Clostridium difficile is a common and potentially fatal cause of antibiotic-associated diarrhoea and pseudomembranous colitis worldwide. It has been isolated from patients and their surroundings, in healthcare facilities and from the community. C. difficile is able to survive for many months on inanimate surfaces in the form of spores. PCR ribotyping is used in the UK to characterise and identify strain diversity. Investigating how the most problematic strains respond to cleaning regimes may influence the control of disease. This work used the University Hospitals of Leicester Trust as a case study for this purpose of understanding the epidemiology of this pathogen within healthcare facilities. Five individual agar media were compared based on their abilities to recover and resuscitate damaged ribotype 027 spores, a strain associated with disease outbreaks and increased severity. Controlled laboratory experiments with a sub-lethal dose of a germicide were conducted before C. difficile recovery from hospital wards. An additional two sampling campaigns acquired environmental strains. C. difficile isolation after routine cleaning demonstrated the inefficiency of the current recovery regime as C. difficile spores were recovered using direct contact plates, enrichment broths, and resuscitation media. This study used layering of non-selective agar over selective agar, identifying a potential link in the proportions of media following the use of sponges in environmental sampling. All strains were characterised by ribotyping; ribotype 027 was isolated from all sampling cohorts. A four-month epidemiological study was conducted into the ribotype prevalence and distribution from C. difficile-positive faecal specimens. A second survey investigated these effects with a modification of C. difficile detection from faecal samples. Hydrogen peroxide vapour is currently being explored as a means of decontamination of healthcare-associated infections. Inactivation kinetics of ribotype 027 spores were analysed in response to vapour and liquid exposure of hydrogen peroxide. No reports thus far have explored such kinetics and controlled decontamination with both clinical and non-clinical strains. Evidence strongly suggests spores can be inactivated with its application. Furthermore, this study revealed there appears to be significant differences in susceptibility and inactivation of different C. difficile ribotypes.

SAMMANFATTNING Syfte: Syftet med denna studie var att undersöka hur närstående till skyddsisolerade patienter på en hematologiavdelning vid ett sjukhus i Mellansverige upplevde vårdtiden och bemötandet från vårdpersonalen under vistelsen på sjukhuset. Metod: Studien är en empirisk studie med kvalitativ design. Deltagarna bestod av fem närstående till skyddsisolerade patienter som valdes ut genom bekvämlighetsurval. Datainsamlingen gjordes genom semistrukturerade intervjuer och innehållsanalys. Resultat: Två teman har identifierats ”Den närstående trygghet är kopplat till hur patienten mår och behandlas.” och ”Närstående förminskar sin egen betydelse i vårdsituationen”. Under dessa två teman utkristalliserade sig fyra kategorier ”Trygghetskänsla”, ”Förlorad kontroll”, ”Att vara närvarande” och ”Copingstrategier. De närstående upplevde inte skyddsisoleringen i sig som något betungande, den förknippades snarast med praktiska problem. Trots detta använde de närstående sig av en rad copingstrategier för att hantera den nya situationen. Vårdpersonalen upplevdes ofta inte bekräfta den närståendes närvaro vilket gav den närstående en känsla av att vara osynlig. Trots att detta upplevdes som någonting negativt strävade ändå de närstående efter att normalisera vårdpersonalens beteende genom att förminska sin egen betydelse i vårdsituationen. Slutsats: Trygghetskänslan för den närstående är starkt kopplad till hur den sjuke mår. Ju sjukare denne är desto mer stöd behöver den närstående. Närstående till patienter i skyddsisolering upplever sig vara i bakgrunden i vårdsituationen och i patientrummet vilket leder till en känsla av att vara osynlig då vårdpersonalen inte upplevs uppmärksamma den närstående som en egen person. Den närstående strävar efter att normalisera personalens beteende genom att förminska sin egen betydelse i vårdsituationen. / ABSTRACT Aim: The aim of this study was to explore how persons related to patients in protective isolation at a hospital in central Sweden perceived their stay at the hospital and the hospital staffs’ behaviour towards them. Method: The study was empirical with a qualitative design. The participants in this study were five people related to patients in protective isolation who were chosen through convenience sample. Semi structured interviews were conducted and analysed utilising a qualitative, content analysis method. Results: Two themes were identified “The relatives feeling of security are connected to how the patient are feeling and how the patient were treated” and “The relatives diminish their own importance in the care situation”. Four categories were found “Sense of security”, “Loss of control”, “To be present” and “Coping strategies”. The participants did not perceived the protective isolation as something stressful in it self, it was more of a practical problem. Nevertheless all the participants used a string of coping strategies in order to more easily manage the new situation. A repetitive theme in the interviews were the feeling of being invisible and that their presence weren’t acknowledged by the hospital staff. Even though this was something that was considered to be stressful, this behaviour from the hospital staff was something that the participants strived to normalize by diminishing their own importance in the care situation. The feeling of security and control over the situation was strongly linked to the patient’s condition and how he or she was treated by the hospital staff. Conclusion: The feeling of security, control over the situation and need for support was strongly linked to the patient’s current condition. Person’s related to patients in protective isolation perceived themselves as being in the background in care situations and the patient’s room which lead to a feeling of invisibility and a feeling of not being seen as an individual. The relatives strived to normalize the hospital staffs behaviour by diminishing their own importance in the care situation.

