This article revisits a locus classicus of British Catholic History, the interpretation of the coin-hoard found in 1611 by the Lancashire squire William Blundell of Little Crosby.1 This article offers new information, approaching the Harkirk silver from several perspectives: Mark Blundell offers a memoir of his ancestor William Blundell, as well as lending his voice to the account of the subsequent fate of the Harkirk silver; Professor Jane Stevenson and Professor Peter Davidson reconsider the sources for William Blundell’s historiography as well as considering wider questions of memory and the recusant community; Dr Dora Thornton analyses the silver pyx made from the Harkirk coins in detail, and surveys analogous silverwork in depth.

Infection surveillance definitions for long-term care facilities (ie, the McGeer Criteria) have not been updated since 1991. An expert consensus panel modified these definitions on the basis of a structured review of the literature. Significant changes were made to the criteria defining urinary tract and respiratory tract infections. New definitions were added for norovirus gastroenteritis and Clostridum difficile infections.

Infect Control Hosp Epidemiol 2012;33(10):965-977

In the elderly, immunosenescence and malnourishment can contribute to increased risk and severity of upper respiratory tract infections (URTI). Gold kiwifruit (Actinidia chinensis ‘Hort16A’) contains nutrients important for immune function and mitigation of symptoms of infection, including vitamins C and E, folate, polyphenols and carotenoids. The objective of the present study was to evaluate whether regular consumption of gold kiwifruit reduces symptoms of URTI in older people, and determine the effect it has on plasma antioxidants, and markers of oxidative stress, inflammation and immune function. A total of thirty-two community-dwelling people ( ≥ 65 years) participated in a randomised crossover study, consuming the equivalent of four kiwifruit or two bananas daily for 4 weeks, with treatments separated by a 4-week washout period. Participants completed the Wisconsin Upper Respiratory Symptom Survey-21 daily, and blood samples were collected at baseline and at the end of each treatment and washout period. Gold kiwifruit did not significantly reduce the overall incidence of URTI compared with banana, but significantly reduced the severity and duration of head congestion, and the duration of sore throat. Gold kiwifruit significantly increased plasma vitamin C, α-tocopherol and lutein/zeaxanthin concentrations, and erythrocyte folate concentrations, and significantly reduced plasma lipid peroxidation. No changes to innate immune function (natural killer cell activity, phagocytosis) or inflammation markers (high-sensitivity C-reactive protein, homocysteine) were detected. Consumption of gold kiwifruit enhanced the concentrations of several dietary plasma analytes, which may contribute to reduced duration and severity of selected URTI symptoms, offering a novel tool for reducing the burden of URTI in older individuals.

Pain frequency and its association with participation, function, and health-related quality of life were evaluated in a sample of 198 children (58% male; mean age 10 years 7 months, SD 3 years 11 months; range 5 to 18 years) with moderate to severe cerebral palsy (CP). Gross Motor Functional Classification System (GMFCS) levels were III to V (23% level III, 23% level IV, 31% level V without a gastrostomy tube, and 23% were level V with a gastrostomy tube). Assessment was carried out using the parent-report Child Health Questionnaire (CHQ) and questions assessing health, medical utilization, and medication use. Pain frequency ranged from ‘none’ to ‘every day’. Eleven percent of parents reported pain almost every day (z score=–0.38, p<0.001). Pain was related to severity of motor impairment and the presence of a gastrostomy; parents of the most severely affected children reported the highest pain frequency (p=0.05). Pain was correlated with school days missed (p=0.03) and days in bed (p=0.01). Children taking gastrointestinal medications were reported to have greater pain frequency (p<0.001). The Parental Impact – Emotional subscale of the CHQ was correlated with reported pain (r=0.38, p<0.001). Pain was frequent in children with moderate or severe CP. Pain was more prevalent with more severe impairment and was associated with educational and social consequences.

Infection control programs were among the first organized efforts to improve the quality of healthcare delivered to patients and are an excellent model for the development of other healthcare performance improvement activities. Whether labeled as infection control, quality improvement, or patient safety, performance improvement initiatives share similar methods and principles. The quality of care in long-term–care facilities (LTCFs) has been scrutinized foryears and has received renewed attention with the recent initiation of public reporting of quality measures by Medicare. This article reviews the principles of performance improvement, discusses the importance of employing evidence-based interventions, and emphasizes the value of local performance improvement in LTCFs. Residents of LTCFs remain at high risk for the development of nosocomial infections, and among performance improvement initiatives, infection control is recom-mended as a high priority for all LTCFs. Fortunately, infection control contains the essential elements for performance improvement, and a successful infection control program can provide the foun-dation for expanding performance improvement throughout the LTCF. There is still much that needs to be done to determine the best clinical practices for LTCFs, and this should remain a priority for future research. Furthermore, efforts should continue to apply these principles at the local level to ensure that all residents of LTCFs receive the best care possible.

One of the challenges faced in using ferroelectrics in high frequency devices is how to effectively use the material in a circuit design. A compact reflection-type phase shifter fabricated on sapphire substrates coated with ferroelectric barium strontium titanate (BST) thin-films has been built which shows the promise of using BST thin films in the design of tunable microwave devices. The phase shifter, fabricated as one monolithic assembly, consists of a 3dB coupler, meandered line inductors and tunable interdigital capacitors. A continuously variable phase shift range of more than 100° using the branch-line coupler was obtained at a center frequency of 2.95 GHz, and more than 90° phase shift over 200 MHz bandwidth with a bias voltage range from 0 V to 175 V. The phase shifter using the Lange coupler has over 700 MHz bandwidth centered at 2.2 GHz with a phase shift of more than 90° and an insertion loss less than 2 dB and return loss of greater than 14 dB, over a bias voltage range from 0 V to 160 V. The loss of the BST phase shifter presented in this work is on the order of other commercially available RF front-end components, such as bandpass filters and RF switches. This holds promise for the practical realization of smart antenna systems in cellular handsets and wireless LAN cards.