Pneumonia and influenza: specific considerations in care homes

This review provides an update on current evidence surrounding epidemiology, treatment and prevention of lower respiratory tract infection, with special reference to pneumonia and influenza, in care home residents. The care home sector is growing and provides a unique ecological niche for infections, housing frail older people with multiple comorbidities and frequent contact with healthcare services. There are therefore considerations in the epidemiology and management of these conditions which are specific to care homes. Opportunities for prevention, in the form of vaccination strategies and improving oral hygiene, may reduce the burden of these diseases in the future. Work is needed to research these infections specifically in the care home setting and this article highlights current gaps in our knowledge.

Substituting outline fonts for bitmap fonts in archived PDF files

As collections of archived digital documents continue to grow the maintenance of an archive, and the quality of reproduction from the archived format, become important long-term considerations. In particular, Adobe s PDF is now an important final form standard for archiving and distributing electronic versions of technical documents. It is important that all embedded images in the PDF, and any fonts used for text rendering, should at the very minimum be easily readable on screen. Unfortunately, because PDF is based on PostScript technology, it allows the embedding of bitmap fonts in Adobe Type 3 format as well as higher-quality outline fonts in TrueType or Adobe Type 1 formats. Bitmap fonts do not generally perform well when they are scaled and rendered on low-resolution devices such as workstation screens. The work described here investigates how a plug-in to Adobe Acrobat enables bitmap fonts to be substituted by corresponding outline fonts using a checksum matching technique against a canonical set of bitmap fonts, as originally distributed. The target documents for our initial investigations are those PDF files produced by (La)TEXsystems when set up in a default (bitmap font) configuration. For all bitmap fonts where recognition exceeds a certain confidence threshold replacement fonts in Adobe Type 1 (outline) format can be substituted with consequent improvements in file size, screen display quality and rendering speed. The accuracy of font recognition is discussed together with the prospects of extending these methods to bitmap-font PDF files from sources other than (La)TEX.

Using Needs Assessment to Understand Continuing Disability in Patients with Enduring Mental Illness. Implications for Considerations of Service Development

Particular strengths of the MRC Needs for Care Assessment Schedule have been used to investigate the treatment status of patients with persistent psychiatric disability in ways that other needs assessment tools are unable to. One hundred and seventy-nine such patients from three settings; a private sector psychiatric hospital, two public sector day hospitals situated in the same town, and a high security hospital, were found to have a high level of need. Although there were differences between settings, overall these needs were well met in all three. The high level of persistent disability found amongst these patients could not be attributed to failure on the part of those treating them to use the best available methods, or to failures to comply or engage with treatment on the patient's part. In some two thirds of instances persistent disability was best explained by the fact that even the most suitable available treatments have to be considered only partially effective.