Number and procedures of involuntary hospital admissions vary in Europe according to the different socio-cultural contexts. The European Commission has funded the EUNOMIA study in 12 European countries in order to develop European recommendations for good clinical practice in involuntary hospital admissions. The recommendations have been developed with the direct and active involvement of national leaders and key professionals, who worked out national recommendations, subsequently summarized into a European document, through the use of specific categories. The need for standardizing the involuntary hospital admission has been highlighted by all centers. In the final recommendations, it has been stressed the need to: providing information to patients about the reasons for hospitalization and its presumable duration; protecting patients’ rights during hospitalization; encouraging the involvement of family members; improving the communication between community and hospital teams; organizing meetings, seminars and focus-groups with users; developing training courses for involved professionals on the management of aggressive behaviors, clinical aspects of major mental disorders, the legal and administrative aspects of involuntary hospital admissions, on communication skills. The results showed the huge variation of involuntary hospital admissions in Europe and the importance of developing guidelines on this procedure.

Antimicrobial resistance (AMR) is a global public health threat. Emergence of AMR occurs naturally, but can also be selected for by antimicrobial exposure in clinical and veterinary medicine. Despite growing worldwide attention to AMR, there are substantial limitations in our understanding of the burden, distribution and determinants of AMR at the population level. We highlight the importance of population-based approaches to assess the association between antimicrobial use and AMR in humans and animals. Such approaches are needed to improve our understanding of the development and spread of AMR in order to inform strategies for the prevention, detection and management of AMR, and to support the sustainable use of antimicrobials in healthcare.

We focus our analysis on an event which occurred at the W-limb on May 30, 2003. The dynamical behavior of the filament, including damped oscillations, was investigated with the CDS and EIT (SoHO) experiments, as well as with Hα filtergrams (movies). The eruptive phase is analyzed taking into account the approximate phasing with other eruptive phenomena occurring at the same time or before, called homologous flares and eruptions.

Defining the causal relationship between a microbe and encephalitis is complex. Over 100 different infectious agents may cause encephalitis, often as one of the rarer manifestations of infection. The gold-standard techniques to detect causative infectious agents in encephalitis in life depend on the study of brain biopsy material; however, in most cases this is not possible. We present the UK perspective on aetiological case definitions for acute encephalitis and extend them to include immune-mediated causes. Expert opinion was primarily used and was supplemented by literature-based methods. Wide usage of these definitions will facilitate comparison between studies and result in a better understanding of the causes of this devastating condition. They provide a framework for regular review and updating as the knowledge base increases both clinically and through improvements in diagnostic methods. The importance of new and emerging pathogens as causes of encephalitis can be assessed against the principles laid out here.

A set of controlled high-Reynolds-number experiments has been conducted at the William B. Morgan Large Cavitation Channel (LCC) in Memphis, Tennessee to investigate the friction drag reduction achieved by injecting aqueous poly(ethylene oxide) (PEO) solutions at three different mean molecular weights into the near-zero-pressure-gradient turbulent boundary layer that forms on a smooth flat test surface having a length of nearly 11m. The test model spanned the 3.05m width of the LCC test section and had an overall length of 12.9m. Skin-friction drag was measured with six floating-plate force balances at downstream-distance-based Reynolds numbers as high as 220 million and free stream speeds up to 20ms−1. For a given polymer type, the level of drag reduction was measured for a range of free stream speeds, polymer injection rates and concentrations of the injected solution. Polymer concentration fields in the near-wall region (0 < y+ < ~103) were examined at three locations downstream of the injector using near-wall planar laser-induced-fluorescence imaging. The development and extent of drag reduction and polymer mixing are compared to previously reported results using the traditional K-factor scaling. Unlike smaller scale and lower speed experiments, speed dependence is observed in the K-scaled results for the higher molecular weight polymers and it is postulated that this dependence is caused by molecular aggregation and/or flow-induced polymer degradation (chain scission). The evolution of near-wall polymer concentration is divided into three regimes: (i) the development region near the injector where drag reduction increases with downstream distance and the polymer is highly inhomogeneous forming filaments near the wall, (ii) the transitional mixing region where drag reduction starts to decrease as the polymer mixes across the boundary layer and where filaments are less pronounced and (iii) the final region where the polymer mixing and dilution is set by the rate of boundary layer growth. Unlike pipe-flow friction-drag reduction, the asymptotic maximum drag reduction (MDR) either was not reached or did not persist in these experiments. Instead, the nearest approach to MDR was transitory and occurred between the development and transitional regions. The length of the development region was observed to increase monotonically with increasing polymer molecular weight, injection rate, concentration and decreasing free stream speed. And finally, the near-wall polymer concentration is correlated to the measured drag reduction for the three polymer molecular weights in the form of a proposed empirical drag-reduction curve.

Extended abstract of a paper presented at Microscopy and Microanalysis 2005 in Honolulu, Hawaii, USA, July 31--August 4, 2005

The finding of bland, sterile vegetations in children with severe tetralogy of Fallot is unexpected, and to our knowledge, has not been reported previously. Eight patients diagnosed with tetralogy between January 1993 and July 1997 had sterile vegetations proven by histological and microbiological evaluation, in their right ventricular outflow tracts. Four of these patients were experiencing severe hyper-cyanotic spells, and four had severely reduced effort tolerance at presentation. They all underwent cardiac catheterization and were submitted for surgical repair. At surgery, the vegetations were thought to be causing further narrowing of the already tight fibrotic infundibular stenosis. Two of these patients had evidence of damaged valves, without evidence of active endocarditis. Although initially sterile, these vegetations, may in some instances, become infected.

The scientific basis for claims of efficacy of nosocomial infection surveillance and control programs was established by the Study on the Efficacy of Nosocomial Infection Control project. Subsequent analyses have demonstrated nosocomial infection prevention and control programs to be not only clinically effective but also cost-effective. Although governmental and professional organizations have developed a wide variety of useful recommendations and guidelines for infection control, and apart from general guidance provided by the Joint Commission on Accreditation of Healthcare Organizations, there are surprisingly few recommendations on infrastructure and essential activities for infection control and epidemiology programs. In April 1996, the Society for Healthcare Epidemiology of America established a consensus panel to develop recommendations for optimal infrastructure and essential activities of infection control and epidemiology programs in hospitals. The following report represents the consensus panel's best assessment of needs for a healthy and effective hospital-based infection control and epidemiology program. The recommendations fall into eight categories: managing critical data and information; setting and recommending policies and procedures; compliance with regulations, guidelines, and accreditation requirements; employee health; direct intervention to prevent transmission of infectious diseases; education and training of healthcare workers; personnel resources; and nonpersonnel resources. The consensus panel used an evidence-based approach and categorized recommendations according to modifications of the scheme developed by the Clinical Affairs Committee of the Infectious Diseases Society of America and the Centers for Disease Control and Prevention's Hospital Infection Control Practices Advisory Committee.