Welch, Sedgwick, and the Hopkins model of hygiene.
(25/790)
William H. Welch and William T. Sedgwick, two of the founding fathers of American public health, were both early generation "Hopkins Men." Sedgwick was part of the first group of graduate students to attend Johns Hopkins University, and Welch was part of the initial faculty at the University's medical school. While they never worked together as colleagues at Hopkins, both became interested in the exciting new discoveries of the microbial nature of human disease and developed similar public health programs based on this information. Sedgwick expanded upon these investigations in the new sanitary science program at MIT, where academic public health first emerged in the United States following Sedgwick's appointment in 1883. Welch, who had been exposed to European research in microbiology, promoted microbial research in pathology in Baltimore in 1884. His laboratory-based investigations expanded until they led to the formation of the country's first school of public health in 1916. Thus, a "Hopkins Model" for hygiene and public health emerged from the efforts of both Welch and Sedgwick. (+info)
The shampoo clue: two cases of infection of a ventriculoatrial shunt.
(26/790)
Despite the use of sophisticated tools, infections of implanted devices may be difficult to diagnose. Two cases of infections of ventriculoatrial shunts, which demonstrate the eminent importance of meticulously taking history, are reported and discussed. (+info)
Study of dust mites in three Birmingham hospitals.
(27/790)
Samples of dust were collected from wards in a general hospital, a geriatric hospital, and a skin hospital. Mites were found on the floors of all three hospitals; Surprisingly, the skin hospital showed fewer mites than the general hospital. The differences were attributed to the variation in ward activity, the number of visitors on the wards, and the differing cleaning regimens. Plastic-covered mattresses were almost completely free from mites, but foci were found on soft furnishings and on the jackets and overcoats of hospital workers. The total numbers of mites were small compared to those found in house dust, and hospital mites probably do not consitute a serious problem for asthmatic patients. (+info)
Childhood housing conditions and later mortality in the Boyd Orr cohort.
(28/790)
STUDY OBJECTIVES: To examine associations between five measures of housing conditions during childhood and subsequent mortality from all causes, coronary heart disease, stroke, and cancer. DESIGN: Historical cohort study. SETTING: Data on housing conditions were collected from survey centres in 16 areas of England and Scotland. PARTICIPANTS: Children of families participating in the Carnegie Survey of Family Diet and Health in pre-war Britain (1937-1939). Analyses are based on a subset of 4168 people who were traced and alive on 1 January 1948. MAIN RESULTS: Poorer housing conditions were generally associated with increased adult mortality. After adjustment for childhood and adult socioeconomic factors, statistically significant associations were only found between lack of private indoor tapped water supply and increased mortality from coronary heart disease (hazard ratio 1.73, (95% CI 1.13, 2.64); and between poor ventilation and overall mortality (hazard ratio for people from households with poorest ventilation relative to best ventilation 1.30, 95% CI 0.97, 1.74). CONCLUSIONS: This study provides evidence that associations between housing conditions in childhood and mortality from common diseases in adulthood are not strong, but are in some respects distinguishable from those of social deprivation. (+info)
Comparative investigations of Listeria monocytogenes isolated from a turkey processing plant, turkey products, and from human cases of listeriosis in Denmark.
(29/790)
Listeria monocytogenes was isolated from critical control points in a Danish turkey processing plant, from turkey products and from cases of human listeriosis. During processing in the plant the prevalence of L. monocytogenes ranged from 25.9 to 41.4%. Cleaning and disinfection decreased the prevalence to 6.4%. Isolates of L. monocytogenes were characterized by pulsed-field gel electrophoresis (PFGE) using restriction endonuclease ApaI. Identical DNA types were obtained from turkey products and the processing line even after cleaning and disinfection. Two identical DNA types were demonstrated among isolates from turkey products and human cases of listeriosis. The prevalence of L. monocytogenes in turkey products ranged from 7.3 to 17.4% for ready-to-eat products and raw products, respectively. Since none of the 27 flocks examined before slaughter sampled positive for L. monocytogenes and the prevalence increased during processing, the potential risk from turkey meat was apparently due to factory hygiene rather than intrinsic contamination of the turkeys. (+info)
The health professional's role in preventing nosocomial infections.
