Search and you will find: detecting extended-spectrum β-lactamase-producing Klebsiella pneumoniae from a patient\u27s immediate environment.

Contamination of inanimate surfaces contribute to the transmission of healthcare-associated infection which is well documented for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci VRE (3, 5, 10). The high rate of skin colonisation with these bacteria among healthcare workers increases the risk of cross-contamination of high-touch surfaces (6). Since Gram-negative bacteria survive poorly on surfaces, their role in transmission of infection has not been as widely investigated. Extended spectrum beta-lactamase-producing enterobacteriaciae (ESBL-PE) are now widespread and endemic in nosocomial settings (2, 4) and given the increasing prevalence of infections involving ESBL-PE, the role of the environment in ESBL-PE transmission should be explored. This study reports the evaluation of two ESBL-PE recovery methods from typical hospital surface materials and their application for recovery of ESBL-PE adjacent to an ESBL-positive patient

Towards codes of practice for navigating the academic peer review process

Peer review is the bedrock of modern academic research and its lasting contributions to science and society. And yet, reviewers can submit “poor” peer review reports, authors can blatantly ignore referee advice, and editors can contravene and undermine the peer review process itself. In this paper, we, the Editors of Energy Research & Social Science (ER&SS), seek to establish peer review codes of practice for the general energy and social science research community. We include suggestions for three of the most important roles: peer reviewers or referees, editors, and authors. We base our 33 recommendations on a collective 60 years of editorial experience at ER&SS. Our hope is that such codes of practice can enable the academic community to navigate the peer review process more effectively, more meaningfully, and more efficiently

Transitioning to home and beyond following stroke: a prospective cohort study of outcomes and needs

Introduction: Understanding of the needs of people with stroke at hospital discharge and in the first six-months is limited. This study aim was to profile and document the needs of people with stroke at hospital discharge to home and thereafter. Methods: A prospective cohort study recruiting individuals with stroke, from three hospitals, who transitioned home, either directly, through rehabilitation, or with early supported discharge teams. Their outcomes (global-health, cognition, function, quality of life, needs) were described using validated questionnaires and a needs survey, at 7–10 days, and at 3-, and 6-months, post-discharge. Results: 72 patients were available at hospital discharge; mean age 70 (SD 13); 61% female; median NIHSS score of 4 (IQR 0–20). 62 (86%), 54 (75%), and 45 (63%) individuals were available respectively at each data collection time-point. Perceived disability was considerable at hospital discharge (51% with mRS ≥ 3), and while it improved at 3-months, it increased thereafter (35% with mRS ≥ 3 at 6-months). Mean physical health and social functioning were “fair” at hospital discharge and ongoing; while HR-QOL, although improved over time, remained impaired at 6-months (0.69+/-0.28). At 6-months cognitive impairment was present in 40%. Unmet needs included involvement in transition planning and care decisions, with ongoing rehabilitation, information, and support needs. The median number of unmet needs at discharge to home was four (range:1–9), and three (range:1–7) at 6-months. Conclusion: Stroke community reintegration is challenging for people with stroke and their families, with high levels of unmet need. Profiling outcomes and unmet needs for people with stroke at hospital-to-home transition and onwards are crucial for shaping the development of effective support interventions to be delivered at this juncture

What is the best method? Recovery of methicillin-resistant Staphylococcus aureus and extended-spectrum β-lactamase-producing Escherichia coli from inanimate hospital surfaces.

