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Automated outbreak detection of hospital-associated pathogens: Value to infection prevention programs
- Meghan A. Baker, Deborah S. Yokoe, John Stelling, Ken Kleinman, Rebecca E. Kaganov, Alyssa R. Letourneau, Neha Varma, Thomas O’Brien, Martin Kulldorff, Damilola Babalola, Craig Barrett, Marci Drees, Micaela H. Coady, Amanda Isaacs, Richard Platt, Susan S. Huang, for the CDC Prevention Epicenters Program
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 41 / Issue 9 / September 2020
- Published online by Cambridge University Press:
- 10 June 2020, pp. 1016-1021
- Print publication:
- September 2020
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Objective:
To assess the utility of an automated, statistically-based outbreak detection system to identify clusters of hospital-acquired microorganisms.
Design:Multicenter retrospective cohort study.
Setting:The study included 43 hospitals using a common infection prevention surveillance system.
Methods:A space–time permutation scan statistic was applied to hospital microbiology, admission, discharge, and transfer data to identify clustering of microorganisms within hospital locations and services. Infection preventionists were asked to rate the importance of each cluster. A convenience sample of 10 hospitals also provided information about clusters previously identified through their usual surveillance methods.
Results:We identified 230 clusters in 43 hospitals involving Gram-positive and -negative bacteria and fungi. Half of the clusters progressed after initial detection, suggesting that early detection could trigger interventions to curtail further spread. Infection preventionists reported that they would have wanted to be alerted about 81% of these clusters. Factors associated with clusters judged to be moderately or highly concerning included high statistical significance, large size, and clusters involving Clostridioides difficile or multidrug-resistant organisms. Based on comparison data provided by the convenience sample of hospitals, only 9 (18%) of 51 clusters detected by usual surveillance met statistical significance, and of the 70 clusters not previously detected, 58 (83%) involved organisms not routinely targeted by the hospitals’ surveillance programs. All infection prevention programs felt that an automated outbreak detection tool would improve their ability to detect outbreaks and streamline their work.
Conclusions:Automated, statistically-based outbreak detection can increase the consistency, scope, and comprehensiveness of detecting hospital-associated transmission.
Remote characterization of photosynthetic communities in the Fryxell basin of Taylor Valley, Antarctica
- Mark R. Salvatore, Schuyler R. Borges, John E. Barrett, Eric R. Sokol, Lee F. Stanish, Sarah N. Power, Paul Morin
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- Journal:
- Antarctic Science / Volume 32 / Issue 4 / August 2020
- Published online by Cambridge University Press:
- 16 March 2020, pp. 255-270
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We investigate the spatial distribution, spectral properties and temporal variability of primary producers (e.g. communities of microbial mats and mosses) throughout the Fryxell basin of Taylor Valley, Antarctica, using high-resolution multispectral remote-sensing data. Our results suggest that photosynthetic communities can be readily detected throughout the Fryxell basin based on their unique near-infrared spectral signatures. Observed intra- and inter-annual variability in spectral signatures are consistent with short-term variations in mat distribution, hydration and photosynthetic activity. Spectral unmixing is also implemented in order to estimate mat abundance, with the most densely vegetated regions observed from orbit correlating spatially with some of the most productive regions of the Fryxell basin. Our work establishes remote sensing as a valuable tool in the study of these ecological communities in the McMurdo Dry Valleys and demonstrates how future scientific investigations and the management of specially protected areas could benefit from these tools and techniques.
Cognitive impairment from early to middle adulthood in patients with affective and nonaffective psychotic disorders
- Josephine Mollon, Samuel R. Mathias, Emma E. M. Knowles, Amanda Rodrigue, Marinka M. G. Koenis, Godfrey D. Pearlson, Abraham Reichenberg, Jennifer Barrett, Dominique Denbow, Katrina Aberizk, Molly Zatony, Russell A. Poldrack, John Blangero, David C. Glahn
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- Journal:
- Psychological Medicine / Volume 50 / Issue 1 / January 2020
- Published online by Cambridge University Press:
- 04 January 2019, pp. 48-57
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Background
Cognitive impairment is a core feature of psychotic disorders, but the profile of impairment across adulthood, particularly in African-American populations, remains unclear.
MethodsUsing cross-sectional data from a case–control study of African-American adults with affective (n = 59) and nonaffective (n = 68) psychotic disorders, we examined cognitive functioning between early and middle adulthood (ages 20–60) on measures of general cognitive ability, language, abstract reasoning, processing speed, executive function, verbal memory, and working memory.
ResultsBoth affective and nonaffective psychosis patients showed substantial and widespread cognitive impairments. However, comparison of cognitive functioning between controls and psychosis groups throughout early (ages 20–40) and middle (ages 40–60) adulthood also revealed age-associated group differences. During early adulthood, the nonaffective psychosis group showed increasing impairments with age on measures of general cognitive ability and executive function, while the affective psychosis group showed increasing impairment on a measure of language ability. Impairments on other cognitive measures remained mostly stable, although decreasing impairments on measures of processing speed, memory and working memory were also observed.
