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Frequency of dressing changes for central venous access devices on catheter-related infections

Background People admitted to intensive care units and those with chronic health care problems often require long-term vascular access. Central venous access devices (CVADs) are used for administering intravenous medications and blood sampling. CVADs are covered with a dressing and secured with an adhesive or adhesive tape to protect them from infection and reduce movement. Dressings are changed when they become soiled with blood or start to come away from the skin. Repeated removal and application of dressings can cause damage to the skin. The skin is an important barrier that protects the body against infection. Less frequent dressing changes may reduce skin damage, but it is unclear whether this practice affects the frequency of catheter-related infections. Objectives To assess the effect of the frequency of CVAD dressing changes on the incidence of catheter-related infections and other outcomes including pain and skin damage. Search methods In June 2015 we searched: The Cochrane Wounds Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE and EBSCO CINAHL. We also searched clinical trials registries for registered trials. There were no restrictions with respect to language, date of publication or study setting. Selection criteria All randomised controlled trials (RCTs) evaluating the effect of the frequency of CVAD dressing changes on the incidence of catheter-related infections on all patients in any healthcare setting. Data collection and analysis We used standard Cochrane review methodology. Two review authors independently assessed studies for inclusion, performed risk of bias assessment and data extraction. We undertook meta-analysis where appropriate or otherwise synthesised data descriptively when heterogeneous. Main results We included five RCTs (2277 participants) that compared different frequencies of CVAD dressing changes. The studies were all conducted in Europe and published between 1995 and 2009. Participants were recruited from the intensive care and cancer care departments of one children's and four adult hospitals. The studies used a variety of transparent dressings and compared a longer interval between dressing changes (5 to15 days; intervention) with a shorter interval between changes (2 to 5 days; control). In each study participants were followed up until the CVAD was removed or until discharge from ICU or hospital. - Confirmed catheter-related bloodstream infection (CRBSI) One trial randomised 995 people receiving central venous catheters to a longer or shorter interval between dressing changes and measured CRBSI. It is unclear whether there is a difference in the risk of CRBSI between people having long or short intervals between dressing changes (RR 1.42, 95% confidence interval (CI) 0.40 to 4.98) (low quality evidence). - Suspected catheter-related bloodstream infection Two trials randomised a total of 151 participants to longer or shorter dressing intervals and measured suspected CRBSI. It is unclear whether there is a difference in the risk of suspected CRBSI between people having long or short intervals between dressing changes (RR 0.70, 95% CI 0.23 to 2.10) (low quality evidence). - All cause mortality Three trials randomised a total of 896 participants to longer or shorter dressing intervals and measured all cause mortality. It is unclear whether there is a difference in the risk of death from any cause between people having long or short intervals between dressing changes (RR 1.06, 95% CI 0.90 to 1.25) (low quality evidence). - Catheter-site infection Two trials randomised a total of 371 participants to longer or shorter dressing intervals and measured catheter-site infection. It is unclear whether there is a difference in risk of catheter-site infection between people having long or short intervals between dressing changes (RR 1.07, 95% CI 0.71 to 1.63) (low quality evidence). - Skin damage One small trial (112 children) and three trials (1475 adults) measured skin damage. There was very low quality evidence for the effect of long intervals between dressing changes on skin damage compared with short intervals (children: RR of scoring ≥ 2 on the skin damage scale 0.33, 95% CI 0.16 to 0.68; data for adults not pooled). - Pain Two studies involving 193 participants measured pain. It is unclear if there is a difference between long and short interval dressing changes on pain during dressing removal (RR 0.80, 95% CI 0.46 to 1.38) (low quality evidence). Authors' conclusions The best available evidence is currently inconclusive regarding whether longer intervals between CVAD dressing changes are associated with more or less catheter-related infection, mortality or pain than shorter intervals.

