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Background: The Australian hospital-acquired complication (HAC) policy was introduced to facilitate negative funding adjustments in Australian hospitals using ICD-10-AM codes. Objective: The aim of this study was to determine the positive predictive value (PPV) of the ICD-10-AM codes in the HAC framework to detect hospital-acquired pneumonia in patients with cancer and to describe any change in PPV before and after implementation of an electronic medical record (EMR) at our centre. Method: A retrospective case review of all coded pneumonia episodes at the Peter MacCallum Cancer Centre in Melbourne, Australia spanning two time periods (01 July 2015 to 30 June 2017 [pre-EMR period] and 01 September 2020 to 28 February 2021 [EMR period]) was performed to determine the proportion of events satisfying standardised surveillance definitions. Results: HAC-coded pneumonia occurred in 3.66% (n = 151) of 41,260 separations during the study period. Of the 151 coded pneumonia separations, 27 satisfied consensus surveillance criteria, corresponding to an overall PPV of 0.18 (95% CI: 0.12, 0.25). The PPV was approximately three times higher following EMR implementation (0.34 [95% CI: 0.19, 0.53] versus 0.13 [95% CI: 0.08, 0.21]; p =.013). Conclusion: The current HAC definition is a poor-to-moderate classifier for hospital-acquired pneumonia in patients with cancer and, therefore, may not accurately reflect hospital-level quality improvement. Implementation of an EMR did enhance case detection, and future refinements to administratively coded data in support of robust monitoring frameworks should focus on EMR systems. Implications: Although ICD-10-AM data are readily available in Australian healthcare settings, these data are not sufficient for monitoring and reporting of hospital-acquired pneumonia in haematology-oncology patients. [ABSTRACT FROM AUTHOR]

The purpose of this study is to understand feminist empowerment through the grant-making and other work of U.S. women's foundations and funds to determine how they incorporate and facilitate empowerment. This study contributes new knowledge on the connections between feminist empowerment theories and the organizational practices of women's philanthropic organizations. To assess the ways in which empowerment manifests in the work of these organizations, feminist empowerment literature was examined along with development literature on women's empowerment, and critiques of empowerment. For this study, a database was created of more than 200 foundations and funds in 43 states by using website and IRS data and a survey administered. The findings speak to the ways in which women's foundations and funds align with empowerment theories and the areas of disconnect. [ABSTRACT FROM AUTHOR]

