The first six years of surveillance in pediatric and neonatal intensive care units in Turkey

BACKGROUND: Patients in resourced-limited neonatal and pediatric intensive care units (NICU and PICU) are vulnerable to healthcare associated infections (HAI). We report the incidence of HAI, multidrug resistant microorganisms (MDROs) and the pattern of antibiotic usage in the first six years of a surveillance program in a teaching hospital in Turkey. METHODS: Between 2007 and 2012 surveillance data for HAI, MDROs and antibiotic usage were collected from the infection control department, pathology, hospital admissions and pharmacy. In 2009 hand hygiene auditing was introduced. Hand sanitizer usage was expressed as liters per 1000 patient-days. Antibiotic usage was presented as defined daily doses (DDD). Evidence of change in the incidence of HAI was tested using Poison regression modeling. RESULTS: The rate of gram negative MDRO in PICU increased significant between 2007 and 2012 (IRR 1.5, P = 0.033) but remained unchanged in NICU (P = 0.824). By 2012 ceftriaxone prescribing in PICU had decreased while carbapenem prescribing increased by 80 %. In NICU carbapenem decreased by 42 % and betalactam decreased by 29 %. Hand hygiene compliance significantly improved in PICU (IRR 1.9, p < 0.001) and NICU (IRR 2.2, p < 0.001) but compliance remained modest after three years with inconsistent levels across the 5 moments. CONCLUSION: The early years of our infection control program highlights the endemicity of HAI and MDROs in our NICU and PICU. The consistent pattern of antibiotic usage, endemic MROs in PICU and modest hand hygiene clearly provide strategic focuses for intervention

Ventilator associated pneumonia and infection control

Ventilator associated pneumonia (VAP) is the leading cause of morbidity and mortality in intensive care units. The incidence of VAP varies from 7% to 70% in different studies and the mortality rates are 20–75% according to the study population. Aspiration of colonized pathogenic microorganisms on the oropharynx and gastrointestinal tract is the main route for the development of VAP. On the other hand, the major risk factor for VAP is intubation and the duration of mechanical ventilation. Diagnosis remains difficult, and studies showed the importance of early initiation of appropriate antibiotic for prognosis. VAP causes extra length of stay in hospital and intensive care units and increases hospital cost. Consequently, infection control policies are more rational and will save money

Doxycycline plus streptomycin versus ciprofloxacin plus rifampicin in spinal brucellosis [ISRCTN31053647]

Background: The optimal treatment regimen and duration of the therapy is still controversial in spinal brucellosis. The aim of this study is to compare the efficacy, adverse drug reactions, complications and cost of ciprofloxacin plus rifampicin versus doxycycline plus streptomycin in the treatment of spinal brucellosis

Effect of Na2S+NaOH pre-identification leaching on oxidized refractory Au-Ag ores

This study was conducted to investigate the effect of the alkaline sulfide (Na2S+NaOH) pre-identification process on cyanide leaching performance in oxidized refractory gold-silver ores. The ore has intensive oxide, carbonate, and silicate content, and contains Au/Ag minerals containing electrum, acanthite, and silver-bearing FePbZn Sulphate-Arsenate/Hydroxide minerals together with Fe, Pb, and Zn minerals. Niğde Ulukışla refractory Au/Ag ore has 8-9 g/T gold and 170-180 g/T silver grades. In mineralogical examinations, it was found that these metals were closed in minerals such as iron oxy/oxyhydroxide, calcite, and quartz or neighboring these minerals. In the cyanide soluble process after alkali sulfide preliminary procedure at room temperature, metal extraction yields were obtained as 62% for gold and 7% for silver. It is seen that silver is adversely affected by this process compared to the direct cyanidation process. However, after the hot alkali treatment process, metal extractions improved by approximately 25% of gold and 74% of silver. This increase in yield can be considered as converting Ag-oxyhydroxide into soluble Ag forms as a result of the effect of hot alkaline sulfur leaching on the cyanide process. The most important advantage of this decomposition process is to achieve high metal extraction efficiency in lower alkali concentrations

