Quantification Of Replication Present In Hiv Reports And Effect Of Patient Movement Between Wards On Mrsa Infection
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Quantification Of Replication Present In Hiv Reports And Effect Of Patient Movement Between Wards On Mrsa Infection
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Author : Wenwen Huo
language : en
Publisher:
Release Date : 2014
Quantification Of Replication Present In Hiv Reports And Effect Of Patient Movement Between Wards On Mrsa Infection written by Wenwen Huo and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2014 with categories.
Outbreaks of widely spread infectious diseases, such as Human Immunodefficiency Virus (HIV), Severe Acute Respiratory Syndrome (SARS) and Swineflu (H1N1) and hospital acquired infections, such as Meticillin-resistant Staphylococcus Aureus (MRSA) and Clostridium Diffcile, are serious health problems which have been tackled by the World Health Organization and international health protection agencies. Various statistical analyses have contributed a remarkable effect on providing scientific evidence on which to base political decisions and infection control strategies. In this project, we focused on two infectious diseases: HIV and MRSA and the research project is divided into two separate parts. One is the quantification of replication in HIV anonymous test reports and the other is the effect of patient movement between wards on the acquisition of MRSA. The first research project is concerned with the analysis of an anonymous HIV test dataset. The data is collected as a set of birthdays and it is possible that there is repeated sampling of the same person. The aim is to quantify the amount of replication in the HIV data using a maximum likelihood technique and then give the confidence intervals for the estimated amount of replication using the bootstrap method. The data were provided by the Public Health Laboratory Service (PHLS), Colindale, London in 1994, who were interested in a statistical method to estimate multiple counting that possibly existed in the database. The data consists of individual records of the number of AIDS cases diagnosed, with birthdates from 1901 to 1973. There were two datasets provided by the PHLS, one of which contained 1,134 records and was provided in 1991. The other dataset was provided in 1994 with the sample size 17,137. An estimate of the true number of distinct individuals as well as the percentage of replication was obtained by programming the maximum likelihood calculation in the languages R and C. This technique is based upon evaluation of the probability that two records with the same birthdate represent two separate individuals as opposed to the same person reported twice. The results for the 1991 dataset showed that there were five out of sixteen birth years (i.e. 31.25% of the observed records in the 1991 dataset) with replication in the true number of distinct individuals. In the results of the 1994 dataset, the majority of the birth years (57/73) recorded the correct number of distinct individuals in the observations. The 95% confidence intervals for the estimated amount of replication were calculated by applying a parametric bootstrap method. The results show that the birth years in the 1991 dataset with non-zero estimated amount of replication (the birth years of 1931, 1934, 1935, 1943 and 1944) have comparatively wide 95% bootstrap confidence intervals, which implies higher uncertainty of the true amount of replication. A similar conclusion was obtained from the results of 95% bootstrap con dence intervals for the 1994 dataset. Comparing the results within the same birth years recorded in the 1991 dataset and the 1994 dataset, the data indicate that the confidence intervals for the 1994 dataset are mainly narrower than the corresponding ones in the 1991 dataset. The conclusion of this study illustrates the drawback of recording the HIV patients only with date of birth, which has now been improved by combining with 'Soundex' codes for the surname and gender. The second part of the project aims to estimate the impact of patient movement within a hospital on the risk of MRSA acquisition by using data from the MRSA screening admission and discharge studies in Scotland which took place in two hospitals in 2010. The data consist of an admission-only database (7,181 patients), a discharge-only database (2,432 patients) and a combined admission-discharge cohort (2,792 patients). The third database has complete information on MRSA status on admission, on discharge, as well as data on the wards the patient was in while in hospital. In order to understand the effect of potential risk factors on MRSA acquisition, a multivariate logistic regression model was constructed to analyse the effects of the number of wards a patient was in on MRSA acquisition as well as other risk factors. Receiver Operating Characteristic (ROC) curves were plotted and the individual area under the curve (AUC) was also calculated for indicating the reliability and the accuracy of the prediction of the models. Furthermore, we modelled the dynamic patient movement and assessed the effect of being in a ward with MRSA by imputing the unknown date of transfer, simulating the missing length of stay (along with the simulation envelope). The timelines of MRSA infection and carriage pressure in each ward of the two hospitals were then mapped for all patients in the three databases, imputing where necessary. Patient movement was measured as a volume indicator in terms of the frequency of ward to ward transfer and as cohabiting in the same ward. By using logistic regression within a bootstrap simulation, we estimated the odds ratio of acquisition of MRSA association with being in a ward with MRSA present, which was given by averaging the estimated effects from the fitted models, and generating the 95% confidence intervals. The results indicate that the number of wards that patients had moved through and patients being in a ward with MRSA present do not affect the risk of acquiring MRSA significantly over and above the patient level risk factors such as age and the presence of open wounds or catheters. Some further work which can be done in an MRSA screening programme is suggested as an implementation study.
