A randomized, open-label, single-visit, crossover study simulating triple-drug delivery with Ellipta compared with dual inhaler combinations in patients with COPD.

Background: Administering maintenance COPD therapy with a combination of multiple inhalers may increase inhaler errors. This study evaluated the potential benefits of using a single Ellipta dry powder inhaler (DPI) compared with two combinations of DPIs commonly used to deliver triple maintenance therapy.

Methods: Patients receiving inhaled COPD medication were enrolled in this multicenter, randomized, open-label, placebo-device, crossover study with a 2×2 complete block design (NCT0298218), which comprised two substudies: Ellipta vs Diskus + HandiHaler (substudy 1) or Turbuhaler + HandiHaler (substudy 2).

TWOC around the clock: a multimodal approach to improving catheter care.

Background: Urinary tract infections (UTI) are the second-largest group of healthcare-associated infections (HCAI). The Saving Lives Urinary Catheter Care Bundle was introduced to reduce catheter-associated urinary tract infections (CAUTI). In response, we implemented a catheter care group to examine ways to improve catheter care in an acute hospital NHS Trust.

Using inherent and elective behavior to improve hand hygiene monitoring in health care.

This study established a method for collecting hand hygiene (HH) performance data based on behavioral drivers (inherent or elective) that can be used by infection preventionists (IPs) to improve practice. Further, we explored the influence that task and setting has on HH behavior. A significant effect was found between task and setting that has implications for improving the usefulness of HH measurement, with positive feedback reported regarding the new measurement method.

Assessing user acceptance towards automated and conventional sink use for hand decontamination using the technology acceptance model.

Hand hygiene (HH) prevents harmful contaminants spreading in settings including domestic, health care and food handling. Strategies to improve HH range from behavioural techniques through to automated sinks that ensure hand surface cleaning. This study aimed to assess user experience and acceptance towards a new automated sink, compared to a normal sink.

Effect of an Education Programme for South Asians with Asthma and Their Clinicians: A Cluster Randomised Controlled Trial (OEDIPUS).

Background: People with asthma from ethnic minority groups experience significant morbidity. Culturally-specific interventions to reduce asthma morbidity are rare. We tested the hypothesis that a culturally-specific education programme, adapted from promising theory-based interventions developed in the USA, would reduce unscheduled care for South Asians with asthma in the UK.

A case study of healthcare professional views on the meaning of data produced by hand hygiene auditing.

Background: Measurement of hand hygiene (HH), crucial for patient safety, has acknowledged flaws stemming from methods available. Even direct observation, the World Health Organization gold standard, may lead to behaviour changes which can affect outcome validity. However, it remains important to understand current levels of HH to allow targeted interventions to be developed.

Review of technologies available to improve hand hygiene compliance - are they fit for purpose?

Hand hygiene has been empirically proven to prevent cross-transmission of infection, which has led to the development of global guidelines such as the World Health Organization's 'My 5 Moments for Hand Hygiene.' Because of the relatively recent launch of these guidelines (2009) technology designed to assist in measuring hand hygiene compliance appears not to fully acknowledge the influence of the WHO 5 Moments for hand hygiene Consequently, they may not be fit for purpose (FFP). This paper uses a review of the literature on current hand hygiene technology to assess the extent to which these are FFP based on these global guidelines.

Performance of an alternative laboratory-based algorithm for diagnosis of HIV infection utilizing a third generation immunoassay, a rapid HIV-1/HIV-2 differentiation test and a DNA or RNA-based nucleic acid amplification test in persons with established HIV-1 infection and blood donors.

Background: The HIV-1 Western blot (WB) and immunofluorescence assay used to confirm HIV infections are less sensitive during seroconversion than immunoassays (IAs) used for screening. An alternative diagnostic algorithm has been proposed to detect early HIV-1 infection and differentiate HIV-1 from HIV-2.

Objectives: We evaluated the performance of an algorithm with a third generation IA that when reactive was followed by a rapid test (Multispot) that differentiates HIV-1 from HIV-2.

Withdrawal of inhaled corticosteroids in people with COPD in primary care: a randomised controlled trial.

Background: Guidelines recommend inhaled corticosteroids (ICS) for patients with severe chronic obstructive pulmonary disease (COPD). Most COPD patients are managed in primary care and receive ICS long-term and irrespective of severity. The effect of withdrawing ICS from COPD patients in primary care is unknown.

Two optimized combination assays to examine apoptosis pathways in clinical samples.

Background: A consequence of a number of diseases is an alteration in apoptosis. Currently, there is no single assay that measures the main stages of apoptosis, requiring that multiple assays be performed. This hinders studies on clinical samples that have limited cell numbers.

Specialist nurse intervention to reduce unscheduled asthma care in a deprived multiethnic area: the east London randomised controlled trial for high risk asthma (ELECTRA).

Objective: To determine whether asthma specialist nurses, using a liaison model of care, reduce unscheduled care in a deprived multiethnic area.

Design: Cluster randomised controlled trial.

Setting: 44 general practices in two boroughs in east London.