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Many foreign aid donors brand development interventions. How do citizens in the donor country react to seeing this branding in action? We test the proposition that citizens will express higher levels of support for foreign aid when they see a branded foreign aid project relative to seeing the same project without branding. We present results from a survey-based laboratory experiment conducted in the United Kingdom where subjects learned about a typical foreign aid project and received a randomized UK branding treatment. Our results suggest that the branding treatments increase the likelihood that donor country respondents believe that aid recipients can identify the source of the foreign aid. Only among conservative respondents, however, does the evidence imply that branding increases support for foreign aid. “UK aid” branding increases conservative opinion that aid dollars are well spent and increases support among this group for the expansion of foreign aid.
This collection of essays takes a fresh look at the important role of illustration in Romantic literature. The late eighteenth century saw an explosion of illustrated editions of literary classics and the emergence of a new culture of literary art, including the innovative literary galleries. The impact of these developments on the reading and viewing of literary texts is explored in a series of case studies covering poetry, historical texts, drama, painting, reproductive prints, magazines and ephemera. Romanticism and Illustration argues for a more detailed study of illustration which includes the context of a wider circulation of images across different media. The modern understanding of the word 'illustration' fails to convey the complex relationship between the artist, the engraver, the publisher, the text and the audience in Romantic Britain. In teasing out the implications of this dynamic cultural matrix, this book opens up a new field of Romantic studies.
To assess variability in antimicrobial use and associations with infection testing in pediatric ventilator-associated events (VAEs).
Descriptive retrospective cohort with nested case-control study.
Pediatric intensive care units (PICUs), cardiac intensive care units (CICUs), and neonatal intensive care units (NICUs) in 6 US hospitals.
Children≤18 years ventilated for≥1 calendar day.
We identified patients with pediatric ventilator-associated conditions (VACs), pediatric VACs with antimicrobial use for≥4 days (AVACs), and possible ventilator-associated pneumonia (PVAP, defined as pediatric AVAC with a positive respiratory diagnostic test) according to previously proposed criteria.
Among 9,025 ventilated children, we identified 192 VAC cases, 43 in CICUs, 70 in PICUs, and 79 in NICUs. AVAC criteria were met in 79 VAC cases (41%) (58% CICU; 51% PICU; and 23% NICU), and varied by hospital (CICU, 20–67%; PICU, 0–70%; and NICU, 0–43%). Type and duration of AVAC antimicrobials varied by ICU type. AVAC cases in CICUs and PICUs received broad-spectrum antimicrobials more often than those in NICUs. Among AVAC cases, 39% had respiratory infection diagnostic testing performed; PVAP was identified in 15 VAC cases. Also, among AVAC cases, 73% had no associated positive respiratory or nonrespiratory diagnostic test.
Antimicrobial use is common in pediatric VAC, with variability in spectrum and duration of antimicrobials within hospitals and across ICU types, while PVAP is uncommon. Prolonged antimicrobial use despite low rates of PVAP or positive laboratory testing for infection suggests that AVAC may provide a lever for antimicrobial stewardship programs to improve utilization.
Veno-arterial extracorporeal membrane oxygenation is frequently used in patients with cardiac disease. We evaluated short-term outcomes and identified factors associated with hospital mortality in cardiac patients supported with veno-arterial extracorporeal membrane oxygenation.
A retrospective review of patients supported with veno-arterial extracorporeal membrane oxygenation at a university-affiliated children’s hospital was performed.
A total of 253 patients with cardiac disease managed with extracorporeal membrane oxygenation were identified; survival to discharge was 48%, which significantly improved from 39% in an earlier era (1995–2001) (p=0.01). Patients were categorised into surgical versus non-surgical groups on the basis of whether they had undergone cardiac surgery before or not, respectively. The most common indication for extracorporeal membrane oxygenation was extracorporeal cardiopulmonary resuscitation: 96 (51%) in the surgical group and 45 (68%) in the non-surgical group. In a multiple covariate analysis, single-ventricle physiology (p=0.01), duration of extracorporeal membrane oxygenation (p<0.01), and length of hospital stay (p=0.03) were associated with hospital mortality. Weekend or night shift cannulation was associated with mortality in non-surgical patients (p=0.05).
We report improvement in survival compared with an earlier era in cardiac patients supported with extracorporeal membrane oxygenation. Single-ventricle physiology continues to negatively impact survival, along with evidence of organ dysfunction during extracorporeal membrane oxygenation, duration of extracorporeal membrane oxygenation, and length of stay.
To test the hypothesis that long-term care facility (LTCF) residents with Clostridium difficile infection (CDI) or asymptomatic carriage of toxigenic strains are an important source of transmission in the LTCF and in the hospital during acute-care admissions.
