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Understanding weight status and dietary intakes among Australian school children by remoteness: a cross-sectional study
- Jane Jacobs, Claudia Strugnell, Denise Becker, Jill Whelan, Josh Hayward, Melanie Nichols, Andrew Brown, Victoria Brown, Steven Allender, Colin Bell, Andrew Sanigorski, Liliana Orellana, Laura Alston
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- Journal:
- Public Health Nutrition / Volume 26 / Issue 6 / June 2023
- Published online by Cambridge University Press:
- 30 January 2023, pp. 1185-1193
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Objective:
To determine whether primary school children’s weight status and dietary behaviours vary by remoteness as defined by the Australian Modified Monash Model (MMM).
Design:A cross-sectional study design was used to conduct secondary analysis of baseline data from primary school students participating in a community-based childhood obesity trial. Logistic mixed models estimated associations between remoteness, measured weight status and self-reported dietary intake.
Setting:Twelve regional and rural Local Government Areas in North-East Victoria, Australia.
Participants:Data were collected from 2456 grade 4 (approximately 9–10 years) and grade 6 (approximately 11–12 years) students.
Results:The final sample included students living in regional centres (17·4 %), large rural towns (25·6 %), medium rural towns (15·1 %) and small rural towns (41·9 %). Weight status did not vary by remoteness. Compared to children in regional centres, those in small rural towns were more likely to meet fruit consumption guidelines (OR: 1·75, 95 % CI (1·24, 2·47)) and had higher odds of consuming fewer takeaway meals (OR: 1·37, 95 % CI (1·08, 1·74)) and unhealthy snacks (OR = 1·58, 95 % CI (1·15, 2·16)).
Conclusions:Living further from regional centres was associated with some healthier self-reported dietary behaviours. This study improves understanding of how dietary behaviours may differ across remoteness levels and highlights that public health initiatives may need to take into account heterogeneity across communities.
The role of fingernail selenium in the association between arsenic, lead and mercury and child development in rural Vietnam: a cross-sectional analysis
- Jacob Egwunye, Barbara R. Cardoso, Sabine Braat, Tran Ha, Sarah Hanieh, Dominic Hare, Alex Xiaofei Duan, Augustine Doronila, Thach Tran, Tran Tuan, Jane Fisher, Beverley-Ann Biggs
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- Journal:
- British Journal of Nutrition / Volume 129 / Issue 9 / 14 May 2023
- Published online by Cambridge University Press:
- 10 May 2022, pp. 1589-1597
- Print publication:
- 14 May 2023
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As, Pb and Hg are common environmental contaminants in low- and middle-income countries. We investigated the association between child toxicant exposure and growth and development and determined if this association was mitigated by Se concentration. Toxicant concentrations in fingernail samples, anthropometry and Bayley’s Scales of Infant Development, 3rd edition domains were assessed in 36-month-old children whose mothers had been part of a randomised controlled trial in rural Vietnam. Multivariable regression analyses were performed to estimate the effect of toxicant exposure on clinical outcomes with adjustments for potential confounders and interaction with fingernail Se concentration. We analysed 658 children who had data for at least one physical or developmental outcome, and at least one toxicant measurement, and each of the covariates. Fingernail As concentration was negatively associated with language (estimate per 10 % increase in As: −0·19, 95 % CI: (–0·32, −0·05)). Pb was negatively associated with cognition (estimate per 10 % increase in Pb: −0·08 (–0·15, −0·02)), language (estimate per 10 % increase in Pb: −0·18 (–0·28, −0·10)) and motor skills (estimate per 10 % increase in Pb: −0·12 (–0·24, 0·00)). Hg was negatively associated with cognition (estimate per 10 % increase in Hg: −0·48, (–0·72, −0·23)) and language (estimate per 10 % increase in Hg −0·51, (–0·88, −0·13)) when Se concentration was set at zero in the model. As Se concentration increased, the negative associations between Hg and both cognition and language scores were attenuated. There was no association between toxicant concentration and growth. As, Pb and Hg concentrations in fingernails of 3-year-old children were associated with lower child development scores. The negative association between Hg and neurological development was reduced in magnitude with increasing Se concentration. Se status should be considered when assessing heavy metal toxicants in children and their impact on neurodevelopmental outcomes.
