Description of a multidisciplinary initiative to improve SCIP measures related to pre-operative antibiotic prophylaxis compliance: a single-center success story

Background: The Surgical Care Improvement Project (SCIP) was launched in 2005. The core prophylactic perioperative antibiotic guidelines were created due to recognition of the impact of proper perioperative prophylaxis on an estimated annual one million inpatient days and $1.6 billion in excess health care costs secondary to preventable surgical site infections (SSIs). An internal study was conducted to create low cost, standardized processes on an institutional level to improve compliance with prophylactic antibiotic administration. Methods: We assessed the impact of auditing and notifying providers of SCIP errors on overall compliance with inpatient antibiotic guidelines and on net financial gain or loss to a large tertiary center between March 1st 2010 and September 31st 2013. We hypothesized that direct physician-to-physician feedback would result in significant compliance improvements. Results: Through physician notification, our hospital was able to significantly improve SCIP compliance and emphasis on patient safety within a year of intervention implementation. The hospital earned an additional$290,612 in 2011 and $209,096 in 2012 for re-investment in patient care initiatives. Conclusions: Provider education and direct notification of SCIP prophylactic antibiotic dosing errors resulted in improved compliance with national patient improvement guidelines. There were differences between the anesthesiology and surgery department feedback responses, the latter likely attributed to diverse surgical department sub-divisions, frequent changes in resident trainees and supervising attending staff, and the comparative ability. Provider notification of guideline non-compliance should be encouraged as standard practice to improve patient safety. Also, the hospital experienced increased revenue for re-investment in patient care as a secondary result of provider notification

Carbon assimilation strategies in ultrabasic groundwater: clues from the integrated study of a serpentinization-influenced aquifer

© The Author(s), 2020. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Seyler, L. M., Brazelton, W. J., McLean, C., Putman, L. I., Hyer, A., Kubo, M. D. Y., Hoehler, T., Cardace, D., & Schrenk, M. O. . Carbon assimilation strategies in ultrabasic groundwater: clues from the integrated study of a serpentinization-influenced aquifer. mSystems, 5(2), (2020): e00607-00619, doi: 10.1128/mSystems.00607-19.Serpentinization is a low-temperature metamorphic process by which ultramafic rock chemically reacts with water. Such reactions provide energy and materials that may be harnessed by chemosynthetic microbial communities at hydrothermal springs and in the subsurface. However, the biogeochemistry mediated by microbial populations that inhabit these environments is understudied and complicated by overlapping biotic and abiotic processes. We applied metagenomics, metatranscriptomics, and untargeted metabolomics techniques to environmental samples taken from the Coast Range Ophiolite Microbial Observatory (CROMO), a subsurface observatory consisting of 12 wells drilled into the ultramafic and serpentinite mélange of the Coast Range Ophiolite in California. Using a combination of DNA and RNA sequence data and mass spectrometry data, we found evidence for several carbon fixation and assimilation strategies, including the Calvin-Benson-Bassham cycle, the reverse tricarboxylic acid cycle, the reductive acetyl coenzyme A (acetyl-CoA) pathway, and methylotrophy, in the microbial communities inhabiting the serpentinite-hosted aquifer. Our data also suggest that the microbial inhabitants of CROMO use products of the serpentinization process, including methane and formate, as carbon sources in a hyperalkaline environment where dissolved inorganic carbon is unavailable.We thank McLaughlin Reserve, in particular Paul Aigner and Cathy Koehler, for hosting sampling at CROMO and providing access to the wells, A. Daniel Jones and Anthony Schilmiller for their advice regarding metabolite extraction and mass spectrometry, Elizabeth Kujawinski for her guidance in metabolomics data analysis and interpretation, and Julia McGonigle, Christopher Thornton, and Katrina Twing for assistance with metagenomic and computational analyses

The effects of financialisation and financial development on investment: Evidence from firm-level data in Europe

In this paper we estimate the effects of financialization on physical investment in selected western European countries using panel data based on the balance-sheets of publicly listed non-financial companies (NFCs) supplied by Worldscope for the period 1995-2015. We find robust evidence of an adverse effect of both financial payments (interests and dividends) and financial incomes on investment in fixed assets by the NFCs. This finding is robust for both the pool of all Western European firms and single country estimations. The negative impacts of financial incomes are non-linear with respect to the companies’ size: financial incomes crowd-out investment in large companies, and have a positive effect on the investment of only small, relatively more credit-constrained companies. Moreover, we find that a higher degree of financial development is associated with a stronger negative effect of financial incomes on companies’ investment. This finding challenges the common wisdom on ‘finance-growth nexus’. Our findings support the ‘financialization thesis’ that the increasing orientation of the non-financial sector towards financial activities is ultimately leading to lower physical investment, hence to stagnant or fragile growth, as well as long term stagnation in productivity

