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Paroxetine in the treatment of chronic posttraumatic stress disorder: results of a placebocontrolled medications like prozac discount carbidopa amex, flexibile dosage trial treatment xerophthalmia order carbidopa with american express. Computerized tomographic scan changes in early schizophrenia ­ preliminary findings treatment yeast buy 110 mg carbidopa fast delivery. Pharmacotherapy of social phobia: a controlled study with moclobemide and phenelzine medicine jobs purchase carbidopa 125 mg amex. Risk of recurrence of bipolar disorder in pregnant and nonpregnant women after discontinuing lithium maintenance. Reduced hippocampal volume and total white matter volume in posttraumatic stress disorder. Psychopharmacological treatment of social phobia: a double blind placebo controlled study with fluvoxamine. Prediction of adult-onset schizophrenia from childhood home movies of the patients. Differences between post traumatic stress disorder patients with delayed and undelayed onset. Further distinction between manic-depressive illness (bipolar disorder) and primary depressive disorder (unipolar depression). Enhanced suppression of cortisol following dexamethasone administration in posttraumatic stress disorder. Cortisol and catecholamines in posttraumatic stress disorder: an epidemiologic community study. Treatment of premenstrual dysphoric disorder with sertraline during the luteal phase: a randomized, double-blind, placebo-controlled crossover trial. These drugs may be taken orally or, after being crushed and dissolved, intravenously. Clinical features Mild intoxication (Hollister and Gillespie 1970) is characterized by increased energy, varying degrees of elation, increased self-confidence, and talkativeness; the pupils are dilated, the blood pressure, both systolic and diastolic, is increased, the heart rate may be increased or reflexively decreased, and the deep tendon reflexes are diffusely brisk. With more severe intoxication there may be agitation and some bizarre behavior: often patients take a particular interest in things mechanical, and hours may be spent first taking apart, and then trying to put back together, various items, such as clocks, radios, televisions, etc. In severe intoxication a delirium may ensue, with confusion, incoherence, and disorientation. Abnormal movements, such as bruxism, chorea (Lundh and Tunving 1981), and, in some cases, generalized dystonia, may occur; intracerebral hemorrhage has also been reported (Harrington et al. The temperature rises, there may be extreme diaphoresis, and patients may experience nausea, vomiting, abdominal cramping, and diarrhea. Arrhythmias may appear, and with severe elevations of blood pressure there may be a hypertensive encephalopathy. Regardless of the degree of intoxication, most patients recover within hours to a day or so. In some cases, delusions and hallucinations, rather than being fleeting, may dominate the clinical picture of the intoxication, and in some of these cases, such symptoms may persist beyond the resolution of the intoxication, thus yielding a stimulant-induced psychosis. Although this is typically seen only with intravenous stimulant use, it has been reported after high-dosage oral use. In some cases there may be bizarre delusions, including Schneiderian first rank symptoms (Janowsky and Risch 1979). This amphetamine-induced psychosis generally clears within a matter of days or weeks, but it may occasionally last many months. With the development of tolerance, patients require ever larger doses to achieve euphoria, in some cases up to several grams daily. Some patients may develop an abusive pattern of use, however, and continue to seek intoxication despite suffering social or legal consequences. Withdrawal symptomatology, if severe and accompanied by suicidal ideation, may require hospitalization. Hospitalization is often required to break the pattern of use, and long-term involvement with groups such as Cocaine Anonymous or Narcotics Anonymous may be helpful. Both the free base and crack preparations evaporate with heating and thus may be smoked. Etiology It appears that the euphoria seen with stimulants occurs secondary to dopamine release within the ventral striatum (Drevets et al. Clinical features Differential diagnosis Intoxication with cocaine may be clinically indistinguishable from stimulant intoxication, and the differential may rest on history or drug screening. Lacking a history (as is