BACKGROUND: Direct observation of healthcare workers is commonly used in hospitals to investigate hand hygiene compliance. However, the hand hygiene compliance rate may increase due to the Hawthorne effect, which is the modification of behavior simply because subjects become aware that they are being observed. The objective of this study was to investigate the occurrence of the Hawthorne effect when directly observing hand hygiene compliance in intensive care unit (ICU) healthcare personnel. METHODS: A total of 87 staff members from the coronary care unit and cardiac surgery ICU of a general hospital in Seoul were included in this study: 24 residents and interns, 55 nurses, and 8 nursing assistants. Both covert and overt observations, where subjects were either unaware or aware of any direct observation, were performed on separate occasions. RESULTS: A total of 1,052 covert and 1,336 overt observations were documented over 30 and 34 occasions, respectively. Overall hand hygiene compliance was significantly higher with overt observation than with covert observation (1,041/1,336, 77.9% vs. 659/1,052, 62.6%, P<0.001). The Hawthorne effect was present in all professions and behaviors, with the exception of nursing assistants, and prior to touching a patient. CONCLUSION: Direct observation of hand hygiene compliance was associated with the Hawthorne effect when observations were made overtly and this was likely to contribute to an overestimation of compliance rate.
Compliance ; Coronary Care Units* ; Delivery of Health Care* ; Effect Modifier, Epidemiologic* ; Hand Hygiene* ; Health Personnel ; Hospitals, General ; Humans ; Intensive Care Units* ; Nursing ; Seoul ; Thoracic Surgery*

Testicular feminization is an uncommon genetic disorder with considerably familial predisposition and results in total feminization due to end-organ unresponsiveness to androgens. It is characterized by the presence of testes in phenotypically female with adequate breast development, normal extemal genitalia, absence of mullerian structures, and meager or absence of body hair. These patients characteristically have male karyotype(XY) and negative sex chromatin and are at increased risk of undergoing malignant transformation of the undescended gonad. In recent times, the malignant potential of the dysgenetic gonads in the intersex patients with a Y chromosome has been stressed by many authors, but few reports of an association between testicular feminization syndrome and benign tumors such as Sertoli cell adenomas. In the present study, postoperative pathology revealed that the gonads were Sertoli cell adenomas. The main features of clinical presentation and histological studies are briefly discussed with a review of the literature.
Adenoma* ; Androgen-Insensitivity Syndrome* ; Androgens ; Breast ; Female ; Feminization ; Genitalia ; Gonads ; Hair ; Humans ; Male ; Pathology ; Sex Chromatin ; Testis ; Y Chromosome

OBJECTIVES: This study was conducted to evaluate the public's awareness of the importance of hand washing and to compare perceptions on the habit of hand washing with actual hand washing behavior. METHODS: Data were collected by observing 2,800 participants washing their hands after using public restrooms in seven cities nationwide and by surveying 1,000 respondents (age > 14 years) through telephone interviews using a structured questionnaire. RESULTS: Although 94% of the survey respondents claimed to mostly or always wash their hands after using public restrooms, only 63.4% of the observed participants did wash their hands after using public restrooms. Significant factors related to increased adherence to hand washing were female gender, approximate ages of 20 to 39 years by their appearance, and the presence of other people from the observation. About 79% of the survey respondents always washed their hands after using bathrooms at home, 73% washed their hands before handling food, and 67% washed their hands upon returning to their home. However, 93.2% and 86.3% of the survey respondents did not wash their hands after coughing or sneezing and after handling money, respectively. Although most of the survey respondents (77.6%) were aware that hand washing is helpful in preventing communicable diseases, 39.6% of the survey respondents did not do so because they were 'not accustomed' to washing their hands and 30.2% thought that washing their hands is 'annoying'. CONCLUSIONS: This is the first comprehensive report on hand washing behavior and awareness of the general population in Korea. The result of this study in terms of individual behavior and awareness of hand washing are comparable with similar studies conducted in other countries. However adherence to hand washing is still low and needs to be increased. The results of this study can be used as a baseline in setting up strategies and activities to Bpromote adherence to hand washing.
Adolescent ; Adult ; Child ; Female ; *Handwashing ; *Health Knowledge, Attitudes, Practice ; Humans ; Korea ; Male ; Middle Aged ; Toilet Facilities

