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Medical equipment can transmit pathogenic bacteria to patients. This single-institution point prevalence study aimed to characterise the types and relative amount of bacteria found on surgical loupes, headlights and their battery packs.
Surgical loupes, headlights and battery packs of 16 otolaryngology staff and residents were sampled, cultured and quantified. Plate scores were summed for each equipment type, and the total was divided by the number of users to generate mean bacterial burden scores. Residents completed a questionnaire regarding their equipment cleaning practices.
The contamination rates of loupes, headlights and battery packs were 68.75 per cent, 100 per cent and 75 per cent, respectively. Battery packs cultured more bacteria (1.58 per swab ± 1.00) than loupes (0.75 per swab ± 0.66; p = 0.024). Headlights had non-significantly greater growth (1.50 per swab ± 0.71) than loupes (p = 0.052). Bacterial growth was significantly higher from inner surfaces of loupes (p = 0.035) and headlights (p = 0.037). Potentially pathogenic bacteria were cultured from the equipment of five participants, including: Pantoea agglomerans, Acinetobacter radioresistens, Staphylococcus aureus, Acinetobacter calcoaceticus baumannii complex and Moraxella osloensis.
This study demonstrates that surgical loupes and headlights used in otolaryngology harbour non-pathogenic skin flora and potentially pathogenic bacteria.
Detailed x-ray double-axis rocking-curve analysis has been made of a series of silicon wafers, polished using various colloidal silicas with a number of different conditions. Significant differences, attributable to the polishing conditions, were observed in the tails of the rocking curves, using a four-reflection, non-dispersive beam conditioner. These have been compared with theoretical simulations in order to deduce the strain profile near the surface.
We present preliminary analysis of new HST observations of the transiting extrasolar planet HD 209458b. Photometric observations were obtained with the Fine Guidance Sensor (FGS) on the Hubble Space Telescope (HST), providing milli-mag precision and high time resolution (40 Hz). The FGS photometry allows us to derive precise stellar/orbital parameters (ephemeris, inclination, limb darkening) and planetary radius, and also allows a search for the presence of planetary rings and satellites. We discuss preliminary results and two approaches to modelling the observations.
A legionellosis outbreak at an industrial site was investigated to identify and control the source. Cases were identified from disease notifications, workplace illness records, and from clinicians. Cases were interviewed for symptoms and risk factors and tested for legionellosis. Implicated environmental sources were sampled and tested for legionella. We identified six cases with Legionnaires’ disease and seven with Pontiac fever; all had been exposed to aerosols from the cooling towers on the site. Nine cases had evidence of infection with either Legionella pneumophila serogroup (sg) 1 or Legionella longbeachae sg1; these organisms were also isolated from the cooling towers. There was 100% DNA sequence homology between cooling tower and clinical isolates of L. pneumophila sg1 using sequence-based typing analysis; no clinical L. longbeachae isolates were available to compare with environmental isolates. Routine monitoring of the towers prior to the outbreak failed to detect any legionella. Data from this outbreak indicate that L. pneumophila sg1 transmission occurred from the cooling towers; in addition, L. longbeachae transmission was suggested but remains unproven. L. longbeachae detection in cooling towers has not been previously reported in association with legionellosis outbreaks. Waterborne transmission should not be discounted in investigations for the source of L. longbeachae infection.
This study aimed to evaluate the oncological and voice outcomes of transoral laser microsurgery for tumour stage T1b stage glottic cancer patients.
A prospective cohort study in a tertiary care head and neck cancer centre included tumour–node–metastasis stage T1bN0M0 glottic cancer patients scheduled to undergo transoral laser microsurgery from January 2002 until June 2014. Kaplan–Meier five-year analyses of local control, overall survival, disease-specific survival and laryngeal preservation were performed. Voice Handicap Index-10 scores and maximum phonation times were also recorded.