Background: Extreme and inequitable heat exposures cause weather-related deaths. Associations between maximum daily temperature and individual-level healthcare utilization have been inadequately characterized.To evaluate and compare demographic and clinical associations for an individual’s healthcare utilization between high- and low-temperature periods.Retrospective, 5-year longitudinal study of acute care utilization comparing high-temperature periods (HHP) and low-temperature periods (LHP) defined by local maximum daily temperature. Using duration of observation, cases served as their own controls. Temperature-dependent utilization was reported as unadjusted incident rate ratio (IRR) using Poisson regression and log-transformed variable coefficients. IRRs were adjusted (aIRR) for demographic characteristics, heat-sensitive conditions/diagnoses, and neighborhood heat vulnerability score; false discovery rate p-values were adjusted for multiple comparisons.Patients aged ≥ 4 years visiting Denver Health between 4/10/2016 and 12/31/2020, with ≥ 2 visits over ≥ 365 days.Comparison of an individual’s acute care visit rates in HHP versus LHP, stratified by demographic characteristics and heat-sensitive clinical conditions.While acute care utilization occurred at similar or higher rates during LHP compared with HHP, certain groups (i.e., Native Americans and those with congestive heart failure, liver failure, and/or alcohol use) had higher rates of utilization during HHP. Significant associations existed for acute care utilization by age, sex, racial and ethnic groupings, clinical characteristics, and neighborhood heat vulnerability. Adjusting for demographic and environmental covariates, individuals with any heat-sensitive clinical condition had higher HHP vs LHP utilization compared to those without (aIRR = 1.93).Significant heat-related utilization occurred among individuals with heat-sensitive clinical conditions compared with those without. Demographic characteristics (e.g., older) and specific clinical conditions (e.g., liver failure) demonstrated higher utilization. In real-time, chronic disease management programs could proactively identify at-risk individuals for interventions which reduce heat-related morbidity and healthcare utilization.Objective: Extreme and inequitable heat exposures cause weather-related deaths. Associations between maximum daily temperature and individual-level healthcare utilization have been inadequately characterized.To evaluate and compare demographic and clinical associations for an individual’s healthcare utilization between high- and low-temperature periods.Retrospective, 5-year longitudinal study of acute care utilization comparing high-temperature periods (HHP) and low-temperature periods (LHP) defined by local maximum daily temperature. Using duration of observation, cases served as their own controls. Temperature-dependent utilization was reported as unadjusted incident rate ratio (IRR) using Poisson regression and log-transformed variable coefficients. IRRs were adjusted (aIRR) for demographic characteristics, heat-sensitive conditions/diagnoses, and neighborhood heat vulnerability score; false discovery rate p-values were adjusted for multiple comparisons.Patients aged ≥ 4 years visiting Denver Health between 4/10/2016 and 12/31/2020, with ≥ 2 visits over ≥ 365 days.Comparison of an individual’s acute care visit rates in HHP versus LHP, stratified by demographic characteristics and heat-sensitive clinical conditions.While acute care utilization occurred at similar or higher rates during LHP compared with HHP, certain groups (i.e., Native Americans and those with congestive heart failure, liver failure, and/or alcohol use) had higher rates of utilization during HHP. Significant associations existed for acute care utilization by age, sex, racial and ethnic groupings, clinical characteristics, and neighborhood heat vulnerability. Adjusting for demographic and environmental covariates, individuals with any heat-sensitive clinical condition had higher HHP vs LHP utilization compared to those without (aIRR = 1.93).Significant heat-related utilization occurred among individuals with heat-sensitive clinical conditions compared with those without. Demographic characteristics (e.g., older) and specific clinical conditions (e.g., liver failure) demonstrated higher utilization. In real-time, chronic disease management programs could proactively identify at-risk individuals for interventions which reduce heat-related morbidity and healthcare utilization.Design: Extreme and inequitable heat exposures cause weather-related deaths. Associations between maximum daily temperature and individual-level healthcare utilization have been inadequately characterized.To evaluate and compare demographic and clinical associations for an individual’s healthcare utilization between high- and low-temperature periods.Retrospective, 5-year longitudinal study of acute care utilization comparing high-temperature periods (HHP) and low-temperature periods (LHP) defined by local maximum daily temperature. Using duration of observation, cases served as their own controls. Temperature-dependent utilization was reported as unadjusted incident rate ratio (IRR) using Poisson regression and log-transformed variable coefficients. IRRs were