scholarly journals The impact of a ‘milking the COW’ campaign in a regional hospital in Singapore

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Surinder Kaur M. S. Pada ◽  
Poh Lishi ◽  
Kim Sim Ng ◽  
Sarathamani Rethenam ◽  
Lilibeth Silagan Alenton ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Pathogenic Bacteria ◽  
Mixed Model ◽  
Mixed Model Analysis ◽  
Colony Forming Units ◽  
Skin Flora ◽  
Before And After ◽  
The Difference ◽  
And Control ◽  
The Impact

Abstract Background Computerisation of various processes in hospitals and reliance on electronic devices raises the concern of contamination of these devices from the patient environment. We undertook this study to determine if an attached hand hygiene device that unlocks the screen of a computer on wheels (COW) on usage can be effective in decreasing the microbiological burden on computer keyboards. Methods An electronic hand sanitizer was integrated onto the COW. A prospective cohort study with a crossover design involving 2 control and 2 intervention wards was used. The study end point was the number of colony forming units found on the keyboards. Bacteria were classified into 4 main groups; pathogenic, skin flora, from the environment or those thought to be commensals in healthy individuals. We then used a mixed effects model for the statistical analysis to determine if there were any differences before and after the intervention. Results Thirty-nine keyboards were swabbed at baseline, day 7 and 14, with 234 keyboards cultured, colony forming units (CFUs) counted and organisms isolated. By mixed model analysis, the difference of mean bacteria count between intervention and control for week 1 was 32.74 (− 32.74, CI − 94.29 to 28.75, p = 0.29), for week 2 by 155.86 (− 155.86, CI − 227.45 to − 83.53, p < 0.0001), and after the 2-week period by 157.04 (− 157.04, CI − 231.53 to − 82.67, p < 0.0001). In the sub-analysis, there were significant differences of pathogenic bacteria counts for the Intervention as compared to the Control in contrast with commensal counts. Conclusion A hand hygiene device attached to a COW may be effective in decreasing the microbiological burden on computer keyboards.

scholarly journals Digit Ratio (2D:4D), Aggression, and Testosterone in Men Exposed to an Aggressive Video Stimulus

2013 ◽  
Vol 11 (5) ◽  
pp. 147470491301100 ◽  
Author(s):  
Liam P. Kilduff ◽  
Renato N. Hopp ◽  
Christian J. Cook ◽  
Blair T. Crewther ◽  
John T. Manning
Keyword(s):  
Negative Correlation ◽  
Free Testosterone ◽  
Digit Ratio ◽  
Testosterone Levels ◽  
Prenatal Testosterone ◽  
Before And After ◽  
Video Stimulus ◽  
The Difference ◽  
And Control ◽  
The Impact

The relative lengths of the 2nd and 4th digits (2D:4D) is a negative biomarker for prenatal testosterone, and low 2D:4D may be associated with aggression. However, the evidence for a 2D:4D-aggression association is mixed. Here we test the hypothesis that 2D:4D is robustly linked to aggression in “challenge” situations in which testosterone is increased. Participants were exposed to an aggressive video and a control video. Aggression was measured after each video and salivary free testosterone levels before and after each video. Compared to the control video, the aggressive video was associated with raised aggression responses and a marginally significant increase in testosterone. Left 2D:4D was negatively correlated with aggression after the aggressive video and the strength of the correlation was higher in those participants who showed the greatest increases in testosterone. Left 2D:4D was also negatively correlated to the difference between aggression scores in the aggressive and control conditions. The control video did not influence testosterone concentrations and there were no associations between 2D:4D and aggression. We conclude that 2D:4D moderates the impact of an aggressive stimulus on aggression, such that an increase in testosterone resulting from a “challenge” is associated with a negative correlation between 2D:4D and aggression.

Introducing Alcohol-Based Hand Rub for Hand Hygiene The Critical Need for Training

2007 ◽  
Vol 28 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Andreas F. Widmer ◽  
Martin Conzelmann ◽  
Milanka Tomic ◽  
Reno Frei ◽  
Anne M. Stranden
Keyword(s):  
Hand Hygiene ◽  
Bacterial Count ◽  
Visual Assessment ◽  
Assessment Method ◽  
Reduction Factor ◽  
Bacterial Killing ◽  
Before And After ◽  
Control And Prevention ◽  
The Difference ◽  
The Impact

