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We used a survey to characterize contemporary infection prevention and antibiotic stewardship program practices across 64 healthcare facilities, and we compared these findings to those of a similar 2013 survey. Notable findings include decreased frequency of active surveillance for methicillin-resistant Staphylococcus aureus, frequent active surveillance for carbapenem-resistant Enterobacteriaceae, and increased support for antibiotic stewardship programs.
To ascertain opinions regarding etiology and preventability of hospital-onset bacteremia and fungemia (HOB) and perspectives on HOB as a potential outcome measure reflecting quality of infection prevention and hospital care.
Hospital epidemiologists and infection preventionist members of the Society for Healthcare Epidemiology of America (SHEA) Research Network.
A web-based, multiple-choice survey was administered via the SHEA Research Network to 133 hospitals.
A total of 89 surveys were completed (67% response rate). Overall, 60% of respondents defined HOB as a positive blood culture on or after hospital day 3. Central line-associated bloodstream infections and intra-abdominal infections were perceived as the most frequent etiologies. Moreover, 61% thought that most HOB events are preventable, and 54% viewed HOB as a measure reflecting a hospital’s quality of care. Also, 29% of respondents’ hospitals already collect HOB data for internal purposes. Given a choice to publicly report central-line–associated bloodstream infections (CLABSIs) and/or HOB, 57% favored reporting either HOB alone (22%) or in addition to CLABSI (35%) and 34% favored CLABSI alone.
Among the majority of SHEA Research Network respondents, HOB is perceived as preventable, reflective of quality of care, and potentially acceptable as a publicly reported quality metric. Further studies on HOB are needed, including validation as a quality measure, assessment of risk adjustment, and formation of evidence-based bundles and toolkits to facilitate measurement and improvement of HOB rates.
This paper discusses the composition and nutritional values of a limited number of materials of tropical or sub-tropical origin encountered in advisory work. These products have emerged in recent years chiefly as minor components of compounds and to a lesser extent as ‘straights’. These by-products are olive pulp, grape pulp pellets, grape seed meal, dried coffee residues, citrus pulp pellets, cocoa shell meal, extracted cocoa meal, shea-nut pellets and shea expeller meal, guar meal, illipe meal and cassava meal. Other foods such as cereal by-products and sugar cane molasses are discussed elsewhere, whilst materials that may originally have been by-products of oil extraction such as soya, ground nut and palm kernel, etc., are now such significant parts of the modern sophisticated feed compounding industry that it may be unfair to classify them as by-products in the usually accepted sense. In any case information on them is well documented and readily available and hence they will not be discussed here.
The by-products listed above form only a small proportion of the imported feeding stuffs bill but nevertheless can be of economic and nutritional significance in isolated circumstances. Some idea of their overall monetary significance is as follows. The total quantity of imported feeding stuffs other than cereals in 1977 was 1 495 973 tonnes. Of the above list of by-products, only olive pulp and grape residues are listed separately on official lists and each account for less than 1% of the total. Olive pulp imports were 33 457 tonnes and grape residues 11 276 tonnes. Undefined residues from oil extraction, which presumably includes some of the above listed products, amounted to 58 791 tonnes, whilst ‘Other products of vegetable origin’ would account for some other imported products totalling 45 013 tonnes.
The immediate postweaning period in pigs is often characterised by a reduced and variable food intake, digestive disorders and poor growth and development. Historically such effects were reduced by the use of in-feed antibiotic growth promoters (AGPs), copper sulphate and zinc oxide to enhance the efficiency of feed conversion and hence maximise nutrient capture. However from January 2006 the routine use of in-feed AGPs was banned and, due to concern over environmental pollution, levels of inclusion of heavy metals are limited by regulation and likely to be further reduced in the future. Weaning pigs at a later age has been suggested as an approach to reduce the potentially negative effects of the AGP ban on the national herd. The objective of the AGEWEAN programme of research was to investigate the effects of weaning age (4, 6 and 8 weeks) in both an indoor and outdoor lactation environment on the biological and economic efficiency of production where diets contain no AGPs and lower levels of copper (<25ppm added) and zinc (<100ppm added).
