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Sample records for infection control strategies

  1. Nosocomial infections and their control strategies

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    Hassan Ahmed Khan

    2015-07-01

    Full Text Available Nosocomial infections are also known as hospital-acquired/associated infections. National Healthcare Safety Network along with Centers for Disease Control for surveillance has classified nosocomial infection sites into 13 types with 50 infection sites, which are specific on the basis of biological and clinical criteria. The agents that are usually involved in hospital-acquired infections include Streptococcus spp., Acinetobacter spp., enterococci, Pseudomonas aeruginosa, coagulase-negative staphylococci, Staphylococcus aureus, Bacillus cereus, Legionella and Enterobacteriaceae family members, namely, Proteus mirablis, Klebsiella pneumonia, Escherichia coli, Serratia marcescens. Nosocomial pathogens can be transmitted through person to person, environment or contaminated water and food, infected individuals, contaminated healthcare personnel's skin or contact via shared items and surfaces. Mainly, multi-drug-resistant nosocomial organisms include methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Pseudomonas aeruginosa and Klebsiella pneumonia, whereas Clostridium difficile shows natural resistance. Excessive and improper use of broad-spectrum antibiotics, especially in healthcare settings, is elevating nosocomial infections, which not only becomes a big health care problem but also causes great economic and production loss in the community. Nosocomial infections can be controlled by measuring and comparing the infection rates within healthcare settings and sticking to the best healthcare practices. Centers for Disease Control and Prevention provides the methodology for surveillance of nosocomial infections along with investigation of major outbreaks. By means of this surveillance, hospitals can devise a strategy comprising of infection control practices.

  2. Prevention and Control Strategies to Counter Dengue Virus Infection.

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    Rather, Irfan A; Parray, Hilal A; Lone, Jameel B; Paek, Woon K; Lim, Jeongheui; Bajpai, Vivek K; Park, Yong-Ha

    2017-01-01

    Dengue is currently the highest and rapidly spreading vector-borne viral disease, which can lead to mortality in its severe form. The globally endemic dengue poses as a public health and economic challenge that has been attempted to suppress though application of various prevention and control techniques. Therefore, broad spectrum techniques, that are efficient, cost-effective, and environmentally sustainable, are proposed and practiced in dengue-endemic regions. The development of vaccines and immunotherapies have introduced a new dimension for effective dengue control and prevention. Thus, the present study focuses on the preventive and control strategies that are currently employed to counter dengue. While traditional control strategies bring temporary sustainability alone, implementation of novel biotechnological interventions, such as sterile insect technique, paratransgenesis, and production of genetically modified vectors, has improved the efficacy of the traditional strategies. Although a large-scale vector control strategy can be limited, innovative vaccine candidates have provided evidence for promising dengue prevention measures. The use of tetravalent dengue vaccine (CYD-TDV) has been the most effective so far in treating dengue infections. Nonetheless, challenges and limitation hinder the progress of developing integrated intervention methods and vaccines; while the improvement in the latest techniques and vaccine formulation continues, one can hope for a future without the threat of dengue virus.

  3. Prevention and Control Strategies to Counter Dengue Virus Infection

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    Irfan A. Rather

    2017-07-01

    Full Text Available Dengue is currently the highest and rapidly spreading vector-borne viral disease, which can lead to mortality in its severe form. The globally endemic dengue poses as a public health and economic challenge that has been attempted to suppress though application of various prevention and control techniques. Therefore, broad spectrum techniques, that are efficient, cost-effective, and environmentally sustainable, are proposed and practiced in dengue-endemic regions. The development of vaccines and immunotherapies have introduced a new dimension for effective dengue control and prevention. Thus, the present study focuses on the preventive and control strategies that are currently employed to counter dengue. While traditional control strategies bring temporary sustainability alone, implementation of novel biotechnological interventions, such as sterile insect technique, paratransgenesis, and production of genetically modified vectors, has improved the efficacy of the traditional strategies. Although a large-scale vector control strategy can be limited, innovative vaccine candidates have provided evidence for promising dengue prevention measures. The use of tetravalent dengue vaccine (CYD-TDV has been the most effective so far in treating dengue infections. Nonetheless, challenges and limitation hinder the progress of developing integrated intervention methods and vaccines; while the improvement in the latest techniques and vaccine formulation continues, one can hope for a future without the threat of dengue virus.

  4. Provoking "Eureka" moments for effective infection control strategies.

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    Pittet, Didier

    2014-01-01

    Safety is now a fundamental principle of patient care and a critical component of quality management. Health care-associated infection prevention strategies need to be constantly revisited and updated to be effective. The "Geneva hand hygiene model" is a typical example of a breakthrough innovatory campaign that caught fire and went viral worldwide, thanks to its adoption by the World Health Organization (WHO) as the First Global Patient Safety Challenge. The campaign remains an inspiration for further innovation. To encourage new and disruptive technologies with the potential to improve patient safety through the successful implementation of the WHO multimodal strategy, the University of Geneva Hospitals/WHO Collaborating Centre on Patient Safety, together with the Aesculap Academy, have created a series of "Hand Hygiene Excellence Awards" and "Hand Hygiene Innovation Awards" worldwide.

  5. Application of optimal control strategies to HIV-malaria co-infection dynamics

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    Fatmawati; Windarto; Hanif, Lathifah

    2018-03-01

    This paper presents a mathematical model of HIV and malaria co-infection transmission dynamics. Optimal control strategies such as malaria preventive, anti-malaria and antiretroviral (ARV) treatments are considered into the model to reduce the co-infection. First, we studied the existence and stability of equilibria of the presented model without control variables. The model has four equilibria, namely the disease-free equilibrium, the HIV endemic equilibrium, the malaria endemic equilibrium, and the co-infection equilibrium. We also obtain two basic reproduction ratios corresponding to the diseases. It was found that the disease-free equilibrium is locally asymptotically stable whenever their respective basic reproduction numbers are less than one. We also conducted a sensitivity analysis to determine the dominant factor controlling the transmission. sic reproduction numbers are less than one. We also conducted a sensitivity analysis to determine the dominant factor controlling the transmission. Then, the optimal control theory for the model was derived analytically by using Pontryagin Maximum Principle. Numerical simulations of the optimal control strategies are also performed to illustrate the results. From the numerical results, we conclude that the best strategy is to combine the malaria prevention and ARV treatments in order to reduce malaria and HIV co-infection populations.

  6. Waterborne microorganisms and biofilms related to hospital infections: strategies for prevention and control in healthcare facilities.

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    Capelletti, Raquel Vannucci; Moraes, Ângela Maria

    2016-02-01

    Water is the main stimulus for the development of microorganisms, and its flow has an important role in the spreading of contaminants. In hospitals, the water distribution system requires special attention since it can be a source of pathogens, including those in the form of biofilms often correlated with resistance of microorganisms to various treatments. In this paper, information relevant to cases of nosocomial infections involving water circuits as a source of contaminants is compiled, with emphasis on the importance of microbiological control strategies to prevent the installation, spreading and growth of microorganisms in hospitals. An overview of the worldwide situation is provided, with emphasis on Brazilian hospitals. Different approaches normally used to control the occurrence of nosocomial infections due to waterborne contaminants are analyzed, and the use of the polysaccharide chitosan for this specific application is briefly discussed.

  7. Quantitative assessment of organizational culture within hospitals and its relevance to infection prevention and control strategies.

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    Borg, M A; Waisfisz, B; Frank, U

    2015-05-01

    It has been suggested that organizational culture (OC) is an important driver of infection prevention and control (IPC) behaviour among healthcare workers. This study examined OC in seven European hospitals using a validated assessment tool based on Hofstede's model, and identified significant variations in OC scores. Hospitals with low prevalence of meticillin-resistant Staphylococcus aureus (MRSA) exhibited high scores for change facilitation and change readiness, whereas hospitals with high prevalence of MRSA exhibited low scores for these determinants. It is possible to use tools, available outside health care, to study OC within hospitals and gain better insight into IPC behaviour change strategies. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  8. Glycemic control strategies and the occurrence of surgical site infection: a systematic review.

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    Domingos, Caroline Maria Herrero; Iida, Luciana Inaba Senyer; Poveda, Vanessa de Brito

    2016-01-01

    To analyze the evidence available in the scientific literature regarding the relationship between the glycemic control strategies used and the occurrence of surgical site infection in adult patients undergoing surgery. This is a systematic review performed through search on the databases of CINAHL, MEDLINE, LILACS, Cochrane Database of Systematic Reviews and EMBASE. Eight randomized controlled trials were selected. Despite the diversity of tested interventions, studies agree that glycemic control is essential to reduce rates of surgical site infection, and should be maintained between 80 and 120 mg/dL during the perioperative period. Compared to other strategies, insulin continuous infusion during surgery was the most tested and seems to get better results in reducing rates of surgical site infection and achieving success in glycemic control. Tight glycemic control during the perioperative period benefits the recovery of surgical patients, and the role of the nursing team is key for the successful implementation of the measure. Analisar as evidências disponíveis na literatura científica sobre a relação entre as estratégias de controle glicêmico efetuadas e a ocorrência de infecção do sítio cirúrgico em pacientes adultos submetidos à cirurgia. Trata-se de revisão sistemática, por meio das bases de dados CINAHL, MEDLINE, LILACS, Cochrane Database of Systematic Reviews e EMBASE. Foram selecionados oito ensaios clínicos randomizados. Apesar da diversidade de intervenções testadas, os estudos concordam que o controle glicêmico é essencial para a redução das taxas de infecção do sítio cirúrgico e deve ser mantido entre 80 e 120 mg/dL durante o perioperatório. A infusão contínua de insulina no transoperatório foi a mais testada e parece obter melhores resultados na redução das taxas de infecção do sítio cirúrgico e sucesso no controle glicêmico comparada às demais estratégias. O controle glicêmico rigoroso durante o perioperat

  9. A simulation-based assessment of strategies to control Clostridium difficile transmission and infection.

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    Michael A Rubin

    Full Text Available BACKGROUND: Clostridium difficile is one of the most common and important nosocomial pathogens, causing severe gastrointestinal disease in hospitalized patients. Although "bundled" interventions have been proposed and promoted, optimal control strategies remain unknown. METHODS: We designed an agent-based computer simulation of nosocomial C. difficile transmission and infection, which included components such as: patients and health care workers, and their interactions; room contamination via C. difficile shedding; C. difficile hand carriage and removal via hand hygiene; patient acquisition of C. difficile via contact with contaminated rooms or health care workers; and patient antimicrobial use. We then introduced six interventions, alone and "bundled" together: aggressive C. difficile testing; empiric isolation and treatment of symptomatic patients; improved adherence to hand hygiene and contact precautions; improved use of soap and water for hand hygiene; and improved environmental cleaning. All interventions were tested using values representing base-case, typical intervention, and optimal intervention scenarios. FINDINGS: In the base-case scenario, C. difficile infection rates ranged from 8-21 cases/10,000 patient-days, with a case detection fraction between 32%-50%. Implementing the "bundle" at typical intervention levels had a large impact on C. difficile acquisition and infection rates, although intensifying the intervention to optimal levels had much less additional impact. Most of the impact came from improved hand hygiene and empiric isolation and treatment of suspected C. difficile cases. CONCLUSION: A "bundled" intervention is likely to reduce nosocomial C. difficile infection rates, even under typical implementation conditions. Real-world implementation of the "bundle" should focus on those components of the intervention that are likely to produce the greatest impact on C. difficile infection rates, such as hand hygiene and empiric

  10. Strategies to promote infection prevention and control in acute care hospitals with the help of infection control link nurses: A systematic literature review.

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    Peter, Daniel; Meng, Michael; Kugler, Christiane; Mattner, Frauke

    2018-02-01

    Infection control link nurses (ICLNs) are important backup personnel for the prevention and control of infections in hospitals. To identify facilitators and barriers for the implementation of and long-term collaboration with ICLNs. We conducted a systematic literature review, following the preferred reporting items for systematic reviews and meta-analyses guidelines. Inclusion criteria were defined as description of de novo implementation of an ICLN system, strengthening of an existing ICLN system, or analysis of an ICLN system. In 10 publications, facilitators and barriers were identified for mode of selection of ICLN candidates, characteristics and responsibilities of ICLNs, composition of a training curriculum, educational strategies, and external influencing factors. Experienced nurses with an interest in infection control seemed appropriate candidates. The importance of psychological skills in addition to technical knowledge was emphasized. A clear definition of responsibilities was important. Viable tasks for ICLNs included surveillance and teaching activities and the implementation of prevention measures. Ongoing teaching was superior to a single course. Management support was pivotal for success. Research on ICLNs is scarce. The potential to decrease health care-associated infections with the help of ICLNs has been demonstrated. The training in psychological skills in addition to technical knowledge deserves more attention. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  11. Global burden of Shigella infections : implications for vaccine development and implementation of control strategies

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    Kotloff, KL; Winickoff, JP; Ivanoff, B; Clemens, JD; Swerdlow, DL; Sansonetti, PJ; Adak, GK; Levine, MM

    1999-01-01

    Few studies provide data on the global morbidity and mortality caused by infection with Shigella spp.; such estimates are needed, however, to plan strategies of prevention and treatment. Here we report the results of a review of the literature published between 1966 and 1997 on Shigella infection.

  12. Positive deviance as a strategy to prevent and control bloodstream infections in intensive care

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    Francimar Tinoco de Oliveira

    Full Text Available Abstract OBJECTIVE To describe the application of positive deviance as a strategy to prevent and control bloodstream infections. METHOD An intervention study with nursing and medical team members working in an intensive care unit in a university hospital, between June and December 2014. The four steps of the positive defiance methodology were applied: to define, to determine, to discover and to design. RESULTS In 90 days, 188 actions were observed, of these, 36.70% (n=69 were related to catheter dressing. In 81.15% (n=56 of these dressings, the professionals most adhered to the use of flexible sterile cotton-tipped swabs to perform antisepsis at catheter entry sites and fixation dressing. CONCLUSION Positive deviance contributed to the implementation of proposals to improve work processes and team development related to problems identified in central venous catheter care.

  13. The projected effectiveness of Clostridium difficile vaccination as part of an integrated infection control strategy.

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    van Kleef, Esther; Deeny, Sarah R; Jit, Mark; Cookson, Barry; Goldenberg, Simon D; Edmunds, W John; Robotham, Julie V

    2016-11-04

    Early clinical trials of a Clostridium difficile toxoid vaccine show efficacy in preventing C. difficile infection (CDI). The optimal patient group to target for vaccination programmes remains unexplored. This study performed a model-based evaluation of the effectiveness of different CDI vaccination strategies, within the context of existing infection prevention and control strategies such as antimicrobial stewardship. An individual-based transmission model of CDI in a high-risk hospital setting was developed. The model incorporated data on patient movements between the hospital, and catchment populations from the community and long-term care facilities (LTCF), using English national and local level data for model-parameterisation. We evaluated vaccination of: (1) discharged patients who had an CDI-occurrence in the ward; (2) LTCF-residents; (3) Planned elective surgical admissions and (4) All three strategies combined. Without vaccination, 10.9 [Interquartile range: 10.0-11.8] patients per 1000 ward admissions developed CDI, of which 31% were ward-acquired. Immunising all three patient groups resulted in a 43% [42-44], reduction of ward-onset CDI on average. Among the strategies restricting vaccination to one target group, vaccinating elective surgical patients proved most effective (35% [34-36] reduction), but least efficient, requiring 146 [133-162] courses to prevent one ICU-onset case. Immunising LTCF residents was most efficient, requiring just 13 [11-16] courses to prevent one case, but considering this only comprised a small group of our hospital population, it only reduced ICU-onset CDI by 9% [8-11]. Vaccination proved most efficient when ward-based transmission rates and antimicrobial consumption were high. Strategy success depends on the interaction between hospital and catchment populations, and importantly, consideration of importations of CDI from outside the hospital which we found to substantially impact hospital dynamics. Vaccination may be most

  14. Communication strategies in acute health care: evaluation within the context of infection prevention and control.

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    Edwards, R; Sevdalis, N; Vincent, C; Holmes, A

    2012-09-01

    Communication in healthcare settings has recently received significant attention in the literature. However, there continues to be a large gap in current understanding of the effectiveness of different communication channels used in acute healthcare settings, particularly in the context of infection prevention and control (IPC). To explore and evaluate the main communication channels used within hospitals to communicate with healthcare workers (HCWs) and to propose practical recommendations. Critical review of the main communication channels used within acute health care to communicate information to HCWs, and analysis of their impact on practice. The analysis covers verbal communications, standardization via guidelines, education and training, electronic communications and marketing strategies. Traditional communication channels have not been successful in changing and sustaining best practice in IPC, but newer approaches (electronic messages and marketing) also have pitfalls. A few simple recommendations are made in relation to the development, implementation and evaluation of communications to HCWs; top-down vs bottom-up communications; and the involvement of HCWs, particularly ward personnel. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  15. Infection control strategies for preventing the transmission of meticillin-resistant Staphylococcus aureus (MRSA) in nursing homes for older people.

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    Hughes, Carmel; Smith, Michael; Tunney, Michael; Bradley, Marie C

    2011-12-07

    Nursing homes for older people provide an environment likely to promote the acquisition and spread of meticillin-resistant Staphylococcus aureus (MRSA), putting residents at increased risk of colonisation and infection. It is recognised that infection prevention and control strategies are important in preventing and controlling MRSA transmission. To determine the effects of infection prevention and control strategies for preventing the transmission of MRSA in nursing homes for older people. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2011, Issue 2), the Cochrane Wounds Group Specialised Register (searched May 27th, 2011). We also searched Ovid MEDLINE (from 1950 to April Week 2 2011), OVID MEDLINE (In-process and Other Non-Indexed Citations, April 26th 2011) Ovid EMBASE (1980 to 2011 Week 16), EBSCO CINAHL (1982 to April 21st 2011), DARE (1992 to 2011, week 16), Web of Science (1981 to May 2011), and the Health Technology Assessment (HTA) website (1988 to May 2011). Research in progress was sought through Current Clinical Trials (www.controlled-trials.com), Medical Research Council Research portfolio, and HSRPRoj (current USA projects). All randomised and controlled clinical trials, controlled before and after studies and interrupted time series studies of infection prevention and control interventions in nursing homes for older people were eligible for inclusion. Two review authors independently reviewed the results of the searches. Another review author appraised identified papers and undertook data extraction which was checked by a second review author. For this second update only one study was identified, therefore it was not possible to undertake a meta-analysis. A cluster randomised controlled trial in 32 nursing homes evaluated the effect of an infection control education and training programme on MRSA prevalence. The primary outcome was MRSA prevalence in residents and staff, and a change in infection

  16. Infection control strategies for preventing the transmission of meticillin-resistant Staphylococcus aureus (MRSA) in nursing homes for older people.

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    Hughes, Carmel; Tunney, Michael; Bradley, Marie C

    2013-11-19

    Nursing homes for older people provide an environment likely to promote the acquisition and spread of meticillin-resistant Staphylococcus aureus (MRSA), putting residents at increased risk of colonisation and infection. It is recognised that infection prevention and control strategies are important in preventing and controlling MRSA transmission. To determine the effects of infection prevention and control strategies for preventing the transmission of MRSA in nursing homes for older people. In August 2013, for this third update, we searched the Cochrane Wounds Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), Database of Abstracts of Reviews of Effects (DARE, The Cochrane Library), Ovid MEDLINE, OVID MEDLINE (In-process and Other Non-Indexed Citations), Ovid EMBASE, EBSCO CINAHL, Web of Science and the Health Technology Assessment (HTA) website. Research in progress was sought through Current Clinical Trials, Gateway to Reseach, and HSRProj (Health Services Research Projects in Progress). All randomised and controlled clinical trials, controlled before and after studies and interrupted time series studies of infection prevention and control interventions in nursing homes for older people were eligible for inclusion. Two review authors independently reviewed the results of the searches. Another review author appraised identified papers and undertook data extraction which was checked by a second review author. For this third update only one study was identified, therefore it was not possible to undertake a meta-analysis. A cluster randomised controlled trial in 32 nursing homes evaluated the effect of an infection control education and training programme on MRSA prevalence. The primary outcome was MRSA prevalence in residents and staff, and a change in infection control audit scores which measured adherence to infection control standards. At the end of the 12 month study, there was no change in MRSA

  17. Horizontal infection control strategy decreases methicillin-resistant Staphylococcus aureus infection and eliminates bacteremia in a surgical ICU without active surveillance.

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    Traa, Maria X; Barboza, Lorena; Doron, Shira; Snydman, David R; Noubary, Farzad; Nasraway, Stanley A

    2014-10-01

    Methicillin-resistant Staphylococcus aureus infection is a significant contributor to morbidity and mortality in hospitalized patients worldwide. Numerous healthcare bodies in Europe and the United States have championed active surveillance per the "search and destroy" model. However, this strategy is associated with significant economic, logistical, and patient costs without any impact on other hospital-acquired pathogens. We evaluated whether horizontal infection control strategies could decrease the prevalence of methicillin-resistant S. aureus infection in the ICU, without the need for active surveillance. Retrospective, observational study in the surgical ICU of a tertiary care medical center in Boston, MA, from 2005 to 2012. A total of 6,697 patients in the surgical ICU. Evidence-based infection prevention strategies were implemented in an iterative fashion, including 1) hand hygiene program with refresher education campaign, 2) chlorhexidine oral hygiene program, 3) chlorhexidine bathing, 4) catheter-associated bloodstream infection program, and 5) daily goals sheets. The prevalence of methicillin-resistant S. aureus infection fell from 2.66 to 0.69 per 1,000 patient days from 2005 to 2012, an average decrease of 21% per year. The biggest decline in rate of infection was detected in 2008, which may suggest that the catheter-associated bloodstream infection prevention program was particularly effective. Among 4,478 surgical ICU admissions over the last 5 years, not a single case of methicillin-resistant S. aureus bacteremia was observed. Aggressive multifaceted horizontal infection control is an effective strategy for reducing the prevalence of methicillin-resistant S. aureus infection and eliminating methicillin-resistant S. aureus bacteremia in the ICU without the need for active surveillance and decontamination.

  18. Strongyle infections and parasitic control strategies in German horses - a risk assessment.

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    Schneider, Stephanie; Pfister, Kurt; Becher, Anne M; Scheuerle, Miriam C

    2014-11-12

    As a consequence of the increasing levels of anthelmintic resistance in cyathostomes, new strategies for equine parasite control are being implemented. To assess the potential risks of these, the occurrence of strongyles was evaluated in a group of 1887 horses. The distribution of fecal egg counts (FECs), the frequency of anthelmintic drug use, and the deworming intervals were also analyzed. Between June 2012 and May 2013, 1887 fecal samples from either selectively or strategically dewormed horses were collected at 195 horse farms all over Germany and analyzed quantitatively with a modified McMaster technique. All samples with FEC ≥20 eggs per gram (EPG) were subjected to coproculture to generate third-stage larvae (LIII) for species differentiation. Egg counts were below the limit of detection (20 EPG) in 1046 (55.4%) samples and above it in 841 (44.6%) samples. Strongylus vulgaris larvae were identified in two of the 841 positive samples. Infections with cyathostomes were found on every farm. The most frequently applied anthelmintic was ivermectin (788/50.8%), followed by pyrantel (336/21.6%). The mean time since last treatment was 6.3 months. High-egg-shedding (>500 EPG) strategically dewormed horses (183/1357) were treated, on average, three times/year. The planned treatment date was already exceeded by 72.5% of the high egg-shedders and by 58.1% of the moderate (200-500 EPG) and low egg-shedders (20-199 EPG). S. vulgaris seems to be rare in Germany and no difference in its frequency has yet been found between selectively treated horses and horses receiving treatment in strategic intervals. However, inconsistent parasite control has been observed. Therefore, to minimize the risks for disease, consistent and efficient parasite control should be implemented.

  19. Staphylococcus aureus epidemic in a neonatal nursery: a strategy of infection control.

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    Bertini, Giovanna; Nicoletti, PierLuigi; Scopetti, Franca; Manoocher, Pourshaban; Dani, Carlo; Orefici, Graziella

    2006-08-01

    The risk of nosocomial infection due to Staphylococcus aureus in fullterm newborns is higher under hospital conditions where there are overcrowded nurseries and inadequate infection control techniques. We report on an outbreak of skin infection in a Maternity Nursery (May 21, 2000) and the measures undertaken to bring the epidemic under control. These measures included: separating neonates already present in the nursery on August 23, 2000 from ones newly arriving by creating two different cohorts, one of neonates born before this date and one of neonates born later; restricting healthcare workers caring for S. aureus- infected infants from working with non-infected infants; disallowing carrier healthcare workers from caring for patients; introducing contact and droplet precautions (including the routine use of gowns, gloves, and mask); ensuring appropriate disinfection of potential sources of contamination. A representative number of isolates were typed by genomic DNA restriction length polymorphism analysis by means of pulsed-field gel electrophoresis (PFGE). Among the 227 cases of skin lesions, microbiological laboratory analyses confirmed that 175 were staphylococcal infections. The outbreak showed a gradual reduction in magnitude when the overcrowding of the Nursery was reduced by separating the newborns into the two different Nurseries (two cohorts). The genotyping of the strains by PFGE confirmed the nurse-to-newborn transmission of S. aureus. The measures adopted for controlling the S. aureus outbreak can, in retrospect, be assessed to have been very effective.

  20. Use of alcohol hand sanitizer as an infection control strategy in an acute care facility.

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    Hilburn, Jessica; Hammond, Brian S; Fendler, Eleanor J; Groziak, Patricia A

    2003-04-01

    Nosocomial infections are a major problem in health care facilities, resulting in extended durations of care, substantial morbidity and mortality, and excess costs. Since alcohol gel hand sanitizers combine high immediate antimicrobial efficacy with ease of use, this study was carried out to determine the effect of the use of an alcohol gel hand sanitizer by caregivers on infection types and rates in an acute care facility. Patients were educated about the study through a poster on the unit, and teachable patients were given portable bottles of the alcohol hand gel for bedside use, along with an educational brochure explaining how and why to practice good hand hygiene. Infection rate and type data were collected in 1 unit of a 498-bed acute care facility for 16 months (February 2000 to May 2001). An alcohol gel hand sanitizer was provided and used by caregivers in the orthopedic surgical unit of the facility during this period. The primary infection types (more than 80%) found were urinary tract (UTI) and surgical site (SSI) infections. Infection types and rates for the unit during the period the alcohol hand sanitizer (intervention) was used were compared with the infection types and rates for the same unit when the alcohol hand sanitizer was not used (baseline); the results demonstrated a 36.1% decrease in infection rates for the 10-month period that the hand sanitizer was used. This study indicates that use of an alcohol gel hand sanitizer can decrease infection rates and provide an additional tool for an effective infection control program in acute care facilities.

  1. Infection dynamics and effective control strategies of tuberculosis in badgers and cattle in Ireland

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    Aznar Asensio, J.I.

    2018-01-01

    Bovine tuberculosis (bTB) is a chronic inflammatory disease of cattle caused by infection with Mycobacterium bovis. In Ireland, a comprehensive control/eradication programme for M. bovis commenced in 1954, and by 1965, cattle incidence had been reduced by more than 95%. Despite

  2. Positive deviance as a strategy to prevent and control bloodstream infections in intensive care.

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    Oliveira, Francimar Tinoco de; Ferreira, Maria Manuela Frederico; Araújo, Silvia Teresa Carvalho de; Bessa, Amanda Trindade Teixeira de; Moraes, Advi Catarina Barbachan; Stipp, Marluci Andrade Conceição

    2017-04-03

    To describe the application of positive deviance as a strategy to prevent and control bloodstream infections. An intervention study with nursing and medical team members working in an intensive care unit in a university hospital, between June and December 2014. The four steps of the positive defiance methodology were applied: to define, to determine, to discover and to design. In 90 days, 188 actions were observed, of these, 36.70% (n=69) were related to catheter dressing. In 81.15% (n=56) of these dressings, the professionals most adhered to the use of flexible sterile cotton-tipped swabs to perform antisepsis at catheter entry sites and fixation dressing. Positive deviance contributed to the implementation of proposals to improve work processes and team development related to problems identified in central venous catheter care. Descrever a aplicação do Positive Deviance como estratégia na prevenção e no controle da infecção de corrente sanguínea. Estudo de intervenção realizado na Unidade de Terapia Intensiva de um hospital universitário, com os membros das equipes de enfermagem e médica, de junho a dezembro de 2014. Foram aplicados os quatro passos da metodologia Positive Deviance: Definir, Determinar, Descobrir e Desenhar. Em 90 dias 188 ações foram observadas, destas, 36,70% (n=69) estavam relacionadas aos curativos dos cateteres. Em 81,15% (n=56) desses curativos, o uso da haste flexível estéril para realização da antissepsia do local de inserção do cateter e de sua placa de fixação foi a ação de maior adesão. O Positive Deviance auxiliou na implementação de propostas de melhorias de processo de trabalho e no desenvolvimento da equipe para os problemas identificados no cuidado com o cateter venoso central.

  3. Impact of different strategies to control Plasmodium infection and anaemia on the island of Bioko (Equatorial Guinea

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    Roche Jesús

    2006-02-01

    Full Text Available Abstract Background On the island of Bioko (Equatorial Guinea, insecticide-treated nets (ITNs have been the main tool used to control malaria over the last 13 years. In 2004, started an indoor residual spraying (IRS campaign to control malaria. The purpose of this study is to asses the impact of the two control strategies on the island of Bioko (Equatorial Guinea, with regards to Plasmodium infection and anaemia in the children under five years of age. Methods Two transversal studies, the first one prior to the start of the IRS campaign and the second one year later. Sampling was carried out by stratified clusters. Malaria infection was measured by means of thick and thin film, and the packed cell volume (PCV percentage. Data related to ITN use and information regarding IRS were collected. The Pearson's chi-square and logistic regression statistical tests were used to calculate odds ratios (OR Results In the first survey, 168 children were sampled and 433 children in the second one. The prevalence of infection was 40% in 2004, and significantly lower at 21.7% in 2005. PCV was 41% and 39%, respectively. 58% of the children surveyed in 2004 and 44.3% in 2005 had slept under an ITN. 78% of the dwellings studied in 2005 had been sprayed. In the 2005 survey, sleeping without a mosquito net meant a risk of infection 3 times greater than sleeping protected with a net hanged correctly and with no holes (p Conclusion IRS and ITNs have proven to be effective control strategies on the island of Bioko. The choice of one or other strategy is, above all, a question of operational feasibility and availability of local resources.

  4. Infection prevention and control of Clostridium difficile: a global review of guidelines, strategies, and recommendations.

    Science.gov (United States)

    Balsells, Evelyn; Filipescu, Teodora; Kyaw, Moe H; Wiuff, Camilla; Campbell, Harry; Nair, Harish

    2016-12-01

    Clostridium difficile is the leading cause of health care-associated infections. Given the high incidence of C. difficile infection (CDI) and the lack of primary prevention through immunization, health care professionals should be aware of the most current guidance, as well as strengths and limitations of the evidence base underpinning this guidance. We identified publicly available national or organizational guidelines related to CDI infection and prevention control (IPC) published between 2000 and 2015 and for any health care setting through an internet search using the Google search engine. We reviewed CDI-targeted IPC recommendations and describe the assessment of evidence in available guidelines. We identified documents from 28 countries/territories, mainly from acute care hospitals in North America, the Western Pacific, and Europe (18 countries). We identified only a few specific recommendations for long-term care facilities (LTCFs) and from countries in South America (Uruguay and Chile), South East Asia (Thailand), and none for Africa or Eastern Mediterranean. Of 10 IPC areas, antimicrobial stewardship was universally recognized as essential and supported by high quality evidence. Five other widely reported "strong" recommendations were: effective environment cleaning (including medical equipment), case isolation, use of personal protective equipment, surveillance, and education. Several unresolved and emerging issues were documented and currently available evidence was classified mainly as of mixed quality. Our review underlines the need for targeted CDI IPC guidelines in several countries and for LTCFs. International harmonisation on the assessment of the evidence for best practices is needed as well as more robust evidence to support targeted recommendations.

  5. Transmission dynamics of carbapenemase-producing Klebsiella pneumoniae and anticipated impact of infection control strategies in a surgical unit.

    Directory of Open Access Journals (Sweden)

    Vana Sypsa

    Full Text Available BACKGROUND: Carbapenemase-producing Klebsiella pneumoniae (CPKP has been established as important nosocomial pathogen in many geographic regions. Transmission from patient to patient via the hands of healthcare workers is the main route of spread in the acute-care setting. METHODOLOGY/PRINCIPAL FINDINGS: Epidemiological and infection control data were recorded during a prospective observational study conducted in a surgical unit of a tertiary-care hospital in Greece. Surveillance culture for CPKP were obtained from all patients upon admission and weekly thereafter. The Ross-Macdonald model for vector-borne diseases was applied to obtain estimates for the basic reproduction number R(0 (average number of secondary cases per primary case in the absence of infection control and assess the impact of infection control measures on CPKP containment in endemic and hyperendemic settings. Eighteen of 850 patients were colonized with CPKP on admission and 51 acquired CPKP during hospilazation. R(0 reached 2 and exceeded unity for long periods of time under the observed hand hygiene compliance (21%. The minimum hand hygiene compliance level necessary to control transmission was 50%. Reduction of 60% to 90% in colonized patients on admission, through active surveillance culture, contact precautions and isolation/cohorting, in combination with 60% compliance in hand hygiene would result in rapid decline in CPKP prevalence within 8-12 weeks. Antibiotics restrictions did not have a substantial benefit when an aggressive control strategy was implemented. CONCLUSIONS/SIGNIFICANCE: Surveillance culture on admission and isolation/cohorting of colonized patients coupled with moderate hand hygiene compliance and contact precautions may lead to rapid control of CPKP in endemic and hyperendemic healthcare settings.

  6. Transmission Dynamics of Carbapenemase-Producing Klebsiella Pneumoniae and Anticipated Impact of Infection Control Strategies in a Surgical Unit

    Science.gov (United States)

    Sypsa, Vana; Psichogiou, Mina; Bouzala, Georgia-Aikaterina; Hadjihannas, Linos; Hatzakis, Angelos; Daikos, Georgios L.

    2012-01-01

    Background Carbapenemase-producing Klebsiella pneumoniae (CPKP) has been established as important nosocomial pathogen in many geographic regions. Transmission from patient to patient via the hands of healthcare workers is the main route of spread in the acute-care setting. Methodology/Principal Findings Epidemiological and infection control data were recorded during a prospective observational study conducted in a surgical unit of a tertiary-care hospital in Greece. Surveillance culture for CPKP were obtained from all patients upon admission and weekly thereafter. The Ross-Macdonald model for vector-borne diseases was applied to obtain estimates for the basic reproduction number R0 (average number of secondary cases per primary case in the absence of infection control) and assess the impact of infection control measures on CPKP containment in endemic and hyperendemic settings. Eighteen of 850 patients were colonized with CPKP on admission and 51 acquired CPKP during hospilazation. R0 reached 2 and exceeded unity for long periods of time under the observed hand hygiene compliance (21%). The minimum hand hygiene compliance level necessary to control transmission was 50%. Reduction of 60% to 90% in colonized patients on admission, through active surveillance culture, contact precautions and isolation/cohorting, in combination with 60% compliance in hand hygiene would result in rapid decline in CPKP prevalence within 8–12 weeks. Antibiotics restrictions did not have a substantial benefit when an aggressive control strategy was implemented. Conclusions/Significance Surveillance culture on admission and isolation/cohorting of colonized patients coupled with moderate hand hygiene compliance and contact precautions may lead to rapid control of CPKP in endemic and hyperendemic healthcare settings. PMID:22859965

  7. Legionella pneumophila: risk assessment and strategy for the prevention and control of nosocomial infections

    Directory of Open Access Journals (Sweden)

    Salvo Torrisi

    2012-06-01

    Full Text Available The term “Legionellosis” includes all forms of disease caused by microorganisms of the genus Legionella; it may manifest as a flu-like shape (Pontiac fever, or with severe pneumonia with high mortality (Legionnaires Disease. The causative agent was Legionella pneumophila in the literature although other strains of the genus Legionella are classified as pathogens, mode of transmission is through inhalation of aerosol particles produced by hot water or air conditioning systems: for this reason in community settings and nosocomial L. pneumophila represents a serious public health problem. In the light of epidemiological data since the year 2000 the Italian State has issued a series of provisions laws concerning the prevention and control of nosocomial Legionellosis environment and community.The present work aims to evaluate the presence of Legionella species and L. pneumophila comparing the different approaches proposed by the Guidelines of the regions of Lombardy and Piedmont in terms of assessment and prevention of risk “Legionellosis” in the field of nosocomial infection. The analytical methods used are those provided by the Regional Guidelines: the official method in the second CSR April 4 Method 2000 and UNI EN ISO 11731-1: 2008. Checks have been performed on equipment for the comparison of cold water, hot water and air conditioning in nursing homes, retirement homes and hospitals.The results obtained show that the method CSR April 4, 2000 restricts the search to L. pneumophila permitting, than the method EN ISO 11731-1: 2008, to carry out a risk assessment well targeted to the actual pathogen.The culture method for the detection of L. pneumophila allows you to not only prevention, but also to implement a series of targeted interventions following the directions of the legislation.

  8. Changing attitudes to infection management in primary care: a controlled trial of active versus passive guideline implementation strategies.

    Science.gov (United States)

    Onion, C W; Bartzokas, C A

    1998-04-01

    When attempting to implement evidence-based medicine, such as through clinical guidelines, we often rely on passive educational tactics, for example didactic lectures and bulletins. These methods involve the recipient in relatively superficial processing of information, and any consequent attitude changes can be expected to be short-lived. However, active methods, such as practice-based discussion, should involve recipients in deep processing, with more enduring attitude changes. In this experiment, the aim was to assess the efficacy of an active strategy at promoting deep processing and its effectiveness, relative to a typical passive method, at changing attitudes between groups of GPs over 12 months across an English Health District. All 191 GPs operating from 69 practices in the Wirral Health District of Northwest England were assigned, with minimization of known confounding variables, to three experimental groups: active, passive and control. The groups were shown to have similar learning styles. The objective of the study was to impart knowledge of best management of infections as captured in a series of locally developed clinical guidelines. The passive group GPs were given a copy of the guidelines and were invited to an hour-long lecture event. The GPs in the deep group were given a copy of the guidelines and were invited to engage in an hour-long discussion about the guideline content at their own premises. The control group received neither the guidelines nor any educational contact regarding them. Three months before and 12 months after the interventions, all GPs were sent a postal questionnaire on their preferred empirical antibiotic for 10 common bacterial infections. The responses were compared in order to ascertain whether increased knowledge of best clinical practice was evident in each group. Seventy-five per cent (144/191) of GPs responded to the pre-intervention questionnaire, 62 % (119/191) post-intervention. Thirty-four per cent (22/64) of GPs

  9. Assessing the oseltamivir-induced resistance risk and implications for influenza infection control strategies

    Directory of Open Access Journals (Sweden)

    Hsieh NH

    2017-07-01

    Full Text Available Nan-Hung Hsieh,1 Yi-Jun Lin,2 Ying-Fei Yang,2 Chung-Min Liao2 1Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA; 2Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, Taiwan Background: Oseltamivir-resistant mutants with higher drug resistance rates and low transmission fitness costs have not accounted for influenza (subtype viruses. Predicting the impacts of neuraminidase inhibitor therapy on infection rates and transmission of drug-resistant viral strains requires further investigation.Objectives: The purpose of this study was to assess the potential risk of oseltamivir-induced resistance for influenza A (H1N1 and A (H3N2 viruses.Materials and methods: An immune-response-based virus dynamic model was used to best fit the oseltamivir-resistant A (H1N1 and A (H3N2 infection data. A probabilistic risk assessment model was developed by incorporating branching process-derived probability distribution of resistance to estimate oseltamivir-induced resistance risk.Results: Mutation rate and sensitive strain number were key determinants in assessing resistance risk. By increasing immune response, antiviral efficacy, and fitness cost, the spread of resistant strains for A (H1N1 and A (H3N2 were greatly decreased. Probability of resistance depends most strongly on the sensitive strain number described by a Poisson model. Risk of oseltamivir-induced resistance increased with increasing the mutation rate for A (H1N1 only. The ≥50% of resistance risk induced by A (H1N1 and A (H3N2 sensitive infected cells were 0.4 (95% CI: 0.28–0.43 and 0.95 (95% CI 0.93–0.99 at a mutation rate of 10−6, respectively. Antiviral drugs must be administrated within 1–1.5 days for A (H1N1 and 2–2.5 days for A (H3N2 virus infections to limit viral production.Conclusion: Probabilistic risk assessment of antiviral drug

  10. Isolation as a strategy for controlling the transmission of hepatitis C virus (HCV) infection in haemodialysis units.

    Science.gov (United States)

    Bravo Zuñiga, Jessica I; Loza Munárriz, César; López-Alcalde, Jesús

    2016-08-11

    The hepatitis C virus (HCV) infection affects about 2% of the world's population and can cause chronic liver infection and persistent long-term sequelae such as cirrhosis and liver cancer.The prevalence of HCV infection among people on haemodialysis is often higher than the general population. The virus is easily transmitted parenterally, and blood transfusions have previously played a significant role in transmission; however, erythropoietin therapy has reduced the need for transfusions, and coupled with improved screening of donated blood, has significantly decreased transmission by transfusion. Although control of hospital-acquired infection has improved with the advent of biosafety measures, stopping HCV transmission in haemodialysis units remains challenging.Isolating people infected with HCV involves physical separation from others to limit direct or indirect transmission and includes a number of strategies during dialysis. The evidence for isolating people infected with HCV during haemodialysis is sparse with some inconsistencies. To evaluate the benefits and harms of isolation of HCV-infected patients during haemodialysis on the transmission of HCV to other patients. We searched the Cochrane Kidney and Transplant Specialised Register to 26 November 2015 through contact with the Information Specialist using search terms relevant to this review. We also searched the Latin American and Caribbean Health Sciences Literature Database (LILACS) (1982 to 2015), Web of Science Conference Proceedings Citation Index-Science (CPCI-S, 1990 to 2015), ProQuest Dissertations & Theses Database (1990 to 2015), and Open Grey (1990 to 2015). We included randomised controlled trials (RCTs), quasi-RCTs and cluster RCTs evaluating the clinical benefits and harms of isolating HCV-infected patients during haemodialysis on the transmission of HCV to other patients. We considered incidence of dialysis-acquired HCV infection, all-cause mortality, and adverse effects associated with

  11. Infection prevention and control strategies in the era of limited resources and quality improvement: a perspective paper.

    Science.gov (United States)

    Vandijck, Dominique; Cleemput, Irina; Hellings, Johan; Vogelaers, Dirk

    2013-11-01

    This paper aims to describe, using an evidence-based approach, the importance of and the resources necessary for implementing effective infection prevention and control (IPC) programmes. The intrinsic and explicit values of such strategies are presented from a clinical, health-economic and patient safety perspective. Policy makers and hospital managers are committed to providing comprehensive, accessible, and affordable healthcare of high quality. Changes in the healthcare system over time accompanied with variations in demographics and case-mix have considerably affected the availability, quality and ultimately the safety of healthcare. The main goal of an IPC programme is to prevent and control healthcare-associated infections (HAI). Many patient-, healthcare provider-, and organizational factors are associated with an increased risk for acquiring HAIs and may impact both the quality and outcome of patient care. Evidence has been published in support of having an effective IPC programme. It has been estimated that about one-third of HAIs could be prevented if key elements of the evidence-based recommendations for IPC are adequately introduced and followed. However, several healthcare agencies from over the world have reported deficits in the essential resources and components of current IPC programmes. To meet its main goal, staffing, training, and infrastructure requirements are needed. Nevertheless, and given the economic crisis, policy makers and hospital managers may be tempted to not increase or even to reduce the budget as it consumes resources and does not generate sufficient visible revenue. IPC is a critical issue in patient safety, as HAIs are by far the most common complication affecting admitted patients. The significant clinical and health-economic burden HAIs place on the healthcare system speak to the importance of getting introduced effective IPC programmes. Copyright © 2013 Australian College of Critical Care Nurses Ltd. Published by Elsevier

  12. 75 FR 22816 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2010-04-30

    ... Infectious Diseases (NCEZID), regarding the practice of hospital infection control and strategies for surveillance, prevention, and control of healthcare-associated infections (e.g., nosocomial infections... policy statements regarding prevention of healthcare- associated infections and healthcare-related...

  13. 75 FR 50770 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2010-08-17

    ... Infectious Diseases (NCEZID), regarding: (1) The practice of hospital infection control; strategies for surveillance, prevention, and control of infections (e.g., nosocomial infections), antimicrobial resistance... and other policy statements regarding prevention of healthcare- associated infections and healthcare...

  14. Field experience with two different vaccination strategies aiming to control infections with Actinobacillus pleuropneumoniae in a fattening pig herd

    Directory of Open Access Journals (Sweden)

    Sjölund Marie

    2010-03-01

    Full Text Available Abstract Background The prevalence of pleurisies recorded at slaughter is increasing in Sweden, and acute outbreaks of actinobacillosis that require antimicrobial treatments have become more frequent. As an increased use of antimicrobials may result in the development of antimicrobial resistance it is essential to develop alternative measures to control the disease. Vaccinations present an appealing alternative to antimicrobial treatments. The aim of this work was to evaluate the potential of two different vaccination strategies in a specialized fattening herd affected by actinobacillosis. Methods The study was conducted in a specialized fattening herd employing age segregated rearing in eight units. The herd suffered from infections caused by Actinobacillus pleuropneumoniae serotype 2, confirmed by necropsy and serology. The study included 54 batches of pigs grouped into five periods. Batches of pigs of the second period were vaccinated against actinobacillosis twice, and pigs in the fourth period were vaccinated three times. Batches of pigs of the first, third and fifth period were not vaccinated. Concentrations of serum antibodies to A. pleuropneumoniae and serum amyloid A (SAA were analysed and production data were recorded. Results Despite vaccinating, medical treatments were required to reduce the impact of the disease. The mean incidence of individual treatments for respiratory diseases during the rearing period ranged from 0 to 4.7 ± 1.8%, and was greatest during the triple vaccination period (period IV; p A. pleuropneumoniae serotype 2 in the absence of a SAA-response. The prevalence of pleuritis decreased from 25.4 ± 6.5% in the first period to 5.0 ± 3.7% in the fifth period (p Conclusions The vaccine did not effectively prevent clinical expression of A. pleuropneumoniae infections, but seroconversion to A. pleuropneumoniae in the absence of a SAA-response in a large number pigs indicated that the vaccine had activated the immune

  15. 75 FR 63844 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2010-10-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare...), regarding the practice of healthcare infection control and strategies for surveillance, prevention, and control of healthcare-associated infections (e.g., nosocomial infections), antimicrobial resistance, and...

  16. [Cost-effectiveness and cost-benefit analysis on the integrated schistosomiasis control strategies with emphasis on infection source in Poyang Lake region].

    Science.gov (United States)

    Lin, Dan-Dan; Zeng, Xiao-Jun; Chen, Hong-Gen; Hong, Xian-Lin; Tao, Bo; Li, Yi-Feng; Xiong, Ji-Jie; Zhou, Xiao-Nong

    2009-08-01

    To evaluate the cost-effectiveness and cost-benefit on the integrated schistosomiasis control strategies with emphasis on infection source, and provide scientific basis for the improvement of schistosomiasis control strategy. Aiguo and Xinhe villages in Jinxian County were selected as intervention group where the new comprehensive strategy was implemented, while Ximiao and Zuxi villages in Xinzi County served as control where routine control program was implemented. New strategy of interventions included removing cattle from snail-infested grasslands and providing farmers with farm machinery, improving sanitation by supplying tap water and building lavatories and methane gas tanks, and implementing an intensive health education program. Routine interventions were carried out in the control villages including diagnosis and treatment for human and cattle, health education, and focal mollusciciding. Data were collected from retrospective investigation and field survey for the analysis and comparison of cost-effectiveness and cost-benefit between intervention and control groups. The control effect of the intervention group was better than that of the control. The cost for 1% decrease of infection rate per 100 people, 100 cattle, and 100 snails in intervention group was 480.01, 6 851.24, and 683.63 Yuan, respectively, which were about 2.70, 4.37 and 20.25 times as those in the control respectively. The total cost/benefit ratio (BCR) was lower than 1 (0.94 in intervention group and 0.08 in the control). But the total benefit of intervention group was higher than that of the control from 2005 to 2008. The forecasting analysis indicated that the total BCR in intervention group would be 1.13 at the 4th year and all cost could be recalled. Sensitivity analysis revealed that the BCR in intervention group changed in the range around 1.0 and that of the control ranged blow 0.5. The cost-benefit of intervention group was evidently higher than that of the control. The integrated

  17. Strategies for the cure of HIV infection.

    Science.gov (United States)

    Rodríguez-Muñoz, Jesús; Moreno, Santiago

    2018-03-03

    The disadvantages of the long-term administration of antiretroviral therapy as well as the huge number of affected persons have placed the cure of HIV as a primary goal of Public Health. HIV may persist in the organism by at least four mechanisms: a latently infected cellular reservoir, the persistent replication of HIV in spite of ART, anatomic sanctuaries, and the immune dysfunction. Several strategies directed against these mechanisms have been developed. With all this, a complete eradication of HIV has been achieved in a patient using the transplantation of haemopoietic stem cells that were resistant to HIV-infection, and there are examples of functional cure either spontaneously (elite controllers) or after antiretroviral therapy (post-treatment controllers). However, no strategies have been successful in reducing the reservoir size, nor in achieving constant, uniform remissions. The failure of isolated strategies makes it likely that the combination of several of them may be the future solution. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  18. Lowbury Lecture 2007: infection prevention and control strategies for tuberculosis in developing countries - lessons learnt from Africa.

    Science.gov (United States)

    Mehtar, S

    2008-08-01

    The World Health Organization ranks South Africa among the top ten of high-burden countries for tuberculosis (TB). The Western Cape Province has the highest prevalence of TB in the country. Studies performed in healthcare facilities both at Tygerberg Hospital and from Kwa-Zulu Natal province indicate a significant risk for nosocomial transmission of tuberculosis. An audit of provision for infection prevention and control (IPC) programmes revealed that although there were adequate supplies of protective clothing, the greatest need was for training and understanding of IPC principles among healthcare workers. In establishing national IPC guidelines for TB in South Africa, it has become evident that most of these were derived from existing guidelines in developed countries. Though the principles were sound, the practices were not realistic for developing economies and generally not implemented in healthcare facilities. Factors that influence a robust TB management programme are poverty, concurrent human immunodeficiency virus infection, overcrowding, ignorance of the disease and a varied level of health service delivery. It is recommended that a foundation of sound knowledge should be established upon which best practices should be built within the framework of good IPC principles.

  19. An Economic Analysis of Strategies to Control Clostridium Difficile Transmission and Infection Using an Agent-Based Simulation Model.

    Science.gov (United States)

    Nelson, Richard E; Jones, Makoto; Leecaster, Molly; Samore, Matthew H; Ray, William; Huttner, Angela; Huttner, Benedikt; Khader, Karim; Stevens, Vanessa W; Gerding, Dale; Schweizer, Marin L; Rubin, Michael A

    2016-01-01

    A number of strategies exist to reduce Clostridium difficile (C. difficile) transmission. We conducted an economic evaluation of "bundling" these strategies together. We constructed an agent-based computer simulation of nosocomial C. difficile transmission and infection in a hospital setting. This model included the following components: interactions between patients and health care workers; room contamination via C. difficile shedding; C. difficile hand carriage and removal via hand hygiene; patient acquisition of C. difficile via contact with contaminated rooms or health care workers; and patient antimicrobial use. Six interventions were introduced alone and "bundled" together: (a) aggressive C. difficile testing; (b) empiric isolation and treatment of symptomatic patients; (c) improved adherence to hand hygiene and (d) contact precautions; (e) improved use of soap and water for hand hygiene; and (f) improved environmental cleaning. Our analysis compared these interventions using values representing 3 different scenarios: (1) base-case (BASE) values that reflect typical hospital practice, (2) intervention (INT) values that represent implementation of hospital-wide efforts to reduce C. diff transmission, and (3) optimal (OPT) values representing the highest expected results from strong adherence to the interventions. Cost parameters for each intervention were obtained from published literature. We performed our analyses assuming low, normal, and high C. difficile importation prevalence and transmissibility of C. difficile. INT levels of the "bundled" intervention were cost-effective at a willingness-to-pay threshold of $100,000/quality-adjusted life-year in all importation prevalence and transmissibility scenarios. OPT levels of intervention were cost-effective for normal and high importation prevalence and transmissibility scenarios. When analyzed separately, hand hygiene compliance, environmental decontamination, and empiric isolation and treatment were the

  20. Update to the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infection (2017): A summary, review, and strategies for implementation.

    Science.gov (United States)

    O'Hara, Lyndsay M; Thom, Kerri A; Preas, Michael Anne

    2018-03-07

    Surgical site infections remain a common cause of morbidity, mortality, and increased length of stay and cost amongst hospitalized patients in the United States. This article summarizes the evidence used to inform the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infection (2017), and highlights key updates and new recommendations. We also present specific suggestions for how infection preventionists can play a central role in guideline implementation by translating these recommendations into evidence-based policies and practices in their facility. Copyright © 2018. Published by Elsevier Inc.

  1. An Economic Analysis of Strategies to Control Clostridium Difficile Transmission and Infection Using an Agent-Based Simulation Model.

    Directory of Open Access Journals (Sweden)

    Richard E Nelson

    Full Text Available A number of strategies exist to reduce Clostridium difficile (C. difficile transmission. We conducted an economic evaluation of "bundling" these strategies together.We constructed an agent-based computer simulation of nosocomial C. difficile transmission and infection in a hospital setting. This model included the following components: interactions between patients and health care workers; room contamination via C. difficile shedding; C. difficile hand carriage and removal via hand hygiene; patient acquisition of C. difficile via contact with contaminated rooms or health care workers; and patient antimicrobial use. Six interventions were introduced alone and "bundled" together: (a aggressive C. difficile testing; (b empiric isolation and treatment of symptomatic patients; (c improved adherence to hand hygiene and (d contact precautions; (e improved use of soap and water for hand hygiene; and (f improved environmental cleaning. Our analysis compared these interventions using values representing 3 different scenarios: (1 base-case (BASE values that reflect typical hospital practice, (2 intervention (INT values that represent implementation of hospital-wide efforts to reduce C. diff transmission, and (3 optimal (OPT values representing the highest expected results from strong adherence to the interventions. Cost parameters for each intervention were obtained from published literature. We performed our analyses assuming low, normal, and high C. difficile importation prevalence and transmissibility of C. difficile.INT levels of the "bundled" intervention were cost-effective at a willingness-to-pay threshold of $100,000/quality-adjusted life-year in all importation prevalence and transmissibility scenarios. OPT levels of intervention were cost-effective for normal and high importation prevalence and transmissibility scenarios. When analyzed separately, hand hygiene compliance, environmental decontamination, and empiric isolation and treatment were the

  2. Cost-effectiveness of post-landing latent tuberculosis infection control strategies in new migrants to Canada.

    Science.gov (United States)

    Campbell, Jonathon R; Johnston, James C; Sadatsafavi, Mohsen; Cook, Victoria J; Elwood, R Kevin; Marra, Fawziah

    2017-01-01

    The majority of tuberculosis in migrants to Canada occurs due to reactivation of latent TB infection. Risk of tuberculosis in those with latent tuberculosis infection can be significantly reduced with treatment. Presently, only 2.4% of new migrants are flagged for post-landing surveillance, which may include latent tuberculosis infection screening; no other migrants receive routine latent tuberculosis infection screening. To aid in reducing the tuberculosis burden in new migrants to Canada, we determined the cost-effectiveness of using different latent tuberculosis infection interventions in migrants under post-arrival surveillance and in all new migrants. A discrete event simulation model was developed that focused on a Canadian permanent resident cohort after arrival in Canada, utilizing a ten-year time horizon, healthcare system perspective, and 1.5% discount rate. Latent tuberculosis infection interventions were evaluated in the population under surveillance (N = 6100) and the total cohort (N = 260,600). In all evaluations, six different screening and treatment combinations were compared to the base case of tuberculin skin test screening followed by isoniazid treatment only in the population under surveillance. Quality adjusted life years, incident tuberculosis cases, and costs were recorded for each intervention and incremental cost-effectiveness ratios were calculated in relation to the base case. In the population under surveillance (N = 6100), using an interferon-gamma release assay followed by rifampin was dominant compared to the base case, preventing 4.90 cases of tuberculosis, a 4.9% reduction, adding 4.0 quality adjusted life years, and saving $353,013 over the ensuing ten-years. Latent tuberculosis infection screening in the total population (N = 260,600) was not cost-effective when compared to the base case, however could potentially prevent 21.8% of incident tuberculosis cases. Screening new migrants under surveillance with an interferon

  3. Sustainable strategies for treatment of bacterial infections

    DEFF Research Database (Denmark)

    Molin, Søren

    2014-01-01

    Resistance to antibiotics and the consequential failures of treatment based on antibiotics makes microbial infections a major threat to human health. This problem combined with rapidly increasing life-style disease problems challenge our healtcare system as well as the pharma industry, and if we do...... not in a foreseeable future develop novel approaches and strategies to combat bacterial infections, many people will be at risk of dying from even trivial infections for which we until recently had highly effective antibiotics. We have for a number of years investigated chronic bacterial lung infections in patients...... suffering from cystic fibrosis. These infections are optimal model scenarios for studies of antibiotic resistance development and microbial adaptation, and we suggest that this information should be useful when designing new anti-microbial strategies. In this respect it will be important to choose...

  4. Photochemotherapeutic Strategy against Acanthamoeba Infections

    Science.gov (United States)

    Aqeel, Yousuf; Siddiqui, Ruqaiyyah; Anwar, Ayaz; Shah, Muhammad Raza; Khoja, Shahrukh

    2015-01-01

    Acanthamoeba is a protist pathogen that can cause serious human infections, including blinding keratitis and a granulomatous amoebic encephalitis that almost always results in death. The current treatment for these infections includes a mixture of drugs, and even then, a recurrence can occur. Photochemotherapy has shown promise in the treatment of Acanthamoeba infections; however, the selective targeting of pathogenic Acanthamoeba has remained a major concern. The mannose-binding protein is an important adhesin expressed on the surface membranes of pathogenic Acanthamoeba organisms. To specifically target Acanthamoeba, the overall aim of this study was to synthesize a photosensitizing compound (porphyrin) conjugated with mannose and test its efficacy in vitro. The synthesis of mannose-conjugated porphyrin was achieved by mixing benzaldehyde and pyrrole, yielding tetraphenylporphyrin. Tetraphenylporphyrin was then converted into mono-nitrophenylporphyrin by selectively nitrating the para position of the phenyl rings, as confirmed by nuclear magnetic resonance (NMR) spectroscopy. The mono-nitrophenylporphyrin was reduced to mono-aminophenylporphyrin in the presence of tin dichloride and confirmed by a peak at m/z 629. Finally, mono-aminoporphyrin was conjugated with mannose, resulting in the formation of an imine bond. Mannose-conjugated porphyrin was confirmed through spectroscopic analysis and showed that it absorbed light of wavelengths ranging from 425 to 475 nm. To determine the antiacanthamoebic effects of the derived product, amoebae were incubated with mannose-conjugated porphyrin for 1 h and washed 3 times to remove extracellular compound. Next, the amoebae were exposed to light of the appropriate wavelength for 1 h. The results revealed that mannose-conjugated porphyrin produced potent trophicidal effects and blocked excystation. In contrast, Acanthamoeba castellanii incubated with mannose alone and porphyrin alone did not exhibit an antiamoebic effect

  5. Removal of waterborne pathogens from liver transplant unit water taps in prevention of healthcare-associated infections: a proposal for a cost-effective, proactive infection control strategy.

