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Antimicrobial resistance is a limiting factor for the success of the treatment of infectious diseases and is associated with increased morbidity and cost. The present study aims to evaluate prescribing patterns of antimicrobials and quantify progress in relation to targets for quality improvement in the prescription of antimicrobials in Northern Ireland's secondary care sector using three repetitive point prevalence surveys (PPS) over a 6-year period: the European Surveillance of Antimicrobial Consumption (ESAC-PPS) in 2009 and 2011 and the Global-PPS on Antimicrobial Consumption and Resistance in 2015. Out of 3605 patients surveyed over the three time points, 1239 (34.4%) were treated with an antibiotic, the most frequently prescribed antibiotic groups were a combination of penicillins, including β-lactamase inhibitors. Compliance with hospital antibiotic policies in 2009, 2011 and 2015 were 54.5%, 71.5% and 79.9%, respectively. Likewise, an indication for treatment was recorded in patient notes 88.5%, 87.7% and 90.6% in 2009, 2011 and 2015, respectively, and surgical prophylactic antibiotic prescriptions for >24 h was 3.9%, 3.2% and 0.7% in 2009, 2011 and 2015, respectively. Treatment based on biomarker data was used in 61.5% of cases. In conclusion, a general trend in the improvement of key antimicrobial-related quality indicators was noted. The PPS tool provided a convenient, inexpensive surveillance system of antimicrobial consumption and should be considered an essential component to establish and maintain informed antibiotic stewardship in hospitals.
The thick disk is the stellar disk-halo connection. At least near the solar circle, this component is on average as old as the system of disk globular clusters, or ~ 12 Gyr. This implies that it most probably formed early in the process of Galaxy formation, so that its properties – chemical abundances, stellar kinematics and spatial distribution – contain clues to the physics of these stages of Galaxy evolution. Its present-day importance for the interstellar disk-halo connection lies in the evolution of its constituent stars – gas loss through winds on the red giant and asymptotic giant branches, through planetary nebulae prior to white dwarf formation, and through supernovae. This gas loss results in mass injection, momentum injection and energy injection into the interstellar medium from a stellar population with a scale height of ~ 1kpc.
We summarise the first year of operation of the Medium Deep Survey - a key project of the HST. Two fields in the LMC are discussed and some preliminary scientific results presented. We also comment on image deconvolution for the extragalactic fields observed as part of the Medium Deep Survey.
We present details of the database from a large Cycle 7 HST project to study the formation and evolution of rich star clusters in the LMC (see Elson et al., this volume). Our data set, which includes NICMOS, WFPC2 and STIS images of 8 clusters, will enable us to derive deep luminosity functions for the clusters and to investigate the universality of the stellar IMF. We will look for age spreads in the youngest clusters, quantify the population of binary stars in the cores of the clusters and at the half-mass radii, and follow the development of mass segregation.
With HST and WFPC2, galaxies in the Medium Deep Survey can be reliably classified to magnitudes I814 ≲ 22.0 in the F814W band, at a mean redshift . The main result is the relatively high proportion (~40%) of objects which are in some way irregular or anomalous, and which are of relevance in understanding the origin of the familiar excess population of faint galaxies. These diverse objects include compact galaxies, apparently interacting pairs, galaxies with superluminous starforming regions and diffuse low surface brightness galaxies of various forms. The ‘irregulars’ and ‘peculiar’ galaxies contribute most of the excess counts in the I-band at our limiting magnitude, and may explain the ‘faint blue galaxy’ problem.
The Gaia Science Alerts project (GSA) aims to augment a precision survey of the Milky Way with a controlled, precision survey of all classes of transient phenomena. While onboard BP/RP spectra from Gaia will ultimately allow us to classify many Gaia Alerts based on Gaia data alone, in the initial phases of the GSA project it is necessary to verify and classify discoveries with ground-based spectroscopic followup. In this article, we describe a subset of the ongoing Gaia Alerts followup programmes, and some of the initial science results from this work.
We describe a laboratory plasma physics experiment at Los Alamos National Laboratory that uses two merging supersonic plasma jets formed and launched by pulsed-power-driven railguns. The jets can be formed using any atomic species or mixture available in a compressed-gas bottle and have the following nominal initial parameters at the railgun nozzle exit: ne ≈ ni ~ 1016 cm−3, Te ≈ Ti ≈ 1.4 eV, Vjet ≈ 30–100 km/s, mean charge
≈ 1, sonic Mach number Ms ≡ Vjet/Cs > 10, jet diameter = 5 cm, and jet length ≈20 cm. Experiments to date have focused on the study of merging-jet dynamics and the shocks that form as a result of the interaction, in both collisional and collisionless regimes with respect to the inter-jet classical ion mean free path, and with and without an applied magnetic field. However, many other studies are also possible, as discussed in this paper.