Adherence to the South African food based dietary guidelines may reduce breast cancer risk in black South African women: the South African Breast Cancer (SABC) study
- Inarie Jacobs, Christine Taljaard-Krugell, Mariaan Wicks, Jane M Badham, Herbert Cubasch, Maureen Joffe, Ria Laubscher, Isabelle Romieu, Carine Biessy, Marc J Gunter, Sabina Rinaldi, Inge Huybrechts
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- Journal:
- Public Health Nutrition / Volume 25 / Issue 10 / October 2022
- Published online by Cambridge University Press:
- 29 November 2021, pp. 2805-2821
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Objective:
To determine the level of adherence and to assess the association between higher adherence to the South African food based dietary guidelines (SAFBDG) and breast cancer risk.
Design:Population-based, case–control study (the South African Breast Cancer study) matched on age and demographic settings. Validated questionnaires were used to collect dietary and epidemiological data. To assess adherence to the SAFBDG, a nine-point adherence score (out of eleven guidelines) was developed, using suggested adherence cut-points for scoring each recommendation (0 and 1). When the association between higher adherence to the SAFBDG and breast cancer risk was assessed, data-driven tertiles among controls were used as cut-points for scoring each recommendation (0, 0·5 and 1). OR and 95 % CI were estimated using multivariate logistic regression models.
Setting:Soweto, South Africa.
Participants:Black urban women, 396 breast cancer cases and 396 controls.
Results:After adjusting for potential confounders, higher adherence (>5·0) to the SAFBDG v. lower adherence (<3·5) was statistically significantly inversely associated with breast cancer risk overall (OR = 0·56, 95 % CI 0·38, 0·85), among postmenopausal women (OR = 0·64, 95 % CI 0·40, 0·97) as well as for oestrogen-positive breast cancers (OR = 0·51, 95 % CI 0·32, 0·89). Only 32·3 % of cases and 39·1 % of controls adhered to at least half (a score >4·5) of the SAFBDG.
Conclusions:Higher adherence to the SAFBDG may reduce breast cancer risk in this population. The concerning low levels of adherence to the SAFBDG emphasise the need for education campaigns and to create healthy food environments in South Africa to increase adherence to the SAFBDG.
ENNOBLE-ATE trial: an open-label, randomised, multi-centre, observational study of edoxaban for children with cardiac diseases at risk of thromboembolism
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- Mihir D. Bhatt, Michael A. Portman, Felix Berger, Jeffrey P. Jacobs, Jane Newburger, Anil Duggal, Michael Grosso, Grishma Pandya, Jay Dave, Neil A. Goldenberg
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- Journal:
- Cardiology in the Young / Volume 31 / Issue 8 / August 2021
- Published online by Cambridge University Press:
- 04 August 2021, pp. 1213-1219
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Children with cardiac diseases suffer from significant morbidity and mortality secondary to thromboembolic complications. Anticoagulant agents currently used for thromboprophylaxis have many limitations, including subcutaneous administration (low molecular weight heparins) and requirement for frequent monitoring via venipuncture (vitamin K antagonists). Edoxaban is an oral direct factor Xa inhibitor without need of monitoring. In the treatment of venous thromboembolism in adults, edoxaban has shown to be effective and safe.
This manuscript summarises the rationale and design of a phase 3, open-label, randomised controlled trial to evaluate and compare the safety and efficacy of edoxaban against standard of care (namely, vitamin K antagonist and low molecular weight heparin) in children with cardiac diseases.
A goal of 150 children with cardiac diseases at risk of thromboembolic complications who need primary or secondary anticoagulant prophylaxis will be recruited. Eligible children between 6 months and <18 years of age will be randomised in a ratio of 2 to 1 for edoxaban versus standard of care. Randomisation will be stratified based on underlying cardiac disease and concomitant use of aspirin for patients other than Kawasaki disease. The primary outcome will be safety, comprised of major and clinically relevant non-major bleeding in first 3 months of treatment. Bleeding beyond 3 months, symptomatic and asymptomatic thromboembolic events, and pharmacokinetic and pharmacodynamic parameters will be evaluated as secondary outcomes.
Randomised controlled anticoagulation trials are challenging in children. This study will evaluate a potentially valuable alternative of oral anticoagulant prophylactic use in children with cardiac diseases.
