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To develop a pediatric research agenda focused on pediatric healthcare-associated infections and antimicrobial stewardship topics that will yield the highest impact on child health.
The study included 26 geographically diverse adult and pediatric infectious diseases clinicians with expertise in healthcare-associated infection prevention and/or antimicrobial stewardship (topic identification and ranking of priorities), as well as members of the Division of Healthcare Quality and Promotion at the Centers for Disease Control and Prevention (topic identification).
Using a modified Delphi approach, expert recommendations were generated through an iterative process for identifying pediatric research priorities in healthcare associated infection prevention and antimicrobial stewardship. The multistep, 7-month process included a literature review, interactive teleconferences, web-based surveys, and 2 in-person meetings.
A final list of 12 high-priority research topics were generated in the 2 domains. High-priority healthcare-associated infection topics included judicious testing for Clostridioides difficile infection, chlorhexidine (CHG) bathing, measuring and preventing hospital-onset bloodstream infection rates, surgical site infection prevention, surveillance and prevention of multidrug resistant gram-negative rod infections. Antimicrobial stewardship topics included β-lactam allergy de-labeling, judicious use of perioperative antibiotics, intravenous to oral conversion of antimicrobial therapy, developing a patient-level “harm index” for antibiotic exposure, and benchmarking and or peer comparison of antibiotic use for common inpatient conditions.
We identified 6 healthcare-associated infection topics and 6 antimicrobial stewardship topics as potentially high-impact targets for pediatric research.
Field experiments were conducted to compare efficacy of BAS 514, bromoxynil, fenoxaprop, sethoxydim, and triclopyr with standard herbicides for barnyardgrass and bearded sprangletop control in rice at four locations. Sequential applications of BAS 514 and fenoxaprop, or propanil and sethoxydim consistently controlled barnyardgrass and bearded sprangletop as well as or better than standard treatments of propanil, thiobencarb, or pendimethalin alone or combined; and rice so treated produced high yields. BAS 514 applied postemergence alone, BAS 514 applied sequentially with sethoxydim, or BAS 514 tank mixed with propanil controlled barnyardgrass but not bearded sprangletop. Bromoxynil or triclopyr tank mixed with fenoxaprop or sethoxydim antagonized activity on barnyardgrass and bearded sprangletop. Combinations of fenoxaprop with BAS 514 or propanil consistently provided barnyardgrass and bearded sprangletop control and high yields.
Density and spatial interference of barnyardgrass with ‘Lemont’ and ‘Newbonnet’ rice cultivars was investigated in 1987 and 1988. Barnyardgrass reduced grain yield of Lemont, a semidwarf cultivar, more than Newbonnet, a short-statured cultivar. Linear regression indicated that season-long interference of barnyardgrass at 1 to 20 plants m–2 reduced grain yields of Lemont and Newbonnet by 301 and 257 kg ha–1 per barnyardgrass plant, respectively. Grain yields of Lemont and Newbonnet were reduced by barnyardgrass densities to 40 plants m–2 but were not affected further at densities ≥40 plants m–2. Barnyardgrass reduced straw yield of Lemont more than of Newbonnet. Although barnyardgrass culms m–2 and straw yield increased as weed density increased, the weed produced more culms per plant at 2 and 5 m–2 than at 20 to 80 m–2. In a spatial interference experiment, Lemont grain yield reduction averaged 21% when plants were grown within 0 to 25 cm of a barnyardgrass plant group (group = 4 plants per 140 cm2). However, rice yields were not reduced when barnyardgrass plant groups were 25 to 50 or 50 to 100 cm away. Additional treatments included two barnyardgrass groups spaced 20, 40, 80, or 100 cm apart When Lemont grew between barnyardgrass groups spaced 20 or 40 cm apart, grain yields were reduced 40 and 27%, respectively, compared with weed-free rice. However, Lemont yield was not reduced when rice plants grew between weed plant groups spaced 100 cm apart.
We agree with Landers and Behrend's (2015) proposition that Amazon's Mechanical Turk (MTurk) may provide great opportunities for organizational research samples. However, some groups are characteristically difficult to recruit because they are stigmatized or socially disenfranchised (Birman, 2005; Miller, Forte, Wilson, & Greene, 2006; Sullivan & Cain, 2004; see Campbell, Adams, & Patterson, 2008, for a review). These groups may include individuals who have not previously been the focus of much organizational research, such as those of low socioeconomic status; individuals with disabilities; lesbian, gay, bisexual, or transgender (LGBT) individuals; or victims of workplace harassment. As Landers and Behrend (2015) point out, there is an overrepresentation of research using “Western, educated, industrialized, rich, and democratic” participants. It is important to extend research beyond these samples to examine workplace phenomena that are specific to special populations. We contribute to this argument by noting the particular usefulness that MTurk can provide for sampling from hard-to-reach populations, which we characterize as groups that are in the numerical minority in terms of nationwide representation. To clarify, we focus our discussion on populations that are traditionally hard to reach in the context of contemporary organizational research within the United States.
On the occasion of the 100th issue of English Today, scholars from around the world were invited to send their thoughts. Excerpts from messages received up to September 6th, 2009 are presented here.
Establishing a clinical diagnosis of infection in residents of long-term–care facilities (LTCFs) is difficult. As a result, deciding when to initiate antibiotics can be particularly challenging. This article describes the establishment of minimum criteria for the initiation of antibiotics in residents of LTCFs. Experts in this area were invited to participate in a consensus conference. Using a modified delphi approach, a questionnaire and selected relevant articles were sent to participants who were asked to rank individual signs and symptoms with respect to their relative importance. Using the results of the weighting by participants, a modification of the nominal group process was used to achieve consensus. Criteria for initiating antibiotics for skin and soft-tissue infections, respiratory infections, urinary infections, and fever where the focus of infection is unknown were developed.
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