Molecular epidemiology of Staphylococcus epidermidis in neonatal intensive care units

Late‐onset sepsis (LOS) in preterm neonates is increasingly reported to be associated with gut‐colonizing Staphylococcus epidermidis. We aimed to describe the molecular epidemiology of S. epidermidis colonizing the gut of neonates hospitalized in two neonatal intensive care units. S. epidermidis from rectal swabs were typed by multilocus variable‐number tandem‐repeat analysis (MLVA), randomly chosen isolates of predominant MLVA types additionally by multilocus sequence typing. Antimicrobial susceptibility, the presence of icaA, IS256, arginine catabolic mobile element (ACME), agr type, and SCCmec type were determined. Of 276 neonates (38.4%), 106 were colonized with S. epidermidis, yielding a total of 139 isolates (62 in one unit and 77 in another unit). Of the 55 MLVA types identified, the five predominant detected in both units corresponded to sequence type (ST) 2, ST5, and ST59 or its single locus variant ST81 and formed three major MLVA clonal complexes accounting for 74.8% of all isolates. Overall, the prevalence of mecA, icaA, IS256, and ACME was 91.4%, 28.1%, 64%, and 77%, respectively. Of the mecA‐positive isolates (n = 127), 43.9% carried SCCmec type IV. Of eight episodes of LOS, four were caused by ST2 and two by ST5. Preventing gut colonization with nosocomial epidemic S. epidermidis in hospitalized neonates could contribute to the prevention of LOS.     

Factors associated with successful functioning in American Indian youths

This study examines environmental and cultural factors related to successful functioning in a stratified random sample of 401 American Indian youths. The success index included seven indicators: good mental health, being alcohol- and drug-free, absence of serious misbehavior, clean police record, good grades, positive psychosocial functioning, and positive behavior and emotions. Family satisfaction was positively related to overall successful functioning, whereas misbehaving peers, living in a dysfunctional neighborhood, and experiencing child abuse had an inverse relationship with success.     

Effect of 7, 14 and 21 Hz modulated 450 MHz microwave radiation on human electroencephalographic rhythms

PURPOSE: The aim of this study was to evaluate the effect of microwaves modulated at different frequencies on human electroencephalographic (EEG) rhythms. MATERIALS AND METHODS: Thirteen healthy volunteers were exposed to microwaves (450 MHz) pulse-modulated at frequencies of 7, 14 and 21 Hz. The field power density at the scalp was 0.16 mW/cm2. Our experimental protocol consisted of two five-cycle (1 min on and 1 min off) series of exposures at fixed modulation frequencies. A relative change in the EEG power with and without exposure was used as a quantitative measure. EEG frequencies recorded in the theta (4-6.8 Hz), alpha (8-13 Hz), betal (15-20 Hz), and beta2 (22-38 Hz) bands were analyzed. RESULTS: Modulated microwaves caused an increase in the average EEG alpha (17%) and beta (7%) power but the theta rhythm remained unaffected. Increases in the EEG alpha and beta power were statistically significant during the first half-period of the exposure interval (30 s) at the modulation frequencies of 14 and 21 Hz. Differences were found in individual sensitivity to exposure. Increases in the EEG beta power appeared statistically significant in the case of four subjects. CONCLUSIONS: Our findings suggest that the effect of the 450 MHz microwave radiation modulated at 7, 14 and 21 Hz varies depending on the modulation frequency. The microwave exposure modulated at 14 and 21 Hz enhanced the EEG power in the alpha and beta frequency bands, whereas no enhancement occurred during exposure to the modulation frequency of 7 Hz.     

Sleep Patterns of School-Age Children with Asperger Syndrome or High-Functioning Autism

Sleep patterns of 32 school-age children with Asperger syndrome (AS) and high-functioning autism (HFA) were compared to those of 32 typically developing age- and gender-matched children, using parent survey and one week of diary and actigraphic monitoring. Parents of children with AS/HFA more commonly reported that their children had difficulty falling asleep. One week of sleep recording with diary and actigraphy confirmed that children in the AS/HFA group spent a longer time awake in bed before falling asleep than children in the control group, possibly because the children in the AS/HFA group had earlier bedtimes. Other essential aspects of sleep patterns coincided between the groups. The sleep patterns of children with AS and HFA did not differ.     

