This study determined the protective effect of antibacterial processing of cerebrospinal fluid (CSF) shunt catheters against infection with staphylococci, which is an important complication following CSF shunt placement for hydrocephalus. Also examined is the effect of a conditioning film such as that seen on the luminal surface of shunts used in posthemorrhagic hydrocephalus. Conventional preventative measures, including antimicrobial prophylaxis, confer a temporary or unproven benefit. The authors have therefore developed a process for impregnation of CSF shunts with rifampicin and clindamycin, and this has been shown previously to achieve the target duration of 28 days of protective activity in vitro. The present study demonstrates the limit of the period of protection and the efficacy of the processing against a wide range of staphylococci, particularly in the presence of a plasma protein conditioning film. Five strains of Staphylococcus aureus and 17 coagulase-negative staphylococci, all clinical isolates, were inoculated into the shunts at 2-week intervals until failure of antimicrobial protection occurred. The results showed that the process protected against all strains for between 42 and 56 days and that the conditioning film did not diminish the protection. Catheters processed by this method show promise of significant reductions in the incidence of CSF shunt infections.

This study represents the first investigation into incidents of safeguarding concern in sport within the UK. Questionnaires were completed by 41 lead welfare officers from national governing bodies. A total of 652 cases were reported by a range of key stakeholders, covering a variety of different forms of abuse. Physical and sexual abuse were found to be the most frequently alleged forms of abuse. The majority of alleged perpetrators and victims were males. The need for a standardised form for collecting case data as part of normal practice is highlighted along with the necessity for training and support to manage safeguarding cases both internally and externally to sport organisations. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Messages: A total of 652 safeguarding cases were managed in sport by this sample during 2011. Physical and sexual abuse were the most frequently reported. The majority of victims were boys. There is a need to collect standardised data regarding all cases.

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Timely and accurate mealtime insulin dosing can be an ongoing challenge for people with type 1 diabetes. This multinational, online study aimed to explore attitudes and behaviors around mealtime insulin dosing and the impact of mealtime dose timing, particularly with regard to premeal dosing (15–20 minutes before a meal). Although the majority of surveyed participants (96%) recognized the importance of accurate mealtime bolus insulin dosing, only a small proportion (35%) reported being “very confident” in accurate bolus insulin estimation. Given the choice, the majority of participants would prefer to administer insulin immediately before or after a meal, as this timing would improve their quality of life.<b></b>