Adherence to hand hygiene and risk factors for poor adherence in 13 Ontario acute care hospitals

Multicenter studies assessing hand hygiene adherence and risk factors for poor performance are scarce. In an observational study involving 13 hospitals across Ontario, Canada, we found a mean adherence rate of 31.2%, and that adherence was positively associated with nurses, single rooms, contact precautions, and the availability of alcohol hand rub dispensers. Copyright © 2011 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Hospital antibiotic use and its relationship to age-adjusted comorbidity and alcohol-based hand rub consumption

SUMMARY The objective of this study was to evaluate the effect of age-adjusted comorbidity and alcohol-based hand rub on monthly hospital antibiotic usage, retrospectively. A multivariate autoregressive integrated moving average (ARIMA) model was built to relate the monthly use of all antibiotics grouped together with age-adjusted comorbidity and alcohol-based hand rub over a 5-year period (April 2005-March 2010). The results showed that monthly antibiotic use was positively related to the age-adjusted comorbidity index (concomitant effect, coefficient 1·103, P = 0·0002), and negatively related to the use of alcohol-based hand rub (2-month delay, coefficient -0·069, P = 0·0533). Alcohol-based hand rub is considered a modifiable factor and as such can be identified as a target for quality improvement programmes. Time-series analysis may provide a suitable methodology for identifying possible predictive variables that explain antibiotic use in healthcare settings. Future research should examine the relationship between infection control practices and antibiotic use, identify other infection control predictive factors for hospital antibiotic use, and evaluate the impact of enhancing different infection control practices on antibiotic use in a healthcare setting.

Being observant and observed: embodied citizenship training in the Home Guard and the Boy Scout Movement, 1907-1945

Building upon recent studies by geographers and social scientists on the everyday practices of (scientific) observation, this paper focuses on the role of two distinct, yet similar organisations that held observation as an essential and 'automatic' embodied skill. Utilising the examples of Home Guard camouflage and the Boy Scout Movement, the paper critically examines how these organisations sought to articulate the individual as both observer and observed, thereby exposing a much more complex entanglement of different visual positions and practices hitherto neglected in studies of observation. Moreover, the paper emphasises the importance of the act of 'not-being-seen' as a complementary and fundamental aspect of (non-)observational practice, accentuated and promoted by civic institutions in terms of duty and responsibility. Finally, the paper considers the evolutionary aspects of observation through the lifecourse, revealing a complex, relational geography of expertise, experience and skill that crossed age-distinctions. © 2012 Elsevier Ltd.

Coal combustion residues valorisation:Research and development on compressed brick production

This paper presents the results of an experimental investigation on compressive strength of unfired compressed brick obtained with coal combustion residues (CCRs) produced by the Niger Coal Society. Preliminary physical and optical (XRD and SEM) characterisation of coal slag, including lixiviation tests, have been carried out. Cement powder, lateritic clayey soil and sand have been chosen as stabilizing agents for bricks. 12 dosages have been tested and about 300 bricks have been produced with a hand-operated press. Results show uniaxial compressive strengths (UCSs) ranging from 4 MPa to 27 MPa for the highest cement stabilisation ratio. UCS higher than 7.5 MPa have been observed for stabilisation with 20% of laterite +10% cement after 45 days of curing. Obtained bricks showed good mechanical resistance and low weight. No health threat has been detected for the obtained samples. Study developments are oriented towards the analysis of Pozzolanic properties of CCRs, properties of hydrated lime stabilisation, thermal properties and durability assessment.© 2012 Elsevier Ltd. All rights reserved.

Laboratory tests for EPB tunnelling soil conditioning

The screw conveyor system plays a fundamental role during the EPB tunnelling operations for the tunnel face pressure control. On the other hand, the use of additives such chemical foams is even more applied in order to extend the EPB technology to the cohesionless soils. Despite the extensive use of the EPB technique in urban environment, little knowledge exists in the understanding of the behavior of such conditioned soil during the excavation operations. At the Turin University of Technology the Tunnelling and Underground Space Centre, in the mainframe of a wider research on soil conditioning, has developed an experimental apparatus that simulates the extraction phase with screw conveyor from a pressurized tank. In this paper the apparatus is presented and the results of a first series of tests carried out on sand are discussed. © 2007 Taylor & Francis Group.

