The association between implementation of second-tier prevention practices and CLABSI incidence: A national survey

2019 ◽  
Vol 40 (10) ◽  
pp. 1094-1099 ◽  
Author(s):  
Debby Ben-David ◽  
Azza Vaturi ◽  
Ester Solter ◽  
Elizabeth Temkin ◽  
Yehuda Carmeli ◽  
...  
Keyword(s):  
Online Survey ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Standard Of Care ◽  
Central Line ◽  
Prevention Measures ◽  
Additional Measure ◽  
General Icus ◽  
Preventive Practices ◽  
Second Tier

AbstractBackground:Prevention of central-line–associated bloodstream infection (CLABSI) represents a complex challenge for the teams involved in device insertion and maintenance. First-tier practices for CLABSI prevention are well established.Objective:We describe second-tier prevention practices in Israeli medical-surgical ICUs and assess their association with CLABSI rates.Methods:In June 2017, an online survey assessing infection prevention practices in general ICUs was sent to all Israeli acute-care hospitals. The survey comprised 14 prevention measures supplementary to the established measures that are standard of care for CLABSI prevention. These measures fall into 2 domains: technology and implementation. The association between the number of prevention measures and CLABSI rate during the first 6 months of 2017 was assessed using Spearman’s correlation. We used negative binomial regression to calculate the incidence rate ratio (IRR) associated with the overall number of prevention measures and with each measure individually.Results:The CLABSI rates in 24 general ICUs varied between 0.0 and 17.0 per 1,000 central-line days. Greater use of preventive measures was associated with lower CLABSI rates (ρ, –0.70; P < .001). For each additional measure, the incidence of CLABSI decreased by 19% (IRR, 0.81; 95% CI, 0.73–0.89). Specific measures associated with lower rates were involvement of ward champions (IRR, 0.47; 95% CI, 0.31–0.71), auditing of insertions by infection control staff (IRR, 0.35; 95% CI, 0.19–0.64), and simulation-based training (IRR, 0.38; 95% CI, 0.22–0.64).Conclusion:Implementation of second-tier preventive practices was protective against CLABSI. Use of more practices was correlated with lower rates.

Exploring the Self-Reported Long-Distance Travel Frequency of Millennials and Generation X in California

2018 ◽  
Vol 2672 (47) ◽  
pp. 208-218 ◽  
Author(s):  
Rosaria M. Berliner ◽  
Lisa Aultman-Hall ◽  
Giovanni Circella
Keyword(s):  
Generation X ◽  
Online Survey ◽  
Negative Binomial ◽  
New Technologies ◽  
Age Groups ◽  
Negative Binomial Regression ◽  
Long Distance ◽  
Brick And Mortar ◽  
Distance Travel ◽  
Long Distance Travel

Long-distance travel research is limited because of the lack of robust data and the complexity of defining a long-distance trip. The patterns of infrequent long-distance trips are poorly understood especially compared with the better studied (and understood) local daily travel patterns. This study contributes to filling that gap by investigating the factors that affect the frequency of long-distance trips of Californian millennials (18–34 years old, in 2015) and members of the preceding Generation X (35–50 years old, in 2015). Data collected with an online survey administered in fall 2015 are used to study the mobility of these age groups. The survey collected information on several travel-related variables, including the number of long-distance trips (defined as trips longer than 100 miles, one way) made by various modes during the previous 12 months. The authors estimate six negative binomial regression models of long-distance travel separated by purpose ( business or leisure) and mode ( overall travel versus air). The study explores the relationship of long-distance trip formation with several sociodemographic, land use, and attitudinal variables. Consistent with expectations, individual income positively affects the number of long-distance trips made by each individual. Among the attitudinal variables, the individuals who are adventurers, have higher “variety seeking” attitudes and are more interested in adopting new technologies are found to make a larger number of long-distance trips. However, those who prefer to shop in brick-and-mortar stores rather than online are found to have lower levels of long-distance travel.

scholarly journals Servant leaders, ethical followers? The effect of servant leadership on employee deviance