Vaccines directed against the influenza virus become ineffective due to continuous mutation. An alternative approach might be to control replication at the genomic level by enzymatic methylation of the polymerase genes. Hence in this study, a method to locate and successfully isolate the H1N1 influenza A polymerase genes was investigated. The virus was cultured in chick embryos via the allantoic route using aseptic techniques. Following incubation, the allantoic fluid was isolated and washed to remove any contaminating blood cells. The allantoic fluid was checked for fungal and bacterial contamination using the blood agar test and the presence of the virus was established by the haemagglutination titration test. Viral particles were pelleted by ultracentrifugation. Electron microscopy verified the morphology and size of these viruses while immunofluorescence studies, using a monoclonal antibody, confirmed the influenza A strain. The ribose test verified the presence of RNA in the samples. Purified viral pellets were pooled and homogenised in buffer containing guanidine thiocyanate, mercaptoethanol and sarkosyl. The samples were incubated on ice before mechanical disruption of the virus. Viral RNA was isolated from the upper aqueous layer after a standard phenol/chloroform extraction procedure. RNA was quantified spectrophotometrically and purity assessed initially by the absorbance ratio readings at 260/280 nm. Electrophoresis of the RNA samples was performed together with RNA molecular weight markers on a 1.5% formamide agarose gel. Five bands were identified and the band containing the polymerase genes was size selected, located and excised. Purification of the polymerase genes from the agarose was achieved by using the BIO 101 RNAid kit. The three isolated polymerase RNAs were reverse transcribed using the Boehringer Mannheim cDNA synthesis kit. The results indicate that the H1N1 influenza virus was successfully grown and isolated from chick embryos. Absence of contamination and verification of viral presence at different stages of the study were indications that asepsis was successfully achieved. The RNA obtained was sufficient and suitable for cDNA synthesis. This cDNA may now be used for further molecular analysis and subsequent DNA methylation studies. Further, transfection studies may then be performed to determine, if any, the the expression of methylated and unmethylated cDNA. / Thesis (M.Med.)-University of Natal, 1992.

This Master’s Thesis seeks to explain the process of initiation undergone by Henry James’s characters. Characters are chosen for initiation into forbidden knowledge, and, like the Biblical Adam and Eve, are exiled as a result. Though initiation is erotic, it is not sexual, and society falsely perceives a sexually charged relationship between the initiator and the initiate, also called the complementary pair. The initiate faces exile and death because of his forbidden knowledge. He no longer has a place in his society, which leads to his social death and eventually physical death. James’s reader is initiated along with the characters, becoming a critical reader who no longer sees reading as a passive activity but brings his own judgment to the text. The Jamesian Reader does not face the same fate as the initiate, but he does change substantively as a result of his new perspective on the text.

2nd International Conference on Advances in Experimental Structural Engineering, Tongji Univ., Shanghai, China, December 4-6, 2007

Decreased number of family mumbers, psychological aspects, distinct differences among social classes, rapid growth of modern information technologies has changed our ways of communication and forms of keeping in touch with the world. Social isolation is increasing rapidly, but the need of depend to sociaty, to be a part of community are still vital. Needless to say that the problem of social isolation is actually must be taken in mind. The aim of the sudy „Social isolation in the lessons of ethics“ is to disclose the problem of social isolation and to examine possibilities to diminish it in the secondary school (8- 10 form) in lessons of ethics. In order to achieve the goal describtion of social isolation is given, reasons and distinctive features are revealed. Moreover, educational strategy of Lithuania and other documents are analized. The most significant part of the study is a practical research. It was impelled by the aim to find ways of diminishing social isolation in the secondary school. It is important to research the lessons of ethics as a tool of solving the increasing problem of isolation. Therefore, questionairing and document content analysis have been performed. The research methods helped to achieve the aim of the study. Schoolchildren of 8-10th forms were chosen for the specific age and complex of developed characteristics. The methods of teaching as tools of encouraging groupwork are emphasised in the study. Social skills, collaborating and contributing to... [to full text]

