Staphylococcus aureus in the oral cavity: a three-year retrospective analysis of clinical laboratory data

OBJECTIVE: A retrospective analysis of laboratory data to investigate the isolation of Staphylococcus aureus from the oral cavity and facial area in specimens submitted to a regional diagnostic oral microbiology laboratory. METHODS: A hand search of laboratory records for a three-year period (1998-2000) was performed for specimens submitted to the regional diagnostic oral microbiology laboratory based at Glasgow Dental Hospital and School. Data were collected from forms where S. aureus was isolated. These data included demographics, referral source, specimen type, methicillin susceptibility and clinical details. RESULTS: For the period 1998-2000, there were 5,005 specimens submitted to the laboratory. S. aureus was isolated from 1,017 specimens, of which 967 (95%) were sensitive to methicillin (MSSA) and 50 (5%) were resistant to methicillin (MRSA). The 1,017 specimens were provided from 615 patients. MRSA was isolated from 37 (6%) of patients. There was an increasing incidence of S. aureus with age, particularly in the greater than 70 years age group. The most common specimen from which MSSA was isolated was an oral rinse (38%) whilst for MRSA isolates this was a tongue swab (28%). The clinical condition most commonly reported for MSSA isolates was angular cheilitis (22%). Erythema, swelling, pain or burning of the oral mucosa was the clinical condition most commonly reported for MRSA isolates (16%). Patients from whom the MSSA isolates were recovered were most commonly (55%) seen in the oral medicine clinic at the dental hospital, whilst patients with MRSA were more commonly seen in primary care settings such as nursing homes, hospices and general dental practice (51%). CONCLUSION: In line with more recent surveys, this retrospective study suggests that S. aureus may be a more frequent isolate from the oral cavity than hitherto suspected. A small proportion of the S. aureus isolates were MRSA. There were insufficient data available to determine whether the S. aureus isolates were colonising or infecting the oral cavity. However, the role of S. aureus in several diseases of the oral mucosa merits further investigation

The Angular-Diameter-Distance-Maximum and Its Redshift as Constraints on Λ≠0\Lambda \neq 0 FLRW Models

The plethora of recent cosmologically relevant data has indicated that our universe is very well fit by a standard Friedmann-Lema\^{i}tre-Robertson-Walker (FLRW) model, with $\Omega_{M} \approx 0.27$ and $\Omega_{\Lambda} \approx 0.73$ -- or, more generally, by nearly flat FLRW models with parameters close to these values. Additional independent cosmological information, particularly the maximum of the angular-diameter (observer-area) distance and the redshift at which it occurs, would improve and confirm these results, once sufficient precise Supernovae Ia data in the range $1.5 < z < 1.8$ become available. We obtain characteristic FLRW closed functional forms for $C = C(z)$ and $\hat{M}_0 = \hat{M}_0(z)$, the angular-diameter distance and the density per source counted, respectively, when $\Lambda \neq 0$, analogous to those we have for $\Lambda = 0$. More importantly, we verify that for flat FLRW models $z_{max}$ -- as is already known but rarely recognized -- the redshift of $C_{max}$, the maximum of the angular-diameter-distance, uniquely gives $\Omega_{\Lambda}$, the amount of vacuum energy in the universe, independently of $H_0$, the Hubble parameter. For non-flat models determination of both $z_{max}$ and $C_{max}$ gives both $\Omega_{\Lambda}$ and $\Omega_M$, the amount of matter in the universe, as long as we know $H_0$ independently. Finally, determination of $C_{max}$ automatically gives a very simple observational criterion for whether or not the universe is flat -- presuming that it is FLRW.Comment: 17 Pages, 1 Figur

With good intentions: complexity in unsolicited informal support for Aboriginal and Torres Strait Islander peoples. A qualitative study

