Automated methods for surveillance of surgical site infections.

Automated data, especially from pharmacy and administrative claims, are available for much of the U.S. population and might substantially improve both inpatient and postdischarge surveillance for surgical site infections complicating selected procedures, while reducing the resources required. Potential improvements include better sensitivity, less susceptibility to interobserver variation, more uniform availability of data, more precise estimates of infection rates, and better adjustment for patients' coexisting illness

Alcohol And Politics In Twentieth-Century Britain

This review surveys recent developments in the historiography of the politics of alcohol in twentieth-century Britain. The 'drink question' has undergone a set of tumultuous shifts, beginning with the decline of the temperance movement after the First World War, diminished conflict in the interwar and post-1945 periods, and the revived concerns over consumption and harm in the late twentieth century. Historians have traditionally presented the drink question as a binary conflict between advocates and opponents of the liberal distribution of drink. Newer narratives question the assumed 'rationality' of modern approaches to alcohol, especially concerning the post-1970s public health model which has been increasingly understood as an indirect manifestation of the temperance movement. The concept of 'moral panics' has been frequently employed to frame the formation of public attitudes towards drink. The article argues that these multifarious developments illustrate how alcohol offers a unique vantage point into various social developments in modern Britain, including that of the changing role of the state, the contested nature of scientific knowledge, and the formation of public opinion. It also suggests that the historiography should overcome its narrow focus on alcohol in modern Britain by juxtaposing it with other substances, regions, and periods

Automated Methods for Surveillance of Surgical Site Infections

Automated data, especially from pharmacy and administrative claims, are available for much of the U.S. population and might substantially improve both inpatient and postdischarge surveillance for surgical site infections complicating selected procedures, while reducing the resources required. Potential improvements include better sensitivity, less susceptibility to interobserver variation, more uniform availability of data, more precise estimates of infection rates, and better adjustment for patients' coexisting illness

Which comorbid conditions should we be analyzing as risk factors for healthcare-associated infections?

OBJECTIVETo determine which comorbid conditions are considered causally related to central-line associated bloodstream infection (CLABSI) and surgical-site infection (SSI) based on expert consensus.DESIGNUsing the Delphi method, we administered an iterative, 2-round survey to 9 infectious disease and infection control experts from the United States.METHODSBased on our selection of components from the Charlson and Elixhauser comorbidity indices, 35 different comorbid conditions were rated from 1 (not at all related) to 5 (strongly related) by each expert separately for CLABSI and SSI, based on perceived relatedness to the outcome. To assign expert consensus on causal relatedness for each comorbid condition, all 3 of the following criteria had to be met at the end of the second round: (1) a majority (&gt;50%) of experts rating the condition at 3 (somewhat related) or higher, (2) interquartile range (IQR)≤1, and (3) standard deviation (SD)≤1.RESULTSFrom round 1 to round 2, the IQR and SD, respectively, decreased for ratings of 21 of 35 (60%) and 33 of 35 (94%) comorbid conditions for CLABSI, and for 17 of 35 (49%) and 32 of 35 (91%) comorbid conditions for SSI, suggesting improvement in consensus among this group of experts. At the end of round 2, 13 of 35 (37%) and 17 of 35 (49%) comorbid conditions were perceived as causally related to CLABSI and SSI, respectively.CONCLUSIONSOur results have produced a list of comorbid conditions that should be analyzed as risk factors for and further explored for risk adjustment of CLABSI and SSI.Infect Control Hosp Epidemiol 2017;38:449–454</jats:sec