Impact of active surveillance and decolonization strategies for methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit.

OBJECTIVE: To assess the impact of active surveillance and decolonization strategies on methicillin-resistant Staphylococcus aureus (MRSA) infection rates in a NICU. STUDY DESIGN: MRSA infection rates were compared before (2014-2016) and during (2017-2022) an active surveillance program. Eligible infants were decolonized with chlorohexidine gluconate (CHG) bathing and/or topical mupirocin. Successful decolonization and rates of recolonization were assessed. RESULTS: Fifty-two (0.57%) of 9 100 hospitalized infants had invasive MRSA infections from 2014 to 2022; infection rates declined non-significantly. During the 6-year surveillance program, the risk of infection was 16.9-times [CI95 8.4, 34.1] higher in colonized infants than uncolonized infants. Those colonized with mupirocin-susceptible MRSA were more likely successfully decolonized (aOR 9.7 [CI95 4.2, 22.5]). Of 57 infants successfully decolonized who remained hospitalized, 34 (60%) became recolonized. CONCLUSIONS: MRSA infection rates did not significantly decline in association with an active surveillance and decolonization program. Alternatives to mupirocin and CHG are needed to facilitate decolonization.

Assessment of self-report response bias in high functioning autistic people.

The study aimed to establish a normative data set for the Paulhus Deception Scales (PDS) and Structured Inventory of Malingered Symptomology (SIMS) in a community adult sample of high functioning autistic (HFA) people. Assessments were administered anonymously online. Seventy surveys were completed, with respondents contributing from 16 countries. The majority of subscales and total scores for the PDS and SIMS fell above cut-off for self-report response bias, suggesting that completion of these measures by HFA individuals may lead to conclusions of intentional response distortion, even when this is not the case. Significant relationships were found between high scores and education level, as well as psychological distress. The findings of the study raise concerns about the use of these measures with HFA people, particularly in 'high stakes' situations.

Irrational rationalities and governmentality-effected neglect in immigration practice: Legal migrants' entitlements to services and benefits in the United Kingdom.

Governments' attempts to manage immigration increasingly restrict immigrants' eligibility to healthcare, education, and welfare benefits. This article examines the operation of these restrictions in the United Kingdom. It draws on qualitative research with civil servants and NGO expert advisors, and applies sociological theories on bureaucracy as a lens to interpret these data. Conceptually, the paper employs a generative synthesis of Ritzer's notion of "irrational rationality" and Foucault's perspective on "governmentality" to explain observed outcomes. Findings show that public service workers struggle with complex and opaque regulations, which grant different entitlements to different categories of migrants. The confusion results in mistakes, arbitrary decisions, and hypercorrection, but also a system-wide indifference to irrational outcomes, supported by human factors in contexts of austerity. I consider this a form of governmentality-effected neglect, where power operates as much through inaction as well as through intention, but which results in exclusions of legal migrants that are harsher in practice than in law.

In vivo neutralization of anti-A and successful transfusion of A antigen-incompatible red blood cells in an animal model.

BACKGROUND: Our aim was to determine if the historical principle of Lewis glycolipid neutralization of antibody and subsequent Lewis-incompatible transfusion could be extended and applied to the ABO blood group system using synthetic glycolipid-like constructs. STUDY DESIGN AND METHODS: In vitro experiments with human blood and blood group A function-spacer-lipid constructs (FSL-A) were used to determine rates and concentrations that caused antigen transformation and anti-A neutralization. FSL-A constructs were intravenously infused into naive and anti-A-immunized mice to determine in vivo antigen transformation, anti-A inhibition, and tolerance to A antigen-incompatible transfusions (A+biotin kodecytes). RESULTS: FSL-A was able to cause in vivo transformation of circulating mouse cells into A antigen-positive cells (in vivo A kodecytes) without consequence in animals either with or without circulating anti-A. FSL-A was able to neutralize circulating anti-A and allow for successful transfusion of incompatible A kodecytes. In the absence of FSL-A neutralization incompatible cells were rapidly destroyed. CONCLUSIONS: FSL constructs have the potential to neutralize circulating antibodies and allow for, or mitigate, the consequences of ABO-incompatible red blood cell transfusion.

Modeling transfusion reactions and predicting in vivo cell survival with kodecytes.

