Incidence of health care-associated extended-spectrum β-lactamase-positive patients before and after discontinuation of contact precautions.

Background: Isolation of patients with multidrug-resistant organisms has been recommended in several guidelines. Recent evidence has suggested potential negative effects of isolation on patient well-being and facility throughput. Published literature shows a difference in transmission risk of extended-spectrum β-lactamase (ESBL)-producing organisms, suggesting that contact precautions may not be necessary for all ESBL-positive organisms.

Water impacts of U.S. biofuels: Insights from an assessment combining economic and biophysical models.

Biofuels policies induce land use changes (LUC), including cropland expansion and crop switching, and this in turn alters water and soil management practices. Policies differ in the extent and type of land use changes they induce and therefore in their impact on water resources. We quantify and compare the spatially varying water impacts of biofuel crops stemming from LUC induced by two different biofuels policies by coupling a biophysical model with an economic model to simulate the economically viable mix of crops, land uses, and crop management choices under alternative policy scenarios.

Assessment of operating room airflow using air particle counts and direct observation of door openings.

Background: The role of the operating room (OR) environment has been thought to contribute to surgical site infection rates. The quality of OR air, disruption of airflow, and other factors may increase contamination risks. We measured air particulate counts (APCs) to determine if they increased in relation to traffic, door opening, and other common activities.

Assessment of Endoscope Reprocessing Using Peer-to-Peer Assessment Through a Clinical Community.

Background: Cleaning, disinfection, and sterilization (CDS) of medical devices are intended to help prevent health care-associated infections (HAIs), a significant cause of mortality and morbidity. In February 2013 the Johns Hopkins Health System (JHHS; Baltimore) formed a clinical community of experts and stakeholders--physicians, nurses, administrators, infection control practitioners, risk managers, and regulatory staff--to assess CDS practices across facilities.

Methods: A survey administered to leadership indicated endoscopy areas of risk.

Recent Trends in Water Use and Production for California Oil Production.

Recent droughts and concerns about water use for petroleum extraction renew the need to inventory water use for oil production. We quantified water volumes used and produced by conventional oil production and hydraulic fracturing (HF) in California. Despite a 25% decrease in conventional oil production from 1999 to 2012, total water use increased by 30% though much of that increase was derived from reuse of produced water.