The use of a CDC biofilm reactor to grow multi-strain Listeria monocytogenes biofilm.

Listeria monocytogenes is one of the most concerning pathogens for the food industry due to its ability to form biofilms, particularly in difficult-to-clean sites of processing facilities. There is a current industry-wide lack of data to refer to when selecting a strategy to control L. monocytogenes biofilms in the food premises. Many strategies have been developed to study biofilm formation of bacteria; however, few have targeted L. monocytogenes biofilms under dynamic conditions. This study addresses the biofilm formation ability of L. monocytogenes on stainless steel and polycarbonate under dynamic conditions using TSBYE or BHI as media culture at 30 °C or 37 °C. Higher cell counts were recovered at 30 °C in TSBYE on polycarbonate while lower counts were obtained at 37 °C in BHI on stainless steel (P < 0.05). Nonetheless, all factors (temperature, media and material) were statistically significant (P < 0.05) and an interaction between temperature and media was observed (P < 0.05). To our knowledge, this work represents an initial framework to develop L. monocytogenes biofilms under different dynamic conditions. The use of CDC Biofilm Reactor is not widely used yet in the food industry and represent a novel approach to help sanitary control strategies implementation.

Inactivation of Pseudomonas aeruginosa biofilms formed under high shear stress on various hydrophilic and hydrophobic surfaces by a continuous flow of ozonated water.

The inactivation of Pseudomonas aeruginosa biofilms grown on glass under high shear stress and exposed to a range of dissolved ozone concentrations (2, 5 and 7 ppm) at 10 and 20 min was investigated. The regression equation, log reduction (biofilm) = 0.64 + 0.59×(C - 2) + 0.33×(T - 10), described the dependence of biofilm inactivation on the dissolved ozone concentration (C, ppm) and contact time (T, min). The predicted D-values were 11.1, 5.7 and 2.2 min at 2, 5 and 7 ppm, respectively. Inactivation of biofilms grown on various surfaces was tested at a single dissolved ozone concentration of 5 ppm and a single exposure time of 20 min. Biofilms grown on plastic materials showed inactivation results similar to that of biofilms on glass, while biofilms grown on ceramics were statistically significantly more difficult to inactivate, suggesting the importance of utilizing non-porous materials in industrial and clinical settings.

Retrospective cohort study of the South Tyneside Exercise Referral Scheme 2009-14: predictors of dropout and barriers to adherence.

Background: Exercise Referral Schemes (ERS) are a prevalent method of increasing physical activity levels. However, they suffer from participant dropout and research predicting dropout or barriers to adherence are limited. This study aimed to focus upon the effect of referral characteristics on dropout, dropout predictors and whether self-reported barriers to exercise predict dropout. Methods: ERS data from 2009 to 2014 were retrieved for analysis. Chi-squared and t-tests were used to investigate differences between referral characteristics, and logistic regression used to investigate dropout predictors. Results: Of 6894 participants, 37.8% (n = 2608) dropped out within 6 weeks and 50.03% (n = 3449) by the final 12th week. More males adhered (P < 0.001) with dropouts being significantly younger (P < 0.001). Dropout predictors were smoking (OR = 1.58, 95% CI: 1.29-1.93) or being a Tier 3 referral (OR = 1.47, 95% CI: 1.25-1.73). Increasing age (OR = 0.98, 95% CI: 0.98-0.99), drinking alcohol (OR = 0.82, 95% CI: 0.71-0.95), secondary care referrals (OR = 0.68, 95% CI: 0.52-0.90), having a lack of motivation (OR = 0.81, 95% CI: 0.69-0.95) or a lack of childcare (OR = 0.69, 95% CI: 0.50-0.95) decreased the likelihood of dropout. Conclusion: ERS dropout continues to be problematic. Smoking and having moderate-high comorbidities predicted dropout. Increasing age and patient-reported barriers of a lack of time or childcare decreased dropout risk. The reasons for dropout require further investigation.

Predictive modeling for hot water inactivation of planktonic and biofilm-associated Sphingomonas parapaucimobilis to support hot water sanitization programs.