(30/790)
Despite their best intentions, health professionals sometimes act as vectors of disease, disseminating new infections among their unsuspecting clients. Attention to simple preventive strategies may significantly reduce disease transmission rates. Frequent hand washing remains the single most important intervention in infection control. However, identifying mechanisms to ensure compliance by health professionals remains a perplexing problem. Gloves, gowns, and masks have a role in preventing infections, but are often used inappropriately, increasing service costs unnecessarily. While virulent microorganisms can be cultured from stethoscopes and white coats, their role in disease transmission remains undefined. There is greater consensus about sterile insertion techniques for intravascular catheters-a common source of infections-and their care. By following a few simple rules identified in this review, health professionals may prevent much unnecessary medical and financial distress to their patients. (+info)
Training traditional birth attendants in clean delivery does not prevent postpartum infection.
(31/790)
OBJECTIVE: To compare the maternal outcome, in terms of postpartum infection, of deliveries conducted by trained traditional birth attendants (TBAs) with those conducted by untrained birth attendants. METHODS: The study took place in a rural area of Bangladesh where a local NGO (BRAC) had previously undertaken TBA training. Demographic surveillance in the study site allowed the systematic identification of pregnant women. Pregnant women were recruited continuously over a period of 18 months. Data on the delivery circumstances were collected shortly after delivery while data on postpartum morbidity were collected prospectively at 2 and 6 weeks. All women with complete records who had delivered at home with a non-formal birth attendant (800) were included in the analysis. The intervention investigated was TBA training in hygienic delivery comprising the 'three cleans' (hand-washing with soap, clean cord care, clean surface). The key outcome measure was maternal postpartum genital tract infection diagnosed by a symptom complex of any two out of three symptoms: foul discharge, fever, lower abdominal pain. RESULTS: Trained TBAs were significantly more likely to practice hygienic delivery than untrained TBAs (45.0 vs. 19.3%, p < 0.0001). However, no significant difference in levels of postpartum infection was found when deliveries by trained TBAs and untrained TBAs were compared. The practice of hygienic delivery itself also had no significant effect on postpartum infection. Logistic regression models confirmed that TBA training and hygienic delivery had no independent effect on postpartum outcome. Other factors, such as pre-existing infection, long labour and insertion of hands into the vagina were found to be highly significant. CONCLUSIONS: Trained TBAs are more likely to practice hygienic delivery than those that are untrained. However, hygienic delivery practices do not prevent postpartum infection in this community. Training TBAs to wash their hands is not an effective strategy to prevent maternal postpartum infection. More rigorous evaluation is needed, not only of TBA training programmes as a whole, but also of the effectiveness of the individual components of the training. (+info)
Growth deficits in Chilean school children.
(32/790)
Stunting is highly prevalent in Latin American countries regardless of socioeconomic performance. The purpose of this study was to identify risk factors of growth deficit among children starting primary education whose parents were of short stature compared with those whose parents were not of short stature, in the poorest districts of Santiago, Chile. A case-control study was carried out with two types of cases. Case 1 included children whose height was between -1.0 and -3.0 (SD) of the height/age of the National Center for Health Statistics/World Health Organization standard and whose parent's height was below -2.0 SD (n = 115). Case 2 included stunted children (as defined previously) whose parent's height was above -2 SD (n = 76). Controls were children whose stature was +/-0.5 SD and whose parent's height was also above -2 SD (n = 115). Logistic regression models were carried out for case 1 and 2 children compared with the controls. Similar risk factors were found in both models, without any significant interaction: these included history of malnutrition, drunkenness in the family, lack of health care, unhygienic housing conditions, small length at birth and short period of exclusive breastfeeding. The most important risk factors for case 1 children were a history of malnutrition [with an odds ratio (OR) of 5.26 and confidence interval (CI) of 2.68-10.34] and short length at birth (OR = 4.87, CI 2.18-10.92). For case 2 children, the most important risk factors were a history of malnutrition (OR = 4.58, CI 2.20-9.53) and unhygienic housing conditions (OR = 4.29, CI 1.76-10.48). In conclusion, similar factors explained growth deficits in children starting primary school independent of the parent's height, suggesting that genetics would have a limited impact at this age and at this socioeconomic level. To reduce stunting in countries with an epidemiological profile such as that of Chile, it is still important to reduce adverse environmental conditions. (+info)