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PubMed1991

Universal precautions are not universally followed.

Adherence to universal blood and body fluid precautions was studied in surgical patient care areas of a university hospital in an effort to identify potentially hazardous health care personnel practices. Surgical teams of an 18-unit operating room, three surgical ward patient care teams, and patient care personnel in a 16-bed surgical intensive care unit were observed during routine patient care activities before (study 1) and after (study 2) specific educational programs were held to improve universal precaution compliance. Overall, infractions occurred in 57% of 549 observed procedures in study 1 and in 58% of 616 observed procedures in study 2. In study 1, infractions occurred in 75% of operating room procedures, 30% of surgical ward procedures, and 75% of surgical intensive care unit procedures. Study 2 procedure infraction rates were 81%, 32%, and 40%, respectively. Only surgical intensive care unit compliance significantly improved. Noncompliance with universal precautions occurs frequently during the care of patients who have undergone surgery, with the type of infraction and specific offender varying according to patient locale. These violations appear unamenable to one-time educational efforts. Substantial overall improvement may arise from ongoing educational programs directed at specific personnel who care for patients who have undergone surgery.

Blood↗
PubMed2004

Alcohol use among university students in Lebanon: prevalence, trends and covariates. The IDRAC University Substance Use Monitoring Study (1991 and 1999).

The practical inexistence of research on alcohol use among university students in Lebanon and other Arab countries spurred us at IDRAC to initiate a university-based substance use monitoring study, so far conducted in two phases (1991 and 1999), to assess the prevalence, patterns, trends, and factors associated with the use and abuse of alcohol (and other substances). In both phases, the sample was a stratified cluster, representing 25% (N = 1850) of the student population of two major universities in Lebanon. The rates of lifetime alcohol use and problem use have increased from 1991 to 1999, the increase being higher in younger cohorts and in females. Belief in God and practice of that belief, irrespective of the students' religion, were associated with less frequent experimentation with alcohol. Although more Christians ever drank alcohol, once users, university students (irrespective of their religion) had the same rates of alcohol problem use and dependence. Several other covariates concordant with the international literature were also delineated such as students' anti-social behavior, and family and peer environment.

Adolescent↗
PubMed2005

[Use of the laryngeal mask airway at german university and university-affiliated hospitals -- results of a nationwide survey].

AIM OF THE STUDY: The aim of this study was to collect comprehensive data on the use of the laryngeal mask airway (LMA) under general anaesthesia at German university and university-affiliated hospitals. METHODS: Questionnaires were mailed to the directors of 452 German university and university-affiliated anaesthesia departments. Twenty-three questions related to the way and frequency of use of the LMA were asked. RESULTS: Data from 212 departments (47 %) could be included into the analysis. The LMA is used in all departments. Depending on the size of the department the LMA is used in 1 - 60 % of all anaesthetics. The LMA is used significantly more often (p > 0.001) in smaller departments providing up to 10 000 anaesthetics per year compared to larger departments providing up to, or more than, 20 000 anaesthetics per year. Controlled ventilation is the preferred mode of ventilation in more than 75 % of all departments. The LMA is used "routinely" or "always" for operations lasting more than 1 hour in more than 75 % of all departments. The LMA is used in the areas of ear, nose, and throat, maxillofacial, and eye surgery "routinely" or "always" only in 11 - 26 % of all departments. CONCLUSION: The role of the LMA in routine anaesthesia practice has clearly increased. Controversial aspects of use are reflected in the practice patterns of LMA use in different departments. The LMA has not been disseminated widely in the areas of ear, nose and throat-, maxillofacial- and eye surgery.

Data Collection↗
PubMed2004

Implementing a university-community-retail partnership model to facilitate community education on universal design.

PURPOSE: A collaborative partnership model was used to develop and implement a state-wide community education program on universal design. DESIGN AND METHODS: University faculty, extension professionals, older adult service agencies, service learning students, and a community retail chain made up the original partnership. RESULTS: This collaboration resulted in a five-stage partnership model. The model was used to develop and disseminate a consumer education program to promote aging in place. The five stages include (a) identifying partner strengths and shared learning, (b) program development, (c) implementing the universal design program, (d) facilitating collaborative outreach, and (e) shifting toward sustainable outreach. IMPLICATIONS: A lack of knowledge exists among consumers, builders, and health care professionals regarding strategies for aging in place. Collaborations between educators, outreach professionals, students, and a retail partner resulted in increased interest and awareness about universal design changes that enable seniors to age in place.

