Failure to Implement Respiratory Isolation: Why Does it Happen?

2002 ◽  
Vol 23 (10) ◽  
pp. 595-599 ◽  
Author(s):  
Kentaro Iwata ◽  
Barbara A. Smith ◽  
Eloisa Santos ◽  
Bruce Polsky ◽  
Emilia M. Sordillo
Keyword(s):  
Chest Radiograph ◽  
Performance Indicator ◽  
The United States ◽  
Acid Fast Bacillus ◽  
Abnormal Chest ◽  
Immunodeficiency Virus ◽  
Control And Prevention ◽  
History Of ◽  
Almost All ◽  
Hispanic White

Background:Respiratory isolation for 90% of individuals with acid-fast bacillus (AFB)-smear–positive tuberculosis (TB) is a recommended performance indicator in recent Infectious Diseases Society of America and Centers for Disease Control and Prevention guidelines. However, compliance with respiratory isolation reported from multiple centers in the United States and Europe falls short of that goal.Objective:To identify missed clues in TB patients who are not appropriately isolated.Design:Retrospective survey.Setting:A 900-bed voluntary hospital.Patients:All patients with AFB-smear–positive TB admitted between January 1995 and December 1999 who were not appropriately isolated.Results:There were 173 TB cases admitted, including 106 with pulmonary TB. AFB smears were positive in 82 cases; 24 (29%) of these were not appropriately isolated. During the study period, the number of TB cases declined, but the proportion of appropriately isolated patients did not change. Most isolation failure cases were men (median age, 45.5 years); 21 of these patients were black, 2 were Hispanic white, and 1 was Asian, but none was non-Hispanic white. All isolation failure cases had at least one characteristic predictive of TB that could have been elicited at admission (eg, abnormal chest radiograph findings consistent with TB, fever, weight loss, a history of TB, a positive result on tuberculin skin test, hemoptysis, and human immunodeficiency virus infection).Conclusion:Consistent with experiences at other hospitals, we found that the rate of isolation failure remained unchanged despite an overall decline in TB cases. In our experience, almost all isolation failures could be avoided by careful review of the history, physical examination, and chest radiograph for characteristics classically considered predictive of TB. (Infect Control Hosp Epidemiol 2002;23:595-599).

scholarly journals Covid-19 pandemic: What is the truth?

2021 ◽  
Vol 12 ◽  
pp. 591
Author(s):  
Russell L. Blaylock
Keyword(s):  
United States ◽  
Young People ◽  
Severe Acute Respiratory Syndrome ◽  
Early Treatment ◽  
The United States ◽  
Treatment Protocols ◽  
Scientific Support ◽  
Control And Prevention ◽  
History Of ◽  
Irreparable Damage

The ongoing “pandemic” involving the severe acute respiratory syndrome coronavirus 2 virus (SARS-CoV-2) has several characteristics that make it unique in the history of pandemics. This entails not only the draconian measures that some countries and individual states within the United States and initiated and made policy, most of which are without precedent or scientific support, but also the completely unscientific way the infection has been handled. For the 1st time in medical history, major experts in virology, epidemiology, infectious diseases, and vaccinology have not only been ignored, but are also demonized, marginalized and in some instances, become the victim of legal measures that can only be characterized as totalitarian. Discussions involving various scientific opinions have been eliminated, top scientists have been frightened into silence by threats to their careers, physicians have lost their licenses, and the concept of early treatment has been virtually eliminated. Hundreds of thousands of people have died needlessly as a result of, in my opinion and the opinion of others, poorly designed treatment protocols, mostly stemming from the Center for Disease Control and Prevention, which have been rigidly enforced among all hospitals. The economic, psychological, and institutional damage caused by these unscientific policies is virtually unmeasurable. Whole generations of young people will suffer irreparable damage, both physical and psychological, possibly forever. The truth must be told.

scholarly journals Managing Uncertainty in Chronic Illness From Patient Perspectives

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Amanda Brown ◽  
Susan Hayden ◽  
Karen Klingman ◽  
Leslie C Hussey
Keyword(s):  
Chronic Illness ◽  
Phenomenological Study ◽  
Management Strategies ◽  
Healthcare Providers ◽  
The United States ◽  
Healthcare Team ◽  
Control And Prevention ◽  
Qualitative Phenomenological ◽  
Almost All ◽  
Qualitative Phenomenological Study

