The Effect of Vocal Fillers on Credibility, Communication Competence, and Likeability

This study examines the impact of vocal fillers on a person’s perceived likeability, communication competence, professional credibility, and personal credibility. Previous studies have suggested that using filler words or discourse markers may decrease professional credibility and discredit communication competence. However, it is unknown how audience members of different genders will respond to the usage of vocal fillers in comparison to each other. A 2 x 2 factorial experimental design was constructed (N = 145) in which four audio recordings contained four responses to an interview question; the amount of vocal fillers were manipulated (absent or many) and the gender of the speaker in the recording was also manipulated (female or male). Results indicated that the more filler words or discourse markers were used, the less professional and personal credibility was shown, regardless of gender. However, when listening to vocal fillers, although both genders viewed them negatively, males perceived vocal fillers significantly more negatively

Prevalence, incidence burden and clinical impact of healthcare-associated infections and antimicrobial resistance: a national prevalent cohort study in acute care hospitals in Greece

Purpose: Assessing the overall burden of healthcare-associated infections (HAIs) is challenging, but imperative in evaluating the cost-effectiveness of infection control programs. This study aimed to estimate the point prevalence and annual incidence of HAIs in Greece and assess the excess length of stay (LOS) and mortality attributable to HAIs, overall and for main infection sites and tracer antimicrobial resistance (AMR) phenotypes and pathogens. Patients and methods: This prevalent cohort study used a nationally representative cross-section of 8,247 inpatients in 37 acute-care hospitals to record active HAIs of all types at baseline and overall LOS and in-hospital mortality up to 90 days following hospital admission. HAI incidence was estimated using prevalence-to-incidence conversion methods. Excess mortality and LOS were assessed by Cox regression and multistate models correcting for confounding and time-dependent biases. Results: HAIs were encountered with daily prevalence of 9.1% (95% confidence interval [CI] 7.8% – 10.6%). The estimated annual HAI incidence was 5.2% (95%CI 4.4% – 5.3%), corresponding to approximately 121,000 (95%CI 103,500 – 123,700) affected patients each year in the country. 90-day mortality risk was increased by 80% in patients with HAI compared to those without HAI (adjusted hazard ratio 1.8; 95%CI 1.3 – 2.6). Lower respiratory tract infections, bloodstream infections and multiple concurrent HAIs doubled the risk of death, whereas surgical site and urinary-tract infections were are not associated with increased mortality. AMR had significant impact on the daily risk of 90-day mortality, which was increased by 90%-110% in patients infected by carbapenem-resistant gram-negative pathogens (CR-GNBs). HAIs increased LOS for an average of 4.3 (95% CI 2.4– 6.2) additional days. Mean excess LOS exceeded 20 days in infections caused by major CR-GNBs. Conclusion: HAIs, alongside with increasing AMR, pose significant burden to the hospital system. Burden estimates obtained in this study will be valuable in future evaluations of infection prevention programs

Degradation and by-products identification of benzothiazoles and benzotriazoles during chlorination by LC-HR-MS/MS

Nowadays, chlorination is the most prevalent disinfection method applied for water treatment in Europe. Chlorine can be supplied as sodium hypochlorite (NaOCl) which reacts in water to produce the disinfectants hypochlorous acid (HOCl) and hypochlorite ion (OCl-), otherwise known as free chlorine. Although the primary purpose of chlorination is the elimination of micropollutants via oxidation, several investigations have shown that chlorine reacts with micropollutants leading in the production of undesired by-products. 1,3-benzothiazoles (BTHs) and 1,2,3-benzotriazoles (BTRs) are classified as high production volume emerging environmental pollutants due to their broad industrial and domestic application, and even though recently several analytical methods have been applied for their determination , there is still a lack of research for their by-products’ identification. Initially, the degradation of three BTHs (BTH, 2-OH-BTH and 2-amino-BTH) and four BTRs (1-H-BTRi, TTRi, XTRi and 1-OH-BTRi) during chlorination was investigated by UHPLC-MS/MS (QqQ). Although chlorination appeared to be an insufficient degradation process for BTH and 1-H-BTRi, all their examined substituted derivatives seem to be significantly degraded when the molar ratio of sodium hypochlorite and the target analytes was between 5000:1 – 1000:1. Then, LC high resolution MS/MS (q-TOFMS) was used to investigate the formation of by-products in the chlorinated samples. Two suspect by-products of 2-amino-BTH and one of XTRi were tentatively identified based on their probable structure, mass accuracy, retention time and fragmentation and isotopic pattern. An interesting observation was the formation of 1-H-BTRi as a degradation product of 1-OH-BTRi during chlorination. Moreover, post-acquisition non-target treatment of the MS data revealed several unknown by-products of the tested analytes

Implementation of multimodal infection control and hand hygiene strategies in acute-care hospitals in Greece: a cross-sectional benchmarking survey

