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In preparation for a multisite antibiotic stewardship intervention, we assessed knowledge and attitudes toward management of asymptomatic bacteriuria (ASB) plus teamwork and safety climate among providers, nurses, and clinical nurse assistants (CNAs).
Prospective surveys during January–June 2018.
All acute and long-term care units of 4 Veterans’ Affairs facilities.
The survey instrument included 2 previously tested subcomponents: the Kicking CAUTI survey (ASB knowledge and attitudes) and the Safety Attitudes Questionnaire (SAQ).
A total of 534 surveys were completed, with an overall response rate of 65%. Cognitive biases impacting management of ASB were identified. For example, providers presented with a case scenario of an asymptomatic patient with a positive urine culture were more likely to give antibiotics if the organism was resistant to antibiotics. Additionally, more than 80% of both nurses and CNAs indicated that foul smell is an appropriate indication for a urine culture. We found significant interprofessional differences in teamwork and safety climate (defined as attitudes about issues relevant to patient safety), with CNAs having highest scores and resident physicians having the lowest scores on self-reported perceptions of teamwork and safety climates (P < .001). Among providers, higher safety-climate scores were significantly associated with appropriate risk perceptions related to ASB, whereas social norms concerning ASB management were correlated with higher teamwork climate ratings.
Our survey revealed substantial misunderstanding regarding management of ASB among providers, nurses, and CNAs. Educating and empowering these professionals to discourage unnecessary urine culturing and inappropriate antibiotic use will be key components of antibiotic stewardship efforts.
Neuromuscular diseases and respiratory failure are common problems encountered in both neurologic and medical intensive care units. Neuromuscular respiratory failure can be caused by diseases of the motor neuron, peripheral nerve, neuromuscular junction, or muscle. Thus, localization of the disorder is essential for adequate management.
Crystallization is one of the most important separation and product-formation technologies in the chemical industry. Typical advantages of crystallization are the low energy consumption, mild process conditions, and high product purity that can be obtained in a single separation step. The future impact of crystallization is even expected to increase further because many new high-added-value products are often in crystalline form. However, future crystalline products are also subject to increasingly stringent product quality requirements related to, for example, flowability, filterability, bioavailability, stability, and dissolution behavior. Product quality requirements for crystalline products typically vary strongly depending on the field of application.
Studies on neighbourhood characteristics and depression show equivocal results.
This large-scale pooled analysis examines whether urbanisation, socioeconomic, physical and social neighbourhood characteristics are associated with the prevalence and severity of depression.
Cross-sectional design including data are from eight Dutch cohort studies (n= 32 487). Prevalence of depression, either DSM-IV diagnosis of depressive disorder or scoring for moderately severe depression on symptom scales, and continuous depression severity scores were analysed. Neighbourhood characteristics were linked using postal codes and included (a) urbanisation grade, (b) socioeconomic characteristics: socioeconomic status, home value, social security beneficiaries and non-Dutch ancestry, (c) physical characteristics: air pollution, traffic noise and availability of green space and water, and (d) social characteristics: social cohesion and safety. Multilevel regression analyses were adjusted for the individual's age, gender, educational level and income. Cohort-specific estimates were pooled using random-effects analysis.
The pooled analysis showed that higher urbanisation grade (odds ratio (OR) = 1.05, 95% CI 1.01–1.10), lower socioeconomic status (OR = 0.90, 95% CI 0.87–0.95), higher number of social security beneficiaries (OR = 1.12, 95% CI 1.06–1.19), higher percentage of non-Dutch residents (OR = 1.08, 95% CI 1.02–1.14), higher levels of air pollution (OR = 1.07, 95% CI 1.01–1.12), less green space (OR = 0.94, 95% CI 0.88–0.99) and less social safety (OR = 0.92, 95% CI 0.88–0.97) were associated with higher prevalence of depression. All four socioeconomic neighbourhood characteristics and social safety were also consistently associated with continuous depression severity scores.
This large-scale pooled analysis across eight Dutch cohort studies shows that urbanisation and various socioeconomic, physical and social neighbourhood characteristics are associated with depression, indicating that a wide range of environmental aspects may relate to poor mental health.
