Impact of Training on Employees' Handwashing Behaviors in School Nutrition Programs.

BACKGROUND: School nutrition employee behavior plays an important role in preventing foodborne outbreaks and protecting the almost 30 million children who partake in daily school lunch. OBJECTIVE: The study aim was to compare the impact of using a food safety training program with or without using a realistic-event video on handwashing behavior modification for school nutrition employees. DESIGN: A 2-group (control and experimental) pretest with 2 post-tests design was used. The control group received training without the video and the experimental group received the food safety training with a realistic-event video. Measurements used to address the purpose and objectives of this study included questionnaires and direct observations. PARTICIPANTS/SETTING: The sample consisted of 443 school nutrition employees responsible for food preparation and service affiliated with 21 school districts in 18 states. Approximately half of the sample attended the original unmodified training and the other half attended the modified training. Data were collected in the United States during 2017. A total of 338 employees participated in the observations and 443 participants completed the questionnaires during the 3 phases; 935 questionnaires were used for the analysis. INTERVENTION: The intervention involved a food safety training program embedded with a realistic-event video related to handwashing. The video used previous research to target antecedents to handwashing behavior among participants. MAIN OUTCOME MEASURES: Actual behavior was observed across 3 phases-pretraining, post training, and final-for both the control and experimental groups. In addition, indirect and direct measures of behavioral intentions for handwashing were measured. STATISTICAL ANALYSIS PERFORMED: For the observation data, a 2-way, fixed-effects, mixed-model procedure was used to analyze the data. Simple and multiple linear regression and contingency table analyses looking for differences among phases and treatments were used for questionnaire data analysis. RESULTS: Most practices were reported as in compliance (51.3% to 80.6%) for both the control and experimental groups during all phases. The experimental group had a higher behavioral intention of properly washing their hands than participants in the control group. CONCLUSIONS: The results showed that handwashing practices were in compliance most of the time for both the control and experimental groups during all 3 observation periods. Differences among the data collection periods on the theory of planned behavior constructs indicated no statistical effect of the treatment (exposure to the video) between the control and intervention groups.

Breakfast Macronutrient Composition Influences Thermic Effect of Feeding and Fat Oxidation in Young Women Who Habitually Skip Breakfast.

The purpose of this study was to determine if breakfast macronutrient composition improved thermic effect of feeding (TEF) and appetite after a one-week adaptation in young women who habitually skip breakfast. A randomized, controlled study was conducted in females (24.1 ± 2 years), who skip breakfast (≥5 times/week). Participants were placed into one of three groups for eight days (n = 8 per group): breakfast skipping (SKP; no breakfast), carbohydrate (CHO; 351 kcal; 59 g CHO, 10 g PRO, 8 g fat) or protein (PRO; 350 kcal; 39 g CHO, 30 g PRO, 8 g fat). On days 1 (D1) and 8 (D8), TEF, substrate oxidation, appetite and blood glucose were measured. PRO had higher (p < 0.05) TEF compared to SKP and CHO on D1 and D8, with PRO having 29% higher TEF than CHO on D8. On D1, PRO had 30.6% higher fat oxidation than CHO and on D8, PRO had 40.6% higher fat oxidation than CHO. SKP had higher (p < 0.05) fat oxidation on D1 and D8 compared to PRO and CHO. There was an interaction (p < 0.0001) of time and breakfast on appetite response. In addition, CHO had a significant increase (p < 0.05) in PP hunger response on D8 vs. D1. CHO and PRO had similar PP (postprandial) glucose responses on D1 and D8. Consumption of PRO breakfast for 8 days increased TEF compared to CHO and SKP, while consumption of CHO for one week increased PP hunger response.

Pelvic organ prolapse.

Pelvic organ prolapse, or genital prolapse, is the descent of one or more of the pelvic structures (bladder, uterus, vagina) from the normal anatomic location toward or through the vaginal opening. Women of all ages may be affected, although pelvic organ prolapse is more common in older women. The cause is a loss of pelvic support from multiple factors, including direct injury to the levator ani, as well as neurologic injury from stretching of the pudendal nerves that may occur with vaginal childbirth. Previous hysterectomy for pelvic organ prolapse; ethnicity; and an increase in intra-abdominal pressure from chronic coughing, straining with constipation, or repeated heavy lifting may contribute. Most patients with pelvic organ prolapse are asymptomatic. A sense of bulging or protrusion in the vagina is the most specific symptom. Evaluation includes a systematic pelvic examination. Management options for women with symptomatic prolapse include observation, pelvic floor muscle training, mechanical support (pessaries), and surgery. Pessary use should be considered before surgery in women who have symptomatic prolapse. Most women can be fitted with a pessary regardless of the stage or site of predominant prolapse. Surgical procedures are obliterative or reconstructive.