Caring For People Who Sniff Petrol Or Other Volatile Substances
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Author : National Health and Medical Research Council (Australia)
language : en
Publisher:
Release Date : 2011
Caring For People Who Sniff Petrol Or Other Volatile Substances written by National Health and Medical Research Council (Australia) and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011 with Aboriginal Australians categories.
These guidelines provide recommendations that outline the critical aspects of infection prevention and control. The recommendations were developed using the best available evidence and consensus methods by the Infection Control Steering Committee. They have been prioritised as key areas to prevent and control infection in a healthcare facility. It is recognised that the level of risk may differ according to the different types of facility and therefore some recommendations should be justified by risk assessment. When implementing these recommendations all healthcare facilities need to consider the risk of transmission of infection and implement according to their specific setting and circumstances.
Sars Mers And Other Viral Lung Infections
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Author : David S. Hui
language : en
Publisher: European Respiratory Society
Release Date : 2016-06-01
Sars Mers And Other Viral Lung Infections written by David S. Hui and has been published by European Respiratory Society this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-06-01 with Medical categories.
Viral respiratory tract infections are important and common causes of morbidity and mortality worldwide. In the past two decades, several novel viral respiratory infections have emerged with epidemic potential that threaten global health security. This Monograph aims to provide an up-to-date and comprehensive overview of severe acute respiratory syndrome, Middle East respiratory syndrome and other viral respiratory infections, including seasonal influenza, avian influenza, respiratory syncytial virus and human rhinovirus, through six chapters written by authoritative experts from around the globe.
Patient Safety And Quality
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Author : Ronda Hughes
language : en
Publisher: Department of Health and Human Services
Release Date : 2008
Patient Safety And Quality written by Ronda Hughes and has been published by Department of Health and Human Services this book supported file pdf, txt, epub, kindle and other format this book has been release on 2008 with Medical categories.
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
Infections In Pregnancy
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Author : Adel Elkady
language : en
Publisher: Cambridge University Press
Release Date : 2019-10-24
Infections In Pregnancy written by Adel Elkady and has been published by Cambridge University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-10-24 with Medical categories.
Provides effective diagnosis and management of infectious diseases in pregnant women in a single comprehensive available resource for busy clinicians.
Textbook Of Neurointensive Care
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Author : A Joseph Layon
language : en
Publisher: Springer Science & Business Media
Release Date : 2013-08-15
Textbook Of Neurointensive Care written by A Joseph Layon and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-08-15 with Medical categories.
This updated and refined new edition is the only book to provide a comprehensive approach to the intensive care of neurologically injured patients from the emergency room and ICU through the operating room and post-surgical period. It reviews neuroanatomy, neuroradiology, and neurophysiology, examines the neurological problems most frequently seen in intensive care, and describes the various types of neurosurgery. General issues are discussed, such as cardiac care, fluids and electrolytes, nutrition, and monitoring as well as more specific conditions and complications including elevated intracranial pressure, seizures, and altered mental states.
Guideline For Isolation Precautions In Hospitals
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Author : Julia S. Garner
language : en
Publisher:
Release Date : 1983
Guideline For Isolation Precautions In Hospitals written by Julia S. Garner and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1983 with Cross infection categories.
Mechanisms Of Antibiotic Resistance
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Author : Jun Lin
language : en
Publisher: Frontiers Media SA
Release Date : 2015-06-01
Mechanisms Of Antibiotic Resistance written by Jun Lin and has been published by Frontiers Media SA this book supported file pdf, txt, epub, kindle and other format this book has been release on 2015-06-01 with Antibiotics categories.
