Adenosine tri-phosphate (ATP)-based cleaning monitoring in health care: how rapidly does environmental ATP deteriorate?

BACKGROUND: Ensuring cleaning compliance of housekeeping staff is critical to ensure adequate application of surface disinfectants. Adenosine triphosphate (ATP) testing has been recommended as a way to monitor cleaning compliance; however, little is known about the stability of ATP on environmental surfaces. AIM: To assess the stability of ATP from various sources to determine if it is stable for sufficient time to be an effective means of assessing environmental cleaning and disinfection in health care. METHODS: Purified ATP, ATP derived from ATS-T (blood-based test soil) and ATP derived from 10(7) colony-forming units/site of micro-organisms (Pseudomonas aeruginosa, Enterococcus faecalis, Candida albicans) were evaluated in liquid suspension and dried on to surfaces to assess stability over 29 days. Cleaners and disinfectants were sprayed on to surface-dried material with no wiping to determine their effect on microbial viability and ATP stability. FINDINGS: Surface-dried P. aeruginosa, E. faecalis and C. albicans retained 65-96% of their original ATP level on Day 29, despite reduced or no viability. Surface-dried ATS-T had 100% and 3% of its original ATP on Days 4 and 29, respectively. Deterioration of the ATP signal was most pronounced for suspensions. Purified ATP was stable over 29 days in suspension or dried on to a surface. CONCLUSIONS: ATP residuals from organic material and micro-organisms (dead or alive) are stable when dried on to surfaces. In the absence of cleaning and disinfection, the relative light unit signal will not deteriorate rapidly, making ATP a good marker to monitor cleaning.

Integration of a suicide risk assessment and intervention approach: the perspective of youth.

The process of suicide risk assessment is often a challenge for mental health nurses, especially when working with an adolescent population. Adolescents who are struggling with particular problems, stressors and life events may exhibit challenging and self-harm behaviour as a means of communication or a way of coping. Current literature provides limited exploration of the effects of loss, separation and divorce, blended families, conflict and abuse on child and adolescent development and the increased vulnerability of at-risk youth. There is also limited research that provides clear and practical models for the assessment and management of youth suicidal ideation and behaviour. This paper will discuss the integration of a number of theories to establish a comprehensive assessment of risk. The research study described the perspective of youth and their families who had experienced this particular model; however, this paper will discuss only the youth perspective. In order for this model to be successful, it is important for mental health nurses to make a connection with the youth and begin to understand the self-harm behaviour in context of the adolescents' family, and their social and school experiences. It also requires recognition that adolescents with challenging and self-harm behaviour are hurting and troubled adolescents with hurtful and troublesome behaviour.

Aerobic endospore-forming bacteria from geothermal environments in northern Victoria Land, Antarctica, and Candlemas Island, South Sandwich archipelago, with the proposal of Bacillus fumarioli sp. nov.

Aerobic endospore-forming bacteria were isolated from soils taken from active fumaroles on Mount Rittmann and Mount Melbourne in northern Victoria Land, Antarctica, and from active and inactive fumaroles on Candlemas Island, South Sandwich archipelago. The Mt Rittmann and Mt Melbourne soils yielded a dominant, moderately thermophilic and acidophilic, aerobic endospore-former growing at pH 5.5 and 50 degrees C, and further strains of the same organism were isolated from a cold, dead fumarole at Clinker Gulch, Candlemas Island. Amplified rDNA restriction analysis, SDS-PAGE and routine phenotypic tests show that the Candlemas Island isolates are not distinguishable from the Mt Rittmann strains, although the two sites are 5600 km apart, and 16S rDNA sequence comparisons and DNA relatedness data support the proposal of a new species, Bacillus fumarioli, the type strain of which is LMG 17489T.

Perceptions of adolescents living with parental alcoholism.

The purpose of this study was to explore and understand the experience of parental alcoholism from an adolescent's perspective. The stories of five adolescents were used to generate descriptions and explanations about the phenomenon. The study was exploratory in nature and was conducted using a qualitative research design. Data were collected by means of in-depth interviews with each adolescent. Field notes, personal reflections, and transcripts of all interviews made over the course of the research process, constituted the data for analysis. Four significant themes emerged from the data, which illuminated and provided a fuller understanding of the perceptions of adolescents living with parental alcoholism. The initial theme, 'The Nightmare', described the adolescents' memories and what it was like for them growing up with parental alcoholism. The second theme, 'The Lost Dream', explored their recognition of loss in terms of the experiences of the nightmare. The third theme, 'The Dichotomies', explained the daily struggles between what the adolescents thought, what they felt, and how their thoughts and feelings influenced their behaviour. The fourth theme, 'The Awakening', described the adolescents' recognition of their present responsibilities, and their understanding about their pasts, which enabled them to begin to let go and move on. The study concludes with reflections on the significance, meaning, and interrelatedness of the identified themes, and a discussion of findings and implications. The main findings were the resilience and strength of the participants, the uniqueness of each of their stories, and the therapeutic benefit to the participants from the opportunity to tell their stories. An understanding of the individual and contextual nature of adolescents' perceptions of parental alcoholism provides professional caregivers with new opportunities to offer specialized services to adolescents and their families.

Is there a place for Phil Donahue in the classroom?

The novel approach of using the Phil Donahue television talk show model in the classroom was successful for us. The model worked well with a panel of guests providing content and the faculty member moderating and directing the discussion by targeting questions and limiting and/or expanding responses as dictated by the objectives for the class. We hypothesize that the Johnny Carson format, where a single guest speaker is interviewed by a faculty member, also would produce excellent results. We encourage colleagues to be creative and experiment in the classroom.