Commerce↗
PubMed2005

The quest for universality: reflections on the Universal Draft Declaration on Bioethics and Human Rights.

This essay focuses on two underlying presumptions that impinge on the effort of UNESCO to engender universal agreement on a set of bioethical norms: the conception of universality that pervades much of the document, and its disregard of structural inequalities that significantly impact health. Drawing on other UN system documents and recent feminist bioethics scholarship, we argue that the formulation of universal principles should not rely solely on shared ethical values, as the draft document affirms, but also on differences in ethical values that obtain across cultures. UNESCO's earlier work on gender mainstreaming illustrates the necessity of thinking from multiple perspectives in generating universal norms. The declaration asserts the 'fundamental equality of all human beings in dignity and rights'(1) and insists that 'the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition'(2) yet it does not explicitly recognize disparities of power and wealth that deny equal dignity and rights to many. Without attention to structural (as opposed to merely accidental) inequities, UNESCO's invocation of rights is so abstract as to be incompatible with its avowed intention.

Bioethical Issues↗
PubMed2006

[Blood pressure levels and their association with cardiovascular risk factors among employees of the University of Brasília, a Brazilian public university].

OBJECTIVE: To verify and classify, according to the JNC 7, the blood pressure levels (BPL) of the employees of University of Brasilia, a public university in Brazil, who are older than 40 years of age, and to estimate the prevalence of cardiovascular risk factors in this population. METHODS: A cross-sectional study was conducted at the University of Brasilia, with employees over 40 years of age. They answered a questionnaire and had their blood pressure, weight and height measured. The BPLs were classified according to the JNC 7 classification and the demographic data of the subjects in each category were analyzed. The percentage of risk factors was calculated. The statistical analysis was carried out using the ANOVA test and the chi-square test, where applicable. RESULTS: Seven hundred and four subjects participated in the study, 438 male and 266 female. The median age was 47. According to the JNC 7, 139 (19.8%) subjects were classified as normotensive; 298 (42.3%) as prehypertensive and 267 (37.9%) as hypertensive. The risk factors assessed were overweight/obesity (56.8%), smoking habit (19.5%), alcohol consumption (53.6%), sedentary lifestyle (48.4%) and hypertension (37.9%). CONCLUSION: The high frequency of elevated blood pressure levels and cardiovascular risk factors among the employees indicates the need for preventive and therapeutic measures for cardiovascular disease targeted at the university's employees.

Adult↗
PubMed1978

[Integration of a university clinic for women into a complex university hospital].

Commonly with all special surgical branches of sciences from a medical university-sphere the hospital for gynäcology and obstetrics from the university will be placed in a "surgical orientated centre". The process--structure is underlieing the project for such a centre (summary from equal activities with equal claims to buildings, fitting and out hygiene). The singular spheres from the hospital of gynäcology and obstetrics will be coordinated to the equivalent central functional spheres of the "surgical orientated centre". The obstetrical--ward with an acute--praepartal--sphere will be commonly with the neonatological-sphere collected to a functional group on the inside of the central surgical-ward. The perceptions by the projection of a "surgical orientated centre" shall be a stimulation for the planning and the construction for medical university complexes and universal hospitals.

Berlin↗
PubMed1990

Universal New York Health Care. A single-payer strategy linking cost control and universal access.