Pen parameters for improving the performance of sheep imported from Australia to Persian Gulf feedlots

Summer in the Persian Gulf region presents physiological challenges for Australian sheep that are part of the live export supply chain coming from the Australian winter. Many feedlots throughout the Gulf have very high numbers of animals during June to August in order to cater for the increased demand for religious festivals. From an animal welfare perspective it is important to understand the necessary requirements of feed and water trough allowances, and the amount of pen space required, to cope with exposure to these types of climatic conditions. This study addresses parameters that are pertinent to the wellbeing of animals arriving in the Persian Gulf all year round. Three experiments were conducted in a feedlot in the Persian Gulf between March 2010 and February 2012, totalling 44 replicate pens each with 60 or 100 sheep. The applied treatments covered animal densities, feed-bunk lengths and water trough lengths. Weights, carcass attributes and health status were the key recorded variables. Weight change results showed superior performance for animal densities of ≥1.2 m2/head during hot conditions (24-h average temperatures greater than 33 °C, or a diurnal range of around 29–37 °C). However the space allowance for animals can be decreased, with no demonstrated detrimental effect, to 0.6 m2/head under milder conditions. A feed-bunk length of ≥5 cm/head is needed, as 2 cm/head showed significantly poorer animal performance. When feeding at 90 ad libitum 10 cm/head was optimal, however under a maintenance feeding regime (1 kg/head/day) 5 cm/head was adequate. A minimum water trough allowance of 1 cm/head is required. However, this experiment was conducted during milder conditions, and it may well be expected that larger water trough lengths would be needed in hotter conditions. Carcass weights were determined mainly by weights at feedlot entry and subsequent weight gains, while dressing percentage was not significantly affected by any of the applied treatments. There was no demonstrated effect of any of the treatments on the number of animals that died, or were classified as unwell. However, across all the treatments, these animals lost significantly more weight than the healthy animals, so the above recommendations, which are aimed at maintaining weight, should also be applicable for good animal health and welfare. Therefore, best practice guidelines for managing Australian sheep in Persian Gulf feedlots in the hottest months (June–August) which present the greatest environmental and physical challenge is to allow feed-bunk length 5 cm/head on a maintenance-feeding program and 10 cm/head for 90 ad libitum feeding, and the space allowance per animal should be ≥1.2 m2/head. Water trough allocation should be at least 1 cm/head with provision for more in the summer when water intake potentially doubles.

Pen parameters for improving the performance of sheep imported from Australia to Persian Gulf feedlots

Summer in the Persian Gulf region presents physiological challenges for Australian sheep that are part of the live export supply chain coming from the Australian winter. Many feedlots throughout the Gulf have very high numbers of animals during June to August in order to cater for the increased demand for religious festivals. From an animal welfare perspective it is important to understand the necessary requirements of feed and water trough allowances, and the amount of pen space required, to cope with exposure to these types of climatic conditions. This study addresses parameters that are pertinent to the wellbeing of animals arriving in the Persian Gulf all year round. Three experiments were conducted in a feedlot in the Persian Gulf between March 2010 and February 2012, totalling 44 replicate pens each with 60 or 100 sheep. The applied treatments covered animal densities, feed-bunk lengths and water trough lengths. Weights, carcass attributes and health status were the key recorded variables. Weight change results showed superior performance for animal densities of ≥1.2 m2/head during hot conditions (24-h average temperatures greater than 33 °C, or a diurnal range of around 29–37 °C). However the space allowance for animals can be decreased, with no demonstrated detrimental effect, to 0.6 m2/head under milder conditions. A feed-bunk length of ≥5 cm/head is needed, as 2 cm/head showed significantly poorer animal performance. When feeding at 90% ad libitum 10 cm/head was optimal, however under a maintenance feeding regime (1 kg/head/day) 5 cm/head was adequate. A minimum water trough allowance of 1 cm/head is required. However, this experiment was conducted during milder conditions, and it may well be expected that larger water trough lengths would be needed in hotter conditions. Carcass weights were determined mainly by weights at feedlot entry and subsequent weight gains, while dressing percentage was not significantly affected by any of the applied treatments. There was no demonstrated effect of any of the treatments on the number of animals that died, or were classified as unwell. However, across all the treatments, these animals lost significantly more weight than the healthy animals, so the above recommendations, which are aimed at maintaining weight, should also be applicable for good animal health and welfare. Therefore, best practice guidelines for managing Australian sheep in Persian Gulf feedlots in the hottest months (June–August) which present the greatest environmental and physical challenge is to allow feed-bunk length 5 cm/head on a maintenance-feeding program and 10 cm/head for 90% ad libitum feeding, and the space allowance per animal should be ≥1.2 m2/head. Water trough allocation should be at least 1 cm/head with provision for more in the summer when water intake potentially doubles.

