Healthcare personnel (HCP) frequently wear gloves when they care for patients in Standard Precautions to prevent contact with potentially infectious blood or body fluids. When HCP use gloves appropriately they reduce the risk of cross-contamination and decrease the risk of healthcare-associated infections (HAI). However, if HCP use gloves inappropriately they may inadvertently spread pathogens to patients and the patients’ environment. This study used a descriptive structured observational design to investigate three aspects of HCP glove use in a United States long-term care facility (LTCF). First, the PI examined the degree of inappropriate HCP glove use in a random sample of 76 HCP. Results indicate that the HCP used gloves inappropriately, failing to change gloves 66% of the time when a glove change was indicated. Over 44% of the HCP gloved touch points were defined as contaminated. Second, the PI examined the reliability of a new glove use tool (GUST). Results indicate the GUST is a reliable tool when used by trained observers documenting HCP glove use during toileting and perineal care events in LTCF, with intraclass correlation coefficients (ICC 2,1) over 0.75 for indicators of inappropriate glove use. Third, exploratory analysis indicated significant differences between inappropriate glove use in females and males. Female HCP had significantly more failed glove changes and contaminated touch points than male HCP in this study (p = 0.003). Future research studies should assess US HCP glove use to provide data needed for development of strategies to improve HCP glove use and reduce HAI.

Thesis (MPH.) --University of Limpopo, 2019. / Background: The purpose of this study was to investigate the extent of adherence to Infection Prevention and Control (IP&C) practices and programs amongst healthcare workers (HCWs) in the neonatal ward at Charlotte Maxeke Central Hospital (CMCH). Methods: Quantitative research was conducted on 57 Clinicians directly providing care to the patients and 5 Health Care Workers indirectly providing care to the patients by means of supporting the environment and logistics where patients are being taken care. Data collection was done using structured questionnaires. Because the population was so small, all available HCWs, who were willing to participate in the study were selected to participate in the study. Furthermore, the SAS statistical software was used to describe and analyse data received from the data collection tools. Results: Two groups of respondents participated in the study which were (n=57) who in the neonatal ward at CMCH and Health Care Workers (n=5), most of the clinicians were having 1 – 4 years’ experience working in the neonatal unit at 54.6% followed by 5 – 9 years at 21.8%. Participants were in the age group ≤ 30 years at 39.3% followed by 31 – 40 years (32.1%) and least being at ≥ 51 years (5.4%). Clinicians included 46% of professional nurses, 28.6% Auxiliary Nursing Assistant, 16.1% student nurses and 8.9% medical doctors. The findings revealed that there are some areas where there’s inconsistent in using gloves when anticipating exposure to blood or body fluids, drying of hands after washing and removing jewellery during clinical care among clinicians particularly doctors, professional nurses and student nurses about IPC practices during clinical care. In Conclusion: There was inadequate compliance with IPC standards and there’s a need for regular trainings to improve the knowledge about IPCs and awareness of its importance among clinicians and health care workers in the neonatal unit. The IPC committee need to be revitalized by the hospital management to be able to undertake its mandate. Furthermore, the Hospital administration should provide copies of IPPC policy Guidelines in all wards/units and ensure effective implementation through vi constant supervision and adequate supplies and conduct regular audits to enhance compliance and implementation of IPPC policy. The study concluded that there was inadequate compliance with IPC and there’s a need for regular trainings to improve the knowledge about IPCs and awareness of its importance among clinicians and health care workers in the neonatal unit.