Cette thèse s'inscrit dans le cadre de l'étude de la stabilisation de modules d'un futur collisionneur linéaire, CLIC (Compact Linear Collider). Afin d'assurer le fonctionnement et la collision des particules dans ce futur grand instrument de physique, il faut garantir l'alignement de modules guidant des faisceaux de dimensions nanométriques. Les travaux développés ont pour support expérimental deux dispositifs : un dispositif de micropositionnement, avec une résolution inférieur au 1µm, où les perturbations peuvent être simulées et un prototype de nanostabilisation active pour charges importantes (>50kg @300Hz), avec une résolution validée expérimentalement inférieur à 0,15 nm, permettant de démontrer la faisabilité du contrôle de la stabilisation subnanométrique en s'intéressant particulièrement au rejet des mouvements du sol. Les problématiques traitées lors de ces travaux portent sur la méthodologie de conception de tels systèmes, ce qui inclue la conception électromécanique et l'instrumentation, ; la mise en œuvre et la modélisation du comportement des prototypes ,; le contrôle avec notamment les aspects de non linéarité des actionneurs. Les performances obtenues de ces différents travaux et validées expérimentalement incluent notamment les points suivants: La bande passante de fonctionnement pour du micro-positionnement à l'aide d'actionneurs piézoélectriques a été augmentée grâce à la compensation d'hystérésis : Rejet de perturbation issue du support jusqu'à 100 Hz et positionnement jusqu'à 190 Hz. Il a été démontré la faisabilité du contrôle à l'aide de capteurs sismiques. L'isolation active réalisée présente une atténuation des nano-mouvement du sol dans une bande passante comprise entre 12 et 100Hz. Expérimentalement, cela conduit à une réduction des mouvements du sol de 0,6nm [rms] à 0,25nm [rms] à 50Hz et de 3,7nm [rms] à 0,9nm [rms] à 20Hz.

Oil companies need to evaluate the risk of annular fluid or gas migration if cement fails during the life of the well. Sustained casing pressure can lead to shutting in the wells to avoid health, safety, and environment (HSE) risks and government fines. To understand the long-term integrity of cement in high temperature and high pressure (HTHP) conditions and the mechanical properties that affect the ability of cements to seal fluids, this project used finite-element models (FEMs) to study the stress-causing phenomena. FEM analyses in ABAQUS version 6.11 were used to determine the potential of cement failure in oil wells. The model uses a 3D section of a well that can be used for different casing and formation types under different loading conditions. The model built in ABAQUS version 6.11 allows incorporating materials with nonlinear mechanical properties; it also uses FEM analysis to forecast fractures inside the cement under different loading scenarios like hydraulic fracture jobs or casing tests. The finite-element model included cases for cement cracking, cement debonding, and plastic deformation of the cement and rock that can generate loss of zonal isolation. Linear manner: set cements behave elastically until a failure criterion is reached, and then they can behave plastically. The FEM approach can reproduce stresses, strains, and volume changes in the material under different environmental HTHP conditions. Cemented wells have both tensile and compressive stresses that make some parts of the cement sheath experience fracture initiation, plastic deformation, or debonding. This dissertation provides a model that will help drillers design the set cement for long-term integrity in HPHT well conditions. The FEM predicts if the cement sheath can develop debonding, cracks or plastic deformations during the life of the well. The cement sheath needs to be designed for long-term zonal isolation to avoid interzonal communications, remedial costs and environmental problems related to cement seal. A CMS™-300 Automated Permeameter, a mechanical properties analyzer, HPHT cement consistometer, annular expansion molds, and tri-axial test equipment were used in this study to test cements for specific applications in three Colombian oil fields, including an oil field with in-situ combustion project.

<p>Species of Campylobacter, Arcobacter and Helicobacter have been associated with various diseases in humans and animals / and chickens have been identified as a reservoir of these microorganisms. Two published techniques and a new technique, developed in this dissertation, were evaluated to test its efficiency in removing PCR inhibitors from chicken samples. All of the techniques were based on agarose/DNA slants and were evaluated using multiplex PCR and an Internal Amplification Control. The new technique was found to be most effective and consequently used further in the study. A novel study was done to evaluate the survival of Campylobacter, Arcobacter and Helicobacter strains in chicken blood at -20, 4, 37 and 42&ordm / C as well as at ambient room temperature (&plusmn / 22&ordm / C). It was found that all strains could survive at all temperatures, albeit at different duration times. Most notably, an A. butzleri strain was able to survive at 4oC for up to 297 days.</p>

An increasing number of older adults is experiencing mental health problems, which may result from loneliness and social isolation. Although research has noted the positive impact that community programs might have on the social connectedness of older adults, there is a scarcity of research exploring older male adults' experiences in these programs. Men's Sheds, developed in Australia in the 1990's, is one program that integrates older men into the community. Men's Sheds have recently begun in Manitoba, allowing me the opportunity to develop a theoretical model of the processes of involvement of older male adults in this program. I conducted in-depth interviews with Men's Sheds participants (N = 12), and analyzed data using constructivist grounded theory (Charmaz, 2006). Findings provide insight into participants’ experiences throughout their initial, current, and continued involvement in Men’s Sheds, which may serve as a model for community organizations attempting to increase participation among this demographic.