Antimicrobial efficacy of a novel silver hydrogel dressing compared to two common silver burn wound dressings: Acticoat™ and PolyMem Silver

A novel burn wound hydrogel dressing has been previously developed which is composed of 2-acrylamido-2-methylpropane sulfonic acid sodium salt with silver nanoparticles. This study compared the antimicrobial efficacy of this novel dressing to two commercially available silver dressings; Acticoat™ and PolyMem Silver(®). Three different antimicrobial tests were used: disc diffusion, broth culture, and the Live/Dead(®) Baclight™ bacterial viability assay. Burn wound pathogens (P. aeruginosa, MSSA, A. baumannii and C. albicans) and antibiotic resistant strains (MRSA and VRE) were tested. All three antimicrobial tests indicated that Acticoat™ was the most effective antimicrobial agent, with inhibition zone lengths of 13.9-18.4mm. It reduced the microbial inocula below the limit of detection (10(2)CFU/ml) and reduced viability by 99% within 4h. PolyMem Silver(®) had no zone of inhibition for most tested micro-organisms, and it also showed poor antimicrobial activity in the broth culture and Live/Dead(®) Baclight™ assays. Alarmingly, it appeared to promote the growth of VRE. The silver hydrogel reduced most of the tested microbial inocula below the detection limit and decreased bacterial viability by 94-99% after 24h exposure. These results support the possibility of using this novel silver hydrogel as a burn wound dressing in the future

Dressing up Tinderella: Interrogating authenticity claims on the mobile dating app Tinder

Mobile dating applications (‘apps’) have increased in popularity over recent years, with Tinder among the first to break into the mainstream heterosexual market. Since mobile dating intensifies the need to confirm that potential dates are not misrepresenting themselves and are safe to meet in person, Tinder’s success indicates that it has allayed these concerns regarding the authenticity of its users. This article combines Giddens’ conceptualization of authenticity, as the ability to reference a coherent biographical narrative, with Callon’s sociology of translation to investigate Tinder’s framing of authenticity within mobile dating. Applying a walkthrough method that interrogates Tinder’s technological architecture, promotional materials, and related media, this hybrid theoretical framework is used to identify how Tinder configures an actor-network that establishes its app as the solution to users’ concerns, enrols individuals in using its features in authenticity claims, and popularizes Tinder’s framing across public discourse. This network of human and non-human actors frames authenticity as being established through one’s Facebook profile and adherence to normative standards relating to age, gender, ethnicity, and socioeconomic status. However, user discourses on other social media identify and challenge negative outcomes of this framing, with normativity fostering discrimination and Facebook verification failing to prevent abusive behavior. This case study of Tinder paves the way for future investigation into user responses to its framing. Further, it demonstrates the efficacy and broader applicability of this theoretical approach for identifying both human and technological influences on the construction of authenticity with digital media.

Evaluation of the carcass and commercial characteristics of carps

The role of carcass evaluation techniques in aquaculture research programs, especially in genetics, breeding, production management, feeding and nutrition, cannot be overemphasized. Knowledge of production efficiencies and growth potentials in relation to desired carcass attributes has provided an impetus to improvements in genetic selection techniques and management of aquatic food animals. Accurate, standard and uniform methods of carcass evaluation are critically important. A standard format developed for collection of data on carps is presented in this paper.

Effect of phosphorous supplementation in the formulated fish feed on carcass quality of Nile tilapia Oreochromis niloticus L.

A study was conducted to evaluate the effect of phosphorus supplementation in the formulated fish diet on carcass quality of Nile tilapia in net-cages suspended in fertilized earthen ponds. In the experiment 3% di-calcium phosphate (DCP), 3% triple supper phosphate (TSP) and 7% 16:20 inorganic fertilizer were added as phosphorous sources to three diets containing fish meal as main protein ingredient. Feeding tilapia in net-cages with these diets significantly (pcarcass quality and bone phosphorous content of Nile tilapia over fish fed with same diet without phosphorous supplementation and fish given no feed. The final body composition and bone phosphorous content of Nile tilapia fed with DCP, TSP and 16:20 grade fertilizer supplemented diets were comparable.

Recovery, growth and carcass composition following periods of restricted ration and full feeding in indian major carp, Rohu (Labeo rohita H.)