often the case, given the deceit and denial seen in many cases), the elation and talkativeness of the intoxication may suggest mania, and the irritability, fatigue, and sleep disturbance of withdrawal may suggest depression. Drug screening is helpful here; however, observation in a controlled environment will also tell the tale, as the symptoms resolve over the expected time period. The stimulant-induced psychosis represents one of the toxic psychoses, discussed in Section 7. The onset of intoxication varies according to the preparation used; after snorting, peak levels are reached within 30­60 minutes, whereas after intravenous injection or smoking, peak levels occur within seconds, creating a much more intense intoxication. During intoxication (Kleber and Gawin 1984), patients become euphoric, hyperalert, talkative, and grandiose. Hyperactivity is common, and with higher doses agitation may occur (Fischman et al. With mild intoxication libido increases, and in males there may be delayed ejaculation; with more severe intoxication, however, there may be erectile dysfunction. In severe intoxication, especially after intravenous use or smoking, a delirium may occur, with confusion, incoherence, lability, and delusions and hallucinations. Other symptoms and signs include mydriasis, hypertension, headache, nausea and vomiting, tachycardia, and arrhythmias or cardiac arrest (Hsue et al. In severe cases one may utilize an antipsychotic such as haloperidol, in a dose of approximately 5 mg, either as the concentrate or parenterally, with repeat doses every hour or so until the patient is calm, limiting side-effects occur or a maximum dose of approximate 20 mg is reached. Stimulant psychosis may be treated with an antipsychotic, such as haloperidol (5­10 mg) or risperidone (2­4 mg), with the understanding that the medication may, given the natural course of the disorder, be eventually discontinued. Clear-cut withdrawal, however, does occur with chronic use and indeed may appear after only a few days of heavy use. This withdrawal reaches a maximum of severity within a few days and then gradually remits over days or weeks. Unfortunately, this tolerance applies only to the euphoriant effects of cocaine and not to its potentially lethal cardiovascular effects. After approximately two or more years of frequent cocaine use, intoxications may become characterized by delusions of persecution and of reference, and by auditory hallucinations (Brady et al. Although initially these symptoms tend to resolve shortly after the intoxication resolves (Brady et al. The intervals between binges vary widely, from only a few days to up to weeks or months. Etiology Within the central nervous system cocaine both inhibits the reuptake and facilitates the release of monoamines by pre-synaptic neurons. Although both serotonin and norepinephrine are involved, it appears that the euphoriant effects of cocaine are related to the increased concentration of dopamine at the terminals of the mesolimbic and mesocortical dopaminergic pathways. Differential diagnosis A clinical differentiation of cocaine intoxication from stimulant intoxication may not be possible, and the differential often rests on history or a drug screen. Withdrawal may suggest depression and, when the history of cocaine use is unavailable, the differential may rest on observation in a controlled environment, which will reveal the fairly rapid resolution of symptoms. The diagnosis of a persistent cocaine psychosis is generally straightforward as it is difficult to hide the history of chronic cocaine addiction. If, however, this history is not available, then the differential for psychosis, as discussed in Section 7. Even in cases of severe intoxication with delirium, observation, given the brevity of the intoxication, is again generally all that is required; if, however, agitation is severe, one may give a dose of parenteral haloperidol in a dose of 5­10 mg. Patients with severe withdrawal and suicidal ideation may require hospitalization to protect themselves; hospitalization may also be required in cases of cocaine abuse or addiction to effect a period of abstinence, during which other measures may be initiated. The overall goal of treatment of cocaine abuse or addiction is abstinence from cocaine and other substances, such as alcohol, benzodiazepines, and opioids. Patients may be referred to organizations such as Cocaine Anonymous or Narcotics Anonymous, and some may undergo cognitive behavioral therapy.

