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Your column here – Silence is Complicity

first_img Ina Thorner says: 3 Comments We all MUST stand together for this inhuman violence to stop. Black, brown, red, yellow, white, mixed. All of us. Black men are being murdered. Red women are being murdered. Brown men, women and children are being kept in cages. Many immigrants are in slavery. Where are the moms? The women of the Me Too movement? The businesses we all sustain? Do they care less for human life than property? Where are the interfaith organizations? The balanced media coverage? The politicians? May 30, 2020 at 12:18 PM I cannot even imagine standing around doing nothing while an adult verbally harasses a child! What is wrong with people??? I hope that I shall always do the right thing and be an ally.Thank you for all that you do! Comments are closed. May 30, 2020 at 1:49 PM May 31, 2020 at 6:32 PM HomeBad BehaviorYour column here – Silence is Complicity May. 30, 2020 at 6:00 amBad BehaviorColumnsFeaturedNewsYour Column HereYour column here – Silence is ComplicityGuest Author1 year ago#blacklivesmattercommittee for racial justiceSanta Monica Bay Human Relations CouncilSURJyour column here Written by the Committee for Racial JusticeEndorsed by the Santa Monica Bay Human Relations CouncilBy now, many people know the names Ahmaud Arbery and, more recently, George Floyd. Many are wondering how/why do these events keep happening. There may be some clues in a local event in Santa Monica that you may have read about in last weekend’s paper. A little black boy was riding his bike home with his mom. They were around 4th and Montana when a young white man started swearing at and using the “N” word while verbally assaulting the boy. That hate crime was bad enough, but this was not a deserted street. There were passers-by and they DID NOTHING! This is nothing new. Robbie Jones, a 62yr Pico Neighborhood resident, says “28 years ago, when my son was attending Roosevelt elementary school. I experienced almost the exact same incident . The guy was a body builder. He came directly at me shouting obscenities and racial slurs at me and then attempted to punch me in the face as people on the street walked pass. I remember being relieved and grateful as I hurriedly got on the bus shaken, disturbed and just cried my eyes out. I remember feeling ashamed (as though I had caused this to come upon myself). I felt frightened, angry and sad all at the same time. I am still shaken by the incident today.”Do white people understand that when we see or hear something and DO NOTHING, we are causing more trauma? Silence is not neutral. Silence is on the side of the oppressor. Our high schools are not immune. When black students are threatened, white students stand by and do nothing and white parents protect the oppressors, and deride the black parents, causing further trauma. In a racist country, especially when witnessing a racist event, to be silent is to strengthen the systems of oppression and increase the trauma. Silence in the face of racism speaks volumes. Silence IS complicity.If we are white and we “Stand by” and “act nice” and are not working to be anti-racist, we are fueling the system. We did not shout at this little boy, but we might as well have. We didn’t shoot Ahmaud Arbery or suffocate George Floyd or murder the thousands of other unnamed victims of racism, but we might as well have. We are a part of the system that allows this to happen. If we are not working to eradicate racism then we are contributing to the problem. From the little boy on 4th and Montana to the man jogging through a white neighborhood, these incidents stem from systemic problems. We have a choice. We can do nothing and allow it to become worse. Or we can actively work to eradicate it. Anti-racist work will be misunderstood by your friends. They will try to convince you that there was a reason for each of these incidents, claiming that in each case, the black person was in the wrong somehow, and that you just don’t have enough evidence/information. You are jumping to conclusions and don’t really understand how life works, they will say. Your friends mean well but they are contributing to the problem. And so are you if you allow them to derail your sense of justice. That is part of how the system reinforces itself.Do not stand by and watch and strengthen the racism that infects our society. Stand with us against racism and work for justice. It does not have to be this way. We can dismantle this system. But it will take a whole lot more of us standing up, calling out and working for a better way. We hope you will join us. #CommitteeForRacialJustice, #SURJ, #BlackLivesMatter, #AWAREWritten by the Committee for Racial Justice. Endorsed by the Santa Monica Bay Human Relations CouncilTags :#blacklivesmattercommittee for racial justiceSanta Monica Bay Human Relations CouncilSURJyour column hereshare on Facebookshare on Twittershow 3 comments Cathie Gentile says: Romney Woods says: Thank you.Thank you.Thank you.Thank you.Thank you so very much.It’s nice to hear someone speak about a SOLUTION to the/this problem, and not just about the Problem !!