adjusted (aIRR) for demographic characteristics, heat-sensitive conditions/diagnoses, and neighborhood heat vulnerability score; false discovery rate p-values were adjusted for multiple comparisons.Patients aged ≥ 4 years visiting Denver Health between 4/10/2016 and 12/31/2020, with ≥ 2 visits over ≥ 365 days.Comparison of an individual’s acute care visit rates in HHP versus LHP, stratified by demographic characteristics and heat-sensitive clinical conditions.While acute care utilization occurred at similar or higher rates during LHP compared with HHP, certain groups (i.e., Native Americans and those with congestive heart failure, liver failure, and/or alcohol use) had higher rates of utilization during HHP. Significant associations existed for acute care utilization by age, sex, racial and ethnic groupings, clinical characteristics, and neighborhood heat vulnerability. Adjusting for demographic and environmental covariates, individuals with any heat-sensitive clinical condition had higher HHP vs LHP utilization compared to those without (aIRR = 1.93).Significant heat-related utilization occurred among individuals with heat-sensitive clinical conditions compared with those without. Demographic characteristics (e.g., older) and specific clinical conditions (e.g., liver failure) demonstrated higher utilization. In real-time, chronic disease management programs could proactively identify at-risk individuals for interventions which reduce heat-related morbidity and healthcare utilization.Subjects: Extreme and inequitable heat exposures cause weather-related deaths. Associations between maximum daily temperature and individual-level healthcare utilization have been inadequately characterized.To evaluate and compare demographic and clinical associations for an individual’s healthcare utilization between high- and low-temperature periods.Retrospective, 5-year longitudinal study of acute care utilization comparing high-temperature periods (HHP) and low-temperature periods (LHP) defined by local maximum daily temperature. Using duration of observation, cases served as their own controls. Temperature-dependent utilization was reported as unadjusted incident rate ratio (IRR) using Poisson regression and log-transformed variable coefficients. IRRs were adjusted (aIRR) for demographic characteristics, heat-sensitive conditions/diagnoses, and neighborhood heat vulnerability score; false discovery rate p-values were adjusted for multiple comparisons.Patients aged ≥ 4 years visiting Denver Health between 4/10/2016 and 12/31/2020, with ≥ 2 visits over ≥ 365 days.Comparison of an individual’s acute care visit rates in HHP versus LHP, stratified by demographic characteristics and heat-sensitive clinical conditions.While acute care utilization occurred at similar or higher rates during LHP compared with HHP, certain groups (i.e., Native Americans and those with congestive heart failure, liver failure, and/or alcohol use) had higher rates of utilization during HHP. Significant associations existed for acute care utilization by age, sex, racial and ethnic groupings, clinical characteristics, and neighborhood heat vulnerability. Adjusting for demographic and environmental covariates, individuals with any heat-sensitive clinical condition had higher HHP vs LHP utilization compared to those without (aIRR = 1.93).Significant heat-related utilization occurred among individuals with heat-sensitive clinical conditions compared with those without. Demographic characteristics (e.g., older) and specific clinical conditions (e.g., liver failure) demonstrated higher utilization. In real-time, chronic disease management programs could proactively identify at-risk individuals for interventions which reduce heat-related morbidity and healthcare utilization.Main Measures: Extreme and inequitable heat exposures cause weather-related deaths. Associations between maximum daily temperature and individual-level healthcare utilization have been inadequately characterized.To evaluate and compare demographic and clinical associations for an individual’s healthcare utilization between high- and low-temperature periods.Retrospective, 5-year longitudinal study of acute care utilization comparing high-temperature periods (HHP) and low-temperature periods (LHP) defined by local maximum daily temperature. Using duration of observation, cases served as their own controls. Temperature-dependent utilization was reported as unadjusted incident rate ratio (IRR) using Poisson regression and log-transformed variable coefficients. IRRs were adjusted (aIRR) for demographic characteristics, heat-sensitive conditions/diagnoses, and neighborhood heat vulnerability score; false discovery rate p-values were adjusted for multiple comparisons.Patients aged ≥ 4 years visiting Denver Health between 4/10/2016 and 12/31/2020, with ≥ 2 visits over ≥ 365 days.Comparison of an individual’s acute care visit rates in HHP versus LHP, stratified by demographic characteristics and heat-sensitive clinical conditions.While acute care utilization occurred at similar or higher rates during LHP compared with HHP, certain groups (i.e., Native Americans and those with congestive heart failure, liver failure, and/or alcohol use) had higher rates of utilization during HHP. Significant associations existed for acute care