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Accordingly treatment quincke edema 300 mg carbidopa with amex, the Exchange does not believe that the proposal will impair the ability of members or competing order execution venues to 9 medications that can cause heartburn purchase generic carbidopa pills maintain their competitive standing in the financial markets treatment 6th feb purchase generic carbidopa from india. Date of Effectiveness of the Proposed Rule Change and Timing for Commission Action the foregoing rule change has become effective pursuant to abro oil treatment order carbidopa 110mg on-line Section 19(b)(3)(A)(ii) of the Act. Copies of the submission, all subsequent amendments, all written statements with respect to the proposed rule change that are filed with the Commission, and all written communications relating to the proposed rule change between the Commission and any person, other than those that may be withheld from the public in accordance with the provisions of 5 U. Copies of the filing also will be available for inspection and copying at the principal office of the Exchange. The Exchange has prepared summaries, set forth in sections A, B, and C below, of the most significant aspects of such statements. B: ``Fee will also apply to the originating and contra side Proprietary/Broker-Dealers, and Professional Customers. For purposes of the fee schedule, orders executed of Crossing Orders, and to Responses to Crossing Orders. While the Exchange is not aware of any member confusion with respect to this fee, the Exchange believes this specificity will help preclude any potential confusion in how its fees will apply. Statutory Basis the Exchange believes that its proposal is consistent with Section 6(b) of the Act,7 in general, and furthers the objectives of Sections 6(b)(4) and 6(b)(5) of the Act,8 in particular, in that it provides for the equitable allocation of reasonable dues, fees, and other charges among members and issuers and other persons using any facility, and is not designed to permit unfair discrimination between customers, issuers, brokers, or dealers. Market Makers, unlike other market participants, take on a number of obligations, including quoting obligations, that other market participants do not have. Priority Customer liquidity provides more trading opportunities, which attracts Market Makers. An increase in the activity of these market participants in turn facilitates tighter spreads, which may cause an additional corresponding increase in order flow from other market participants. For the foregoing reasons, the Exchange believes that the proposed changes do not impose an undue burden on competition. Date of Effectiveness of the Proposed Rule Change and Timing for Commission Action the foregoing rule change has become effective pursuant to Section 19(b)(3)(A)(ii) of the Act 10 and Rule 19b­4(f)(2) 11 thereunder. At any time within 60 days of the filing of the proposed rule change, the Commission summarily may temporarily suspend such rule change if it appears to the Commission that such action is: (i) Necessary or appropriate in the public interest; (ii) for the protection of investors; or (iii) otherwise in furtherance of the purposes of the Act. Solicitation of Comments Interested persons are invited to submit written data, views, and arguments concerning the foregoing, including whether the proposed rule change is consistent with the Act. Purpose the Exchange proposes to amend Exchange Rule 514, Priority on the Exchange. Members of the Exchange may either be Market Makers or Electronic Exchange Members. In such a case, the System will cancel the oldest of the orders back to the entering party prior to execution. The Exchange believes the proposed changes promote just and equitable principles of trade, remove impediments to and perfect the mechanism of a free and open market and a national market system by providing Market Makers with additional flexibility to configure selftrade protections offered by the Exchange. Therefore, the Exchange is proposing to provide Exchange Members flexibility with respect to how self-trade protections are implemented. The Exchange does not believe that providing more flexibility to members will have any significant impact on competition. Conversely, the Exchange believes that the proposed rule change will foster competition as Market Makers may send more orders to the Exchange knowing that there is no chance that they will trade with their own orders on the other side of the market. The Exchange does not believe that the proposed rule change will impose any burden on intra-market competition as self-trade protection is available to all Market Makers on the Exchange. Further, the Exchange does not believe that the proposed rule change will impose any burden on inter-market competition, and rather could potentially promote inter-market competition and result in more competitive order flow to the Exchange by more widely preventing Market Makers from trading with their own orders. Date of Effectiveness of the Proposed Rule Change and Timing for Commission Action Because the foregoing proposed rule change does not: (i) Significantly affect the protection of investors or the public interest; (ii) impose any significant burden on competition; and (iii) become operative for 30 days after the date of the filing, or such shorter time as the Commission may designate, it has become effective pursuant