    Science.gov (United States)

    Zhou, Z Y; Hu, B J; Qin, L; Lin, Y E; Watanabe, H; Zhou, Q; Gao, X D

    2014-04-01

    Hospital water supplies often contain waterborne pathogens, which can become a reservoir for healthcare-associated infections (HAIs). We surveyed the extent of waterborne pathogen contamination in the water supply of a Liver Transplant Unit. The efficacy of point-of-use (POU) water filters was evaluated by comparative analysis in routine clinical use. Our baseline environmental surveillance showed that Legionella spp. (28%, 38/136), Pseudomonas aeruginosa (8%, 11/136), Mycobacterium spp. (87%, 118/136) and filamentous fungi (50%, 68/136) were isolated from the tap water of the Liver Transplant Unit. 28.9% of Legionella spp.-positive water samples (n = 38) showed high-level Legionella contamination (≥10(3) CFU/L). After installation of the POU water filter, none of these pathogens were found in the POU filtered water samples. Furthermore, colonizations/infections with Gram-negative bacteria determined from patient specimens were reduced by 47% during this period, even if only 27% (3/11) of the distal sites were installed with POU water filters. In conclusion, the presence of waterborne pathogens was common in the water supply of our Liver Transplant Unit. POU water filters effectively eradicated these pathogens from the water supply. Concomitantly, healthcare-associated colonization/infections declined after the POU filters were installed, indicating their potential benefit in reducing waterborne HAIs. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  6. Supervisory Control Strategy Development

    International Nuclear Information System (INIS)

    Gary D Storrick; Bojan Petrovic

    2007-01-01

    Task 4 of this collaborative effort between ORNL, Brazil, and Westinghouse for the International Nuclear Energy Research Initiative entitled 'Development of Advanced Instrumentation and Control for an Integrated Primary System Reactor' focused on the design of the hierarchical supervisory control for multiple-module units. The state of the IRIS plant design--specifically, the lack of a detailed secondary system design--made developing a detailed hierarchical control difficult at this time. However, other simultaneous and ongoing efforts have contributed to providing the needed information. This report summarizes the results achieved under Task 4 of this Financial Assistance Award. Section 1.2 describes the scope of this effort. Section 2 discusses the IRIS control functions. Next, it briefly reviews the current control concepts, and then reviews the maneuvering requirements for the IRIS plant. It closes by noting the benefits that automated sequences have in reducing operator workload. Section 3 examines reactor loading in the frequency domain to establish some guidelines for module operation, paying particular attention to strategies for using process steam for desalination and/or district heating. The final subsection discusses the implications for reactor control, and argues that using the envisioned percentage (up to 10%) of the NSSS thermal output for these purposes should not significantly affect the NSSS control strategies. Section 4 uses some very general economic assumptions to suggest how one should approach multi-module operation. It concludes that the well-known algorithms used for economic dispatching could be used to help manage a multi-unit IRIS site. Section 5 addresses the human performance factors of multi-module operation. Section 6 summarizes our conclusions

  7. Interactive Control System, Intended Strategy, Implemented Strategy dan Emergent Strategy

    Directory of Open Access Journals (Sweden)

    Tubagus Ismail

    2012-09-01

    Full Text Available The purpose of this study was to examine the relationship between management control system (MCS and strategy formation processes, namely: intended strategy, emergent strategy and impelemented strategy. The focus of MCS in this study was interactive control system. The study was based on Structural Equation Modeling (SEM as its multivariate analyses instrument. The samples were upper middle managers of manufacturing company in Banten Province, DKI Jakarta Province and West Java Province. AMOS Software 16 program is used as an additional instrument to resolve the problem in SEM modeling. The study found that interactive control system brought a positive and significant influence on Intended strategy; interactive control system brought a positive and significant influence on implemented strategy; interactive control system brought a positive and significant influence on emergent strategy. The limitation of this study is that our empirical model only used one way relationship between the process of strategy formation and interactive control system.

  8. 75 FR 3912 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2010-01-25

    ..., Detection, and Control of Infectious Diseases (NCPDCID), regarding: (1) The practice of hospital infection control; (2) strategies for surveillance, prevention, and control of infections (e.g., nosocomial... healthcare-associated infections Recovery Act efforts; discussion on the draft guideline for prevention of...

  9. Inventory control strategies

    International Nuclear Information System (INIS)

    Primrose, D.

    1998-01-01

    Finning International Inc. is in the business of selling, financing and servicing Caterpillar and complementary equipment. Its main markets are in western Canada, Britain and Chile. This paper discusses the parts inventory strategies system for Finning (Canada). The company's territory covers British Columbia, Alberta, the Yukon and the Northwest Territories. Finning's parts inventory consists of 80,000 component units valued at more than $150 M. Distribution centres are located in Langley, British Columbia and Edmonton, Alberta. To make inventory and orders easier to control, Finning has designed a computer-based system, with software written exclusively for Caterpillar dealers. The system makes use of a real time electronic interface with all Finning locations, plus all Caterpillar facilities and other dealers in North America. Details of the system are discussed, including territorial stocking procedures, addition to stock, exhaustion of stock, automatic/suggest order controls, surplus inventory management, and procedures for jointly managed inventory. 3 tabs., 1 fig

  10. Tax Strategy Control

    DEFF Research Database (Denmark)

    Rossing, Christian Plesner

    2013-01-01

    This paper examines how a functional tax strategy impacts the management control system (MCS) in a multinational enterprise (MNE) facing transfer pricing tax risks. Based on case study findings it is argued that the MCS in a multinational setting is contingent upon the MNE's response to its tax...... environment. Moreover, the paper extends existing contingency-based theory on MCS by illustrating the role of inter-organisational network collaboration across MNE transfer pricing tax experts. This collaboration, caused by a widely dispersed tax knowledge base, fuels the formal interactive control system...... and reduces tax uncertainty. The paper adopts an interdisciplinary approach for explaining findings, using contingency-based theory and network theory at the inter-organisational level....

  11. [Anti-infective defence strategies and methods of escape from entomologic pathogens under immunologic control of insects].

    Science.gov (United States)

    Jarosz, J

    1996-01-01

    Insect immunity comprises a complex of several distinct systems, both haemocytic and humoral in nature, that cooperate together in a more or less coordinated way to provide protection of the body cavity from invading microorganisms. Insects can respond to infections by a selective synthesis of haemolymph immune proteins that are responsible for antibacterial immunity. Antibacterial activity of insect blood is attributable to innate compounds such as lysozome, and to induced polypeptides or small basic proteins absent in non-immunized insects. The cecropins and attacins in Lepidoptera, and diptericins in Diptera are the inducible antibacterial immune proteins well defined biochemically. Bacterial pathogens and some parasites of insects, preferably entomogenous rhabditid nematodes, have developed the mechanism by which they may counteract insect immunity. This phenomenon is realized either by escaping immune reactions or by degrading antimicrobial factors of haemolymph in an active process. Passive resistance of parasites to insect immunity is a result of a strong evolutionary pressure on parasites to develop mechanisms to escape insect immune reactions or to minimize their effectiveness through changes in the parasite itself. Active resistance to the insect non-self response system involves a partial or total destruction of immune proteins by extracellular proteinases released during parasitism.

  12. Interactive Control System, Intended Strategy, Implemented Strategy dan Emergent Strategy

    OpenAIRE

    Tubagus Ismail; Darjat Sudrajat

    2012-01-01

    The purpose of this study was to examine the relationship between management control system (MCS) and strategy formation processes, namely: intended strategy, emergent strategy and impelemented strategy. The focus of MCS in this study was interactive control system. The study was based on Structural Equation Modeling (SEM) as its multivariate analyses instrument. The samples were upper middle managers of manufacturing company in Banten Province, DKI Jakarta Province and West Java Province. AM...

  13. 78 FR 62636 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2013-10-22

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Healthcare Quality Promotion, the Director, National Center for Emerging and Zoonotic Infectious Diseases... healthcare infection prevention and control; (2) strategies for surveillance, prevention, and control of...

  14. 78 FR 28221 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2013-05-14

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Healthcare Quality Promotion, the Director, National Center for Emerging and Zoonotic Infectious Diseases... healthcare infection prevention and control; (2) strategies for surveillance, prevention, and control of...

  15. Establishment of Chronic Infection: Brucella's Stealth Strategy

    Science.gov (United States)

    Ahmed, Waqas; Zheng, Ke; Liu, Zheng-Fei

    2016-01-01

    Brucella is a facultative intracellular pathogen that causes zoonotic infection known as brucellosis which results in abortion and infertility in natural host. Humans, especially in low income countries, can acquire infection by direct contact with infected animal or by consumption of animal products and show high morbidity, severe economic losses and public health problems. However for survival, host cells develop complex immune mechanisms to defeat and battle against attacking pathogens and maintain a balance between host resistance and Brucella virulence. On the other hand as a successful intracellular pathogen, Brucella has evolved multiple strategies to evade immune response mechanisms to establish persistent infection and replication within host. In this review, we mainly summarize the “Stealth” strategies employed by Brucella to modulate innate and the adaptive immune systems, autophagy, apoptosis and possible role of small noncoding RNA in the establishment of chronic infection. The purpose of this review is to give an overview for recent understanding how this pathogen evades immune response mechanisms of host, which will facilitate to understanding the pathogenesis of brucellosis and the development of novel, more effective therapeutic approaches to treat brucellosis. PMID:27014640

  16. Elevator Control Strategies

    OpenAIRE

    Ceder, Frederick; Nordin, Alexandra

    2013-01-01

    The purpose of this essay is to investigate if it is eective to switch strategies for elevators during one day in an oce building. This essay describes some of the strategies in use today, followed by a comparison and analysis of two of the strategies described. We have also implemented optimizations to one of these strategies. From our test results we can conclude that our optimized strategy worked and produced better results on average waiting time and total traveling time than the two stra...

  17. Targeted screening strategies to detect Trypanosoma cruzi infection in children.

    Directory of Open Access Journals (Sweden)

    Michael Z Levy

    2007-12-01

    Full Text Available Millions of people are infected with Trypanosoma cruzi, the causative agent of Chagas disease in Latin America. Anti-trypanosomal drug therapy can cure infected individuals, but treatment efficacy is highest early in infection. Vector control campaigns disrupt transmission of T. cruzi, but without timely diagnosis, children infected prior to vector control often miss the window of opportunity for effective chemotherapy.We performed a serological survey in children 2-18 years old living in a peri-urban community of Arequipa, Peru, and linked the results to entomologic, spatial and census data gathered during a vector control campaign. 23 of 433 (5.3% [95% CI 3.4-7.9] children were confirmed seropositive for T. cruzi infection by two methods. Spatial analysis revealed that households with infected children were very tightly clustered within looser clusters of households with parasite-infected vectors. Bayesian hierarchical mixed models, which controlled for clustering of infection, showed that a child's risk of being seropositive increased by 20% per year of age and 4% per vector captured within the child's house. Receiver operator characteristic (ROC plots of best-fit models suggest that more than 83% of infected children could be identified while testing only 22% of eligible children.We found evidence of spatially-focal vector-borne T. cruzi transmission in peri-urban Arequipa. Ongoing vector control campaigns, in addition to preventing further parasite transmission, facilitate the collection of data essential to identifying children at high risk of T. cruzi infection. Targeted screening strategies could make integration of diagnosis and treatment of children into Chagas disease control programs feasible in lower-resource settings.

  18. Imaging strategies in pediatric urinary tract infection

    Energy Technology Data Exchange (ETDEWEB)

    Dacher, Jean-Nicolas [University of Rouen, Quant-IF Laboratory, School of Medicine and Pharmacy, Rouen (France); Rouen University Hospital Charles Nicolle, Department of Radiology, Rouen (France); UFR Medecine Pharmacie de Rouen, Laboratoire Quant-If, Rouen (France); Hitzel, Anne; Vera, Pierre [University of Rouen, Quant-IF Laboratory, School of Medicine and Pharmacy, Rouen (France); CRLCC Henri Becquerel, Department of Nuclear Medicine, Rouen (France); Avni, Fred E. [Free University of Brussels, Department of Radiology, Erasmus Hospital, Brussels (Belgium)

    2005-07-01

    This article is focused on the controversial topic of imaging strategies in pediatric urinary tract infection. A review of the recent literature illustrates the complementary roles of ultrasound, diagnostic radiology and nuclear medicine. The authors stress the key role of ultrasound which has recently been debated. The commonly associated vesicoureteric reflux has to be classified as congenital or secondary due to voiding dysfunction. A series of frequently asked questions are addressed in a second section. The proposed answers are not the product of a consensus but should rather be considered as proposals to enrich the ongoing debate concerning the evaluation of urinary tract infection in children. (orig.)

  19. Imaging strategies in pediatric urinary tract infection

    International Nuclear Information System (INIS)

    Dacher, Jean-Nicolas; Hitzel, Anne; Vera, Pierre; Avni, Fred E.

    2005-01-01

    This article is focused on the controversial topic of imaging strategies in pediatric urinary tract infection. A review of the recent literature illustrates the complementary roles of ultrasound, diagnostic radiology and nuclear medicine. The authors stress the key role of ultrasound which has recently been debated. The commonly associated vesicoureteric reflux has to be classified as congenital or secondary due to voiding dysfunction. A series of frequently asked questions are addressed in a second section. The proposed answers are not the product of a consensus but should rather be considered as proposals to enrich the ongoing debate concerning the evaluation of urinary tract infection in children. (orig.)

  20. Infection control in Indonesian Hospitals

    OpenAIRE

    Duerink, Daphne Offra

    2009-01-01

    The studies in this thesis were performed as part of the AMRIN (Antimicrobial Resistance in Indonesia) study that addressed antimicrobial resistance, antibiotic usage and infection control in Indonesia. They are the first studies that give insight into the incidence of healthcare-associated infections, determinants for carriage of resistant bacteria in Indonesian individuals and the implementation of measures for the prevention of the spread of bacteria and nosocomial infections in Indonesian...

  1. Strategies for humidity control

    Energy Technology Data Exchange (ETDEWEB)

    Baumgarth, S

    1987-01-01

    Humidity and temperature control in air-conditioning systems mostly involves coupled closed-loop control circuits. The author discusses their uncoupling and resulting consequences as well as energy-optimized control of recirculation air flaps or enthalpy recovering systems (h-x control) in detail. Special reference is made of the application of the DDC technology and its scope, limits and preconditions. In conclusions, the author presents pertinent measurement results. (orig.).

  2. Infection Control: MedlinePlus Health Topic

    Science.gov (United States)

    ... Staph infections - hospital (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Infection Control updates ... infections when visiting Staph infections - hospital Related Health Topics Hepatitis HIV/AIDS MRSA National Institutes of Health ...

  3. National Drug Control Strategy, 2011

    Science.gov (United States)

    Office of National Drug Control Policy, 2011

    2011-01-01

    In May of 2010, President Obama released the Administration's inaugural "National Drug Control Strategy". Based on the premise that drug use and its consequences pose a threat not just to public safety, but also to public health, the 2010 "Strategy" represented the first comprehensive rebalancing of Federal drug control policy in the nearly 40…

  4. Infection control in developing countries.

    Science.gov (United States)

    Meers, P D

    1988-02-01

    The level of socio-political and economic development achieved by a country determines the quality and quantity of the health care its citizens receive. These factors also govern the amount of attention given to hospital-acquired infection. The problems of infection control in 'developing' countries include, first, the international problems that arise from clashes of personality and viewpoint among those responsible for it, exacerbated in some places by ethnic or religious traditions. Second are problems imposed by factors that affect the spectrum of infectious disease, and third is a variable deficiency of human and financial resources. In the search for solutions, an analysis suggests that nurses are particularly suited to take the lead in the prevention of infection, so that a special initiative directed towards their education in the rapidly developing science of hospital infection and its control is likely to be the most cost effective and appropriate initial approach. This needs to be accompanied by parallel improvements in the education of medical undergraduates. Anything else should be applied in response to measured need, and then only as money and manpower permit. Careful thought is required to avoid squandering scarce resources by applying inappropriate infection control technology.

  5. 77 FR 58397 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2012-09-20

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare...) strategies for surveillance, prevention, and control of healthcare-associated infections (e.g., nosocomial infections) antimicrobial resistance and related events in settings where healthcare is provided, including...

  6. National Drug Control Strategy. Update.

    Science.gov (United States)

    Office of National Drug Control Policy, Washington, DC.

    President Bush's new National Drug Control Strategy for 2003 focuses on three core priorities: stopping drug use before it starts; healing America's drug users; and disrupting the market. The 2003 strategy reports progress toward meeting the President's goals of reducing drug use by 10 percent over 2 years, and 25 percent over 5 years. With regard…

  7. Industrial strategy for nondestructive control

    International Nuclear Information System (INIS)

    Martin, P.; Michaut, J.P.

    1994-01-01

    For Electricite de France, the nondestructive control strategy passes by a responsibility of services, a competition between companies, a clarification of the market access and a dialogue with the companies

  8. Therapeutic and prevention strategies against human enterovirus 71 infection

    Science.gov (United States)

    Kok, Chee Choy

    2015-01-01

    Human enterovirus 71 (HEV71) is the cause of hand, foot and mouth disease and associated neurological complications in children under five years of age. There has been an increase in HEV71 epidemic activity throughout the Asia-Pacific region in the past decade, and it is predicted to replace poliovirus as the extant neurotropic enterovirus of highest global public health significance. To date there is no effective antiviral treatment and no vaccine is available to prevent HEV71 infection. The increase in prevalence, virulence and geographic spread of HEV71 infection over the past decade provides increasing incentive for the development of new therapeutic and prevention strategies against this emerging viral infection. The current review focuses on the potential, advantages and disadvantages of these strategies. Since the explosion of outbreaks leading to large epidemics in China, research in natural therapeutic products has identified several groups of compounds with anti-HEV71 activities. Concurrently, the search for effective synthetic antivirals has produced promising results. Other therapeutic strategies including immunotherapy and the use of oligonucleotides have also been explored. A sound prevention strategy is crucial in order to control the spread of HEV71. To this end the ultimate goal is the rapid development, regulatory approval and widespread implementation of a safe and effective vaccine. The various forms of HEV71 vaccine designs are highlighted in this review. Given the rapid progress of research in this area, eradication of the virus is likely to be achieved. PMID:25964873

  9. Infection control in Indonesian Hospitals

    NARCIS (Netherlands)

    Duerink, Daphne Offra

    2009-01-01

    The studies in this thesis were performed as part of the AMRIN (Antimicrobial Resistance in Indonesia) study that addressed antimicrobial resistance, antibiotic usage and infection control in Indonesia. They are the first studies that give insight into the incidence of healthcare-associated

  10. The immune strategies of mosquito Aedes aegypti against microbial infection.

    Science.gov (United States)

    Wang, Yan-Hong; Chang, Meng-Meng; Wang, Xue-Li; Zheng, Ai-Hua; Zou, Zhen

    2018-06-01

    Yellow fever mosquito Aedes aegypti transmits many devastating arthropod-borne viruses (arboviruses), such as dengue virus, yellow fever virus, Chikungunya virus, and Zika virus, which cause great concern to human health. Mosquito control is an effective method to block the spread of infectious diseases. Ae. aegypti uses its innate immune system to fight against arboviruses, parasites, and fungi. In this review, we briefly summarize the recent findings in the immune response of Ae. aegypti against arboviral and entomopathogenic infections. This review enriches our understanding of the mosquito immune system and provides evidence to support the development of novel mosquito control strategies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. BWR control blade replacement strategies

    Energy Technology Data Exchange (ETDEWEB)

    Kennard, M W [Stoller Nuclear Fuel, NAC International, Pleasantville, NY (United States); Harbottle, J E [Stoller Nuclear Fuel, NAC International, Thornbury, Bristol (United Kingdom)

    2000-02-01

    The reactivity control elements in a BWR, the control blades, perform three significant functions: provide shutdown margin during normal and accident operating conditions; provide overall core reactivity control; and provide axial power shaping control. As such, the blades are exposed to the core's neutron flux, resulting in irradiation of blade structural and absorber materials. Since the absorber depletes with time (if B{sub 4}C is used, it also swells) and the structural components undergo various degradation mechanisms (e.g., embrittlement, corrosion), the blades have limits on their operational lifetimes. Consequently, BWR utilities have implemented strategies that aim to maximize blade lifetimes while balancing operational costs, such as extending a refuelling outage to shuffle high exposure blades. This paper examines the blade replacement strategies used by BWR utilities operating in US, Europe and Asia by assembling information related to: the utility's specific blade replacement strategy; the impact the newer blade designs and changes in core operating mode were having on those strategies; the mechanical and nuclear limits that determined those strategies; the methods employed to ensure that lifetime limits were not exceeded during operation; and blade designs used (current and replacement blades). (author)

  12. BWR control blade replacement strategies

    International Nuclear Information System (INIS)

    Kennard, M.W.; Harbottle, J.E.

    2000-01-01

    The reactivity control elements in a BWR, the control blades, perform three significant functions: provide shutdown margin during normal and accident operating conditions; provide overall core reactivity control; and provide axial power shaping control. As such, the blades are exposed to the core's neutron flux, resulting in irradiation of blade structural and absorber materials. Since the absorber depletes with time (if B 4 C is used, it also swells) and the structural components undergo various degradation mechanisms (e.g., embrittlement, corrosion), the blades have limits on their operational lifetimes. Consequently, BWR utilities have implemented strategies that aim to maximize blade lifetimes while balancing operational costs, such as extending a refuelling outage to shuffle high exposure blades. This paper examines the blade replacement strategies used by BWR utilities operating in US, Europe and Asia by assembling information related to: the utility's specific blade replacement strategy; the impact the newer blade designs and changes in core operating mode were having on those strategies; the mechanical and nuclear limits that determined those strategies; the methods employed to ensure that lifetime limits were not exceeded during operation; and blade designs used (current and replacement blades). (author)

  13. Development and evaluation of an avian influenza, neuraminidase subtype 1, indirect enzyme-linked immunosorbent assay for poultry using the differentiation of infected from vaccinated animals control strategy.

    Science.gov (United States)

    Liu, Y; Mundt, E; Mundt, A; Sylte, M; Suarez, D L; Swayne, D E; García, M

    2010-03-01

    An indirect enzyme-linked immunosorbent assay (ELISA) was developed using baculovirus, purified, recombinant N1 protein from A/chicken/Indonesia/PA7/2003 (H5N1) virus. The N1-ELISA showed high selectivity for detection of N1 antibodies, with no cross-reactivity with other neuraminidase subtypes, and broad reactivity with sera to N1 subtype isolates from North American and Eurasian lineages. Sensitivity of the N1-ELISA to detect N1 antibodies in turkey sera, collected 3 wk after H1N1 vaccination, was comparable to detection of avian influenza antibodies by the commercial, indirect ELISAs ProFLOK AIV Plus ELISA Kit (Synbiotics, Kansas City, MO) and Avian Influenza Virus Antibody Test Kit (IDEXX, Westbrook, ME). However, 6 wk after vaccination, the Synbiotics ELISA kit performed better than the N1-ELISA and the IDEXX ELISA kit. An evaluation was made of the ability of the N1-ELISA to discriminate vaccinated chickens from subsequently challenged chickens. Two experiments were conducted, chickens were vaccinated with inactivated H5N2 and H5N9 viruses and challenged with highly pathogenic H5N1 virus, and chickens were vaccinated with recombinant poxvirus vaccine encoding H7 and challenged with highly pathogenic H7N1 virus. Serum samples were collected at 14 days postchallenge and tested by hemagglutination inhibition (HI), quantitative neuraminidase inhibition (NI), and N1-ELISA. At 2 days postchallenge, oropharyngeal swabs were collected for virus isolation (VI) to confirm infection. The N1-ELISA was in fair agreement with VI and HI results. Although the N1-ELISA showed a lower sensitivity than the NI assay, it was demonstrated that detection of N1 antibodies by ELISA was an effective and rapid assay to identify exposure to the challenge virus in vaccinated chickens. Therefore, N1-ELISA can facilitate a vaccination strategy with differentiation of infected from vaccinated animals using a neuraminidase heterologous approach.

  14. Manual of infection prevention and control

    National Research Council Canada - National Science Library

    Damani, N. N

    2012-01-01

    .... Unlike other books on infection control, the main strength of this book is to provide clear, up-to-date and practical guidance in infection control in an easy to read format which can act as a quick...

  15. 42 CFR 483.65 - Infection control.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Infection control. 483.65 Section 483.65 Public... Care Facilities § 483.65 Infection control. The facility must establish and maintain an infection control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the...

  16. 38 CFR 52.190 - Infection control.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Infection control. 52.190... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.190 Infection control. The program management must establish and maintain an infection control program designed to prevent the development and...

  17. 38 CFR 51.190 - Infection control.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Infection control. 51.190... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.190 Infection control. The facility management must establish and maintain an infection control program designed to provide a safe, sanitary, and...

  18. 42 CFR 460.74 - Infection control.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Infection control. 460.74 Section 460.74 Public...) PACE Administrative Requirements § 460.74 Infection control. (a) Standard procedures. The PACE organization must follow accepted policies and standard procedures with respect to infection control, including...

  19. Efficient community-based control strategies in adaptive networks

    International Nuclear Information System (INIS)

    Yang Hui; Tang Ming; Zhang Haifeng

    2012-01-01

    Most studies on adaptive networks concentrate on the properties of steady state, but neglect transient dynamics. In this study, we pay attention to the emergence of community structure in the transient process and the effects of community-based control strategies on epidemic spreading. First, by normalizing the modularity, we investigate the evolution of community structure during the transient process, and find that a strong community structure is induced by the rewiring mechanism in the early stage of epidemic dynamics, which, remarkably, delays the outbreak of disease. We then study the effects of control strategies started at different stages on the prevalence. Both immunization and quarantine strategies indicate that it is not ‘the earlier, the better’ for the implementation of control measures. And the optimal control effect is obtained if control measures can be efficiently implemented in the period of a strong community structure. For the immunization strategy, immunizing the susceptible nodes on susceptible–infected links and immunizing susceptible nodes randomly have similar control effects. However, for the quarantine strategy, quarantining the infected nodes on susceptible–infected links can yield a far better result than quarantining infected nodes randomly. More significantly, the community-based quarantine strategy performs better than the community-based immunization strategy. This study may shed new light on the forecast and the prevention of epidemics among humans. (paper)

  20. Effects of national antibiotic stewardship and infection control strategies on hospital-associated and community-associated meticillin-resistant Staphylococcus aureus infections across a region of Scotland: a non-linear time-series study.

    Science.gov (United States)

    Lawes, Timothy; Lopez-Lozano, José-María; Nebot, Cesar A; Macartney, Gillian; Subbarao-Sharma, Rashmi; Dare, Ceri Rj; Wares, Karen D; Gould, Ian M

    2015-12-01

    Restriction of antibiotic consumption to below predefined total use thresholds might remove the selection pressure that maintains antimicrobial resistance within populations. We assessed the effect of national antibiotic stewardship and infection prevention and control programmes on prevalence density of meticillin-resistant Staphylococcus aureus (MRSA) infections across a region of Scotland. This non-linear time-series analysis and quasi-experimental study explored ecological determinants of MRSA epidemiology among 1,289,929 hospital admissions and 455,508 adults registered in primary care in northeast Scotland. Interventions included antibiotic stewardship to restrict use of so-called 4C (cephalosporins, co-amoxiclav, clindamycin, and fluoroquinolones) and macrolide antibiotics; a hand hygiene campaign; hospital environment inspections; and MRSA admission screening. Total effects were defined as the difference between scenarios with intervention (observed) and without intervention (predicted from time-series models). The primary outcomes were prevalence density of MRSA infections per 1000 occupied bed days (OBDs) in hospitals or per 10,000 inhabitants per day (IDs) in the community. During antibiotic stewardship, use of 4C and macrolide antibiotics fell by 47% (mean decrease 224 defined daily doses [DDDs] per 1000 OBDs, 95% CI 154-305, p=0·008) in hospitals and 27% (mean decrease 2·52 DDDs per 1000 IDs, 0·65-4·55, p=0·031) in the community. Hospital prevalence densities of MRSA were inversely related to intensified infection prevention and control, but positively associated with MRSA rates in neighbouring hospitals, importation pressures, bed occupancy, and use of fluoroquinolones, co-amoxiclav, and third-generation cephalosporins, or macrolide antibiotics that exceeded hospital-specific thresholds. Community prevalence density was predicted by hospital MRSA rates and above-threshold use of macrolides, fluoroquinolones, and clindamycin. MRSA prevalence

  1. Case finding strategies for hepatitis C infection

    NARCIS (Netherlands)

    Helsper, C.W.

    2011-01-01

    Hepatitis C virus infection (HCV) is a viral liver disease affecting approximately 3% of the world’s population and 0.1 to 0.4% of the population of the Netherlands. HCV infection can lead to liver cirrhosis and liver cancer. In addition to the severe burden of disease, the failure to find and treat

  2. Multidrug-resistant opportunistic pathogens challenging veterinary infection control.

    Science.gov (United States)

    Walther, Birgit; Tedin, Karsten; Lübke-Becker, Antina

    2017-02-01

    Although the problems associated with healthcare-associated infections (HAI) and the emergence of zoonotic and multidrug-resistant pathogens in companion animal (dogs, cats and horses) medicine have been well-known for decades, current progress with respect to practical implementation of infection control programs in veterinary clinics has been limited. Clinical outbreak events reported for methicillin-resistant Staphylooccus aureus (MRSA) and Staphylococcus pseudintermedius (MRSP), extended spectrum beta-lactamase (ESBL)-producing Escherichia coli and multidrug-resistant (MDR) Salmonella Serovars indicate the necessity of infection control strategies for protecting animal patients at risk as well as veterinary personnel. The close bond between humans and their companion animals provides opportunities for exchange of microorganisms, including MDR pathogens. This particular aspect of the "One Health" idea requires more representative surveillance efforts and infection control strategies with respect to animal-species specific characters. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. 78 FR 6329 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2013-01-30

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... charged with providing advice and guidance to the Director, Division of Healthcare Quality Promotion, the... regarding: (1) The practice of healthcare infection prevention and control; (2) strategies for surveillance...

  4. Abstract: Implementing Infection Control Measures in Neonatology ...

    African Journals Online (AJOL)

    Abstract. Background Neonatal infection is a primary cause of morbidity and mortality globally. Objective The project's objective is to facilitate quality improvement by reduction of hospital-acquired infection (HAI) in hospitalized neonates. Methods Current infection control practices were surveyed and three main areas were ...

  5. Infection control in design and construction work.

    Science.gov (United States)

    Collinge, William H

    2015-01-01

    To clarify how infection control requirements are represented, communicated, and understood in work interactions through the medical facility construction project life cycle. To assist project participants with effective infection control management by highlighting the nature of such requirements and presenting recommendations to aid practice. A 4-year study regarding client requirement representation and use on National Health Service construction projects in the United Kingdom provided empirical evidence of infection control requirement communication and understanding through design and construction work interactions. An analysis of construction project resources (e.g., infection control regulations and room data sheets) was combined with semi-structured interviews with hospital client employees and design and construction professionals to provide valuable insights into the management of infection control issues. Infection control requirements are representationally indistinct but also omnipresent through all phases of the construction project life cycle: Failure to recognize their nature, relevance, and significance can result in delays, stoppages, and redesign work. Construction project resources (e.g., regulatory guidance and room data sheets) can mask or obscure the meaning of infection control issues. A preemptive identification of issues combined with knowledge sharing activities among project stakeholders can enable infection control requirements to be properly understood and addressed. Such initiatives should also reference existing infection control regulatory guidance and advice. © The Author(s) 2015.

  6. Enterobiasis (Pinworm Infection): Prevention and Control

    Science.gov (United States)

    ... General Information Pinworm Infection FAQs Epidemiology & Risk Factors Biology Disease Diagnosis Treatment Prevention & Control Resources for Health Professionals Publications Get Email Updates ...

  7. Journal of the Nigerian Infection Control Association

    African Journals Online (AJOL)

    The Journal of the Nigerian Infection Control Association publishes articles which deal with clinical medicine, basic medical science, dental sciences, pharmaceutical, veterinary sciences, nursing services and medical education and other related disciplines which are pertinent to infection control. Language of Publication: ...

  8. Infection control in the intensive care unit.

    Science.gov (United States)

    Osman, Mohamed F; Askari, Reza

    2014-12-01

    It is critical for health care personnel to recognize and appreciate the detrimental impact of intensive care unit (ICU)-acquired infections. The economic, clinical, and social expenses to patients and hospitals are overwhelming. To limit the incidence of ICU-acquired infections, aggressive infection control measures must be implemented and enforced. Researchers and national committees have developed and continue to develop evidence-based guidelines to control ICU infections. A multifaceted approach, including infection prevention committees, antimicrobial stewardship programs, daily reassessments-intervention bundles, identifying and minimizing risk factors, and continuing staff education programs, is essential. Infection control in the ICU is an evolving area of critical care research. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Strategies for combating bacterial biofilm infections

    DEFF Research Database (Denmark)

    Wu, Hong; Moser, Claus Ernst; Wang, Heng-Zhuang

    2015-01-01

    Formation of biofilm is a survival strategy for bacteria and fungi to adapt to their living environment, especially in the hostile environment. Under the protection of biofilm, microbial cells in biofilm become tolerant and resistant to antibiotics and the immune responses, which increases the di.......International Journal of Oral Science advance online publication, 12 December 2014; doi:10.1038/ijos.2014.65....

  10. ICMR programme on Antibiotic Stewardship, Prevention of Infection & Control (ASPIC).

    Science.gov (United States)

    Chandy, Sujith J; Michael, Joy Sarojini; Veeraraghavan, Balaji; Abraham, O C; Bachhav, Sagar S; Kshirsagar, Nilima A

    2014-02-01

    Antimicrobial resistance and hospital infections have increased alarmingly in India. Antibiotic stewardship and hospital infection control are two broad strategies which have been employed globally to contain the problems of resistance and infections. For this to succeed, it is important to bring on board the various stakeholders in hospitals, especially the clinical pharmacologists. The discipline of clinical pharmacology needs to be involved in themes such as antimicrobial resistance and hospital infection which truly impact patient care. Clinical pharmacologists need to collaborate with faculty in other disciplines such as microbiology to achieve good outcomes for optimal patient care in the hospital setting. The ASPIC programme was initiated by the Indian Council of Medical Research (ICMR) in response to the above need and was designed to bring together faculty from clinical pharmacology, microbiology and other disciplines to collaborate on initiating and improving antibiotic stewardship and concurrently curbing hospital infections through feasible infection control practices. This programme involves the participation of 20 centres per year throughout the country which come together for a training workshop. Topics pertaining to the above areas are discussed in addition to planning a project which helps to improve antibiotic stewardship and infection control practices in the various centres. It is hoped that this programme would empower hospitals and institutions throughout the country to improve antibiotic stewardship and infection control and ultimately contain antimicrobial resistance.

  11. [Infection prevention and control in neonatal intensive care unit].

    Science.gov (United States)

    Lorenzini, Elisiane; Lorenzini, Elisiane; da Costa, Tatiane Costa; da Silva, Eveline Franco

    2013-12-01

    This study was aimed to identify the knowledge of the nursing team of a Neonatal Intensive Care Unit (NICU) on infection control, identijfying the factors that facilitate or hinder the prevention and control of Healthcare Associated Infections (HICAI). A descriptive study using a qualitative research method conducted with three nurses and 15 nurse technicians, who work in a NICU of a charitable organization, in southern Brazil. It became evident that the nursing staff had great knowledge about the factors that facilitate the prevention and control of HCAI in NICU, the most important factor being proper hand hygiene. Among the factors that hinder infection prevention and control are to overcrowding and excessive workload. The efficient performance of the nursing staff is an important part of the strategy for prevention and control of HCAI.

  12. Ebola virus (EBOV) infection: Therapeutic strategies.

    Science.gov (United States)

    De Clercq, Erik

    2015-01-01

    Within less than a year after its epidemic started (in December 2013) in Guinea, Ebola virus (EBOV), a member of the filoviridae, has spread over a number of West-African countries (Guinea, Sierra Leone and Liberia) and gained allures that have been unprecedented except by human immunodeficiency virus (HIV). Although EBOV is highly contagious and transmitted by direct contact with body fluids, it could be counteracted by the adequate chemoprophylactic and -therapeutic interventions: vaccines, antibodies, siRNAs (small interfering RNAs), interferons and chemical substances, i.e. neplanocin A derivatives (i.e. 3-deazaneplanocin A), BCX4430, favipiravir (T-705), endoplasmic reticulum (ER) α-glucosidase inhibitors and a variety of compounds that have been found to inhibit EBOV infection blocking viral entry or by a mode of action that still has to be resolved. Much has to be learned from the mechanism of action of the compounds active against VSV (vesicular stomatitis virus), a virus belonging to the rhabdoviridae, that in its mode of replication could be exemplary for the replication of filoviridae. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Epidemic spreading on random surfer networks with infected avoidance strategy

    International Nuclear Information System (INIS)

    Feng Yun; Ding Li; Huang Yun-Han; Guan Zhi-Hong

    2016-01-01

    In this paper, we study epidemic spreading on random surfer networks with infected avoidance (IA) strategy. In particular, we consider that susceptible individuals’ moving direction angles are affected by the current location information received from infected individuals through a directed information network. The model is mainly analyzed by discrete-time numerical simulations. The results indicate that the IA strategy can restrain epidemic spreading effectively. However, when long-distance jumps of individuals exist, the IA strategy’s effectiveness on restraining epidemic spreading is heavily reduced. Finally, it is found that the influence of the noises from information transferring process on epidemic spreading is indistinctive. (paper)

  14. [Social marketing: applying commercial strategies to the prevention of nosocomial infections].

    Science.gov (United States)

    Sax, Hugo; Longtin, Yves; Alvarez-Ceyssat, Raymonde; Bonfillon, Chantal; Cavallero, Sabrina; Dayer, Pierre; Ginet, Claude; Herrault, Pascale

    2009-04-01

    Although a large proportion of healthcare-associated infections are avoidable, healthcare workers do not always practice evidence-based preventive strategies. Marketing technologies might help to improve patient safety. This article presents the basic principles of marketing and its potential use to promote good infection control practices. The marketing mix (Product, Price, Place, and Promotion) should be taken into account to induce behaviour change. By placing the emphasis on the perceived "profits" for healthcare workers the approach might lose its moral aspect and gain in effectiveness. VigiGerme, a non-commercial registered trademark, applies social marketing techniques to infection control and prevention.

  15. Graft-Sparing Strategy for Thoracic Prosthetic Graft Infection.

    Science.gov (United States)

    Uchino, Gaku; Yoshida, Takeshi; Kakii, Bunpachi; Furui, Masato

    2018-04-01

     Thoracic prosthetic graft infection is a rare but serious complication with no standard management. We reported our surgical experience on graft-sparing strategy for thoracic prosthetic graft infection.  This study included patients who underwent graft-sparing surgery for thoracic prosthetic graft infection at Matsubara Tokushukai Hospital in Japan from January 2000 to October 2017.  There were 17 patients included in the analyses, with a mean age at surgery of 71.0 ± 10.5 years; 11 were men. In-hospital mortality was observed in five patients (29.4%).  Graft-sparing surgery for thoracic prosthetic graft infection is an alternative option particularly for early graft infection after hemiarch replacement. Georg Thieme Verlag KG Stuttgart · New York.

  16. Infection control during filoviral hemorrhagic fever outbreaks

    Directory of Open Access Journals (Sweden)

    N Raabe Vanessa

    2012-01-01

    Full Text Available Breaking the human-to-human transmission cycle remains the cornerstone of infection control during filoviral (Ebola and Marburg hemorrhagic fever outbreaks. This requires effective identification and isolation of cases, timely contact tracing and monitoring, proper usage of barrier personal protection gear by health workers, and safely conducted burials. Solely implementing these measures is insufficient for infection control; control efforts must be culturally sensitive and conducted in a transparent manner to promote the necessary trust between the community and infection control team in order to succeed. This article provides a review of the literature on infection control during filoviral hemorrhagic fever outbreaks focusing on outbreaks in a developing setting and lessons learned from previous outbreaks. The primary search database used to review the literature was PUBMED, the National Library of Medicine website.

  17. Designing a sustainable strategy for malaria control?

    Directory of Open Access Journals (Sweden)

    Mharakurwa Sungano

    2011-08-01

    Full Text Available Abstract Malaria in the 21st century is showing signs of declining over much of its distribution, including several countries in Africa where previously this was not thought to be feasible. Yet for the most part the strategies to attack the infection are similar to those of the 1950s. Three major Journals have recently drawn attention to the situation, stressing the importance of research, describing the successes and defining semantics related to control. But there is a need to stress the importance of local sustainability, and consider somewhat urgently how individual endemic countries can plan and implement the programmes that are currently financed, for the most part, by donor institutions. On an immediate basis research should be more focused on a data driven approach to control. This will entail new thinking on the role of local infrastructure and in training of local scientists in local universities in epidemiology and field malariology so that expanded control programmes can become operational. Donor agencies should encourage and facilitate development of career opportunities for such personnel so that local expertise is available to contribute appropriately.

  18. Occupant satisfaction with two blind control strategies

    DEFF Research Database (Denmark)

    Karlsen, Line Røseth; Heiselberg, Per Kvols; Bryn, Ida

    2015-01-01

    Highlights •Occupant satisfaction with two blind control strategies has been studied. •Control based on cut-off position of slats was more popular than closed slats. •Results from the study are helpful in development of control strategies for blinds. •The results give indications of how blinds...

  19. Nutrition acquisition strategies during fungal infection of plants.

    Science.gov (United States)

    Divon, Hege H; Fluhr, Robert

    2007-01-01

    In host-pathogen interactions, efficient pathogen nutrition is a prerequisite for successful colonization and fungal fitness. Filamentous fungi have a remarkable capability to adapt and exploit the external nutrient environment. For phytopathogenic fungi, this asset has developed within the context of host physiology and metabolism. The understanding of nutrient acquisition and pathogen primary metabolism is of great importance in the development of novel disease control strategies. In this review, we discuss the current knowledge on how plant nutrient supplies are utilized by phytopathogenic fungi, and how these activities are controlled. The generation and use of auxotrophic mutants have been elemental to the determination of essential and nonessential nutrient compounds from the plant. Considerable evidence indicates that pathogen entrainment of host metabolism is a widespread phenomenon and can be accomplished by rerouting of the plant's responses. Crucial fungal signalling components for nutrient-sensing pathways as well as their developmental dependency have now been identified, and were shown to operate in a coordinate cross-talk fashion that ensures proper nutrition-related behaviour during the infection process.

  20. Mixed Infections and their Control

    Science.gov (United States)

    1983-04-29

    of cultures are available. Anaerobes predominate in abscesses in ’.he vulvo- vaginal , buttocks, perirectal, finger, and head areas, but aerobes are 7...trauma-induced infections is that most of them are polymicrobial, including multiple aerobic and anaerobic organisms. Furthermore, due to the depletion...species of Gram-negative aerobic • . bacteria and at least one obligate anaerobe such as Bacteroides, Peptostrepto- coccus, or Peptococcus. Cutaneous

  1. Control Strategy Tool (CoST)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The EPA Control Strategy Tool (CoST) is a software tool for projecting potential future control scenarios, their effects on emissions and estimated costs. This tool...

  2. Economics of eradicating Foot-and-Mouth disease epidemics with alternative control strategies

    NARCIS (Netherlands)

    Bergevoet, R.H.M.; Asseldonk, van M.A.P.M.

    2014-01-01

    The paper presents an economic analysis of Foot-and-Mouth Disease (FMD) control strategies for livestock herds. Alternative vaccination-to-live control strategies were compared to the strategy that involves culling of all susceptible animals in an area of 1 km around infected herds in addition to

  3. New strategies for local treatment of vaginal infections.

    Science.gov (United States)

    Palmeira-de-Oliveira, Rita; Palmeira-de-Oliveira, Ana; Martinez-de-Oliveira, José

    2015-09-15

    Vaginal infections are extremely prevalent, particularly among women of reproductive age. Although they do not result in high mortality rates, these infections are associated with high levels of anxiety and reduction of quality of life. In most cases, topical treatment of vaginal infections has been shown to be at least as effective as oral treatment, resulting in higher local drug concentrations, with fewer drug interactions and adverse effects. Furthermore, the emergence of microbial resistance to chemotherapeutics and the difficulties in managing infection recurrences sustain the need for more effective local treatments. However, conventional dosage forms have been associated with low retention in the vagina and discomfort. Formulation strategies such as the development of bioadhesive, thermogelling systems and microtechnological or nanotechnological approaches have been proposed to improve delivery of traditional drugs, and other treatment modalities such as new drugs, plant extracts, and probiotics are being studied. This article reviews the recent strategies studied to improve the treatment and prevention of the commonest vaginal infections-namely, vaginal bacteriosis, aerobic vaginitis, vulvovaginal candidosis, and trichomoniasis-through the intravaginal route. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Optimal control of anthracnose using mixed strategies.

    Science.gov (United States)

    Fotsa Mbogne, David Jaures; Thron, Christopher

    2015-11-01

    In this paper we propose and study a spatial diffusion model for the control of anthracnose disease in a bounded domain. The model is a generalization of the one previously developed in [15]. We use the model to simulate two different types of control strategies against anthracnose disease. Strategies that employ chemical fungicides are modeled using a continuous control function; while strategies that rely on cultivational practices (such as pruning and removal of mummified fruits) are modeled with a control function which is discrete in time (though not in space). For comparative purposes, we perform our analyses for a spatially-averaged model as well as the space-dependent diffusion model. Under weak smoothness conditions on parameters we demonstrate the well-posedness of both models by verifying existence and uniqueness of the solution for the growth inhibition rate for given initial conditions. We also show that the set [0, 1] is positively invariant. We first study control by impulsive strategies, then analyze the simultaneous use of mixed continuous and pulse strategies. In each case we specify a cost functional to be minimized, and we demonstrate the existence of optimal control strategies. In the case of pulse-only strategies, we provide explicit algorithms for finding the optimal control strategies for both the spatially-averaged model and the space-dependent model. We verify the algorithms for both models via simulation, and discuss properties of the optimal solutions. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Discourse of 'transformational leadership' in infection control.

    Science.gov (United States)

    Koteyko, Nelya; Carter, Ronald

    2008-10-01

    The article explores the impact of the ;transformational leadership' style in the role of modern matron with regards to infection control practices. Policy and guidance on the modern matron role suggest that it is distinctive in its combination of management and clinical components, and in its reliance on transformational leadership. Senior nurses are therefore expected to motivate staff by creating high expectations, modelling appropriate behaviour, and providing personal attention to followers by giving respect and responsibility. In this article, we draw on policy documents and interview data to explore the potential impact of this new management style on infection control practices. Combining the techniques of discourse analysis and corpus linguistics, we identify examples where matrons appear to disassociate themselves from the role of ;an empowered manager' who has control over human and financial resources to resolve problems in infection control efficiently.

  6. [Integrated prevention and control strategy for dengue in Mesoamerica].

    Science.gov (United States)

    Gómez-Dantés, Héctor; San Martín, José Luis; Danis-Lozano, Rogelio; Manrique-Saide, Pablo

    2011-01-01

    Dengue in the Americas is a public health problem in ascent. The control strategies have not been effective when sustained in the intensive use of insecticides and poor community participation. The Mesoamerican Initiative for the Prevention and the Integrated Control of Dengue synthesizes the works generated by the Integrated Strategy of the Pan-American Health Organization (PAHO) and the risks stratification strategy designed by the countries of the Mesoamerican region. The objective is to progressively reduce the incidence of dengue cases until a 50% reduction is reached over a five years period. This document describes the elements for the risk stratification, the activities for prevention and control organized by levels of intensity and frequency and the indicators used to pursuit the objectives. To face the dispersion of the problem a concentration of efforts for control in the areas of greater risk is presented; the opportunity in the detection of cases is highlighted to tackle the fast dissemination of the infection; focus on the most productive breeding sites is proposed to battle against the vast dissemination of the breeding sites; and the severity of the infection must be addressed by capable clinical human resources. This strategy was designed along with the national representatives of the control programs to create master plans that provided the basis for the integrated prevention and control of dengue in the Mesoamerican region.

  7. Control Strategy for Echinococcus multilocularis

    OpenAIRE

    Hegglin, Daniel; Deplazes, Peter

    2008-01-01

    Echinococcus multilocularis, the causative agent of zoonotic alveolar echinococcosis, can be controlled effectively by the experimental delivery of anthelminthic baits for urban foxes. Monthly baiting over a 45-month period was effective for long-lasting control. Trimonthly baiting intervals were far less effective and did not prevent parasite recovery.

  8. Strategies for Industrial Multivariable Control

    DEFF Research Database (Denmark)

    Hangstrup, M.

    dynamics and gains strongly depend upon one or more physical parameters characterizing the operating point. This class covers many industrial systems such as airplanes, ships, robots and process control systems. Power plant boilers are representatives for process control systems in general. The dynamics...

  9. Epidemic spreading on random surfer networks with infected avoidance strategy

    Science.gov (United States)

    Feng, Yun; Ding, Li; Huang, Yun-Han; Guan, Zhi-Hong

    2016-12-01

    In this paper, we study epidemic spreading on random surfer networks with infected avoidance (IA) strategy. In particular, we consider that susceptible individuals’ moving direction angles are affected by the current location information received from infected individuals through a directed information network. The model is mainly analyzed by discrete-time numerical simulations. The results indicate that the IA strategy can restrain epidemic spreading effectively. However, when long-distance jumps of individuals exist, the IA strategy’s effectiveness on restraining epidemic spreading is heavily reduced. Finally, it is found that the influence of the noises from information transferring process on epidemic spreading is indistinctive. Project supported in part by the National Natural Science Foundation of China (Grant Nos. 61403284, 61272114, 61673303, and 61672112) and the Marine Renewable Energy Special Fund Project of the State Oceanic Administration of China (Grant No. GHME2013JS01).

  10. Infective endocarditis in patients on haemodialysis - possible strategies for prevention.

    Science.gov (United States)

    Oun, Hadi A; Price, Andrew J; Traynor, Jamie P

    2016-05-01

    Infective endocarditis is an important cause of morbidity and mortality in patients receiving haemodialysis for established renal failure. We carried out a prospective audit of patients developing infective endocarditis in a single renal unit. From 1 January 2000 to 31 December 2013, we collected data on all cases of endocarditis occurring in patients receiving haemodialysis at Monklands Hospital, Airdrie. Twenty-nine patients developed endocarditis during our audit period. Twenty-three (79.3%) of the patients had pre-existing cardiac valve abnormalities such as regurgitation or calcification. Staphylococcus aureus was the most common microorganism cultured from the blood of 22 patients (75.9%). MRSA bacteraemia was identified in eight of these patients and all eight patients died during that first presentation. Different strategies were introduced within the unit during the audit period aiming to reduce the rate of bacteraemia. Since 2011, a successful strategy has been introduced under the auspices of the Scottish Patient Safety Programme. This led to our Staph aureus bacteraemia rate related to non-tunnelled venous catheters going from an average of 15 days between episodes to having had no episodes between 2 December 2011 and the end of the study period (760 days). This also appears to have had a positive impact on reducing the rate of endocarditis. Infective endocarditis remains a devastating consequence of bacteraemia in patients receiving haemodialysis. An effective strategy aimed at reducing the rate of bacteraemia appears to have a similar effect on the rate of endocarditis. © The Author(s) 2016.

  11. Control strategies for bovine dermatophilosis with particular ...

    African Journals Online (AJOL)

    The various control strategies for Dermatophilosis are discussed in this paper. Recommendations for control of Dermatophilosis in Nigeria on short term include ecto-parasite control by regular use of insecticide/acaricide in dips with added 0.03% copper sulphate or 1% solution of alum (potassium aluminium sulphate) ...

  12. Accreditation: a cultural control strategy.

    Science.gov (United States)

    Paccioni, André; Sicotte, Claude; Champagne, François

    2008-01-01

    The purpose of this paper is to describe and understand the effects of the accreditation process on organizational control and quality management practices in two Quebec primary-care health organizations. A multiple-case longitudinal study was conducted taking a mixed qualitative/quantitative approach. An analytical model was developed of the effects of the accreditation process on the type of organizational control exercised and the quality management practices implemented. The data were collected through group interviews, semi-directed interviews of key informers, non-participant observations, a review of the literature, and structured questionnaires distributed to all the employees working in both institutions. The accreditation process has fostered the implementation of consultation mechanisms in self-assessment teams. Improving assessments of client satisfaction was identified as a prime objective but, in terms of the values promoted in organizations, accreditation has little effect on the perceptions of employees not directly involved in the process. As long as not all staff members have integrated the basis for accreditation and its outcomes, the accreditation process appears to remain an external, bureaucratic control instrument. This study provides a theoretical model for understanding organizational changes brought about by accreditation of primary services. Through self-assessment of professional values and standards, accreditation may foster better quality management practices.

  13. Some thoughts on separation control strategies

    Indian Academy of Sciences (India)

    Flow separation generally leads to increased energy losses, instability and so ... Separation control strategy often refers to a clever (or intelligent) fluid ... bubble will have a certain influence, directly or indirectly, on the development of the shear.

  14. [Aedes aegypti control strategies: a review].

    Science.gov (United States)

    Zara, Ana Laura de Sene Amâncio; Santos, Sandra Maria Dos; Fernandes-Oliveira, Ellen Synthia; Carvalho, Roberta Gomes; Coelho, Giovanini Evelim

    2016-01-01

    to describe the main strategies to control Aedes aegypti, with emphasis on promising technological innovations for use in Brazil. this study is a non-systematic review of the literature. several technologies have been developed as alternatives in the control of Ae. aegypti, using different mechanisms of action, such as selective monitoring of the infestation, social interventions, dispersing insecticides, new biological control agents and molecular techniques for population control of mosquitoes, also considering the combination between them. Evolving technologies require evaluation of the effectiveness, feasibility and costs of implementation strategies as complementary to the actions already recommended by the National Program for Dengue Control. the integration of different compatible and effective vector control strategies, considering the available technologies and regional characteristics, appears to be a viable method to try to reduce the infestation of mosquitoes and the incidence of arbovirus transmitted by them.

  15. HTGR Resilient Control System Strategy

    International Nuclear Information System (INIS)

    Stevens, Lynne M.

    2010-01-01

    A preeminent objective for corporate and government organizations is the protection of major investments, which is attained by achieving state awareness, a comprehensive understanding of security and safety, for critical infrastructures. Given the dependence of critical infrastructure on control systems for automation, the integrity of these systems and their ability to provide owner/operators a high degree of state awareness is essential in attaining a high degree of investment protection and public acceptance. Operators as well as government are therefore burdened to ensure they have a timely understanding of the status of their plant or all plants, respectively, to ensure efficient operations and investment and public protection. 'This characterization is a significant objective that must consider many aspects of instrumentation, control, and intelligent systems in order to achieve the required result. These aspects include sensory, communication, analysis, decision, and human system interfaces necessary to achieve fusion of data and presentation of results that will provide an understanding of what issues are important and why.

  16. HTGR Resilient Control System Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Lynne M. Stevens

    2010-09-01

    A preeminent objective for corporate and government organizations is the protection of major investments, which is attained by achieving state awareness, a comprehensive understanding of security and safety, for critical infrastructures. Given the dependence of critical infrastructure on control systems for automation, the integrity of these systems and their ability to provide owner/operators a high degree of state awareness is essential in attaining a high degree of investment protection and public acceptance. Operators as well as government are therefore burdened to ensure they have a timely understanding of the status of their plant or all plants, respectively, to ensure efficient operations and investment and public protection. “This characterization is a significant objective that must consider many aspects of instrumentation, control, and intelligent systems in order to achieve the required result. These aspects include sensory, communication, analysis, decision, and human system interfaces necessary to achieve fusion of data and presentation of results that will provide an understanding of what issues are important and why.

  17. Focus on Infection Control in Child Care.

    Science.gov (United States)

    Biblio Alert! New Resources for Child Care Health and Safety, 1994

    1994-01-01

    The first in a series intended to provide child caregivers, parents, schools, health departments, and regulatory agencies with recent resources on child health and safety, this bibliography cites sources on the topic of controlling infections in child care settings. The list of annotated references contains background information and resource…

  18. Prevention of catheter-associated urinary tract infection: implementation strategies of international guidelines.

    Science.gov (United States)

    Andrade, Vera Lúcia Fonseca; Fernandes, Filipa Alexandra Veludo

    2016-01-01

    to describe strategies used by health professionals on the implementation of the Centers for Disease Control and Prevention guidelines for the prevention of urinary infection related to catheterism. systematic review on literature based on data from CINAHL(r), Nursing & Allied Health Collection, Cochrane Plus Collection, MedicLatina, MEDLINE(r), Academic Search Complete, ACS - American Chemical Society, Health Reference Center Academic, Nursing Reference Center, ScienceDirect Journals and Wiley Online Library. A sample of 13 articles was selected. studies have highlighted the decrease of urinary tract infection related to catheterism through reminder systems to decrease of people submitted to urinary catheterism, audits about nursing professionals practice and bundles expansion. the present review systemizes the knowledge of used strategies by health professionals on introduction to international recommendations, describing a rate decrease of such infection in clinical practice.

  19. Strategy and technology to prevent hospital-acquired infections: Lessons from SARS, Ebola, and MERS in Asia and West Africa

    OpenAIRE

    Rajakaruna, Sanjeewa Jayachandra; Liu, Wen-Bin; Ding, Yi-Bo; Cao, Guang-Wen

    2017-01-01

    Hospital-acquired infections (HAIs) are serious problems for healthcare systems, especially in developing countries where public health infrastructure and technology for infection preventions remain undeveloped. Here, we characterized how strategy and technology could be mobilized to improve the effectiveness of infection prevention and control in hospitals during the outbreaks of Ebola, Middle East respiratory syndrome (MERS), and severe acute respiratory syndrome (SARS) in Asia and West Afr...

  20. Infection Prevention and Control in Pediatric Ambulatory Settings.

    Science.gov (United States)

    Rathore, Mobeen H; Jackson, Mary Anne

    2017-11-01

    Since the American Academy of Pediatrics published its statement titled "Infection Prevention and Control in Pediatric Ambulatory Settings" in 2007, there have been significant changes that prompted this updated statement. Infection prevention and control is an integral part of pediatric practice in ambulatory medical settings as well as in hospitals. Infection prevention and control practices should begin at the time the ambulatory visit is scheduled. All health care personnel should be educated regarding the routes of transmission and techniques used to prevent the transmission of infectious agents. Policies for infection prevention and control should be written, readily available, updated every 2 years, and enforced. Many of the recommendations for infection control and prevention from the Centers for Disease Control and Prevention for hospitalized patients are also applicable in the ambulatory setting. These recommendations include requirements for pediatricians to take precautions to identify and protect employees likely to be exposed to blood or other potentially infectious materials while on the job. In addition to emphasizing the key principles of infection prevention and control in this policy, we update those that are relevant to the ambulatory care patient. These guidelines emphasize the role of hand hygiene and the implementation of diagnosis- and syndrome-specific isolation precautions, with the exemption of the use of gloves for routine diaper changes and wiping a well child's nose or tears for most patient encounters. Additional topics include respiratory hygiene and cough etiquette strategies for patients with a respiratory tract infection, including those relevant for special populations like patients with cystic fibrosis or those in short-term residential facilities; separation of infected, contagious children from uninfected children when feasible; safe handling and disposal of needles and other sharp medical devices; appropriate use of personal

  1. Host control of human papillomavirus infection and disease.

    Science.gov (United States)

    Doorbar, John

    2018-02-01

    Most human papillomaviruses cause inapparent infections, subtly affecting epithelial homeostasis, to ensure genome persistence in the epithelial basal layer. As with conspicuous papillomas, these self-limiting lesions shed viral particles to ensure population level maintenance and depend on a balance between viral gene expression, immune cell stimulation and immune surveillance for persistence. The complex immune evasion strategies, characteristic of high-risk HPV types, also allow the deregulated viral gene expression that underlies neoplasia. Neoplasia occurs at particular epithelial sites where vulnerable cells such as the reserve or cuboidal cells of the cervical transformation zone are found. Beta papillomavirus infection can also predispose an individual with immune deficiencies to the development of cancers. The host control of HPV infections thus involves local interactions between keratinocytes and the adaptive immune response. Effective immune detection and surveillance limits overt disease, leading to HPV persistence as productive microlesions or in a true latent state. Copyright © 2017. Published by Elsevier Ltd.

  2. [Strategies for avoiding hepatitis B infection recurrence following liver transplantation].

    Science.gov (United States)

    Prieto, Martín; García-Eliz, María

    2014-07-01

    Hepatitis B is currently an excellent indication for liver transplantation due to the highly effective strategies of prophylaxis and treatment for recurrent hepatitis B infection. The combined administration of low-dose hepatitis B hyperimmune gamma globulin and a nucleoside/nucleotide analogue with a high genetic barrier to resistance, such as entecavir (except for patients with lamivudine resistance) or tenofovir, represents the standard for the prophylaxis of recurrent hepatitis B infection and is used in most centers. The drawbacks of long-term administration of hyperimmune gamma globulin have led to research on regimens in which this agent is withdrawn after a certain amount of time in combination treatment, a strategy that appears to be safe in patients with undetectable viremia at the time of liver transplantation if the patients adhere to the treatment. In recent years, there has also been research into regimens of gamma-globulin-free prophylaxis, based only on the administration of oral antiviral drugs, which appear to be safe if antivirals with a high genetic barrier to resistance are used. Hepatitis B prophylaxis should be maintained indefinitely; therefore, the total withdrawal of prophylaxis is not an accepted strategy at present in daily clinical practice if not in the context of a clinical trial. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  3. Control strategies for demand controlled ventilation in dwellings

    DEFF Research Database (Denmark)

    Nielsen, Toke Rammer; Drivsholm, Christian

    2011-01-01

    and efficient fans is becoming the standard solution. The building regulation requirement for air change in dwellings is often a constant value that has been chosen to avoid moisture related problems in the indoor environment. This required air change is sometimes sufficient, sometimes too low and sometimes too....... In the studied house two control strategies were tested. A simple strategy where all sensors and controls were located in the air handling unit and only the speed of the fans can be controlled, and a complex strategy where sensors were placed in each room and where individual control of air flow in each room...

