Capabilities of global high-level isolation units: A pre-workshop survey

2021 ◽  
pp. 1-7
Author(s):  
Jocelyn J. Herstein ◽  
Timo Wolf ◽  
Emanuele Nicastri ◽  
Yee Sin Leo ◽  
Poh Lian Lim ◽  
...  
Keyword(s):  
The United States ◽  
Infection Prevention And Control ◽  
Electronic Survey ◽  
Physical Infrastructure ◽  
The Us ◽  
Control Procedures ◽  
The Mean ◽  
High Level ◽  
Staffing And Training ◽  
And Control

Abstract Objective: To assess experience, physical infrastructure, and capabilities of high-level isolation units (HLIUs) planning to participate in a 2018 global HLIU workshop hosted by the US National Emerging Special Pathogens Training and Education Center (NETEC). Design: An electronic survey elicited information on general HLIU organization, operating costs, staffing models, and infection control protocols of select global units. Setting and participants: The survey was distributed to site representatives of 22 HLIUs located in the United States, Europe, and Asia; 19 (86%) responded. Methods: Data were coded and analyzed using descriptive statistics. Results: The mean annual reported budget for the 19 responding units was US$484,615. Most (89%) had treated a suspected or confirmed case of a high-consequence infectious disease. Reported composition of trained teams included a broad range of clinical and nonclinical roles. The mean number of HLIU beds was 6.37 (median, 4; range, 2–20) for adults and 4.23 (median, 2; range, 1–10) for children; however, capacity was dependent on pathogen. Conclusions: Responding HLIUs represent some of the most experienced HLIUs in the world. Variation in reported unit infrastructure, capabilities, and procedures demonstrate the variety of HLIU approaches. A number of technical questions unique to HLIUs remain unanswered related to physical design, infection prevention and control procedures, and staffing and training. These key areas represent potential focal points for future evidence and practice guidelines. These data are important considerations for hospitals considering the design and development of HLIUs, and there is a need for continued global HLIU collaboration to define best practices.

Relation of Statistically Significant, Abnormal, and Typical WAIS-R VIQ-PIQ Discrepancies to Full Scale IQs

2000 ◽  
Vol 16 (2) ◽  
pp. 107-114 ◽  
Author(s):  
Louis M. Hsu ◽  
Judy Hayman ◽  
Judith Koch ◽  
Debbie Mandell
Keyword(s):  
Graphical Method ◽  
The United States ◽  
Full Scale ◽  
True Score ◽  
Absolute Value ◽  
Normative Population ◽  
The Us ◽  
The Mean ◽  
And Performance ◽  
Quadratic Models

Summary: In the United States' normative population for the WAIS-R, differences (Ds) between persons' verbal and performance IQs (VIQs and PIQs) tend to increase with an increase in full scale IQs (FSIQs). This suggests that norm-referenced interpretations of Ds should take FSIQs into account. Two new graphs are presented to facilitate this type of interpretation. One of these graphs estimates the mean of absolute values of D (called typical D) at each FSIQ level of the US normative population. The other graph estimates the absolute value of D that is exceeded only 5% of the time (called abnormal D) at each FSIQ level of this population. A graph for the identification of conventional “statistically significant Ds” (also called “reliable Ds”) is also presented. A reliable D is defined in the context of classical true score theory as an absolute D that is unlikely (p < .05) to be exceeded by a person whose true VIQ and PIQ are equal. As conventionally defined reliable Ds do not depend on the FSIQ. The graphs of typical and abnormal Ds are based on quadratic models of the relation of sizes of Ds to FSIQs. These models are generalizations of models described in Hsu (1996) . The new graphical method of identifying Abnormal Ds is compared to the conventional Payne-Jones method of identifying these Ds. Implications of the three juxtaposed graphs for the interpretation of VIQ-PIQ differences are discussed.

scholarly journals Infection Prevention Considerations for a Multi-Mission Convention Center Field Hospital in Baltimore, Maryland during the COVID-19 Pandemic

2021 ◽  
pp. 1-21
Author(s):  
Jennifer A. Jones ◽  
Zishan K. Siddiqui ◽  
Charles Callahan ◽  
Surbhi Leekha ◽  
Sharon Smyth ◽  
...  
Keyword(s):  
Best Practices ◽  
Infection Prevention ◽  
Diagnostic Testing ◽  
The United States ◽  
Infection Prevention And Control ◽  
Field Hospital ◽  
First Case ◽  
Convention Center ◽  
Set Up ◽  
And Control