ConclusionsThese findings suggest similarities, but also differences in the profile of cognitive dysfunction in adults with affective and nonaffective psychotic disorders. Both affective and nonaffective patients showed substantial and relatively stable impairments across adulthood. The nonaffective group also showed increasing impairments with age in general and executive functions, and the affective group showed an increasing impairment in verbal functions, possibly suggesting different underlying etiopathogenic mechanisms.
A proposal to standardize soil/solution herbicide distribution coefficients
- Jerome B. Weber, Gail G. Wilkerson, H. Michael Linker, John W. Wilcut, Ross B. Leidy, Scott Senseman, William W. Witt, Michael Barrett, William K. Vencill, David R. Shaw, Thomas C. Mueller, Donnie K. Miller, Barry J. Brecke, Ronald E. Talbert, Thomas F. Peeper
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- Journal:
- Weed Science / Volume 48 / Issue 1 / February 2000
- Published online by Cambridge University Press:
- 20 January 2017, pp. 75-88
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Herbicide soil/solution distribution coefficients (Kd) are used in mathematical models to predict the movement of herbicides in soil and groundwater. Herbicides bind to various soil constituents to differing degrees. The universal soil colloid that binds most herbicides is organic matter (OM), however clay minerals (CM) and metallic hydrous oxides are more retentive for cationic, phosphoric, and arsenic acid compounds. Weakly basic herbicides bind to both organic and inorganic soil colloids. The soil organic carbon (OC) affinity coefficient (Koc) has become a common parameter for comparing herbicide binding in soil; however, because OM and OC determinations vary greatly between methods and laboratories, Koc values may vary greatly. This proposal discusses this issue and offers suggestions for obtaining the most accurate Kd, Freundlich constant (Kf), and Koc values for herbicides listed in the WSSA Herbicide Handbook and Supplement.
Recovery of Antarctic stream epilithon from simulated scouring events
- Tyler J. Kohler, Ethan Chatfield, Michael N. Gooseff, John E. Barrett, Diane M. McKnight
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- Journal:
- Antarctic Science / Volume 27 / Issue 4 / August 2015
- Published online by Cambridge University Press:
- 17 March 2015, pp. 341-354
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Microbial mats are common in polar streams and often dominate benthic biomass. Climate change may be enhancing the variability of stream flows in the Antarctic, but so far studies investigating mat responses to disturbance have been limited in this region. Mat regrowth was evaluated following disturbance by experimentally scouring rocks from an ephemeral McMurdo Dry Valley stream over two summers (2001–02 and 2012–13). Mats were sampled at the beginning and resampled at the end of the flow season. In 2012–13, mats were additionally resampled mid-season along with previously undisturbed controls. In 2001–02 rocks regained 47% of chlorophyll a and 40% of ash-free dry mass by the end of the summer, while in 2012–13 rocks regrew 18% and 27%, respectively. Mat stoichiometry differed between summers, and reflected differences in biomass and discharge. Oscillatoria spp. were greatest on scoured rocks and Phormidium spp. on undisturbed rocks. Small diatoms Humidophila and Fistulifera spp. increased throughout the summer in all mats, with the latter more abundant in scoured communities. Collectively, these data suggest that mats are variable intra-annually, responsive to hydrology and require multiple summers to regrow initial biomass once lost. These results will aid the interpretation of long-term data, as well as inform Antarctic Specially Managed Area protocols.
Notes on Contributors
