Use of antimicrobial biodegradable packaging to control Listeria monocytogenes during storage of cooked ham

The antimicrobial effect against L. monocytogenes of biodegradable films (alginate, zein and polyvinyl alcohol) containing enterocins was investigated. Survival of the pathogen was studied by means of challenge tests performed at 6 °C during 8 and 29 days, for air-packed and vacuum-packed sliced cooked ham, respectively. Air packaging was tested with two concentrations of enterocins (200 and 2000 AU/cm2). Control air-packed cooked ham showed an increase of L. monocytogenes from 104 to 107 CFU/g after 8 days. By contrast, packaging with antimicrobial films effectively slowed down the pathogen's growth, leading to final counts lower than in control lots. Air-packaging with alginate films containing 2000 AU/cm2 of enterocins effectively controlled L. monocytogenes for 8 days. An increase of only 1 log unit was observed in zein and polyvinyl alcohol lots at the same enterocin concentration. Vacuum packaging with films containing enterocins (2000 AU/cm2) also delayed the growth of the pathogen. No increase from inoculated levels was observed during 15 days in antimicrobial alginate films. After 29 days of storage, the lowest counts were obtained in samples packed with zein and alginate films containing enterocins, as well as with zein control films. The most effective treatment for controlling L. monocytogenes during 6 °C storage was vacuum-packaging of sliced cooked ham with alginate films containing 2000 AU/cm2 of enterocins. From the results obtained it can concluded that antimicrobial packaging can improve the safety of sliced cooked ham by delaying and reducing the growth of L. monocytogenes.

Hand-disinfectant alcoholic vapors in incubators

La désinfection des mains avant d'effectuer des soins est un acte indispensable en médecine clinique pour limiter le risque de transmission de germes. Après utilisation des produits désinfectants mis à disposition dans les services de soins, il se dégage une odeur alcoolique forte et désagréable, liée directement aux alcools antimicrobiens des solutions. Une étude a montré qu'une exposition aiguë et brève aux vapeurs d'éthanol et isopropanol chez des enfants prématurés pouvait être mise en relation avec des changements hémodynamiques au niveau de la zone olfactive orbito-frontale [1]. Aucune norme réglementant les concentrations de vapeurs d'éthanol ou isopropanol auxquelles les nouveau-nés peuvent être exposés n'existe. Cette thèse avait pour but d'étudier l'exposition des nouveaux nés soignés dans des incubateurs à des vapeurs d'alcool (éthanol et isopropanol). Elle était composée de 2 parties qui ont été publiées dans 2 articles différents et qui représentent le travail de doctorat [2-3]. La 1ère partie était une étude observationnelle d'une série de cas [2], Des mesures des concentrations des vapeurs d'alcool ont été effectuées auprès de 9 nouveau-nés soignés dans des incubateurs de même modèle au sein de l'unité de néonatologie du Centre Hospitalier Universitaire Vaudois à Lausanne. Sur 4 heures, les concentrations instantanées et moyennes ont été mesurées par deux techniques (photoionisation et respectivement chromatographic après absorption sur charbon actif). Onze analyses ont été effectuées en 2004-2005. Elles ont révélé des taux très variables d'éthanol et d'isopropanol dans les incubateurs (avec des valeurs maximales de 1982 ppm pour l'isopropanol et 906 ppm pour l'éthanol) correspondant aux introduction de mains fraîchement désinfectées dans les isolettes. Les concentrations moyennes variaient entre 9.8 ppm et plus de 61 ppm pour l'éthanol et < 0.01 ppm et 119 ppm pour l'isopropanol. La 2e partie a été réalisée en collaboration avec le PD Dr D. Vernez de l'Institut Universitaire Romand de Santé au Travail [3], Un modèle théorique prédictif des concentrations alcooliques dans des incubateurs pour nouveau-nés a été développé. Des séries de mesures standardisées des variations des concentrations alcooliques dans un incubateur sans patient ont été effectuées en changeant trois variables: 1) le renouvellement de l'air dans l'incubateur en variant le nombre de portes ouvertes, 2) la quantité de solution alcoolique versée sur les mains avant de les introduire dans l'incubateur 3) le temps de séchage des mains après désinfection et avant de les introduire dans l'incubateur. La modélisation a permis de décrire la cinétique des concentrations d'alcool dans les incubateurs et d'évaluer les pistes potentielles pour diminuer les risques d'exposition des nouveau-nés à ces vapeurs dans leurs incubateurs. En conclusion, la 1 ère partie a mis en évidence, pour la première fois, que des nouveau- nés soignés en incubateurs peuvent être exposés à des vapeurs d'alcool. Comme il η y a aucune norme d'exposition pour cette population et que les seules limites d'exposition existantes sont destinées à des travailleurs adultes, aucune conclusion précise ne peut être avancée sur les risques toxicologiques. L'exposition à des vapeurs polluantes d'un nouveau-né à terme ou prématuré, en plein développement neuro-sensoriel, devrait toutefois, à priori, être évitée. La 2ème partie permet de proposer des pistes pratiques pour diminuer les concentrations des vapeurs d'alcool dans les incubateurs: respecter le temps de séchage des mains après leur désinfection et avant de les introduire dans les isolettes et/ou préférer un désinfectant alcoolique à faible temps d'évaporation.