Chronic illness is an increasing concern in the United States as the Centers for Disease Control and Prevention reports that 50% of adults have at least one chronic illness. When individuals must adjust to chronic illness, they may experience uncertainty regarding the illness, prognosis, and symptoms. The purpose of this qualitative, phenomenological study was to explore the management strategies of uncertainty in chronic illness from patients’ perspectives. Merle Mishel’s uncertainty in illness theory was the framework used to explore the lives of individuals diagnosed and living with chronic illness. In-depth interviews were conducted with eight individuals who have chronic disease. Results revealed themes that individuals with chronic illness do experience uncertainty and that it impacts almost all aspects of their lives. Some of the themes identified were chronic illness, uncertainty, impact of uncertainty on daily living, coping or managing uncertainty, and communication from the healthcare team about uncertainty. The individuals expressed changes in daily activities and retraining their minds to accept their new normal. This study offers coping and management strategies that healthcare professionals can implement into treatment plans to improve the quality of life for individuals with uncertainty in chronic illness. The information produced from this study will aid healthcare providers in understanding the need to address the uncertainty at diagnoses and offer ways to assist patients in coping and managing uncertainty

scholarly journals The Impact of COVID-19 on Epilepsy Care: A Survey of the American Epilepsy Society Membership

2020 ◽  
Vol 20 (5) ◽  
pp. 316-324
Author(s):  
Dara V. F. Albert ◽  
Rohit R. Das ◽  
Jayant N. Acharya ◽  
Jong Woo Lee ◽  
John R. Pollard ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Clinical Care ◽  
Single Point ◽  
The United States ◽  
Prior History ◽  
Delivery Of Care ◽  
History Of ◽  
Almost All ◽  
The Impact ◽  
New Onset

The COVID-19 pandemic has impacted the delivery of care to people with epilepsy (PWE) in multiple ways including limitations on in-person contact and restrictions on neurophysiological procedures. To better study the effect of the pandemic on PWE, members of the American Epilepsy Society were surveyed between April 30 and June 14, 2020. There were 366 initial responses (9% response rate) and 337 respondents remained for analysis after screening out noncompleters and those not directly involved with clinical care; the majority were physicians from the United States. About a third (30%) of respondents stated that they had patients with COVID-19 and reported no significant change in seizure frequency. Conversely, one-third of respondents reported new onset seizures in patients with COVID-19 who had no prior history of seizures. The majority of respondents felt that there were at least some barriers for PWE in receiving appropriate clinical care, neurophysiologic procedures, and elective surgery. Medication shortages were noted by approximately 30% of respondents, with no clear pattern in types of medication involved. Telehealth was overwhelmingly found to have value. Among the limitation of the survey was that it was administered at a single point in time in a rapidly changing pandemic. The survey showed that almost all respondents were affected by the pandemic in a variety of ways.

Historical Sociology in the History of American Sociology

1987 ◽  
Vol 11 (1) ◽  
pp. 1-16 ◽  
Author(s):  
Mildred A. Schwartz
Keyword(s):  
United States ◽  
Critical Review ◽  
Good Deal ◽  
Historical Sociology ◽  
The United States ◽  
Historical Research ◽  
American Sociology ◽  
Historical Materials ◽  
History Of ◽  
Almost All

In a Recent Critical review of sociological perspectives on historical problems, Skocpol observed, “Until the 1970s, ‘historical sociology’ was not a phrase one often, if ever, heard in conversations among sociologists in the United States” (Skocpol, 1984: 356). Of course there was a good deal of prior historical work by sociologists, some of which Skocpol herself goes on to cite. Yet, by her phrasing, she has inadvertently raised a question about the place of history in the discipline of sociology. Like almost all sociologists who use historical materials or perspectives, Skocpol sees reason to complain about the failure of sociology to give a larger place to history. But for me, a prior issue, in the spirit of a historically minded sociology, involves discovering what happened to the name “historical sociology.” The naming of an activity, in this case historical sociology, and its performance—historical research and interpretations by sociologists—are quite distinct. The first task is to clarify their relationship.

scholarly journals As mulheres e a afirmação histórica da profissão jornalística: contributos para uma não-ossificação da História do jornalismo.