Hierarchy of conversational rule violations involving utterance-based augmentative and alternative communication systems.

This study examined the effects of using messages with conversational rule violations on attitudes toward people who used utterance-based augmentative and alternative communication (AAC) systems in transactional interactions. Specifically, the ratings were compared across messages with relevance, informativeness, and brevity violations, when latency remained constant (i.e., short). The 96 participating sales clerks viewed scripted, videotaped bookstore conversations and completed an attitude questionnaire. Results indicated that the prestored message with repeated words/phrases was rated the highest, followed by the message with excessive information; next was the message with inadequate information, followed by the message with partly relevant information. The findings may be useful to those using utterance-based systems when making message choices during interactions with service providers. Technological implications point to the development of schema/script-based systems and intelligent editing.

Brevity and speed of message delivery trade-offs in augmentative and alternative communication.

This study is the third in a series of studies that have concentrated on utterance-based systems--which allow the relatively quick selection of full sentences--and investigated trade-offs faced by users of such systems when there is a pragmatic mismatch between the prestored sentence and the current discourse context. While the previous studies focused on trade-offs between speed of message delivery and either relevance or informativeness, this study investigated the effects of trade-offs between speed of message delivery and brevity on public attitudes. Participating were 96 sales clerks who viewed scripted, videotaped trade-off message conditions in the context of a bookstore interaction and completed a questionnaire designed to assess their attitudes toward customers who used utterance-based systems and his or her communication. Significantly higher mean ratings were found for the trade-off condition involving the quickly delivered message with repetition when compared to each of the slowly delivered, non-repetitive message conditions (i.e., with and without a preceding conversational floorholder). Implications regarding the model of conversational trade-off choices and its technological applications are discussed.

Dry aging of beef in a bag highly permeable to water vapour.

The objective of this experiment was to compare traditional dry aging of beef with a novel technique of dry aging in a highly moisture-permeable bag. Four equal-sized sections from paired beef strip loins were dry aged traditionally, unpackaged, or packaged in the experimental bag for 14 or 21d at 3°C. No differences (P>0.05) were noted for pH, moisture, fat, total plate counts, cook loss, shear force, or any measured sensory attribute between the two aging treatments after either aging period. After 21d, however, dry aging in the bag (versus traditional dry aging) decreased (P<0.05) weight loss during aging, trim loss after aging, and yeast counts on lean tissue and increased lactic acid bacteria counts (P<0.05) on adipose and lean tissue. Dry aging in a highly moisture-permeable bag is feasible, will positively impact yields and reduce microbial spoilage, and will have no negative impact on product quality.

Trade-offs between informativeness and speed of message delivery in augmentative and alternative communication.

This report is the second in a series of investigations designed to develop a working model identifying the effects of trade-offs between selected conversational maxims on public attitudes toward augmentative and alternative communication (AAC) system users and their communication. In the current study, tradeoffs between the informativeness of a prestored message and its speed of delivery were examined. A total of 96 salesclerks participated. Sixteen scripted, videotaped conversational conditions, involving an AAC customer and a clerk at a checkout counter, were used to manipulate message informativeness and speed of message delivery. Following each assigned viewing, participants completed a questionnaire designed to assess their attitudes toward the AAC user and his or her communication. The conditions involving (a) the quickly delivered message with excessive information, (b) the slowly delivered message with adequate information preceded by a "floorholder," and (c) the slowly delivered message with adequate information without a floorholder were rated higher than (d) the quickly delivered message with inadequate information. There was no main effect for participant or AAC user gender. Implications regarding a model of conversational trade-offs and technological applications are discussed.

White birch (Betula papyrifera Marshall) foliar litter decomposition in relation to trace metal atmospheric inputs at metal-contaminated and uncontaminated sites near Sudbury, Ontario and Rouyn-Noranda, Quebec, Canada.

