NTIMICROBIAL RESISTANCE IS A serious public threat that is exacerbated by the gradual withdrawal of the pharmaceutical industry from new antimicrobial agent development. 1 Overuse of antimicrobial agents fosters the spread of antimicrobial-resistant organisms. 2,3 Despite recent trends that demonstrate reduced outpatient use of antimicrobial agents, prescribing continues to significantly exceed prudent levels. 4-8 Approximately 50% of courses of ambulatory antimicrobial drugs are prescribed for patients with viral respiratory infections and therefore are not clinically indicated. 9-12 Behavioral facilitators of antimicrobial overuse and barriers to prudent use operate on both clinicians and patients. 13-16 Patient demand, perceived or actual, creates chal-See also pp 2315 and 2354.

Background: Foodborne antimicrobial-resistant Escherichia coli may colonize and cause infections in humans, but definitive proof is elusive and supportive evidence is limited. Methods: Approximately contemporaneous antimicrobial-resistant (n ¼ 181) and antimicrobial-susceptible (n ¼ 159) E. coli isolates from retail meats and from human stool and clinical specimens from a single rural U.S. community were compared for polymerase chain reaction (PCR)-defined phylogenetic group (A, B1, B2, or D) and virulence genotype. Meat and human isolates from the same phylogenetic group with similar virulence profiles underwent sequential two-locus sequence analysis, random amplified polymorphic DNA (RAPD) analysis, and pulsed-field gel electrophoresis (PFGE) analysis. Results: According to phylogenetic distribution, resistant stool isolates were more similar to resistant meat isolates than to susceptible stool isolates. Overall, 19% of meat isolates satisfied molecular criteria for extraintestinal pathogenic E. coli (ExPEC). Nine sequence groups included meat and human isolates, and 17 of these 64 isolates demonstrated >80% RAPD profile similarity to an isolate from the alternate source group (meat vs. human). However, PFGE profiles of the 17 isolates were unique, excepting two stool isolates from the same household. Conclusion: Nearly 20% of meat-source resistant E. coli represented ExPEC. The observed molecular similarity of certain meat and human-source E. coli isolates, including antimicrobial-resistant and potentially pathogenic strains, supports possible foodborne transmission.

Mechanisms by which antimicrobials contribute to dissemination of pneumococcal resistance are incompletely characterized. A serial cross-sectional study of nasopharyngeal pneumococcal carriage in healthy, home-living children

The WebQuest as an instructional tool has recently been widely adopted in K-16 education. However, its underlying principles and functionality are not well understood, which has resulted in an inconsistency in practice. This study identifies the underlying constructs of WebQuests as perceived by teachers and variables affecting their perceptions on WebQuests. A survey was conducted on teachers (n = 226) recruited from one large research university in the USA and a professional listserv. The findings reveal three constructs perceived by teachers as critical to WebQuests: constructivist problem solving, social interaction and scaffolded learning. Results also show that variables like purpose of WebQuest use, years of teaching, years of WebQuest use and gender predict, at various degrees, teachers' perceptions on WebQuests. Discussions are made on how the constructs identified can be used to improve online teaching and learning. Suggestions for future study are included by examining the influences of social, psychological and affective factors on learners' learning in WebQuests.