2012 ◽  
Vol 21 ◽  
pp. 165-182
Author(s):  
Maria João Silveirinha
Keyword(s):  
United States ◽  
Nineteenth Century ◽  
Twentieth Century ◽  
Early Stage ◽  
The United States ◽  
Industrial Activities ◽  
Female Journalists ◽  
History Of ◽  
History Of Journalism ◽  
Almost All

The place and role that women played in the history of journalism is still, amongst us, quite invisible and unquestioned. In the spirit of not only documenting, but theorizing history, the text aims to consider the intersection of the early stages of journalism as a profession with the entrance of the first women in the profession, and revisits the national and international press in the nineteenth century and the turn to the twentieth century, recalling the papers and female journalists of the time. As with almost all industrial activities, women were strongly sidelined in the early stage of industrialization of journalism in the terms under which it was defined. Learning about the experiences that make up the affirmation of journalism as a profession not only in Portugal but also in countries such as France, England or the United States establishes knowledge of a bodily and gendered experience. Assigning gender to the news, as it was originally defined, extends the range of problems we study and allows a deeper understanding not only of what may or may not be journalism, but also of a set of transnational problems and issues shared by women in their historical relations with the profession.

From Advent to Easter: Catholic Preaching in New York City, 1808–1809.

1994 ◽  
Vol 63 (3) ◽  
pp. 365-377
Author(s):  
James M. O'toole
Keyword(s):  
New York ◽  
The United States ◽  
White House ◽  
White Males ◽  
History Of ◽  
American Catholic History ◽  
Catholic History ◽  
American Catholic ◽  
Almost All ◽  
Scholarly Discourse

The recent interest in reconstructing the history of spirituality and religious belief is nowhere more welcome than in the history of Roman Catholicism in the United States. From the very point of its emergence as a recognizable subdiscipline at the turn of the century and lasting into very recent scholarship, American Catholic history has been a relentlessly “topdown”affair. It focused on the leaders of the church—almost all of them white males—and on official church institutions. Episcopal biography was the preferred form and, as often as not, “progress” was the theme: the hierarchy established itself steadily along the advancing frontier; populations of clergy, religious, and laity all increased heroically; immigrants once despised were transformed into the American mainstream. There was even an inspirational final chapter to the tale, as one American Catholic finally grasped the brass ring of acceptance and moved into the White House. The story was a deliberately edifying one, but it was a story primarily for insiders. Perhaps for that reason alone, American Catholic history seemed to remain, as Leslie Tender has recently observed, “on the margins” of serious scholarly discourse.

Science: Part of the Problem, Most of the Answer

1983 ◽  
Vol 17 (7-8) ◽  
pp. 566-569
Author(s):  
Jere E. Goyan
Keyword(s):  
Small Businesses ◽  
Drug Approval ◽  
The United States ◽  
New Drugs ◽  
Great Debate ◽  
History Of ◽  
Drug Approval Process ◽  
Almost All ◽  
Small Manufacturers ◽  
Scientific Questions

The history of the drug approval process in the United States includes three phases. First, the Food and Drug Act of 1906 essentially required that the labeling of drugs be truthful. The 1938 Food, Drug, and Cosmetic Act added a requirement that drugs be proven safe, and the 1962 act added the requirement that drugs be efficacious. Each of these steps required more and more sophisticated science. Subsequent to the Kefauver-Harris Amendments of 1962, the number of innovative molecular entities each year has declined, the reasons for which have been subject to great debate. This decline has paralleled decreases in innovation across almost all American industry, leading to questions about the future of our country as an industrialized society. Both the Carter and Reagan administrations attempted to address this problem in a number of ways, including cutting back on those regulations that are perceived as unnecessary. Other innovative approaches have been used, such as the establishment of an Office of Small Manufacturers Assistance in the FDA Bureau of Medical Devices, mandated by the 1976 Medical Device Amendments. The latter came about in recognition of the fact that small businesses tend to be more creative and efficient than larger industries and more adversely affected by regulation. However, the problems raised in the regulation of technology transfer almost inevitably arise because of perceived scientific questions. Such questions, in turn, can only be answered by good science performed by the sponsor and understood by the regulator. Thus, it is essential that the FDA be staffed with knowledgeable scientists who can interact easily with their peers in academia and industry. Although science is often the cause of our troubles, it is also our only hope for minimizing the costs of new drugs and other technology. In turn, minimizing such costs will maximize the opportunities for innovation.

