Can changes in clinical attire reduce likelihood of cross-infection without jeopardising the doctor-patient relationship?

Research has shown that healthcare workers' clothes can become contaminated with pathogens. This study aimed to determine whether hospital doctors can change their attire to reduce the possibility of cross-infection without jeopardising the doctor-patient relationship. In this experimental repeated-measures study, 55 male and 45 female inpatients (mean age: 52.89 years) were randomly selected. Participants were shown photographs of medical dresscodes and asked to rate their appropriateness on a 5-point Likert scale. They were then read a standardised statement regarding the significance of attire to cross-infection and the exercise was repeated. Pre statement, there was no significant difference between the majority of dress options, though casual dress (male and female) and short-sleeved top (female) were considered significantly less appropriate. Post statement, surgical 'scrubs' and short-sleeved top/shirt were deemed most appropriate (P<0.0001). There was no significant difference between short-sleeved shirt and scrubs for males. For females, scrubs were preferred (P=0.0005). Participants expressed no significant preference for medical attire, with the exception of a dislike of casual dress. However, once informed of the significance of attire to cross-infection, preference changes to favour dresscodes which may minimise infection risk.

Initial experience and safety in the treatment of chronic total occlusions with fiberoptic guidance technology: optical coherent reflectometry.

Percutaneous treatment of chronic total coronary occlusions has been limited by procedural complications such as vessel injury or perforation. Optimizing visualization in the vessel with optical coherent reflectometry and a forward-looking fiberoptic guidance technology may improve the safety and efficacy of percutaneous treatment of these lesions.

Bipolar shoulder arthroplasty for rotator cuff arthropathy.

Between July 1991 and February 1995, 33 patients underwent bipolar shoulder arthroplasty for painful rotator cuff arthropathy of the shoulder. Twenty-two of these patients have been followed for an average of 28 months (range 24 to 48 months) and comprised the study group. All patients had massive, irreparable rotator cuff tears and presented with preserved passive motion, good deltoid function, and obliterated glenohumeral joint surfaces. Function and comfort were dramatically improved in all patients, with an average increase in active forward elevation of 29 degrees and a gain in active external rotation of 39 degrees. There was one complication requiring reoperation at 4 years. Utilizing the UCLA and Swanson scoring systems, all patients were rated fair or better.

Fish movement behaviour: variability within and between groups.

The movement behaviour of mullet, Mugil cephalus (Linnaeus), an obligate schooling fish species, was recorded for individuals in small groups. Mean speeds and mean turning frequencies both declined significantly with increasing group size. Significant differences between groups were attributed to individual variation. However, within groups the movements of individuals were highly coordinated. As the size of fish schools increases, behavioural convergence mediated by the monitoring of companions rapidly masks individual variation and leads to the characteristic uniformity of such aggregations.

Tendency-distance models of social cohesion in animal groups.

Although it has been assumed that attraction and repulsion between social individuals constitute a basis for group cohesion, there has been no systematic study of the possible ways in which these tendencies might vary with inter-individual distance (IID), or of associated implications for group structure. In this paper, a family of attraction/repulsion--distance functions is described. Computer simulation was used to examine the effects of each function on group cohesion, as reflected by mean values and variability in IID and group shape. Our results showed that: (a) all models led to stability in group structure, but differed significantly in terms of stable IID and group shape characteristics; (b) cohesion was best served by an upwardly convex behaviour--distance function in which maximum attraction equaled maximum repulsion (and the biological plausibility of this function is discussed); (c) group elongation and variability in mean IID were significantly positively correlated; (d) although dyads maintained an equilibrial separation distance, at which attraction balanced repulsion, in larger groups stable nearest neighbour distances were often less than the equilibrium distance; and (e) individuals needed to monitor and respond to only relatively few of their companions in order to avoid group fragmentation.