Background: In this first attempt to suggest achievable standards for improvement in hospital infection prevention and control (IPC) in Greece, we assessed main IPC structure and process indicators emphasizing on hand hygiene. Methods: Acute-care hospitals across the country participated in a cross-sectional survey by completing the World Health Organization Hand Hygiene Self-Assessment Framework (HHSAF) and by providing hospital-level IPC indicators. Results: Seventeen hospitals completed the survey, comprising 14% of the country’s public hospitals. Median IPC staffing levels were 0.8 nurses and 0.5 doctors per 250 beds, respectively. Few hospitals implemented full multimodal IPC programs. HHSAF indicated that appropriate hand hygiene practices and promotion strategies were in place in most hospitals, but mean HHSAF score (289) was lower compared to studies in Italy (332, p=0.040) and the USA (373, p<0.001). Presence of one additional IPC nurse was independently associated with increases by 53% in the HHSAF median score for training-education (p=0.035) and by 38% in the lower 30th percentile score for safety climate (p=0.049). Conclusions: Surveyed hospitals are, on average, at an intermediate level in hand hygiene practice but require improvements on training-education, evaluation-feedback and safety climate. Ensuring adequate IPC nurse staffing levels and systematically implementing multimodal IPC programs may lead to substantial improvements

Burden of multidrug and extensively drug-resistant ESKAPEE pathogens in a secondary hospital care setting in Greece

Bacterial antibiotic resistance (AMR) is a significant threat to public health, with the sentinel ‘ESKAPEE’ pathogens, being of particular concern. A cohort study spanning 5.5 years (2016–2021) was conducted at a provincial general hospital in Crete, Greece, to describe the epidemiology of ESKAPEE-associated bacteraemia regarding levels of AMR and their impact on patient outcomes. In total, 239 bloodstream isolates were examined from 226 patients (0.7% of 32 996 admissions) with a median age of 75 years, 28% of whom had severe comorbidity and 46% with prior stay in ICU. Multidrug resistance (MDR) was lowest for Pseudomonas aeruginosa (30%) and Escherichia coli (33%), and highest among Acinetobacter baumannii (97%); the latter included 8 (22%) with extensive drug-resistance (XDR), half of which were resistant to all antibiotics tested. MDR bacteraemia was more likely to be healthcare-associated than community-onset (RR 1.67, 95% CI 1.04–2.65). Inpatient mortality was 22%, 35% and 63% for non-MDR, MDR and XDR episodes, respectively (P = 0.004). Competing risks survival analysis revealed increasing mortality linked to longer hospitalisation with increasing AMR levels, as well as differential pathogen-specific effects. A. baumannii bacteraemia was the most fatal (14-day death hazard ratio 3.39, 95% CI 1.74–6.63). Differences in microbiology, AMR profile and associated mortality compared to national and international data emphasise the importance of similar investigations of local epidemiology

Impact of SARS-CoV-2 preventive measures against healthcare-associated infections from antibiotic-resistant ESKAPEE pathogens: a two-center, natural quasi-experimental study in Greece

The COVID-19 pandemic led to unprecedented stress on healthcare systems worldwide, forming settings of concern for increasing antimicrobial resistance. We investigated the impact of SARS-CoV-2 preventive measures against healthcare-associated infections (HAIs) from antibiotic-resistant bacteria in two tertiary-care hospitals. We compared infection rates between March 2019 and February 2020 (pre-intervention period) and March 2020 and February 2021 (COVID-19 intervention period) from drug-resistant ESKAPEE bacteria (methicillin-resistant Staphylococcus aureus; vancomycin-resistant Enterococci; carbapenem-resistant Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter species and Escherichia coli). Over 24 months, 586 drug-resistant ESKAPEE HAIs occurred in 439 patients (0.3% of 179,629 inpatients) with a mean age of 63 years, with 43% being treated in intensive care units (ICUs), and having a 45% inpatient mortality rate. Interrupted time series analysis revealed increasing infection rates before the intervention that were sharply interrupted by abrupt drops for most pathogens and henceforth remained stable in the ICUs but progressively increased in ordinary wards. In the ICUs, the pooled infection rate was 44% lower over the intervention period compared to the pre-intervention period (incidence rate ratio (IRR) 0.56, 95%CI 0.41–0.75, p < 0.001). Pooled infection rates in the wards were slightly higher over the COVID-19 period (IRR 1.12, 95%CI 0.87–1.45, p = 0.368). The findings confirmed the ancillary beneficial impact of the enhanced bundle of transmission-based precautions adopted against SARS-CoV-2 in rapidly constraining antimicrobial-resistant HAIs in two Greek hospitals

Reversal of renal allograft rejection with intravenous methylprednisolone "pulse" therapy,

Intravenous administration of large doses of methylprednisolone sodium succinate was demonstrated to modify rejection in both canine and human renal allografts. One dose of intravenous methylprednisolone 30 mg./kg. administered during acute rejection in dogs resulted in an increase in urine volume and osmolality, and a decrease in serum and urine LDH. In two dogs treated with a single dose and in one dog treated with four consecutive daily doses histologic evidence of reversal of rejection with reduction of cellular infiltrate was achieved. Ninety-two percent of rejections encountered in 100 consecutive human recipients of renal allografts were halted or reversed with intravenous methylprednisolone 30 mg./ kg. given every 48-72 hours to a maximum of three or four doses. No significant side effects were observed either in dogs or humans with this therapy. The mean circulating half-life of intravenous methylprednisolone was determined to be 3.48 +/- 0.7 hours in dogs. Intermittent intravenous administration of methylprednisolone has the potential advantage of being associated with fewer side effects than frequent oral administration and has been shown to be an effective method for modifying rejection.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34145/1/0000430.pd