A small increase in handwashing adherence may be seen after implementing the use of alcoholic hand rubs, to decrease the effort required to wash hands. However, the facilitation of compliance is not simply related to effort but is highly dependent on altering behavioral perceptions. Thus, introduction of hand rub alone without an associated behavioral modification program is unlikely to induce a sustained increase in hand hygiene compliance.

Objective-The purpose of this study was to examine the influence of laryngoplasty on racing performance and to determine if any of the following variables had a significant effect on outcome: breed (Thoroughbred v Standardbred), endoscopic grade of laryngeal function, ventriculectomy versus no ventriculectomy, type of prosthetic suture used, and number of prostheses placed. Study Design-Retrospective study of laryngoplasty with or without ventriculectomy for treatment of left laryngeal hemiplegia in racehorses between 1986 and 1993. Animals or Sample Population-230 horses (1 74 Thoroughbreds, 56 Standardbreds). Methods-The medical records of racehorses or horses intended for racing were reviewed. Signalment, admitting complaints, physical examination findings, resting endoscopic grade of laryngeal function, type of prosthetic suture material used, number of prosthetic sutures placed, presence or absence of ventriculectomy, and postoperative complications were recorded. Results-Upper respiratory tract noise and exercise intolerance were the most common presenting complaints. Two horses had a laryngeal grade of 2, 109 horses a laryngeal grade of 3, and 119 horses a laryngeal grade of 4. Two double-strand braided polyester sutures were used in 147 horses, a single double-strand polyester suture was used in 49 horses, and a single doublestrand nylon suture was used in 34 horses. Ventriculectomy was performed on 186 horses. The most common complication recognized during hospitalization was coughing in 50 horses. Telephone follow-up was obtained for 176 horses. For 168 horses, respiratory noise after surgery was decreased in 126 horses, the same in 28, and increased in 14. After hospital discharge, coughing occurred in 43 of 166 horses, and a nasal discharge occurred in 26 horses. Postoperative racing performance for 167 horses was subjectively evaluated by respondents as being improved in 69% of the horses. Overall owner satisfaction with the outcome after surgery was 81%. Of 230 horses, 178 raced at least one time after surgery. Overall, 117 horses raced three or more times before and after surgery, and 65 of these horses had improved performance index scores. None of the variables of surgical interest affected performance index scores. Conclusions and Clinical Relevance-Laryngoplasty with or without ventriculectomy allowed 77% of the horses to race at least one time after surgery, improved racing performance in 56% of the horses that completed three races before and after surgery, and improved subjectively evaluated racing performance in 69% of the horses. OCopyright 1997 by The American College of Vererinary Surgeons ETHODS FOR SURGICAL management of M left laryngeal hemiplegia have included laryngeal ventriculectomy or ventriculocordectomy, prosthetic laryngoplasty, arytenoidectomy, and neu-romuscular pedicle grafts. ' -I 2 Laryngoplasty, frequently combined with ventriculectomy, is the surgical technique most commonly used to improve upper respiratory tract function in horses with left laryngeal

Aims-The aim of this study was to compare patterns of drug use and dependence between homosexually experienced and exclusively heterosexually experienced individuals.Design-We used a cross-sectional national household interview survey conducted in the United States.Setting-Secondary data analysis of the 1996 National Household Survey on Drug Abuse was employed.Participants-Participants were sexually active individuals, aged 18 years and older, who reported the genders of their sexual partners in the past 12 months; included 174 homosexually experienced (98 men, 96 women) and 9714 exclusively heterosexually experienced (3922 men, 5792 women) respondents.Measurements-Life-time, past 30 days and daily use of nine classes of drugs. Symptoms of dysfunctional use and dependence.Findings-There were consistent patterns of elevated drug use in homosexually experienced individuals for life-time drug use, but these were greatly attenuated for recent use. Homosexually experienced men were more likely to report use of marijuana, cocaine and heroin, and homosexually experienced women more likely to report use of marijuana and analgesics than individuals reporting only opposite-sex partners. Both homosexually active men and women were more likely than exclusively heterosexually active respondents to report at least one symptom indicating dysfunctional drug use across all drug classes, and to meet criteria for marijuana dependence syndrome. The only difference between homosexually experienced men and women was that men were more likely to report any daily drug use. Conclusions-These data are consistent with surveys suggesting that there is a moderate elevation of drug, particularly marijuana, use and dependence in gay and bisexual men and women when compared to heterosexual men and women. NIH Public Access

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The aim of this paper is to advance rigorous Internet-based HIV/STD Prevention quantitative research by providing guidance to fellow researchers, faculty supervising graduates, human subjects' committees, and review groups about some of the most common and challenging questions about Internet-based HIV prevention quantitative research. The authors represent several research groups who have gained experience conducting some of the first Internet-based HIV/STD prevention quantitative surveys in the US and elsewhere. Sixteen questions specific to Internet-based HIV prevention survey research are identified. To aid rigorous development and review of applications, these questions are organized around six common criteria used in federal review groups in the US: significance, innovation, approach (broken down further by research design, formative development, procedures, sampling considerations, and data collection); investigator, environment and human subjects' issues. Strategies promoting minority participant recruitment, minimizing attrition, validating participants, and compensating participants are discussed. Throughout, the implications on budget and realistic timetabling are identified.