Transfer of microorganisms from dry surface biofilms and the influence of long survival under conditions of poor nutrition and moisture on the virulence of Staphylococcus aureus

Background: Biofilms on dry hospital surfaces can enhance the persistence of micro-organisms on dry harsh clinical surfaces and can potentially act as reservoirs of infectious agents on contaminated surfaces. Aim: This study was conducted to quantify the transfer of viable Staphylococcus aureus cells from dry biofilms through touching and to investigate the impact of nutrient and moisture deprivation on virulence levels in S. aureus. Methods: Dry biofilms of S. aureus ATCC 25923 and a defective biofilm-forming ability mutant, S. aureus 1132, were formed in 24-well plates under optimized conditions mimicking dry biofilm formation on clinical surfaces. Microbial cell transfer was induced through the touching of the dry biofilms, which were quantified on nutrient agar. To investigate the impact of nutrient and moisture deprivation on virulence levels, dry and standard biofilms as well as planktonic cells of S. aureus ATCC 25923 were inoculated into Galleria mellonella and their kill rates compared. Findings: Results of this study showed that viable cells from dry biofilms of S. aureus ATCC 25923 were significantly more virulent and readily transferrable from dry biofilms through a touch test, therefore representing a greater risk of infection. The biofilm-forming capability of S. aureus strains had no significant impact on their transferability with more cells transferring when biofilm surfaces were wet. Conclusions: These findings indicate that dry biofilms on hospital surfaces may serve as a reservoir for the dissemination of pathogenic micro-organisms in hospitals, thus highlighting the importance of regular cleaning and adequate disinfection of hospital surfaces.</p

“You don’t get resilience overnight”: a grounded theory framework of the A-R-C sporting resilience development

Resilience in sport is growing as a topic of investigation but comparatively less focus is placed on how resilience develops in athletes. This study explored sporting resilience development in elite athletes over time using grounded theory. Participants included 10 competitive-elite athletes (5 men and women) who scored high, competing in individual/team sports from diverse cultural contexts. Experiential life-story interviews on sporting resilience development over time was conducted. Grounded theory was employed across ideation, data collection and analysis with structured methodological quality criteria to ensure rigour. Findings are synthesised into A-R-C Development Model of sporting resilience indicating that antecedent protective factors (A) enable the engine of sporting resilience (R) which through metacognition-emotion-behaviour produces consequences (C) of positive adaptation or critical adaptation failure. The emergent theory is the first comprehensive outline providing an understanding of how sporting resilience develops over time in competitive-elite athletes. Implications for developing athlete resilience for performance and mental health are discussed.<br/

Control intervention design for preclinical and clinical trials: consensus-based core recommendations from the third Stroke Recovery and Rehabilitation Roundtable

Control comparator selection is a critical trial design issue. Preclinical and clinical investigators who are doing trials of stroke recovery and rehabilitation interventions must carefully consider the appropriateness and relevance of their chosen control comparator as the benefit of an experimental intervention is established relative to a comparator. Establishing a strong rationale for a selected comparator improves the integrity of the trial and validity of its findings. This Stroke Recovery and Rehabilitation Roundtable (SRRR) taskforce used a graph theory voting system to rank the importance and ease of addressing challenges during control comparator design. “Identifying appropriate type of control” was ranked easy to address and very important, “variability in usual care” was ranked hard to address and of low importance, and “understanding the content of the control and how it differs from the experimental intervention” was ranked very important but not easy to address. The CONtrol DeSIGN (CONSIGN) decision support tool was developed to address the identified challenges and enhance comparator selection, description, and reporting. CONSIGN is a web-based tool inclusive of seven steps that guide the user through control comparator design. The tool was refined through multiple rounds of pilot testing that included more than 130 people working in neurorehabilitation research. Four hypothetical exemplar trials, which span preclinical, mood, aphasia, and motor recovery, demonstrate how the tool can be applied in practice. Six consensus recommendations are defined that span research domains, professional disciplines, and international borders.</p

The need for One Health systems-thinking approaches to understand multiscale dissemination of antimicrobial resistance

Although the effects of antimicrobial resistance (AMR) are most obvious at clinical treatment failure, AMR evolution, transmission, and dispersal happen largely in environmental settings, for example within farms, waterways, livestock, and wildlife. We argue that systems-thinking, One Health approaches are crucial for tackling AMR, by understanding and predicting how anthropogenic activities interact within environmental subsystems, to drive AMR emergence and transmission. Innovative computational methods integrating big data streams (eg, from clinical, agricultural, and environmental monitoring) will accelerate our understanding of AMR, supporting decision making. There are challenges to accessing, integrating, synthesising, and interpreting such complex, multidimensional, heterogeneous datasets, including the lack of specific metrics to quantify anthropogenic AMR. Moreover, data confidentiality, geopolitical and cultural variation, surveillance gaps, and science funding cause biases, uncertainty, and gaps in AMR data and metadata. Combining systems-thinking with modelling will allow exploration, scaling-up, and extrapolation of existing data. This combination will provide vital understanding of the dynamic movement and transmission of AMR within and among environmental subsystems, and its effects across the greater system. Consequently, strategies for slowing down AMR dissemination can be modelled and compared for efficacy and cost-effectiveness