Registry-based trials: a potential model for cost savings?
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- Brett R. Anderson, Evelyn G. Gotlieb, Kevin Hill, Kimberly E. McHugh, Mark A. Scheurer, Carlos M. Mery, Glenn J. Pelletier, Jonathan R. Kaltman, Owen J. White, Felicia L. Trachtenberg, Danielle Hollenbeck-Pringle, Brian W. McCrindle, Donna M. Sylvester, Aaron W. Eckhauser, Sara K. Pasquali, Jeffery B. Anderson, Marcus S. Schamberger, Subhadra Shashidharan, Jeffrey P. Jacobs, Marshall L. Jacobs, Marko Boskovski, Jane W. Newburger, Meena Nathan
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- Journal:
- Cardiology in the Young / Volume 30 / Issue 6 / June 2020
- Published online by Cambridge University Press:
- 08 May 2020, pp. 807-817
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Background/Aims:
Registry-based trials have emerged as a potentially cost-saving study methodology. Early estimates of cost savings, however, conflated the benefits associated with registry utilisation and those associated with other aspects of pragmatic trial designs, which might not all be as broadly applicable. In this study, we sought to build a practical tool that investigators could use across disciplines to estimate the ranges of potential cost differences associated with implementing registry-based trials versus standard clinical trials.
Methods:We built simulation Markov models to compare unique costs associated with data acquisition, cleaning, and linkage under a registry-based trial design versus a standard clinical trial. We conducted one-way, two-way, and probabilistic sensitivity analyses, varying study characteristics over broad ranges, to determine thresholds at which investigators might optimally select each trial design.
Results:Registry-based trials were more cost effective than standard clinical trials 98.6% of the time. Data-related cost savings ranged from $4300 to $600,000 with variation in study characteristics. Cost differences were most reactive to the number of patients in a study, the number of data elements per patient available in a registry, and the speed with which research coordinators could manually abstract data. Registry incorporation resulted in cost savings when as few as 3768 independent data elements were available and when manual data abstraction took as little as 3.4 seconds per data field.
Conclusions:Registries offer important resources for investigators. When available, their broad incorporation may help the scientific community reduce the costs of clinical investigation. We offer here a practical tool for investigators to assess potential costs savings.
Variation in care for children undergoing the Fontan operation for hypoplastic left heart syndrome
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- Aaron W. Eckhauser, Maria I. Van Rompay, Chitra Ravishankar, Jane W. Newburger, S. Ram Kumar, Christian Pizarro, Nancy Ghanayem, Felicia L. Trachtenberg, Kristin M. Burns, Garick D. Hill, Andrew M. Atz, Michelle S. Hamstra, Mjaye Mazwi, Patsy Park, Marc E. Richmond, Michael Wolf, Jeffrey D. Zampi, Jeffrey P. Jacobs, L. LuAnn Minich, for the Pediatric Heart Network Investigators
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- Journal:
- Cardiology in the Young / Volume 29 / Issue 12 / December 2019
- Published online by Cambridge University Press:
- 26 November 2019, pp. 1510-1516
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Background:
The Single Ventricle Reconstruction Trial randomised neonates with hypoplastic left heart syndrome to a shunt strategy but otherwise retained standard of care. We aimed to describe centre-level practice variation at Fontan completion.
Methods:Centre-level data are reported as median or median frequency across all centres and range of medians or frequencies across centres. Classification and regression tree analysis assessed the association of centre-level factors with length of stay and percentage of patients with prolonged pleural effusion (>7 days).
Results:The median Fontan age (14 centres, 320 patients) was 3.1 years (range from 1.7 to 3.9), and the weight-for-age z-score was −0.56 (−1.35 + 0.44). Extra-cardiac Fontans were performed in 79% (4–100%) of patients at the 13 centres performing this procedure; lateral tunnels were performed in 32% (3–100%) at the 11 centres performing it. Deep hypothermic circulatory arrest (nine centres) ranged from 6 to 100%. Major complications occurred in 17% (7–33%). The length of stay was 9.5 days (9–12); 15% (6–33%) had prolonged pleural effusion. Centres with fewer patients (<6%) with prolonged pleural effusion and fewer (<41%) complications had a shorter length of stay (<10 days; sensitivity 1.0; specificity 0.71; area under the curve 0.96). Avoiding deep hypothermic circulatory arrest and higher weight-for-age z-score were associated with a lower percentage of patients with prolonged effusions (<9.5%; sensitivity 1.0; specificity = 0.86; area under the curve 0.98).