Bakgrund: Främre korsbandsskador är en av de vanligaste idrottsskadorna, speciellt bland idrottande kvinnor. Uppkomstmekanismerna bakom främre korsbandsskador är många och skadan inträffar oftast i samband med snabba riktningsförändringar, inbromsningar eller landningar. Efter en främre korsbandsskada ökar risken för återfall samt utveckling av artros. Att förebygga denna skada är av vikt då det ofta innebär negativa konsekvenser för individen och dess idrottskarriär.  Syfte: Att genom en systematisk litteraturstudie granska studier som använt neuromuskulär träning (NMT) som preventionsåtgärd för främre korsbandsskador hos idrottande kvinnor samt utvärdera ifall någon kombination av NMT visats ha bättre effekt än annan.  Metod: Litteratursökningen genomfördes i databaserna Pubmed samt Web of Science. Randomiserade kontrollerade studier (RCT) granskades enskilt samt gemensamt av författarna enligt PEDro-skalan. Tillförlitligheten av resultatet bedömdes enskilt med hjälp av GRADEstud innan gemensam bedömning genomfördes.  Resultat: Litteratursökningen resulterade i 524 träffar, dessa granskades i relation till PICO vilket resulterade i åtta inkluderade artiklar. Samtliga artiklar bedömdes ha hög kvalitet. Gällande incidensen av främre korsbandsskador presenterade endast två studier en signifikant mellangruppsskillnad. Samtliga studier redovisade en generellt minskad incidens av främre korsbandsskador, förutom en studie. Tillförlitligheten av det sammanvägda resultatet bedömdes som begränsad (++) på grund av bristande samstämmighet samt precision. Konklusion: Denna litteraturstudie bidrar inte med ett vetenskapligt underlag som tyder på att NMT bör rekommenderas för kvinnliga idrottare för att förebygga främre korsbandsskador. Ingen slutsats kan dras gällande vilken kombination av neuromuskulära övningar som kan anses mer effektiva än andra. / Background: Anterior cruciate ligament (ACL) injury is one of the most common knee injuries among female athletes. There are multiple risk factors and the injury normally occurs with quick change of direction, decelerations or landings. The risk of reinjury and developing arthritis increases considerably after a first injury. Preventing this injury is important considering the negative effects an injured athlete and their sports career will experience.  Objective: Through a systematic review, determine the effectiveness of neuromuscular training (NMT) in preventing anterior cruciate ligament injuries among athletic females. Also, explore if any specific combination of NMT exercises does have a superior outcome. Method: A literature search was made in the databases Pubmed and Web of Science. Randomised controlled studies (RCT) were reviewed separately and then jointly by the authors according to PEDro, and for assessment of reliability, with GRADEstud.  Results: The literature search resulted in 524 articles and they all were assessed by PICO. A final number of eight articles were included and were assessed to be of good quality and the level of evidence was considered limited (++). Solely two studies presented a significant result. All studies except one, presented a reduced incidence of ACL injury.  Conclusion: This systematic review does not provide a result which implies that NMT is an effective preventative measure for the incidence of ACL injuries among female athletes. No conclusion could be drawn if any combination of NMT exercises was more effective.

This dissertation reports the findings of a study which was carried out in the Cape Town City Council area, in order to establish whether the offering of rifampicin to household contacts, of patients with meningococcal disease, resulted in protection of those contacts against developing the disease during a 32 week follow up period. The study took the form of a retrospective follow up of 3 350 household contacts of 412 cases notified over a 4-year period (mid 1988-mid 1992). It was found that the offering of rifampicin to the household contacts resulted in an odds ratio of not developing meningococcal disease over the 32-week follow up period of 14, 17 (SD = 12, 34). Although there was a tendency for contacts who were not offered rifampicin to have been younger, and of male gender, when compared to those who were offered prophylaxis, these demographic differences were not statistically significant at the 0,05 level. Furthermore, three out of the four male second cases, all in the younger age group, were in fact offered prophylaxis. It seems desirable that prophylaxis should be given as soon as possible. It is concluded, therefore, that the offering of rifampicin to household contacts of patients with meningococcal disease, living under the prevailing social circumstances in the Western Cape, has protective benefit for those contacts. It is likely that the chemoprophylaxis programme prevented up to 88 cases of meningococcal disease over the study period of four years, as well as preventing 8 deaths from this disease, in the CCC population.