Firn temperatures at the Dome Summit South drill site, East Antarctica, are simulated by driving a thermal model of the ice sheet with observed instrumental records over the period 1960-96. The model incorporates firn density and thermal properties to reproduce measured borehole temperatures as shallow as 5 m below the surface, where the seasonal temperature wave is readily apparent. The study shows that ice-sheet temperatures are approximately 0.8°C cooler than mean 4 m air temperatures. It also finds that non-conductive processes such as ventilation and radiation can be simulated at this site by assuming perfect thermal contact between the top ∼1 m of firn and the atmosphere on monthly time-scales.
We present techniques developed to calibrate and correct Murchison Widefield Array low-frequency (72–300 MHz) radio observations for polarimetry. The extremely wide field-of-view, excellent instantaneous (u, v)-coverage and sensitivity to degree-scale structure that the Murchison Widefield Array provides enable instrumental calibration, removal of instrumental artefacts, and correction for ionospheric Faraday rotation through imaging techniques. With the demonstrated polarimetric capabilities of the Murchison Widefield Array, we discuss future directions for polarimetric science at low frequencies to answer outstanding questions relating to polarised source counts, source depolarisation, pulsar science, low-mass stars, exoplanets, the nature of the interstellar and intergalactic media, and the solar environment.
The current generation of experiments aiming to detect the neutral hydrogen signal from the Epoch of Reionisation (EoR) is likely to be limited by systematic effects associated with removing foreground sources from target fields. In this paper, we develop a model for the compact foreground sources in one of the target fields of the MWA’s EoR key science experiment: the ‘EoR1’ field. The model is based on both the MWA’s GLEAM survey and GMRT 150 MHz data from the TGSS survey, the latter providing higher angular resolution and better astrometric accuracy for compact sources than is available from the MWA alone. The model contains 5 049 sources, some of which have complicated morphology in MWA data, Fornax A being the most complex. The higher resolution data show that 13% of sources that appear point-like to the MWA have complicated morphology such as double and quad structure, with a typical separation of 33 arcsec. We derive an analytic expression for the error introduced into the EoR two-dimensional power spectrum due to peeling close double sources as single point sources and show that for the measured source properties, the error in the power spectrum is confined to high k⊥ modes that do not affect the overall result for the large-scale cosmological signal of interest. The brightest 10 mis-modelled sources in the field contribute 90% of the power bias in the data, suggesting that it is most critical to improve the models of the brightest sources. With this hybrid model, we reprocess data from the EoR1 field and show a maximum of 8% improved calibration accuracy and a factor of two reduction in residual power in k-space from peeling these sources. Implications for future EoR experiments including the SKA are discussed in relation to the improvements obtained.
Measures of the equivalent widths of major stellar features in the visible and UV regions of a sample of the LMC supergiants whose types range from 05 to A1 have been derived. Their low resolution UV spectra were obtained with the IUE and complemented in the visual with spectra from ESO 3.6 m and SAAO 1.95 m telescopes. The methods used are entirely numerical and as far as possible free from subjective estimates. The data for the LMC members have been compared with those obtained for their Galactic counterparts. The variation of CIV 1550 Å and Si IV 1400 Å absorptions with spectral type has been investigated. It may be that the intensity of HeI lines is smaller for the middle and late B supergiant members of the LMC as compared with those Galactic standards, otherwise there is no systematic difference within the observational errors between the Galactic and LMC supergiants in the strengths of the principal stellar features observed in the visible as a function of spectral type. Galactic 0 and early B supergiants have greater equivalent widths of Si IV λ 1400 and C IV λ 1550 absorptions than the LMC supergiants of similar spectral types, confirming earlier observations of Hutchings.
The star SK 80 in the SMC is classified as 07Iaf by Walborn (1976) who notes that it is the only confirmed Of star in that Galaxy known to date. A knowledge of the mass loss properties of OB stars in the Magellanic Clouds is of interest because of the recent evidence that such stars show reduced mass loss properties than their galactic counterparts (Hutchings 1980) and for Of stars because of the possible link between such stars and Pop I transition WNL stars (Conti 1976).
We have secured HIRES IUE and optical spectra of SK 80 and have attempted to derive the mass loss rate from these data.
We examined longitudinally the course and predictors of treatment resistance in a large cohort of first-episode psychosis (FEP) patients from initiation of antipsychotic treatment. We hypothesized that antipsychotic treatment resistance is: (a) present at illness onset; and (b) differentially associated with clinical and demographic factors.
The study sample comprised 323 FEP patients who were studied at first contact and at 10-year follow-up. We collated clinical information on severity of symptoms, antipsychotic medication and treatment adherence during the follow-up period to determine the presence, course and predictors of treatment resistance.