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- By Charles Altieri, Faith Barrett, Alfred Bendixen, David Bergman, Edward Brunner, Stephen Burt, Susan Castillo Street, Michael C. Cohen, Robert Daly, Betty Booth Donohue, Jim Egan, Richard Flynn, Ed Folsom, Stephen Fredman, Frank Gado, Roger Gilbert, Rigoberto González, Nick Halpern, Jeffrey A. Hammond, Kevin J. Hayes, Matthew Hofer, Tyler Hoffman, Christoph Irmscher, Virginia Jackson, Joseph Jonghyun Jeon, John D. Kerkering, George S. Lensing, Mary Loeffelholz, Wendy Martin, Cristanne Miller, David Chioni Moore, Walton Muyumba, John Timberman Newcomb, Bob Perelman, Siobhan Phillips, Brian M. Reed, Elizabeth Renker, Eliza Richards, Reena Sastri, Robin G. Schulze, Mark Scroggins, David E. E. Sloane, Angela Sorby, Juliana Spahr, Willard Spiegelman, Lisa M. Steinman, Ernest Suarez, Joseph T. Thomas, Lesley Wheeler, David Wojahn
- Edited by Alfred Bendixen, Princeton University, New Jersey, Stephen Burt, Harvard University, Massachusetts
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- Book:
- The Cambridge History of American Poetry
- Published online:
- 05 December 2014
- Print publication:
- 27 October 2014, pp xi-xviii
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- By Federica Agosta, Alberto Albanese, Timothy J. Amrhein, A. M. Barrett, Walter S. Bartynski, Felix Benninger, Thomas Brandt, Andrew G. Burke, Michelle Cameron, Elisa Canu, Louis R. Caplan, Christine M. Carr, Daniel J. A. Connolly, Firouz Daneshgari, John DeLuca, Marianne de Visser, Marianne Dieterich, Antonio E. Elia, Joseph H. Feinberg, Massimo Filippi, Lauren C. Frey, Gaëtan Garraux, Andrea Ginestroni, Peter J. Goadsby, Bronwyn E. Hamilton, Simon J. Hickman, Holly E. Hinson, Jon P. Jennings, Jan Kassubek, Horacio Kaufmann, David M. Kaylie, Joanna Kitley, Vladimir S. Kostic, C. T. Paul Krediet, Megan C. Leary, Farooq H. Maniyar, Ken R. Maravilla, Mario Mascalchi, Rajarshi Mazumder, Priyesh Mehta, Jacqueline A. Palace, Raj M. Paspulati, Christopher A. Potter, Angelo Quattrini, Louis P. Riccelli, Nilo Riva, Maria A. Rocca, Mirabelle B. Sajisevi, Richard Salazar-Montero, Nicholas D. Schiff, Jack H. Simon, Israel Steiner, Carl D. Stevens, Bart P. van de Warrenburg, Judith van Gaalen, William J. Weiner, Jane L. Weissman, Jay Yao, G. Bryan Young
- Edited by Massimo Filippi, Jack H. Simon
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- Book:
- Imaging Acute Neurologic Disease
- Published online:
- 05 October 2014
- Print publication:
- 11 September 2014, pp vi-viii
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- By Frank Andrasik, Melissa R. Andrews, Ana Inés Ansaldo, Evangelos G. Antzoulatos, Lianhua Bai, Ellen Barrett, Linamara Battistella, Nicolas Bayle, Michael S. Beattie, Peter J. Beek, Serafin Beer, Heinrich Binder, Claire Bindschaedler, Sarah Blanton, Tasia Bobish, Michael L. Boninger, Joseph F. Bonner, Chadwick B. Boulay, Vanessa S. Boyce, Anna-Katharine Brem, Jacqueline C. Bresnahan, Floor E. Buma, Mary Bartlett Bunge, John H. Byrne, Jeffrey R. Capadona, Stefano F. Cappa, Diana D. Cardenas, Leeanne M. Carey, S. Thomas Carmichael, Glauco A. P. Caurin, Pablo Celnik, Kimberly M. Christian, Stephanie Clarke, Leonardo G. Cohen, Adriana B. Conforto, Rory A. Cooper, Rosemarie Cooper, Steven C. Cramer, Armin Curt, Mark D’Esposito, Matthew B. Dalva, Gavriel David, Brandon Delia, Wenbin Deng, Volker Dietz, Bruce H. Dobkin, Marco Domeniconi, Edith Durand, Tracey Vause Earland, Georg Ebersbach, Jonathan J. Evans, James W. Fawcett, Uri Feintuch, Toby A. Ferguson, Marie T. Filbin, Diasinou Fioravante, Itzhak Fischer, Agnes Floel, Herta Flor, Karim Fouad, Richard S. J. Frackowiak, Peter H. Gorman, Thomas W. Gould, Jean-Michel Gracies, Amparo Gutierrez, Kurt Haas, C.D. Hall, Hans-Peter Hartung, Zhigang He, Jordan Hecker, Susan J. Herdman, Seth Herman, Leigh R. Hochberg, Ahmet Höke, Fay B. Horak, Jared C. Horvath, Richard L. Huganir, Friedhelm C. Hummel, Beata Jarosiewicz, Frances E. Jensen, Michael Jöbges, Larry M. Jordan, Jon H. Kaas, Andres M. Kanner, Noomi Katz, Matthew S. Kayser, Annmarie Kelleher, Gerd Kempermann, Timothy E. Kennedy, Jürg Kesselring, Fary Khan, Rachel Kizony, Jeffery D. Kocsis, Boudewijn J. Kollen, Hubertus Köller, John W. Krakauer, Hermano I. Krebs, Gert Kwakkel, Bradley Lang, Catherine E. Lang, Helmar C. Lehmann, Angelo C. Lepore, Glenn S. Le Prell, Mindy F. Levin, Joel M. Levine, David A. Low, Marilyn MacKay-Lyons, Jeffrey D. Macklis, Margaret Mak, Francine Malouin, William C. Mann, Paul D. Marasco, Christopher J. Mathias, Laura McClure, Jan Mehrholz, Lorne M. Mendell, Robert H. Miller, Carol Milligan, Beth Mineo, Simon