Turkey Links

We at the Ye Olde Humble Controversies Blog (YOHCB) wish you a safe and happy Thanksgiving. We have lots to be thankful for including the many tireless state and federal partners in infection prevention, fantastic infection preventionists, colleagues across many clinical disciplines and our readership. Thank you!

While you are out and about or gathered around a turkey or television, you might want to browse these studies/posts which we haven't covered yet. Just promise that you won't read any while driving, OK?

Links:

1) Stephan Harbarth's group has published in BMJ Open a surgical patient sub-study under MOSAR comparing the impact of (1) enhanced hand hygiene promotion (2) universal MRSA screening and decolonization  or (3) risk-factor based, targeted MRSA screening and enhanced hand hygiene in 10 hospitals encompassing 33 surgical wards. This quasi-experimental study found that neither intervention alone reduced monthly MRSA clinical culture rates. However, the combined intervention (3) was associated with a 12% reduction in monthly clinical cultures.

2) The CDDEP Blog has a new post by Stan Deresinksi covering Antibiotic Stewardship Programs and Education. Stanford's antimicrobial stewardship program has just posted an online course covering appropriate antimicrobial use.

3) Think Like an Anthropologist (HBR). Even though this is a business-oriented article, I think its points are generalizable to health-related administrative data. Key portion of the article: "efforts are typically driven by econometricians, computer scientists, and IT technicians—the people who are expert in database management. They understand digital information, but they don’t always understand how to get from information to meaning. So they boil the data down to percentages, treating random comments (and pictures of people with foil on their legs) as noise. But if you want meaning, you have to think like an anthropologist."

4) Marin Schweizer and colleagues from CDDEP recently published an study in ARIC looking at whether clinicians prescribed antibiotics based on national MRSA or local MRSA data. Clinicians appeared to prescribe linezolid and clindamycin based on national MRSA data but not local data suggesting that providing better local antibiogram data might help with outpatient antimicrobial stewardship efforts.

5) There's a really nice paper in Pediatrics that explores the importance of clustering of unvaccinated patients in the recent California pertussis epidemic. It appears that non-medical exemptions may be contributing significantly to the spread of pertussis. h/t Melissa W

6) There's a new study in PLoS Medicine that recalculated the mortality associated with pandemic 2009 H1N1. This study found mortality to be ten times prior low estimates but in line with a typical influenza season. NPR covered the study. h/t Jonathan Eisen

7) The physician at the center of a Las Vegas clinic Hepatitis C outbreak received a life sentence. h/t Daniel Sexton

8) Finally, we have nothing to worry about. The dragonfly's nano-tech black silicon will eliminate those nasty bacteria. It'll even kill spores.  h/t Judy Stone

Turkey: Best recipe (h/t MO Wright)

Photo Credit: Bob Evans

Dissonance, the hyperlink and blogs

“Learning how to think, means being conscious and aware enough to choose what you pay attention to and to choose how you construct meaning from experience.” - David Foster Wallace

I've been meaning to write about this all week, but I got distracted. I was probably reading about where LeBron James is headed and clicked on some links, ended up reading about the Cubs then the Illinois Senate race, then the South Carolina Governor race...you get my point. Nicholas Carr's latest book “The Shallows: What the Internet Is Doing to Our Brains,” has just arrived on bookshelves and he has posed some interesting questions, some of which I think relate to how we use or perhaps should use the internet to communicate. A major question he poses is if links should be listed at the end of web posts. Carr credits Steve Gillmor, who eliminated hyperlinks from his posts a few years ago, with starting this crusade, which is apparently starting to catch on, and with good reason. Have you noticed how hard it is to NOT click on a link in the middle of a post? Do you ever even finish one of our posts before ending up in some far-away place and forgetting how you got there and even forgetting that conference call that you were supposed to be on 15 minutes ago. Me neither.

Carr describes links as "...tiny distractions, little textual gnats buzzing around your head. Even if you don't click on a link, your eyes notice it, and your frontal cortex has to fire up a bunch of neurons to decide whether to click or not. You may not notice the little extra cognitive load placed on your brain, but it's there and it matters. People who read hypertext comprehend and learn less, studies show, than those who read the same material in printed form. The more links in a piece of writing, the bigger the hit on comprehension." So what to do? The general feeling is that links should be listed at the end of the text. This allows you to calmly read through the post and THEN decide which primary, or at least non-tertiary, sources you would like to review. I think it's a good idea. Cheers.

New York Times Sunday Book Review of Carr's new book
New York Times Nicholas Carr Q&A
Carr's original blogpost on the subject
Link to Amazon's DFW "Infinite Jest" page (What Carr is Reading)
Link to Amazon's DFW "Brief Interviews with Hideous Men" (What I'm reading) - "Forever Overhead" - wow