Now that universal access to health care is back on the governmental agenda, elected officials are faced with the dilemma of expanding our present pluralistic system of numerous private and public payers, with its built-in administrative inefficiencies and inflationary pressures, or scrapping the present system of financing and moving to a tax-based scheme like the Canadian Medicare program, an option fraught with political difficulties. There is, however, a third option. The New York State Department of Health has developed a proposal for universal access--Universal New York Health Care, or UNY-Care--that would retain the existing payers, including employer-based insurance coverage, but combine them in a one-payer framework. Providers would no longer have to interact with the many public and private payers, each with its own rules, criteria, and levels of payment. The single payer would serve as the only payer for most health care services and would also negotiate reimbursement rates. The single-payer framework should bring savings in administrative and billing costs and should move government closer to the goal of buying health care services--getting good value for payment rendered--rather than simply paying bills as they are submitted. Although the single-payer strategy could be implemented at either the state or the federal level, it seems ideal as the principal responsibility of the states in a national plan for universal coverage.

Cost Control↗
PubMed1979

The variation of a Midwest Catholic University's drug use pattern from other Catholic University findings: why?

For over a decade, survey studies concerning drug use and college students have portrayed a significantly lower pattern of drug use by students attending Catholic controlled universities than other university types. In the spring of 1972 the author conducted a study of the undergraduates of a large Midwest Catholic University to assess various aspects of its drug scene. The involvement with drugs, especially marijuana, on this campus departed substantially from the usual Catholic control-low drug use nexus. The discussion presents a description of this departure and suggest that certain demographic and social characteristics of this Midwest Catholic University, when interacting, suffice to offset the religious control and religiosity influences that usually effect the low drug use--religious control nexus.

Cross-Sectional Studies↗
PubMed2000

[University cooperation in the development of the University of Liège: a tradition].

This article present the landscape of university cooperation for development realized by the University of Liège (ULg). The nature and variety of actions are globally described as well as the institutional cooperation organization. On a larger scale, university cooperation carried out through the Inter University Council of french speaking Community of Belgium (CIUF), is also touched on. This cooperation, is which ULg is involved closely, has been recently totally re-organised and has new tools which presented here.

Belgium↗
PubMed2006

[Decision making of Hebrew University and Tel Aviv University Dental Schools graduates in every day dentistry--is there a difference?].

This study was designed to evaluate decision-making among Jerusalem Hebrew-University and Tel Aviv University dental schools graduates in various restorative dentistry, endodontics and oral surgery issues. A survey was conducted among 52 dentists during a dental military convention. Most of the dentists stated they will not recommend of re-treatment of endodontic-treated tooth with asymptomatic peri-apical pathology that does not need further rehabilitation. The study reveals over treatment and over-medication in restorative and surgery decisions. More than half of the dentists decided to treat caries lesions that extend to the dentino enamel junction, in low and moderate caries risk patients. More Hebrew University graduates than Tel Aviv University graduates recommend of removal of asymptomatic horizontal fully impacted mandibular third molar and disease-free maxillary third molar antagonist. Most of Tel Aviv graduates routinely prescribe antibiotic coverage after complicated tooth extraction. This study supports the need for continuing education on daily performed dental procedures.

Antibiotic Prophylaxis↗
PubMed1990

HIV, trauma, and infection control: universal precautions are universally ignored.

The medical, legal, and ethical problems associated with routine HIV screening have led to the recommendation that all patients should be presumed to be seropositive and thus protective measures should be taken by all health care workers. This philosophy, termed "universal precautions," has been difficult to adhere to or enforce, however. Nevertheless, in some trauma population subsets, the prevalence of HIV seropositivity runs as high as 19%, and thus presents an occupational hazard to the trauma health care worker. The mainstays of universal precautions (UP) are barrier techniques against body fluid contact and protection from inadvertent needlestick. To judge compliance with a strict UP protocol, surgical residents engaged in trauma room resuscitations were observed on a random basis by trauma nurse coordinators. Previously, UP had been discussed in conferences and by memo. Over 2 months, 81 trauma rooms were observed, involving 18 house officers. Overall, there was only 16% compliance with strict UP. The most common protocol variations involved sharps technique. While glove use was nearly universal, protective eye wear, ankle and foot protection, and body protection such as gowns or aprons were commonly ignored. Even in the presence of invasive procedures such as endotracheal intubation or insertion of chest tubes, compliance was less than 40%. The reasons most commonly given by house officers for the lapse in UP were not knowing the protocol, forgetting the protocol, or not having time to implement the protocol. Even for the nine patients residents identified as suspected of being in a high-risk category, UP was strictly adhered to only once. Compliance with universal precautions is difficult to achieve under the best of circumstances. It cannot be assumed that passive informational measures can achieve this goal. Active infection control surveillance and ongoing housestaff inservice are required to minimize the risk of inadvertent injury or contamination.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Promoting competence in a model trial of a complementary course of study in health sciences/public health at the Berlin Technical University in cooperation with the Free University and other science and general practice institutions].