W. Moore, Jennifer Morgan, Charbel E-H. Moussa, Martin Munz, Randolph J. Nudo, Joseph J. Pancrazio, Theresa Pape, Alvaro Pascual-Leone, Kristin M. Pearson-Fuhrhop, P. Hunter Peckham, Tamara L. Pelleshi, Catherine Verrier Piersol, Thomas Platz, Marcus Pohl, Dejan B. Popović, Andrew M. Poulos, Maulik Purohit, Hui-Xin Qi, Debbie Rand, Mahendra S. Rao, Josef P. Rauschecker, Aimee Reiss, Carol L. Richards, Keith M. Robinson, Melvyn Roerdink, John C. Rosenbek, Serge Rossignol, Edward S. Ruthazer, Arash Sahraie, Krishnankutty Sathian, Marc H. Schieber, Brian J. Schmidt, Michael E. Selzer, Mijail D. Serruya, Himanshu Sharma, Michael Shifman, Jerry Silver, Thomas Sinkjær, George M. Smith, Young-Jin Son, Tim Spencer, John D. Steeves, Oswald Steward, Sheela Stuart, Austin J. Sumner, Chin Lik Tan, Robert W. Teasell, Gareth Thomas, Aiko K. Thompson, Richard F. Thompson, Wesley J. Thompson, Erika Timar, Ceri T. Trevethan, Christopher Trimby, Gary R. Turner, Mark H. Tuszynski, Erna A. van Niekerk, Ricardo Viana, Difei Wang, Anthony B. Ward, Nick S. Ward, Stephen G. Waxman, Patrice L. Weiss, Jörg Wissel, Steven L. Wolf, Jonathan R. Wolpaw, Sharon Wood-Dauphinee, Ross D. Zafonte, Binhai Zheng, Richard D. Zorowitz
- Edited by Michael Selzer, Stephanie Clarke, Leonardo Cohen, Gert Kwakkel, Robert Miller, Case Western Reserve University, Ohio
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- Book:
- Textbook of Neural Repair and Rehabilitation
- Published online:
- 05 May 2014
- Print publication:
- 24 April 2014, pp ix-xvi
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- By Frank Andrasik, Melissa R. Andrews, Ana Inés Ansaldo, Evangelos G. Antzoulatos, Lianhua Bai, Ellen Barrett, Linamara Battistella, Nicolas Bayle, Michael S. Beattie, Peter J. Beek, Serafin Beer, Heinrich Binder, Claire Bindschaedler, Sarah Blanton, Tasia Bobish, Michael L. Boninger, Joseph F. Bonner, Chadwick B. Boulay, Vanessa S. Boyce, Anna-Katharine Brem, Jacqueline C. Bresnahan, Floor E. Buma, Mary Bartlett Bunge, John H. Byrne, Jeffrey R. Capadona, Stefano F. Cappa, Diana D. Cardenas, Leeanne M. Carey, S. Thomas Carmichael, Glauco A. P. Caurin, Pablo Celnik, Kimberly M. Christian, Stephanie Clarke, Leonardo G. Cohen, Adriana B. Conforto, Rory A. Cooper, Rosemarie Cooper, Steven C. Cramer, Armin Curt, Mark D’Esposito, Matthew B. Dalva, Gavriel David, Brandon Delia, Wenbin Deng, Volker Dietz, Bruce H. Dobkin, Marco Domeniconi, Edith Durand, Tracey Vause Earland, Georg Ebersbach, Jonathan J. Evans, James W. Fawcett, Uri Feintuch, Toby A. Ferguson, Marie T. Filbin, Diasinou Fioravante, Itzhak Fischer, Agnes Floel, Herta Flor, Karim Fouad, Richard S. J. Frackowiak, Peter H. Gorman, Thomas W. Gould, Jean-Michel Gracies, Amparo Gutierrez, Kurt Haas, C.D. Hall, Hans-Peter Hartung, Zhigang He, Jordan Hecker, Susan J. Herdman, Seth Herman, Leigh R. Hochberg, Ahmet Höke, Fay B. Horak, Jared C. Horvath, Richard L. Huganir, Friedhelm C. Hummel, Beata Jarosiewicz, Frances E. Jensen, Michael Jöbges, Larry M. Jordan, Jon H. Kaas, Andres M. Kanner, Noomi Katz, Matthew S. Kayser, Annmarie Kelleher, Gerd Kempermann, Timothy E. Kennedy, Jürg Kesselring, Fary Khan, Rachel Kizony, Jeffery D. Kocsis, Boudewijn J. Kollen, Hubertus Köller, John W. Krakauer, Hermano I. Krebs, Gert Kwakkel, Bradley Lang, Catherine E. Lang, Helmar C. Lehmann, Angelo C. Lepore, Glenn S. Le Prell, Mindy F. Levin, Joel M. Levine, David A. Low, Marilyn MacKay-Lyons, Jeffrey D. Macklis, Margaret Mak, Francine Malouin, William C. Mann, Paul D. Marasco, Christopher J. Mathias, Laura McClure, Jan Mehrholz, Lorne M. Mendell, Robert H. Miller, Carol Milligan, Beth Mineo, Simon W. Moore, Jennifer Morgan, Charbel E-H. Moussa, Martin Munz, Randolph J. Nudo, Joseph J. Pancrazio, Theresa Pape, Alvaro Pascual-Leone, Kristin M. Pearson-Fuhrhop, P. Hunter Peckham, Tamara L. Pelleshi, Catherine Verrier Piersol, Thomas Platz, Marcus Pohl, Dejan B. Popović, Andrew M. Poulos, Maulik Purohit, Hui-Xin Qi, Debbie Rand, Mahendra S. Rao, Josef P. Rauschecker, Aimee Reiss, Carol L. Richards, Keith M. Robinson, Melvyn Roerdink, John C. Rosenbek, Serge Rossignol, Edward S. Ruthazer, Arash Sahraie, Krishnankutty Sathian, Marc H. Schieber, Brian J. Schmidt, Michael E. Selzer, Mijail D. Serruya, Himanshu Sharma, Michael Shifman, Jerry Silver, Thomas Sinkjær, George M. Smith, Young-Jin Son, Tim Spencer, John D. Steeves, Oswald Steward, Sheela Stuart, Austin J. Sumner, Chin Lik Tan, Robert W. Teasell, Gareth Thomas, Aiko K. Thompson, Richard F. Thompson, Wesley J. Thompson, Erika Timar, Ceri T. Trevethan, Christopher Trimby, Gary R. Turner, Mark H. Tuszynski, Erna A. van Niekerk, Ricardo Viana, Difei Wang, Anthony B. Ward, Nick S. Ward, Stephen G. Waxman, Patrice L. Weiss, Jörg Wissel, Steven L. Wolf, Jonathan R. Wolpaw, Sharon Wood-Dauphinee, Ross D. Zafonte, Binhai Zheng, Richard D. Zorowitz