  4. Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update

    Science.gov (United States)

    Anderson, Deverick J.; Podgorny, Kelly; Berríos-Torres, Sandra I.; Bratzler, Dale W.; Dellinger, E. Patchen; Greene, Linda; Nyquist, Ann-Christine; Saiman, Lisa; Yokoe, Deborah S.; Maragakis, Lisa L.; Kaye, Keith S.

    2014-01-01

    PURPOSE Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their surgical site infection (SSI) prevention efforts. This document updates “Strategies to Prevent Surgical Site Infections in Acute Care Hospitals,”1 published in 2008. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.2 PMID:24799638

  5. Brushless DC motor speed control strategy of simulation research

    Directory of Open Access Journals (Sweden)

    Xiang Wen

    2017-01-01

    Full Text Available In view of the brushless DC motor speed regulation problem, an ideal control strategy is designed. Through the model and analysis of Brushless DC motor, the mathematical model of the brushless DC motor is obtained. By comparing three control strategies of PID control strategy, fuzzy control strategy and fuzzy PID control strategy, PID controller, fuzzy controller and fuzzy PID controller are designed respectively for simulation test. The simulation results show that the fuzzy PID controller has good control effect.

  6. Wind farm models and control strategies

    Energy Technology Data Exchange (ETDEWEB)

    Soerensen, Poul; Hansen, Anca D.; Iov, F.; Blaabjerg, F.; Donovan, M.H.

    2005-08-01

    This report describes models and control strategies for 3 different concepts of wind farms. Initially, the potential in improvement of grid integration, structural loads and energy production is investigated in a survey of opportunities. Then simulation models are described, including wind turbine models for a fixed speed wind turbine with active stall control and a variable speed wind turbine with doubly-fed induction generator. After that, the 3 wind farm concepts and control strategies are described. The 3 concepts are AC connected doubly fed turbines, AC connected active stall turbines and DC connected active stall turbines. Finally, some simulation examples and conclusions are presented. (au)

  7. Control strategies and sensitivity analysis of anthroponotic visceral leishmaniasis model.

    Science.gov (United States)

    Zamir, Muhammad; Zaman, Gul; Alshomrani, Ali Saleh

    2017-12-01

    This study proposes a mathematical model of Anthroponotic visceral leishmaniasis epidemic with saturated infection rate and recommends different control strategies to manage the spread of this disease in the community. To do this, first, a model formulation is presented to support these strategies, with quantifications of transmission and intervention parameters. To understand the nature of the initial transmission of the disease, the reproduction number [Formula: see text] is obtained by using the next-generation method. On the basis of sensitivity analysis of the reproduction number [Formula: see text], four different control strategies are proposed for managing disease transmission. For quantification of the prevalence period of the disease, a numerical simulation for each strategy is performed and a detailed summary is presented. Disease-free state is obtained with the help of control strategies. The threshold condition for globally asymptotic stability of the disease-free state is found, and it is ascertained that the state is globally stable. On the basis of sensitivity analysis of the reproduction number, it is shown that the disease can be eradicated by using the proposed strategies.

  8. Creutzfeldt-Jakob Disease and Infection Control

    Directory of Open Access Journals (Sweden)

    Lynn Johnston

    2001-01-01

    Full Text Available Over the past year, several situations have occurred in Canada in which patients who had recently undergone a surgical procedure were subsequently diagnosed with confirmed or suspected Creutzfeldt-Jakob disease (CJD. This raised concerns over contamination of surgical instruments: which instruments might have been contaminated from direct exposure to tissues; can instruments become cross-contaminated by exposure to other contaminated instruments; what assessment is necessary to determine cross-contamination; and what should be done with instruments that have been contaminated. Additionally, should there be a patient traceback in the face of potential but unproven exposure? Unfortunately, there are no easy answers to most of the above questions. Australia, the United Kingdom and the World Health Organization have developed guidelines for the infection control management of patients with CJD, as well as instruments and devices that come into contact with them and their tissues (1-3. Health Canada's draft CJD infection control guidelines, withdrawn from the Health Canada Web site until safety concerns regarding sodium hydroxide can be addressed, closely mirrored recommendations made in those documents. The Centers for Disease Control and Prevention guidelines for CJD are under revision. However, a recent American publication made recommendations on what procedures should be used for reprocessing items that have been in contact with the prion protein (PrP (4. These recommendations differ substantially from the draft Canadian guidelines. This article reviews current knowledge about CJD, and highlights some of the infection control concerns and controversies.

  9. Can rewiring strategy control the epidemic spreading?

    Science.gov (United States)

    Dong, Chao; Yin, Qiuju; Liu, Wenyang; Yan, Zhijun; Shi, Tianyu

    2015-11-01

    Relation existed in the social contact network can affect individuals' behaviors greatly. Considering the diversity of relation intimacy among network nodes, an epidemic propagation model is proposed by incorporating the link-breaking threshold, which is normally neglected in the rewiring strategy. The impact of rewiring strategy on the epidemic spreading in the weighted adaptive network is explored. The results show that the rewiring strategy cannot always control the epidemic prevalence, especially when the link-breaking threshold is low. Meanwhile, as well as strong links, weak links also play a significant role on epidemic spreading.

  10. Humans, 'things' and space: costing hospital infection control interventions.

    Science.gov (United States)

    Page, K; Graves, N; Halton, K; Barnett, A G

    2013-07-01

    Previous attempts at costing infection control programmes have tended to focus on accounting costs rather than economic costs. For studies using economic costs, estimates tend to be quite crude and probably underestimate the true cost. One of the largest costs of any intervention is staff time, but this cost is difficult to quantify and has been largely ignored in previous attempts. To design and evaluate the costs of hospital-based infection control interventions or programmes. This article also discusses several issues to consider when costing interventions, and suggests strategies for overcoming these issues. Previous literature and techniques in both health economics and psychology are reviewed and synthesized. This article provides a set of generic, transferable costing guidelines. Key principles such as definition of study scope and focus on large costs, as well as pitfalls (e.g. overconfidence and uncertainty), are discussed. These new guidelines can be used by hospital staff and other researchers to cost their infection control programmes and interventions more accurately. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  11. Hospital infection prevention and control issues relevant to extensive floods.

    Science.gov (United States)

    Apisarnthanarak, Anucha; Mundy, Linda M; Khawcharoenporn, Thana; Glen Mayhall, C

    2013-02-01

    The devastating clinical and economic implications of floods exemplify the need for effective global infection prevention and control (IPC) strategies for natural disasters. Reopening of hospitals after excessive flooding requires a balance between meeting the medical needs of the surrounding communities and restoration of a safe hospital environment. Postflood hospital preparedness plans are a key issue for infection control epidemiologists, healthcare providers, patients, and hospital administrators. We provide recent IPC experiences related to reopening of a hospital after extensive black-water floods necessitated hospital closures in Thailand and the United States. These experiences provide a foundation for the future design, execution, and analysis of black-water flood preparedness plans by IPC stakeholders.

  12. Hospital design for better infection control

    Directory of Open Access Journals (Sweden)

    Lateef Fatimah

    2009-01-01

    Full Text Available The physical design and infrastructure of a hospital or institution is an essential component of its infection control measure. Thus is must be a prerequisite to take these into consideration from the initial conception and planning stages of the building. The balance between designing a hospital to be an open, accessible and public place and the control to reduce the spread of infections diseases is a necessity. At Singapore General Hospital, many lessons were learnt during the SARS outbreak pertaining to this. During and subsequent to the SARS outbreak, many changes evolved in the hospital to enable us to handle and face any emerging infectious situation with calm, confidence and the knowledge that staff and patients will be in good stead. This paper will share some of our experiences as well as challenges

  13. Low Activity Waste Feed Process Control Strategy

    International Nuclear Information System (INIS)

    STAEHR, T.W.

    2000-01-01

    The primary purpose of this document is to describe the overall process control strategy for monitoring and controlling the functions associated with the Phase 1B high-level waste feed delivery. This document provides the basis for process monitoring and control functions and requirements needed throughput the double-shell tank system during Phase 1 high-level waste feed delivery. This document is intended to be used by (1) the developers of the future Process Control Plan and (2) the developers of the monitoring and control system

  14. Organization of infection control in European hospitals.

    Science.gov (United States)

    Hansen, S; Zingg, W; Ahmad, R; Kyratsis, Y; Behnke, M; Schwab, F; Pittet, D; Gastmeier, P

    2015-12-01

    The Prevention of Hospital Infections by Intervention and Training (PROHIBIT) survey was initiated to investigate the status of healthcare-associated infection (HCAI) prevention across Europe. This paper presents the methodology of the quantitative PROHIBIT survey and outlines the findings on infection control (IC) structure and organization including management's support at the hospital level. Hospitals in 34 countries were invited to participate between September 2011 and March 2012. Respondents included IC personnel and hospital management. Data from 309 hospitals in 24 countries were analysed. Hospitals had a median (interquartile range) of four IC nurses (2-6) and one IC doctor (0-2) per 1000 beds. Almost all hospitals (96%) had defined IC objectives, which mainly addressed hand hygiene (87%), healthcare-associated infection reduction (84%), and antibiotic stewardship (66%). Senior management provided leadership walk rounds in about half of hospitals, most often in Eastern and Northern Europe, 65% and 64%, respectively. In the majority of hospitals (71%), sanctions were not employed for repeated violations of IC practices. Use of sanctions varied significantly by region (P hospitals should be a public health priority. Copyright © 2015. Published by Elsevier Ltd.

  15. Malaria vector control: current and future strategies

    NARCIS (Netherlands)

    Takken, W.; Knols, B.G.J.

    2009-01-01

    The recently announced call for malaria eradication represents a new page in the history of this disease. This has been triggered by remarkable reductions in malaria resulting from combined application of effective drugs and vector control. However, this strategy is threatened by development of

  16. Influence of staff infection control training on infection-related quality measures in US nursing homes.

    Science.gov (United States)

    Kaur, Jasjit; Stone, Patricia W; Travers, Jasmine L; Cohen, Catherine C; Herzig, Carolyn T A

    2017-09-01

    Health care-associated infections are a leading cause of morbidity and mortality in US nursing home residents. Ongoing training of nursing home staff is vital to the implementation of infection prevention and control processes. Our aim was to describe associations between methods, frequency, and timing of staff infection prevention and control training and infection-related quality measures. In this national survey of nursing homes, timing of staff infection prevention and control training was associated with reduced indwelling urinary catheter use. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  17. 42 CFR 482.42 - Condition of participation: Infection control.

    Science.gov (United States)

    2010-10-01

    ... Hospital Functions § 482.42 Condition of participation: Infection control. The hospital must provide a... be an active program for the prevention, control, and investigation of infections and communicable... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Infection control. 482...

  18. Conventional and molecular diagnostic strategies for prosthetic joint infections.

    Science.gov (United States)

    Esteban, Jaime; Sorlí, Luisa; Alentorn-Geli, Eduard; Puig, Lluís; Horcajada, Juan P

    2014-01-01

    An accurate diagnosis of prosthetic joint infection (PJI) is the mainstay for an optimized clinical management. This review analyzes different diagnostic strategies of PJI, with special emphasis on molecular diagnostic tools and their current and future applications. Until now, the culture of periprosthetic tissues has been considered the gold standard for the diagnosis of PJI. However, sonication of the implant increases the sensitivity of those cultures and is being increasingly adopted by many centers. Molecular diagnostic methods compared with intraoperative tissue culture, especially if combined with sonication, have a higher sensitivity, a faster turnaround time and are not influenced by previous antimicrobial therapy. However, they still lack a system for detection of antimicrobial susceptibility, which is crucial for an optimized and less toxic therapy of PJI. More studies are needed to assess the clinical value of these methods and their cost-effectiveness.

  19. Hierarchical MAS based control strategy for microgrid

    Energy Technology Data Exchange (ETDEWEB)

    Xiao, Z.; Li, T.; Huang, M.; Shi, J.; Yang, J.; Yu, J. [School of Information Science and Engineering, Yunnan University, Kunming 650091 (China); Xiao, Z. [School of Electrical and Electronic Engineering, Nanyang Technological University, Western Catchment Area, 639798 (Singapore); Wu, W. [Communication Branch of Yunnan Power Grid Corporation, Kunming, Yunnan 650217 (China)

    2010-09-15

    Microgrids have become a hot topic driven by the dual pressures of environmental protection concerns and the energy crisis. In this paper, a challenge for the distributed control of a modern electric grid incorporating clusters of residential microgrids is elaborated and a hierarchical multi-agent system (MAS) is proposed as a solution. The issues of how to realize the hierarchical MAS and how to improve coordination and control strategies are discussed. Based on MATLAB and ZEUS platforms, bilateral switching between grid-connected mode and island mode is performed under control of the proposed MAS to enhance and support its effectiveness. (authors)

  20. The rate of following infection control principles in educational hospitals of Khorramabad

    Directory of Open Access Journals (Sweden)

    tahereh Toulabi

    2006-11-01

    Results: The degree of following infection control principles in most of the personnel’s was medium (53.7% and in hand washing was low (90%. Wards status about physical environment (47.83%, resources and equipment (78.3% were medium level. Conclusion: Continuous education of personnel in different job categories, using instruments and methods to reduce infection, improvement of resources and equipment and physical environment, establishment of National Nosocomial Infection surveillance system (NNISS, yearly epidemiological investigations and performing regular microbiological cultures are the most important strategies for infection control, that must be performed in educational hospitals.

  1. Managing Air Quality - Control Strategies to Achieve Air Pollution Reduction

    Science.gov (United States)

    Considerations in designing an effective control strategy related to air quality, controlling pollution sources, need for regional or national controls, steps to developing a control strategy, and additional EPA resources.

  2. Photodynamic antimicrobial polymers for infection control.

    Directory of Open Access Journals (Sweden)

    Colin P McCoy

    Full Text Available Hospital-acquired infections pose both a major risk to patient wellbeing and an economic burden on global healthcare systems, with the problem compounded by the emergence of multidrug resistant and biocide tolerant bacterial pathogens. Many inanimate surfaces can act as a reservoir for infection, and adequate disinfection is difficult to achieve and requires direct intervention. In this study we demonstrate the preparation and performance of materials with inherent photodynamic, surface-active, persistent antimicrobial properties through the incorporation of photosensitizers into high density poly(ethylene (HDPE using hot-melt extrusion, which require no external intervention except a source of visible light. Our aim is to prevent bacterial adherence to these surfaces and eliminate them as reservoirs of nosocomial pathogens, thus presenting a valuable advance in infection control. A two-layer system with one layer comprising photosensitizer-incorporated HDPE, and one layer comprising HDPE alone is also described to demonstrate the versatility of our approach. The photosensitizer-incorporated materials are capable of reducing the adherence of viable bacteria by up to 3.62 Log colony forming units (CFU per square centimeter of material surface for methicillin resistant Staphylococcus aureus (MRSA, and by up to 1.51 Log CFU/cm(2 for Escherichia coli. Potential applications for the technology are in antimicrobial coatings for, or materials comprising objects, such as tubing, collection bags, handrails, finger-plates on hospital doors, or medical equipment found in the healthcare setting.

  3. A comparison of WEC control strategies

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, David G. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Bacelli, Giorgio [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Coe, Ryan Geoffrey [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Bull, Diana L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Abdelkhalik, Ossama [Michigan Technological Univ., Houghton, MI (United States); Korde, Umesh A. [South Dakota School of Mines and Technology, Rapid City, SD (United States); Robinett, Rush D. [Michigan Technological Univ., Houghton, MI (United States)

    2016-04-01

    The operation of Wave Energy Converter (WEC) devices can pose many challenging problems to the Water Power Community. A key research question is how to significantly improve the performance of these WEC devices through improving the control system design. This report summarizes an effort to analyze and improve the performance of WEC through the design and implementation of control systems. Controllers were selected to span the WEC control design space with the aim of building a more comprehensive understanding of different controller capabilities and requirements. To design and evaluate these control strategies, a model scale test-bed WEC was designed for both numerical and experimental testing (see Section 1.1). Seven control strategies have been developed and applied on a numerical model of the selected WEC. This model is capable of performing at a range of levels, spanning from a fully-linear realization to varying levels of nonlinearity. The details of this model and its ongoing development are described in Section 1.2.

  4. Pinning Control Strategy of Multicommunity Structure Networks

    Directory of Open Access Journals (Sweden)

    Chao Ding

    2017-01-01

    Full Text Available In order to investigate the effects of community structure on synchronization, a pinning control strategy is researched in a class of complex networks with community structure in this paper. A feedback control law is designed based on the network community structure information. The stability condition is given and proved by using Lyapunov stability theory. Our research shows that as to community structure networks, there being a threshold hT≈5, when coupling strength bellows this threshold, the stronger coupling strength corresponds to higher synchronizability; vice versa, the stronger coupling strength brings lower synchronizability. In addition the synchronizability of overlapping and nonoverlapping community structure networks was simulated and analyzed; while the nodes were controlled randomly and intensively, the results show that intensive control strategy is better than the random one. The network will reach synchronization easily when the node with largest betweenness was controlled. Furthermore, four difference networks’ synchronizability, such as Barabási-Albert network, Watts-Strogatz network, Erdös-Rényi network, and community structure network, are simulated; the research shows that the community structure network is more easily synchronized under the same control strength.

  5. International pollution control: Cooperative versus noncooperative strategies

    International Nuclear Information System (INIS)

    Dockner, E.J.; Van Long, N.

    1993-01-01

    International pollution control involving two neighboring countries is modeled as a simple two-player dynamic game. Each country produces a good that is consumed by domestic households. Production of each consumption good results in emissions of pollutants. Households in each country derive utility from the consumption of the domestically produced good but incur costs through the total stock of pollution (stock externality). In this setting we characterize cooperative as well as noncooperative pollution control strategies of the governments of the two countries that maximize the discounted stream of net benefits of a representative consumer. It turns out that when the governments are restricted to use linear strategies noncooperative behavior results in overall losses for both countries. If, on the contrary, governments use nonlinear Markov-perfect strategies and the discount rate is small enough a Pareto-efficient steady-state pollution stock can be supported as a differentiable subgame-perfect equilibrium. Thus, the emergence of first-best solutions (cooperative outcomes) does not require any institutional arrangements (threats, retaliation, etc.) but can be brought about through the use of nonlinear Markov-perfect equilibrium strategies. 20 refs., 1 tab

  6. Evaluation of testing strategies to identify infected animals at a single round of testing within dairy herds known to be infected with Mycobacterium avium ssp. paratuberculosis.

    Science.gov (United States)

    More, S J; Cameron, A R; Strain, S; Cashman, W; Ezanno, P; Kenny, K; Fourichon, C; Graham, D

    2015-08-01

    As part of a broader control strategy within herds known to be infected with Mycobacterium avium ssp. paratuberculosis (MAP), individual animal testing is generally conducted to identify infected animals for action, usually culling. Opportunities are now available to quantitatively compare different testing strategies (combinations of tests) in known infected herds. This study evaluates the effectiveness, cost, and cost-effectiveness of different testing strategies to identify infected animals at a single round of testing within dairy herds known to be MAP infected. A model was developed, taking account of both within-herd infection dynamics and test performance, to simulate the use of different tests at a single round of testing in a known infected herd. Model inputs included the number of animals at different stages of infection, the sensitivity and specificity of each test, and the costs of testing and culling. Testing strategies included either milk or serum ELISA alone or with fecal culture in series. Model outputs included effectiveness (detection fraction, the proportion of truly infected animals in the herd that are successfully detected by the testing strategy), cost, and cost-effectiveness (testing cost per true positive detected, total cost per true positive detected). Several assumptions were made: MAP was introduced with a single animal and no management interventions were implemented to limit within-herd transmission of MAP before this test. In medium herds, between 7 and 26% of infected animals are detected at a single round of testing, the former using the milk ELISA and fecal culture in series 5 yr after MAP introduction and the latter using fecal culture alone 15 yr after MAP introduction. The combined costs of testing and culling at a single round of testing increases with time since introduction of MAP infection, with culling costs being much greater than testing costs. The cost-effectiveness of testing varied by testing strategy. It was also

  7. Controlling the Seedbeds of Tuberculosis: Diagnosis and Treatment of Tuberculosis Infection

    Science.gov (United States)

    Rangaka, Molebogeng X.; Cavalcante, Solange C.; Marais, Ben J.; Thim, Sok; Martinson, Neil A.; Swaminathan, Soumya; Chaisson, Richard E.

    2015-01-01

    The billions of people with latent tuberculosis infection serve as the seedbeds for future cases of active tuberculosis. Virtually all episodes of tuberculosis disease are preceded by a period of asymptomatic Mycobacterium tuberculosis infection; therefore, identifying infected individuals most likely to progress to disease and treating such subclinical infections to prevent future disease provides a critical opportunity to interrupt tuberculosis transmission and reduce the global burden of tuberculosis disease. Programs focusing on single strategies rather than comprehensive programs that deliver an integrated arsenal for tuberculosis control may continue to struggle. Tuberculosis preventive therapy is a poorly utilized tool that is essential for controlling the reservoirs of disease that drive the current epidemic. Comprehensive control strategies that combine preventive therapy for the most high-risk populations and communities with improved case-finding and treatment, control of transmission and health systems strengthening could ultimately lead to worldwide tuberculosis elimination. This paper outlines challenges to implementation of preventive therapy and provides pragmatic suggestions for overcoming them. It further advocates for tuberculosis preventive therapy as the core of a renewed global focus to implement a comprehensive epidemic control strategy that would reduce new tuberculosis cases to elimination targets. This strategy would be underpinned by accelerated research to further understand the biology of subclinical tuberculosis infections, develop novel diagnostics, and drug regimens specifically for subclinical tuberculosis infection, strengthen health systems, community engagement, and enhance sustainable large scale implementation of preventive therapy programs. PMID:26515679

  8. Engineered biomaterial and biophysical stimulation as combinatorial strategies to address prosthetic infection by pathogenic bacteria.

    Science.gov (United States)

    Boda, Sunil Kumar; Basu, Bikramjit

    2017-10-01

    A plethora of antimicrobial strategies are being developed to address prosthetic infection. The currently available methods for implant infection treatment include the use of antibiotics and revision surgery. Among the bacterial strains, Staphylococcus species pose significant challenges particularly, with regard to hospital acquired infections. In order to combat such life threatening infectious diseases, researchers have developed implantable biomaterials incorporating nanoparticles, antimicrobial reinforcements, surface coatings, slippery/non-adhesive and contact killing surfaces. This review discusses a few of the biomaterial and biophysical antimicrobial strategies, which are in the developmental stage and actively being pursued by several research groups. The clinical efficacy of biophysical stimulation methods such as ultrasound, electric and magnetic field treatments against prosthetic infection depends critically on the stimulation protocol and parameters of the treatment modality. A common thread among the three biophysical stimulation methods is the mechanism of bactericidal action, which is centered on biophysical rupture of bacterial membranes, the generation of reactive oxygen species (ROS) and bacterial membrane depolarization evoked by the interference of essential ion-transport. Although the extent of antimicrobial effect, normally achieved through biophysical stimulation protocol is insufficient to warrant therapeutic application, a combination of antibiotic/ROS inducing agents and biophysical stimulation methods can elicit a clinically relevant reduction in viable bacterial numbers. In this review, we present a detailed account of both the biomaterial and biophysical approaches for achieving maximum bacterial inactivation. Summarizing, the biophysical stimulation methods in a combinatorial manner with material based strategies can be a more potent solution to control bacterial infections. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B

  9. Internal quality control: planning and implementation strategies.

    Science.gov (United States)

    Westgard, James O

    2003-11-01

    The first essential in setting up internal quality control (IQC) of a test procedure in the clinical laboratory is to select the proper IQC procedure to implement, i.e. choosing the statistical criteria or control rules, and the number of control measurements, according to the quality required for the test and the observed performance of the method. Then the right IQC procedure must be properly implemented. This review focuses on strategies for planning and implementing IQC procedures in order to improve the quality of the IQC. A quantitative planning process is described that can be implemented with graphical tools such as power function or critical-error graphs and charts of operating specifications. Finally, a total QC strategy is formulated to minimize cost and maximize quality. A general strategy for IQC implementation is recommended that employs a three-stage design in which the first stage provides high error detection, the second stage low false rejection and the third stage prescribes the length of the analytical run, making use of an algorithm involving the average of normal patients' data.

  10. Optimization of control strategies for epidemics in heterogeneous populations with symmetric and asymmetric transmission

    OpenAIRE

    Ndeffo Mbah , Martial L.; Gilligan , Christopher A.

    2010-01-01

    Abstract There is growing interest in incorporating economic factors into epidemiological models in order to identify optimal strategies for disease control when resources are limited. In this paper we consider how to optimize the control of a pathogen that is capable of infecting multiple hosts with different rates of transmission within and between species. Our objective is to find control strategies that maximize the discounted number of healthy individuals. We consider two clas...

  11. Infection control practice in countries with limited resources.

    NARCIS (Netherlands)

    Alp, E.; Leblebicioglu, H.; Doganay, M.; Voss, A.

    2011-01-01

    Nosocomial infections and their control are a world-wide challenge. The prevalence of nosocomial infections is generally higher in developing countries with limited resources than industrialized countries. In this paper we aimed to further explain the differences with regard to infection control

  12. Comprehensive Control of Human Papillomavirus Infections and Related Diseases

    Science.gov (United States)

    Bosch, F. Xavier; Broker, Thomas R.; Forman, David; Moscicki, Anna-Barbara; Gillison, Maura L.; Doorbar, John; Stern, Peter L.; Stanley, Margaret; Arbyn, Marc; Poljak, Mario; Cuzick, Jack; Castle, Philip E.; Schiller, John T.; Markowitz, Lauri E.; Fisher, William A.; Canfell, Karen; Denny, Lynette A.; Franco, Eduardo L.; Steben, Marc; Kane, Mark A.; Schiffman, Mark; Meijer, Chris J.L.M.; Sankaranarayanan, Rengaswamy; Castellsagué, Xavier; Kim, Jane J.; Brotons, Maria; Alemany, Laia; Albero, Ginesa; Diaz, Mireia; de Sanjosé, Silvia

    2014-01-01

    Infection with human papillomavirus (HPV) is recognized as one of the major causes of infection-related cancer worldwide, as well as the causal factor in other diseases. Strong evidence for a causal etiology with HPV has been stated by the International Agency for Research on Cancer for cancers of the cervix uteri, penis, vulva, vagina, anus and oropharynx (including base of the tongue and tonsils). Of the estimated 12.7 million new cancers occurring in 2008 worldwide, 4.8% were attributable to HPV infection, with substantially higher incidence and mortality rates seen in developing versus developed countries. In recent years, we have gained tremendous knowledge about HPVs and their interactions with host cells, tissues and the immune system; have validated and implemented strategies for safe and efficacious prophylactic vaccination against HPV infections; have developed increasingly sensitive and specific molecular diagnostic tools for HPV detection for use in cervical cancer screening; and have substantially increased global awareness of HPV and its many associated diseases in women, men, and children. While these achievements exemplify the success of biomedical research in generating important public health interventions, they also generate new and daunting challenges: costs of HPV prevention and medical care, the implementation of what is technically possible, socio-political resistance to prevention opportunities, and the very wide ranges of national economic capabilities and health care systems. Gains and challenges faced in the quest for comprehensive control of HPV infection and HPV-related cancers and other disease are summarized in this review. The information presented may be viewed in terms of a reframed paradigm of prevention of cervical cancer and other HPV-related diseases that will include strategic combinations of at least four major components: 1) routine introduction of HPV vaccines to women in all countries, 2) extension and simplification of

  13. An Antipersister Strategy for Treatment of Chronic Pseudomonas aeruginosa Infections.

    Science.gov (United States)

    Koeva, Martina; Gutu, Alina D; Hebert, Wesley; Wager, Jeffrey D; Yonker, Lael M; O'Toole, George A; Ausubel, Frederick M; Moskowitz, Samuel M; Joseph-McCarthy, Diane

    2017-12-01

    Bacterial persisters are a quasidormant subpopulation of cells that are tolerant to antibiotic treatment. The combination of the aminoglycoside tobramycin with fumarate as an antibacterial potentiator utilizes an antipersister strategy that is aimed at reducing recurrent Pseudomonas aeruginosa infections by enhancing the killing of P. aeruginosa persisters. Stationary-phase cultures of P. aeruginosa were used to generate persister cells. A range of tobramycin concentrations was tested with a range of metabolite concentrations to determine the potentiation effect of the metabolite under a variety of conditions, including a range of pH values and in the presence of azithromycin or cystic fibrosis (CF) patient sputum. In addition, 96-well dish biofilm and colony biofilm assays were performed, and the cytotoxicity of the tobramycin-fumarate combination was determined utilizing a lactate dehydrogenase (LDH) assay. Enhanced killing of up to 6 orders of magnitude of P. aeruginosa persisters over a range of CF isolates, including mucoid and nonmucoid strains, was observed for the tobramycin-fumarate combination compared to killing with tobramycin alone. Furthermore, significant fumarate-mediated potentiation was seen in the presence of azithromycin or CF patient sputum. Fumarate also reduced the cytotoxicity of tobramycin-treated P. aeruginosa to human epithelial airway cells. Finally, in mucoid and nonmucoid CF isolates, complete eradication of P. aeruginosa biofilm was observed in the colony biofilm assay due to fumarate potentiation. These data suggest that a combination of tobramycin with fumarate as an antibacterial potentiator may be an attractive therapeutic for eliminating recurrent P. aeruginosa infections in CF patients through the eradication of bacterial persisters. Copyright © 2017 American Society for Microbiology.

  14. Cost Effectiveness Analysis of Optimal Malaria Control Strategies in Kenya

    Directory of Open Access Journals (Sweden)

    Gabriel Otieno

    2016-03-01

    Full Text Available Malaria remains a leading cause of mortality and morbidity among the children under five and pregnant women in sub-Saharan Africa, but it is preventable and controllable provided current recommended interventions are properly implemented. Better utilization of malaria intervention strategies will ensure the gain for the value for money and producing health improvements in the most cost effective way. The purpose of the value for money drive is to develop a better understanding (and better articulation of costs and results so that more informed, evidence-based choices could be made. Cost effectiveness analysis is carried out to inform decision makers on how to determine where to allocate resources for malaria interventions. This study carries out cost effective analysis of one or all possible combinations of the optimal malaria control strategies (Insecticide Treated Bednets—ITNs, Treatment, Indoor Residual Spray—IRS and Intermittent Preventive Treatment for Pregnant Women—IPTp for the four different transmission settings in order to assess the extent to which the intervention strategies are beneficial and cost effective. For the four different transmission settings in Kenya the optimal solution for the 15 strategies and their associated effectiveness are computed. Cost-effective analysis using Incremental Cost Effectiveness Ratio (ICER was done after ranking the strategies in order of the increasing effectiveness (total infections averted. The findings shows that for the endemic regions the combination of ITNs, IRS, and IPTp was the most cost-effective of all the combined strategies developed in this study for malaria disease control and prevention; for the epidemic prone areas is the combination of the treatment and IRS; for seasonal areas is the use of ITNs plus treatment; and for the low risk areas is the use of treatment only. Malaria transmission in Kenya can be minimized through tailor-made intervention strategies for malaria control

  15. Pregnancy and postpartum control in HIV infected women

    Directory of Open Access Journals (Sweden)

    Eduardo M. Warley

    2017-04-01

    Full Text Available Pregnancy and postpartum control in HIV infected women. We present data from a retrospective observational descriptive study with the objective of evaluating characteristics of HIV-infected pregnant women, analyze the level of control of pregnancy and assess adherence to treatment and loss of follow up after delivery. We analyzed reported data of 104 pregnancies, 32.7% of them under 25 years old. The diagnosis was performed as part of pregnancy control in 36.5% of women. TARV started before 24 weeks of pregnancy in 70% of them and a regimen with 2 nucleos(tides and 1 ritonavir potenciated protease inhibitor (PIr was prescribed in 84.5%. Elective c-section was the most frequent mode of delivery. The viral load after 32 weeks of pregnancy was available in 82.7%, being less than 1000 cop/ml in 78 (75%, less than 200 cop/ml in 70 (67.3% and not available in 18 (17.3% of cases. We observed a considered high rate of adherence failure and loss of follow up after delivery. Reported data should alert programs on the need to implement strategies to promote early pregnancy control and increase adherence and retention in care, especially in the postpartum period

  16. [Pregnancy and postpartum control in HIV infected women].

    Science.gov (United States)

    Warley, Eduardo M; Tavella, Silvina; Rosas, Alejandra

    2017-01-01

    Pregnancy and postpartum control in HIV infected women. We present data from a retrospective observational descriptive study with the objective of evaluating characteristics of HIV-infected pregnant women, analyze the level of control of pregnancy and assess adherence to treatment and loss of follow up after delivery. We analyzed reported data of 104 pregnancies, 32.7% of them under 25 years old. The diagnosis was performed as part of pregnancy control in 36.5% of women. TARV started before 24 weeks of pregnancy in 70% of them and a regimen with 2 nucleos(t)ides and 1 ritonavir potenciated protease inhibitor (PIr) was prescribed in 84.5%. Elective c-section was the most frequent mode of delivery. The viral load after 32 weeks of pregnancy was available in 82.7%, being less than 1000 cop/ml in 78 (75%), less than 200 cop/ml in 70 (67.3%) and not available in 18 (17.3%) of cases. We observed a considered high rate of adherence failure and loss of follow up after delivery. Reported data should alert programs on the need to implement strategies to promote early pregnancy control and increase adherence and retention in care, especially in the postpartum period.

  17. 76 FR 29756 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2011-05-23

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Director, Division of Healthcare Quality Promotion regarding (1) The practice of healthcare infection... infections), antimicrobial resistance, and related events in settings where healthcare is provided; and (3...

  18. 76 FR 63622 - Healthcare Infection Control Practices Advisory Committee, (HICPAC)

    Science.gov (United States)

    2011-10-13

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Director, Division of Healthcare Quality Promotion regarding (1) The practice of healthcare infection... infections), antimicrobial resistance, and related events in settings where healthcare is provided; and (3...

  19. 75 FR 29772 - Healthcare Infection Control Practices Advisory Committee, (HICPAC)

    Science.gov (United States)

    2010-05-27

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Emerging and Zoonotic Infectious Diseases (NCEZID) regarding (1) The practice of healthcare infection... infections), antimicrobial resistance, and related events in settings where healthcare is provided; and (3...

  20. Pathology Laboratories and Infection Prevention and Control

    Directory of Open Access Journals (Sweden)

    R Baral

    2014-11-01

    Full Text Available Laboratory health care workers are vulnerable to infection with the Hospital Acquired Infections (HAIs while receiving, handling and disposing biological samples. Ideally the infrastructure of the lab should be according to the best practices like good ventilation, room pressure differential, lighting, space adequacy, hand hygiene facilities, personal protective equipments, biological safety cabinets etc. Disinfection of the environment, and specific precautions with sharps and microbial cultures should follow the protocols and policies of the Infection Prevention and Control Practices (IPAC. If Mycobacterium tuberculosis or Legionella pneumophila are expected, diagnostic tests should be performed in a bio-safety level 3 facilities (for agents which may cause serious or potentially lethal disease in healthy adults after inhalation. Laboratory access should be limited only to people working in it.Along with the advent of new technologies and advanced treatment we are now facing problems with the dreadful HAIs with Antimicrobial Resistant Organisms (AROs which is taking a pandemic form. According to WHO, hundreds of millions of patients develop HAI every year worldwide and as many as 1.4 million occur each day in hospitals alone. The principal goals for hospital IPAC programs are to protect the patient, protect the health care worker (HCW, visitors, and other persons in the health environment, and to accomplish the previous goals in a cost-effective manner like hand hygiene, surveillance, training of the HCWs, initiating awareness programs and making Best Practices and Guidelines to be followed by everyone in the hospital.The initiation for the best practices in the Pathology Laboratories can be either Sporadic or Organizational. Sporadic initiation is when the laboratories make their own IPAC policies. It has been seen that in few centres these policies have been conceptualized but not materialized. Organizational initiation is much more

  1. Opt-out screening strategy for HIV infection among patients attending emergency departments: systematic review and meta-analysis.

    Science.gov (United States)

    Henriquez-Camacho, C; Villafuerte-Gutierrez, P; Pérez-Molina, J A; Losa, J; Gotuzzo, E; Cheyne, N

    2017-07-01

    International health agencies have promoted nontargeted universal (opt-out) HIV screening tests in different settings, including emergency departments (EDs). We performed a systematic review and meta-analysis to assess the testing uptake of strategies (opt-in targeted, opt-in nontargeted and opt-out) to detect new cases of HIV infection in EDs. We searched the Pubmed and Embase databases, from 1984 to April 2015, for opt-in and opt-out HIV diagnostic strategies used in EDs. Randomized controlled or quasi experimental studies were included. We assessed the percentage of positive individuals tested for HIV infection in each programme (opt-in and opt-out strategies). The mean percentage was estimated by combining studies in a random-effect meta-analysis. The percentages of individuals tested in the programmes were compared in a random-effect meta-regression model. Data were analysed using stata version 12. Quality assessments were performed using the Newcastle-Ottawa Scale. Of the 90 papers identified, 28 were eligible for inclusion. Eight trials used opt-out, 18 trials used opt-in, and two trials used both to detect new cases of HIV infection. The test was accepted and taken by 75 155 of 172 237 patients (44%) in the opt-out strategy, and 73 581 of 382 992 patients (19%) in the opt-in strategy. The prevalence of HIV infection detected by the opt-out strategy was 0.40% (373 cases), that detected by the opt-in nontargeted strategy was 0.52% (419 cases), and that detected by the opt-in targeted strategy was 1.06% (52 cases). In this meta-analysis, the testing uptake of the opt-out strategy was not different from that of the opt-in strategy to detect new cases of HIV infection in EDs. © 2016 British HIV Association.

  2. A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates.

    Science.gov (United States)

    Yokoe, Deborah S; Anderson, Deverick J; Berenholtz, Sean M; Calfee, David P; Dubberke, Erik R; Ellingson, Katherine D; Gerding, Dale N; Haas, Janet P; Kaye, Keith S; Klompas, Michael; Lo, Evelyn; Marschall, Jonas; Mermel, Leonard A; Nicolle, Lindsay E; Salgado, Cassandra D; Bryant, Kristina; Classen, David; Crist, Katrina; Deloney, Valerie M; Fishman, Neil O; Foster, Nancy; Goldmann, Donald A; Humphreys, Eve; Jernigan, John A; Padberg, Jennifer; Perl, Trish M; Podgorny, Kelly; Septimus, Edward J; VanAmringe, Margaret; Weaver, Tom; Weinstein, Robert A; Wise, Robert; Maragakis, Lisa L

    2014-08-01

    Since the publication of "A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals" in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

  3. Cannulae and infection control in theatre.

    Science.gov (United States)

    Aziz, Ann-Marie

    Healthcare-associated infections (HAIs) are those that are not present or incubating when an individual enters hospital, but are acquired while in hospital. At any one time, 8% of patients have an infection acquired in hospital (Department of Health (DH), 2008). On average, an infection adds 3-10 days to the length of a patient's stay in hospital. It can cost pound4000- pound10 000 more to treat a patient with an infection than one without an infection (DH, 2008). It is not surprising, then, that attention has been focused on tackling HAIs and, in particular, in-dwelling devices such as cannulae that have a potential for causing infections.

  4. Effect of effort-reward imbalance and burnout on infection control among Ecuadorian nurses.

    Science.gov (United States)

    Colindres, C V; Bryce, E; Coral-Rosero, P; Ramos-Soto, R M; Bonilla, F; Yassi, A

    2018-06-01

    Nurses are frequently exposed to transmissible infections, yet adherence to infection control measures is suboptimal. There has been inadequate research into how the psychosocial work environment affects compliance with infection control measures, especially in low- and middle-income countries. To examine the association between effort-reward imbalance, burnout and adherence to infection control measures among nurses in Ecuador. A cross-sectional study linking psychosocial work environment indicators to infection control adherence. The study was conducted among 333 nurses in four Ecuadorian hospitals. Self-administered questionnaires assessed demographic variables, perceived infection risk, effort-reward imbalance, burnout and infection control adherence. Increased effort-reward imbalance was found to be a unique incremental predictor of exposure to burnout, and burnout was a negative unique incremental predictor of nurses' self-reported adherence with infection control measures. Results suggest an effort-reward imbalance-burnout continuum, which, at higher levels, contributes to reduce adherence to infection control. The Ecuadorean government has made large efforts to improve universal access to health care, yet this study suggests that workplace demands on nurses remain problematic. This study highlights the contribution of effort-reward-imbalance-burnout continuum to the chain of infection by decreased adherence to infection control of nurses. Health authorities should closely monitor the effect of new policies on psychosocial work environment, especially when expanding services and increasing public accessibility with limited resources. Additionally, organizational and psychosocial interventions targeting effort-reward imbalance and burnout in nurses should be considered part of a complete infection prevention and control strategy. Further study is warranted to identify interventions that best ameliorate effort-reward imbalance and burnout in low- and middle

  5. Ventilator associated pneumonia and infection control

    Directory of Open Access Journals (Sweden)

    Alp Emine

    2006-04-01

    Full Text Available Abstract 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.

  6. Economic Analysis of Immunization Strategies for PRRS Control [corrected].

    Directory of Open Access Journals (Sweden)

    Daniel C L Linhares

    Full Text Available Porcine reproductive and respiratory syndrome virus (PRRSv is a swine-specific pathogen that causes significant increases in production costs. When a breeding herd becomes infected, in an attempt to hasten control and elimination of PRRSv, some veterinarians have adopted a strategy called load-close-expose which consists of interrupting replacement pig introductions into the herd for several weeks (herd closure and exposing the whole herd to a replicating PRRSv to boost herd immunity. Either modified-live virus (MLV vaccine or live field-virus inoculation (FVI is used. This study consisted of partial budget analyses to compare MLV to FVI as the exposure method of load-close-expose program to control and eliminate PRRSv from infected breeding herds, and secondly to estimate benefit / cost of vaccinating sow herds preventatively. Under the assumptions used in this study, MLV held economic advantage over FVI. However, sensitivity analysis revealed that decreasing margin over variable costs below $ 47.32, or increasing PRRSv-attributed cost above $18.89 or achieving time-to-stability before 25 weeks resulted in advantage of FVI over MLV. Preventive vaccination of sow herds was beneficial when the frequency of PRRSv infection was at least every 1 year and 9 months [corrected]. The economics of preventative vaccination was minimally affected by cost attributed to field-type PRRSv infection on growing pigs or by the breeding herd productivity level. The models developed and described in this paper provide valuable tools to assist veterinarians in their efforts to control PRRSv.

  7. Urinary tract infections in extended care facilities: preventive management strategies.

    Science.gov (United States)

    Regal, Randolph E; Pham, Co Q D; Bostwick, Thomas R

    2006-05-01

    To provide health care professionals with an overview of interventions that may be done to reduce the incidence of urinary tract infections (UTIs) in elderly patients, especially those residing in extended care facilities. A Medline search of the English literature was performed from 1980 to January 2006 to find literature relevant to urinary tract prophylaxis. Further references were hand-searched from relevant sources. When assessing the effectiveness of various clinical interventions for reducing the incidence of UTIs in the elderly, preference was given to more recent, double-blind, placebo-controlled randomized studies, but studies of less robust design also were included in the discussions when the former were lacking. Where possible, recent publications were favored over older studies. References were all reviewed by the authors and chosen to present key citations. Data selection was prioritized to address specific subtopics. Though still frequent in occurrence and quite costly in terms of morbidity, mortality, and cost to the health care system, numerous measures may be taken to ameliorate the incidence of UTIs in elderly, institutionalized residents. First and foremost, establishing and adhering to good infection-control practices by health care givers and minimizing the use of indwelling catheters are essential. Adequate staffing and training are germane to this effort. Reasonably well-designed clinical studies also give credence to the use of topical estrogens and lactobacillus "probiotics" for female subgroups and cranberry juice for a wider array of patients. Vitamin C is of no proven benefit. With regard to antibiotics, with the relative paucity of data available for this patient population, concerns for resistance proliferation must be balanced against perceived gains in UTI reduction.

  8. An Integrated Control Strategy Takes Clonorchis sinensis Under Control in an Endemic Area in South China.

    Science.gov (United States)

    Huang, Yalan; Huang, Dana; Geng, Yijie; Fang, Shisong; Yang, Fan; Wu, Chunli; Zhang, Hailong; Wang, Miao; Zhang, Ran; Wang, Xin; Wu, Shuang; Cao, Jianping; Zhang, Renli

    2017-12-01

    Clonorchis sinensis is an important foodborne zoonosis worldwide and prevalent in China for more than 2000 years. According to the experience of controlling Schistosoma japonica, China started to establish the integrated control strategy for C. sinensis in endemic areas. Lou village, the largest village in Shenzhen city in South China was taken as a pilot site. This longitudinal study assessed the infection status of C. sinensis among people and intermediate hosts from 2006 to 2014 in Lou village. After a continuous intervention with the integrated control strategy, the prevalence of C. sinensis decreased significantly to 2.01% in 2014. The infection intensity also reduced significantly with eggs per gram varying from 45.6 ± 3.4 in 2010 to 21.7 ± 1.6 in 2012. There is also a statistically significant decrease of the prevalence of C. sinensis metacercariae in fish hosts from 16.51% in 2008 before the intervention to 5.33% in 2014. All the old-styled toilets were replaced by sanitary ones with a harmless processing design in 2014. No viable parasite eggs were detected in stool samples from the reconstructed toilets. Health education played an important role in changing the eating habits among the local residents, with a significant decrease in the prevalence of eating raw fish from 91.99% in 2008 to 59.87% in 2014. The evaluation suggested that the integrated strategy we have performed in Lou village is effective in controlling the C. sinensis infection and maintaining the infection rate at a lower level, which can be promoted in other endemic areas.

  9. MSM actuators: design rules and control strategies

    Energy Technology Data Exchange (ETDEWEB)

    Holz, Benedikt; Janocha, Hartmut [Laboratory of Process Automation (LPA), Saarland University, Saarbruecken (Germany); Riccardi, Leonardo; Naso, David [Department of Electronics and Electrical Science (DEE), Politecnico di Bari (Italy)

    2012-08-15

    Magnetic shape memory (MSM) alloys are comparatively new active materials which can be used for several industrial applications, ranging from precise positioning systems to advanced robotics. Beyond the material research, which deals with the basic thermo-magneto-mechanical properties of the crystals, the design as well as the control of the actuators displacement is an essential challenge. This paper addresses those two topics, trying to give to the reader a useful overview of existing results, but also presents new ideas. First, it introduces and discusses in details some possible designs, with a special emphasis on innovative actuator design concepts which are able to exploit the particular potentialities of MSM elements. The second focus of the paper is on the problem of designing a controller, i.e., an algorithm that allows to obtain a required performance from the actuator. The proposed control strategies try to take into account two main characteristics of MSM elements: the hysteresis and the temperature dependence. The effectiveness of the strategies is emphasized by experimental results performed on a commercially available MSM actuator demonstrator. (Copyright copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  10. Therapeutic strategies to improve control of hypertension.

    Science.gov (United States)

    Armario, Pedro; Waeber, Bernard

    2013-03-01

    Blood pressure is poorly controlled in most European countries and the control rate is even lower in high-risk patients such as patients with chronic kidney disease, diabetic patients or previous coronary heart disease. Several factors have been associated with poor control, some of which involve the characteristic of the patients themselves, such as socioeconomic factors, or unsuitable life-styles, other factors related to hypertension or to associated comorbidity, but there are also factors directly associated with antihypertensive therapy, mainly involving adherence problems, therapeutic inertia and therapeutic strategies unsuited to difficult-to-control hypertensive patients. It is common knowledge that only 30% of hypertensive patients can be controlled using monotherapy; all the rest require a combination of two or more antihypertensive drugs, and this can be a barrier to good adherence and log-term persistence in patients who also often need to use other drugs, such as antidiabetic agents, statins or antiplatelet agents. The fixed combinations of three antihypertensive agents currently available can facilitate long-term control of these patients in clinical practice. If well tolerated, a long-term therapeutic regimen that includes a diuretic, an ACE inhibitor or an angiotensin receptor blocker, and a calcium channel blocker is the recommended optimal triple therapy.

  11. Infection control in neonatal intensive care unit : from a certified nurse in infection control's point of view

    OpenAIRE

    坂木, 晴世

    2007-01-01

    Neonates, especially those in neonatal intensive care units (NICU), are at high risk for infection. And nosocomial infections are responsible for almost 50% of the deaths that occur beyond 2 weeks of age. Advances in neonatal intensive care have resulted in survival of more low birth weight and sick infants. On the other hand, infection control measures in NICU are hard to say that we established. Therefore it is often that infection control measure in NICU of our country is taken in original...

  12. A Paratransgenic Strategy for the Control of Chagas Disease

    Directory of Open Access Journals (Sweden)

    Ivy Hurwitz

    2012-01-01

    Full Text Available Chagas disease results from infection with the parasite Trypanosoma cruzi. This disease remains a significant cause of morbidity and mortality in central and south America. Chagas disease now exists and is detected worldwide because of human migration. Control of Chagas disease has relied mainly on vector eradication however, the development of insect resistance to pesticides, coupled with cost and adverse health effects of insecticide treatments, has prompted our group to investigate novel methods of transmission control. Our laboratory has been instrumental in the development of the paratransgenic strategy to control vectorial transmission of T. cruzi. In this paper, we discuss various components of the paratransgenic approach. Specifically, we describe classes of molecules that can serve as effectors, including antimicrobial peptides, endoglucanases, and highly specific single chain antibodies that target surface glycoprotein tags on the surface of T. cruzi. Furthermore, we address evolving concepts related to field dispersal of engineered bacteria as part of the paratransgenic control strategy and attendant risk assessment evaluation.

  13. Novel strategies for control of fermentation processes

    DEFF Research Database (Denmark)

    Mears, Lisa

    to highly optimised industrial host strains. The focus of this project is instead on en-gineering of the process. The question to be answered in this thesis is, given a highly optimised industrial host strain, how can we operate the fermentation process in order to maximise the productivity of the system...... (2012). This model describes the fungal processes operated in the fermentation pilot plant at Novozymes A/S. This model is investigated using uncertainty analysis methods in order to as-sess the applicability to control applications. A mechanistic model approach is desirable, as it is a predictive....... This provides a prediction of the future trajectory of the process, so that it is possible to guide the system to the desired target mass. The control strategy is applied on-line at 550L scale in the Novozymes A/S fermentation pilot plant, and the method is challenged with four different sets of process...

  14. Decentralized Coordinated Control Strategy of Islanded Microgrids

    DEFF Research Database (Denmark)

    Wu, Dan

    as grid voltage/frequency regulation. In order to enhance the reliability of overall islanded Microgrid operation, basic functions of coordinated control which taking into account the state of charge (SoC) limitation and power availability of renewable energy sources is implemented in a distributed level...... control strategies in this thesis, in order to promote the decentralization of the overall system. Especially the consensus algorithm based secondary level is investigated in the thesis in order to simplify the communication configuration which only flood information through the neighboring units......Facing the challenges brought by the traditional large power system concerning the environmental and economic issues, along recent years distributed generation is considered as an alternative solution to provide clean energy in a local manner. In this context, Microgrid which performing as a local...

  15. Radioactive demonstration of DWPF product control strategy

    International Nuclear Information System (INIS)

    Andrews, M.K.; Bibler, N.E.

    1992-01-01

    The effectiveness of the product and process control strategies that will be utilized by the Defense Waste Processing Facility (DWPF) was demonstrated during a campaign in the Shielded Cells Facility (SCF) of the Savannah River Technology Center (SRTC). The remotely operated process included the preparation of the melter feed, vitrification in a slurry-fed 1/100th scale melter and analysis of the glass product both for its composition and durability. The campaign processed approximately 10 kg (on a dry basis) of radioactive sludge from Tank 51. This sludge is representative of the first batch of sludge that will be sent to the DWPF for immobilization into borosilicate glass. Additions to the sludge were made based on calculations using the Product Composition Control System (PCCS). Analysis of the glass produced during the campaign showed that a durable glass was produced with a composition similar to that predicted using the PCCS

  16. Neural PID Control Strategy for Networked Process Control

    Directory of Open Access Journals (Sweden)

    Jianhua Zhang

    2013-01-01

    Full Text Available A new method with a two-layer hierarchy is presented based on a neural proportional-integral-derivative (PID iterative learning method over the communication network for the closed-loop automatic tuning of a PID controller. It can enhance the performance of the well-known simple PID feedback control loop in the local field when real networked process control applied to systems with uncertain factors, such as external disturbance or randomly delayed measurements. The proposed PID iterative learning method is implemented by backpropagation neural networks whose weights are updated via minimizing tracking error entropy of closed-loop systems. The convergence in the mean square sense is analysed for closed-loop networked control systems. To demonstrate the potential applications of the proposed strategies, a pressure-tank experiment is provided to show the usefulness and effectiveness of the proposed design method in network process control systems.

  17. The effects of rhythm control strategies versus rate control strategies for atrial fibrillation and atrial flutter

    DEFF Research Database (Denmark)

    Sethi, Naqash; Safi, Sanam; Nielsen, Emil E

    2017-01-01

    by Jakobsen and colleagues. We plan to include all relevant randomised clinical trials assessing the effects of any rhythm control strategy versus any rate control strategy. We plan to search the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS, Science Citation Index Expanded...... on Web of Science, and BIOSIS to identify relevant trials. Any eligible trial will be assessed and classified as either high risk of bias or low risk of bias, and our conclusions will be based on trials with low risk of bias. The analyses of the extracted data will be performed using Review Manager 5....... This protocol for a systematic review aims at identifying the best overall treatment strategy for atrial fibrillation and atrial flutter. METHODS: This protocol for a systematic review was performed following the recommendations of the Cochrane Collaboration and the eight-step assessment procedure suggested...

  18. Understanding HIV infection for the design of a therapeutic vaccine. Part II: Vaccination strategies for HIV.

    Science.gov (United States)

    de Goede, A L; Vulto, A G; Osterhaus, A D M E; Gruters, R A

    2015-05-01

    HIV infection leads to a gradual loss CD4(+) T lymphocytes comprising immune competence and progression to AIDS. Effective treatment with combined antiretroviral drugs (cART) decreases viral load below detectable levels but is not able to eliminate the virus from the body. The success of cART is frustrated by the requirement of expensive lifelong adherence, accumulating drug toxicities and chronic immune activation resulting in increased risk of several non-AIDS disorders, even when viral replication is suppressed. Therefore, there is a strong need for therapeutic strategies as an alternative to cART. Immunotherapy, or therapeutic vaccination, aims to increase existing immune responses against HIV or induce de novo immune responses. These immune responses should provide a functional cure by controlling viral replication and preventing disease progression in the absence of cART. The key difficulty in the development of an HIV vaccine is our ignorance of the immune responses that control of viral replication, and thus how these responses can be elicited and how they can be monitored. Part one of this review provides an extensive overview of the (patho-) physiology of HIV infection. It describes the structure and replication cycle of HIV, the epidemiology and pathogenesis of HIV infection and the innate and adaptive immune responses against HIV. Part two of this review discusses therapeutic options for HIV. Prevention modalities and antiretroviral therapy are briefly touched upon, after which an extensive overview on vaccination strategies for HIV is provided, including the choice of immunogens and delivery strategies. Copyright © 2014. Published by Elsevier Masson SAS.

  19. 42 CFR 494.30 - Condition: Infection control.

    Science.gov (United States)

    2010-10-01

    ... of potentially infectious waste; and (ii) Cleaning and disinfection of contaminated surfaces, medical... adjacent hospital or other public areas. (a) Standard: Procedures for infection control. The facility must...

  20. Introduction to the Centers for Disease Control and Prevention and Healthcare Infection Control Practices Advisory Committee Guideline for Prevention of Surgical Site Infection: Prosthetic Joint Arthroplasty Section.

    Science.gov (United States)

    Segreti, John; Parvizi, Javad; Berbari, Elie; Ricks, Philip; Berríos-Torres, Sandra I

    Peri-prosthetic joint infection (PJI) is a severe complication of total joint arthroplasty that appears to be increasing as more of these procedures are performed. Numerous risk factors for incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSIs) have been identified. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional SSI and PJI. The Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recently updated the national Guideline for Prevention of Surgical Site Infection. The updated guideline applies evidence-based methodology, presents recommendations for potential strategies to reduce the risk of SSI, and includes an arthroplasty-specific section. This article serves to introduce the guideline development process and to complement the Prosthetic Joint Arthroplasty section with background information on PJI-specific economic burden, epidemiology, pathogenesis and microbiology, and risk factor information.

  1. Development of predictive control strategies for building climate control

    OpenAIRE

    NAGPAL, HIMANSHU

    2018-01-01

    APPROVED The rapid growth in energy usage and CO2 emissions has become a critical issue for the whole world. It is noteworthy that buildings are a major contributor to global primary energy consumption. Among building services, use of energy in heating-ventilation-air-conditioning (HVAC) system is particularly significant (about 50\\% of the total building energy consumption). Therefore, the development and implementation of effective control strategies to optimize the operation of HVAC sys...

  2. SP-100 initial startup and restart control strategy

    Science.gov (United States)

    Halfen, Frank J.; Wong, Kwok K.; Switick, Dennis M.; Shukla, Jaikaran N.

    Startup control strategies for SP-100 are described. Revised control and operating strategies are discussed which have been developed and tested using the SP-100 dynamic simulation model Aries-GFS (Generic Flight System).

  3. Web malware spread modelling and optimal control strategies

    Science.gov (United States)

    Liu, Wanping; Zhong, Shouming

    2017-02-01

    The popularity of the Web improves the growth of web threats. Formulating mathematical models for accurate prediction of malicious propagation over networks is of great importance. The aim of this paper is to understand the propagation mechanisms of web malware and the impact of human intervention on the spread of malicious hyperlinks. Considering the characteristics of web malware, a new differential epidemic model which extends the traditional SIR model by adding another delitescent compartment is proposed to address the spreading behavior of malicious links over networks. The spreading threshold of the model system is calculated, and the dynamics of the model is theoretically analyzed. Moreover, the optimal control theory is employed to study malware immunization strategies, aiming to keep the total economic loss of security investment and infection loss as low as possible. The existence and uniqueness of the results concerning the optimality system are confirmed. Finally, numerical simulations show that the spread of malware links can be controlled effectively with proper control strategy of specific parameter choice.

  4. Environmental management: a re-emerging vector control strategy.

    Science.gov (United States)

    Ault, S K

    1994-01-01

    Vector control may be accomplished by environmental management (EM), which consists of permanent or long-term modification of the environment, temporary or seasonal manipulation of the environment, and modifying or changing our life styles and practices to reduce human contact with infective vectors. The primary focus of this paper is EM in the control of human malaria, filariasis, arboviruses, Chagas' disease, and schistosomiasis. Modern EM developed as a discipline based primarily in ecologic principles and lessons learned from the adverse environmental impacts of rural development projects. Strategies such as the suppression of vector populations through the provision of safe water supplies, proper sanitation, solid waste management facilities, sewerage and excreta disposal systems, water manipulation in dams and irrigation systems, vector diversion by zooprophylaxis, and vector exclusion by improved housing, are discussed with appropriate examples. Vectors of malaria, filariasis, Chagas' disease, and schistosomiasis have been controlled by drainage or filling aquatic breeding sites, improved housing and sanitation, the use of expanded polystyrene beads, zooprophylaxis, or the provision of household water supplies. Community participation has been effective in the suppression of dengue vectors in Mexico and the Dominican Republic. Alone or combined with other vector control methods, EM has been proven to be a successful approach to vector control in a number of places. The future of EM in vector control looks promising.

  5. 40 CFR 123.46 - Individual control strategies.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Individual control strategies. 123.46... PROGRAM REQUIREMENTS Transfer of Information and Permit Review § 123.46 Individual control strategies. (a..., approval, and implementation an individual control strategy for each point source identified by the State...

  6. Radioactive demonstration of DWPF product control strategy

    International Nuclear Information System (INIS)

    Andrews, M.K.; Bibler, N.E.