<p>Abstract</p> <p>Background</p> <p>Understanding people's social lived experiences of chronic illness is fundamental to improving health service delivery and health outcomes, particularly in relation to self-management activity. In explorations of social lived experiences this paper uncovers the ways in which Aboriginal and Torres Strait Islander people with chronic illness experience informal unsolicited support from peers and family members.</p> <p>Methods</p> <p>Nineteen Aboriginal and Torres Islander participants were interviewed in the Serious and Continuing Illness Policy and Practice Study (SCIPPS). Participants were people with Type 2 diabetes (N = 17), chronic obstructive pulmonary disease (N = 3) and/or chronic heart failure (N = 11) and family carers (N = 3). Participants were asked to describe their experience of having or caring for someone with chronic illness. Content and thematic analysis of in-depth semi-structured interviews was undertaken, assisted by QSR Nvivo8 software.</p> <p>Results</p> <p>Participants reported receiving several forms of unsolicited support, including encouragement, practical suggestions for managing, nagging, growling, and surveillance. Additionally, participants had engaged in 'yarning', creating a 'yarn' space, the function of which was distinguished as another important form of unsolicited support. The implications of recognising these various support forms are discussed in relation to responses to unsolicited support as well as the needs of family carers in providing effective informal support.</p> <p>Conclusions</p> <p>Certain locations of responsibility are anxiety producing. Family carers must be supported in appropriate education so that they can provide both solicited and unsolicited support in effective ways. Such educational support would have the added benefit of helping to reduce carer anxieties about caring roles and responsibilities. Mainstream health services would benefit from fostering environments that encourage informal interactions that facilitate learning and support in a relaxed atmosphere.</p

The 2dF Galaxy Redshift Survey: correlation functions, peculiar velocities and the matter density of the Universe

We present a detailed analysis of the two-point correlation function, ξ(σ, π), from the 2dF Galaxy Redshift Survey (2dFGRS). The large size of the catalogue, which contains ∼220 000 redshifts, allows us to make high-precision measurements of various properties of the galaxy clustering pattern. The effective redshift at which our estimates are made is zs≈ 0.15, and similarly the effective luminosity, Ls≈ 1.4L*. We estimate the redshift-space correlation function, ξ(s), from which we measure the redshift-space clustering length, s0= 6.82 ± 0.28 h−1 Mpc. We also estimate the projected correlation function, Ξ(σ), and the real-space correlation function, ξ(r), which can be fit by a power law (r/r0), with r0= 5.05 ± 0.26 h−1 Mpc, γr= 1.67 ± 0.03. For r≳ 20 h−1 Mpc, ξ drops below a power law as, for instance, is expected in the popular Λ cold dark matter model. The ratio of amplitudes of the real- and redshift-space correlation functions on scales of 8–30 h−1 Mpc gives an estimate of the redshift-space distortion parameter β. The quadrupole moment of ξ(σ, π) on scales 30–40 h−1 Mpc provides another estimate of β. We also estimate the distribution function of pairwise peculiar velocities, ƒ(v), including rigorously the significant effect due to the infall velocities, and we find that the distribution is well fit by an exponential form. The accuracy of our ξ(σ, π) measurement is sufficient to constrain a model, which simultaneously fits the shape and amplitude of ξ(r) and the two redshift-space distortion effects parametrized by β and velocity dispersion, a. We find β= 0.49 ± 0.09 and a= 506 ± 52 km s−1, although the best-fitting values are strongly correlated. We measure the variation of the peculiar velocity dispersion with projected separation, a(σ), and find that the shape is consistent with models and simulations. This is the first time that β and ƒ(v) have been estimated from a self-consistent model of galaxy velocities. Using the constraints on bias from recent estimates, and taking account of redshift evolution, we conclude that β (L=L*, z= 0) = 0.47 ± 0.08, and that the present-day matter density of the Universe, Ωm≈ 0.3, consistent with other 2dFGRS estimates and independent analyses

Experiencing visual impairment in a lifetime home: an interpretative phenomenological inquiry

