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2. The impact of inpatient bloodstream infections caused by antibiotic-resistant bacteria in low- and middle-income countries: A systematic review and meta-analysis

Author

Allel, Kasim, Stone, Jennifer, Undurraga, Eduardo A., Day, Lucy, Moore, Catrin E., Lin, Leesa, Furuya-Kanamori, Luis, and Yakob, Laith

Subjects
Diagnosis, Care and treatment, Prevention, Analysis, Health care costs -- Analysis, Bacteremia -- Diagnosis -- Care and treatment, Microbial drug resistance -- Prevention, Hospital stays -- Analysis, Medical care, Cost of -- Analysis, Drug resistance in microorganisms -- Prevention, Hospital utilization -- Length of stay
Abstract

Author(s): Kasim Allel 1,2,3,4,*, Jennifer Stone 5, Eduardo A. Undurraga 4,6,7,8, Lucy Day 1, Catrin E. Moore 9, Leesa Lin 10,11,12, Luis Furuya-Kanamori 13, Laith Yakob 1,2 Introduction Antibiotic-resistant bacteria [...], Background Bloodstream infections (BSIs) produced by antibiotic-resistant bacteria (ARB) cause a substantial disease burden worldwide. However, most estimates come from high-income settings and thus are not globally representative. This study quantifies the excess mortality, length of hospital stay (LOS), intensive care unit (ICU) admission, and economic costs associated with ARB BSIs, compared to antibiotic-sensitive bacteria (ASB), among adult inpatients in low- and middle-income countries (LMICs). Methods and findings We conducted a systematic review by searching 4 medical databases (PubMed, SCIELO, Scopus, and WHO&apos;s Global Index Medicus; initial search n = 13,012 from their inception to August 1, 2022). We only included quantitative studies. Our final sample consisted of n = 109 articles, excluding studies from high-income countries, without our outcomes of interest, or without a clear source of bloodstream infection. Crude mortality, ICU admission, and LOS were meta-analysed using the inverse variance heterogeneity model for the general and subgroup analyses including bacterial Gram type, family, and resistance type. For economic costs, direct medical costs per bed-day were sourced from WHO-CHOICE. Mortality costs were estimated based on productivity loss from years of potential life lost due to premature mortality. All costs were in 2020 USD. We assessed studies&apos; quality and risk of publication bias using the MASTER framework. Multivariable meta-regressions were employed for the mortality and ICU admission outcomes only. Most included studies showed a significant increase in crude mortality (odds ratio (OR) 1.58, 95% CI [1.35 to 1.80], p < 0.001), total LOS (standardised mean difference "SMD" 0.49, 95% CI [0.20 to 0.78], p < 0.001), and ICU admission (OR 1.96, 95% CI [1.56 to 2.47], p < 0.001) for ARB versus ASB BSIs. Studies analysing Enterobacteriaceae, Acinetobacter baumanii, and Staphylococcus aureus in upper-middle-income countries from the African and Western Pacific regions showed the highest excess mortality, LOS, and ICU admission for ARB versus ASB BSIs per patient. Multivariable meta-regressions indicated that patients with resistant Acinetobacter baumanii BSIs had higher mortality odds when comparing ARB versus ASB BSI patients (OR 1.67, 95% CI [1.18 to 2.36], p 0.004). Excess direct medical costs were estimated at $12,442 (95% CI [$6,693 to $18,191]) for ARB versus ASB BSI per patient, with an average cost of $41,103 (95% CI [$30,931 to $51,274]) due to premature mortality. Limitations included the poor quality of some of the reviewed studies regarding the high risk of selective sampling or failure to adequately account for relevant confounders. Conclusions We provide an overview of the impact ARB BSIs in limited resource settings derived from the existing literature. Drug resistance was associated with a substantial disease and economic burden in LMICs. Although, our results show wide heterogeneity between WHO regions, income groups, and pathogen-drug combinations. Overall, there is a paucity of BSI data from LMICs, which hinders implementation of country-specific policies and tracking of health progress.

Published
2023
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3. Real world research impact for PGRs

Author

Walker, Emily, Potts, June, Edwards, Liz, and Day, Lucy

Abstract

This presentation will tie to the themes of student experience, research and knowledge exchange specifically engaging with our partners in impactful, connected knowledge exchange that delivers transformative benefit. The Impact Officers (Emily and Lucy) will provide a short introduction to what impact is and why it’s important. The main bulk of the presentation will be PhD student Jack Fitzpatrick from the School of Education talking about his experiences of creating real world impact and change with Merseyside Police and the College of Policing through his research on Modern Policing in the 21st Century and why it’s time for an inclusive shift. He’ll explain how he has developed relationships with stakeholders, how he has engaged with them and the impacts that have resulted from these activities. He will also talk about what this has meant for him as a PGR, why PGRs need to think about telling their own impact stories and how to do it. This session will help to develop a vibrant diverse and intellectually curious postgraduate research community, helping to prepare our PGRs for their own career development as well as to deliver tangible public engagement and change for our communities in line with the aims of the UN Sustainable Development Goals. Real world research impact for PGRs, PowerPoint, please note only LJMU staff and students have access to this document., Student Experience Proceedings, 2023: Students at the Heart Conference

Published
2023
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9. NMR Investigations of the Interaction Between the Azo-Dye Sunset Yellow and Fluorophenol

Author

Katz, Jonathan R., Day, Lucy J., and Day, Iain J.