Transgressing Contemporary Boundaries:The Narrator as True Custodian of Cultural Knowledge in Ulster Society

Historically in Gaelic culture, the bard was greatly valued and admired as an important and integral part of society. Travelled, schooled and specifically trained in their art, the bard helped ensure identity and reassurance for Gaelic families by grounding them both temporarily and spatially into their landscape. Entrusted with the duty and responsibility of recording place and event, the bards worked without writing and by transgressing man-made boundaries, travelled throughout the land weaving their histories into the very fabric of society.

Now no longer with us, we find ourselves without the distinguished chronicler to undertake this duty. Yet the responsibility of the Gaelic bard is one still shared by all artists today; to facilitate memory and identity, whether good or bad. Many Ulster writers, by happenstance and geography have found themselves located in a place of painful histories. An immediate difficulty for those local writers becomes manifest by being intrinsically implicated into those histories – whilst having first-hand knowledge and comprehension beyond that of the outsider, the local writer is automatically damned by association and relationship, thereby tarnishing their voice in comparison to the perceived impartiality of others.
Some writers however have successfully sought ways to escape this limitation and have worked in ways that can transgress the restrictions of prejudgement. John Hewitt, by purposely becoming a self-imposed tourist was able to distance himself to write impartially about the past, recognising that ’the place without its ghosts is a barren place.’1 In ‘The Colony’,2 tradition, peoples and mapping of the land are all narrated by Hewitt in a similar way to the Gaelic bardic topographic poems of Sean O'Dubhagain and Giolla Na Naomh O'Huidhrin3 in compiling a rich cultural atlas.

Similarly the Belfast poet and novelist Ciaran Carson also writes and records the city from an intermediary position; that of translator. Mediating between reader and aisling,4 Carson himself takes the reader on a journey into name, meaning, time and place, focusing primarily on the city of Belfast, familiar in name but impenetrable in depth to most.

Furthermore, this once-forgotten tradition to chronicle is now being continued by the new breed of Irish crime writers where the likes of Brian McGilloway, Stuart Neville and Adrian McKinty can, by way of the crime novel, accurately record contemporary society. Thus, ghost estates, listed buildings, archaeological digs, street and city have all provided setting and subject matter for recent novels. Moreover by choosing the ‘outsider from within’ as their chief protagonist, whether detective or criminal, each author is able to transgress the boundaries of prejudice and preconception that hinder genuine understanding and knowledge.

Looking in turn at the Gaelic bard, the twentieth century Ulster poet and the new breed of Irish crime writer, the authors will outline the real value of the narrator, by being able to act as cultural transgressor beyond the seeming and alleged as the true chronicler in society, and then with specific reference to city and countryside in Ireland, as a valuable custodian of knowledge in architecture and place.

Keywords
Architecture, Crime Fiction, Cultural Atlas, Place, Poetry.

1 From ‘The Bloody Brae’, a one act play written by John Hewitt in the 1930’s.
2 Hewitt, J. (1968) published in Collected Poems 1932-67. London:McGibbon & Kee.
3 Lengthy and detailed medieval Gaelic poems composed in the fourteenth and fifteenth centuries first edited by John O'Donovan in 1862 for the Irish Archaeological and Celtic Society in Dublin.
4 The aisling is the Irish song or poem genre when the poet is visited by their muse in a daydream or dream-vision state.

Impact of composite ply continuity constraints on aerospace stiffened panel design

Considering the development of aerospace composite components, designing for reduced manufacturing layup cost and structural complexity is increasingly important. While the advantage of composite materials is the ability to tailor designs to various structural loads for minimum mass, the challenge is obtaining a design that is manufacturable and minimizes local ply incompatibility. The focus of the presented research is understanding how the relationships between mass, manufacturability and design complexity, under realistic loads and design requirements, can be affected by enforcing ply continuity in the design process. Presented are a series of sizing case studies on an upper wing cover, designed using conventional analyses and the tabular laminate design process. Introducing skin ply continuity constraints can generate skin designs with minimal ply discontinuities, fewer ply drops and larger ply areas than designs not constrained for continuity. However, the reduced design freedom associated with the addition of these constraints results in a weight penalty over the total wing cover. Perhaps more interestingly, when considering manual hand layup the reduced design complexity is not translated into a reduced recurring manufacturing cost. In contrast, heavier wing cover designs appear to take more time to layup regardless of the laminate design complexity. © 2012 AIAA.

