UHSP Collections (University of Health Sciences and Pharmacy)
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A cohort study of bacteremic pneumonia the importance of antibiotic resistance and appropriate initial therapy?
No full textBacteremic pneumonia is usually associated with greater mortality. However, risk factors associated with hospital mortality in bacteremic pneumonia are inadequately described. The study was a retrospective cohort study, conducted in Barnes-Jewish Hospital (2008-2015). For purposes of this investigation, antibiotic susceptibility was determined according to ceftriaxone susceptibility, as ceftriaxone represents the antimicrobial agent most frequently recommended for hospitalized patients with community-acquired pneumonia as opposed to nosocomial pneumonia. Two multivariable analyses were planned: the first model included resistance to ceftriaxone as a variable, whereas the second model included the various antibiotic-resistant species (methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Enterobacteriaceae). In all, 1031 consecutive patients with bacteremic pneumonia (mortality 37.1%) were included. The most common pathogens associated with infection were S aureus (34.1%; methicillin resistance 54.0%), Enterobacteriaceae (28.0%), P aeruginosa (10.6%), anaerobic bacteria (7.3%), and Streptococcus pneumoniae (5.6%). Compared with ceftriaxone-susceptible pathogens (46.8%), ceftriaxone-resistant pathogens (53.2%) were significantly more likely to receive inappropriate initial antibiotic treatment (IIAT) (27.9% vs 7.1%; P\u3c0.001) and to die during hospitalization (41.5% vs 32.0%; P=0.001). The first logistic regression analysis identified IIAT with the greatest odds ratio (OR) for mortality (OR 2.2, 95% confidence interval [CI] 1.5-3.2, P\u3c0.001). Other independent predictors of mortality included age, mechanical ventilation, immune suppression, prior hospitalization, prior antibiotic administration, septic shock, comorbid conditions, and severity of illness. In the second multivariable analysis that included the antibiotic-resistant species, IIAT was still associated with excess mortality, and P aeruginosa infection was identified as an independent predictor of mortality (OR 1.6, 95% CI 1.1-2.2, P=0.047), whereas infection with ceftriaxone-resistant Enterobacteriaceae (OR 0.6, 95% CI 0.4-1.0, P= 0.050) was associated with lower mortality. More than one-third of our patients hospitalized with bacteremic pneumonia died. IIAT was identified as the most important risk factor for hospital mortality and the only risk factor amenable to potential intervention. Specific antibiotic-resistant pathogen species were also associated with mortality
Hot Work Permit Policy
No full textThe purpose of the UHSP Hot Work Permit Policy is to specify the approval process for a temporary operation involving open flames, heat and/or sparks at the University of Health Sciences and Pharmacy in St. Louis. This includes, but is not limited to, operations such as brazing, cutting, soldering, thawing pipes, torch-applied roofing, welding, or propane torches used for floor tile or cove base.
This policy applies to all UHSP employees, vendors and contractors performing hot work in any existing occupied building or structure on campus
Unmanned Aircraft Systems Use Policy
No full textThe University of Health Sciences and Pharmacy in St. Louis Unmanned Aircraft Systems (UAS) Use Policy has been implemented to safeguard the wellbeing and the privacy of UHSP students, faculty, staff, visitors, and neighbors, protect University buildings and property, and establish a safe and compliant UAS operating culture for research, teaching, and professional activities
Copyright Policy
No full textCopyright law protects the tangible expression of original works of authorship. Ideas are not protected under copyright but may be protected under patent law if they meet the criteria for a patent. Copyright owners have certain exclusive rights to reproduce works, make derivative works, and disseminate works through performance, display, distribution, sales and licensing. These rights are limited by some exceptions, including “fair use” of insubstantial portions of copyrighted materials for teaching and other academic purposes. This policy sets forth the rights and responsibilities of University of Health Sciences and Pharmacy in St. Louis (“UHSP”), its faculty, students, and employees in their roles as members of the UHSP community in creating and using copyrighted works. The copyright policy is subject to UHSP policies addressing conflicts of interest, conflicts of commitment, and patents
Patent Policy
No full textUniversity of Health Sciences and Pharmacy in St. Louis ( UHSP ) is dedicated to advancing the knowledge and practice of pharmacy and the health sciences through its mission of education, research, scholarship, and patient care. UHSP strives to provide an environment that encourages and supports innovation, and promotes the discovery of new knowledge and inventions. UHSP may seek to protect and reduce new knowledge or inventions to practice whenever there is the potential to make a significant contribution to UHSP\u27s mission or the greater good for the general public. This policy provides a framework for establishing ownership of patentable inventions while rewarding inventors and sustaining the research enterprise at UHSP.
