Role of infection control in combating antibiotic resistance

Infection control has been identified as one of the key interventions in controlling the threat of antibiotic resistance. Reducing thetransmission of multidrug-resistant organisms (MDROs) reduces the need for broad-spectrum antibiotics in particular, while interventionsthat decrease the risk of infection have an impact on the use of any antibiotic. Hand hygiene remains the cornerstone of decreasing thetransmission of MDROs. Alcohol-based hand rubs are a cheap, effective and convenient means of performing hand hygiene. Patientscolonised or infected with MDROs should be placed on contact precautions, although implementation remains challenging in resourcelimitedenvironments. Screening for certain MDROs may play a role in curbing transmission of these organisms. If implemented, screeningmust be part of a comprehensive infection control strategy. In resource-limited settings, the costs and potential benefits of screeningprogrammes need to be carefully weighed up. Care bundles have been shown to reduce the incidence of common healthcare-associatedinfections, including catheter-associated urinary tract infection, ventilator-associated pneumonia, central line-associated bloodstreaminfection and surgical site infection. These bundles are relatively inexpensive, and can play an important role in reducing antibiotic use andimproving clinical outcomes

William, an Englishman (1919) and the Collapse of Cicely Hamilton’s Pre-war Meliorism

William, an Englishman is a novel written in a tent near the French front by a ‘non-combatant’: the wartime volunteer nurse, postal overseer and theatrical performer Cicely Hamilton. A well-known playwright, actress, suffrage militant, polemical essayist before the conflict, Hamilton, nowadays largely overlooked, performed here a post-mortem exploration of some influential attitudes which were transformed by the experience of war. Coming from someone who had been particularly active on the British radical scene, the text’s denunciation of social progress, pacifism, internationalism, and even votes for women as naive ideals may appear unexpected. She drew from long personal knowledge as well as contemporary documentation to write a novel that, while not untouched by sympathy for her characters, is often brutal. The collapse of Hamilton’s previous political optimism, her (self-ironical) criticism of any belief in the perfectibility of human beings may come as a shock even today. But those familiar with Senlis (1917) might have anticipated Hamilton’s sombre 1919 text. ‘Modern warfare is so monstrous, allengrossing and complex, that there is a sense, and a very real sense, in which hardly a civilian stands outside it; where the strife is to the death with an equal opponent the non-combatant ceases to exist.’ The abuse and strategic bombing of civilian populations, the collapse of former distinctions between combatants and non-combatants, the mobilization of almost entire nations were early on denounced by the writer. ‘No modern nation could fight for its life with its men in uniform only; it must mobilize, nominally or not, every class of its population for a struggle, too great and too deadly for the combatant to carry alone.’ (Senlis 34) Her discerning eye read the Great War for what it was: a conflict which was leaving no domain of social, economic and political life unsullied, a total war.info:eu-repo/semantics/acceptedVersio

Developing flow in S-shaped ducts. 1: Square cross-section duct

Laser-Doppler velocimetry was used to measure the laminar and turbulent flow in an S-duct formed with two 22.5 deg sectors of a bend with ratio of mean radius of curvature to hydraulic diameter of 7.0. The boundary layers at the inlet to the bend were about 25% and 15% of the hydraulic diameter for the laminar and turbulent flows, respectively. Pressure-driven secondary flows develop in the first half of the S-duct and persist into the second half but are largely reversed by the exit plane as a consequence of the change in the sense of curvature. There is, however, a region near the outer wall of the second bend where the redistribution of the streamwise isotachs results in a reinforcement of the secondary flow which was established in the first half of the S-duct. The net redistribution of the streamwise isotachs is comparable to that occurring in unidirectional bends of stronger curvature. The wall pressure distribution was also measured for the turbulent flow and quantifies the expected large variations in the longitudinal pressure gradient distributions which occur at different radial locations

