but only to a minimal extent by reduction in effort (weightedβ= 1.13). Inherent community behavior (weightedβ= 2.92), attitudes (weightedβ= 0.84), and peer behavior (weightedβ= 1.08) were strongly predictive of inherent handwashing intent.Conclusions.A small increase in handwashing adherence may be seen after implementing the use of alcoholic hand rubs, to decrease the effort required to wash hands. However, the facilitation of compliance is not simply related to effort but is highly dependent on altering behavioral perceptions. Thus, introduction of hand rub alone without an associated behavioral modification program is unlikely to induce a sustained increase in hand hygiene compliance.
Lack of Association Between the Increased Incidence ofClostridium difficile–Associated Disease and the Increasing Use of Alcohol-Based Hand Rubs
Authors: Boyce John M. , Ligi Cathy , Kohan Cindy , Dumigan Diane , Havill Nancy L. 
Published: May 2006

Objective.To determine whether there is an association between the increasing use of alcohol-based hand rubs (ABHRs) and the increased incidence ofClostridium difficile–associated disease (CDAD).Setting.A 500-bed university-affiliated community teaching hospital.Methods.Use of ABHRs during the period 2000-2003 was expressed as the number of liters of ABHR used per 1000 patient-days. The proportion of hand hygiene episodes performed by using an ABHR was determined by periodic observational surveys. CDAD was defined as a physician-ordered stool assay positive forC. difficiletoxin A or A/B. The incidence of CDAD was expressed as the number of unique patients who had 1 or more positive CDAD test results per 1,000 patient-days.Results.During 2000-2003, the use of ABHR increased 10-fold, from 3 to greater than 30 L/1,000 patient-days (P< .001). The proportion of hand hygiene episodes performed using an ABHR increased from 10% to 85% (P< .001). The incidence of CDAD in 2000, 2001, 2002, and 2003 was 1.74, 2.33, 1.14, and 1.18 cases/1,000 patient-days, respectively.Conclusion.Despite a significant and progressive increase in the use of ABHRs in our facility during a 3-year period, there was no evidence that the incidence of CDAD increased. These findings suggest that factors other than the increased use of ABHRs are responsible for the increasing incidence of CDAD noted since 2000 in other facilities.
Epidemiologic Study and Containment of a Nosocomial Outbreak of Severe Acute Respiratory Syndrome in a Medical Center in Kaohsiung, Taiwan
Authors: Liu Jien-Wei , Lu Sheng-Nan , Chen Shun-Sheng , Yang Kuender D. , Lin Meng-Chih , Wu Chao-Chien , Bloland Peter B. , Park Sarah Y. , Wong William , Tsao Kuo-Chien , Lin Tzou-Yien , Chen Chao-Long 
Published: May 2006

Objective.We conducted an epidemiologic investigation at the beginning of a nosocomial outbreak of severe acute respiratory syndrome (SARS) to clarify the dynamics of SARS transmission, the magnitude of the SARS outbreak, and the impact of the outbreak on the community.Methods.We identified all potential cases of nosocomially acquired SARS, linked them to the most likely infection source, and described the hospital containment measures.Setting.A 2,300-bed medical center in Kaohsiung, Taiwan.Results.A total of 55 cases of SARS were identified, and 227 hospital workers were quarantined. The index patient and neighboring patients were isolated. A chest physician team reviewed medical charts and chest radiographs and monitored the development of SARS in patients staying in the ward. The presence of underlying lung disease and immunocompromise in some patients made the diagnosis of SARS difficult. Some cases of SARS were diagnosed after the patients had died. Medical personnel were infected only if they cared for patients with unrecognized SARS, and caretakers played important roles in transmission of SARS to family members. As the number of cases of nosocomial SARS increased, the hospital closed the affected ward and expedited construction of negative-pressure rooms on other vacated floors for patient cohorting, and the last case in the hospital was identified 1 week later.Conclusions.Timely recognition of SARS is extremely important. However, given the limitations of SARS testing, possible loss of epidemic links, and the nonspecific clinical presentations in hospitalized patients, it is very important to establish cohorts of persons with low, medium, and high likelihoods of SARS acquisition. Rapid closure of affected wards may minimize the impact on hospital operations. Establishment of hospitals dedicated to appropriate treatment of patients with SARS might minimize the impact of the disease in future epidemics.
Infection Control Practices to Reduce Airborne Bacteria During Total Knee Replacement: A Hospital Survey in Four States
Authors: Miner Andrew L. , Losina Elena , Katz Jeffrey N. , Fossel Anne H. , Piatt Richard 
Published: May 2006

