scholarly journals Assessing the Potential Impact of a Long-Acting Skin Disinfectant in the Prevention of MRSA

2020 ◽  
Vol 41 (S1) ◽  
pp. s131-s132
Author(s):  
Eric Lofgren
Keyword(s):  
Single Point ◽  
Research Priorities ◽  
Subsequent Development ◽  
Potential Utility ◽  
Persistent Problem ◽  
Hypothetical Treatment ◽  
Duration Of Infection ◽  
Clinical Illness ◽  
Long Acting ◽  
Acquisition Rates

Background: Healthcare-associated transmission of methicillin-resistant Staphylococcus aureus (MRSA) remains a persistent problem despite advances in prevention. The use of chlorhexidine gluconate (CHG) as a means of decolonizing patients, either through targeted decolonization or daily bathing, is a frequently used measure to supplement other MRSA reduction interventions. However, there is room for new and innovative decolonizing agents. We explored the potential utility of a long-acting CHG-like disinfectant with a persistent protective effect as well as an immediate decolonizing action in the prevention of MRSA acquisition as well as the subsequent development of clinical illness and MRSA-related mortality. Methods: We modeled MRSA transmission throughout an 18-bed intensive care unit, based on previously published models. A baseline model with no daily decolonizing protocol was used as a baseline and was compared to a scenario assuming that patients were bathed with CHG, which decolonizes them but provides no ongoing protection, as well as a scenario involving a hypothetical treatment that both decolonizes and provides ongoing protection from subsequent colonization. We varied the duration and efficacy of this protection to fully explore the potential utility of such a treatment. Results: The results of the simulations are shown in Fig. 1, where duration and efficacy of protection varied. The number of MRSA acquisitions from each combination is depicted as a single point, with blue points indicating correspondingly fewer MRSA acquisitions. Overall, improved efficacy of the hypothetical disinfectant resulted in immediate improvements in MRSA acquisition rates when compared to the baseline. To see major improvements in the MRSA acquisition rate due to the duration of infection, that duration must be well above 10 hours in many scenarios. There is also little evidence of synergy between the two. Conclusions: Based on recent results suggesting CHG has a relatively modest per-use efficacy (<.20), there is room for improvement in the formulation and administration of decolonizing agents. Although there has been considerable excitement about the possibility of long-acting agents that not only decolonize but provide long-acting protection against colonization, these results suggest that such protection would only result in markedly decreased acquisition rates only if that duration of protection was extremely long, or if the agent itself was also considerably more efficacious than CHG. These results may be used to help consider the necessary study size for clinical studies of these agents in the future, or to set research priorities and properly calibrate expectations.Funding: NoneDisclosures: None

scholarly journals Assessing the Potential Impact of a Long-Acting Skin Disinfectant in the Prevention of Methicillin-Resistant Staphylococcus aureus Transmission

2020 ◽  
Vol 17 (5) ◽  
pp. 1500
Author(s):  
Christopher T. Short ◽  
Matthew S. Mietchen ◽  
Eric T. Lofgren
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistant ◽  
Persistent Problem ◽  
Additional Protection ◽  
Hypothetical Treatment ◽  
Clinical Illness ◽  
Long Acting ◽  
Healthcare Associated ◽  
Duration Of Protection

Healthcare-associated transmission of methicillin-resistant Staphylococcus aureus (MRSA) remains a persistent problem. The use of chlorhexidine gluconate (CHG) as a means of decolonizing patients, either through targeted decolonization or daily bathing, is frequently used to supplement other interventions. We explore the potential of a long-acting disinfectant with a persistent effect, immediate decolonizing action in the prevention of MRSA acquisition, and clinical illness and mortality in an 18-bed intensive care unit, based on a previous model. A scenario with no intervention is compared to CHG bathing, which decolonizes patients but provides no additional protection, and a hypothetical treatment that both decolonizes them and provides protection from subsequent colonization. The duration and effectiveness of this protection is varied to fully explore the potential utility of such a treatment. Increasing the effectiveness of the decolonizing agent reduces colonization, with a 10% increase resulting in a colonization rate ratio (RR) of 0.89 (95% CI: 0.89,0.90). Increasing the duration of protection results in a much more modest reduction, with a 12-hour increase in protection resulting in an RR of 0.99 (95% CI: 0.99, 0.99). There is little evidence of synergy between the two.