- Edited by Michael E. Selzer, Stephanie Clarke, Leonardo G. Cohen, Gert Kwakkel, Robert H. Miller, Case Western Reserve University, Ohio
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- Book:
- Textbook of Neural Repair and Rehabilitation
- Published online:
- 05 June 2014
- Print publication:
- 24 April 2014, pp ix-xvi
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- By John A. Bargh, Lisa Feldman Barrett, Veronica Benet-Martínez, Elliot T. Berkman, Jim Blascovich, Marilynn B. Brewer, Heining Cham, Tanya L. Chartrand, Robert B. Cialdini, William D. Crano, William A. Cunningham, Rick Dale, Jan De Houwer, Alice H. Eagly, J. Mark Eddy, Craig K. Enders, Leandre R. Fabrigar, Susan T. Fiske, Shelly L. Gable, Bertram Gawronski, Kevin J. Grimm, K. Paige Harden, Richard E. Heyman, Oliver P. John, Blair T. Johnson, Charles M. Judd, Deborah A. Kashy, David A. Kenny, Norbert L. Kerr, Nuri Kim, Jon A. Krosnick, Paul J. Lavrakas, Matthew D. Lieberman, Kristen A. Lindquist, Todd D. Little, Yu Liu, Michael F. Lorber, Michael R. Maniaci, Kerry L. Marsh, Gina L. Mazza, Gary H. McClelland, Dominique Muller, Elizabeth Levy Paluck, Karen S. Quigley, Harry T. Reis, Mijke Rhemtulla, Michael J. Richardson, Ronald D. Rogge, Alexander M. Schoemann, Eliot R. Smith, R. Scott Tindale, Eric Turkheimer, Penny S. Visser, Duane T. Wegener, Stephen G. West, Tessa V. West, Keith F. Widaman, Vincent Y. Yzerbyt
- Edited by Harry T. Reis, University of Rochester, New York, Charles M. Judd, University of Colorado Boulder
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- Book:
- Handbook of Research Methods in Social and Personality Psychology
- Published online:
- 05 June 2014
- Print publication:
- 24 February 2014, pp vii-viii
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Effect of exercise on postprandial endothelial function in adolescent boys
- Matthew J. Sedgwick, John G. Morris, Mary E. Nevill, Keith Tolfrey, Alan Nevill, Laura A. Barrett
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- Journal:
- British Journal of Nutrition / Volume 110 / Issue 2 / 28 July 2013
- Published online by Cambridge University Press:
- 10 December 2012, pp. 301-309
- Print publication:
- 28 July 2013
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The ingestion of high-fat meals induces a state of endothelial dysfunction in adults. This dysfunction is attenuated by prior exercise. The response of young people to these nutritional and physiological stressors has not been established. Thus, the purpose of the present study was to investigate if a bout of moderate-intensity exercise influenced endothelial function (as indicated by flow-mediated dilation (FMD)) following the ingestion of a high-fat breakfast and lunch in adolescent boys (aged 12·6–14·3 years). Two, 2 d main trials (control and exercise) were completed by thirteen adolescent boys in a counter-balanced, cross-over design. Participants were inactive on day 1 of the control trial, but completed 60 min of walking at 60 % peak oxygen uptake in the exercise trial. On day 2, endothelial function was assessed via FMD prior to, and following, ingestion of a high-fat breakfast and lunch. There was no difference in fasting FMD between the control and exercise trial (P= 0·449). In the control trial, FMD was reduced by 32 % following consumption of the high-fat breakfast and by 24 % following lunch. In the exercise trial, the corresponding reductions were 6 and 10 %, respectively (main effect trial, P= 0·002). These results demonstrate that moderate-intensity exercise can attenuate the decline in FMD seen following the consumption of high-fat meals in adolescent boys.