AbstractObjective:To describe the use of laminar airflow, body exhaust, and ultraviolet lights during total knee replacement (TKR) in four U.S. states.Design:Survey of healthcare facilities.Setting:Hospitals in Illinois, North Carolina, Ohio, and Tennessee that performed TKR during 2000 as identified by Medicare claims data.Participants:Hospitals responding to a mailed questionnaire.Results:Two hundred ninety-five (73%) of 405 eligible hospitals that performed 18,374 primary and revision TKR procedures responded to the questionnaire. Among responding hospitals, 30% reported regular use (for > 75% of procedures) of laminar airflow, 42% reported regular use of body exhaust, and 5% reported regular use of ultraviolet lights. Among hospitals providing complete data, 150 (58%) performing 66% of procedures reported regular use of at least one of these techniques. On regression analyses, laminar airflow was used more often by hospitals with a TKR volume greater than 25 procedures per year (odds ratio [OR], 2.0; 95% confidence interval [CI95], 1.1-3.7) and orthopedic residency programs (OR,2.8;CI95,1.3-6.3), but its use was not significantly related to hospital setting or ownership status.Conclusions:Although these clean air practices are not recommended by any U.S. governmental or professional organization, they are used in nearly two-thirds of TKR procedures. Better information about their impact on current practice and more explicit guidelines may aid decisions about the use of these resource-intensive infection control practices.
Surgical vs wire‐guided cricothyroidotomy: a randomised crossover study of cuffed and uncuffed tracheal tube insertion
Authors: Sulaiman L. , Tighe S. Q. M. , Nelson R. A. 
Published: May 2006

SummaryUsing an airway mannequin and artificial lung model, we compared surgical cricothyroidotomy with a 6.0‐mm cuffed Portex tracheostomy tube with wire‐guided cricothyroidotomy using a 5.0‐mm cuffed Melker or 6.0‐mm uncuffed Melker tube. The trial was carried out by 27 anaesthetists using a randomised, crossover design. Surgical cricothyroidotomy proved significantly faster (mean (SD) time to first breath 44.3 (12.5) s for Portex surgical, 87.2 (21.6) s for cuffed Melker, 87.8 (19.2) s for uncuffed Melker, p < 0.001). With a standardised ventilator model, the cuffed tubes provided more effective ventilation (mean (SD) tidal volume 446 (41) ml Portex, 436 (52) ml cuffed Melker, 19 (5) ml uncuffed Melker, p < 0.001). Fourteen of the participants preferred the wire‐guided system. We conclude that, in this model, a cuffed device is preferable when cricothyroidotomy is needed. In addition, the surgical method is quicker than a wire‐guided approach.
Poor correlation between 6β‐hydroxycortisol:cortisol molar ratios and midazolam clearance as measure of hepatic CYP3A activity
Authors: Chen Ya‐Chi , Gotzkowsky S. Karl. , Nafziger Anne N. , Kulawy Robert W. , Rocci Mario L. , Bertino Joseph S. , Kashuba Angela D. M. 
Published: May 2006

AimsA non‐invasive proposed method for measuring CYP3A activity is the urinary 6β‐hydroxycortisol:cortisol ratio. This ratio has been used as an indicator of CYP3A induction and inhibition, with mixed results. This investigation evaluated the relationship between a validated, biomarker, intravenous midazolam clearance and the urinary cortisol ratio under constitutive conditions and with the influence of a moderate CYP3A inhibitor.MethodsThis was a sequential, cross‐over study design. Intravenous midazolam 0.025 mg kg−1 was administered to 10 male and 10 female subjects once every 14 days for 4 months. Fluvoxamine 150 mg day−1 was given to all subjects during the last two visits. Total body clearance of midazolam and urinary 6β‐hydroxycortisol:cortisol molar ratio were used as biomarkers of hepatic CYP3A activity.ResultsNo significant correlations were found between these two markers (r2 < 0.5, P > 0.05). Larger interindividual and intra‐individual variability in CYP3A activity was observed in 6β‐hydroxycortisol:cortisol ratios compared with midazolam clearances. With fluvoxamine therapy, midazolam clearance values decreased approximately 1.5‐fold and cortisol ratios decreased approximately 1.9‐fold.ConclusionsThe high intra‐individual variability of the urinary cortisol ratio, compared with midazolam, makes this a suboptimal CYP3A phenotyping tool.
Effect of widely used combinations of antiretroviral therapy on liver CYP3A4 activity in HIV‐infected patients
Authors: Mouly Stéphane , Rizzo‐Padoin Nathalie , Simoneau Guy , Verstuyft Céline , Aymard Guy , Salvat Cécile , Mahé Isabelle , Bergmann Jean‐François 
Published: May 2006