Background.Use of an alcohol-based hand rub for hand hygiene has recently been recommended by the Centers for Disease Control and Prevention. However, the proper technique for using hand rub has not been well described and is not routinely taught in hospitals.Objective.To evaluate the impact of training on proper technique as outlined by the European Standard for testing alcohol-based hand rubs (European Norm 1500) in a clinical study.Design, Setting, and Patients.Prospective study including 180 healthcare workers (HCWs) in a 450-bed, university-affiliated geriatric hospital where alcohol-based hand rub was introduced in the late 1970s.Intervention.Structured training program in hand hygiene with alcohol-based hand rub. Technique for using hand rub was tested by the addition of a fluorescent dye to the disinfectant and the number of areas missed was quantified by a validated visual assessment method. In addition, the number of bacteria eradicated was estimated by calculating the difference between the log10 number of colony-forming units (cfu) of bacteria on the fingertips before and after the procedure, and reported as reduction factor (RF).Main Outcome Measure.Log10 cfu bacterial counts on fingertips before and after training in the appropriate technique for using hand rub.Results.At baseline, only 31% of HCWs used proper technique, yielding a low RF of 1.4 log10 cfu bacterial count. Training improved HCW compliance to 74% and increased the RF to 2.2 log10 cfu bacterial count, an increase of almost 50% (P < .001). Several factors, such as applying the proper amount of hand rub, were significantly associated with the increased RF.Conclusion.These results demonstrate that education on the proper technique for using hand rub, as outlined in EN 1500, can significantly increase the degree of bacterial killing.

Experimental Study of the Impact of Alisma plantago-aquatica Secretions on Pathogenic Bacteria

2014 ◽  
Vol 1 (3) ◽  
pp. 3-7
Author(s):  
O. Zhukorskyy ◽  
O. Hulay
Keyword(s):  
Pathogenic Bacteria ◽  
Initial Density ◽  
Biologically Active ◽  
Erysipelothrix Rhusiopathiae ◽  
Natural Focus ◽  
Test Species ◽  
Popula Tions ◽  
And Control ◽  
The Impact

Aim. To estimate the impact of in vivo secretions of water plantain (Alisma plantago-aquatica) on the popula- tions of pathogenic bacteria Erysipelothrix rhusiopathiae. Methods. The plants were isolated from their natural conditions, the roots were washed from the substrate residues and cultivated in laboratory conditions for 10 days to heal the damage. Then the water was changed; seven days later the selected samples were sterilized using fi lters with 0.2 μm pore diameter. The dilution of water plantain root diffusates in the experimental samples was 1:10–1:10,000. The initial density of E. rhusiopathiae bacteria populations was the same for both experimental and control samples. The estimation of the results was conducted 48 hours later. Results. When the dilution of root diffusates was 1:10, the density of erysipelothrixes in the experimental samples was 11.26 times higher than that of the control, on average, the dilution of 1:100 − 6.16 times higher, 1:1000 – 3.22 times higher, 1:10,000 – 1.81 times higher, respectively. Conclusions. The plants of A. plantago-aquatica species are capable of affecting the populations of E. rhusiopathiae pathogenic bacteria via the secretion of biologically active substances into the environment. The consequences of this interaction are positive for the abovementioned bacteria, which is demon- strated by the increase in the density of their populations in the experiment compared to the control. The intensity of the stimulating effect on the populations of E. rhusiopathiae in the root diffusates of A. plantago-aquatica is re- ciprocally dependent on the degree of their dilution. The investigated impact of water plantain on erysipelothrixes should be related to the topical type of biocenotic connections, the formation of which between the test species in the ecosystems might promote maintaining the potential of natural focus of rabies. Keywords: Alisma plantago-aquatica, in vivo secretions, Erysipelothrix rhusiopathiae, population density, topical type of connections.

scholarly journals 216. Are Automatic Antimicrobial Stop Orders an Effective Stewardship Tool for Urinary Tract and Intra-Abdominal Infections?

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S110-S110
Author(s):  
Christina Maguire ◽  
Dusten T Rose ◽  
Theresa Jaso
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Therapy ◽  
Source Control ◽  
Clostridioides Difficile ◽  
Days Of Therapy ◽  
Before And After ◽  
The Difference ◽  
Tract Infections ◽  
Length Of Therapy ◽  
The Impact

