Client Factors That Predict the Therapeutic Alliance in a Chronic, Complex Trauma Sample

This investigation aimed to examine how specific client characteristics of individuals with chronic, complex trauma are associated with the type coping strategies they employ and the quality of the therapeutic alliance. Fifty-nine adult participants with diagnostic levels of posttraumatic stress disorder (PTSD) and who attended therapy for complex trauma in Northern Ireland were obtained via opportunity sampling. Participants completed self-report measures of client attachment style, alexithymia, coping strategies, and the therapeutic alliance. Preoccupied attachment factors such as “Need for Approval” and “Preoccupation with Relationships” were related to use of maladaptive coping strategies. In contrast, the adaptive coping strategies of “Acceptance” and “Instrumental Support” were significant predictors of a positive therapeutic alliance, whereas established psychological and traumatogenic factors (e.g., attachment, number of traumatic events) did not significantly predict the therapeutic alliance. The findings have implications for understanding the relationship between client characteristics and the therapeutic alliance within complex trauma populations, as well as developing protocols to assist this process

Decreasing Clostridium Difficile Health Care - Associated Infections Through Use of a Launderable Mattress Cover

BACKGROUND: The annual incidence of Clostridium difficile infection (CDI) in the United States is estimated to be 330,000 cases. We evaluated the impact of using a launderable mattress and bed deck cover on the incidence of hospital-onset CDI in two long-term acute care hospitals (LTACH)s. METHODS: Two LTACH hospitals began using a launderable mattress and bed deck cover on beds starting in May of 2013. One facility had 74 beds and the other had 30 beds. Covers were changed after every patient. The covers were laundered using hot water, detergent, and chlorine. Rates for CDIs were compared using Poisson regression between the 16 months before use of the launderable cover and the 14 months after the cover started being used. RESULTS: At Hospital A, the use of bedcovers reduced the rate of infections by 47.8% (95% CI 47.1 – 48.6), controlling for the rate of hand washing compliance and length of stay in days. At Hospital B, the use of bedcovers reduced the rate of infections by 50% (95% CI 47.5 – 52.7), controlling for the rate of hand washing compliance and length of stay in days. CONCLUSIONS: The use of a launderable cover for mattresses and bed decks of hospital beds was associated with a decreased rate of healthcare associated CDIs in two LTACHs

On the physical origins of the negative index of refraction

The physical origins of negative refractive index are derived from a dilute microscopic model, producing a result that is generalized to the dense condensed phase limit. In particular, scattering from a thin sheet of electric and magnetic dipoles driven above resonance is used to form a fundamental description for negative refraction. Of practical significance, loss and dispersion are implicit in the microscopic model. While naturally occurring negative index materials are unavailable, ferromagnetic and ferroelectric materials provide device design opportunities.Comment: 4 pages, 1 figur

Sub-100 nm resolution microscopy based on proximity projection grating scheme

Structured illumination microscopy (SIM) has been widely used in life science imaging applications. The maximum resolution improvement of SIM, compared to conventional bright field system is a factor of 2. Here we present an approach to structured illumination microscopy using the proximity projection grating scheme (PPGS), which has the ability to further enhance the SIM resolution without invoking any nonlinearity response from the sample. With the PPGS-based SIM, sub-100 nm resolution has been obtained experimentally, and results corresponding to 2.4 times resolution improvement are presented. Furthermore, it will be shown that an improvement of greater than 3 times can be achieved

Exhaled breath hydrogen cyanide as a marker of early Pseudomonas aeruginosa infection in children with cystic fibrosis