Abstract

The interaction of small molecules with larger noncovalent assemblies is important across a wide range of disciplines. Here, we apply two complementary NMR spectroscopic methods to investigate the interaction of various fluorophenol isomers with sunset yellow. This latter molecule is known to form noncovalent aggregates in isotropic solution, and form liquid crystals at high concentrations. We utilize the unique fluorine-19 nucleus of the fluorophenol as a reporter of the interactions via changes in both the observed chemical shift and diffusion coefficients. The data are interpreted in terms of the indefinite self-association model and simple modifications for the incorporation of a second species into an assembly. A change in association mode is tentatively assigned whereby the fluorophenol binds end-on with the sunset yellow aggregates at low concentration and inserts into the stacks at higher concentrations.

Published
2024
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10. Artwrite 38

Author

Domanski, Leah, Art History & Art Education, College of Fine Arts, UNSW, Johnstone, Melissa , Art History & Art Education, College of Fine Arts, UNSW, Villaroel, Patricia , Art History & Art Education, College of Fine Arts, UNSW, Paige, A., Art History & Art Education, College of Fine Arts, UNSW, Carr, Leeanne, Art History & Art Education, College of Fine Arts, UNSW, Columbo, Pablo, Art History & Art Education, College of Fine Arts, UNSW, Rivai, Mirna Novita , Art History & Art Education, College of Fine Arts, UNSW, Day, Lucy, Art History & Art Education, College of Fine Arts, UNSW, Creighton, Annalice , Art History & Art Education, College of Fine Arts, UNSW, Hsieh, Jennifer , Art History & Art Education, College of Fine Arts, UNSW, Hawkes, Wendy , Art History & Art Education, College of Fine Arts, UNSW, Bailey-Charteris, Bronwyn, Art History & Art Education, College of Fine Arts, UNSW, Putra, Andi, Art History & Art Education, College of Fine Arts, UNSW, van Eijk, Marisa , Art History & Art Education, College of Fine Arts, UNSW, Cooper, Marcel, Art History & Art Education, College of Fine Arts, UNSW, Singhal, Noopur, Art History & Art Education, College of Fine Arts, UNSW, Hairs, Danielle, Art History & Art Education, College of Fine Arts, UNSW, Berkowitz, Kathryn , Art History & Art Education, College of Fine Arts, UNSW, Morawetz, Sara, Art History & Art Education, College of Fine Arts, UNSW, Reed, Stewart, Art History & Art Education, College of Fine Arts, UNSW, Johnson, Sarah , Art History & Art Education, College of Fine Arts, UNSW, Hilton, Sally, Art History & Art Education, College of Fine Arts, UNSW, Leven, Mirri, Art History & Art Education, College of Fine Arts, UNSW, Mendelssohn, Joanna Christine, Art History & Art Education, College of Fine Arts, UNSW, Domanski, Leah, Art History & Art Education, College of Fine Arts, UNSW, Johnstone, Melissa , Art History & Art Education, College of Fine Arts, UNSW, Villaroel, Patricia , Art History & Art Education, College of Fine Arts, UNSW, Paige, A., Art History & Art Education, College of Fine Arts, UNSW, Carr, Leeanne, Art History & Art Education, College of Fine Arts, UNSW, Columbo, Pablo, Art History & Art Education, College of Fine Arts, UNSW, Rivai, Mirna Novita , Art History & Art Education, College of Fine Arts, UNSW, Day, Lucy, Art History & Art Education, College of Fine Arts, UNSW, Creighton, Annalice , Art History & Art Education, College of Fine Arts, UNSW, Hsieh, Jennifer , Art History & Art Education, College of Fine Arts, UNSW, Hawkes, Wendy , Art History & Art Education, College of Fine Arts, UNSW, Bailey-Charteris, Bronwyn, Art History & Art Education, College of Fine Arts, UNSW, Putra, Andi, Art History & Art Education, College of Fine Arts, UNSW, van Eijk, Marisa , Art History & Art Education, College of Fine Arts, UNSW, Cooper, Marcel, Art History & Art Education, College of Fine Arts, UNSW, Singhal, Noopur, Art History & Art Education, College of Fine Arts, UNSW, Hairs, Danielle, Art History & Art Education, College of Fine Arts, UNSW, Berkowitz, Kathryn , Art History & Art Education, College of Fine Arts, UNSW, Morawetz, Sara, Art History & Art Education, College of Fine Arts, UNSW, Reed, Stewart, Art History & Art Education, College of Fine Arts, UNSW, Johnson, Sarah , Art History & Art Education, College of Fine Arts, UNSW, Hilton, Sally, Art History & Art Education, College of Fine Arts, UNSW, Leven, Mirri, Art History & Art Education, College of Fine Arts, UNSW, and Mendelssohn, Joanna Christine, Art History & Art Education, College of Fine Arts, UNSW

Abstract

This issue of Artwrite is the collective effort of students studying the Master of Art Administration in the College of Fine Arts, UNSW working under the direction of Associate Professor Joanna MendelssohnIt concerns exhibitions and issues current in Australian art in the first half of 2008, including the Biennale of Sydney, ethics and art practices

Published
2008

13. HIROSHIMA.

Author

Day, Lucy Lang

Subjects
HIROSHIMA (Poem), DAY, Lucille Lang
Published
2021

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