Antibiotics represent one of the most successful forms of therapy in medicine. But the efficiency of antibiotics is compromised by the growing number of antibiotic-resistant pathogens. Antibiotic resistance, which is implicated in elevated morbidity and mortality rates as well as in the increased treatment costs, is considered to be one of the major global public health threats (www.who.int/drugresistance/en/) and the magnitude of the problem recently prompted a number of international and national bodies to take actions to protect the public (http://ec.europa.eu/dgs/health_consumer/docs/road-map-amr_en.pdf: http://www.who.int/drugresistance/amr_global_action_plan/en/; http://www.whitehouse.gov/sites/default/files/docs/carb_national_strategy.pdf). Understanding the mechanisms by which bacteria successfully defend themselves against the antibiotic assault represent the main theme of this eBook published as a Research Topic in Frontiers in Microbiology, section of Antimicrobials, Resistance, and Chemotherapy. The articles in the eBook update the reader on various aspects and mechanisms of antibiotic resistance. A better understanding of these mechanisms should facilitate the development of means to potentiate the efficacy and increase the lifespan of antibiotics while minimizing the emergence of antibiotic resistance among pathogens.
Extending The Cure
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Author : Ramanan Laxminarayan
language : en
Publisher: Routledge
Release Date : 2010-09-30
Extending The Cure written by Ramanan Laxminarayan and has been published by Routledge this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010-09-30 with Medical categories.
Our ability to treat common bacterial infections with antibiotics goes back only 65 years. However, the authors of this report make it clear that sustaining a supply of effective and affordable antibiotics cannot be without changes to the incentives facing patients, physicians, hospitals, insurers, and pharmaceutical manufacturers. In fact, increasing resistance to these drugs is already exacting a terrible price. Every day in the United States, approximately 172 men, women, and children die from infections caused by antibiotic-resistant bacteria in hospitals alone. Beyond those deaths, antibiotic resistance is costing billions of dollars through prolonged hospital stays and the need for doctors to resort to ever more costly drugs to use as substitute treatments. Extending the Cure presents the problem of antibiotic resistance as a conflict between individual decision makers and their short-term interest and the interest of society as a whole, in both present and future: The effort that doctors make to please each patient by prescribing a drug when it might not be properly indicated, poor monitoring of discharged patients to ensure that they do not transmit drug-resistant pathogens to other persons, excesses in the marketing of new antibiotics, and the broad overuse of antibiotics all contribute to the development and spread of antibiotic-resistant bacteria. The book explores a range of policy options that would encourage patients, health care providers, and managed care organizations to serve as more responsible stewards of existing antibiotics as well as proposals that would give pharmaceutical firms greater incentives to develop new antibiotics and avoid overselling. If the problem continues unaddressed, antibiotic resistance has the potential to derail the health care system and return us to a world where people of all ages routinely die from simple infections. As a basis for future research and a spur to a critically important dialogue, Extending the Cure is a fundamental first step in addressing this public health crisis. The Extending the Cure project is funded in part by the Robert Wood Johnson Foundation through its Pioneer Portfolio.
Emerging Viral Diseases
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Author : Institute of Medicine
language : en
Publisher: National Academies Press
Release Date : 2015-03-19
Emerging Viral Diseases written by Institute of Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2015-03-19 with Medical categories.
In the past half century, deadly disease outbreaks caused by novel viruses of animal origin - Nipah virus in Malaysia, Hendra virus in Australia, Hantavirus in the United States, Ebola virus in Africa, along with HIV (human immunodeficiency virus), several influenza subtypes, and the SARS (sudden acute respiratory syndrome) and MERS (Middle East respiratory syndrome) coronaviruses - have underscored the urgency of understanding factors influencing viral disease emergence and spread. Emerging Viral Diseases is the summary of a public workshop hosted in March 2014 to examine factors driving the appearance, establishment, and spread of emerging, re-emerging and novel viral diseases; the global health and economic impacts of recently emerging and novel viral diseases in humans; and the scientific and policy approaches to improving domestic and international capacity to detect and respond to global outbreaks of infectious disease. This report is a record of the presentations and discussion of the event.