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Dispersal of gram-negative bacilli from sink drains has been implicated as a source of transmission in multiple outbreaks.
Methods:
In an acute care hospital, we assessed how often patient care supplies and other frequently touched items were within 1 meter of sink drains. We tested the efficacy of a ceiling-mounted far ultraviolet-C (UV-C) light technology for decontamination of sink bowls and surfaces near sinks with and without a wall-mounted film that reflects far UV-C light.
Results:
Of 190 sinks assessed, 55 (29%) had patient care supplies or other frequently touched items within 1 meter of the drain. The far UV-C technology reduced Pseudomonas aeruginosa, Enterobacter cloacae and Candida auris on steel disk carriers by ≥1.5 log10 colony-forming units (CFU) in 45 minutes. On inoculated real-world items, ≥1.9 log10 CFU reductions in P. aeruginosa were achieved on sites in line with the light source versus 0.4–1.8 log10 CFU reductions on shaded surfaces. The addition of the reflective surface significantly enhanced efficacy in shaded sites (P < 0.01).
Conclusions:
In a hospital setting, patient care supplies and other frequently touched items were often in proximity to sinks. The far UV-C light technology could potentially be useful for sink decontamination in high-risk areas.
To examine if smaller size at birth, an indicator of growth restriction in utero, is associated with lower cognition in late life, and whether this may be mediated by impaired early life brain development and/or adverse cardiometabolic programming.
Design:
Longitudinal follow-up of a birth cohort.
Setting:
CSI Holdsworth Memorial Hospital (HMH), Mysore South India.
Participants:
721 men and women (55–80 years) whose size at birth was recorded at HMH. Approximately 20 years earlier, a subset (n = 522) of them had assessments for cardiometabolic disorders in mid-life.
Measurements:
Standardized measurement of cognitive function, depression, sociodemographic, and lifestyle factors; blood tests and assessments for cardiometabolic disorders
Results:
Participants who were heavier at birth had higher composite cognitive scores (0.12 SD per SD birth weight [95% CI 0.05, 0.19] p = 0.001) in late life. Other lifecourse factors independently positively related to cognition were maternal educational level and participants’ own educational level, adult leg length, body mass index, and socioeconomic position, and negatively were diabetes in mid-life and current depression and stroke. The association of birth weight with cognition was independent cardiometabolic risk factors and was attenuated after adjustment for all lifecourse factors (0.08 SD per SD birth weight [95% CI −0.01, 0.18] p = 0.07).
Conclusions:
The findings are consistent with positive effects of early life environmental factors (better fetal growth, education, and childhood socioeconomic status) on brain development resulting in greater long-term cognitive function. The results do not support a pathway linking poorer fetal development with reduced late life cognitive function through cardiometabolic programming.
The Geriatric Mental State (GMS) is the most widely used psychiatric research assessment for older persons. Evidence for validity comes from the developed world.
Aims
To assess the validity of GMS/AGECAT organicity and depression diagnoses in 26 centres in India, China, Latin America and Africa.
Method
We studied 2941 persons aged 60 years and over: 742 people with dementia and three groups free of dementia (697 with depression, 719 with high and 783 with low levels of education). Local clinicians diagnosed dementia (DSM–IV) and depression (Montgomery – Åsberg Depression Rating Scale score ⩾18).
Results
For dementia diagnosis GMS/AGECAT performed well in many centres but educational bias was evident. Specificity was poor in India and sensitivity sub-optimal in Latin America. A predictive algorithm excluding certain orientation items but including interviewer judgements improved upon the AGECAT algorithm. For depression, sensitivity was high. The EURO–D depression scale, derived from GMS items using European data, has a similar factor structure in Latin America, India and, to a lesser extent, China.
Conclusions
Valid, comprehensive mental status assessment across cultures seems achievable in principle.
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