Since October 1992 (winter semester 92/93) graduates are being educated in Public Health at Berlin Technical University in cooperation with the Free University of Berlin as well as with the Humboldt University of Berlin and other institutions of science and practice in Berlin and Brandenburg. For the time being the course of studies is a pilot project for 4 years. The aim of the postgraduate studies is the creation of permanent structures and therefore institutionalisation. It is open to graduates and college graduates of public-health relevant subject areas of specialisation are "Health Promotion in the community and at the workplace" and "Planning and Management in Health Services". The course of studies takes 4 semesters and is divided into basic studies, studies of main points of emphasis and project studies. Social medicine and especially epidemiology are part of the basic disciplines, which are indispensable for finding the way of looking at problems concerning public health. The reason for the peculiarity with regard to establishing public health at other German universities are the main topics representing the interaction between the technical and ecological development of health. The graduate degree is "Magister of Public Health". During the time of the pilot project the course of studies is subjected to external and internal surveillance regarding quality assurance and quality optimisation of teaching and organisation of the studies. On the one hand this is done by an external advisory committee and on the other hand by internal and external evaluation.

Community Medicine↗
PubMed1993

An evaluation of the role of omentopexy and of early perioperative corticosteroid administration in clinical lung transplantation. The University of Toronto and Washington University Lung Transplant Programs.

Early success in clinical lung transplantation was believed due in part to the technique of bronchial anastomosis, routine bronchial omentopexy, and avoidance of early postoperative corticosteroid therapy. A recent 16-month consecutive experience at the University of Toronto and Washington University with single or bilateral lung transplantation was compared to study the current short-term effect of these perioperative strategies. At the University of Toronto, of 37 patients undergoing lung transplantation, 30 (group I) had telescoped bronchial anastomoses, coverage of the bronchus with local tissue only (no omentopexy), and routine perioperative corticosteroid administration. At Washington University, of 50 patients having lung transplantation, 44 (group II) had end-to-end bronchial anastomoses wrapped in omentum and received no routine perioperative corticosteroid. In group I, septic lung disease was the most frequent indication (14 of 29 patients), whereas in group II obstructive lung disease was the most frequently encountered condition (24 of 44 patients). Sepsis accounted for three of five early deaths in group I (all due to resistant Pseudomonas cepacia infection in recipients who had cystic fibrosis) and for two of four perioperative deaths in group II (one Pseudomonas, and Candida). In group I, cytomegalovirus prophylaxis was administered to all patients except recipients negative for cytomegalovirus receiving grafts from donors also negative for cytomegalovirus. Cytomegalovirus infection requiring treatment was encountered in 5 of 30 patients in group I in comparison with 23 of 44 recipients in group II where only D+ and R- mismatches received prophylaxis. Routine omentopexy is not essential for successful lung transplantation. Early postoperative corticosteroids do not impair airway healing, but neither do these agents appear to protect against acute rejection episodes. While routine corticosteroids do not predispose the recipient to cytomegalovirus infection, their use may increase the likelihood of postoperative bacterial sepsis.

Adolescent↗
PubMed1991

A University of California State-supported AIDS research award program--a unique state and university partnership in AIDS research.

This article describes the State-supported University of California AIDS research award program and its major accomplishments. It shows how a partnership between a University and a State resulted in the formation of a successful, efficient, and cost-effective AIDS research award program. This program provides funds for rapid testing of investigator-initiated meritorious research ideas, new drugs, and treatment modalities. Funds were also utilized to establish three AIDS Clinical Research Centers, which evolved into regional consortia that coordinate trials of new drugs and other modalities. This program succeeded in involving investigators whose efforts have led to excellent medical care, advanced technologies, and new drugs for treating AIDS and AIDS-related diseases. The University remains committed to continuing support of all areas of AIDS research, emphasizing drug and vaccine development, pediatric AIDS, and AIDS prevention studies in groups at high risk for HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Systematized HIV/AIDS education for student nurses at the University of Ibadan, Nigeria: impact on knowledge, attitudes and compliance with universal precautions.

