Postoperative wound infection after laminectomy is uncommon. In February 1997, 3 patients were confirmed to have postlaminectomy deep wound infections due to Candida albicans. No similar case had been seen during the previous 10 years. The infections were indolent, with a mean time from initial operation to diagnosis of 54 days (range, 26-83 days). All patients were successfully treated. Pulsed-field gel electrophoresis revealed the Candida isolates to be identical. A case-controlled study and medical record review revealed that a single operating room technician scrubbed on all 3 infected case patients but on only 32% of the uninfected controls. The technician had worn artificial nails for a 3-month period that included the dates of laminectomy site infections, and C. albicans was isolated from her throat. She was treated with fluconazole and removed from duty. No subsequent cases have occurred during the ensuing 3 years. Artificial nails are known to promote subungual growth of gram-negative bacilli and yeast. This may be clinically relevant, and hospitals should enforce policies to prevent operating room personnel from wearing artificial nails.

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Objective: Short-term improvements in hospital room cleaning can readily be achieved but are difficult to maintain. This is particularly true for high-risk, “high-touch” surfaces. Therefore, we embarked on a process to sustain improvements in surface cleaning and disinfection to reduce hospital-acquired infection (HAI) rates. Interventions: Our environmental services (EVS) and infection prevention departments incorporated a formal education, monitoring, and feedback process for focused cleaning and disinfection of high-touch surfaces into their routine policies and procedures in 2011. Cleaning validation was performed by infection prevention liaison nurses using a fluorescent targeting method to evaluate the thoroughness of cleaning. Results: Surface cleaning performance on medical-surgical units in 2011 was 74.7%, but this rate incrementally increased in response to the interventions and has been sustained at >90% for the past 6 years. Similar patterns of improvement were observed in the operating room, labor and delivery, endoscopy suite and cardiac catheterization laboratory. Conversely, HAI rates, particularly C. difficile rates, decreased by 75% and surgical site infection rates decreased by 55%. Conclusions: EVS training, monitoring, and feedback interventions, instituted 10 years ago have enhanced our environmental cleaning and disinfection efforts in multiple areas of the hospital and have been sustained to the present. Although other concurrent initiatives to reduce infection rates also existed, the improvements in environmental cleaning were associated with dramatic reductions in HAI rates over the 10-year period.

JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.. Agenda Feminist Media is collaborating with JSTOR to digitize, preserve and extend access to Agenda: Empowering Women for Gender Equity.BRENDA GRANT argues that the continued vulnerability of women in the domestic sector has layers of colonial and racial oppression to blame. Unions and the law have still to protect domestic workers against some of IN BRIEF the most exploitative labour practices in the workplace of the home D omestic workers constitute the largest single sector where women are employed in the labour market. It is estimated that over one million people are engaged in this service, comprising 11 percent of overall employment in the formal sector of the economy. At the same time this significantly large sector of the labour market performs its work under some of the most oppressive working conditions and experiences a high degree of economic and physical abuse with little or no protection from the law or society.The Limbrick Report (1993), discussed in Budlender's research (1997) on domestic workers indicates that this sector is larger than mining and agriculture. The profile of domestic workers reveals that 89 percent are African, most of whom are women. A large proportion of these women are either single breadwinners or the only breadwinner in households (Madonsela, 1994:17).In this in brief, I look at the reasons for the apparent neglect of domestic workers as a sector of employees, and advance some thoughts on why this situation is perpetuated. Some solutions to the problems which beset the women workers in the domestic economy will also be considered.The law, and society, has yet been unable to see its way clear to treating domestic workers as employees: they are regarded as servants for ideological and historical reasons, thus making practical reform of working conditions difficult.

BackgroundThe pharmacist’s role in dispensing emergency contraception (EC) has become controversial due to the intersection of personal and professional ethics. Therefore, to examine the issue of EC availability, we surveyed a sample of West Texas pharmacists. West Texas is a religiously and politically conservative region where no methods of EC have been made available.Objectiveto survey a sample of pharmacists in West Texas about their experience, beliefs, and knowledge of EC both before and after a presentation of the current literature about EC.MethodsWe asked a convenience sample of 75 pharmacists about their experience, beliefs, and knowledge of EC both before and after a presentation of the current literature about EC.ResultsSixty-four (85%) pharmacists agreed to complete the study questionnaire. None carries EC in his/her pharmacy, and scientific understanding of EC was generally poor. Fourteen percent stated EC conflicts with their religious views, 17% considered it a method of abortion, 11% would not be willing to fill an EC prescription written by a doctor. 58% would be willing to offer EC over the counter. The presentation encouraged more to offer it over the counter, but in general did not significantly change their beliefs.ConclusionOur sample of West Texas pharmacists demonstrated very little experience with, a general lack of knowledge about, and some personal and religious objections to EC.