Pro Re Nata Drug Use in Nursing Home Residents: A Systematic Review

Objectives

In addition to routinely administered long-term medication, complex drug regimens of nursing home residents often include as needed or pro re nata (PRN) medication. However, there has been no systematic evaluation of the frequency and concomitants of PRN medication in nursing homes. The main objective of this systematic review was to provide a current assessment of PRN drug use in nursing homes.

Enzymes Enhance Biofilm Removal Efficiency of Cleaners

Efficient removal of biofilms from medical devices is a big challenge in health care to avoid hospital-acquired infections, especially from delicate devices like flexible endoscopes, which cannot be reprocessed using harsh chemicals or high temperatures. Therefore, milder solutions such as enzymatic cleaners have to be used, which need to be carefully developed to ensure efficacious performance. In vitro biofilm in a 96-well-plate system was used to select and optimize the formulation of novel enzymatic cleaners. Removal of the biofilm was quantified by crystal violet staining, while the disinfecting properties were evaluated by a BacTiter-Glo assay. The biofilm removal efficacy of the selected cleaner was further tested by using European standard (EN) for endoscope cleaning EN ISO 15883, and removal of artificial blood soil was investigated by treating TOSI (Test Object Surgical Instrument) cleaning indicators. Using the process described here, a novel enzymatic endoscope cleaner was developed, which removed 95% of Staphylococcus aureus and 90% of Pseudomonas aeruginosa biofilms in the 96-well plate system. With a >99% reduction of CFU and a >90% reduction of extracellular polymeric substances, this cleaner enabled subsequent complete disinfection and fulfilled acceptance criteria of EN ISO 15883. Furthermore, it efficiently removed blood soil and significantly outperformed comparable commercial products. The cleaning performance was stable even after storage of the cleaner for 6 months. It was demonstrated that incorporation of appropriate enzymes into the cleaner enhanced performance significantly.     

Implementing Non-violent Resistance,a Method to Cope with Aggression in Child and Adolescent Residential Care: Exploration of Staff Members Experiences

Staff members in residential care for youth are frequently confronted with aggressive behaviour, which has adverse effects on their stress levels and work satisfaction. This paper describes a qualitative evaluation to find out how staff members benefit from Non-violent Resistance (NVR), a method to create an aggression mitigating residential climate. Staff members were positive about NVR and reported feeling more relaxed. Most valued aspects of this method were the focus on being a team, delayed response and giving up the illusion of control. However, training and the intention to use NVR isn't enough, high quality implementation and maintenance are crucial.     

How the human brain exchanges information across sensory modalities to recognize other people

Recognizing the identity of other individuals across different sensory modalities is critical for successful social interaction. In the human brain, face‐ and voice‐sensitive areas are separate, but structurally connected. What kind of information is exchanged between these specialized areas during cross‐modal recognition of other individuals is currently unclear. For faces, specific areas are sensitive to identity and to physical properties. It is an open question whether voices activate representations of face identity or physical facial properties in these areas. To address this question, we used functional magnetic resonance imaging in humans and a voice‐face priming design. In this design, familiar voices were followed by morphed faces that matched or mismatched with respect to identity or physical properties. The results showed that responses in face‐sensitive regions were modulated when face identity or physical properties did not match to the preceding voice. The strength of this mismatch signal depended on the level of certainty the participant had about the voice identity. This suggests that both identity and physical property information was provided by the voice to face areas. The activity and connectivity profiles differed between face‐sensitive areas: (i) the occipital face area seemed to receive information about both physical properties and identity, (ii) the fusiform face area seemed to receive identity, and (iii) the anterior temporal lobe seemed to receive predominantly identity information from the voice. We interpret these results within a prediction coding scheme in which both identity and physical property information is used across sensory modalities to recognize individuals. Hum Brain Mapp, 36:324–339, 2015. © 2014 Wiley Periodicals, Inc .