Tyrosine kinases are one of the most important regulators for intracellular signal transduction related to inflammatory responses. However, there are no reports describing the effects of tyrosine kinases on neutrophil apoptosis induced by Entamoeba histolytica. In this study, isolated human neutrophils from peripheral blood were incubated with live trophozoites in the presence or absence of tyrosine kinase inhibitors. Entamoeba-induced receptor shedding of CD16 and PS externalization in neutrophils were inhibited by pre-incubation of neutrophils with the broad-spectrum tyrosine kinase inhibitor genistein or the Src family kinase inhibitor PP2. Entamoeba-induced ROS production was also inhibited by genistein or PP2. Moreover, genistein and PP2 blocked the phosphorylation of ERK and p38 MAPK in neutrophils induced by E. histolytica. These results suggest that Src tyrosine kinases may participate in the signaling event for ROS-dependent activation of MAPKs during neutrophil apoptosis induced by E. histolytica.
*Apoptosis ; Cells, Cultured ; Entamoeba histolytica/*immunology/*pathogenicity ; GPI-Linked Proteins/metabolism ; Genistein/metabolism ; Humans ; Neutrophils/*immunology ; Protein Kinase Inhibitors/metabolism ; Pyrimidines/metabolism ; Reactive Oxygen Species/metabolism ; Receptors, IgG/metabolism ; src-Family Kinases/antagonists & inhibitors/*metabolism

Cadmium is known to exert toxic effects on multiple organs, including the testes. To determine if alpha-tocopherol, an antioxidant, could protect testicular tissues and spermatogenesis from the toxic effects of cadmium, six-week old male Sprague-Dawley rats were randomized to receive cadmium at doses of 0 (control), 1, 2, 4 or 8 mg/kg by the intraperitoneal route (Group A) or alpha-tocopherol for 5 days before being challenged with cadmium (Group B) in an identical dose-dependent manner. When both groups received cadmium at 1 mg/kg, there were no changes in testicular histology relative to controls. When Group A received cadmium at 2 mg/kg, undifferentiated spermatids and dead Sertoli cells increased in the seminiferous tubules while interstitial cells decreased and inflammatory cells increased in the interstitial tissues. On flow cytometric analysis, the numbers of elongated spermatids (M1) and round spermatids (M2) decreased while 2c stage cells (M3, diploid) increased. In contrast, when Group B received cadmium at 2 mg/kg, the histological insults were reduced and the distribution of the germ cell population remained comparable to controls. However, alpha-tocopherol had no protective effects with higher cadmium doses of 4 and 8 mg/kg. These findings indicate that alpha-tocopherol treatment can protect testicular tissue and preserve spermatogenesis from the detrimental effects of cadmium but its effectiveness is dependent on the dose of cadmium exposed.
alpha-Tocopherol/*pharmacology ; Testis/*drug effects/pathology ; Spermatogenesis/*drug effects ; Rats, Sprague-Dawley ; Rats ; Male ; Inflammation ; Flow Cytometry ; Dose-Response Relationship, Drug ; Cadmium Poisoning/*pathology ; Cadmium/metabolism/*pharmacology ; Antioxidants/pharmacology ; Animals

Cryptosporidium parvum is a zoonotic protozoan parasite that causes cryptosporidial enteritis. Numerous outbreaks of cryptosporidiosis have been reported worldwide. Cryptosporidium is transmitted to hosts via consumption of contaminated water and food but also by direct contact with contaminated soil or infected hosts. The present study investigated farm soil collected from 34 locations along the western Korean peninsula and 24 vegetables purchased from local grocery markets in Seoul. The soil and vegetable samples were examined by real-time polymerase chain reaction (qPCR) to estimate the risk of infection. Eleven of 34 locations (32.4%) and 3 of 24 vegetable samples (12.5%) were contaminated with Cryptosporidium parvum, as confirmed by TaqI enzyme digestion of qPCR products and DNA sequencing. It is suggested that Cryptosporidium infection can be mediated via farm soil and vegetables. Therefore, it is necessary to reduce contamination of this organism in view of public health.
Base Sequence ; Cryptosporidiosis/parasitology ; Cryptosporidium parvum/*genetics/*isolation & purification ; DNA, Protozoan/analysis/genetics ; Enteritis/parasitology ; Foodborne Diseases/*parasitology ; Humans ; Sequence Alignment ; Sequence Analysis, DNA ; Soil/*parasitology ; Vegetables/*parasitology

Background: This study investigates changes in infection control organizations and the roles of infection control nurses in healthcare institutions during the prolonged COVID-19 pandemic. It aims to provide evidence for preparing effective responses to future emerging infectious diseases. Methods: A survey was conducted from August 9 to 27, 2021, targeting infection control nurses working in infection control departments of general hospitals in South Korea with more than 100 beds. Results: A total of 118 (38.3%) healthcare institutions responded, and 113 questionnaires ultimately analyzed. Changes in infection control organizations observed during the COVID-19 pandemic included alterations in infection control department staffing (34.5%), work arrangements (92.0%), IT systems development (45.1%), facilities and equipment (92.9%), and systems for responding to emerging infectious diseases (99.1%). Over 50% of infection control tasks were performed either frequently or daily during the pandemic, with the most significant workload increase observed in epidemiological investigations (77.9%). The most challenging task for infection control nurses was establishing and operating epidemic management systems (82.3%). Among personal factors hindering their work, a sense of responsibility for their duties scored the highest (mean 4.73/5 points). The primary structural and environmental barrier was insufficient staffing (mean 4.36/5 points). The most critical need for improving infection control efforts was increased staffing in infection control departments and enhanced administrative support (mean 4.63/5 points). Conclusion The COVID-19 pandemic brought significant changes to infection control organizations and the roles of infection control nurses. Based on the lessons learned, healthcare institutions must systematically restructure infection control organizations and enhance the expertise of infection control nurses to respond effectively to future outbreaks of emerging infectious diseases.

