On the Bias and Mean Square Error of the Ratio of Two Biased Estimators

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Effect of carbapenem restriction on prescribing trends for immunocompromised wards at an academic medical center

The recently described proportion of carbapenem consumption metric was used to assess the effectiveness of formulary restriction for carbapenems for 2 units housing predominantly immunocompromised patients at a large academic medical center. Interrupted time series analysis revealed a significant decrease in meropenem use for hematology-oncology and bone marrow transplant units after restriction. (C) 2019 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved

Lee region of Gran Canaria

21 páginas, 9 figuras.The mountainous Canary Islands present obstacles to the trade winds and to the Canary Current flowing equatorward past them. In situ observations of hydrographic properties and surface winds south of Gran Canaria, together with advanced very high resolution radiometer and synthetic aperture radar images during 2 weeks in summer 1995 are analyzed. A cyclonic eddy shed from the west of the island drifted southwestward at 5 cm s−1, while the southeast coast was approached by an upwelling filament originating off NW Africa. A wind lee region bounded by intense horizontal shear lines had a weak return islandward wind in its center. The lee formed a triangular, diurnally varying, warm water pool with two sea surface temperature maxima separated by lower temperatures below the return wind. Shallow temperature stratification occurred behind the island in contrast to the uniform surface mixed layer in exposed regions. Upwelling and downwelling of 10 – 20 m d−1 were indicated on the cyclonic and anticyclonic sides of the lee region. In the SAR images, lines of strong current shear along a temperature front between the cyclonic eddy and the upwelling filament were identifiable. However, the radar images were dominated by atmospheric phenomena, including mountain lee wave packets, windrows, and wind shear lines. Estimation of the wind field from the SAR backscatter intensity revealed complex structure and intensification on the edges of the warm lee.The field work was carried out during the European Institute for Advanced Studies in Oceanography 1995 Summer School on Upwelling Systems held at the Universidad de Las Palmas de Gran Canaria funded by the Commission of the European Union and the United Nations Education and Science Organisation. E.G. Mitchelson-Jacob and E.D. Barton were Investigators in project AO2.UK131 and P . Flament was Investigator in project AO2.USA198 of the European Space Agency, which provided the ERS-1 and 2 data.Peer reviewe

Healthcare Personnel Attire in Non-Operating-Room Settings

Healthcare personnel (HCP) attire is an aspect of the medical profession steeped in culture and tradition. The role of attire in cross-transmission remains poorly established and until more definitive information exists, priority should be placed on evidence-based measures to prevent hospital acquired infections (HAI). This paper aims to provide a general guidance to the medical community regarding HCP attire outside the operating room. In addition to the initial guidance statement, the manuscript has three major components: 1. A review and interpretation of the medical literature regarding a) perceptions of HCP attire (from both HCP and patients) and b) evidence for contamination of attire and its potential contribution to cross-transmission; 2. A review of hospital policies related to HCP attire, as submitted by members of the SHEA Guidelines Committee; 3. A survey of SHEA and SHEA Research Network members, which assessed both institutional HCP attire policies and perceptions of HCP attire in the cross-transmission of pathogens. Recommendations for HCP attire should attempt to balance professional appearance, comfort, and practicality with the potential role of apparel in the cross-transmission of pathogens. Although the optimal choice of HCP attire for inpatient care remains undefined, we provide recommendations on the use of white coats, neck ties, footwear, the bare-below-the-elbows strategy, and laundering. Institutions considering these optional measures should introduce them with a well-organized communication and education effort directed at both HCP and patients. Appropriately designed studies are needed to better define the relationship between HCP attire and HAIs