A microbiologic surveillance study was performed in order to estimate the point prevalence, source, and nosocomial acquisition of methicillin-resistant Staphylococcus aureus (MRSA) within the Iowa City Veterans Affairs Medical Center (IC VAMC). Immediately following the microbiologic surveillance study, a cluster of nosocomial MRSA infections was detected by routine infection control surveillance. An epidemiologic investigation was conducted and all isolates of MRSA detected during the microbiologic surveillance study and the subsequent cluster of nosocomial infections were characterized by restriction endonuclease analysis of plasmid DNA (REAP). REAP subtyping defined a total of ten distinct subtypes from 24 patients infected or colonized with MRSA. The documentation of a single subtype of MRSA (subtype A2) in nine patients from the surgical service, eight of which were hospitalized in the surgical intensive care unit, provided convincing evidence of a breakdown of infection control practices in that unit. REAP subtyping was a highly discriminating means of identifying different subtypes among the various isolates of MRSA and was useful in directing infection control efforts to specific problem areas within the hospital. Molecular typing methods, such as REAP, when used appropriately in conjunction with careful epidemiologic investigation provide an effective approach to the investigation and control of the spread of MRSA within the hospital.

Clindamycin↗

PubMedDate not supplied

Indwelling catheter care: dispelling the misconceptions.

Long-term indwelling catheters often are incorrectly used and managed. Nurses insert and manage catheters, yet studies have shown that most nurses have limited scientific knowledge in the area of catheters and their care. This article will review the Agency for Health Care Policy and Research guidelines for recommended catheter use and suggest troubleshooting tips for catheter-related problems. The problems of infection, catheter selection and size, urinary leakage, encrustation, catheter blockage, and inadvertent catheter removal will be addressed. Patient and caregiver education tips also will be listed.

Aged↗

PubMedDate not supplied

Age at menarche of European, Afro-Caribbean and Indo-Pakistani schoolgirls living in London.

Age at menarche is reported for 1,365 European, 530 Afro-Caribbean and 282 Indo-Pakistani schoolgirls taking part in a cross-sectional anthropometric survey in the London Area Health Authorities of Kensington, Chelsea and Westminster, and Brent and Harrow, in 1980-81. Mean ages at menarche are 13.59 +/- 0.37 years (European), 13.18 +/- 0.11 years (Afro-Caribbean) and 13.06 +/- 0.20 years (Indo-Pakistani). The European value is significantly higher than those for Afro-Caribbean and Indo-Pakistani girls, and for Europeans living in the same areas of London in 1966. Social class has an effect on age at menarche in Afro-Caribbean and European girls, but not Indo-Pakistani girls, whilst family size has an effect on age at menarche in Europeans and Indo-Pakistanis.

Adolescent↗

PubMedDate not supplied

Background and initial case studies into the effects of prospective memory training.

Two preliminary case studies are presented introducing the technique of Prospective Memory Training (PMT) as a potential means to manage severe memory impairments. PMT involves repetitive administration of prospective memory tasks in which the patient is asked to initiate a specific action at a future designated time. Background information relevant to the concept of prospective memory is presented. Possible theoretical foundations for PMT are also discussed.

Adult↗

PubMedDate not supplied

An investigation of the effects of prospective memory training.

A within-subject operant design was used to evaluate the efficacy of prospective memory training in a 51-year-old brain-injured male with a severe memory impairment. Training consisted of repetitive administration of prospective memory tasks whereby the subject was given actions to perform at specified future times. The length of time between task administration and task execution was systematically lengthened. Probes were taken evaluating generalization to performance on naturalistic, real-life prospective memory tasks and to performance on retrospective memory or recall measures. Results suggested a significant and steady increase in the subject's prospective memory ability over time; however, changes were not experimentally controlled, thus the data are descriptive in nature. Methodological limitations and issues pertinent to the future investigation of prospective memory are discussed at length, in the hope of encouraging further evaluation of this preliminary, promising technique.

Activities of Daily Living↗