Self-mixing in a diode laser as a method for cardiovascular diagnostics

Our aim is the development of a simple optical method for pulse wave profile, pulse wave delay time, and blood flow measurement. The method is based on recording the Doppler frequency shift related to a moving target--blood vessel walls or small particles. The Doppler signal is detected using the self-mixing that occurs in the diode laser cavity when radiation scatters back from the moving target into the laser and interferes with the field inside. Two different ways can be simultaneously used for the self-mixing signal extraction: a photodiode accommodated in the rear facet of the diode laser package and a resistor from the laser pump current. An experimental device with a pigtail laser diode is developed that is able to detect the pulsation of major arteries with potentially useful information, including the pulse wave profile and the pulse wave delay time. The pulse wave delay time in different regions of the human body is measured relative to the electrocardiogram (ECG) signal. Also the flow velocity of a liquid suspension containing particles the size of erythrocytes (equivalent to blood flow) is measured. Registered signals are stored after digitalization and preprocessed using LabView for a Windows environment. The described device has the application of the self-mixing method and highlights significant advantages of simplicity, compactness, and robustness as well as the self-aligning and self-detecting abilities of such method, compared with the use of conventional interferometric method.     

Outcomes for Implementation Research: Conceptual Distinctions,Measurement Challenges,and Research Agenda

An unresolved issue in the field of implementation research is how to conceptualize and evaluate successful implementation. This paper advances the concept of “implementation outcomes” distinct from service system and clinical treatment outcomes. This paper proposes a heuristic, working “taxonomy” of eight conceptually distinct implementation outcomes—acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability—along with their nominal definitions. We propose a two-pronged agenda for research on implementation outcomes. Conceptualizing and measuring implementation outcomes will advance understanding of implementation processes, enhance efficiency in implementation research, and pave the way for studies of the comparative effectiveness of implementation strategies.     

From early to late adolescence: American Indian youths' behavioral trajectories and their major influences

OBJECTIVE: This article identifies behavioral trajectories of American Indian adolescents and examines their predictors. METHOD: A total of 401 urban and reservation American Indian adolescents were interviewed yearly from 2001 to 2004 (with 341 youths, or 85%, retained to 2004, and 385 completing at least two interviews). The Youth Self-Report total problem score is used to model behavior change trajectories, with psychological (addictions and mental health) and environmental (family, peer, community, and services) variables as independent variables. Analyses were based on PROC TRAJ, an SAS macro. RESULTS: Five trajectory groups were found. Youths who started with a Youth Self-Report score less than the clinical cutoff were low stable (n = 142) or low improving (n = 175). Youths with initial scores over the cutoff were very high chronic (n = 5), high improving (n = 30), or high chronic (n = 33). High improvers scored close to the low improving group by 2004. At baseline, the high improving group was more likely than the high chronic group to be from the reservation (odds ratio 5.94), have greater family satisfaction (1.14), and have fewer school problems (0.84). Over time, the high improving group had substance use and depression drop, family satisfaction increase, fewer parents with mental health or addictions problems, fewer peers using substances, and a decrease in neighborhood problems and stressors. CONCLUSIONS: A significant majority (more than 82%) of the youths exhibited relatively low levels of problem behaviors over all 4 years, and 42% of those with clinically significant problems improved over time.     

Sleep Patterns in School-age Children with Asperger Syndrome or High-functioning Autism: A Follow-up Study

The course of sleep patterns over 2–3 years was compared between 16 school-age children with Asperger syndrome (AS) or high-functioning autism (HFA) and 16 age- and gender-matched typically developing children, using 1-week actigraphy at baseline and follow-up. At baseline (mean age 11.1 years), children with AS/HFA had longer sleep latency and lower sleep efficiency during school days, but earlier sleep start and sleep end during weekends. At follow-up (mean age 13.7 years), children with AS/HFA had longer night wakings and lower sleep efficiency during weekends than the controls. The overall change of sleep patterns, however, is similar in children with AS/HFA and typically developing controls over a 2 to 3-year period. There is one change in affiliation since the time of the study, namely, Hiie Allik has defended her thesis, and obtained a doctoral degree at the Karolinska Institutet, Stockholm, Sweden. Dr. Allik conducted this study in partial fulfilment of the requirements for a doctoral degree at the Karolinska Institutet, Stockholm, Sweden.