An outbreak of Candida tropicalis peritonitis in patients on intermittent peritoneal dialysis.

An outbreak of Candida tropicalis peritonitis in intermittent peritoneal dialysis patients during a 6-week period is reported from a general hospital. Five patients were involved and there were three deaths. The strains recovered from affected patients were identical to those recovered from the water baths on the basis of biotyping, antimicrobial susceptibility pattern and chromosomal DNA fingerprints. No further cases were identified on subsequent surveillance after the prohibition of wet-warming of peritoneal dialysate in the hospital.

The enhancement of infection control in-service education by ward opinion leaders.

Opinion leaders are members within a social group with significant social influence over others. A guideline on urinary catheter care was introduced in three groups (A, B, and C) of two randomly allocated wards. Two opinion leaders per ward were identified by nurses in groups A and B with the use of a sociometric method. For education, in-service lectures for 30% of nurses and opinion leaders' tutorials for all nurses were used in group A; opinion leaders' tutorials alone in B, and lectures alone in C. Before and after the education program, the guideline's frequency of practice was assessed by surveying 30% of randomly selected nurses and by direct observation. Results of the survey were comparable for groups A and B and both groups were significantly higher (p less than 0.05) than C, suggesting that informational transmission by opinion leaders was superior to that by the lecture. However, practices by direct observation in group A were significantly better (p less than 0.05) than those in B, indicating that staff compliance is best achieved by using both opinion leaders and lectures. The lecture probably endorsed the opinion leaders' leadership, enhancing their ability to influence the staff.

Evaluation of staff compliance with 'influencing' tactics in relation to infection control policy implementation.

The efficacy of 'influencing' tactics for inducing compliance to infection control policies was assessed in 20 Hong Kong hospitals. In phase 1, 45 infection control nurses (ICNs) were surveyed on the frequency of use of possible tactics. Twenty-three of the more frequently used tactics were selected for phase 2 in which a random sample of 881 nurses were questioned on whether they would willingly, reluctantly or not comply with these tactics. Based on factor analysis of the responses in phase 2, six dimensions of compliance were identified. These were, in their order of effectiveness in achieving compliance: professional-resources (providing specialized or expert help); professional-respect (esteeming others as fellow professionals); coalition (obtaining staff support), ingratiation (cultivating goodwill), hierarchical (exerting pressure derived from rank) and non-communicative (ignoring or disregarding other's point of view).

Familial dementia of adult onset with pathological findings of a 'non-specific' nature.

A family is described in which 4 of 10 siblings developed a dementing illness that culminated in death within five to six years of onset. The pathological findings in 3 members were strikingly similar, and consisted of widespread nerve cell loss and astrocytosis within the cerebral cortex, status spongiosus within the outer cortical layers and, in 2, nerve cell loss and astrocytosis within the dorsomedial nucleus of the thalamus. It is concluded that the disorder described in this report does not conform precisely to any of the currently recognized categories of familial dementing disease.