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Describe the epidemiological and molecular characteristics of an outbreak of Klebsiella pneumoniae carbapenemase (KPC)–producing organisms and the novel use of a cohorting unit for its control.
A 566-room academic teaching facility in Milwaukee, Wisconsin.
Solid-organ transplant recipients.
Infection control bundles were used throughout the time of observation. All KPC cases were intermittently housed in a cohorting unit with dedicated nurses and nursing aids. The rooms used in the cohorting unit had anterooms where clean supplies and linens were placed. Spread of KPC-producing organisms was determined using rectal surveillance cultures on admission and weekly thereafter among all consecutive patients admitted to the involved units. KPC-positive strains underwent pulsed-field gel electrophoresis and whole-genome sequencing.
A total of 8 KPC cases (5 identified by surveillance) were identified from April 2016 to April 2017. After the index patient, 3 patients acquired KPC-producing organisms despite implementation of an infection control bundle. This prompted the use of a cohorting unit, which immediately halted transmission, and the single remaining KPC case was transferred out of the cohorting unit. However, additional KPC cases were identified within 2 months. Once the cohorting unit was reopened, no additional KPC cases occurred. The KPC-positive species identified during this outbreak included Klebsiella pneumoniae, Enterobacter cloacae complex, and Escherichia coli. blaKPC was identified on at least 2 plasmid backbones.
A complex KPC outbreak involving both clonal and plasmid-mediated dissemination was controlled using weekly surveillances and a cohorting unit.
This paper will present a comparative analysis of the ethnographic writings of three colonial travellers trained in medicine at the University of Edinburgh: William Anderson (1750–78), Archibald Menzies (1754–1842) and Robert Brown (1773–1858). Each travelled widely beyond Scotland, enabling them to make a series of observations of non-European peoples in a wide variety of colonial contexts. William Anderson, Archibald Menzies and Robert Brown in particular travelled extensively in the Pacific with (respectively) James Cook on his second and third voyages (1771–8), with George Vancouver (1791–5) and with Matthew Flinders (1801–3). Together, their surviving writings from these momentous expeditions illustrate a growing interest in natural-historical explanations for diversity among human populations. Race emerged as a key concept in this quest, but it remained entangled with assumptions about the stadial historical progress or “civilization” of humanity. A comparative examination of their ethnographic writings thus presents a unique opportunity to study the complex interplay between concepts of race, savagery and civilization in the varied colonial contexts of the Scottish Enlightenment.
In 2018, the Clostridium difficile LabID event methodology changed so that hospitals doing 2-step tests, nucleic acid amplification test (NAAT) plus enzyme immunofluorescence assay (EIA), had their adjustment modified to EIA-based tests, and only positive final tests (eg, EIA) were counted in the numerator. We report the immediate impact of this methodological change at 3 Milwaukee hospitals.
Under international humanitarian law it is prohibited to make the object of attack a person who has surrendered. This article explores the circumstances in which the act of surrender is effective under international humanitarian law and examines, in particular, how surrender can be achieved in practical terms during land warfare in the context of international and non-international armed conflict. First, the article situates surrender within its broader historical and theoretical setting, tracing its legal development as a rule of conventional and customary international humanitarian law and arguing that its crystallisation as a law of war derives from the lack of military necessity to directly target persons who have placed themselves outside the theatre of armed conflict, and that such conduct is unacceptable from a humanitarian perspective. Second, after a careful examination of state practice, the article proposes a three-stage test for determining whether persons have surrendered under international humanitarian law: (1) Have persons attempting to surrender engaged in a positive act which clearly reveals that they no longer intend to participate in hostilities? (2) Is it reasonable in the circumstances prevailing at the time for the opposing force to discern the offer of surrender? and (3) Have surrendered persons unconditionally submitted to the authority of their captor?
