National survey of variations in practice in the prevention of surgical site infections in adult cardiac surgery, United Kingdom and Republic of Ireland

Background: Currently no national standards exist for the prevention of surgical site infection (SSI) in cardiac surgery. SSI rates range from 1% to 8% between centres. Aim: The aim of this study was to explore and characterize variation in approaches to SSI prevention in the UK and the Republic of Ireland (ROI). Methods: Cardiac surgery centres were surveyed using electronic web-based questionnaires to identify variation in SSI prevention at the level of both institution and consultant teams. Surveys were developed and undertaken through collaboration between the Cardiothoracic Interdisciplinary Research Network (CIRN), Public Health England (PHE) and the National Cardiac Benchmarking Collaborative (NCBC) to encompass routine pre-, intra- and postoperative practice. Findings: Nineteen of 38 centres who were approached provided data and included responses from 139 consultant teams. There was no missing data from those centres that responded. The results demonstrated substantial variation in over 40 aspects of SSI prevention. These included variation in SSI surveillance, reporting of SSI infection rates to external bodies, utilization of SSI risk prediction tools, and the use of interventions such as sternal support devices and gentamicin impregnated sponges. Conclusion: Measured variation in SSI prevention in cardiac centres across the UK and ROI is evidence of clinical uncertainty as to best practice, and has identified areas for quality improvement as well as knowledge gaps to be addressed by future research

Ike Hawai‘i – A Training Program for Working with Native Hawaiians

Native Hawaiians in Hawai‘i experience multiple health and social problems and are highly represented in the child welfare system, in particular. There is increasing attention to the argument that some problems derive from historic trauma. The importance of the relationship of history to contemporary problems was a fundamental premise in the development of a training model for social work students. This paper describes ‘Ike Hawai‘i, a training model intended to improve the cultural competency of social work students working with Native Hawaiian clients in the public child welfare system. There are six main elements of this training: 1) Self-Disclosure, 2) Hawaiian Worldview, 3) Grief and Loss, 4) Hawaiian Historical Events, with a focus on the Mahele and the overthrow of the Hawaiian Monarchy, 5) Current Day Strengths and Challenges, and 6) Cultural Ways of Healing and Practical Suggestions for Working with Native Hawaiians. Evaluative scores and comments from students indicate that the training program has been found to be useful and helpful in their work with Native Hawaiian clients. Such a model, with its emphasis on experiential learning, self-awareness, cultural knowledge, and service implications, may have applicability for other populations and, in particular, other native peoples

An evaluation of the credit standards set by commercial banks in the Philippines

The study is intended to asses whether local commercial banks comply with the industry standard policy. The paper also identified problems such as illiquidity of borrowing companies, faced by commercial banks regarding their credit collection. Established standards of the different commercial banks were compared with that of their combined credit policies in order to evaluate significant strength and differences in the credit standards

Species 2000 & ITIS Catalogue of Life

A digital resource, which aims to become a comprehensive catalogue of all known species of organisms on Earth

Therapeutic immunization protects dopaminergic neurons in a mouse model of Parkinson's disease

Degeneration of the nigrostriatal dopaminergic pathway, the hallmark of Parkinson's disease, can be recapitulated in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-intoxicated mice. Herein, we demonstrate that adoptive transfer of copolymer-1 immune cells to MPTP recipient mice leads to T cell accumulation within the substantia nigra pars compacta, suppression of microglial activation, and increased local expression of astrocyte-associated glial cell line-derived neurotrophic factor. This immunization strategy resulted in significant protection of nigrostriatal neurons against MPTP-induced neurodegeneration that was abrogated by depletion of donor T cells. Such vaccine treatment strategies may provide benefit for Parkinson's disease