What makes you not a Buddhist? : a preliminary mapping of values

This study sets out to establish which Buddhist values contrasted with or were shared by adolescents from a non-Buddhist population. A survey of attitude toward a variety of Buddhist values was fielded in a sample of 352 non-Buddhist schoolchildren aged between 13 and 15 in London. Buddhist values where attitudes were least positive concerned the worth of being a monk/nun or meditating, offering candles & incense on the Buddhist shrine, friendship on Sangha Day, avoiding drinking alcohol, seeing the world as empty or impermanent and Nirvana as the ultimate peace. Buddhist values most closely shared by non-Buddhists concerned the Law of Karma, calming the mind, respecting those deserving of respect, subjectivity of happiness, welfare work, looking after parents in old age and compassion to cuddly animals. Further significant differences of attitude toward Buddhism were found in partial correlations with the independent variables of sex, age and religious affiliation. Correlation patterns paralleled those previously described in theistic religions. Findings are applied to spiritual, moral, social and cultural development and for the teaching of religious to pupils of no faith adherence. The study recommends that quantitative psychometrics employed to conceptualize Buddhist values by discriminant validity in this study could be extended usefully to other aspects of the study of Buddhism, particularly in quest of validity in the conceptualization of Buddhist identity within specifically Buddhist populations

Aviation Maintenance Safety Management Challenges : Thematic Analysis

Aircraft maintenance is a fundamental and necessary element in any aviation operation. In order to be considered safe and airworthy, operators must be diligent in the way aircraft are maintained and how employees are performing. A safety management system (SMS) is an organized approach by management to include every employee of a company that standardizes the procedures a company will follow to improve safety. The structure of SMS was designed by the International Civil Aviation Organization in order to be standardized across different countries and types of operations. Currently, only part 121 U.S. commercial airlines are mandated by the Federal Aviation Administration to have a safety management system in place

Financial production and the subprime mortgage crisis

The causes of the 2007-8 subprime crisis continue to be the subject of much debate, with explanations ranging from de-regulation and fraudulent behavior to global imbalances and rising inequality. However, a comprehensive analysis of the endogenous forces that made the crisis inevitable has yet to be presented. This paper offers a ‘structural’ interpretation of the crisis by synthesising insights from conventional financial economics and the Minskyian and Schumpeterian literature. While highlighting the innovative character of US financial firms evolving from credit providers to producers of financial commodities, we stress the key features of their path towards financial fragility. We contend that financial institutions were able to achieve progressively unsustainable positions due to the ‘enforced indebtedness’ of US households, which played a functional, albeit secondary, role in the development of the crisis

Peer Victimization and Child Physical Health: The Moderating Role of Pessimism

Objective—Involvement in peer victimization has been associated with numerous negative consequences, including poor physical health. The purpose of this study is to improve on previous research evaluating the victimization– health relationship by examining the health (i.e., health-related quality of life [HRQoL], medical service utilization) of both victims and aggressors and examining individual variation in this relationship through the moderating effect of pessimism. Method—Sample included 125 ethnically diverse youth aged 8–11 years recruited from a low-income medical practice. Child-report of involvement in peer victimization and pessimism was assessed along with parent-report of HRQoL. 2-year medical service utilization was extracted from medical records. Results—Although not all hypotheses were supported, victims and aggressors were found to be at increased risk for certain poor health outcomes, which were exacerbated by high levels of pessimism. Conclusion—Findings expand on research into peer victimization and health and provide important implications for identification, prevention, and intervention strategies with at-risk youth

Peer Victimization and Child Physical Health: The Moderating Role of Pessimism

Objective—Involvement in peer victimization has been associated with numerous negative consequences, including poor physical health. The purpose of this study is to improve on previous research evaluating the victimization– health relationship by examining the health (i.e., health-related quality of life [HRQoL], medical service utilization) of both victims and aggressors and examining individual variation in this relationship through the moderating effect of pessimism. Method—Sample included 125 ethnically diverse youth aged 8–11 years recruited from a low-income medical practice. Child-report of involvement in peer victimization and pessimism was assessed along with parent-report of HRQoL. 2-year medical service utilization was extracted from medical records. Results—Although not all hypotheses were supported, victims and aggressors were found to be at increased risk for certain poor health outcomes, which were exacerbated by high levels of pessimism. Conclusion—Findings expand on research into peer victimization and health and provide important implications for identification, prevention, and intervention strategies with at-risk youth