Contributors
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- By Amy F.T. Arnsten, Darrick T. Balu, Anthony W. Bannon, James E. Barrett, Craig W. Berridge, David L. Braff, Jiang-Fan Chen, Guang Chen, Joseph T. Coyle, David M. Devilbiss, Wayne C. Drevets, Craig A. Erickson, Michael Gandal, Maciej Gasior, Charles F. Gillespie, Donald C. Goff, Swati Gupta, Ioline D. Henter, Tong Li, Farah D. Lubin, Christopher J. McDougle, Husseini K. Manji, Nicholas J. Maragakis, Charles P. O'Brien, Ryley Parrish, David J. Posey, Donald L. Price, Jorge A. Quiroz, Kerry J. Ressler, Timothy P.L. Roberts, Richard A. Rudick, Alfred W. Sandrock, Alena V. Savonenko, Brooke E. Schmeichel, Steven J. Siegel, Robert C. Spencer, Kimberly A. Stigler, Paulo Vianney-Rodrigues, John P. Welsh, Tamara Weiss, Frank Wiegand, Michael Williams, Philip C. Wong
- Edited by James E. Barrett, Joseph T. Coyle, Michael Williams
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- Book:
- Translational Neuroscience
- Published online:
- 05 July 2012
- Print publication:
- 28 June 2012, pp vi-viii
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- By Derek Barrett, Mark C. Bellamy, Andrew R. Bodenham, Pieter A.J. Borg, Ian Calder, Tim Cook, Joy E. Curran, Philippa Evans, Andrew D. Farmery, Chris Frerk, Priya Gauthama, Ankie E.W. Hamaekers, John Henderson, Eric Hodgson, Jeremy A. Langton, Andrew D.M. McLeod, Abhiram Mallick, Viki Mitchell, James Nicholson, Anil Patel, Adrian Pearce, Will Peat, John Picard, Mansukh Popat, Brian Prater, Mridula Rai, Om Sanehi, Jane Stanford, Richard Vanner, Peter J.H. Venn, Steven M. Yentis
- Edited by Ian Calder, Adrian Pearce
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- Book:
- Core Topics in Airway Management
- Published online:
- 10 January 2011
- Print publication:
- 16 December 2010, pp vii-viii
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Resolving environmental drivers of microbial community structure in Antarctic soils
- Julie L. Smith, John E. Barrett, Gábor Tusnády, Lídia Rejtö, S. Craig Cary
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- Journal:
- Antarctic Science / Volume 22 / Issue 6 / December 2010
- Published online by Cambridge University Press:
- 02 December 2010, pp. 673-680
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Antarctic soils are extremely cold, dry, and oligotrophic, yet harbour surprisingly high bacterial diversity. The severity of environmental conditions has constrained the development of multi-trophic communities, and species richness and distribution is thought to be driven primarily by abiotic factors. Sites in northern and southern Victoria Land were sampled for bacterial community structure and soil physicochemical properties in conjunction with the US and New Zealand Latitudinal Gradient Project. Bacterial community structure was determined using a high-resolution molecular fingerprinting method for 80 soil samples from Taylor Valley and Cape Hallett sites which are separated by five degrees of latitude and have distinct soil chemistry. Taylor Valley is part of the McMurdo Dry Valleys, while Cape Hallett is the site of a penguin rookery and contains ornithogenic soils. The influence of soil moisture, pH, conductivity, ammonia, nitrate, total nitrogen and organic carbon on community structure was revealed using Spearman rank correlation, Mantel test, and principal components analysis. High spatial variability was detected in bacterial communities and community structure was correlated with soil moisture and pH. Both unique and shared bacterial community members were detected at Taylor Valley and Cape Hallett despite the considerable distance between the sites.
Hydrologic response to extreme warm and cold summers in the McMurdo Dry Valleys, East Antarctica
- Peter T. Doran, Christopher P. McKay, Andrew G. Fountain, Thomas Nylen, Diane M. McKnight, Chris Jaros, John E. Barrett
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- Journal:
- Antarctic Science / Volume 20 / Issue 5 / October 2008
- Published online by Cambridge University Press:
- 16 May 2008, pp. 499-509
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The meteorological characteristics and hydrological response of an extreme warm, and cold summer in the McMurdo Dry Valleys are compared. The driver behind the warmer summer conditions was the occurrence of down-valley winds, which were not present during the colder summer. Occurrence of the summer down-valley winds coincided with lower than typical mean sea level pressure in the Ross Sea region. There was no significant difference in the amount of solar radiation received during the two summers. Compared to the cold summer, glaciological and hydrological response to the warm summer in Taylor Valley included significant glacier mass loss, and 3- to nearly 6000-fold increase in annual streamflow. Lake levels decreased slightly during the cold summer, and increased between 0.54 and 1.01 m during the warm summer, effectively erasing the prior 14 years of lake level lowering in a period of three months. Lake level rise during the warm summer was shown to be strongly associated with and increase in degree days above freezing at higher elevations. We suggest that strong summer down-valley winds may have been responsible for the generation of large glacial lakes during the Last Glacial Maximum when ice core records recorded annual temperatures significantly colder than present.