to 19(b)(3)(A) of the Act 17 and Rule 19b­4(f)(6) 18 thereunder. At any time within 60 days of the filing of the proposed rule change, the Commission summarily may temporarily suspend such rule change if it appears to the Commission that such action is necessary or appropriate in the public interest, for the protection of investors, or otherwise in furtherance of the purposes of the Act. If the Commission takes such action, the Commission shall institute proceedings to determine whether the proposed rule should be approved or disapproved. The Exchange has prepared summaries, set forth in Sections A, B, and C below, of the most significant parts of such statements. The Exchange has operated the pilot for a six year period and believes that it has been successful in its stated goal of providing price improvement opportunities to retail investors. The analysis conducted by the Exchange shows that retail investors have been provided a total of $4. The proposal provides an analysis of the economic benefits to retail investors and the marketplace flowing from operation of the Program, which the Exchange believes supports making the Program permanent. Background In November 2012, the Commission approved the Program on a pilot basis. The Program is currently limited to trades occurring at prices equal to or greater than $1. This would help to ensure that retail investors benefit from competitive price improvement that exchange-based liquidity providers provide. As discussed below, the Exchange believes that the Program data supports the conclusion that it provides valuable price [sic] to retail investors that they may not otherwise have received, and that it is therefore appropriate to make the Program permanent. The ceiling or floor price is the amount above or below which the User does not wish to trade. Finally, Retail Orders are designated as Type 1 or Type 2 without regard to the size of the order. The disapproved applicant could appeal the disapproval by the Exchange as provided in Rule 11. When disqualification determinations are made, the Exchange provides a written disqualification notice to the Member. Such written policies and procedures must require the Member to (i) exercise due diligence before entering a Retail Order to assure that entry as a Retail Order is in compliance with the requirements of this rule, and (ii) monitor whether orders entered as Retail Orders meet the applicable requirements. The Retail Liquidity Identifier is disseminated through consolidated data streams. The identifier is also available through the consolidated public market data stream for Tape C securities. Any remaining unexecuted portion of the Retail Order will cancel or execute in accordance with Rule 11. User 1 is not filled because the entire size of the Retail Order to sell 1,000 is depleted. The Exchange limits the Program to trades occurring at prices equal to or greater than $1. However, if the Retail Order was Type 2 as defined the Program,23 it would be able to interact at $0. In addition to facilitating an orderly 24 and operationally intuitive program, the Exchange believes that limiting the Program to trades equal to or greater than $1. As part of that review, the Exchange produced data throughout the pilot, which included statistics about participation, the frequency and level of price improvement provided by the Program, and any effects on the broader market structure. In addition, the non-displayed nature of the liquidity in the Program simply has no potential to disrupt displayed, protected quotes. Rationale for Making the Program Pilot Permanent the Exchange established the Program in an attempt to attract retail order flow to the Exchange by providing an opportunity for price improvement to such order flow. Such competition promotes efficiency by facilitating the price discovery process and generating additional investor interest in trading securities, thereby promoting capital formation and retail investment opportunities. The Program will continue to be limited to trades occurring at prices equal to or greater than $1. In accordance with its filing establishing the pilot, the Exchange did ``produce data throughout the pilot, which will include statistics about participation, the frequency and level of price improvement provided by the Program, and any effects on the broader market structure. The Exchange believes that the data provided to the Commission to date, as well as the data being provided in this proposed rule change, support the continued operation of the Program on a permanent basis. The data also demonstrates that the Program had an overall negligible impact on broader market quality outside of the Program. The Exchange believes that the Program has satisfied this goal, having provided a total of $4. Furthermore, while the amount of price improvement provided in the Program varies month to month, the amount of price improvement provided in recent months has generally increased relative to prior months due to additional participation in the Program by market participants with retail order flow. The Exchange believes that this supports permanent approval of the pilot as retail investors continue to reap the benefits afforded by the Program. The amount of monthly and cumulative price improvement provided in the Program is illustrated in Chart 1 below. Overall Analysis of the Program Brokers route retail orders to a wide range of different trading systems.

