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While text reading is still a preferred form of learning, topic interest can be considered an important predictor of reading comprehension. However, the nature of the relationship between interest and comprehension is not yet fully understood. The present study investigates whether topic interest is related to comprehension when measured in advance and whether two indicators of attention (i.e., mind wandering and cognitive coupling) mediate this relation. Participants were 238 university students. Participants rated their interest in three different topics. One week later, they read one text on each of these topics. The texts' levels of difficulty were manipulated to change during reading. Measured variables during reading were the individual adaptation of the reading speed to the text difficulty (cognitive coupling) and the frequency of mind wandering. In addition, comprehension was measured after reading each text. Preliminary assessed topic interest was found to be indirectly but not directly associated with reading comprehension. Specifically, topic interest negatively predicted mind wandering during reading, while mind wandering was, in turn, negatively associated with reading comprehension. In addition, partial evidence was found for the mediating role of cognitive coupling. The present study adds to the research by showing that topic interest can predict future mind wandering and one type of cognitive coupling. Because mind wandering was, in turn, negatively related to reading comprehension, the study's findings further suggest that topic interest should be encouraged to minimize harmful mind wandering, promote adaption to text properties, and thus improve comprehension. • Pre-assessed topic interest predicts future mind wandering during reading. • Mind wandering fully mediates the effect of topic interest on comprehension. • Topic interest is not directly related to reading comprehension. [ABSTRACT FROM AUTHOR]

Background The Researching Effective Approaches to Cleaning in Hospitals (REACH) study tested a multimodal cleaning intervention in Australian hospitals. This article reports findings from a pre/post questionnaire, embedded into the REACH study, that was administered prior to the implementation of the intervention and at the conclusion of the study. Methods A cross-sectional questionnaire, nested within a stepped-wedge trial, was administered. The REACH intervention was a cleaning bundle comprising 5 interdependent components. The questionnaire explored the knowledge, reported practice, attitudes, roles, and perceived organizational support of environmental services staff members in the hospitals participating in the REACH study. Results Environmental services staff members in 11 participating hospitals completed 616 pre- and 307 post-test questionnaires (n = 923). Increases in knowledge and practice were seen between the pre-and post-test questionnaires. Minimal changes were observed in attitudes regarding the role of cleaning and in perceived organizational support. Conclusion To our knowledge, this is the first study to report changes in knowledge, attitudes, and perceived organizational support in environmental services staff members, in the context of a large multicenter clinical trial. In this underexplored group of hospital workers, findings suggest that environmental services staff members have a high level of knowledge related to cleaning practices and understand the importance of their role. [ABSTRACT FROM AUTHOR]

The present article reports on a study that examined how individual differences in habitual reading motivation affect a reader's tendency to engage in text-related and text-unrelated thinking during reading. Two-hundred participants read each three texts about finance and meteorology topics and answered comprehension questions afterward. Participants' thoughts during reading were assessed with retrospective ratings and thought samples. Habitual reading motivation was assessed with questionnaires in a separate session prior to reading. Structural equation models fit to this data revealed that more motivated readers reported less mind wandering, more engagement in elaborative thinking and comprehension monitoring, as well as higher topic interest. Furthermore, the beneficial effect of reading motivation on comprehension was partially mediated by mind wandering, elaboration, comprehension monitoring, and interest. Our findings offer a novel explanation for the well-known beneficial effects of reading motivation on comprehension: habitually motivated readers are more likely to engage in text-related thinking and avoid text-unrelated thoughts. • Habitual reading motivation reduces mind wandering during reading. • Habitual reading motivation promotes elaboration and comprehension monitoring. • Habitual reading motivation promotes comprehension by reducing mind wandering. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: In January 1999, a new institutional structure for Poland's health care system was laid out, instigated by the dramatic change in both the political and economic system. Following the dissolution of state socialism, private financing of health care services was encouraged to fill an important role in meeting rising consumer demand and to encourage a more efficient use of resources through competition and private initiative. However, from the outset of the intended transformations, systemic limitations to the privatization process hindered progression, resulting in varying rates of privatization amongst the distinct health care sectors. The aim of this paper is to describe the privatization process and to analyze its pace and differences in strategic approach in all major health care sectors. Methods: Policy analysis of legislation, government directives, and published national and international scientific literature on Polish health reforms between 1999 and 2012 was conducted. Results: The analysis demonstrates a clear disparity in privatization rates in different sectors. The pharmaceutical industry is fully privatized in 2012, and the ambulatory and dental sectors both systematically increased their private market shares to around 70% of all services provided. However, despite a steady increase in the number of private hospitals in Poland since 1999, their overall role in the health care system is comparatively limited. Conclusions: Unclear legal regulations have resulted in a gray area between public and private health care, where informal payments impede the intended function of the system. If left unchanged, official health care in Poland is likely to become an increasingly residual service for the worst-off population segments that are unable to afford the legal private sector or the informal payments which guarantee a higher quality service in the public sector. [Copyright &y& Elsevier]

