Where do hands go? An audit of sequential hand-touch events on a hospital ward

Reservoirs of pathogens could establish themselves at forgotten sites on a ward, posing a continued risk for transmission to patients via unwashed hands. To track potential spread of organisms between surfaces and patients, and to gaina greater understanding into transmission pathways of pathogens during patient care. Hand-touch activities were audited covertly for 40 30 min sessions during summer and winter, and included hand hygiene on entry; contact with near-patient sites; patient contact; contact with clinical equipment; hand hygiene on exit; and contact with sites outside the room. There were 104 entries overall: 77 clinical staff (59 nurses; 18 doctors), 21 domestic staff, one pharmacist and five relatives. Hand-hygiene compliance among clinical staff before and after entry was 25% (38/154), with higher compliance during 20 summer periods [47%; 95% confidence interval (CI): 35.6e58.8] than during 20 winter periods (7%; 95% CI: 3.2e14.4; P < 0.0001). More than half of the staff (58%; 45/77) touched the patient. Staff were more likely to clean their hands prior to contact with a patient [odds ratio (OR): 3.44; 95% CI: 0.94e16.0); P ¼ 0.059] and sites beside the patient (OR: 6.76; 95% CI: 1.40e65.77; P ¼ 0.0067). Nearly half (48%; 37/77) handled patient notes and 25% touched the bed. Most frequently handled equipment inside the room were intravenous drip (30%) and blood pressure stand (13%), and computer (26%), notes trolley (23%) and telephone (21%) outside the room. Hand-hygiene compliance remains poor during covert observation; understanding the most frequent interactions between hands and surfaces could target sites for cleaning

Anarchism and non-representational theory in the social sciences

My hope in this article is to demonstrate some ways in which anarchism is relevant for social science, specifically in a post-representational environment. To do this, I explore some of the productive links between the stance of anarchism and recent work in non-representational theorising in the social sciences (Ingold, 2015; Dewsbury, 2010; Thrift, 2008). By doing so, I do not suggest that non-representational theory has to be anarchist. Rather, I argue that it lends itself strongly to a reconsideration, even a revalorization, of anarchism in the social sciences. Finally, to illustrate this link I will turn in the last section to the sociologist Andrew Pickering (2010) for his thought-provoking exposition of performative, non-representational approaches as a sustainable and viable alternative social ontology.Publisher PD

The perception of self-produced sensory stimuli in patients with auditory hallucinations and passivity experiences: evidence for a breakdown in self-monitoring

BACKGROUND: To test the hypothesis that certain psychotic symptomatology is due to a defect in self-monitoring, we investigated the ability of groups of psychiatric patients to differentiate perceptually between self-produced and externally produced tactile stimuli. METHODS: Responses to tactile stimulation were assessed in three groups of subjects: schizophrenic patients; patients with bipolar affective disorder or depression; and normal control subjects. Within the psychiatric groups subjects were divided on the basis of the presence or absence of auditory hallucinations and/or passivity experiences. The subjects were asked to rate the perception of a tactile sensation on the palm of their left hand. The tactile stimulation was either self-produced by movement of the subject's right hand or externally produced by the experimenter. RESULTS: Normal control subjects and those psychiatric patients with neither auditory hallucinations nor passivity phenomena experienced self-produced stimuli as less intense, tickly and pleasant than identical, externally produced tactile stimuli. In contrast, psychiatric patients with these symptoms did not show a decrease in their perceptual ratings for tactile stimuli produced by themselves as compared with those produced by the experimenter. This failure to show a difference in perception between self-produced and externally produced stimuli appears to relate to the presence of auditory hallucinations and/or passivity experiences rather than to the diagnosis of schizophrenia. CONCLUSIONS: We propose that auditory hallucinations and passivity experiences are associated with an abnormality in the self-monitoring mechanism that normally allows us to distinguish self-produced from externally produced sensations

