Improved hand hygiene compliance after eliminating mandatory glove use from contact precautions-Is less more?

BACKGROUND Guidelines recommend that health care personnel (HCP) wear gloves for all interactions with patients on contact precautions. We aimed to assess hand hygiene (HH) compliance during contact precautions before and after eliminating mandatory glove use. METHODS We assessed HH compliance of HCP in the care of patients on contact precautions in 50 series before (2009) and 6 months after (2012) eliminating mandatory glove use and compared these results with the hospital-wide HH compliance. RESULTS We assessed 426 HH indications before and 492 indications after the policy change. Compared with 2009, we observed a significantly higher HH compliance in patients on contact precautions in 2012 (52%; 95% confidence interval [95% CI], 47-57) vs 85%; 95% CI, 82-88; P < .001). During the same period, hospital-wide HH compliance also increased from 63% (95% CI, 61-65) to 81% (95% CI 80-83) (P < .001). However, the relative improvement (RI) of HH compliance during contact precautions was significantly higher than the hospital-wide relative improvement (RI, 1.6; 95% CI, 1.49-1.81 vs 1.29; 95% CI, 1.25-1.34), with a relative improvement ratio of 1.27 (95% CI, 1.15-1.41). CONCLUSION Eliminating mandatory glove use in the care of patients on contact precautions increased HH compliance in our institution, particularly before invasive procedures and before patient contacts. Further studies on the effect on pathogen transmission are needed before revisiting the current official guidelines on the topic.

Medical, psychological and socio-economic implications of chronic hand eczema: a cross-sectional study.

BACKGROUND Hand eczema (HE) is a common skin disease with major medical psychological and socio-economic implications. Onset and prognosis of HE are determined by individual as well as environmental factors. So far, most epidemiological data on HE have been reported from Scandinavian and recently German studies. OBJECTIVE To investigate the characteristics and medical care of patients with chronic HE (CHE) in Switzerland, and identify risk factors. METHODS In this cross-sectional study, data from patients with chronic HE were obtained by means of medical history, dermatological examination and patient questionnaires. Multiple logistic regression analysis was applied to identify risk factors for high severity and dermatology life quality index (DLQI). RESULTS In seven dermatology departments, 199 patients (mean age 40.4 years, 50.8% female) with CHE (mean duration 6.6 years) were enrolled. Moderate to severe HE was reported by 70.9% of patients, and was associated with age <30 or >50 years, localization of lesions and pruritus. Because of the CHE, 37.3% of patients were on sick leave over the past 12 months, 14.8% had changed or lost their job. Practically all patients applied topical therapy, 21% were treated with alitretinoin, and 21% with psoralen plus UVA light (PUVA). The effects on the health-related quality of life was moderate to large in 33.7% and 39.4% of CHE patients, respectively. Factors associated with a high impact on DLQI (mean 9.7 ± 5.8) were female sex, lesions on back of the hands and pruritus as well as mechanical skin irritation and wearing gloves. CONCLUSION In agreement with recent studies, the Swiss data demonstrate the high impact of CHE on medical well-being, patient quality of life and work ability. As it is associated with an intense use of health care services, high rate of sick leave, job loss and change, CHE may cause a high socio-economic burden.

Escala de medición del miedo a la atención dental

El miedo al dolor constituye un obstáculo que interfiere la consul- ta dental del paciente y, con el objeto de prevenirlos, se diseña una escala de exploración del miedo a la consulta dental y de las estra- tegias deseables para disminuirlo. Se utilizó el Método de Escalonamiento de Likert y se aplicó a 105 pacientes en la Facultad de Odontología de la Universidad Nacional de Cuyo, Mendoza. Los pacientes responden que sienten mucho miedo a que el odontólo- go pueda trasmitirles una infección, ser revisados sin guantes, o que no se los cambie, y a las consecuencias de la mala higiene. En segundo lugar tienen mucho miedo a que el odontólogo pueda tocar un nervio, que perfore excesivamente, que se quiebre una pieza dentaria o se equivoque en el diagnóstico. La mayoría desea ser tratada comprensivamente y que se le explique los procedi- mientos y anticipe lo que va a sentir.

A data-globe and immersive virtual reality environment for upper limb rehabilitation after spinal cord injury

While a number of virtual data-gloves have been used in stroke, there is little evidence about their use in spinal cord injury (SCI). A pilot clinical experience with nine SCI subjects was performed comparing two groups: one carried out a virtual rehabilitation training based on the use of a data glove, CyberTouch combined with traditional rehabilitation, during 30 minutes a day twice a week along two weeks; while the other made only conventional rehabilitation. Furthermore, two functional indexes were developed in order to assess the patient’s performance of the sessions: normalized trajectory lengths and repeatability. While differences between groups were not statistically significant, the data-glove group seemed to obtain better results in the muscle balance and functional parameters, and in the dexterity, coordination and fine grip tests. Related to the indexes that we implemented, normalized trajectory lengths and repeatability, every patient showed an improvement in at least one of the indexes, either along Y-axis trajectory or Z-axis trajectory. This study might be a step in investigating new ways of treatments and objective measures in order to obtain more accurate data about the patient’s evolution, allowing the clinicians to develop rehabilitation treatments, adapted to the abilities and needs of the patients.