The business format franchise model has been widely adopted in many nations throughout the Asia-Pacific region because it provides an opportunity for individuals to establish their own small to medium-sized business as a franchisee. It also enables thriving businesses to expand quickly, and without compromising quality, into foreign and domestic jurisdictions as franchisors. Competition law, however, often impacts on franchise operations. The effects arise both from the general impact of competition law on business but also because of the vertical and horizontal structures associated with the franchisor/franchisee relationship. This chapter identifies the relevant competition laws throughout the Asia-Pacific Economic Cooperation (APEC) economies and provides examples of the competition law breaches that franchise networks must avoid. In particular, it examines the difficulties of market definition associated with franchise models and the challenges faced by competition regulators in communicating policy to franchisees and small and medium-sized enterprises (SMEs).
Numerous small and medium-sized enterprises (SMEs) throughout the twenty-one Asia-Pacific Economic Cooperation (APEC) economies are operated as business format franchises. Two forms of franchising are widely recognized. In product franchising, a franchisor supplies branded products or services to a franchisee (seller), but does not control all aspects of how the franchisee conducts the retail business. The other form, business format franchising, is more allencompassing. It involves a franchisor creating a retail business, testing it, and resolving any problems, then documenting every aspect of the business and, finally, advertising for franchisees to purchase and operate franchised clones. The franchisor sells its franchisees a licence, typically for a fixed term. Franchisees then invest their own time and finances in establishing legally independent, but functionally dependent businesses, under the franchisor's brand while following the rules set out by the franchisor. The focus of this chapter is on business format franchising.
This model of franchising is increasingly popular, and has become ever more versatile and sophisticated since the mid-twentieth century. Franchising currently exists along a spectrum, from being a widely studied, highly regulated, and pervasive business model in countries such as Australia and the United States, to an unregulated, data-poor, fledgling activity in countries such as Papua New Guinea.
There are dangers and pleasures in reducing stories to universal themes. The Odyssey seems all too aware of this. Part of its appeal comes from whether this tale of a single man returning home can stand for far greater questions of what it means to be human. Our pleasure as we recognize these familiar stories mirrors the delight of the poem's characters as they recognize Odysseus. We want such events to be universal, because the pleasure of the familiar helps us on our own journey through the dangers and uncertainties of life. But, as an increasingly vast scholarly bibliography reminds us, recognition in this poem is far from simple. The poem's delight in riddles and trickery means that the joy of any delight in recognition conflicts with its rhetoric of suspicion and the almost paranoid need of its hero for self-preservation. This to and fro is also part of the poem's wider economy of thrift, as if we must pay for any pleasure we gain in recognition with the pain of belated reflection.
As a matter of survival, we need to educate current and future generations to live sustainably. We need to ensure that future generations have access to quality environmental education.
This paper provides guidelines for educators and managers to use to better understand and manage the learning environment in which environmental education, particularly sustainability, programs take place. This is done through the introduction of two tools. Firstly, through a model of the learning environment that can be used to understand the educational environment and its various interactions and secondly, through the introduction of an Adaptive Management Conceptual Framework. This framework provides a step by step approach to guide the process of assessing the state of the current learning environment, and to guide the processes of decision making and implementation by educators.
These tools have broad application to a variety of educational environments; schools, universities and community education. A specific case study of the application of these tools in a university environmental science degree is outlined.
…fiction may be admitted to vouch for the genius of nations, while history has nothing to offer that is intitled to credit. The Greek fable accordingly conveying a character of its authors, throws light on an age of which no other record remains. The superiority of this people is indeed in no circumstance more evident than in the strain of their fictions…
On 11 May 1745, a British, Hanoverian and Dutch army under the command of King George II's second son, the Duke of Cumberland, was defeated by a French army under the command of Marshal de Saxe at the battle of Fontenoy. Today the battle is remembered as a striking example of European Enlightenment warfare, characterized by disciplined close-order fighting according to ‘civilized’ rules of engagement. As I will show however, much of this legacy rests on tales of battlefield civility that may never have taken place. Curiously, among the fictions of that day are some that relate to the purported presence at and participation in the battle by one of the Scottish Enlightenment's most prescient social and political theorists, Adam Ferguson.
