Implementation research for the prevention of antimicrobial resistance and healthcare-associated infections; 2017 Geneva infection prevention and control (IPC)-think tank (part 1)

Background Around 5–15% of all hospital patients worldwide suffer from healthcare-associated infections (HAIs), and years of excessive antimicrobial use in human and animal medicine have created emerging antimicrobial resistance (AMR). A considerable amount of evidence-based measures have been published to address these challenges, but the largest challenge seems to be their implementation. Methods In June 2017, a total of 42 experts convened at the Geneva IPC-Think Tank to discuss four domains in implementation science: 1) teaching implementation skills; 2) fostering implementation of IPC and antimicrobial stewardship (AMS) by policy making; 3) national/international actions to foster implementation skills; and 4) translational research bridging social sciences and clinical research in infection prevention and control (IPC) and AMR. Results Although neglected in the past, implementation skills have become a priority in IPC and AMS. They should now be part of any curriculum in health care, and IPC career paths should be created. Guidelines and policies should be aligned with each other and evidence-based, each document providing a section on implementing elements of IPC and AMS in patient care. International organisations should be advocates for IPC and AMS, framing them as patient safety issues and emphasizing the importance of implementation skills. Healthcare authorities at the national level should adopt a similar approach and provide legal frameworks, guidelines, and resources to allow better implementation of patient safety measures in IPC and AMS. Rather than repeating effectiveness studies in every setting, we should invest in methods to improve the implementation of evidence-based measures in different healthcare contexts. For this, we need to encourage and financially support collaborations between social sciences and clinical IPC research. Conclusions Experts of the 2017 Geneva Think Tank on IPC and AMS, CDC, and WHO agreed that sustained efforts on implementation of IPC and AMS strategies are required at international, country, and hospital management levels, to provide an adequate multimodal framework that addresses (not exclusively) leadership, resources, education and training for implementing IPC and AMS. Future strategies can build on this agreement to make strategies on IPC and AMS more effective

Holographic Superconductors with Lifshitz Scaling

Black holes in asymptotically Lifshitz spacetime provide a window onto finite temperature effects in strongly coupled Lifshitz models. We add a Maxwell gauge field and charged matter to a recently proposed gravity dual of 2+1 dimensional Lifshitz theory. This gives rise to charged black holes with scalar hair, which correspond to the superconducting phase of holographic superconductors with z > 1 Lifshitz scaling. Along the way we analyze the global geometry of static, asymptotically Lifshitz black holes at arbitrary critical exponent z > 1. In all known exact solutions there is a null curvature singularity in the black hole region, and, by a general argument, the same applies to generic Lifshitz black holes.Comment: 23 pages, 4 figures; v2: added references; v3: matches published versio

Thermodynamics of Dyonic Lifshitz Black Holes

Black holes with asymptotic anisotropic scaling are conjectured to be gravity duals of condensed matter system close to quantum critical points with non-trivial dynamical exponent z at finite temperature. A holographic renormalization procedure is presented that allows thermodynamic potentials to be defined for objects with both electric and magnetic charge in such a way that standard thermodynamic relations hold. Black holes in asymptotic Lifshitz spacetimes can exhibit paramagnetic behavior at low temperature limit for certain values of the critical exponent z, whereas the behavior of AdS black holes is always diamagnetic.Comment: 26 pages, 4 figure