An outbreak of Serratia marcescens on the neonatal unit:a tale of two clones

Serratia spp. are an important cause of hospital-acquired infections and outbreaks in high-risk settings. Twenty-one patients were infected or colonized over a nine-month period during 2001-2002 on a neonatal unit. Twenty-two isolates collected were examined for antibiotic susceptibility, β-lactamase production and genotype. Random-amplified polymorphic DNA polymerase chain reaction and pulsed-field gel electrophoresis revealed that two clones were present. The first clone caused invasive clinical infection in four babies, and was subsequently replaced by a non-invasive clone that affected 14 babies. Phenotypically, the two strains also differed in their prodigiosin production; the first strain was non-pigmented whereas the second strain displayed pink-red pigmentation. Clinical features suggested a difference in their pathogenicity. No environmental source was found. The outbreak terminated following enhanced compliance with infection control measures and a change of antibiotic policy. Although S. marcescens continued to be isolated occasionally for another five months of follow-up, these were sporadic isolates with distinct molecular typing patterns. © 2005 The Hospital Infection Society.

e-CAF: flexible marking schemes for electronic coursework assessment and feedback

Recent surveys reveal that many university students in the U.K. are not satisfied with the timeliness and usefulness of the feedback given by their tutors. Ensuring timeliness in marking can result in a reduction in the quality of feedback. Though suitable use of Information and Communication Technology should alleviate this problem, existing Virtual Learning Environments are inadequate to support detailed marking scheme creation and they provide little support for giving detailed feedback. This paper describes a unique new web-based tool called e-CAF for facilitating coursework assessment and feedback management directed by marking schemes. Using e-CAF, tutors can create or reuse detailed marking schemes efficiently without sacrificing the accuracy or thoroughness in marking. The flexibility in marking scheme design also makes it possible for tutors to modify a marking scheme during the marking process without having to reassess the students’ submissions. The resulting marking process will become more transparent to students.

Liposome-based cationic adjuvant formulations (CAF):past, present, and future

The use of liposomes as vaccine adjuvants has been investigated extensively over the last few decades. In particular, cationic liposomal adjuvants have drawn attention, with dimethyldioctadecylammonium (DDA) liposomes as a prominent candidate. However, cationic liposomes are, in general, not sufficiently immunostimulatory, which is why the combination of liposomes with immunostimulators has arisen as a strategy in the development of novel adjuvant systems in recent years. One such adjuvant system is CAF01. In this review, we summarize the immunological properties making CAF01 a promising versatile adjuvant system, which was developed to mediate protection against tuberculosis (TB) but, in addition, has shown promising protective efficacy against other infectious diseases requiring different immunological profiles. Further, we describe the stabilization properties that make CAF01 suitable in vaccine formulation for the developing world, which in addition to vaccine efficacy, are important prerequisites for any novel TB vaccine to reach global implementation. The encouraging nonclinical data led to a preclinical vaccine toxicology study of the TB model vaccine, Ag85B-ESAT-6/CAF01, that concluded that CAF01 has a satisfactory safety profile to advance the vaccine into phase I clinical trials, which are scheduled to start in 2009.

A study of the flow performance of a sodium silicate furnace

The flow characteristics of neutral sodium silicate glass in an open hearth regenerative furnace have been studied using a one tenth scale physical model. The constraints of similarity have been investigated and discussed, and the use of sodium liquor as a cold modelling solution has been developed. Methylene Blue and Sulphacid Brill Pink are used as delineators, and a technique for analysing the concentration of each even in a mixture has been developed. The residence/time distributions from the model have been simulated using a mixed model computer program which identifies the nature and size of the most significant flow streams within the furnace. The results clearly show that the model gives a true representation of the furnace and illustrates a number of alternatives for operating or design changes which will lead to improved production efficiency.