Conclusions:Fontan perioperative practices varied widely among study centres. Strategies to decrease the duration of pleural effusion and minimise complications may decrease the length of stay. Further research regarding deep hypothermic circulatory arrest is needed to understand its association with prolonged pleural effusion.
A comparison of the modelled impacts on CVD mortality if attainment of public health recommendations was achieved in metropolitan and rural Australia
- Laura Alston, Jane Jacobs, Steven Allender, Melanie Nichols
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- Journal:
- Public Health Nutrition / Volume 23 / Issue 2 / February 2020
- Published online by Cambridge University Press:
- 13 August 2019, pp. 339-347
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Objective:
To (i) determine the proportion of deaths from CVD that could be avoided in both rural and metropolitan Australia if public health recommendations were met; (ii) assess the impact on the rural CVD mortality; and (iii) determine if policy priorities should be different by rurality for CVD prevention.
Design:A macro-simulation modelling study of population data. Population, risk factor and CVD death data stratified by rurality were analysed using the Preventable Risk Integrated Model. The baseline scenario was the current risk factor levels (including physical activity, smoking, diet and alcohol). The counterfactual scenario was the population levels of these risk factors expected if public health recommendations were met.
Setting:Metropolitan and rural Australia.
Participants:Rural- and metropolitan-dwelling adults in Australia.
Results:Both populations would experience similar relative declines in the proportion of deaths from CVD. A total of 14 892 deaths from CVD would be avoided annually; with similar declines in the proportions of deaths by rurality. Critically, the order of policy priorities for public health recommendation attainment would differ by rurality CVD prevention, with addressing fat intakes being a higher priority in rural areas.
Conclusions:Achieving public health recommendations in Australia would result in large declines in CVD mortality. Despite declines in overall CVD mortality under this scenario, an inequality in CVD burden would persist for rural populations. The order of risk factor priorities would differ by rurality.
Enhancing efficiency and scientific impact of a clinical trials network: the Pediatric Heart Network Integrated CARdiac Data and Outcomes (iCARD) Collaborative
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- Sara K. Pasquali, Jonathan R. Kaltman, J. William Gaynor, Brian W. McCrindle, Jane W. Newburger, Brett R. Anderson, Mark A. Scheurer, Nelangi M. Pinto, Jeffrey B. Anderson, Matthew E. Oster, Jeffrey P. Jacobs, Bradley S. Marino, Carlos M. Mery, Gail D. Pearson
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- Journal:
- Cardiology in the Young / Volume 29 / Issue 9 / September 2019
- Published online by Cambridge University Press:
- 06 August 2019, pp. 1121-1126
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Recent years have seen an exponential increase in the variety of healthcare data captured across numerous sources. However, mechanisms to leverage these data sources to support scientific investigation have remained limited. In 2013 the Pediatric Heart Network (PHN), funded by the National Heart, Lung, and Blood Institute, developed the Integrated CARdiac Data and Outcomes (iCARD) Collaborative with the goals of leveraging available data sources to aid in efficiently planning and conducting PHN studies; supporting integration of PHN data with other sources to foster novel research otherwise not possible; and mentoring young investigators in these areas. This review describes lessons learned through the development of iCARD, initial efforts and scientific output, challenges, and future directions. This information can aid in the use and optimisation of data integration methodologies across other research networks and organisations.
Variation in care for infants undergoing the Stage II palliation for hypoplastic left heart syndrome
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- Aaron Eckhauser, Sara K. Pasquali, Chitra Ravishankar, Linda M. Lambert, Jane W. Newburger, Andrew M. Atz, Nancy Ghanayem, Steven M. Schwartz, Chong Zhang, Jeffery P. Jacobs, L. LuAnn Minich
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- Journal:
- Cardiology in the Young / Volume 28 / Issue 10 / October 2018
- Published online by Cambridge University Press:
- 24 July 2018, pp. 1109-1115
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Background
The Single Ventricle Reconstruction trial randomised neonates with hypoplastic left heart syndrome to a systemic-to-pulmonary-artery shunt strategy. Patients received care according to usual institutional practice. We analysed practice variation at the Stage II surgery to attempt to identify areas for decreased variation and process control improvement.
