Cluster randomised controlled trial of an infection control education and training intervention programme focusing on meticillin-resistant Staphylococcus aureus in nursing homes for older people

The aim of this cluster randomised controlled trial was to test the impact of an infection control education and training programme on meticillin-resistant Staphylococcus aureus (MRSA) prevalence in nursing homes. Nursing homes were randomised to intervention (infection control education and training programme; N¼16) or control (usual practice continued; N¼16). Staff in intervention homes were educated and trained (0, 3 and 6 months) in the principles and implementation of good infection control practice with infection control audits conducted in all sites (0, 3, 6 and 12 months) to assess compliance with good practice. Audit scores were fed back to nursing home managers in intervention homes, together with a written report indicating where practice could be improved. Nasal swabs were taken from all consenting residents and staff at 0, 3, 6 and 12 months. The primary outcome was MRSA prevalence in residents and staff, and the secondary outcome was a change in infection control audit scores. In all, 793 residents and 338 staff were recruited at baseline. MRSA prevalence did not change during the study in residents or staff. The relative risk of a resident being colonised with MRSA in an intervention home compared with a control home at 12 months was 0.99 (95% con?dence interval: 0.69, 1.42) after adjustment for clustering. Mean infection control audit scores were signi?cantly higher in the intervention homes (82%) compared with the control homes (64%) at 12 months (P<0.0001). Consideration should be given to other approaches which may help to reduce MRSA in this setting.

Quantitative mapping of aqueous microfluidic temperature with sub-degree resolution using fluorescence lifetime imaging microscopy

The use of a water-soluble, thermo-responsive polymer as a highly sensitive fluorescence-lifetime probe of microfluidic temperature is demonstrated. The fluorescence lifetime of poly(N-isopropylacrylamide) labelled with a benzofurazan fluorophore is shown to have a steep dependence on temperature around the polymer phase transition and the photophysical origin of this response is established. The use of this unusual fluorescent probe in conjunction with fluorescence lifetime imaging microscopy (FLIM) enables the spatial variation of temperature in a microfluidic device to be mapped, on the micron scale, with a resolution of less than 0.1 degrees C. This represents an increase in temperature resolution of an order of magnitude over that achieved previously by FLIM of temperature-sensitive dyes

Understanding Everyday Homes of Urban Communities: The Case of Local Streets (Hawari) of Old Cairo

This paper aims at investigating architectural and urban heritage from the socio-cultural point of view, which stands on the human asset of traditional sites such as the hawari of old Cairo. It analyzes the social practice of everyday life in one of the oldest Cairene hawari, Haret al-Darb al-Asfar. The focus is on architectural and spatial organization of outdoor and indoor spaces that coordinate the spatial practices of local community. A daily monitoring of people’s activities and interviews was conducted in an investigation of how local people perceive their built environment between the house’s interior and the outdoor shared space. It emerges that people construct their own field of private spheres according to complex patterns of daily activities that are not in line with the classical segregation between private and public in Islamic cities. This paper reports that the harah is basically a construct of social spheres that are organized spatially by the flexible development of individual buildings over time and in response to changes in individuals’ needs and capabilities. In order to achieve sustainability in old urban quarters, the paper concludes, the focus should be directed towards the local organization of activities and a comprehensive upgrading of deteriorating buildings to match the changing needs of current population.