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Biomedical subjects

E Larson

Publications and source records attributed to E Larson.

At least 19 recordsLinked to original sources
PubMed2006

Behavioural considerations for hand hygiene practices: the basic building blocks.

Hand hygiene is considered to be the most effective measure to prevent microbial pathogen cross-transmission and healthcare-associated infections. In October 2005, the World Health Organization (WHO) World Alliance for Patient Safety launched the first Global Patient Safety Challenge 2005-2006, 'Clean Care is Safer Care', to tackle healthcare-associated infection on a large scale. Within the Challenge framework, international infection control experts and consultative taskforces met to develop new WHO Guidelines on Hand Hygiene in Healthcare. The taskforce was asked to explore aspects underlying hand hygiene behaviour that may influence its promotion among healthcare workers. The dynamics of behavioural change are complex and multi-faceted, but are of vital importance when designing a strategy to improve hand hygiene compliance. A reflection on challenges to be met and areas for future research are also proposed.

Attitude of Health Personnel↗
PubMed2004

A prospective open-label study to evaluate the effects of the oral contraceptive Harmonet (gestodene75/EE20) on body fat.

This open-label study evaluated the effects on body fat of the use of a low-dose oral contraceptive (gestodene75/EE20) in a group of 61 women (OC-U group) as compared to a nonuser group (OC-N group) of 51 women who did not receive an oral contraceptive. Weight, body mass index (BMI), waist-over-hip ratio and body composition data, obtained by bioelectrical impedance [percentages of body fat (%FAT), water (%TBW) and lean mass (%FFM)], were assessed before and after six treatment cycles. Baseline OC-U group weight, BMI, %FAT, %TBW and %FFM did not differ from the OC-N group, either at baseline or at the end of the study, and did not significantly change within each group during the study. Also, there was no modification of fat distribution in either group. Among women in the OC-U group, there was a slight increase in total cholesterol levels and a trend towards higher triglycerides levels. No changes were detected in blood pressure. In conclusion, this low-dose oral contraceptive did not affect weight or body composition. Thus, our data suggest that gestodene75/EE20 represents an appropriate OC choice and may enhance compliance of women who mistakenly believe that the use of oral contraceptives always leads to weight gain.

Adolescent↗
PubMed2001

Understanding adherence to hand hygiene recommendations: the theory of planned behavior.

BACKGROUND: Most health care workers (HCWs) are aware of the rationale for hand hygiene procedures, yet failure to adhere to guidelines is common. Little is known about factors that motivate HCWs to practice hand hygiene. PURPOSE: The purposes of this study were to (1) estimate adherence to hand hygiene recommendations; (2) describe relationships among motivational factors, adherence, and intensity of nursing unit activity; and (3) test an explanatory model for adherence to hand hygiene guidelines based on the theory of planned behavior (TPB). METHOD: A longitudinal, observational design was used to collect data from 120 registered nurses employed in critical care and postcritical care units. Nurses provided information about motivational factors and intentions and a self-report of the proportion of time they followed guidelines. At least 2 weeks later, the nurses' hand hygiene performance was observed while they provided patient care. Structural equation modeling was used to test the TPB-based model. RESULTS: Rate of adherence to recommendations for 1248 hand hygiene indications was 70%. The correlation between self-reported and observed adherence to handwashing recommendations was low (r = 0.21). TPB variables predicted intention to handwash, and intention was related to self-reported hand hygiene. Intensity of activity in the nursing unit, rather than TPB variables, predicted observed adherence to hand hygiene recommendations. CONCLUSIONS: The limited association between self-reported and observed hand hygiene scores remains an enigma to be explained. Actual hand hygiene behavior may be more sensitive to the intensity of work activity in the clinical setting than to internal motivational factors.

Attitude of Health Personnel↗
PubMed2001

Generation and mapping of expressed sequence tags from virus-infected swine macrophages.

In an effort to identify genes that have a major effect on macrophage function during viral infection, we employed differential display reverse transcription (DDRT)-PCR to capture expressed sequence tags (ESTs) of swine alveolar macrophages infected by the porcine reproductive and respiratory syndrome virus (PRRSV). Sequence analyses showed that approximately 60% of these ESTs had significant similarity (> or =93%) to known pig ESTs or genes or matched sequences from other species with homology > or =80%. To determine chromosomal localization, PCR-based mapping was performed across either swine somatic cell hybrid or radiation hybrid panels. A total of 48 porcine viral response ESTs were mapped via the swine somatic cell panel or the INRA-Minnesota porcine Radiation Hybrid (IMpRH) panel (LOD > 6.0). Northern blot analyses confirmed PRRSV-induced altered transcript expression for several ESTs, including a 2'-5' oligoadenylate synthetase and a putative dual-specificity phosphatase. These virus-response ESTs represent good candidate genes for understanding PRRSV pathogenesis and for dissecting host genes which may have major effect on disease resistance.

