Neisseria gonorrhoeae with high-level resistance to azithromycin: case report of the first isolate identified in the United States

We report on the first Neisseria gonorrhoeae isolate in the United States identified with high-level resistance to azithromycin. This report discusses the epidemiologic case investigation, the molecular studies of resistance-associated mutations and N. gonorrhoeae multiantigen sequence typing, and challenges posed by emerging gonococcal antimicrobial resistance.     

Comparison of activities of daily living (ADLs) in two different one arm drive wheelchairs: a study of individuals/participants with hemiplegia

Aims: This pilot study measured activities of daily living performance in individuals/participants with hemiplegia propelling both a standard dual handrim Action 3 wheelchair and a standard Action 3 wheelchair with a Neater Uni-Wheelchair kit attachment. The kit consists of a steerable front. Research questions: Does the use of the NUW affect the performance quality of activities of daily living in individuals/participants with hemiplegia. Is there a difference in the motor and process skills during activities of daily living performance, and in the time taken to complete the activities. Methods: Four individuals/participants with hemiplegia were used in a cross over, repeated measures trial. Assessment of Motor and Process Skills of users undertaking making a bed and laying a table “Swedish style”, tasks were measured and time taken to complete each task were recorded. Results: Bed making completion time was quicker in the Neater Uni-wheelchair (p?p?Conclusion: Activities of daily living tasks in the Neater Uni-wheelchair were completed more efficiently with no loss in quality of motor and process skills performance. This suggests that the Neater Uni-wheelchair is a viable alternative to current one arm drive provision.

• Implications for Rehabilitation

• Inappropriate wheelchair provision can result in capacity limitation and poorer quality of ADL motor skill as well-lowered process performance skill.

• AMPS can help to explain motor and process skill differences in complex activities.

     

Blood pressure tracking in children and adolescents

Background

High blood pressure is a major risk factor for cardiovascular disease. Blood pressure tracking could help to identify individuals with potential hypertension. Therefore, we have asked whether or not tracking was of predictive value for the development of hypertension in early life.

Methods

Blood pressure was routinely measured in 13,261 children and adolescents in outpatient clinics as well as during hospitalization. In one analysis, 568 individuals with elevated and normotensive blood pressure values were evaluated after 2, 4, and 6 years of follow-up. In a second analysis, 2,157 individuals with normotensive blood pressure were examined in a paired t test.

Results

The follow-up analysis showed a significant tracking effect. However, the Pearson correlation coefficients of the systolic and diastolic blood pressure standard deviation scores (SDS) decreased over time. Upon the follow-up after 6 years, 35.6 % of the children and adolescents with elevated blood pressure values remained in the elevated range group. Of the children within the normotensive blood pressure range, 80.4 % remained normotensive after 6 years. Children with normotensive blood pressure showed a stronger tracking than those who had had one hypertensive blood pressure reading. Children with higher body mass index (BMI) at follow-up changed blood pressure SDS track from initially normal to higher blood pressure values.

Conclusions

Blood pressure tracking in children and adolescents is moderate. We conclude that the predictive power of a single hypertensive blood pressure measurement during a single visit is rather small, and thus repetitive measurements across several consecutive visits are necessary.     

Using the matron's charter to improve hospital cleaning

The new Matron's Charter places the responsibility of cleaning wards and equipment firmly within the remit of the matron. The matron can lead innovations that promote and empower staff to take control of their environment by using the simple, effective methods discussed in this article.     

Systematic Review of Vocational Preferences on Behavioral Outcomes of Individuals with Disabilities

Assessing performance of individuals with disabilities in relation to their preferences is a method of determining the social validity of practices. The benefits of using vocational preferences on related behavioral outcomes of individuals with disabilities such as task completion, challenging behavior, and indices of happiness, have been explored through several studies. The purpose of this systematic review was to assess the effects of preference for certain vocational activities on performance outcomes for individuals with disabilities. A comprehensive search resulted in a total of 16 included studies. Studies were analyzed according to (a) participant characteristics (e.g., diagnosis, age), (b) setting, (c) work tasks, (d) service provider, (e) experimental design or observational method, (f) preference assessment method, (g) independent variable, and (h) outcomes. Studies were appraised with quality indicators for single-case research. While outcomes were primarily positive in support of incorporating preferred vocational conditions, quality indicators were generally lacking and there are numerous areas calling for future research.