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Biomedical subjects

A Jeanes

Publications and source records attributed to A Jeanes.

At least 19 recordsLinked to original sources
PubMed2002

Marketing hand hygiene in hospitals--a case study.

Hand hygiene of healthcare workers is frequently poor despite the efforts of infection control teams to promote hand decontamination as the most important method to prevent transmission of hospital-acquired infections. In this case study, we describe how principles of societal marketing were applied to improve hand hygiene. Pre-marketing analysis of strengths, weaknesses, opportunities and threats to implementation; attention to product, price, promotion and placement; and post-marketing 'customer' surveys were the essential components of the marketing strategy and its implementation. Placement of an alcohol-based gel decontaminant (Spirigel) at the bedside of every patient was widely welcomed in the hospital, and has played a major role in improving hand hygiene of healthcare workers. In the twelve months following the implementation, the decontaminant was used at least 440,000 times. The cost of purchasing the decontaminant was approximately 5000 pounds sterling. Following the introduction of Spirigel, there was a consistent reduction in the proportion of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) in each of the quarters of 2000-2001 compared with 1999-2000. In the period 1999-2000, nearly 50% of the MRSA were hospital acquired compared with 39% in 2000-2001. Similarly, the average incidence of Clostridium difficile associated diarrhoea (CDAD) decreased in each of the quarters in 2000-2001 following the introduction of Spirigel. During this period, there was an average incidence of 9.5 cases of CDAD/1000 admissions compared with 11.5 cases of CDAD/1000 admissions in 1999-2000. This represents a 17.4% reduction in the incidence of CDAD. However, this reduction was not statistically significant (P=0.2). Our case study demonstrates that principles of societal marketing methods can be used effectively to promote and sustain hand hygiene in hospitals. Improvement in hand hygiene will lead to considerable reduction in hospital-acquired infections.

Guideline Adherence↗
PubMed2001

Use of first line bronchoalveolar lavage in the immunosuppressed oncology patient.

Immunosuppressed oncology patients who develop pulmonary infiltrates during treatment have a mortality rate of the order of 55-90%. Early diagnosis and treatment is associated with increased survival. At present, diagnosis relies on invasive sampling of the respiratory tract using fibre-optic bronchoscopy. We have looked at a 30-month period, from June 1997 to December 1999, where 25 bronchoscopies were performed on patients from the Lymphoma and BMT units at The Royal Marsden Hospital for the further investigation of pulmonary infiltrates. Nine bronchoscopies (36%) yielded a positive result and seven (28%) led to a change in management. Analysis of the data showed that neither a positive result nor a change in management had any impact on overall survival. After reviewing the background literature on the investigation of pulmonary infiltrates in this group and discussion of the respective merits and limitations, we propose a management flowchart, with high-resolution computed tomography (HRCT) as the test arm in a future randomised trial of these patients.

Adult↗
PubMed2001

Rational protocols for testing faeces in the investigation of sporadic hospital-acquired diarrhoea.

Many recent studies have demonstrated that routine examination of faeces for conventional enteric pathogens such as salmonella, shigella, campylobacter and parasites in patients who develop sporadic hospital-acquired diarrhoea is unnecessary and wasteful. In this paper the advantages and disadvantages of a restricted testing protocol in patients with hospital-acquired diarrhoea are reviewed. Practical issues for safe implementation of such a protocol are also discussed.

Clinical Protocols↗
PubMed2001

Nail art: a review of current infection control issues.

Nail art or nail technology is a form of nail decoration which frequently entails applying extensions to the natural nail and then adding decorative effects. There have been a number of outbreaks of infection which have implicated nail art. These infections are likely to be as a result of difficulties in cleaning and maintaining the nail extensions. Nail art appears to be incompatible with clinical care.

Attitude of Health Personnel↗
PubMed1986

Immunochemical and related interactions with dextrans reviewed in terms of improved structural information.

Structurally diverse dextrans from Leuconostoc mesenteroides and related bacteria have been used extensively in fundamental immunochemical studies such as induction and characterization of anti-dextran antibodies, as well as in studies of their interaction with pneumococcal antisera, normal bovine serum, concanavalin A, dextran-binding myeloma immunoglobulins and hybridoma antibodies. The inherent lack of specificity of structural data obtained by POSA and general lack of insight into other limitations of these analyses has often led to inaccurate and superficial interpretations. Proper interpretation of past and future studies necessitates pointing out previous inadequacies of dextran structural data and detailing more recently acquired structural information on the dextrans. Unambiguous terminology has been achieved by a new system of linkage symbols that includes the designation of structural positions, such as (1----3; l)- and (1----3; b) as linear-chain and branch-point positions, respectively. Results of immunological studies are reviewed. Improved interpretations and correlations are made on the basis of structural data from MSA and several other techniques which have become available on the dextrans.

Dextrans↗
PubMed1976

An extracellular fungal polysaccharide composed of 2-acetamido-2-deoxy-D-glucuronic acid residues.