Ferguson's thought was characterized by a distinctive awareness of the relationship between ‘fiction’ and ‘civilization’. Despite his obvious enthusiasm for civilization, he remained concerned that its further progress would render its obvious benefits, such as politeness, polished manners and discipline, entirely fictional. Civilization, he felt, may prove to be an all too shaky facade of politeness masking the corruption of virtue by luxury or indolence. I will explore this distinctive feature of Ferguson's thought by examining the two fictions of Fontenoy. Those fictions are first, that which relates to the legend of battlefield civility and second, that which centres on Ferguson's supposed presence at the battle. Both of these stories point us to a reconsideration of the role of fiction in Ferguson's complex appraisal of civilization.
Captain George Grey and Edward John Eyre shot to prominence in the 1840s on the back of their separate journeys of ‘discovery’, each made possible by their reliance on the knowledge of Aboriginal guides and trackers. Both publicized their successes very effectively in time-honoured imperial fashion, Grey in his Journals of Two Expeditions of Discovery (1841) and Eyre in his Journals of Expeditions of Discovery (1845). Both journals provided the platform for their elevation to the ranks of colonial administration – Eyre as a (highly esteemed) resident magistrate at Moorundi (in South Australia) and subsequently as (highly controversial) Governor of Jamaica; Grey as Governor of South Australia, and subsequently Governor of New Zealand (reappointed for a second term), and of the Cape Colony. Perhaps part of the reason for the success of both journals was that while they apparently confirmed the general pessimism about the prospects of ‘civilizing’ Australia's Indigenous peoples, they sought to provide an analysis of why. In doing so, they both gave voice to a sense that Australia's Indigenous people lacked the capacity for society.
Grey was willing to concede that the Indigenous tribes possessed some ‘social habits’, engaged in ‘social intercourse and conversation’, and even had ‘institutions’. But both Grey's and Eyre's journals confirm that whatever ‘social habits’ the Indigenous people possessed they did not have any kind of recognizable ‘society’. Eyre, for instance, who also incorporated the observations of Grey and the South Australian Protector of Aborigines Matthew Moorhouse, spoke of the present inability of a supposedly ‘savage’ people for making ‘social ties and connections’ because the power of the elders drives them back ‘among the savage hordes’. What distinguishes these ‘hordes’ from ‘society’ was the fact that the former did not possess ‘any form of government’ and any member of the tribe ‘is at liberty to act as he likes, except, in so far as he may be influenced by the general opinions or wishes of the tribe …’.
I have argued in this book that concepts of ‘civilization and savagery’ provided an intellectual foundation for the colonial government of Australia's Indigenous peoples. It was this foundation that enabled colonists and colonial administrators in Britain and Australia to perceive Indigenous people as ‘problems’ for colonial government to ‘resolve’. It also provided a framework of concepts with which the various policies and techniques of government devised to ‘resolve’ those ‘problems’ could be articulated and justified. As previous chapters have shown, the application of these concepts did not entail any uniformity in the precise definitions of the ‘problems’ of Indigenous government. Nonetheless, the influence and continuity of that discourse was an important, if not the central intellectual framework for Australia's early colonization.
By the time of Australia's Federation and political independence in 1901, however, the predominance of this discourse was already beginning to fade. In its place arose a more anthropological language in which older assumptions about civilization and historical development were gradually replaced by sociological analyses of Indigenous culture and social structure. Of course, this was not an ‘overnight’ replacement, and some of the anthropologists who came to influence early twentieth-century Indigenous policy in Australia – such as Baldwin Spencer and A. P. Elkin – continued to make use of the concept of civilization. As the influential anthropologist and Indigenous policy mandarin Elkin expressed it, the problem of Indigenous policy in the early twentieth century was that it amounted to a haphazard ‘drift to civilization’, whereas it should aim for an orderly ‘advance towards and in civilization’ through the adaptation of Indigenous culture (informed by white/European anthropological expertise) to ‘civilized’ white/European culture.
