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77 results

Page 1 of 4

  • 6 - Jesus and the Triune God

  • from Part I - Origins
  • Edited by Markus Bockmuehl, University of Oxford
  • Book:
    The New Cambridge Companion to Jesus
    Published online:
    15 November 2024
    Print publication:
    05 December 2024, pp 88-102

  • Summary

    This chapter considers the ways in which the classical credal and conciliar formulae provide a framework for understanding who Jesus Christ is and how God saves through the Incarnate Word. These credal and conciliar formulae provide the foundation for theologies across the spectrum of Christian traditions. The chapter is broadly divided into two sections, one focusing on the fourth century Trinitarian controversies, the second focusing on the christological controversies of the fifth to the seventh centuries. For classical Christian theology, only when Jesus is known as the Word made flesh, and as one coequal to Father and Spirit in the divine life, can the work of redemption be understood.

  • Immediate Use Steam Sterilization and the Effect on Surgical Site Infections in an Acute Care Facility

  • Casey Lewis, Victoria Crall, Graham Snyder, Ashley Ayres, Avisha Risnear, Jason Miller, Joanne Sherer
  • Journal:
    Antimicrobial Stewardship & Healthcare Epidemiology / Volume 4 / Issue S1 / July 2024
    Published online by Cambridge University Press:
    16 September 2024, p. s143
    • Article
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  • Background: Immediate use steam sterilization (IUSS) shortens the time from sterilization to the aseptic transfer onto the surgical sterile field. Published data incompletely defines the extent to which IUSS increases risk of surgical site infection (SSI), compared to standard sterile reprocessing methods. We aimed to measure the association between IUSS use for surgical instrument reprocessing and SSI risk in a facility where IUSS use increased due to staffing constraints and case volumes. Methods: In this retrospective observational study at a tertiary care hospital with a diverse mix of surgery types, we used sterile reprocessing logs and SSI outcomes defined using National Health and Safety Network definitions to compare SSI rates among surgeries using surgical devices sterilized using IUSS compared to standard terminal sterilization methods. We calculated a risk ratio (RR) and 95% confidence interval (95%CI), including stratification by eleven high-volume service lines. Results: Among 23,919 surgical procedures, 416 (1.74%) developed SSIs. IUSS was used to sterilize instruments prior to 1,524 (6.37%) surgical procedures, and of these procedures 39 (2.56%) developed an SSI, compared to 1.68% of non-IUSS procedures (377 SSI in 22,395 procedures; risk ratio [RR] 1.52, 95% confidence interval [95%CI] 1.10-2.11). Two surgical services had statistically significant RRs for SSI development after IUSS: transplant surgery (RR 2.47, 95%CI 1.32-4.60] and plastic surgery (RR 3.64, 95%CI 1.13-11.74; Figure). Conclusion: IUSS is associated with a significant increase in SSIs, including among varied surgery types. IUSS utilization should be minimized.

  • 1 - Modes of Knowing and Ordering Knowledge in Early Christianity

  • Edited by Lewis Ayres, University of Durham and Australian Catholic University, Melbourne, Michael W. Champion, Australian Catholic University, Melbourne, Matthew R. Crawford, Australian Catholic University, Melbourne
  • Book:
    The Intellectual World of Late Antique Christianity
    Published online:
    05 October 2023
    Print publication:
    26 October 2023, pp 1-20

  • Summary

    This introductory chapter provides an overview to the volume, arguing that early Christian modes of knowing and ordering knowledge involved complex processes of appropriation, adaptation, reproduction, and reconfiguration of Jewish and classical epistemologies. This resulted in practices of knowing that established powerful ways of acting in the world and negotiating late-antique social structures. It shaped the behaviour of individuals and established norms for communal life. We argue that studying these phenomena requires consideration of intersections between a range of elite discourses, institutional forms, and the material world of the period. Foregrounding the myriad ways in which early Christian epistemology was embedded in earlier intellectual traditions and forms of life, we make a case that Christian theological commitments, in all their diversity, were an essential component in the development of distinctively Christian ways of knowing and ordering knowledge. Attention to theological assumptions and arguments is one essential element in understanding significant contours of late-antique life and society.

The Intellectual World of Late Antique Christianity
  • Reshaping Classical Traditions
  • Edited by Lewis Ayres, Michael W. Champion, Matthew R. Crawford
  • Published online:
    05 October 2023
    Print publication:
    26 October 2023
  • The Intellectual World of Late-Antique Christianity explores new perspectives on early Christian epistemology in relation to the changing discourses, institutions, and material culture of late antiquity. Early Christian modes of knowing and ordering knowledge involved complex processes of appropriation, reproduction, and reconfiguration of Jewish and classical epistemologies. This helped Christians develop cultures of interpretation and argument as textually oriented religious communities within the Roman Empire and beyond. It laid an intellectual foundation that would be built upon and modified in a variety of later contexts. Encompassing Greek, Latin, and Syriac Christianity, and an historical arc that stretches from the New Testament to Bede, this volume traces how diverse theological commitments resulted in distinctive Christian accounts of knowing. It foregrounds the myriad ways in which early Christian epistemology was embedded in earlier intellectual traditions and forms of life, and how they established norms for communal life and powerful ways of acting in the world.

