CAUTI prevention bundles: improving best practices within Western Health for continued success

Background: Persons in acute care settings who have indwelling urethral catheters are at higher risk of acquiring a urinary tract infection (UTI). Other complications related to prolonged indwelling urinary catheters include decreased mobility, damage to the meatus and/or urethra, increase use of antibiotics, increased length of stay, and pain. UTIs in acute care settings account for 30 to 40% of all health care associated infections (HAIs). Of these, 80% are catheter associated UTIs (CAUTIs). Purpose: To utilized the CDC (2009) bundle approach for CAUTI prevention and create a program which supports a multimodal method to improving urinary catheter use, maintenance, and removal, including a continuing competency program where role expansion is anticipated. Methods: A comprehensive review of the literature was conducted. Physicians were consulted through a power point presentation followed by a letter explaining the project, a questionnaire, and two selections of relevant literature. Nursing staff and allied health professionals from the target units of 3A and 3B medicine attended one of two lunch and learns. They were presented the project via a power point presentation and the same questionnaire as distributed to physicians. Results: Five e-learning modules, a revised policy, and clinical pathway have been developed to support staff with best practice knowledge transfer. Conclusion: Behaviour changes need to be approached with a framework, extensive consultation, and education. Sustainability of any practice change cannot occur without having completed the background work to ensure staff have access to tools to support the change.

(Table 1) Mineral composition of sand- and silt-sized fractions of bottom sediments from the Romanche Trench

A study was made of mineral composition of sand- and silt-sized fractions of recent clastic (riftogenic) sediments and solidified deposits collected from the bottom of the Romanche Trench during the first voyage of R/V Akademik Kurchatov. Similarity between mineral compositions of sediments and bedrocks (ultrabasites, gabbroids, diabases) was established. This similarity is a basis for considering the mineral complex of the deposits that have been derived from the bedrocks of the trench slopes, and have formed due to their submarine denudation accompanied by tectonic crushing. The same mineral composition was found in pieces of older consolidated deposits; this suggests that conditions of sedimentation similar to those at recent times have existed for a long time in the Romanche Trench.

Chemical composition of <0.001 mm grain size fractions of bottom sediments and cementing mass of basalt breccia from the North Atlantic

A comprehensive study of 102 samples of grain size fractions 0.010-0.005; 0.005-0.001, and <0.001 mm showns that clay mineral compositions from bottom sediments of the Faroe-Iceland Threshold and Faroe-Shetland Trench are different. In the first case it is essentially smectite-chlorite, in the second - mainly hydromicaceous. The difference in composition of clay minerals is due to influence of different source areas of terrigenous material.

Influence des fractions hydrophobique et hydrophilique de la matière organique dissoute sur la sorption de Cd, Cu et Pb dans l'horizon B de Podzol

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Influence des fractions hydrophobique et hydrophilique de la matière organique dissoute sur la sorption de Cd, Cu et Pb dans l'horizon B de Podzol

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

d11B and metal/Ca ratios versus size fractions in the Surface and deep dwelling species, ODP Holes 130-806B and 108-664C

We have assessed the reliability of several foraminifer-hosted proxies of the ocean carbonate system (d11B, B/Ca, and U/Ca) using Holocene samples from the Atlantic and Pacific oceans. We examined chemical variability over a range of test sizes for two surface-dwelling foraminifers (Globigerinoides sacculifer and Globigerinoides ruber). Measurements of d11B in G. ruber show no significant relationship with test size in either Atlantic or Pacific sites and appear to provide a robust proxy of surface seawater pH. Likewise there is no significant variability in the d11B of our Atlantic core top G. sacculifer, but we find that d11B increases with increasing test size for G. sacculifer in the Pacific. These systematic differences in d11B are inferred to be a consequence of isotopically light gametogenic calcite in G. sacculifer and its preferential preservation during postdepositional dissolution. The trace element ratio proxies of ocean carbonate equilibria, U/Ca and B/Ca, show systematic increases in both G. ruber and G. sacculifer with increasing test size, possibly as a result of changing growth rates. This behavior complicates their use in paleoceanographic reconstructions. In keeping with several previous studies we find that Mg/Ca ratios increase with increasing size fraction in our well-preserved Atlantic G. sacculifer but not in G. ruber. In contrast to previous interpretations we suggest that these observations reflect a proportionally larger influence of compositionally distinct gametogenic calcite in small individuals compared to larger ones. As with d11B this influences G. sacculifer but not G. ruber, which has negligible gametogenic calcite.