Partial Palmprint Matching Using Invariant Local Minutiae Descriptors

In forensic investigations, it is common for forensic investigators to obtain a photograph of evidence left at the scene of crimes to aid them catch the culprit(s). Although, fingerprints are the most popular evidence that can be used, scene of crime officers claim that more than 30% of the evidence recovered from crime scenes originate from palms. Usually, palmprints evidence left at crime scenes are partial since very rarely full palmprints are obtained. In particular, partial palmprints do not exhibit a structured shape and often do not contain a reference point that can be used for their alignment to achieve efficient matching. This makes conventional matching methods based on alignment and minutiae pairing, as used in fingerprint recognition, to fail in partial palmprint recognition problems. In this paper a new partial-to-full palmprint recognition based on invariant minutiae descriptors is proposed where the partial palmprint’s minutiae are extracted and considered as the distinctive and discriminating features for each palmprint image. This is achieved by assigning to each minutiae a feature descriptor formed using the values of all the orientation histograms of the minutiae at hand. This allows for the descriptors to be rotation invariant and as such do not require any image alignment at the matching stage. The results obtained show that the proposed technique yields a recognition rate of 99.2%. The solution does give a high confidence to the judicial jury in their deliberations and decision.

In the Shadows of the Old Town: Thomas Anna and 19th-century Glasgow

In 1858, a volume entitled Midnight Scenes and Social Photographs – being sketches of life in the streets, wynds and dens of the city of Glasgow was published under the pseudonym of ‘Shadow’ by Alexander Brown, a Glaswegian flâneur and reformer. Its frontispiece is an etching which depicts a theatre-like proscenium arch whose curtains have been withdrawn to reveal to the audience all the poverty, destitution and disorder that one was likely to find after dark in the insalubrious quarters of the city. At the extreme left-hand side, partly obscured by the curtain a silhouetted figure stands behind an unwieldy camera perched on a tripod. Distinctly unaffected by the mêlée, an arm is calmly raised and a finger precisely arched in the moment before the shutter is clicked and the scene committed to record. The volume, however, relies exclusively on textual descriptions to evoke the underside of the city and contains no photographs at all. Instead, the use of the word photograph in the title can be understood as a metaphor for detached scientific objectivity, a quality much celebrated by nineteenth-century reformers and investigators of social ills. As it happened, a decade after Shadow disappeared into the labyrinthine back-lands of Old Town Glasgow, he was followed there by a real photographer. In 1868, Thomas Annan was commissioned by the City Improvements Trust to take photographs of the Old Town in its last moments of existence before it was pulled down under a series of legislative acts. But perhaps paradoxically, given Shadow’s faith in the analytical properties of photography, Annan’s work seems to refute much of the material contained in Midnight Scenes and other similar tracts. Instead of the dens, shebeens, labyrinths and rowdy crowds described by Shadow, Annan’s depictions of the Old Town convey a static, calm environment, one which is often sparsely inhabited by a curious but apparently orderly population.

Taking account of the sensational tendencies of many reformists’ texts, this paper investigates the discrepancies between the two representations, focussing in particular on the constraints which operated on Annan during his commission. It argues that Annan’s compositions – which became very influential on other 19th century photographers of everyday life such as John Thomson or Jacob Riis – far from being dispassionate analytical works, emerged as a result of a matrix of factors which included: photographic and artistic precedents; Annan’s own predilections as a photographer; technological limitations; the nature of the commission from the City Improvements Trust and political climate in which it was given; the medieval urban fabric in which he had to operate; and, perhaps, most importantly, the identity of the Old Towns inhabitants themselves.

Is Longer-Distance Migration Slowing? An Analysis of the Annual Record for England and Wales since the 1970s

This paper is prompted by the widespread acceptance that the rates of inter-county and inter-state migration have been falling in the USA and sets itself the task of examining whether this decline in migration intensities is also the case in the UK. It uses annual inter-area migration matrices available for England and Wales since the 1970s by broad age group. The main methodological challenge, arising from changes in the geography of health areas for which the inter-area flows are given, is addressed by adopting the lowest common denominator of 80 areas. Care is also taken to allow for the effect of economic cycles in producing short-term fluctuations on migration rates and to isolate the effect of a sharp rise in rates for 16-24 year olds in the 1990s, which is presumed to be related to the expansion of higher education. The findings suggest that, unlike for the USA, there has not been a substantial decline in the intensity of internal migration between the first two decades of the study period and the second two. If there has been any major decline in the intensity of address changing in England and Wales, it can only be for the within-area moves that this time series does not cover. This latter possibility is examined in a companion paper using a very different data set (Champion and Shuttleworth, 2016).