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Contact precautions are a traditional strategy to prevent transmission of methicillin-resistant Staphylococcus aureus (MRSA). Chlorhexidine bathing is increasingly used to decrease MRSA burden and transmission in intensive care units (ICUs). We sought to evaluate a hospital policy change from routine contact precautions for MRSA compared with universal chlorhexidine bathing, without contact precautions. We measured new MRSA acquisition in ICU patients and surveyed for MRSA environmental contamination in common areas and non-MRSA patient rooms before and after the policy change. During the baseline and chlorhexidine bathing periods, the number of patients (453 vs. 417), ICU days (1999 vs. 1703) and MRSA days/1000 ICU days (109 vs. 102) were similar. MRSA acquisition (2/453 vs. 2/457, P = 0·93) and environmental MRSA contamination (9/474 vs. 7/500, P = 0·53) were not significantly different between time periods. There were 58% fewer contact precaution days in the ICU during the chlorhexidine period (241/1993 vs. 102/1730, P < 0·01). We found no evidence that discontinuation of contact precautions for patients with MRSA in conjunction with adoption of daily chlorhexidine bathing in ICUs is associated with increased MRSA acquisition among ICU patients or increased MRSA contamination of ICU fomites. Although underpowered, our findings suggest this strategy, which has the potential to reduce costs and improve patient safety, should be assessed in similar but larger studies.
We have modeled the local Galactic magnetic field using pulsar rotation measures (RMs), of which there are now about 200 available. The North Polar Spur has a significant effect on pulsar RMs. Using RMs of 116 pulsars nearer than 3 kpc, we find that the local field has a strength B0 = 1.6 ± 0.2 μG toward longitude lB =96° ± 4°, with a reversal of the field at a distance Dr = 600 ± 80 pc toward the inner Galaxy. Relaxing the 3 kpc distance restriction, we find that a concentric ring model with reversals is superior to a bisymmetric spiral model as a fit to the data.
The present study examined the development of a cohort of 279 early adolescents (52% female) from 1990 to 2005. Guided by the interactionist model of socioeconomic status and human development, we proposed that parent aggressive personality, economic circumstances, interparental conflict, and parenting characteristics would affect the development of adolescent aggressive personality traits. In turn, we hypothesized that adolescent aggressiveness would have a negative influence on adolescent functioning as an adult in terms of economic success, personality development, and close relationships 11 years later. Findings were generally supportive of the interactionist model proposition that social and economic difficulties in the family of origin intensify risk for adolescent aggressive personality (the social causation hypothesis) and that this personality trait impairs successful transition to adult roles (the social selection hypothesis) in a transactional process over time and generations. These results underscore how early development leads to child influences that appear to directly hamper the successful transition to adult roles (statistical main effects) and also amplify the negative impact of dysfunctional family systems on the transition to adulthood (statistical interaction effects). The findings suggest several possible points of intervention that might help to disrupt this negative developmental sequence of events.
There is an increased appreciation of the need for horizon scanning: the identification and assessment of issues that could be serious in the future but have currently attracted little attention. However, a process is lacking to identify appropriate responses by policy makers and practitioners. We thus suggest a process and trial its applicability. Twelve environmental conservation organizations assessed each of 15 previously identified horizon scanning issues for their impact upon their organization and the urgency with which they should consider the issue. They also identified triggers that would result in changes in their scoring of the likely urgency and impact of the issues. This process enables organizations to identify priority issues, identify issues they can ignore until there are further developments, benchmark priorities across organizations and identify cross-organizational priorities that warrant further attention, so providing an agenda for collation of evidence, research and policy development. In this trial the review of responses by other organizations resulted in the upgrading of response by a substantial proportion of organizations for eight of the 15 issues examined. We suggest this approach, with the novel components of collaborative assessment and identification of triggers, could be adopted widely, both within conservation organizations and across a wider range of policy issues.