MethodsProspectively collected data were available in the Single Ventricle Reconstruction public-use database. Practice variation across 14 centres was described for 397 patients who underwent Stage II surgery. Data are centre-level specific and reported as interquartile ranges across all centres, unless otherwise specified.
ResultsPreoperative Stage II median age and weight across centres were 5.4 months (interquartile range 4.9–5.7) and 5.7 kg (5.5–6.1), with 70% performed electively. Most patients had pre-Stage-II cardiac catheterisation (98.5–100%). Digoxin was used by 11/14 centres in 25% of patients (23–31%), and 81% had some oral feeds (68–84%). The majority of the centres (86%) performed a bidirectional Glenn versus hemi-Fontan. Median cardiopulmonary bypass time was 96 minutes (75–113). In aggregate, 26% of patients had deep hypothermic circulatory arrest >10 minutes. In 13/14 centres using deep hypothermic circulatory arrest, 12.5% of patients exceeded 10 minutes (8–32%). Seven centres extubated 5% of patients (2–40) in the operating room. Postoperatively, ICU length of stay was 4.8 days (4.0–5.3) and total length of stay was 7.5 days (6–10).
ConclusionsIn the Single Ventricle Reconstruction Trial, practice varied widely among centres for nearly all perioperative factors surrounding Stage II. Further analysis may facilitate establishing best practices by identifying the impact of practice variation.
Yes, not now, or never: an analysis of reasons for refusing or accepting emergency department-based take-home naloxone
- Andrew Kestler, Amanda Giesler, Jane Buxton, Gray Meckling, Michelle Lee, Garth Hunte, Jacob Wilkins, Dalya Marks, Frank Scheuermeyer
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- Journal:
- Canadian Journal of Emergency Medicine / Volume 21 / Issue 2 / March 2019
- Published online by Cambridge University Press:
- 23 May 2018, pp. 226-234
- Print publication:
- March 2019
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Objective
Take-home naloxone (THN) reduces deaths from opioid overdose. To increase THN distribution to at-risk emergency department (ED) patients, we explored reasons for patients’ refusing or accepting THN.
MethodsIn an urban teaching hospital ED, we identified high opioid overdose risk patients according to pre-specified criteria. We offered eligible patients THN and participation in researcher-administered surveys, which inquired about reasons to refuse or accept THN and about THN dispensing location preferences. We analyzed refusal and acceptance reasons in open-ended responses, grouped reasons into categories (absolute versus conditional refusals,) then searched for associations between patient characteristics and reasons.
ResultsOf 247 patients offered THN, 193 (78.1%) provided reasons for their decision. Of those included, 69 (35.2%) were female, 91 (47.2%) were under age 40, 61 (31.6%) were homeless, 144 (74.6%) reported injection drug use (IDU), and 131 (67.9%) accepted THN. Of 62 patients refusing THN, 19 (30.7%) felt “not at risk” for overdose, while 28 (45.2%) gave conditional refusal reasons: “too sick,” “in a rush,” or preference to get THN elsewhere. Non-IDU was associated with stating “not at risk,” while IDU, homelessness, and age under 40 were associated with conditional refusals. Among acceptances, 86 (65.7%) mentioned saving others as a reason. Most respondents preferred other dispensing locations beside the ED, whether or not they accepted ED THN.
ConclusionED patients refusing THN felt “not at risk” for overdose or felt their ED visit was not the right time or place for THN. Most accepting THN wanted to save others.
