Cloxacillin-Resistant Staphylococcus aureus in a Children's Hospital

A group of cultures of cloxacillin-resistant Staphylococcus aureus was collected over a period of 6 months. The method of determination of resistance to cloxacillin is described. The use of the disc diffusion test for cloxacillin was found to be unsatisfactory. The incidence of cloxacillin-resistant Staph. aureus at the Red Cross War Memorial Children's Hospital (inpatients as well as outpatients) is slightly less than 2% of all isolates of Staph. aureus. Of the total non-White ward patients with penicillin-resistant Staph. aureus infections, 6,5% have staphylococci resistant to cloxacillin. Reaction of these isolates to Fucidin, c1indamycin and erythromycin is described.S. Afr. Med. J., 48, 1341 (1974)

Zola à rebours

Cet article s’interroge sur un fil particulier du métadiscours littéraire : la définition du naturalisme zolien comme un « idéalisme à rebours ». C’est une définition que l’on retrouve sous la plume de plusieurs critiques des années 1880, soucieux de saisir le naturalisme à travers l’esthétique même qu’il a voulu discréditer. Si, selon certains critiques, l’idéalisme et le naturalisme se laissent opposer au niveau du sujet, il n’en est pas de même au niveau du procédé esthétique. Cet article se propose d’analyser cette lecture antinaturaliste de la forme du roman zolien. Comment a-t-on voulu mettre en question l’identité et la cohérence du projet naturaliste ? Comment, et dans quel but, s’est-on représenté un Zola à rebours ? Faut-il y voir une manière de lire Zola – à rebours de lui-même – qui caractérise toujours les approches de la critique contemporaine

A decision aid for nutrition support is acceptable in the pediatric hospital setting

Purpose: Incorporating a Decision Aid (DA) about nutrition support into the general pediatric healthcare setting may improve parent and patient understanding about the risks and benefits of nutrition support options. We aimed to evaluate the acceptability and usability of our newly developed DA for parents of children in the general pediatric healthcare setting who require nutrition support. Design and methods: Participants were 18 parents with a child who had received nutrition support; and 12 Healthcare Professionals (HCPs) involved in pediatric nutrition support discussions. Parents' and HCPs' ratings of acceptability and feasibility of the booklet, and parents' perceived knowledge acquisition after reading the booklet were assessed. Results: Parents were satisfied with the DA, reporting that it was an appropriate length and unbiased. Most parents felt the DA was relevant to their decision-making, improved understanding, and would recommend it to other parents. HCPs felt that the booklet clearly described the essential information for nutrition support options, but less certain of the booklets' impact on parent decision-making. Regardless, most HCPs would recommend the booklet to other clinicians. Conclusion: Our decision aid appears to be acceptable and useful for parents deciding on nutrition support for their child in the general pediatric hospital setting. Practice implications: A DA may facilitate shared decision-making through improved understanding of the risks and benefits of different nutrition support options in the pediatric setting. Further evaluation is required with specific pediatric conditions, to determine the effectiveness for parents actively deciding on their child's nutrition support

An efficient and locking-free material point method for three dimensional analysis with simplex elements

The Material Point Method is a relative newcomer to the world of solid mechanicsmodelling. Its key advantage is the ability to model problems having large defor-mations while being relatively close to standard nite element methods, howeverits use for realistic engineering applications will happen only if the material pointcan be shown to be both ecient and accurate (compared to standard nite elementmethods), when modelling complex geometries with a range of material models. Inthis paper we present developments of the standard material point method aimed atrealising these goals. The key contribution provided here is the development of amaterial point method that avoids volumetric locking (arising from elastic or elasto-plastic material behaviour) whilst using low order tetrahedral nite elements forthe background computational mesh, hence allowing unstructured background gridsto be used for complex geometries. We also show that these developments can beeectively parallelised to improve computational ecienc

A roadmap for production of cement and concrete with low-CO2 emissions

This review will show that low-CO2 cements can be produced to give superior durability, based on a sound understanding of their microstructure and how it impacts macro-engineering properties. For example, it is essential that aluminium is available in calcium-rich alkali-activated systems to offset the depolymerisation effect of alkali cations on C-(N-)A-S-H gel. The upper limit on alkali cation incorporation into a gel greatly affects mix design and source material selection. A high substitution of cement clinker in low-CO2 cements may result in a reduction of pH buffering capacity, hence susceptibility to carbonation and corrosion of steel reinforcement. With careful mix design, a more refined pore structure and associated lower permeability can still give a highly durable concrete. It is essential to expand thermodynamic databases for current and prospective cementitious materials so that concrete performance and durability can be predicted when using low-CO2 binders. Cationic copolymer and amphoteric plasticisers, when available commercially, will enhance the development of alkali-activated materials. The development of supersonic shockwave reactors will enable the conversion of a wide range of virgin and secondary source materials into cementitious materials, replacing blast furnace slag and coal fly ash that have dwindling supply. A major obstacle to the commercial adoption of low-CO2 concrete is the prescriptive nature of existing standards and design codes, so there is an urgent need to shift towards performance-based standards. The roadmap presented here is not an extension of current cement practice, but a new way of integrating fundamental research, equipment innovation, and commercial opportunity

Beyond greenspace: an ecological study of population general health and indicators of natural environment type and quality.

