RESUMEN

Two American football players on the same team were diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections on the same day. Our investigation, including whole genome sequencing, confirmed that players did not transmit MRSA to one another nor did they acquire the MRSA from a single source within the training facility.

RESUMEN

BACKGROUND: There has been an intensified focus on quality initiatives within health care. Clinical Networks have been established in Alberta as a structure to improve care within and across settings. One method used by Clinical Networks to improve care is clinical care pathways. The objective of this study was to evaluate an evidence-informed hip fracture acute care pathway before broad implementation. METHODS: The pathway was developed by a provincial Clinical Network and implemented at four of 14 hospitals across the province. Within four months of implementing the pathway, experienced interviewers conducted focus groups with end-users at the four sites. Domains of inquiry focused on indentifying barriers and facilitators to use of the pathway. RESULTS: Fifteen physicians and 29 other health-care providers participated in eight focus groups. Common themes identified around the pathway order sets included issues with format, workflow and workload, and dissemination. The patient/family educational materials were deemed to be beneficial. Health-care provider education required better support. Overall the pathway was seen to be comprehensive. However, communication about the pathway could have been improved. CONCLUSIONS: This care model is novel in that it combines the concepts of clinical networks, care pathways, and knowledge translation in an effort to provide high-quality, evidence-informed care in a standardized equitable manner across a diverse geographic area.

RESUMEN

The impact of a confinement dairy operation (>2000 head) using best management practices for land application of animal wastes, on estrogenic activity (E-Screen), estrogens, and nutrients of associated surface waters and tile drain runoff were evaluated. Farm tile drain and creek samples were collected from the drainage region: above and below a municipal wastewater treatment plant located upstream from the dairy; and downstream from animal housing, parlor, and fields receiving applied wastes. Fifty-four thousand tons of waste (from approximately 1000 milking head) were applied to approximately 809 ha from April to July. Maximum estradiol equivalents (E(2)Eqs) present in tile drain samples (17alpha-E(2) > 17beta-E(2). Creek nutrient concentrations were similar above and below the dairy, with higher concentrations found in tile drain samples: tile ammonia ranged from <0.05 to 0.70 mg/L, nitrate/ite from 1.2 to 14 mg/L, and total phosphorus from 0.04 to 0.34 mg/L. No differences in estrogenic activity or nitrate/ite, ammonia, and phosphorus concentrations were detected in surface waters downstream of a large confinement dairy facility and measured nutrients were within regional norms.

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