5 results
Modified reporting of positive urine cultures to reduce inappropriate antibiotic treatment of catheter-associated asymptomatic bacteriuria (CA-ASB) among inpatients, a randomized controlled trial
- Claire L. Pratt, Zahra Rehan, Lydia Xing, Laura Gilbert, Brenda Fillier, Brendan Barrett, Peter Daley
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 42 / Issue 10 / October 2021
- Published online by Cambridge University Press:
- 04 June 2021, pp. 1221-1227
- Print publication:
- October 2021
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Objective:
To determine whether modified reporting of positive urine cultures collected from indwelling catheters improved treatment decisions without causing harm.
Design:Prospective, unblinded, randomized control trial.
Setting:Two tertiary-care hospitals.
Participants:Overall, 100 consecutive positive urine cultures collected from catheterized inpatients were randomized between standard and modified laboratory reporting between November 2018 and June 2019. Exclusion criteria were pregnancy, current antibiotic treatment, ICU or urology admission, or neutropenia.
Intervention:The modified report included significant growth without providing identification, quantification, or susceptibility. The standard report included identification, quantitation and susceptibility. Diagnosis of catheter-associated asymptomatic bacteriuria (CA-ASB) and catheter-associated urinary tract infection (CA-UTI) followed published criteria, using prospective chart review. The appropriate antibiotic treatment was defined as treatment of CA-UTI, and no treatment of CA-ASB. Patients were followed for 7 days.
Results:Of 543 urine cultures, 443 (82%) were excluded. Of 100 patients, 75 (75%) had CA-ASB and 25 (25%) had CA-UTI. Treatment was given to 45 of 75 CA-ASB patients (60%) and all 25 CA-UTI patients (100%). Appropriate treatment rate was higher in the modified reporting arm than in the standard reporting arm: 57% vs 50% (+7.4%; relative risk [RR], 1.15; P = .45). Untreated CA-ASB was higher in the modified reporting arm: 45% vs 33% (+12%; RR, 1.36; P = .30). The standard report was requested for 33% of modified reports. Furthermore, 4 deaths and 26.9% adverse events occurred in the modified reporting arm, and 3 deaths and 41.3% adverse events occurred in the standard reporting arm.
Conclusions:Modified reporting increased the appropriateness of treatment, and may be safe.
Clinical trials identifier: ClinicalTrials.gov#NCT03488355.
Short sleep duration and poor sleep quality predict next-day suicidal ideation: an ecological momentary assessment study
- Donna L. Littlewood, Simon D. Kyle, Lesley-Anne Carter, Sarah Peters, Daniel Pratt, Patricia Gooding
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- Journal:
- Psychological Medicine / Volume 49 / Issue 3 / February 2019
- Published online by Cambridge University Press:
- 26 April 2018, pp. 403-411
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Background
Sleep problems are a modifiable risk factor for suicidal thoughts and behaviors. Yet, sparse research has examined temporal relationships between sleep disturbance, suicidal ideation, and psychological factors implicated in suicide, such as entrapment. This is the first in-the-moment investigation of relationships between suicidal ideation, objective and subjective sleep parameters, and perceptions of entrapment.
MethodsFifty-one participants with current suicidal ideation completed week-long ecological momentary assessments. An actigraph watch was worn for the duration of the study, which monitored total sleep time, sleep efficiency, and sleep latency. Daily sleep diaries captured subjective ratings of the same sleep parameters, with the addition of sleep quality. Suicidal ideation and entrapment were measured at six quasi-random time points each day. Multi-level random intercept models and moderation analyses were conducted to examine the links between sleep, entrapment, and suicidal ideation, adjusting for anxiety and depression severity.
ResultsAnalyses revealed a unidirectional relationship whereby short sleep duration (both objective and subjective measures), and poor sleep quality, predicted the higher severity of next-day suicidal ideation. However, there was no significant association between daytime suicidal ideation and sleep the following night. Sleep quality moderated the relationship between pre-sleep entrapment and awakening levels of suicidal ideation.
ConclusionsThis is the first study to report night-to-day relationships between sleep disturbance, suicidal ideation, and entrapment. Findings suggest that sleep quality may alter the strength of the relationship between pre-sleep entrapment and awakening suicidal ideation. Clinically, results underscore the importance of assessing and treating sleep disturbance when working with those experiencing suicidal ideation.
