An assessment of high touch object cleaning thoroughness using a fluorescent marker in two Australian hospitals

An Unassigned Group, An Unassigned DepartmentFull Tex

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Predicting influenza A and 2009 H1N1 influenza in patients admitted to hospital with acute respiratory illness

Objective To create a clinical decision tool for suspected influenza A (including 2009 H1N1) to facilitate treatment and isolation decisions for patients admitted to hospital with an acute respiratory illness from the emergency department (ED) during a 2009 H1N1 pandemic. Methods Cross-sectional study conducted in two hospitals in Queensland, Australia. All patients admitted to hospital from the ED between 24 May and 16 August 2009 with an acute respiratory illness were included. All had nasal and throat swabs taken. Data were collected from clinical chart review regarding clinical symptoms, co-morbidities, examination findings, pathology and radiology results. Influenza A status was detected by reverse transcription-PCR assay. Univariate and multivariate regression analyses were performed to identify independent predictors of influenza A status. Results 346 consecutive patients were identified, of which 106 were positive for 2009 H1N1 influenza; an additional 11 patients were positive for other influenza A viruses. Independent clinical predictors (with points allocated using weighted scoring) for all types of influenza A in patients admitted with acute respiratory illness were: age 18-64 years (2 points); history of fever (2); cough (1); normal level of consciousness (2); C-reactive protein >5 and =100 mg/l (2) and normal leucocyte count (1). A clinical score of 5 (presence of two or three predictors) gave a sensitivity of 93% (95% CI 87% to 96%), specificity of 36% (95% CI 30% to 42%), resulting in a negative-predictive value of 91% (95% CI 83% to 95%). Conclusion A clinical prediction tool was developed that may be able to assist in making appropriate isolation decisions during future 2009 H1N1 outbreaks.No Full Tex

The Birds of Australia

v.1 (1910-1911

The Birds of Australia

v.10 (1922-1923);suppl.2 (1923

The Birds of Australia

v.12 (1925-1927

Storm-time response of the mid-latitude thermosphere: Observations from a network of Fabry-Perot interferometers

Observations of thermospheric neutral winds and temperatures obtained from a network of five Fabry-Perot interferometers deployed in the midwest United States during a geomagnetic storm on 2 October 2013 showed that coincident with the commencement of the storm, the horizontal wind was observed to surge westward and southward (towards the equator). Simultaneous with this surge in the horizontal winds, an apparent downward wind of approximately 100 m/s lasting for 6 hours was also observed. The neutral temperature was observed to increase by approximately 400 K over all of the sites. Similar results of downward vertical winds and sustained heating have been seen in other geomagnetic storm events. The large sustained apparent downward winds are interpreted as arising from the contamination of the nominal spectral profile of the 630.0-nm population distribution, which is thermalized within the thermosphere region, by fast O related to the infusion of low-energy O+ ions that are generated by charge exchange and momentum transfer collisions. This interpretation is supported through simultaneous observations made by the Helium, Oxygen, Proton, and Electron spectrometer instruments on the twin Van Allen Probes spacecrafts, which show an influx of low-energy ions well correlated with the period of apparent downward winds. These results emphasize the importance of distributed networks of instruments in understanding the complex dynamics that occur in the upper atmosphere during disturbed conditions and represent an example of magnetosphere-ionosphere coupling