Hot water sanitization is a common means to maintain microbial control in process equipment for industries where microorganisms can degrade product or cause safety issues. This study compared the hot water inactivation kinetics of planktonic and biofilm-associated Sphingomonas parapaucimobilis at temperatures relevant to sanitization processes used in the pharmaceutical industry, viz. 65, 70, 75, and 80°C. Biofilms exhibited greater resistance to hot water than the planktonic cells. Both linear and nonlinear statistical models were developed to predict the log reduction as a function of temperature and time. Nonlinear Michaelis-Menten modeling provided the best fit for the inactivation data. Using the model, predictions were calculated to determine the times at which specific log reductions are achieved. While ≥80°C is the most commonly cited temperature for hot water sanitization, the predictive modeling suggests that temperatures ≥75°C are also effective at inactivating planktonic and biofilm bacteria in timeframes appropriate for the pharmaceutical industry.

Patients' and carers' experiences of interacting with home haemodialysis technology: implications for quality and safety.

BACKGROUND: Little is known about patients' and carers' experiences of interacting with home haemodialysis (HHD) technology, in terms of user experience, how the design of the technology supports safety and fits with home use, and how the broader context of service provision impacts on patients' use of the technology. METHODS: Data were gathered through ethnographic observations and interviews with 19 patients and their carers associated with four different hospitals in the UK, using five different HHD machines. All patients were managing their condition successfully on HHD. Data were analysed qualitatively, focusing on themes of how individuals used the machines and how they managed their own safety. RESULTS: Findings are organised by three themes: learning to use the technology, usability of the technology, and managing safety during dialysis. Home patients want to live their lives fully, and value the freedom and autonomy that HHD gives them; they adapt use of the technology to their lives and their home context. They also consider the machines to be safe; nevertheless, most participants reported feeling scared and having to learn through mistakes in the early months of dialysing at home. Home care nurses and technicians provide invaluable support. Although participants reported on strategies for anticipating problems and keeping safe, perceived limitations of the technology and of the broader system of care led some to trade off safety against immediate quality of life. CONCLUSIONS: Enhancing the quality and safety of the patient experience in HHD involves designing technology and the broader system of care to take account of how individuals manage their dialysis in the home. Possible design improvements to enhance the quality and safety of the patient experience include features to help patients manage their dialysis (e.g. providing timely reminders of next steps) and features to support communication between families and professionals (e.g. through remote monitoring).

Hand hygiene product use by food employees in casual dining and quick-service restaurants.

Hand hygiene product usage characteristics by food employees when hand sanitizers are made available are not well understood. To investigate hand hygiene product usage in casual dining and quick-service restaurants, we placed automated monitoring soap and sanitizer dispensers side-by-side at handwash sinks used by food employees in seven restaurants. Dispenses were monitored, and multiple dispenses that occurred within 60 s of each other were considered a single hand hygiene event. This resulted in 186,998 events during the study (149,779 soap only, 21 985 sanitizer only, and 15,234 regimen [defined as soap followed by sanitizer at the same sink within 60 s]) over 15,447 days of use. Soap was the most frequently used hand hygiene method by food employees in both restaurant types. Regimen use, despite being the preferred hand hygiene method by both restaurant chains, was the least used hand hygiene method. When pooled over restaurant types, the median daily usage for soap was statistically significantly highest of all methods at 23.5 dispenses per sink per day (p < 0.0001), the sanitizer median daily usage was 4.27 dispenses per sink per day, and regimen use was statistically significantly lowest of all methods at 4.02 dispenses per sink per day (p < 0.0001). When hand hygiene event types were pooled, casual dining restaurants had similar median hand hygiene event rates (11.4 dispenses per sink per day) compared to quick-service restaurants (11.9 dispenses per sink per day; p = 0.890). The number of events by sink location varied, with sinks located at a warewash station having the highest number of events (19.3 dispenses per sink per day; p < 0.0001), while sinks located by a ready-to-eat food preparation area had the lowest number of events (6.8 dispenses per sink per day; p < 0.0001). These data provide robust baseline benchmarks for future hand hygiene intervention studies in these settings.

Harvesting and Disaggregation: An Overlooked Step in Biofilm Methods Research.

Biofilm methods consist of four distinct steps: growing the biofilm in a relevant model, treating the mature biofilm, harvesting the biofilm from the surface and disaggregating the clumps, and analyzing the sample. Of the four steps, harvesting and disaggregation are the least studied but nonetheless critical when considering the potential for test bias. This article demonstrates commonly used harvesting and disaggregation techniques for biofilm grown on three different surfaces. The three biofilm harvesting and disaggregation techniques, gleaned from an extensive literature review, include vortexing and sonication, scraping and homogenization, and scraping, vortexing and sonication. Two surface types are considered: hard non-porous (polycarbonate and borosilicate glass) and porous (silicone). Additionally, we provide recommendations for the minimum information that should be included when reporting the harvesting technique followed and an accompanying method to check for bias.