This thesis concerns a melanoma-derived growth regulatory factor that inhibited proliferation of several malignant human cell lines, and, in particular, a line designated UCT-BR-1, which was derived from a human breast cancer metastasis. The work is presented in four chapters. Chapter 1 provides a review of the relevant literature at the time of writing; Chapters 2 and 3 describe the experimental work that was done; and in Chapter 4 I discuss the implications of my results for current and future work in growth factors. Experimental results are presented as Charts (which may be Figures or Tables) and the methods and experimental protocols that I used are described in the Chart legends and not in the main text of the thesis. The Appendix contains details of the tissue culture techniques and descriptions of the cell lines that were used. Sources of the various laboratory materials as well as the methods that were employed for the more routine procedures are also described in the appendix.

The concept of “Environmental authoritarian” becomes the focus of discussion in the academic field of environmental politics since it has limited observations. In the recent years, the severe air pollute issue is considered as a threat by both citizens and authorities in China. Along with the more stricter environmental protection laws being issued, even the measures of the factory closings and coal ban seems to become acceptable as the population  have suffered in the heavy smog for years. Does this led to the rise of “environmental authoritarian” in China?  Taking this as a heuristic point, I observe the positions of various stakeholders in the environmental governance as well as present the findings from research on the implementation and enforcement of air pollution controls measures in Jing-Jin-Ji region. I offer a critical examination of “environmental authoritarian”, especially the levels of public participation at the policy process. After to do the research, the key funding is that the concept of “Environmental authoritarian” is too simplified, it cannot cover the complex and detailed environmental governance at local empirical cases.

Indiana University-Purdue University Indianapolis (IUPUI) / Whitening dentifrices use different mechanisms for stain removal and prevention. These approaches are abrasives, oxidizing agents, and chemical cleaning agents. The objectives of this in-vitro study were: 1) To compare the whitening effect of commercial whitening and non-whitening dentifrices; 2) To verify the mechanism of action of whitening dentifrices by contrasting two experimental models: chemical model (toothpaste exposure only) and chemo-mechanical (toothpaste exposure with tooth-brushing abrasion). The 256 bovine enamel specimens (10 mm x10 mm) were prepared and partially stained. They were assigned to 8 groups: 6 whitening dentifrices, 1 non-whitening reference dentifrice and deionized water (control); and they were further divided in 2 subgroups (n = 16), chemical and chemo-mechanical. Specimens were exposed to dentifrice slurries 2X/day for 1 min and brushed or not, according to each model. In between dentifrice treatments, specimens were exposed to the staining solution for 5 h. This protocol was repeated for 5 consecutive days and enamel color changes (∆E, ∆L) were measured by spectrophotometry after each day. The abrasivity of the toothpastes was determined using a standard test (ISO 11609). Significantly higher ∆E values (whitening effect) were observed for all groups (p < 0.05), except for the control, when tested in the chemo-mechanical model. In this model, the whitening ability of the toothpastes was mainly determined by their abrasive levels. For the chemical model, no significant differences were observed among groups (p > 0.05). Whitening dentifrices can be effective in preventing and removing enamel surface staining, when associated with tooth-brushing abrasion. This was modulated by the abrasive level of the tested toothpastes, with no chemical action attributed to the chemical agents. / indefinitely

BACKGROUND: Firearm-related violence is a significant public health issue in the US. Research has found an increase in guns used in crimes sourced from low gun law states into high gun law states. The purpose of this study is to evaluate the effect of distance from states without universal background checks (UBC), background checks at shows (BCS), or permit to purchase (PTP) laws on firearm homicide rates in states with them. METHODS: States were identified based on their enactment of laws that are designed to prevent the private sale of firearms to criminals. Demographic data for each county were obtained for the years 2014 through 2017. The border distance from a county in a state with the evaluated gun laws to the nearest border state without the gun laws was obtained using Google Maps. Multiple regression analyses were performed to test the relationship between border distance and firearm homicide rates. RESULTS: The regression model evaluating all formats found the border distance was negatively associated with firearm homicides (p=.009). The parameter estimate indicated as border distance increased, the firearm homicide rate decreased. When counties with UBC or PTP on all guns were evaluated separately from all formats model, the statistical significance was lost (p=.62). In counties where all handgun sales either require a background check or a PTP is required, the distance was also not statistically significant (p=.11). CONCLUSIONS: This study provides evidence that there may be a mitigating effect on the reduction of firearm homicides in states that require background checks or PTP on private sales when there is a state in close proximity that did not have these laws. Limited counties at certain distances may have contributed to the insignificant findings in other models.