Effects of muscle fibre shortening on the characteristics of surface motor unit potentials.

Traditionally, studies dealing with muscle shortening have concentrated on assessing its impact on conduction velocity, and to this end, electrodes have been located between the end-plate and tendon regions. Possible morphologic changes in surface motor unit potentials (MUPs) as a result of muscle shortening have not, as yet, been evaluated or characterized. Using a convolutional MUP model, we investigated the effects of muscle shortening on the shape, amplitude, and duration characteristics of MUPs for different electrode positions relative to the fibre-tendon junction and for different depths of the MU in the muscle (MU-to-electrode distance). It was found that the effects of muscle shortening on MUP morphology depended not only on whether the electrodes were between the end-plate and the tendon junction or beyond the tendon junction, but also on the specific distance to this junction. When the electrodes lie between the end-plate and tendon junction, it was found that (1) the muscle shortening effect is not important for superficial MUs, (2) the sensitivity of MUP amplitude to muscle shortening increases with MU-to-electrode distance, and (3) the amplitude of the MUP negative phase is not affected by muscle shortening. This study provides a basis for the interpretation of the changes in MUP characteristics in experiments where both physiological and geometrical aspects of the muscle are varied.

Stability of the Helical TomoTherapy Hi·Art II detector for treatment beam irradiations.

The Hi·Art II Helical TomoTherapy (HT) unit is equipped with a built-in onboard MVCT detector used for patient imaging and beam monitoring. Our aim was to study the detector stability for treatment beam measurements. We studied the MVCT detector response with the 6 MV photon beam over time, throughout short-term (during an irradiation) and long-term (two times 50 days) periods. Our results show a coefficient of variation ≤ 1% for detector chambers inside the beam (excluding beam gradients) for short- and long-term response of the MVCT detector. Larger variations were observed in beam gradients and an influence of the X-ray target where degradation was found. The results assume that an 'air scan' procedure is performed daily to recalibrate the detector with the imaging beam. On short term, the detector response stability is comparable to other devices. Long-term measure- ments during two 50-day periods show a good reproducibility. 

L'aplicació de la normativa comptable europea en el sector sanitari públic: estudi comparat sobre l'aplicació del Sistema Europeu de Comptes SEC-95 als centres sanitaris del Regne Unit, França i Alemanya

Aquest informe té per objecte analitzar com s'interpreta i aplica la normativa comptable europea (el Sistema Europeu de Comptes SEC-95) en el sector sanitari públic, des d'una perspectiva de Dret comparat. Concretament, l'estudi es centra en l'aplicació del SEC-95 als centres sanitaris del Regne Unit, França i Alemanya, amb la finalitat de poder extreure conclusions que resultin d'utilitat en l'àmbit de les Empreses Públiques i Consorcis (EPIC) del Sistema Sanitari Català.

Caveolin expression changes in the neurovascular unit after juvenile traumatic brain injury: signs of blood-brain barrier healing?