utilization by age, sex, racial and ethnic groupings, clinical characteristics, and neighborhood heat vulnerability. Adjusting for demographic and environmental covariates, individuals with any heat-sensitive clinical condition had higher HHP vs LHP utilization compared to those without (aIRR = 1.93).Significant heat-related utilization occurred among individuals with heat-sensitive clinical conditions compared with those without. Demographic characteristics (e.g., older) and specific clinical conditions (e.g., liver failure) demonstrated higher utilization. In real-time, chronic disease management programs could proactively identify at-risk individuals for interventions which reduce heat-related morbidity and healthcare utilization.Key Results: Extreme and inequitable heat exposures cause weather-related deaths. Associations between maximum daily temperature and individual-level healthcare utilization have been inadequately characterized.To evaluate and compare demographic and clinical associations for an individual’s healthcare utilization between high- and low-temperature periods.Retrospective, 5-year longitudinal study of acute care utilization comparing high-temperature periods (HHP) and low-temperature periods (LHP) defined by local maximum daily temperature. Using duration of observation, cases served as their own controls. Temperature-dependent utilization was reported as unadjusted incident rate ratio (IRR) using Poisson regression and log-transformed variable coefficients. IRRs were adjusted (aIRR) for demographic characteristics, heat-sensitive conditions/diagnoses, and neighborhood heat vulnerability score; false discovery rate p-values were adjusted for multiple comparisons.Patients aged ≥ 4 years visiting Denver Health between 4/10/2016 and 12/31/2020, with ≥ 2 visits over ≥ 365 days.Comparison of an individual’s acute care visit rates in HHP versus LHP, stratified by demographic characteristics and heat-sensitive clinical conditions.While acute care utilization occurred at similar or higher rates during LHP compared with HHP, certain groups (i.e., Native Americans and those with congestive heart failure, liver failure, and/or alcohol use) had higher rates of utilization during HHP. Significant associations existed for acute care utilization by age, sex, racial and ethnic groupings, clinical characteristics, and neighborhood heat vulnerability. Adjusting for demographic and environmental covariates, individuals with any heat-sensitive clinical condition had higher HHP vs LHP utilization compared to those without (aIRR = 1.93).Significant heat-related utilization occurred among individuals with heat-sensitive clinical conditions compared with those without. Demographic characteristics (e.g., older) and specific clinical conditions (e.g., liver failure) demonstrated higher utilization. In real-time, chronic disease management programs could proactively identify at-risk individuals for interventions which reduce heat-related morbidity and healthcare utilization.Conclusions: Extreme and inequitable heat exposures cause weather-related deaths. Associations between maximum daily temperature and individual-level healthcare utilization have been inadequately characterized.To evaluate and compare demographic and clinical associations for an individual’s healthcare utilization between high- and low-temperature periods.Retrospective, 5-year longitudinal study of acute care utilization comparing high-temperature periods (HHP) and low-temperature periods (LHP) defined by local maximum daily temperature. Using duration of observation, cases served as their own controls. Temperature-dependent utilization was reported as unadjusted incident rate ratio (IRR) using Poisson regression and log-transformed variable coefficients. IRRs were adjusted (aIRR) for demographic characteristics, heat-sensitive conditions/diagnoses, and neighborhood heat vulnerability score; false discovery rate p-values were adjusted for multiple comparisons.Patients aged ≥ 4 years visiting Denver Health between 4/10/2016 and 12/31/2020, with ≥ 2 visits over ≥ 365 days.Comparison of an individual’s acute care visit rates in HHP versus LHP, stratified by demographic characteristics and heat-sensitive clinical conditions.While acute care utilization occurred at similar or higher rates during LHP compared with HHP, certain groups (i.e., Native Americans and those with congestive heart failure, liver failure, and/or alcohol use) had higher rates of utilization during HHP. Significant associations existed for acute care utilization by age, sex, racial and ethnic groupings, clinical characteristics, and neighborhood heat vulnerability. Adjusting for demographic and environmental covariates, individuals with any heat-sensitive clinical condition had higher HHP vs LHP utilization compared to those without (aIRR = 1.93).Significant heat-related utilization occurred among individuals with heat-sensitive clinical conditions compared with those without. Demographic characteristics (e.g., older) and specific clinical conditions (e.g., liver failure) demonstrated higher utilization. In real-time, chronic disease management programs could proactively identify at-risk individuals for interventions which reduce heat-related morbidity and healthcare utilization. [ABSTRACT FROM AUTHOR]