Metal fluxes in the Mersey Narrows

International audienceSurveys of the Mersey estuary in north-west England were undertaken near the mouth of the estuary in the region known as the Mersey Narrows. Tidal fluxes of suspended and dissolved matter, particularly heavy metals, through the Mersey Narrows were investigated. This paper gives results of conducting four intensive cross-sectional surveys of the Narrows, during which currents, salinities, turbidity and water samples were obtained systematically at numerous positions, throughout selected tidal cycles. Over 300 water samples per survey were analysed to yield suspended and dissolved concentrations of the elements As, Cd, Cr, Cu, Hg, Ni, Pb and Zn, at all states of the tide. Suspended solids, concentrations and salinities were also measured. Suspended particulates account for the majority of each element present, except for cadmium, which was present in roughly equal dissolved and suspended fractions. From the tidal current and water quality data, calculations were made of hour-by-hour fluxes of each component, to show the detailed ebb and flow of heavy metals and the net tidal transport of each component. Although some differences between landward transport on the flood tide and seaward transport on the ebb were not significant, the more definite results consistently showed a seawards net transport. For spring tides of high tidal range, there was an indication of an opposite tendency, reducing the seawards transport or even reversing it, for certain suspended components. Keywords: Mersey estuary, surveys, tidal flux, dissolved metals, particulate metals, salinity, suspended particulate matter, suspended solid

A framework for preventing healthcare-associated infection in neonates and children in South Africa

Healthcare-associated infection (HAI) is a frequent and serious complication affecting 4 - 8% of hospitalised children and neonates in high-income countries. The burden of HAI in South African (SA) paediatric and neonatal wards is substantial but underappreciated, owing to a lack of HAI surveillance and reporting. Maternal and child health and infection prevention are priority areas for healthcare quality improvement in the National Core Standards programme. Despite increasing recognition in SA, infection prevention efforts targeting hospitalised children and neonates are hampered by health system, institutional and individual patient factors. To ensure safe healthcare delivery to children, a co-ordinated HAI prevention strategy should promote development of infection prevention norms and policies, education, patient safety advocacy, healthcare infrastructure, surveillance and research. We present a framework for SA to develop and expand HAI prevention in hospitalised neonates and children

Measurements in Turbulent Water and Two-Phase Flows by Laser Anemometry

Measurements of the mean and rms values of the longitudinal velocity in a rectangular duct are reported. These results were obtained in a water flow using a laser anemometer. The important design criteria which facilitated the measurements are described and gradient, transit-time, noise and refractive-index corrections are specifically discussed. The results demonstrate the development of a rectangular duct flow and, in particular, reveal that a small lack of symmetry at the duct entrance can readily be identified in the normal- stress results, 37 hydraulic diameters downstream. The possibility of utilizing water droplets in steam and gas bubbles in water to scatter light and thereby to assist laser-anemometer studies of turbulence is discussed. Experimental evidence obtained by the authors and their colleagues is used to support the conclusions

Does angiotensin-1 converting enzyme genotype influence motor or cognitive development after pre-term birth?

BACKGROUND: Raised activity of the renin-angiotensin system (RAS) may both amplify inflammatory and free radical responses and decrease tissue metabolic efficiency and thus enhance cerebral injury in the preterm infant. The angiotensin-converting enzyme (ACE) DD genotype is associated with raised ACE and RAS activity as well as potentially adverse stimuli such as inflammation. The DD genotype has been associated with neurological impairments in the elderly, and thus may be also associated with poorer motor or cognitive development amongst children born preterm prematurely. METHODS: The association of DD genotype with developmental progress amongst 176 Caucasian children born at less than 33 weeks gestation (median birthweight 1475 g, range 645–2480 g; gestation 30 weeks, range 22–32; 108 male) was examined at 2 and 5 1/2 years of age. Measured neuro-cognitive outcomes were cranial ultrasound abnormalities, cerebral palsy, disability, Griffiths Developmental Quotient [DQ] at 2 yrs, and General Cognitive Ability [British Ability Scales-11] and motor performance [ABC Movement], both performed at 5 1/2 yrs. All outcomes were correlated with ACE genotype. RESULTS: The DD genotype was not associated with lower developmental quotients even after accounting for important social variables. CONCLUSION: These data do not support either a role for ACE in the development of cognitive or motor function in surviving infants born preterm or inhibition of ACE as a neuroprotective therapy