Traumatic brain injury (TBI) is one of the major causes of death and disability in pediatrics, and results in a complex cascade of events including the disruption of the blood-brain barrier (BBB). A controlled-cortical impact on post-natal 17 day-old rats induced BBB disruption by IgG extravasation from 1 to 3 days after injury and returned to normal at day 7. In parallel, we characterized the expression of three caveolin isoforms, cav-1, cav-2 and cav-3. While cav-1 and cav-2 are expressed on endothelial cells, both cav-1 and cav-3 were found to be present on reactive astrocytes, in vivo and in vitro. Following TBI, cav-1 expression was increased in blood vessels at 1 and 7 days in the perilesional cortex. An increase of vascular cav-2 expression was observed 7 days after TBI. In contrast, astrocytic cav-3 expression decreased 3 and 7 days after TBI. Activation of eNOS (via its phosphorylation) was detected 1 day after TBI and phospho-eNOS was detected both in association with blood vessels and with astrocytes. The molecular changes involving caveolins occurring in endothelial cells following juvenile-TBI might participate, independently of eNOS activation, to a mechanism of BBB repair while, they might subserve other undefined roles in astrocytes.

Concrete Pavement Mixture Design and Analysis (MDA): Evaluation of Foam Drainage Test to Measure Air Void Stability in Concrete

The stability of air bubbles in fresh concrete can have a profound influence of the potential durability of the system, because excessive losses during placement and consolidation can compromise the ability of the mixture to resist freezing and thawing. The stability of air void systems developed by some air entraining admixtures (AEAs) could be affected by the presence of some polycarboxylate-based water reducing admixtures (WRAs). The foam drainage test provides a means of measuring the potential stability of air bubbles in a paste. A barrier to acceptance of the test was that there was little investigation of the correlation with field performance. The work reported here was a limited exercise seeking to observe the stability of a range of currently available AEA/WRA combinations in the foam drainage test; then, to take the best and the worst and observe their stabilities on concrete mixtures in the lab. Based on the data collected, the foam drainage test appears to identify stable combinations of AEA and WRA.

Tracheostomy in children.

We reviewed the records of 108 patients who had a tracheostomy performed over a 10-year period from July 1979 to April 1989. Median age at tracheostomy was 6 months (1 week-15 years). Indications for surgery were acquired subglottic stenosis (31.4%), bilateral vocal cord paralysis (22.2%), congenital airway malformations (22.2%) and tumours (11.1%). No epiglottis and no emergency situation had to be managed by tracheostomy. Operation was uneventful in all, but 8 patients (7.4%) developed a pneumothorax in the postoperative period. Twenty-one (19.5%) had severe complications during the cannulation period (tube obstruction in 11 patients with cardiorespiratory arrest in 4; dislocation of the tube in 6 patients). Fifteen patients (13.8%) had severe complications after decannulation (2 had a cardiorespiratory arrest); all 15 had to be recannulated. At the end of the study period 85 patients (78.7%) were successfully decannulated with a median period of tracheostomy of 486 days (8 days-6.6 years). The median hospital stay was 159 days (13 days-2.7 years). All patients could be discharged. Eight patients (7.4%) died but no death was related to tracheostomy. In summary the mortality rate is lower than reported in previous reviews and tracheostomy is a safe operation even in small children but cannula-related complications may lead to life-threatening events. The management of tracheostomized small children and infants in a highly staffed and monitored intensive care unit has allowed better handling of complications and has resulted in a reduction in cannula-related deaths.

L'incontinence urinaire chez des personnes âgées hospitalisées en unité de gériatrie: est-ce vraiment une priorité pour les infirmières [Urinary incontinence in hospitalized geriatric patients : is it really a priority for nurses?].