Contributors
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- By Aakash Agarwala, Linda S. Aglio, Rae M. Allain, Paul D. Allen, Houman Amirfarzan, Yasodananda Kumar Areti, Amit Asopa, Edwin G. Avery, Patricia R. Bachiller, Angela M. Bader, Rana Badr, Sibinka Bajic, David J. Baker, Sheila R. Barnett, Rena Beckerly, Lorenzo Berra, Walter Bethune, Sascha S. Beutler, Tarun Bhalla, Edward A. Bittner, Jonathan D. Bloom, Alina V. Bodas, Lina M. Bolanos-Diaz, Ruma R. Bose, Jan Boublik, John P. Broadnax, Jason C. Brookman, Meredith R. Brooks, Roland Brusseau, Ethan O. Bryson, Linda A. Bulich, Kenji Butterfield, William R. Camann, Denise M. Chan, Theresa S. Chang, Jonathan E. Charnin, Mark Chrostowski, Fred Cobey, Adam B. Collins, Mercedes A. Concepcion, Christopher W. Connor, Bronwyn Cooper, Jeffrey B. Cooper, Martha Cordoba-Amorocho, Stephen B. Corn, Darin J. Correll, Gregory J. Crosby, Lisa J. Crossley, Deborah J. Culley, Tomas Cvrk, Michael N. D'Ambra, Michael Decker, Daniel F. Dedrick, Mark Dershwitz, Francis X. Dillon, Pradeep Dinakar, Alimorad G. Djalali, D. John Doyle, Lambertus Drop, Ian F. Dunn, Theodore E. Dushane, Sunil Eappen, Thomas Edrich, Jesse M. Ehrenfeld, Jason M. Erlich, Lucinda L. Everett, Elliott S. Farber, Khaldoun Faris, Eddy M. Feliz, Massimo Ferrigno, Richard S. Field, Michael G. Fitzsimons, Hugh L. Flanagan Jr., Vladimir Formanek, Amanda A. Fox, John A. Fox, Gyorgy Frendl, Tanja S. Frey, Samuel M. Galvagno Jr., Edward R. Garcia, Jonathan D. Gates, Cosmin Gauran, Brian J. Gelfand, Simon Gelman, Alexander C. Gerhart, Peter Gerner, Omid Ghalambor, Christopher J. Gilligan, Christian D. Gonzalez, Noah E. Gordon, William B. Gormley, Thomas J. Graetz, Wendy L. Gross, Amit Gupta, James P. Hardy, Seetharaman Hariharan, Miriam Harnett, Philip M. Hartigan, Joaquim M. Havens, Bishr Haydar, Stephen O. Heard, James L. Helstrom, David L. Hepner, McCallum R. Hoyt, Robert N. Jamison, Karinne Jervis, Stephanie B. Jones, Swaminathan Karthik, Richard M. Kaufman, Shubjeet Kaur, Lee A. Kearse Jr., John C. Keel, Scott D. Kelley, Albert H. Kim, Amy L. Kim, Grace Y. Kim, Robert J. Klickovich, Robert M. Knapp, Bhavani S. Kodali, Rahul Koka, Alina Lazar, Laura H. Leduc, Stanley Leeson, Lisa R. Leffert, Scott A. LeGrand, Patricio Leyton, J. Lance Lichtor, John Lin, Alvaro A. Macias, Karan Madan, Sohail K. Mahboobi, Devi Mahendran, Christine Mai, Sayeed Malek, S. Rao Mallampati, Thomas J. Mancuso, Ramon Martin, Matthew C. Martinez, J. A. Jeevendra Martyn, Kai Matthes, Tommaso Mauri, Mary Ellen McCann, Shannon S. McKenna, Dennis J. McNicholl, Abdel-Kader Mehio, Thor C. Milland, Tonya L. K. Miller, John D. Mitchell, K. Annette Mizuguchi, Naila Moghul, David R. Moss, Ross J. Musumeci, Naveen Nathan, Ju-Mei Ng, Liem C. Nguyen, Ervant Nishanian, Martina Nowak, Ala Nozari, Michael Nurok, Arti Ori, Rafael A. Ortega, Amy J. Ortman, David Oxman, Arvind Palanisamy, Carlo Pancaro, Lisbeth Lopez Pappas, Benjamin Parish, Samuel Park, Deborah S. Pederson, Beverly K. Philip, James H. Philip, Silvia Pivi, Stephen D. Pratt, Douglas E. Raines, Stephen L. Ratcliff, James P. Rathmell, J. Taylor Reed, Elizabeth M. Rickerson, Selwyn O. Rogers Jr., Thomas M. Romanelli, William H. Rosenblatt, Carl E. Rosow, Edgar L. Ross, J. Victor Ryckman, Mônica M. Sá Rêgo, Nicholas Sadovnikoff, Warren S. Sandberg, Annette Y. Schure, B. Scott Segal, Navil F. Sethna, Swapneel K. Shah, Shaheen F. Shaikh, Fred E. Shapiro, Torin D. Shear, Prem S. Shekar, Stanton K. Shernan, Naomi Shimizu, Douglas C. Shook, Kamal K. Sikka, Pankaj K. Sikka, David A. Silver, Jeffrey H. Silverstein, Emily A. Singer, Ken Solt, Spiro G. Spanakis, Wolfgang Steudel, Matthias Stopfkuchen-Evans, Michael P. Storey, Gary R. Strichartz, Balachundhar Subramaniam, Wariya Sukhupragarn, John Summers, Shine Sun, Eswar Sundar, Sugantha Sundar, Neelakantan Sunder, Faraz Syed, Usha B. Tedrow, Nelson L. Thaemert, George P. Topulos, Lawrence C. Tsen, Richard D. Urman, Charles A. Vacanti, Francis X. Vacanti, Joshua C. Vacanti, Assia Valovska, Ivan T. Valovski, Mary Ann Vann, Susan Vassallo, Anasuya Vasudevan, Kamen V. Vlassakov, Gian Paolo Volpato, Essi M. Vulli, J. Matthias Walz, Jingping Wang, James F. Watkins, Maxwell Weinmann, Sharon L. Wetherall, Mallory Williams, Sarah H. Wiser, Zhiling Xiong, Warren M. Zapol, Jie Zhou
