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Purpose The purpose of this paper is to determine the impact of a workplace placement on the student participants’ self-reported entrepreneurial attitude (EA). Design/methodology/approach A review of relevant literature informed questions incorporated in the university’s annual feedback questionnaire completed by students (n=461) on return from a work placement of between 44 and 52 weeks. Findings The study has shown that both gender and entrepreneurial legacy influence baseline and post-placement EA (p Originality/value This research provides context for further qualitative work in this area, especially the influence of gender and entrepreneurial legacy on reported baseline EA and EA post work placement and will inform pedagogical development in terms of embedding entrepreneurial teaching in future curriculum development at the university.

The global market for poultry meat is growing and represents an important opportunity for producers. However, much of the growth is occurring in developing markets which are very different to the markets of developed countries. The aim of this chapter is to identify and consider some of the key market-based factors impacting on international growth in the poultry sector using a case-study approach and primary research conducted in the UK and China. The chapter concludes that while markets in developing countries are often large and growing and that there may be some similarities with developed markets, there are also differences that will probably be unique to specific developing markets and require a unique marketing response in order to successfully satisfy consumer wants and needs.

A prospective observational cohort study to assess rates of and risk factors for tuberculin skin test (TST) conversion among health care workers (HCWs) was conducted at an urban hospital located in a high tuberculosis-incidence area in 1994-1998. All hospital employees undergoing required testing every 6 months were included. A total of 69 (1.2%) of 5773 susceptible employees had a documented TST conversion (overall rate, 0.38 per 100 person-years worked). No significant difference existed in conversion rates among employees with frequent, limited, or no patient contact. HCWs with a TST conversion lived in zip codes with higher tuberculosis case rates (P< or =.05). In multivariate analysis, TST conversion was associated with history of bacille Calmette-Guerin vaccination (relative risk [RR], 11.63), annual salary

Tuberculosis cases have recently declined in the United States, renewing interest in disease elimination. We examined the epidemiology of tuberculosis from 1991 through 1997 at an inner-city public hospital and assessed population-based tuberculosis rates by ZIP code in the 8 metropolitan Atlanta counties. During the 7 years, 1378 new patients had tuberculosis diagnosed at our hospital (mean, 197 patients/year), accounting for 25% of tuberculosis cases in Georgia. Coinfection with human immunodeficiency virus (HIV) was common, but a significant decrease in the proportion of HIV-infected patients with tuberculosis was noted over time. Most patients were members of a minority group (93%) and were born in the United States (96%). Two inner-city ZIP code areas had annual tuberculosis rates >120 cases per 100,000 persons, and 8 ZIP code areas had annual rates of 47-88 cases per 100,000 persons between 1993 and 1997, compared with the annual national average of 8.7 cases per 100,000 persons. Our hospital continues to care for large numbers of tuberculosis patients, and rates of tuberculosis remain high in the inner city. These data mandate a concentration of efforts and resources in urban locations if tuberculosis control and elimination is to be achieved in the United States.

Tuberculosis in the United States has become primarily an inner-city disease. We examined the epidemiology of culture-confirmed tuberculous meningitis among patients cared for at an urban public hospital in Atlanta. During an 11.5-year period (January 1984-June 1995) cerebrospinal fluid cultures for Mycobacterium tuberculosis were positive in 34 patients, accounting for 1.5% of all culture-confirmed tuberculosis cases. All patients were born in the United States, 31 (91%) were black, 16 (47%) of 34 were human immunodeficiency virus (HIV) seropositive, 9 (26.5%) were HIV seronegative, and 9 (26.5%) had an unknown HIV serostatus. No significant differences were seen in clinical presentation, cerebrospinal fluid, or other laboratory data between HIV seropositive and HIV seronegative/ unknown groups, except for a lower serum white blood cell count among HIV seropositive patients. Mortality was striking; 14 (41.2%) died because of tuberculous meningitis despite appropriate therapy initiated a mean of 3 days after admission. Six survivors had permanent neurologic sequelae. Univariate analysis of outcome was not statistically associated with any measured demographic, laboratory value, stage at presentation, treatment regimen, or HIV serostatus. Multivariate analysis of outcome using 13 independent variables also demonstrated no significant association between these variables and outcome, although a trend was seen for increased mortality for white people (P = 0.09) and increasing age (P = 0.09). Tuberculous meningitis among inner-city residents remains a devastating disease associated with high morbidity and mortality that has changed little during the past 4 decades. HIV infection does not change markedly the clinical presentation or the response to therapy.