2',5'-Oligoadenylate Synthetase↗
PubMed2000

Nurses' job satisfaction and organizational climate in a dynamic work environment.

The infrastructure and organization of hospitals are changing rapidly as a result of major transitions in health care. Downsizing in hospitals has caused employees to have to take on new tasks and, often, multiple tasks with a decrease in available resources and an increase in job complexity. Naturally, such organizational changes have a profound effect on the nature and duration of patient hospitalization and on the job responsibilities and roles of inpatient staff. In many hospitals, there is a perception of chaos, sometimes resulting in frustration among the nursing personnel. The purpose of this study was to describe the relationship between nurses' job satisfaction and organizational climate.

Adult↗
PubMed2000

Evidence for a protein related immunologically to the jaagsiekte sheep retrovirus in some human lung tumours.

Human bronchioloalveolar carcinoma (BAC) is a lung cancer, morphologically similar to an endemic contagious lung neoplasm of sheep called sheep pulmonary adenomatosis (SPA) or jaagsiekte. SPA is caused by an exogenous type B/D retrovirus (jaagsiekte sheep retrovirus (JSRV)), which prompted the present study to obtain evidence of a retrovirus in BAC. A panel of 249 human lung tumours, 21 nontumour lung lesions, four normal lung tissues, 23 adenocarcinomas from other organs and a cell line expressing a human endogenous retrovirus protein was examined immunohistochemically using a rabbit antiserum directed against the JSRV capsid protein. Specific staining was detected only in the cytoplasm of recognizably neoplastic cells in the pulmonary alveoli of 39 of 129 (30%) BACs, 17 of 65 (26%) lung adenocarcinomas and two of seven large cell carcinomas. The remaining samples were negative. These results support the hypothesis that some human pulmonary tumours may be associated with a jaagsiekte sheep retrovirus-related retrovirus, warranting further studies.

Adenocarcinoma↗
PubMed2000

MNT: an innovative employee-friendly benefit that saves.

In an effort to address the rising cost of health care within employee and retiree populations, many large employers are turning to an innovative health care solution: the registered dietitian and medical nutrition therapy and prevention. Research and case histories show the effectiveness of this approach.

Cost Savings↗
PubMed1999

Skin hygiene and infection prevention: more of the same or different approaches?

The purpose of this article is to review research indicating a link between hand hygiene and nosocomial infections and the effects of hand care practices on skin integrity and to make recommendations for potential changes in clinical practice and for further research regarding hand hygiene practices. Despite some methodological flaws and data gaps, evidence for a causal relationship between hand hygiene and reduced transmission of infections is convincing, but frequent handwashing causes skin damage, with resultant changes in microbial flora, increased skin shedding, and risk of transmission of microorganisms, suggesting that some traditional hand hygiene practices warrant reexamination. Some recommended changes in practice include use of waterless alcohol-based products rather than detergent-based antiseptics, modifications in lengthy surgical scrub protocols, and incorporation of moisturizers into skin care regimens of health care professionals.

Cross Infection↗
PubMed1999

The impact of physician-nurse interaction on patient care.

The perceptions of physicians and nurses vary in a number of respects, including the extent to which collaboration and joint decision making are valued, the definition of what constitutes adequate and appropriate interprofessional communication, the quality of nurse-physician interactions, and the understanding of respective areas of responsibility as well as patient goals. Reasons for these differences have been attributed to gender, historical origins of the two professions, and disparities between physicians and nurses with regard to socioeconomic status, education, and socialization. Failure of physicians and nurses to interact in a coordinated and positive fashion results in unhealthy work environments and poor patient outcomes. Both professions must examine their will to improve interprofessional interactions.

Communication↗
PubMed1998

Effect of several interventions on the frequency of handwashing among elementary public school children.

BACKGROUND: The purpose of this educational project was to assess the effect of several interventions on the frequency of handwashing among elementary public school children. METHODS: Participants in this project were first-graders and fourth-graders from jurisdictions within a mid-Atlantic metropolitan area. Phase I included a baseline assessment of bathroom cleanliness as well as adequacy of supplies for handwashing in each school. During phase 2, the frequency of handwashing before lunch or after bathroom use was monitored and recorded during a 2-month period. The schools were separated into four groups: a peer education group, a hand wipes and instructional poster group, a combination of the education and hand wipes/poster groups, and a (control) comparison school. RESULTS: Overall, a significant increase occurred in the proportion of handwashing frequency from preintervention to postintervention for each intervention group (wipes: 0.50 vs 0.66, p = 0.03; education only: 0.64 vs 0.72, p = 0.02; and education and wipes: 0.45 vs 0.67, p = 0.03) but not in the control group (0.42 vs 0.46, p = 0.26). When the first 3 weeks and the last 3 weeks after intervention were compared, handwashing frequency remained unchanged in the wipes only group (0.66 vs 0.66, p = 0.96), decreased in the education group (0.77 vs 0.65, p = 0.006), and increased in the education and wipes group (0.58 vs 0.75, p = 0.003), as well as in the control group (0.37 vs 0.52, p = 0.01). CONCLUSION: Education combined with accessible convenient hand hygiene may result in a sustainable increase in the frequency of handwashing among elementary school children.