Quality Standard for the Treatment of Bacteremia
- Peter A. Gross, Trisha L. Barrett, E. Patchen Dellinger, Peter J. Krause, William J. Martone, John E. McGowan, Jr, Richard L. Sweet, Richard P. Wenzel
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 15 / Issue 3 / March 1994
- Published online by Cambridge University Press:
- 02 January 2015, pp. 189-192
- Print publication:
- March 1994
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Objective:
The objective of this quality standard is to optimize the treatment of bacteremia in hospitalized patients by ensuring that the antibiotic given is appropriate in terms of the blood culture susceptibility of the pathogen. Although this standard may appear to be minimal in scope, it is needed because appropriate antimicrobial treatment is not given in 5% to 17% of cases. To implement the standard, physicians, pharmacists, and microbiologists will need to devise a coordinated strategy.
Options:We considered criteria for appropriate dosing, most cost-effective selection, proper antibiotic levels in serum, least toxicity, narrowest spectrum, specific clinical indications, and optimal duration of treatment. All these criteria were rejected as the basis for the standard because they were too controversial and too difficult to be applied by a nonphysician chart reviewer. In contrast, the selection of an antibiotic to which the pathogen is sensitive is a non-controversial criterion and easy for a chart reviewer to apply.
Outcomes:The standard is designed to reduce the incidence of adverse outcomes of septicemia such as renal failure, prolonged hos-pitalization, and death.
Evidence:Several well-designed clinical trials without randomization as well as case-controlled studies have confirmed the benefit of using an antibiotic that is appropriate in light of the susceptibility of the isolate in blood culture. Prospective, randomized, placebo-controlled trials are not available.
Values:Our premise is that the presence of bacteremia is a risk factor for serious adverse outcomes. We also believe that the administration of antibiotics must always be guided by the susceptibility report for the pathogen(s) obtained from blood cultures. This concern is more critical for pathogens from the blood than for those from most other body sites. We had evidence that susceptibility reports for pathogens from positive blood cultures were not always used properly. We used group discussion to reach a consensus among the members of the Quality Standards Subcommittee.
Benefits, Harms, and Costs:Through the implementation of this standard, at least 5% of bacteremias could be treated more appropriately. An unknown number of deaths would likely be prevented, and mortality from bacteremia treated inappropriately would probably be reduced. The primary undesirable feature of the standard is an increased workload of pharmacists and microbiologists.
Recommendations:Treatment of bacteremia with an antibiotic that is appropriate in terms of the pathogen's blood-culture susceptibility is a minimal standard of care for all patients.
Validation:We consulted more than 50 experts in infectious diseases from the fields of medicine, surgery, pediatrics, obstetrics and gynecology, nursing, epidemiology, pharmacology, and government. In addition, the methods for its implementation were reviewed by the American Society of Hospital Pharmacists and were tested by one of the members of the Quality Standards Subcommittee.
Sponsors:The Quality Standards Subcommittee of the Clinical Affairs Committee of the Infectious Diseases Society of America (IDSA) developed the standard. The subcommittee was composed of representatives of the IDSA (Drs. Gross and McGowan), the Society for Hospital Epidemiology of America (Dr. Wenzel), the Surgical Infection Society (Dr. Dellinger), the Pediatric Infectious Diseases Society (Dr. Krause), the Centers for Disease Control and Prevention (Dr. Martone), the Obstetrics and Gynecology Infectious Diseases Society (Dr. Sweet), and the Association of Practitioners of Infection Control (Ms. Barrett). Funding was provided by the IDSA and the other cooperating organizations. This standard is endorsed by the IDSA.
Consensus Development of Quality Standards
- Peter A. Gross, Trisha L. Barrett, E. Patchen Dellinger, Peter J. Krause, William J. Martone, John E. McGowan, Jr, Richard L. Sweet, Richard P. Wenzel
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 15 / Issue 3 / March 1994
- Published online by Cambridge University Press:
- 02 January 2015, pp. 180-181
- Print publication:
- March 1994
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Quality Standard for Antimicrobial Prophylaxis in Surgical Procedures
- E. Patchen Dellinger, Peter A. Gross, Trisha L. Barrett, Peter J. Krause, William J. Martone, John E. McGowan, Jr, Richard L. Sweet, Richard P. Wenzel
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 15 / Issue 3 / March 1994
- Published online by Cambridge University Press:
- 02 January 2015, pp. 182-188
- Print publication:
- March 1994
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Objective:
The objectives of this quality standard are 1) to provide an implementation mechanism that will facilitate the reliable administration of prophylactic antimicrobial agents to patients undergoing operative procedures in which such a practice is judged to be beneficial and 2) to provide a guideline that will help local hospital committees formulate policies and set up mechanisms for their implementation. Although standards in the medical literature spell out recommendations for specific procedures, agents, schedules, and doses, other reports document that these standards frequently are not followed in practice.
Options:We have specified the procedures in which the administration of prophylactic antimicrobial agents has been shown to be beneficial, those in which this practice is widely thought to be beneficial but in which compelling evidence is lacking, and those in which this practice is controversial. We have examined the evidence regarding the optimal timing of drug administration, the optimal dose, and the optimal duration of prophylaxis.
Outcomes:The intended outcome is more uniform and reliable administration of prophylactic antibiotics in those circumstances where their value has been demonstrated or their use has been judged by the local practicing medical community to be desirable. The result should be a reduction in rates of postoperative wound infection with a limitation on the quantities of antimicrobial agents used in circumstances where they are not likely to help.