A low-carbohydrate, high-protein (LCHP) diet is often recommended for the prevention and management of diabetes in cats; however, the effect of macronutrient composition on insulin sensitivity and energetic efficiency for weight gain is not known. The present study compared the effect in adult cats (n 32) of feeding a LCHP (23 and 47 % metabolisable energy (ME)) and a high-carbohydrate, low-protein (HCLP) diet (51 and 21 % ME) on fasting and postprandial glucose and insulin concentrations, and on insulin sensitivity. Tests were done in the 4th week of maintenance feeding and after 8 weeks of ad libitum feeding, when weight gain and energetic efficiency of each diet were also measured. When fed at maintenance energy, the HCLP diet resulted in higher postprandial glucose and insulin concentrations. When fed ad libitum, the LCHP diet resulted in greater weight gain (P < 0·01), and was associated with higher energetic efficiency. Overweight cats eating the LCHP diet had similar postprandial glucose concentrations to lean cats eating the HCLP diet. Insulin sensitivity was not different between the diets when cats were lean or overweight, but glucose effectiveness was higher after weight gain in cats fed the HCLP diet. According to the present results, LCHP diets fed at maintenance requirements might benefit cats with multiple risk factors for developing diabetes. However, ad libitum feeding of LCHP diets is not recommended as they have higher energetic efficiency and result in greater weight gain.
We report an essentially complete characterization of energies and relaxation processes of the lowest seven electronic states of the N-V (nitrogen-vacancy) center in diamond using several different nonlinear laser spectroscopie techniques. We have also applied ultrafast optical techniques to measure dielectric properties of CVD and bulk diamond in the 0.3–1.6 THz range for the first time.
Doping polymers with inorganic nanomaterials to form hybrid nanocomposites is an attractive approach to develop new lightweight optoelectronic materials with unique or improved properties. In this work, poly(3-hexylthiophene) (P3HT) Schottky diodes, doped with ZnO nanowires at different P3HT-to-ZnO concentrations, were studied. Device fabrication was carried out by drop casting the nanocomposite on a Pt electrode followed by thermal evaporation of an Al top electrode. ZnO nanowires were prepared via a physical vapor method with Zn as a source. The nanowires were dispersed in chlorobenzene, then the P3HT powder was added. Properties of the diodes were investigated using capacitance-voltage and current-voltage measurements. In addition, electrical resistance of the nanocomposite films was also investigated using a two-point probe measurement with Pt as Ohmic contacts. Results showed that ZnO nanowire doping decreases the built in potential of the diode and the electrical resistance of the nanocomposite film.
White OLEDs (WOLEDTMs) fabricated using energy efficient phosphorescent OLED (PHOLEDTM) technology open up exciting new ways to develop efficient white lighting. WOLEDs have the potential to transform the lighting industry. In this presentation, phosphorescent WOLEDs with high conductivity transport layers will be discussed. White light can be generated by partial energy transfer from blue to green and red. Single WOLED stacks are demonstrated that match the Energy Star® lighting color criteria for 2700K and 3000K with high efficiency (˜80 lm/W) and high color rendering indices (˜80). Both devices had operational lifetimes (LT70%) over 30,000 hours measured from an initial luminance of 1,000 cd/m2. Different techniques to improve optical outcoupling will also be discussed.
Juvenile pelagic fishes are integral members of many coastal river communities. Many of these systems are boldly influenced by variable wind stress and freshwater inputs that can increase heterogeneity in estuarine habitat for fishes. We use mobile sonar surveys within the Neuse River Estuary System, NC, USA to assess the distribution and behavioral patterns of juvenile anchovies, Anchoa spp. 25-65 mm TL, over a broad range of spatial scales in relation to diel and seasonal changes in water quality including stratification, hypoxic events and copepod distribution. Results from our study indicate that episodic stratification-induced hypoxic events can reduce suitable habitat volume for anchovies by more than 50%. Furthermore, our sampling suggests that hypoxia causes spatial separation between plankton and the grazing fishes. Under stratified oxygen conditions, we observe higher densities of copepods in hypoxic bottom water. Finally, we report that reductions in available habitat caused an increase in local densities of fishes and may result in increased competition for resources. These spatially explicit data are critical for developing trophic dynamic models that predict the response of fish communities to natural and anthropogenic impacts on the system.
Old age psychiatrists' main concern with regard to incapacity is with patients with dementia. Dementia is predominantly a disorder of old age, probably affecting over half a million people in the UK, and it inevitably affects decision-making capacity. The 1983 Mental Health Act does not appear to have been framed with particular consideration for this group and it is vital that any new laws pay special attention to people with dementia.
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