Using a measure of person-perception skills to identify outstanding home care workers.

This study involved university-community collaboration with an international home care company for the purpose of developing a tool to identify talented caregivers. Tested was the hypothesis that workers' ability to provide care in person-centered ways would be positively associated with their ability to describe others in complex ways--that is, their person-perception skills. Company coordinators functioning as supervisors used an innovative 10-item instrument to screen 554 home health aides for their person centeredness. The most and least person-centered workers were evaluated for their person-perception skills. Person centeredness was positively associated with the complexity of home care workers' descriptions of others.

Family caregivers at risk: who are they?

This study examined the characteristics, activities, challenges, and perceived burden of high-risk family caregivers of persons diagnosed with Alzheimer's disease. A descriptive design was used. A convenience sample of 121 family caregivers participated in the interview. High-risk family caregivers with poor health and one medical condition were compared with low-risk family caregivers. Caregivers with low income, depressive symptoms, and high care demands are more likely to be in the high-risk group. Health care providers need to screen family caregivers for depression and monitor those with high care demands.

Youth Therapist Strategies to Enhance Client Homework Completion.

BACKGROUND: This study examined strategies youth therapists use to attempt to enhance their clients' therapeutic homework completion. METHOD: Thirty-two youth mental health therapists participated. All participants completed a 'Follow-Through Strategy' survey and 13 also participated in a semi-structured interview. Interviews were recorded, transcribed and analysed. RESULTS: On the survey, therapists reported using a broad range of strategies to attempt to enhance therapeutic homework completion. Interview results indicated participants emphasized strategies related to therapeutic engagement to attempt to enhance homework completion. CONCLUSIONS: Future studies should employ prospective design and examine the differential and collective impact of strategies therapists described using.

Conditions for creativity: lessons for lesbians in the lives of Romaine Brooks and Terry Wolverton.

This article considers the lives of Terry Wolverton, former lesbian separatist artist at The Women's Building, Los Angeles and now a mythical writer and visionary, and lesbian painter, Romaine Brooks. Whereas superficially their lives appear to have little in common other than that they were both lesbian artists, similarities can be found in stories linking them in ways previously un-examined before. Both came from abusive family backgrounds, Wolverton surviving sexual abuse and alcoholism, while Brooks' life was marred by a frightening mother and a father who deserted her. Using autobiography and biographical sources, Walker analyzes the creative conditions under which lesbian art may thrive. For a time, gay and lesbian art flourished in the United States. Brooks' portraits of "butch" lesbians became synonymous with popular images of twentieth-century lesbians. Wolverton's work with other lesbian artists in The Lesbian Art Project of 1977-1980 documents their engagement with art. The conditions required for creativity of whatever kind involves journeys and Walker uses the concept of "journeying" as a metaphor to describe the internal and external processes that of necessity accompany the creative act. The content of the article examines what can be learned from the lives of Brooks and Wolverton. Historically the "artist story" (Kunstlerroman) has focused on male and female heterosexual artists. The study of more recent autobiographical accounts permits an examination of the development of artists with cultural differences, and makes it possible to ask what conditions need be in place for lesbian artists to create art to "unfetter the self" when the self in question is different. Walker concludes that the early experiences of Wolverton and Brooks had a profound effect on their adult lives, as both made circuitous creative journeys in attempts to overcome the trauma of childhood years. Whereas one succeeded, the other failed due to the different cultural conditions of the time.

Alzheimer's Disease Awareness Month: how home care can help.

In November, among other themes, we recognize National Alzheimer's Awareness Month. Despite the sobering fact that there is still no cure for Alzheimer's disease, this year we have witnessed some very exciting progress toward that goal, and home care continues to play a crucial role in meeting the needs of those with Alzheimer's disease and their loved ones.

Personality and nonjudging make you happier: Contribution of the Five-Factor Model, mindfulness facets and a mindfulness intervention to subjective well-being.

