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The escalating conflicts in the Middle East have been associated with the rapid collapse of the existing healthcare systems in affected countries. As millions of refugees flee their countries, they become vulnerable and exposed to communicable diseases that easily grow into epidemic crises. Here, we describe infectious disease epidemics that have been associated with conflicts in the Middle East, including cholera, poliomyelitis, measles, cutaneous leishmaniasis, and diphtheria, that call for appropriate preventive measures. Local ongoing wars and failing healthcare systems have resulted in regional and global health threats that warrant international medical interventions.
To determine the impact of an environmental disinfection intervention on the incidence of healthcare-associated Clostridium difficile infection (CDI).
A multicenter randomized trial.
In total,16 acute-care hospitals in northeastern Ohio participated in the study.
We conducted a 12-month randomized trial to compare standard cleaning to enhanced cleaning that included monitoring of environmental services (EVS) personnel performance with feedback to EVS and infection control staff. We assessed the thoroughness of cleaning based on fluorescent marker removal from high-touch surfaces and the effectiveness of disinfection based on environmental cultures for C. difficile. A linear mixed model was used to compare CDI rates in the intervention and postintervention periods for control and intervention hospitals. The primary outcome was the incidence of healthcare-associated CDI.
Overall, 7 intervention hospitals and 8 control hospitals completed the study. The intervention resulted in significantly increased fluorescent marker removal in CDI and non-CDI rooms and decreased recovery of C. difficile from high-touch surfaces in CDI rooms. However, no reduction was observed in the incidence of healthcare-associated CDI in the intervention hospitals during the intervention and postintervention periods. Moreover, there was no correlation between the percentage of positive cultures after cleaning of CDI or non-CDI rooms and the incidence of healthcare-associated CDI.
An environmental disinfection intervention improved the thoroughness and effectiveness of cleaning but did not reduce the incidence of healthcare-associated CDI. Thus, interventions that focus only on improving cleaning may not be sufficient to control healthcare-associated CDI.
Transitioning to low-carbon energy systems depends on fundamental changes in technologies, policies, and institutions. In Western democracies, public perceptions and engagement with energy have encouraged innovation while also slowing deployment of low-carbon energy technologies (LCETs).
Transitioning to low-carbon energy systems requires re-engineering technologies and changing the ways people interact with energy. This shift involves both technological and social changes including modifications in policies and institutional configurations. In Western democracies, public perceptions and engagement with energy have encouraged innovation while also slowing deployment of low-carbon energy technologies (LCETs). To aid understanding of how energy systems are evolving toward lower-carbon technologies in Western democracies, this study reviews the literature on public perception of and engagement with emerging LCETs. Focusing primarily on electricity generating technologies, we explore how multiple factors related to place and process shape public perceptions of and engagement with LCETs, thereby influencing their development and deployment. This study first reviews literature related to how place and process influence emerging LCETs and then provides a comparative example of differential development of wind energy in Texas and Massachusetts (USA) to demonstrate how place and process may interact to influence the patterns of LCET deployment.
Prominent authorities have called for the creation of a Code of Ethics for those engaged in legal education. The purpose of this essay is to advance the discussion by proposing a specific set of standards for consideration.
A preliminary question to be answered is why have a code of ethics for law educators?
Ethics are adopted in order to foster unique relationships created by specialized human institutions. Professional codes of ethics differ from morality and law in that they impose additional expectations upon the professional. If they did not, ethical codes would be superfluous, and professionals might simply be expected to act morally and to obey the law. As it is, the ethical demands of a profession are often foreign or contrary to generally applicable principles of morality and law.
Assuming that one agrees that professional codes of ethics are generally salutary, one might disagree about the necessity of drafting a new one for legal academicians. The American Association of University Professors Statement on Professional Ethics may be thought to suffice for defining a teacher's academic responsibilities, as may the American Bar Association Model Rules of Professional Conduct for all ethical questions encountered in the practice of law.