scholarly journals The foot-health of people with diabetes in regional and rural Australia: baseline results from an observational cohort study

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Byron M. Perrin ◽  
Penny Allen ◽  
Marcus J. Gardner ◽  
Andrew Chappell ◽  
Bronwyn Phillips ◽  
...  
Keyword(s):  
Multivariable Analysis ◽  
Clinical Population ◽  
Publicly Funded ◽  
Foot Health ◽  
University Of Texas ◽  
Hba1c Target ◽  
The University ◽  
Evidence Based Care ◽  
Rural Australia ◽  
Foot Morbidity

Abstract Background There is limited Australian epidemiological research that reports on the foot-health characteristics of people with diabetes, especially within rural and regional settings. The objective of this study was to explore the associations between demographic, socio-economic and diabetes-related variables with diabetes-related foot morbidity in people residing in regional and rural Australia. Methods Adults with diabetes were recruited from non-metropolitan Australian publicly-funded podiatry services. The primary variable of interest was the University of Texas diabetic foot risk classification designated to each participant at baseline. Independent risk factors for diabetes-related foot morbidity were identified using multivariable analysis. Results Eight-hundred and ninety-nine participants enrolled, 443 (49.3%) in Tasmania and 456 (50.7%) in Victoria. Mean age was 67 years (SD 12.7), 9.2% had type 1 diabetes, 506 (56.3%) were male, 498 (55.4%) had diabetes for longer than 10 years and 550 (61.2%) either did not know the ideal HbA1c target or reported that it was ≥7.0. A majority had peripheral neuropathy or worse foot morbidity (61.0%). Foot morbidity was associated with male sex (OR 2.42, 95% CI 1.82–3.22), duration of diabetes > 20 years (OR 3.25, 95% CI 2.22–4.75), and Tasmanian residence (OR 3.38, 95% CI 2.35–4.86). Conclusions A high proportion of the regional Australian clinical population with diabetes seen by the publicly-funded podiatric services in this study were at high risk of future limb threatening foot morbidity, and participants residing in Northern Tasmania are more likely to have worse diabetes-related foot morbidity than those from regional Victoria. Service models should be reviewed to ensure that diabetes-related foot services are appropriately developed and resourced to deliver interdisciplinary evidence-based care.

Not a “Nonissue”: Perceptions and Realities of Campus Carry at The University of Texas at Austin

2020 ◽  
pp. 1-13
Author(s):  
SAMPO RUOPPILA ◽  
ALBION M. BUTTERS
Keyword(s):  
Publicly Funded ◽  
Campus Life ◽  
University Of Texas ◽  
The Law ◽  
The University

As a publicly funded institution,The University of Texas at Austin had to implement the state's legislation to allow concealed handguns on campus. Yet its own Campus Carry policy has sought to erase the matter from everyday campus life. The administration deems it a “nonissue,” presuming that students have become accustomed to the idea, do not think about it actively, and have a low interest in acquiring a handgun license. This paper, based on a survey of the university's undergraduates, questions these ideas. It shows that a majority of students think that the issue is important and examines in what sense the students are troubled by its effects. While opinions differ between supporters and opponents of Campus Carry, divergences also exist within their ranks, such as among supporters of the law regarding where guns should specifically be allowed at the university. On the basis of the survey, the essay also examines how many licensed carriers are actually on campus, compared to the university's estimates.

scholarly journals 44. Antibiotic Class-Based Distribution and Analysis of Reported Beta-Lactam Allergies amongst Hospitalized Patients

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S45-S45
Author(s):  
Joseph Patrik Hornak ◽  
David Reynoso
Keyword(s):  
Bacterial Infections ◽  
Drug Resistant ◽  
Beta Lactam ◽  
Resistance Development ◽  
Texas Medical ◽  
University Of Texas ◽  
Icd 10 ◽  
Mrsa Infection ◽  
The University ◽  
Alternative Antibiotic

Abstract Background Reported β-lactam allergy (BLA) is very common, yet less than 10% of these patients exhibit true hypersensitivity. When faced with reported BLAs, physicians often choose alternative antibiotics which can be associated with C. difficile infection, drug-resistance development, poorer outcomes, & increased costs. Effective identification of these patients is necessary for subsequent, appropriate BLA “de-labeling.” Here, we conducted a single-center analysis of alternative antibiotic utilization amongst patients reporting BLA and compare the frequency of drug-resistant infections and C. difficile infection in allergic & non-allergic patients. Methods This is a retrospective review of adult patients hospitalized at The University of Texas Medical Branch from 1/1/2015 to 12/31/2019. Pooled electronic medical records were filtered by antibiotic orders and reported allergies to penicillins or cephalosporins. Patients with drug-resistant and/or C. difficile infection (CDI) were identified by ICD-10 codes. Microsoft Excel & MedCalc were used for statistical calculations. Results Data were available for 118,326 patients and 9.3% (11,982) reported a BLA, with the highest rates seen in those receiving aztreonam (85.9%, 530/617) & clindamycin (33.7%, 3949/11718). Amongst patients reporting BLA, high ratios-of-consumption (relative to all patients receiving antibiotics) were seen with aztreonam (7.0), clindamycin (2.7), cephalosporin/β-lactamase inhibitors (2.4), & daptomycin (2.1). Compared to the non-BLA population, BLA patients more frequently experienced MRSA infection (3.0% vs 1.5%, OR 1.99, 95% CI 1.79–2.23, p< 0.0001), β-lactam resistance (1.2% vs 0.6%, OR 2.07, 95% CI 1.72–2.49, p< 0.0001), and CDI (1.2% vs 0.7%, OR 1.85, 95% CI 1.54–2.23, p< 0.0001). Conclusion Our measured BLA rate matches approximate expectations near 10%. Moreover, these patients experienced significantly higher frequencies of drug-resistant bacterial infections and CDI. Targeted inpatient penicillin allergy testing stands to be particularly effective in those patients receiving disproportionately utilized alternative agents (e.g. aztreonam, clindamycin, daptomycin). β-lactam allergy “de-labeling” in these patients is likely a valuable antimicrobial stewardship target. Disclosures All Authors: No reported disclosures

The David O Selznick storyboard rehousing project: A case study

IFLA Journal ◽  
2021 ◽  
pp. 034003522110230
Author(s):  
Genevieve Pierce
Keyword(s):  
Process Management ◽  
University Of Texas ◽  
The University

In 2018, the Harry Ransom Center at the University of Texas at Austin rehoused over 300 illustrated movie storyboards from the popular and frequently used David O Selznick Collection. Preservation technicians tracked this project from its inception to the survey and design conception, and through to its execution. By creating a new housing model and refining it over the course of a year, the Preservation Unit was able to consider how housing affects an object, which led to new systems and structures to facilitate process management and workflow, and how an object is impacted by its housing.

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