  • Diagnostic stewardship for Clostridioides difficile testing in an acute care hospital: A quality improvement intervention

  • Madeline L. Berg, Ashley M. Ayres, David R. Weber, Melissa McCullough, Victoria D. Crall, Casey L. Lewis, Abby L. Valek, Lizabeth A. Vincent, Joseph Penzelik, Crystal A. Sasinoski, Amanda L. Cheng, Claire F. Bradford, Elizabeth O. Bell, Kimberly M. Edwards, Isabella A. Castronova, Mya B. Brady, Julie Slaughter, Louise-Marie Oleksiuk, Graham M. Snyder
  • Journal:
    Antimicrobial Stewardship & Healthcare Epidemiology / Volume 3 / Issue 1 / 2023
    Published online by Cambridge University Press:
    05 April 2023, e67
    • Article
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  • Objective:

    To evaluate the impact of a diagnostic stewardship intervention on Clostridioides difficile healthcare-associated infections (HAI).

    Design:

    Quality improvement study.

    Setting:

    Two urban acute care hospitals.

    Interventions:

    All inpatient stool testing for C. difficile required review and approval prior to specimen processing in the laboratory. An infection preventionist reviewed all orders daily through chart review and conversations with nursing; orders meeting clinical criteria for testing were approved, orders not meeting clinical criteria were discussed with the ordering provider. The proportion of completed tests meeting clinical criteria for testing and the primary outcome of C. difficile HAI were compared before and after the intervention.

    Results:

    The frequency of completed C. difficile orders not meeting criteria was lower [146 (7.5%) of 1,958] in the intervention period (January 10, 2022–October 14, 2022) than in the sampled 3-month preintervention period [26 (21.0%) of 124; P < .001]. C. difficile HAI rates were 8.80 per 10,000 patient days prior to the intervention (March 1, 2021–January 9, 2022) and 7.69 per 10,000 patient days during the intervention period (incidence rate ratio, 0.87; 95% confidence interval, 0.73–1.05; P = .13).

    Conclusions:

    A stringent order-approval process reduced clinically nonindicated testing for C. difficile but did not significantly decrease HAIs.

  • Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound endoscope reprocessing: Variables impacting contamination risk

  • Ashley M. Ayres, Julia Wozniak, Jose O’Neil, Kimberly Stewart, John St. Leger, A. William Pasculle, Casey Lewis, Kevin McGrath, Adam Slivka, Graham M Snyder
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 44 / Issue 9 / September 2023
    Published online by Cambridge University Press:
    16 January 2023, pp. 1485-1489
    Print publication:
    September 2023
    • Article
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      • Open access
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  • Objective:

    To evaluate variables that affect risk of contamination for endoscopic retrograde cholangiopancreatography and endoscopic ultrasound endoscopes.

    Design:

    Observational, quality improvement study.

    Setting:

    University medical center with a gastrointestinal endoscopy service performing ∼1,000 endoscopic retrograde cholangiopancreatography and ∼1,000 endoscopic ultrasound endoscope procedures annually.

    Methods:

    Duodenoscope and linear echoendoscope sampling (from the elevator mechanism and instrument channel) was performed from June 2020 through September 2021. Operational changes during this period included standard reprocessing with high-level disinfection with ethylene oxide gas sterilization (HLD–ETO) was switched to double high-level disinfection (dHLD) (June 16, 2020–July 15, 2020), and duodenoscopes changed to disposable tip model (March 2021). The frequency of contamination for the co-primary outcomes were characterized by calculated risk ratios.

    Results:

    The overall pathogenic contamination rate was 4.72% (6 of 127). Compared to duodenoscopes, linear echoendoscopes had a contamination risk ratio of 3.64 (95% confidence interval [CI], 0.69–19.1). Reprocessing using HLD-ETO was associated with a contamination risk ratio of 0.29 (95% CI, 0.06–1.54). Linear echoendoscopes undergoing dHLD had the highest risk of contamination (2 of 18, 11.1%), and duodenoscopes undergoing HLD-ETO and the lowest risk of contamination (0 of 53, 0%). Duodenoscopes with a disposable tip had a 0% contamination rate (0 of 27).

    Conclusions:

    We did not detect a significant reduction in endoscope contamination using HLD-ETO versus dHLD reprocessing. Linear echoendoscopes have a risk of contamination similar to that of duodenoscopes. Disposable tips may reduce the risk of duodenoscope contamination.

  • 1 - Of Scholarship, Piety and Community

  • Edited by James Carleton Paget, University of Cambridge, Simon Gathercole, University of Cambridge
  • Book:
    Celsus in his World
    Published online:
    18 November 2021
    Print publication:
    25 November 2021, pp 36-68

  • Summary

    This essay considers the implied self-portrait of the Christian scholar that Origen offers in his response to Celsus. That self-portrait both shows the Christian scholar to be one whose panoply of skills should be recognized as the equal of the non-Christian scholar, and yet also the Christian scholar claims a place within a community of those – including the martyrs – who can only but seem irrational and quintessentially unscholarly to Celsus.

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