    1994-01-01

    The Defense Waste Processing Facility at the Savannah River Site (SRS) will vitrify high-level nuclear waste into borosilicate glass. The waste will be mixed with properly formulated glass-making frit and fed to a melter at 1150 degrees C. Process reliability and product quality are ensured by proper control of the melter feed composition. The effectiveness of the product and process control strategies that will be utilized by the Defense Waste Processing Facility (DWPF) was demonstrated during a campaign in the Shielded Cells Facility of the Savannah River Technology Center (SRTC). The remotely operated process included the preparation of the melter feed, vitrification in a slurry-fed 1/100th scale melter an analysis of the glass product both for its composition an durability. The campaign processed approximately 10 kg (on a dry basis) of radioactive sludge from Tank 51. This sludge is representative of the first batch of sludge that will be sent to the DWPF for immobilization into borosilicate glass. Additions to the sludge were made based on calculations using the Product Composition Control System (PCCS). Analysis of the glass produced during the campaign showed that a durable glass was produced with a composition very close to that predicted using the PCCS. 10 refs., 4 tabs

  7. [Infection control and hand hygiene in nursing homes in Oslo].

    Science.gov (United States)

    Sie, Ingrid; Thorstad, Margrete; Andersen, Bjørg Marit

    2008-06-26

    Nosocomial infections and transmission can be substantially reduced by good infection control. The laws and regulations for infection control in heath care institutions emphasize establishment of infection control programs and improved hand hygiene. Our study reviews some factors that are important for practicing adequate hand hygiene (knowledge about infection control and hand-washing facilities). Health care workers (HCW) in nursing homes in Oslo participated in this study in 2006-2007. A questionnaire was made and SPSS was used to analyse the data . 70.7% of 324 HCW (in 42 nursing homes) answered the questionnaires. Nearly all of the respondents (95.6%) knew about the written procedures for hygiene and infection control; 88.5% knew that an infection control program was in place and about 50% had received information through internal education. Three of four had read the National guidelines for hand hygiene, 77.5% thought that hand disinfection was more effective than hand washing, and 97% reported hand hygiene after contact with a patient having an infection. Dispensers for hand disinfection were situated at central work places. At the same time, 17.9% informed that they worked in more than one place at the same time. This study confirms that most nursing homes in Oslo have an infection control program and training that improves the knowledge and awareness of hand hygiene among HCWs. However, the fact that nursing homes in Oslo have the resources, knowledge and education, is not the same as compliance.

  8. Infection control practice in countries with limited resources

    Directory of Open Access Journals (Sweden)

    Alp Emine

    2011-10-01

    Full Text Available Abstract Nosocomial infections and their control are a world-wide challenge. The prevalence of nosocomial infections is generally higher in developing countries with limited resources than industrialized countries. In this paper we aimed to further explain the differences with regard to infection control challenges between Turkey, a country with "limited" resources, and the Netherlands, a country with "reasonable" resources. Infrastructure of hospitals, low compliance of hand hygiene, understaffing, overcrowding, heavy workload, misuse of personal protective equipments, late establishment of infection control programme are major problems in limited-resources countries. These problems cause high infection rates and spread of multi-drug resistant pathogens. To improve the control and prevention of infections in countries with limited resources, a multi-facet approach is needed.

  9. Modelling approach for biological control of insect pest by releasing infected pest

    International Nuclear Information System (INIS)

    Tan Yuanshun; Chen Lansun

    2009-01-01

    Models of biological control have a long history of theoretical development that have focused on the interactions between a predator and a prey. Here we have extended the classical epidemic model to include a continuous and impulsive pest control strategies by releasing the infected pests bred in laboratory. For the continuous model, the results imply that the susceptible pest goes to extinct if the threshold condition R 0 0 > 1, the positive equilibrium of continuous model is globally asymptotically stable. Similarly, the threshold condition which guarantees the global stability of the susceptible pest-eradication periodic solution is obtained for the model with impulsive control strategy. Consequently, based on the results obtained in this paper, the control strategies which maintain the pests below an acceptably low level are discussed by controlling the release rate and impulsive period. Finally, the biological implications of the results and the efficiency of two control strategies are also discussed

  10. Intervention strategies for control of foodborne pathogens

    Science.gov (United States)

    Juneja, Vijay K.

    2004-03-01

    The increasing numbers of illnesses associated with foodborne pathogens such as Listeria monocytogenes and Escherichia coli O157:H7, has renewed concerns about food safety because of consumer preferences for minimally processed foods that offer convenience in availability and preparation. Accordingly, the need for better control of foodborne pathogens has been paramount in recent years. Mechanical removal of microorganisms from food can be accomplished by centrifugation, filtration, trimming and washing. Cleaning and sanitation strategies can be used for minimizing the access of microorganisms in foods from various sources. Other strategies for control of foodborne pathogens include established physical microbiocidal treatments such as ionizing radiation and heating. Research has continued to demonstrate that food irradiation is a suitable process to control and possibly eliminate foodborne pathogens, for example Listeria monocytogenes and Escherichia coli O157:H7, from a number of raw and cooked meat and poultry products. Heat treatment is the most common method in use today for the inactivation of microorganisms. Microorganisms can also be destroyed by nonthermal treatments, such as application of high hydrostatic pressure, pulsed electric fields, oscillating magnetic fields or a combination of physical processes such as heat-irradiation, or heat-high hydrostatic pressure, etc. Each of the non-thermal technologies has specific applications in terms of the types of food that can be processed. Both conventional and newly developed physical treatments can be used in combination for controlling foodborne pathogens and enhancing the safety and shelf life of foods. Recent research has focused on combining traditional preservation factors with emerging intervention technologies. However, many key issues still need to be addressed for combination preservation factors or technologies to be useful in the food industry to meet public demands for foods with enhanced safety

  11. Strategies for the prevention of hospital-acquired infections in the neonatal intensive care unit.

    Science.gov (United States)

    Borghesi, A; Stronati, M

    2008-04-01

    Nosocomial infections are among the leading causes of mortality and morbidity in neonatal intensive care units. Prevention of healthcare-associated infections is based on strategies that aim to limit susceptibility to infections by enhancing host defences, interrupting transmission of organisms by healthcare workers and by promoting the judicious use of antimicrobials. Several strategies are available and include: hand hygiene practices; prevention of central venous catheter-related bloodstream infections; judicious use of antimicrobials for therapy and prophylaxis; enhancement of host defences; skin care; and early enteral feeding with human milk.

  12. [Harm reduction strategy in tobacco control].

    Science.gov (United States)

    Gorini, Giuseppe

    2011-01-01

    .Thus, California Department of Health Services prohibits promotion of snus and medicinal nicotine as a harm reduction strategy. However, the US Federal Family Smoking Prevention and Tobacco Control Act, signed by President Obama in 2009, places tobacco products under FDA jurisdiction: FDA must define criteria for lowering carcinogens and toxicants in tobacco products, making more available medicinal nicotine, evaluating PREPs, creating a federal Tobacco Control Agency.Which approaches is Italy going to follow?

  13. High infection control rate and function after routine one-stage exchange for chronically infected TKA.

    Science.gov (United States)

    Jenny, Jean-Yves; Barbe, Bruno; Gaudias, Jeannot; Boeri, Cyril; Argenson, Jean-Noël

    2013-01-01

    Many surgeons consider two-stage exchange the gold standard for treating chronic infection after TKA. One-stage exchange is an alternative for infection control and might provide better knee function, but the rates of infection control and levels of function are unclear. We asked whether a one-stage exchange protocol would lead to infection control rates and knee function similar to those after two-stage exchange. We followed all 47 patients with chronically infected TKAs treated with one-stage exchange between July 2004 and February 2007. We monitored for recurrence of infection and obtained Knee Society Scores. We followed patients a minimum of 3 years or until death or infection recurrence. Three of the 47 patients (6%) experienced a persistence or recurrence of the index infection with the same pathogen isolated. Three patients (6%) had control of the index infection but between 6 and 17 months experienced an infection with another pathogen. The 3-year survival rates were 87% for being free of any infection and 91% for being healed of the index infection. Twenty-five of the 45 patients (56%) had a Knee Society Score of more than 150 points. While routine one-stage exchange was not associated with a higher rate of infection recurrence failure, knee function was not improved compared to that of historical patients having two-stage exchange. One stage-exchange may be a reasonable alternative in chronically infected TKA as a more convenient approach for patients without the risks of two operations and hospitalizations and for reducing costs. The ideal one stage-exchange candidate should be identified in future studies.

  14. The effects of rhythm control strategies versus rate control strategies for atrial fibrillation and atrial flutter

    DEFF Research Database (Denmark)

    Sethi, Naqash J; Feinberg, Joshua; Nielsen, Emil E

    2017-01-01

    -effect meta-analysis and chose the most conservative result as our primary result. We used Trial Sequential Analysis (TSA) to control for random errors. Statistical heterogeneity was assessed by visual inspection of forest plots and by calculating inconsistency (I2) for traditional meta-analyses and diversity...... (D2) for TSA. Sensitivity analyses and subgroup analyses were conducted to explore the reasons for substantial statistical heterogeneity. We assessed the risk of publication bias in meta-analyses consisting of 10 trials or more with tests for funnel plot asymmetry. We used GRADE to assess the quality...... of the body of evidence. RESULTS: 25 randomized clinical trials (n = 9354 participants) were included, all of which were at high risk of bias. Meta-analysis showed that rhythm control strategies versus rate control strategies significantly increased the risk of a serious adverse event (risk ratio (RR), 1...

  15. Organizational culture and its implications on infection prevention and control

    Directory of Open Access Journals (Sweden)

    R Baral

    2015-09-01

    Full Text Available The hospital acquired infections are becoming common in our hospitals lately. These infections are difficult to treat and maybe life threatening. Hospital acquired infection  can be minimized or eradicated by good Infection Prevention and Control guidelines and good hand hygiene practices. The success of Infection Prevention and Control guidelines program in any hospital is largely impacted by the organizational culture.  In any health care setting the management is challenged by the organizational culture to change of any kind. Where implementation of Infection Prevention and Control guidelines program is easily implemented in some hospitals it is very difficult in others. Moreover, hand hygiene is not only biomedical practice but also has more behavioral factors. 

  16. Genetic management strategies for controlling infectious diseases in livestock populations

    Directory of Open Access Journals (Sweden)

    Bishop Stephen C

    2003-06-01

    Full Text Available Abstract This paper considers the use of disease resistance genes to control the transmission of infection through an animal population. Transmission is summarised by R0, the basic reproductive ratio of a pathogen. If R0 > 1.0 a major epidemic can occur, thus a disease control strategy should aim to reduce R0 below 1.0, e.g. by mixing resistant with susceptible wild-type animals. Suppose there is a resistance allele, such that transmission of infection through a population homozygous for this allele will be R02 01, where R01 describes transmission in the wildtype population. For an otherwise homogeneous population comprising animals of these two groups, R0 is the weighted average of the two sub-populations: R0 = R01ρ + R02 (1 - ρ, where ρ is the proportion of wildtype animals. If R01 > 1 and R02 0 ≤ 1, i.e. ρ ≤ (R0 - R02/(R01 - R02. If R02 = 0, the proportion of resistant animals must be at least 1 - 1/R01. For an n genotype model the requirement is still to have R0 ≤ 1.0. Probabilities of epidemics in genetically mixed populations conditional upon the presence of a single infected animal were derived. The probability of no epidemic is always 1/(R0 + 1. When R0 ≤ 1 the probability of a minor epidemic, which dies out without intervention, is R0/(R0 + 1. When R0 > 1 the probability of a minor and major epidemics are 1/(R0 + 1 and (R0 - 1/(R0 + 1. Wherever possible a combination of genotypes should be used to minimise the invasion possibilities of pathogens that have mutated to overcome the effects of specific resistance alleles.

  17. How to Manage and Control Healthcare Associated Infections

    Science.gov (United States)

    Wijaya, L.

    2018-03-01

    Healthcare associated infections (HAI) are the major complications of modern medical therapy. The most important HAIs are related to invasive devices including central line- associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP) and surgical-site infections (SSI). Excessive use of antibiotics has also led to the emergence and the global dissemination of antibiotic resistant bacteria over the last few decades. Reducing HAIs will involve a multi-modal approach to infection control practices as well as antibiotic stewardship program.

  18. Evaluating surveillance strategies for the early detection of low pathogenicity avian influenza infections.

    Science.gov (United States)

    Comin, Arianna; Stegeman, Arjan; Marangon, Stefano; Klinkenberg, Don

    2012-01-01

    In recent years, the early detection of low pathogenicity avian influenza (LPAI) viruses in poultry has become increasingly important, given their potential to mutate into highly pathogenic viruses. However, evaluations of LPAI surveillance have mainly focused on prevalence and not on the ability to act as an early warning system. We used a simulation model based on data from Italian LPAI epidemics in turkeys to evaluate different surveillance strategies in terms of their performance as early warning systems. The strategies differed in terms of sample size, sampling frequency, diagnostic tests, and whether or not active surveillance (i.e., routine laboratory testing of farms) was performed, and were also tested under different epidemiological scenarios. We compared surveillance strategies by simulating within-farm outbreaks. The output measures were the proportion of infected farms that are detected and the farm reproduction number (R(h)). The first one provides an indication of the sensitivity of the surveillance system to detect within-farm infections, whereas R(h) reflects the effectiveness of outbreak detection (i.e., if detection occurs soon enough to bring an epidemic under control). Increasing the sampling frequency was the most effective means of improving the timeliness of detection (i.e., it occurs earlier), whereas increasing the sample size increased the likelihood of detection. Surveillance was only effective in preventing an epidemic if actions were taken within two days of sampling. The strategies were not affected by the quality of the diagnostic test, although performing both serological and virological assays increased the sensitivity of active surveillance. Early detection of LPAI outbreaks in turkeys can be achieved by increasing the sampling frequency for active surveillance, though very frequent sampling may not be sustainable in the long term. We suggest that, when no LPAI virus is circulating yet and there is a low risk of virus introduction

  19. Evaluating surveillance strategies for the early detection of low pathogenicity avian influenza infections.

    Directory of Open Access Journals (Sweden)

    Arianna Comin

    Full Text Available In recent years, the early detection of low pathogenicity avian influenza (LPAI viruses in poultry has become increasingly important, given their potential to mutate into highly pathogenic viruses. However, evaluations of LPAI surveillance have mainly focused on prevalence and not on the ability to act as an early warning system. We used a simulation model based on data from Italian LPAI epidemics in turkeys to evaluate different surveillance strategies in terms of their performance as early warning systems. The strategies differed in terms of sample size, sampling frequency, diagnostic tests, and whether or not active surveillance (i.e., routine laboratory testing of farms was performed, and were also tested under different epidemiological scenarios. We compared surveillance strategies by simulating within-farm outbreaks. The output measures were the proportion of infected farms that are detected and the farm reproduction number (R(h. The first one provides an indication of the sensitivity of the surveillance system to detect within-farm infections, whereas R(h reflects the effectiveness of outbreak detection (i.e., if detection occurs soon enough to bring an epidemic under control. Increasing the sampling frequency was the most effective means of improving the timeliness of detection (i.e., it occurs earlier, whereas increasing the sample size increased the likelihood of detection. Surveillance was only effective in preventing an epidemic if actions were taken within two days of sampling. The strategies were not affected by the quality of the diagnostic test, although performing both serological and virological assays increased the sensitivity of active surveillance. Early detection of LPAI outbreaks in turkeys can be achieved by increasing the sampling frequency for active surveillance, though very frequent sampling may not be sustainable in the long term. We suggest that, when no LPAI virus is circulating yet and there is a low risk of virus

  20. Infection prevention and control in deployed military medical treatment facilities.

    Science.gov (United States)

    Hospenthal, Duane R; Green, Andrew D; Crouch, Helen K; English, Judith F; Pool, Jane; Yun, Heather C; Murray, Clinton K

    2011-08-01

    Infections have complicated the care of combat casualties throughout history and were at one time considered part of the natural history of combat trauma. Personnel who survived to reach medical care were expected to develop and possibly succumb to infections during their care in military hospitals. Initial care of war wounds continues to focus on rapid surgical care with debridement and irrigation, aimed at preventing local infection and sepsis with bacteria from the environment (e.g., clostridial gangrene) or the casualty's own flora. Over the past 150 years, with the revelation that pathogens can be spread from patient to patient and from healthcare providers to patients (including via unwashed hands of healthcare workers, the hospital environment and fomites), a focus on infection prevention and control aimed at decreasing transmission of pathogens and prevention of these infections has developed. Infections associated with combat-related injuries in the recent operations in Iraq and Afghanistan have predominantly been secondary to multidrug-resistant pathogens, likely acquired within the military healthcare system. These healthcare-associated infections seem to originate throughout the system, from deployed medical treatment facilities through the chain of care outside of the combat zone. Emphasis on infection prevention and control, including hand hygiene, isolation, cohorting, and antibiotic control measures, in deployed medical treatment facilities is essential to reducing these healthcare-associated infections. This review was produced to support the Guidelines for the Prevention of Infections Associated With Combat-Related Injuries: 2011 Update contained in this supplement of Journal of Trauma.

  1. Feedback control strategies for the Liu chaotic system

    International Nuclear Information System (INIS)

    Zhu Congxu; Chen Zhigang

    2008-01-01

    This Letter proposed three strategies of the dislocated feedback control, enhancing feedback control and speed feedback control of the Liu chaotic system to its unstable equilibrium points. It is found that the coefficients of enhancing feedback control and speed feedback control are smaller than those of ordinary feedback control, so, the complexity and cost of the system control are reduced. Theoretical analysis and numerical simulation are given, revealing the effectiveness of these strategies

  2. 40 CFR 52.2088 - Control strategy: Ozone.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Ozone. 52.2088... strategy: Ozone. (a) Revisions to the State Implementation Plan submitted by the Rhode Island Department of... revised text is set forth as follows: § 52.2088 Control strategy: Ozone. (c) Determination of Attainment...

  3. Plant RNA binding proteins for control of RNA virus infection

    Directory of Open Access Journals (Sweden)

    Sung Un eHuh

    2013-12-01

    Full Text Available Plant RNA viruses have effective strategies to infect host plants through either direct or indirect interactions with various host proteins, thus suppressing the host immune system. When plant RNA viruses enter host cells exposed RNAs of viruses are recognized by the host immune system through processes such as siRNA-dependent silencing. Interestingly, some host RNA binding proteins have been involved in the inhibition of RNA virus replication, movement, and translation through RNA-specific binding. Host plants intensively use RNA binding proteins for defense against viral infections in nature. In this mini review, we will summarize the function of some host RNA binding proteins which act in a sequence-specific binding manner to the infecting virus RNA. It is important to understand how plants effectively suppresses RNA virus infections via RNA binding proteins, and this defense system can be potentially developed as a synthetic virus defense strategy for use in crop engineering.

  4. Current standards for infection control: audit assures compliance.

    Science.gov (United States)

    Flanagan, Pauline

    Having robust policies and procedures in place for infection control is fundamentally important. However, each organization has to go a step beyond this; evidence has to be provided that these policies and procedures are followed. As of 1 April 2009, with the introduction of the Care Quality Commission and The Health and Social Care Act 2008 Code of Practice for the NHS on the Prevention and Control of Healthcare-Associated Infections and Related Guidance, the assurance of robust infection control measures within any UK provider of health care became an even higher priority. Also, the commissioning of any service by the NHS must provide evidence that the provider has in place robust procedures for infection control. This article demonstrates how the clinical audit team at the Douglas Macmillan Hospice in North Staffordshire, UK, have used audit to assure high rates of compliance with the current national standards for infection control. Prior to the audit, hospice staff had assumed that the rates of compliance for infection control approached 100%. This article shows that a good quality audit tool can be used to identify areas of shortfall in infection control and the effectiveness of putting in place an action plan followed by re-audit.

  5. Strategy to Ensure Institutional Control Implementation at Superfund Sites

    Science.gov (United States)

    This document sets forth EPA’s strategy (Strategy) for ensuring that institutional controls (ICs) are successfully implemented at Superfund sites, with an emphasis on evaluating ICs at sites where all construction of all remedies is complete (construction complete sites).

  6. Force Control Strategies in Hydraulically Actuated Legged Robots

    Directory of Open Access Journals (Sweden)

    Hector Montes

    2016-03-01

    Full Text Available In this contribution, several strategies of force control have been proposed to be implemented and evaluated in ROBOCLIMBER, a quadruped robot of large dimensions. A first group of strategies proposed in this paper is based on impedance control, which is intended to adapt the foot-ground contact forces according to the experimentally specified damping ratio and the undamped natural frequency. A second control strategy of interest for many practical cases is called the parallel force/position control, which has one inner loop position control and two external control loops, one of force and another of position. A third group of control strategies is the posture stabilization for ROBOCLIMBER using the feedback of the ZMP calculation and the position of its legs. Finally, a control strategy for the control of a quasi-static gait using ZMP feedback is proposed and tested by simulation.

  7. Solar shading control strategy for office buildings in cold climate

    DEFF Research Database (Denmark)

    Røseth Karlsen, Line; Heiselberg, Per Kvols; Bryn, Ida

    2016-01-01

    Highlights •Solar shading control strategy for office buildings in cold climate is developed. •Satisfying energy and indoor environmental performance is confirmed. •Importance of integrated evaluations when selecting shading strategy is illustrated.......Highlights •Solar shading control strategy for office buildings in cold climate is developed. •Satisfying energy and indoor environmental performance is confirmed. •Importance of integrated evaluations when selecting shading strategy is illustrated....

  8. Diagnostic strategy for occult hepatitis B virus infection

    Science.gov (United States)

    Ocana, Sara; Casas, Maria Luisa; Buhigas, Ingrid; Lledo, Jose Luis

    2011-01-01

    In 2008, the European Association for the study of the liver (EASL) defined occult hepatitis B virus infection (OBI) as the “presence of hepatitis B virus (HBV) DNA in the liver (with detectable or undetectable HBV DNA in the serum) of individuals testing hepatitis B surface antigen (HBsAg) negative by currently available assays”. Several aspects of occult HBV infection are still poorly understood, including the definition itself and a standardized approach for laboratory-based detection, which is the purpose of this review. The clinical significance of OBI has not yet been established; however, in terms of public health, the clinical importance arises from the risk of HBV transmission. Consequently, it is important to detect high-risk groups for occult HBV infection to prevent transmission. The main issue is, perhaps, to identify the target population for screening OBI. Viremia is very low or undetectable in occult HBV infection, even when the most sensitive methods are used, and the detection of the viral DNA reservoir in hepatocytes would provide the best evaluation of occult HBV prevalence in a defined set of patients. However, this diagnostic approach is obviously unsuitable: blood detection of occult hepatitis B requires assays of the highest sensitivity and specificity with a lower limit of detection < 10 IU/mL for HBV DNA and < 0.1 ng/mL for HBsAg. PMID:21472120

  9. Diagnostic strategies for urinary tract infections in French general practice.

    Science.gov (United States)

    Kinouani, S; de Lary de Latour, H; Joseph, J-P; Letrilliart, L

    2017-10-01

    We aimed to describe the diagnostic management procedures for detection of urinary tract infections in general practice and their correlated factors. We analyzed data from the ECOGEN study on urinary tract infections, collected in France between November 2011 and April 2012. This national cross-sectional study was carried out in general practices. Data was coded according to the International Classification of Primary Care. A total of 340 consultations or home visits were held for urinary tract infections. The five most frequent diagnostic procedures were (in descending order) clinical examination (67.6%), urine cytobacteriological examination (UCBE) (47.9%), urine dipstick test (15.6%), blood test (8.5%), and imaging (6.5%). No urine dipstick test or UCBE was performed in 43% of cases. Factors correlated with diagnostic procedures were age and gender of patients, annual number of consultations held by family physicians, and duration of consultation. Family physicians did not comply with guidelines on diagnostic management for detection of urinary tract infections. We hypothesized that this non-compliance could be due to the family physicians' environment and characteristics, and to clinical practice guidelines. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  10. Novel antibacterial strategies to combat biomaterial-associated infection

    NARCIS (Netherlands)

    Riool, M.

    2017-01-01

    The use of medical devices has grown significantly over the last decades, and has become a major part of modern medicine and our daily life. The risk of infection is a significant problem with any inserted or implanted foreign body material, and is the number one cause of failure of implanted

  11. Lactobacillus paracasei feeding improves the control of secondary experimental meningococcal infection in flu-infected mice.

    Science.gov (United States)

    Belkacem, Nouria; Bourdet-Sicard, Raphaëlle; Taha, Muhamed-Kkeir

    2018-04-10

    The use of probiotics to improve anti-microbial defence, such as for influenza infections, is increasingly recommended. However, no data are available on the effect of probiotics on flu-associated secondary bacterial infections. There is strong evidence of a spatiotemporal association between influenza virus infection and invasive Neisseria meningitidis. We thus investigated the effect of feeding mice Lactobacillus paracasei CNCM I-1518 in a mouse model of sequential influenza-meningococcal infection. We intranasally infected BALB/c mice with a strain of influenza A virus (IAV) H3N2 that was first adapted to mice. Seven days later, a secondary bacterial infection was induced by intranasal administration of bioluminescent N. meningitidis. During the experiment, mice orally received either L. paracasei CNCM I-1518 or PBS as a control. The effect of L. paracasei administration on secondary bacterial infection by N. meningitidis was evaluated. Oral consumption of L. paracasei CNCM I-1518 reduced the weight loss of infected mice and lowered the bioluminescent signal of infecting meningococci. This improvement was associated with higher recruitment of inflammatory myeloid cells, such as interstitial monocytes and dendritic cells, to the lungs. Our data highlight the role of the gut-lung axis. L. paracasei CNCM I-1518 may boost the defence against IAV infection and secondary bacterial infection, which should be further studied and validated in clinical trials.

  12. Infection control for SARS in a tertiary neonatal centre.

    Science.gov (United States)

    Ng, P C; So, K W; Leung, T F; Cheng, F W T; Lyon, D J; Wong, W; Cheung, K L; Fung, K S C; Lee, C H; Li, A M; Hon, K L E; Li, C K; Fok, T F

    2003-09-01

    The Severe Acute Respiratory Syndrome (SARS) is a newly discovered infectious disease caused by a novel coronavirus, which can readily spread in the healthcare setting. A recent community outbreak in Hong Kong infected a significant number of pregnant women who subsequently required emergency caesarean section for deteriorating maternal condition and respiratory failure. As no neonatal clinician has any experience in looking after these high risk infants, stringent infection control measures for prevention of cross infection between patients and staff are important to safeguard the wellbeing of the work force and to avoid nosocomial spread of SARS within the neonatal unit. This article describes the infection control and patient triage policy of the neonatal unit at the Prince of Wales Hospital, Hong Kong. We hope this information is useful in helping other units to formulate their own infection control plans according to their own unit configuration and clinical needs.

  13. Where does infection control fit into a hospital management structure?

    Science.gov (United States)

    Brannigan, E T; Murray, E; Holmes, A

    2009-12-01

    To be effective, infection prevention and control must be integrated into the complex and multiple interlinking systems within a hospital's management structure. Each of the systems must consider how activity associated with it can be optimised to minimise infection risk to patients. The components of an organisational structure to achieve these quality assurance and patient safety aims are discussed. The use of performance management tools in relation to infection control metrics is reviewed, and the use of hospital-acquired infection as a proxy indicator for deficiencies of system management is considered. Infection prevention and control cannot be the role and responsibility of a single individual or a small dedicated team; rather it should be a priority at all levels and integrated within all management systems, including the research and educational agendas.

  14. HIV infection and treatment: beyond viral control

    NARCIS (Netherlands)

    Sprenger, Herman

    2017-01-01

    Since 1996, Infection caused by the human immunodeficiency virus(HIV) can be successfully treated with a combination therapy of 3 antiviral drugs from 2 different classes. Life expectancy has increased dramatically by this treatment. Especially in the early years these combination therapies had many

  15. Job embeddedness factors as a predictor of turnover intention among infection control nurses in Korea.

    Science.gov (United States)

    Choi, Jeong Sil; Kim, Kyung Mi

    2015-11-01

    Job embeddedness indicates the degree to which an employee of an organization intends to remain in his or her position at that organization. This study examined how job embeddedness affects infection control nurses' turnover intention along with general characteristics, job satisfaction, and perceived job alternatives. We collected data from a total of 133 infection control nurses using self-reporting questionnaire methods. All questions were answered on a 5-point Likert scale. The average turnover intention was 3.01 ± 0.72 (100-point conversion, 60.2%), and average job satisfaction was 3.48 ± 0.79 (100-point conversion, 69.6%). The average perceived availability of job alternatives was 3.02 ± 0.78 (100-point conversion, 60.4%), and average job embeddedness was 3.33 ± 0.57 (100-point conversion, 66.6%). Predictors of turnover intention were monthly income, perceived availability of job alternatives, and job embeddedness. Job embeddedness among predictors has high explanatory power as a predictor of infection control nurses' turnover intention. Through this study we identified predictors of turnover intention and found that job embeddedness among predictors has high explanatory power as a predictor of infection control nurses' turnover intention. Strategies to enhance infection control nurses' job embeddedness are needed. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  16. Building new hospitals: a UK infection control perspective.

    Science.gov (United States)

    Stockley, J M; Constantine, C E; Orr, K E

    2006-03-01

    Infection control input is vital throughout the planning, design and building stages of a new hospital project, and must continue through the commissioning (and decommissioning) process, evaluation and putting the facility into full clinical service. Many hospitals continue to experience problems months or years after occupying the new premises; some of these could have been avoided by infection control involvement earlier in the project. The importance of infection control must be recognized by the chief executive of the hospital trust and project teams overseeing the development. Clinical user groups and contractors must also be made aware of infection control issues. It is vital that good working relationships are built up between the infection control team (ICT) and all these parties. ICTs need the authority to influence the process. This may require their specific recognition by the Private Finance Initiative National Unit, the Department of Health or other relevant authorities. ICTs need training in how to read design plans, how to write effective specifications, and in other areas with which they may be unfamiliar. The importance of documentation and record keeping is paramount. External or independent validation of processes should be available, particularly in commissioning processes. Building design in relation to infection control needs stricter national regulations, allowing ICTs to focus on more local usage issues. Further research is needed to provide evidence regarding the relationship between building design and the prevalence of infection.

  17. Exploring the context for effective clinical governance in infection control.

    Science.gov (United States)

    Halton, Kate; Hall, Lisa; Gardner, Anne; MacBeth, Deborough; Mitchell, Brett G

    2017-03-01

    Effective clinical governance is necessary to support improvements in infection control. Historically, the focus has been on ensuring that infection control practice and policy is based on evidence, and that there is use of surveillance and auditing for self-regulation and performance feedback. There has been less exploration of how contextual and organizational factors mediate an infection preventionists (IP's) ability to engage with evidence-based practice and enact good clinical governance. A cross sectional Web-based survey of IPs in Australia and New Zealand was undertaken. Questions focused on engagement in evidence-based practice and perceptions about the context, culture, and leadership within the infection control team and organization. Responses were mapped against dimensions of Scally and Donaldson's clinical governance framework. Three hundred surveys were returned. IPs appear well equipped at an individual level to undertake evidence-based practice. The most serious set of perceived challenges to good clinical governance related to a lack of leadership or active resistance to infection control within the organization. Additional challenges included lack of information technology solutions and poor access to specialist expertise and financial resources. Focusing on strengthening contextual factors at the organizational level that otherwise undermine capacity to implement evidence-based practice is key to sustaining current infection control successes and promoting further practice improvements. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  18. Mathematical modelling : a tool for hospital infection control

    NARCIS (Netherlands)

    Grundmann, H; Hellriegel, B

    Health-care-associated infections caused by antibiotic-resistant pathogens have become a menace in hospitals worldwide and infection control measures have lead to vastly different outcomes in different countries. During the past 6 years, a theoretical framework based on mathematical models has

  19. Mathematical modelling: a tool for hospital infection control

    NARCIS (Netherlands)

    Grundmann, Hajo; Hellriegel, B.

    2006-01-01

    Health-care-associated infections caused by antibiotic-resistant pathogens have become a menace in hospitals worldwide and infection control measures have lead to vastly different outcomes in different countries. During the past 6 years, a theoretical framework based on mathematical models has

  20. Mathematical modelling: a tool for hospital infection control.

    NARCIS (Netherlands)

    Grundmann, Hajo; Hellriegel, B

    2006-01-01

    Health-care-associated infections caused by antibiotic-resistant pathogens have become a menace in hospitals worldwide and infection control measures have lead to vastly different outcomes in different countries. During the past 6 years, a theoretical framework based on mathematical models has

  1. Knowledge, awareness and practice of infection control by health ...

    African Journals Online (AJOL)

    Training workshop on infection control should be organized for all ICU health care ... across the world are infected at any given time. ... er during the course of their stay in the hospital.4,5 The ... which permits unrestricted use, distribution, and reproduction in any medium, ..... Batuduwaarachchi VR, Balasubramanium M, Bal-.

  2. Education in infection control : A need for European certification

    NARCIS (Netherlands)

    Zingg, W.; Mutters, N. T.; Harbarth, S.; Friedrich, A. W.

    2015-01-01

    Healthcare-associated infections are common adverse events in acute-care medicine, causing significant morbidity and mortality. There has been a significant increase in the commitment to infection prevention and control (IPC) among European countries in recent years. However, there is still

  3. Infection prevention and control practices in children's hospitals.

    Science.gov (United States)

    Bender, Jeffrey M; Virgallito, Mary; Newland, Jason G; Sammons, Julia S; Thorell, Emily A; Coffin, Susan E; Pavia, Andrew T; Sandora, Thomas J; Hersh, Adam L

    2015-05-01

    We surveyed hospital epidemiologists at 28 Children's Hospital Association member hospitals regarding their infection prevention and control programs. We found substantial variability between children's hospitals in both the structure and the practice of these programs. Research and the development of evidence-based guidelines addressing infection prevention in pediatrics are needed.

  4. 40 CFR 52.1982 - Control strategy: Ozone.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Ozone. 52.1982... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Oregon § 52.1982 Control strategy... emission control equipment, selected from a specific list on file at DEQ, is in place and operating...

  5. Enabling Passive Immunization as an Alternative to Antibiotics for Controlling Enteric Infections in Production Animals

    DEFF Research Database (Denmark)

    Heegaard, Peter M. H.; Hald, Birthe; Madsen, M.

    Enteric infections cause major problems in most intensive animal production sectors, including poultry, pigs and cattle, leading to disease, reduced production and compromised welfare. In addition some of these infections are zoonotic, and they are to a large extent responsible for the continued ...... as a viable strategy for control of infectious diseases in the intensive animal production, with the potential to significantly reduce antibiotics consumption.......Enteric infections cause major problems in most intensive animal production sectors, including poultry, pigs and cattle, leading to disease, reduced production and compromised welfare. In addition some of these infections are zoonotic, and they are to a large extent responsible for the continued...... massive use of antibiotics in food animals. Thus there is a pressing need for economically feasible, efficient, non-antibiotics based means for controlling the problem. Passive immunization has been known for decades as an efficient way of endowing humans or animals with short-term (weeks) immunity...

  6. [Critical role of clinical laboratories in hospital infection control].

    Science.gov (United States)

    Yagi, Tetsuya

    2010-11-01

    The hospital infection control and prevention is recognized to be more and more important according to the advances in modern medical treatment and care. Clinical microbiology laboratory play critical roles in the hospital infection control as a member of infection control team (ICT). They are the first in a hospital to identify outbreak of MRSA in NICU and molecular epidemiological analysis of the isolates lead proper intervention of ICT to the concerned ward. From a viewpoint of infectious disease specialist, rapid and precise microbiological information is essential for the appropriate diagnosis and treatment of infectious diseases. Each medical technologist need to make efforts to understand the characteristics of the examinations for infectious diseases and send out information useful for clinical practices. In our hospital, with the participation of all members of medical technologists, rapid reporting system was developed for blood culture examinations, which greatly contribute to the appropriate treatment of bloodstream infections. Collaborations of clinical microbiology laboratory with other members of ICT realize high quality hospital infection control. They also need to be aware of themselves as good practitioners of infection control measures to prevent hospital infections.

  7. Spontaneous strategy use protects against visual working memory deficits in older adults infected with HIV.

    Science.gov (United States)

    Woods, Steven Paul; Weber, Erica; Cameron, Marizela V; Dawson, Matthew S; Delano-Wood, Lisa; Bondi, Mark W; Grant, Igor

    2010-12-01

    Recent studies suggest that older human immunodeficiency virus (HIV)-infected adults are at particular risk for HIV-associated neurocognitive disorders (HAND), including dementia. Deficits in attention/working memory are posited to play a central role in the development of HAND among older adults. The aim of the present study was to examine the possible protective benefits of spontaneous strategy use during a visual working memory task in 46 older and 42 younger adults infected with HIV. Results revealed a significant interaction between age and strategy use, with older adults who used a meta-cognitive strategy demonstrating superior working memory performance versus non-strategy users. This effect was not observed in the younger HIV-infected sample and was not better explained by possible confounding factors, such as education, comorbid medical conditions, or HIV disease severity. Within the older group, strategy use was associated with better executive functions and higher estimated verbal intelligence. Findings from this study suggest that working memory declines in older HIV-infected adults are moderated by the use of higher-level mnemonic strategies and may inform cognitive neurorehabilitation efforts to improve cognitive and everyday functioning outcomes in older persons living with HIV infection.

  8. [Infection control and hygiene management in equine hospitals].

    Science.gov (United States)

    Walther, Birgit; Janssen, Traute; Gehlen, Heidrun; Vincze, Szilvia; Borchers, Kerstin; Wieler, Lothar H; Barton, Ann Kristin; Lübke-Becker, Antina

    2014-01-01

    With the rising importance of nosocomial infections in equine hospitals, increased efforts with regard to biosecurity and infection control are necessary. This even more since nosocomial infections are often associated with multi-drug resistant pathogens. Consequently, the implementation of targeted prevention programs is essential. Since nosocomial infections are usually multifactorial events, realization of only a single measure is rarely effective to overcome nosocomial spread in clinical practice. Equine patients may be colonized at admission with multi-drug resistant pathogens such as methicillin resistant Staphylococcus aureus (MRSA) and/or extended spectrum beta lactamase-producing (ESBL-) Enterobacteriaceae. Regardless of their individual resistance properties, these bacteria are common and usually unnoticed colonizers of either the nasopharynx or the intestinal tract. Also viral diseases caused by equine herpesvirus 1 (EHV-1) and EHV-4 may reach a clinic by patients which are latently infected or in the incubation period. To prevent nosocomal outbreaks, achieve an interruption in the infection chain and to eradicate infectious agents from the hospital environment, a professional hospital management is necessary. This should be adapted to both the wide range of pathogens causing nosocomial infections and the individual needs of equine patients. Amongst others, this approach includes a risk classification of equine patients at admission and information/enlightenment of the animal owners at discharge. An efficient management of inpatients, a targeted hygiene management and clear responsibilities with respect to biosecurity together with a surveillance of nosocomial infections form the cornerstone of infection control in equine hospitals.

  9. Knowledge and attitudes of infection prevention and control among ...

    African Journals Online (AJOL)

    EB

    infection prevention and control is imparted early before they are introduced to the wards. ... professional nurses in Namibia instead of depending .... Table 3: ANOVA results for overall IPC Knowledge Score for gender, student area, high ...

  10. How to Treat Impetigo and Control This Common Skin Infection

    Science.gov (United States)

    ... Home For Consumers Consumer Updates How to Treat Impetigo and Control This Common Skin Infection Share Tweet ... Thomas D. Smith, MD, of FDA. What Causes Impetigo Two types of bacteria found on our skin ...

  11. 77 FR 4820 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2012-01-31

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... the Director, Division of Healthcare Quality Promotion regarding (1) the practice of healthcare... infections), antimicrobial resistance, and related events in settings where healthcare is provided; and (3...

  12. 77 FR 28392 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2012-05-14

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... the Director, Division of Healthcare Quality Promotion regarding 1) the practice of healthcare... infections), antimicrobial resistance, and related events in settings where healthcare is provided; and 3...

  13. Bowel Retraining: Strategies for Establishing Bowel Control

    Science.gov (United States)

    ... helpful, please consider supporting IFFGD with a small tax-deductible donation. Adapted from IFFGD Publication: Strategies for ... arises requiring an expert’s care. © Copyright 1998-2018 International Foundation for Functional Gastrointestinal Disorders, Inc. (IFFGD). All ...

  14. Potential strategies for the eradication of multidrug-resistant Gram-negative bacterial infections.

    Science.gov (United States)

    Huwaitat, Rawan; McCloskey, Alice P; Gilmore, Brendan F; Laverty, Garry

    2016-07-01

    Antimicrobial resistance is one of the leading threats to society. The increasing burden of multidrug-resistant Gram-negative infection is particularly concerning as such bacteria are demonstrating resistance to nearly all currently licensed therapies. Various strategies have been hypothesized to treat multidrug-resistant Gram-negative infections including: targeting the Gram-negative outer membrane; neutralization of lipopolysaccharide; inhibition of bacterial efflux pumps and prevention of protein folding. Silver and silver nanoparticles, fusogenic liposomes and nanotubes are potential strategies for extending the activity of licensed, Gram-positive selective, antibiotics to Gram-negatives. This may serve as a strategy to fill the current void in pharmaceutical development in the short term. This review outlines the most promising strategies that could be implemented to solve the threat of multidrug-resistant Gram-negative infections.

  15. International Narcotics Control Strategy Report, 1997

    National Research Council Canada - National Science Library

    1998-01-01

    .... Continued warfare, destmction of the economic infrastmcture and absence of a recognized central government with administrative control over the entire country remain obstacles to effective dmg control...

  16. Strategies for Prevention and Treatment of Trichomonas vaginalis Infections.

    Science.gov (United States)

    Bouchemal, Kawthar; Bories, Christian; Loiseau, Philippe M

    2017-07-01

    The last estimated annual incidence of Trichomonas vaginalis worldwide exceeds that of chlamydia and gonorrhea combined. This critical review updates the state of the art on advances in T. vaginalis diagnostics and strategies for treatment and prevention of trichomoniasis. In particular, new data on treatment outcomes for topical administration of formulations are reviewed and discussed. Copyright © 2017 American Society for Microbiology.

  17. Hand hygiene promotion and the participation of infection control link nurses: an effective innovation to overcome campaign fatigue.

    Science.gov (United States)

    Seto, Wing Hong; Yuen, Shanny W S; Cheung, Christina W Y; Ching, Patricia T Y; Cowling, Benjamin J; Pittet, Didier

    2013-12-01

    Campaign fatigue was evident in a large hospital in Hong Kong when hand hygiene compliance remained just above 50% after 4 years of aggressive and varied promotional activities. A new innovative strategy was developed that directly involved the infection control link nurses both in formulating the strategy and in implementing the various proposed programs. The new strategy was successful in increasing hand hygiene compliance to 83%. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  18. Infection control practices across Canada: do dentists follow the recommendations?

    Science.gov (United States)

    McCarthy, G M; Koval, J J; John, M A; MacDonald, J K

    1999-10-01

    This study investigated provincial and territorial differences in dentists' compliance with recommended infection control practices in Canada (1995). Questionnaires were mailed to a stratified random sample of 6,444 dentists, of whom 66.4% responded. Weighted analyses included Pearson's chi-square test and multiple logistic regression. Significant provincial and territorial differences included testing for immune response after hepatitis B virus (HBV) vaccination, HBV vaccination for all clinical staff, use of infection control manuals and post-exposure protocols, biological monitoring of heat sterilizers, handwashing before treating patients, using gloves and changing them after each patient, heat-sterilizing handpieces between patients, and using masks and uniforms to protect against splatter of blood and saliva. Excellent compliance (compliance with a combination of 18 recommended infection control procedures) ranged from 0% to 10%; the best predictors were more hours of continuing education on infection control in the last two years, practice location in larger cities (> 500,000) and sex (female). Clearly, improvements in infection control are desirable for dentists in all provinces and territories. Extending mandatory continuing education initiatives to include infection control may promote better compliance with current recommendations.

  19. Impact of Infection Prevention and Control Initiatives on Acute Respiratory Infections in a Pediatric Long-Term Care Facility.

    Science.gov (United States)

    Murray, Meghan T; Jackson, Olivia; Cohen, Bevin; Hutcheon, Gordon; Saiman, Lisa; Larson, Elaine; Neu, Natalie

    2016-07-01

    We evaluated the collective impact of several infection prevention and control initiatives aimed at reducing acute respiratory infections (ARIs) in a pediatric long-term care facility. ARIs did not decrease overall, though the proportion of infections associated with outbreaks and average number of cases per outbreak decreased. Influenza rates decreased significantly. Infect Control Hosp Epidemiol 2016;37:859-862.

  20. Progress in research, control and elimination of helminth infections in Asia.

    Science.gov (United States)

    Utzinger, Jürg; Brattig, Norbert W; Leonardo, Lydia; Zhou, Xiao-Nong; Bergquist, Robert

    2015-01-01

    Global health has substantially improved over the past 20 years. In low- and middle-income countries, in particular, great strives have been made in the control of communicable diseases, including helminth infections. Nevertheless, the most marginalised communities still suffer from infectious diseases that are intimately connected with poverty and lack of access to essential commodities and services, such as clean water, improved sanitation and sufficient food. A two-pronged approach is thus necessary: (i) intensifying control in remaining high-endemicity areas and pockets of high transmission; and (ii) moving from morbidity control to interruption of disease transmission in low-endemicity areas with the goal of local elimination. The latter will require new tools and strategies, going hand-in-hand with strong partnerships and new strategic alliances. In this special issue of Acta Tropica, 35 articles are featured that, together, provide an up-to-date overview of the latest progress made in research, control and elimination of helminth infections in East and Southeast Asia. The first 12 articles expound tools and approaches for improved detection, surveillance and monitoring of helminth infections. Control and elimination approaches for the most important helminth infections are revisited in the next 20 articles. The three remaining articles are cross-cutting pieces examining the interface of agriculture, environment and helminth infections and providing a rationale for integrated, multi-sectorial control approaches that are necessary for sustaining helminthiasis control and progressively moving towards elimination. An interesting aspect revealed through an in-depth analysis of the provenance of the 35 contributions is that the People's Republic of China emerges as a key player in global health, which is documented through its prominent role in research and control of helminth infection and networking throughout Asia. Policy implications are discussed and will

  1. Metabolome strategy against Edwardsiella tarda infection through glucose-enhanced metabolic modulation in tilapias.

    Science.gov (United States)

    Peng, Bo; Ma, Yan-Mei; Zhang, Jian-Ying; Li, Hui

    2015-08-01

    Edwardsiella tarda causes fish disease and great economic loss. However, metabolic strategy against the pathogen remains unexplored. In the present study, GC-MS based metabolomics was used to investigate the metabolic profile from tilapias infected by sublethal dose of E. tarda. The metabolic differences between the dying group and survival group allow the identification of key pathways and crucial metabolites during infections. More importantly, those metabolites may modulate the survival-related metabolome to enhance the anti-infective ability. Our data showed that tilapias generated two different strategies, survival-metabolome and death-metabolome, to encounter EIB202 infection, leading to differential outputs of the survival and dying. Glucose was the most crucial biomarker, which was upregulated and downregulated in the survival and dying groups, respectively. Exogenous glucose by injection or oral administration enhanced hosts' ability against EIB202 infection and increased the chances of survival. These findings highlight that host mounts the metabolic strategy to cope with bacterial infection, from which crucial biomarkers may be identified to enhance the metabolic strategy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Population-based biomedical sexually transmitted infection control interventions for reducing HIV infection.

    Science.gov (United States)

    Ng, Brian E; Butler, Lisa M; Horvath, Tara; Rutherford, George W

    2011-03-16

    The transmission of sexually transmitted infections (STIs) is closely related to the sexual transmission of human immunodeficiency virus (HIV). Similar risk behaviours, such as frequent unprotected intercourse with different partners, place people at high risk of HIV and STIs, and there is clear evidence that many STIs increase the likelihood of HIV transmission. STI control, especially at the population or community level, may have the potential to contribute substantially to HIV prevention.This is an update of an existing Cochrane review. The review's search methods were updated and its inclusion and exclusion criteria modified so that the focus would be on one well-defined outcome. This review now focuses explicitly on population-based biomedical interventions for STI control, with change in HIV incidence being an outcome necessary for a study's inclusion. To determine the impact of population-based biomedical STI interventions on the incidence of HIV infection. We searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science/Social Science, PsycINFO, and Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS), for the period of 1 January1980 - 16 August 2010. We initially identified 6003 articles and abstracts. After removing 776 duplicates, one author (TH) removed an additional 3268 citations that were clearly irrelevant. Rigorously applying the inclusion criteria, three authors then independently screened the remaining 1959 citations and abstracts. Forty-six articles were chosen for full-text scrutiny by two authors. Ultimately, four studies were included in the review.We also searched the Aegis database of conference abstracts, which includes the Conference on Retroviruses and Opportunistic Infections (CROI), the International AIDS Conference (IAC), and International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS) meetings from their inception dates (1993, 1985 and

  3. Controlled Human Malaria Infection: Applications, Advances, and Challenges.

    Science.gov (United States)

    Stanisic, Danielle I; McCarthy, James S; Good, Michael F

    2018-01-01

    Controlled human malaria infection (CHMI) entails deliberate infection with malaria parasites either by mosquito bite or by direct injection of sporozoites or parasitized erythrocytes. When required, the resulting blood-stage infection is curtailed by the administration of antimalarial drugs. Inducing a malaria infection via inoculation with infected blood was first used as a treatment (malariotherapy) for neurosyphilis in Europe and the United States in the early 1900s. More recently, CHMI has been applied to the fields of malaria vaccine and drug development, where it is used to evaluate products in well-controlled early-phase proof-of-concept clinical studies, thus facilitating progression of only the most promising candidates for further evaluation in areas where malaria is endemic. Controlled infections have also been used to immunize against malaria infection. Historically, CHMI studies have been restricted by the need for access to insectaries housing infected mosquitoes or suitable malaria-infected individuals. Evaluation of vaccine and drug candidates has been constrained in these studies by the availability of a limited number of Plasmodium falciparum isolates. Recent advances have included cryopreservation of sporozoites, the manufacture of well-characterized and genetically distinct cultured malaria cell banks for blood-stage infection, and the availability of Plasmodium vivax -specific reagents. These advances will help to accelerate malaria vaccine and drug development by making the reagents for CHMI more widely accessible and also enabling a more rigorous evaluation with multiple parasite strains and species. Here we discuss the different applications of CHMI, recent advances in the use of CHMI, and ongoing challenges for consideration. Copyright © 2017 American Society for Microbiology.

  4. Dengue infection and miscarriage: a prospective case control study.

    Directory of Open Access Journals (Sweden)

    Peng Chiong Tan

    Full Text Available BACKGROUND: Dengue is the most prevalent mosquito borne infection worldwide. Vertical transmissions after maternal dengue infection to the fetus and pregnancy losses in relation to dengue illness have been reported. The relationship of dengue to miscarriage is not known. METHOD: We aimed to establish the relationship of recent dengue infection and miscarriage. Women who presented with miscarriage (up to 22 weeks gestation to our hospital were approached to participate in the study. For each case of miscarriage, we recruited 3 controls with viable pregnancies at a similar gestation. A brief questionnaire on recent febrile illness and prior dengue infection was answered. Blood was drawn from participants, processed and the frozen serum was stored. Stored sera were thawed and then tested in batches with dengue specific IgM capture ELISA, dengue non-structural protein 1 (NS1 antigen and dengue specific IgG ELISA tests. Controls remained in the analysis if their pregnancies continued beyond 22 weeks gestation. Tests were run on 116 case and 341 control sera. One case (a misdiagnosed viable early pregnancy plus 45 controls (39 lost to follow up and six subsequent late miscarriages were excluded from analysis. FINDINGS: Dengue specific IgM or dengue NS1 antigen (indicating recent dengue infection was positive in 6/115 (5·2% cases and 5/296 (1·7% controls RR 3·1 (95% CI 1·0-10 P = 0·047. Maternal age, gestational age, parity and ethnicity were dissimilar between cases and controls. After adjustments for these factors, recent dengue infection remained significantly more frequently detected in cases than controls (AOR 4·2 95% CI 1·2-14 P = 0·023. INTERPRETATION: Recent dengue infections were more frequently detected in women presenting with miscarriage than in controls whose pregnancies were viable. After adjustments for confounders, the positive association remained.

  5. Control Strategies for Arrays of Wave Energy Devices

    OpenAIRE

    Westphalen, J; Bacelli, G; Balitsky, P; Ringwood, John

    2011-01-01

    In this paper, we investigate the differences between two control strategies for a two-device linear array of wave energy converters (WEC) for device spacings of 4 to 80 times the device diameter. The WECs operate in heave only and are controlled in real time. The control strategies, called the independent device and global array control, estimate the excitation forces and calculate the optimum vertical velocity trajectory and reactive power take off force to achieve the ...

  6. Efficacy of an infection control programme in reducing nosocomial bloodstream infections in a Senegalese neonatal unit.

    Science.gov (United States)

    Landre-Peigne, C; Ka, A S; Peigne, V; Bougere, J; Seye, M N; Imbert, P

    2011-10-01

    Neonatal nosocomial infections are public health threats in the developing world, and successful interventions are rarely reported. A before-and-after study was conducted in the neonatal unit of the Hôpital Principal de Dakar, Senegal to assess the efficacy of a multi-faceted hospital infection control programme implemented from March to May 2005. The interventions included clustering of nursing care, a simple algorithm for empirical therapy of suspected early-onset sepsis, minimal invasive care and promotion of early discharge of neonates. Data on nosocomial bloodstream infections, mortality, bacterial resistance and antibiotic use were collected before and after implementation of the infection control programme. One hundred and twenty-five infants were admitted immediately before the programme (Period 1, January-February 2005) and 148 infants were admitted immediately after the programme (Period 2, June-July 2005). The two groups of infants were comparable in terms of reason for admission and birth weight. After implementation of the infection control programme, the overall rate of nosocomial bloodstream infections decreased from 8.8% to 2.0% (P=0.01), and the rate of nosocomial bloodstream infections/patient-day decreased from 10.9 to 2.9/1000 patient-days (P=0.03). Overall mortality rates did not differ significantly. The proportion of neonates who received antimicrobial therapy for suspected early-onset sepsis decreased significantly from 100% to 51% of at-risk infants (Punit, simple, low-cost and sustainable interventions led to the control of a high incidence of bacterial nosocomial bloodstream infections, and the efficacy of these interventions was long-lasting. Such interventions could be extended to other low-income countries. Copyright © 2011 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  7. New control strategies for neuroprosthetic systems

    NARCIS (Netherlands)

    Crago, Patrick E.; Veltink, Petrus H.; Lan, Ning; Abbas, James J.; Kantor, Carole

    1996-01-01

    The availability of techniques to artificially excite paralyzed muscles opens enormous potential for restoring both upper and lower extremity movements with neuroprostheses. Neuroprostheses must stimulate muscle, and control and regulate the artificial movements produced. Control methods to

  8. Australian Infection Control Association members' use of skills and resources that promote evidence-based infection control.

    Science.gov (United States)

    Murphy, C L; McLaws, M

    2000-04-01

    To adopt an evidence-based approach, professionals must be able to access, identify, interpret, and critically appraise best evidence. Critical appraisal requires essential skills, such as computer literacy and an understanding of research principles. These skills also are required for professionals to contribute to evidence. In 1996, members of the Australian Infection Control Association were surveyed to establish a profile including the extent to which they were reading infection control publications, using specific documents for policy and guideline development, developing and undertaking research, publishing research, and using computers. The relationships between demographics, computer use, and research activity were examined. The response rate was 63. 4% (630/993). The study group comprised mostly women (96.1%), and most (66.4%) were older than 40 years of age. Median infection control experience was 4 years (mean, 5.4 years; range, Australian infection control professionals must be adequately prepared to contribute to, access, appraise, and where appropriate, apply best evidence to their practice. We suggest that computer literacy, an understanding of research principles, and familiarity with infection control literature are three essential skills that infection control professionals must possess and regularly exercise.

  9. 40 CFR 52.1582 - Control strategy and regulations: Ozone.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy and regulations: Ozone... Control strategy and regulations: Ozone. (a) Subchapter 16 of the New Jersey Administrative Code, entitled... demonstration that emissions from growth in vehicle miles traveled will not increase motor vehicle emissions and...

  10. 40 CFR 52.724 - Control strategy: Sulfur dioxide.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Control strategy: Sulfur dioxide. 52... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Illinois> § 52.724 Control strategy: Sulfur... Energy Incorporated. This disapproval does not in and of itself result in the growth restrictions of...

  11. 40 CFR 52.2332 - Control Strategy: Ozone.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control Strategy: Ozone. 52.2332 Section 52.2332 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Utah § 52.2332 Control Strategy...

  12. 40 CFR 52.377 - Control strategy: Ozone.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Control strategy: Ozone. 52.377 Section 52.377 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Connecticut § 52.377 Control strategy: Ozone. (a...

  13. 40 CFR 52.1885 - Control strategy: Ozone.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Ozone. 52.1885 Section 52.1885 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Ohio § 52.1885 Control strategy...

  14. 40 CFR 52.378 - Control strategy: PM10

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Control strategy: PM10 52.378 Section 52.378 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Connecticut § 52.378 Control strategy: PM10 (a) Approval...

  15. 40 CFR 52.1023 - Control strategy: Ozone.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Ozone. 52.1023 Section 52.1023 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Maine § 52.1023 Control strategy...

  16. 40 CFR 52.66 - Control Strategy: Ozone.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Control Strategy: Ozone. 52.66 Section 52.66 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Alabama § 52.66 Control Strategy: Ozone. (a) The...

  17. 40 CFR 52.582 - Control strategy: Ozone.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Control strategy: Ozone. 52.582 Section 52.582 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Georgia> § 52.582 Control strategy: Ozone. (a) Approval...

  18. 40 CFR 52.930 - Control strategy: Ozone.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Control strategy: Ozone. 52.930 Section 52.930 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Kentucky § 52.930 Control strategy: Ozone. (a) The VOC...

  19. 40 CFR 52.350 - Control strategy: Ozone.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Control strategy: Ozone. 52.350 Section 52.350 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Colorado § 52.350 Control strategy: Ozone. (a) Revisions...

  20. 40 CFR 52.476 - Control strategy: ozone.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Control strategy: ozone. 52.476 Section 52.476 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS District of Columbia § 52.476 Control strategy: ozone. (a...

  1. 40 CFR 52.2236 - Control strategy; lead.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy; lead. 52.2236 Section...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Tennessee § 52.2236 Control strategy; lead... on October 6, 1994. These revisions address the requirements necessary to change a lead nonattainment...

  2. 40 CFR 52.58 - Control strategy: Lead.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Control strategy: Lead. 52.58 Section...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Alabama § 52.58 Control strategy: Lead. The lead plan... the lead standard throughout Alabama. The lead plan submitted by the State on October 7, 1985, and...

  3. 40 CFR 52.1375 - Control strategy: Lead.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Lead. 52.1375 Section...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Montana § 52.1375 Control strategy: Lead. Determination—EPA has determined that the East Helena Lead nonattainment area has attained the lead national...

  4. 40 CFR 52.1681 - Control strategy: Lead.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Lead. 52.1681 Section...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) New York § 52.1681 Control strategy: Lead. As part of the attainment demonstration for lead, the State of New York has committed to rate all sources...

  5. 40 CFR 52.65 - Control Strategy: Nitrogen oxides.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Control Strategy: Nitrogen oxides. 52.65 Section 52.65 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Alabama § 52.65 Control Strategy: Nitrogen...

  6. Rethinking Strategies to Select Antibiotic Therapy in Clostridium difficile infection.

    Science.gov (United States)

    Chopra, Teena; Goldstein, Ellie J C; Gorbach, Sherwood L

    2016-12-01

    In recent years, Clostridium difficile infection (CDI) has become a global public health threat associated with increased morbidity, mortality, and economic burden, all of which are exacerbated with disease recurrence. Current guidelines informing treatment decisions are largely based on definitions of disease severity at diagnosis, with subjective components not well delineated across treatment algorithms and clinical trials. Furthermore, there is little evidence linking severity at onset to outcome. However, reducing the risk of recurrence may offer both a better outcome for the individual and decreased downstream economic impact. The authors present data supporting the opinion that patients deemed at low risk for recurrence should receive vancomycin (or metronidazole when cost is an issue), while those at higher risk of recurrence would benefit from fidaxomicin treatment. Although further prospective studies are needed, choosing treatment with the goal of preventing recurrent CDI may offer a better guide than disease severity. © 2016 Pharmacotherapy Publications, Inc.