The purpose of this essay is to explore the implications of #metoo and #aidtoo for understanding nonprofit/nongovernmental organization (NPO/NGO) theory and practice. We provide an overview of how women have experienced sexual violence in the context of NPOs/NGOs and draw on an intersectional feminist theory lens to highlight the context that enables violence to persist, and which requires more than implementing bureaucratic accountability reforms. We end by discussing potential avenues for creating change to end such violence. [ABSTRACT FROM AUTHOR]

Background: Physical removal of soil rather than biocidal activity is the focus for this safer cleaning method. Methods: We compared 11 years of Victorian healthcare norovirus and suspected viral gastroenteritis outbreak data. Results: Improvements in infection control practice, including the Victorian hand hygiene program corresponds with reduced illness across Victoria during that time. Monash Health reductions are statistically significant and coincide with the implementation of a novel cleaning methodology. Conclusion: Cleaning without chemicals has not increased the risk of norovirus or suspected viral gastroenteritis illness at Monash Health. [ABSTRACT FROM AUTHOR]

In 2015 the University of Liverpool's Library Service embarked upon a three-part usability study to better understand how library users were engaging with our resource discovery platform, to identify any usability issues and assess the extent to which it was currently meeting their needs. Doing so enabled us to make informed, evidence-based changes to the interface, improving its overall usability and providing a more user-friendly and intuitive resource. In this paper we will detail not only the methodologies employed, what we found out about our users, what they liked and disliked and the changes subsequently made, but also the lessons learnt about the platform, the process itself and ourselves. [ABSTRACT FROM AUTHOR]

Periodic microbiological monitoring of endoscopes is a recommendation of the Gastroenterological Society of Australia (GENSA). The aim of monitoring has been to provide quality assurance of the cleaning and disinfection of endoscopes; however, there is controversy regarding its frequency. This lack of consensus stimulated a review of the experience within our health service. At Southern Health, routine microbiological sampling has involved 4-weekly monitoring of bronchoscopes, duodenoscopes and automated flexible endoscope reprocessors (AFER), and 3-monthly monitoring of all other gastrointestinal endoscopes. Records of testing were reviewed from 1 January 2002 until 31 December 2006. A literature review was conducted, cost analysis performed and positive cultures investigated. There were 2374 screening tests performed during the 5-year period, including 287 AFER, 631 bronchoscopes for mycobacteria and 1456 endoscope bacterial screens. There were no positive results of the AFER or bronchoscopes for mycobacteria. Of the 1456 endoscopic bacterial samples, six were positive; however, retesting resulted in no growth. The overall cost of tests performed and cost in time for nursing staff to collect the samples was estimated at $AUD 100 400. Periodic monitoring of endoscopes is both time-consuming and costly. Our review demonstrates that AFER (Soluscope) perform well in cleaning endoscopes. Based on our 5-year experience, assurance of quality for endoscopic use could be achieved through process control as opposed to product control. Maintenance of endoscopes and AFER should be in accordance with the manufacturer's instructions and microbiological testing performed on commissioning, annually and following repair. Initial prompt manual leak testing and manual cleaning followed by mechanical leak testing, cleaning and disinfection should be the minimum standard in reprocessing of endoscopes. [ABSTRACT FROM AUTHOR]