Abstract The state of Maryland identified its first case of COVID-19 on March 5, 2020. The Baltimore Convention Center (BCCFH) quickly became a selected location to set up a 250-bed inpatient Field Hospital and Alternate Care Site. In contrast to other field hospitals throughout the United States, the BCCFH remained open throughout the pandemic and took on additional COVID-19 missions, including community SARS-CoV-2 diagnostic testing, monoclonal antibody infusions for COVID-19 outpatients, and community COVID-19 vaccinations. At the time of publication, the BCCFH had cared for 1,478 COVID-19 inpatients, performed 108,155 COVID-19 tests, infused 2,166 COVID-19 patients, and administered 115,169 doses of COVID-19 vaccine. To prevent the spread of pathogens during operations, infection prevention and control guidelines were essential to ensure the safety of staff and patients. Through multi-agency collaboration, utilization of infection prevention best practices, and answering what we describe as “PPE-ESP”, an operational framework was established to reduce infection risks for those providing or receiving care at the BCCFH during the COVID-19 pandemic.

Assessment of the Implementation of AUC Dosing and Monitoring Practices With Vancomycin at Hospitals Across the United States

2021 ◽  
pp. 089719002110123
Author(s):  
Nicole Bradley ◽  
Yuman Lee ◽  
Muaz Sadeia
Keyword(s):  
The United States ◽  
Descriptive Statistics ◽  
Therapeutic Drug ◽  
User Friendliness ◽  
Electronic Survey ◽  
The Us ◽  
Institutional Adoption ◽  
American Society ◽  
Trough Levels ◽  
Do So

Introduction: The latest vancomycin therapeutic drug monitoring guidelines for serious MRSA infections have made a pivotal change in dosing, switching from targeting trough levels to AUC dosing. Because of these new recommendations, antimicrobial stewardship programs across the country are tasked with implementing AUC based dosing. Objectives: To assess plans for institutional adoption of vancomycin AUC dosing programs and perceptions of currently used programs in hospitals across the US. Methods: An electronic survey was distributed to members of the American College of Clinical Pharmacy IDprn Listserv and American Society of Health-System Pharmacists between May and June 2020 to assess current institutional vancomycin dosing. Institutional program use and multiple software user parameters were analyzed using descriptive statistics. Results: Two hundred two pharmacists responded to the survey with the majority practicing in institutions with 251-500 beds. Most respondents have yet to implement AUC dosing (142/202, 70.3%) with many of them planning to do so in the next year (81/142, 57.0%). Of those that already implemented AUC dosing programs, purchased Bayesian software (23/60, 38.3%) and homemade software (21/60, 35.0%) were the 2 methods most frequently utilized. Purchased Bayesian software users were more likely to recommend their software to other institutions and ranked user friendliness higher compared to non-purchased software. Conclusion: Most respondents have not made the switch to vancomycin AUC dosing, but there is a growing interest with many institutions looking to adopt a program within the next year.

scholarly journals Mortality after surgery with SARS-CoV-2 infection in England: A population-wide epidemiological study

2021 ◽  
Author(s):  
T. E. F. Abbott ◽  
A. J. Fowler ◽  
T. D. Dobbs ◽  
J. Gibson ◽  
T. Shahid ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
High Mortality ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Surgical Patients ◽  
Infection Prevention And Control ◽  
List Type ◽  
Control Procedures ◽  
And Control