State Phobia, Then and Now: Three Waves of Conflict over Wisconsin's Public Sector, 1930–2013
- Jane L. Collins, H. Jacob Carlson
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- Journal:
- Social Science History / Volume 42 / Issue 1 / Spring 2018
- Published online by Cambridge University Press:
- 10 November 2017, pp. 57-80
- Print publication:
- Spring 2018
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While state legislative rollbacks of public-sector workers’ collective bargaining rights in Wisconsin and other US states in 2011 appeared to signal an unprecedented wave of hostility toward the public sector, such episodes have a long history. Drawing on recent work on “governance repertoires,” this article compares antistate initiatives in Wisconsin in 2011 to two previous periods of conflict over the size and shape of government: the 1930s and the 1970s. We find that while small government advocates in all three periods used similar language and emphasized comparable themes, the outcomes of their advocacy were different due to the distinct historical moments in which they unfolded and the way local initiatives were linked to political projects at the national level. We explore the relationship of local versions of small government activism to their national-level counterparts in each period to show how national-level movements and the ideological, social, and material resources they provided shaped governance repertoires in Wisconsin. We argue that the three moments of conflict over the size of government are deeply intertwined with the prehistory, emergence, and rise to dominance of neoliberal political rationality and can provide insight into how that new “governance repertoire” was experienced and built at the local level.
The Wages of Women in England, 1260–1850
- Jane Humphries, Jacob Weisdorf
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- Journal:
- The Journal of Economic History / Volume 75 / Issue 2 / June 2015
- Published online by Cambridge University Press:
- 04 June 2015, pp. 405-447
- Print publication:
- June 2015
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This paper presents two wage-series for unskilled English women workers 1260–1850, one based on daily wages and one on the daily remuneration implied in annual contracts. The series are compared with each other and with evidence for men, informing several debates. Our findings suggest first that women servants did not share the post-Black Death “golden age” and so offer little support for a “girl-powered” economic breakthrough; and second that during the industrial revolution, women who were unable to work long hours lost ground relative to men and to women who could work full-time and fell increasingly adrift from any “High Wage Economy.”
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. 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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. 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- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- The Cambridge Dictionary of Christianity
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- By Sylke Andreas, Thomas Becker, Peter Brann, Tom Callaly, Tim Coombs, Mark Deady, James Healy, Rowena Jacobs, Michael J. Lambert, Regina McDonald, Rod McKay, Graham Mellsop, Allen Morris-Yates, Tricia Nagel, Andrew C. Page, Jane Pirkis, Bernd Puschner, Dee Roth, Mirella Ruggeri, Torleif Ruud, Holger Schulz, Mike Slade, David Smith, Mark Smith, Maree Teesson, Glen Tobias, Tom Trauer
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Investigation and Control of an Outbreak of Enterobacter aerogenes Bloodstream Infection in a Neonatal Intensive Care Unit in Fiji
- Swastika A. Narayan, Jacob L. Kool, Miriama Vakololoma, Andrew C. Steer, Amelita Mejia, Anne Drake, Adam Jenney, Jane F. Turton, Joseph Kado, Lisi Tikoduadua
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- 02 January 2015, pp. 797-800
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Ten neonates developed blood stream infection with extended-spectrum β-lactamase-producing Enterobacter aerogenes in a neonatal intensive care unit in Fiji. The source of the outbreak was traced to a bag of contaminated normal saline in the ward, which was used for multiple patients. All isolates recovered from patients were indistinguishable from the bacteria recovered from the normal saline by pulsed-field gel electrophoresis. The outbreak was controlled using simple infection control practices such as reinforcement of strict hand hygiene policy, provision of single use vials of normal saline, and strict aseptic technique for injections.
Modernising social care services for older people: scoping the United Kingdom evidence base
- SALLY JACOBS, CHENGQIU XIE, SIOBHAN REILLY, JANE HUGHES, DAVID CHALLIS
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- 21 April 2009, pp. 497-538
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In common with other developed countries at the end of the 20th century, modernising public services was a priority of the United Kingdom (UK) Labour administration after its election in 1997. The modernisation reforms in health and social care exemplified their approach to public policy. The authors were commissioned to examine the evidence base for the modernisation of social care services for older people, and for this purpose conducted a systematic review of the relevant peer-reviewed UK research literature published from 1990 to 2001. Publications that reported descriptive, analytical, evaluative, quantitative and qualitative studies were identified and critically appraised under six key themes of modernisation: integration, independence, consistency, support for carers, meeting individuals' needs, and the workforce. This paper lists the principal features of each study, provides an overview of the literature, and presents substantive findings relating to three of the modernisation themes (integration, independence and individuals' needs). The account provides a systematic portrayal both of the state of social care for older people prior to the modernisation process and of the relative strengths and weaknesses of the evidence base. It suggests that, for evidence-based practice and policy to become a reality in social care for older people, there is a general need for higher quality studies in this area.