Who lies beneath? Reflections on Scotland's unseen change makers

As a former Rape Crisis and Women’s Aid support worker turned feminist academic, I have had the privilege of working with some of the most inspirational and courageous women in Scotland. I see these women as the unsung heroines who are ultimately responsible for changing Scotland and making it internationally renowned for innovative and progressive practice in preventing Gender-Based Violence. For decades, women have worked as volunteers and/or paid staff to support survivors, run refuges, helplines, and campaigns whilst also training local authorities, police, and other agencies. Without them, we would have no women’s support organisations, many more victims would remain in relationships with abusive men, and many more women would be dead at the hands of their partners or ex-partners. Yet, the organisations they run are desperately under-funded and many workers are on insecure contracts with low pay – a form of structural violence that reinforces gender inequality in Scotland. Equally important and unrecognised are the victim/survivors who have raised their voices to ask for help, to resist their abusers, and who risk everything to try to secure their survival. Without them we wouldn’t know about the horrors many endure, and many others would not have been inspired to work tirelessly to change Scotland for the better. Collectively and individually, their achievements are significant. This article explores their resistance and resilience that has allowed Scotland to earn its stellar reputation

Mind the gaps: challenges of implementing policy for Scotland’s rural third sector

After Brexit, pandemics and through continuing global economic shocks, the rural third sector continues to navigate a landscape of crisis and challenge while serving communities. We examine Scottish Government policy for the rural third sector and policy implementation mechanisms. Our paper argues, and our evidence shows, that current policy is aspirational and there are deficiencies between rural third sector policy making, policy implementation and the voice of rural communities. Our critical review of Scottish Government documentation examined policy for the third sector in rural conditions, then continued to search government documentation for evidence of action plans and viable implementation strategies. We found that policy makers were aspirational, there are few mechanisms or action plans that support sustainable policy implementation and limited examples of ongoing community consultation. The concern is that while gaps exist between policy making and implementation, government policy will underperform leaving a rural third sector struggling to service their communities and deliver their social mission

Women and the Preston Lock-Out: not just 'ten per cent'

Women and girls comprised the majority of the striking cotton operatives during the Preston lock-out of 1853–1854. While history has acknowledged women’s participation, their story has been neglected in favour of the strike’s importance to the labour movement, both locally and nationally. This article highlights how working-class women’s strike participation formed part of broader women’s activism and was motivated by labour and domestic considerations. Utilising newspapers, strike papers and contemporary accounts, this article argues that women operatives were respected co-workers with men and received equal strike pay to men – something that was reflected in later Lancashire strikes. Married women’s sustained support was influenced by a decrease in domestic violence, increased educational opportunities for children and adults, and more family time. More broadly, if we are to fully understand women’s complex decision-making related to their dual role as workers and household managers, a gendered approach to labour activism is needed

Efficacy of hydroxypropyl-guar drops in improving tear film index and ocular surface dynamics using two treatment methods under a controlled desiccating environment

Aim: This study aimed to assess the efficacy of hp-guar eye drops on tear film index and ocular surface dynamics under desiccating conditions using protection and relief treatment modalities.Methodology: The 12 normal, non-dry eye participants were subjected to adverse environmental conditions using a Controlled Environment Chamber (CEC) where the relative humidity (RH) was 5% and the ambient temperature was 21 °C. The participants were screened for ocular symptoms, tear osmolarity, ocular surface temperature (OST), tear production using the Ocular Surface Disease Index questionnaire (OSDI), OcuSense TearLab Osmometer, FLIR System ThermaCAM P620, and Schirmer strips. Tear production was calculated by the Tear Function Index test (TFI).Results: The mean tear film osmolarity decreased significantly from 296 mOsm/L at 40% RH to 285 mOsm/L at 5% RH (p = 0.01). Conflicting responses were seen for osmolarity in protection and relief. Mean tear osmolarity was significantly higher in the protection method in comparison to the relief method (p = 0.005). The mean TFI increased from 557 at 40% to 854 at 5% (p = 0.02). A significant increase in TFI was observed in the relief method in comparison with both 40% (p = 0.001) and 5% (p = 0.04). In the relief method, the mean TFI score went up to 1139 when hp-guar was installed. A significant improvement in ocular comfort was experienced in both the protection (p = 0.041) and relief (p = 0.010) methods at 5% RH. The instillation of hp-guar drops in the relief method resulted in a significant reduction in OST. The mean OST dropped to 33.01 ºC, significantly lower than the recorded OST for both normal (p = 0.040) and dry (p = 0.014) environmental conditions. Conclusion: Hp-guar drops significantly improve tear film parameters under a desiccating environment, however, tear film parameters respond differently to the management modalities. In the protection method, tear film osmolarity was protected against a dry environment, while in the relief mode, an improvement in tear production and a decrease in ocular surface temperature were seen. Hp-guar performance could be maximized for the management of exposure to adverse environments by using a treatment protocol that targets the most affected parameters in each group of patients. Using CEC has the potential to provide researchers with a readily available method to evaluate the efficiency of tear supplementation.</p

Navigating the ‘meaningless’ of social innovation: perspectives of social care practitioners in Scotland

Social innovation is an umbrella concept that allows space for a diverse range of perspectives to co-exist. In this paper, we explore how practitioners negotiate this complexity. Conducting 19 interviews with stakeholders involved in social enterprise and social care in Scotland, we show that almost anything can be conceived of as a social innovation as defined by the European Union. The EU definition can be a useful tool for organizations to demonstrate to funders how and why they are socially innovative. However, in failing to interrogate the power dimension of social innovation, the EU definition neglects any transformative potential.</p