Methicillin-resistant Staphylococcus aureus (MRSA) in rehabilitation and chronic-care-facilities: what is the best strategy?

BACKGROUND: The risk associated with methicillin-resistant Staphylococcus aureus (MRSA) has been decreasing for several years in intensive care departments, but is now increasing in rehabilitation and chronic-care-facilities (R-CCF). The aim of this study was to use published data and our own experience to discuss the roles of screening for MRSA carriers, the type of isolation to be implemented and the efficiency of chemical decolonization. DISCUSSION: Screening identifies over 90% of patients colonised with MRSA upon admission to R-CCF versus only 50% for intensive care units. Only totally dependent patients acquire MRSA. Thus, strict geographical isolation, as opposed to "social reinsertion", is clearly of no value. However, this should not lead to the abandoning of isolation, which remains essential during the administration of care. The use of chemicals to decolonize the nose and healthy skin appeared to be of some value and the application of this procedure could make technical isolation unnecessary in a non-negligible proportion of cases. SUMMARY: Given the increase in morbidity associated with MRSA observed in numerous hospitals, the emergence of a community-acquired disease associated with these strains and the evolution of glycopeptide-resistant strains, the voluntary application of a strategy combining screening, technical isolation and chemical decolonization in R-CCF appears to be an urgent matter of priority

Interaction of Audition and Vision for the Perception of Prosodic Contrastive Focus

International audienceProsodic contrastive focus is used to attract the listener's attention to a specific part of the utterance. Mostly conceived of as auditory/acoustic, it also has visible correlates which have been shown to be perceived. This study aimed at analyzing auditory-visual perception of prosodic focus by elaborating a paradigm enabling an auditory-visual advantage measurement (avoiding the ceiling effect) and by examining the interaction between audition and vision. A first experiment proved the efficiency of a whispered speech paradigm to measure an auditory-visual advantage for the perception of prosodic features. A second experiment used this paradigm to examine and characterize the auditory-visual perceptual processes. It combined performance assessment (focus detection score) to reaction time measurements and confirmed and extended the results from the first experiment. This study showed that adding vision to audition for perception of prosodic focus can not only improve focus detection but also reduce reaction times. A further analysis suggested that audition and vision are actually integrated for the perception of prosodic focus. Visual only perception appeared to be facilitated for whispered speech suggesting an enhancement of visual cues in whispering. Moreover, the potential influence of the presence of facial markers on perception is discussed

Unraveling the functional attributes of the language connectome: crucial subnetworks, flexibility and variability

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