AimsTo evaluate the effects of combined antiretroviral drugs (HAART) on liver CYP3A4 activity using the [14C‐N‐methyl]‐erythromycin breath test (ERMBT).MethodsHIV‐infected patients (31 women, 30 men) with mean (± SD) age of 38 ± 9 years were enrolled and underwent complete clinical and laboratory evaluation. Patients were divided into five groups and were treated with two nucleoside analogues (NAs) and one of the following: nelfinavir alone (n = 13), any ritonavir‐boosted protease inhibitor with (n = 8) or without (n = 13) nevirapine, nevirapine alone (n = 15), or a third NA (n = 12). Three or four ERMBTs were performed 7 days prior to (D−7) and at the beginning of treatment (D0), D14 (only for patients taking nevirapine) and on D28.ResultsMean baseline liver CYP3A4 activity displayed high interindividual variability (47%) but low intraindividual variability (15%). Women had 30% higher ERMBT values than men [2.7 ± 1.3vs.1.9 ± 0.7; 95% confidence interval (CI) 20.5, 49.5;P = 0.003]. The ERMBT data correlated with body weight, α‐ and β‐globulins and alanin aminotransferases (0.10 < rs < 0.20;P < 0.01). Whereas nevirapine had no effect on liver CYP3A4 activity, nelfinavir‐based and ritonavir‐boosted drug regimens inhibited it by 69% (95% CI 64.7, 72.9;P = 0.005) and by 95% (95% CI 93.3, 96.7;P = 0.001), respectively.ConclusionEvaluation of the effect of HAART on liver CYP3A4 activity may aid in preventing inappropriate treatment regimens in HIV‐infected patients.
Undetectable salivary testosterone in young women with premature ovarian failure
Authors: Mason A. , Wallace A. M. , MacIntyre H. , Teoh Y. P. , Bath L. E. , Critchley H. O. , Kelnar C. J. H. , Wallace W. H. B. , Ahmed S. F. 
Published: May 2006

SummaryBackground  The extent of androgen deficiency in young women with premature ovarian failure (POF) is unclear.Aim  Cross‐sectional study of androgen status in young women with POF.Patients  Twenty women with POF: six had Turner syndrome (group A); eight had iatrogenic POF either secondary to bilateral oophorectomy or treatment of malignancy (group B); and six had idiopathic POF (group C). The median age was 30·5 years (range 19–39); in groups B and C the median duration of ovarian failure was 10·0 years (range 1–35).Methods  After a 2‐month wash‐out period without sex steroid replacement (SSR), serum testosterone (T), androstenedione (A4), dehydroepiandrosterone (DHEAS), SHBG, salivary testosterone (SalT) and the free androgen index [FAI = (serum T/SHBG) × 100] were measured.Results  Median serum A4 was 4·6 nmol/l (10th, 90th centiles, 3·6, 5·1) and DHEAS was 3·2 µmol/l (10th, 90th centiles, 2·3, 9·3). Although median serum T was relatively low at 1·4 nmol/l (10th, 90th centiles, 1·1, 1·7), median SHBG was also low at 34 nmol/l (10th, 90th centiles 22·2, 67·5) and the median calculated FAI was within the normal range at 3·7 (10th, 90th centiles, 2·3, 7·0). However, SalT was undetectable in almost all subjects in the three groups of POF.Conclusions  Serum T and SHBG are relatively low in young women with POF and their FAI is therefore within the normal range. However, SalT, which measures free testosterone, is consistently low to undetectable in these young women with POF. The reliability of the FAI as a marker of androgen deficiency remains questionable.
Estimating diesel degradation rates from N2, O2 and CO2 concentration versus depth data in a loamy sand
Authors: Van De Steene J. , Verplancke H. 
Published: May 2006

