Interventions to improve healthcare workers’ hand hygiene compliance: a systematic review of systematic reviews

Objective: To synthesize the existing evidence base of systematic reviews of interventions to improve healthcare worker (HCW) hand hygiene compliance (HHC). Methods: PRISMA guidelines were followed, and 10 information sources were searched in September 2017, with no limits to language or date of publication, and papers were screened against inclusion criteria for relevance. Data were extracted and risk of bias was assessed. Results: Overall, 19 systematic reviews (n=20 articles) were included. Only 1 article had a low risk of bias. Moreover, 15 systematic reviews showed positive effects of interventions on HCW HHC, whereas 3 reviews evaluating monitoring technology did not. Findings regarding whether multimodal rather than single interventions are preferable were inconclusive. Targeting social influence, attitude, self-efficacy, and intention were associated with greater effectiveness. No clear link emerged between how educational interventions were delivered and effectiveness. Conclusions: This is the first systematic review of systematic reviews of interventions to improve HCW HHC. The evidence is sufficient to recommend the implementation of interventions to improve HCW HHC (except for monitoring technology), but it is insufficient to make specific recommendations regarding the content or how the content should be delivered. Future research should rigorously apply behavior change theory, and recommendations should be clearly described with respect to intervention content and how it is delivered. Such recommendations should be tested for longer terms using stronger study designs with clearly defined outcomes

CONSTRUCTING KNOWLEDGE: A PEDAGOGICAL EVALUATION OF DESIGN-BASED LEARNING.

In relation to architectural education this article introduces and discusses design-based learning. It outlines key characteristics and pedagogic theories that support this style of teaching and analyses how students acquire subject specific knowledge as well as key transferable employability and life-long learning skills

Some thoughts about the value of an OECD international assessment framework for early childhood services in Aotearoa New Zealand

We were alerted to this warning from James Gee because it is from a chapter that reflects on assessment from a sociocultural-situated perspective. The New Zealand early childhood education curriculum, Te Whāriki, also takes this perspective and, in this short article, we argue that the use of Organisation for Economic Co-operation and Development (OECD) standardized tests to evaluate our early childhood education sector, while it may be perfectly ‘scientific’, could be disastrous for Te Whāriki

Family group conferences : what do they tell us about the importance of relationships?

[no abstract available

The consequences of tree disease and pre-emptive felling on functional and genetic connectivity for woodland invertebrates

Funding FAP was funded by the Macaulay Development Trust and the Woodland Trust. RJM and JAS were supported by the Scottish Government’s Rural and Environment Research and Analysis Directorate 2016-2021 strategic research programme. Development by SCFP of the landscape genetics capability in the customised version of RangeShifter was funded by programme Blanc of l’Agence nationale de la recherche. JMJT was supported by NERC grant NE/T006935/1 ‘Wildlife Corridors: Do they work and who benefits?’ Acknowledgments We thank the Macaulay Development Trust and the Woodland Trust for funding FAP, the Scottish Government’s Rural and Environment Research and Analysis Directorate for funding RJM and JAS, programme Blanc of l’Agence nationale de la recherche for funding SCFP, and NERC for funding JT. We thank the Woodland Trust for access to the National Canopy Map for England and WalesPeer reviewedPublisher PD

A change in temperature modulates defence to yellow (stripe) rust in wheat line UC1041 independently of resistance gene Yr36

Background Rust diseases are of major importance in wheat production worldwide. With the constant evolution of new rust strains and their adaptation to higher temperatures, consistent and durable disease resistance is a key challenge. Environmental conditions affect resistance gene performance, but the basis for this is poorly understood. Results Here we show that a change in day temperature affects wheat resistance to Puccinia striiformis f. sp tritici (Pst), the causal agent of yellow (or stripe) rust. Using adult plants of near-isogenic lines UC1041 +/- Yr36, there was no significant difference between Pst percentage uredia coverage in plants grown at day temperatures of 18°C or 25°C in adult UC1041 + Yr36 plants. However, when plants were transferred to the lower day temperature at the time of Pst inoculation, infection increased up to two fold. Interestingly, this response was independent of Yr36, which has previously been reported as a temperature-responsive resistance gene as Pst development in adult UC1041 -Yr36 plants was similarly affected by the plants experiencing a temperature reduction. In addition, UC1041 -Yr36 plants grown at the lower temperature then transferred to the higher temperature were effectively resistant and a temperature change in either direction was shown to affect Pst development up to 8 days prior to inoculation. Results for seedlings were similar, but more variable compared to adult plants. Enhanced resistance to Pst was observed in seedlings of UC1041 and the cultivar Shamrock when transferred to the higher temperature. Resistance was not affected in seedlings of cultivar Solstice by a temperature change in either direction. Conclusions Yr36 is effective at 18°C, refining the lower range of temperature at which resistance against Pst is conferred compared to previous studies. Results reveal previously uncharacterised defence temperature sensitivity in the UC1041 background which is caused by a change in temperature and independently of Yr36. This novel phenotype is present in some cultivars but absent in others, suggesting that Pst defence may be more stable in some cultivars than others when plants are exposed to varying temperatures

Water Pollution and Environmental Concerns in Anesthesiology

Medications administered by anesthesia health care providers and subsequently excreted into the water supply system have the potential to affect ecological systems. Presently, there is a lack of literature examining which medications or metabolites enter the waste stream. Further, assessments of their potential environmental impact are often unknown or simply not considered as an externality of medical practice. Recent work examining the practice of anesthesiology has explored the solid waste stream, and the global warming potential of anesthetic gases, however the potential aquatic impacts remain unexplored. To address the potential for waterborne pollution and environmental toxicity, we extracted the total intravenous medications (by mass) administered by anesthesiologists in 2017 at The University of Vermont Medical Center (UVMMC), a mid-size regional Level 1 trauma center in Burlington, VT. The most commonly administered medications were: cefazolin, propofol, acetaminophen, sugammadex and lidocaine. To estimate the amount of each medication that entered the wastewater stream, we used published metabolism profiles to adjust from the total amount administered to the amount excreted unchanged or as prominent metabolites. For each medication we reviewed existing literature concerning their environmental fate and impacts in water. Due to the constraints of current knowledge, it is not possible to determine the exact fate and impacts of these drugs. Some medications, like propofol, have the potential for significant bioaccumulation and persistence. Others, such as lidocaine and acetaminophen, have short half-lives in the environment but their constant delivery and excretion result in pseudo-persistence. The current literature mostly assesses acute exposure at doses higher than could be expected in the environment on select species. While significant toxicities across a variety of species have been found repeatedly, chronic low dose exposures require further study for all the medications discussed. Finally, multi-drug impacts are likely to be more impactful than single-drug toxicities. While we cannot state definitive impacts, the pharmaceuticals most used in anesthesiology have a clear toxic potential and future studies should more closely examine the relative contribution of anesthesia to pharmaceutical pollution, as well as points of intervention for minimizing these unintended consequences of healthcare delivery

Healthy Workplace Activities: At a Glance

This four page brochure provides practical suggestions for physical activity and healthy eating activities that can be easily implemented in your workplace to promote a healthy lifestyle for your employees