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No this does not affect service users Can you foresee a negative impact on any Protected Characteristic 10 Group(s)? No - there is no impact on protected groups Equality Risk Have you got any general intelligence (research symptoms kidney pain purchase carbidopa with a mastercard, consultation symptoms pulmonary embolism order carbidopa 300 mg otc, etc symptoms pink eye generic carbidopa 110mg overnight delivery. Include any "Decision Reports" 15 Yes- information will be uploaded onto the website in due course symptoms 3 days before period purchase 300mg carbidopa with amex. No - not applicable Will the policy/decision breach the positive obligation to protect human rights? No - there are no plans to increase/ or charge for this service 4 Does this issue plan to make a change to a commissioned service? No- there Is no affect on Service Users Can you foresee a negative impact on any Protected Characteristic 10 Group(s)? No- there are no plans to introduce a service or increase a charge to an existing service. No - there are no plans to make changes to a commissioned service Does this issue plan to introduce, review or change a policy, strategy or procedure? No - this does not affect service users Can you foresee a negative impact on any Protected Characteristic 10 Group(s)? No - there is no forseen negative impact on Protected Groups Equality Risk Have you got any general intelligence (research, consultation, etc. Include any "Decision Reports" 15 Yes information will be published on the website in due course. Not applicable Will the policy/decision breach the positive obligation to protect human rights? No- there is no plan to introduce or increase a charge for the service 4 Does this issue plan to make a change to a commissioned service? No- there are no plans to make a change to a commissioned service Does this issue plan to introduce, review or change a policy, strategy or procedure? No there is no impact on Service Users Can you foresee a negative impact on any Protected Characteristic 10 Group(s)? No - there is no negative impact on protected groups Equality Risk Have you got any general intelligence (research, consultation, etc. Not applicable 20 Will the policy/decision lead to degrading or inhuman treatment? No there are no plans to reduce this service 3 Does this issue plan to introduce or increase a charge for Service? No there are no plans to make any changes Does this issue plan to introduce, review or change a policy, strategy or procedure? No- there is no negative impact on protected groups Equality Risk Have you got any general intelligence (research, consultation, etc. Human Rights Impact 19 Will the policy/decision or refusal to treat result in the death of a person? A number of policies have been grouped under the heading of Respiratory, Thoracic/Wound Care. No - there are no plans to introduce or increase charges for any of the policies that fall under thoracic /respiratory/or woundcare. No - these policies are existing policies which have been reviewed and there are no changes to these policies. Does this issue plan to introduce, review or change a policy, strategy or procedure? Does this affect Employees or levels of training for those who will be delivering the service? Consultation has been carried out with consultant specialist for thoracic/respiratory/wound care. No - the policy will not result in the death of a person 20 Will the policy/decision lead to degrading or inhuman treatment? No - there are no plans to introduce a charge for this service 4 Does this issue plan to make a change to a commissioned service? No - there are no plans to make changes to this service Does this issue plan to introduce, review or change a policy, strategy or procedure? No there are no plans to introduce a new service or activity 7 Is this primarily about improving access to, or delivery of a service? No this does not affect Service Users Can you foresee a negative impact on any Protected Characteristic 10 Group(s)? No there is no negative impact on Protected Groups Equality Risk Have you got any general intelligence (research, consultation, etc. No- not applicable 20 Will the policy/decision lead to degrading or inhuman treatment? No - there are no plans to introduce a charge or increase any charges for this service. No - there are no plans to introduce a new service or activity 7 Is this primarily about improving access to, or delivery of a service? No - this will not affect service users Can you foresee a negative impact on any Protected Characteristic 10 Group(s)? Consultation has been carried out with consultant specialist for Vascular services. No not applicable 20 Will the policy/decision lead to degrading or inhuman treatment? No not applicable Will the policy/decision breach the positive obligation to protect human rights? There have been no changes made to this policies that fall under the suite of Vascular policies. Treshold criteria has been set so that patients receive the most benefit from the procedure/ treatment and do not receive unnecessary treatment. Some policies move the activity in to primary care - where there are already services and work force available. What is the impact on the organisations safeguarding duty to protect children, young people and adults? Does it ensure care is delivered in the most clinically appopriate and cost effective setting? Who from Medicines Optimisation Teams/Pharmacy Teams have been involved in these discussions? Add in what