Abstract Background Automatic antimicrobial stop orders (ASOs) are a stewardship initiative used to decrease days of therapy, prevent resistance, and reduce drug costs. Limited evidence outside of the perioperative setting exists on the effects of ASOs on broad spectrum antimicrobial use, discharge prescription duration, and effects of missed doses. This study aims to evaluate the impact of an ASO policy across a health system of adult academic and community hospitals for treatment of intra-abdominal (IAI) and urinary tract infections (UTI). ASO Outcome Definitions ASO Outcomes Methods This multicenter retrospective cohort study compared patients with IAI and UTI treated before and after implementation of an ASO. Patients over the age of 18 with a diagnosis of UTI or IAI and 48 hours of intravenous (IV) antimicrobial administration were included. Patients unable to achieve IAI source control within 48 hours or those with a concomitant infection were excluded. The primary outcome was the difference in sum length of antimicrobial therapy (LOT). Secondary endpoints include length and days of antimicrobial therapy (DOT) at multiple timepoints, all cause in hospital mortality and readmission, and adverse events such as rates of Clostridioides difficile infection. Outcomes were also evaluated by type of infection, hospital site, and presence of infectious diseases (ID) pharmacist on site. Results This study included 119 patients in the pre-ASO group and 121 patients in the post-ASO group. ASO shortened sum length of therapy (LOT) (12 days vs 11 days respectively; p=0.0364) and sum DOT (15 days vs 12 days respectively; p=0.022). This finding appears to be driven by a decrease in outpatient LOT (p=0.0017) and outpatient DOT (p=0.0034). Conversely, ASO extended empiric IV LOT (p=0.005). All other secondary outcomes were not significant. Ten patients missed doses of antimicrobials due to ASO. Subgroup analyses suggested that one hospital may have influenced outcomes and reduction in LOT was observed primarily in sites without an ID pharmacist on site (p=0.018). Conclusion While implementation of ASO decreases sum length of inpatient and outpatient therapy, it may not influence inpatient length of therapy alone. Moreover, ASOs prolong use of empiric intravenous therapy. Hospitals without an ID pharmacist may benefit most from ASO protocols. Disclosures All Authors: No reported disclosures

scholarly journals Evaluating the Impact of Floods on Housing Price Using a Spatial Matching Difference-In-Differences (SM-DID) Approach

2021 ◽  
Vol 13 (2) ◽  
pp. 804
Author(s):  
Jean Dubé ◽  
Maha AbdelHalim ◽  
Nicolas Devaux
Keyword(s):  
Housing Price ◽  
Hedonic Pricing ◽  
Environmental Amenities ◽  
Sale Price ◽  
Difference In Differences ◽  
Hedonic Pricing Model ◽  
The Difference ◽  
And Control ◽  
The Impact ◽  
The City

Many applications have relied on the hedonic pricing model (HPM) to measure the willingness-to-pay (WTP) for urban externalities and natural disasters. The classic HPM regresses housing price on a complete list of attributes/characteristics that include spatial or environmental amenities (or disamenities), such as floods, to retrieve the gradients of the market (marginal) WTP for such externalities. The aim of this paper is to propose an innovative methodological framework that extends the causal relations based on a spatial matching difference-in-differences (SM-DID) estimator, and which attempts to calculate the difference between sale price for similar goods within “treated” and “control” groups. To demonstrate the potential of the proposed spatial matching method, the researchers present an empirical investigation based on the case of a flood event recorded in the city of Laval (Québec, Canada) in 1998, using information on transactions occurring between 1995 and 2001. The research results show that the impact of flooding brings a negative premium on the housing price of about 20,000$ Canadian (CAN).

The impact of a multimodel approach to designing a new orthopedic department

2020 ◽  
pp. 1-6
Author(s):  
Elad Keren ◽  
Abraham Borer ◽  
Lior Nesher ◽  
Tali Shafat ◽  
Rivka Yosipovich ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Antibiotic Stewardship ◽  
Infection Prevention ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Antibiotic Use ◽  
Prevention Measures ◽  
Orthopedic Department ◽  
Before And After ◽  
The Impact

Abstract Objective: To determine whether a multifaceted approach effectively influenced antibiotic use in an orthopedics department. Design: Retrospective cohort study comparing the readmission rate and antibiotic use before and after an intervention. Setting: A 1,000-bed, tertiary-care, university hospital. Patients: Adult patients admitted to the orthopedics department between January 2015 and December 2018. Methods: During the preintervention period (2015–2016), 1 general orthopedic department was in operation. In the postintervention period (2017–2018), 2 separate departments were created: one designated for elective “clean” surgeries and another that included a “complicated wound” unit. A multifaceted strategy including infection prevention measures and introducing antibiotic stewardship practices was implemented. Admission rates, hand hygiene practice compliance, surgical site infections, and antibiotic treatment before versus after the intervention were analyzed. Results: The number of admissions and hospitalization days in the 2 periods did not change. Seven-day readmissions per annual quarter decreased significantly from the preintervention period (median, 7 days; interquartile range [IQR], 6–9) to the postintervention period (median, 4 days; IQR, 2–7; P = .038). Hand hygiene compliance increased and surgical site infections decreased in the postintervention period. Although total antibiotic use was not reduced, there was a significant change in the breakdown of the different antibiotic classes used before and after the intervention: increased use of narrow-spectrum β-lactams (P < .001) and decreased use of β-lactamase inhibitors (P < .001), third-generation cephalosporins (P = .044), and clindamycin (P < .001). Conclusions: Restructuring the orthopedics department facilitated better infection prevention measures accompanied by antibiotic stewardship implementation, resulting in a decreased use of broad-spectrum antibiotics and a significant reduction in readmission rates.