Today, the very concepts of ‘savagery’ and ‘civilization’ seem as alien to Australian political and public discourse as it is possible to be. And yet, the implications and long influence of those terms continue to reverberate in contemporary Australia. One of the most profound legacies of the terms is the continuous denial of Indigenous sovereignty in Australia. As I have argued in previous chapters, the colonial assertion of sovereignty was made on the basis that the Indigenous inhabitants of Australia were ‘savages’.
Fifteen years after his death at Kealakekua Bay on Hawai'i in 1779, the figure of Captain Cook was immortalized in a print designed by P. J. de Loutherbourg entitled The Apotheosis of Captain Cook. The Apotheosis is an artistic rendering of the moment of Cook's supposed elevation to the heavens, immediately following his violent death at the hands of a crowd of enraged Hawai'ian islanders. None of the many contemporary images of this already legendary figure, nor any that were to follow, captures more completely his status as hero of empire. As he is whisked heavenward, the island of Hawai'i and the encircling Pacific Ocean he had done so much to expose to European vision recede beneath and behind him. The viewer is invited to see the Pacific, its lands and its peoples as a backdrop to his greatness, but also to see it in perspective – like the detailed maps he had meticulously prepared for the Admiralty. The viewer sees the previously unknown (to Europeans) Pacific from the vantage point of elevation. This is what the Apotheosis invites us to see as Cook's accomplishment. Cook is immortalized because he was the one to have reduced the unknown and unseen to the scrutiny of European vision, European charts and European navigation.
The viewer of course cannot be unaware that Cook's accomplishments have been won at the cost of his life at the hands of people he had made known to Europe. Much ink was later to be spilled over the question of whether Cook's death was caused by his misjudgements and violence on the beach, or by the islanders’ belief that he was the personification of their god of peace and productivity, Lono, who had outstayed his ritually-prescribed welcome. Cook's European divinity, however, was assured by his apotheosis. If the viewer harboured any doubts as to the viciousness of the ‘savages’, the iconography of the Apotheosis removed them. Cook is shown floating upward on a cloud flanked by two allegorical female figures.
When Captain Arthur Phillip had his official instructions read to the assembled officers, marines, convicts and assorted other colonists at Sydney Cove on 7 February 1788, the sovereignty of His Majesty's government was asserted ‘over all those Territories, belonging to his Britannic Majesty’, investing ‘full power and authority’ in the office of his Governor of the colony. This was not, as the British saw it, a dispossession of Indigenous people, because they did not regard the Indigenous peoples to be exclusive owners of the entire surface of the continent. Above all, however, this taking of possession and the blank assertion of British sovereignty was not considered to be a conquest. There had been and would be no war and no peace negotiation over the presumptive right the British assumed they had to take possession. Consequently, there would be and indeed in the eyes of British officials there could be no treaty with the Indigenous inhabitants of Australia.
Some have argued that this decision was based on the ‘lie’ of terra nullius and the consequent failure to extend citizenship status to Indigenous Australians contrary to ‘the British rules of citizenship’. This argument, however, overlooks the complexity of contemporary British discourse, especially in regard to citizenship:
So diverse was the [British] empire assumed to be that the peoples of the British Isles seem rarely to have envisaged themselves as citizens of a greater Britain that incorporated the peoples of the empire in a common Britishness with them … In the absence of any concept of common citizenship, the peoples of the empire tended to be ordered in public debate in Britain according to whatever hierarchical system was in vogue, be it progress towards civility or innate racial characteristics. Britain's supremacy in this ranking was rarely questioned.
Indeed, the very assumption that the British had uniform ‘rules’ of citizenship in 1788 is as problematic as the assertion that the notion of citizenship could be extended to the Indigenous peoples of Australia. As Claeys has masterfully demonstrated, there was no single or uncontested public discourse in Britain at this time, much less one that stipulated full adult male suffrage or citizenship.