The Pattern of Electoral Rules in the United States: a Deviant Case among the Industralized Democracies

1985 ◽  
Vol 20 (1) ◽  
pp. 18-28 ◽  
Author(s):  
Arend Lijphart
Keyword(s):  
United States ◽  
The United States ◽  
West Germany ◽  
Electoral Rules ◽  
American Model ◽  
Long Time ◽  
History Of ◽  
Almost All ◽  
Established Democracies ◽  
Deviant Case

THE UNITED STATES IS THE WORLD'S SECOND LARGEST DEMOcracy (after India) and the largest of the older well-established democracies, with a very long and uninterrupted history of free elections. For this reason, it can be argued that the American democratic example has been and, should be an important model for other countries to follow. This article will focus on one important aspect of the American democratic system - the pattern of electoral rules - and it will emphasize the striking differences between the American electoral process and that of most other democracies. This contrast obviously affects the applicability of the American model to other countries that may be in the process of revising their electoral rules: because the United States is a deviant case in almost all respects, it presents clear alternatives to the more common attern but also dternatives that are so radical that they may ge difficult to transplant. The democracies with which the American pattern of electoral systems will be compared and contrasted are the 20 countries which, Me the United States, have been democratic without interruption for a relatively long time, that is, since approximately the end of the Second world War: the four large West European countries (Great Britain, France, West Germany, and Italy), the five Nordic countries (Sweden, Denmark, Norway, Finland, and Iceland), the Benelux countries (the Netherlands, Belgium and Luxembourg), Ireland, Switzerland, Austria, and five countries outside Europe (Canada, Israel, Japan, Australia, and New Zealand).

scholarly journals King Zumbi and the Male Movement in Brazil

1992 ◽  
Vol 9 (3) ◽  
pp. 397-409
Author(s):  
T. B. Irving
Keyword(s):  
The United States ◽  
African Origin ◽  
European Settlement ◽  
Las Casas ◽  
The Pacific ◽  
Bartolome De Las Casas ◽  
Spanish Colonies ◽  
History Of ◽  
The Caribbean ◽  
Almost All

Three great regions of America deserve a Muslim's attedon because oftheir Islamic past: Brazil in South America; the Caribbean, which scarcely hasbeen explored in this tespect; and the United States. Over 12 percent of theUnited States' population, and even more in the Caribbean, is of African origin,whereas Brazil has a similar or greater proportion of African descent.The enslavement and transportation of Africans to the New World continuedfor another three or four centuries after the region's indigenous Indianpopulations had either been killed off or driven into the plains and wooc1s.While knowledge of the original African Muslims in Notth America is vaguely acknowledged, teseatch is still required on the West Indies. Brazil's case,however, is clearer due to its proud history of the Palmares republic, whichalmost achieved its freedom in the seventeenth century, and the clearly Islamicnineteenth-century Male movement. As a postscript, the Canudos movement in 1897 also contained some Islamic features.In the Spanish colonies, the decline of the indigenous Indian populationsbegan quickly. To offset this development, Bartolome de Las Casas (1474-1566), Bishop of Chiapas, Mexico, suggested the importation of enslavedAfricans to the new colonies, whete they could then be converted to Christianity.Few persons have exercised such a baneful effect on society as thisman, who is often called the "Apostle of the Indies." However, othes knewhim as the "Enslaver of Africans," especially the Muslims, who he called"Moots." These facts of African slavery apply to almost all of the Atlanticcoast of the Americas, from Maryland and Virginia to Argentina, as well asto some countries along the Pacific coast such as Ecuador and Peru. If thisaspect of Muslim history and the Islamic heritage is to be preserved for humanhistory, we need to devote more study to it.This tragedy began in the sixteenth century and, after mote than four hundredyears, its effects are still apparent. If those Africans caught and sold intoslavery were educated, as many of them were, they were generally Muslimsand wrote in Arabic. Thus, many educated and literate slaves kept the recordsfor their sometimes illiterate plantation masters, who often could not read ormake any mathematical calculations, let alone handle formal bookkeeping.In 1532, the first permanent European settlement was established in Brazil,a country which since that date has never been wholly cut off from WestAfrica: even today trade is carried on with the Guinea coast. Yoruba influencefrom Nigeria and Benin has been almost as pervasive in some regions of ...

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