13,910 research outputs found
Using a simple point-prevalence survey to define appropriate antibiotic prescribing in hospitalised children across the UK.
No full textBACKGROUND: The National Health Service England, Commissioning for Quality and Innovation for Antimicrobial Resistance (CQUIN AMR) aims to reduce the total antibiotic consumption and the use of certain broad-spectrum antibiotics in secondary care. However, robust baseline antibiotic use data are lacking for hospitalised children. In this study, we aim to describe, compare and explain the prescription patterns of antibiotics within and between paediatric units in the UK and to provide a baseline for antibiotic prescribing for future improvement using CQUIN AMR guidance. METHODS: We conducted a cross-sectional study using a point prevalence survey (PPS) in 61 paediatric units across the UK. The standardised study protocol from the Antibiotic Resistance and Prescribing in European Children (ARPEC) project was used. All inpatients under 18 years of age present in the participating hospital on the day of the study were included except neonates. RESULTS: A total of 1247 (40.9%) of 3047 children hospitalised on the day of the PPS were on antibiotics. The proportion of children receiving antibiotics showed a wide variation between both district general and tertiary hospitals, with 36.4% ( 95% CI 33.4% to 39.4%) and 43.0% (95% CI 40.9% to 45.1%) of children prescribed antibiotics, respectively. About a quarter of children on antibiotic therapy received either a medical or surgical prophylaxis with parenteral administration being the main prescribed route for antibiotics (>60% of the prescriptions for both types of hospitals). General paediatrics units were surprisingly high prescribers of critical broad-spectrum antibiotics, that is, carbapenems and piperacillin-tazobactam. CONCLUSIONS: We provide a robust baseline for antibiotic prescribing in hospitalised children in relation to current national stewardship efforts in the UK. Repeated PPS with further linkage to resistance data needs to be part of the antibiotic stewardship strategy to tackle the issue of suboptimal antibiotic use in hospitalised children
Systemic antifungal prescribing in neonates and children: outcomes from the Antibiotic Resistance and Prescribing in European Children (ARPEC) Study
No full textContains fulltext :
154061.pdf (Publisher’s version ) (Open Access)The appropriate use of systemic antifungals is vital in the prevention and treatment of invasive fungal infection (IFI) in immunosuppressed children and neonates. This multicenter observational study describes the inpatient prescribing practice of antifungal drugs for children and neonates and identifies factors associated with prescribing variability. A single-day point prevalence study of antimicrobial use in hospitalized neonates and children was performed between October and December 2012. The data were entered through a study-specific Web-based portal using a standardized data entry protocol. Data were recorded from 17,693 patients from 226 centers. A total of 136 centers recorded data from 1,092 children and 380 neonates receiving at least one antifungal agent. The most frequently prescribed systemic antifungals were fluconazole (n=355) and amphotericin B deoxycholate (n=195). The most common indications for antifungal administration in children were medical prophylaxis (n=325), empirical treatment of febrile neutropenia (n=122), and treatment of confirmed or suspected IFI (n=100 [14%]). The treatment of suspected IFI in low-birthweight neonates accounted for the majority of prescriptions in the neonatal units (n=103). An analysis of variance (ANOVA) demonstrated no significant effect of clinical indication (prophylaxis or treatment of systemic or localized infection) on the total daily dose (TDD). Fewer than one-half of the patients (n=371) received a TDD within the dosing range recommended in the current guidelines. Subtherapeutic doses were prescribed in 416 cases (47%). The predominance of fluconazole and high incidence of subtherapeutic doses in participating hospitals may contribute to suboptimal clinical outcomes and an increased predominance of resistant pathogenic fungi. A global consensus on antifungal dosing and coordinated stewardship programs are needed to promote the consistent and appropriate use of antifungal drugs in neonates and children
The teaching of aerospace vehicle design at Cranfield University with particular reference to the group design project
No full textOver the years, the aircraft design course at Cranfield has evolved into the
postgraduatemaster's programme in aerospace vehicle design that we have today.
One of the unique featuresof the course is the extensive group design project,
which has played a fundamental part inaircraft design education right from 1948
up to the current day. The success of the course, andthe student experience,
depends on the success of the group design project. The philosophy ofthe role of
the group design project in the teaching of aircraft design is discussed in
detail in thispaper. Examples are presented of recent subject aircraft along
with some novel features ofthese designs
Unlocking the mysteries of the past: Searching for clues in medieval manuscripts
No full textThis project looks at the reproduction of one mid-12th-century Roman text by analyzing sixteen versions of it that still exist, copied from c. 1160 through c. 1325. The author was Nicolaus Maniacutius, a cleric at St. John Lateran Basilica in Rome. That original copy is lost, but versions quickly appeared in monasteries and cathedrals in Italy, Germany, France, and England. Somehow, through networks of communication and travel, reproductions were made and collected by prominent monasteries and churches, and by the Guildhall, a secular institution in the City of London
The Worldwide Antibiotic Resistance and Prescribing in European Children (ARPEC) point prevalence survey: developing hospital-quality indicators of antibiotic prescribing for children.
