Reference materials selection for the stable carbon isotope analysis of dissolved carbon using a wet oxidation system.

Rationale: Wet chemical oxidation combined with isotope ratio mass spectrometry has become a routine technique for analyzing the stable carbon isotope composition of dissolved organic (DOC) and inorganic (DIC) carbon. However, methodological inconsistencies between laboratories in using different reference materials lead to a discrepancy in results. We experimentally tested the precision and accuracy of the analysis of commonly available international reference materials and other chemicals potentially suitable for laboratory standards.

Quality improvement in hospitals: barriers and facilitators.

Purpose The purpose of this paper is to examine quality improvement (QI) initiatives in acute care hospitals, the factors associated with success, and the impacts on patient care and safety. Design/methodology/approach An extensive online survey was completed by senior managers responsible for QI. The survey assessed QI project types, QI methods, staff engagement, and barriers and factors in the success of QI initiatives.

Environmental cleaning resources and activities in Canadian acute care hospitals.

Background: Environmental cleaning interventions have increased cleaning effectiveness and reduced antibiotic-resistant organisms in hospitals. This study examined cleaning in Canadian acute care hospitals with the goal of developing strategies to improve cleaning and reduce antibiotic-resistant organism rates.

Methods: Managers most responsible for environmental services (EVS) completed an extensive online survey that assessed EVS resources and cleaning practices.

Working relationships of infection prevention and control programs and environmental services and associations with antibiotic-resistant organisms in Canadian acute care hospitals.

Background: Environmental contamination in hospitals with antibiotic-resistant organisms (AROs) is associated with patient contraction of AROs. This study examined the working relationship of Infection Prevention and Control (IPAC) and Environmental Services and the impact of that relationship on ARO rates.

Methods: Lead infection control professionals completed an online survey that assessed the IPAC and Environmental Services working relationship in their acute care hospital in 2011.

Stable isotope analysis of saline water samples on a cavity ring-down spectroscopy instrument.

The analysis of the stable hydrogen and oxygen isotope composition of water using cavity ring-down spectroscopy (CRDS) instruments utilizing infrared absorption spectroscopy have been comprehensively tested. However, potential limitations of infrared spectroscopy for the analysis of highly saline water have not yet been evaluated. In this study, we assessed uncertainty arising from elevated salt concentrations in water analyzed on a CRDS instrument and the necessity of a correction procedure.

Efficacy and safety of clopidogrel in children with diarrhea associated hemolytic uremic syndrome.

Introduction: Hemolytic uremic syndrome is a thrombotic microangiopathy. Clopidogrel, a recently developed platelet aggregation inhibitor, has not been previously reported as a treatment for this illness. Our study's objective was to explore the efficacy and safety of clopidogrel in children with diarrhea associated hemolytic uremic syndrome.

Successful utilization of high-flux hemodialysis for treatment of vancomycin toxicity in a child.

Vancomycin is routinely used for empiric antibiotic therapy in children. Higher-serum-concentration targets for serious infections are now being recommended. This recommendation may result in aggressive dosing with increased potential for toxicity.

The pandemic influenza planning process in Ontario acute care hospitals.

Background: There will be little time to prepare when an influenza pandemic strikes; hospitals need to develop and test pandemic influenza plans beforehand.

Methods: Acute care hospitals in Ontario were surveyed regarding their pandemic influenza preparedness plans.

Results: The response rate was 78.

A comparison of infection control program resources, activities, and antibiotic resistant organism rates in Canadian acute care hospitals in 1999 and 2005: pre- and post-severe acute respiratory syndrome.

Introduction: The Resources for Infection Control in Hospitals (RICH) project assessed infection control programs and rates of antibiotic-resistant organisms (AROs) in Canadian acute care hospitals in 1999. In the meantime, the Severe Acute Respiratory Syndrome (SARS) outbreak and the concern over pandemic influenza have stimulated considerable government and healthcare institutional efforts to improve infection control systems in Canada.

Methods: In 2006, a version of the RICH survey similar to the original RICH instrument was mailed to infection control programs in all Canadian acute care hospitals with 80 or more beds.

A cross-Canada survey of infection prevention and control in long-term care facilities.

