NICE Review Essay

Antibiotics-resistant organisms have become one of the most serious threats to public health, infecting over two million people and killing approximately 23,000 people annually.1 According to the CDC, “total inappropriate antibiotic use,” such as prescribing unnecessary antibiotics or giving the wrong dose or duration, makes up to 50% of all outpatient antibiotic use,2,3 and in 2009, the United States spent $10.7 billion on antibiotics, indicating that there is a lot of potential money to save.4

First, the article provides a short explanation regarding central line associated bloodstream infections (CLABSI) and CLABSI related deaths that occur annually in the US. A national campaign, ‘On the CUSP,’ is briefly discussed. This was a collaborative cohort study of 1,071 adult intensive care units (ICUs) in 44 states, Puerto Rico, and Washington D.C. Their goal was to evaluate the impact of the ‘On the CUSP’ campaign in relation to CLASI reduction. Extensive education and training was provided prior and during the intervention. The multi-level Poisson regression model showed CLABSIs dropped from 1.96 to 1.15 per 1,000 line-days, a 43% decrease. Limitations included: this was not a randomized controlled trial (RCT), lack of resources to validate CLABSI data or collect intervention compliance data. However, the study indicates CLABSIs are preventable with standardized nursing interventions, which improves patient outcomes.

The central theme to this essay will be to answer the question “Discuss the roll that graphic design played in political/social change in a specific period”. This essay will look into what Hitler’s propaganda meant for the Nazis and the population of Germany. Propaganda is the dissemination of information to influence or control large groups of people. In totalitarian regimes like Nazi Germany, propaganda plays a significant role in consolidating power in the hands of the controlling party. (ushmm, 2015) This essay in conjunction will look into what Hitler’s propaganda meant, what methods conducted by Adolf Hitler and the Propaganda Ministry, directed by Dr. Joseph Goebbels use to infiltrate their enemies and commit mass genocide of the

Jim Collins and his research team have done a wonderful job identifying what it takes for a company to go from good to great. I found this book extremely interesting and would like to share several of my thoughts. The study looks at companies that appeared on the Fortune 500 from the years of 1965 to 1995, looking for those that, for 15 years, either tracked or underperformed the stock market, followed by a transition, and subsequently returning at least 3 times the stock market for at least 15 years. The eleven companies included in the

Baddour, L. M., Wilson, W. R., Bayer, A. S., Fowler, V. G., Tleyjeh, I. M., Rybak, M. J., ... & Bolger, A. F. (2015). Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation, 132(15), 1435-1486.

While Shapiro et al. was not able to recommend antimicrobial prophylaxis with amoxicillin Nadelman et al. devised

This video shows the reunion of a Belgian Malinois “Pretty” and her previous trainer, and friend being reintroduced after a year or more of separation. The video is rather short but the response from Pretty when she lays her eyes on Bryan is remarkable. Pretty, immediately recognizes Bryan and runs too him and jumps on him overjoyed to see him once again. This video takes place outside somewhere and pretty is being led by a young woman to Bryan as soon as Pretty recognizes her wanting for her, she immediately responds abundant jovialness. In fact, Pretty clings to Bryan for almost the entire length of the video which is about seventeen seconds long. I choose this video because it showed a dog recognizing and greeting someone from her past

Frequent use of broad-spectrum antibiotics is the most widely recognized modifiable risk factor. (p. 26)

In the last decade, the number of prescriptions for antibiotics has increases. Even though, antibiotics are helpful, an excess amount of antibiotics can be dangerous. Quite often antibiotics are wrongly prescribed to cure viruses when they are meant to target bacteria. Antibiotics are a type of medicine that is prone to kill microorganisms, or bacteria. By examining the PBS documentary Hunting the Nightmare Bacteria and the article “U.S. government taps GlaxoSmithKline for New Antibiotics” by Ben Hirschler as well as a few other articles can help depict the problem that is of doctors prescribing antibiotics wrongly or excessively, which can led to becoming harmful to the body.

According with the new guidelines of the AHA, the conditions that require preventive antibiotics (premedication) prior to dental treatment are artificial heart valves, a history of infective endocarditis, serious congenital heart conditions, and a cardiac transplant that develops a problem in a heart valve. For patients that present one or more of these conditions the standard regimen for premedication is 2 grams of amoxicillin orally, 30 to 60 minutes before procedure; and for patients allergic to amoxicillin, 600 mg of clindamycin 30 to 60

It is thought that overuse of antibiotics is related to the development of antimicrobial resistance (AMR) (Austin). As a consequence, there has been an increasing trend to promote appropriate prescribing of antibiotics so as to maximise their therapeutic efficacy and minimise the outbreak of resistance. Antimicrobial stewardship (AMS) programs in hospitals are exemplary of a method used to promote rational prescription of antibiotics. In this review, we will briefly introduce some examples of AMR to illustrate the extent of this issue. We will then move on to describe AMS programs and the strategies required to

This study is a retrospective chart review of 360 patients with definite or possible Infective Endocarditis according to modified Duke Criteria [1-2] who were admitted to Detroit Receiving Hospital and Harper University Hospital in Detroit from 2006 to 2014. Both hospitals are teaching hospitals in Detroit, Michigan. For a patient with repeated episodes of Infective Endocarditis, one episode was only included at our institutions. Clinical, microbiological, and echocardiographic data of all patients with definite IE were collected using a standard data collection form.

Different from most modern bureaucrats, these political appointees and their subordinates acquire their positions through elections or answer directly to elected officials. In the view of the public, they are responsible for the operations of the bureaucracies that make up their respective branches. They are expected to set general policy and directions and provide leadership in order to manage government agencies and programs. In order to achieve these expectations they need some degree of influence, if not control, over bureaucratic agencies that may not be the main concern in the political success of failure of the executive. Deliberate strategies and influence is necessary in dealing with administrative agencies, if they want to succeed in leading administrative behavior toward satisfaction of their policy objectives. They are also dependent on bureaucracy for policy development due to the diversity of information sources within the executive staffs, and those used outside the government.

Eighty percent of antibiotic prescribing takes place in general practice (Haddox, 2013). Therefore, focus of limiting antibiotic

Everyone wants to be famous, be in charge, be powerful. It is human to reach for more power or authority and that ambition tends to clouds people’s judgement and block who they truly are inside so that they can get what they want. Throughout the play Macbeth, it is evident that ambition will take over a person of power and make them commit evil without considering the consequences because it corrupts the mind of those it consumes. The destructive actions of a person in power with too much ambition are noted in the first two acts of Macbeth.