Infection-control strategies for preventing the transmission of meticillin-resistant Staphylococcus aureus (MRSA) in nursing homes for older people (Review)

Background: Nursing homes for older people provide an environment likely to promote the acquisition and spread of meticillin-resistant Staphylococcus aureus (MRSA), putting residents at increased risk of colonisation and infection. It is recognised that infection control strategies are important in preventing and controlling MRSA transmission.

Objectives: The objective of this review was to determine the effects of infection control strategies for preventing the transmission of MRSA in nursing homes for older people.

Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2009, Issue 2), the Cochrane Wounds Group Specialised Register (searched May 29th, 2009). We also searched MEDLINE (from 1950 to May Week 4 2009), Ovid EMBASE (1980 to 2009 Week 21), EBSCO CINAHL (1982 to May Week 4 2009), British Nursing Index (1985 to May 2009), DARE (1992 to May 2009), Web of Science (1981 to May 2009), and the Health Technology Assessment (HTA) website (1988 to May 2009). Research in progress was sought through Current Clinical Trials (www.controlled-trials.com), Medical Research Council Research portfolio, and HSRPRoj (current USA projects). SIGLE was also searched in order to identify atypical material which was not accessible through more conventional sources.

Selection criteria: All randomised and controlled clinical trials, controlled before and after studies and interrupted time series studies of infection control interventions in nursing homes for older people were eligible for inclusion.

Data collection and analysis: Two authors independently reviewed the results of the searches.

Main results: Since no studies met the selection criteria, neither a meta-analysis nor a narrative description of studies was possible.

Authors' conclusions: The lack of studies in this field is surprising. Nursing homes for older people provide an environment likely to promote the acquisition and spread of infection, with observational studies repeatedly reporting that being a resident of a nursing home increases the risk of MRSA colonisation. Much of the evidence for recently-issued United Kingdom guidelines for the control and prevention of MRSA in health care facilities was generated in the acute care setting. It may not be possible to transfer such strategies directly to the nursing home environment, which serves as both a healthcare setting and a resident's home. Rigorous studies should be conducted in nursing homes, to test interventions that have been specifically designed for this unique environment.

The Governance of Sexual Offending Across Europe: Penal Policies, Political Economies and the Institutionalization of Risk

This article examines why England and Wales have comparatively one of the most stringent systems for the governance of sexual offending within Western Europe. While England and Wales, like the USA, have adopted broadly exclusionary, managerialist penal policies based around incapacitation and targeted surveillance, many other Western European countries have opted for more inclusionary therapeutic interventions. Divergences in state approaches to sex offender risk, particularly in relation to notification and vetting schemes, are initially examined with reference to the respective theoretical frameworks of ‘policy transfer’ and differing political economies. Chiefly, however, differences in penal policies are attributed to the social and political construction of risk and its control. There may be multiple expressions of risk relating to expert, lay, moral or emotive aspects. It is argued, however, that it is the particular convergence and alignment of these dimensions on the part of the various stakeholders in the UK – government, media, public and professional – that leads to risk becoming institutionalized in the form of punitive regulatory policies for managing the dangerous.

'Grooming' and the Sexual Abuse of Children:Institutional, Internet and Familial Dimensions

‘Grooming’ and the Sexual Abuse of Children: Institutional, Internet and Familial Dimensions critically examines the official and popular discourses on grooming, predominantly framed within the context of on-line sexual exploitation and abuse committed by strangers, and institutional child abuse committed by those in positions of trust.

Set against the broader theoretical framework of risk, security and governance, this book argues that due to the difficulties of drawing clear boundaries between innocuous and harmful motivations towards children, pre-emptive risk-based criminal law and policy are inherently limited in preventing, targeting and criminalising ‘grooming’ behaviour prior to the manifestation of actual harm. Through examination of grooming against the complexities of the onset of sexual offending against children and its actual role in this process, the author broadens existing discourses by providing a fuller, more nuanced conceptualisation of grooming, including its role in intra-familial and extra-familial contexts. There is also timely discussion of new and emerging forms of grooming, such as ‘street’ or ‘localised’ grooming, as typified by recent cases in Rochdale and Oldham, and ‘peer-to-peer’ grooming.

The first inter-disciplinary, thematic, and empirical investigation of grooming in a multi-jurisdictional context, ‘Grooming’ and the Sexual Abuse of Children draws on extensive empirical research in the form of over fifty interviews with professionals, working in the fields of sex offender risk assessment, management or treatment, as well as child protection or victim support in the four jurisdictions of the United Kingdom and the Republic of Ireland. Impeccably presented and meticulously considered, this book will be of interest to criminologists and those working and studying in the field of policing and criminal justice studies, as well as policy makers and practitioners in the areas of child protection and sex offender management.