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A 54-question survey about System Healthcare Infection Prevention Programs (SHIPPs) was sent out to SHEA Research Network participants in August 2023. Thirty-eight United States-based institutions responded (38/93, 41%), of which 23 have SHIPPs. We found heterogeneity in the structure, staffing, and resources for system infection prevention (IP) programs.
Prior studies evaluating the impact of discontinuation of contact precautions (DcCP) on methicillin-resistant Staphylococcus aureus (MRSA) outcomes have characterized all healthcare-associated infections (HAIs) rather than those likely preventable by contact precautions. We aimed to analyze the impact of DcCP on the rate of MRSA HAI including transmission events identified through whole genome sequencing (WGS) surveillance.
Design:
Quasi experimental interrupted time series.
Setting:
Acute care medical center.
Participants:
Inpatients.
Methods:
The effect of DcCP (use of gowns and gloves) for encounters among patients with MRSA carriage was evaluated using time series analysis of MRSA HAI rates from January 2019 through December 2022, compared to WGS-defined attributable transmission events before and after DcCP in December 2020.
Results:
The MRSA HAI rate was 4.22/10,000 patient days before and 2.98/10,000 patient days after DcCP (incidence rate ratio [IRR] 0.71 [95% confidence interval 0.56–0.89]) with a significant immediate decrease (P = .001). There were 7 WGS-defined attributable transmission events before and 11 events after DcCP (incident rate ratio 0.90 [95% confidence interval 0.30–2.55]).
Conclusions:
DcCP did not result in an increase in MRSA HAI or, in WGS-defined attributable transmission events. Comprehensive analyses of the effect of transmission prevention measures should include outcomes specifically measuring transmission-associated HAI.
A theory is presented for wave-driven propulsion of floating bodies driven into oscillation at the fluid interface. By coupling the equations of motion of the body to a quasipotential flow model of the fluid, we derive expressions for the drift speed and propulsive thrust of the body which in turn are shown to be consistent with global momentum conservation. We explore the efficacy of our model in describing the motion of SurferBot (Rhee et al., Bioinspir. Biomim., vol. 17, issue 5, 2022), demonstrating close agreement with the experimentally determined drift speed and oscillatory dynamics. The efficiency of wave-driven propulsion is then computed as a function of driving oscillation frequency and the forcing location, revealing optimal values for both of these parameters which await confirmation in experiments. A comparison with other modes of locomotion and applications of our model with competitive water sports is discussed in conclusion.
“All or none” approaches to the use of contact precautions for methicillin-resistant Staphylococcus aureus (MRSA) both fail to recognize that transmission risk varies. This qualitative study assessed healthcare personnel perspectives regarding the feasibility of a risk-tailored approach to use contact precautions for MRSA more strategically in the acute care setting.
In this chapter, the subjection of the Israelites in Egypt and their later liberation from oppression is examined with extracts from the Hebrew Torah, and the Greek Septuagint. The vocabulary of servitude of both Hebrew and Greek is discussed through the account of Joseph’s service and disgrace in the house of Potiphar, followed by the suffering of the Israelites, the later descendants of Jacob. The oppression inflicted by the Egyptians and their pharaoh on the Israelites in Egypt is to be seen in their forced labour in making bricks and construction work. Liberation involved leaving the country together, under the leadership of Moses. A final section examines a few further literary texts dating from the Hellenistic and Roman periods that treat related Jewish subjects.
In this chapter tomb paintings join the selection of texts (preserved on stone, papyrus, and leather) to show the role of dependence as a structural feature of pharaonic society. Foreigners were acquired through raiding and warfare, and settled in both existing and new communities. An actual trade in persons is also documented and varying aspects of the experience of such individuals is examined, as they were exploited by those who purchased them or passed them on as gifts. Changes over time in the vocabulary of dependence are discussed, as are the different types of work and production in which such dependents were involved. Non-free dependents were employed on the land, in animal herding, and in artisanal workshops, especially textiles, as well as in the home. The key economic role of Egyptian temples is a constant feature of the period.
This chapter introduces the following corpus of texts from ancient Egypt, and outlines the differing meanings ascribed to slavery and dependence from antiquity to modern times. The terms used for dependents and slaves in the various languages of the texts translated here – Egyptian (Hieroglyphic, Hieratic, Demotic, and Coptic), Greek, and Arabic – are briefly presented, and defining features of the condition of those so labelled are discussed. How and from where such persons were acquired, their life experiences, and the different forms of exploitation in which they were involved are introduced, as are forms of slave resistance and limits to the archaeological and textual evidence available, and so to what we can learn from it.
Covering late antique Egypt into the period of Arab rule, this chapter introduces documents and literary texts translated from Greek, Coptic, and Arabic. In the countryside, coloni joined slaves and dependents at work on the great estates of Byzantine Egypt, while in the cities slavery continued as before. Coptic literature from the same period introduces servitude within Christian monasteries. The writings of Shenoute and Gnostic texts regularly employ the vocabulary of slavery in a negative sense. The trade, employment, and emancipation of slaves continued. Conscripted labour is also documented. Children and adults donated to monasteries represent a new form of sacred servitude. With the Arab conquest of Egypt, war and raiding resurface as important sources of slaves. Nubia and the Near East were again key areas for their acquisition, and slaves are illustrated as active in most areas of life and integrated into the religious life of their owners’ households.