2019 ◽  
Vol 40 (5) ◽  
pp. 624-646
Author(s):  
Heidi Paesen ◽  
Kristel Wouters ◽  
Jeroen Maesschalck
Keyword(s):  
Servant Leadership ◽  
Protective Effect ◽  
Online Survey ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Situational Factor ◽  
Strengthening Effect ◽  
Content Type ◽  
Employee Deviance ◽  
The Impact

Purpose Leadership is considered to be a crucial situational factor in predicting and explaining employee deviance. The purpose of this paper therefore is to investigate the relationship between servant leadership on the one hand and employee deviance on the other. While previous studies on the impact of servant leadership on employee deviance typically aggregated all its dimensions into a single scale, this study also explores the impact of the various dimensions of servant leadership separately. Design/methodology/approach Data were collected via an online survey in two ministries of the Belgian Federal Government (n=3,445). The analyses were conducted using confirmatory factor analysis and multiple linear and negative binomial regression analysis. Findings The empirical results suggest that the generic servant leadership scale has the expected negative, protective effect on both self-reported and observer-reported employee deviance. As for the dimensions, the authors found that only the “putting subordinates first” dimension had a significant negative, protective effect on both self-reported and observer-reported employee deviance. The dimensions “behaving ethically” and “emotional healing” negatively impacted only observer-reported employee deviance and the dimension “creating value for society” negatively impacted only self-reported employee deviance. Surprisingly, the dimension “empowering” had a significant positive, strengthening effect on both self-reported and observer-reported employee deviance. Originality/value While most research assesses servant leadership’s impact on desirable behaviour, this study is about its impact on employee deviance. Also unlike most previous research, this study looks not only at the overall effect of servant leadership, but also at the impact of the various dimensions of servant leadership separately.

scholarly journals Knowledge and practice of physicians during COVID-19 pandemic: a cross-sectional study in Lebanon

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Linda Abou-Abbas ◽  
Zeina Nasser ◽  
Youssef Fares ◽  
Mohammad Chahrour ◽  
Rana El Haidari ◽  
...  
Keyword(s):  
Online Survey ◽  
Occupational Safety ◽  
Good Practice ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Good Knowledge ◽  
Prevention Measures ◽  
Sectional Study ◽  
Cross Sectional ◽  
Preventive Practices

Abstract Background As the Coronavirus disease 2019 (COVID-19) pandemic continues to evolve, physicians must be equipped with adequate knowledge, skills on the prevention measures, and confidence in diagnosing and treating COVID-19 patients. Therefore, it is of great interest to assess the knowledge and practices of Physicians to identify existing gaps and improve occupational safety and viral surveillance. Methods A cross-sectional study was conducted in Lebanon between 28th March and 11th April 2020. Data was collected through an online survey that included information on socio-demographic characteristics, knowledge, practice, physicians fear towards COVID-19 as well as their perceptions regarding actions/policies implemented by the Ministry of Public Health (MOPH) and their health care facilities. Multivariable logistic regression analyses were carried out to identify the factors associated with good knowledge of COVID-19 and good practice toward its prevention. Adjusted odds ratio and their 95% confidence intervals were reported. Results Our survey revealed that the majority of Lebanese physicians had good knowledge about the disease (89.5%) while approximately half of the respondents adopted good preventive practices (49.7%). The odds of having good knowledge was 2.16 times higher among physicians aged 40 and above (adjusted OR = 2.16 with a 95% confidence interval (CI) of 1.08 to 4.34) compared to their counterparts aged less than 40 years old. Our results also showed that the odds of good practice was 2 times higher among frontline compared to the second line workers (adjusted OR = 2.01 with 95% CI of 1.21 to 3.34). Physicians with an experience of 10 years and above were 3.35 times more likely to have good practice compared to their counterparts (adjusted OR = 3.35 with 95% CI of 1.60 to 7.02). Finally, participants with good knowledge of COVID-19 were 2.04 times more likely to have a good practice (OR = 2.04 with 95% CI of 1.01 to 4.12). Conclusion Lebanese physicians revealed a good level of knowledge; however, they had limited comprehension of the precautionary measures that protect them from this virus. Our findings have important implications for the development of strategies suitable for improving the level of practice among physicians and enhance prevention programs.

scholarly journals Intentional and unintentional non-adherence to social distancing measures during COVID-19: A mixed-methods analysis.