- Edited by Charles Vacanti, Scott Segal, Pankaj Sikka, Richard Urman
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- Book:
- Essential Clinical Anesthesia
- Published online:
- 05 January 2012
- Print publication:
- 11 July 2011, pp xv-xxviii
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A spectroscopy and isotope study of sediments from the Antarctic Dry Valleys as analogues for potential paleolakes on Mars
- Janice L. Bishop, Brandy L. Anglen, Lisa M. Pratt, Howell G. M. Edwards, David J. Des Marais, Peter T. Doran
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- Journal:
- International Journal of Astrobiology / Volume 2 / Issue 4 / October 2003
- Published online by Cambridge University Press:
- 09 March 2004, pp. 273-287
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A spectroscopy and isotope study has been performed on igneous sediments from Lake Hoare, a nearly isolated ecosystem in the Dry Valleys region of Antarctica. The mineralogy and chemistry of these sediments were studied in order to gain insights into the biogeochemical processes occurring in a permanently ice-covered lake and to assist in characterizing potential habitats for life in paleolakes on Mars. Obtaining visible/near-infrared, mid-infrared and Raman spectra of such sediments provides the ground truth needed for using reflectance, emittance and Raman spectroscopy for exploration of geology, and perhaps biology, on Mars. Samples measured in this study include a sediment from the ice surface, lake bottom sediment cores from oxic and anoxic zones of the lake and the magnetic fractions of two samples.
These sediments are dominated by quartz, pyroxene, plagioclase and K-feldspar, but also contain calcite, organics, clays, sulphides and iron oxides/hydroxides that resulted from chemical and biological alteration processes. Chlorophyll-like bands are observed in the spectra of the sediment-mat layers on the surface of the lake bottom, especially in the deep anoxic region. Layers of high calcite concentration in the oxic sediments and layers of high pyrite concentration in the anoxic sediments are indicators of periods of active biogeochemical processing in the lake. Micro-Raman spectra revealed the presence of ~5 μm-sized pyrite deposits on the surface of quartz grains in the anoxic sediments. C, N and S isotope trends are compared with the chemistry and spectral properties. The δ13C and δ15N trends highlight the differences in the balance of microbial processes in the anoxic sediments versus the oxic sediments. The biogenic pyrite found in the sediments from the anoxic zone is associated with depleted δ34S values, high organic C levels and chlorophyll spectral bands and could be used as a potential biomarker mineral for paleolakes on Mars.
The Development of Microstructure in Calcium Sulphoaluminate Expansive Cement
- John Herrick, Karen L. Scrivener, Peter L. Pratt
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- Journal:
- MRS Online Proceedings Library Archive / Volume 245 / 1991
- Published online by Cambridge University Press:
- 15 February 2011, 277
- Print publication:
- 1991
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Using backscattered electron images, it is shown that an expansive clinker is polymineralic in nature, with individual particles containing the constituents (lime, anhydrite and anhydrous calcium sulphoaluminate) to form ettringite on hydration. The hydration reaction with time of a simple paste of a mixture of this expansive clinker with Ordinary Portland Cement (OPC) has been monitored using backscattered electron images, and the formation of ettringite and a change in the morphology of the calcium hydroxide formed from the added free lime from the expansive clinker is observed. Thermal analysis studies on pastes of the pure expansive clinker have confirmed this apparent change in morphology.
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