From the 23% of the patients, who were treatment resistant, 84% were treatment resistant from illness onset. Multivariable regression analysis revealed that diagnosis of schizophrenia, negative symptoms, younger age at onset, and longer duration of untreated psychosis predicted treatment resistance from illness onset.
The striking majority of treatment-resistant patients do not respond to first-line antipsychotic treatment even at time of FEP. Clinicians must be alert to this subgroup of patients and consider clozapine treatment as early as possible during the first presentation of psychosis.
Around 70% of total seed phosphorus is represented by phytate which must be hydrolysed to be bioavailable in non-ruminant diets. The limited endogenous phytase activity in non-ruminant animals make it common practice to add an exogenous phytase source to most poultry and pig feeds. The mature grain phytase activity (MGPA) of cereal seeds provides a route for the seeds themselves to contribute to phytate digestion, but MGPA varies considerably between species and most varieties in current use make negligible contributions. Currently, all phytases used for feed supplementation and transgenic improvement of MGPA are derived from microbial enzymes belonging to the group of histidine acid phosphatases (HAP). Cereals contain HAP phytases, but the bulk of MGPA can be attributed to phytases belonging to a completely different group of phosphatases, the purple acid phosphatases (PAPhy). In recent years, increased MGPAs were achieved in cisgenic barley holding extra copies of barley PAPhy and in the wheat HIGHPHY mutant, where MGPA was increased to ~6200 FTU/kg. In the present study, the effect of replacing 33%, 66% and 100% of a standard wheat with HIGHPHY wheat was compared with a control diet with and without 500 FTU of supplemental phytase. Diets were compared by evaluating broiler performance, ileal Ca and P digestibility and tibia development, using nine replicate pens of four birds per diet over 3 weeks from hatch. There were no differences between treatments in any tibia or bird performance parameters, indicating the control diet did not contain sufficiently low levels of phosphorus to distinguish effect of phytase addition. However, in a comparison of the two wheats, the ileal Ca and P digestibility coefficients for the 100% HIGHPHY wheat diets are 22.9% and 35.6% higher, respectively, than for the control diet, indicating the wheat PAPhy is functional in the broiler digestive tract. Furthermore, 33% HIGHPHY replacement of conventional wheat, significantly improved Ca and P digestibility over the diet-supplemented exogenous phytase, probably due to the higher phytase activity in the HIGHPHY diet (1804 v. 1150 FTU). Full replacement by HIGHPHY gave 14.6% and 22.8% higher ileal digestibility coefficients for Ca and P, respectively, than for feed supplemented with exogenous HAP phytase at 500 FTU. This indicates that in planta wheat PAPhys has promising potential for improving P and mineral digestibility in animal feed.
Cannabis is a widely used drug associated with increased risk for psychosis. The dopamine hypothesis of psychosis postulates that altered salience processing leads to psychosis. We therefore tested the hypothesis that cannabis users exhibit aberrant salience and explored the relationship between aberrant salience and dopamine synthesis capacity.
We tested 17 cannabis users and 17 age- and sex-matched non-user controls using the Salience Attribution Test, a probabilistic reward-learning task. Within users, cannabis-induced psychotic symptoms were measured with the Psychotomimetic States Inventory. Dopamine synthesis capacity, indexed as the influx rate constant Kicer, was measured in 10 users and six controls with 3,4-dihydroxy-6-[18F]fluoro-l-phenylalanine positron emission tomography.
There was no significant difference in aberrant salience between the groups [F1,32 = 1.12, p = 0.30 (implicit); F1,32 = 1.09, p = 0.30 (explicit)]. Within users there was a significant positive relationship between cannabis-induced psychotic symptom severity and explicit aberrant salience scores (r = 0.61, p = 0.04) and there was a significant association between cannabis dependency/abuse status and high implicit aberrant salience scores (F1,15 = 5.8, p = 0.03). Within controls, implicit aberrant salience was inversely correlated with whole striatal dopamine synthesis capacity (r = −0.91, p = 0.01), whereas this relationship was non-significant within users (difference between correlations: Z = −2.05, p = 0.04).
Aberrant salience is positively associated with cannabis-induced psychotic symptom severity, but is not seen in cannabis users overall. This is consistent with the hypothesis that the link between cannabis use and psychosis involves alterations in salience processing. Longitudinal studies are needed to determine whether these cognitive abnormalities are pre-existing or caused by long-term cannabis use.