Impact of varying intensities of blue-light exposure on 3T3 cells

There is the need to develop a compatible sterilisation method for hybrid biomaterials. High-intensity blue light in the 405 nm region has been shown to be an effective bacterial decontamination method [1], to cause no noticeable damage to the gross structure of type-I collagen monomer (when treated at 10 mW/cm2) [2], and to have no noticeable effect on 3T3 cell viability, growth rate, redox state or lactate dehydrogenase (LDH) leakage (at 1.0 mW/cm2) [2]. The purpose of this research was to investigate the effect of varying the blue-light intensity on the 3T3 cell response parameters

Estimating the damage and marginal cost of different vehicle types on rail infrastructure: combining economic and engineering approaches

EU legislation requires that European infrastructure managers set access charges based on the marginal cost of running trains on their networks. Two methods have been used in the literature for this purpose. Top-down methods relate actual costs to traffic volumes. Bottom-up methods use engineering models to simulate damage and then translate damage into costs based on assumptions about interventions and their unit costs. Whilst top down methods produce sensible results for marginal cost overall, they have struggled to differentiate between traffic types. The challenge for bottom-up approaches is how to translate damage into cost, with numerous assumptions being required which may be invalid. This paper proposes a new, two stage approach to estimating the marginal cost of rail infrastructure usage. The first stage uses engineering models to simulate damage caused by vehicles on the network. The second stage seeks to establish a statistical relationship between actual costs and damage. It is thus possible to convert damage estimates into costs using actual cost data, rather than through a set of potentially invalid assumptions as in previous approaches. Only the first stage is implemented in this paper. We show that it possible to produce total (annualised) damage measures for three damage mechanisms on five actual track sections in Sweden. Once extended, it will be possible to model the relationship between damage and actual costs for the first time; and thus better understand the relative costs of the different damage mechanisms and in turn inform the level and structure of track access charges

Tribological optimisation of the internal combustion engine piston to bore conjunction through surface modification

Internal combustion (IC) engines used in road transport applications employ pistons to convert gas pressure into mechanical work. Frictional losses abound within IC engines, where only 38- 51% of available fuel energy results in useful mechanical work. Piston-bore and ring-bore conjunctions are fairly equally responsible for circa 30% of all engine friction - equivalent to 1.6% of the input fuel each. Therefore, reduction in piston assembly friction would have a direct impact on specific performance and / or fuel consumption. In motorsport, power outputs and duty cycles greatly exceed road applications. Consequently, these engines have a shorter useful life and a high premium is placed on measures which would increase the output power without further reducing engine life. Reduction of friction offers such an opportunity, which may be achieved by improved tribological design in terms of reduced contact area or enhanced lubrication or both. However, the developments in the motorsport sector are typically reactive due to a lack of relative performance or an ad-hoc reliance, based upon a limited number of actual engine tests in order to determine if any improvement can be achieved as the result of some predetermined action. A representative scientific model generally does not exist and as such, investigated parameters are often driven by the supply chain with the promise of improvement. In cylinder investigations are usually limited to bore surface finish, bore and piston geometrical form, piston skirt coatings and the lubricant employed. Of these investigated areas newly emerging surface coatings are arguably seen as predominate. This thesis highlights a scientific approach which has been developed to optimise piston-bore performance. Pre-existing methods of screening and benchmarking alterations have been retained such as engine testing. However, this has been placed in the context of validation of scientifically driven development. A multi-physics numerical model is developed, which combines piston inertial dynamics, as well as thermo-structural strains within a thermoelastohydrodynamic tribological framework. Experimental tests were performed to validate the findings of numerical models. These tests include film thickness measurement and incylinder friction measurement, as well as the numerically-indicated beneficial surface modifications. Experimental testing was performed on an in-house motored engine at Capricorn Automotive, a dynamometer mounted single-cylinder ‘fired’ engine at Loughborough University, as well as on other engines belonging to third party clients of Capricorn. The diversity of tests was to ascertain the generic nature of any findings. The multi-physics multi-scale combined numerical-experimental investigation is the main contribution of this thesis to knowledge. One major finding of the thesis is the significant role that bulk thermo-structural deformation makes on the contact conformity of piston skirt to cylinder liner contact, thus advising piston skirt design. Another key finding is the beneficial role of textured surfaces in the retention of reservoirs of lubricant, thus reducing friction