Augmented and Virtual Reality techniques for footwear

The use of 3D imaging techniques has been early adopted in the footwear industry. In particular, 3D imaging could be used to aid commerce and improve the quality and sales of shoes. Footwear customization is an added value aimed not only to improve product quality, but also consumer comfort. Moreover, customisation implies a new business model that avoids the competition of mass production coming from new manufacturers settled mainly in Asian countries. However, footwear customisation implies a significant effort at different levels. In manufacturing, rapid and virtual prototyping is required; indeed the prototype is intended to become the final product. The whole design procedure must be validated using exclusively virtual techniques to ensure the feasibility of this process, since physical prototypes should be avoided. With regard to commerce, it would be desirable for the consumer to choose any model of shoes from a large 3D database and be able to try them on looking at a magic mirror. This would probably reduce costs and increase sales, since shops would not require storing every shoe model and the process of trying several models on would be easier and faster for the consumer. In this paper, new advances in 3D techniques coming from experience in cinema, TV and games are successfully applied to footwear. Firstly, the characteristics of a high-quality stereoscopic vision system for footwear are presented. Secondly, a system for the interaction with virtual footwear models based on 3D gloves is detailed. Finally, an augmented reality system (magic mirror) is presented, which is implemented with low-cost computational elements that allow a hypothetical customer to check in real time the goodness of a given virtual footwear model from an aesthetical point of view.

Catheter-related bloodstream infection: burden of disease in a tertiary hospital

Background: Surveillance programmes have become the most effective tool for controlling catheter-related bloodstream infections (CRBSI). However, few studies have investigated programmes covering all hospital settings. Aim: To describe the results of a control and prevention programme for CRBSI based on compliance with recommendations for insertion and maintenance, using annual burden of disease in a tertiary level hospital. Methods: A CRBSI control and prevention programme involving all hospital settings was implemented. The programme consisted of CRBSI surveillance, direct observation of insertion and maintenance of catheters to determine performance, and education for healthcare workers. Findings: In total, 2043 short-term catheters were inserted in 1546 patients for 18,570 catheter-days, and 279 long-term catheters were inserted in 243 patients for 40,440 catheter-days. The annual incidence density was 5.98 (first semester 6.40, second semester 5.64) CRBSI per 1000 catheter-days for short-term catheters, and 0.57 (first semester 0.66, second semester 0.43) CRBSI per 1000 catheter-days for long-term catheters. One hundred and forty insertion procedures were observed, with an average insertion time of 13 (standard deviation 7) min. Compliance with recommendations was as follows: hand hygiene, 86.8%; use of alcoholic chlorhexidine solution for skin disinfection, 35.5%; use of mask, 93.4%; use of gloves, 98.7%; use of gown, 75.0%; use of sterile cloth, 93.8%; use of cap, 92.2%; bandage application, 62.7%; and use of aseptic technique, 89.5%. Forty-five maintenance procedures were observed, and compliance rates were as follows: hand hygiene, 42.1%; use of gloves, 78.1%; and port disinfection with alcoholic chlorhexidine solution, 32.5%. Conclusion: The CRBSI control and prevention programme implemented at the study hospital has decreased the rate of CRBSI, provided important information about the total burden of disease, and revealed possible ways to improve interventions in the future.

List of further "instances of crimes and misdemeanors" allegedly committed by Nathan Prince (3 copies), Nov. 26, 1741

These three copies are not identical. One copy, which appears to be the original, is signed by Edward Holyoke, Henry Flynt, Joseph Mayhew, and Thomas Marsh. A note on the verso of one copy indicates that it was intended for delivery to Prince. Among many other things, the President and Tutors accused Prince of having said "in a Town meeting at Cambridge [...] that [Edmund Trowbridge] had not the manners to give him a pair of gloves at his Uncle's funeral."

Letter from Samuel Willard, Lancaster, Massachusetts to Catherine Willard, Petersham, Massachusetts, June 18, 1799

Willard asks his sister to bring some of his clothes to a tailor, and also to make him a pair of linen gloves, and to send him various items from home, including books, a jacket, and a hat.

British manufactures.

[Vols. 4-6] are called "Series IV-VI."

Popular tales /

Lame Jervas.--The will.--The limerick gloves.--Out of debt, out of danger.--The lottery.--Rosanna.--Murad the unlucky.--The manufacturers.--The contrast.--The grateful Negro.--Tomorrow.

Physiologie du gant : suivie de notes historiques, philologiques et physiognomoniques /

Mode of access: Internet.

Tales and novels,

Added t.-p., engr.: Novels and tales ... N. Y., 1832-34.

Popular tales.

Contents: 1. Lame Jervas. The will. Limerick gloves. Out of debt, out of danger.--2. The lottery. Rosanna. Murad the unlucky. The manufacturers.--3. The contrast. The grateful Negro. To-morrow.

Des gants portés par les évêques : par d'autres membres du clergé et même par des laîques dans les cérémonies religieuses /

Includes bibliographical references.

Tales and novels /

Each bound vol. has added t.p. engraved, from another edition: Novels and tales / by Maria Edgeworth. In ten volumes. -- New York : Harper.