#Solutions To The Problem (#STP)#MeToo,Too Virus ignited in US no earlier than mid-January, study saysAirport artists create drive-by art in isolationYou Might Also LikeFeaturedNewsBobadilla rejects Santa Monica City Manager positionMatthew Hall6 hours agoColumnsOpinionYour Column HereBring Back Library ServicesGuest Author12 hours agoFeaturedNewsProtesting parents and Snapchat remain in disagreement over child protection policiesClara Harter17 hours agoFeaturedNewsDowntown grocery to become mixed use developmenteditor17 hours agoNewsBruised but unbowed, meme stock investors are back for moreAssociated Press17 hours agoNewsWedding boom is on in the US as vendors scramble to keep upAssociated Press17 hours agolast_img read more

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SHEA offers cautious guidance on easing contact precautions for drug-resistant infections

first_imgA panel of experts in infection prevention and control has released new expert guidance for acute care hospitals to help them determine when it’s safe to discontinue contact precautions for patients with antibiotic-resistant infections.The recommendations from members of the Society for Healthcare Epidemiology of America (SHEA) Guidelines Committee, published yesterday in Infection Control and Hospital Epidemiology, address discontinuation of contact precautions for patients with one of the following organisms: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Clostridium difficile, and multidrug-resistant Enterobacteriaceae (MDR-E), including carbapenem-resistant Enterobacteriaceae (CRE) and extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E).The SHEA Guidelines Committee developed the guidance based on available literature, a survey of institutions within the SHEA Research Network, author opinion, practical considerations, and consideration of potential harm. The authors note that the guidance lacks the quality of evidence needed for formal guidelines, and is not meant to be a substitute for professional judgment.Questions about durationContact precautions are used by hospitals to prevent these easily transmitted pathogens from spreading from patient to patient. They generally call for putting patients with a known or suspected infection in a single occupancy room and having healthcare workers don gloves and gowns when coming into contact with the patient or the patient’s immediate environment.While guidelines exist for when contact precautions should be initiated by hospitals, however, few publications address when, and under what circumstances, these safety measures should be discontinued. As a result, there’s a wide variation in how hospitals handle discontinuation of contact precautions for different organisms.”There’s a lot of uncertainty and confusion as to when it’s safe to consider removing contact precautions on select patients for select organisms,” Gonzalo Bearman, MD, MPH, an author of the study and chair of the division of infectious diseases at Virginia Commonwealth University, said in an interview. Although keeping patients under contact precautions for long periods will prevent the spread of pathogens, Bearman said keeping patients isolated unnecessarily may have a negative impact on care by reducing patient interaction with providers.”There have been some reports of patients complaining of decreased satisfaction with care, and maybe some increased feelings of isolation and depression,” he said.One of the reasons that the optimal duration of contact precautions is unknown is because it remains unclear how long patients colonized with these organisms remain colonized. As a result, Bearman explained, it’s challenging to provide definitive answers as to when it’s safe to end contact precautions.For example, while evidence indicates that most patients will remain negative for MRSA colonization if they have three negative weekly surveillance cultures, some patients colonized with MRSA, including those with chronic wounds and those who’ve been transferred from long-term care facilities, are persistent, long-term carriers.C difficile is an organism that can hang around in the hospital environment well after an infection has cleared, and has proven difficult for hospitals to control even when they are following appropriate infection prevention and control measures. The guidance notes that while the CDC currently recommends discontinuing contact precautions 48 hours after the resolution of diarrhea, some C difficile carriers continue to shed spores in their stool for weeks. And recent data, the authors add, suggest that isolating asymptomatic C difficile carriers has reduced incidence in