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Biomedical subjects

B Barnard

Publications and source records attributed to B Barnard.

10 recordsLinked to original sources
PubMed2000

The fifth evolutionary era in infection control: interventional epidemiology.

A historical review of infection control over the last 4 decades indicates that the field has evolved from being one whose investigative work laid the foundation for understanding the chain of infection to an influential profession whose research on effective prevention methods have revoluntionized clinical practice throughout the world. Underlying our successes is the fact that growth in the profession has brought with it an enormous expansion in responsibilities, which in turn has impacted, in some cases severely, the personnel and time resources of infection control departments. At the same time, the economic pressures brought on by the upheavals in the business of health care have trickled down wherein it now influences the makeup and effectiveness of infection control programs. To continue with our mission of reducing morbidity and mortality, and perhaps to avoid a diminishing of our own professional influence, it will become essential that new approaches to the management of infection control programs be implemented. The approach must start by incorporating a basic mandate for change in the infection control professional.

Cross Infection↗
PubMed1999

Aggregation and distribution of strains in microparasites.

Recent research has shown that many parasite populations are made up of a number of epidemiologically distinct strains or genotypes. The implications of strain structure or genetic diversity for parasite population dynamics are still uncertain, partly because there is no coherent framework for the interpretation of field data. Here, we present an analysis of four published data sets for vector-borne microparasite infections where strains or genotypes have been distinguished: serotypes of African horse sickness (AHS) in zebra; types of Nannomonas trypanosomes in tsetse flies; parasite-induced erythrocyte surface antigen (PIESA) based isolates of Plasmodium falciparum malaria in humans, and the merozoite surface protein 2 gene (MSP-2) alleles of P. falciparum in humans and in anopheline mosquitoes. For each data set we consider the distribution of strains or types among hosts and any pairwise associations between strains or types. Where host age data are available we also compare age-prevalence relationships and estimates of the force of infection. Multiple infections of hosts are common and for most data sets infections have an aggregated distribution among hosts with a tendency towards positive associations between certain strains or types. These patterns could result from interactions (facilitation) between strains or types, or they could reflect patterns of contact between hosts and vectors. We use a mathematical model to illustrate the impact of host-vector contact patterns, finding that even if contact is random there may still be significant aggregation in parasite distributions. This effect is enhanced if there is non-random contact or other heterogeneities between hosts, vectors or parasites. In practice, different strains or types also have different forces of infection. We anticipate that aggregated distributions and positive associations between microparasite strains or types will be extremely common.

Adolescent↗
PubMed1990

Care of HIV-infected patients: nurses' concerns, opinions, and precautions.

The purpose of this study was to describe nurses' concerns, opinions, and precautions related to nursing patients infected with the human immunodeficiency virus (HIV). Of special interest was a comparison of responses by nurses who reported exposure to the HIV through broken skin or mucous membranes with the responses of nurses who reported no such exposure. The sample included all staff nurses employed in either the ambulatory/home health care unit or in one of seven inpatient critical care units of a large urban medical center. Of the 323 respondents, 64 (20%) reported HIV exposure, 77 (24%) reported no exposure, and 180 (56%) reported not knowing if they had been exposed. A 15-item Likert-type scale was used. More HIV-exposed nurses than non-exposed nurses reported: (a) worrying about becoming HIV-infected; (b) considering a change of specialty or profession because of the acquired immunodeficiency syndrome (AIDS) risk; and (c) favoring selected HIV-related policies. Of the total sample, nearly all subjects agreed that staff nurses should be involved in developing HIV-related policies affecting nurses; and over one-half said that, if the agency gave them the option, they would refuse assignment to HIV-infected patients. Nearly 30% said that they had considered changing their profession because of the AIDS risk. Some implications are that nursing administrators should involve well-informed staff nurses in formulating HIV-related policies that affect nurses. The HIV-exposed nurses may need support in dealing with their concerns resulting from HIV-exposure, and they may need more information about HIV-infection control and seroconversion rates of HIV-exposed nurses.

Attitude of Health Personnel↗