Candidate central stars can be seen in some (≤10%) of the many (~1000) new planetary nebulae found during scans of the AAO/UKST Hα survey of the Milky Way (Parker et al. 2002). Spectroscopic observations have identified seven with Wolf-Rayet emission features, thereby adding significantly to the 56 [WR] central stars already known (Jeffery et al. 1996). Two of these are late-type stars – [WC8] and [WC9-10], and four are early-type around [WC4] or possibly [WO4]. Two of the early-type stars have unusual strong emission features near 4610Å which may be attributed to [N V] and could be indicative of enhanced nitrogen in their atmospheres and unusual stellar evolution. The seventh star is of the [WN] sequence and, if confirmed, would be the only known [WN] central star in the Galaxy. Its surrounding circular nebula has emission lines with expansion velocities exceeding 150 km/s suggesting that the object may not a conventional planetary nebula. The possibility that it is a Population I star with a ring nebula, although looking increasingly less likely, cannot be finally ruled out at this stage. Full details of the [WC] stars have been given by Morgan, Parker, & Russeil (2001) and Parker & Morgan (2002). The candidate [WN] star is described by Morgan & Parker (2002).
We report on version 1.0 of the Edinburgh/AAO/Strasbourg catalogue of new and possible Planetary Nebulae (PN) distributed via cdrom at this meeting. We provide accurate positions, designations, images and other descriptive parameters for the PN. In future releases this will be supplemented by inclusion of spectra and related material such as line ratios, velocities etc.
The 900+ PN have been discovered solely from visual scrutiny of narrow-band exposures taken for the AAO/UKST H-alpha survey of the Southern Galactic Plane. Most have classic PN-type morphologies (i.e. bi-polar, rings, shells or ovals). SuperCOSMOS data will soon supersede our visual scanning but it proved an effective preliminary technique to identify candidate PN on the basis of morphology, isolation and identification as an H-alpha nebulosity. We already have confirmatory spectroscopy for ~ 700 objects. Much of our new sample are of very low surface brightness, with no obvious central star, and so have remained undetected in previous surveys. They are revealed here due to the excellent depth, resolution, coverage and uniformity of the H-alpha survey. Many PN are also well extended. The average angular size is 51″ with the median of 27″ but examples extend to several arcminutes. This may indicate many are in a highly evolved state where the central star has faded from easy optical detection and the nebula itself is dissipating into the ambient ISM. Large numbers of candidate PN have also been found in the Galactic Bulge region, most of which have been confirmed via UKST FLAIR/6dF MOS spectroscopy (Parker et al, in preparation and these proceedings).
By version 2.0 (release in 2002) we will have doubled the number of Galactic PN accrued from all sources over the last 75 years. This new catalogue should have a profound impact on many aspects of PN research.
We report on an unprecedented source of Planetary Nebulae (PN) discovered from AAO/UKST Hα survey images of the Southern Galactic Plane. A pristine region of PN discovery space is being sampled due to the excellent depth, coverage, resolution and uniformity of the Hα survey. Large numbers of new PN are being found (~1000 so far). They are typically more evolved, obscurred and of lower surface brightness than in most other surveys. The doubling of known PN should have a significant impact on many aspects of PN research.
The stellar associations are defined as loose unbound concentrations of young stars with a bright OB stellar component, mainly located at the most recent star forming regions, representing the smallest units in the hierarchy of stellar systems in galaxies. The definition of the associations is discussed and the main properties of their stellar content are summarized. Using plates taken with the 1.2m UK Schmidt Telescope a method is developed to detect all stellar associations in the LMC and to find their spatial distribution relative to the LMC's recent star formation history. In 40% of the LMC region, the number of “single peak” associations has increased considerably (~ 3x). A very interesting result is that the faint limit, where the identified associations are revealed, varies by about 3 mag. This indicates not only extinction differences but also the presence of pre-main sequence stars at a wide range of masses.
A new Hα survey of the Magellanic Clouds which is being carried out on fine-grained Tech-Pan emulsion with the UK 1.2m Schmidt Telescope will have the best combination of depth and resolution of any that cover such a wide area in and around the Magellanic Clouds. Preliminary results show that the films will provide identifications of new emission-line stars and nebulae.