Hydrogen cyanide is readily detected in the headspace above Pseudomonas aeruginosa cultures and in the breath of cystic fibrosis (CF) patients with chronic (P. aeruginosa) infection. We investigated if exhaled breath HCN is an early marker of P. aeruginosa infection. 233 children with CF who were free from P. aeruginosa infection were followed for 2 years. Their median (interquartile range) age was 8.0 (5.0–12.2) years. At each study visit, an exhaled breath sample was collected for hydrogen cyanide analysis. In total, 2055 breath samples were analysed. At the end of the study, the hydrogen cyanide concentrations were compared to the results of routine microbiology surveillance. P. aeruginosa was isolated from 71 children during the study with an incidence (95% CI) of 0.19 (0.15–0.23) cases per patient-year. Using a random-effects logistic model, the estimated odds ratio (95% CI) was 3.1 (2.6–3.6), which showed that for a 1- ppbv increase in exhaled breath hydrogen cyanide, we expected a 212% increase in the odds of P. aeruginosa infection. The sensitivity and specificity were estimated at 33% and 99%, respectively. Exhaled breath hydrogen cyanide is a specific biomarker of new P. aeruginosa infection in children with CF. Its low sensitivity means that at present, hydrogen cyanide cannot be used as a screening test for this infection

Optically excited nanoscale ultrasonic transducers

In order to work at higher ultrasonic frequencies, for instance, to increase the resolution, it is necessary to fabricate smaller and higher frequency transducers. This paper presents an ultrasonic transducer capable of being made at a very small size and operated at GHz frequencies. The transducers are activated and read optically using pulsed lasers and without physical contact between the instrumentation and the transducer. This removes some of the practical impediments of traditional piezoelectric architectures (such as wiring) and allows the devices to be placed immediately on or within samples, reducing the significant effect of attenuation which is very strong at frequencies above 1 GHz. The transducers presented in this paper exploit simultaneous optical and mechanical resonances to couple the optical input into ultrasonic waves and vice versa. This paper discusses the mechanical and optical design of the devices at a modest scale (a few lm) and explores the scaling of the transducers toward the sub-micron scale. Results are presented that show how the transducers response changes depending on its local environment and how the resonant frequency shifts when the transducer is loaded by a printed protein sample

Investigation of Exhaust Particles on Different TEM Grids: A Comparison between Graphene Oxide and Silicon Nitride Grids

Two different TEM (Transmission Electron Microscopy) grids - graphene oxide (GO) and silicon nitride (SiN) - were used to capture the particulates emitted with the exhaust of a modern 1.0 L GDI (Gasoline Direct Injection) engine. One speed-load condition (1250 rpm - idle) was chosen to generate a nanometric particulate output in the sub-23 nm regime which has been traditionally difficult to analyse in terms of composition and morphology. The overall aim was to understand if additional benefits can be obtained by analysing the particles captured in the exhaust on a nanoporous silicon nitride grid compared to state-of- the-art graphene oxide grids. The behaviour of porous SiN support films was of interest since nanopores are present in the grid in the 20 nm regime and the material is thermally and dimensionally stable under high temperatures, allowing thermophoretic capture directly within the engine exhaust stream. In addition to nanostructural and morphological comparison, the elemental composition of the particles was also analysed by EDX (Energy Dispersive X-Ray). Particles were thermophoretically captured directly in the exhaust stream using a dedicated probe holding the grid. Because of their tiny 2 nm thickness, GO grids work well for studying particle nanostructure, however background noise from copper and carbon interferes with compositional analysis by EDX. In contrast, the silicon nitride grids enable particle observation without this background noise, providing an intriguing platform for the analysis of the suspended particles collected by the pores. Future research will concentrate on producing particles with graphitic areas to assess imaging advantages in terms of morphological and nanostructural examination. The two grids were similar in their particle capture within the engine, with close mean primary particle diameters using both: 13.5 ± 3.1 nm standard deviation (SD) on GO and 14.1 ± 2.6 nm SD on SiN. EDX analysis suggests SiN grids, as C-free substrates, are preferable to GO for determining the carbon load in captured particles. This investigation is part of a larger project focusing on decarbonised fuels, so a carbon-free support film is pivotal in understanding the nature and composition of the fine particles linked to the lubricant oil