scholarly journals Using Brain-Breaks® as a Technology Tool to Increase Attitude towards Physical Activity among Students in Singapore

2021 ◽  
Vol 11 (6) ◽  
pp. 784
Author(s):  
Govindasamy Balasekaran ◽  
Ahmad Arif Bin Ibrahim ◽  
Ng Yew Cheo ◽  
Phua Kia Wang ◽  
Garry Kuan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mixed Model ◽  
School Curriculum ◽  
Control Group ◽  
School Students ◽  
Mixed Model Analysis ◽  
Before And After ◽  
Brain Breaks ◽  
Student's Attitudes ◽  
The Brain

The purpose of this study was to investigate the effects of classroom-based Brain Breaks® Physical Activity Solution in Southeast Asia Singaporean primary school students and their attitude towards physical activity (PA) over a ten-week intervention. A total of 113 participants (8–11 years old) were randomly assigned to either an experimental (EG) or a control group (CG), with six classes to each group; the Brain Breaks® group (EG: six classes) and the Control group (CG: six classes). All EG members participated in a Brain Breaks® video intervention (three–five min) during academic classes and the CG continued their lessons as per normal. The student’s attitudes towards PA in both research conditions were evaluated using the self–reported Attitudes toward Physical Activity Scale (APAS), applied before and after intervention. The effects of the intervention on APAS scores were analysed using a mixed model analysis of variance with Time as within-subject and Group as between-subject factors. The analysis revealed evidence in support of the positive effect of classroom video interventions such as Brain Breaks® on student’s attitudes toward benefits, importance, learning, self-efficacy, fun, fitness, and trying to do their personal best in PA. The Brain Breaks® intervention provided a positive significant impact on students in Singapore. This study also revealed that interactive technology tools implemented into the school curriculum benefit students in terms of health and education.

Impact of Louisiana’s HPV Vaccine Awareness Policy on HPV Vaccination Among 13- to 17-Year-Old Females

2017 ◽  
Vol 44 (4) ◽  
pp. 548-558 ◽  
Author(s):  
Dudith Pierre-Victor ◽  
Mary Jo Trepka ◽  
Timothy F. Page ◽  
Tan Li ◽  
Dionne P. Stephens ◽  
...  
Keyword(s):  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Female Adolescents ◽  
Physician Recommendation ◽  
Vaccination Rates ◽  
National Immunization ◽  
Before And After ◽  
The Difference ◽  
Vaccine Information ◽  
The Impact

The Advisory Committee on Immunization Practices recommends routine human papillomavirus (HPV) immunization for 11- to 12-year-old adolescents. In 2008, Louisiana required the school boards to distribute HPV vaccine information to parents or guardian of students in Grades 6 to 12. This article investigates the impact of this policy on HPV vaccination among 13- to 17-year-old female adolescents using National Immunization Survey-Teen (NIS-Teen) data. Drawing on the data from the 2008 to 2012 NIS-Teen, we compared the difference in proportions of females who have been vaccinated before and after the policy. Using difference-indifference estimation, we explored the change in vaccination rates before and after the policy implementation in Louisiana compared with Alabama and Mississippi, two states that did not have such a policy in place. The difference-in-differences estimates for HPV vaccination were not significant. Physician recommendation for HPV vaccination was significantly associated with vaccination among females in Louisiana and Alabama (adjusted odds ratio [aOR] = 7.74; 95% confidence interval [CI; 5.22, 11.5]), and for those in Louisiana and Mississippi (aOR = 7.05; 95% CI [4.6, 10.5]). Compared to the proportion of female adolescents who had received physician recommendation in Alabama or Mississippi, the proportion in Louisiana did not increase significantly in the postpolicy period. HPV vaccination rates did not increase significantly in Louisiana compared to Alabama or Mississippi following the implementation of the policy. Despite Louisiana’s policy, physician recommendation remains the key determinant of HPV vaccination. HPV vaccine awareness does not necessarily result in HPV vaccination.