2021 ◽  
Author(s):  
Yolanda Eraso ◽  
Stephen Hills
Keyword(s):  
Mixed Methods ◽  
Online Survey ◽  
Negative Binomial ◽  
Ecological Model ◽  
Negative Binomial Regression ◽  
Local Area ◽  
Individual Risk ◽  
Negative Binomial Regression Model ◽  
Framework Analysis ◽  
Social Distancing

Social distancing measures implemented by governments worldwide during the COVID-19 pandemic have proven an effective intervention to control the transmission of SARS-CoV-2. There is a growing literature on predictors of adherence behaviours to social distancing measures, however, there are no comprehensive insights into the nature and types of non-adherence behaviours. To address this gap in the literature, we studied non-adherence in terms of counts of infringements and people's accounts on their behaviours in a representative sample of North London residents. We focused on the following social distancing rules: keeping 2 mts. distancing, meeting family and friends, and going out for non-essential reasons. A mixed-methods explanatory sequential design was used comprising an online survey (1st - 31st May 2020) followed by semi-structured in-depth interviews held with a purposive sample of survey respondents (5th August - 21st September 2020). A negative binomial regression model (quantitative) and Framework Analysis (qualitative) were undertaken. 681 individuals completed the survey, and 30 individuals were interviewed. We integrated survey and interview findings following three levels of the Social Ecological model: individual, interpersonal and community levels. We identified non-adherence behaviours as unintentional (barriers beyond individual's control) and intentional (deliberate decision). Unintentional adherence was associated with and reported as emotional inability to stay at home, lack of controllability in keeping 2 mts. distancing, social responsibility towards the community and feeling low risk. Intentional non-adherence included individual risk assessment and decision-making on the extent to following the rules, support from friends, and perceived lack of adherence in the local area. Our findings indicate that unintentional and intentional non-adherence should be improved by Government partnerships with local communities to build trust in social distancing measures; tailored messaging to young adults emphasising the need of protecting others whilst clarifying the risk of transmission; and ensuring COVID-secured environments by working with environmental health officers.

scholarly journals Adolescents’ Exposure to Online Risks: Gender Disparities and Vulnerabilities Related to Online Behaviors

2021 ◽  
Author(s):  
Elena Savoia ◽  
Nigel Walsh Harriman ◽  
Max Su ◽  
Tyler Cote ◽  
Neil Shortland
Keyword(s):  
Social Media ◽  
Online Survey ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Female Gender ◽  
The Internet ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Online Risk ◽  
Use Of Social Media

In the last decade, readily available electronic devices have created unprecedented opportunities for teens to access a wide variety of information and media &ndash; both positive and negative &ndash; on the internet. Despite the increasing number of initiatives taking place worldwide intended to assess and mitigate the online risks encountered by children and adolescents, there is still a need for a better understanding of how adolescents use the internet and what consequences they may face. We conducted a cross sectional online survey of a convenience sample of 733 8th and 9th grade students in Utah. The survey contained eight questions regarding students&rsquo; exposure to three types of online risk scenarios: content risk, contact risk, and commercial risk. Independent variables included students&rsquo; online behaviors, use of social media and private messaging apps, and adult supervision of online activities. Logistic and negative binomial regression models indicated that female gender, social media use, and chatting with strangers were associated with exposure to multiple unsafe online scenarios. Our results provide critical information to practitioners involved in the development of educational initiatives by building a profile of potentially risky online behaviors and allow them to tailor their initiatives to meet the needs of more vulnerable populations.

scholarly journals Adolescents’ Exposure to Online Risks: Gender Disparities and Vulnerabilities Related to Online Behaviors

