Tackling the problem of blood culture contamination in the intensive care unit using an educational intervention

Blood culture contamination (BCC) has been associated with unnecessary antibiotic use, additional laboratory tests and increased length of hospital stay thus incurring significant extra hospital costs. We set out to assess the impact of a staff educational intervention programme on decreasing intensive care unit (ICU) BCC rates to <3% (American Society for Microbiology standard). BCC rates during the pre-intervention period (January 2006-May 2011) were compared with the intervention period (June 2011-December 2012) using run chart and regression analysis. Monthly ICU BCC rates during the intervention period were reduced to a mean of 3·7%, compared to 9·5% during the baseline period (P < 0·001) with an estimated potential annual cost savings of about £250 100. The approach used was simple in design, flexible in delivery and efficient in outcomes, and may encourage its translation into clinical practice in different healthcare settings.

Contamination of Donana food-chains after the Aznalcollar mine disaster

On 25 April 1998 part of the tailings pond dike of the Aznalcollar Zn mine north of the Guadalquivir marshes (Donana) in southern Spain collapsed releasing an estimated 5 million m³ of acidic metal-rich waste. This event contaminated farmland and wetland up to >40 km downstream, including the 900-ha 'Entremuros', an important area for birds within the Donana world heritage site. In spite of the contamination, birds continued to feed in this area. Samples of two abundant macrophytes (Typha dominguensis and Scirpus maritimus) were taken from the Entremuros and nearby uncontaminated areas; these plants are important food items for several bird species. Analyses showed that in the Entremuros mean plant tissue concentrations of Cd were 3-40-fold (0.8-7.4 ppm) and Zn 20-100-fold (20-3384 ppm) greater than those from control areas. Comparable dietary concentrations of Zn have been reported to cause severe physiological damage to aquatic birds under experimental conditions. Elevated Cd concentrations are of concern as Cd bioconcentrates and is a cumulative poison. Metals released in this accident are moving into this food-chain and present a considerable risk to species feeding on Typha sp. and Scirpus sp. Many other food-webs exist in this area and require detailed examination to identify the species at risk, and to facilitate the management of these risks to minimise future impacts to the wildlife of Donana. Copyright (C) 1999 Elsevier Science Ltd.

72 Potential for airborne bacterial contamination in an outpatient respiratory clinic

Finite element modeling of debonding failures in FRP-strengthened RC beams: A dynamic approach

This paper is concerned with the finite element simulation of debonding failures in FRP-strengthened concrete beams. A key challenge for such simulations is that common solution techniques such as the Newton-Raphson method and the arc-length method often fail to converge. This paper examines the effectiveness of using a dynamic analysis approach in such FE simulations, in which debonding failure is treated as a dynamic problem and solved using an appropriate time integration method. Numerical results are presented to show that an appropriate dynamic approach effectively overcomes the convergence problem and provides accurate predictions of test results.

Finite element modelling of FRP-to-concrete bond behaviour using the concrete damage plasticity theory combined with a plastic degradation model

The technique of externally bonding fibre reinforced polymer (FRP) composites has been becoming popular worldwide for retrofitting existing reinforced concrete (RC) structures. A major failure mode in such strengthened structures is the debonding of FRP from the concrete substrate. The bond behaviour between FRP and concrete thus plays a crucial role in these structures. The FRP-to-concrete bond behaviour has been extensively investigated experimentally, commonly using the pull-off test of FRP-to-concrete bonded joint. Comparatively, much less research has been concerned with the numerical simulation of this bond behaviour, chiefly due to difficulties in accurately modelling the complex behaviour of concrete. This paper proposes a robust finite element (FE) model for simulating the bond behaviour in the entire loading process in the pull-off test. A concrete damage plasticity model based on the plastic degradation theory is proposed to overcome the weakness of the elastic degradation theory which has been commonly adopted in previous studies. The model produces results in very close agreement with test data. © Tsinghua University Press, Beijing and Springer-Verlag Berlin Heidelberg 2011.

Micromechanical analysis of cohesive granular materials using the discrete element method with an adhesive elasto-plastic contact model

An adhesive elasto-plastic contact model for the discrete element method with three dimensional non-spherical particles is proposed and investigated to achieve quantitative prediction of cohesive powder flowability. Simulations have been performed for uniaxial consolidation followed by unconfined compression to failure using this model. The model has been shown to be capable of predicting the experimental flow function (unconfined compressive strength vs. the prior consolidation stress) for a limestone powder which has been selected as a reference solid in the Europe wide PARDEM research network. Contact plasticity in the model is shown to affect the flowability significantly and is thus essential for producing satisfactory computations of the behaviour of a cohesive granular material. The model predicts a linear relationship between a normalized unconfined compressive strength and the product of coordination number and solid fraction. This linear relationship is in line with the Rumpf model for the tensile strength of particulate agglomerate. Even when the contact adhesion is forced to remain constant, the increasing unconfined strength arising from stress consolidation is still predicted, which has its origin in the contact plasticity leading to microstructural evolution of the coordination number. The filled porosity is predicted to increase as the contact adhesion increases. Under confined compression, the porosity reduces more gradually for the load-dependent adhesion compared to constant adhesion. It was found that the contribution of adhesive force to the limiting friction has a significant effect on the bulk unconfined strength. The results provide new insights and propose a micromechanical based measure for characterising the strength and flowability of cohesive granular materials. 

Experimental and discrete element modelling of cohesive iron ore fines

In this study, the behaviour of iron ore fines with varying levels of adhesion was investigated using a confined compression test and a uniaxial test. The uniaxial test was conducted using the semi-automated uniaxial EPT tester in which the cohesive strength of a bulk solid is evaluated from an unconfined compression test following a period of consolidation to a pre-defined vertical stress. The iron ore fines were also tested by measuring both the vertical and circumferential strains on the cylindrical container walls under vertical loading in a separate confined compression tester - the K0 tester, to determine the lateral pressure ratio. Discrete Element Method simulations of both experiments were carried out and the predictions were compared with the experimental observations. A recently developed DEM contact model for cohesive solids, an Elasto-Plastic Adhesive model, was used. This particle contact model uses hysteretic non-linear loading and unloading paths and an adhesion parameter which is a function of the maximum contact overlap. The model parameters for the simulations are phenomenologically based to reproduce the key bulk characteristics exhibited by the solid. The simulation results show a good agreement in capturing the stress history dependent behaviour depicted by the flow function of the cohesive iron ore fines while also providing a reasonably good match for the lateral pressure ratio observed during the confined compression K0 tests. This demonstrates the potential for the DEM model to be used in the simulation of bulk handling applications.