This is a freely-available open access publication. Please cite the published version which is available via the DOI link in this record.BACKGROUND: Many studies suggest that exposure to natural environments ('greenspace') enhances human health and wellbeing. Benefits potentially arise via several mechanisms including stress reduction, opportunity and motivation for physical activity, and reduced air pollution exposure. However, the evidence is mixed and sometimes inconclusive. One explanation may be that "greenspace" is typically treated as a homogenous environment type. However, recent research has revealed that different types and qualities of natural environments may influence health and wellbeing to different extents. METHODS: This ecological study explores this issue further using data on land cover type, bird species richness, water quality and protected or designated status to create small-area environmental indicators across Great Britain. Associations between these indicators and age/sex standardised prevalence of both good and bad health from the 2011 Census were assessed using linear regression models. Models were adjusted for indicators of socio-economic deprivation and rurality, and also investigated effect modification by these contextual characteristics. RESULTS: Positive associations were observed between good health prevalence and the density of the greenspace types, "broadleaf woodland", "arable and horticulture", "improved grassland", "saltwater" and "coastal", after adjusting for potential confounders. Inverse associations with bad health prevalence were observed for the same greenspace types, with the exception of "saltwater". Land cover diversity and density of protected/designated areas were also associated with good and bad health in the predicted manner. Bird species richness (an indicator of local biodiversity) was only associated with good health prevalence. Surface water quality, an indicator of general local environmental condition, was associated with good and bad health prevalence contrary to the manner expected, with poorer water quality associated with better population health. Effect modification by income deprivation and urban/rural status was observed for several of the indicators. CONCLUSIONS: The findings indicate that the type, quality and context of 'greenspace' should be considered in the assessment of relationships between greenspace and human health and wellbeing. Opportunities exist to further integrate approaches from ecosystem services and public health perspectives to maximise opportunities to inform policies for health and environmental improvement and protection.Economic and Social Research CouncilEuropean Regional Development Fund Programme 2007 to 2013 and European Social Fund Convergence Programme for Cornwall and the Isles of Scill

Arylazopyrazoles: azoheteroarene photoswitches offering quantitative isomerization and long thermal half-lives

Arylazopyrazoles, a novel class of five-membered azo photoswitches, offer quantitative photoswitching and high thermal stability of the Z isomer (half-lives of 10 and ∼1000 days). The conformation of the Z isomers of these compounds, and also the arylazopyrroles, is highly dependent on the substitution pattern on the heteroarene, allowing a twisted or planar geometry, which in turn has a significant impact on the electronic spectral properties of the compounds

Cost-Effective Use of Silver Dressings for the Treatment of Hard-to-Heal Chronic Venous Leg Ulcers

Aim To estimate the cost-effectiveness of silver dressings using a health economic model based on time-to-wound-healing in hard-to-heal chronic venous leg ulcers (VLUs). Background Chronic venous ulceration affects 1–3% of the adult population and typically has a protracted course of healing, resulting in considerable costs to the healthcare system. The pathogenesis of VLUs includes excessive and prolonged inflammation which is often related to critical colonisation and early infection. The use of silver dressings to control this bioburden and improve wound healing rates remains controversial. Methods A decision tree was constructed to evaluate the cost-effectiveness of treatment with silver compared with non-silver dressings for four weeks in a primary care setting. The outcomes: ‘Healed ulcer’, ‘Healing ulcer’ or ‘No improvement’ were developed, reflecting the relative reduction in ulcer area from baseline to four weeks of treatment. A data set from a recent meta-analysis, based on four RCTs, was applied to the model. Results Treatment with silver dressings for an initial four weeks was found to give a total cost saving (£141.57) compared with treatment with non-silver dressings. In addition, patients treated with silver dressings had a faster wound closure compared with those who had been treated with non-silver dressings. Conclusion The use of silver dressings improves healing time and can lead to overall cost savings. These results can be used to guide healthcare decision makers in evaluating the economic aspects of treatment with silver dressings in hard-to-heal chronic VLUs

The modern pollen-vegetation relationship of a tropical forest-savannah mosaic landscape, Ghana, West Africa

Transitions between forest and savannah vegetation types in fossil pollen records are often poorly understood due to over-production by taxa such as Poaceae and a lack of modern pollen-vegetation studies. Here, modern pollen assemblages from within a forest-savannah transition in West Africa are presented and compared, their characteristic taxa discussed, and implications for the fossil record considered. Fifteen artificial pollen traps were deployed for 1 year, to collect pollen rain from three vegetation plots within the forest-savannah transition in Ghana. High percentages of Poaceae and Melastomataceae/Combretaceae were recorded in all three plots. Erythrophleum suaveolens characterised the forest plot, Manilkara obovata the transition plot and Terminalia the savannah plot. The results indicate that Poaceae pollen influx rates provide the best representation of the forest-savannah gradient, and that a Poaceae abundance of >40% should be considered as indicative of savannah-type vegetation in the fossil record

Work-related psychological health among clergywomen in Australia

Drawing on the classic model of balanced affect, the Francis Burnout Inventory conceptualises good work-related psychological health among clergy in terms of negative affect being balanced by positive affect. This paper sets out to explore the relationship between work-related psychological health and psychological type (as assessed by the Francis Psychological-Type Scales) among a sample of 212 Australian clergywomen who completed the National Church Life Survey Form L in 2006. The data supported the internal consistency reliability of the Francis Burnout Inventory and Francis Psychological-Type Scales and found that work-related psychological health was positively related to extraversion and sensing