SummaryThe degradation rate of the pollutant is often an important parameter for designing and maintaining an active treatment system or for determining the rate of natural attenuation. A quasi‐steady‐state gas transport model based on Fick’s law with a correction term for advective flux, for estimating diesel degradation rates from N2, O2 and CO2 concentration versus depth data, was evaluated in a laboratory column study. A loamy sand was spiked with diesel fuel at 0, 1000, 5000 and 10 000 mg kg−1 soil (dry weight basis) and incubated for 15 weeks. Soil gas was sampled weekly at 6 selected depths in the columns and analysed for O2, CO2 and N2 concentrations. The agreement between the measured and the modelled concentrations was good for the untreated soil (R2= 0.60) and very good for the soil spiked with 1000 mg kg−1 (R2= 0.96) and 5000 mg kg−1 (R2= 0.97). Oxygen consumption ranged from −0.15 to −2.25 mol O2 m−3 soil day−1 and CO2 production ranged from 0.20 to 2.07 mol CO2 m−3 soil day−1. A significantly greater mean O2 consumption (P < 0.001) and CO2 production (P < 0.005) over time was observed for the soils spiked with diesel compared with the untreated soil, which suggests biodegradation of the diesel substrate. Diesel degradation rates calculated from respiration data were 1.5–2.1 times less than the change in total petroleum hydrocarbon content. The inability of this study to correlate respiration data to actual changes in diesel concentration could be explained by volatilization, long‐term sorption of diesel hydrocarbons to organic matter and incorporation of diesel hydrocarbons into microbial biomass, aspects of which require further investigation.
Individual Differences in Approach and Avoidance Movements: How the Avoidance Motive Influences Response Force
Authors: Puca Rosa Maria , Rinkenauer Gerhard , Breidenstein Christian 
Published: May 2006

ABSTRACTThe present research is based on the assumption that people differ in their responsiveness to incentives and threats. In two experiments we examined whether the trait corresponding to the responsiveness to threats (avoidance motive) and the trait corresponding to the responsiveness to incentives (approach motive) influence voluntary motor behavior toward or away from stimuli. In Experiment 1, stimuli consisted of positive and negative words within a lexical decision task. Participants moved their arms backward in order to withdraw from the stimuli or forward in order to approach them. In Experiment 2, participants responded with forward or backward arm movements to neutral sounds coming from behind or in front of them.The main dependent variable was the strength of the approach and avoidance movements. In both experiments this variable was related to participants' avoidance‐motive disposition but not to their approach‐motive disposition. Avoidance‐motivated individuals generally showed more forceful avoidance movements than approach movements. There was no effect of stimulus valence on the strength of the movements in Experiment 1. Furthermore, the results of Experiment 2 suggest that it is not the physical direction (forward or backward) but rather the movement's effect of distance reduction (approach) or distance increase (avoidance) in regard to the stimulus that defines a movement as an approach or an avoidance movement.
CELL WALL METABOLISM I. HEMICELLULASES OF BROMUS SEEDS
Authors: MACLEOD ANNA M. , SANDIE R. 
Published: May 2006

SummaryReadily extractable hemicelluloses account for approximately 14% of the dry weight of grains of five species of Bromus. In B. mollis, although 10% of cellulose is present in the whole grain, only one‐eighth of this cellulose is located within the true seed, the remainder being restricted to the husk. Crude preparations of enzymes extracted from B. mollis can rapidly solubilize and degrade pentosan and hexosan hemicelluloses but are without apparent effect on suspensions of cellulose, and there appears to be no real evidence for the action of a true cellulase during germination.Extracts of Bromus seeds are also extremely active in transglucosylation and can readily catalyse synthesis of β‐linked oligosaccharides from 1% solutions of cellobiose.
CYTOTAXONOMIC STUDIES IN HOLCUS
Authors: CARROLL CHRISTOPHER P. , JONES KEITH 
Published: May 2006

SummaryA statistical study has been made of the morphology of Holcus lanatus (2n= 14), H. mollis (2n= 28) and of three F1 progenies (2n= 21).The hybrids, while intermediate in some respects, tends to resemble the mollis parent strongly in morphology and growth form. This could be accounted for by their genomic composition.The occurrence of natural F1 hybrids is reported, and considered in the light of the experimental results. Their importance in the evolution of the H. mollis complex is discussed. It is shown that interspecific hybrids could easily be confused with authentic H. mollis in the wild. A list of tentative diagnostic characters is given, but only chromosome counting can provide decisive identification.
SEASONAL VARIATIONS IN THE SECONDARY PHLOEM OF SOME FOREST TREES FROM NIGERIA
Authors: LAWTON JUNE R. , LAWTON J. R. S. 
Published: May 2006

