Impact of neonatal intensive care bed configuration on rates of late-onset bacterial sepsis and methicillin-resistant Staphylococcus aureus colonization

OBJECTIVES: Infections cause significant morbidity and mortality in neonatal intensive care units (NICUs). The association between nursery design and nosocomial infections has not been delineated. We hypothesized that rates of colonization by methicillin-resistant Staphylococcus aureus (MRSA), late-onset sepsis, and mortality are reduced in single-patient rooms. DESIGN: Retrospective cohort study. SETTING: NICU in a tertiary referral center. METHODS: Our NICU is organized into single-patient and open-unit rooms. Clinical datasets including bed location and microbiology results were examined over a 29-month period. Differences in outcomes between bed configurations were determined by Chi-square and Cox regression. PATIENTS: All NICU patients. RESULTS: Among 1823 patients representing 55,166 patient-days, single-patient and open-unit models had similar incidences of MRSA colonization and MRSA colonization-free survival times. Average daily census was associated with MRSA colonization rates only in single-patient rooms (hazard ratio 1.31, p=0.039), while hand hygiene compliance on room entry and exit was associated with lower colonization rates independent of bed configuration (hazard ratios 0.834 and 0.719 per 1% higher compliance, respectively). Late-onset sepsis rates were similar in single-patient and open-unit models as were sepsis-free survival and the combined outcome of sepsis or death. After controlling for demographic, clinical and unit-based variables, multivariate Cox regression demonstrated that bed configuration had no effect on MRSA colonization, late-onset sepsis, or mortality. CONCLUSIONS: MRSA colonization rate was impacted by hand hygiene compliance, regardless of room configuration, while average daily census only affected infants in single-patient rooms. Single-patient rooms did not reduce the rates of MRSA colonization, late-onset sepsis or death

Report of the Commission of Enquiry into Certain Allegations of Cruelty and Human Rights Abuse Against ANC Prisoners and Detainees by ANC Members

The Motsuenyane Commission of Inquiry was appointed by the President of the African National Congress of South Africa (ANC), Dr. Nelson Mandela, to investigate allegations of human rights abuses and alleged disappearances among its members. Its terms of reference were dated the 12th January, 1993. This is a historic event insofar as it is the first time that a liberation movement has engaged an independent commission to review allegations that its members violated human rights guarantees within its ranks

Incorporating detection probability into northern Great Plains pronghorn population estimates

Pronghorn (Antilocapra americana) abundances commonly are estimated using fixed-wing surveys, but these estimates are likely to be negatively biased because of violations of key assumptions underpinning line-transect methodology. Reducing bias and improving precision of abundance estimates through use of detection probability and mark-resight models may allow for more responsive pronghorn management actions. Given their potential application in population estimation, we evaluated detection probability and mark-resight models for use in estimating pronghorn population abundance. We used logistic regression to quantify probabilities that detecting pronghorn might be influenced by group size, animal activity, percent vegetation, cover type, and topography. We estimated pronghorn population size by study area and year using mixed logit-normal mark-resight (MLNM) models. Pronghorn detection probability increased with group size, animal activity, and percent vegetation; overall detection probability was 0.639 (95% CI = 0.612–0.667) with 396 of 620 pronghorn groups detected. Despite model selection uncertainty, the best detection probability models were 44% (range = 8–79%) and 180% (range = 139–217%) greater than traditional pronghorn population estimates. Similarly, the best MLNM models were 28% (range = 3–58%) and 147% (range = 124–180%) greater than traditional population estimates. Detection probability of pronghorn was not constant but depended on both intrinsic and extrinsic factors. When pronghorn detection probability is a function of animal group size, animal activity, landscape complexity, and percent vegetation, traditional aerial survey techniques will result in biased pronghorn abundance estimates. Standardizing survey conditions, increasing resighting occasions, or accounting for variation in individual heterogeneity in mark-resight models will increase the accuracy and precision of pronghorn population estimates

Integrating Sunda clouded leopard (Neofelis diardi) conservation into development and restoration planning in Sabah (Borneo)