To report a large outbreak of Clostridium difficile infection (CDI; ribotype 027) between June 2007 and August 2008, describe infection control measures, and evaluate the impact of restricting the use of fluoroquinolones in controlling the outbreak.
Outbreak investigation in 3 acute care hospitals of the Northern Health and Social Care Trust in Northern Ireland.
Implementation of a series of CDI control measures that targeted high-risk antibiotic agents (ie, restriction of fluoroquinolones), infection control practices, and environmental hygiene.
A total of 318 cases of CDI were identified during the outbreak, which was the result of the interaction between C. difficile ribotype 027 being introduced into the affected hospitals for the first time and other predisposing risk factors (ranging from host factors to suboptimal compliance with antibiotic guidelines and infection control policies). The 30-day all-cause mortality rate was 24.5%; however, CDI was the attributable cause of death for only 2.5% of the infected patients. Time series analysis showed that restricting the use of fluoroquinolones was associated with a significant reduction in the incidence of CDI (coefficient, —0.054; lag time, 4 months; P = .003).
These findings provide additional evidence to support the value of antimicrobial stewardship as an essential element of multifaceted interventions to control CDI outbreaks. The present CDI outbreak was ended following the implementation of an action plan improving communication, antibiotic stewardship, infection control practices, environmental hygiene, and surveillance.
A spectroscopic survey of nearly 700 stars probing the Galactic Thick Disc far from the
Solar neighbourhood is performed. The MATISSE (MATrix Inversion for Spectral SynthEsis)
algorithm is developed and trained in order to automatically obtain atmospheric parameters
of stars. The derived effective temperatures, surface gravities and overall metallicities
are then combined to stellar evolution isochrones, radial velocities and proper motions to
derive the distances, kinematics and orbital parameters of the sample stars. Results are
compared with simulations from the Besançon model of the Milky Way.
A key to the ultimate technological applications of core-shell nanoparticle materials is the understanding of the structure-property correlation. This work focuses on the characterizations of the structural properties for composite thin films derived from gold nanoparticles and thiolates using infrared reflectance spectroscopic (IRS) and electron spin resonance (ESR) techniques. IRS provides information on molecular packing and ordering of the shell components in the films, which relates to the molecular interactions and interfacial reactivities. ESR probes the conduction electron spin resonance properties of the nanosized cores, which can be correlated with the network or environmental electronic effects on the crystal cores. Results are discussed in terms of their correlation with the nanoparticle core sizes and the organic shell functionality.
Poor fertility is a major problem on dairy farms. On-farm studies indicate than pregnancy rates to first service have declined from approximately 55% between 1975 and 1982 to 39% between 1995 and 1998 (Royal et al., 2000), illustrating a decline of approximately 1% per year during this period. The cause is multifactorial and influenced by many factors including genetics, management and nutrition. Previous studies have reported improved fertility through nutritional modification in early lactation (Gong et al., 2002). The aim of this study was to evaluate the effect of nutritional strategy in early lactation on reproductive performance.
Improving the sustainability and overall longevity and health of modern Holstein Friesian (HF) dairy cattle is essential in order to maintain overall farm profitability. Prolonged negative energy balance in early lactation can result in metabolic stress, as well as long term problems with fertility (Pryce et al., 2004). In addition, maximising the efficiency of nitrogen (N) utilisation by strategies such as reducing the crude protein content of the diet is of crucial importance in minimising the environmental impact of dairying. The aim of this study was to evaluate the effect of a range of nutritional strategies on milk production, energy balance and efficiency of N use in early lactation.
Gaia is an ESA cornerstone mission which will observe some billion stars in the galaxy enabling micro-arcsec astrometric catalogues to be constructed. In addition Gaia will produce high quality photometric and spectroscopic catalogues.
The data processing tasks are large and complex. A European consortium has been formed - the Gaia Data Processing and Analysis Consortium (DPAC). This paper describes the form of the UK Gaia Data Flow System Project contribution to the DPAC.
Massive star clusters in the Magellanic Clouds are observed to follow a striking trend in size with age – older clusters exhibit a much greater spread in core radius than do younger clusters, which are generally compact. We present results from realistic N-body modelling of massive star clusters, aimed at investigating a dynamical origin for the radius-age trend. We find that stellar-mass black holes, formed as remnants of the most massive stars in a cluster, can constitute a dynamically important population. If retained, these objects rapidly form a dense core where interactions are common, resulting in the scattering of black holes into the cluster halo, and the ejection of black holes from the cluster. These processes heat the stellar component, resulting in prolonged core expansion of a magnitude matching the observations. Core expansion at early times does not result from the action of black holes, but can be reproduced by the effects of rapid mass-loss due to stellar evolution in a primordially mass segregated cluster.
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