SummarySamples of bark were taken from the main trunk of trees of Antiaris (two), Tectona, Bombax, Albizia, Ricinodendron and Holarrhena at monthly intervals for two consecutive years. Phloem zones were characterized, inter alia, by the amount and type of callose present, as indicated by the callose fluorescence. The greatest amount of the ‘active’ phloem coincided in all cases with some part of the rainy season. Bud break generally occurred at some time during the dry season, normally at the very end, and this coincided with the lowest amount of ‘active’ phloem, although it was rapidly followed by an increase in the amount of ‘active’ phloem. In only two genera, Ricinodendron and Tectona, could it be deduced that there was any cessation of cambial activity during the dry season, as indicated by the lack of ‘active’ phloem. In all other cases ‘active’ phloem was present throughout the dry season. The depth of the total fluorescent zone indicates that there is a large amount of phloem produced during the year in many of these trees.Tylosoids were formed in three of the six genera at the time of formation of the definitive callose; in Antiaris and possibly Ricinodendron the tylosoids became lignified, but not in Bombax.
THE INTERNAL CONTROL OF NITRATE UPTAKE INTO EXCISED BARLEY ROOTS WITH DIFFERING SALT CONTENTS
Authors: SMITH F. A. 
Published: May 2006

SummaryMeasurements of net NO3‐ influx have been made with excised bailey roots of differing salt status. With roots grown in 0.2 mM CaSO4, net NO3‐ influx shows partial saturation with external NO3‐ concentrations greater than 0.5 mM, and is greatly reduced in the absence of external K+ or Na+. Net NO3‐ influx from NaNO3 solution is as rapid as from KNO3 solution, but when both K+ and Na+ are present the roots show high specificity for K+ over Na+. When roots are high in Cl‐, net NO3‐ influx is greatly reduced, and the reciprocal effect of reduction in Cl‐ influx into roots high in NO3‐ is also found. There is some decrease in net NO3‐ influx and in Cl‐ influx when roots are high in organic anions, and under these conditions net NO3‐ influx is completely independent of cation influx. There is no effect of external Cl‐ (up to 10 mM) on net NO3‐ influx (1 mM solution), and very little or no effect of external NO3‐ on Cl‐ influx. The results are considered in relation to the hypothesis that influx of NO3‐ and Cl‐ is subject to feedback control from the internal NO3‐ plus Cl‐ content, but it is concluded that organic anions can also play an important part in controlling influx of NO3‐ and Cl‐. The interactions between cation and anion fluxes are discussed, and a unifying model for ion transport proposed.
A NEW SPECIES OF MYCORRHIZAL ENDOGONE FROM NIGERIA WITH A DISTINCTIVE SPORE WALL
Authors: OLD K. M. , NICOLSON T. H. , REDHEAD J. F. 
Published: May 2006

SummaryAn unnamed species of mycorrhizal Etidogone from Nigeria is described. It belongs to the zygosporic or azygosporic group and the spore wall resembles that of a ‘honey‐coloured’ species recently described by Mosse. The most conspicuous feature is seen in the outer layers. These show a porous and meshwork construction and ultrastructural aspects are described. The species is not formally named at this stage as reorganization of the genus is currently taking place.
XYLEM FLECKS: A NOTE ON SOME UNEXPLAINED ABNORMALITIES IN THE WOOD OF EUROPEAN LARCH AND OTHER TREES
Authors: BUCZACKI S. T. 
Published: May 2006

SummarySmall patches of abnormal tissue in the wood of European larch, termed xylem flecks, are described. They are particularly prevalent in the wood formed in the penultimate internode. Similar tissues were also seen in four other tree species. Fleck formation varied from year to year. Although xylem flecks resemble the tissue abnormalities associated with frost damage, it seems unlikely that their causation is climatic. All larch trees suffering from epidemic dieback contained xylem flecks and the possibility of an association with adelgid infestations is discussed. It is concluded that the flecks may have been a response to stress conditions, although a positive correlation in one tree between numbers of flecks and annual radial increment indicated a less simple explanation.