This paper reports the findings of a study which examines changes in a group of Bachelor of Science (BSc) nursing students' perceptions, knowledge of and attitudes towards human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), accruing from attempts at a systematized education for the cohort. Based upon a 3-month study of 141 registered nurses enrolled in a BSc nursing programme at the University of Ibadan, Nigeria, it investigates alterations in knowledge and attitudes resulting from intense instruction on HIV/AIDS, AIDS patient care, and compliance with universal precautions. With regard to knowledge enhancement and attitudinal transformation, the research reveals that a number of positive changes occurred over the period of the study. Not only were the nurses better informed about AIDS than previously, but their attitudes towards the disease and patient care had become considerably more liberal, as well as their disposition to comply with universal precautions. The conclusion emphasizes that it is very important for education about HIV/AIDS to be incorporated within current undergraduate and in-service training programmes for Nigerian nurses.

Adult↗
PubMed2003

Antimicrobial resistance in Staphylococcus aureus at the University of Chicago Hospitals: a 15-year longitudinal assessment in a large university-based hospital.

OBJECTIVES: To describe a longitudinal profile of resistance to beta-lactam antimicrobials among isolates of Staphylococcus aureus at a large university teaching hospital and to evaluate the impact of the methicillin resistance phenotype on resistance trends for non-beta-lactam antimicrobials. DESIGN: Retrospective evaluation of antimicrobial susceptibility data for all 17,287 S. aureus isolates obtained from January 1986 through December 2000. SETTING: The University of Chicago Hospitals, a family of tertiary-care, university-affiliated hospitals in Chicago, Illinois, consisting of 547 adult and pediatric beds. RESULTS: The annual rate of resistance to methicillin increased from 13% in 1986 to 28% in 2000 (P < .001) and has not plateaued. For each non-beta-lactam antimicrobial tested, the annual rates of resistance were far higher among methicillin-resistant S. aureus (MRSA) isolates than among methicillin-susceptible S. aureus (MSSA) isolates. The annual rates of resistance to the macrolide, lincosamide, and streptogramin (MLS) antimicrobials erythromycin and clindamycin increased among MSSA isolates (P < .01), but remained lower than 20%. Resistance to the MLS antimicrobials was higher among MRSA isolates (higher than 60%), but the annual rate decreased significantly during the study (P < .01). CONCLUSION: The prevalence of methicillin resistance among S. aureus isolates has continued to increase; resistance to non-beta-lactam antimicrobials is far more common among MRSA isolates. Recent decreases in the proportion of MRSA isolates resistant to non-beta-lactam antimicrobials suggest important changes in the epidemiology of this pathogen.

Anti-Bacterial Agents↗
PubMed2006

University students' Internet attitudes and Internet self-efficacy: a study at three universities in Taiwan.

This study was conducted to explore university students' attitudes and self-efficacy toward the Internet. Moreover, the relationships between their attitudes and self-efficacy toward the Internet were also investigated. The sample of this study included 1,313 students, coming from three universities in Taiwan. It was found that male students expressed significantly more positive attitudes than females on their "perceived control" of the Internet. The male students also revealed better Internet self-efficacy than their female counterparts. Moreover, students having more on-line hours per week, in general, displayed more positive Internet attitudes and Internet self-efficacy. In addition, students' grade level also played an important role in their Internet attitudes; graduate students tended to possess more positive Internet attitudes. More importantly, students' Internet attitudes were highly correlated with their Internet self-efficacy. The results in this study seemed to reveal that students' attitudes toward the Internet could be viewed as one of the important indicators for predicting their Internet self-efficacy. It is also suggested that some training programs or courses may be helpful in improving university students' attitudes and self-efficacy toward the Internet.

Adolescent↗