No description available.

Com o objetivo de avaliar o desempenho do teste rápido DPP® LVC comparando com os testes de ELISA e RIFI (Bio-Manguinhos, Br), assim como ELISA e RIFI in-house, empregando como antígeno formas promastigotas de L. (L.) infantum chagasi, com ênfase a reatividade cruzada com outros agentes infecciosos, soros de cães infectados por L. (L.) infantum chagasi, clinicamente sintomáticos (n=48) e assintomáticos (n=39), assim como soros de cães sadios e não infectados (n=18), e soros de cães infectados por Babesia canis (n=9), Dirofilaria immitis (n=4), Trypanosoma cruzi (n=6), Ehrlichia canis (n=17), Neospora caninum (n=6), Toxoplasma gondii (n=9), Neospora/Toxoplasma coinfecção (n=4) e Toxocara canis (n=9) foram avaliados pelas diferentes técnicas de diagnóstico. DPP e ELISA in-house mostraram alta sensitividade (90.81% e 94.25%) e especificidade (95.06% e 97.53%), respectivamente para o diagnóstico de LVC sintomática e assintomática, mas apresentaram reação cruzada com Babesia canis, 44% para DPP e 22% para ELISA in-house. Os dois testes mostraram uma excelente concordância de resultados (kappa=0.9405, p < 0.0001). ELISA Bio-Manguinhos assim como o RIFI Bio-Manguinhos e RIFI in-house mostraram boa sensitividade (90.81%, 96.47% e 89.41%), mas baixa especificidade (77.78%, 69.14% e 65.82%), respectivamente; e mostraram reação cruzada com soros de animais infectados com Babesia canis, Dirofilaria immitis, Trypanosoma cruzi, Ehrlichia canis, Neospora caninum, Toxoplasma gondii. Os resultados mostraram que o DPP® CVL apresentou um bom desempenho para o diagnóstico da leishmaniose visceral canina sintomática e assintomática / In order to investigate the performance of the DPP® CVL rapid test comparing with ELISA and IFA (Bio-Manguinhos, Br), as well as ELISA and IFAT in house using L. (L.) infantum chagasi promastigotes as antigen with emphasis in the cross-reactivity with others infectious agents, sera from clinically symptomatic (n=48) and asymptomatic (n=39) L. (L.) infantum chagasi infected dogs, as well as from healthy non-infected (n=18) dogs and from Babesia canis (n=9), Dirofilaria immitis (n=4), Trypanosoma cruzi (n=6), Ehrlichia canis (n=17), Neospora caninum (n=6), Toxoplasma gondii (n=9), Neospora/Toxoplasma co-infection (n=4) and Toxocara canis (n=9) infected dogs were tested for different diagnosis techniques. DPP and ELISA in-house showed high sensitivity (90.81% and 94.25%) and specificity (95.06% and 97.53%), respectively for symptomatic and asymptomatic CVL diagnosis, but presented cross-reactivity with Babesia canis, 44% for DPP and 22% for ELISA in-house. Both test showed an excellent agreement (kappa=0.9405, p < 0.0001). ELISA Bio-Manguinhos as well as IFA Bio-Manguinhos and IFA in-house showed good sensitivity 90.81%, 96.47% and 89.41%) but low specificity (77.78%, 69.14% and 65.82%), respectively; and showed cross-reactivity with sera from animals infected with Babesia canis, Dirofilaria immitis, Trypanosoma cruzi, Ehrlichia canis, Neospora caninum, Toxoplasma gondii. The results showed that DPP® CVL had a good performance for the diagnosis of of both symptomatic and asymptomatic canine visceral leishmaniasis