Research Priorities as Defined by the Subcommittees

PEDIATRICS ◽  
1990 ◽  
Vol 86 (5) ◽  
pp. 832-832
Keyword(s):  
Neuropathic Pain ◽  
Side Effects ◽  
Cancer Pain ◽  
Local Anesthesia ◽  
Pediatric Cancer ◽  
Research Priorities ◽  
Transdermal Application ◽  
Long Acting ◽  
Future Work ◽  
The Impact

The following are areas of priority for future work in pediatric cancer pain. ASSESSMENT AND METHODOLOGY 1. Research on the description, prevalence, and correlates of pediatric cancer pain. 2. Evaluation of the effects of coursework and workshops about pediatric cancer pain on professional practice. 3. Development and evaluation of the impact of quality assurance programs on the management of pain in childhood cancer. 4. Further refinement and validation of instruments to measure cancer pain in children. DISEASE-RELATED PAIN 1. Development of more convenient drug delivery systems, including transdermal application. 2. Development of new analgesics which provide relief of intense pain with fewer side effects than opioids that are currently available. In particular, agents that can relieve severe pain but produce less respiratory depression would be extremely useful for infants and patients with diminished respiratory reserve. 3. Development of more effective agents for management of side effects. For example, antiemetics for patients unable to tolerate phenothiazines or butyrophenones, or antipruritics for patients whose itching is refractory to antihistamines. 4. Comparisons of short-acting and long-acting oral analgesics in children. 5. Study of the importance of neuropathic pain in cancer pain in children and comparisons of the various treatments for neuropathic pain, including tricyclics and anticonvulsants. PROCEDURE-RELATED PAIN 1. Local anesthesia a. When should local anesthesia be used? b. What local anesthetics are most effective? c. Are anesthetic creams effective? d. What is the feasibility and efficacy of ionophoresis of lidocaine and other local an-esthetic delivery methods, including buffered lidocaine?

scholarly journals 259 IDENTIFYING THE TOP 10 RESEARCH PRIORITIES FOR FAMILY CARERS: THE INTERFACE PROJECT

2021 ◽  
Vol 50 (Supplement_3) ◽  
Author(s):  
O Donegan ◽  
I Hartigan ◽  
K Cowan ◽  
N Dunne ◽  
R Hally ◽  
...  
Keyword(s):  
Healthcare Professionals ◽  
Research Priorities ◽  
Subsequent Development ◽  
Financial Strain ◽  
Family Carers ◽  
Group Discussions ◽  
Policy Makers ◽  
Health And Wellbeing ◽  
Multi Stakeholder

Abstract Background In assessing the global impact of the COVID-19 pandemic on society, it is important to understand the communities most affected and develop methods of support. Family carers provide a vital, yet often invisible role in our society and healthcare system. Identifying research priorities for carers helps establish overall gaps in the research agenda and increases awareness of the role of carers in the community. Methods A priority setting partnership methodology was engaged and through collaboration with carers, healthcare professionals and researchers, a participatory process was conducted to identify gaps in the current literature and prioritise research questions and uncertainties. Focus group discussions followed, the first consisted of family carers (n = 5). The second (n = 3) interviewed stakeholders namely healthcare professionals, researchers and policy makers. After collating the data, researchable questions were developed through an iterative process with a Multi Stakeholder Advisory Committee to identify the top 10 research priorities for Family Carers Ireland. Results The top 10 researchable questions were distilled from a list of 16 and fit into 7 broad categories. 1) economic impact and financial strain 2) Systemic issues, education, resources and policy 3) technology 4) support services and infrastructure 5) mental health and wellbeing of the carer 6) carers in society 7) Recognition and acknowledgment of the family carer. Conclusion The partnership focus of this project allowed the ‘ground-up’ development of research priorities for carers by carers. The COVID-19 pandemic served to magnify systemic issues already present in society, as well as highlight new burdens. As a result, the subsequent development of 10 researchable questions will guide further investigation to improve the support and wellbeing of family carers.

