Arab-Israeli Conflict Four: A Preliminary Assessment

The dust on the latest Arab-Israeli war has not yet settled.The combatants and their supporters brace themselves for the oncoming political or, possibly, military--struggle. Many questions raised during the conduct of hostilities are still unanswered, and others will undoubtedly remain so for time to come. Yet, a preliminary assessment of some of the general characteristics of the last war is already possible

How Undergraduates Are Affected by Service Participation

Based on entering freshman and follow-up data collected from 3,450 students (2,287 women and 1,163 men) attending 42 institutions with federally funded community service programs, the impact of community service participation on undergraduate student development was examined. Even after regression analyses controlled for individual student characteristics at the time of college entry, including the propensity to engage in service, results indicate that participating in service during the undergraduate years substantially enhances the student\u27s academic development, life skill development, and sense of civic responsibility

Long-Term Effects of Volunteerism During the Undergraduate Years

A growing number of colleges and universities in the United States have become actively engaged in encouraging their undergraduate students to participate in some form of volunteer service (Cohen & Kinsey, 1994; Levine, 1994; Markus, Howard, & King, 1993; O\u27Brien, 1993). Further, service is increasingly being incorporated into the curriculums of major and general education courses (Cohen & Kinsey, 1994; Levine, 1994). While relatively few colleges include service learning or volunteer service as a curricular requirement, the number is growing and such a requirement has become an increasingly frequent topic of debate (Markus, Howard, & King, 1993). That the top leadership in higher education has become increasingly supportive of service as part of the [End Page 187] undergraduate experience is reflected in the phenomenal growth of the Campus Compact, a consortium of colleges and universities dedicated to promoting service among students and faculty. The Campus Compact now numbers well over 500 institutions

Choice Architectures in the Digital Economy: Towards a New Understanding of Digital Vulnerability

In the digital economy, consumer vulnerability is not simply a vantage point from which to assess some consumers’ lack of ability to activate their awareness of persuasion. Instead, digital vulnerability describes a universal state of defencelessness and susceptibility to (the exploitation of) power imbalances that are the result of the increasing automation of commerce, datafied consumer–seller relations, and the very architecture of digital marketplaces. Digital vulnerability, we argue, is architectural, relational, and data-driven. Based on our concept of digital vulnerability, we demonstrate how and why using digital technology to render consumers vulnerable is the epitome of an unfair digital commercial practice

Mycobacterium chimaera infections associated with heater–cooler units in cardiac surgery

Purpose of review: Mycobacterium chimaera infections following cardiac surgery have been reported from an increasing number of countries. These infections are characterized by a poor prognosis with a case fatality rate around 50% despite treatment. Since the first description in 2013, our understanding has grown steadily. Several outbreak investigations, case series, and experiments with heater–cooler units (HCUs) have been published. This review summarizes the current knowledge. Recent findings: M. chimaera transmission occurs during cardiopulmonary bypass via bioaerosols emitted from contaminated HCU water systems. Manifestations of M. chimaera infection comprise endocarditis, vascular graft infections, surgical site infections, and dissemination. So far, all cases were exposed to a single HCU brand. Samples from the manufacturing site as well as clonality of M. chimaera strains isolated from HCUs and patients suggest a contamination already at time of delivery representing the main source for the outbreak. Nevertheless, HCU contamination in hospitals cannot be excluded. Summary: Improved awareness of physicians of M. chimaera infection is crucial to prompt adequate diagnostic workup in patients that have been exposed to HCU presenting with compatible symptoms. For risk mitigation, strict separation between the air volume in contact with HCUs and critical clinical areas such as operating rooms is essential

Documentation of adherence to infection prevention best practice in patient records: a mixed-methods investigation.

BACKGROUND Healthcare-associated infections remain a preventable cause of patient harm in healthcare. Full documentation of adherence to evidence-based best practices for each patient can support monitoring and promotion of infection prevention measures. Thus, we reviewed the extent, nature, and determinants of the documentation of infection prevention (IP) standards in patients with HAI. METHODS We reviewed electronic patient records (EMRs) of patients included in four annual point-prevalence studies 2013-2016 who developed a device- or procedure-related HAI (surgical site infection (SSI), catheter-associated urinary tract infection (CAUTI), ventilator-associated infection (VAP), catheter-related bloodstream infection (CRBSI)). We examined the documentation quality of mandatory preventive measures published as institutional IP standards. Additionally, we undertook semi-structured interviews with healthcare providers and a two-step inductive (grounded theory) and deductive (Theory of Planned Behaviour) content analysis. RESULTS Of overall 2972 surveyed patients, 249 (8.4%) patients developed 272 healthcare-associated infections. Of these, 116 patients met the inclusion criteria, classified as patients with SSI, CAUTI, VAP, CRBSI in 78 (67%), 21 (18%), 10 (9%), 7 (6%), cases, respectively. We found documentation of IP measures in EMRs in 432/1308 (33%) cases. Documentation of execution existed in the study patients' EMRs for SSI, CAUTI, VAP, CRBSI, and overall, in 261/931 (28%), 27/104 (26%), 46/122 (38%), 26/151 (17%), and 360/1308 (28%) cases, respectively, and documentation of non-execution in 67/931 (7%), 2/104 (2%), 0/122 (0%), 3/151 (2%), and 72/1308 (6%) cases, respectively. Healthcare provider attitudes, subjective norms, and perceived behavioural control indicated reluctance to document IP standards. CONCLUSIONS EMRs rarely included conclusive data about adherence to IP standards. Documentation had to be established indirectly through data captured for other reasons. Mandatory institutional documentation protocols or technically automated documentation may be necessary to address such shortcomings in patient safety documentation

Educating healthcare workers to optimal hand hygiene practices: addressing the need

The education of healthcare workers is essential to improve practices and is an integral part of hand hygiene promotional strategies. According to the evidence reviewed here, healthcare worker education has a positive impact on improving hand hygiene and reducing healthcare-associated infection. Detailed practical guidance on steps for the organization of education programmes in healthcare facilities and teaching-learning strategies are provided using the World Health Organization (WHO) Guidelines for Hand Hygiene in Health Care as the basis for recommendations. Several key elements for a successful educational programme are also identified. A particular emphasis is placed on concepts included in the tools developed by WHO for education, monitoring and performance feedbac

Free field realization of the exceptional current superalgebra \hat{D(2,1;\a)}_k

The free-field representations of the D(2,1;\a) current superalgebra and the corresponding energy-momentum tensor are constructed. The related screening currents of the first kind are also presented.Comment: Latex file, 10 page