AbstractObjectivesTo confirm the incidence of perioperative SARS-CoV-2 infection and associated mortality after surgery.Design and settingAnalysis of routine electronic health record data from National Health Service (NHS) hospitals in England.MethodsWe extracted data from Hospital Episode Statistics in England describing adult patients undergoing surgery between 1st January 2020 and 31st October 2020. The exposure was SARS-CoV-2 infection defined by ICD-10 codes. The primary outcome measure was 90-day in-hospital mortality. Data were analysed using multivariable logistic regression adjusted for age, sex, Charlson co-morbidity index, index of multiple deprivation, presence of cancer, surgical procedure type and admission acuity. Results are presented as n (%) and odds ratios (OR) with 95% confidence intervals.ResultsWe identified 1,972,153 patients undergoing surgery of whom 11,940 (0.6%) had SARS-CoV-2. In total, 19,100 (1.0%) patients died in hospital. SARS-CoV-2 infection was associated with a much greater risk of death (SARS-CoV-2: 2,618/11,940 [21.9%] vs No SARS-CoV-2: 16,482/1,960,213 [0.8%]; OR: 5.8 [5.5 – 6.1]; p<0.001). Amongst patients undergoing elective surgery 1,030/1,374,985 (0.1%) had SARS-CoV-2 of whom 83/1,030 (8.1%) died, compared with 1,092/1,373,955 (0.1%) patients without SARS-CoV-2 (OR: 29.0 [22.5 −37.3]; p<0.001). Amongst patients undergoing emergency surgery 9,742/437,891 (2.2%) patients had SARS-CoV-2, of whom 2,466/9,742 (25.3%) died compared with 14,817/428,149 (3.5%) patients without SARS-CoV-2 (OR: 5.7 [5.4 – 6.0]; p<0.001).ConclusionsThe low incidence of SARS-CoV-2 infection in NHS surgical pathways suggests current infection prevention and control policies are highly effective. However, the high mortality amongst patients with SARS-CoV-2 suggests these precautions cannot be safely relaxed.Summary boxesWhat is already known on this topicHigh mortality rates have been reported amongst surgical patients who develop COVID-19 but we don’t know how this compares to the concurrent surgical population unaffected by COVID-19.Strict infection prevention and control procedures have substantially reduced the capacity of surgical treatment pathways in many hospitals.The very large backlog in delayed and cancelled surgical procedures is a growing public health concern.What this study addsFewer than 1 in 100 surgical patients are affected by COVID-19 in the English National Health Service.Elective surgical patients who do develop COVID-19 are 30 times more likely to die while in hospital.Infection prevention and control procedures in NHS surgical pathways are highly effective but cannot be safely relaxed.

Trajectories of Injectable Cancer Drug Costs After Launch in the United States

2018 ◽  
Vol 36 (4) ◽  
pp. 319-325 ◽  
Author(s):  
Noa Gordon ◽  
Salomon M. Stemmer ◽  
Dan Greenberg ◽  
Daniel A. Goldstein
Keyword(s):  
Drug Administration ◽  
Food And Drug Administration ◽  
The United States ◽  
Drug Costs ◽  
Cancer Drug ◽  
Steady Increase ◽  
Drug Prices ◽  
The Us ◽  
The Mean ◽  
Over Time

Purpose Cancer drug prices at launch have increased in recent years. It is unclear how individual drug prices change over time after launch and what market determinants influence these changes. We measured the price trajectories of a cohort of cancer drugs after their launch into the US market and assessed the influence of market structure on price changes. Methods We studied the changes in mean monthly costs for a cohort of 24 patented, injectable anticancer drugs that were approved by the US Food and Drug Administration between 1996 and 2012. To account for discounts and rebates, we used the average sales prices published by the Centers for Medicare and Medicaid Services. Costs were adjusted to US general and health-related inflation rates. For each drug, we calculated the cumulative and annual drug cost changes. We then used a multivariable regression model to evaluate the association between market and cost changes over time. Results With a mean follow-up period of 8 years, the mean percent change in cost for all drugs was +25% (range, −14% to +96%). After adjusting for inflation, the mean cost change was +18% (range, −16% to +59%). Rituximab and trastuzumab followed a similar pattern in cost increases over time, and the inflation-adjusted monthly costs rose since approval by 49% and 44%, respectively. New supplemental US Food and Drug Administration approvals, new off-label indications, and new competitors did not influence the annual cost change rates. Conclusion Anticancer drug costs may change substantially after launch. Regardless of competition or supplemental indications, there is a steady increase in costs of patented anticancer agents over time. New regulations may be needed to prevent additional increases in drug costs after launch.