the reduced risk is likely to be Does it reduce/impact on variation in care provision? There is a small risk as some patients may want the procedure and now cannot have it so the expereince will be reduced. These will be picked up as part of the monitoring process described above 3 3 9 What is the impact of possible unintended consequences? The report covers the period 1 April 2018 ­ 30 June 2018 (Quarter1) and 1 July 2018 30 September 2018 (Quarter 2) this report includes updates on the number of complaints, freedom of information requests and enquiries received during these quarters, as well as a summary of the themes related to these enquiries. Improve the quality of care ­ clinical X Listening to our patients and public ­ X effectiveness, safety and patient acting on what patients and the public experience tell us. Reduce inequalities in access to Living within our means using public healthcare money effectively Implementing key enablers to support the strategic aims. Our statutory duties are described in the Equality Act 2010 and the Health and Social Care Act 2012. Over and above these, we are also mindful that the Francis Report (2013) strengthens the need to capture and make informed decisions based on the patient voice. The engagement process ran from 20 June to 24 July 2018 and consisted of stakeholder, patient and public engagement. The findings from the public engagement were used to shape the future model of services and to inform the development of the service specification. Changes were made to the original proposals based on public feedback meaning the original proposed reduction in opening hours at weekends and Bank Holidays will not now go ahead due to public concerns regarding the lack of alternative services in local areas. Both committees also received an update on the outcome of the engagement and the changes made to the proposals based on feedback from the public. Letters of support for the proposals were received from Chairs of both committees in August 2018. Further conversations are due to take place shortly with local people to determine the future location of a new urgent care service in the Blaby District area. During the summer of 2018 patients in East Leicestershire and Rutland were asked for their views on changes to the prescribing of over the counter medicines.

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Reduction of central line infections in Veterans Administration intensive care units: An observational cohort using a central infrastructure to treatment nausea order carbidopa 300 mg free shipping support learning and improvement medications qt prolongation buy on line carbidopa. From October 2006 through September 2007 medicine 003 best carbidopa 110mg, the teams implemented insertion and maintenance bundles symptoms wheat allergy order carbidopa mastercard. By the end of the first year, sustained insertion bundle adherence was 84% and maintenance bundle compliance was 82%. This is believed to be the first study regarding the impact of insertionrelated practices versus maintenance-related practices on bloodstream infection rates in either adult or pediatric populations. Continued on next page 27 Preventing Central Line­Associated Bloodstream Infections: A Global Challenge, A Global Perspective Table 2-5. This voluntary intervention was designed collaboratively, led by infection preventionists and medical staff from the participating hospitals. The teams used repetitive, structured social interactions such as conference calls, e-mails, and workshops to share stories about checklist and bundle successes and barriers, and to receive updated information on performance data. Impact of a a tertiary care center prevention strategy targeted at vascularDeveloped by: University access care on of Geneva Hospital incidence of infections acquired in intensive Time frame: October care. March 1997­November 1997 (intervention period) the University of Geneva Hospital is a 1,500-bed primary and tertiary care center. Impact of a program to prevent Developed by: Hospital central line­associated Israelita, Sгo Paulo, bloodstream infection in Brazil the zero tolerance era. Impact of a prevention strategy targeting hand hygiene and catheter care on the incidence of catheterrelated bloodstream infections. At baseline they identified differences in health care personnel performance of catheter maintenance care; education focused, therefore, on current evidence-based practices. Additionally, while the overall adherence to proper hand hygiene did not improve significantly between the two periods (59. Continued on next page 29 Preventing Central Line­Associated Bloodstream Infections: A Global Challenge, A Global Perspective Table 2-5. Thammasat University Hospital is a 500-bed tertiary care university hospital in central Thailand. The third period included an intensified hand hygiene effort that provided continuous education on hand hygiene and feedback to staff of hand hygiene adherence rates and adherence to the use of maximum sterile barriers. Barriers at the Organizational Level ship is essential to patient safety in all types of settings, including outpatient settings, long term care facilities, home care, and others. Lack of leadership support and commitment the importance of leadership involvement in, and support of, any effort to promote organizational change to improve patient safety cannot be overstated. This commitment, however, must be a shared one, with the board of trustees and all senior management supportive