some hospitals.Then there are multidrug-resistant pathogens like CRE, which have limited treatment options and could have a devastating impact in a hospital if they spread among patients and caused infections. Hospitals are more likely to maintain contact precautions indefinitely for patients with a history of carrying these organisms.”For an endemic organism such as MRSA or VRE, we generally tend to be more liberal about discontinuing contact precautions,” Bearman said. “But for things that are multidrug-resistant that can lead to outbreaks and have devastating consequences, we certainly want to be more cautious.”A cautious approachBased on these factors, the SHEA Guidelines Committee came up with recommendations that acknowledge this uncertainty. The guidance includes the following recommendations:For patients who’ve been previously colonized or infected with MRSA, they recommend a discontinuation policy based on 1 to 3 negative screening cultures for those patients not on antibiotics with activity against MRSA. For high-risk patients, hospitals should consider extending contact precautions.For patients infected or colonized with VRE, the guidance recommends that decisions on discontinuation should be guided by 1 to 3 negative stool or rectal swab cultures. For those patients who are highly immunosuppressed, being treated with broad antibiotic therapy without VRE activity, and receiving care in protected environments (i.e. burn units) or institutions with high VRE rates, hospitals should consider extending contact precautions prior to assessing for discontinuation.For patients infected or colonized with CRE or ESBL-E, the guidance recommends continuing contact precautions for the duration of the patient’s index hospital stay. Hospitals should consider discontinuation on a case-by-case basis, and only when at least 6 months have elapsed since the last positive culture and at least 2 consecutive negative rectal swab samples have been obtained. For extensively drug-resistant Enterobacteriaceae, hospitals should continue contact precautions indefinitely.For patients with C difficile, the guidance recommends maintaining contact precautions for at least 48 hours after resolution of diarrhea, but suggests hospitals with elevated rates of incidence should consider extending them for the duration of hospitalization. The guidance makes no recommendation on whether patients with C difficile should be placed on contact precautions if they are readmitted to the hospital.”The common thread is that we’re trying to be cautious in how we approach the removal of contact precautions, and we’re trying to use as much background knowledge or data that we have to make a reasonable suggestion,” Bearman said.Bearman and his coauthors also say that insufficient evidence exists to make a formal recommendation supporting the use of molecular testing, such as polymerase chain reaction (PCR) testing, to determine duration of contact precautions.The authors conclude that further studies in “real-world” settings are needed to determine the optimal use and duration of contact precautions. Until then, they add, hospitals considering adopting policies for discontinuation of contact precautions should carefully assess their institutional risks, priorities, and resources, and revisit those policies in outbreak situations.The guidance is endorsed by the Association for Professionals in Infection Control and Epidemiology, the Society of Hospital Medicine, and the Association of Medical Microbiology and Infectious Disease Canada.See also:Jan 11 Infect Control Hosp Epidemiol SHEA Expert GuidanceJan 11 SHEA press releaselast_img read more

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Industry seeks ways out of a jungle of uncertainty

first_imgIndustry seeks ways out of a jungle of uncertaintyINTRO: Set up to inject long-term thinking into a fragmented industry, Britain’s Strategic Rail Authority has just seen the fruits of its labours torn up by a government desperate to find a quick political fix for the troubled national rail network. The challenge facing the private companies is to chart a path out of the turmoil inflicted on Britain’s railways by the Hatfield derailment and successive policy changes, finds Murray HughesIT IS, PERHAPS, the end of the beginning for Britain’s privatised rail network. When British Rail ended life on April 1 1994 as a national railway owning tracks and running trains, we wrote that Britain’s railways were starting a journey into the unknown, with passengers and freight customers the guinea pigs in a complex and ambitious experiment. No-one dreamt then just what turmoil that experiment would cause.The hasty sale in 1995-97 of around 100 companies that had formed BR was the most drastic process of railway reform ever attempted, and since then many of the companies that bought chunks of the business have experienced a rocky and unpredictable