Changes in land use/cover are the main drivers of global biodiversity loss, and thus tools to evaluate effects of landscape change on biodiversity are crucial. In this study we integrated several methods from landscape ecology and landscape genetics into a GIS-based analytical framework, and evaluated the impacts of development and forest restoration scenarios on landscape connectivity, population dynamics and genetic diversity of Sunda clouded leopard in the Malaysian state of Sabah. We also investigated the separate and interactive effects of changing mortality risk and connectivity. Our study suggested that the current clouded leopard population size is larger (+26%) than the current carrying capacity of the landscape due to time lag effects and extinction debt. Additionally, we predicted that proposed developments in Sabah may decrease landscape connectivity by 23% and, when including the increased mortality risk associated with these developments, result in a 40–63% decrease in population size and substantial reduction in genetic diversity. These negative impacts could be mitigated only to a very limited degree through extensive and targeted forest restoration. Our results suggest that realignment of roads and railways based on resistance to movement, without including mortality risk, might be misleading and may in some cases lead to decrease in population size. We therefore recommend that efforts to optimally plan road and railway locations base the optimization on effects of development on population size, density and distribution rather than solely on population connectivity

Genome-wide analysis of ivermectin response by Onchocerca volvulus reveals that genetic drift and soft selective sweeps contribute to loss of drug sensitivity

Treatment of onchocerciasis using mass ivermectin administration has reduced morbidity and transmission throughout Africa and Central/South America. Mass drug administration is likely to exert selection pressure on parasites, and phenotypic and genetic changes in several Onchocerca volvulus populations from Cameroon and Ghana-exposed to more than a decade of regular ivermectin treatment-have raised concern that sub-optimal responses to ivermectin's anti-fecundity effect are becoming more frequent and may spread.Pooled next generation sequencing (Pool-seq) was used to characterise genetic diversity within and between 108 adult female worms differing in ivermectin treatment history and response. Genome-wide analyses revealed genetic variation that significantly differentiated good responder (GR) and sub-optimal responder (SOR) parasites. These variants were not randomly distributed but clustered in ~31 quantitative trait loci (QTLs), with little overlap in putative QTL position and gene content between the two countries. Published candidate ivermectin SOR genes were largely absent in these regions; QTLs differentiating GR and SOR worms were enriched for genes in molecular pathways associated with neurotransmission, development, and stress responses. Finally, single worm genotyping demonstrated that geographic isolation and genetic change over time (in the presence of drug exposure) had a significantly greater role in shaping genetic diversity than the evolution of SOR.This study is one of the first genome-wide association analyses in a parasitic nematode, and provides insight into the genomics of ivermectin response and population structure of O. volvulus. We argue that ivermectin response is a polygenically-determined quantitative trait (QT) whereby identical or related molecular pathways but not necessarily individual genes are likely to determine the extent of ivermectin response in different parasite populations. Furthermore, we propose that genetic drift rather than genetic selection of SOR is the underlying driver of population differentiation, which has significant implications for the emergence and potential spread of SOR within and between these parasite populations

The evolution of pattern camouflage strategies in waterfowl and game birds.

This is the final version of the article. It first appeared from Wiley via http://dx.doi.org/10.1002/ece3.1482Visual patterns are common in animals. A broad survey of the literature has revealed that different patterns have distinct functions. Irregular patterns (e.g., stipples) typically function in static camouflage, whereas regular patterns (e.g., stripes) have a dual function in both motion camouflage and communication. Moreover, irregular and regular patterns located on different body regions ("bimodal" patterning) can provide an effective compromise between camouflage and communication and/or enhanced concealment via both static and motion camouflage. Here, we compared the frequency of these three pattern types and traced their evolutionary history using Bayesian comparative modeling in aquatic waterfowl (Anseriformes: 118 spp.), which typically escape predators by flight, and terrestrial game birds (Galliformes: 170 spp.), which mainly use a "sit and hide" strategy to avoid predation. Given these life histories, we predicted that selection would favor regular patterning in Anseriformes and irregular or bimodal patterning in Galliformes and that pattern function complexity should increase over the course of evolution. Regular patterns were predominant in Anseriformes whereas regular and bimodal patterns were most frequent in Galliformes, suggesting that patterns with multiple functions are broadly favored by selection over patterns with a single function in static camouflage. We found that the first patterns to evolve were either regular or bimodal in Anseriformes and either irregular or regular in Galliformes. In both orders, irregular patterns could evolve into regular patterns but not the reverse. Our hypothesis of increasing complexity in pattern camouflage function was supported in Galliformes but not in Anseriformes. These results reveal a trajectory of pattern evolution linked to increasing function complexity in Galliformes although not in Anseriformes, suggesting that both ecology and function complexity can have a profound influence on pattern evolution.This work was funded by a Biotechnology and Biological Sciences Research Council studentship to K.L.A.M. and an Australian Postgraduate Award and the Cambridge Overseas Trust to T-LG