BACKGROUND: The availability of suitable animal models is a limitation in research on transfusion reactions. KODE technology allows for the artificial attachment of incompatible blood group antigens, plus visualization and recovery constructs onto red blood cells (RBCs), making them potentially suitable to study both transfusion reactions and determine in vivo cell survival. STUDY DESIGN AND METHODS: Function-spacer-lipid (FSL) constructs representing blood group A antigen (FSL-A) and biotin (FSL-biotin) together with FSL-GB3 as a benign antigen were used to create a range of murine kodecytes. Compatible and incompatible kodecytes were transfused into naive or anti-A hyperimmune mice. FSL-biotin constructs simultaneously included in the same RBC were visualized with avidin Alexa Fluor 488 and fluorescence microscopy to determine circulating cell survival or to demonstrate recovery of kodecytes. RESULTS: Using fluorescence microscopy of blood films, biotin, and GB3+biotin kodecyte transfusions, all showed similar survival and were present in the circulation at more than 72 hours in naive and anti-A-immunized mice. A+ biotin kodecytes were also present in the circulation at more than 72 hours in naive mice but were mostly cleared within 6 minutes in anti-A-immunized mice. Avidin agarose beads in gel cards were used to demonstrate recovery of A+ biotin kodecytes from blood samples. CONCLUSIONS: KODE technology not only enables the creation of artificial transfusion reactions in animal models, but also has the potential to be used clinically in man to determine 24-hour cell survival. The ability to recover the kodecytes for further analysis has valuable research and diagnostic potential.

The effect of sexual priming cues on emotional recognition in nonviolent child sexual abusers: a preliminary study.

This article describes a study that used a computer-based task to investigate the emotional recognition skills of child sexual abusers. The experiment consisted of two phases (prime and probe) and measured both response time and error rates to facial expressions. The priming phase of the experiment consisted of the presentation of short phrases via computer of either sexual or neutral content. The probe phase of the experiment consisted of the presentation of adult facial expressions depicting either the emotion fear or surprise. Results showed child sexual abusers to be slightly less accurate overall. Furthermore, contrary to prediction, the effect of sexual priming appeared to make child sexual abusers actually better at recognizing fearful faces (p = .055). This result is discussed in relation to current victim empathy theory and treatment implications for sexual offenders.

A comparison of rapists and sexual murderers on demographic and selected psychometric measures.

This study compared 58 sexual murderers and 112 rapists who were about to undergo treatment in prison for their sexual offending behavior. The two groups were compared on background, personality, offense, and victim characteristics. The sexual murderer group were less likely to have been involved in a relationship at the time of their index offense, generally attacked older victims, and had higher self-esteem. The rapist sample were found to have more violent previous convictions and scored higher on measures of historical deviance (nonsexual), paranoid suspicion, and resentment. No differences were found on the personality or clinical syndrome scales of the Millon Clinical Multiaxial Inventory-III. However, the rapist sample had significantly higher mean scores on the Paranoid Suspicion, Resentment, and Self-Esteem subscales of the Antisocial Personality Questionnaire. Future research should compare the two groups on dynamic or changeable factors to determine differential treatment needs.

Who cares? The views of sexual offenders about the group treatment they receive.

This paper describes one of the first systematic focused attempts to elicit the views of sexual offenders about the treatment that they have received. The paucity of previous research in this area is suggested to be the result of negative societal attitudes towards sexual offenders, as exemplified by recent tabloid newspaper coverage of this population. It is suggested that these attitudes may have a negative impact upon the attitudes of clinicians and researchers, and thus upon the treatment offered to this client group. Therefore, it is argued that seeking the views of the clients is essential in order to ensure that treatment is relevant and reflexive, and promotes relapse prevention. A questionnaire was distributed to participants who had completed treatment groups run by the Psychology Service at a Regional Secure Unit and at a Probation Service Sexual Offender Unit. The questionnaire aimed to elicit their views of the group experience, including issues to do with programme structure and content, group process, and therapeutic style of group facilitators. The results (including a pilot study) indicated that, on the whole, participants' experiences of the group were positive, for example aspects of the group process, understanding and preventing reoffending. Some suggestions for the modification and development of future sexual offender treatment are outlined, based on the feedback from subjects, for example, consideration of alternative treatment modalities, enhancing the content of group sessions, improving the organization of groups and modifying the training of groups leaders.