Twenty-one participants with a mean age of 66.8 years were enrolled. The mean follow up was 56.5 months. Kaplan–Meier 5-year survival analysis illustrated a local control rate of 82 per cent, overall survival of 88 per cent, disease-specific survival of 100 per cent, and laryngeal preservation of 100 per cent. The pre-operative Voice Handicap Index-10 score was 19.1 ± 9.47 (mean ± standard deviation (SD)) and the post-operative scores were 13.5 ± 9.29 at three months, 10.44 ± 9.70 at one year and 5.83 ± 4.91 at two years. The pre-operative maximum phonation time was 16.23 ± 5.46 seconds (mean ± SD) and the post-operative values were 14.44 ± 6.73 seconds at three months, 15.27 ± 5.71 seconds at one year and 14.33 ± 6.44 seconds at two years.
Transoral laser microsurgery yields relatively high rates of oncological control and acceptable voice outcomes, and thus shows utility as a primary treatment modality for T1b glottic cancer.
To develop latent classes of exposure to traumatic experiences before the age of 13 years in an urban community sample and to use these latent classes to predict the development of negative behavioral outcomes in adolescence and young adulthood.
A total of 1815 participants in an epidemiologically based, randomized field trial as children completed comprehensive psychiatric assessments as young adults. Reported experiences of nine traumatic experiences before age 13 years were used in a latent class analysis to create latent profiles of traumatic experiences. Latent classes were used to predict psychiatric outcomes at age ⩾13 years, criminal convictions, physical health problems and traumatic experiences reported in young adulthood.
Three latent classes of childhood traumatic experiences were supported by the data. One class (8% of sample), primarily female, was characterized by experiences of sexual assault and reported significantly higher rates of a range of psychiatric outcomes by young adulthood. Another class (8%), primarily male, was characterized by experiences of violence exposure and reported higher levels of antisocial personality disorder and post-traumatic stress. The final class (84%) reported low levels of childhood traumatic experiences. Parental psychopathology was related to membership in the sexual assault group.
Classes of childhood traumatic experiences predict specific psychiatric and behavioral outcomes in adolescence and young adulthood. The long-term adverse effects of childhood traumas are primarily concentrated in victims of sexual and non-sexual violence. Gender emerged as a key covariate in the classes of trauma exposure and outcomes.
Little is known about the relative extent of crime against people with
severe mental illness (SMI).
To assess the prevalence and impact of crime among people with SMI
compared with the general population.
A total of 361 psychiatric patients were interviewed using the national
crime survey questionnaire, and findings compared with those from 3138
general population controls participating in the contemporaneous national
Past-year crime was experienced by 40% of patients v.
14% of controls (adjusted odds ratio (OR) = 2.8, 95% CI 2.0–3.8); and
violent assaults by 19% of patients v. 3% of controls
(adjusted OR = 5.3, 95% CI 3.1–8.8). Women with SMI had four-, ten- and
four-fold increases in the odds of experiencing domestic, community and
sexual violence, respectively. Victims with SMI were more likely to
report psychosocial morbidity following violence than victims from the
People with SMI are at greatly increased risk of crime and associated
morbidity. Violence prevention policies should be particularly focused on
people with SMI.
Domestic and sexual violence are significant public health problems but little is known about the extent to which men and women with severe mental illness (SMI) are at risk compared with the general population. We aimed to compare the prevalence and impact of violence against SMI patients and the general population.
Three hundred and three randomly recruited psychiatric patients, in contact with community services for ⩾1 year, were interviewed using the British Crime Survey domestic/sexual violence questionnaire. Prevalence and correlates of violence in this sample were compared with those from 22 606 general population controls participating in the contemporaneous 2011/12 national crime survey.
Past-year domestic violence was reported by 27% v. 9% of SMI and control women, respectively [odds ratio (OR) adjusted for socio-demographics, aOR 2.7, 95% confidence interval (CI) 1.7–4.0], and by 13% v. 5% of SMI and control men, respectively (aOR 1.6, 95% CI 1.0–2.8). Past-year sexual violence was reported by 10% v. 2.0% of SMI and control women respectively (aOR 2.9, 95% CI 1.4–5.8). Family (non-partner) violence comprised a greater proportion of overall domestic violence among SMI than control victims (63% v. 35%, p < 0.01). Adulthood serious sexual assault led to attempted suicide more often among SMI than control female victims (53% v. 3.4%, p < 0.001).
