Supporting transgender patients with their personal hygiene

Attending to one's personal hygiene is a private and ritualistic act that is linked to self-expression and is important for one's well-being and self-esteem. Providing effective support with personal hygiene to patients can demonstrate thoughtfulness and sensitivity to their individual needs. Nurses in all fields of nursing may encounter patients who identify as transgender, but many nurses have expressed concerns about their lack of knowledge and confidence in that area of care. This article discusses the use of gender-affirming language and the factors to consider when supporting transgender patients with their personal hygiene as part of personalised, equitable and inclusive nursing care.

Persistence of the immune response at 5 years of age following infant immunisation with investigational quadrivalent MenACWY conjugate vaccine formulations

BACKGROUND AND AIMS

Serogroup A, C, W-135 and Y meningococcal (MenACWY) conjugate vaccines are recommended for routine adolescent immunisation in the United States and Canada. We evaluated the persistence of bactericidal antibodies through early childhood, following infant immunisation with varying schedules of MenACWY-CRM(197) vaccine.

METHODS

UK and Canadian infants were immunised with 2-3 doses of MenACWY-CRM(197) or 2 doses of serogroup C meningococcal (MenC) conjugate vaccine, and either MenACWY-CRM(197), 1/5 dose of MenACWY polysaccharide vaccine or no booster at 12 months. Control groups recruited at 60 months had received country-specific infant doses of MenC conjugate vaccine. hSBA titres were measured in participants at 40 and 60 months of age.

RESULTS

382 children were enrolled in 12 groups (22-40 per group). By age 60 months, 3-11% of children primed and boosted with MenACWY-CRM(197) had hSBA titres≥1:8 against serogroup A, 14-45% against serogroup C, 57-85% against serogroup W-135 and 42-71% against serogroup Y. Children primed with MenC and boosted with MenACWY-CRM(197) had similar results, except for serogroup C (59%). In age-matched controls administered MenC vaccine at 2, 3, and 4 months (UK), 2 and 12 months or 12 months only (Canada), percentages with hSBA titres≥1:8 were 0-3%, 29-53%, 34-36% and 10-29% against serogroups A, C, W-135 and Y respectively.

CONCLUSIONS

Serogroup-specific bactericidal antibody wane following infant immunisation with MenACWY-CRM(197), most markedly against serogroup A. Best persistence against serogroup C is observed with MenC conjugate vaccine priming and MenACWY-CRM(197) at 12 months, compared to schedules using only MenACWY-CRM(197), with the potential for providing broader protection compared to monovalent MenC vaccines alone.

Influence of antibiotic-supplemented feed on occurrence and persistence of Salmonella typhimurium in experimentally infected swine

The effect of chlortetracycline given at a concentration of 220.5 g/metric ton of feed and of a combination product which supplies chlortetracycline (110.2 g/metric ton), sulfamethazine (110.2 g/metric ton), and penicilin G (55.1 g/metric ton) on the occurrence and persistence of Salmonella typhimurium in experimentally infected swine was studied. Weanling pigs (av weight, 8.2 kg) were inoculated via the feed with 10(11) colony-forming units of S typhimurium 298-1NA. An equal number of nonexposed swine given identical treatment were used as controls. Infected pigs had increased temperatures (maximal av, 41 C) for the first 4 days after infection and severe diarrhea during the first 21 days. The use of chlortetracycline and a combination product at subtherapeutic concentrations in feed did not increase the Salmonella pool or prolong the carrier state in swine. A decrease in number of Salmonella shed from swine given chlortetracycline at the concentration of 220.5 g/metric ton was observed. Significant differences did not occur in Salmonella-related deaths or in emergence of multiple antibiotic-resistant Salmonella by antibiotic selection or R factor transfer. Zoonotic transmission of the infecting Salmonella to animal caretakers was not detected.