Lifetime home standards (LTHS) are a set of standards aimed at making homes more accessible. Previous research, however, indicates that LTHS do not adequately meet the needs of those with sensory impairments. Now, with visual impairment set to increase globally and acknowledging the recognised link between quality of dwelling and wellbeing, this article aims to examine the experiences of visually impaired people living in lifetime homes. The objectives are to investigate existing lifetime homes and to identify whether LTHS meet occupants’ needs. Qualitative semi-structured interviews were carried out with six visually impaired people living in homes designed to LTHS in Northern Ireland. Collected data was analysed using interpretative phenomenological analysis identifying three super-ordinate themes: (1) living with visual impairment; (2) design considerations and (3) coping strategies. A core theme of balance between psychological and physical needs emerged through interconnection of super-ordinate themes. Although there are benefits to living in lifetime homes, negative aspects are also apparent with occupants employing several coping strategies to overcome difficulties. Whilst residents experience negative emotions following visual impairment diagnoses, results suggest that occupants still regard their homes as key places of security and comfort in addition to then highlighting the need for greater consideration of specific individual needs within general guidelines

Molecular Analysis of Microbial Communities in Endotracheal Tube Biofilms

Ventilator-associated pneumonia is the most prevalent acquired infection of patients on intensive care units and is associated with considerable morbidity and mortality. Evidence suggests that an improved understanding of the composition of the biofilm communities that form on endotracheal tubes may result in the development of improved preventative strategies for ventilator-associated pneumonia. (n = 5). DGGE profiling of the endotracheal biofilms revealed complex banding patterns containing between 3 and 22 (mean 6) bands per tube, thus demonstrating the marked complexity of the constituent biofilms. Significant inter-patient diversity was evident. The number of DGGE bands detected was not related to total viable microbial counts or the duration of intubation.Molecular profiling using DGGE demonstrated considerable biofilm compositional complexity and inter-patient diversity and provides a rapid method for the further study of biofilm composition in longitudinal and interventional studies. The presence of oral microorganisms in endotracheal tube biofilms suggests that these may be important in biofilm development and may provide a therapeutic target for the prevention of ventilator-associated pneumonia

Clustering of Low-Redshift (z <= 2.2) Quasars from the Sloan Digital Sky Survey

We present measurements of the quasar two-point correlation function, \xi_{Q}, over the redshift range z=0.3-2.2 based upon data from the SDSS. Using a homogeneous sample of 30,239 quasars with spectroscopic redshifts from the DR5 Quasar Catalogue, our study represents the largest sample used for this type of investigation to date. With this redshift range and an areal coverage of approx 4,000 deg^2, we sample over 25 h^-3 Gpc^3 (comoving) assuming the current LCDM cosmology. Over this redshift range, we find that the redshift-space correlation function, xi(s), is adequately fit by a single power-law, with s_{0}=5.95+/-0.45 h^-1 Mpc and \gamma_{s}=1.16+0.11-0.16 when fit over s=1-25 h^-1 Mpc. Using the projected correlation function we calculate the real-space correlation length, r_{0}=5.45+0.35-0.45 h^-1 Mpc and \gamma=1.90+0.04-0.03, over scales of rp=1-130 h^-1 Mpc. Dividing the sample into redshift slices, we find very little, if any, evidence for the evolution of quasar clustering, with the redshift-space correlation length staying roughly constant at s_{0} ~ 6-7 h^-1 Mpc at z<2.2 (and only increasing at redshifts greater than this). Comparing our clustering measurements to those reported for X-ray selected AGN at z=0.5-1, we find reasonable agreement in some cases but significantly lower correlation lengths in others. We find that the linear bias evolves from b~1.4 at z=0.5 to b~3 at z=2.2, with b(z=1.27)=2.06+/-0.03 for the full sample. We compare our data to analytical models and infer that quasars inhabit dark matter haloes of constant mass M ~2 x 10^12 h^-1 M_Sol from redshifts z~2.5 (the peak of quasar activity) to z~0. [ABRIDGED]Comment: 28 pages, 26 figures, ApJ accepted. Online materials (including source code, catalogues and high-resolution figures) can be found at http://www.astro.psu.edu/users/npr/DR5

Should patients with hip joint prosthesis receive antibiotic prophylaxis before dental treatment?

The safety committee of the American Academy of Orthopedic Surgeons (AAOS) recommended in 2009 that clinicians should consider antibiotic prophylaxis for all patients with total joint replacement before any invasive procedure that may cause bacteremia. This has aroused confusion and anger among dentists asking for the evidence. The present review deals with different aspects of the rationale for this recommendation giving attention to views both in favor of and against it