INTRODUCTION: urinary incontinence (UI) is a phenomenon with high prevalence in hospitalized elderly patients, effecting up to 70% of patients requiring long term care. However, despite the discomfort it causes and its association with functional decline, it seems to be given insufficient attention by nurses in geriatric care. OBJECTIVES: to assess the prevalence of urinary incontinence in geriatric patients at admission and the level of nurse involvement as characterized by the explicit documentation of UI diagnosis in the patient's record, prescription of nursing intervention, or nursing actions related to UI. METHODS: cross-sectional retrospective chart review. One hundred cases were randomly selected from those patients 65 years or older admitted to the geriatric ward of a university hospital. The variables examined included: total and continence scores on the Measure of Functional Independence (MIF), socio-demographic variables, presence of a nursing diagnosis in the medical record, prescription of or documentation of a nursing intervention related to UI. RESULTS: the prevalence of urinary incontinence was 72 % and UI was positively correlated with a low MIF score, age and status of awaiting placement. Of the examined cases, nursing diagnosis of UI was only documented in 1.4 % of cases, nursing interventions were prescribed in 54 % of cases, and at least one nursing intervention was performed in 72 % of cases. The vast majority of the interventions were palliative. DISCUSSION: the results on the prevalence of IU are similar to those reported in several other studies. This is also the case in relation to nursing interventions. In this study, people with UI were given the same care regardless of their MIF score MIF, age or gender. One limitation of this study is that it is retrospective and therefore dependent on the quality of the nursing documentation. CONCLUSIONS: this study is novel because it examines UI in relation to nursing interventions. It demonstrates that despite a high prevalence of UI, the general level of concern for nurses remains relatively low. Individualized care is desirable and clinical innovations must be developed for primary and secondary prevention of UI during hospitalization.

Air Content and Permeability of PCC Pavements: 1909 to 2006, MLR-05-02, 2007

Portland cement concrete pavements have given excellent service history for Iowa. Many of these pavements placed during the 1920’s and 1930’s are still in service today. Many factors go in to achieve a long term durable concrete pavement. Probably the most important is the durability of the aggregate. Until the 1930’s, pit run gravel was the most predominant aggregate used. Many of these gravels provided long term performance and their durability is dependent upon the carbonate fraction of the gravel. Later, limestone (calcium carbonate) and dolomite (calcium, magnesium carbonate) sources were mined across Iowa. The durability of these carbonate aggregates is largely dependent upon the pore system which can cause freeze thaw problems known as D-cracking, which was a problem with some sources during the 1960’s. Also, some of these carbonate aggregates are also susceptible to deterioration from deicing salts. Geologists have identified the major components that affect the durability of these carbonate aggregates and sources are tested to ensure long term performance in Portland cement concrete. Air entrainment was originally put in concrete to improve scaling resistance. It is well known that air entrainment is required to provide freeze thaw protection in concrete pavements today. In Iowa, air entrainment was not introduced in concrete pavements until 1952. This research investigates properties that made older concrete pavements durable without air entrainment.

Plastic Air Content versus Hardened Air Content by High Pressure Air Meter, MLR-99-03, 2001

Plastic air content is typically tested by the pressure method, ASTM C138. Loss of air content through the paver has been shown to exceed 2 percent at times. Research has shown that early deterioration of pavements in Iowa may be directly or indirectly related to low or inadequate air content. Hardened air content is typically checked using the linear traverse method, ASTM C457. The linear traverse method is very time consuming and could not be used on a production scale. A quick and effective method of testing in place air content is needed. Research has shown a high degree of correlation with the high-pressure method of determining air content of hardened concrete versus plastic air content in laboratory conditions. This research indicated that air contents are more variable when comparing core results to plastic air content, although the overall average for the air content was comparable. Perhaps, the location of the plastic air content test, obtained from construction records, versus location of the cores was not as accurate as needed.

Black culture, white youth: la tradició cultural jamaicana al Regne Unit

Amb aquest projecte es pretén documentar tres dècades d'influència jamaicana en la cultura britànica, a partir de l’arribada del vaixell Empire Windrush al 1948, de la independència de Jamaica al 1962 i fins a finals dels anys setanta, coincidint amb l’arribada del rastafarisme. Es tracta de posar de manifest la contribució cultural i social dels jamaicans que, en gran part, ha ajudat al desenvolupament del Regne Unit.Els sound systems, els segells discogràfics i les seves subsidiàries, les gires i concerts d’artistes jamaicans... són una clara mostra de les aportacions de la comunitat jamaicana al país i que molts cops es posen de manifest amb celebracions tan populars com el famós Carnaval de Notting Hill. I és que la música i la cultura jamaicana és quelcom més del que molts es pensen, no només és Bob Marley i el consum de marihuana.