This policy applies to all faculty, staff, students, and third-parties who use the University\u27s facilities or resources
The use of commitment techniques to support weight loss maintenance in obese adolescents
No full textObjectives: Obesity is a rising problem in adolescents related to unhealthy behaviours. Commitment devises are one type of behavioural intervention that may help people change their behaviours. The current pilot trial tests whether commitment devices delivered via text message help adolescents maintain their recent weight loss. Methods: During a 12-week pilot trial, adolescents who attended a weight loss camp were randomly assigned to either received text messages that contained only information, i.e. advice, about weight loss management (n = 13) or asked for them to commit to following the same advise (n = 14). Results: The BMI of the adolescents in the commitment group did not change. In contrast, the BMI of adolescents in the information group increased. A linear regression revealed that group was a significant predictor of BMI change. A logistic regression revealed that adolescents in the information group were nearly eight times more likely to regain weight than those in the commitment group. Conclusions: This is the first study with adolescents to show weight maintenance using a commitment device. The results suggest that commitment devices can help adolescents maintain their recent weight loss
Personal Protective Equipment (PPE) Policy
No full textUniversity departments shall provide employees adequate personal protective equipment where necessary in the performance of their duties. Departments shall determine and document what constitutes adequate personal protective equipment (PPE) through completion of a job hazard assessment or development of a standard operating procedure (SOP). Adequate PPE shall be provided to employees at no cost, including replacement resulting from regular use. All required PPE items identified during the hazard assessment or in the SOP will be reviewed by the Emergency Management Coordinator and EH&S and/or the Unversity Safety Committee before purchase. Departments shall ensure that employees are adequately trained and that assigned PPE is worn when hazards are present.
Employees shall be expected to use assigned PPE when called for by the hazard assessment, standard operating procedure, container label, or material safety data sheet. PPE shall be maintained by the employee in a clean, sanitary and usable condition and all PPE failure shall be reported to the supervisor immediately.
Visitors shall be provided appropriate PPE when visiting a hazardous area and they are expected to comply with this policy
Customer and Personally Identifiable Information - Security Policy
No full textUniversity of Health Sciences and Pharmacy in St. Louis (the “University”) has developed this policy to ensure that appropriate guidelines are followed to protect the privacy of Customer Information (“CI”) and Personally Identifiable Information (“PII”) maintained or used by the University
Inhibition of RORα/γ suppresses atherosclerosis via inhibition of both cholesterol absorption and inflammation
No full textObjective Cardiovascular diseases (CVDs) are the leading cause of mortality in Western countries. Atherosclerosis is a multi-step inflammatory disease characterized at early stages by accumulation of cholesterol in the arterial wall followed by recruitment of immune cells. We sought to determine if pharmacological suppression of RORα/γ activity is beneficial in treatment of atherosclerosis. Methods To identify the role of RORα and RORγ in atherosclerosis, we used the LDL-R−/− mouse model of atherosclerosis placed on a high cholesterol diet treated with SR1001, a RORα/γ inverse agonist, for four weeks. Results Our results demonstrate that treatment with the ROR inverse agonist substantially decreases plaque formation in vivo. The mechanism of the anti-atherogenic activity of the inhibition of RORα/γ activity appeared to be due to targeting two distinct pathways. SR1001 treatment reduced plasma low density lipoprotein (LDL) level without affecting high density lipoprotein (HDL) via increasing intestinal cholesterol excretion. Treatment with SR1001 also induced an anti-atherogenic immune profile that was characterized by a reduction in Th17 cells and an increase in Treg and Th2 cells. Our data suggest that RORα and RORγ play a critical role in atherosclerosis development by regulating at least two major pathways important in the pathology of this disease: cholesterol flux and inflammation. Conclusion Our data suggest that pharmacological targeting of RORα/γ may be an effective method for treatment of atherosclerosis offering a distinct mechanism of action relative to statins
Implementing a labor monitoring guideline and midwives responsibilities to increase the completion rate of partograph in Muhima Hospital, Rwanda
No full textPurpose: Complete health documentation during childbirth can reduce complications and improve maternal and foetal outcomes. One such document is the partograph which allows health workers to record and follow the labour progress. However, the completion rates of partograph remain low in some hospitals. This study describes the implementation of a quality improvement project to increase the completion rate of partograph in a district hospital in Rwanda. Design/methodology/approach: The project team tackled the root cause of partograph incompletion by implementing a labour monitoring guideline, assigning patients and duties to midwives and by providing support and supervision. Findings: The intervention successfully increased overall partograph completion rates from 11 to 61 per cent, p \u3c 0.001. This study also showed that completeness of the partograph was statistically associated with a decrease in foetal deaths and higher Apgar score with p \u3c 0.001 for both. Practical implications: This study describes the establishment of a quality improvement project following the strategic problem solving approach to increase the completion rate of partograph documentation. The intervention was simple, data-driven and cost-neutral. The team achieved its objectives by integrating staff input, obtaining commitment from the multidisciplinary team and applying leadership skills. Originality/value: The results are useful for hospitals in limited resources settings wishing to improve overall partograph completion and improve foetal and maternal outcomes during labour, in an efficient and cost-neutral way