  7. Cost-Effectiveness of Competing Treatment Strategies for Clostridium difficile Infection: A Systematic Review.

    Science.gov (United States)

    Le, Phuc; Nghiem, Van T; Mullen, Patricia Dolan; Deshpande, Abhishek

    2018-04-01

    BACKGROUND Clostridium difficile infection (CDI) presents a substantial economic burden and is associated with significant morbidity. While multiple treatment strategies have been evaluated, a cost-effective management strategy remains unclear. OBJECTIVE We conducted a systematic review to assess cost-effectiveness analyses of CDI treatment and to summarize key issues for clinicians and policy makers to consider. METHODS We searched PubMed and 5 other databases from inception to August 2016. These searches were not limited by study design or language of publication. Two reviewers independently screened the literature, abstracted data, and assessed methodological quality using the Drummond and Jefferson checklist. We extracted data on study characteristics, type of CDI, treatment characteristics, and model structure and inputs. RESULTS We included 14 studies, and 13 of these were from high-income countries. More than 90% of these studies were deemed moderate-to-high or high quality. Overall, 6 studies used a decision-tree model and 7 studies used a Markov model. Cost of therapy, time horizon, treatment cure rates, and recurrence rates were common influential factors in the study results. For initial CDI, fidaxomicin was a more cost-effective therapy than metronidazole or vancomycin in 2 of 3 studies. For severe initial CDI, 2 of 3 studies found fidaxomicin to be the most cost-effective therapy. For recurrent CDI, fidaxomicin was cost-effective in 3 of 5 studies, while fecal microbiota transplantation (FMT) by colonoscopy was consistently cost-effective in 4 of 4 studies. CONCLUSIONS The cost-effectiveness of fidaxomicin compared with other pharmacologic therapies was not definitive for either initial or recurrent CDI. Despite its high cost, FMT by colonoscopy may be a cost-effective therapy for recurrent CDI. A consensus on model design and assumptions are necessary for future comparison of CDI treatment. Infect Control Hosp Epidemiol 2018;39:412-424.

  8. Staffing and structure of infection prevention and control programs.

    Science.gov (United States)

    Stone, Patricia W; Dick, Andrew; Pogorzelska, Monika; Horan, Teresa C; Furuya, E Yoko; Larson, Elaine

    2009-06-01

    The nature of infection prevention and control is changing; however, little is known about current staffing and structure of infection prevention and control programs. Our objectives were to provide a snapshot of the staffing and structure of hospital-based infection prevention and control programs in the United States. A Web-based survey was sent to 441 hospitals that participate in the National Healthcare Safety Network. The response rate was 66% (n = 289); data were examined on 821 professionals. Infection preventionist (IP) staffing was significantly negatively related to bed size, with higher staffing in smaller hospitals (P hospital epidemiologists were reported to have authority to close beds for outbreaks always or most of the time (n = 225, 78%). Only 32% (n = 92) reported using an electronic surveillance system to track infections. This study is the first to provide a comprehensive description of current infection prevention and control staffing, organization, and support in a select group of hospitals across the nation. Further research is needed to identify effective staffing levels for various hospital types as well as examine how the IP role is changing over time.

  9. Strategies for Prevention of Methicillin Resistant Staphylococcus aureus (MRSA) Infections and Decolonization.

    Science.gov (United States)

    Kaushik, Ashlesha; Wagner, Cassie; Consoer, Hollie; Chatterjee, Archana

    2016-12-01

    Methicillin resistant Staphylococcus aureus (MRSA) invasive infections can be severe in the pediatric population with high morbidity and mortality. MRSA colonization can predispose to recurrent skin and soft tissue infections and invasive MRSA disease and is a frequent challenge faced by clinicians. This article reviews the importance of MRSA as a pathogen, MRSA colonization and various MRSA decolonization strategies. Copyright© South Dakota State Medical Association.

  10. Post-translational modifications are key players of the Legionella pneumophila infection strategy

    Science.gov (United States)

    Michard, Céline; Doublet, Patricia

    2015-01-01

    Post-translational modifications (PTMs) are widely used by eukaryotes to control the enzymatic activity, localization or stability of their proteins. Traditionally, it was believed that the broad biochemical diversity of the PTMs is restricted to eukaryotic cells, which exploit it in extensive networks to fine-tune various and complex cellular functions. During the last decade, the advanced detection methods of PTMs and functional studies of the host–pathogen relationships highlight that bacteria have also developed a large arsenal of PTMs, particularly to subvert host cell pathways to their benefit. Legionella pneumophila, the etiological agent of the severe pneumonia legionellosis, is the paradigm of highly adapted intravacuolar pathogens that have set up sophisticated biochemical strategies. Among them, L. pneumophila has evolved eukaryotic-like and rare/novel PTMs to hijack host cell processes. Here, we review recent progress about the diversity of PTMs catalyzed by Legionella: ubiquitination, prenylation, phosphorylation, glycosylation, methylation, AMPylation, and de-AMPylation, phosphocholination, and de-phosphocholination. We focus on the host cell pathways targeted by the bacteria catalyzed PTMs and we stress the importance of the PTMs in the Legionella infection strategy. Finally, we highlight that the discovery of these PTMs undoubtedly made significant breakthroughs on the molecular basis of Legionella pathogenesis but also lead the way in improving our knowledge of the eukaryotic PTMs and complex cellular processes that are associated to. PMID:25713573

  11. Tuberculosis in Healthcare Workers and Infection Control Measures at Primary Healthcare Facilities in South Africa

    Science.gov (United States)

    Claassens, Mareli M.; van Schalkwyk, Cari; du Toit, Elizabeth; Roest, Eline; Lombard, Carl J.; Enarson, Donald A.; Beyers, Nulda; Borgdorff, Martien W.

    2013-01-01

    Background Challenges exist regarding TB infection control and TB in hospital-based healthcare workers in South Africa. However, few studies report on TB in non-hospital based healthcare workers such as primary or community healthcare workers. Our objectives were to investigate the implementation of TB infection control measures at primary healthcare facilities, the smear positive TB incidence rate amongst primary healthcare workers and the association between TB infection control measures and all types of TB in healthcare workers. Methods One hundred and thirty three primary healthcare facilities were visited in five provinces of South Africa in 2009. At each facility, a TB infection control audit and facility questionnaire were completed. The number of healthcare workers who had had TB during the past three years was obtained. Results The standardised incidence ratio of smear positive TB in primary healthcare workers indicated an incidence rate of more than double that of the general population. In a univariable logistic regression, the infection control audit score was significantly associated with reported cases of TB in healthcare workers (OR=1.04, 95%CI 1.01-1.08, p=0.02) as was the number of staff (OR=3.78, 95%CI 1.77-8.08). In the multivariable analysis, the number of staff remained significantly associated with TB in healthcare workers (OR=3.33, 95%CI 1.37-8.08). Conclusion The high rate of TB in healthcare workers suggests a substantial nosocomial transmission risk, but the infection control audit tool which was used did not perform adequately as a measure of this risk. Infection control measures should be monitored by validated tools developed and tested locally. Different strategies, such as routine surveillance systems, could be used to evaluate the burden of TB in healthcare workers in order to calculate TB incidence, monitor trends and implement interventions to decrease occupational TB. PMID:24098461

  12. Tuberculosis in healthcare workers and infection control measures at primary healthcare facilities in South Africa.

    Science.gov (United States)

    Claassens, Mareli M; van Schalkwyk, Cari; du Toit, Elizabeth; Roest, Eline; Lombard, Carl J; Enarson, Donald A; Beyers, Nulda; Borgdorff, Martien W

    2013-01-01

    Challenges exist regarding TB infection control and TB in hospital-based healthcare workers in South Africa. However, few studies report on TB in non-hospital based healthcare workers such as primary or community healthcare workers. Our objectives were to investigate the implementation of TB infection control measures at primary healthcare facilities, the smear positive TB incidence rate amongst primary healthcare workers and the association between TB infection control measures and all types of TB in healthcare workers. One hundred and thirty three primary healthcare facilities were visited in five provinces of South Africa in 2009. At each facility, a TB infection control audit and facility questionnaire were completed. The number of healthcare workers who had had TB during the past three years was obtained. The standardised incidence ratio of smear positive TB in primary healthcare workers indicated an incidence rate of more than double that of the general population. In a univariable logistic regression, the infection control audit score was significantly associated with reported cases of TB in healthcare workers (OR=1.04, 95%CI 1.01-1.08, p=0.02) as was the number of staff (OR=3.78, 95%CI 1.77-8.08). In the multivariable analysis, the number of staff remained significantly associated with TB in healthcare workers (OR=3.33, 95%CI 1.37-8.08). The high rate of TB in healthcare workers suggests a substantial nosocomial transmission risk, but the infection control audit tool which was used did not perform adequately as a measure of this risk. Infection control measures should be monitored by validated tools developed and tested locally. Different strategies, such as routine surveillance systems, could be used to evaluate the burden of TB in healthcare workers in order to calculate TB incidence, monitor trends and implement interventions to decrease occupational TB.

  13. Backstepping Strategy for Induction Motor Control

    DEFF Research Database (Denmark)

    Rasmussen, Henrik; Vadstrup, P.; Børsting, H.

    2000-01-01

    Using backstepping, which is a recursive nonlinear design method, a novel approach to control of induction motors is developed. The resulting scheme leads to a nonlinear controller for the torque and the amplitude of the field. A combination of nonlinear damping and observer backstepping with a s......Using backstepping, which is a recursive nonlinear design method, a novel approach to control of induction motors is developed. The resulting scheme leads to a nonlinear controller for the torque and the amplitude of the field. A combination of nonlinear damping and observer backstepping...... with a simple flux observer is used in the design. Assuming known motor parameters the design achieves stability with guaranteed region of attraction. It is also shown how a conventional field oriented controller may be obtained by omitting parts of the nonlinear controller....

  14. Pandemic preparedness - Risk management and infection control for all respiratory infection outbreaks.

    Science.gov (United States)

    Nori, Annapurna; Williams, Mary-Anne

    2009-11-01

    There has been substantial effort and activity in regards to pandemic planning, preparedness and response, mainly in the realm of public health. However, general practitioners and other primary care providers are important players in the health response to a pandemic. To discuss the importance of general practice preparedness for managing respiratory infection outbreaks and to provide a model for the general practice response. Pandemic planning and preparedness in general practice is ultimately a crucial risk management exercise, the cornerstone of which is sound infection control. As planning will be significantly aided by, and should extend to, other respiratory outbreaks, we propose a framework for managing outbreaks of respiratory infections with a focus on planned, practised and habitual infection control measures, and a stepwise response according to the extent and severity of the outbreak.

  15. Strategies for reactive power control in wind farms with STATCOM

    Energy Technology Data Exchange (ETDEWEB)

    Diaz Gonzalez, Francisco [Catalonia Institute for Energy Research (IREC), Barcelona (Spain); Martinez-Rojas, Marcela [Centre d' Innovacio Tecnologica en Convertidors Estatics i Accionaments (CITCEA-UPC), Barcelona (Spain). Dept. d' Enginyeria Electrica; Sumper, Andreas; Gomis-Bellmunt, Oriol [Catalonia Institute for Energy Research (IREC), Barcelona (Spain); Centre d' Innovacio Tecnologica en Convertidors Estatics i Accionaments (CITCEA-UPC), Barcelona (Spain). Dept. d' Enginyeria Electrica

    2010-07-01

    This paper presents two strategies for reactive current control in wind farms with STATCOM under fault ride-through (FRT) situations. First, the technical requirements of the Spanish and German grid codes related to the reactive current under FRT situations are presented. Second, STATCOM and its control system are introduced. Third, the modeling done of the wind farm, the STATCOM, and the network are presented. Finally, control strategies for reactive current delivered by the park to the network under FRT situations are shown. The result of the implementation of each control strategy is shown by simulation. (orig.)

  16. Coping with parvovirus infections in mice: health surveillance and control.

    Science.gov (United States)

    Janus, Lydia M; Bleich, Andre

    2012-01-01

    Parvoviruses of mice, minute virus of mice (MVM) and mouse parvovirus (MPV), are challenging pathogens to eradicate from laboratory animal facilities. Due to the impediment on rodent-based research, recent studies have focused on the assessment of re-derivation techniques and parvoviral potential to induce persistent infections. Summarizing recent data, this review gives an overview on studies associated with parvoviral impact on research, diagnostic methods, parvoviral persistence and re-derivation techniques, demonstrating the complex nature of parvovirus infection in mice and unfolding the challenge of controlling parvovirus infections in laboratory animal facilities.

  17. Optimal combinations of control strategies and cost-effective analysis for visceral leishmaniasis disease transmission.

    Directory of Open Access Journals (Sweden)

    Santanu Biswas

    Full Text Available Visceral leishmaniasis (VL is a deadly neglected tropical disease that poses a serious problem in various countries all over the world. Implementation of various intervention strategies fail in controlling the spread of this disease due to issues of parasite drug resistance and resistance of sandfly vectors to insecticide sprays. Due to this, policy makers need to develop novel strategies or resort to a combination of multiple intervention strategies to control the spread of the disease. To address this issue, we propose an extensive SIR-type model for anthroponotic visceral leishmaniasis transmission with seasonal fluctuations modeled in the form of periodic sandfly biting rate. Fitting the model for real data reported in South Sudan, we estimate the model parameters and compare the model predictions with known VL cases. Using optimal control theory, we study the effects of popular control strategies namely, drug-based treatment of symptomatic and PKDL-infected individuals, insecticide treated bednets and spray of insecticides on the dynamics of infected human and vector populations. We propose that the strategies remain ineffective in curbing the disease individually, as opposed to the use of optimal combinations of the mentioned strategies. Testing the model for different optimal combinations while considering periodic seasonal fluctuations, we find that the optimal combination of treatment of individuals and insecticide sprays perform well in controlling the disease for the time period of intervention introduced. Performing a cost-effective analysis we identify that the same strategy also proves to be efficacious and cost-effective. Finally, we suggest that our model would be helpful for policy makers to predict the best intervention strategies for specific time periods and their appropriate implementation for elimination of visceral leishmaniasis.

  18. Infection Control and Prevention: A Review of Hospital-Acquired Infections and the Economic Implications

    OpenAIRE

    Reed, Deoine; Kemmerly, Sandra A.

    2009-01-01

    The Centers for Disease Control and Prevention estimates that 2 million patients suffer from hospital-acquired infections every year and nearly 100,000 of them die. Most of these medical errors are preventable. Hospital-acquired infections result in up to $4.5 billion in additional healthcare expenses annually. The U.S. government has responded to this financial loss by focusing on healthcare quality report cards and by taking strong action to curb healthcare spending. The Medicare Program ha...

  19. Novel Strategies in the Prevention and Treatment of Urinary Tract Infections

    Science.gov (United States)

    Lüthje, Petra; Brauner, Annelie

    2016-01-01

    Urinary tract infections are one of the most common bacterial infections, especially in women and children, frequently treated with antibiotics. The alarming increase in antibiotic resistance is a global threat to future treatment of infections. Therefore, alternative strategies are urgently needed. The innate immune system plays a fundamental role in protecting the urinary tract from infections. Antimicrobial peptides form an important part of the innate immunity. They are produced by epithelial cells and neutrophils and defend the urinary tract against invading bacteria. Since efficient resistance mechanisms have not evolved among bacterial pathogens, much effort has been put into exploring the role of antimicrobial peptides and possibilities to utilize them in clinical practice. Here, we describe the impact of antimicrobial peptides in the urinary tract and ways to enhance the production by hormones like vitamin D and estrogen. We also discuss the potential of medicinal herbs to be used in the prophylaxis and the treatment of urinary tract infections. PMID:26828523

  20. Nitrate control strategies in an activated sludge wastewater treatment process

    Energy Technology Data Exchange (ETDEWEB)

    Shen, Wenhao; Tao, Erpan; Chen, Xiaoquan; Liu, Dawei [South China University of Technology, Guangzhou (China); Liu, Hongbin [Kyung Hee University, Yongin (Korea, Republic of)

    2014-03-15

    We studied nitrate control strategies in an activated sludge wastewater treatment process (WWTP) based on the activated sludge model. Two control strategies, back propagation for proportional-integral-derivative (BP-PID) and adaptive-network based fuzzy inference systems (ANFIS), are applied in the WWTP. The simulation results show that the simple local constant setpoint control has poor control effects on the nitrate concentration control. However, the ANFIS (4*1) controller, which considers not only the local constant setpoint control of the nitrate concentration, but also three important indices in the effluent--ammonia concentration, total suspended sludge concentration and total nitrogen concentration--demonstrates good control performance. The results also prove that ANFIS (4*1) controller has better control performance than that of the controllers PI, BP-PID and ANFIS (2*1), and that the ANFIS (4*1) controller is effective in improving the effluent quality and maintaining the stability of the effluent quality.

  1. Evaluation of bovine viral diarrhoea virus control strategies in dairy herds in Hokkaido, Japan, using stochastic modelling.

    Science.gov (United States)

    Sekiguchi, S; Presi, P; Omori, R; Staerk, K; Schuppers, M; Isoda, N; Yoshikawa, Y; Umemura, T; Nakayama, H; Fujii, Y; Sakoda, Y

    2018-02-01

    Bovine viral diarrhoea virus (BVDV) infection in cattle can result in growth retardation, reduced milk production, reproductive disorders and death. Persistently infected animals are the primary source of infection. In Hokkaido, Japan, all cattle entering shared pastures in summer are vaccinated before movement for disease control. Additionally, these cattle may be tested for BVDV and culled if positive. However, the effectiveness of this control strategy aiming to reduce the number of BVDV-infected animals has not been assessed. The aim of this study was to evaluate the effectiveness of various test-and-cull and/or vaccination strategies on BVDV control in dairy farms in two districts of Hokkaido, Nemuro and Hiyama. A stochastic model was developed to compare the different control strategies over a 10-year period. The model was individual-based and simulated disease dynamics both within and between herds. Parameters included in the model were obtained from the literature, the Hokkaido government and the Japanese Ministry of Agriculture, Forestry and Fisheries. Nine different scenarios were compared as follows: no control, test-and-cull strategies based on antigen testing of either calves or only cattle entering common pastures, vaccination of all adult cattle or only cattle entering shared pastures and combinations thereof. The results indicate that current strategies for BVDV control in Hokkaido slightly reduced the number of BVDV-infected animals; however, alternative strategies such as testing all calves and culling any positives or vaccinating all susceptible adult animals dramatically reduced those. To our knowledge, this is the first report regarding the comparison of the effectiveness between the current strategies in Hokkaido and the alternative strategies for BVDV control measures. © 2017 Blackwell Verlag GmbH.

  2. Awareness of Infection Control Protocols Among Dental Students in Babylon Dental Faculty

    Directory of Open Access Journals (Sweden)

    Khalil Ibraheem Zaidan

    2018-02-01

    Full Text Available Infection control and knowledge of common "infectious diseases" is essential for safe dental practice. Conveyance of infectious diseases is likely "from one individual to another during dental procedures", thorough" blood-borne" viruses and bacteria   "such as hepatitis" , human immunodeficiency virus (HIV. Thence in dental practice, the  sterilization and particular protection  is of most importance Process in  dental procedures,  and patient sponsor settings seek specific strategies guide to prevent the  transmission of diseases among dental students , oral verdure care staffs and their patients. Aim: Current study highlight  the methods and behavior  to evaluate  the  benefits of awareness, stance and pursuit of infection control between dental students in training dental clinic at Babylon  dental collage . Materials and Methods: A cross-sectional wipe using a rear ordered questionnaire was executed. The reconnaissance consisted of 38 closed-ended questions that included the key areas of infection control, including hand hygiene, personal preservation, sterilization and disinfection and ecological infection monitoring. There were also questions to elicit perceptions regarding the treatment of HBV and HIV/AIDS patients. Results: Survey study was done for dental students replied to the reconnaissance. Their situation and realization across infection control in college teaching  clinic .The results were assorted between 100% were orderly using gloves and 96% mask   with patient to 6% were orderly wore eye glasses. The type of sterilization of instrument was 90% autoclave and 10% oven and from analysis of data revealed most teaching clinics devoid of instruction post about control of infection control measures   Conclusion: "Improved compliance with recommended infection control procedures is required for all dentists" and graduated dental students  predestined in the existing project. Enduring instruction "programs and short

  3. Glycerin-Based Hydrogel for Infection Control.

    Science.gov (United States)

    Stout, Edward I; McKessor, Angie

    2012-02-01

    Infection is a major problem in the health and wellbeing of patients in hospitals, nursing homes, and other medical facilities as well as the homecare patients and the general public. According to Scientia Advisors, wound care costs the healthcare system over $7 billion in 2009. After adding the cost associated with potential complications such as infections, extended physician care, and lengthy hospital stays, the annual wound care expenditures well exceeded over $20 billion. 1 There are 20 million reported cases of diabetes per year and more every day. Because of the fact that leg ulcers are the number one health problem of men coupled with the rise in drug resistance of infections, the importance of providing the professional and the public with relatively simple and affordable wound care is of extreme importance. Often the wounds can become chronic wounds, which then result in long-term nursing expense in time and supplies or, worse yet, can result in expensive amputations ranging from $5000 to $40,000 per patient. There are many dressing options now available for treating wounds with components such as glycerin, honey, salt, and many other natural products, with some dressings being more appropriate than others. In 1988, a patented glycerin-based dressing was introduced to the market, called Elasto-Gel™. 2. Elasto-Gel™ is a glycerin-based gel sheet (65%) combined with a hydrophilic polymer that causes the sheet to absorb the exudate from the wound and simultaneously release the glycerin from the gel, which adds many benefits to the wound for excellent healing outcomes. The gel sheet is 1/8th of an inch thick with a four-way stretch backing. It has the ability to absorb 3-4 times its own weight of fluids. The dressing will not dry out or allow the exudate to dry out, thus keeping the dressing from becoming bonded to the wound or the surrounding tissue. It does not have adhesive properties and, therefore, will not cause damage to the wound bed or periwound

  4. Influence of different disease control pesticide strategies on multiple pesticide residue levels in apple

    DEFF Research Database (Denmark)

    Poulsen, Mette Erecius; Naef, A.; Gasser, S.

    2009-01-01

    Seven pesticide application strategies were investigated to control apple scab (Venturia inaequalis) and powdery mildew (Podosphaera leucotricha) and, at the same time.. fulfil the new quality standards implemented by some German retailers. These demand that pesticide residues should be below 80....... The trials were conducted at two sites in Switzerland, in 2007, and all strategies and applications were in accordance with actual practice. Four replicates of apple samples from each strategy were then analysed for pesticide residues. The incidence of infection with apple scab and powdery mildew were...... monitored during the season in order to evaluate the efficacy of the different strategies. The efficacies of the different strategies against apple scab and powdery mildew were between 84% and 100% successful. In general, the level of pesticide residues found correlated with application rate and time...

  5. Compressor Load Stand: Commissioning and Control Strategies

    National Research Council Canada - National Science Library

    Causey, Andrew

    1998-01-01

    .... The purpose of this research project was to commission this load stand, which includes setting up the hardware, setting up a control system, a data acquisition system, and an automatic test sequence system...

  6. Fusion instrumentation and control: a development strategy

    International Nuclear Information System (INIS)

    Hsu, P.Y.; Greninger, R.C.; Longhurst, G.R.; Madden, P.

    1981-01-01

    We have examined requirements for a fusion instrumentation and control development program to determine where emphasis is needed. The complex, fast, and closely coupled system dynamics of fusion reactors reveal a need for a rigorous approach to the development of instrumentation and control systems. A framework for such a development program should concentrate on three principal need areas: the operator-machine interface, the data and control system architecture, and fusion compatible instruments and sensors. System dynamics characterization of the whole fusion reactor system is also needed to facilitate the implementation process in each of these areas. Finally, the future need to make the instrumentation and control system compatible with the requirements of a commercial plant is met by applying transition technology. These needs form the basis for the program tasks suggested

  7. Construction machine control guidance implementation strategy.

    Science.gov (United States)

    2010-07-01

    Machine Controlled Guidance (MCG) technology may be used in roadway and bridge construction to improve construction efficiencies, potentially resulting in reduced project costs and accelerated schedules. The technology utilizes a Global Positioning S...

  8. Strategies to control vehicular emissions: Indian scenario

    Energy Technology Data Exchange (ETDEWEB)

    Virupaksha, T. [Central Institute of Road Transport, Pune (India)

    2002-07-01

    The paper presents a common urban transport policy framework to protect the local and global environment and a state-of-the-art review of recommendations and measures suggested by the local administration in Indian cities from time to time. The measures to combat pollution in urban areas is identified by different cities but there is no cohesive strategy for implementing them. The pursuit of some of these measures are that the haphazard and piecemeal measures have not helped to gain optimum benefit possible or to make a discernible impact on mobility demand and vehicular emissions. A more practical strategy is required to reduce both emission and congestion, using a mixed set of instruments. The instruments are taxes on fuels, vehicles, and parking, incentives and regulations affecting vehicle ownership, usage and movement, traffic management more importantly encouraging non-motorized transport like bicycles by providing suitable lanes. Some of the policy measures seriously needed to be implemented to reduce ongoing pollution menace are enforcing higher maintenance standards, introducing vehicles designed to meet stricter emission standards, retrofitting vehicles to use other kinds of clean fuel, reducing urban congestion through transport management measures, scrapping highly polluting and high usage vehicles, and strengthening institutional links and regulatory issues. 5 refs., 1 tab.

  9. Control Strategies for Guided Collective Motion

    Science.gov (United States)

    2015-02-27

    J.K. Parrish , “Oscillator models and collective motion,” IEEE Control Systems Magzine, Vol. 27, 2007, pp. 89-105. [18] S. H. Strogatz , “From Kuramoto...Automatic Control, 54(2), 2009, pp. 353-357. [21] H. Hong and S. H. Strogatz , “Kuramoto Model of Coupled Oscillators with Positive and Negative...2013) provided similar results by utilizing a modified Kuramoto model ( Strogatz (2000)). Paley (2008) proposed a Lyapunov-based design methodology to

  10. Strategies for controlling acid rain: economic considerations

    International Nuclear Information System (INIS)

    Forster, B.A.; Crocker, T.D.

    1992-01-01

    There are two competing approaches to reducing pollution such as the acid rain precursors SOsub(2) and NOsub(x). In the command and control approach, pollution control legislation may dictate the technological method by which specified pollution reductions are to be achieved. A key feature of command-and-control regulations is their inflexibility. The alternative approach relies on market mechanisms and incentives to induce firms to reduce pollution voluntarily. Economists generally prefer this approach because it permits flexibility for firms in selecting abatement methods to minimize costs. This chapter deals with qualitative issues in determining and achieving an ''optimal'' pollution level using various taxes, subsidies or quantitative restrictions. Alternative permit schemes for achieving regional pollution control are considered. Statistical studies are discussed which compare the command-and-control approach with the economic incentives approach and show that there are substantial cost differences between them in most cases. Finally, some institutional factors, that may lead to more costly acid rain control schemes being selected, are examined. A list of 61 references is appended. (UK)

  11. Patient safety and infection control: bases for curricular integration.

    Science.gov (United States)

    Silva, Andréa Mara Bernardes da; Bim, Lucas Lazarini; Bim, Felipe Lazarini; Sousa, Alvaro Francisco Lopes; Domingues, Pedro Castania Amadio; Nicolussi, Adriana Cristina; Andrade, Denise de

    2018-05-01

    To analyze curricular integration between teaching of patient safety and good infection prevention and control practices. Integrative review, designed to answer the question: "How does curricular integration of content about 'patient safety teaching' and content about 'infection prevention and control practices' occur in undergraduate courses in the health field?". The following databases were searched for primary studies: CINAHL, LILACS, ScienceDirect, Web of Science, Scopus, Europe PMC and MEDLINE. The final sample consisted of 13 studies. After content analysis, primary studies were grouped into two subject categories: "Innovative teaching practices" and "Curricular evaluation. Patient safety related to infection prevention and control practices is present in the curriculum of health undergraduate courses, but is not coordinated with other themes, is taught sporadically, and focuses mainly on hand hygiene.

  12. Control strategies for friction dampers: numerical assessment and experimental investigations.

    Directory of Open Access Journals (Sweden)

    Coelho H.T.

    2014-01-01

    Full Text Available The use of friction dampers has been proposed in a wide variety of mechanical systems for which it is not possible to apply viscoelastic materials, fluid based dampers or others viscous dampers. An important example is the application of friction dampers in aircraft engines to reduce the blades vibration amplitudes. In most cases, friction dampers have been studied in a passive way, however, a significant improvement can be achieved by controlling the normal force in the dampers. The aim of this paper is to study three control strategies for friction dampers based on the hysteresis cycle. The first control strategy maximizes the energy removal in each harmonic oscillation cycle, by calculating the optimum normal force based on the last displacement peak. The second control strategy combines the first one with the maximum energy removal strategy used in the smart spring devices. Finally, is presented the strategy which homogenously modulates the friction force. Numerical studies were performed with these three strategies defining the performance metrics. The best control strategy was applied experimentally. The experimental test rig was fully identified and its parameters were used for the numerical simulations. The obtained results show the good performance for the friction damper and the selected strategy.

  13. A reduced energy supply strategy in active vibration control

    Science.gov (United States)

    Ichchou, M. N.; Loukil, T.; Bareille, O.; Chamberland, G.; Qiu, J.

    2011-12-01

    In this paper, a control strategy is presented and numerically tested. This strategy aims to achieve the potential performance of fully active systems with a reduced energy supply. These energy needs are expected to be comparable to the power demands of semi-active systems, while system performance is intended to be comparable to that of a fully active configuration. The underlying strategy is called 'global semi-active control'. This control approach results from an energy investigation based on management of the optimal control process. Energy management encompasses storage and convenient restitution. The proposed strategy monitors a given active law without any external energy supply by considering purely dissipative and energy-demanding phases. Such a control law is offered here along with an analysis of its properties. A suboptimal form, well adapted for practical implementation steps, is also given. Moreover, a number of numerical experiments are proposed in order to validate test findings.

  14. A reduced energy supply strategy in active vibration control

    International Nuclear Information System (INIS)

    Ichchou, M N; Loukil, T; Bareille, O; Chamberland, G; Qiu, J

    2011-01-01

    In this paper, a control strategy is presented and numerically tested. This strategy aims to achieve the potential performance of fully active systems with a reduced energy supply. These energy needs are expected to be comparable to the power demands of semi-active systems, while system performance is intended to be comparable to that of a fully active configuration. The underlying strategy is called 'global semi-active control'. This control approach results from an energy investigation based on management of the optimal control process. Energy management encompasses storage and convenient restitution. The proposed strategy monitors a given active law without any external energy supply by considering purely dissipative and energy-demanding phases. Such a control law is offered here along with an analysis of its properties. A suboptimal form, well adapted for practical implementation steps, is also given. Moreover, a number of numerical experiments are proposed in order to validate test findings

  15. Integrated control programmes for schistosomiasis and other helminth infections in P.R. China.

    Science.gov (United States)

    Xu, Jing; Xu, Jun-Fang; Li, Shi-Zhu; Zhang, Li-Juan; Wang, Qiang; Zhu, Hui-Hui; Zhou, Xiao-Nong

    2015-01-01

    The prevalence of human schistosomiasis and soil-transmitted helminthiasis (STH) has decreased significantly in the People's Republic of China (P.R. China), particularly after 2005 when the national control programmes were reinforced by forming of integrated control strategies. Furthermore, social-economic development also contributed to the decrease of schistosome and soil-transmitted helminth infections. The prevalence of the zoonotic helminthiasis, including clonorchiasis and echinococcosis, on the other hand, is either underestimated or has in fact increased due to changes in social and environmental factors. In comparison with the control strategies in force and their effects on those four kinds of helminthiasis, the challenges and control priorities for the potential transfer from control to elimination of each disease is reviewed, to provide evidence for policy-makers to act upon. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Hydrocarbon control strategies for gasoline marketing operations

    Energy Technology Data Exchange (ETDEWEB)

    Norton, R.L.; Sakaida, R.R.; Yamada, M.M.

    1978-05-01

    This informational document provides basic and current descriptions of gasoline marketing operations and methods that are available to control hydrocarbon emissions from these operations. The three types of facilities that are described are terminals, bulk plants, and service stations. Operational and business trends are also discussed. The potential emissions from typical facilities, including transport trucks, are given. The operations which lead to emissions from these facilities include (1) gasoline storage, (2) gasoline loading at terminals and bulk plants, (3) gasoline delivery to bulk plants and service stations, and (4) the refueling of vehicles at service stations. Available and possible methods for controlling emissions are described with their estimated control efficiencies and costs. This report also includes a bibliography of references cited in the text, and supplementary sources of information.

  17. FACTS device control strategy using PMU

    Directory of Open Access Journals (Sweden)

    Mohd Tauseef Khan

    2016-09-01

    Full Text Available The laying and commissioning of new transmission line is very difficult due to socio-economic problems, like environmental clearances, right of way, etc. Therefore, there is an emphasis on better utilization of available transmission infrastructure. FACTS devices can provide reactive power compensation, transmission capability enhancement, and voltage and stability improvement. FACTS devices operate under the command of system operator who analyses its demand by the data acquired through traditional SCADA system, state estimation algorithms and PMUs. SCADA together with PMU give accurate information about the operational state of power system. This paper proposes a scheme to automate the FACTS devices in collaboration with PMUs in a more efficient way. Highly precised data from PMUs can be fed to intelligent controllers for effective analyzing and automating the FACTS device through control command. Thus, this combination can provide real time control of reactive power, together with enhancement of power handling capability and stability improvement.

  18. Control Plane Strategies for Elastic Optical Networks

    DEFF Research Database (Denmark)

    Turus, Ioan

    Networks (EONs) concept is proposed as a solution to enable a more flexible handling of the optical capacity and allows an increase of available capacity over the existing optical infrastructure. One main requirement for enabling EONs is to have a flexible spectrum structure (i.e.Flex-Grid) which allows...... the spectrum to be used as an on-demand resource. Flex-Grid raises new challenges for controlling the dynamic spectrum slots environment. This thesis addresses, as part of the Celtic project “Elastic Optical Networks” (EONet), the control of Flex-Grid architectures by extending the capabilities of a GMPLS...... (Generalized Multi-Protocol Label Switching)-based control framework in accordance with existing IETF standards and recommendations. The usual approach of extending capacity in transport networks by incrementally adding more optical resources results in a very inefficient usage and determines a high power...

  19. Infection control practice in private dental laboratories in Riyadh

    International Nuclear Information System (INIS)

    AlKheraif, Abdulaziz A; Mobarak, Fahmy A

    2008-01-01

    In view of the risk of infection of dental health care workers and patients, interruption of possible chains of infection is to be demanded. The objective of this study was to assess infection control practice in private dental laboratories in Riyadh City, Kingdom of Saudi Arabia. The study was conducted on thirty-two private dental laboratories in Riyadh City regarding infection control practiced by these laboratories. The instrument of the study consisted of ten open-ended questions that were asked from the laboratories directors. A large percentage of the surveyed laboratories (87.5 %) did not implement any infection control protocol during their practice. The mean number of impressions received per week was 16. Most of the surveyed laboratories (90.6 %) had no way of communication with the clinics regarding the disinfection procedures. The results indicated that 62.5 % of the laboratories reported that they were aware that they may get infection from non-disinfected items. Only a small percentage (6.2%) of the laboratories added disinfecting agent to pumice slurry. Wearing laboratory coats was reported by 75% of the laboratory workers. The use of gloves during work was reported by 59.3% of the laboratories while 56.2% reported the use protective eyewear. Only 21.8% of the laboratories use face masks during work. Construction of infection control manuals that contain updated and recommended guidelines to ensure aseptic practice in private dental laboratories is highly recommended. Also, a way of communication between dentists and dental technicians regarding disinfection of laboratory items should be strongly encouraged. (author)

  20. Advanced control strategies for a drill rig

    International Nuclear Information System (INIS)

    Banerjee, A.; Hiller, M.; Fink, B.

    1996-01-01

    The construction of tunnels is usually undertaken using a combination of blasting and drilling to achieve rock excavation. Easy handling and high accuracy, and thus greater efficiency, in drilling rigs is an essential ingredient of successful competition in the market place. This article describes a cartesian control concept used for a twin boom drill rig. This simplifies the handling of a drilling boom, reduces the duration of a working cycle and increases security. A remote control system has been added to the drill rig to support the operator working in complicated environments. (UK)

  1. Discrete Current Control Strategy of Permanent Magnet Synchronous Motors

    Directory of Open Access Journals (Sweden)

    Yan Dong

    2013-01-01

    Full Text Available A control strategy of permanent magnet synchronous motors (PMSMs, which is different from the traditional vector control (VC and direct torque control (DTC, is proposed. Firstly, the circular rotating magnetic field is analyzed on the simplified model and discredited into stepping magnetic field. The stepping magnetomotive force will drive the rotor to run as the stepping motor. Secondly, the stator current orientation is used to build the control model instead of rotor flux orientation. Then, the discrete current control strategy is set and adopted in positioning control. Three methods of the strategy are simulated in computer and tested on the experiment platform of PMSM. The control precision is also verified through the experiment.

  2. A new inertia weight control strategy for particle swarm optimization

    Science.gov (United States)

    Zhu, Xianming; Wang, Hongbo

    2018-04-01

    Particle Swarm Optimization is a member of swarm intelligence algorithms, which is inspired by the behavior of bird flocks. The inertia weight, one of the most important parameters of PSO, is crucial for PSO, for it balances the performance of exploration and exploitation of the algorithm. This paper proposes a new inertia weight control strategy and PSO with this new strategy is tested by four benchmark functions. The results shows that the new strategy provides the PSO with better performance.

  3. Post-infection immunodeficiency virus control by neutralizing antibodies.

    Directory of Open Access Journals (Sweden)

    Hiroyuki Yamamoto

    Full Text Available BACKGROUND: Unlike most acute viral infections controlled with the appearance of virus-specific neutralizing antibodies (NAbs, primary HIV infections are not met with such potent and early antibody responses. This brings into question if or how the presence of potent antibodies can contribute to primary HIV control, but protective efficacies of antiviral antibodies in primary HIV infections have remained elusive; and, it has been speculated that even NAb induction could have only a limited suppressive effect on primary HIV replication once infection is established. Here, in an attempt to answer this question, we examined the effect of passive NAb immunization post-infection on primary viral replication in a macaque AIDS model. METHODS AND FINDINGS: The inoculums for passive immunization with simian immunodeficiency virus mac239 (SIVmac239-specific neutralizing activity were prepared by purifying polyclonal immunoglobulin G from pooled plasma of six SIVmac239-infected rhesus macaques with NAb induction in the chronic phase. Passive immunization of rhesus macaques with the NAbs at day 7 after SIVmac239 challenge resulted in significant reduction of set-point plasma viral loads and preservation of central memory CD4 T lymphocyte counts, despite the limited detection period of the administered NAb responses. Peripheral lymph node dendritic cell (DC-associated viral RNA loads showed a remarkable peak with the NAb administration, and DCs stimulated in vitro with NAb-preincubated SIV activated virus-specific CD4 T lymphocytes in an Fc-dependent manner, implying antibody-mediated virion uptake by DCs and enhanced T cell priming. CONCLUSIONS: Our results present evidence indicating that potent antibody induction post-infection can result in primary immunodeficiency virus control and suggest direct and indirect contribution of its absence to initial control failure in HIV infections. Although difficulty in achieving requisite neutralizing titers for

  4. On Control Strategies for Responsive Architectural Structures

    DEFF Research Database (Denmark)

    Kirkegaard, Poul Henning; Parigi, Dario

    2012-01-01

    The present paper considers control of responsive architectural structures for improvement of structural performance by recognizing changes in their environments and loads, adapting to meet goals, and using past events to improve future performance or maintain serviceability. The general scope of...

  5. Host fishes and infection strategies of freshwater mussels in large Mobile Basin streams, USA

    Science.gov (United States)

    Wendell R. Haag; Melvin L. Warren

    2003-01-01

    We investigated host fishes, timing and modes of glochidial release, and host-attraction strategies for 7 species of freshwater mussels from the Buttahatchee and Sipsey rivers (Mobile Basin), Alabama and Mississippi, USA. We determined hosts as fish species that produced juvenile mussels from laboratory-induced glochidial infections. We established the following...

  6. Locus of control and learning strategies as predictors of academic ...

    African Journals Online (AJOL)

    The aim of the research was to determine the relationships which exist between academic success, learning strategies and locus of control. In order to achieve this aim a small-scale quantitative study, utilising two inventories, was done. The first measuring instrument is the Learning and Study Strategies Inventory, which is ...

  7. 40 CFR 52.2585 - Control strategy: Ozone.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Ozone. 52.2585... strategy: Ozone. (a) Disapproval—On November 6, 1986, the Wisconsin Department of Natural Resources... would not be necessary to offset growth in emissions. (h) Approval—On November 15, 1993, the Wisconsin...

  8. 40 CFR 52.1534 - Control strategy: Ozone.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Ozone. 52.1534 Section 52.1534 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... strategy: Ozone. (a) Revisions to the State Implementation Plan submitted by the New Hampshire Department...

  9. 40 CFR 52.2235 - Control strategy: Ozone.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Ozone. 52.2235 Section 52.2235 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... strategy: Ozone. (a) Determination—EPA is determining that, as of August 8, 1995, the Nashville ozone...

  10. 40 CFR 52.1129 - Control strategy: Ozone.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Ozone. 52.1129 Section 52.1129 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... strategy: Ozone. (a) Revisions to the State Implementation Plan submitted by the Massachusetts Department...

  11. 40 CFR 52.1576 - Control strategy: Nitrogen dioxide.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Nitrogen dioxide. 52.1576 Section 52.1576 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... strategy: Nitrogen dioxide. (a) The requirements of § 52.14(c)(3) of this chapter as of May 8, 1974 (39 FR...

  12. The rectal microbiota of cats infected with feline immunodeficiency virus infection and uninfected controls.

    Science.gov (United States)

    Weese, J S; Nichols, J; Jalali, M; Litster, A

    2015-10-22

    Rectal swabs were collected from 31 cats, 16 with FIV infection and 15 uninfected controls, to evaluate and compare the rectal bacterial microbiota in cats with feline immunodeficiency virus (FIV) infection and uninfected controls. The rectal microbiota was characterized via next generation sequencing of 16S rRNA gene (V4 region) polymerase chain reaction products. Eighteen different phyla were identified. Firmicutes dominated in both groups, followed by Proteobacteria and Actinobacteria, but there were no significant differences between groups. When predominant orders are compared, FIV-infected cats had significant higher median relative abundances of Bifidobacteriales (P=0.022), Lactobacillales (P=0.022) and Aeromonadales (P=0.043). No differences were identified in the 50 most common genera when adjusted for false discovery rate. There were significant differences in community membership (Jaccard index, unifrac P=0.008, AMOVA P<0.001) and community structure (Yue&Clayton index, unifrac P=0.03, AMOVA P=0.005) between groups. However, only one metacommunity (enterotype) was identified. The rectal microbiota differed between cats with FIV infection and uninfected controls. Some of the changes that were noted have been associated with 'dysbiosis' and proinflammatory states in other species, so it is possible that subclinical alteration in the intestinal microbiota could influence the health of FIV-infected cats. Evaluation of the reasons for microbiota alteration and the potential impact on cat health is required. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. [Infection control and safety culture in German hospitals].

    Science.gov (United States)

    Hansen, Sonja; Schwab, Frank; Gropmann, Alexander; Behnke, Michael; Gastmeier, Petra

    2016-07-01

    Healthcare-associated infections (HAI) are the most frequent adverse events in the healthcare setting and their prevention is an important contribution to patient safety in hospitals. To analyse to what extent safety cultural aspects with relevance to infection control are implemented in German hospitals. Safety cultural aspects of infection control were surveyed with an online questionnaire; data were analysed descriptively. Data from 543 hospitals with a median of [IQR] 275 [157; 453] beds were analysed. Almost all hospitals (96.6 %) had internal guidelines for infection control (IC) in place; 82 % defined IC objectives, most often regarding hand hygiene (HH) (93 %) and multidrug resistant organisms (72 %) and less frequently for antibiotic stewardship (48 %) or prevention of specific HAI. In 94 % of hospitals, a reporting system for adverse events was in place, which was also used to report low compliance with HH, outbreaks and Clostridium difficile-associated infections. Members of the IC team were most often seen to hold daily responsibility for IC in the hospital, but rarely other hospital staff (94 versus 19 %). Safety cultural aspects are not fully implemented in German hospitals. IC should be more strongly implemented in healthcare workers' daily routine and more visibly supported by hospital management.

  14. Infection control resources in New York State hospitals, 2007.

    Science.gov (United States)

    Stricof, Rachel L; Schabses, Karolina A; Tserenpuntsag, Boldtsetseg

    2008-12-01

    In July 2005, New York State legislation requiring the mandatory reporting of specific hospital-associated infections (HAIs) was passed by the legislature and signed by the governor. In an effort to measure the impact of this legislation on infection control resources, the New York State Department of Health (NYSDOH) conducted a baseline survey in March 2007. This report presents an overview of the methods and results of this survey. An electronic survey of infection control resources and responsibilities was conducted by the NYSDOH on their secure data network. The survey contained questions regarding the number and percent time for infection prevention and control professional (ICP) and hospital epidemiologist (HE) staff members, ICP/HE educational background and certification, infection control program support services, activities and responsibilities of infection prevention and control program staff, and estimates of time dedicated to various activities, including surveillance. Practitioners in 222 of 224 acute care hospitals (99%) responded. The average number of ICPs per facility depended on the average daily census of acute care beds and ranged from a mean of 0.64 full-time equivalent (FTE) ICP in facilities with an average daily census of or = 900 beds. Averaging the ICP resources over the health care settings for which they were responsible revealed that the "average full-time ICP" was responsible for 151 acute care facility beds, 1.3 intensive care units (ICUs) (average, 16 ICU beds), 21 long-term care facility beds, 0.6 dialysis centers, 0.5 ambulatory surgery centers, 4.8 ambulatory/outpatient clinics, and 1.1 private practice offices. The ICPs reported that 45% of their time is dedicated to surveillance. Other activities for which ICPs reported at least partial responsibility include staff education, quality assurance, occupational health, emergency preparedness, construction, central supply/processing, and risk management. This survey was designed to

  15. Measuring the quality of infection control in Dutch nursing homes using a standardized method; the Infection prevention RIsk Scan (IRIS)

    NARCIS (Netherlands)

    Willemsen, I.; Nelson-Melching, J.; Hendriks, Y.; Mulders, A.; Verhoeff, S.; Kluytmans-Vandenbergh, M.; Kluytmans, J.

    2014-01-01

    BACKGROUND: We developed a standardised method to assess the quality of infection control in Dutch Nursing Home (NH), based on a cross-sectional survey that visualises the results. The method was called the Infection control RIsk Infection Scan (IRIS). We tested the applicability of this new tool in

  16. Gorbachev’s Arms Control Strategy.

    Science.gov (United States)

    1987-01-22

    on- site inspection for verifying nuclear tests as well as for dismantling missiles on Soviet territory. Clearlv Gorbachev wants an arms , -4- control...bring its seismological test equipment to what he called the "holy of holies", the area adjoining the Soviet proving ground near Semipalatinsk to offer...prenotification and observation of military exercises including on- site inspection on Soviet territory. But on the big issues--- nuclear testing , strategic weapons

  17. Evaluation of control strategies in forming processes

    Directory of Open Access Journals (Sweden)

    Calmano Stefan

    2015-01-01

    Full Text Available Products of forming processes are subject to quality fluctuations due to uncertainty in semi-finished part properties as well as process conditions and environment. An approach to cope with these uncertainties is the implementation of a closed-loop control taking into account the actual product properties measured by sensors or estimated by a mathematical process model. Both methods of uncertainty control trade off with a financial effort. In case of sensor integration the effort is the cost of the sensor including signal processing as well as the design and manufacturing effort for integration. In case of an estimation model the effort is mainly determined by the time and knowledge needed to derive the model, identify the parameters and implement the model into the PLC. The risk of mismatch between model and reality as well as the risk of wrong parameter identification can be assumed as additional uncertainty (model uncertainty. This paper evaluates controlled and additional uncertainty by taking into account process boundary conditions like the degree of fluctuations in semi-finished part properties. The proposed evaluation is demonstrated by the analysis of exemplary processes.

  18. Controlled Human Infection for Vaccination Against Streptococcus Pyogenes

    Science.gov (United States)

    2018-04-26

    Streptococcus Pyogenes Pharyngitis; Streptococcus Pharyngitis; Strep Throat; Streptococcus Pyogenes Infection; Group A Streptococcus: B Hemolytic Pharyngitis; Group A Streptococcal Infection; Gram-Positive Bacterial Infections; Bacterial Infections

  19. Improving Walkability Through Control Strategies at Signalized Intersections

    Science.gov (United States)

    2017-01-01

    As cities and communities nationwide seek to develop Complete Streets that foster livability and accommodate all modes, signal timing control strategies that include pedestrians in the operational decision process are gaining importance. This researc...

  20. Implementation strategy for the ITER plasma control system

    International Nuclear Information System (INIS)

    Winter, A.; Ambrosino, G.; Bauvir, B.; De Tommasi, G.; Humphreys, D.A.; Mattei, M.; Neto, A.; Raupp, G.; Snipes, J.A.; Stephen, A.V.; Treutterer, W.; Walker, M.L.; Zabeo, L.

    2015-01-01

    This paper gives an overview of the scope and context of the CODAC high-level real-time applications (Supervision and Plasma Control) and presents the strategy and current state of design of the tools to support the implementation. A real-time framework, which is currently under development with strong support of the worldwide fusion community will not only support the implementation of plasma control strategies with the extensive exception handling and forecasting functionality foreseen for ITER, but also integrated commissioning, orchestration and supervision as well as the real-time needs of ITER plant system developers. A second cornerstone in the implementation strategy is the development of a powerful simulation environment (Plasma Control System Simulation Platform – PCSSP) to design and verify control strategies, event handling and orchestration and automation. The development of PCSSP is currently under contract and this paper will also give an overview of its current state of development.

  1. 40 CFR 52.728 - Control strategy: Nitrogen dioxide. [Reserved

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Control strategy: Nitrogen dioxide. [Reserved] 52.728 Section 52.728 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR...: Nitrogen dioxide. [Reserved] ...

  2. Implementation strategy for the ITER plasma control system

    Energy Technology Data Exchange (ETDEWEB)

    Winter, A., E-mail: axel.winter@iter.org [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St Paul Lez Durance Cedex (France); Ambrosino, G. [CREATE/Università di Napoli Federico II, Dip. Ingegneria Elettrica e delle Tecnologie dell’Informazione (Italy); Bauvir, B. [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St Paul Lez Durance Cedex (France); De Tommasi, G. [CREATE/Università di Napoli Federico II, Dip. Ingegneria Elettrica e delle Tecnologie dell’Informazione (Italy); Humphreys, D.A. [General Atomics, San Diego, CA (United States); Mattei, M. [CREATE/Seconda Università di Napoli, Dip. Ingegneria Industriale e dell’Informazione (Italy); Neto, A. [Fusion for Energy, Barcelona (Spain); Raupp, G. [Max Planck Institute for Plasma Physics, EURATOM Association, Garching (Germany); Snipes, J.A. [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St Paul Lez Durance Cedex (France); Stephen, A.V. [Culham Centre for Fusion Energy, Culham Science Centre, Abingdon (United Kingdom); Treutterer, W. [Max Planck Institute for Plasma Physics, EURATOM Association, Garching (Germany); Walker, M.L. [General Atomics, San Diego, CA (United States); Zabeo, L. [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St Paul Lez Durance Cedex (France)

    2015-10-15

    This paper gives an overview of the scope and context of the CODAC high-level real-time applications (Supervision and Plasma Control) and presents the strategy and current state of design of the tools to support the implementation. A real-time framework, which is currently under development with strong support of the worldwide fusion community will not only support the implementation of plasma control strategies with the extensive exception handling and forecasting functionality foreseen for ITER, but also integrated commissioning, orchestration and supervision as well as the real-time needs of ITER plant system developers. A second cornerstone in the implementation strategy is the development of a powerful simulation environment (Plasma Control System Simulation Platform – PCSSP) to design and verify control strategies, event handling and orchestration and automation. The development of PCSSP is currently under contract and this paper will also give an overview of its current state of development.

  3. Aerodynamic load control strategy of wind turbine in microgrid

    Science.gov (United States)

    Wang, Xiangming; Liu, Heshun; Chen, Yanfei

    2017-12-01

    A control strategy is proposed in the paper to optimize the aerodynamic load of the wind turbine in micro-grid. In grid-connection mode, the wind turbine adopts a new individual variable pitch control strategy. The pitch angle of the blade is rapidly given by the controller, and the pitch angle of each blade is fine tuned by the weight coefficient distributor. In islanding mode, according to the requirements of energy storage system, a given power tracking control method based on fuzzy PID control is proposed. Simulation result shows that this control strategy can effectively improve the axial aerodynamic load of the blade under rated wind speed in grid-connection mode, and ensure the smooth operation of the micro-grid in islanding mode.

  4. Novel strategies for control of fermentation processes

    DEFF Research Database (Denmark)

    Mears, Lisa; Stocks, Stuart; Sin, Gürkan

    Bioprocesses are inherently sensitive to fluctuations in processing conditions and must be tightly regulated to maintain cellular productivity. Industrial fermentations are often difficult to replicate across production sites or between facilities as the small operating differences in the equipment...... of a fermentation. Industrial fermentation processes are typically operated in fed batch mode, which also poses specific challenges for process monitoring and control. This is due to many reasons including non-linear behaviour, and a relatively poor understanding of the system dynamics. It is therefore challenging...

  5. A tool to assess knowledge, attitude and behavior of Indonesian health care workers regarding infection control.

    Science.gov (United States)

    Duerink, D O; Hadi, U; Lestari, E S; Roeshadi, Djoko; Wahyono, Hendro; Nagelkerke, N J D; Van der Meulen, R G; Van den Broek, P J

    2013-07-01

    to investigate knowledge, attitude and behaviour toward infection control in two teaching hospitals on the island of Java by means of a questionnaire and to evaluate the use of the questionnaire as a tool. we investigated knowledge, attitude and behaviour toward infection control in two teaching hospitals on the island of Java by means of a questionnaire to identify problem areas, barriers and facilitators. The target was to include at least 50% of all health care workers (physicians, nurses, assistant nurses and infection control nurses) in each hospital, department and profession. Differences between demographic variables and scores for individual questions and groups of questions were compared using the chi-square statistic and analysis of variance and Spearman's rho was used to test for correlations between knowledge, attitude, self-reported behaviour and perceived obstacles. more than half of the health care workers of the participating departments completed the questionnaire. Of the 1036 respondents (44% nurses, 37% physicians and 19% assistant nurses), 34% were vaccinated against hepatitis B, 77% had experienced needle stick accidents and 93% had been instructed about infection control. The mean of the correct answers to the knowledge questions was 44%; of the answers to the attitude questions 67% were in agreement with the correct attitude; obstacles to compliance with infection control guidelines were perceived in 30% of the questions and the mean self-reported compliance was 63%. Safe handling of sharps, hand hygiene and the use of personal protective equipment were identified as the most important aspects for interventions. Significant positive correlations were found between knowledge, attitude, self-reported behaviour and perceived obstacles. the questionnaire in conjunction with site visits and interviews was a valuable strategy to identify trouble spots in the hospitals and to determine barriers to facilitators of change that should be taken into

  6. Why sensitive bacteria are resistant to hospital infection control.

    Science.gov (United States)

    van Kleef, Esther; Luangasanatip, Nantasit; Bonten, Marc J; Cooper, Ben S

    2017-01-01

    Large reductions in the incidence of antibiotic-resistant strains of Staphylococcus aureus and Clostridium difficile have been observed in response to multifaceted hospital-based interventions. Reductions in antibiotic-sensitive strains have been smaller or non-existent. It has been argued that since infection control measures, such as hand hygiene, should affect resistant and sensitive strains equally, observed changes must have largely resulted from other factors, including changes in antibiotic use. We used a mathematical model to test the validity of this reasoning. We developed a mechanistic model of resistant and sensitive strains in a hospital and its catchment area. We assumed the resistant strain had a competitive advantage in the hospital and the sensitive strain an advantage in the community. We simulated a hospital hand hygiene intervention that directly affected resistant and sensitive strains equally. The annual incidence rate ratio (IRR) associated with the intervention was calculated for hospital- and community-acquired infections of both strains. For the resistant strain, there were large reductions in hospital-acquired infections (0.1 ≤ IRR ≤ 0.6) and smaller reductions in community-acquired infections (0.2 ≤ IRR ≤ 0.9). These reductions increased in line with increasing importance of nosocomial transmission of the strain. For the sensitive strain, reductions in hospital acquisitions were much smaller (0.6 ≤ IRR ≤ 0.9), while community acquisitions could increase or decrease (0.9 ≤ IRR ≤ 1.2). The greater the importance of the community environment for the transmission of the sensitive strain, the smaller the reductions. Counter-intuitively, infection control interventions, including hand hygiene, can have strikingly discordant effects on resistant and sensitive strains even though they target them equally. This follows from differences in their adaptation to hospital- and community-based transmission. Observed lack of

  7. Strategies for the photo-control of endogenous protein activity.

    Science.gov (United States)

    Brechun, Katherine E; Arndt, Katja M; Woolley, G Andrew

    2017-08-01

    Photo-controlled or 'optogenetic' effectors interfacing with endogenous protein machinery allow the roles of endogenous proteins to be probed. There are two main approaches being used to develop optogenetic effectors: (i) caging strategies using photo-controlled conformational changes, and (ii) protein relocalization strategies using photo-controlled protein-protein interactions. Numerous specific examples of these approaches have been reported and efforts to develop general methods for photo-control of endogenous proteins are a current focus. The development of improved screening and selection methods for photo-switchable proteins would advance the field. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Comparison of Power Control Strategies for DFIG Wind Turbines

    DEFF Research Database (Denmark)

    Teodorescu, Remus; Luna, A.; Rodríguez, P.

    2008-01-01

    The classical control techniques for regulating the active and reactive power delivery in doubly fed induction generators (DFIG), for wind power applications, are normally based on voltage oriented control (VOC) strategies. Among these algorithms, those that work in a synchronous reference frame...... VOC strategy able to control the operation of a DFIG in the αβ reference frame, with no need of flux position estimation, something that conducts to a more simple and robust algorithm. In order to evaluate the advantages of this new control proposal, namely VOC-RRF, their performance will be compared...

  9. Control Strategies for DFIG Wind Turbines Under Grid Fault

    DEFF Research Database (Denmark)

    Luna, Alvara; Rolan, A.; Medeiros, G.

    2009-01-01

    The classical control techniques for regulating the active and reactive power delivery in doubly fed induction generators (DFIG), for wind power applications, are normally based on voltage oriented control (VOC) strategies. Among these algorithms, those that work in a synchronous reference frame...... VOC strategy able to control the operation of a DFIG in the αβ reference frame, with no need of flux position estimation, something that conducts to a more simple and robust algorithm. In order to evaluate the advantages of this new control proposal, namely VOC-RRF, their performance will be compared...

  10. Control strategies for VSC-based HVDC transmission system

    DEFF Research Database (Denmark)

    Stan, Ana-Irina; Stroe, Daniel Ioan; Silva, Rodrigo Da

    2011-01-01

    Throughout this paper the modeling and control of the VSC-based HVDC systems are investigated and described. Two different control methods capable of controlling such systems are proposed. Both developed control strategies are implemented in the dq synchronous reference frame. In order to analyze...... the behavior of the developed VSC-based HVDC transmission system two study cases are carried out using MATLAB/Simulink. The results obtained from simulations show acceptable performances, of the proposed strategies, when changes in the reference parameters are considered. The active power flow between...

  11. Control and Protection Cooperation Strategy for Voltage Instability

    DEFF Research Database (Denmark)

    Liu, Zhou; Chen, Zhe; Sun, Haishun

    2012-01-01

    Most cascaded blackouts are caused by unexpected backup relay operations due to low voltage or overload state caused by post fault load restoration dynamics. If such state can be sensed and adjusted appropriately prior to those relay actions, system stability might be sustained. This paper proposed...... a control and protection cooperation strategy to prevent post fault voltage instability. The multi-agent technology is applied for the strategy implementation; the criteria based on wide area measured apparent impedances are defined to choose the control strategy, such as tap changer adjusting or load...

  12. Infection control in anaesthesia in regional, tertiary and central ...

    African Journals Online (AJOL)

    2012-09-10

    Sep 10, 2012 ... Describe how self-inflating resuscitation bags (Ambu®) are decontamined? Question 8. Do you feel that you have enough time between each case to adequately clean anaesthetic equipment and still perform your other duties? Table II: Definitions and classifications used in infection control practices.

  13. Role of antibodies in controlling dengue virus infection

    NARCIS (Netherlands)

    van der Schaar, Hilde M.; Wilschut, Jan C.; Smit, Jolanda M.

    The incidence and disease burden of arthropod-borne flavivirus infections have dramatically increased during the last decades due to major societal and economic changes, including massive urbanization, lack of vector control, travel, and international trade. Specifically, in the case of dengue virus

  14. Knowledge, attitude, and infection control practices of two tertiary ...

    African Journals Online (AJOL)

    2014-04-02

    Apr 2, 2014 ... This study assessed the effects of the implementation of the policy in a tertiary hospital in Port Harcourt, ... malpractice suit in developing countries, not only for the ... Infection control policy has however been shown to reduce the burden of ..... SSIs‑activities that mirror the plan‑do‑check‑act that is applied in ...