Compared to the general population, patients with SMI are at substantially increased risk of domestic and sexual violence, with a relative excess of family violence and adverse health impact following victimization. Psychiatric services, and public health and criminal justice policies, need to address domestic and sexual violence in this at-risk group.
To describe treatment and referral patterns and National Health Service resource use in patients with chronic pain associated with low back pain or osteoarthritis, from a Primary Care perspective.
Osteoarthritis and low back pain are the two commonest debilitating causes of chronic pain, with high health and social costs, and particularly important in primary care. Understanding current practice and resource use in their management will inform health service and educational requirements and the design and optimisation of future care.
Multi-centre, retrospective, descriptive study of adults (⩾18 years) with chronic pain arising from low back pain or osteoarthritis, identified through primary care records. Five general practices in Scotland, England (two), Northern Ireland and Wales. All patients with a diagnosis of low back pain or osteoarthritis made on or before 01/09/2006 who had received three or more prescriptions for pain medication were identified and a sub-sample randomly selected then consented to an in-depth review of their medical records (n=264). Data on management of chronic pain were collected retrospectively from patients’ records for three years from diagnosis (‘newly diagnosed’ patients) or for the most recent three years (‘established’ patients).
Patients received a wide variety of pain medications with no overall common prescribing pattern. GP visits represented the majority of the resource use and ‘newly diagnosed’ patients were significantly more likely to visit their GP for pain management than ‘established’ patients. Although ‘newly diagnosed’ patients had more referrals outside the GP practice, the number of visits to secondary care for pain management was similar for both groups.
This retrospective study confirmed the complexity of managing these causes of chronic pain and the associated high resource use. It provides an in-depth picture of prescribing and referral patterns and of resource use.
Reproductive aspects of the intensively traded ornamental shrimp Lysmata boggessi were examined. Abundance, reproductive biology (fecundity, reproductive output and egg size) and population structure (frequency distribution, size at sex phase change and sex phase ratio) were examined at three different fishing grounds off south and west-central Florida between May 2011 and February 2012. Fishery-dependent densities of L. boggessi varied between 2.51 ± 1.39 and 13.05 ± 9.30 shrimps per 1000 m2 at two different localities. The proportion of brooding shrimp varied considerably at one locality during two different dates, suggesting reproductive seasonality. Reproductive output increased linearly with shrimp body weight (SBW) at one locality (May 2011), but scaled negatively with SBW at a second locality (January–February 2012). Lastly, no correlation between embryo size and shrimp carapace length (CL) was recorded at one locality (May 2011), but a slight negative correlation between embryo size and CL was found at the second locality (January–February 2012). Lysmata boggessi might be experiencing trade-offs between different reproductive parameters driven by environmental, probably seasonal, conditions during the year. All of this information needs to be considered in assessing shrimp stocks and establishing a sustainable management plan.
High-resolution spectroscopy and spectropolarimetry have been undertaken at the Anglo-Australian Telescope in order to identify suitable targets for magnetic studies of young Sun-like stars, for the proxy study of early solar evolution. This study involved the investigation of some variable late F- / early G-type Sun-like stars originally identified by the Hipparcos mission. Of the 38 stars observed for this study, HIP 31021, HIP 64732, HIP 73780 were found to be spectroscopic binary stars, while HIP 19072, HIP 67651 and HIP 75636 are also likely to be binaries and HIP 33111 could even be a triple system. Magnetic fields were detected on a number of the survey stars: HIP 21632, HIP 43720, HIP 48770, HIP 62517, HIP 71933, HIP 77144, HIP 89829, HIP 90899 and HIP 105388, making these stars good candidates for follow-up Zeeman Doppler imaging studies.