The Effects of a Saffron Extract (affron®) on Menopausal Symptoms in Women during Perimenopause: A Randomised, Double-Blind, Placebo-Controlled Study

Objectives There is preliminary evidence suggesting saffron may effectively treat menopausal symptoms. The aim of this study was to examine the tolerability and efficacy of a standardised saffron extract (affron®) on menopausal complaints in perimenopausal women. Methods In this 12-week, parallel-group, double-blind, randomised controlled trial, 86 perimenopausal women experiencing menopausal complaints received either a placebo or 14 mg of a saffron extract (affron®), twice daily. Outcome measures included the Greene Climacteric Scale (GCS), Positive and Negative Affect Schedule (PANAS), and Short Form-36 Health Survey (SF-36). Results Based on data collected from 82 participants, saffron was associated with greater improvements in mood and psychological symptoms compared to the placebo. Results from the GCS revealed a significantly greater reduction in the GCS psychological score (P = 0.032), characterised by a 33% reduction in anxiety and a 32% reduction in depression scores from baseline to week 12. There was also a significantly greater reduction in the PANAS negative affect score (P = 0.043) compared to the placebo. However, compared to the placebo, saffron was not associated with greater improvements in vasomotor symptoms, somatic symptoms, or other quality of life measures. Saffron intake was well tolerated with no reported major adverse events. Conclusions The saffron extract, affron®, administered for 12 weeks at a dose of 14 mg twice daily was associated with greater improvements in psychological symptoms. Further studies in perimenopausal women presenting with varying severity of menopausal symptoms, using different doses of saffron will be useful to examine in future clinical trials

Dynamics of tilt-based browsing on mobile devices

A tilt-controlled photo browsing method for small mobile devices is presented. The implementation uses continuous inputs from an accelerometer, and a multimodal (visual, audio and vibrotactile) display coupled with the states of this model. The model is based on a simple physical model, with its characteristics shaped to enhance usability. We show how the dynamics of the physical model can be shaped to make the handling qualities of the mobile device fit the browsing task. We implemented the proposed algorithm on Samsung MITs PDA with tri-axis accelerometer and a vibrotactile motor. The experiment used seven novice users browsing from 100 photos. We compare a tilt-based interaction method with a button-based browser and an iPod wheel. We discuss the usability performance and contrast this with subjective experience from the users. The iPod wheel has significantly poorer performance than button pushing or tilt interaction, despite its commercial popularity

Wave transformation across a macrotidal shore platform under low to moderate energy conditions

We investigate how waves are transformed across a shore platform as this is a central question in rock coast geomorphology. We present results from deployment of three pressure transducers over four days, across a sloping, wide (~200 m) cliff-backed shore platform in a macrotidal setting, in South Wales, United Kingdom. Cross shore variations in wave heights were evident under the predominantly low to moderate (significant wave height &#60; 1.4 m) energy conditions measured. At the outer transducer 50 m from the seaward edge of the platform (163 m from the cliff) high tide water depths were 8+ m meaning that waves crossed the shore platform without breaking. At the mid platform position water depth was 5 m. Water depth at the inner transducer (6 m from the cliff platform junction) at high tide was 1.4 m. This shallow water depth forced wave breaking, thereby limiting wave heights on the inner platform. Maximum wave height at the middle and inner transducers were 2.41 and 2.39 m respectively and significant wave height 1.35 m and 1.34 m respectively. Inner platform high tide wave heights were generally larger where energy was up to 335% greater than near the seaward edge where waves were smaller. Infragravity energy was less than 13% of the total energy spectra with energy in the swell, wind and capillary frequencies accounting for 87% of the total energy. Wave transformation is thus spatially variable and is strongly modulated by platform elevation and the tidal range. While shore platforms in microtidal environments have been shown to be highly dissipative, in this macro-tidal setting up to 90% of the offshore wave energy reached the landward cliff at high tide, so that the shore platform cliff is much more reflective