The black yeast-like fungus NRRL YB-4163, now tentatively identified as Rhinocladiella elatior Mangenot, has been found to produce an extracellular microbial polysaccharide composed mainly of 2-acetamido-2-deoxy-D-glucuronic acid residues. Polysaccharide (PS) YB-4163, when isolated in good yield as the neutral potassium salt, dissolves readily in water to produce extremely viscous solutions, which form stable foams and emulsions. By depolymerizing PS YB-4163 with [14C]methanol-HCl, the polysaccharide can be both identified and quantitated radiochemically by determining the individual [14C]methyl glycosides after their separation by paper chromatography. When the methyl glycosides of PS YB-4163 were reduced with NaB3H4, only the methyl glycosides of 2-acetamido-2-deoxy-D-[6-3H]glucose were found. Analysis of the monosaccharide released from carboxyl-reduced PS YB-4163 by acid hydrolysis or methanolysis also showed 2-acetamido-2-deoxy-D-glucuronic acid to be the main constituent. Previously, the only polysaccharides known to be composed entirely or hexosaminuronic acid have been cellular products from pathogens. Of these, the antigenic polysaccharide (SPSA) from Staphylococcus aureus is composed entirely of 2-amino-2-deoxy-D-glucuronic acid, but its amino groups are substituted equally with acetyl and N-acetylalanyl groups. The specific optical rotation of PS YB-4163, [alpha]20D -75 degrees (c 0.5, water), is similar to that of SPSA (-91 degrees), and suggests beta-D-linkages that must be either (1 leads to 3) or (1 leads to 4).

Glucuronates↗
PubMed1976

Colonial variation in Xanthomonas campestris NRRL B-1459 and characterization of the polysaccharide from a variant strain.

Stock cultures of Xanthomonas campestris NRRL B-1459 require special attention to maintenance and propagation to assure consistent production in good yields of the extracellular polysaccharide xanthan. Under customary conditions of propagative maintenance on agar slants, variant colony types develop that are smaller in size than the normal type. The rate of regression of the normal to the variant forms was diminished when the D-glucose content of the stock medium was sufficient to avoid depletion during storage and when transfer to fresh medium was reduced to 14-day intervals. Under conditions for polysaccharide production, the normal large-colony type gives crude culture liquors after 48 h of 7000 centipoise (cp) viscosity; the predominant variant form gives only 4000 cp. On the basis of 2.1% initial D-glucose, biopolymer yields for the normal and variant strains were 62 and 43%, respectively. Polysaccharide produced by the variant (small-colony type) differs adversely in solution properties from that of the parent strain (large-colony type); it differs also in its lower content of pyruvic acid and O-acetyl substituents. The molar ratios of constituent sugars (D-glucose, D-mannose, and D-glucuronic acid), however, were identical in polysaccharides with the normal and variant strains. Exclusion of colonial variants from fermentations is prerequisite to production of xanthan optimum in properties and yield.

Agar↗
PubMed1975

Extracellular polysaccharide from the black yeast NRRL Y-6272: improved methods for preparing a high-viscosity, pigment-free product.

When the extracellular polysaccharide from the black yeast NRRL Y-6272, composed of two parts N-acetyl-D-glucosamine and one part N-acetyl-D-glucosaminuronic acid, is isolated at maximum culture viscosity, adhering black pigment gives the polysaccharide preparations a gray-to-black appearance. Precipitation of the polysaccharide from cell-free culture supernatants with either ethanol of hexadecyltrimethylammonium bromide failed to remove the pigment. Various other methods were therefore tried for obtaining a high-viscosity polysaccharide product free of pigment. By systematically varying ingredients of defined and semidefined media, an improved medium was found that not only gave polysaccharide preparations of increased viscosity, but also increased yield. A key ingredient in this medium is L-asparagine. Also, adding autoclaved bovine serum albumin or egg albumin to this medium at the time of inoculation allowed a pigment-free polysaccharide to be isolated by standard procedures. None of several other proteins of synthetic polyamides tested were as effective as bovine serum albumin or egg albumin. In an alternate approach, pink mutants obtained by irradiation of the parent black strain with ultraviolet light, apparently produce the same extracellular polysaccharide free of any pigment but in lower yields or inferior in quality.

Acetylglucosamine↗
PubMedDate not supplied

Zero-Stik-Safety Syringe: an automatic safety syringe.

Needlestick injury (NSI) is an important although rare cause of the transmission of blood-borne viruses to healthcare staff. Many NSIs are avoidable. The use of universal precautions and careful sharps disposal are key factors in the prevention of injury. The availability of safety devices is increasing as it is recognized that action is necessary to prevent NSI. Devices that are easy to use and require no extra effort on behalf of the healthcare worker are preferred. There is evidence that safety devices decrease the rate of NSI. Zero-Stik Safety Syringe, manufactured by New Medical Technology, automatically retracts the needle once the injection is complete. It is simple to use and requires no formal training.

Accidents, Occupational↗