A 6-month cohort study with identification of transmission events was conducted based on tracking of patient movement combined with restriction endonuclease analysis (REA) and whole-genome sequencing (WGS).
Veterans Affairs hospital and affiliated LTCF.
The study included 29 LTCF residents identified as asymptomatic carriers of toxigenic C. difficile based on every other week perirectal screening and 37 healthcare facility-associated CDI cases (ie, diagnosis >3 days after admission or within 4 weeks of discharge to the community), including 26 hospital-associated and 11 LTCF-associated cases.
Of the 37 CDI cases, 7 (18·9%) were linked to LTCF residents with LTCF-associated CDI or asymptomatic carriage, including 3 of 26 hospital-associated CDI cases (11·5%) and 4 of 11 LTCF-associated cases (36·4%). Of the 7 transmissions linked to LTCF residents, 5 (71·4%) were linked to asymptomatic carriers versus 2 (28·6%) to CDI cases, and all involved transmission of epidemic BI/NAP1/027 strains. No incident hospital-associated CDI cases were linked to other hospital-associated CDI cases.
Our findings suggest that LTCF residents with asymptomatic carriage of C. difficile or CDI contribute to transmission both in the LTCF and in the affiliated hospital during acute-care admissions. Greater emphasis on infection control measures and antimicrobial stewardship in LTCFs is needed, and these efforts should focus on LTCF residents during hospital admissions.
This paper addresses activities carried out in a late-sixteenth or seventeenth century Maya council house (popol nah) just before its abandonment. Structure 719 at the site of Zacpeten in the central Peten lakes district is considered a noble residence remodeled into a council house with an adjacent temple. Excavations revealed quantities of de facto refuse inside the structure's two rooms and around the exterior; recent studies focused on ceramics, lithics, faunal remains, and net sinkers. The back room held abundant lithics and diverse fauna, with evidence of grinding red pigment and snapping obsidian prismatic blades into segments for fashioning arrow points. Pottery and faunal remains indicate feasting, as well as possible use of animal parts in ritual and in making ceremonial objects. The Group 719 complex served as a center of production of various goods and community ritual until its abrupt abandonment, likely in the first decade or so of the eighteenth century.
Exotic annual grasses such as medusahead [Taeniatherum caput-medusae (L.) Nevski] and downy brome (Bromus tectorum L.) dominate millions of hectares of grasslands in the western United States. Applying picloram, aminopyralid, and other growth regulator herbicides at late growth stages reduces seed production of most exotic annual grasses. In this study, we applied aminopyralid to T. caput-medusae to determine how reducing seed production in the current growing season influenced cover in the subsequent growing season. At eight annual grassland sites, we applied aminopyralid at 55, 123, and 245 g ae ha−1 in spring just before T. caput-medusae heading. The two higher rates were also applied pre-emergence (PRE) in fall to allow comparisons with this previously tested timing. When applied in spring during the roughly 10-d period between the flag leaf and inflorescence first becoming visible, just 55 g ae ha−1 of aminopyralid greatly limited seed production and subsequently reduced T. caput-medusae cover to nearly zero. Fall aminopyralid applications were less effective against T. caput-medusae, even at a rate of 245 g ae ha−1. The growing season of application, fall treatments, but not spring treatments, sometimes reduced cover of desirable winter annual forage grasses. The growing season after application, both spring and fall treatments tended to increase forage grasses, though spring treatments generally caused larger increases. Compared with other herbicide treatment options, preheading aminopyralid treatments are a relatively inexpensive, effective approach for controlling T. caput-medusae and increasing forage production.
The purpose of this paper is to describe the formation, operation, and evaluation of a Community Engagement Advisory Board (CEAB) that serves as a resource of the University of Illinois at Chicago’s (UIC) Center for Clinical and Translational Sciences (CCTS).
Current CEAB roles and functions, operating procedures for research consultations and program evaluation strategies were described. Investigators receiving a consultation from 2009 to 2017 (n=91, response rate 78%) were surveyed via an online survey immediately after the consultation and at 12-month follow-up.
Overall, CEAB members were viewed as having sufficient information (92%) and expertise (79%) to provide consultation. Satisfaction levels with the specific consultation received and the overall consultation service were high. The majority of investigators indicated that they would come back to the CEAB for a future consultation, if needed, and would recommend a consultation to others (93% and 96%, respectively). At 12-months, 87% of respondents indicated they had implemented at least some of the recommendations received and 93% said that the consultation influenced their subsequent research.
Data from recent annual evaluations highlight the benefits of CEAB for consulting investigators. Our model can be used to inform the development of future CEAB boards.