Evidence:Many prospective, randomized, controlled trials comparing placebo with antibiotic and comparing one antibiotic with another have been conducted. In addition, some trials have compared the efficacy of different doses or methods of administration. Other papers have reported on the apparent efficacy of administration at different times and on actual practice in specific communities. Only a small group of relevant articles found through 1993 are cited herein. When authoritative reviews are available, these-rather than an exhaustive list of original references-are cited.
Values:We assumed that reducing rates of postoperative infection was valuable but that reducing the total amount of antimicrobial agents employed was also worthwhile. The cost of and morbidity attributable to postoperative wound infections should be weighed against the cost and potential morbidity associated with excessive use of antimicrobial agents.
Benefits, Harms, and Costs:More reliable administration of antimicrobial agents according to recognized guidelines should prevent some postoperative wound infections while lowering the total quantity of these drugs used. No harms are anticipated. The costs involved are those of the efforts needed on a local basis to design and implement the mechanism that supports uniform and reliable administration of prophylactic antibiotics.
Recommendations:All patients for whom prophylactic antimicrobial agents are recommended should receive them. The agents given should be appropriate in light of published guidelines. A short duration of prophylaxis (usually < 24 hours) is recommended.
Validation:More than 50 experts in infectious disease and 10 experts in surgical infectious disease and surgical subspecialties reviewed the standard. In addition, the methods for its implementation were reviewed by the American Society of Hospital Pharmacists.
Sponsors:The Quality Standards Subcommittee of the Clinical Affairs Committee of the Infectious Disease Society of America (IDSA) developed the standard. The subcommittee was composed of representatives of the IDSA (Drs. Gross and McGowan), the Society for Hospital Epidemiology of America (Dr. Wenzel), the Surgical Infection Society (Dr. Dellinger), the Pediatric Infectious Disease Society (Dr. Krause), the Centers for Disease Control and Prevention (Dr. Martone), the Obstetrics and Gynecology Infectious Diseases Society (Dr. Sweet), and the Association of Practitioners of Infection Control (Ms. Barrett). Funding was provided by the IDSA and the other cooperating organizations. The standard is endorsed by the IDSA.
Quality Standard for Assurance of Measles Immunity Among Health Care Workers
- Peter J. Krause, Peter A. Gross, Trisha L. Barrett, E. Patchen Dellinger, William J. Martone, John E. McGowan, Jr, Richard L. Sweet, Richard P. Wenzel
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 15 / Issue 3 / March 1994
- Published online by Cambridge University Press:
- 02 January 2015, pp. 193-199
- Print publication:
- March 1994
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Objective:
The objective of this quality standard is to prevent nosocomial transmission of measles by assuring universal measles-mumps-rubella (MMR) vaccination of all healthcare workers who lack immunity to measles. Although the primary emphasis is on healthcare workers in hospitals, those at other sites, such as clinics, nursing homes, and schools, are also included. It will be the responsibility of designated individuals at these institutions to implement the standard.
Options:We considered advocating the use of measles vaccine rather than MMR but chose the latter because it also protects against mumps and rubella and because it is more readily available.
Outcomes:The desired outcome is a reduction in the nosocomial transmission of measles.
Evidence:Although direct comparative studies are lacking, nosocomial outbreaks of measles have been reported (as recently as 1992) in institutions where measles immunization of nonimmune healthcare workers is not universal, whereas such outbreaks have not been reported in institutions with universal immunization.
Values and Validation:We consulted more than 50 infectious-disease experts in epidemiology, government, medicine, nursing, obstetrics and gynecology pediatrics, and surgery. In light of disagreement regarding the implementation of the standard, we used group discussions to reach a consensus.
Benefits, Harms, and Cost:The consequences of the transmission of measles (and of mumps and rubella) in a healthcare institution include not only the morbidity and mortality attributable to the disease, but also the significant cost of evaluating and containing an outbreak and the serious disruption of regular hospital routines when control measures are instituted. The potential harm to healthcare workers after the implementation of the standard consists of untoward effects of MMR vaccine, although the reactions of vaccines should be minimal with adherence to recommended vaccination procedures. Implementation of the standard should entail no expense to healthcare workers; the precise cost to institutions is unknown, but the expense would be mitigated by prevention of measles outbreaks.
Recommendations:We recommend MMR vaccination of all healthcare workers who lack immunity to measles.
Sponsors:The Quality Standards Subcommittee of the Clinical Affairs Committee of the Infectious Diseases Society of America (IDSA) developed the standard. The subcommittee was composed of representatives of the IDSA (Drs. Gross and McGowan), the Society for Hospital Epidemiology of America (Dr. Wenzel), the Surgical Infection Society (Dr. Dellinger), the Pediatric Infectious Diseases Society (Dr. Krause), the Centers for Disease Control and Prevention (Dr. Martone), the Obstetrics and Gynecology Infectious Diseases Society (Dr. Sweet), and the Association of Practitioners of Infection Control (Ms. Barrett). Funding was provided by the IDSA and the other cooperating organizations. The standard is endorsed by the IDSA.
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