The Effect of Roasting on the Mineralogical Structure and Cyanidation Performance of Gossan Type Oxidized Refractory Gold-Silver Ores

This article includes the application of roasting pretreatment by assisting the cyanidation process in the recovery of Au-Ag from Bolkardag Gossan refractory ore and the characterization studies of the ore, roasting sample, and post-cyanidation waste sample. While ore contained many metals along with gold and silver, the environment in which these metals were found was carbonate, sulfated, silicated, and iron oxide-containing deposits that have undergone oxidation. In mineralogical studies, there were Fe oxy/oxyhydroxides, Pb/Zn carbonates, and jarosite-bearing structures such as beudantite, calcite, dolomite, clay, and quartz in the ore. The sample used in the experiments was d(80) = 29.6 & mu;m, and the test parameters were determined by examining the TG analysis made to the ore. Preroasting experiments were carried out at a roasting temperature range of 200-800 & DEG;C, during a roasting period of 10.0 min. Three different samples were characterized by TG for temperature changes, FT-IR for bond structures and permeability, SEM/EDX for visual inspection of structural changes, and XRD Rietveld's analysis for mineral % content differences. As a result of the cyanidation experiments carried out after the pretreatment, gold was recovered with 80-90% yields and silver with 40-48% yields, respectively.Scientific Research Projects Directorate of NOHU [MMT 2019/03 BAGEP]This study was supported by the Scientific Research Projects Directorate of NOHU under the MMT 2019/03 BAGEP. The authors wish to thank Guemuestas Mining for the sample supply, as well as the managers of the NOHU Central Research Laboratory for the provision of laboratory facilities for the experiments

GOSSAN YAPILI CEVHERLERDE Au/Ag KAZANIMI ÜZERİNE SİYANÜRLEME PARAMETRELERİNİN ETKİSİ

Bu çalışma da, Niğde Ulukışla Gossan yapılı altın gümüş cevherlerine, alkali ortamda siyanür parametresininetkinliği incelenmiştir. Cevherin mineral yapısında; demir cevherleri (limonit-götit-lepidokrosit), çinkomineralleri (smitsonit-hidrozinkit-hemimorfit), kurşun mineralleri (serüzit-plumbojarosit) ve gang mineralleri(kil-kuvars-kalsit) bulunmaktadır. Tüm bu minerallerin yanı sıra cevherdeki farklı jarosit formları da Gossancevheri yapısı ile uyumludur. Cevher mikroskobisi ile altının limotit-götit-lepidokrosit mineralleri ile beraberbulunduğu belirlenmiştir. Direk siyanürleme testlerinde altın ve gümüş düşük verimlerle kazanılmıştır. Buamaçla, siyanürleme öncesinde sıcak alkali kireç ön işlemi ve ardından da siyanür araştırmalarıgerçekleştirilmiştir. Siyanür miktarı tayini 24 saat ve 60°C sıcaklıkta, 0,125-4 g/L NaCN konsantrasyonlarıarasında, siyanür süre araştırmaları ise, 1,5 g/L NaCN konsantrasyonunda, 60 °C sıcaklıkta, 1-84 saat arasındakisürelerde gerçekleştirilmiştir. Sonuçta, altının % 64-97 arasına, gümüşün de % 55-76 arasına kadar arttığıbelirlenmiştir

Evaluation of fatigue-related kinesiophobia and associated factors in individuals with lung cancer with and without respiratory comorbidity

Aim: To investigate fatigue-related kinesiophobia and associated factors in individuals with lung cancer. Methods: A total of 52 individuals were included in the study and the individuals were divided into two groups, each consisting of 26 individuals. Charlson comorbidity index, Brief Fatigue Inventory, modified Medical Research Council dyspnea scale, Tampa Kinesiophobia Scale-Fatigue are applied as data collection tools. Results: The individuals in the study had similar demographic characteristics. There was no difference between the groups in the study in terms of fatigue-related kinesiophobia. There was a difference between the pain and performance status of the individuals in the study in activities of daily living (p&lt;0.05). Conclusion: At the end of this study, it was observed that individuals with lung cancer with respiratory comorbidity had worse pain, fatigue and performance values in activities of daily living, while kinesiophobia values related to fatigue were similar

