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Prior studies evaluating the impact of discontinuation of contact precautions (DcCP) on methicillin-resistant Staphylococcus aureus (MRSA) outcomes have characterized all healthcare-associated infections (HAIs) rather than those likely preventable by contact precautions. We aimed to analyze the impact of DcCP on the rate of MRSA HAI including transmission events identified through whole genome sequencing (WGS) surveillance.
Design:
Quasi experimental interrupted time series.
Setting:
Acute care medical center.
Participants:
Inpatients.
Methods:
The effect of DcCP (use of gowns and gloves) for encounters among patients with MRSA carriage was evaluated using time series analysis of MRSA HAI rates from January 2019 through December 2022, compared to WGS-defined attributable transmission events before and after DcCP in December 2020.
Results:
The MRSA HAI rate was 4.22/10,000 patient days before and 2.98/10,000 patient days after DcCP (incidence rate ratio [IRR] 0.71 [95% confidence interval 0.56–0.89]) with a significant immediate decrease (P = .001). There were 7 WGS-defined attributable transmission events before and 11 events after DcCP (incident rate ratio 0.90 [95% confidence interval 0.30–2.55]).
Conclusions:
DcCP did not result in an increase in MRSA HAI or, in WGS-defined attributable transmission events. Comprehensive analyses of the effect of transmission prevention measures should include outcomes specifically measuring transmission-associated HAI.
With the efflorescence of palaeoscientific approaches to the past, historians have been confronted with a wealth of new evidence on both human and natural phenomena, from human disease and migration to landscape change and climate. These new data require a rewriting of our narratives of the past, questioning what constitutes an authoritative historical source and who is entitled to recount history to contemporary societies. Humanities-based historical inquiry must embrace this new evidence, but to do so historians need to engage with it critically, just as they do with textual and material sources. This article highlights the most vital methodological issues, ranging from the spatiotemporal scales and heterogeneity of the new evidence to the new roles attributed to quantitative methods and the place of scientific data in narrative construction. It considers areas of study where the palaeosciences have “intruded” into fields and subjects previously reserved for historians, especially socioeconomic, climate, and environmental history. The authors argue that active engagement with new approaches is urgently needed if historians want to contribute to our evolving understanding of the challenges of the Anthropocene.
Avec l’efflorescence des approches paléoscientifiques du passé, les historiens ont été confrontés à une multitude de nouveaux indices sur des phénomènes tant humains que naturels, des maladies aux migrations en passant par les transformations du paysage et le climat. Ces données inédites exigent une réécriture des récits portant sur les périodes lointaines, remettant en cause à la fois les fondements de l’autorité des sources historiques traditionnelles et la légitimité des personnes habilitées à narrer le passé aux sociétés contemporaines. Les travaux d’histoire appuyés sur les sciences humaines doivent embrasser ces nouveaux types d’indices ; cependant, pour y parvenir, il est nécessaire pour les chercheurs de s’engager dans cette voie de manière critique, comme ils le font pour les sources textuelles et matérielles. Cet article souhaite mettre en lumière les questions méthodologiques les plus essentielles, qui vont des échelles spatio-temporelles et de l’hétérogénéité des nouvelles preuves au rôle à attribuer aux méthodes quantitatives et à la place des données scientifiques dans la construction narrative. Il examine les domaines d’étude où les paléosciences se sont « immiscées » dans des champs et des sujets auparavant réservés aux historiens, notamment l’histoire socio-économique, climatique et environnementale. Les auteurs soutiennent qu’il est urgent pour ces spécialistes d’explorer activement ces pistes novatrices, s’ils entendent contribuer à l’évolution de notre compréhension des défis de l’Anthropocène.
The systematic review examined the phenomenon of trust during public health emergency events. The literature reviewed was field studies done with people directly affected or likely to be affected by such events and included quantitative, qualitative, mixed-method, and case study primary studies in English (N = 38) as well as Arabic, Chinese, French, Russian, and Spanish (all non-English N = 30). Studies were mostly from high- and middle-income countries, and the event most covered was infectious disease. Findings from individual studies were first synthesized within methods and evaluated for certainty/confidence, and then synthesized across methods. The final set of 11 findings synthesized across methods identified a set of activities for enhancing trust and showed that it is a multi-faceted and dynamic concept.
Mass loss from mountain glaciers contributes to sea-level rise and reduces freshwater availability in glacier-fed river basins, with negative effects on hydropower generation, agriculture and the health of aquatic ecosystems. In this study, we determine the volume of lower Peyto Glacier, Alberta, Canada, from ground-penetrating radar surveys in 2008–10, and compare our volume estimate with previous estimates from 1966 and 1984. The long-term record of mass-balance estimates on Peyto Glacier highlights Peyto’s importance as an ‘index’ glacier for the region. We calculate a mean volume of (3.39 ± 0.30) × 107 m3 for the glacier snout for the period 2008–10. Glacier volume decreased linearly from 1966 to 2010. If this trend persists, the glacier snout will disappear by ~2019 and Peyto Glacier will have retreated by ~1 km. Our results agree with modelling studies, which suggest that Peyto Glacier and other nearby glaciers along the eastern slopes of the Canadian Rocky Mountains will likely lose 80–90% of their present-day volume by 2100.
Disks of commercial Al-1050 and ZK60A alloys were stacked together and then processed by conventional high-pressure torsion (HPT) through 1 and 5 turns at room temperature to investigate the synthesis of an Al–Mg alloy system. Measurements of microhardness and observations of the microstructures and local compositions after processing through 5 turns revealed the formation of an ultrafine multi-layered structure in the central region of the disk but with an intermetallic β-Al3Mg2 phase in the form of nano-layers in the nanostructured Al matrix near the edge of the disk. The activation energy for diffusion bonding of the Al and Mg phases was estimated and it is shown that this value is low and consistent with surface diffusion due to the very high density of vacancy-type defects introduced by HPT processing. The results demonstrate a significant potential for making use of HPT processing in the preparation of new alloy systems.