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Palo Alto, CA, United States

The introduction of mandatory surveillance of Clostridium difficile infection (CDI) in 2004 showed the scale of the challenge: cases in patients >64 years old reached 55,681 in 2006. The first type 027 outbreaks had been in 2005 and CDI was a headline issue. The prevention and control of CDI requires a tripartite partnership between clinicians, health service managers, and the government/Department of Health which needs to set standards, ensure that CDI is a priority, set targets and monitor outcome. Government can also legislate; the Health Act 2006 introduced a statutory Code of Practice for infection prevention and control for the NHS and extended to all independent health and care settings in 2010. In 2008, a national target was set for a 30% reduction in CDI by 2010-11 (baseline 2007-8). It was population-based and set a standard (ceiling) rate/10,000 in each area, within which acute hospitals had a target/1000 admissions (diagnosed after day 3). In the first year (2008-9), a 35% reduction was achieved from 55,499 to 36,079 cases in all ages and in 2009-10 the total was 25,604, a 54% reduction from 2007-8. However, in 2009, cases >64 years old were 29% down from 2008 but only 9% down in the 2-64 year old group; also, by this stage, cases in acute hospitals and in other settings were almost equal. Death certification showing CDI fell for the first time in 2008 and in 2009 there were 3550 total mentions (7816 in 2007) of which 1510 (42%) were as underlying cause (3875, 49%, in 2007). The reductions in CDI have been achieved by a raft of measures. Crucially, the targets focused management emphasis on infection prevention and control. This was supported by enhanced surveillance. Clinical practice protocols were implemented through the high impact interventions (care bundle) approach, and there was a major emphasis on cleanliness and hygiene (particularly hand washing for clinical staff and environmental cleaning and disinfection in patient areas). Achievement of the target is not the end of the road; it is to be transformed into an objective (benchmark) for 2011 and beyond based on median rates to maintain pressure for reduction. © 2010. Source


Humphreys K.,House of Control | Humphreys K.,Stanford University
Substance Abuse | Year: 2012

The Obama Administration is striving to promote both public health and public safety by improving the public policy response to criminal offenders who have substance use disorders. This includes supporting drug courts, evidence-based probation and parole programs, addiction treatment and re-entry programs. Scientists and clinicians in the addiction field have a critical role to play in this much-needed effort to break the cycle of addiction, crime and incarceration. Copyright © 2012 Taylor and Francis Group, LLC. Source


Patterson M.,University of Maine, United States | Patterson M.,House of Control | Alyokhin A.,University of Maine, United States
Crop Protection | Year: 2014

Phosphite is a general term used to describe the salts of phosphorous acid H3PO3. It is effective in suppressing a number of plant diseases caused by oomycetes and has been shown to reduce populations of several insect species. We investigated the effects of phosphite on the Colorado potato beetles in the field and laboratory. Beetle numbers and defoliation on phosphite-treated plots were lower compared to the control plots during one out of two years of the study. No phosphite effects were detected in the field during the second year of the study. However, larval mortality was significantly higher the second year in the laboratory when larvae were fed on potato foliage excised from the potato plants treated with phosphite in the field. Laboratory tests with excised leaves dipped in a solution of phosphite revealed lower beetle survivorship and prolonged development on the treated foliage. Because of its dual properties as a fungicide and an insecticide, as well as its low toxicity to vertebrates, phosphite is a potentially good fit for integrated pest management programs. © 2014 Elsevier Ltd. Source


Durosinlorun A.,House of Control | Umoh J.U.,Ahmadu Bello University | Abdu P.A.,Ahmadu Bello University | Ajogi I.,Ahmadu Bello University
Avian Diseases | Year: 2010

A serologic survey for antibodies against H5 subtype influenza virus in 605 apparently healthy local chickens using a hemagglutination inhibition test was carried out in 12 local government areas of Kaduna state, Nigeria. An overall prevalence of 18.1% was recorded, with a higher prevalence of 27.3% in six local government areas that have not reported outbreaks of highly pathogenic avian influenza (HPAI) H5N1 virus and a lower prevalence of 7.5% in six local government areas that had reported and confirmed outbreaks of HPAI H5N1 virus between 2006 and 2007. There was association between the presence of ducks and detection of H5 antibodies (P = 0.000, odds ratio = 0.22). The implication of this finding is discussed, although a virologic investigation to verify the findings of this study is highly recommended. © 2010 American Association of Avian Pathologists. Source


Gorrell M.,House of Control
Journal of Infection Prevention | Year: 2012

The National Health Service (NHS) in England is facing significant challenges ahead as a result of the government's plans to reduce national debt. The challenge for infection control practitioners will be to continue to support the development and delivery of high quality clinical services without the level of funding previously experienced over the last decade. In order to achieve this all healthcare professionals will be required to embrace improvement strategies. The purpose of this paper is therefore to report on a review of a clinical reporting and root cause analysis (CRRCA) process coordinated by a community-based infection prevention and control team. The paper outlines the issues surrounding the current CRRCA process and analyses the process using lean concepts. A series of change options are put forward in order to illustrate how a failure to effectively scope improvement project boundaries can constrain change thereby limiting the potential for productivity and quality improvement. © The Author(s) 2012. Source

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