of the common goal. Also, lack of ongoing surveillance for infections results in delays in detecting outbreaks, which causes increases in costs and infection-associated mortality. Barriers at the Staff Level Nurse staffing variables, such as nurse-to-patient staffing ratios and use of nonpermanent staff, can adversely affect patient safety in the following ways: Of all health care personnel, nurses have the most direct, ongoing role in the care of patients and the interventions or procedures that put patients at risk of infection. Having competent, adequately educated and trained staff who insert and maintain central lines may be a bigger challenge in resource-poor areas of the world. Damani points out that lack of trained infection preventionists in developing countries is a key barrier to the implementation of evidence-based practices. Developing evidence-based clinical practice guidelines in hospitals in Australia, Indonesia, Malaysia, the Philippines and Thailand: Values, requirements and barriers. Towards evidence-based clinical practice: An international survey of 18 clinical guideline programs. Adams K, Corrigan J, Institute of Medicine Committee on Identifying Priority Areas for Quality Improvement. Reduction in central line­associated bloodstream infections among patients in intensive care units-Pennsylvania, April 2001­March 2005. Preventing catheterassociated bloodstream infections: A survey of policies for insertion and care of central venous catheters from hospitals in the prevention epicenter program. The attributable cost, length of hospital stay, and mortality of central line­ associated bloodstream infection in intensive care departments in Argentina: A prospective, matched analysis. Device-associated nosocomial infection rates in intensive care units of Argentina. Device-associated infection rate and mortality in intensive care units of 9 Columbian hospitals: Findings of the International Nosocomial Infection Control Consortium. Device-associated nosocomial infection rates in intensive care units in four Mexican public hospitals. Device-associated nosocomial infection rates in intensive care units of seven Indian cities. Device-associated infection rates and mortality in intensive care units of Peruvian hospitals: Findings of the International Nosocomial Infection Control Consortium. Deviceassociated infection rates in intensive care units of Brazilian hospitals: Findings of the International Nosocomial Infection Control Consortium. International Nosocomial Infection Control Consortium findings of device-associated infections rate in an intensive care unit of a Lebanese university hospital. Effect of an infection control program using education and performance feedback on rates of intravascular device-associated bloodstream infections in intensive care units in Argentina. Effect of education and performance feedback on rates of catheter-associated urinary tract infection in intensive care units in Argentina. Reduction in nosocomial infection with improved hand hygiene in intensive care units of a tertiary care hospital in Argentina. Impact of an infection control program on rates of ventilator-associated pneumonia in intensive care units in 2 Argentinean hospitals. Sustaining reductions in catheter related bloodstream infections in Michigan intensive care units: Observational study. Using evidence, rigorous measurement, and collaboration to eliminate central catheter­associated bloodstream infections. Reproducibility of the surveillance effect to decrease nosocomial infection rates. A quality improvement initiative to reduce line-associated bloodstream infections in a neonatal intensive care unit. Systems ambiguity and guideline compliance: A qualitative study of how intensive care units follow evidence-based guidelines to reduce healthcare-associated infections. The United States approach to strategies in the battle against healthcare-associated infections, 2006: Transitioning from benchmarking to zero tolerance and clinician accountability. Allegranzi B, Bagheri Nejad S, Combescure C, Graafmans W, Attar H, Donaldson L, Pittet D. Hospital staffing and health care-associated infections: A systematic review of the literature. Impact of organisation and management factors on infection control in hospitals: A scoping view. The role of understaffing in central venous catheter-associated bloodstream infections. Feasibility and efficacy of infectioncontrol interventions to reduce the number of nosocomial infec- 91. Long-term retention of central venous catheter insertion skills after simulationbased mastery learning. The impact of hospital practice on central venous catheter associated bloodstream infection rates at the patient and unit level: A multicenter study. Effect of education on the rate of and the understanding of risk factors for intravascular catheter­related infections. Use of simulation-based education to reduce catheter-related bloodstream infections. Simulation-based mastery learning reduces complications during central venous catheter insertion in a medical intensive care unit. Although case definitions, surveillance methodologies, risk-adjustment strategies, and rate calculations may be consistent within individual research studies, they are not consistent across studies. Effect of an infection control program using education and performance feedback on rates of intravascular device­associated bloodstream infections in intensive care units in Argentina.

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