The bacteriology of oil sardine (Sardinella longiceps) and mackerel (Rastrelliger kanagurta) caught from tropical waters off Cochin. 1 - Quantitative aspects

The total aerobic viable plate counts (TPCs) of skin, gills and intestine of newly caught oil sardine (Sardinella longiceps) and Indian mackerel ( Rastrelliger kanagurta) at four different temperatures, namely 36 ± 1°C, 28 ± 2°C (RT), 8 ± 1°C and 1 ±1°C, are reported. The total plate count at RT of the skin of oil sardine and Indian mackerel were in the range of l0 super(3) to 10 super(7) and 10 super(4) to 10 super(6) per cm², that of gills in the range of 10 super(5) to 10 super(9) and 10 super(4) to 10 super(8) per g and that intestine in the range of 10 super(5) to 10 sueper(9) and 10 super(5) to 10 super(8) per g respectively. The TPCs were markedly affected by the incubation temperature. Incubation at 28 ± 2°C gave the highest count; at 36 ± 1°C and 8 ± 1°C, the counts decreased by nearly 1-2 log cycles from that at RT. Incubation at 1 ± 1°C registered the lowest count. The peak values for bacterial counts of these fishes occurred at different periods of the year.

The bacteriology of oil sardine (Sardinella longiceps) and mackerel (Rastrelliger kanagurta) from tropical waters off Cochin. 2. Qualitative aspects

80% of the flora of skin, gills and intestines of oil sardine and mackerel at isolation temperature 28 ± 2°C consisted of Gram negative asporogenous rods or cocci, belonging to the genera Vibrio, Pseudomonas, Moraxella, Acinetobacter and Flavobacteria/Cytophaga. Nearly 10% of the flora was constituted by Gram positives, Micrococcus and Arthrobacter. Incubation temperature of 36 ± 1°C recovered more Vibrio spp. and Gram positives, while at lower temperatures of 8 ± 1°C and 1 ± 1°C, more Pseudomonas, Acinetobacter and Moraxella spp. were recovered. Significant changes with respect to season were observed in the relative distribution of different genera.

Technology confidence in early stage development of medical devices

Innovation is a critical factor in ensuring commercial success within the area of medical technology. Biotechnology and Healthcare developments require huge financial and resource investment, in-depth research and clinical trials. Consequently, these developments involve a complex multidisciplinary structure, which is inherently full of risks and uncertainty. In this context, early technology assessment and 'proof of concept' is often sporadic and unstructured. Existing methodologies for managing the feasibility stage of medical device development are predominantly suited to the later phases of development and favour detail in optimisation, validation and regulatory approval. During these early phases, feasibility studies are normally conducted to establish whether technology is potentially viable. However, it is not clear how this technology viability is currently measured. This paper aims to redress this gap through the development of a technology confidence scale, as appropriate explicitly to the feasibility phase of medical device design. These guidelines were developed from analysis of three recent innovation studies within the medical device industry.

Physicians in leadership: the association between medical director involvement and staff-to-patient ratios

In a hospital environment that demands a careful balance between commercial and clinical interests, the extent to which physicians are involved in hospital leadership varies greatly. This paper assesses the influence of the extent of this involvement on staff-to-patient ratios. Using data gathered from 604 hospitals across Germany, this study evidences the positive relationship between a full-time medical director (MD) or heavily involved part-time MD and a higher staff-to-patient ratio. The data allows us to control for a range of confounding variables, such as size, rural/urban location, ownership structure, and case-mix. The results contribute to the sparse body of empirical research on the effect of clinical leadership on organizational outcomes.

Stakeholder challenges in purchasing medical devices for patient safety.

OBJECTIVE: This study identifies the stakeholders who have a role in medical device purchasing within the wider system of health-care delivery and reports on their particular challenges to promote patient safety during purchasing decisions. METHODS: Data was collected through observational work, participatory workshops, and semi-structured qualitative interviews, which were analyzed and coded. The study takes a systems-based and engineering design approach to the study. Five hospitals took part in this study, and the participants included maintenance, training, clinical end-users, finance, and risk departments. RESULTS: The main stakeholders for purchasing were identified to be staff from clinical engineering (Maintenance), device users (Clinical), device trainers (Training), and clinical governance for analyzing incidents involving devices (Risk). These stakeholders display varied characteristics in terms of interpretation of their own roles, competencies for selecting devices, awareness and use of resources for purchasing devices, and attitudes toward the purchasing process. The role of "clinical engineering" is seen by these stakeholders to be critical in mediating between training, technical, and financial stakeholders but not always recognized in practice. CONCLUSIONS: The findings show that many device purchasing decisions are tackled in isolation, which is not optimal for decisions requiring knowledge that is currently distributed among different people within different departments. The challenges expressed relate to the wider system of care and equipment management, calling for a more systemic view of purchasing for medical devices.