128 Differences in PRRSV Resilience for Reproductive Performance Between Landrace and Duroc Sows

2021 ◽  
Vol 99 (Supplement_1) ◽  
pp. 18-19
Author(s):  
Felipe Hickmann ◽  
José Braccini Neto ◽  
Luke M Kramer ◽  
Kent A Gray ◽  
Yijian Huang ◽  
...  
Keyword(s):  
Reproductive Performance ◽  
Mixed Model ◽  
Performance Data ◽  
The Other ◽  
Wild Type ◽  
Prrs Virus ◽  
The Difference ◽  
The Impact

Abstract Studies on differences in resilience to porcine reproductive and respiratory syndrome (PRRS) virus (PRRSV) between breeds are scarce in the literature. Thus, the objective of this work was to assess PRRSV resilience in PRRSV wild-type infected sows from two breeds. Farrowing data included 2546 and 2522 litters from 894 Duroc and 813 Landrace sows, respectively, which were housed together and experienced the same PRRSV outbreak. Traits used for this study were number of piglets born alive (NBA), number born dead (NBD), total number born (TNB), and number weaned (NW). The impact of PRRSV infection was evaluated by comparing the reproductive performance of breeds between PRRS phases (pre-PRRS, PRRS, and post-PRRS). PRRS phases were defined based on the reproductive performance data. NBA, NBD, and NW were analyzed as a proportion of TNB using a Poisson mixed model. Pre-defined contrasts were used to evaluate the effect of breed on PRRSV resilience and on return to PRRSV-free performance, representing the differences between breeds for the difference between pre-PRRS and PRRS phases, and pre-PRRS and post-PRRS phases, respectively. There was a significant (P ≤ 0.003) interaction between PRRS phase and breed for all traits, as shown in Table 1. In general, reproductive performance reduced from pre-PRRS to PRRS, and then increased from PRRS to post-PRRS, as expected. The resilience contrast was significant for all traits (P ≤ 0.003). In all cases, the drop in percent reproductive performance from pre-PRRS to PRRS was lower for Duroc than for Landrace, indicating that Duroc sows have greater PRRSV resilience than Landrace sows. The return to PRRSV-free performance contrast had a trending effect for NBD (P = 0.055), and it was not significant for the other traits (P ≥ 0.515). These results indicate that Duroc sows have overall greater phenotypic PRRSV resilience for reproductive performance than Landrace sows.

A Case–Control Study Evaluating the Impact of Dedicated Palliative Care Training on Critical Care Interventions at the end of Life

2021 ◽  
pp. 082585972110374
Author(s):  
Jee Y. You ◽  
Lie D. Ligasaputri ◽  
Adarsh Katamreddy ◽  
Kiran Para ◽  
Elizabeth Kavanagh ◽  
...  
Keyword(s):  
Palliative Care ◽  
Critical Care ◽  
High Risk ◽  
End Of Life ◽  
Poor Prognosis ◽  
Medical Interventions ◽  
Risk Of Death ◽  
Before And After ◽  
The Difference ◽  
The Impact

Many patients admitted to intensive care units (ICUs) are at high risk of dying. We hypothesize that focused training sessions for ICU providers by palliative care (PC) certified experts will decrease aggressive medical interventions at the end of life. We designed and implemented a 6-session PC training program in communication skills and goals of care (GOC) meetings for ICU teams, including house staff, critical care fellows, and attendings. We then reviewed charts of ICU patients treated before and after the intervention. Forty-nine of 177 (28%) and 63 of 173 (38%) patients were identified to be at high risk of death in the pre- and postintervention periods, respectively, and were included based on the study criteria. Inpatient mortality (45% vs 33%; P = .24) and need for mechanical ventilation (59% vs 44%, P = .13) were slightly higher in the preintervention population, but the difference was not statistically significant. The proportion of patients in whom the decision not to initiate renal replacement therapy was made because of poor prognosis was significantly higher in the postintervention population (14% vs 67%, P = .05). There was a nonstatistically significant trend toward earlier GOC discussions (median time from ICU admission to GOC 4 vs 3 days) and fewer critical care interventions such as tracheostomies (17% vs 4%, P = .19). Our study demonstrates that directed PC training of ICU teams has a potential to reduce end of life critical care interventions in patients with a poor prognosis.

Sign in / Sign up

Export Citation Format

Share Document