How Does Aggressive Working Capital Policy Affect Firm Performance? Heterogeneous Panel Data Analysis in The Case of ISE Food Companies

The working capital policies to be applied by enterprises provide important information to_x000D_ the interested parties about the ratio of short and long term debts to be used in financing_x000D_ current assets and investments to be made to these assets. Businesses' choice between_x000D_ profitability and risk is shaped by the aggressive or conservative working capital policy_x000D_ they adopt. In this context, the study was conducted to determine the working capital_x000D_ financing and investment strategies of food companies traded in ISE in the period 2009-_x000D_ 2018 and to investigate the impact of these strategies on business performance by panel_x000D_ data analysis. As a result of the analysis, it was determined that there was a significant_x000D_ relationship between working capital policies and return on assets. It was found that the_x000D_ businesses increase their profitability by adopting conservative policy and reduce their_x000D_ profitability by adopting aggressive policy.The working capital policies to be applied by enterprises provide important information to the interested parties about the ratio of short and long term debts to be used in financing current assets and investments to be made to these assets. Businesses' choice between profitability and risk is shaped by the aggressive or conservative working capital policy they adopt. In this context, the study was conducted to determine the working capital financing and investment strategies of food companies traded in ISE in the period 2009- 2018 and to investigate the impact of these strategies on business performance by panel data analysis. As a result of the analysis, it was determined that there was a significant relationship between working capital policies and return on assets. It was found that the businesses increase their profitability by adopting conservative policy and reduce their profitability by adopting aggressive policy

The Role of Information and Communication Technology in the Acculturation of Vietnamese Refugees

One of the most significant refugee populations in the United States is the Vietnamese. This group initially fled their native country to escape political oppression at the conclusion of the Vietnam War in 1975 and continued to flee in a series of separate waves that continued for more than three decades. As a relatively new immigrant group in the U.S., the Vietnamese still face a variety of challenges as they try to reestablish their lives and adapt in a new cultural environment. Acculturation is a complex process that is influenced by a number of factors. Throughout history, U.S. immigration policy has significantly affected the admission and adaptation of refugees. As shifts in the ideological frameworks, economic demands, and attitudes towards the rest of the world occurred in the twentieth century, which eventually brought the liberalization of immigration policy, this influence slowly decreased. This allowed for factors in the domestic political, economic, and social environments to become more powerful in affecting how refugees adapt in the U.S. Information and communication technologies (ICTs) have become integral aspects in both assisting and complicating the acculturation process for refugees. These technologies are helping Vietnamese refugees culturally adjust in American communities as well as maintain ties with their native culture; thus, illustrating the multifaceted nature of acculturation. However, the impact of ICTs is not uniform across all of the different waves of refugees who fled from Vietnam. This study demonstrates that interaction and communication are key aspects in cross-cultural adaptation and the importance of media in contemporary everyday life

Incidence, risk factors and mortality of nosocomial pneumonia in Intensive Care Units: A prospective study

To determine the frequency, risk factors and mortality of nosocomial pneumonia a prospective study was conducted in the intensive care units. In the study period, 2402 patients were included. The nosocomial pneumonia was defined according to the Centers for Disease Control Criteria. Overall, 163 (6.8%) of the patients developed nosocomial pneumonia and 75.5% (n = 123) of all patients with nosocomial pneumonia were ventilator-associated pneumonia. 163 patients who were admitted to the intensive care unit during the same period but had no bacteriologic or histologic evidence of pneumonia were used as a control group. The APACHE II score, coma, hypoalbuminemia, mechanical ventilation, tracheotomy, presence of nasogastric tube were found as independent risk factors. Crude and attributable mortality were 65% and 52.6%, respectively. The mortality rate was five times greater in the cases (OR: 5.2; CI 95%: 3.2–8.3). The mean length of stay in the intensive care unit and hospital in the cases were longer than controls (p < 0.0001). Patients requiring mechanical ventilation have a high frequency of nosocomial pneumonia