2021 ◽  
Vol 18 (11) ◽  
pp. 5786
Author(s):  
Elena Savoia ◽  
Nigel Walsh Harriman ◽  
Max Su ◽  
Tyler Cote ◽  
Neil Shortland
Keyword(s):  
Social Media ◽  
Online Survey ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
The Internet ◽  
Cross Sectional ◽  
Convenience Sample ◽  
9Th Grade ◽  
Online Risk ◽  
Use Of Social Media

In the last decade, readily available electronic devices have created unprecedented opportunities for teens to access a wide variety of information and media–both positive and negative–on the internet. Despite the increasing number of initiatives taking place worldwide intended to assess and mitigate the online risks encountered by children and adolescents, there is still a need for a better understanding of how adolescents use the internet and their susceptibility to exposure to risks in the online space. We conducted a cross-sectional online survey of a convenience sample of 733 8th and 9th grade students in Utah. The survey contained eight questions regarding students’ exposure to three types of online risk scenarios: content risk, contact risk, and criminal risk. Independent variables included students’ online behaviors, use of social media and private messaging apps, and adult supervision of online activities. Logistic and negative binomial regression models indicated that gender, social media use, and chatting with strangers were associated with exposure to multiple risky online scenarios. Our results provide critical information to educators involved in the development of initiatives focusing on the reduction of youth online risk by identifying correlates of risky online events, allowing them to tailor their initiatives to meet the needs of potentially vulnerable populations.

scholarly journals Association Between Vaso-Occlusive Crises and Opioid Prescriptions Among Patients with Sickle Cell Disease: A Retrospective Claims-Based Study

2020 ◽  
Vol 7 (1) ◽  
pp. 94-101 ◽  
Author(s):  
Hyeun Ah Kang ◽  
Jamie C. Barner ◽  
Kristin M. Richards ◽  
Menaka Bhor ◽  
Jincy Paulose ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Charlson Comorbidity Index Score ◽  
Prevention Measures ◽  
Cell Disease ◽  
Opioid Use ◽  
Opioid Prescription ◽  
Binomial Regression

Background/Objectives: Among sickle cell disease (SCD) patients, vaso-occlusive crises (VOCs) are recurrent and unpredictable attacks of acute pain. These pain crises are often treated with analgesics, including opioids, which have been associated with misuse and overdose. The aim of this study was to examine the association between VOC events and opioid use and assess the association between opioid prescriptions and health care resource utilization among SCD patients. Methods: This was a retrospective cohort study using Texas Medicaid medical and prescription claims between September 2011 and August 2016. The index date was the first SCD diagnosis. Patients (2–63 years) with at least one inpatient or two outpatient SCD diagnoses, who were continuously enrolled during 12 months postindex, were included in the study. The primary outcome was number of opioid prescriptions, while the independent variable was number of VOC events. Covariates included age, gender, nonopioid medication use, nonstudy SCD-related medication (penicillin and folic acid) use, evidence of blood transfusions, number of SCD-related complications, number of SCD-related comorbid conditions, and Charlson Comorbidity Index score. Negative binomial regression analysis was used to address study objectives. Results: Of 3368 included patients, 1978 (58.7%) had at least one opioid prescription with a mean of 4.2 (SD=7.2). Overall, 2071 (61.5%) had at least one VOC event with an average of 2.9 (SD=4.4). The results from the negative binomial regression showed that for every increase in VOC events, the number of opioid prescriptions increased by 9.5% (Incidence rate ratio=1.095, 95% CI: 1.078–1.111; P ≤ 0.0001). Other significant covariates associated with higher opioid use included age (13 and older compared to 2–12) and increase in the number of nonopioid pain medications, nonstudy SCD-related medications, and SCD-related complications. Conclusions: The majority of SCD patients had at least one VOC event and were prescribed opioids during the 12-month study period. We found that each VOC event was associated with a 9.5% increase in the use of opioids. SCD guidelines recommend opioids for the treatment of VOC-related pain. Payers and providers should be aware of opioid use in this population, consider appropriate VOC prevention measures, and provide SCD patients with access to appropriate pain management.

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