No full textObjectives: Previously, web-based tools for cross-sectional antimicrobial point prevalence surveys (PPSs) have been used in adults to develop indicators of quality improvement. We aimed to determine the feasibility of developing similar quality indicators of improved antimicrobial prescribing focusing specifically on hospitalized neonates and children worldwide. Methods: A standardized antimicrobial PPS method was employed. Included were all inpatient children and neonates receiving an antimicrobial at 8:00 am on the day of the PPS. Denominators included the total number of inpatients. A web-based application was used for data entry, validation and reporting. We analysed 2012 data from 226 hospitals (H) in 41 countries (C) from Europe (174H; 24C), Africa (6H; 4C), Asia (25H; 8C), Australia (6H), Latin America (11H; 3C) and North America (4H). Results: Of 17 693 admissions, 6499 (36.7%) inpatients received at least one antimicrobial, but this varied considerably between wards and regions. Potential indicators included very high broad-spectrum antibiotic prescribing in children of mainly ceftriaxone (ranked first in Eastern Europe, 31.3%; Asia, 13.0%; Southern Europe, 9.8%), cefepime (ranked third in North America, 7.8%) and meropenem (ranked first in Latin America, 13.1%). The survey identified worryingly high use of critically important antibiotics for hospital-acquired infections in neonates (34.9%; range from 14.2% in Africa to 68.0% in Latin America) compared with children (28.3%; range from 14.5% in Africa to 48.9% in Latin America). Parenteral administration was very common among children in Asia (88%), Latin America (81%) and Europe (67%). Documentation of the reasons for antibiotic prescribing was lowest in Latin America (52%). Prolonged surgical prophylaxis rates ranged from 78% (Europe) to 84% (Latin America). Conclusions: Simple web-based PPS tools provide a feasible method to identify areas for improvement of antibiotic use, to set benchmarks and to monitor future interventions in hospitalized neonates and children. To our knowledge, this study has derived the first global quality indicators for antibiotic use in hospitalized neonates and childre
How to find Group, Collection, Project and Author numbers on the Loughborough University Research Repository
No full textA presentation on how to find group, collection, project and author numbers on the Loughborough University Research Repository.</p
Valdosta Project Change, Scrapbook, April 2000
No full textValdosta Project Change. “Valdosta Project Change Scrapbook, April 2000,” Lowndes County Historical Society. Valdosta State University Archives and Special Collections, MS-181: Valdosta Project Change Scrapbook Collection, 1997-2003. 1 PDF document and scans, 24 pages. 727 MB (763,097,964 bytes).4/3- Marchers urge removal of confederate flag- Associated Press; 4/4- Ten reasons for having art in county schools- Joann McDaniel-Haldeman, Clyattville; 4/7- Crowds seek confederate flag removal: Opponents, supporters rally at Statehouse- Associated Press; 4/10- The Leadership Style of Fred Davis- no author; 4/10- Report: Black women are subjected to more intrusive searches: Officials say new not reflected in report- Associated Press; 4/11- Racial imbalance- no author; 4/11- Great record- no author; 4/11- Move on- no author; 4/11- Bad water- no author; 4/11- No comparison- no author; 4/11- Board to hear public on Davis, Evans moves- Peter Failor; 4/12- Waiting for answers: Citizen’s group decries lack of BOE accountability- Peter Failor; 4/19- We must support elementary P.E., art- Dr. Stan Andrews, Valdosta; April 2000- Youth march to protest hate crimes- Associated Press
Valdosta Project Change, Scrapbook, December 1998
No full textValdosta Project Change. “Valdosta Project Change Scrapbook, December 1998.” Lowndes County Historical Society. Valdosta State University Archives and Special Collections, MS-181: Valdosta Project Change scrapbook Collection, 1998-2003. 1 PDF document and scans, 41 pages. 840 MB (881,697,568 bytes).12/1- School counselor complains about parents- Yvonne Fournier; 12/2- Williams’ death inquest held today: Public expected to observe ‘utmost decorum’ during inquest of Williams death- Jodi M. Scott; 12/2- Sister denies brother’s jail death was ‘suspicious’: Autopsy shows Williard McFarland died in 1994 of natural causes- Jodi M. Scott; 12/2- Church member doesn’t like using term ‘reverend’- Robert L. Scott, Lake Park ; 12/2- People’s Tribunal calls for economic ‘reciprocity’- Mailbox Post Staff; 12/4- Inquest jurors split on racial lines: Coroner incorrectly reported the verdict of the inquest as unanimous- Jodi M. Scott; 12/4- Coroner’s inquest efforts undermined by mistake- no author; 12/4- Williams speaks out against racism- no author; 12/5- Finding truth remains goal in Williams case- no author; 12/7- ‘Granny’s Place’ offers help for kids- Jodi M. Scott; 12/9- Coroner’s jury returns accidental death- Suzanne Harris; 12/9- Coroner’s inquest did its job- no author; 12/13- Local businesses deal with People’s Tribunal- Lowell Vickers Jr. ; 12/13- Protest group prepares list: Businesses asked for money, support- Lowell Vickers Jr.; 12/15- Tribunal incorporated as nonprofit group: Organization approved for incorporation last month- Jodi M. Scott; 12/16- People’s Tribunal wanting ‘Cooperative Reciprocity’- Suzanne Harris; 12/16- Inquest doesn’t answer all question, dispel all doubts- Charles Moore; 12/17- Evidence in Willie Williams’ death reaches grand jury: District attorney mum on details of testimony- Jodi M. Scott; 12/17- Give us the list- no author; 12/17- Truth is Out- no author; 12/17- Double standard- no author; 12/17- Don’t understand- no author; 12/17- Whites help blacks- no author; 12/18- Civil rights leader praises work of People’s Tribunal- Joe Dunlop; 12/19- Deputy ‘no billed’ in inmate’s death: No evidence found of beatings, abuse- Jodi M. Scott; 12/21- Tribunal letter causes concern: Officials ‘tense’ about group’s plan asking for support- Shelby G. Spires ; 12/23- Examine Procedures Now- no author; 12/30- Sheriff plans no change in arrest procedures- Suzanne Harris
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