  15. Control of pestivirus infections in the management of wildlife populations

    Science.gov (United States)

    The lack of host-specificity allow pestiviruses to infect domestic livestock as well as captive and free-ranging wildlife, posing unique challenges to different stakeholders. While current control measures for bovine viral diarrhea virus (BVDV) are focused only on cattle, increased attention on the ...

  16. Risk control of surgical site infection after cardiothoracic surgery

    NARCIS (Netherlands)

    Segers, P.; de Jong, A. P.; Kloek, J. J.; Spanjaard, L.; de Mol, B. A. J. M.

    2006-01-01

    The purpose of this prospective study was to investigate whether a risk control programme based on risk assessment, new treatment modalities and the presence of a surveillance programme reduces the incidence of surgical site infections (SSI). Between January 2001 and December 2003, 167 patients were

  17. Impact of an Infection Control Program on the Prevalence of Nosocomial Infections at a Tertiary Care Center in Switzerland

    OpenAIRE

    Ebnöther, Corina; Tanner, Beate; Schmid, Flavia; Rocca, Vittoria La; Heinzer, Ivo; Bregenzer, Thomas

    2017-01-01

    Objective. To study the impact of a multimodal infection control program on the rate of nosocomial infections at a 550-bed tertiary care center. Methods. Before and after the implementation of an infection control program, the rate of nosocomial infection was recorded in time-interval prevalence studies. Hand hygiene compliance was studied before and after the intervention. As a surrogate marker of compliance, the amount of alcohol-based hand rub consumed before the intervention was compared ...

  18. Control of Maillard Reactions in Foods: Strategies and Chemical Mechanisms.

    Science.gov (United States)

    Lund, Marianne N; Ray, Colin A

    2017-06-14

    Maillard reactions lead to changes in food color, organoleptic properties, protein functionality, and protein digestibility. Numerous different strategies for controlling Maillard reactions in foods have been attempted during the past decades. In this paper, recent advances in strategies for controlling the Maillard reaction and subsequent downstream reaction products in food systems are critically reviewed. The underlying mechanisms at play are presented, strengths and weaknesses of each strategy are discussed, and reasonable reaction mechanisms are proposed to reinforce the evaluations. The review includes strategies involving addition of functional ingredients, such as plant polyphenols and vitamins, as well as enzymes. The resulting trapping or modification of Maillard targets, reactive intermediates, and advanced glycation endproducts (AGEs) are presented with their potential unwanted side effects. Finally, recent advances in processing for control of Maillard reactions are discussed.

  19. UAV Robust Strategy Control Based on MAS

    Directory of Open Access Journals (Sweden)

    Jian Han

    2014-01-01

    Full Text Available A novel multiagent system (MAS has been proposed to integrate individual UAV (unmanned aerial vehicle to form a UAV team which can accomplish complex missions with better efficiency and effect. The MAS based UAV team control is more able to conquer dynamic situations and enhance the performance of any single UAV. In this paper, the MAS proposed and established combines the reacting and thinking abilities to be an initiative and autonomous hybrid system which can solve missions involving coordinated flight and cooperative operation. The MAS uses BDI model to support its logical perception and to classify the different missions; then the missions will be allocated by utilizing auction mechanism after analyzing dynamic parameters. Prim potential algorithm, particle swarm algorithm, and reallocation mechanism are proposed to realize the rational decomposing and optimal allocation in order to reach the maximum profit. After simulation, the MAS has been proved to be able to promote the success ratio and raise the robustness, while realizing feasibility of coordinated flight and optimality of cooperative mission.

  20. Perceptions of Clostridium difficile infections among infection control professionals in Taiwan.

    Science.gov (United States)

    Hung, Yuan-Pin; Lee, Jen-Chieh; Lin, Hsiao-Ju; Chiu, Chun-Wei; Wu, Jia-Ling; Liu, Hsiao-Chieh; Huang, I-Hsiu; Tsai, Pei-Jane; Ko, Wen-Chien

    2017-08-01

    High Clostridium difficile colonization and infection rates among hospitalized patients had been noted in Taiwan. Nevertheless, the cognition about clinical diagnosis and management of CDI among infection control professionals in Taiwan is not clear. A 24-item survey questionnaire about the diagnosis, therapy, or infection control policies toward CDI was distributed in the annual meeting of the Infectious Disease Society of Taiwan (IDST) in October 2015 and Infectious Control Society of Taiwan (ICST) in April 2016. Totally 441 individuals responded to the survey, and 280 (63.5%) participants would routinely monitor the prevalence of CDI and 347 (78.7%) reported the formulation of infection control policies of CDI in their hospital, including contact precaution (75.7%), wearing gloves (88.9%) or dressing (80.0%) at patient care, single room isolation (49.7%), preference of soap or disinfectant-based sanitizer (83.2%) and avoidance of alcohol-based sanitizer (63.3%), and environmental disinfection with 1000 ppm bleach (87.1%). For the timing of contact precaution discontinuation isolation for CDI patients, most (39.9%) participants suggested the time point of the absence of C. difficile toxin in feces. To treat mild CDI, most (61.9%) participants preferred oral metronidazole, and for severe CDI 26.1% would prescribe oral vancomycin as the drug of choice. There were substantial gaps in infection control polices and therapeutic choices for CDI between international guidelines and the perceptions of medical professionals in Taiwan. Professional education program and the setup of guideline for CDI should be considered in Taiwan. Copyright © 2017. Published by Elsevier B.V.

  1. Uniform-related infection control practices of dental students

    Directory of Open Access Journals (Sweden)

    Aljohani Y

    2017-04-01

    Full Text Available Yazan Aljohani,1 Mohammed Almutadares,1 Khalid Alfaifi,1 Mona El Madhoun,1 Maysoon H Albahiti,2 Nadia Al-Hazmi3 1Internship Program, Faculty of dentistry, King Abdulaziz University, 2Department of Endodontics, King Abdulaziz University, 3Department of Oral Biology, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia Background: Uniform-related infection control practices are sometimes overlooked and underemphasized. In Saudi Arabia, personal protective equipment must meet global standards for infection control, but the country’s Islamic legislature also needs to be taken into account. Aim: To assess uniform-related infection control practices of a group of dental students in a dental school in Saudi Arabia and compare the results with existing literature related to cross-contamination through uniforms in the dental field. Method: A questionnaire was formulated and distributed to dental students at King Abdulaziz University Faculty of Dentistry in Jeddah, Saudi Arabia, which queried the students about their uniform-related infection control practices and their methods and frequency of laundering and sanitizing their uniforms, footwear, and name tags. Results: There is a significant difference between genders with regard to daily uniform habits. The frequency of uniform washing was below the standard and almost 30% of students were not aware of how their uniforms are washed. Added to this, there is no consensus on a unified uniform for male and female students. Conclusion: Information on preventing cross-contamination through wearing uniforms must be supplied, reinforced, and emphasized while taking into consideration the cultural needs of the Saudi society. Keywords: cross-contamination, infection control, dental students, uniforms

  2. Infection Prevention Strategy in Hospitals in the Era of Community-Associated Methicillin-Resistant Staphylococcus aureus in the Asia-Pacific Region: A Review.

    Science.gov (United States)

    Cho, Sun Young; Chung, Doo Ryeon

    2017-05-15

    Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has emerged as an important cause of healthcare-associated infection. CA-MRSA clones have replaced classic hospital MRSA clones in many countries and have shown higher potential in transmission and virulence than hospital MRSA clones. In particular, the emergence of CA-MRSA in the Asia-Pacific region is concerning owing to insufficient infection control measures in the region. The old strategies for infection prevention and control of MRSA comprised adherence to standard precaution and policy of active screening of MRSA carriers and decolonization, and it has been controversial which strategy is better in terms of outcome and cost-effectiveness. Epidemiological changes in MRSA has made the development of infection prevention strategy more complicated. Based on the literature review and the questionnaire survey, we considered infection prevention strategies for healthcare settings in the Asia-Pacific region in the era of CA-MRSA. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  3. Control of HIV infection by IFN-α: implications for latency and a cure.

    Science.gov (United States)

    Bourke, Nollaig M; Napoletano, Silvia; Bannan, Ciaran; Ahmed, Suaad; Bergin, Colm; McKnight, Áine; Stevenson, Nigel J

    2018-03-01

    Viral infections, including HIV, trigger the production of type I interferons (IFNs), which in turn, activate a signalling cascade that ultimately culminates with the expression of anti-viral proteins. Mounting evidence suggests that type I IFNs, in particular IFN-α, play a pivotal role in limiting acute HIV infection. Highly active anti-retroviral treatment reduces viral load and increases life expectancy in HIV positive patients; however, it fails to fully eliminate latent HIV reservoirs. To revisit HIV as a curable disease, this article reviews a body of literature that highlights type I IFNs as mediators in the control of HIV infection, with particular focus on the anti-HIV restriction factors induced and/or activated by IFN-α. In addition, we discuss the relevance of type I IFN treatment in the context of HIV latency reversal, novel therapeutic intervention strategies and the potential for full HIV clearance.

  4. Aggressive active case detection: a malaria control strategy based on the Brazilian model.

    Science.gov (United States)

    Macauley, Cameron

    2005-02-01

    Since 1996, the Brazilian Ministry of Health has adopted a malaria control strategy known as aggressive active case detection (AACD) in which most or all members of every community are tested and treated for malaria on a monthly basis. The strategy attempts to identify and treat cases of asymptomatic malaria, which, if untreated, continue to transmit the infection. Malaria remains uncontrolled because almost all health care systems in the world rely on passive case detection: the treatment of only symptomatic cases of malaria. Research has shown conclusively that asymptomatic cases exist in any population where malaria transmission is stable and incidence is high: therefore passive case detection simply will not succeed in breaking the cycle of transmission. Numerous case studies show that malaria has been successfully controlled on a regional or national level by mass blood surveys. AACD is an effective malaria control strategy if used in conjunction with other methods, especially when (1) an effective treatment exists, (2) influx of potential carriers of the infection can be monitored, and (3) people are inclined to cooperate with monthly blood testing. AACD requires access to rapid diagnostic tests (RDTs), microscopy supplies, extensive human resources, and prompt, affordable, and effective treatment. AACD is compared to PCD in terms of clinical efficacy and cost effectiveness in a case study of malaria in the Brazilian Yanomami Indians. Where it is feasible, AACD could drastically reduce the incidence of malaria and should be an integral part of the World Health Organization's Roll Back Malaria strategy.

  5. Latent M. tuberculosis infection--pathogenesis, diagnosis, treatment and prevention strategies.

    Science.gov (United States)

    Druszczyńska, Magdalena; Kowalewicz-Kulbat, Magdalena; Fol, Marek; Włodarczyk, Marcin; Rudnicka, Wiesława

    2012-01-01

    One third of the earths population is infected with Mycobacterium tuberculosis (Mtb), but only 5-10% of the infected individuals develop active tuberculosis (TB) over their lifetime. The remaining 90-95% stay healthy and are called latently infected individuals. They are the biggest reservoir of the tubercle bacilli and identifying the cases of latent TB is a part of the global plan of TB control. From the clinical point of view detection of latent TB infections (LTBI) in individuals with the highest active TB risk including cases of HIV infection, autoimmune inflammatory diseases or cancer, is a priority. This review summarizes the recent findings in the pathogenesis of latent TB, its diagnosis, treatment and prevention.

  6. Predictors of certification in infection prevention and control among infection preventionists: APIC MegaSurvey findings.

    Science.gov (United States)

    Kalp, Ericka L; Harris, Jeanette J; Zawistowski, Grace

    2018-06-06

    The 2015 APIC MegaSurvey was completed by 4,078 members to assess infection prevention practices. This study's purpose was to examine MegaSurvey results to relate infection preventionist (IP) certification status with demographic characteristics, organizational structure, compensation benefits, and practice and competency factors. Descriptive statistics were used to examine population characteristics and certification status. Bivariate logistic regression was performed to evaluate relationships between independent variables and certification status. Variables demonstrating statistical significance (P Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  7. Optimized Control Strategy For Over Loaded Offshore Wind Turbines

    DEFF Research Database (Denmark)

    Odgaard, Peter Fogh; Knudsen, Torben; Wisniewski, Rafal

    2015-01-01

    controller tuning for a given wind turbine. It also enables a very safe and robust comparison between a new control strategy and the present one. Main body of abstract Is it true that power de-rating indeed the best way to reduce loads? The power de-rating approach has the drawback of only indirectly...

  8. Strategies for controlling pollution from vehicular emissions in Beijing

    International Nuclear Information System (INIS)

    Wang, Qidong; He, Kebin; Li, Tiejun; Fu, Lixin

    2002-01-01

    The paper describes the severe situation of vehicular emission in Beijing and discusses the following mitigation strategies: Improving fuel quality, controlling the exhaust from new vehicles, controlling the emissions from vehicles in use through e.g. Inspection Maintenance (I/M), renovating in-use vehicles and scrapping of old vehicles and road infrastructure and traffic policies. (Author)

  9. Oxygen uptake rate (OUR) control strategy for improving avermectin B

    African Journals Online (AJOL)

    Glucose metabolism plays a crucial role in the process of avermectin B1a biosynthesis. Controlling glucose feeding based on oxygen uptake rate (OUR) was established to improve the efficiency of avermectin B1a production. The result showed that avermectin B1a production was greatly enhanced by OUR control strategy.

  10. 40 CFR 52.1126 - Control strategy: Sulfur oxides.

    Science.gov (United States)

    2010-07-01

    ... Department of Environmental Quality Engineering.). Gardner State Hospital, Gardner. Grafton State Hospital... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Sulfur oxides. 52... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Massachusetts § 52.1126 Control...

  11. Plant-wide Control Strategy for Improving Produced Water Treatment

    DEFF Research Database (Denmark)

    Yang, Zhenyu; Pedersen, Simon; Løhndorf, Petar Durdevic

    2016-01-01

    This work focuses on investigation and development of an innovative Produced Water Treatment (PWT) technology for offshore oil & gas production by employing the model-based plant-wide control strategy. The key contributions lie in two folds: (i) the advanced anti-slug analysis and control...

  12. Novel deadbeat power control strategy for grid connected systems

    Directory of Open Access Journals (Sweden)

    Yousry Atia

    2015-09-01

    Full Text Available This paper introduces a novel approach for power control of three phase voltage source inverter (VSI in grid connected distribution generation system. In this approach, the control of active and reactive power is based on deadbeat control strategy. First, the difference between the reference and actual currents are introduced in different approach. Then current to power substitutions are carried out to obtain direct relationship between the required inverter voltage and instantaneous power errors. There is no need for coordinate transformation or PLL, where the required inverter voltage vector calculations carried out in α–β stationary reference frame. The proposed technique introduces two cross coupling components in the control function. Including these two components, the controller can achieve nearly zero steady-state tracking error of the controlled variables. To obtain fixed switching frequency operations, space vector modulation (SVM is used to synthesize the required inverter voltage vector and to generate the switching pulses for the VSI. The proposed strategy has the simplicity of the direct power control (DPC technique and doesn’t require any current control loops. The proposed strategy is experimentally implemented using fixed-point microcontroller. Simulation and experimental results are presented to confirm the superiority of the proposed strategy.

  13. Strategies for controlling pollution from vehicular emissions in Beijing

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Qidong; He, Kebin; Li, Tiejun; Fu, Lixin

    2002-07-01

    The paper describes the severe situation of vehicular emission in Beijing and discusses the following mitigation strategies: Improving fuel quality, controlling the exhaust from new vehicles, controlling the emissions from vehicles in use through e.g. Inspection Maintenance (I/M), renovating in-use vehicles and scrapping of old vehicles and road infrastructure and traffic policies. (Author)

  14. Short Horizon Control Strategies for an Alternating Activated Sludge Process

    DEFF Research Database (Denmark)

    Isaacs, Steven Howard

    1996-01-01

    Three control strategies allowing improved operational flexibility of an alternating type activated sludge process are presented in a unified model based framework. The control handles employed are the addition rate of an external carbon source to denitrification, the cycle length, and the dissol...

  15. Parasitism performance and fitness of Cotesia vestalis (Hymenoptera: Braconidae infected with Nosema sp. (Microsporidia: Nosematidae: implications in integrated pest management strategy.

    Directory of Open Access Journals (Sweden)

    Nadia Kermani

    Full Text Available The diamondback moth (DBM Plutella xylostella (L. has traditionally been managed using synthetic insecticides. However, the increasing resistance of DBM to insecticides offers an impetus to practice integrated pest management (IPM strategies by exploiting its natural enemies such as pathogens, parasitoids, and predators. Nevertheless, the interactions between pathogens and parasitoids and/or predators might affect the effectiveness of the parasitoids in regulating the host population. Thus, the parasitism rate of Nosema-infected DBM by Cotesia vestalis (Haliday (Hym., Braconidae can be negatively influenced by such interactions. In this study, we investigated the effects of Nosema infection in DBM on the parasitism performance of C. vestalis. The results of no-choice test showed that C. vestalis had a higher parasitism rate on non-infected host larvae than on Nosema-treated host larvae. The C. vestalis individuals that emerged from Nosema-infected DBM (F1 and their progeny (F2 had smaller pupae, a decreased rate of emergence, lowered fecundity, and a prolonged development period compared to those of the control group. DBM infection by Nosema sp. also negatively affected the morphometrics of C. vestalis. The eggs of female C. vestalis that developed in Nosema-infected DBM were larger than those of females that developed in non-infected DBM. These detrimental effects on the F1 and F2 generations of C. vestalis might severely impact the effectiveness of combining pathogens and parasitoids as parts of an IPM strategy for DBM control.

  16. Infection prevention and control measures for acute respiratory infections in healthcare settings: an update.

    Science.gov (United States)

    Seto, W H; Conly, J M; Pessoa-Silva, C L; Malik, M; Eremin, S

    2013-01-01

    Viruses account for the majority of the acute respiratory tract infections (ARIs) globally with a mortality exceeding 4 million deaths per year. The most commonly encountered viruses, in order of frequency, include influenza, respiratory syncytial virus, parainfluenza and adenovirus. Current evidence suggests that the major mode of transmission of ARls is through large droplets, but transmission through contact (including hand contamination with subsequent self-inoculation) and infectious respiratory aerosols of various sizes and at short range (coined as "opportunistic" airborne transmission) may also occur for some pathogens. Opportunistic airborne transmission may occur when conducting highrisk aerosol generating procedures and airborne precautions will be required in this setting. General infection control measures effective for all respiratory viral infections are reviewed and followed by discussion on some of the common viruses, including severe acute respiratory syndrome (SARS) coronavirus and the recently discovered novel coronavirus.

  17. Comparative strategies and success of sympatric and allopatric Fasciola hepatica infecting Galba truncatula of different susceptibilities.

    Science.gov (United States)

    Sanabria, R; Mouzet, R; Courtioux, B; Vignoles, P; Rondelaud, D; Dreyfuss, G; Cabaret, J; Romero, J

    2013-06-01

    Allopatric infections of French Galba truncatula with an Argentinean isolate of Fasciola hepatica were carried out to determine the infectivity of foreign miracidia in three snail populations differing by their susceptibility to French miracidia (two highly and one poorly susceptible populations). Sympatric infections of G. truncatula with French miracidia were used as controls. Compared to sympatric infections of G. truncatula, snail survival at day 30 post-infection in allopatric groups was significantly lower in a highly susceptible population and significantly greater in the other two. Prevalence in snails infected with the allopatric isolate was significantly lower (16.4-34.5 % instead of 58.6-72.1 %), whereas their patent period was significantly longer (a mean of 69.9-85.9 days instead of 6.4-20.7 days). The mean number of metacercariae was also higher in allopatric groups (236.5-897.3 per cercariae-shedding snail instead of 70.7-222.1). Owing to longer patent periods, the Argentinean isolate of F. hepatica was less pathogenic for these snails. The lower prevalence of infection, the longer patent period and the higher number of metacercariae noted in allopatric groups might be the consequence of an adaptive mechanism used by this digenean introduced to the New World to infect new populations of unusual intermediate hosts.

  18. A new control strategy for nuclear power reactors

    International Nuclear Information System (INIS)

    Wakabayashi, H.; Sasaki, K.; Takegaki, M.

    1990-01-01

    A new automatic direct digital control strategy for nuclear power reactors is presented. It is based on a simple control logic of comparison between the available time (the time for the error signal to disappear) and the required time (the time for the time derivative to match that of the target trend). The method aims to control the system to an acceptable state within a minimum time under a number of restraints. The control capability of the method is shown for two typical transients. This method is generally applicable to process control in which time-optimal control based on the maximum principle is sought

  19. Adaptive Landing Gear: Optimum Control Strategy and Potential for Improvement

    Directory of Open Access Journals (Sweden)

    Grzegorz Mikułowski

    2009-01-01

    Full Text Available An adaptive landing gear is a landing gear (LG capable of active adaptation to particular landing conditions by means of controlled hydraulic force. The objective of the adaptive control is to mitigate the peak force transferred to the aircraft structure during touch-down, and thus to limit the structural fatigue factor. This paper investigates the ultimate limits for improvement due to various strategies of active control. Five strategies are proposed and investigated numerically using a~validated model of a real, passive landing gear as a reference. Potential for improvement is estimated statistically in terms of the mean and median (significant peak strut forces as well as in terms of the extended safe sinking velocity range. Three control strategies are verified experimentally using a laboratory test stand.

  20. Regulatory controls for NORM contamination: Emerging issues and strategies

    International Nuclear Information System (INIS)

    Wennerberg, Linda

    1992-01-01

    Naturally occurring and accelerator-produced radioactive material (NORM) faces the increasing likelihood of federal or state regulatory control. Public concern and limited preliminary survey data fuel the debate over the necessity, approach, and jurisdiction of a NORM regulatory strategy. This debate requires the resolution of technical controversies and potentially competing state and federal agency interests. An additional facet of the debate is the impact of regulation upon traditionally non-nuclear industries, such as oil and gas production. Regulatory response has been initiated in several states, such as Louisiana's controls on equipment used in oil and gas production, to control specific industrial activities which generate NORM. A more comprehensive, generic federal strategy to control NORM contamination is also under review by the Environmental Protection Agency. This paper will detail the emerging technical issues, federal and state regulatory strategies under consideration, and evaluate the efficacy of selected regulatory approaches. (author)

  1. Structural and process factors affecting the implementation of antimicrobial resistance prevention and control strategies in U.S. hospitals.

    Science.gov (United States)

    Chou, Ann F; Yano, Elizabeth M; McCoy, Kimberly D; Willis, Deanna R; Doebbeling, Bradley N

    2008-01-01

    To address increases in the incidence of infection with antimicrobial-resistant pathogens, the National Foundation for Infectious Diseases and Centers for Disease Control and Prevention proposed two sets of strategies to (a) optimize antibiotic use and (b) prevent the spread of antimicrobial resistance and control transmission. However, little is known about the implementation of these strategies. Our objective is to explore organizational structural and process factors that facilitate the implementation of National Foundation for Infectious Diseases/Centers for Disease Control and Prevention strategies in U.S. hospitals. We surveyed 448 infection control professionals from a national sample of hospitals. Clinically anchored in the Donabedian model that defines quality in terms of structural and process factors, with the structural domain further informed by a contingency approach, we modeled the degree to which National Foundation for Infectious Diseases and Centers for Disease Control and Prevention strategies were implemented as a function of formalization and standardization of protocols, centralization of decision-making hierarchy, information technology capabilities, culture, communication mechanisms, and interdepartmental coordination, controlling for hospital characteristics. Formalization, standardization, centralization, institutional culture, provider-management communication, and information technology use were associated with optimal antibiotic use and enhanced implementation of strategies that prevent and control antimicrobial resistance spread (all p prevention and control (p support these organizational processes. These findings suggest concrete strategies for evaluating current capabilities to implement effective practices and foster and sustain a culture of patient safety.

  2. An optimal control strategies using vaccination and fogging in dengue fever transmission model

    Science.gov (United States)

    Fitria, Irma; Winarni, Pancahayani, Sigit; Subchan

    2017-08-01

    This paper discussed regarding a model and an optimal control problem of dengue fever transmission. We classified the model as human and vector (mosquito) population classes. For the human population, there are three subclasses, such as susceptible, infected, and resistant classes. Then, for the vector population, we divided it into wiggler, susceptible, and infected vector classes. Thus, the model consists of six dynamic equations. To minimize the number of dengue fever cases, we designed two optimal control variables in the model, the giving of fogging and vaccination. The objective function of this optimal control problem is to minimize the number of infected human population, the number of vector, and the cost of the controlling efforts. By giving the fogging optimally, the number of vector can be minimized. In this case, we considered the giving of vaccination as a control variable because it is one of the efforts that are being developed to reduce the spreading of dengue fever. We used Pontryagin Minimum Principle to solve the optimal control problem. Furthermore, the numerical simulation results are given to show the effect of the optimal control strategies in order to minimize the epidemic of dengue fever.

  3. The role of education in the prevention and control of infection: a review of the literature.

    Science.gov (United States)

    Ward, Deborah J

    2011-01-01

    This paper discusses a literature review which was undertaken prior to a research study about student nurses' and midwives' experiences of learning infection control in clinical practice. Its aim is to identify the role of education in the prevention and control of infection, with a specific focus on compliance with infection control precautions and reduction in infection rates. It also identifies the methods used for teaching infection control. The review concludes that there is no rigorous and convincing evidence that education improves compliance with infection control precautions or reduces rates of infection, particularly in the long-term. Areas for future research are identified. 2010 Elsevier Ltd. All rights reserved.

  4. Mission impossible or border security – Practical and effective infection control on air ambulances

    Directory of Open Access Journals (Sweden)

    M. Kuhn*

    2013-12-01

    These principles have been applied to our air ambulance system based from Lanseria International Airport. By combining preventative and control measures, there has been no breach in our infection control strategies, as evidenced by no growth noted on specific and random swabs even when more and more ”super bugs” are being identified in hospital. As an air ambulance service flying patients from various African countries, we have the responsibility to conduct our own ”Border Security” to keep our hospitals, patients, aircraft and crews clean and safe. In this presentation we will share our ”Border Security” principles and experiences with the audience.

  5. Management of aortic graft infections - the present strategy and future perspectives.

    Science.gov (United States)

    Treska, V; Certik, B; Molacek, J

    2016-01-01

    Aortic graft infections (AGI) are serious complications of open and endovascular types of surgery with an incidence rate of 0.6-3 %. AGI are associated with 30-60 % perioperative mortality and 40-60 % morbidity rate with limb amputation rates between 10 % and 40 %. The economic cost of AGI is substantial. At the time of aortic reconstruction, almost 90 % of patients have one or more predisposing factors for AGI. The diagnosis is based on clinical symptomatology, laboratory markers, microbial cultures, and imaging modalities. The general principle of surgical treatment lies in the removal of infected graft, debridement of infected periprosthetic tissues, and vascular reconstruction by in situ or extra-anatomic bypass with long-term antibiotic therapy. The conservative treatment is used only for selected patients with endograft infection. This review summarizes the current knowledge about the incidence, predisposing factors, etiology, diagnosis, treatment options, and prevention of aortic vascular graft and endograft infections. With the growing number of endovascular procedures we can expect more cases of infected aortic endografts in patients with severe comorbidities in the near future, where the recent radical surgical approach (graft excision, debridement, and new revascularization) cannot be used. Therefore the less invasive, sophisticated and individualized treatment strategies will have to be used in search of the best therapeutic approach to each specific patient (Fig. 4, Ref. 82).

  6. Japanese encephalitis virus infection, diagnosis and control in domestic animals.

    Science.gov (United States)

    Mansfield, Karen L; Hernández-Triana, Luis M; Banyard, Ashley C; Fooks, Anthony R; Johnson, Nicholas

    2017-03-01

    Japanese encephalitis virus (JEV) is a significant cause of neurological disease in humans throughout Asia causing an estimated 70,000 human cases each year with approximately 10,000 fatalities. The virus contains a positive sense RNA genome within a host-derived membrane and is classified within the family Flaviviridae. Like many flaviviruses, it is transmitted by mosquitoes, particularly those of the genus Culex in a natural cycle involving birds and some livestock species. Spill-over into domestic animals results in a spectrum of disease ranging from asymptomatic infection in some species to acute neurological signs in others. The impact of JEV infection is particularly apparent in pigs. Although infection in adult swine does not result in symptomatic disease, it is considered a significant reproductive problem causing abortion, still-birth and birth defects. Infected piglets can display fatal neurological disease. Equines are also infected, resulting in non-specific signs including pyrexia, but occasionally leading to overt neurological disease that in extreme cases can lead to death. Veterinary vaccination is available for both pigs and horses. This review of JEV disease in livestock considers the current diagnostic techniques available for detection of the virus. Options for disease control and prevention within the veterinary sector are discussed. Such measures are critical in breaking the link to zoonotic transmission into the human population where humans are dead-end hosts. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  7. Randomized controlled trials for influenza drugs and vaccines: a review of controlled human infection studies

    Directory of Open Access Journals (Sweden)

    Shobana Balasingam

    2016-08-01

    Conclusions: Controlled human infection studies are an important research tool in assessing promising influenza vaccines and antivirals. These studies are performed quickly and are cost-effective and safe, with a low incidence of serious adverse events.

  8. A microgrid cluster structure and its autonomous coordination control strategy

    DEFF Research Database (Denmark)

    Zhou, Xiaoping; Zhou, Leming; Chen, Yandong

    2018-01-01

    This paper proposes a microgrid cluster structure and its autonomous coordination control strategy. Unlike existing microgrids that are purely AC or DC, the microgrid cluster studied here is an interconnected system with multiple AC and DC microgrids, which enables mutual power support among...... control method combining the normalized droop-based control and adaptive control is proposed for PEU, which can effectively realize mutual power support among microgrids and reduce the bus voltage or frequency deviation in microgrids. In addition, the adaptive control strategy of PEU can ensure...... that the bigger the normalized index of microgrid is, the larger the active power exchange coefficient is, which can make all of microgrids operate around the rated state as much as possible. Besides, EP is mainly used to balance the system power, and the hierarchical coordinated control method of EP is proposed...

  9. Relationship Between Strategy Shaping and Management Control Systems

    Directory of Open Access Journals (Sweden)

    Marcia Athayde Moreira

    2017-04-01

    Full Text Available This research analyzed the interactions between strategy shaping and management control systems, having as parameter of analysis the system of levers of control recommended by Simons (1995. A multiple case study was carried out of two companies in the construction sector in Brazil. It was found that these companies use generic niche strategies to sell the properties they have built. One of these companies uses long-term planning while the other is guided by short-term perspectives and perceptions. Both companies employ various formal control tools. It was noted, however, that some of these tools exist for the purpose of meeting the requirements of standards and audits established by certifying bodies and are not being used as tools for decision making. It was thus concluded that the relationship between managerial controls and the shaping of strategy in these organizations occurs in a passive way, with the management control systems serving as guarantors of the accomplishment of organizational strategies and goals, but not being used effectively to identify opportunities or as a source for shaping new strategies.

  10. Reading comprehension metacognitive strategies as a means for controlling behavior

    Directory of Open Access Journals (Sweden)

    Dinorah Aladina Caballero López

    2014-07-01

    Full Text Available Textual comprehension implies the use of various metacognitive strategies by the students when they have to face a text to be competent readers. That is why the objective of this article is to illustrate the application of metacognitive strategies in order to achieve an efficient textual comprehension, taking into account the self – regulation the student exerts over his own learning process. It is applied as the main method historical-logical studies based on a professional-researching systematic practice; at the same time observation is largely used. The main result is the introduction of metacognitive strategies in reading comprehension, which subsequently favor the self-control of personal behavior. The article is the result of a research project sponsored by the department of Special Education. Key words: reading comprehension, metacognitive strategies, behavior self-control.

  11. Modelling and Optimal Control of Typhoid Fever Disease with Cost-Effective Strategies.

    Science.gov (United States)

    Tilahun, Getachew Teshome; Makinde, Oluwole Daniel; Malonza, David

    2017-01-01

    We propose and analyze a compartmental nonlinear deterministic mathematical model for the typhoid fever outbreak and optimal control strategies in a community with varying population. The model is studied qualitatively using stability theory of differential equations and the basic reproductive number that represents the epidemic indicator is obtained from the largest eigenvalue of the next-generation matrix. Both local and global asymptotic stability conditions for disease-free and endemic equilibria are determined. The model exhibits a forward transcritical bifurcation and the sensitivity analysis is performed. The optimal control problem is designed by applying Pontryagin maximum principle with three control strategies, namely, the prevention strategy through sanitation, proper hygiene, and vaccination; the treatment strategy through application of appropriate medicine; and the screening of the carriers. The cost functional accounts for the cost involved in prevention, screening, and treatment together with the total number of the infected persons averted. Numerical results for the typhoid outbreak dynamics and its optimal control revealed that a combination of prevention and treatment is the best cost-effective strategy to eradicate the disease.

  12. The impact of economic recession on infection prevention and control.

    Science.gov (United States)

    O'Riordan, M; Fitzpatrick, F

    2015-04-01

    The economic recession that began in 2007 led to austerity measures and public sector cutbacks in many European countries. Reduced resource allocation to infection prevention and control (IPC) programmes is impeding prevention and control of tuberculosis, HIV and vaccine-preventable infections. In addition, higher rates of infectious disease in the community have a significant impact on hospital services, although the extent of this has not been studied. With a focus on quick deficit reduction, preventive services such IPC may be regarded as non-essential. Where a prevention programme succeeds in reducing disease burden to a low level, its very success can undermine the perceived need for the programme. To mitigate the negative effects of recession, we need to: educate our political leaders about the economic benefits of IPC; better quantify the costs of healthcare-associated infection; and evaluate the effects of budget cuts on healthcare outcomes and IPC activities. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  13. Validation of a proposal for evaluating hospital infection control programs.

    Science.gov (United States)

    Silva, Cristiane Pavanello Rodrigues; Lacerda, Rúbia Aparecida

    2011-02-01

    To validate the construct and discriminant properties of a hospital infection prevention and control program. The program consisted of four indicators: technical-operational structure; operational prevention and control guidelines; epidemiological surveillance system; and prevention and control activities. These indicators, with previously validated content, were applied to 50 healthcare institutions in the city of São Paulo, Southeastern Brazil, in 2009. Descriptive statistics were used to characterize the hospitals and indicator scores, and Cronbach's α coefficient was used to evaluate the internal consistency. The discriminant validity was analyzed by comparing indicator scores between groups of hospitals: with versus without quality certification. The construct validity analysis was based on exploratory factor analysis with a tetrachoric correlation matrix. The indicators for the technical-operational structure and epidemiological surveillance presented almost 100% conformity in the whole sample. The indicators for the operational prevention and control guidelines and the prevention and control activities presented internal consistency ranging from 0.67 to 0.80. The discriminant validity of these indicators indicated higher and statistically significant mean conformity scores among the group of institutions with healthcare certification or accreditation processes. In the construct validation, two dimensions were identified for the operational prevention and control guidelines: recommendations for preventing hospital infection and recommendations for standardizing prophylaxis procedures, with good correlation between the analysis units that formed the guidelines. The same was found for the prevention and control activities: interfaces with treatment units and support units were identified. Validation of the measurement properties of the hospital infection prevention and control program indicators made it possible to develop a tool for evaluating these programs

  14. Control Strategies for the DAB Based PV Interface System.

    Directory of Open Access Journals (Sweden)

    Hadi M El-Helw

    Full Text Available This paper presents an interface system based on the Dual Active Bridge (DAB converter for Photovoltaic (PV arrays. Two control strategies are proposed for the DAB converter to harvest the maximum power from the PV array. The first strategy is based on a simple PI controller to regulate the terminal PV voltage through the phase shift angle of the DAB converter. The Perturb and Observe (P&O Maximum Power Point Tracking (MPPT technique is utilized to set the reference of the PV terminal voltage. The second strategy presented in this paper employs the Artificial Neural Network (ANN to directly set the phase shift angle of the DAB converter that results in harvesting maximum power. This feed-forward strategy overcomes the stability issues of the feedback strategy. The proposed PV interface systems are modeled and simulated using MATLAB/SIMULINK and the EMTDC/PSCAD software packages. The simulation results reveal accurate and fast response of the proposed systems. The dynamic performance of the proposed feed-forward strategy outdoes that of the feedback strategy in terms of accuracy and response time. Moreover, an experimental prototype is built to test and validate the proposed PV interface system.

  15. Innovation in Active Vibration Control Strategy of Intelligent Structures

    Directory of Open Access Journals (Sweden)

    A. Moutsopoulou

    2014-01-01

    Full Text Available Large amplitudes and attenuating vibration periods result in fatigue, instability, and poor structural performance. In light of past approaches in this field, this paper intends to discuss some innovative approaches in vibration control of intelligent structures, particularly in the case of structures with embedded piezoelectric materials. Control strategies are presented, such as the linear quadratic control theory, as well as more advanced theories, such as robust control theory. The paper presents sufficiently a recognizable advance in knowledge of active vibration control in intelligent structures.

  16. High-Level Waste (HLW) Feed Process Control Strategy

    International Nuclear Information System (INIS)

    STAEHR, T.W.

    2000-01-01

    The primary purpose of this document is to describe the overall process control strategy for monitoring and controlling the functions associated with the Phase 1B high-level waste feed delivery. This document provides the basis for process monitoring and control functions and requirements needed throughput the double-shell tank system during Phase 1 high-level waste feed delivery. This document is intended to be used by (1) the developers of the future Process Control Plan and (2) the developers of the monitoring and control system

  17. A new control strategy of SMES for mitigating subsynchronous oscillations

    Energy Technology Data Exchange (ETDEWEB)

    Farahani, Mohsen, E-mail: m.farahani@basu.ac.ir [Bu-Ali Sina University, Department of Electrical Engineering, Hamedan-Iran (Iran, Islamic Republic of)

    2012-12-14

    This paper proposes a new strategy to mitigate the subsynchronous oscillations in power systems compensated by series capacitors via control of active power of superconducting magnetic energy storage (SMES) unit. The strategy is based on the generator acceleration signal. So, the SMES absorbs or generates the energy imbalance caused by different disturbances in the power system and suppresses the subsynchronous oscillations. The chaotic optimization algorithm (COA) is used to achieve the optimal parameter of the proposed controller. To validate the capability of the SMES in damping oscillations, some simulations with different disturbances are performed on the first model of IEEE second benchmark model. All the simulation results show that the subsynchronous resonance as well as low frequency oscillation (LFO) is satisfactorily mitigated by the SMES controlled by the proposed strategy.

  18. A new control strategy of SMES for mitigating subsynchronous oscillations

    International Nuclear Information System (INIS)

    Farahani, Mohsen

    2012-01-01

    This paper proposes a new strategy to mitigate the subsynchronous oscillations in power systems compensated by series capacitors via control of active power of superconducting magnetic energy storage (SMES) unit. The strategy is based on the generator acceleration signal. So, the SMES absorbs or generates the energy imbalance caused by different disturbances in the power system and suppresses the subsynchronous oscillations. The chaotic optimization algorithm (COA) is used to achieve the optimal parameter of the proposed controller. To validate the capability of the SMES in damping oscillations, some simulations with different disturbances are performed on the first model of IEEE second benchmark model. All the simulation results show that the subsynchronous resonance as well as low frequency oscillation (LFO) is satisfactorily mitigated by the SMES controlled by the proposed strategy.

  19. Improved Droop Control Strategy for Grid-Connected Inverters

    DEFF Research Database (Denmark)

    Abusara, Mohammad; Sharkh, Suleiman; Guerrero, Josep M.

    2015-01-01

    An improved control strategy for grid-connected inverters within microgrids is presented in this paper. The strategy is based on the classical P-ω and Q-V droop method. The improvement in the proposed control strategy is twofold: Firstly, the transient response of the droop controller is improved...... by replacing the traditional method of measuring average power, which is based on using a first order low pass filter, by a real time integration filter. This is shown to reduce the imported transient energy when connecting to the grid. Secondly, the steady state output current quality is improved by utilising...... a virtual inductance, which is shown to reject grid voltage harmonics disturbance and thus improve the output current THD. A small signal model of the inverter based on the transfer function approach is developed to analyse is stability and determine droop gains. Simulation and experimental results...

  20. [Infection control team (ICT) in cooperation with microbiology laboratories].

    Science.gov (United States)

    Okazaki, Mitsuhiro

    2012-10-01

    Infection control as a medical safety measure is an important issue in all medical facilities. In order to tackle this measure, cooperation between the infection control team (ICT) and microbiological laboratory is indispensable. Multiple drug-resistant bacteria have shifted from Gram-positive bacteria to Gram-negative bacilli within the last ten years. There are also a variety of bacilli, complicating the examination method and test results further. Therefore, cooperation between the ICT and microbiological laboratory has become important to understand examination results and to use them. In order to maintain functional cooperation, explanatory and communicative ability between the microbiological laboratory and ICT is required every day. Such positive information exchange will develop into efficient and functional ICT activity.

  1. YELLOW FEVER PREVENTION STRATEGIES AWARENESS AMONG HIV-INFECTED PATIENTS IN SÃO PAULO, BRAZIL

    Directory of Open Access Journals (Sweden)

    Vivian Iida Avelino-Silva

    2014-09-01

    Full Text Available Introduction: Vaccination is the main preventive strategy against Yellow Fever (YF, which is a public health concern in Brazil. However, HIV-infected patients might have insufficient knowledge regarding YF, YF prevention, and vaccines in general. Methods: In this questionnaire-based study, data from 158 HIV-infected individuals were addressed in three distinct outpatient clinics in São Paulo. Information was collected on demographic and clinical characteristics, as well as patients' knowledge of vaccines, YF and YF preventive strategies. In addition, individual YF vaccine recommendations and vaccine status were investigated. Results: Although most participants adequately ascertain the vaccine as the main prevention strategy against YF, few participants were aware of the severity and lack of specific treatment for YF. Discrepancy in YF vaccine (patients who should have taken the vaccine, but did not was observed in 18.8% of participants. Conclusion: YF is an important and preventable public health concern, and these results demonstrate that more information is necessary for the HIV-infected population.

  2. Strategies for time of culling in control of paratuberculosis in dairy herds.

    Science.gov (United States)

    Kudahl, A B; Nielsen, S S; Ostergaard, S

    2011-08-01

    Effect of time for culling cows infected with Mycobacterium avium ssp. paratuberculosis on prevalence and profitability was identified through simulations. Seven test-and-cull strategies with different culling criteria and no attempts to close infection routes were compared with strategies with (1) no control and (2) closure of infection routes and no culling. The effects on true prevalence and gross margin were evaluated in a herd with typical reproduction management (heat detection rate of 38%). This was repeated in a herd with poor reproduction management (heat detection rate of 28%), because poor reproduction leads to lack of replacement animals, which was hypothesized to affect the economic effects of culling. Effects of varying prices of milk, replacement heifers, and hourly wages were also evaluated. The simulated results predicted that immediate culling after the first positive antibody ELISA test would be the most effective culling strategy to reduce prevalence. However, closing transmission routes was even more effective in reducing the prevalence. In the first 3 to 6 yr, all test-and-cull strategies reduced gross margin by US$5 to 55/stall per year. These losses were fully compensated by increased gross margin in yr 6 to 19. In the short run (7 yr with typical reproduction and 10 yr with poor reproduction), it was most profitable to cull test-positive cows when their milk yield decreased below 85% of that expected according to their parity and lactation stage, especially in herds with poor reproduction management. However, this strategy only stabilized the prevalence and did not reduce it. In the long term (>7 yr from implementation of a strategy), it was most profitable to cull cows immediately or as soon as possible after testing positive the first time. Varying milk prices did not affect the ranking between the different culling strategies. Increased market price (20%) of replacement heifers made all culling strategies less profitable and made culling

  3. Optimal Energy Control Strategy Design for a Hybrid Electric Vehicle

    Directory of Open Access Journals (Sweden)

    Yuan Zou

    2013-01-01

    Full Text Available A heavy-duty parallel hybrid electric truck is modeled, and its optimal energy control is studied in this paper. The fundamental architecture of the parallel hybrid electric truck is modeled feed-forwardly, together with necessary dynamic features of subsystem or components. Dynamic programming (DP technique is adopted to find the optimal control strategy including the gear-shifting sequence and the power split between the engine and the motor subject to a battery SOC-sustaining constraint. Improved control rules are extracted from the DP-based control solution, forming near-optimal control strategies. Simulation results demonstrate that a significant improvement on the fuel economy can be achieved in the heavy-duty vehicle cycle from the natural driving statistics.

  4. Control Systems Cyber Security:Defense in Depth Strategies

    Energy Technology Data Exchange (ETDEWEB)

    David Kuipers; Mark Fabro

    2006-05-01

    Information infrastructures across many public and private domains share several common attributes regarding IT deployments and data communications. This is particularly true in the control systems domain. A majority of the systems use robust architectures to enhance business and reduce costs by increasing the integration of external, business, and control system networks. However, multi-network integration strategies often lead to vulnerabilities that greatly reduce the security of an organization, and can expose mission-critical control systems to cyber threats. This document provides guidance and direction for developing ‘defense-in-depth’ strategies for organizations that use control system networks while maintaining a multi-tier information architecture that requires: Maintenance of various field devices, telemetry collection, and/or industrial-level process systems Access to facilities via remote data link or modem Public facing services for customer or corporate operations A robust business environment that requires connections among the control system domain, the external Internet, and other peer organizations.

  5. Isotype Diversification of IgG Antibodies to HIV Gag Proteins as a Therapeutic Vaccination Strategy for HIV Infection.

    Science.gov (United States)

    French, Martyn A; Abudulai, Laila N; Fernandez, Sonia

    2013-08-09

    The development of vaccines to treat and prevent human immunodeficiency virus (HIV) infection has been hampered by an incomplete understanding of "protective" immune responses against HIV. Natural control of HIV-1 infection is associated with T-cell responses against HIV-1 Gag proteins, particularly CD8⁺ T-cell responses restricted by "protective" HLA-B alleles, but other immune responses also contribute to immune control. These immune responses appear to include IgG antibodies to HIV-1 Gag proteins, interferon-a-dependant natural killer (NK) cell responses and plasmacytoid dendritic cell (pDC) responses. Here, it is proposed that isotype diversification of IgG antibodies against HIV-1 Gag proteins, to include IgG2, as well as IgG3 and IgG1 antibodies, will broaden the function of the antibody response and facilitate accessory cell responses against HIV-1 by NK cells and pDCs. We suggest that this should be investigated as a vaccination strategy for HIV-1 infection.

  6. Isotype Diversification of IgG Antibodies to HIV Gag Proteins as a Therapeutic Vaccination Strategy for HIV Infection

    Directory of Open Access Journals (Sweden)

    Sonia Fernandez

    2013-08-01

    Full Text Available The development of vaccines to treat and prevent human immunodeficiency virus (HIV infection has been hampered by an incomplete understanding of “protective” immune responses against HIV. Natural control of HIV-1 infection is associated with T-cell responses against HIV-1 Gag proteins, particularly CD8+ T-cell responses restricted by “protective” HLA-B alleles, but other immune responses also contribute to immune control. These immune responses appear to include IgG antibodies to HIV-1 Gag proteins, interferon-a-dependant natural killer (NK cell responses and plasmacytoid dendritic cell (pDC responses. Here, it is proposed that isotype diversification of IgG antibodies against HIV-1 Gag proteins, to include IgG2, as well as IgG3 and IgG1 antibodies, will broaden the function of the antibody response and facilitate accessory cell responses against HIV-1 by NK cells and pDCs. We suggest that this should be investigated as a vaccination strategy for HIV-1 infection.

  7. 40 CFR 93.120 - Consequences of control strategy implementation plan failures.

    Science.gov (United States)

    2010-07-01

    ... Consequences of control strategy implementation plan failures. (a) Disapprovals. (1) If EPA disapproves any submitted control strategy implementation plan revision (with or without a protective finding), the... is determined. (2) If EPA disapproves a submitted control strategy implementation plan revision...

  8. Direct harmonic voltage control strategy for shunt active power filter

    DEFF Research Database (Denmark)

    Munir, Hafiz Mudassir; Zou, JianXiao; Xie, Chuan

    2017-01-01

    generation system (DPGS) where the nonlinear loads are highly dispersed. Local harmonic voltage detection based Resistive-APF (R-APF) seems more suitable to be applied in the DPGS, however, R-APF suffers from poor compensation performance and difficulty of parameter tuning. In this paper, a direct harmonic...... voltage control strategy for the S-APF is proposed with local point of common coupling (PCC) voltage detection only. The control strategy design procedure is given in detail. Simulation is conducted in Matlab/Simulink to compare the performance between the R-APF and the proposed method. The results...

  9. Maternal geohelminth infections are associated with an increased susceptibility to geohelminth infection in children: a case-control study.

    Directory of Open Access Journals (Sweden)

    Raaj S Mehta

    Full Text Available Children of mothers infected with soil-transmitted helminths (STH may have an increased susceptibility to STH infection.We did a case-control study nested in a birth cohort in Ecuador. Data from 1,004 children aged 7 months to 3 years were analyzed. Cases were defined as children with Ascaris lumbricoides and/or Trichuris trichiura, controls without. Exposure was defined as maternal infection with A. lumbricoides and/or T. trichiura, detected during the third trimester of pregnancy. The analysis was restricted to households with a documented infection to control for infection risk. Children of mothers with STH infections had a greater risk of infection compared to children of uninfected mothers (adjusted OR 2.61, 95% CI: 1.88-3.63, p<0.001. This effect was particularly strong in children of mothers with both STH infections (adjusted OR: 5.91, 95% CI: 3.55-9.81, p<0.001. Newborns of infected mothers had greater levels of plasma IL-10 than those of uninfected mothers (p=0.033, and there was evidence that cord blood IL-10 was increased among newborns who became infected later in childhood (p=0.060.Our data suggest that maternal STH infections increase susceptibility to infection during early childhood, an effect that was associated with elevated IL-10 in cord plasma.

  10. Suggested strategies for the laboratory diagnosis of HIV infection in Italy

    Directory of Open Access Journals (Sweden)

    Stefano Buttò

    2010-03-01

    Full Text Available HIV/AIDS surveillance data indicate that, in 2008, approximately one-fourth of all HIV infections in adults remain undiagnosed in Italy and that close to 60% of Aids diagnosed individuals discovered their seropositivity at the diagnosis of AIDS. Late diagnosis of HIV infection is associated with increased mortality and morbidity and increased cost to healthcare services. From a public health perspective, knowledge of HIV status is associated with a reduction in risk behaviour. Thus, a routine screening for HIV infection is important for both a better prognostic outcome, and control of HIV spreading in the population. In Italy there are not shared guidelines for the laboratory diagnosis. In this paper, we suggest two algorithms that can be adopted for the diagnosis of HIV infection in individuals undergoing HIV testing.

  11. The first step in infection control is hand hygiene.

    Science.gov (United States)

    Canham, Leslie

    2011-01-01

    A dental health care worker (DHCW) has an obligation to prevent the spread of health care associated infections. Adhering to proper hand hygiene procedures, selecting appropriate hand hygiene products and the use of gloves are all important elements of infection control. The CDC Guidelines for Hand Hygiene state that improved hand hygiene practices can reduce transmission of pathogenic microorganisms to patients and personnel in health care settings. DHCWs must also protect themselves by recognizing pitfalls such as irritants or allergies that may pose obstacles to proper hand hygiene. Occupational irritants and allergies can be caused by frequent hand washing, exposure to hand hygiene products, exposure to chemicals and shear forces associated with wearing or removing gloves. Since the primary defense against infection and transmission of pathogens is healthy, unbroken skin, DHCWs must take steps to ensure that their skin remains healthy and intact. These steps include evaluating different types of hand hygiene products, lotions and gloves for the best compatibility. If the DHCW sees a breakdown of his or her skin barrier, steps should be taken to determine the cause and remedy. Remedies can include the use of alcohol-based hand sanitizers containing emollients and moisturizers and regular use of a medical grade hand lotion. The bottom line: healthy skin protects you at work and at home. Selection and use of appropriate hand hygiene products, including moisturizers, are an essential part ofa dental office infection control program. My coworker lost the use of her thumb for several months due to complications of a staph infection. She was unable to work and found even simple tasks such as closing a button hard to do. Think of how difficult your work would be if something happened to your hands. Injury, irritation or allergies could alter your ability to work or even perform routine tasks. Our hands provide us with the ability to work in clinical dentistry. It makes

  12. Research progress on influencing factors of hospital infection and prevention and control measures

    Directory of Open Access Journals (Sweden)

    He Wenlong

    2015-03-01

    Full Text Available Hospital infections are associated with the emergence of hospitals. As the understanding of hospital infections deepen and prevention and control measures improve, hospital infections have become manageable. In recent years, affected by the increase in invasive treatment technology, antimicrobial abuse, and other factors, the control of hospital infection has encountered new problems. This paper reviews the influencing factors of hospital infections and their prevention and control measures.

  13. Why sensitive bacteria are resistant to hospital infection control

    Science.gov (United States)

    van Kleef, Esther; Luangasanatip, Nantasit; Bonten, Marc J; Cooper, Ben S

    2017-01-01

    Background: Large reductions in the incidence of antibiotic-resistant strains of Staphylococcus aureus and Clostridium difficile have been observed in response to multifaceted hospital-based interventions. Reductions in antibiotic-sensitive strains have been smaller or non-existent. It has been argued that since infection control measures, such as hand hygiene, should affect resistant and sensitive strains equally, observed changes must have largely resulted from other factors, including changes in antibiotic use. We used a mathematical model to test the validity of this reasoning. Methods: We developed a mechanistic model of resistant and sensitive strains in a hospital and its catchment area. We assumed the resistant strain had a competitive advantage in the hospital and the sensitive strain an advantage in the community. We simulated a hospital hand hygiene intervention that directly affected resistant and sensitive strains equally. The annual incidence rate ratio ( IRR) associated with the intervention was calculated for hospital- and community-acquired infections of both strains. Results: For the resistant strain, there were large reductions in hospital-acquired infections (0.1 ≤ IRR ≤ 0.6) and smaller reductions in community-acquired infections (0.2 ≤ IRR ≤  0.9). These reductions increased in line with increasing importance of nosocomial transmission of the strain. For the sensitive strain, reductions in hospital acquisitions were much smaller (0.6 ≤ IRR ≤ 0.9), while communityacquisitions could increase or decrease (0.9 ≤ IRR ≤ 1.2). The greater the importance of the community environment for the transmission of the sensitive strain, the smaller the reductions. Conclusions: Counter-intuitively, infection control interventions, including hand hygiene, can have strikingly discordant effects on resistant and sensitive strains even though they target them equally, following differences in their adaptation to hospital and community

  14. Immune Evasion Strategies during Chronic Hepatitis B and C Virus Infection

    Science.gov (United States)

    Ortega-Prieto, Ana Maria; Dorner, Marcus

    2017-01-01

    Both hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are a major global healthcare problem with more than 240 million and 70 million infected, respectively. Both viruses persist within the liver and result in progressive liver disease, resulting in liver fibrosis, cirrhosis and hepatocellular carcinoma. Strikingly, this pathogenesis is largely driven by immune responses, unable to clear an established infection, rather than by the viral pathogens themselves. Even though disease progression is very similar in both infections, HBV and HCV have evolved distinct mechanisms, by which they ensure persistence within the host. Whereas HCV utilizes a cloak-and-dagger approach, disguising itself as a lipid-like particle and immediately crippling essential pattern-recognition pathways, HBV has long been considered a “stealth” virus, due to the complete absence of innate immune responses during infection. Recent developments and access to improved model systems, however, revealed that even though it is among the smallest human-tropic viruses, HBV may, in addition to evading host responses, employ subtle immune evasion mechanisms directed at ensuring viral persistence in the absence of host responses. In this review, we compare the different strategies of both viruses to ensure viral persistence by actively interfering with viral recognition and innate immune responses. PMID:28862649

  15. Analysis of Control Strategies for Aircraft Flight Upset Recovery

    Science.gov (United States)

    Crespo, Luis G.; Kenny, Sean P.; Cox, David E.; Muri, Daniel G.

    2012-01-01

    This paper proposes a framework for studying the ability of a control strategy, consisting of a control law and a command law, to recover an aircraft from ight conditions that may extend beyond the normal ight envelope. This study was carried out (i) by evaluating time responses of particular ight upsets, (ii) by evaluating local stability over an equilibrium manifold that included stall, and (iii) by bounding the set in the state space from where the vehicle can be safely own to wings-level ight. These states comprise what will be called the safely recoverable ight envelope (SRFE), which is a set containing the aircraft states from where a control strategy can safely stabilize the aircraft. By safe recovery it is implied that the tran- sient response stays between prescribed limits before converging to a steady horizontal ight. The calculation of the SRFE bounds yields the worst-case initial state corresponding to each control strategy. This information is used to compare alternative recovery strategies, determine their strengths and limitations, and identify the most e ective strategy. In regard to the control law, the authors developed feedback feedforward laws based on the gain scheduling of multivariable controllers. In regard to the command law, which is the mechanism governing the exogenous signals driving the feed- forward component of the controller, we developed laws with a feedback structure that combines local stability and transient response considera- tions. The upset recovery of the Generic Transport Model, a sub-scale twin-engine jet vehicle developed by NASA Langley Research Center, is used as a case study.

  16. Latent Toxoplasma gondii infection leads to improved action control.

    Science.gov (United States)

    Stock, Ann-Kathrin; Heintschel von Heinegg, Evelyn; Köhling, Hedda-Luise; Beste, Christian

    2014-03-01

    The parasite Toxoplasma gondii has been found to manipulate the behavior of its secondary hosts to increase its own dissemination which is commonly believed to be to the detriment of the host (manipulation hypothesis). The manipulation correlates with an up-regulation of dopaminergic neurotransmission. In humans, different pathologies have been associated with T. gondii infections but most latently infected humans do not seem to display overt impairments. Since a dopamine plus does not necessarily bear exclusively negative consequences in humans, we investigated potential positive consequences of latent toxoplasmosis (and the presumed boosting of dopaminergic neurotransmission) on human cognition and behavior. For this purpose, we focused on action cascading which has been shown to be modulated by dopamine. Based on behavioral and neurophysiological (EEG) data obtained by means of a stop-change paradigm, we were able to demonstrate that healthy young humans can actually benefit from latent T. gondii infection as regards their performance in this task (as indicated by faster response times and a smaller P3 component). The data shows that a latent infection which is assumed to affect the dopaminergic system can lead to paradoxical improvements of cognitive control processes in humans. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Controlling nosocomial infection based on structure of hospital social networks.

    Science.gov (United States)

    Ueno, Taro; Masuda, Naoki

    2008-10-07

    Nosocomial infection (i.e. infection in healthcare facilities) raises a serious public health problem, as implied by the existence of pathogens characteristic to healthcare facilities such as methicillin-resistant Staphylococcus aureus and hospital-mediated outbreaks of influenza and severe acute respiratory syndrome. For general communities, epidemic modeling based on social networks is being recognized as a useful tool. However, disease propagation may occur in a healthcare facility in a manner different from that in a urban community setting due to different network architecture. We simulate stochastic susceptible-infected-recovered dynamics on social networks, which are based on observations in a hospital in Tokyo, to explore effective containment strategies against nosocomial infection. The observed social networks in the hospital have hierarchical and modular structure in which dense substructure such as departments, wards, and rooms, are globally but only loosely connected, and do not reveal extremely right-skewed distributions of the number of contacts per individual. We show that healthcare workers, particularly medical doctors, are main vectors (i.e. transmitters) of diseases on these networks. Intervention methods that restrict interaction between medical doctors and their visits to different wards shrink the final epidemic size more than intervention methods that directly protect patients, such as isolating patients in single rooms. By the same token, vaccinating doctors with priority rather than patients or nurses is more effective. Finally, vaccinating individuals with large betweenness centrality (frequency of mediating connection between pairs of individuals along the shortest paths) is superior to vaccinating ones with large connectedness to others or randomly chosen individuals, which was suggested by previous model studies.

  18. Prevention and control of blood stream infection using the balanced scorecard approach.

    Science.gov (United States)

    Rohsiswatmo, Rinawati; Rafika, Sarah; Marsubrin, Putri M T

    2014-07-01

    to obtain formulation of an effective and efficient strategy to overcome blood stream infection (BSI). operational research design with qualitative and quantitative approach. The study was divided into two stages. Stage I was an operational research with problem solving approach using qualitative and quantitative method. Stage II was performed using quantitative method, a form of an interventional study on strategy implementation, which was previously established in stage I. The effective and efficient strategy for the prevention and control of infection in neonatal unit Cipto Mangunkusumo (CM) Hospital was established using Balanced Scorecard (BSC) approach, which involved several related processes. the BSC strategy was proven to be effective and efficient in substantially reducing BSI from 52.31°/oo to 1.36°/oo in neonates with birth weight (BW) 1000-1499 g (p=0.025), and from 29.96°/oo to 1.66°/oo in BW 1500-1999 g (p=0.05). Gram-negative bacteria still predominated as the main cause of BSI in CMH Neonatal Unit. So far, the sources of the microorganisms were thought to be from the environment of treatment unit (tap water filter and humidifying water in the incubator). Significant reduction was also found in neonatal mortality rate weighing 1000-1499 g at birth, length of stay, hospitalization costs, and improved customer satisfaction. effective and efficient infection prevention and control using BSC approach could significantly reduce the rate of BSI. This approach may be applied for adult patients in intensive care unit with a wide range of adjustment.