The intelligence of six-year-olds in Hong Kong

1989 ◽  
Vol 21 (4) ◽  
pp. 461-464 ◽  
Author(s):  
Jimmy Chan ◽  
Richard Lynn
Keyword(s):  
United States ◽  
Hong Kong ◽  
Ethnic Minorities ◽  
The United States ◽  
Chinese Children ◽  
Pacific Basin ◽  
The Pacific ◽  
The Us ◽  
The Mean ◽  
The Uk

SummaryEvidence has accumulated to suggest that the mean IQs of Orientals in the United States and in the countries of the Pacific Basin are higher than those of Whites (Caucasoids) in the United States and Britain. This paper presents evidence from IQ tests on 4858 6-year-old Chinese children in Hong Kong. On the Coloured Progressive Matrices these children obtained a mean IQ of 116. Samples from Australia, Czechoslovakia, Germany, Romania, the UK and the US obtain IQs in the range 95–102. It is suggested that these results pose difficulties for the environmentalist explanations commonly advanced to explain the low mean IQs obtained by some ethnic minorities in the United States.

scholarly journals Obesity trends in populations of the Russian Federation and the United States of America. Thirty-year long dynamics

2018 ◽  
Vol 17 (4) ◽  
pp. 67-73 ◽  
Author(s):  
V. G. Vilkov ◽  
S. A. Shalnova ◽  
A. D. Deev ◽  
Yu. A. Balanova ◽  
S. E. Efstifeeva ◽  
...  
Keyword(s):  
Russian Federation ◽  
Age Groups ◽  
The United States ◽  
Men And Women ◽  
The Us ◽  
Obesity Trends ◽  
Prevalence Of Obesity ◽  
The Mean ◽  
And Gender ◽  
Gender Categories

Aim. To evaluate the dynamics of obesity and mean body mass index (BMI) in Russia and USA in various age and gender categories during 1975-2014.Material and methods. By a repeat analysis of one-moment studies of Russian and US population in 1975-1982 and 2007-2014, the values of obesity and BMI were assessed in men and women age 25-64 y. o. Into analysis, the data was included from Russian part of the Lipid Clinics study and multicenter ESSE-RF study (Epidemiology of cardiovascular diseases and risk factors in various regions of Russian Federation). American data acquired from the studies NHANES (National Health And Nutrition Examination Survey), open access. Total number of observations 48974.Results. In the 80s of XX century in all age groups of women the mean BMI levels were lower in USA comparing to Russia, in men there were no significant differences. For the following 30 years in Russia the situation improved for men and women <45 y. o. — differences with USA changed modality, and currently BMI in Russia is lower than in USA.Conclusion. Russia was below the US 30 years ago by the mean BMI in females of all ages, with no differences for males. For the following 30 years in the US there was significant increase of BMI in all age strata of men and women, and in Russia dynamics was the same, but lesser. Comparison of the prevalence of obesity in men 30 years ago showed some predominance of obesity in American males, especially young, but not statistically significant. Russian women had higher prevalence of obesity regardless of age. Currently, obesity in young age is more prevalent in men and women of USA, and >45 years old — in Russia.

Panama

2020 ◽  
Author(s):  
Michael E. Donoghue
Keyword(s):  
United States ◽  
World Economy ◽  
The United States ◽  
Military Dictatorship ◽  
Nationalist Movement ◽  
New Granada ◽  
The Us ◽  
Full Independence ◽  
And Control ◽  
The Military

Since declaring independence from Spain in 1821, Panama struggled for nearly two centuries to forge a true sovereignty. Free from Madrid’s control, the province found itself subordinated first by Gran Colombia, later New Granada, and after gaining a measure of independence in a 1903 secessionist revolution, by the United States which built a canal and attached zone through which Washington dominated the nation. Domestically, Panama also wrestled with the complexities of a multiracial, class-divided society ruled by a European-descended elite and political infighting among populists and the military that impeded liberal democracy. Gradually, a nationalist movement that sought greater state formation and control over the canal coalesced around mid-century. But the importance of the waterway to Washington imposed constraints on this movement’s success until the 1978 ratification of the Carter-Torrijos treaties which ensured the transfer of the canal to Panama by century’s end. In 1989, concerns over political tyranny, drug trafficking, and the integrity of the upcoming canal transfer compelled the United States to invade Panama and end the military dictatorship (1968–1989) while restoring a form of elite-dominated democracy. After nearly a hundred years of resistance and diplomacy, Panama finally won full independence on December 31, 1999, taking possession of the canal and the remnants of the US-run enclave. Problems of how to reorganize the republic’s economy and political structure, as well as persistent corruption and poverty, complicated the post-US era. Still, with its unique geostrategic position in the world economy, opportunities as well as obstacles confront Panama today finally freed from a century of neocolonialism.

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