Three wt% each of Cs and Tc were mixed with the standard Synroc precursor
and the ceramic was formed by hot-pressing. Attempts were made to
incorporate the Tc as either metal or Tc 4+, using different
redox conditions in processing. Volatile losses of Tc during calcination
were < 0.1% in all cases. Short-term Tc leach rates when the Tc was
present as a metal alloy were in the order of 10−4 g/m /d at 90°C
with frequently changed water, and decreased with increasing leaching time.
The valence of the Tc was monitored by X-ray absorption spectroscopy at the
drying and calcination stages of the production. The general viability of
Synroc/glass composites for immobilising the Hanford HLW sludges is further
demonstrated by using further refinements of additive schemes for the
inactive “All-blend” formulation and initial studies using the U-containing
“All-blend” waste formulation.
Between April and August 2005 Christchurch, New Zealand experienced an outbreak of Legionnaires' disease. There were 19 laboratory-confirmed case including three deaths. Legionella pneumophila serogroup 1 (Lpsg1) was identified as the causative agent for all cases. A case-control study indicated a geographical association between the cases but no specific common exposures. Rapid spatial epidemiological investigation confirmed the association and identified seven spatially significant case clusters. The clusters were all sourced in the same area and exhibited a clear anisotropic process (noticeable direction) revealing a plume effect consistent with aerosol dispersion from a prevailing southwesterly wind. Four out of five cases tested had indistinguishable allele profiles that also matched environmental isolates from a water cooling tower within the centre of the clusters. This tower was considered the most probable source for these clusters. The conclusion would suggest a maximum dispersal distance in this outbreak of 11·6 km. This work illustrated the value of geostatistical techniques for infectious disease epidemiology and for providing timely information during outbreak investigations.
Gas-filled capillary discharge waveguides are a commonly employed medium in laser–plasma interaction applications, such as the laser wakefield accelerator, because they can simultaneously guide high-power laser pulses while acting as the medium for acceleration. In this paper, the production of both straight and linearly tapered capillaries using a femtosecond laser micromachining technique is presented. A tapered capillary is shown to possess a smooth variation in diameter (from 305 μm to 183 μm) along its entire 40 mm length, which would lead to a longitudinal plasma density gradient, thereby dramatically improving the laser–plasma interaction efficiency in applications. Efficient guiding with up to 82% energy transmission of the fundamental Gaussian mode of a low intensity, 50 fs duration laser pulse is shown for both types of capillary waveguide.
Palaeomagnetic data define a polar wander path for the Dalradian tectonic block of the Scottish Highlands but resolve no relative motion between the Dalradian and Midland Valley blocks from early Ordo vician onwards. The history of structural episodes (D1 to D4) is traced for the Dalradian rocks of the Southern Highlands, and peak metamorphic temperatures are closely associated with D3 in the 520–490 Ma (early Ordovician) time period, whilst retrograde events are mostly associated with D4. Throughout the structural history, the influence of a lineament or lineaments parallel to the Highland Border is seen and is particularly demonstrated by the formation of the major Highland Border downbend (D4) structure. This monoform is interpreted as lying structurally above a major step in the basement and is associated with uplift of the Dalradian flat belt in the period 460–440 Ma (late Ordovician).
The mechanism of emplacement of the slivers of Highland Border Complex (HBC) rocks adjacent to the Dalradian Supergroup along the Highland Boundary fault zone is considered given that structural and palaeontological evidence indicates the emplacement to be post- D3 in the Dalradian rocks. The steep attitude of rocks along the Highland Boundary fault zone is probably due to vertical movements but either thrust or strike-slip movements are also indicated. Thrust emplacement prior to downbend formation (D4 in the Dalradian rocks) would also precede uplift and have to take place at considerable depth (10–20 km). Thrust emplacement subsequent to downbend formation is difficult to reconcile with the existing structural relations, whilst strike-slip motion offers a straightforward mechanism of placement.