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7 results

  • Effectiveness of oral vancomycin as prophylaxis against Clostridioides difficile infection in hematopoietic stem cell transplant patients

  • Kelly M. Reitmeyer, Brijesh Rana, David Awad, Esther Huang, Jiyeon J. Park, Arsheena Yassin, John P. Mills, Ahmed Abdul Azim, Pinki J. Bhatt, Navaneeth Narayanan
  • Journal:
    Antimicrobial Stewardship & Healthcare Epidemiology / Volume 4 / Issue 1 / 2024
    Published online by Cambridge University Press:
    05 August 2024, e107
    • Article
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  • Objective:

    Patients receiving hematopoietic stem cell transplants (HSCT) are at increased risk for Clostridioides difficile infection (CDI). The purpose of this study was to assess the effectiveness of oral vancomycin prophylaxis (OVP) for CDI in HSCT patients.

    Design:

    Single-center, retrospective cohort.

    Setting:

    Tertiary care academic medical center in New Jersey.

    Patients:

    Patients ≥18 years old during admission for the HSCT were included. Patients who were admitted <72 hours or who had an active CDI prior to HSCT day 0 were excluded.

    Methods:

    Medical records of patients admitted between January 2015 and August 2022 to undergo an allogeneic or autologous HSCT were reviewed. The primary end point was the incidence of in-hospital CDI. Secondary end points included the incidence of vancomycin-resistant enterococci (VRE) bloodstream infections, VRE isolated from any clinical culture, gram-negative bloodstream infections, hospital survival, and hospital length of stay. Exploratory end points, including 1-year survival, relapse, and incidence of graft-versus-host disease, were also collected.

    Results:

    A total of 156 HSCT patients were included. There was 1 case of CDI (1 of 81, 1.23%) in the OVP group compared to 8 CDI cases (8 of 75, 10.67%) in the no OVP group (P = .0147). There were no significant (P > .05) between-group differences in incidence of gram-negative bloodstream infections, hospital survival, and length of stay. There were zero clinical cultures positive for VRE.

    Conclusions:

    In-hospital incidence of CDI in HSCT patients was significantly decreased with OVP. Randomized controlled trials are needed in this high-risk population to assess the efficacy and risks of OVP for CDI.

  • Unpredictable robots elicit responsibility attributions

  • Matija Franklin, Edmond Awad, Hal Ashton, David Lagnado
  • Journal:
    Behavioral and Brain Sciences / Volume 46 / 2023
    Published online by Cambridge University Press:
    05 April 2023, e30
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  • Do people hold robots responsible for their actions? While Clark and Fischer present a useful framework for interpreting social robots, we argue that they fail to account for people's willingness to assign responsibility to robots in certain contexts, such as when a robot performs actions not predictable by its user or programmer.

  • Chapter 1 - Introduction to Health Systems

  • from Section 1 - Analyzing Health Systems: Concepts, Components, Performance
  • Edited by Sameen Siddiqi, Aga Khan University, Awad Mataria, World Health Organization, Egypt, Katherine D. Rouleau, University of Toronto, Meesha Iqbal, UTHealth School of Public Health, Houston
  • Book:
    Making Health Systems Work in Low and Middle Income Countries
    Published online:
    08 December 2022
    Print publication:
    29 December 2022, pp 1-19

  • Summary

    Well-performing health systems are critical for pursuing universal health coverage and for achieving health-related SDGs. It is important to grasp key concepts such as systems approach, analysis, and thinking before taking a deeper dive into health systems. Health systems can be described in broad or restricted terms. The most widely accepted definition includes all the institutions, actors, and activities whose primary purpose is to promote, restore or maintain health. There are many health system frameworks and models of which four have been reviewed - WHO’s Health System Conceptual Framework, Control Knobs Framework, Kielmann’s and Roemer’s Health System Models. No single framework addresses all aspects of a health system. It is more useful to know the strengths and limitations, and usefulness of each in achieving a specific objective such as for description and analysis, designing system reform, or evaluation. Interventions whether system-led, programmatic or those addressing health determinants are part of the wider health system and offer the best opportunity for improving health outcomes when addressed together.

  • ‘Choose and Book’ in ENT: the GP perspective

  • David Pothier, Zaid Awad, Paul Tierney
  • Journal:
    The Journal of Laryngology & Otology / Volume 120 / Issue 3 / March 2006
    Published online by Cambridge University Press:
    27 January 2006, pp. 222-225
    Print publication:
    March 2006

  • Objectives: ‘Choose and Book’ is a UK government initiative devised to allow a greater freedom of choice for National Health Service patients. The system is designed to give patients a choice of hospitals and appointment times, as well as giving their general practitioner (GP) more responsibility for appropriate prioritization. We set out to determine the attitudes of UK GPs to the new Choose and Book project and to assess the impact that these changes are likely to have on ENT practice.

    Design: Postal questionnaire survey.

    Methods: Five hundred GPs were sent a questionnaire about the planned Choose and Book referral project.

    Results: Three hundred and eighty GPs (76 per cent) replied to the questionnaire after reminders were sent. Most were aware of the project and had been sent information about it. Of those who had heard of it, 61.5 per cent did not think it was a good thing. Most stated that both they and their patients were satisfied with current prioritization practices. Many GPs would be willing to delegate responsibility for prioritization to non-clinical staff. Important time and responsibility issues were identified.

    Conclusions: The majority of GPs were not in favour of Choose and Book. Many cited difficulties with time constraints and an inflexible system as factors that made Choose and Book unacceptable.