The effects of coloured light filter overlays on reading rates in age-related macular degeneration

Purpose: To determine the effect of coloured light filter overlays on reading rates for people with age-related macular degeneration (AMD). Method: Using a prospective clinical trial design, we examined the null hypothesis that coloured light filter overlays do not improve reading rates in AMD when compared to a clear filter. Reading rates for 12 subjects with non-exudative AMD, associated with a relative scotoma and central fixation (mean age 81 years, SD 5.07 years) were determined using the Rate of Reading Test® (printed, nonsense, lower case sans serif, stationary text) with 10 different, coloured light filter overlays (Intuitive Overlays®; figures in brackets are percentage transmission values); rose (78%), pink (78%), purple (67%), aqua (81%), blue (74%), lime-green (86%), mint-green (85%), yellow (93%), orange (83%) and grey (71%). A clear overlay (Roscolene # 00) (360 cdm-2) with 100% transmittance was used as a control. Results: ANOVA indicated that there was no statistically significant difference in reading rates with the coloured light filter overlays compared to the clear filter. Furthermore, chi-squared analysis indicated that the rose, purple and blue filters had a significantly poorer overall ranking in terms of reading rates compared to the other coloured and clear light filters. Conclusion: Coloured light filter overlays are unlikely to provide a clinically significant improvement in reading rates for people with non-exudative AMD associated with a relative scotoma and central fixation. Copyright © Acta Ophthalmol Scand 2004.

Dosage form preference consultation study in children and young adults:paving the way for patient-centred and patient-informed dosage form development

Objectives: The current study aims to evaluate dosage form preferences in children and young adults together with identifying the key pragmatic dosage form characteristics that would enable appropriate formulation of orally disintegrating tablets (ODTs). Methods: International, multisite, cross-sectional questionnaire of children and young adults aged from 6 to 18 years. Eligibility was based on age, ability to communicate and previous experience in taking medications. The study was carried out at three locations: the UK, Saudi Arabia and Jordan. The questionnaire instrument was designed for participant self-completion under supervision of the study team.Results 104 questionnaires were completed by the study cohort (n=120, response rate 87%). Results: showed that ODTs were the most preferred oral dosage forms (58%) followed by liquids (20%), tablets (12%) and capsules (11%). The preferred colours were pink or white while the preferred size was small (<8 mm) with a round shape. With regard to flavour, strawberry was the most preferred (30.8%), while orange was the least preferred (5.8%). The results also showed that the most important physical characteristics of ODTs were disintegration time followed by taste, size and flavour, respectively. Conclusions: The results of our study support the WHO's claim for a shift of paradigm from liquid towards ODTs dosage forms for drug administration to young children older than 6 years. Data from this study will also equip formulators to prioritise development of key physical/performance attributes within the delivery system.

The state of the nations:current and future developments in technology enhanced learning

Right across Europe technology is playing a vital part in enhancing learning for an increasingly diverse population of learners. Learning is increasingly flexible, social and mobile and supported by high quality multi-media resources. Institutional VLEs are seeing a shift towards open source products and these core systems are supplemented by a range of social and collaborative learning tools based on web 2.0 technologies. Learners undertaking field studies and those in the workplace are coming to expect that these off-campus experiences will also be technology-rich whether supported by institutional or user-owned devices. As well as keeping European businesses competitive, learning is seen as a means of increasing social mobility and supporting an agenda of social justice. For a number of years the EUNIS E-Learning Task Force (ELTF) has conducted snapshot surveys of e-learning across member institutions, collected case studies of good practice in e-learning see (Hayes, et al., 2009) in references, supported a group looking at the future of e-learning, and showcased the best of innovation in its e-learning Award. Now for the first time the ELTF membership has come together to undertake an analysis of developments in the member states and to assess what this might mean for the future. The group applied the techniques of World Café conversation and Scenario Thinking to develop its thoughts. The analysis is unashamedly qualitative and draws on expertise from leading universities across eight of the EUNIS member states. What emerges is interesting in terms of the common trends in developments in all of the nations and similarities in hopes and concerns about the future development of learning.