Browsing by Author "Jones, C."

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    Invasive Propionibacterium acnes infections in a non-selective patient cohort: clinical manifestations, management and outcome
    (Springer, 2014-10-18) Tebruegge, M.; Jones, C.; de Graaf, H.; Sukhtankar, P.; Allan, Raymond N.; Howlin, R.P.; Browning, D.; Schuster, H.; Pallett, A.; Patel, S.; Faust, S.N.
    Purpose An increasing number of reports suggest that Propionibacterium acnes can cause serious invasive infections. Currently only limited data exist regarding the spectrum of invasive P. acnes infections. Methods Non-selective cohort study at a tertiary hospital in the UK over a nine-year-period (2003-2012) investigating clinical manifestations, risk factors, management and outcome of invasive P. acnes infections. Results Forty-nine cases were identified; the majority were neurosurgical infections and orthopaedic infections (n=28 and n=15, respectively). Only two cases had no predisposing factors; all neurosurgical and 93.3% of orthopaedic cases had a history of previous surgery and/or trauma. Foreign material was in situ at the infection site in 59.3% and 80.0% of neurosurgical and orthopaedic cases, respectively. All neurosurgical and orthopaedic cases required one or more surgical interventions to treat P. acnes infection, with or without concomitant antibiotic therapy; the duration of antibiotic therapy was significantly longer in the group of orthopaedic cases (median 53 versus 19 days; p=0.0025). All tested P. acnes isolates were susceptible to penicillin, ampicillin and chloramphenicol; only one was clindamycin-resistant. Conclusions Neurosurgical and orthopaedic infections account for the majority of invasive P. acnes infections. The majority of cases have predisposing factors, including previous surgery and/or trauma; spontaneous infections are rare. Foreign material is commonly present at the site of infection, indicating that the pathogenesis of invasive P. acnes infections likely involves biofilm formation. Since invasive P. acnes infections are associated with considerable morbidity, further studies are needed to establish effective prevention and optimal treatment strategies.
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    Public Sector Failure and Resilience: Lessons for Healthcare Policy
    (University of Leicester, Cardiff University & The Health Foundation, 2017) Jones, C.; Chivers, S.; Rosell, T.; Chamdal, V.; Maltby, J.
    Since the publication of the Francis Report into the failings in care at Mid Staffordshire NHS Foundation Trust and the Berwick Review into patient safety, Trust leadership has needed to embrace the problem of delivering more efficient, effective and integrated care whilst balancing finances and fostering “an inquisitive, curious and hungry learning culture” to improve the delivery of patient care3. In response to the Policy challenge fund, the team at University of Leicester and Cardiff University examined failure and resilience in other sectors to inform healthcare leadership and policy. With the aim to build interest and expertise in rapid policy analysis within the academic and policy communities, and generate insight that will support high quality decision making and improve the quality of the policy debate. Other public-sector organisations, such as the police, prisons and schools, which have faced comparable challenging circumstances, are exemplars of how to achieve positive outcomes. The research examines these once failing or poorly performing organisations’ journey to recovery, to identify the key strategic themes and actions that are relevant for healthcare policy and practice.