Between a rock and a hard place: Associations between Mentzos' “dilemma”, self‐reported interpersonal problems, and psychosocial functioning in individuals with non‐affective psychoses

Primary aim of this study was to determine the extent and type of self-reported interpersonal problems in patients with non-affective psychoses and their impact on psychosocial functioning. Furthermore, we aimed to explore potential links with the psychodynamic construct of Stavros Mentzos' "psychotic dilemma", which describes an insufferable inner tension caused by an individual's struggle of being torn between "self-oriented" and "object-oriented" tendencies. In a cross-sectional study among 129 patients with non-affective psychoses, measures of cognition, symptom load and social functioning as well as a tentative, psychodynamic assessment of Mentzos' "dilemma" were obtained during a clinical research visit. Self-report data on interpersonal problems were gathered using the Inventory of Interpersonal Problems (IIP-64D) and compared with a German representative standard sample. Second, IIP-64D scores were compared between groups with or without Mentzos' "dilemma". Hierarchical regression analyses were performed to test for the impact of interpersonal problems on psychosocial functioning, while controlling for cognitive deficits and psychopathology. Results showed that IIP-64D scores differed significantly from healthy controls, except for "self-centred" and "intrusive" interpersonal styles. Participants with a potential "psychotic dilemma" scored significantly higher on the subscales: "domineering", "self-centred", "cold", and "socially avoidant" than the group without a "psychotic dilemma". The total amount of interpersonal problems, and particularly high scores on the IIP-64D "socially avoidant" subscale, predicted psychosocial dysfunction, whereas a "cold" interpersonal style had an opposite effect. In conclusion, specific interpersonal problems may predict psychotherapeutic outcome measures like psychosocial functioning and are partly compatible with the psychodynamic construct of Stavros Mentzos' "psychotic dilemma"

Resource Selection and Its Implications for Wide-Ranging Mammals of the Brazilian Cerrado

Conserving animals beyond protected areas is critical because even the largest reserves may be too small to maintain viable populations for many wide-ranging species. Identification of landscape features that will promote persistence of a diverse array of species is a high priority, particularly, for protected areas that reside in regions of otherwise extensive habitat loss. This is the case for Emas National Park, a small but important protected area located in the Brazilian Cerrado, the world's most biologically diverse savanna. Emas Park is a large-mammal global conservation priority area but is too small to protect wide-ranging mammals for the long-term and conserving these populations will depend on the landscape surrounding the park. We employed novel, noninvasive methods to determine the relative importance of resources found within the park, as well as identify landscape features that promote persistence of wide-ranging mammals outside reserve borders. We used scat detection dogs to survey for five large mammals of conservation concern: giant armadillo (Priodontes maximus), giant anteater (Myrmecophaga tridactyla), maned wolf (Chrysocyon brachyurus), jaguar (Panthera onca), and puma (Puma concolor). We estimated resource selection probability functions for each species from 1,572 scat locations and 434 giant armadillo burrow locations. Results indicate that giant armadillos and jaguars are highly selective of natural habitats, which makes both species sensitive to landscape change from agricultural development. Due to the high amount of such development outside of the Emas Park boundary, the park provides rare resource conditions that are particularly important for these two species. We also reveal that both woodland and forest vegetation remnants enable use of the agricultural landscape as a whole for maned wolves, pumas, and giant anteaters. We identify those features and their landscape compositions that should be prioritized for conservation, arguing that a multi-faceted approach is required to protect these species

Conceptual Art

Providing a re-examination of what Osborne identifies as a major turning point in contemporary art, this monograph takes a chronological and stylistic look at conceptual art from its “pre-history” (1950-1960) to contemporary practices that use conceptual strategies. Osborne surveys the development of the movement in relation to the social, cultural and political contexts within which it evolved. With extended captions, key works are compiled according to ten themes that also serve to present a collection of critical texts, artists’ statements, interviews and commentaries. Includes biographical notes on artists (6 p.) and authors (2 p.), a bibliography (2 p.) and an onomastic index (4 p.) Circa 150 bibl. ref