Environmental sampling in hospitals, when required, needs to be reliable. We evaluated different methods of sampling methicillin-resistant Staphylococcus aureus and extended-spectrum β-lactamase-producing Escherichia coli on 5 materials of the hospital setting. Petrifilms and contact plates were superior to swabs for all of the surfaces studied

Towards codes of practice for navigating the academic peer review process

Peer review is the bedrock of modern academic research and its lasting contributions to science and society. And yet, reviewers can submit “poor” peer review reports, authors can blatantly ignore referee advice, and editors can contravene and undermine the peer review process itself. In this paper, we, the Editors of Energy Research & Social Science (ER&SS), seek to establish peer review codes of practice for the general energy and social science research community. We include suggestions for three of the most important roles: peer reviewers or referees, editors, and authors. We base our 33 recommendations on a collective 60 years of editorial experience at ER&SS. Our hope is that such codes of practice can enable the academic community to navigate the peer review process more effectively, more meaningfully, and more efficiently

Doctors\u27 attitudes to, beliefs about, and experiences of the regulation of professional competence: A scoping review protocol

Background: Historically, individual doctors were responsible for maintaining their own professional competence. More recently, changing patient expectations, debate about the appropriateness of professional self-regulation, and high-profile cases of malpractice have led to a move towards formal regulation of professional competence (RPC). Such programmes require doctors to demonstrate that they are fit to practice, through a variety of means. Participation in RPC is now part of many doctors’ professional lives, yet it remains a highly contested area. Cost, limited evidence of impact, and lack of relevance to practice are amongst the criticisms cited. Doctors’ attitudes towards RPC, their beliefs about its objectives and effectiveness, and their experiences of trying to meet its requirements can impact engagement with the process. We aim to conduct a scoping review to map the empirical literature in this area, to summarise the key findings, and to identify gaps for future research. Methods: We will conduct our review following the six phases outlined by Arksey and O’Malley, and Levac. We will search seven electronic databases: Academic Search Complete, Business Source Complete, CINAHL, PsycINFO, PubMed, Social Sciences Full Text, and SocINDEX for relevant publications, and the websites of medical regulatory and educational organisations for documents. We will undertake backward and forward citation tracking of selected studies and will consult with international experts regarding key publications. Two researchers will independently screen papers for inclusion and extract data using a piloted data extraction tool. Data will be collated to provide a descriptive summary of the literature. A thematic analysis of the key findings will be presented as a narrative summary of the literature. Discussion: We believe that this review will be of value to those tasked with the design and implementation of RPC programmes, helping them to maximise doctors’ commitment and engagement, and to researchers, pointing to areas that would benefit from further enquiry. This research is timely; internationally existing programmes are evolving, new programmes are being initiated, and many jurisdictions do not yet have programmes in place. There is an opportunity for learning across different programmes and from the experiences of established programmes. Our review will support that learning. Systematic review registration: PROSPERO does not register scoping reviews

Evaluation of screening risk and nonrisk patients for methicillin-resistant Staphylococcus aureus on admission in an acute care hospital

Background: screening for methicillin-resistant Staphylocccus aureus (MRSA) is advocated as part of control measures, but screening all patients on admission to hospital may not be cost-effective.Objective: our objective was to evaluate the additional yield of screening all patients on admission compared with only patients with risk factors and to assess cost aspects.Methods: a prospective, nonrandomized observational study of screening nonrisk patients ?72 hours of admission compared with only screening patients with risk factors over 3 years in a tertiary referral hospital was conducted. We also assessed the costs of screening both groups.Results: a total of 48 of 892 (5%) patients was MRSA positive; 28 of 314 (9%) during year 1, 12 of 257 (5%) during year 2, and 8 of 321 (2%) during year 3. There were significantly fewer MRSA-positive patients among nonrisk compared with MRSA-risk patients: 4 of 340 (1%) versus 44 of 552 (8%), P ? .0001, respectively. However, screening nonrisk patients increased the number of screening samples by 62% with a proportionate increase in the costs of screening. A backward stepwise logistic regression model identified age > 70 years, diagnosis of chronic pulmonary disease, previous MRSA infection, and admission to hospital during the previous 18 months as the most important independent predictors to discriminate between MRSA-positive and MRSA-negative patients on admission (94.3% accuracy, P < .001).Conclusion: screening patients without risk factors increased the number of screenings and costs but resulted in few additional cases being detected. In a hospital where MRSA is endemic, targeted screening of at-risk patients on admission remains the most efficient strategy for the early identification of MRSA-positive patient