The resurgence of tuberculosis (TB) in the 1980s and early 1990s in the United States was also accompanied by numerous hospital outbreaks of TB and nosocomial transmission to health care workers.To determine whether a dedicated airborne infection isolation (AII) unit improves efficiency in "ruling-out" patients suspected of having pulmonary TB. This is important because, to prevent nosocomial transmission of TB, the number and ratio of patients isolated who are subsequently found to have TB is much higher than those "ruled out" and have TB excluded.A prospective cohort study was conducted of all patients 18 years and older admitted to respiratory isolation during 3 separate time periods before and after opening of an 26-bed AII unit in a 1000-bed, public, university-affiliated, innercity hospital.A total of 879 patients were admitted during the 3 study periods. Most were black and males (87%, 72%, respectively). The median age was 42 years, and 70% of patients included in the study were HIV positive. Among patients who "ruled out," ie, TB was excluded by having 3 negative AFB smears of respiratory specimens for TB, there was a significant decrease in time from 5.0 days in period I to 3.3 days in period III (P.0001). In period III, patients who were admitted to rule out TB in areas outside of the AII unit in other wards of the hospital required a significantly longer period to have TB excluded: 5.9 days compared with 3.5 on the AII unit (P = .0015).The decrease in isolation time after the opening of the dedicated AII unit demonstrates that a concerted effort to rule patients out by having nurses and respiratory therapists trained in tuberculosis control is efficacious and efficient and results in significant cost savings.

Objective:To evaluate the risk of tuberculosis (TB) transmission to patients potentially exposed to two healthcare providers who worked in outpatient settings for several weeks prior to being diagnosed with acid-fast bacilli smear-positive pulmonary TB.Design:Potentially exposed patients were notified by letter and television reports of the recommended evaluation for TB infection or disease and availability of free screening at the hospital. Prevalence of infection in the screened patients and the incidence rate of TB over the subsequent 2 years were compared to those of a control group of unexposed outpatients.Setting:An urban inner-city hospital.Patients:1,905 patients with potential exposure to the ill healthcare workers; 487 (25%) presented for evaluation. Controls consisted of 951 unexposed patients.Results:361 potentially exposed patients had their tuberculin test read; 97 (27%) had a purified protein derivative ≥10 mm. In the comparison group, 148 (25%) of 600 with test readings had a ≥10-mm reaction (risk ratio, 1.18; 95% confidence interval, 0.86-1.60). In multivariate analysis, male gender, non-white race, and older age were significantly associated with a positive tuberculin test; exposure was not. No TB cases were identified during screening. Two years after the exposure, 7 TB cases had been reported to the state registry among 1,905 potentially exposed patients (184 cases/100,000 person-years) versus 4 cases in the comparison group of 951 (210 cases/100,000 person-years).Conclusions:Evaluation of patients exposed to health-care workers with TB disease in ambulatory settings of an inner-city hospital revealed no evidence of transmission ofMycobacterium tuberculosisdue to the exposure.

During a six-month period, 187 inpatients had bacteremia associated with community-acquired infection and 91 patients had bacteremia from a nosocomial infection. The most frequently identified sites of infection in both types of bacteremia were the respiratory and urinary tracts.Escherichia coliandDiplococcus pneumoniaewere the organisms most frequently isolated from cultures of patients with community-acquired bacteremia, andE coli, Staphylococcus aureus, andKlebsiellawere most frequently isolated from patients with nosocomial bacteremia. Bacteremic nosocomial infections were related to urinary catheters, respiratory and intravenous therapy, or hyperalimentation in 32 of the 91 cases. Even assuming the unproved hypotheses that rigid adherence to current guidelines would prevent all of these procedure-related cases, 59 cases of bacteremia would still have occurred. This emphasizes the need for further research into prevention of nosocomial infection. (JAMA237:2727-2729, 1977)

A substantial increase in blood cultures positive for a Serratia marcescens strain unusually sensitive to antibiotics was noted in two large hospitals within six months. Because the patients' illnesses seemed incompatible with Serratia bacteremia, contamination of blood cultures was suspected. Investigation suggested that pediatric-sized vacuum tubes containing ethylenediamine tetraacetic acid (EDTA) were the source of the organisms, and the epidemic strain of Serratia was recovered from 41 (35%) of the 116 tubes cultured. Mock trials showed that reflux from tube to syringe can occur while vacuum tubes are being filled. Because contaminated EDTA tubes were sometimes inoculated before blood culture bottles in these hospitals, cross-contamination occurred. Most evacuated specimen tubes are not guaranteed sterile by the manufacturer. False-positive blood cultures stemming from the use of nonsterile tubes can be eliminated by inoculating blood culture bottles before other specimen tubes. Because false-positive blood cultures may lead to unnecessary antibiotic therapy, health-care workers should guard against the potential hazard associated with use of these tubes. (JAMA236:2073-2075, 1976)