Genetic predispositions play an important role in the development of internalizing and externalizing behaviors. Understanding the mechanisms through which genetic risk unfolds to influence these developmental outcomes is critical for developing prevention and intervention efforts, capturing key elements of Irv's research agenda and scientific legacy. In this study, we examined the role of parenting and personality in mediating the effect of genetic risk on adolescents’ major depressive disorder and conduct disorder symptoms. Longitudinal data were drawn from a sample of 709 European American adolescents and their mothers from the Collaborative Studies on Genetics of Alcoholism. Results from multivariate path analysis indicated that adolescents’ depressive symptoms genome-wide polygenic scores (DS_GPS) predicted lower parental knowledge, which in turn was associated with more subsequent major depressive disorder and conduct disorder symptoms. Adolescents’ DS_GPS also had indirect effects on these outcomes via personality, with a mediating effect via agreeableness but not via other dimensions of personality. Findings revealed that the pattern of associations was similar across adolescent gender. Our findings emphasize the important role of evocative gene–environment correlation processes and intermediate phenotypes in the pathways of risk from genetic predispositions to complex adolescent outcomes.
To investigate the potential dietary impact of the opening of new retailers of healthy foods.
Systematic review of the peer-reviewed research literature.
References published before November 2015 were retrieved from MEDLINE, EMBASE and Web of Science databases using keyword searches.
The outcome of the review was change in fruit and vegetable consumption among adults.
Of 3514 references retrieved, ninety-two articles were reviewed in full text, and twenty-three articles representing fifteen studies were included. Studies used post-test only (n 4), repeated cross-sectional (n 4) and repeated measures designs (n 7) to evaluate the dietary impact of supermarket (n 7), farmers’ market (n 4), produce stand (n 2) or mobile market (n 2) openings. Evidence of increased fruit and vegetable consumption was most consistent among adults who began shopping at the new retailer. Three of four repeated measures studies found modest, albeit not always statistically significant, increases in fruit and vegetable consumption (range 0·23–0·54 servings/d) at 6–12 months after baseline. Dietary change among residents of the broader community where the new retailer opened was less consistent.
The methodological quality of studies, including research designs, sampling methods, follow-up intervals and outcome measures, ranged widely. Future research should align methodologically with previous work to facilitate meta-analytic synthesis of results. Opening a new retailer may result in modest short-term increases in fruit and vegetable consumption among adults who choose to shop there, but the potential longer-term dietary impact on customers and its impact on the broader community remain unclear.
We present first results from pilot observations using a phased array feed (PAF) mounted on the Parkes 64-m radio telescope. The observations presented here cover a frequency range from 1 150 to 1 480 MHz and are used to show the ability of PAFs to suppress standing wave problems by a factor of ~10, which afflict normal feeds. We also compare our results with previous HIPASS observations and with previous H i images of the Large Magellanic Cloud. Drift scan observations of the GAMA G23 field resulted in direct H i detections at z = 0.0043 and z = 0.0055 of HIPASS galaxies J2242-30 and J2309-30. Our new measurements generally agree with archival data in spectral shape and flux density, with small differences being due to differing beam patterns. We also detect signal in the stacked H i data of 1 094 individually undetected galaxies in the GAMA G23 field in the redshift range 0.05 ⩽ z ⩽ 0.075. Finally, we use the low standing wave ripple and wide bandwidth of the PAF to set a 3σ upper limit to any positronium recombination line emission from the Galactic Centre of <0.09 K, corresponding to a recombination rate of <3.0 × 1045 s−1.
The Square Kilometre Array will be an amazing instrument for pulsar astronomy. While the full SKA will be sensitive enough to detect all pulsars in the Galaxy visible from Earth, already with SKA1, pulsar searches will discover enough pulsars to increase the currently known population by a factor of four, no doubt including a range of amazing unknown sources. Real time processing is needed to deal with the 60 PB of pulsar search data collected per day, using a signal processing pipeline required to perform more than 10 POps. Here we present the suggested design of the pulsar search engine for the SKA and discuss challenges and solutions to the pulsar search venture.
PSR B1820–30A is located in the globular cluster NGC 6624 and has the smallest projected distance to the centre of any globular cluster in the sky plane. We observe this millisecond pulsar over more than 25 years and obtain higher-order rotational frequency time derivative measurements through high-precision timing. Modelling these higher-order derivatives as being due to orbital motion, we find that the pulsar is in either a low-eccentricity smaller orbit with a low mass companion or a high-eccentricity larger orbit with a massive companion. The cluster mass properties and the observed properties of other nearby sources indicate that the high-eccentricity solution is more probably. This reveals that the pulsar is orbiting around an intermediate-mass black hole (IMBH) of mass >7500 M⊙ located at the cluster centre. This contribution is based on previous work published in MNRAS 471, 1258 (2017).