Background: The hospital environment is a reservoir for the transmission of microorganisms. The effect of improved cleaning on patient-centred outcomes remains unclear. We aimed to evaluate the effectiveness of an environmental cleaning bundle to reduce health care-associated infections in hospitals.Methods: The REACH study was a pragmatic, multicentre, randomised trial done in 11 acute care hospitals in Australia. Eligible hospitals had an intensive care unit, were classified by the National Health Performance Authority as a major hospital (public hospitals) or having more than 200 inpatient beds (private hospitals), and had a health-care-associated infection surveillance programme. The stepped-wedge design meant intervention periods varied from 20 weeks to 50 weeks. We introduced the REACH cleaning bundle, a multimodal intervention, focusing on optimising product use, technique, staff training, auditing with feedback, and communication, for routine cleaning. The primary outcomes were incidences of health-care-associated Staphylococcus aureus bacteraemia, Clostridium difficile infection, and vancomycin-resistant enterococci infection. The secondary outcome was the thoroughness of cleaning of frequent touch points, assessed by a fluorescent marking gel. This study is registered with the Australian and New Zealand Clinical Trial Registry, number ACTRN12615000325505.Findings: Between May 9, 2016, and July 30, 2017, we implemented the cleaning bundle in 11 hospitals. In the pre-intervention phase, there were 230 cases of vancomycin-resistant enterococci infection, 362 of S aureus bacteraemia, and 968 C difficile infections, for 3 534 439 occupied bed-days. During intervention, there were 50 cases of vancomycin-resistant enterococci infection, 109 of S aureus bacteraemia, and 278 C difficile infections, for 1 267 134 occupied bed-days. After the intervention, vancomycin-resistant enterococci infections reduced from 0·35 to 0·22 per 10 000 occupied bed-days (relative risk 0·63, 95% CI 0·41-0·97, p=0·0340). The incidences of S aureus bacteraemia (0·97 to 0·80 per 10 000 occupied bed-days; 0·82, 0·60-1·12, p=0·2180) and C difficile infections (2·34 to 2·52 per 10 000 occupied bed-days; 1·07, 0·88-1·30, p=0·4655) did not change significantly. The intervention increased the percentage of frequent touch points cleaned in bathrooms from 55% to 76% (odds ratio 2·07, 1·83-2·34, p<0·0001) and bedrooms from 64% to 86% (1·87, 1·68-2·09, p<0·0001).Interpretation: The REACH cleaning bundle was successful at improving cleaning thoroughness and showed great promise in reducing vancomycin-resistant enterococci infections. Our work will inform hospital cleaning policy and practice, highlighting the value of investment in both routine and discharge cleaning practice.Funding: National Health and Medical Research Council (Australia). [ABSTRACT FROM AUTHOR]