Mindful individuals are able to acknowledge mind wandering and live in the present moment in a nonjudgmental way. Previous studies have found that both mind wandering and mindfulness are associated with subjective well-being. However, the main predictor of happiness is personality; more specifically, happier people are emotionally stable and extraverted. The present study aimed to explore the contribution of the five factors of personality, dispositional mindfulness facets and a mindfulness intervention to happiness. A sample of 372 university students was assessed with the NEO-Five Factor Inventory, and another sample of 217 community adults answered the Big Five Personality Trait Short Questionnaire. Both samples, 589 participants in all, completed the Five Facet Mindfulness Questionnaire and the Subjective Happiness Scale. Furthermore, 55 participants from the general population sample took a 6-week training course in meditation and developing mindfulness. The regression analyses showed that emotional stability and extraversion traits were the strongest predictors of subjective well-being. Nonetheless, the nonjudging facet, which is nonevaluative/acceptance awareness of thoughts and feelings, still remained a significant predictor of happiness when personality was accounted for. Finally, mindfulness training did not increase subjective well-being. Being nonjudgmental of one's inner thoughts, feelings and sensations contributes to happiness even when personality is taken into account. Accordingly, it seems reasonable that mindfulness training that intends to improve subjective well-being should focus on noticing thoughts without judging them.

Drip flow reactor method exhibits excellent reproducibility based on a 10-laboratory collaborative study.

A standard method for growing Pseudomonas aeruginosa biofilm in the Drip Flow Biofilm Reactor was assessed in a 10-laboratory study. The mean log density was 9.29 Log10(CFU/cm2). The repeatability and reproducibility SDs were equal to 0.22 and 0.24, respectively, providing statistical confidence in data generated by the method.

Development, standardization, and validation of a biofilm efficacy test: The single tube method.

Methods validated by a standard setting organization enable public, industry and regulatory stakeholders to make decisions on the acceptability of products, devices and processes. This is because standard methods are demonstrably reproducible when performed in different laboratories by different researchers, responsive to different products, and rugged when small (usually inadvertent) variations from the standard procedure occur. The Single Tube Method (ASTM E2871) is a standard method that measures the efficacy of antimicrobials against biofilm bacteria that has been shown to be reproducible, responsive and rugged. In support of the reproducibility assessment, a six-laboratory study was performed using three antimicrobials: a sodium hypochlorite, a phenolic and a quaternary/alcohol blend, each tested at low and high efficacy levels. The mean log reduction in viable bacteria in this study ranged from 2.32 to 4.58 and the associated reproducibility standard deviations ranged from 0.89 to 1.67. Independent follow-up testing showed that the method was rugged with respect to deviations in sonication duration and sonication power but slightly sensitive to sonicator reservoir degassing and tube location within the sonicator bath. It was also demonstrated that when a coupon was dropped into a test tube, bacteria can splash out of reach of the applied antimicrobials, resulting in substantial bias when estimating log reductions for the products tested. Bias can also result when testing products that hinder the harvesting of microbes from test surfaces. The culmination of this work provided recommended changes to the early version of the standard method E2871-13 (ASTM, 2013b) including use of splashguards and microscopy checks. These changes have been incorporated into a revised ASTM method E2871-19 (ASTM 2019) that is the basis for the first regulatory method (ATMP-MB-20) to substantiate "kills biofilm" claims for antimicrobials registered and sold in the US.

Learning scientific and medical terminology with a mnemonic strategy using an illogical association technique.

For students pursuing careers in medical fields, knowledge of technical and medical terminology is prerequisite to being able to solve problems in their respective disciplines and professions. The Dean Vaughn Medical Terminology 350 Total Retention System, also known as Medical Terminology 350 (25), is a mnemonic instructional and learning strategy that combines mental imagery and keyword mnemonic elaboration processes to help students recall the scientific meaning of Greek and Latin word parts. High school students in Anatomy and Physiology classes at a career technology center were divided into experimental (Medical Terminology 350), control (rote memorization), or combination (Medical Terminology 350 and rote memorization) groups and completed pre- and posttests of standardized word recall tests. Students in the Dean Vaughn Medical Terminology 350 Total Retention System group achieved significantly greater pre- to posttest word recall improvement compared with students in both the rote memorization (P

Grounded theory: an exploration of process and procedure.

Grounded theory, as an evolving qualitative research method, is a product of its history as well as of its epistemology. Within the literature, there have been a number of discussions focusing on the differences between Glaser's (1978, 1992) and Strauss's (1987, 1990) versions of grounded theory. The purpose of this article is to add a level of depth and breadth to this discussion through specifically exploring the Glaser-Strauss debate by comparing the data analysis processes and procedures advocated by Glaser and by Strauss. To accomplish this task, the authors present the article in two sections. First, they provide relevant background information on grounded theory as a research method. Second, they pursue a more in-depth discussion of the positions of Glaser, using Glaser's work, and Strauss, using Strauss's and Strauss and Corbin's (1990) work, regarding the different phases of data analysis, specifically addressing the coding procedures, verification, and the issue of forcing versus emergence.