A 90-day experiment was conducted to determine the effect of restricted ration and full feeding on the recovery growth and carcass compositions of fingerlings (average weight - 20.74 ± 0.13 g) of rohu, Labeo rohita (H.). Rohu fingerlings procured from a local fish breeder were fed with commercial pelleted feed (27% crude protein) during the two-week acclimatization in the laboratory condition. Experimental pelleted diet (30% crude protein) was prepared and the control group (T sub(CFR)) was fed at 3% of body weight for the 90-day trial period. The experimental group T sub(1FR) was fed for three days at 1% of body weight and the next three days at 3% of body weight, T sub(2FR) was fed for seven days at 1% of body weight and the next seven days at 3% of body weight, T sub(3FR) was fed for 15 days at l% of body weight and the 15 days at 3% of body weight and T sub(4FR) was fed for 25 days at 1% of body weight and the next 25 days at 3% of body weight, alternating between 1 and 3% for the specified period during the 90-day trial period. Daily rations were divided into two equal meals per day at 09.00 and 16.00 hours. Average percent survival rate of rohu during the 90-day trial period was more than 90. Percent live weight gain (98.90 ± 0.34, 113.0 ± 5.93, 125.71 ± 11.01 and 141.90 ± 2.89), specific growth rate (1.53 ± 0.01 1.68 ± 0.06, 1.80 ± 0.10 and 1.96 ± 0.02%/d) and absolute growth rate (1.33 ± 0.13, 1.38 ± 0.07, 1.39 ± 0.04 and 1.44 ± 0.07g/d) of the experimental groups (T sub(1FR), T sub(2FR), T sub(3FR) and T sub(4FR) respectively) increased with the advancement of the experiment in comparison to those in control, T sub(CFR) (90.92 ± 5.81%, 1.44 ± 0.07%/d and 1.34 ± 0.20g/d, respectively) and were proportionately correlated with the degree of deprivation probably through the mechanism of increased feed intake (hyperphagia), feed efficiency ratio or gross growth efficiency, protein efficiency ratio and the superior feed conversion ratio reflecting in better performance index. The body length and muscle composition of fish indicated that recovery growth happened due to protein growth but certainly not due to fat deposition in the gut. Feeding at 1 and 3% of body weight alternating over a period of 25 days might economize the culture operation of rohu.

Identification and association of the single nucleotide polymorphisms in calpain3 (CAPN3) gene with carcass traits in chickens

Background: The aim of this study is to screen single nucleotide polymorphisms (SNP) of chicken Calpain3 (CAPN3) gene and to analyze the potential association between CAPN3 gene polymorphisms and carcass traits in chickens. We screened CAPN3 single nucleo

Interactions of three dual-dressing effects of four-wave mixing in a five-level atomic system

We study the four-wave mixing (FWM) in an opening five-level system with two dressing fields. There are three kinds of doubly dressing mechanisms (parallel cascade, sequential cascade, and nested cascade) in the system for doubly dressed four-wave mixing. These mechanisms reflect different correlations between two dressing fields and different effects of two dressing fields to the FWM. Investigation of these mechanisms is helpful to understand the generated high-order nonlinear optical signal dressed by multi-fields.

Influence of regrouping strategy on performance, behaviour and carcass parameters in pigs

One thousand two hundred pigs were weaned at 4 weeks of age and mixed to form groups of ten animals that were balanced for gender. The groups consisted of uniform weight groups (i.e. separate groups of small, medium or large pigs), or mixed weight groups (i.e. groups containing small, medium and large pigs). Half of the groups were retained from weaning until slaughter at 21 weeks of age, and half were regrouped at the start of the finishing period at 10 weeks of age. In this regrouping, uniform weight groups were regrouped to form mixed weight groups, and mixed weight groups were regrouped to form uniform weight groups. In addition, some mixed weight groups were regrouped to form mixed weight groups in order to assess the effect of regrouping at 10 weeks of age on performance and aggressive behaviour.

Effect of target slaughter weight on production efficiency, carcass traits and behaviour of restrictively-fed gilts and intact male finisher pigs

The effect of 3 slaughter weights (85.95 or 105 kg) on performance and carcass traits of 481 pigs in single-gender groups of 13 (18 groups of gilts and 19 groups of intact males) was evaluated. Pigs (39.5 +/- 3.3 kg) were fed a liquid diet 3 times daily in a long trough. The behaviour of pigs slaughtered at 105 kg was recorded at 50, 60 and 70 days after the start of the experiment (5 groups of gilts and 4 groups of intact males). Behaviour (active, inactive, feeding) and posture (standing, lying, dog-sitting) of all pigs was recorded at 5-min intervals for 30 min prior to and 1 h after each feeding event. Slaughtering pigs at 95 kg and 105 kg delayed production by 7 and 16 days, respectively, compared to slaughtering at 85 kg (P0.05). Muscle depth increased with increasing slaughter weight (P