Catheter-related bloodstream infection: burden of disease in a tertiary hospital

Background: Surveillance programmes have become the most effective tool for controlling catheter-related bloodstream infections (CRBSI). However, few studies have investigated programmes covering all hospital settings. Aim: To describe the results of a control and prevention programme for CRBSI based on compliance with recommendations for insertion and maintenance, using annual burden of disease in a tertiary level hospital. Methods: A CRBSI control and prevention programme involving all hospital settings was implemented. The programme consisted of CRBSI surveillance, direct observation of insertion and maintenance of catheters to determine performance, and education for healthcare workers. Findings: In total, 2043 short-term catheters were inserted in 1546 patients for 18,570 catheter-days, and 279 long-term catheters were inserted in 243 patients for 40,440 catheter-days. The annual incidence density was 5.98 (first semester 6.40, second semester 5.64) CRBSI per 1000 catheter-days for short-term catheters, and 0.57 (first semester 0.66, second semester 0.43) CRBSI per 1000 catheter-days for long-term catheters. One hundred and forty insertion procedures were observed, with an average insertion time of 13 (standard deviation 7) min. Compliance with recommendations was as follows: hand hygiene, 86.8%; use of alcoholic chlorhexidine solution for skin disinfection, 35.5%; use of mask, 93.4%; use of gloves, 98.7%; use of gown, 75.0%; use of sterile cloth, 93.8%; use of cap, 92.2%; bandage application, 62.7%; and use of aseptic technique, 89.5%. Forty-five maintenance procedures were observed, and compliance rates were as follows: hand hygiene, 42.1%; use of gloves, 78.1%; and port disinfection with alcoholic chlorhexidine solution, 32.5%. Conclusion: The CRBSI control and prevention programme implemented at the study hospital has decreased the rate of CRBSI, provided important information about the total burden of disease, and revealed possible ways to improve interventions in the future.

The resource wealth burden - oil and gas sectors in the former USSR. OSW Study 12/2003

The former USSR area plays a great role in the international oil and gas market. Russia is a real gas giant, with the richest deposits of this material in the world. Russia is also the main exporter of natural gas to many European countries. Keeping a strong position in this market remains a priority for the Russian Federation's economic policy. Europe is a very attractive region because its demand for gas is expected to grow steadily, while its own gas production keeps decreasing. In the long term, the Far East will be an important market for Russian exports, too. According to estimates, demand there will grow even faster than in Europe. Caspian gas producers, for the time being, can not really compete with Russia in this field, and this status quo will most probably be preserved in the nearest future.

Macroeconomic Conditionality in Cohesion Policy: Added Value or Unnecessary Burden? European Policy Brief No. 13, November 2012

Macroeconomic conditionality has become one of the major elements in discussions on the future of EU cohesion policy. Such conditional-ity would make the cohesion budget dependent on EU economic governance rules. This would have advantages for economic governance and, to a lesser extent, the efficiency of cohesion policy and the EU’s Multiannual Financial Framework negotiations. Yet, conditionality also risks entailing serious disadvantages for the end beneficiaries and cohesion policy itself. If the EU decides to put macroeconomic conditionality in place, it needs to reconsider the design and agree on an ample cohesion budget.

The trucking industry's federal paperwork burden should be reduced. Comptroller General's report to the chairman, Joint Economic Committee.

Mode of access: Internet.

Excessive truck weight: an expensive burden we can no longer support.

Mode of access: Internet.

The day's burden

Mode of access: Internet.

Federal paperwork burden [microform] : hearing before the Subcommittee on Investigations of the Committee on Post Office and Civil Service, House of Representatives, Ninety-sixth Congress, first session, November 12, 1979.

Reuse of record except for individual research requires license from Congressional Information Service, Inc.

Dulce domum, the burden of the song.

Poems.

The burden of the South, in verse; or, Poems on slavery,

Also appears in his Stanzas to Queen Victoria, 1866, p. 5-96.

The burden of neutrality : notes for onlookers in time of war /

Mode of access: Internet.