  19. An Efficient Modal Control Strategy for the Active Vibration Control of a Truss Structure

    Directory of Open Access Journals (Sweden)

    Ricardo Carvalhal

    2007-01-01

    Full Text Available In this paper an efficient modal control strategy is described for the active vibration control of a truss structure. In this approach, a feedback force is applied to each mode to be controlled according to a weighting factor that is determined by assessing how much each mode is excited by the primary source. The strategy is effective provided that the primary source is at a fixed position on the structure, and that the source is stationary in the statistical sense. To test the effectiveness of the control strategy it is compared with an alternative, established approach namely, Independent Modal Space Control (IMSC. Numerical simulations show that with the new strategy it is possible to significantly reduce the control effort required, with a minimal reduction in control performance.

  20. Chaos Control on a Duopoly Game with Homogeneous Strategy

    Directory of Open Access Journals (Sweden)

    Manying Bai

    2016-01-01

    Full Text Available We study the dynamics of a nonlinear discrete-time duopoly game, where the players have homogenous knowledge on the market demand and decide their outputs based on adaptive expectation. The Nash equilibrium and its local stability are investigated. The numerical simulation results show that the model may exhibit chaotic phenomena. Quasiperiodicity is also found by setting the parameters at specific values. The system can be stabilized to a stable state by using delayed feedback control method. The discussion of control strategy shows that the effect of both firms taking control method is better than that of single firm taking control method.

  1. Sensor-Based Model Driven Control Strategy for Precision Irrigation

    Directory of Open Access Journals (Sweden)

    Camilo Lozoya

    2016-01-01

    Full Text Available Improving the efficiency of the agricultural irrigation systems substantially contributes to sustainable water management. This improvement can be achieved through an automated irrigation system that includes a real-time control strategy based on the water, soil, and crop relationship. This paper presents a model driven control strategy applied to an irrigation system, in order to make an efficient use of water for large crop fields, that is, applying the correct amount of water in the correct place at the right moment. The proposed model uses a predictive algorithm that senses soil moisture and weather variables, to determine optimal amount of water required by the crop. This proposed approach is evaluated against a traditional irrigation system based on the empirical definition of time periods and against a basic soil moisture control system. Results indicate that the use of a model predictive control in an irrigation system achieves a higher efficiency and significantly reduce the water consumption.

  2. Comparison of different control strategies on FMD in Denmark

    DEFF Research Database (Denmark)

    Boklund, Anette; Hisham Beshara Halasa, Tariq; Christiansen, Lasse Engbo

    2012-01-01

    The purpose of this study was to compare different control strategies that could be used in Denmark during an outbreak of FMD, based on epidemiological, ethical and economic parameters. Nearly a hundred different control strategies and more than 30 sensitivity analyses were run, changing between...... to extract the essence of the results. All results will be presented in the final project report, which will be available on request to the authors. Comparing epidemiological outputs showed that extra control measures will always reduce the average duration and size of an epidemic. However, the variations...... in duration and size of epidemics are large, and if epidemics are small, extra control measures may not always be necessary. Comparing depopulation to suppressive and protective vaccination shows that from an epidemiologic point of view, vaccination will be beneficial. However, comparing the economy...

  3. Control strategies used in the control software for the Heavy Ion Research Facility in Lanzhou

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Wen-Xiong [College of Power Engineering, Chongqing University, Chongqing 400044 (China); Postdoctoral Station, Chongqing University, Chongqing 400044 (China); Wang, Yan-Yu [Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000 (China); Pan, Liang-Ming [College of Power Engineering, Chongqing University, Chongqing 400044 (China); Tu, Sheng-Pan [State Grid Chongqing Maintenance Company, Chongqing 400044 (China)

    2016-07-01

    Automation control systems are important for the operation of an accelerator. To ensure the reliable, stable and flexible operation of the Heavy Ion Research Facility in Lanzhou (HIRFL), several control systems are developed. The developed control systems are the SECRAL control system, the LECR3 control system, the LAPECR1 control system and the Electro-Static septum control system. The corresponding control software systems are developed using Visual C++. To ensure the accuracy, stability and flexibility of the control systems, some special control strategies are developed in the control software systems. This paper provides a detailed description of the main control strategies used in the control software systems. The main control strategies are composed of a reliable communication mechanism, a correct data/command transmission mechanism, an efficient data storage mechanism and an interlock protection mechanism. To guarantee a reliable communication between the devices for the commercially purchased devices and the built in-house ones, a modified heartbeat method is developed. To provide flexible reconstitution function for the control systems, the command queue and the state machine are combined. The message mechanism and the multiple windows mechanism are also used for the module mechanism. The relevant control systems are introduced as examples of these control strategies. These systems have been running stably for several years.

  4. Control strategies used in the control software for the Heavy Ion Research Facility in Lanzhou

    International Nuclear Information System (INIS)

    Zhou, Wen-Xiong; Wang, Yan-Yu; Pan, Liang-Ming; Tu, Sheng-Pan

    2016-01-01

    Automation control systems are important for the operation of an accelerator. To ensure the reliable, stable and flexible operation of the Heavy Ion Research Facility in Lanzhou (HIRFL), several control systems are developed. The developed control systems are the SECRAL control system, the LECR3 control system, the LAPECR1 control system and the Electro-Static septum control system. The corresponding control software systems are developed using Visual C++. To ensure the accuracy, stability and flexibility of the control systems, some special control strategies are developed in the control software systems. This paper provides a detailed description of the main control strategies used in the control software systems. The main control strategies are composed of a reliable communication mechanism, a correct data/command transmission mechanism, an efficient data storage mechanism and an interlock protection mechanism. To guarantee a reliable communication between the devices for the commercially purchased devices and the built in-house ones, a modified heartbeat method is developed. To provide flexible reconstitution function for the control systems, the command queue and the state machine are combined. The message mechanism and the multiple windows mechanism are also used for the module mechanism. The relevant control systems are introduced as examples of these control strategies. These systems have been running stably for several years.

  5. Sampling strategies to measure the prevalence of common recurrent infections in longitudinal studies

    Directory of Open Access Journals (Sweden)

    Luby Stephen P

    2010-08-01

    Full Text Available Abstract Background Measuring recurrent infections such as diarrhoea or respiratory infections in epidemiological studies is a methodological challenge. Problems in measuring the incidence of recurrent infections include the episode definition, recall error, and the logistics of close follow up. Longitudinal prevalence (LP, the proportion-of-time-ill estimated by repeated prevalence measurements, is an alternative measure to incidence of recurrent infections. In contrast to incidence which usually requires continuous sampling, LP can be measured at intervals. This study explored how many more participants are needed for infrequent sampling to achieve the same study power as frequent sampling. Methods We developed a set of four empirical simulation models representing low and high risk settings with short or long episode durations. The model was used to evaluate different sampling strategies with different assumptions on recall period and recall error. Results The model identified three major factors that influence sampling strategies: (1 the clustering of episodes in individuals; (2 the duration of episodes; (3 the positive correlation between an individual's disease incidence and episode duration. Intermittent sampling (e.g. 12 times per year often requires only a slightly larger sample size compared to continuous sampling, especially in cluster-randomized trials. The collection of period prevalence data can lead to highly biased effect estimates if the exposure variable is associated with episode duration. To maximize study power, recall periods of 3 to 7 days may be preferable over shorter periods, even if this leads to inaccuracy in the prevalence estimates. Conclusion Choosing the optimal approach to measure recurrent infections in epidemiological studies depends on the setting, the study objectives, study design and budget constraints. Sampling at intervals can contribute to making epidemiological studies and trials more efficient, valid

  6. Combined strategies to control antinematicidal -resistant gastrointestinal nematodes in small ruminants on organized farms in pakistan

    Energy Technology Data Exchange (ETDEWEB)

    Hamad, K. K. [University of Agriculture, Faisalabad (Pakistan). Dept. of Parasitology

    2014-03-15

    Combined strategies to control antinematicidal -resistant gastrointestinal nematodes in small ruminants on organized farms in Pakistan Antinematicidal resistance has been rooted on all the continents particularly in areas where ovine and caprine are being reared intensively due to frequent annual use of broad-spectrum dewormers. Farmers rely on mono-strategic scheme by using synthetic drugs to treat their livestock which is deemed the easier way to control gastrointestinal nematode infections as compared to the other strategies. On the other hand, recurrent employment of antinematicidal chemotherapeutics has conduced to development and prevalence of resistance among nematode populations. In this regard, other advocating strategies such as grazing management, rotation of antinematicidal drugs (although it is too late), amelioration of animal immunity, genetic approaches, biological control, nutritional supplementation, avoidance of mass treatment, improvement of management, eradication of concurrent diseases, and phytotherapy should be considered too. Although, by far there are no commercialized substantial alternatives to chemotherapy, but the current substitutes could decrease the parasitic burden, which, in turn, restrict indiscriminate use of synthetic drugs. The resistance is more rampant on organized farms as compared to non organized farms in rural areas in Asian, African and South Latin American countries because tamed animal raisers in those areas depend on ethnobotanicals to treat parasitism due to high cost of allopathic drugs. Therefore, in this review, the different strategies to control the antinematicidal resistance on organized farms in Pakistan will be elaborated. (author)

  7. Combined strategies to control antinematicidal -resistant gastrointestinal nematodes in small ruminants on organized farms in pakistan

    International Nuclear Information System (INIS)

    Hamad, K.K.

    2014-01-01

    Combined strategies to control antinematicidal -resistant gastrointestinal nematodes in small ruminants on organized farms in Pakistan Antinematicidal resistance has been rooted on all the continents particularly in areas where ovine and caprine are being reared intensively due to frequent annual use of broad-spectrum dewormers. Farmers rely on mono-strategic scheme by using synthetic drugs to treat their livestock which is deemed the easier way to control gastrointestinal nematode infections as compared to the other strategies. On the other hand, recurrent employment of antinematicidal chemotherapeutics has conduced to development and prevalence of resistance among nematode populations. In this regard, other advocating strategies such as grazing management, rotation of antinematicidal drugs (although it is too late), amelioration of animal immunity, genetic approaches, biological control, nutritional supplementation, avoidance of mass treatment, improvement of management, eradication of concurrent diseases, and phytotherapy should be considered too. Although, by far there are no commercialized substantial alternatives to chemotherapy, but the current substitutes could decrease the parasitic burden, which, in turn, restrict indiscriminate use of synthetic drugs. The resistance is more rampant on organized farms as compared to non organized farms in rural areas in Asian, African and South Latin American countries because tamed animal raisers in those areas depend on ethnobotanicals to treat parasitism due to high cost of allopathic drugs. Therefore, in this review, the different strategies to control the antinematicidal resistance on organized farms in Pakistan will be elaborated. (author)

  8. Control of tropical theileriosis (Theileria annulata infection) of cattle.

    Science.gov (United States)

    Brown, C G

    1990-04-01

    Tropical bovine theileriosis caused by Theileria annulata and transmitted by ticks of the genus Hyalomma may be controlled by one or more of the following methods: i) management, with particular emphasis on movement control; ii) vector control by application of acaricides, preventing transmission of disease; iii) treatment of clinical disease using specific chemotherapeutics; iv) immunization with live vaccines; and v) the use of cattle resistant to ticks or the disease. Of these the most important and effective control method is the use of a live cell culture vaccine attenuated by prolonged culture in vitro of mononuclear cells persistently infected with macroschizonts of T. annulata. This vaccine, used chiefly in susceptible taurine dairy cattle, can now be complemented by using novel chemotherapeutic naphthoquinones--parvaquone and buparvaquone--which are very effective in treatment of the clinical disease in these valuable cattle.

  9. Managing Work and Family: Do Control Strategies Help?

    Science.gov (United States)

    Versey, H. Shellae

    2015-01-01

    How can we effectively manage competing obligations from work and family without becoming overwhelmed? This question inspires the current study by examining control strategies that may facilitate better work-life balance, with a specific focus on the role of lowered aspirations and positive reappraisals, attitudes that underlie adaptive coping…

  10. Between architecture and model: Strategies for cognitive control

    NARCIS (Netherlands)

    Taatgen, Niels

    One major limitation of current cognitive architectures is that models are typically constructed in an “empty” architecture, and that the knowledge specifications (typically production rules) are specific to the particular task. This means that general cognitive control strategies have to be

  11. A fault tolerant superheat control strategy for supermarket refrigeration systems

    DEFF Research Database (Denmark)

    Vinther, Kasper; Izadi-Zamanabadi, Roozbeh; Rasmussen, Henrik

    2013-01-01

    , based on a maximum slope-seeking control method and only a single temperature sensor, is developed to drive the evaporator outlet temperature to a level that gives a suitable superheat of the refrigerant. The FTC strategy requires no a priori system knowledge or additional hardware and functions...

  12. Benchmarking of Control Strategies for Wastewater Treatment Plants

    DEFF Research Database (Denmark)

    Wastewater treatment plants are large non-linear systems subject to large perturbations in wastewater flow rate, load and composition. Nevertheless these plants have to be operated continuously, meeting stricter and stricter regulations. Many control strategies have been proposed in the literature...

  13. Modeling an impact control strategy using HyPA

    NARCIS (Netherlands)

    Cuijpers, P.J.L.; Reniers, M.A.; Cassandras, C.G.; Giua, A.; Seatzu, C.; Zaytoon, J.

    2006-01-01

    We analyze a control strategy for the pick-and-place module of a component mounting device.We use a combination of techniques from bondgraph-theory, systems theory, process algebra and differential algebra to achieve this, and we show how the hybrid process algebra HyPA aides us in combining these

  14. Control strategies for laser separation of carbon isotopes

    Indian Academy of Sciences (India)

    Unknown

    Control strategies for laser separation of carbon isotopes. V PARTHASARATHY*, A K ... The emerging market for medical applications of C-13 is projected to be in the range of hundreds of ..... thermal effects during irradiation. In the absence of ...

  15. 40 CFR 52.1676 - Control strategy: Nitrogen dioxide.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Nitrogen dioxide. 52.1676 Section 52.1676 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS...: Nitrogen dioxide. (a) The requirements of § 52.14(c)(3) of this chapter as of May 8, 1974 (39 FR 16347...

  16. 40 CFR 52.1876 - Control strategy: Nitrogen dioxide.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Nitrogen dioxide. 52.1876 Section 52.1876 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS...: Nitrogen dioxide. (a) The condition to EPA's approval of the oxides of nitrogen State Implementation Plan...

  17. National infection prevention and control programmes: Endorsing quality of care.

    Science.gov (United States)

    Stempliuk, Valeska; Ramon-Pardo, Pilar; Holder, Reynaldo

    2014-01-01

    Core components Health care-associated infections (HAIs) are a major cause of morbidity and mortality. In addition to pain and suffering, HAIs increase the cost of health care and generates indirect costs from loss of productivity for patients and society as a whole. Since 2005, the Pan American Health Organization has provided support to countries for the assessment of their capacities in infection prevention and control (IPC). More than 130 hospitals in 18 countries were found to have poor IPC programmes. However, in the midst of many competing health priorities, IPC programmes are not high on the agenda of ministries of health, and the sustainability of national programmes is not viewed as a key point in making health care systems more consistent and trustworthy. Comprehensive IPC programmes will enable countries to reduce the mobility, mortality and cost of HAIs and improve quality of care. This paper addresses the relevance of national infection prevention and control (NIPC) programmes in promoting, supporting and reinforcing IPC interventions at the level of hospitals. A strong commitment from national health authorities in support of national IPC programmes is crucial to obtaining a steady decrease of HAIs, lowering health costs due to HAIs and ensuring safer care.

  18. Electric Water Heater Modeling and Control Strategies for Demand Response

    Energy Technology Data Exchange (ETDEWEB)

    Diao, Ruisheng; Lu, Shuai; Elizondo, Marcelo A.; Mayhorn, Ebony T.; Zhang, Yu; Samaan, Nader A.

    2012-07-22

    Abstract— Demand response (DR) has a great potential to provide balancing services at normal operating conditions and emergency support when a power system is subject to disturbances. Effective control strategies can significantly relieve the balancing burden of conventional generators and reduce investment on generation and transmission expansion. This paper is aimed at modeling electric water heaters (EWH) in households and tests their response to control strategies to implement DR. The open-loop response of EWH to a centralized signal is studied by adjusting temperature settings to provide regulation services; and two types of decentralized controllers are tested to provide frequency support following generator trips. EWH models are included in a simulation platform in DIgSILENT to perform electromechanical simulation, which contains 147 households in a distribution feeder. Simulation results show the dependence of EWH response on water heater usage . These results provide insight suggestions on the need of control strategies to achieve better performance for demand response implementation. Index Terms— Centralized control, decentralized control, demand response, electrical water heater, smart grid

  19. Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review.

    Science.gov (United States)

    Meddings, Jennifer; Rogers, Mary A M; Krein, Sarah L; Fakih, Mohamad G; Olmsted, Russell N; Saint, Sanjay

    2014-04-01

    Catheter-associated urinary tract infections (CAUTI) are costly, common and often preventable by reducing unnecessary urinary catheter (UC) use. To summarise interventions to reduce UC use and CAUTIs, we updated a prior systematic review (through October 2012), and a meta-analysis regarding interventions prompting UC removal by reminders or stop orders. A narrative review summarises other CAUTI prevention strategies including aseptic insertion, catheter maintenance, antimicrobial UCs, and bladder bundle implementation. 30 studies were identified and summarised with interventions to prompt removal of UCs, with potential for inclusion in the meta-analyses. By meta-analysis (11 studies), the rate of CAUTI (episodes per 1000 catheter-days) was reduced by 53% (rate ratio 0.47; 95% CI 0.30 to 0.64, pSMD) in catheterisation duration (days) was -1.06 overall (p=0.065) including a statistically significant decrease in stop-order studies (SMD -0.37; pSMD, -1.54; p=0.071). No significant harm from catheter removal strategies is supported. Limited research is available regarding the impact of UC insertion and maintenance technique. A recent randomised controlled trial indicates antimicrobial catheters provide no significant benefit in preventing symptomatic CAUTIs. UC reminders and stop orders appear to reduce CAUTI rates and should be used to improve patient safety. Several evidence-based guidelines have evaluated CAUTI preventive strategies as well as emerging evidence regarding intervention bundles. Implementation strategies are important because reducing UC use involves changing well-established habits.

  20. Emerging trends in vibration control of wind turbines: a focus on a dual control strategy.

    Science.gov (United States)

    Staino, Andrea; Basu, Biswajit

    2015-02-28

    The paper discusses some of the recent developments in vibration control strategies for wind turbines, and in this context proposes a new dual control strategy based on the combination and modification of two recently proposed control schemes. Emerging trends in the vibration control of both onshore and offshore wind turbines are presented. Passive, active and semi-active structural vibration control algorithms have been reviewed. Of the existing controllers, two control schemes, active pitch control and active tendon control, have been discussed in detail. The proposed new control scheme is a merger of active tendon control with passive pitch control, and is designed using a Pareto-optimal problem formulation. This combination of controllers is the cornerstone of a dual strategy with the feature of decoupling vibration control from optimal power control as one of its main advantages, in addition to reducing the burden on the pitch demand. This dual control strategy will bring in major benefits to the design of modern wind turbines and is expected to play a significant role in the advancement of offshore wind turbine technologies. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  1. Robust predictive control strategy applied for propofol dosing using BIS as a controlled variable during anesthesia

    NARCIS (Netherlands)

    Ionescu, Clara A.; De Keyser, Robin; Torrico, Bismark Claure; De Smet, Tom; Struys, Michel M. R. F.; Normey-Rico, Julio E.

    This paper presents the application of predictive control to drug dosing during anesthesia in patients undergoing surgery. The performance of a generic predictive control strategy in drug dosing control, with a previously reported anesthesia-specific control algorithm, has been evaluated. The

  2. Hand Hygiene Intervention Strategies to Reduce Diarrhoea and Respiratory Infections among Schoolchildren in Developing Countries: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Balwani Chingatichifwe Mbakaya

    2017-04-01

    Full Text Available Effective and appropriate hand-washing practice for schoolchildren is important in preventing infectious diseases such as diarrhoea, which is the second most common cause of death among school-age children in sub-Saharan Africa. The objective of the review was to identify hand hygiene intervention strategies to reduce infectious diseases such as diarrhoea and respiratory tract infections among schoolchildren aged 6–12 years in developing countries. Published research articles were searched from databases covering a period from as far back as the creation of the databases to November 2015. Eight randomized controlled trials (RCT/CRCT from developing countries met the inclusion criteria. The Jadad Scale for appraising RCT/CRCT studies revealed methodological challenges in most studies, such that 75% (6/8 were rated as low-quality articles. The review found that hand hygiene can reduce the incidence of diarrhoea and respiratory conditions. Three hand hygiene intervention strategies utilized were training, funding and policy, with training and funding implemented more commonly than policy. These strategies were not only used in isolation but also in combination, and they qualified as multi-level interventions. Factors that influenced hand washing were contextual, psychosocial and technological. Findings can inform school health workers in categorizing and prioritizing activities into viable strategies when implementing multi-level hand-washing interventions. This review also adds to the existing evidence that multi-level hand-washing interventions can reduce the incidence of diarrhoea, respiratory infections, and school absenteeism. Further evidence-based studies are needed with improved methodological rigour in developing countries, to inform policy in this area.

  3. Limited-sampling strategies for anti-infective agents: systematic review.

    Science.gov (United States)

    Sprague, Denise A; Ensom, Mary H H

    2009-09-01

    Area under the concentration-time curve (AUC) is a pharmacokinetic parameter that represents overall exposure to a drug. For selected anti-infective agents, pharmacokinetic-pharmacodynamic parameters, such as AUC/MIC (where MIC is the minimal inhibitory concentration), have been correlated with outcome in a few studies. A limited-sampling strategy may be used to estimate pharmacokinetic parameters such as AUC, without the frequent, costly, and inconvenient blood sampling that would be required to directly calculate the AUC. To discuss, by means of a systematic review, the strengths, limitations, and clinical implications of published studies involving a limited-sampling strategy for anti-infective agents and to propose improvements in methodology for future studies. The PubMed and EMBASE databases were searched using the terms "anti-infective agents", "limited sampling", "optimal sampling", "sparse sampling", "AUC monitoring", "abbreviated AUC", "abbreviated sampling", and "Bayesian". The reference lists of retrieved articles were searched manually. Included studies were classified according to modified criteria from the US Preventive Services Task Force. Twenty studies met the inclusion criteria. Six of the studies (involving didanosine, zidovudine, nevirapine, ciprofloxacin, efavirenz, and nelfinavir) were classified as providing level I evidence, 4 studies (involving vancomycin, didanosine, lamivudine, and lopinavir-ritonavir) provided level II-1 evidence, 2 studies (involving saquinavir and ceftazidime) provided level II-2 evidence, and 8 studies (involving ciprofloxacin, nelfinavir, vancomycin, ceftazidime, ganciclovir, pyrazinamide, meropenem, and alpha interferon) provided level III evidence. All of the studies providing level I evidence used prospectively collected data and proper validation procedures with separate, randomly selected index and validation groups. However, most of the included studies did not provide an adequate description of the methods or

  4. The Strategy to Survive Primary Malaria Infection: An Experimental Study on Behavioural Changes in Parasitized Birds.

    Directory of Open Access Journals (Sweden)

    Andrey Mukhin

    Full Text Available Avian malaria parasites (Haemosporida, Plasmodium are of cosmopolitan distribution, and they have a significant impact on vertebrate host fitness. Experimental studies show that high parasitemia often develops during primary malaria infections. However, field studies only occasionally reveal high parasitemia in free-living birds sampled using the traditional methods of mist-netting or trapping, and light chronic infections predominate. The reason for this discrepancy between field observation and experimental data remains insufficiently understood. Since mist-netting is a passive capture method, two main parameters determine its success in sampling infected birds in wildlife, i. e. the presence of parasitized birds at a study site and their mobility. In other words, the trapping probability depends on the survival rate of birds and their locomotor activity during infection. Here we test (1 the mortality rate of wild birds infected with Plasmodium relictum (the lineage pSGS1, (2 the changes in their behaviour during presence of an aerial predator, and (3 the changes in their locomotor activity at the stage of high primary parasitemia.We show that some behavioural features which might affect a bird's survival during a predator attack (time of reaction, speed of flush flight and take off angle did not change significantly during primary infection. However, the locomotor activity of infected birds was almost halved compared to control (non-infected birds during the peak of parasitemia. We report (1 the markedly reduced mobility and (2 the 20% mortality rate caused by P. relictum and conclude that these factors are responsible for the underrepresentation of birds in mist nets and traps during the stage of high primary parasitemia in wildlife. This study indicates that the widespread parasite, P. relictum (pSGS1 influences the behaviour of birds during primary parasitemia. Experimental studies combined with field observations are needed to better

  5. The Strategy to Survive Primary Malaria Infection: An Experimental Study on Behavioural Changes in Parasitized Birds

    Science.gov (United States)

    Mukhin, Andrey; Palinauskas, Vaidas; Platonova, Elena; Kobylkov, Dmitry; Vakoliuk, Irina; Valkiūnas, Gediminas

    2016-01-01

    Avian malaria parasites (Haemosporida, Plasmodium) are of cosmopolitan distribution, and they have a significant impact on vertebrate host fitness. Experimental studies show that high parasitemia often develops during primary malaria infections. However, field studies only occasionally reveal high parasitemia in free-living birds sampled using the traditional methods of mist-netting or trapping, and light chronic infections predominate. The reason for this discrepancy between field observation and experimental data remains insufficiently understood. Since mist-netting is a passive capture method, two main parameters determine its success in sampling infected birds in wildlife, i. e. the presence of parasitized birds at a study site and their mobility. In other words, the trapping probability depends on the survival rate of birds and their locomotor activity during infection. Here we test (1) the mortality rate of wild birds infected with Plasmodium relictum (the lineage pSGS1), (2) the changes in their behaviour during presence of an aerial predator, and (3) the changes in their locomotor activity at the stage of high primary parasitemia.We show that some behavioural features which might affect a bird's survival during a predator attack (time of reaction, speed of flush flight and take off angle) did not change significantly during primary infection. However, the locomotor activity of infected birds was almost halved compared to control (non-infected) birds during the peak of parasitemia. We report (1) the markedly reduced mobility and (2) the 20% mortality rate caused by P. relictum and conclude that these factors are responsible for the underrepresentation of birds in mist nets and traps during the stage of high primary parasitemia in wildlife. This study indicates that the widespread parasite, P. relictum (pSGS1) influences the behaviour of birds during primary parasitemia. Experimental studies combined with field observations are needed to better understand the

  6. Dairy farmers' perceptions toward the implementation of on-farm Johne's disease prevention and control strategies.

    Science.gov (United States)

    Ritter, C; Jansen, J; Roth, K; Kastelic, J P; Adams, C L; Barkema, H W

    2016-11-01

    Implementation of specific management strategies on dairy farms is currently the most effective way to reduce the prevalence of Johne's disease (JD), an infectious chronic enteritis of ruminants caused by Mycobacterium avium subspecies paratuberculosis (MAP). However, dairy farmers often fail to implement recommended strategies. The objective of this study was to assess perceptions of farmers participating in a JD prevention and control program toward recommended practices, and explore factors that influence whether or not a farmer adopts risk-reducing measures for MAP transmission. Semi-structured interviews were conducted with 25 dairy farmers enrolled in a voluntary JD control program in Alberta, Canada. Principles of classical grounded theory were used for participant selection, interviewing, and data analysis. Additionally, demographic data and MAP infection status were collected and analyzed using quantitative questionnaires and the JD control program database. Farmers' perceptions were distinguished according to 2 main categories: first, their belief in the importance of JD, and second, their belief in recommended JD prevention and control strategies. Based on these categories, farmers were classified into 4 groups: proactivists, disillusionists, deniers, and unconcerned. The first 2 groups believed in the importance of JD, and proactivists and unconcerned believed in proposed JD prevention and control measures. Groups that regarded JD as important had better knowledge about best strategies to reduce MAP transmission and had more JD risk assessments conducted on their farm. Although not quantified, it also appeared that these groups had more JD prevention and control practices in place. However, often JD was not perceived as a problem in the herd and generally farmers did not regard JD control as a "hot topic" in communications with their herd veterinarian and other farmers. Recommendations regarding how to communicate with farmers and motivate various

  7. Role of the clinical microbiology laboratory in infection control - a Danish perspective

    DEFF Research Database (Denmark)

    Kolmos, H J

    2001-01-01

    for standardization and documentation of quality. Currently a national standard for infection control is being prepared. It consists of a main standard defining requirements for the management system and 12 subsidiary standards defining requirements for specific areas of infection control. Adoption of the standard...... will undoubtedly require additional resources for infection control at a local level, and some organizational changes may also be needed. Infection control should be maintained as an integrated part of clinical microbiology....

  8. Economic implications of three strategies for the control of taeniasis.

    Science.gov (United States)

    Alexander, Anu; John, K R; Jayaraman, T; Oommen, Anna; Venkata Raghava, M; Dorny, Pierre; Rajshekhar, Vedantam

    2011-11-01

    To evaluate the cost-effectiveness of three strategies for the control of taeniasis in a community, in terms of cost per case treated. A study was conducted in South India to determine the prevalence of taeniasis by screening stool samples from 653 randomly chosen subjects, for coproantigens. The costs incurred in the project were used to estimate the cost per case screened and treated. A one-way sensitivity analysis was carried out for varying rates of taeniasis, different screening strategies and mass therapy. Further sensitivity analysis was carried out with different manpower and test costs. The rate of taeniasis as detected by ELISA for coproantigen was 3 per 1000 (2 of 653 samples). Our study showed that mass therapy without screening for taeniasis would be the most economical strategy in terms of cost per case treated if field workers are employed exclusively for either mass therapy or screening. For each strategy, costs per case treated are higher at low prevalence of taeniasis, with a sharp rise below 15%. In places that are endemic for taeniasis and neurocysticercosis, mass therapy or screening for taeniasis should be considered. Screening by stool microscopy is not cost-effective in terms of cost per case of taeniasis treated owing to its low sensitivity. Although the cost per case of taeniasis treated is high at low prevalence of taeniasis for all options, incorporating mass therapy into existing mass drug distribution programmes might prove to be the most cost-effective control strategy. © 2011 Blackwell Publishing Ltd.

  9. Control strategies for crane systems: A comprehensive review

    Science.gov (United States)

    Ramli, Liyana; Mohamed, Z.; Abdullahi, Auwalu M.; Jaafar, H. I.; Lazim, Izzuddin M.

    2017-10-01

    Crane systems are tremendously utilised in numerous heavy load transportation industries, and therefore, the control of crane systems is a well-established research field. As the last review paper was published more than a decade ago, there is a lack of collected and organised information regarding the latest and the newest updates on control strategies for crane control systems. Hence, this paper presents a comprehensive review of crane control strategies discussing the latest research works during the years from 2000 to 2016. Various crane types and control issues are highlighted, followed by the main focus of this paper, an extensive review of the control schemes for diverse types of crane systems that have been carried out in the 21st century. A brief review on modelling of single-pendulum and double-pendulum crane systems is also given. In addition, anti-sway control systems for industrial cranes that are available on the market is described. This paper summarises most of the related work and also pays a special focus on research trends regarding the control of crane systems that have been previously published in the literature. It is envisaged that this review paper will be helpful to new researchers when identifying research directions for this particular area of interest.

  10. Controlled invasive mechanical ventilation strategies in obese patients undergoing surgery.

    Science.gov (United States)

    Maia, Lígia de Albuquerque; Silva, Pedro Leme; Pelosi, Paolo; Rocco, Patricia Rieken Macedo

    2017-06-01

    The obesity prevalence is increasing in surgical population. As the number of obese surgical patients increases, so does the demand for mechanical ventilation. Nevertheless, ventilatory strategies in this population are challenging, since obesity results in pathophysiological changes in respiratory function. Areas covered: We reviewed the impact of obesity on respiratory system and the effects of controlled invasive mechanical ventilation strategies in obese patients undergoing surgery. To date, there is no consensus regarding the optimal invasive mechanical ventilation strategy for obese surgical patients, and no evidence that possible intraoperative beneficial effects on oxygenation and mechanics translate into better postoperative pulmonary function or improved outcomes. Expert commentary: Before determining the ideal intraoperative ventilation strategy, it is important to analyze the pathophysiology and comorbidities of each obese patient. Protective ventilation with low tidal volume, driving pressure, energy, and mechanical power should be employed during surgery; however, further studies are required to clarify the most effective ventilation strategies, such as the optimal positive end-expiratory pressure and whether recruitment maneuvers minimize lung injury. In this context, an ongoing trial of intraoperative ventilation in obese patients (PROBESE) should help determine the mechanical ventilation strategy that best improves clinical outcome in patients with body mass index≥35kg/m 2 .

  11. Mine-hoist active fault tolerant control system and strategy

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Z.; Wang, Y.; Meng, J.; Zhao, P.; Chang, Y. [China University of Mining and Technology, Xuzhou (China)] wzjsdstu@163.com

    2005-06-01

    Based on fault diagnosis and fault tolerant technologies, the mine-hoist active fault-tolerant control system (MAFCS) is presented with corresponding strategies, which includes the fault diagnosis module (FDM), the dynamic library (DL) and the fault-tolerant control model (FCM). When a fault is judged from some sensor by the FDM, FCM reconfigures the state of the MAFCS by calling the parameters from all sub libraries in DL, in order to ensure the reliability and safety of the mine hoist. The simulating result shows that MAFCS is of certain intelligence, which can adopt the corresponding control strategies according to different fault modes, even when there is quite a difference between the real data and the prior fault modes. 7 refs., 5 figs., 1 tab.

  12. Control of group of mobile autonomous agents via local strategies

    Institute of Scientific and Technical Information of China (English)

    Lixin GAO; Daizhan CHENG; Yiguang HONG

    2008-01-01

    This paper considers the formation control problem of multi-agent systems in a distributed fashion.Two cases of the information propagating topologies among multiple agents,characterized by graphics model,are considered.One is fixed topology.The other is switching topology which represents the limited and less reliable information exchange.The local formation control strategies established in this paper are based on a simple modification of the existing consensus control strategies.Moreover,some existing convergence conditions ale shown to be a special case of our model even in the continuous-time consensus case.Therefore.the results of this paper extend the existing results about the consensus problem.

  13. An Integrative Review of Infection Control Research in Korean Nursing Journals

    Directory of Open Access Journals (Sweden)

    Kyung Mi Kim, RN, PhD

    2014-06-01

    Conclusions: To enhance the quality of infection control studies and establish infection control studies as a nursing knowledge body, meta-analyses and systematic literature reviews as well as quantitative studies are needed. Moreover, studies employing behavioral science to identify factors influencing the level of knowledge and practice and to change infection control behaviors are also warranted.

  14. Strategies for glucose control in people with type 1 diabetes

    DEFF Research Database (Denmark)

    Boiroux, Dimitri; Finan, Daniel Aaron; Jørgensen, John Bagterp

    2011-01-01

    the patient. We minimize the risk of hypoglycemia by introducing a time-varying glucose setpoint based on the announced meal size and the physiological model of the patient. The simulation results are based on a virtual patient simulated by the Hovorka model. They include the cases where the insulin...... sensitivity changes, and mismatches in meal estimation. They demonstrate that the designed controller is able to achieve offset-free control when the insulin sensitivity change, and that having a time-varying reference signal enables more robust control of blood glucose in the cases where the meal size......In this paper we apply a robust feedforward-feedback control strategy to people with type 1 diabetes. The feedforward controller consists of a bolus calculator which compensates the disturbance coming from meals. The feedback controller is based on a linearized description of the model describing...

  15. Numerical simulation of energy efficiency measures: control and operational strategies

    International Nuclear Information System (INIS)

    Ardehali, M. M.

    2006-01-01

    The inherent limitation in performance of building envelop components and heating ventilating and air conditioning (HVAC) equipment necessitates the examination of operational strategies for improvement in energy-efficient operation of buildings. Due to the ease of installation and increasing availability of electronic controllers, operational strategies that could be programmed are of particular interest. The Iowa Energy Center in the US has taken the initiative to conduct the necessary assessment of current HVAC technology and the commonly-used operational strategies for commercial and industrial buildings, as applied to the midwestern part of the country, with weather and energy cost data for Des Moines, Iowa. The first part of this study focused on the energy consumption and cost effectiveness of HVAC systems. The objectives of the second part is concerned with examination of various operational strategies, namely, night purge (NP), fan optimum start and stop (OSS), condenser water reset (CWR), and chilled water reset (CHWR) applied to order and newer-type commercial office buildings. The indoor air quality requirement are met and the latest applicable energy rates from local utility companies are used. The results show that, in general, NP is not an effective strategy in buildings with low thermal mass storage, OSS reduced fan energy, and CWR and CHWR could be effective and require chillers with multi-stage unloading characteristics. The most operationally efficient strategies are the combination of OSS, CWR, and CHWR for the older-type building, and OSS for the newer-type building. Economically, the most effective is the OSS strategy for the older-type building and the CHWR strategy for the newer-type building.(Author)

  16. Healthcare Associated Infections of Methicillin-Resistant Staphylococcus aureus: A Case-Control-Control Study.

    Directory of Open Access Journals (Sweden)

    Zhenjiang Yao

    Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA is one of the most widespread and dangerous pathogens in healthcare settings. We carried out this case-control-control study at a tertiary care hospital in Guangzhou, China, to examine the antimicrobial susceptibility patterns, risk factors and clinical outcomes of MRSA infections.A total of 57 MRSA patients, 116 methicillin-susceptible Staphylococcus aureus (MSSA patients and 102 S. aureus negative patients were included in this study. We applied the disk diffusion method to compare the antimicrobial susceptibilities of 18 antibiotics between MRSA and MSSA isolates. Risk factors of MRSA infections were evaluated using univariate and multivariate logistic regression models. We used Cox proportional hazards models and logistic regression analysis to assess the hospital stay duration and fatality for patients with MRSA infections.The MRSA group had significantly higher resistance rates for most drugs tested compared with the MSSA group. Using MSSA patients as controls, the following independent risk factors of MRSA infections were identified: 3 or more prior hospitalizations (OR 2.8, 95% CI 1.3-5.8, P = 0.007, chronic obstructive pulmonary disease (OR 5.9, 95% CI 1.7-20.7, P = 0.006, and use of a respirator (OR 3.6, 95% CI 1.0-12.9, P = 0.046. With the S. aureus negative patients as controls, use of a respirator (OR 3.8, 95% CI 1.0-13.9, P = 0.047 and tracheal intubation (OR 8.2, 95% CI 1.5-45.1, P = 0.016 were significant risk factors for MRSA infections. MRSA patients had a longer hospital stay duration and higher fatality in comparison with those in the two control groups.MRSA infections substantially increase hospital stay duration and fatality. Thus, MRSA infections are serious issues in this healthcare setting and should receive more attention from clinicians.

  17. Specific schistosomiasis treatment as a strategy for disease control

    Directory of Open Access Journals (Sweden)

    José Rodrigues Coura

    2010-07-01

    Full Text Available The great hope for schistosomiasis treatment began with the development of oxamniquine and praziquantel. These drugs can be administered orally in a single dose and have a high curative power with minor side effects. In this study, we carried out a field experiment involving a population of 3,782 people. The population was examined at four localities in Minas Gerais within the valleys of the Doce and Jequitinhonha Rivers. In this cohort, there were 1,790 patients infected with Schistosoma mansoni (47.3% and we showed that only 1,403 (78.4% could be treated with oxamniquine in a single dose of 12.5-20 mg/kg orally. The other 387 (21.6% were not treated during the first stage because of contraindications (pregnancy or impeditive diseases, absences or refusals. It was observed that, on average, 8.8-17% of the infected patients continued to excrete S. mansoni eggs at the end of the 2nd month after treatment and 30-32% of the cohort was infected by the end of the 24th month. In one of the areas that we followed-up for a total of 30 years, the prevalence of the infection with S. mansoni fell from 60.8-19.3% and the hepatosplenic form of the disease dropped from 5.8-1.3%. We conclude that specific treatment of schistosomiasis reduces the prevalence of infection in the short-term and the morbidity due to schistosomiasis in medium to long-term time frames, but does not help to control disease transmission.

  18. Nutritional strategies to boost immunity and prevent infection in elderly individuals.

    Science.gov (United States)

    High, K P

    2001-12-01

    Older adults are at risk for malnutrition, which may contribute to their increased risk of infection. Nutritional supplementation strategies can reduce this risk and reverse some of the immune dysfunction associated with advanced age. This review discusses nutritional interventions that have been examined in clinical trials of older adults. The data support use of a daily multivitamin or trace-mineral supplement that includes zinc (elemental zinc, >20 mg/day) and selenium (100 microg/day), with additional vitamin E, to achieve a daily dosage of 200 mg/day. Specific syndromes may also be addressed by nutritional interventions (for example, cranberry juice consumption to reduce urinary tract infections) and may reduce antibiotic use in older adults, particularly those living in long-term care facilities. Drug-nutrient interactions are common in elderly individuals, and care providers should be aware of these interactions. Future research should evaluate important clinical end points rather than merely surrogate markers of immunity.

  19. A case-control study of risk factors associated with scrub typhus infection in Beijing, China.

    Directory of Open Access Journals (Sweden)

    Yanning Lyu

    Full Text Available To investigate the risk factors of scrub typhus infection in Beijing, China, a case-control study was carried out. Cases (n = 56 were defined as persons who were diagnosed by PCR and serological method within three years. Three neighborhood control subjects were selected by matching for age and occupation. Living at the edge of the village, living in the houses near grassland, vegetable field or ditch, house yard without cement floor, piling weeds in the house or yard, all of these were risk factors for scrub typhus infection. Working in vegetable fields and hilly areas, and harvesting in autumn posed the highest risks, with odds ratios (ORs and 95% confidence intervals (CIs of 3.7 (1.1-11.9, 8.2 (1.4-49.5, and 17.2 (5.1-57.9, respectively. These results would be useful for the establishment of a detail control strategy for scrub typhus infection in Beijing, China.

  20. Hierarchical Control Strategy for the Cooperative Braking System of Electric Vehicle

    OpenAIRE

    Peng, Jiankun; He, Hongwen; Liu, Wei; Guo, Hongqiang

    2015-01-01

    This paper provides a hierarchical control strategy for cooperative braking system of an electric vehicle with separated driven axles. Two layers are defined: the top layer is used to optimize the braking stability based on two sliding mode control strategies, namely, the interaxle control mode and signal-axle control strategies; the interaxle control strategy generates the ideal braking force distribution in general braking condition, and the single-axle control strategy can ensure braking s...

  1. Controlled human infection models for vaccine development: Zika virus debate.

    Science.gov (United States)

    Gopichandran, Vijayaprasad

    2018-01-01

    An ethics panel, convened by the National Institute of Health and other research bodies in the USA, disallowed researchers from the Johns Hopkins University and University of Vermont from performing controlled human infection of healthy volunteers to develop a vaccine against Zika virus infection. The members published their ethical analysis and recommendations in February 2017. They have elaborated on the risks posed by human challenge with Zika virus to the volunteers and other uninvolved third parties and have systematically analysed the social value of such a human challenge experiment. They have also posited some mandatory ethical requirements which should be met before allowing the infection of healthy volunteers with the Zika virus. This commentary elaborates on the debate on the ethics of the human challenge model for the development of a Zika virus vaccine and the role of systematic ethical analysis in protecting the interests of research participants. It further analyses the importance of this debate to the development of a Zika vaccine in India.

  2. Cost-effectiveness of competing strategies for management of recurrent Clostridium difficile infection: a decision analysis.

    Science.gov (United States)

    Konijeti, Gauree G; Sauk, Jenny; Shrime, Mark G; Gupta, Meera; Ananthakrishnan, Ashwin N

    2014-06-01

    Clostridium difficile infection (CDI) is an important cause of morbidity and healthcare costs, and is characterized by high rates of disease recurrence. The cost-effectiveness of newer treatments for recurrent CDI has not been examined, yet would be important to inform clinical practice. The aim of this study was to analyze the cost effectiveness of competing strategies for recurrent CDI. We constructed a decision-analytic model comparing 4 treatment strategies for first-line treatment of recurrent CDI in a population with a median age of 65 years: metronidazole, vancomycin, fidaxomicin, and fecal microbiota transplant (FMT). We modeled up to 2 additional recurrences following the initial recurrence. We assumed FMT delivery via colonoscopy as our base case, but conducted sensitivity analyses based on different modes of delivery. Willingness-to-pay threshold was set at $50 000 per quality-adjusted life-year. At our base case estimates, initial treatment of recurrent CDI using FMT colonoscopy was the most cost-effective strategy, with an incremental cost-effectiveness ratio of $17 016 relative to oral vancomycin. Fidaxomicin and metronidazole were both dominated by FMT colonoscopy. On sensitivity analysis, FMT colonoscopy remained the most cost-effective strategy at cure rates >88.4% and CDI recurrence rates cost cost-effectiveness threshold. In clinical settings where FMT is not available or applicable, the preferred strategy appears to be initial treatment with oral vancomycin. In this decision analysis examining treatment strategies for recurrent CDI, we demonstrate that FMT colonoscopy is the most cost-effective initial strategy for management of recurrent CDI.

  3. Anti-tobacco control industry strategies in Turkey.

    Science.gov (United States)

    Keklik, Seda; Gultekin-Karakas, Derya

    2018-02-26

    Transnational tobacco companies (TTCs) penetrated the Turkish cigarette market due to trade and investment liberalization in the post-1980 period and eventually secured full control. Despite tobacco control policies put in place in reaction to accelerating consumption, TTCs reinforced their market power through a variety of strategies. This paper explores industry strategies that counteract tobacco control policies in Turkey. The study employs both qualitative and quantitative analyses to explore industry strategies in Turkey. Besides the content analyses of industry and market reports, descriptive analyses were conducted for the sub-periods of 1999-2015. The analyses focus on the market strategies of product innovation, advertisement-promotion, cost management and pricing. Rising sales of low tar, ultra-low tar, slim, super-slim and flavoured cigarettes indicate that product innovation served to sustain consumption. Besides, the tobacco industry, using its strong distribution channels, the Internet, and CSR projects, were found to have promoted smoking indirectly. The industry also rationalized manufacturing facilities and reduced the cost of tobacco, making Turkey a cigarette-manufacturing base. Tobacco manufacturers, moreover, offered cigarettes in different price segments and adjusted net prices both up and down according to price categories and market conditions. In response to the successful effect of shifts in price margins, the market share of mid-priced cigarettes expanded while those within the economy category maintained the highest market share. As a result of pricing strategies, net sales revenues increased. Aside from official cigarette sales, the upward trends in the registered and unregistered sales of cigarette substitutes indicate that the demand-side tobacco control efforts remain inadequate. The Turkish case reveals that the resilience of the tobacco industry vis-à-vis mainstream tobacco control efforts necessitates a new policy perspective

  4. Biological Control Strategies for Mosquito Vectors of Arboviruses.

    Science.gov (United States)

    Huang, Yan-Jang S; Higgs, Stephen; Vanlandingham, Dana L

    2017-02-10

    Historically, biological control utilizes predatory species and pathogenic microorganisms to reduce the population of mosquitoes as disease vectors. This is particularly important for the control of mosquito-borne arboviruses, which normally do not have specific antiviral therapies available. Although development of resistance is likely, the advantages of biological control are that the resources used are typically biodegradable and ecologically friendly. Over the past decade, the advancement of molecular biology has enabled optimization by the manipulation of genetic materials associated with biological control agents. Two significant advancements are the discovery of cytoplasmic incompatibility induced by Wolbachia bacteria, which has enhanced replacement programs, and the introduction of dominant lethal genes into local mosquito populations through the release of genetically modified mosquitoes. As various arboviruses continue to be significant public health threats, biological control strategies have evolved to be more diverse and become critical tools to reduce the disease burden of arboviruses.

  5. Biological Control Strategies for Mosquito Vectors of Arboviruses

    Directory of Open Access Journals (Sweden)

    Yan-Jang S. Huang

    2017-02-01

    Full Text Available Historically, biological control utilizes predatory species and pathogenic microorganisms to reduce the population of mosquitoes as disease vectors. This is particularly important for the control of mosquito-borne arboviruses, which normally do not have specific antiviral therapies available. Although development of resistance is likely, the advantages of biological control are that the resources used are typically biodegradable and ecologically friendly. Over the past decade, the advancement of molecular biology has enabled optimization by the manipulation of genetic materials associated with biological control agents. Two significant advancements are the discovery of cytoplasmic incompatibility induced by Wolbachia bacteria, which has enhanced replacement programs, and the introduction of dominant lethal genes into local mosquito populations through the release of genetically modified mosquitoes. As various arboviruses continue to be significant public health threats, biological control strategies have evolved to be more diverse and become critical tools to reduce the disease burden of arboviruses.

  6. Dual motor drive vehicle speed synchronization and coordination control strategy

    Science.gov (United States)

    Huang, Hao; Tu, Qunzhang; Jiang, Chenming; Ma, Limin; Li, Pei; Zhang, Hongxing

    2018-04-01

    Multi-motor driven systems are more and more widely used in the field of electric engineering vehicles, as a result of the road conditions and the variable load of engineering vehicles, makes multi-motors synchronization coordinated control system as a key point of the development of the electric vehicle drive system. This paper based on electrical machinery transmission speed in the process of engineering vehicles headed for coordinated control problem, summarized control strategies at home and abroad in recent years, made analysis and comparison of the characteristics, finally discussed the trend of development of the multi-motor coordination control, provided a reference for synchronized control system research of electric drive engineering vehicles.

  7. Optimal management strategies in variable environments: Stochastic optimal control methods

    Science.gov (United States)

    Williams, B.K.

    1985-01-01

    Dynamic optimization was used to investigate the optimal defoliation of salt desert shrubs in north-western Utah. Management was formulated in the context of optimal stochastic control theory, with objective functions composed of discounted or time-averaged biomass yields. Climatic variability and community patterns of salt desert shrublands make the application of stochastic optimal control both feasible and necessary. A primary production model was used to simulate shrub responses and harvest yields under a variety of climatic regimes and defoliation patterns. The simulation results then were used in an optimization model to determine optimal defoliation strategies. The latter model encodes an algorithm for finite state, finite action, infinite discrete time horizon Markov decision processes. Three questions were addressed: (i) What effect do changes in weather patterns have on optimal management strategies? (ii) What effect does the discounting of future returns have? (iii) How do the optimal strategies perform relative to certain fixed defoliation strategies? An analysis was performed for the three shrub species, winterfat (Ceratoides lanata), shadscale (Atriplex confertifolia) and big sagebrush (Artemisia tridentata). In general, the results indicate substantial differences among species in optimal control strategies, which are associated with differences in physiological and morphological characteristics. Optimal policies for big sagebrush varied less with variation in climate, reserve levels and discount rates than did either shadscale or winterfat. This was attributed primarily to the overwintering of photosynthetically active tissue and to metabolic activity early in the growing season. Optimal defoliation of shadscale and winterfat generally was more responsive to differences in plant vigor and climate, reflecting the sensitivity of these species to utilization and replenishment of carbohydrate reserves. Similarities could be seen in the influence of both

  8. Analysis of Hydrogen Control Strategy Using Igniter during Severe Accident

    International Nuclear Information System (INIS)

    Lee, Sung Bok; Kim, Hyeong Taek; Lee, Keo Hyoung

    2008-01-01

    The Severe Accident Management Guidelines (SAMGs) for the operating pressurized water reactor (PWR) have been completed within 2006. Among the SAMG strategies, mitigation-07 is the most important strategy for managing a severe accident of a PWR in order to reduce containment hydrogen. The fastest way to reduce the containment hydrogen concentration is to intentionally ignite the hydrogen. For this strategy, igniters exist in Optimized Power Reactor 1000 (OPR 1000) to burn hydrogen for a severe accident. For using the igniters during a severe accident, the adverse effects such as the explosion of the hydrogen mixture should be considered for containment integrity. However, an applicable discrimination method to activate the igniters does not exist, so that the hydrogen control strategy using the igniters cannot be chosen during a severe accident. Thus, this study focused on suggesting an applicable discrimination method to carry out the strategy of using the igniters. In this study, the specific plant used for this analysis is Ulchin Unit 5 and 6, OPR 1000 plant, in Korea

  9. Dynamic flow control strategies of vehicle SCR Urea Dosing System

    Science.gov (United States)

    Lin, Wei; Zhang, Youtong; Asif, Malik

    2015-03-01

    Selective Catalyst Reduction(SCR) Urea Dosing System(UDS) directly affects the system accuracy and the dynamic response performance of a vehicle. However, the UDS dynamic response is hard to keep up with the changes of the engine's operating conditions. That will lead to low NO X conversion efficiency or NH3 slip. In order to optimize the injection accuracy and the response speed of the UDS in dynamic conditions, an advanced control strategy based on an air-assisted volumetric UDS is presented. It covers the methods of flow compensation and switching working conditions. The strategy is authenticated on an UDS and tested in different dynamic conditions. The result shows that the control strategy discussed results in higher dynamic accuracy and faster dynamic response speed of UDS. The inject deviation range is improved from being between -8% and 10% to -4% and 2% and became more stable than before, and the dynamic response time was shortened from 200 ms to 150 ms. The ETC cycle result shows that after using the new strategy the NH3 emission is reduced by 60%, and the NO X emission remains almost unchanged. The trade-off between NO X conversion efficiency and NH3 slip is mitigated. The studied flow compensation and switching working conditions can improve the dynamic performance of the UDS significantly and make the UDS dynamic response keep up with the changes of the engine's operating conditions quickly.

  10. What is the role of health education in the integrated strategy to control transmission of Schistosoma japonicum in China?

    Science.gov (United States)

    Liu, Rong; Dong, Hui-Fen; Jiang, Ming-Sen

    2012-05-01

    In 2009, Wang et al.'s field trial published in the New England Journal of Medicine, reported that a comprehensive strategy aiming to reduce the roles of humans and cattle as sources of Schistosoma japonicum infection in snails was implemented and proved effective and promising in dramatically reducing the percentage of infected humans and snails, which had been extended to other endemic provinces in China afterwards. This implies that the integrated schistosomiasis-control strategies of interventions including political will, financial support and residents' participation to control human and bovine sources of S. japonicum infection in snails may direct to successfully interrupt the parasitic transmission and to ultimately eliminate schistosomiasis. Confusingly, however, the role of health education, which is a critical part of the integrated strategy and should play an active role in schistosomiasis control, was not reflected. We wish the authors to provide the readers a better and clearer statement of the role of health education as part of the integrated control strategy and so we write this comment.

  11. [Epidemic situation and prevention and control strategy of clonorchiasis in Guangdong Province, China].

    Science.gov (United States)

    Zhuo-Hui, Deng; Yue-Yi, Fang

    2016-05-24

    Clonorchiasis is one of the food-borne parasitic diseases. Adult parasites live in the human liver and gallbladder tube system, causing serious complications, such as gallstones, cholecystitis and cholangitis, and even bile duct cancer. The disease is very popular in our country, and the population infection rate is high. It is an important public health problem. Guangdong Province is the earliest province being found of clonorchiasis and with serious epidemic. In the second national human parasitic diseases distribution survey, the results showed that the average infection rate of Clonorchis sinensis in the epidemic areas in Guangdong was 16.42%. It is estimated that the population of C. sinensis infection is over 6 million. The prevention and control of clonorchiasis in China is still in the initial stage currently and we face many challenges such as unclear epidemic characteristics and transmission mode, and lack of long-term prevention and control mechanism. This article introduces the epidemic situation of clonorchiasis and prevention and control strategies and measures in Guangdong.

  12. An agent-based simulation model for Clostridium difficile infection control.

    Science.gov (United States)

    Codella, James; Safdar, Nasia; Heffernan, Rick; Alagoz, Oguzhan

    2015-02-01

    Control of Clostridium difficile infection (CDI) is an increasingly difficult problem for health care institutions. There are commonly recommended strategies to combat CDI transmission, such as oral vancomycin for CDI treatment, increased hand hygiene with soap and water for health care workers, daily environmental disinfection of infected patient rooms, and contact isolation of diseased patients. However, the efficacy of these strategies, particularly for endemic CDI, has not been well studied. The objective of this research is to develop a valid, agent-based simulation model (ABM) to study C. difficile transmission and control in a midsized hospital. We develop an ABM of a midsized hospital with agents such as patients, health care workers, and visitors. We model the natural progression of CDI in a patient using a Markov chain and the transmission of CDI through agent and environmental interactions. We derive input parameters from aggregate patient data from the 2007-2010 Wisconsin Hospital Association and published medical literature. We define a calibration process, which we use to estimate transition probabilities of the Markov model by comparing simulation results to benchmark values found in published literature. In a comparison of CDI control strategies implemented individually, routine bleach disinfection of CDI-positive patient rooms provides the largest reduction in nosocomial asymptomatic colonization (21.8%) and nosocomial CDIs (42.8%). Additionally, vancomycin treatment provides the largest reduction in relapse CDIs (41.9%), CDI-related mortalities (68.5%), and total patient length of stay (21.6%). We develop a generalized ABM for CDI control that can be customized and further expanded to specific institutions and/or scenarios. Additionally, we estimate transition probabilities for a Markov model of natural CDI progression in a patient through calibration. © The Author(s) 2014.

  13. Infection control challenges in deployed US military treatment facilities.

    Science.gov (United States)

    Hospenthal, Duane R; Crouch, Helen K

    2009-04-01

    Personnel sustaining combat-related injuries in current overseas conflicts continue to have their care complicated by infections caused by multidrug-resistant organisms, including Acinetobacter, Klebsiella, and Pseudomonas. Although presumed to be due to multiple factors both within and outside of the combat theater, concern has been raised about the difficulties in establishing and maintaining standard infection control (IC) practices in deployed medical treatment facilities and in the evacuation of the injured back to the United States. Level III facilities (hospitals capable of holding patients >72 hours) in Iraq and Afghanistan and the evacuation system from Iraq to the continental US were reviewed by an expert IC-infectious disease team. All reviewed facilities had established IC programs, but these were staffed by personnel with limited IC experience, often without perceived adequate time dedicated to perform their duties, and without uniform levels of command emphasis or support. Proper hand hygiene between patients was not always ideal. Isolation and cohorting of patients to decrease multidrug-resistant organism colonization and infection varied among facilities. Review of standard operating procedures found variability among institutions and in quality of these documents. Application of US national and theater-specific guidelines and of antimicrobial control measures also varied among facilities. Effective IC practices are often difficult to maintain in modern US hospitals. In the deployed setting, with ever-changing personnel in a less than optimal practice environment, IC is even more challenging. Standardization of practice with emphasis on the basics of IC practice (e.g., hand hygiene and isolation procedures) needs to be emplaced and maintained in the deployed setting.

  14. Impact of a multidimensional infection control approach on central line-associated bloodstream infections rates in adult intensive care units of 8 cities of Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

    Science.gov (United States)

    2013-01-01

    Background Central line-associated bloodstream infections (CLABs) have long been associated with excess lengths of stay, increased hospital costs and mortality attributable to them. Different studies from developed countries have shown that practice bundles reduce the incidence of CLAB in intensive care units. However, the impact of the bundle strategy has not been systematically analyzed in the adult intensive care unit (ICU) setting in developing countries, such as Turkey. The aim of this study is to analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control approach to reduce the rates of CLAB in 13 ICUs of 13 INICC member hospitals from 8 cities of Turkey. Methods We conducted active, prospective surveillance before-after study to determine CLAB rates in a cohort of 4,017 adults hospitalized in ICUs. We applied the definitions of the CDC/NHSN and INICC surveillance methods. The study was divided into baseline and intervention periods. During baseline, active outcome surveillance of CLAB rates was performed. During intervention, the INICC multidimensional approach for CLAB reduction was implemented and included the following measures: 1- bundle of infection control interventions, 2- education, 3- outcome surveillance, 4- process surveillance, 5- feedback of CLAB rates, and 6- performance feedback on infection control practices. CLAB rates obtained in baseline were compared with CLAB rates obtained during intervention. Results During baseline, 3,129 central line (CL) days were recorded, and during intervention, we recorded 23,463 CL-days. We used random effects Poisson regression to account for clustering of CLAB rates within hospital across time periods. The baseline CLAB rate was 22.7 per 1000 CL days, which was decreased during the intervention period to 12.0 CLABs per 1000 CL days (IRR 0.613; 95% CI 0.43 – 0.87; P 0.007). This amounted to a 39% reduction in the incidence rate of CLAB

  15. Extreme value analysis for evaluating ozone control strategies.

    Science.gov (United States)

    Reich, Brian; Cooley, Daniel; Foley, Kristen; Napelenok, Sergey; Shaby, Benjamin

    2013-06-01

    Tropospheric ozone is one of six criteria pollutants regulated by the US EPA, and has been linked to respiratory and cardiovascular endpoints and adverse effects on vegetation and ecosystems. Regional photochemical models have been developed to study the impacts of emission reductions on ozone levels. The standard approach is to run the deterministic model under new emission levels and attribute the change in ozone concentration to the emission control strategy. However, running the deterministic model requires substantial computing time, and this approach does not provide a measure of uncertainty for the change in ozone levels. Recently, a reduced form model (RFM) has been proposed to approximate the complex model as a simple function of a few relevant inputs. In this paper, we develop a new statistical approach to make full use of the RFM to study the effects of various control strategies on the probability and magnitude of extreme ozone events. We fuse the model output with monitoring data to calibrate the RFM by modeling the conditional distribution of monitoring data given the RFM using a combination of flexible semiparametric quantile regression for the center of the distribution where data are abundant and a parametric extreme value distribution for the tail where data are sparse. Selected parameters in the conditional distribution are allowed to vary by the RFM value and the spatial location. Also, due to the simplicity of the RFM, we are able to embed the RFM in our Bayesian hierarchical framework to obtain a full posterior for the model input parameters, and propagate this uncertainty to the estimation of the effects of the control strategies. We use the new framework to evaluate three potential control strategies, and find that reducing mobile-source emissions has a larger impact than reducing point-source emissions or a combination of several emission sources.