Decomposition of white birch (Betula papyrifera Marshall) foliar litter was examined at metal-contaminated and uncontaminated sites established along gradients of soil Cu, Ni, Pb and Zn concentrations near Sudbury, Ontario and Rouyn-Noranda, Quebec. Over an 18-month study period, a significantly lower rate of litter mass loss was observed at the Sudbury contaminated site (S1) than at the uncontaminated site (S2). This result was not duplicated at corresponding sites (RN1, RN2) in Rouyn-Noranda, despite similar levels of soil metal contaminants and atmospheric inputs. Concentrations of metals in litter increased at all sites with time. However, the greatest litter Cu and Ni concentrations were observed at S1 (188 and 192 microg/g, respectively), a result of substantial net gains of these elements from atmospheric inputs. On a per hectare basis, Cu accumulation in litter at S1 approached recommended application rates of Cu as copper sulphate for control of fungal diseases in agricultural operations, indicating that the current rate of Cu smelter emissions in Sudbury may cause the observed impairment of decomposition.

Necrotizing fasciitis after tension-free vaginal tape (TVT) placement.

A 62-year-old homemaker underwent an uneventful TVT (tension-free vaginal tape) procedure. Eleven days postoperatively she presented to the Emergency Department with agonizing low abdominal pain, elbow pain, fever, and drainage from her suprapubic puncture sites. Her evaluation was consistent with a diagnosis of necrotizing fasciitis and she was started on antibiotics and taken to surgery for exploration and debridement, where the diagnosis was confirmed. This is the first report of necrotizing fasciitis following TVT placement.

Randomized clinical trial of therapeutic exercise in subacute stroke.

BACKGROUND AND PURPOSE: Rehabilitation care after stroke is highly variable and increasingly shorter in duration. The effect of therapeutic exercise on impairments and functional limitations after stroke is not clear. The objective of this study was to determine whether a structured, progressive, physiologically based exercise program for subacute stroke produces gains greater than those attributable to spontaneous recovery and usual care. METHODS: This randomized, controlled, single-blind clinical trial was conducted in a metropolitan area and 17 participating healthcare institutions. We included persons with stroke who were living in the community. One hundred patients (mean age, 70 years; mean Orpington score, 3.4) consented and were randomized from a screened sample of 582. Ninety-two subjects completed the trial. Intervention was a structured, progressive, physiologically based, therapist-supervised, in-home program of thirty-six 90-minute sessions over 12 weeks targeting flexibility, strength, balance, endurance, and upper-extremity function. Main outcome measures were postintervention strength (ankle and knee isometric peak torque, grip strength), upper- and lower-extremity motor control (Fugl Meyer), balance (Berg and functional reach), endurance (peak aerobic capacity and exercise duration), upper-extremity function (Wolf Motor Function Test), and mobility (timed 10-m walk and 6-minute walk distance). RESULTS: In the intention-to-treat multivariate analysis of variance testing the overall effect, the intervention produced greater gains than usual care (Wilk's lambda=0.64, P=0.0056). Both intervention and usual care groups improved in strength, balance, upper- and lower-extremity motor control, upper-extremity function, and gait velocity. Gains for the intervention group exceeded those in the usual care group in balance, endurance, peak aerobic capacity, and mobility. Upper-extremity gains exceeded those in the usual care group only in patients with higher baseline function. CONCLUSIONS: This structured, progressive program of therapeutic exercise in persons who had completed acute rehabilitation services produced gains in endurance, balance, and mobility beyond those attributable to spontaneous recovery and usual care.

Depressive symptoms and independence in BADL and IADL.

PURPOSE: This study examined the relationship between depressive symptoms and time courses in achieving independence in basic activities of daily living (BADL) and instrumental activities of daily living (IADL). METHODS: At baseline, 1, 3, and 6 months after stroke, 459 stroke patients were prospectively assessed. We used the Geriatric Depression Scale to determine depressive status. Outcomes were times to achieve independence in BADL (Barthel >95) and independ-ence in at least three IADL. We used the Kaplan-Meier method and time-dependent Cox proportional hazards regression to examine the relationship between depression and stroke recovery. RESULTS: Depressed patients were 0.3 times less likely than nondepressed patients to achieve BADL of >95 and 0.4 times less likely to be independent in three or more IADL. The cumulative percentages for the nondepressed patients to achieve a BADL of >95 at 1, 3, and 6 months after stroke were 47%, 63%, and 72%, and for the depressed patients, they were 19%, 34%, and 52%, respectively. Similarly, the cumulative percentages for nondepressed patients to achieve complete independence in three or more IADL at 1, 3, and 6 months after stroke were 56%, 72%, and 85%, and for the depressed patients, they were 32%, 47%, and 72%, respectively. Depressed patients had poorer recovery patterns and took longer to achieve the outcomes. CONCLUSION: Stroke patients with depressive symptoms progressed slower in achieving independence of BADL and IADL compared to patients without depressive symptoms.