Factors affecting adherence to use of hip protectors amongst residents of nursing homes - A correlation study

Background: Hip protectors are protective pads designed to cover the greater trochanter and attenuate or disperse the force of a fall sufficiently to prevent a hip fracture. Promising results from randomised controlled trials in nursing homes have resulted in hip protectors being widely recommended in the health care literature and in national guidelines. Objectives: The objectives of the study were to identify characteristics of individual residents, and the organisational features of the homes in which they live, which may affect adherence to wearing hip protectors. Design: An observational, correlation study designed to identify factors related to adherence. Setting: Forty nursing and residential homes in the UK. Participants: 1346 residents of the homes who were not confined to bed and with no pressure sore on the hip. Methods: The introduction of an evidence-based policy to offer Safehips hip protectors to residents free of charge and with support from a nurse facilitator. Adherence to wearing the hip protectors was observed over 72 weeks. Results: Initial acceptance of the hip protectors was 37.2%. Continued adherence was 23.9% at 24 weeks; 23.2% at 48 weeks; and 19.9% at 72 weeks. Greater adherence was associated with the following individual resident characteristics: a greater degree of dependency (95% CI 1.39 - m3.78) and cognitive impairment (95% CI 1.01 - 2.98); being male rather than female (95% CI 1.06 - 2.48). Greater adherence was also associated with the following organisational characteristics of homes: fewer changes of senior manager during the study period (95% CI 1.01 - 8.51), and being resident in a home with a resident profile showing a greater proportion of residents with a higher degree of dependency (95% CI 1.04 - 1.27). There was wide a variation in the degree of success in implementation between homes (adherence of 0 - 100% at 24 weeks). Conclusions: Those implementing a policy of introducing hip protectors into nursing and residential homes should consider targeting residents with cognitive impairment. Such residents are at greater risk of hip fracture and appear to be more likely to continue wearing hip protectors. Those charged with implementing changes inpractice or policy should consider how the context for implementation can be optimised to increase the likelihood of success.

Platinum and Palladium in Semiconductor Photocatalytic Systems FACTORS AFFECTING THE PURIFICATION OF WATER AND AIR

A wide range of organic pollutants can be destroyed by semiconductor photocatalysis using titania. The purification of water and air contaminated with organic pollutants has been investigated by semiconductor photocatalysis for many years and in attempts to improve the purification rate platinum and palladium have been deposited, usually as fine particles, on the titania surface. Such deposits are expected to improve the rate of reduction of oxygen and so reduce the probability of electron-hole recombination and increase the overall rate of the reaction. The effectiveness of the deposits is reviewed here and appears very variable with reported rate enhancement factors ranging from 8 to 0.1. Semiconductor photocatalysis can be used to purify air (at temperatures > 100 degrees C) and Pt deposits can markedly improve the overall rate of mineralisation. However, volatile organic compounds containing an heteroatom can deactivate the photocatalyst completely and irreversibly. Factors contributing to the success of the processes are considered. The use of chloro-Pt(IV)-titania and other chloro-platinum group metals-titania complexes as possible visible light sensitisers for water and air purification is briefly reviewed.

FACTORS AFFECTING THE KINETICS OF METHYL-ORANGE REDUCTION PHOTOSENSITIZED BY COLLOIDAL CDS

The kinetics of photoreduction of methyl orange by ascorbic acid sensitized by colloidal CdS has been studied. Different experimental factors such a [O2], pH and temperature, as well as the presence of potential competitive species like MV2+ and Cd2+ have been taken as variables in this study. O2 and Cd2+ clearly inhibit the photoreduction but the presence of MV2+ increases the reaction rate. The pH greatly influences the kinetics and temperature (T) has little effect. The results are interpreted using a reaction scheme proposed in earlier papers where dispersions of crystalline CdS were used as the photocatalyst and EDTA as the hole scavenger.

Factors affecting in vitro adherence of ureteral stent biofilm isolates to polyurethane

Adherence of bacteria to biomaterials is the first stage in the development of a device-related infection. The adherence of bacterial cells to biomaterials may be influenced by surface characteristics of the cell, its growth conditions and the biomaterial surface chemistry. Following growth in human urine, the cell surface,hydrophobicity and zeta potential of two ureteral stent biofilm isolates, Enterococcus faecalis and Escherichia coli, were significantly altered. In addition, the adherence of human urine-grown Enterococcus faecalis and Escherichia coli to polyurethane was significantly increased by up to 52.1% and 58.6%, respectively. Treatment of the polyurethane with human urine rendered the polymer surface more hydrophilic (mean advancing water contact angle reduced from 97.59 degrees to 26.37 degrees). However, organisms grown in human urine showed less adherence (up to 90.4%) to the treated polymer than those grown in Mueller-Hinton broth. The results presented in this study indicate that in vivo conditions should be simulated as far as possible when carrying out in vitro bacterial adherence assays, especially if assessing novel methods for reduction of adherence. (C) 1997 Elsevier Science B.V.

PHYSICAL FACTORS AFFECTING THE SPORICIDAL ACTIVITY OF CHLORHEXIDINE GLUCONATE

The effects of pH and indirect ultrasonication on the cidal activity of aqueous and alcoholic solutions of chlorhexidine gluconate against Bacillus subtilis spores were examined. At moderately elevated temperatures, increasing pH enhanced sporicidal activity. pH markedly enhanced the sporicidal activity between indirect ultrasound and chlorhexidine. 'Alcoholic' chlorhexidine gluconate was more sporicidal than its aqueous counterpart.

Critical factors affecting management of site operatives and personal in confined construction site

The aim of this paper is to identify and classify the numerous managerial issues encountered in the management of personnel in confined site construction. For the purpose of this research, a confined construction site is defined as a site where permanent works fit the site footprint, extending to levels above and/or below ground level, leaving spatial restrictions for other operations (e.g. plant and material movements, materials storage and temporary accommodation etc.) and require effective resource co-ordination beyond normal on-site management input. A literature review and analysis, case studies incorporating interviews and focus groups along with a questionnaire survey were used in order to gain a comprehensive insight into the issues in the management of personnel in a confined construction site environment. The following are the top five leading issues highlighted in the management of personnel in confined site construction; (1) Accidents due to an untidy site, (2) One contractor holding up another because of the lack of space, (3) A risk to personnel because of vehicular traffic on-site, (4) Difficult to facilitate several contractors at one work location, and (5) Numerous personnel working within the one space. In today’s modern environment, spatial restrictions are quickly becoming the norm in the industry. Therefore, the management of personnel on-site becomes progressively more difficult with the decrease in available space on-site. Where such environments exist, acknowledging the numerous issues highlighted above, aids site management in the supervision and co-ordination of personnel on-site, thus reducing accidents, increasing productivity and increase profit margins, in spatially restricted environments. As on-site management professionals successfully identify, acknowledge and counteract the numerous issues illustrated, the successful management of personnel on a confined construction site is achievable. By identifying the numerous issues, on-site management can proactively mitigate such issues through adopting counteractive measures and through successful identification of the traits identified.