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This paper describes the design and optimization of a 10 ml cartridge for patient sample processing using a 3.5 GHz (empty resonant frequency) TM010 cylindrical microwave cavity. The cartridge has been designed to augment a novel approach for the rapid diagnosis of M. tuberculosis (the causative agent of Ttuberculosis), which uses the direct application of microwaves to a bacteria-containing sample to release pathogen-specific DNA. The target bacterial DNA is then captured and recovered using magnetic nanoparticles coated with pathogen-specific DNA probes. Excitation parameters were optimized using three surrogates for M. tuberculosis, namely, M. smegmatis, M. abscessus, and M. bovis suspended in water and simulated sputum. The paper also explores the mechanism of microwave-mediated DNA release from bacteria using scanning electron microscopy. Examination of bacteria exposed to microwaves at power levels known to mediate the release of DNA reveals no obvious signs of permanent cell disruption, suggesting that a more subtle interaction is taking place. Finally, the presence of microwave-liberated M. bovis DNA was able to be detected at a level of sensitivity comparable to that achieved using microscopy. [ABSTRACT FROM AUTHOR]

Adéle Stewart-Lord,1 Clare Beanlands,2 Ricardo Khine,3 Shani Shamah,4 Noreen Sinclair,1 Sandie Woods,2 Nick Woznitza,5 Lesley Baillie6 1Therapeutic Radiography Allied Health Sciences School of Health and Social Care London South Bank University, London, UK; 2Occupational Therapy, Allied Health Sciences, London South Bank University, London, UK; 3Therapeutic Radiography, City University of London, London, UK; 4Service-User; Research (Public Patient Involvement) Consultant, Independent, London, UK; 5Diagnostic Radiography, Homerton University Hospital NHS Foundation Trust, London, UK; 6Adult Nursing, London South Bank University, London, UKCorrespondence: Adéle Stewart-LordTherapeutic Radiography Allied Health Sciences School of Health and Social Care London South Bank University, 103 Borough Road, London SE1 0AA, UKTel +44 207 815 7931Fax +44 207 815 7933Email adele.stewart-lord@lsbu.ac.ukObjective: To investigate the profiles of advanced clinical practitioners (ACPs) in the allied health professions (AHPs) and their skills, attributes, experiences and involvement in new models of care.Methods: A 2 phase, cross sectional, mixed method survey of AHP ACPs across London was conducted in 2018– 2019. Online questionnaires were completed by 127 AHP ACPs and then semi-structured interviews were conducted with 15 AHP ACPs.Results: The survey results gave a comprehensive overview of the attributes of AHPs in ACP roles across London. There was considerable variability between role titles, types and levels of qualification, and evolution of the roles. The respondents predominately worked in clinical practice, and less frequently in other ACP domains (research, leadership and management, education). The interview findings provided in-depth insights into the AHP ACP roles within four themes: being advanced, career pathways, outcomes of the advanced practitioner role and influencing and transforming. The “Being advanced” theme highlighted that expert practice comprised confident and autonomous practice, leadership, and applying specialist and expert decision-making skills. “Career pathways” highlighted the diversity within the participants’ roles, titles, career opportunities and development. In the “Outcomes of the advanced clinical practitioner role” theme, the ACPs described their services as prompter, more accessible and providing an improved patient journey. The “Influencing and transforming” theme highlighted networking and dissemination and ideas for innovation, influencing and transforming services.Conclusion: This is the first comprehensive profile of ACP roles across AHPs and indicates that these roles are already having a positive impact on healthcare services and supporting new models of care. However, establishing the necessary infrastructure, standardization and governance for ACP roles across sectors, along with the career pathways, funding, sustainability and education, could increase impact in the future.Keywords: allied health professionals, advanced practice, role development, expert practice, models of care, pathway configuration

Thirty per cent of school districts in British Columbia do not ban smoking outright on school grounds, and in several instances, smoking is permitted in smoking pits, regardless of school district policy. While there is evidence to suggest that enforcing a tobacco-free environment for students does reduce adolescent smoking rates, the concomitant safety and discipline problems it creates for school staff and administration are demanding and complex, and may override concerns regarding student smoking. This study uses a qualitative approach to explore the meanings that students place on tobacco control policy and the impact that these meanings have on their own smoking behaviours. We found that students were surprised and concerned that smoking was permitted on school property and that it negatively impacted their own tobacco prevention/control/cessation attempts. (Contains 1 table.)

Clostridium difficile is the primary cause of healthcare-associated diarrhoea globally and produces spores which are resistant to commonly used biocides and are able persist on contaminated surfaces for months. This study examined the effect of sublethal concentrations of the biocide sodium dichloroisocyanurate (Na DCC) on the viability of spores produced by 21 clinical isolates of C. difficile representing a range of PCR ribotypes. Spores exposed to 500 ppm Na DCC for 10 min exhibited between a 4-6 log10 reduction in viability which was independent of spore PCR ribotype. The effect of sublethal concentrations of biocide on the surface properties of exosporium positive and negative clinical isolates was determined using a spore adhesion to hydrocarbon (SATH) assay. These isolates differed markedly in their responses suggesting that exposure to biocide can have a profound effect on hydrophobicity and thus the ability of spores to adhere to surfaces. This raises the intriguing possibility that sublethal exposure to Na DCC could inadvertently promote the spread of the pathogen in healthcare facilities. Significance and Impact of the Study This study is the first to report on changes in Clostridium difficile spore surface property after exposure to sublethal levels of the commonly used biocide sodium dichloroisocyanurate. The implications of these changes to the spore surface include increased adherence of the spores to inorganic surfaces which can directly contribute to persistence and spread of spores within the hospital environment. [ABSTRACT FROM AUTHOR]