Methicillin-resistant Staphylococcus aureus (MRSA) is associated with high morbidity, mortality, and outbreaks in neonatal intensive care units (NICU). For MRSA-colonized patients in the NICU, the Society for Healthcare Epidemiology in America recommends continuing contact isolation until NICU discharge, reflecting limited evidence to support safe discontinuation and recolonization concerns. We evaluated MRSA colonization dynamics in a NICU with an active surveillance program to better inform the evidence base for contact isolation practices. All patients in the 58-bed NICU at UCSF Benioff Children’s Hospital San Francisco undergo weekly or biweekly MRSA culture screening. Colonized patients are placed in single-patient rooms on contact isolation for the duration of their NICU admission and undergo decolonization with intranasal mupirocin and topical mupirocin or chlorhexidine wipes; parents are also offered decolonization. We conducted a retrospective review of MRSA surveillance data from January 1, 2021 through December 31, 2024. A patient colonization episode was defined as one or more consecutive positive screens, with multiple episodes separated by at least one negative screen. Comparisons between patients with single and multiple colonization episodes were performed using the Mann-Whitney U test. Among 2,352 patients screened, 111 (5%) had at least one positive MRSA screen and of these, 80 (72%) had a single positive screen. The median time to first positivity (TFP) was 20 days (interquartile range [IQR]: 6-59) and the median length of stay (LOS) was 65 days (IQR: 24-134). Ninety-three (84%) patients had a single colonization episode and 18 (16%) had multiple colonization episodes (Figure 1). Compared with patients with one colonization episode, patients with multiple colonizations had similar median TFP (18 vs. 21 days; p=0.25), but a longer median LOS (98 vs. 49 days; p<0.01) (Figure 2). Colonized patients were placed on a cumulative 5,180 contact isolation days (median: 26 days per patient, IQR: 12-63 days); of these, 2,543 contact isolation days (49%) were during weeks with a negative screen. In a NICU with active MRSA surveillance, targeted decolonization, and robust horizontal infection prevention practices (e.g. hand hygiene, personal protective equipment, and environmental cleaning), MRSA colonization and recolonization detection was lower than previously reported in the literature. Despite this, contact isolation days accumulated substantially, with almost half of the days occurring during periods of negative surveillance testing. These findings highlight the need for further studies to assess MRSA recolonization risk and optimize the duration of contact isolation in NICU patients, ideally guided by local epidemiology and active surveillance.

Christianity is a religion of the book, and in particular of one book, the Bible. More precisely, it is a religion of a library of plural books (biblia) that eventually became one single book. It is possible to view the history of all Christian traditions, and not Protestantism alone, as a history of the canonical formation, liturgical and devotional use, cultural influence, contested theological interpretation and geographical diffusion of the Bible. In view of the magnitude of the subject, it is not surprising that very few historians have set out to encapsulate this grand narrative in a single volume. Bruce Gordon, the distinguished historian of early modern European Protestantism, has now made the attempt, and it is a valiant effort of stupendous chronological and geographical range, extending across the entire span of Christian history and covering all continents, though Australasia receives only a paragraph, oddly devoted to the New Hebrides. Not quite so rare are historians who have set out to chart the impact of one translation of the Bible on a single nation or family of nations – notably the role of the King James Bible of 1611 (the Authorised Version) in shaping the language and religious culture of English-speaking peoples, including those in the New World of North America.1

Identifying actionable stewardship targets in immunocompromised patients is challenging due to limited data and high morbidity. One approach could be targeting therapy with limited evidence, like cytomegalovirus immune globulin (CMV-IGIV). We implemented a drug restriction program that increased appropriate use of CMV-IGIV, highlighting a unique stewardship opportunity in immunocompromised populations.

It may appear odd to write a review article focused on two books that are fundamentally different in intention and scope. The first is a self-conscious attempt by a moral theologian of conservative inclinations to contribute a Christian ethical perspective to the culture wars currently raging on both sides of the Atlantic on empire, race, and slavery. Its author, Nigel Biggar, is the Emeritus Professor of Moral and Pastoral Theology at the University of Oxford. The second book is a collection of papers by imperial and mission historians given at a workshop at the Victoria University of Wellington, New Zealand, in July 2018. Its brief is more limited, namely to explore the professed commitment of nineteenth-century Christian missions to bringing a gospel of peace into contexts that were frequently sites of violence, not least between indigenous peoples and European settlers and other colonial actors. Its geographical remit is limited to Africa and the Pacific. Biggar's book has provoked a predictable storm of criticism, both within the historical academy and beyond it. The Journal of Imperial and Commonwealth History, for example, rapidly published a 15,000–word rebuttal of Biggar's arguments by Alan Lester, Professor of Historical Geography at the University of Sussex, together with an almost equally lengthy reply by Biggar.1 In contrast, Geoffrey Troughton's edited volume, extremely valuable though it undoubtedly is, seems unlikely to attract notice beyond the limited constituencies of professional historians and scholars of mission studies. Although obviously differing in character, these two books, when set in juxtaposition, bring into focus some of the most pertinent issues raised for Christianity by the imperial past and the ambiguous role played within it by Christian missions.

This article analyses the intellectual sources and global influence of the demonology of Derek Prince (1915–2003), a former philosophy fellow of King's College, Cambridge, who, after his move to the United States in 1963, became a globally influential Pentecostal teacher and author. It argues that his academic expertise in the philosophy of Plato shaped his understanding of the invisible realm of spiritual powers and its impact on the health and material well-being of Christians. Prince's teaching on ancestral curses and the vulnerability of Christians to demonization has been widely received in Africa and other parts of the non-Western world, appearing to provide answers to endemic problems of chronic sickness and impoverishment.

Seven half-day regional listening sessions were held between December 2016 and April 2017 with groups of diverse stakeholders on the issues and potential solutions for herbicide-resistance management. The objective of the listening sessions was to connect with stakeholders and hear their challenges and recommendations for addressing herbicide resistance. The coordinating team hired Strategic Conservation Solutions, LLC, to facilitate all the sessions. They and the coordinating team used in-person meetings, teleconferences, and email to communicate and coordinate the activities leading up to each regional listening session. The agenda was the same across all sessions and included small-group discussions followed by reporting to the full group for discussion. The planning process was the same across all the sessions, although the selection of venue, time of day, and stakeholder participants differed to accommodate the differences among regions. The listening-session format required a great deal of work and flexibility on the part of the coordinating team and regional coordinators. Overall, the participant evaluations from the sessions were positive, with participants expressing appreciation that they were asked for their thoughts on the subject of herbicide resistance. This paper details the methods and processes used to conduct these regional listening sessions and provides an assessment of the strengths and limitations of those processes.