  16. Minimal average consumption downlink base station power control strategy

    OpenAIRE

    Holtkamp H.; Auer G.; Haas H.

    2011-01-01

    We consider single cell multi-user OFDMA downlink resource allocation on a flat-fading channel such that average supply power is minimized while fulfilling a set of target rates. Available degrees of freedom are transmission power and duration. This paper extends our previous work on power optimal resource allocation in the mobile downlink by detailing the optimal power control strategy investigation and extracting fundamental characteristics of power optimal operation in cellular downlink. W...

  17. Economic implications of three strategies for the control of taeniasis

    OpenAIRE

    Alexander, A.; John, K. R.; Jayaraman, T.; Oommen, A.; Venkata Raghava, M.; Dorny, P.; Rajshekhar, V.

    2011-01-01

    Objective To evaluate the cost-effectiveness of three strategies for the control of taeniasis in a community, in terms of cost per case treated. Methods A study was conducted in South India to determine the prevalence of taeniasis by screening stool samples from 653 randomly chosen subjects, for coproantigens. The costs incurred in the project were used to estimate the cost per case screened and treated. A one-way sensitivity analysis was carried out for varying rates of taeniasis, different ...

  18. Candida auris: Disinfectants and Implications for Infection Control.

    Science.gov (United States)

    Ku, Tsun S N; Walraven, Carla J; Lee, Samuel A

    2018-01-01

    Candida auris is a rapidly emerging pathogen and is able to cause severe infections with high mortality rates. It is frequently misidentified in most clinical laboratories, thus requiring more specialized identification techniques. Furthermore, several clinical isolates have been found to be multidrug resistant and there is evidence of nosocomial transmission in outbreak fashion. Appropriate infection control measures will play a major role in controlling the management and spread of this pathogen. Unfortunately, there are very few data available on the effectiveness of disinfectants against C. auris . Chlorine-based products appear to be the most effective for environmental surface disinfection. Other disinfectants, although less effective than chlorine-based products, may have a role as adjunctive disinfectants. A cleaning protocol will also need to be established as the use of disinfectants alone may not be sufficient for maximal decontamination of patient care areas. Furthermore, there are fewer data on the effectiveness of antiseptics against C. auris for patient decolonization and hand hygiene for healthcare personnel. Chlorhexidine gluconate has shown some efficacy in in vitro studies but there are reports of patients with persistent colonization despite twice daily body washes with this disinfectant. Hand hygiene using soap and water, with or without chlorhexidine gluconate, may require the subsequent use of alcohol-based hand sanitizer for maximal disinfection. Further studies will be needed to validate the currently studied disinfectants for use in real-world settings.

  19. Candida auris: Disinfectants and Implications for Infection Control

    Directory of Open Access Journals (Sweden)

    Tsun S. N. Ku

    2018-04-01

    Full Text Available Candida auris is a rapidly emerging pathogen and is able to cause severe infections with high mortality rates. It is frequently misidentified in most clinical laboratories, thus requiring more specialized identification techniques. Furthermore, several clinical isolates have been found to be multidrug resistant and there is evidence of nosocomial transmission in outbreak fashion. Appropriate infection control measures will play a major role in controlling the management and spread of this pathogen. Unfortunately, there are very few data available on the effectiveness of disinfectants against C. auris. Chlorine-based products appear to be the most effective for environmental surface disinfection. Other disinfectants, although less effective than chlorine-based products, may have a role as adjunctive disinfectants. A cleaning protocol will also need to be established as the use of disinfectants alone may not be sufficient for maximal decontamination of patient care areas. Furthermore, there are fewer data on the effectiveness of antiseptics against C. auris for patient decolonization and hand hygiene for healthcare personnel. Chlorhexidine gluconate has shown some efficacy in in vitro studies but there are reports of patients with persistent colonization despite twice daily body washes with this disinfectant. Hand hygiene using soap and water, with or without chlorhexidine gluconate, may require the subsequent use of alcohol-based hand sanitizer for maximal disinfection. Further studies will be needed to validate the currently studied disinfectants for use in real-world settings.

  20. Strategies and criteria for risk-based configuration control

    International Nuclear Information System (INIS)

    Samanta, P.K.; Kim, I.S.; Vesely, W.E.

    1991-01-01

    A configuration, as used here, is a set of component operability or statuses that define the state of a nuclear power plant. Risk-based configuration control is the management of component configurations using a risk perspective to control risk and assure safety. If the component configurations that have high risk implications do not occur then the risk from the operation of nuclear power plants would be minimal. The control of component configurations, i.e., the management of component statuses, so that the risk from components being unavailable is minimized, becomes difficult because the status of a standby safety system component is often not apparent unless it is tested. In this paper, we discuss the strategies and criteria for risk-based configuration control in nuclear power plants. In developing these strategies and criteria, the primary objective is to obtain more direct risk control but the added benefit is the effective use of plant resources. Implementation of such approaches can result in replacement/modification of parts of Technical Specifications. Specifically, the risk impact or safety impact of a configuration depends upon four factors: (1) The configuration components which are simultaneously down (i.e., inoperable); (2) the backup components which are known to be up (i.e., operable); (3) the duration of time the configuration exists (the outage time); and (4) the frequency at which the configuration occurs. Risk-based configuration control involves managing these factors using risk analyses and risk insights. In this paper, we discuss each of the factors and illustrate how they can be controlled. The information and the tools needed in implementing configuration control are also discussed. The risk-based calculation requirements in achieving the control are also delineated. 4 refs., 4 figs., 1 tab

  1. SP-100 initial startup and restart control strategy

    International Nuclear Information System (INIS)

    Halfen, F.J.; Wong, K.K.; Switick, D.M.; Shukla, J.N.

    1992-01-01

    This paper reports that recent Generic Flight System (GFS) updates have necessitated revisions in the initial startup and restart control strategies. The design changes that have had the most impact on the control strategies are the addition of the Auxiliary Cooling and Thaw (ACT) system for preheating the lithium filled components, changes in the reactivity worths of the reflectors and safety-rods such that initial cold criticality is achieved with only a small amount of reflector movement following the withdrawal of the safety-rods, and the removal of the scram function from the reflectors. Revised control and operating strategies have been developed and tested using the SP-100 dynamic simulation model, ARIES-GFS. The change in the total reactivity worths of the reflectors and safety-rods has eliminated the need for the use of fast and slow reflector drive speeds during the initial on-orbit approach to criticality. The relatively fast removal of the safety-rods results in a near-critical condition so that the use of slow moving (single speed) reflector drives does not add significant time to achieve full power for the initial startup. The use of the ACT system (with its NaK trace-lines for preheating and auxiliary cooling) affects the main Thermoelectric Electro-Magnetic (TEM) pump startup and the time after a shutdown before freezing occurs in the main heat transfer systems

  2. Cost-Effectiveness Analysis of Six Strategies to Treat Recurrent Clostridium difficile Infection.

    Directory of Open Access Journals (Sweden)

    Lauren Lapointe-Shaw

    Full Text Available To assess the cost-effectiveness of six treatment strategies for patients diagnosed with recurrent Clostridium difficile infection (CDI in Canada: 1. oral metronidazole; 2. oral vancomycin; 3.oral fidaxomicin; 4. fecal transplantation by enema; 5. fecal transplantation by nasogastric tube; and 6. fecal transplantation by colonoscopy.Public insurer for all hospital and physician services.Ontario, Canada.A decision analytic model was used to model costs and lifetime health effects of each strategy for a typical patient experiencing up to three recurrences, over 18 weeks. Recurrence data and utilities were obtained from published sources. Cost data was obtained from published sources and hospitals in Toronto, Canada. The willingness-to-pay threshold was $50,000/QALY gained.Fecal transplantation by colonoscopy dominated all other strategies in the base case, as it was less costly and more effective than all alternatives. After accounting for uncertainty in all model parameters, there was an 87% probability that fecal transplantation by colonoscopy was the most beneficial strategy. If colonoscopy was not available, fecal transplantation by enema was cost-effective at $1,708 per QALY gained, compared to metronidazole. In addition, fecal transplantation by enema was the preferred strategy if the probability of recurrence following this strategy was below 8.7%. If fecal transplantation by any means was unavailable, fidaxomicin was cost-effective at an additional cost of $25,968 per QALY gained, compared to metronidazole.Fecal transplantation by colonoscopy (or enema, if colonoscopy is unavailable is cost-effective for treating recurrent CDI in Canada. Where fecal transplantation is not available, fidaxomicin is also cost-effective.

  3. Cost-Effectiveness Analysis of Six Strategies to Treat Recurrent Clostridium difficile Infection.

    Science.gov (United States)

    Lapointe-Shaw, Lauren; Tran, Kim L; Coyte, Peter C; Hancock-Howard, Rebecca L; Powis, Jeff; Poutanen, Susan M; Hota, Susy

    2016-01-01

    To assess the cost-effectiveness of six treatment strategies for patients diagnosed with recurrent Clostridium difficile infection (CDI) in Canada: 1. oral metronidazole; 2. oral vancomycin; 3.oral fidaxomicin; 4. fecal transplantation by enema; 5. fecal transplantation by nasogastric tube; and 6. fecal transplantation by colonoscopy. Public insurer for all hospital and physician services. Ontario, Canada. A decision analytic model was used to model costs and lifetime health effects of each strategy for a typical patient experiencing up to three recurrences, over 18 weeks. Recurrence data and utilities were obtained from published sources. Cost data was obtained from published sources and hospitals in Toronto, Canada. The willingness-to-pay threshold was $50,000/QALY gained. Fecal transplantation by colonoscopy dominated all other strategies in the base case, as it was less costly and more effective than all alternatives. After accounting for uncertainty in all model parameters, there was an 87% probability that fecal transplantation by colonoscopy was the most beneficial strategy. If colonoscopy was not available, fecal transplantation by enema was cost-effective at $1,708 per QALY gained, compared to metronidazole. In addition, fecal transplantation by enema was the preferred strategy if the probability of recurrence following this strategy was below 8.7%. If fecal transplantation by any means was unavailable, fidaxomicin was cost-effective at an additional cost of $25,968 per QALY gained, compared to metronidazole. Fecal transplantation by colonoscopy (or enema, if colonoscopy is unavailable) is cost-effective for treating recurrent CDI in Canada. Where fecal transplantation is not available, fidaxomicin is also cost-effective.

  4. Cost-Effectiveness Analysis of Six Strategies to Treat Recurrent Clostridium difficile Infection

    Science.gov (United States)

    Lapointe-Shaw, Lauren; Tran, Kim L.; Coyte, Peter C.; Hancock-Howard, Rebecca L.; Powis, Jeff; Poutanen, Susan M.; Hota, Susy

    2016-01-01

    Objective To assess the cost-effectiveness of six treatment strategies for patients diagnosed with recurrent Clostridium difficile infection (CDI) in Canada: 1. oral metronidazole; 2. oral vancomycin; 3.oral fidaxomicin; 4. fecal transplantation by enema; 5. fecal transplantation by nasogastric tube; and 6. fecal transplantation by colonoscopy. Perspective Public insurer for all hospital and physician services. Setting Ontario, Canada. Methods A decision analytic model was used to model costs and lifetime health effects of each strategy for a typical patient experiencing up to three recurrences, over 18 weeks. Recurrence data and utilities were obtained from published sources. Cost data was obtained from published sources and hospitals in Toronto, Canada. The willingness-to-pay threshold was $50,000/QALY gained. Results Fecal transplantation by colonoscopy dominated all other strategies in the base case, as it was less costly and more effective than all alternatives. After accounting for uncertainty in all model parameters, there was an 87% probability that fecal transplantation by colonoscopy was the most beneficial strategy. If colonoscopy was not available, fecal transplantation by enema was cost-effective at $1,708 per QALY gained, compared to metronidazole. In addition, fecal transplantation by enema was the preferred strategy if the probability of recurrence following this strategy was below 8.7%. If fecal transplantation by any means was unavailable, fidaxomicin was cost-effective at an additional cost of $25,968 per QALY gained, compared to metronidazole. Conclusion Fecal transplantation by colonoscopy (or enema, if colonoscopy is unavailable) is cost-effective for treating recurrent CDI in Canada. Where fecal transplantation is not available, fidaxomicin is also cost-effective. PMID:26901316

  5. Effect of rearing diet on the infection rate in flies released for the control of tsetse populations by sterile males

    International Nuclear Information System (INIS)

    Maudlin, I.

    1990-01-01

    In areas where sleeping sickness is endemic, it is the practice of sterile insect technique (SIT) programmes to give sterilized males a bloodmeal before release into the wild in order to reduce the risk of these released flies acting as disease vectors. This strategy has been adopted because of experimental evidence which showed that it was essential to infect flies at their first feed to establish a Tripanosoma brucei gambiense or T. b rhodesiense infection in tsetse flies. The aim of the work was to test artificial tsetse diets produced in the IAEA Laboratory at Seibersdorf in order to determine whether they were as effective as whole blood in inhibiting T. brucei sensu lato (sl) infections in flies. Seven artificial diets were tested with T.b. rhodesiense; Glossina morsitans morsitans males were fed one meal of the diet and then starved for 3 days before the infective feed. None of these diets significantly altered the infection rate of the treated flies and the seven groups produced statistically homogeneous results, with a mean midgut rate of 16% (control flies fed pig blood: 17%). Flies infected as tenerals with the same trypanosome stock produced midgut rates of 61%. Three of the diets were also tested with a T. congolense stock. There were no significant differences between flies fed artificial (mean midgut infection rate: 15%) and whole blood diets (19%). G. m. morsitans infected as tenerals with this trypanosome stock produced midgut rates of 66%. As with T. brucei sl infections, teneral flies were far more likely to develop a T. congolense infection than fed flies; this result suggests that all the tsetse flies used in SIT programmes should be fed before release in order to reduce the risk both to man and his livestock. Artificial diets are as effective as whole blood in inhibiting trypanosome infections. The effect of bloodmeal on the fly infection rates is discussed in relation to lectin production in fed flies. (author). 13 refs, 2 tabs

  6. Cell lineage branching as a strategy for proliferative control.

    Science.gov (United States)

    Buzi, Gentian; Lander, Arthur D; Khammash, Mustafa

    2015-02-19

    How tissue and organ sizes are specified is one of the great unsolved mysteries in biology. Experiments and mathematical modeling implicate feedback control of cell lineage progression, but a broad understanding of what lineage feedback accomplishes is lacking. By exploring the possible effects of various biologically relevant disturbances on the dynamic and steady state behaviors of stem cell lineages, we find that the simplest and most frequently studied form of lineage feedback - which we term renewal control - suffers from several serious drawbacks. These reflect fundamental performance limits dictated by universal conservation-type laws, and are independent of parameter choice. Here we show that introducing lineage branches can circumvent all such limitations, permitting effective attenuation of a wide range of perturbations. The type of feedback that achieves such performance - which we term fate control - involves promotion of lineage branching at the expense of both renewal and (primary) differentiation. We discuss the evidence that feedback of just this type occurs in vivo, and plays a role in tissue growth control. Regulated lineage branching is an effective strategy for dealing with disturbances in stem cell systems. The existence of this strategy provides a dynamics-based justification for feedback control of cell fate in vivo.

  7. Control strategies for wind farm power optimization: LES study

    Science.gov (United States)

    Ciri, Umberto; Rotea, Mario; Leonardi, Stefano

    2017-11-01

    Turbines in wind farms operate in off-design conditions as wake interactions occur for particular wind directions. Advanced wind farm control strategies aim at coordinating and adjusting turbine operations to mitigate power losses in such conditions. Coordination is achieved by controlling on upstream turbines either the wake intensity, through the blade pitch angle or the generator torque, or the wake direction, through yaw misalignment. Downstream turbines can be adapted to work in waked conditions and limit power losses, using the blade pitch angle or the generator torque. As wind conditions in wind farm operations may change significantly, it is difficult to determine and parameterize the variations of the coordinated optimal settings. An alternative is model-free control and optimization of wind farms, which does not require any parameterization and can track the optimal settings as conditions vary. In this work, we employ a model-free optimization algorithm, extremum-seeking control, to find the optimal set-points of generator torque, blade pitch and yaw angle for a three-turbine configuration. Large-Eddy Simulations are used to provide a virtual environment to evaluate the performance of the control strategies under realistic, unsteady incoming wind. This work was supported by the National Science Foundation, Grants No. 1243482 (the WINDINSPIRE project) and IIP 1362033 (I/UCRC WindSTAR). TACC is acknowledged for providing computational time.

  8. Questionnaire-based survey on structural quality of hospitals and nursing homes for the elderly, their staffing with infection control personal, and implementation of infection control measures in Germany.

    Science.gov (United States)

    Kramer, A; Assadian, O; Helfrich, J; Krüger, C; Pfenning, I; Ryll, S; Perner, A; Loczenski, B

    2013-01-01

    From January to May 2012, 1,860 hospitals throughout Germany received a questionnaire encompassing 77 items. Additionally, 300 outpatient care services and 310 nursing homes for elderly in Berlin also received a 10-item questionnaire asking on their implemented infection control practices. All questionnaires were anonymous. A total of 229 completed questionnaires from hospitals, 14 questionnaires from outpatient care services, and 16 questionnaires from nursing homes were eligible for further analysis. The lack of Infection Control physicians was identified as the largest issue. In hospitals sized 400-999 beds a gap of 71%, and in hospitals sized ≥1,000 beds a gap of 17% was reported. Depending on the number of hospital beds, 13-29% of hospitals sized ≥100 beds reported not havening one infection control nurse. Since based on the number of beds in larger institutions or in facilities caring for high-risk patients several infection control nurses may be required, the deficiency in infection control nurses may even be higher, particularly in secondary and tertiary care facilities. Furthermore, the analysis revealed that the legal requirements for surveillance and reporting of notifiable infectious diseases have not yet been implemented in 11% of the facilities. The implementation of antibiotic strategies did show significant gaps. However, deficiencies in the implemented measures for the prevention of surgical site infections were less frequent. Yet 12% of the participants did not have a dedicated infection control concept for their surgical services. Eight percent of hospitals were not prepared for an outbreak management and 10% did not have established regulations for wearing surgical scrubs. Deficiencies in waste disposal and the control of air-conditioning systems were also noted. Based on the results of this survey, conclusions on the optimal resource allocation for further improvement of patient safety may be drawn. While all participating nursing homes had

  9. Design strategy for control of inherently safe reactors

    International Nuclear Information System (INIS)

    Chisholm, G.H.

    1984-01-01

    Reactor power plant safety is assured through a combination of engineered barriers to radiation release (e.g., reactor containment) in combination with active reactor safety systems to shut the reactor down and remove decay heat. While not specifically identified as safety systems, the control systems responsible for continuous operation of plant subsystems are the first line of defense for mitigating radiation releases and for plant protection. Inherently safe reactors take advantage of passive system features for decay-heat removal and reactor shutdown functions normally ascribed to active reactor safety systems. The advent of these reactors may permit restructuring of the present control system design strategy. This restructuring is based on the fact that authority for protection against unlikely accidents is, as much as practical, placed upon the passive features of the system instead of the traditional placement upon the PPS. Consequently, reactor control may be simplified, allowing the reliability of control systems to be improved and more easily defended

  10. Chaos control in an economic model via minimum entropy strategy

    Energy Technology Data Exchange (ETDEWEB)

    Salarieh, Hassan [Center of Excellence in Design, Robotics and Automation, Department of Mechanical Engineering, Sharif University of Technology, P.O. Box 11365-9567, Tehran (Iran, Islamic Republic of)], E-mail: salarieh@mech.sharif.edu; Alasty, Aria [Center of Excellence in Design, Robotics and Automation, Department of Mechanical Engineering, Sharif University of Technology, P.O. Box 11365-9567, Tehran (Iran, Islamic Republic of); National Research Institute for Science Policy (NRISP), Soheil Street, Shirazi Avenue, Tehran (Iran, Islamic Republic of)], E-mail: aalasti@sharif.edu

    2009-04-30

    In this paper, minimum entropy algorithm for controlling chaos, is applied to a Cournot duopoly with different constant marginal costs, as a discrete-time dynamical system which shows chaotic behavior. The ME control is implemented through delayed feedback. It is assumed that the equations of the dynamical system are not known, so the feedback gain cannot be obtained analytically from the system equations. In the ME method the feedback gain is obtained adaptively in such a way that the entropy of the system converges to zero, hence a fixed point of the system will be stabilized. Application of the proposed method with different economic control strategies is numerically investigated. Simulation results show the effectiveness of the ME method for controlling chaos in economic systems with unknown equations.

  11. Sexually Transmitted Infections: A Novel Screening Strategy for Improving Women’s Health in Vulnerable Populations

    Science.gov (United States)

    Frati, Elena R.; Fasoli, Ester; Martinelli, Marianna; Colzani, Daniela; Bianchi, Silvia; Carnelli, Luciana; Amendola, Antonella; Olivani, Pierfranco; Tanzi, Elisabetta

    2017-01-01

    Background: Migrant women are one of the most vulnerable population to health problems and well-being. This study aimed at implementing a counseling and preventive strategy for sexually transmitted infections (STIs) in undocumented migrant women in Milan, Italy. Methods: Women (ages 18–65) were enrolled at the NAGA Centre (2012–2013) and asked for a urine sample in order to carry out molecular detection of Human papillomavirus (HPV), Chlamydia trachomatis (Ct), Trichomonas vaginalis (Tv), Neisseria gonorrhoeae (Ng)-DNA. Socio-demographic and sexual behavior information were collected. All HPV/Ct+ women were offered Pap tests and/or were prescribed antibiotic treatment. Results: 537/757 women participated in the study (acceptability rate: 70.9%). Most of the women were from Latin America (45.6%) and Eastern Europe (30.7%); >60% of them had stable partners, did not use contraception and had had at least one pregnancy. The prevalence rates of HPV, Ct, Tv and Ng infections were 24.2%, 7.8%, 4.8% and 0%, respectively. In all, 43.2% of the positive women agreed to undergo a gynecological examination and accepted suitable treatment. Conclusions: This study shows an overall high prevalence of STIs in undocumented migrant women in Milan. The screening strategy based on counseling and urine testing contributed to the successfully high acceptability rate. More appropriate health services that adequately address all aspects of women’s health are required. PMID:28632191

  12. Sexually Transmitted Infections: A Novel Screening Strategy for Improving Women's Health in Vulnerable Populations.

    Science.gov (United States)

    Frati, Elena R; Fasoli, Ester; Martinelli, Marianna; Colzani, Daniela; Bianchi, Silvia; Carnelli, Luciana; Amendola, Antonella; Olivani, Pierfranco; Tanzi, Elisabetta

    2017-06-20

    Migrant women are one of the most vulnerable population to health problems and well-being. This study aimed at implementing a counseling and preventive strategy for sexually transmitted infections (STIs) in undocumented migrant women in Milan, Italy. Women (ages 18-65) were enrolled at the NAGA Centre (2012-2013) and asked for a urine sample in order to carry out molecular detection of Human papillomavirus (HPV), Chlamydia trachomatis ( Ct ), Trichomonas vaginalis ( Tv ), Neisseria gonorrhoeae ( Ng )-DNA. Socio-demographic and sexual behavior information were collected. All HPV/ Ct + women were offered Pap tests and/or were prescribed antibiotic treatment. 537/757 women participated in the study (acceptability rate: 70.9%). Most of the women were from Latin America (45.6%) and Eastern Europe (30.7%); >60% of them had stable partners, did not use contraception and had had at least one pregnancy. The prevalence rates of HPV, Ct , Tv and Ng infections were 24.2%, 7.8%, 4.8% and 0%, respectively. In all, 43.2% of the positive women agreed to undergo a gynecological examination and accepted suitable treatment. This study shows an overall high prevalence of STIs in undocumented migrant women in Milan. The screening strategy based on counseling and urine testing contributed to the successfully high acceptability rate. More appropriate health services that adequately address all aspects of women's health are required.

  13. Behavioral risk-reduction strategies to prevent HIV infection among homosexual men: a grounded theory approach.

    Science.gov (United States)

    de Wit, J B; Teunis, N; van Griensven, G J; Sandfort, T G

    1994-12-01

    To be able to design effective health education interventions for homosexual men, it is necessary to understand determinants of safe and unsafe sex from the perspective of those involved. In this qualitative study, therefore, an open approach was taken to allow for this perspective. Interviews were conducted with 50 randomly selected HIV-antibody negative participants in the Amsterdam Cohort Study. Detailed questions were asked about sexual interactions and behaviors with steady and nonsteady partners. Whether or not homosexual men consciously protected themselves from HIV infection and which strategy they adopted was found to depend on three major factors: 1) motivation and intention, 2) significance of anal sex, and 3) risk perception within specific relationships. From a theoretical perspective results indicate that, next to the centrality of individual motivation as postulated in both the Theory of Reasoned Action and the Theory of Planned Behavior, symbolic meaning inherent in sexual acts, as well as type of relationship are important determinants of protective sexual behaviors that have to be taken into account to understand adequately why homosexual men engage in safe or unsafe sex. Some strategies employed by homosexual men carry uncertainties that continue to put them at increased risk for HIV infection. Health education interventions can be designed to address these issues.

  14. Sexually Transmitted Infections: A Novel Screening Strategy for Improving Women’s Health in Vulnerable Populations

    Directory of Open Access Journals (Sweden)

    Elena R. Frati

    2017-06-01

    Full Text Available Background: Migrant women are one of the most vulnerable population to health problems and well-being. This study aimed at implementing a counseling and preventive strategy for sexually transmitted infections (STIs in undocumented migrant women in Milan, Italy. Methods: Women (ages 18–65 were enrolled at the NAGA Centre (2012–2013 and asked for a urine sample in order to carry out molecular detection of Human papillomavirus (HPV, Chlamydia trachomatis (Ct, Trichomonas vaginalis (Tv, Neisseria gonorrhoeae (Ng-DNA. Socio-demographic and sexual behavior information were collected. All HPV/Ct+ women were offered Pap tests and/or were prescribed antibiotic treatment. Results: 537/757 women participated in the study (acceptability rate: 70.9%. Most of the women were from Latin America (45.6% and Eastern Europe (30.7%; >60% of them had stable partners, did not use contraception and had had at least one pregnancy. The prevalence rates of HPV, Ct, Tv and Ng infections were 24.2%, 7.8%, 4.8% and 0%, respectively. In all, 43.2% of the positive women agreed to undergo a gynecological examination and accepted suitable treatment. Conclusions: This study shows an overall high prevalence of STIs in undocumented migrant women in Milan. The screening strategy based on counseling and urine testing contributed to the successfully high acceptability rate. More appropriate health services that adequately address all aspects of women’s health are required.

  15. Cancer in Angola, resources and strategy for its control.

    Science.gov (United States)

    Lopes, Lygia Vieira; Conceição, Ana Vaz; Oliveira, João Blasques; Tavares, António; Domingos, Clarinha; Santos, Lucio Lara

    2012-01-01

    Cancer is an increasingly important health problem in Africa. The number of cancer cases in this region could double, ranging between 700 000 and 1 600 000 new cases in 2030. The mortality rate is higher than 80% and is explained, mainly, by a lack of early detection, diagnostics and treatment resources. In Angola, about 7,000 patients die of cancer every year. Data were derived from open-ended interviews conducted in 2010-11 with health authorities, clinicians, nurses and Administration of Hospitals. According Angola epidemiological data, results of interviews and international published advocacy for cancer control we develop a potential strategy for its control. The objectives are to identify existing resources for cancer control and describe the needs thereto, in order to establish an oncological program to guide the development of Angola cancer control strategies. Malaria remains the leading cause of illness and death in Angola, and other communicable diseases remain a public health problem. However, 9 000 new cases of cancer are diagnosed each year.The most common types of cancer are: cancer of the cervix, breast, prostate, esophagus, stomach and head and neck, as well as cancers with infectious origin, such as Kaposi's sarcoma and liver and bladder cancer. The foundation for developing national cancer control strategies includes: oncological data; investment and training; identifying and removing barriers; guidance and protection of the patient. Angolan National Cancer Centre, Sagrada Esperança Clinic and Girassol Clinic are now developing a cancer program. Improving the economic situation of Angola creates conditions for an increase in life expectancy which in itself is associated with an increased risk of oncological diseases. On the other hand, infectious diseases, associated with the risk of malignant tumors, are endemic. Thus, an increase in patients with malignant disease is expected. A plan is therefore necessary to organize the response to this old

  16. Nonlinear control strategy based on using a shape-tunable neural controller

    Energy Technology Data Exchange (ETDEWEB)

    Chen, C.; Peng, S. [Feng Chia Univ, Taichung (Taiwan, Province of China). Department of chemical Engineering; Chang, W. [Feng Chia Univ, Taichung (Taiwan, Province of China). Department of Automatic Control

    1997-08-01

    In this paper, a nonlinear control strategy based on using a shape-tunable neural network is developed for adaptive control of nonlinear processes. Based on the steepest descent method, a learning algorithm that enables the neural controller to possess the ability of automatic controller output range adjustment is derived. The novel feature of automatic output range adjustment provides the neural controller more flexibility and capability, and therefore the scaling procedure, which is usually unavoidable for the conventional fixed-shape neural controllers, becomes unnecessary. The advantages and effectiveness of the proposed nonlinear control strategy are demonstrated through the challenge problem of controlling an open-loop unstable nonlinear continuous stirred tank reactor (CSTR). 14 refs., 11 figs.

  17. Cost-effectiveness of strategies to prevent methicillin-resistant Staphylococcus aureus transmission and infection in an intensive care unit.

    Science.gov (United States)

    Gidengil, Courtney A; Gay, Charlene; Huang, Susan S; Platt, Richard; Yokoe, Deborah; Lee, Grace M

    2015-01-01

    OBJECTIVE To create a national policy model to evaluate the projected cost-effectiveness of multiple hospital-based strategies to prevent methicillin-resistant Staphylococcus aureus (MRSA) transmission and infection. DESIGN Cost-effectiveness analysis using a Markov microsimulation model that simulates the natural history of MRSA acquisition and infection. PATIENTS AND SETTING Hypothetical cohort of 10,000 adult patients admitted to a US intensive care unit. METHODS We compared 7 strategies to standard precautions using a hospital perspective: (1) active surveillance cultures; (2) active surveillance cultures plus selective decolonization; (3) universal contact precautions (UCP); (4) universal chlorhexidine gluconate baths; (5) universal decolonization; (6) UCP + chlorhexidine gluconate baths; and (7) UCP+decolonization. For each strategy, both efficacy and compliance were considered. Outcomes of interest were: (1) MRSA colonization averted; (2) MRSA infection averted; (3) incremental cost per colonization averted; (4) incremental cost per infection averted. RESULTS A total of 1989 cases of colonization and 544 MRSA invasive infections occurred under standard precautions per 10,000 patients. Universal decolonization was the least expensive strategy and was more effective compared with all strategies except UCP+decolonization and UCP+chlorhexidine gluconate. UCP+decolonization was more effective than universal decolonization but would cost $2469 per colonization averted and $9007 per infection averted. If MRSA colonization prevalence decreases from 12% to 5%, active surveillance cultures plus selective decolonization becomes the least expensive strategy. CONCLUSIONS Universal decolonization is cost-saving, preventing 44% of cases of MRSA colonization and 45% of cases of MRSA infection. Our model provides useful guidance for decision makers choosing between multiple available hospital-based strategies to prevent MRSA transmission.

  18. Factors Leading to the Loss of Natural Elite Control of HIV-1 Infection.

    Science.gov (United States)

    Pernas, María; Tarancón-Diez, Laura; Rodríguez-Gallego, Esther; Gómez, Josep; Prado, Julia G; Casado, Concepción; Dominguez-Molina, Beatriz; Olivares, Isabel; Coiras, Maite; León, Agathe; Rodriguez, Carmen; Benito, Jose Miguel; Rallón, Norma; Plana, Montserrat; Martinez-Madrid, Onofre; Dapena, Marta; Iribarren, Jose Antonio; Del Romero, Jorge; García, Felipe; Alcamí, José; Muñoz-Fernández, M Ángeles; Vidal, Francisco; Leal, Manuel; Lopez-Galindez, Cecilio; Ruiz-Mateos, Ezequiel

    2017-12-06

    inflammatory biomarkers between subjects with persistent control of viral replication and EC that will loss the virological control. The identification of these factors could be a key point for a right medical care of those EC who are going to lose the natural control of viral replication, and for the design of future immunotherapeutic strategies using as a model the natural persistent control of HIV-infection. Copyright © 2017 American Society for Microbiology.

  19. Control strategies for vehicular NOx emissions in Guangzhou, China

    International Nuclear Information System (INIS)

    Shao Min; Zhang Yuanhang; Raufer, Roger

    2001-01-01

    Guangzhou is a city in southern China that has experienced very rapid economic development in recent years. The city's air has very high concentrations of various pollutants, including sulphur dioxide (SO 2 , oxides of nitrogen (NOx), ozone (O 3 ) and particulate. This paper reviews the changes in air quality in the city over the past 15 years, and notes that a serious vehicular-related emissions problem has been superimposed on the traditional coal-burning problem evident in most Chinese cities. As NOx concentrations have increased, oxidants and photochemical smog now interact with the traditional SO 2 and particulate pollutants, leading to increased health risks and other environmental concerns. Any responsible NOx control strategy for the city must include vehicle emission control measures. This paper reviews control strategies designed to abate vehicle emissions to fulfill the city's air quality improvement target in 2010. A cost-effectiveness analysis suggests that, while NOx emission control is expensive, vehicular emission standards could achieve a relatively sizable emissions reduction at reasonable cost. To achieve the 2010 air quality target of NOx, advanced implementation of EURO3 standards is recommended, substituting for the EURO2 currently envisioned in the national regulations Related technical options, including fuel quality improvements and inspection/maintenance (I/M) upgrades (ASM or IM240) are assessed as well. (author)

  20. Strategies for the plasma position and shape control in IGNITOR

    International Nuclear Information System (INIS)

    Villone, F.; Albanese, R.; Ambrosino, G.; Pironti, A.; Rubinacci, G.; Ramogida, G.; Alladio, F.; Bombarda, F.; Coletti, A.; Cucchiaro, A.; Maddaluno, G.; Pizzicaroli, G.; Pizzuto, A.; Roccella, M.; Santinelli, M.; Coppi, B.

    2007-01-01

    The capability of the poloidal field coil system, as presently designed, to provide an effective vertical stabilization of the plasma in the IGNITOR machine has been investigated using the CREATE L response model. An optimization of the vertical position control strategy has been carried out and the most effective coil combination has been selected to stabilize the plasma while fulfilling engineering constraints on the coils and minimizing the required power and voltage. The growth rate of the vertical instability and the power required by the active stabilization system has been estimated with this model. The possible failure of the relevant electromagnetic diagnostics has been taken into account, evaluating the robustness of the plasma position reconstruction strategy. A realistic description of the power supply system has permitted to carry out the optimization of the proportional-integrative-derivative (PID) controller, both with a voltage and a current loop control scheme. An assessment of the requirements for the plasma cross section shape control has been carried out considering perturbations of the plasma global parameters independent of each other and showing that the undesired shape modification rejection is possible with the present PFC and power supply system. The PF coils have been rated relative to their capability to restore shape modifications due to different plasma disturbances. The most effective coil combination, that minimizes recovery time and voltage required, has been identified

  1. Energy Optimal Control Strategy of PHEV Based on PMP Algorithm

    Directory of Open Access Journals (Sweden)

    Tiezhou Wu

    2017-01-01

    Full Text Available Under the global voice of “energy saving” and the current boom in the development of energy storage technology at home and abroad, energy optimal control of the whole hybrid electric vehicle power system, as one of the core technologies of electric vehicles, is bound to become a hot target of “clean energy” vehicle development and research. This paper considers the constraints to the performance of energy storage system in Parallel Hybrid Electric Vehicle (PHEV, from which lithium-ion battery frequently charges/discharges, PHEV largely consumes energy of fuel, and their are difficulty in energy recovery and other issues in a single cycle; the research uses lithium-ion battery combined with super-capacitor (SC, which is hybrid energy storage system (Li-SC HESS, working together with internal combustion engine (ICE to drive PHEV. Combined with PSO-PI controller and Li-SC HESS internal power limited management approach, the research proposes the PHEV energy optimal control strategy. It is based on revised Pontryagin’s minimum principle (PMP algorithm, which establishes the PHEV vehicle simulation model through ADVISOR software and verifies the effectiveness and feasibility. Finally, the results show that the energy optimization control strategy can improve the instantaneity of tracking PHEV minimum fuel consumption track, implement energy saving, and prolong the life of lithium-ion batteries and thereby can improve hybrid energy storage system performance.

  2. From expert data collectors to interventionists: changing the focus for infection control professionals.

    Science.gov (United States)

    Murphy, Denise M

    2002-04-01

    The current economic and political environments challenge health care organizations in the United States to provide affordable, accessible, and comprehensive health services. However, changes in reimbursement to health care providers can affect their ability to offer access to cutting-edge services while reducing costs. Consequently, organizations are restructuring, re-engineering, right-sizing, downsizing, and redesigning, all in an effort to save money while also hoping to maintain a reputation for quality and customer service. Dr Vicky Fraser, in her keynote address at the APIC conference in 2000, reminded us that ICHE programs are cost centers rather than revenue generators, and are often targets for budget cuts. Although Haley's Study on the Efficacy of Nosocomial Infection Control (SENIC), published in 1985, was a landmark event demonstrating the importance of our profession's mission, it is becoming dated. Infection control professionals (ICPs) must continue Haley's work, finding innovative ways to market or demonstrate the value of ICHE programs to health care executives. Closing the 1999 APIC conference with a symposium entitled "Breaking Out of the Box," Jackson and Massanari challenged ICPs to educate themselves about the changing health care environment, to be proactive, and constructively help organizations "re-engineer" more efficiently, rather than feel victimized and helplessly await being re-engineered out of existence. The threat of downsizing prompted ICPs at BJC HealthCare to realize that the time had come to change their own culture and attitudes and to focus on the business of infection control. This change required challenging the traditional roles of solo practitioner, data collector, and keeper of infection control data and knowledge. The goals now include leading intervention teams committed to reducing health care-associated infections, partnering rather than accepting sole responsibility for lowering infection rates, and learning to

  3. Antibiotic susceptibility, heteroresistance, and updated treatment strategies in Helicobacter pylori infection.

    Science.gov (United States)

    Mascellino, Maria Teresa; Porowska, Barbara; De Angelis, Massimiliano; Oliva, Alessandra

    2017-01-01

    In this review, we discuss the problem of antibiotic resistance, heteroresistance, the utility of cultures and antibiotic susceptibility tests in Helicobacter pylori ( Hp ) eradication, as well as the updated treatment strategies for this infection. The prevalence of antibiotic resistance is increasing all over the world, especially for metronidazole and clarithromycin, because of their heavy use in some geographical areas. Heteroresistance (simultaneous presence of both susceptible and resistant strains in different sites of a single stomach) is another important issue, as an isolate could be mistakenly considered susceptible if a single biopsy is used for antimicrobial tests. We also examined literature data regarding eradication success rates of culture-guided and empiric therapies. The empiric therapy and the one based on susceptibility testing, in Hp eradication, may depend on several factors such as concomitant diseases, the number of previous antibiotic treatments, differences in bacterial virulence in individuals with positive or negative cultures, together with local antibiotic resistance patterns in real-world settings. Updated treatment strategies in Hp infection presented in the guidelines of the Toronto Consensus Group (2016) are reported. These suggest to prolong eradication therapy up to 14 days, replacing the old triple therapy with a quadruple therapy based on proton pump inhibitor (PPI), bismuth, metronidazole, and tetracycline for most of the patients, or as an alternative quadruple therapy without bismuth, based on the use of PPI, amoxicillin, metronidazole, and clarithromycin. The new drug vonoprazan, a first-in-class potassium-competitive acid blocker recently approved in Japan, is also considered to be a promising solution for Hp eradication, even for clarithromycin-resistant strains. Furthermore, there is growing interest in finding new therapeutic strategies, such as the development of vaccines or the use of natural resources, including

  4. Application of new control strategy for sun tracking

    International Nuclear Information System (INIS)

    Rubio, F.R.; Ortega, M.G.; Gordillo, F.; Lopez-Martinez, M.

    2007-01-01

    The application of high concentration solar cells technology allows a significant increase in the amount of energy collected by solar arrays per unit area. However, to make it possible, more severe specifications on the sun pointing error are required. In fact, the performance of solar cells with concentrators decreases drastically if this error is greater than a small value. These specifications are not fulfilled by simple tracking systems due to different sources of errors (e.g., small misalignments of the structure with respect to geographical north) that appear in practice in low cost, domestic applications. This paper presents a control application of a sun tracker that is able to follow the sun with high accuracy without the necessity of either a precise procedure of installation or recalibration. A hybrid tracking system that consists of a combination of open loop tracking strategies based on solar movement models and closed loop strategies using a dynamic feedback controller is presented. Energy saving factors are taken into account, which implies that, among other factors, the sun is not constantly tracked with the same accuracy, to prevent energy overconsumption by the motors. Simulation and experimental results with a low cost two axes solar tracker are exposed, including a comparison between a classical open loop tracking strategy and the proposed hybrid one

  5. Strategies to control odours in livestock facilities: a critical review

    Directory of Open Access Journals (Sweden)

    Y. Ubeda

    2013-11-01

    Full Text Available Odours generated in livestock buildings constitute one of the most relevant air quality issues of intensive livestock production. Reducing nuisance episodes related to odour exposure is therefore essential for a sustainable livestock production. In this study, the state-of-the-art on odour mitigation techniques in livestock housing is critically reviewed. Scientific advances in the last decade are revised and research needs are also identified. The complex nature of livestock odours is firstly reviewed and examined. Then, the most relevant odour control strategies are analyzed in terms of present knowledge and future needs. The strategies considered are: nutritional strategies, manure additives, building design, air filtration, manure covers, manure treatment systems and windbreaks. Finally, future research needs and priorities when establishing mitigation techniques are identified. Despite important recent advances, there are still some challenges for scientists, producers and regulators, particularly related to field evaluation of odours. Therefore, to control livestock odours effectively, using standardized field assessment techniques will be required. Also, investigating measurement and model errors may be useful to better understand the limitations of the current methods, as well as to identify research priorities.

  6. Managing work and family: Do control strategies help?

    Science.gov (United States)

    Versey, H Shellae

    2015-11-01

    How can we effectively manage competing obligations from work and family without becoming overwhelmed? This question inspires the current study by examining control strategies that may facilitate better work-life balance, with a specific focus on the role of lowered aspirations and positive reappraisals, attitudes that underlie adaptive coping behaviors. Data from the Midlife in the United States Survey (MIDUS II) were used to explore the relationship between negative spillover, control strategies, and well-being among full-time working men and women (N = 2,091). In this nationally representative sample, findings indicate that while positive reappraisals function as a protective buffer, lowering aspirations exacerbate the relationship between work-family spillover and well-being, with moderating effects stronger among women. This study extends prior research tying work-life conflict to health and mental health, and suggests further investigation is needed to consider types of resources that may be effective coping strategies in balancing work and family. (c) 2015 APA, all rights reserved).

  7. [Bibliometric analysis of literature regarding integrated schistosomiasis control strategy with emphasis on infectious source control].

    Science.gov (United States)

    Qian, Yi-Li; Wang, Wei; Hong, Qing-Biao; Liang, You-Sheng

    2014-12-01

    To evaluate the outcomes of implementation of integrated schistosomiasis control strategy with emphasis on infectious source control using a bibliometric method. The literature pertaining to integrated schistosomiasis control strategy with emphasis on infectious source control was retrieved from CNKI, Wanfangdata, VIP, PubMed, Web of Science, BIOSIS and Google Scholar, and a bibliometric analysis of literature captured was performed. During the period from January 1, 2004 through September 30, 2014, a total of 94 publications regarding integrated schistosomiasis control strategy with emphasis on infectious source control were captured, including 78 Chinese articles (82.98%) and 16 English papers (17.02%). The Chinese literature was published in 21 national journals, and Chinese Journal of Schistosomiasis Control had the largest number of publications, consisting of 37.23% of total publications; 16 English papers were published in 12 international journals, and PLoS Neglected Tropical Diseases had the largest number of publications (3 publications). There were 37 affiliations publishing these 94 articles, and National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (16 publications), Anhui Institute of Schistosomiasis Control (12 publications) and Hunan Institute of Schistosomiasis Control (9 publications) ranked top three affiliations in number of publications. A total of 157 persons were co-authored in these 94 publications, and Wang, Zhou and Zhang ranked top 3 authors in number of publications. The integrated schistosomiasis control strategy with emphasis on infectious source control has been widely implemented in China, and the achievements obtained from the implementation of this strategy should be summarized and transmitted internationally.

  8. Observations on the epidemiology and control of Strongylus vulgaris infections.

    Science.gov (United States)

    Eysker, M; Wemmenhove, R

    1987-01-01

    The epidemiology and control of helminth infections in the horse were studied in four small grazing experiments between 1981 and 1984 at the University of Utrecht. At autopsy in November or December negligible Strongylus vulgaris burdens were found in the cranial mesenteric artery of four groups of ponies, which had been treated with an anthelmintic in July and subsequently transferred to a clean pasture. Considerable arterial S. vulgaris burdens were seen in three groups of ponies which were treated with an anthelmintic in July without a move to clean pasture, and in another group of ponies in 1984, which was set stocked on a pasture used for horses in 1983 and which was treated with an anthelmintic (albendazole) 2 days before turnout in April and subsequently in May, June and July. A tracer pony, grazed with this group between the middle of September and the middle of November, harboured an even higher burden of arterial S. vulgaris larvae. The arterial S. vulgaris in the latter group could not be the result of contamination of the pasture with S. vulgaris eggs before July, as in the three other groups with considerable arterial S. vulgaris burdens. Pasture larval counts showed that S. vulgaris larvae do not only overwinter, but are able to survive in considerable numbers until autumn, longer than most other gastrointestinal nematodes. There were some indications that translation of infective larvae, which overwintered on pasture in some free living stage, occurred between May and July.

  9. System integration and control strategy analysis of PEMFC car

    International Nuclear Information System (INIS)

    Sun, L.; Chen, Y.; Liu, Y.; Shi, P.

    2004-01-01

    A new fuel car was designed according to the prototype LN2000 hydrogen-oxygen fuel cell car. The new prototype consists of a compact fuel cell engine with separated fuel cell stack, nickel metal hydride battery, a motor with power of 30Kw/100Kw and an inverter with high efficiency. With in the powertrain, a two-shift Planet gear transmission was employed. The power performance was greatly improved. New battery with EMS, new self-developed fuel cell engine, the motor propulsion system and electronic controlled transmission make it feasible to control the whole fuel car automatically and efficiently with optimization. The presents the system integration and the control strategy analysis of the fuel cell car prototype. The paper can be used for reference for engineers in the field of fuel cell vehicle. (author)

  10. Instrumentation and control strategies for an integral pressurized water reactor

    Directory of Open Access Journals (Sweden)

    Belle R. Upadhyaya

    2015-03-01

    Full Text Available Several vendors have recently been actively pursuing the development of integral pressurized water reactors (iPWRs that range in power levels from small to large reactors. Integral reactors have the features of minimum vessel penetrations, passive heat removal after reactor shutdown, and modular construction that allow fast plant integration and a secure fuel cycle. The features of an integral reactor limit the options for placing control and safety system instruments. The development of instrumentation and control (I&C strategies for a large 1,000 MWe iPWR is described. Reactor system modeling—which includes reactor core dynamics, primary heat exchanger, and the steam flashing drum—is an important part of I&C development and validation, and thereby consolidates the overall implementation for a large iPWR. The results of simulation models, control development, and instrumentation features illustrate the systematic approach that is applicable to integral light water reactors.

  11. Effective Fragmentation and Flyrock Control Strategies at Quarries

    Directory of Open Access Journals (Sweden)

    Sedat Esen

    2017-01-01

    Full Text Available This paper presents the effective fragmentation and flyrock control strategies that could be applied at quarries to improve the productivity and safety. Fragmentation measurement and modelling as well as a comprehensive drill and blast audit are essential for improving the fragmentation. Face profiling and bore tracking are good tools to manage the ―as-designed‖ and ―as-drilled‖ conditions to get reasonable fragmentation from face burden zone and minimise the flyrock risk. In general, a large scatter in fragmentation data was observed at sites and the causes should be analysed by a detailed root-cause analysis technique. Two case studies were presented in this paper showing some of the effective fragmentation strategies. Finally, a flyrock model was shown to determine the safe blast exclusion zone for the mining equipment and personnel. Some key guidelines were suggested to minimise the occurrence of the flyrock.

  12. Secondary side water chemistry pH control strategy improvements

    Energy Technology Data Exchange (ETDEWEB)

    Roumiguiere, Fernando-Mario; Fandrich, Joerg; Ramminger, Ute; Hoffmann-Wankerl, Stephan; Drexler, Andreas [AREVA NP GmbH, Erlangen (Germany)

    2012-11-15

    When selecting a pH control strategy, plant design and operation characteristics have to be carefully considered. The strategy should be tailored to the plant-specific needs and requirements. Owing to the complexity of the interrelated variables, the best way is to perform a modeling with a suitable computer code. This work investigated the possibility of complementing the classic high pH all-volatile treatment (H-AVT) by addition of an organic amine at low concentrations complementarily to ammonia dosing to locally increase the pH in the water phase of the wet steam areas to counteract flow-assisted corrosion (FAC). Alternative conditioning scenarios were considered and calculated for comparative analysis using a computer code. The results obtained argue for the convenience of using ammonia as the main alkalizing agent whenever possible, avoiding multiple amine concepts and their associated drawbacks. (orig.)

  13. FINANCIAL CONTROL STRATEGIES FOR COLLECTING BODY OF A MUNICIPAL TAX

    Directory of Open Access Journals (Sweden)

    Ernesto Rodríguez

    2015-07-01

    Full Text Available This article's main purpose is to propose fiscal control strategies for tax collection in a Hall of Carabobo state, taking into account the responsibility of municipal governments within its governance process to provide optimal services to citizens the municipality, in order to improve their quality of life. This research focused on the modality of feasible project and descriptive. The population under study consisted of 10 staff of the institution, applying a survey as a tool for information gathering, allowing coding, tabulating and analyzing the results. The findings established that the institution is presenting negatives in tax revenue of the municipality, which generates large arrears and tax evasion by citizens, hence leading to the importance of design strategies that lead to minimize this situation.

  14. Toxocara infection in psychiatric inpatients: a case control seroprevalence study.

    Directory of Open Access Journals (Sweden)

    Cosme Alvarado-Esquivel

    Full Text Available BACKGROUND: There is poor knowledge about the epidemiology of toxocariasis in psychiatric patients. AIMS: Determine the seroepidemiology of Toxocara infection in psychiatric patients. METHODS: Through a case-control seroprevalence study, 128 psychiatric inpatients and 276 control subjects were compared for the presence of anti-Toxocara IgG antibodies in Durango, Mexico. Socio-demographic, clinical, and behavioral characteristics of inpatients associated with toxocariasis were also investigated. RESULTS: Six of the 128 (4.7% psychiatric inpatients, and 3 (1.1% of the 276 controls were positive for anti-Toxocara IgG antibodies (P = 0.03. Stratification by age showed that Toxocara seroprevalence was significantly (P = 0.02 higher in patients aged ≤50 years old (6/90∶6.7% than controls of the same age (2/163∶1.2%. While Toxocara seroprevalence was similar in patients and controls aged >50 years old. Stratification by gender showed that Toxocara seroprevalence was significantly (P = 0.03 higher in female patients (2/37∶5.4% than in female controls (0/166∶0%. No statistically significant associations between Toxocara seropositivity and clinical characteristics were found. In contrast, Toxocara seropositivity was associated with consumption of goat meat and raw sea snail. CONCLUSIONS: This is the first report of toxocariasis in psychiatric inpatients in Mexico. Further studies with larger sample sizes are needed to elucidate the association of toxocariasis with psychiatric diseases. The role of the consumption of goat meat and raw sea snail in the transmission of Toxocara deserve further investigation.

  15. Viral infections as controlling factors for the deep biosphere? (Invited)

    Science.gov (United States)

    Engelen, B.; Engelhardt, T.; Sahlberg, M.; Cypionka, H.

    2009-12-01

    The marine deep biosphere represents the largest biotope on Earth. Throughout the last years, we have obtained interesting insights into its microbial community composition. However, one component that was completely overlooked so far is the viral inventory of deep-subsurface sediments. While viral infections were identified to have a major impact on the benthic microflora of deep-sea surface sediments (Danavaro et al. 2008), no studies were performed on deep-biosphere samples, so far. As grazers probably play only a minor role in anoxic and highly compressed deep sediments, viruses might be the main “predators” for indigenous microorganisms. Furthermore, the release of cell components, called “the viral shunt”, could have a major impact on the deep biosphere in providing labile organic compounds to non-infected microorganisms in these generally nutrient depleted sediments. However, direct counting of viruses in sediments is highly challenging due to the small size of viruses and the high background of small particles. Even molecular surveys using “universal” PCR primers that target phage-specific genes fail due to the vast phage diversity. One solution for this problem is the lysogenic viral life cycle as many bacteriophages integrate their DNA into the host genome. It is estimated that up to 70% of cultivated bacteria contain prophages within their genome. Therefore, culture collections (Batzke et al. 2007) represent an archive of the viral composition within the respective habitat. These prophages can be induced to become free phage particles in stimulation experiments in which the host cells are set under certain stress situations such as a treatment with UV exposure or DNA-damaging antibiotics. The study of the viral component within the deep biosphere offers to answer the following questions: To which extent are deep-biosphere populations controlled by viral infections? What is the inter- and intra-specific diversity and the host-specific viral

  16. Perceived Barriers to Adherence to Tuberculosis Infection Control Measures among Health Care Workers in the Dominican Republic.

    Science.gov (United States)

    Chapman, Helena J; Veras-Estévez, Bienvenido A; Pomeranz, Jamie L; Pérez-Then, Eddy N; Marcelino, Belkys; Lauzardo, Michael

    2017-01-01

    INTRODUCTION Health care workers have an increased risk of infection due to occupational Mycobacterium tuberculosis exposure, including multidrug-resistant strains. Health care workers' risk of developing tuberculosis is greater than that of the general population, whether in low-, intermediate- or high-incidence countries. Adherence to infection control measures (administrative controls, environmental controls, and personal respiratory protection) is essential to reduce risk of disease transmission between suspected tuberculosis patients and health care workers, but for different reasons, both objective and subjective, adherence is low. Identifying the causes of low adherence is a prerequisite to effective programming to reduce risk. OBJECTIVE Identify perceived barriers to adherence to tuberculosis infection control measures among health care workers in the Dominican Republic. METHODS During August 2014, a qualitative study was conducted in two tertiary-level hospitals in different regions of the Dominican Republic. A semi-structured interview guide of nine questions was developed, based on the scientific literature and with consensus of clinical experts. Nine semi-structured interviews were conducted with a purposive sample of seven physicians (five men, two women) and two baccalaureate nurses (both women) working in the emergency medicine, internal medicine or nursing departments of those institutions. Question topics included clinical experience of M. tuberculosis infection and disease; knowledge of disease transmission and preventive practices; clinical management strategies; and perceptions of effectiveness of directly observed treatment, short-course, and disease coping strategies. RESULTS Perceived barriers were described as: 1) sense of invincibility of health care workers; 2) personal beliefs of health care workers related to direct patient communication; 3) low provider-to-patient ratios in hospitals; 4) absence of tuberculosis isolation units for

  17. Health care workers' knowledge, attitudes and practices on tuberculosis infection control, Nepal.

    Science.gov (United States)

    Shrestha, Anita; Bhattarai, Dipesh; Thapa, Barsha; Basel, Prem; Wagle, Rajendra Raj

    2017-11-17

    Infection control remains a key challenge for Tuberculosis (TB) control program with an increased risk of TB transmission among health care workers (HCWs), especially in settings with inadequate TB infection control measures. Poor knowledge among HCWs and inadequate infection control practices may lead to the increased risk of nosocomial TB transmission. An institution-based cross-sectional survey was conducted in 28 health facilities providing TB services in the Kathmandu Valley, Nepal. A total of 190 HCWs were assessed for the knowledge, attitudes and practices on TB infection control using a structured questionnaire. The level of knowledge on TB infection control among almost half (45.8%) of the HCWs was poor, and was much poorer among administration and lower level staff. The knowledge level was significantly associated with educational status, and TB training and/or orientation received. The majority (73.2%) of HCWs had positive attitude towards TB infection control. Sixty-five percent of HCWs were found to be concerned about being infected with TB. Use of respirators among the HCWs was limited and triage of TB suspects was also lacking. Overall knowledge and practices of HCWs on TB infection control were not satisfactory. Effective infection control measures including regular skill-based training and/or orientation for all categories of HCWs can improve infection control practices in health facilities.

  18. Improvements in cross-infection control in general dental practice.

    Science.gov (United States)

    Bentley, E M; Sarll, D W

    1995-07-08

    A questionnaire about cross-infection control was sent to all GDPs in five FHSAs in the North Western Region. Replies came from 312 dentists, a response rate of 74%. They worked in 185 practices, a response rate of 85%. Gloves were worn routinely by 86% of dentists and 80% of DSAs. Handpieces were autoclaved between patients in 77% of practices. Much however, remains to be improved. DSAs could be better protected if more ultrasonic cleaners were used, eye protection encouraged and heavy duty gloves were available for cleaning instruments. BDA guidelines were reported as being the most influential factor, though it would appear that the media did persuade many practitioners to use autoclavable handpieces and sterilise them after each use.

  19. Nuclear techniques in the control of parasitic infections

    International Nuclear Information System (INIS)

    Mulligan, W.

    1976-01-01

    The development of radiation-attenuated vaccines against economically important parasitic diseases of farm animals has met with mixed success. Examples are presented ranging from the highly effective and much used commercial vaccine against cattle lungworm to the almost completely unsuccessful attempts to immunize sheep against liver fluke. The results presented emphasize that this approach is likely to be successful only if there is evidence of a strong degree of acquired immunity to the natural infection. The extension of immunological control to those systems where the parasite provokes only a modest resistance by the host will probably depend on a much greater understanding of the mechanism of the immune response. Such fundamental studies are likely to rely heavily on nuclear techniques, e.g. in the labelling of antigens, antibodies and parasites with radioactive isotopes. (author)

  20. [Evaluation of practices for the prevention and control of bloodstream infections in a government hospital].

    Science.gov (United States)

    Jardim, Jaquelline Maria; Lacerda, Rúbia Aparecida; Soares, Naury de Jesus Danzi; Nunes, Bruna Kosar

    2013-02-01

    The aim of this study was to observe clinical procedures in order to evaluate the practices used for the control and prevention of bloodstream infections associated with short-term central venous catheters (BSI-ACVC). The study data came from 5877 assessments distributed among selected practices. The results revealed the following adherence rates among the practices selected: 91.6% for recording the indication and permanence time of the CVC, 51.5% for adhering to the care and maintenance of the dressing at the CVC insertion site and its devices, 10.7% for hand hygiene practices while performing procedures related to the CVC, and 0.0% for the practices related to the insertion of the central venous catheter (CVC). The results demonstrate the need for further elaboration of strategies that ensure sustainable compliance practices for prevention and control BSI-ACVC in the institution being assessed.