Zoonotic diseases represent one of the leading causes of illness and death from infectious disease. Defined by the World Health Organization, zoonoses are "those diseases and infections that are ...naturally transmitted between vertebrate animals and man with or without an arthropod intermediate." Worldwide, zoonotic diseases have a negative impact on commerce, travel, and economies. In most developing countries, zoonotic diseases are among those diseases that contribute significantly to an already overly burdened public health system. In industrialized nations, zoonotic diseases are of particular concern for at-risk groups such as the elderly, children, childbearing women, and immunocompromised individuals.
The Emergence of Zoonotic Diseases: Understanding the Impact on Animal and Human Health , covers a range of topics, which include: an evaluation of the relative importance of zoonotic diseases against the overall backdrop of emerging infections; research findings related to the current state of our understanding of zoonotic diseases; surveillance and response strategies to detect, prevent, and mitigate the impact of zoonotic diseases on human health; and information about ongoing programs and actions being taken to identify the most important needs in this vital area.
The resistance topic is timely given current events. The emergence of mysterious new diseases, such as SARS, and the looming threat of bioterrorist attacks remind us of how vulnerable we can be to ...infectious agents. With advances in medical technologies, we have tamed many former microbial foes, yet with few new antimicrobial agents and vaccines in the pipeline, and rapidly increasing drug resistance among infectious microbes, we teeter on the brink of loosing the upperhand in our ongoing struggle against these foes, old and new. The Resistance Phenomenon in Microbes and Infectious Disease Vectors examines our understanding of the relationships among microbes, disease vectors, and human hosts, and explores possible new strategies for meeting the challenge of resistance.
Current methods of measuring continuous quality improvement (CQI) implementation are too long and not comprehensive. A new survey for CQI implementation was developed and tested for content validity ...using a panel of 8 experts-7 from the United States and 1 from England. The survey was reduced from 70 items to 22. The resultant survey had a clarity interrater agreement (IR) of .91, a representativeness IR of .93, a clarity content validity index (CVI) of .73, and a representativeness CVI of .91. Content validity served as an excellent data reduction method in building a valid, concise, and comprehensive measure of CQI implementation.
A study was conducted in 2000 to describe service quality problems in a large tertiary care teaching hospital and evaluate the effect of a pre-discharge program for active complaint surveillance and ...resolution on patient satisfaction.
The pre-post intervention study with temporal controls was conducted at a tertiary care teaching hospital in St Louis. Eighty-four percent (1,023 of 1,218) of patients admitted to a general medical unit between October 2, 2000, and December 22, 2000, were interviewed by a patient advocate to identify and address patient complaints about service quality. Patient satisfaction was measured, using a validated instrument administered by telephone interview 7-10 days after discharge.
The advocate completed 1,233 patient interviews and received 695 complaints about service quality. Half of the complaints concerned local unit care, most frequently delays in response to patient requests. Patients also complained about food, delays in admission and discharge, and inadequate communication about procedures. Concurrently, the hospital's formal reporting system received 12 complaints. Patients satisfaction scores were unchanged during the intervention.
Active surveillance using predischarge patient interviews by a patient advocate identified many local and systemwide service quality problems in a large tertiary care teaching hospital that needed to be addressed to improve the quality of patient care. However, patient satisfaction scores were unchanged.
Saturation has attained widespread acceptance as a methodological principle in qualitative research. It is commonly taken to indicate that, on the basis of the data that have been collected or ...analysed hitherto, further data collection and/or analysis are unnecessary. However, there appears to be uncertainty as to how saturation should be conceptualized, and inconsistencies in its use. In this paper, we look to clarify the nature, purposes and uses of saturation, and in doing so add to theoretical debate on the role of saturation across different methodologies. We identify four distinct approaches to saturation, which differ in terms of the extent to which an inductive or a deductive logic is adopted, and the relative emphasis on data collection, data analysis, and theorizing. We explore the purposes saturation might serve in relation to these different approaches, and the implications for how and when saturation will be sought. In examining these issues, we highlight the uncertain logic underlying saturation—as essentially a predictive statement about the unobserved based on the observed, a judgement that, we argue, results in equivocation, and may in part explain the confusion surrounding its use. We conclude that saturation should be operationalized in a way that is consistent with the research question(s), and the theoretical position and analytic framework adopted, but also that there should be some limit to its scope, so as not to risk saturation losing its coherence and potency if its conceptualization and uses are stretched too widely.
We have developed a precision technique to measure sine-wave sources with the use of a quantum-accurate AC programmable Josephson voltage standard. This paper describes a differential method that ...uses an integrating sampling voltmeter to precisely determine the amplitude and phase of high-purity and low-frequency (a few hundred hertz or less) sine-wave voltages. We have performed a variety of measurements to evaluate this differential technique. After averaging, the uncertainty obtained in the determination of the amplitude of a 1.2 V sine wave at 50 Hz is 0.3 muV/V (type A). Finally, we propose a dual-waveform approach for measuring two precision sine waves with the use of a single Josephson system. Currently, the National Institute of Standards and Technology (NIST) is developing a new calibration system for electrical power measurements based on this technique.
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