Characterization of an actin-binding site within the talin FERM domain.

Talin is a large cytoskeletal protein that couples integrins to F-actin. Three actin-binding sites (ABS1-3) have been reported: one in the N-terminal head, and two in the C-terminal rod domain. Although the C-terminal ABS3 has been partially characterized, the presence and properties of ABS1 within the talin head are less well defined. We show here that the talin head binds F-actin in vitro and in vivo at a specific site within the actin filament. Thus, purified talin head liberated from gizzard talin by calpain cleavage cosediments with F-actin in a low salt buffer at pH 6.4 (conditions that are optimal for binding intact talin), and using recombinant polypeptides, we have mapped ABS1 to the FERM domain within the talin head. Both the F2 and F3 FERM subdomains contribute to binding, and EGFP-tagged FERM subdomains colocalize with actin stress fibers when expressed in COS cells. High-resolution electron microscopy of actin filaments decorated with F2F3 localizes binding to a site that is distinct from that recognized by members of the calponin-homology superfamily. Finally, we show that the FERM domain can couple F-actin to PIPkin, and by inference to integrins, since they bind to the same pocket in the F3 subdomain. This suggests that the talin FERM domain functions as a linker between PIPkin or integrins and F-actin at sites of cell-matrix adhesions.

Molecular markers that identify human astrocytomas and oligodendrogliomas.

The classification of human gliomas is currently based solely on neuropathological criteria. Prognostic and therapeutic parameters are dependent upon whether the tumors are deemed to be of astrocytic or oligodendroglial in origin. We sought to identify molecular reagents that might provide a more objective parameter to assist in the classification of these tumors. In order to identify mRNA transcripts for genes normally transcribed exclusively by oligodendrocytes. Northern blot analysis was carried out on RNA samples from 138 human gliomas. Transcripts encoding the myelin basic protein (MBP) were found in an equally high percentage of tumors that by neuropathological criteria were either astrocytic or oligodendroglial. In contrast, proteolipid protein (PLP) and cyclic nucleotide phosphodiesterase (CNP) mRNA molecules were found significantly more often in oligodendrogliomas than in astrocytomas. The strongest association with histological typing was found with the transcript for the myelin galactolipid biosynthetic enzyme UDP-galactose: ceramide galactosytransferase (CGT), which was about twice as frequently detected in tumors of oligodendroglial type. Results of glycolipid analyses were previously reported on a subset of the tumors studied herein. Statistical analyses of both molecular and biochemical data on this subset of astrocytomas, oligoastrocytomas, and oligodendrogliomas were performed to determine if a panel of markers could be used to separate astrocytic and oligodendroglial tumors. The presence of asialo GM1 (GA1) and the absence of paragloboside occurred most frequently in oligodendrogliomas. Ceramide monohexoside (CMH) levels correlated highly with the expression of mRNA for 4 myelin proteins: CGT, MBP, CNP, and PLP. The best combination of 2 markers of oligodendroglial tumors was CGT and GA1; the best combination of 3 markers was the presence of CGT, GA1, and the absence of paragloboside. We conclude that this combination of markers could be useful in distinguishing between astrocytic and oligodendroglial tumors.

A method for growing a biofilm under low shear at the air-liquid interface using the drip flow biofilm reactor.

This protocol describes how to grow a Pseudomonas aeruginosa biofilm under low fluid shear close to the air-liquid interface using the drip flow reactor (DFR). The DFR can model environments such as food-processing conveyor belts, catheters, lungs with cystic fibrosis and the oral cavity. The biofilm is established by operating the reactor in batch mode for 6 h. A mature biofilm forms as the reactor operates for an additional 48 h with a continuous flow of nutrients. During continuous flow, the biofilm experiences a low shear as the media drips onto a surface set at a 10 degrees angle. At the end of 54 h, biofilm accumulation is quantified by removing coupons from the reactor channels, rinsing the coupons to remove planktonic cells, scraping the biofilm from the coupon surface, disaggregating the clumps, then diluting and plating for viable cell enumeration. The entire procedure takes 13 h of active time that is distributed over 5 d.