Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations

Abstract Health care-associated infections (HAI) are a major public health problem with a significant impact on morbidity, mortality and quality of life. They represent also an important economic burden to health systems worldwide. However, a large proportion of HAI are preventable through effective infection prevention and control (IPC) measures. Improvements in IPC at the national and facility level are critical for the successful containment of antimicrobial resistance and the prevention of HAI, including outbreaks of highly transmissible diseases through high quality care within the context of universal health coverage. Given the limited availability of IPC evidence-based guidance and standards, the World Health Organization (WHO) decided to prioritize the development of global recommendations on the core components of effective IPC programmes both at the national and acute health care facility level, based on systematic literature reviews and expert consensus. The aim of the guideline development process was to identify the evidence and evaluate its quality, consider patient values and preferences, resource implications, and the feasibility and acceptability of the recommendations. As a result, 11 recommendations and three good practice statements are presented here, including a summary of the supporting evidence, and form the substance of a new WHO IPC guideline

Evolution of crop yields and qualities in a short rotation coppice alley cropping system in Central Germany

PosterA modern form of agroforestry are alley cropping systems where annual field crops are grown in combination with strips of fast-growing tree species, so-called short rotation coppices (SRCs). Besides fulfilling the farmers requirements to keep the field in the state of production, SRC strips provide many of the well-known positive functions of hedges. They act as wind shelter, reducing soil erosion. By influencing microclimate, they can balance out short periods of extreme climatic conditions leading to higher and more stable biomass yields of the field crops. Furthermore, they may affect quality parameters of crops and disease pressure. SRCs increase the structural and habitat diversity in the landscape, thus promoting biodiversity. Studies on these various aspects are carried out in five agroforestry systems (AFS) within the joint project “AgroForstEnergie”, funded by the Federal Ministry of Food and Agriculture, Germany, since 2007. The sub-project of the Thuringian State Institute of Agriculture focuses on influences on crop yield and quality. Crop yield data were collected by GPS-equipped harvesters and evaluated with the software ArcGIS. Along a transect with defined distances from SRC strips, we recorded data on crop quality and fungus infection rate and conducted vegetation surveys. Results showed a reduction of wheat and barley yields in close vicinity to SRC strips and an increase towards the middle of the field. No such pattern was observed for rape seed. Increased fungus infections and effects on quality parameters were found in some years, but only in the immediate SRC strip vicinity. SRC strips had a much higher plant species richness than field strips, showing their valuable contribution to an increase in biodiversity. The weed pressure on adjacent crops strips was comparable to the one found along conventional field edges

Investigation of characteristics of Silicon APDs for use in scintillating fiber trackers

this paper concern exclusively the operation in the avalanche mode. 2 APD samples and producer dat

Use of face masks by non-scrubbed operating room staff: a randomized controlled trial

Background: Ambiguity remains about the effectiveness of wearing surgical face masks. The purpose of this study was to assess the impact on surgical site infections when non-scrubbed operating room staff did not wear surgical face masks. Design: Randomised controlled trial. Participants: Patients undergoing elective or emergency obstetric, gynecological, general, orthopaedic, breast or urological surgery in an Australian tertiary hospital. Intervention: 827 participants were enrolled and complete follow-up data was available for 811 (98.1%) patients. Operating room lists were randomly allocated to a ‘Mask roup’ (all non-scrubbed staff wore a mask) or ‘No Mask group’ (none of the non-scrubbed staff wore masks). Primary end point: Surgical site infection (identified using in-patient surveillance; post discharge follow-up and chart reviews). The patient was followed for up to six weeks. Results: Overall, 83 (10.2%) surgical site infections were recorded; 46/401 (11.5%) in the Masked group and 37/410 (9.0%) in the No Mask group; odds ratio (OR) 0.77 (95% confidence interval (CI) 0.49 to 1.21), p = 0.151. Independent risk factors for surgical site infection included: any pre-operative stay (adjusted odds ratio [aOR], 0.43 (95% CI, 0.20; 0.95), high BMI aOR, 0.38 (95% CI, 0.17; 0.87), and any previous surgical site infection aOR, 0.40 (95% CI, 0.17; 0.89). Conclusion: Surgical site infection rates did not increase when non-scrubbed operating room personnel did not wear a face mask

A systematic review of maternal intrinsic risk factors associated with surgical site infection following Caeasrean sections.

We undertook a systematic review of maternal intrinsic risk factors associated with surgical site infection (SSI) following Caesarean section (CS). Studies published in the English language from 1990 to 2007, meeting specific inclusion criteria, were identified from searches of six health and medical literature electronic databases. Two reviewers independently assessed studies for inclusion and extracted data. Fifteen included studies found two independent risk factors for overall SSI: obesity and chorioamnionitis. Premature ruptured membrane >6 h and anaemia were associated with incisional SSI. Anaemia was associated with organ/space SSI. The maternal intrinsic risk factors identified can be used in surveillance programs to identify women at risk of SSI and to risk-adjust hospital infection rates for between-institution comparison