The majority of fast radio bursts (FRBs) are poorly localised, hindering their potential scientific yield as galactic, intergalactic, and cosmological probes. LOFT-e, a digital backend for the U.K.’s e-MERLIN seven-telescope interferometer will provide commensal search and real-time detection of FRBs, taking full advantage of its field of view (FoV), sensitivity, and observation time. Upon burst detection, LOFT-e will store raw data offline, enabling the sub-arcsecond localisation provided by e-MERLIN and expanding the pool of localised FRBs. The high-time resolution backend will additionally introduce pulsar observing capabilities to e-MERLIN.
W49 A is a star-forming region (SFR) found in the constellation of Aquila. It contains 3 active regions: W49 North (W49 N), W49 South West (W49 SW) and W49 South (W49 S). We present preliminary results from two epochs (e-)MERLIN observations of all ground-state OH masers towards the star-forming region (SFR) complex W49 A. The first epoch of observations was done in full-polarization mode with MERLIN in 2005 while the second epoch was obtained only in dual circular polarization during the test observations of the upgraded e-MERLIN in 2013. The overall maser spatial distributions in both epochs are in good agreement. We found several new high velocity maser features up to +34 km s−1 and −28 km s−1. The magnetic field strengths are between 1.1 to 10.8 mG. All three sources show evidence of magnetic field reversal.
PSR B1828–11 is a young pulsar once thought to be undergoing free precession and recently found instead to be switching magnetospheric states in tandem with spin-down changes. Here we show the two extreme states of the mode-changing found for this pulsar and comment briefly on its interpretation.
Multi-decade observing campaigns of the globular clusters 47 Tucanae and M15 have led to an outstanding number of discoveries. Here, we report on the latest results of the long-term observations of the pulsars in these two clusters. For most of the pulsars in 47 Tucanae we have measured, among other things, their higher-order spin period derivatives, which have in turn provided stringent constraints on the physical parameters of the cluster, such as its distance and gravitational potential. For M15, we have studied the relativistic spin precession effect in PSR B2127+11C. We have used full-Stokes observations to model the precession effect, and to constrain the system geometry. We find that the visible beam of the pulsar is swiftly moving away from our line of sight and may very soon become undetectable. On the other hand, we expect to see the opposite emission beam sometime between 2041 and 2053.
An evolution of the low-frequency pulse profile of PSR B2217+47 is observed during a six-year observing campaign with the LOFAR telescope at 150 MHz. The evolution is manifested as a new component in the profile trailing the main peak. The leading part of the profile, including a newly-observed weak component, is steady during the campaign. The transient component is not visible in simultaneous observations at 1500 MHz using the Lovell telescope, implying a chromatic effect. A variation in the dispersion measure of the source is detected in the same timespan. Precession of the pulsar and changes in the magnetosphere are investigated to explain the profile evolution. However, the listed properties favour a model based on turbulence in the interstellar medium (ISM). This interpretation is confirmed by a strong correlation between the intensity of the transient component and main peak in single pulses. Since PSR B2217+47 is the fourth brightest pulsar visible to LOFAR, we speculate that ISM-induced pulse profile evolution might be relatively common but subtle and that SKA-Low will detect many similar examples. In this scenario, similar studies of pulse profile evolution could be used in parallel with scintillation arcs to characterize the properties of the ISM.
We present the results from the Australian Long Baseline Array (LBA) observations of the ground- and excited-state OH masers at high resolutions towards the massive star-forming region G351.417+0.645 in 2012. We obtain the most accurate spatial gradient of magnetic fields at ground state transitions and verify the reliability of magnetic field strengths measured from previous lower resolution observations. In comparison with previous LBA observations in 2001 at 6.0 GHz, we identified several matched Zeeman pairs. We found that the OH maser features have no significant change of magnetic field strengths and directions with small internal proper motions, implying quite stable physical conditions. Additionally, we found that 1665- and 6035-MHz OH maser features reveal the same trend of reversal of magnetic fields. Moreover, we also analyzed the physical conditions at different locations from the coincidence of different OH maser transitions based on current OH maser models.
We present the results from an ongoing long-term monitoring of the 22 GHz H2O maser in W49N with the 100-m Effelsberg radio telescope from February 2014 to September 2017. The unique Effelsbergs spectral line observation capability provides a broad velocity range coverage from −500 to +500 km s−1 with a spectral resolution better than 0.1 km/s. Following the strong major outburst in W49N in late 2013, we have started a long-term monitoring programme at Effelsberg. The major outburst feature (up to 80,000 Jy at VLSR − 98 km s−1) faded away by June 2014. However, we found that the site is still active with several high velocity outbursts (both blue and redshifted). Some features appear at extremely high velocities (up to ±280 km s−1) and show rapid flux variations within a 1-2 month period. This sub-year scale variability implies that the water masers could be excited by episodic shock propagation caused by a high-velocity protostellar jet.