Colonization of neonatal intensive care units by Serratia marcescens is associated with clinical outbreaks. We report the management of an outbreak in a newborn services unit (NBS), in 2004, of a strain of S. marcescens that was present in the unit from 1994. Over the 10-year period, increases in clinical isolates demonstrated three epidemic curves, each spanning 3–4 years and each involving positive blood cultures. In 2004, clinical isolates of S. marcescens bacteremia prompted an investigation. Control measures including screening, creation of a separate unit, use of contact precautions, education, environmental sampling, strategies to reduce overcrowding, surveillance and molecular epidemiological techniques were implemented. In total, 99 babies were either colonized or infected with S. marcescens between December 2003 and December 2005. Isolates were tested with ribotyping identifying one main endemic strain. No environmental source was found, however, the outbreak terminated following adherence to infection control principles. Epidemiological information, structural and practice changes were used to prevent transmission and control the outbreak. [ABSTRACT FROM AUTHOR]

Building expertise in climate and planetary health among healthcare professionals cannot come with greater urgency as the threats from climate change become increasingly apparent. Current and future healthcare professionals—particularly internists—will increasingly need to understand the interconnectedness of natural systems and human health to better serve their patients longitudinally. Despite this, few national medical societies and accreditation bodies espouse frameworks for climate change and planetary health–related education at the undergraduate (UME), graduate (GME), and continuing (CME) medical education level. As a community of medical educators with an enduring interest in climate change and planetary health, the Society of General Internal Medicine (SGIM) recognizes the need to explicitly define structured educational opportunities and core competencies in both UME and GME as well as pathways for faculty development. In this position statement, we build from the related SGIM Climate and Health position statement, and review and synthesize existing position statements made by US-based medical societies and accreditation bodies that focus on climate change and planetary health–related medical education, identify gaps using Bloom's Hierarchy, and provide recommendations on behalf of SGIM regarding the development of climate and planetary health curricula development. Identified gaps include (1) limited systematic approach to climate and planetary health medical education at all levels; (2) minimal emphasis on learner-driven approaches; (3) limited focus on physician and learner well-being; and (4) limited role for health equity and climate justice. Recommendations include a call to relevant accreditation bodies to explicitly include climate change and planetary health as a competency, extend the structural competency framework to climate change and planetary health to build climate justice, proactively include learners in curricular development and teaching, and ensure resources and support to design and implement climate and planetary health–focused education that includes well-being and resiliency. [ABSTRACT FROM AUTHOR]

Background: Patients with cancer are at high risk for infection, but the epidemiology of healthcare‐associated Staphylococcus aureus bacteraemia (HA‐SAB) and Clostridioides difficile infection (HA‐CDI) in Australian cancer patients has not previously been reported. Aims: To compare the cumulative aggregate incidence and time trends of HA‐SAB and HA‐CDI in a predefined cancer cohort with a mixed statewide patient population in Victoria, Australia. Methods: All SAB and CDI events in patients admitted to Victorian healthcare facilities between 1 July 2010 and 31 December 2018 were submitted to the Victorian Healthcare Associated Infection Surveillance System Coordinating Centre. Descriptive analyses and multilevel mixed‐effects Poisson regression modelling were applied to a standardised data extract. Results: In total, 10 608 and 13 118 SAB and CDI events were reported across 139 Victorian healthcare facilities, respectively. Of these, 89 (85%) and 279 (88%) were healthcare‐associated in the cancer cohort compared with 34% (3561/10 503) and 66% (8403/12 802) in the statewide cohort. The aggregate incidence was more than twofold higher in the cancer cohort compared with the statewide cohort for HA‐SAB (2.25 (95% confidence interval (CI): 1.74–2.77) vs 1.11 (95% CI: 1.07–1.15) HA‐SAB/10 000 occupied bed‐days) and threefold higher for HA‐CDI (6.26 (95% CI: 5.12–7.41) vs 2.31 (95% CI: 2.21–2.42) HA‐CDI/10 000 occupied bed‐days). Higher quarterly diminishing rates were observed in the cancer cohort than the statewide data for both infections. Conclusions: Our findings demonstrate a higher burden of HA‐SAB and HA‐CDI in a cancer cohort when compared with state data and highlight the need for cancer‐specific targets and benchmarks to meaningfully support quality improvement. [ABSTRACT FROM AUTHOR]

