Supporting High-impAct useRs in Emergency Departments (SHarED) quality improvement: a mixed-method evaluation.

Background: The need to better manage frequent attenders or high-impact users (HIUs) in hospital emergency departments (EDs) is widely recognised. These patients often have complex medical needs and are also frequent users of other health and care services. The West of England Academic Health Science Network launched its Supporting High impAct useRs in Emergency Departments (SHarED) quality improvement programme to spread a local HIU intervention across six other EDs in five Trusts.

SEPARATION OF TEICHOIC ACID OF STAPHYLOCOCCUS AUREUS INTO TWO IMMUNOLOGICALLY DISTINCT SPECIFIC POLYSACCHARIDES WITH ALPHA- AND BETA-N-ACETYLGLUCOSAMINYL LINKAGES RESPECTIVELY. ANTIGENICITY OF THEICHOIC ACIDS IN MAN.

Human sera were found to contain antibodies precipitating with each of two samples of teichoic acid of Staphylococcus aureus prior to immunization; these antibodies were probably formed as a result of contact or infection with this microorganism. Injection of teichoic acid into two individuals resulted in a rise in circulating antibody to teichoic acid; a third subject probably had a primary response to alpha-teichoic acid. Quantitative precipitin and agar diffusion studies revealed the presence of two distinct antibodies in the sera and showed that each specimen of teichoic acid was a mixture of two polymers an alpha-linked N-acetylglucosaminyl-ribitol polymer and a beta-linked N-acetylglucosaminyl-ribitol polymer, termed alpha- and beta-teichoic acids respectively.