Dirty Love

2018 ◽  
Author(s):  
Tim Whitmarsh
Keyword(s):  
Single Point ◽  
Subsequent Development ◽  
Cultural Hybridity ◽  
The Novel ◽  
Greek Literature ◽  
Founding Fathers ◽  
Straight Line ◽  
The Moment ◽  
Alexander Romance ◽  
Greek Novel

Where does the Greek novel come from? This book argues that whereas much of Greek literature was committed to a form of cultural purism, presenting itself as part of a continuous tradition reaching back to definitively Greek founding fathers, the novel revelled in cultural hybridity. The earliest Greek novelistic literature combined Greek and non-Greek traditions (or at least affected to combine them: it is often hard to tell how ‘authentic’ the non-Greek material is). More than this, however, it also often self-consciously explored its own hybridity by focusing on stories of cultural hybridisation, or what we would now call ‘mixed race’ relations. This book is thus not a conventional account of the origins of the Greek novel: it is not an attempt to pinpoint the moment of invention, and to trace its subsequent development in a straight line. Rather, it makes a virtue of the murkiness, or ‘dirtiness’, of the origins of the novel: there is no single point of creation, no pure tradition, only transgression, transformation and mess. The novel thus emerges as an outlier within the Greek literary corpus: a form of literature written in Greek, but not always committing to Greek cultural identity. Dirty Love focuses particularly on the relationship between Persian, Egyptian, Jewish and Greek literature, and covers such texts as Ctesias’s Persica, Joseph and Aseneth, the Alexander Romance and the tale of Ninus and Semiramis.

scholarly journals The measurement of the duration of infection in paratyphoid fever

1953 ◽  
Vol 51 (4) ◽  
pp. 532-540 ◽  
Author(s):  
T. C. R. George ◽  
R. W. S. Harvey ◽  
Scott Thomson
Keyword(s):  
Clearance Rates ◽  
Duration Of Infection ◽  
Clinical Illness ◽  
Paratyphoid Fever

Cases of paratyphoid fever are often not diagnosed until the second, third or subsequent weeks of illness. When calculating clearance rates of a series of cases the calculations must be based only on the numbers known to be positive at the week under consideration. If based throughout on the total number of cases the rates of clearance in the early weeks are greatly reduced.Cases for which laboratory records are incomplete must not be entirely rejected when calculating clearance rates but must be retained in the population for as long as they were known to be positive.Analyses designed to show the duration of infection in paratyphoid fever can only be made with accuracy under the most favourable conditions.A large number of cases of paratyphoid fever were repeatedly examined bacteriologically to establish the duration of the infection as distinct from the clinical illness. After an initial lag the proportion of cases remaining infected fell logarithmically until the carriers revealed themselves.We are grateful to many medical officers for information about their cases, and to Dr Lewis Fanning and Dr Ian Sutherland for much helpful criticism.

Micropatterning of Permalloy Films by Electron Lithography

1976 ◽  
Vol 34 ◽  
pp. 448-449
Author(s):  
J. K. Maurin
Keyword(s):  
Electron Beam ◽  
Subsequent Development ◽  
Electron Optical System ◽  
Microelectronic Device ◽  
Magnetic Bubble ◽  
Control Beam ◽  
Photosensitive Material ◽  
Direct Exposure ◽  
Electron Lithography ◽  
Scanning Electron

Conductor, resistor, and dielectric patterns of microelectronic device are usually defined by exposure of a photosensitive material through a mask onto the device with subsequent development of the photoresist and chemical removal of the undesired materials. Standard optical techniques are limited and electron lithography provides several important advantages, including the ability to expose features as small as 1,000 Å, and direct exposure on the wafer with no intermediate mask. This presentation is intended to report how electron lithography was used to define the permalloy patterns which are used to manipulate domains in magnetic bubble memory devices.The electron optical system used in our experiment as shown in Fig. 1 consisted of a high resolution scanning electron microscope, a computer, and a high precision motorized specimen stage. The computer is appropriately interfaced to address the electron beam, control beam exposure, and move the specimen stage.

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