Extreme heat exposure increases the risk for heat-related illnesses (HRIs) and deaths, and comprehensive strategies to prevent HRIs are increasingly important in a warming climate (1). An estimated 702 HRI-associated deaths and 67,512 HRI-associated emergency department visits occur in the United States each year (2,3). In 2020, Phoenix and Yuma, Arizona, experienced a record 145 and 148 days, respectively, of temperatures >100°F (37.8°C), and a record 522 heat-related deaths occurred in the state. HRIs are preventable through individual and community-based strategies*,†; cooling centers,§ typically air-conditioned or cooled buildings designated as sites to provide respite and safety during extreme heat, have been established in Maricopa and Yuma counties to reduce HRIs among at-risk populations, such as older adults. This analysis examined trends in HRIs by age during 2010-2020 for Maricopa and Yuma counties and data from a survey of older adults related to cooling center availability and use in Yuma County during 2018-2019. Data from CDC's Social Vulnerability Index (SVI) were also used to overlay cooling center locations with SVI scores. During 2010-2020, heat days, defined as days with an excessive heat warning issued by the National Weather Service Phoenix Office,¶ for any part of Maricopa and Yuma counties (4), increased in both Maricopa County (1.18 days per year) and Yuma County (1.71 days per year) on average. Adults aged ≥65 years had higher rates of HRI hospitalization compared with those aged <65 years. In a survey of 39 adults aged ≥65 years in Yuma County, 44% reported recent HRI symptoms, and 18% reported electricity cost always or sometimes constrained their use of air conditioning. Barriers to cooling center access among older adults include awareness of location and transportation. Collaboration among diverse community sectors and health profession education programs is important to better prepare for rising heat exposure and HRIs. States and communities can implement adaptation and evaluation strategies to mitigate and assess heat risk, such as the use of cooling centers to protect communities disproportionately affected by HRI during periods of high temperatures. [ABSTRACT FROM AUTHOR]

In recent years there has been an increasing demand for respite care in the community setting, as advances in medicine and technology have enhanced the life expectancy of children and young people with a life-limiting illness. However, the need for flexible respite provision in the home frequently presents a challenge for those health care professionals involved in caring for these children and their families. Following a review of literature this paper will demonstrate how a family-centred approach to respite provision and palliative care can enhance the quality of life for a child nearing the end of life and support the expressed needs of the child's family with accessible respite care. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) kinetics remain understudied, including the impact of remdesivir. In hospitalized individuals, peak sputum viral load occurred in week 2 of symptoms, whereas viremia peaked within 1 week of symptom-onset, suggesting early systemic seeding of SARS-CoV-2. Remdesivir treatment was associated with faster viral decay. [ABSTRACT FROM AUTHOR]

Presents several letters to the editor concerning on science in the January 1981 issue of the journal 'The New York Academy of Sciences.' Various process of gathering visual information; Correlation between linear programming and journalism; Interpretation of visual information.

Abstract: Reuse of single-use devices is common in most countries worldwide. We provide an overview of the issue from an international perspective. In many developing and transitional countries reuse of cheap single-use devices (needles, syringes, surgical gloves) is common leading to large numbers of unsafe interventions, specifically injections and, as a consequence, infection with hepatitis B, C or HIV. There are various reasons for reuse: limited resources, insufficient knowledge of healthcare workers and the belief of patients that injection is more beneficial than oral medication. Reuse of cheap single-use devices should cease and both medical staff and the public should be informed about potential safety risks associated with injection. In developed countries, reuse of single-use items is less common but may include expensive technical products. Reuse is regulated in many countries (e.g. US, Canada, some European countries) demanding ethical and legal considerations, high standards of reprocessing and training of staff, risk assessment, management and validation of reprocessing. Well regulated reprocessing can decrease the number of single-use devices reprocessed. In developing as well as developed countries, a decision to reprocess single-use devices should only be made after a critical reflection of advantages and disadvantages. [Copyright &y& Elsevier]