Background: Residents in long-term care facilities (LTCFs) are at considerable risk for developing infections. This is the first comprehensive examination of infection control programs in Canadian LTCFs in almost 20 years.

Methods: A survey designed to assess resident and LTCF characteristics; personnel, laboratory, computer, and reference resources; and surveillance and control activities of infection prevention and control programs was sent in 2005 to all eligible LTCFs across Canada.

A comparison of infection control program resources, activities, and antibiotic resistant organism rates in Canadian acute care hospitals in 1999 and 2005: pre- and post-severe acute respiratory syndrome.

Background: The Resources for Infection Control in Hospitals (RICH) project assessed infection control programs and rates of antibiotic-resistant organisms (AROs) in Canadian acute care hospitals in 1999. In the meantime, the severe acute respiratory syndrome (SARS) outbreak and the concern over pandemic influenza have stimulated considerable government and health care institutional efforts to improve infection control systems in Canada.

Methods: In 2006, a version of the RICH survey similar to the original RICH instrument was mailed to infection control programs in all Canadian acute care hospitals with 80 or more beds.

Malnutrition among children younger than 5 years-old in conflict zones of Chiapas, Mexico.

We performed a cross-sectional, community-based survey, supplemented by interviews with community leaders in Chiapas, Mexico, to examine the prevalence and predictors of child malnutrition in regions affected by the Zapatista conflict. The prevalence rates of stunting, wasting, and underweight were 54.1%, 2.

Pregnancy outcomes, site of delivery, and community schisms in regions affected by the armed conflict in Chiapas, Mexico.

The Zapatista armed conflict began in the state of Chiapas, Mexico, in 1994, and overlaps pre-existing local disputes about land, religion, and other issues. Related disruptions in access to and utilization of health services have been alleged to have compromised local health status, particularly in vulnerable subgroups such as indigenous women and infants. The study objective was to measure maternal and perinatal mortality ratios and utilization of pregnancy-related health services in the region affected by the Zapatista conflict, and to describe associations between these primary outcome measures, socioeconomic and demographic factors, and factors associated with inter-party and intra-community conflict.

The relationship between hospital infection surveillance and control activities and antibiotic-resistant pathogen rates.

Background: Antibiotic-resistant pathogen rates are rising in Canada and the United States with significant health and economic costs. The examination of the relationship of surveillance and control activities in hospitals with rates of nosocomial methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile -associated diarrhea (CDAD), and vancomycin-resistant Enterococcus (VRE) may identify strategies for controlling this growing problem.

Methods: Surveys were sent to infection control programs in hospitals that participated in an earlier survey of infection control practices in Canadian acute care hospitals.

Fabrication of a functionally generated, implant-retained fixed partial denture.

Partially edentulous patients are frequently restored with implant-supported restorations between and opposing natural teeth. Differences in horizontal and vertical mobility of teeth and dental implants necessitate occlusal contact modification to create prostheses that harmonize with the opposing dentition. This article describes a functionally generated path technique to achieve optimal articulation between an implant-retained fixed partial denture and the patient's dentition.

Mental health of detained asylum seekers.

Asylum seekers arriving in the USA are likely to be held in detention for months or years pending adjudication of their asylum claims. We interviewed 70 asylum seekers detained in New York, New Jersey, and Pennsylvania. We used self-report questionnaires to assess symptoms of anxiety, depression, and post-traumatic stress disorder.

The impact of detention on the health of asylum seekers.

Asylum seekers arriving in the United States are often imprisoned for months or years while their asylum claims are processed. Recently, Physicians for Human Rights and the Bellevue/New York University Program for Survivors of Torture released the findings of the first systematic study examining the health of detained asylum seekers. The study found that the mental health of asylum seekers interviewed was extremely poor, including high levels of symptoms for anxiety, depression, and posttraumatic stress disorder, which worsened the longer individuals were in detention.

The state of infection surveillance and control in Canadian acute care hospitals.

Background: Nosocomial infections and antibiotic-resistant pathogens cause significant morbidity, mortality, and economic costs. The infection surveillance and control resources and activities in Canadian acute care hospitals had not been assessed in 20 years.

Methods: In 2000, surveys were mailed to infection control programs in all Canadian hospitals with more than 80 acute care beds.