Background: This study investigates changes in infection control organizations and the roles of infection control nurses in healthcare institutions during the prolonged COVID-19 pandemic. It aims to provide evidence for preparing effective responses to future emerging infectious diseases. Methods: A survey was conducted from August 9 to 27, 2021, targeting infection control nurses working in infection control departments of general hospitals in South Korea with more than 100 beds. Results: A total of 118 (38.3%) healthcare institutions responded, and 113 questionnaires ultimately analyzed. Changes in infection control organizations observed during the COVID-19 pandemic included alterations in infection control department staffing (34.5%), work arrangements (92.0%), IT systems development (45.1%), facilities and equipment (92.9%), and systems for responding to emerging infectious diseases (99.1%). Over 50% of infection control tasks were performed either frequently or daily during the pandemic, with the most significant workload increase observed in epidemiological investigations (77.9%). The most challenging task for infection control nurses was establishing and operating epidemic management systems (82.3%). Among personal factors hindering their work, a sense of responsibility for their duties scored the highest (mean 4.73/5 points). The primary structural and environmental barrier was insufficient staffing (mean 4.36/5 points). The most critical need for improving infection control efforts was increased staffing in infection control departments and enhanced administrative support (mean 4.63/5 points). Conclusion The COVID-19 pandemic brought significant changes to infection control organizations and the roles of infection control nurses. Based on the lessons learned, healthcare institutions must systematically restructure infection control organizations and enhance the expertise of infection control nurses to respond effectively to future outbreaks of emerging infectious diseases.

Background: This study investigates changes in infection control organizations and the roles of infection control nurses in healthcare institutions during the prolonged COVID-19 pandemic. It aims to provide evidence for preparing effective responses to future emerging infectious diseases. Methods: A survey was conducted from August 9 to 27, 2021, targeting infection control nurses working in infection control departments of general hospitals in South Korea with more than 100 beds. Results: A total of 118 (38.3%) healthcare institutions responded, and 113 questionnaires ultimately analyzed. Changes in infection control organizations observed during the COVID-19 pandemic included alterations in infection control department staffing (34.5%), work arrangements (92.0%), IT systems development (45.1%), facilities and equipment (92.9%), and systems for responding to emerging infectious diseases (99.1%). Over 50% of infection control tasks were performed either frequently or daily during the pandemic, with the most significant workload increase observed in epidemiological investigations (77.9%). The most challenging task for infection control nurses was establishing and operating epidemic management systems (82.3%). Among personal factors hindering their work, a sense of responsibility for their duties scored the highest (mean 4.73/5 points). The primary structural and environmental barrier was insufficient staffing (mean 4.36/5 points). The most critical need for improving infection control efforts was increased staffing in infection control departments and enhanced administrative support (mean 4.63/5 points). Conclusion The COVID-19 pandemic brought significant changes to infection control organizations and the roles of infection control nurses. Based on the lessons learned, healthcare institutions must systematically restructure infection control organizations and enhance the expertise of infection control nurses to respond effectively to future outbreaks of emerging infectious diseases.

Background: This study investigates changes in infection control organizations and the roles of infection control nurses in healthcare institutions during the prolonged COVID-19 pandemic. It aims to provide evidence for preparing effective responses to future emerging infectious diseases. Methods: A survey was conducted from August 9 to 27, 2021, targeting infection control nurses working in infection control departments of general hospitals in South Korea with more than 100 beds. Results: A total of 118 (38.3%) healthcare institutions responded, and 113 questionnaires ultimately analyzed. Changes in infection control organizations observed during the COVID-19 pandemic included alterations in infection control department staffing (34.5%), work arrangements (92.0%), IT systems development (45.1%), facilities and equipment (92.9%), and systems for responding to emerging infectious diseases (99.1%). Over 50% of infection control tasks were performed either frequently or daily during the pandemic, with the most significant workload increase observed in epidemiological investigations (77.9%). The most challenging task for infection control nurses was establishing and operating epidemic management systems (82.3%). Among personal factors hindering their work, a sense of responsibility for their duties scored the highest (mean 4.73/5 points). The primary structural and environmental barrier was insufficient staffing (mean 4.36/5 points). The most critical need for improving infection control efforts was increased staffing in infection control departments and enhanced administrative support (mean 4.63/5 points). Conclusion The COVID-19 pandemic brought significant changes to infection control organizations and the roles of infection control nurses. Based on the lessons learned, healthcare institutions must systematically restructure infection control organizations and enhance the expertise of infection control nurses to respond effectively to future outbreaks of emerging infectious diseases.