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Optimizing needleless connector hub disinfection practice is a key strategy in central-line–associated bloodstream infection (CLABSI) prevention. In this mixed-methods evaluation, 3 products with varying scrub times were tested for experimental disinfection followed by a qualitative nursing assessment of each.
Needleless connectors were inoculated with varying concentrations of Staphylococcus epidermidis, Pseudomonas aeruginosa, and Staphylococcus aureus followed by disinfection with a 70% isopropyl alcohol (IPA) wipe (a 15-second scrub time and a 15-second dry time), a 70% IPA cap (a 10-second scrub time and a 5-second dry time), or a 3.15% chlorhexidine gluconate with 70% IPA (CHG/IPA) wipe (a 5-second scrub time and a 5-second dry time). Cultures of needleless connectors were obtained after disinfection to quantify bacterial reduction. This was followed by surveying a convenience sample of nursing staff with intensive care unit assignments at an academic tertiary hospital on use of each product.
All products reduced overall bacterial burden when compared to sterile water controls, however the IPA and CHG/IPA wipes were superior to the IPA caps when product efficacy was compared. Nursing staff noted improved compliance with CHG/IPA wipes compared with the IPA wipes and the IPA caps, with many preferring the lesser scrub and dry times required for disinfection.
Achieving adequate bacterial disinfection of needleless connectors while maximizing healthcare staff compliance with scrub and dry times may be best achieved with a combination CHG/IPA wipe.
This chapter analyzes Livy’s narrative of the events of 207 BCE, when Roman officials addressed a pressing religious and military crisis by commissioning an innovative musical event – a Greek-style maiden procession with a hymn composed by Rome’s first known poet, Livius Andronicus. Livy’s account asks us to confront the question of how Roman musical and ritual traditions were created and remembered, by inviting the reader to witness a tradition in the very process of being invented. On the one hand, great emphasis is placed on how the hymn’s ritual actors created a collective memory of its success and incorporated it into the religious traditions of Rome. On the other, Livy refuses to record the hymn himself on the basis of its primitive aesthetics, with the paradoxical result that a significant document in the history of Roman music is simultaneously remembered and forgotten. Self-consciously aware of ritual song and narrative history as differently constituted repositories of collective memory, I propose, Livy draws attention to the processes by which his account of Rome’s early song culture shapes his reader’s musical memory.
The editors’ Introduction provides an overview of and rationale for the volume as a whole. It highlights the book’s key contributions and conceptual frameworks, in part by offering two brief case studies – or “snapshots” – of the dynamic interplay of music and memory in different times, places, and media: Etruscan tomb painting and Athenian comedy.
In Greek mythology, the Muses are Memory's daughters. Their genealogy suggests a deep connection between music and memory in Graeco-Roman culture, but how was this connection understood and experienced by ancient authors, artists, performers, and audiences? How is music remembered and how does it memorialize in a world before recording technology, where sound accumulated differently than it does today? This volume explores music's role in the discourses of cultural memory, communication, and commemoration in ancient Greek and Roman societies. It reveals the many and varied ways in which musical memory formed a fundamental part of social, cultural, ritual, and political life in ancient Greek- and Latin-speaking communities, from classical Athens to Ptolemaic Alexandria and ancient Rome. Drawing on the contributors' interdisciplinary expertise in art history, philology, performance studies, history, and ethnomusicology, eleven original chapters and the editors' Introduction offer new approaches for the study of Graeco-Roman music and musical culture.
Around 60 000 people in England live in mental health supported accommodation. There are three main types: residential care, supported housing and floating outreach. Supported housing and floating outreach aim to support service users in moving on to more independent accommodation within 2 years, but there has been little research investigating their effectiveness.
A 30-month prospective cohort study investigating outcomes for users of mental health supported accommodation.
We used random sampling, accounting for relevant geographical variation factors, to recruit 87 services (22 residential care, 35 supported housing and 30 floating outreach) and 619 service users (residential care 159, supported housing 251, floating outreach 209) across England. We contacted services every 3 months to investigate the proportion of service users who successfully moved on to more independent accommodation. Multilevel modelling was used to estimate how much of the outcome and cost variations were due to service type and quality, after accounting for service-user characteristics.
Overall 243/586 participants successfully moved on (residential care 15/146, supported housing 96/244, floating outreach 132/196). This was most likely for floating outreach service users (versus residential care: odds ratio 7.96, 95% CI 2.92–21.69, P < 0.001; versus supported housing: odds ratio 2.74, 95% CI 1.01–7.41, P < 0.001) and was associated with reduced costs of care and two aspects of service quality: promotion of human rights and recovery-based practice.
Most people do not move on from supported accommodation within the expected time frame. Greater focus on human rights and recovery-based practice may increase service effectiveness.