Child↗
PubMed1998

Reframing the meaning of disability to families: the embrace of paradox.

In our society, families turn to medical science and health practitioners for assistance when a family member becomes disabled. In the cases of chronic illnesses and developmental disabilities, health professionals may focus interventions on the disease processes, feeling unprepared to deal with the broader issues families struggle with in managing disability. In addition, collaboration between professionals and parents may be strained when family's discourse is viewed as unrealistic, overly emotional, exceedingly optimistic and confusing by professionals. Using in-depth case studies, this qualitative research examined the daily occupations and subjective well-being of six Mexican-origin mothers parenting children with disabilities. Emergent findings demonstrated that these mothers do express apparently contradictory emotions of grief and joy, hope and fear that influenced their subjective well-being. The meaning of the mothers' contrary statements was illuminated in a life metaphor, the embrace of paradox. The embrace of paradox was the management of the internal tension of opposing forces between loving the child as he or she was and wanting to erase the disability, between dealing with the incurability while pursuing solutions and between maintaining hopefulness for the child's future while being given negative information and battling their own fears. The tensions created by the paradox promoted an internal striving to maintain a tenuous hopefulness despite "crashes" in their maternal work, and promoted an extension of maternal skills working toward a hopeful life trajectory for the mother and her child. In the embrace of paradox mothers created a positive bias and regained a sense of control that fueled their optimism in maternal work.

Activities of Daily Living↗
PubMed1998

Quality of diabetes care for non-English-speaking patients. A comparative study.

To determine the quality of care provided to non-English-speaking patients with non-insulin-dependent (type 2) diabetes mellitus compared with English-speaking patients, we did a retrospective cohort study of 622 patients with type 2 diabetes, of whom 93 were non-English-speaking and 529 were English-speaking. They were patients at primary and specialty care clinics at a university and a county hospital, and the study was based on clinical and administrative database records with a 12-month follow-up. Professional interpreters were provided to all non-English-speaking patients. Patients were identified using interpreter services records, which reliably included all patients who did not speak English. After adjusting for demographic differences, significantly more non-English-speaking patients received care that met the American Diabetes Association guidelines of 2 or more glycohemoglobin tests per year (odds ratio, 1.9; 95% confidence interval, 1.2-3.0) and 2 or more clinic visits per year (odds ratio, 2.6; 95% confidence interval, 1.2-5.4). More non-English-speaking patients had 1 or more dietary consultations (odds ratio, 2.8; 95% confidence interval, 1.3-6.1). No other significant differences were found in routine laboratory test use or in the number of ophthalmologic examinations. Outcome variables also did not differ, including standardized glycohemoglobin and other laboratory results, complication rates, use of health services, and total charges. At these institutions, the quality of diabetes care for non-English-speaking patients appear to be as good as, if not better than, for English-speaking patients. Physicians may be achieving these results through more frequent visits and laboratory testing.

Adult↗
PubMed1998

Vancomycin resistant enterococcus in a hospital-based dialysis unit.

OBJECTIVE: The emergence of vancomycin resistant enterococcus (VRE) poses a serious threat to the health care community. Reservoirs of VRE are thought to exist in certain high-risk patient groups who reintroduce the organism into the hospital environment. The frequent use of vancomycin in dialysis patients may place this population at higher risk of developing VRE. This article describes the development of VRE and a point prevalence study conducted in a hospital-based dialysis unit. SETTING/SAMPLE: A dialysis unit of a tertiary care center in the eastern United States was selected as the study site. Patients who agreed to participate in the study after giving informed consent were included. Of the 85 members of this target population 33 (38.8%) agreed to participate in the study. The duration of the study was 30 days. DESIGN: After the literature was reviewed, a point prevalence study was completed at the study site. Stool samples or rectal swabs were collected from the study participants and analyzed for the presence of VRE. A chart review of patient demographic and prior treatment information was completed in order to help identify factors that correlate to the presence of VRE. METHODS: Stool or rectal swab samples were cultured on selective media and sensitivity to vancomycin was measured. RESULTS: A 9.1% prevalence of VRE was detected within the study group. The number of VRE positive subjects (3) did not allow statistically significant correlation with the demographic and prior treatment data collected. CONCLUSION: Although VRE remains a serious threat to the health care community, the prevalence of VRE within the study group does not vary markedly from rates previously reported.

Adult↗