Few concepts in Western political thought have been more closely entwined with the history of empire, colonization and colonial policy than ‘civilization’ and ‘savagery’. While these concepts are likely to be considered today as superannuated or unfashionable, it was not always so. In 1837 a writer in the Edinburgh Review, who was probably Herman Merivale, the then Drummond Professor of Political Economy at Oxford University, wrote that,
Savages – ‘septs of hunters and fishers’, – are of great use to political economists, as well as to political philosophers; their condition serves as a sort of zero in the thermometer of civilization, – a point from which there is a gradual rise towards perfection. They are thus very valuable in hypothetical reasoning …
Here, some ten years before he became Permanent Undersecretary of the Colonial Office and before the publication of his celebrated Lectures on Colonization and Colonies (1839), Merivale captured the conceptual significance of ‘savagery’ and ‘civilization’ in European political thought. That significance rested on their dualistic nature. Both concepts hovered uneasily between fiction and reality or, as Merivale put it, between ‘hypothesis’ and ‘condition’. ‘Savagery’ served as both a real condition of social life (exemplified by ‘septs of hunters and fishers’) and as the foundation for claims to civilization. This foundation was conceived as both historical (in the sense that progress towards civilization began in savagery) and normative (in the sense that the notion of civilization was deemed superior to savagery).
The Empire of Political Thought traces the discursive construction of ‘savagery and civilization’ in relation to Australia's Indigenous peoples from 1788 to the end of the nineteenth century. The Australian colonial context has characteristically received less attention from scholars of political thought than the more familiar Atlantic colonial heritage. Typically, Australia's colonization has been seen as an ‘exception’ to the Atlantic pattern (and to the later colonization of New Zealand) due to the absence of any treaties between the colonizers and Australia's Indigenous inhabitants.
Empire of Political Thought investigates how European colonists in Australia represented the indigenous peoples they found there, and how they governed them using Western political thought. Buchan argues that an ideological framework drawn from Western traditions rendered indigenous peoples familiar to Europeans. Rather than effacing indigenous difference, colonists employed a conceptual language that recognised those differences but assimilated them and rendered them as deficiencies. This is the first study to link the imperial government in Australia with comparative colonial contexts in North America. The contemporary relevance of this book is underscored by the continuing efforts of Indigenous peoples in Australia and elsewhere to articulate their visions of political and cultural self-government and self-determination.
The British government took the opportunity to present their case to the British public for establishing a penal colony in New South Wales by the publication in 1787 of an anonymous History of New Holland. Included in the publication was a discourse on the transportation of convicted felons written by Sir William Eden, an influential jurist, penal reformer, MP and member of the Committee for Trade and Plantations which oversaw the management of Britain's Empire. Transportation of convicted felons to the distant colony, he argued, could be justified as the means ‘to convert the Indians’, quite aside from its remedial effects on the felons themselves. Alexander Dalrymple had ridiculed this argument in his Serious Admonition of the previous year, arguing that convicts were the least likely candidates for effecting a conversion and were more likely to become a nuisance to British trade. Eden, however, persisted with the argument, noting that, while it seemed incongruous,
To carry amongst the rude inhabitants of New Wales [sic] a picture of society, which, though its features may be harsh to the ideas of an European, will appear even for the present a degree more perfect than any subsisting among them, would of itself be an act suitable to the beneficence of a civilized power; how much more will the conversion, if practicable, of the natives, still lost in pitiable ignorance, be an endeavour worthy of a polished age …
Two features of the phrasing of this argument are worthy of note, the first being the recognition that Eden saw transportation not only as a means of exporting felons for punishment, but of exporting society itself. The second feature is that while the society of felons may have been thought harsh by polished and refined standards among the educated elite who consumed the History of New Holland, it was nonetheless far superior to the rudeness and ignorance in which the ‘savages’ lived.
Here Eden combined what would become recurrent themes in the ideology of British imperial expansion in the nineteenth century, civilization and benevolence.