Determinants of hand hygiene compliance in Egypt: building blocks for a communication strategy

Hand hygiene of health-care staff is one of the most important interventions in reducing transmission of nosocomial infections. This qualitative study aimed to understand the behavioural determinants of hand hygiene in order to develop sustainable interventions to promote hand hygiene in hospitals. Fourteen focus group discussions were conducted with nurses in 2 university hospitals in Egypt. The interviews were tape recorded and transcribed. Thematic analysis was conducted by 2 independent investigators. The findings highlighted that nurses did not perceive the benefits of hand hygiene, and that they linked the need to wash hands to a sense of dirtiness. Knowledge of hand hygiene and related products was limited and preference for water and soap was obvious. Environmental constraints, lack of role models and social control were identified as barriers for compliance with hand hygiene. A multi-faceted hand hygiene strategy was developed based on existing cultural concepts valued by the hospital staff

Type-D personality: a predictor of quality of life and coronary heart disease

The present study examined the association of type - D personality [and its components] with quality of life in cardiac patients compared with healthy people. A sample of 80 patients with myocardial infarction [Ml] and 70 healthy people aged 45-60 years completed the WHO quality of life brief questionnaire and the 14-item type-D personality scale. A significantly higher percentage of the Ml group scored positive for type-D personality compared with healthy individuals [71% versus 33%]. Significantly more Ml patients had low quality of life scores than did healthy individuals [64% versus 20%]. Regression analysis showed that higher scores on type-D personality had a negative impact on quality of life in Ml patients and that the social inhibition component had a greater impact than negative affectivity. Psychological assessment for type-D personality may be helpful in developing health care plans

Clonal origins of human endometrial cancer

The aim of this study was to analyze the X inactivation in DNA extracted from microdissected endometrial carcinoma by Hpa II restriction and PCR of the androgen receptor exon I CAG polymorphism. The results revealed that monoclonality was confirmed in 105/133 samples of carcinoma cells from 31/32 informative endometrial cancers. Clonality was identical in seven cases. Unexpectedly, four of twelve cancers with two or more monoclonal samples available were mosaic [polyclonal] in respect of X chromosome inactivation between morphologically homogeneous tumor cell samples. It was concluded that concordant clonality supports a common clonal origin of high grade and low grade endometrial cancers, but frequent mosaic X inactivation in endometrial cancer cannot be explained by non-tumor cell contamination. These carcinomas are probably multiclonal. Possible mechanisms include simultaneous transformation of cell groups straddling X chromosome inactivation, or recruitment of bystander stem cells by DNA transfer from necrotic or apoptotic tumor cells