ride. The private sector is by nature risk-averse, and initially managers of train operating companies were able to plan on the basis of known funding levels agreed under the franchise terms. Infrastructure company Railtrack too could plan in advance thanks to the contractually-agreed access payments it received from the operators.Despite attempts to reform the industry to give long-term financial security, events have conspired to confound many business plans, and the position has been made worse by changes in government policy. In July, newly-appointed Secretary of State for Transport Stephen Byers ordered another change of course that threatens to take the industry back into the stranglehold of short-term thinking that so bedevilled the nationalised railway.Although two companies that entered the railway industry as train operators failed to make the grade, buoyant traffic growth – until last October’s derailment at Hatfield – helped the survivors make up for the decline in subsidy levels set out in the franchise agreements. Under the original franchise programme, government support for the passenger railway was due to fall from £1·8bn in 1997-98 to £724m in 2003-04, but that aspiration has long been abandoned as the extent of neglect during Railtrack’s stewardship of the network has become clear.Railtrack’s apparent ability to spend vast sums of money yet not improve the network in its charge has led to the collapse of its share price and to its present parlous financial state, in turn preventing it from generating badly-needed investment funds. Hopes now rest on changes instigated by Chairman John Robinson, who since his appointment in June has acted swiftly to start rebuilding confidence.At the moment, Railtrack and the train operating companies are engaged in frantic attempts to restore their credibility after the recent unprecedented chaos. Pre-Hatfield, a question about the success of privatisation generated a generally positive answer, based on strong growth in both freight and passenger traffic, although there were serious problems with major projects and day-to-day management of engineering work. Post-Hatfield, it has been a vastly different story, for that single accident exposed deep and grave flaws in the complicated structure of the industry.Above all, Hatfield highlighted Railtrack’s neglect of the wheel-rail interface on an intensively-used railway. Ironically, it has drawn attention to the need for strong engineering and expertise in railway technology at management level – not long ago dismissed as irrelevant by politicians who blithely considered that private-sector acumen alone would suffice to revitalise the railways at minimal cost. But recruiting good engineers to a business perceived to be in trouble is not proving easy.Investment plans collapseThe 10-year plan that former Transport Secretary John Prescott launched in July 2000 with a promise of over £60bn of investment in the national railway has foundered, as has the Strategic Rail Authority’s refranchising programme (p591). SRA Chairman Sir Alastair Morton, on whom many hopes of frontline industry leadership were pinned when he was appointed early in 1999, is poised to stand down. Rail Regulator Tom Winsor is entrenched in a battle with Railtrack over its performance and its responsibilities, although regulatory pronouncements seem almost irrelevant against the enormity of the task facing the infrastructure company.The cost of major investment projects has escalated far beyond anyone’s predictions (p597), with the ultimate test case of the West Coast Main Line modernisation programme now heading for £7bn against an original price tag of around £2·1bn.Project costs have been inflated by several factors, including the effects of media hysteria about safety following accidents at Southall in 1997, Ladbroke Grove in 1999 and Hatfield last year. Public inquiries into Southall and Ladbroke Grove have so far generated three major safety reports with 221 formal recommendations, and a fourth, covering ’factors which affect safety management and the appropriateness of the current regulatory regime’ is expected this month. No doubt this too will include recommendations that will add further costs into a business whose competitors on the roads consistently escape the draconian safety standards expected from rail.The collision at Great Heck on February 28 this year highlighted the scandalously different treatment applied to road and rail. A GNER IC225 hit a road vehicle that had run off the side of a motorway and down an embankment on to the track, and then collided with a freight train, causing the deaths of six passengers and four train crew. No public enquiry was required, and there was no serious call for roadside barriers to be fitted to prevent similar accidents happening.What now?Given this gloomy panorama, what hope is there for rebuilding an efficient railway able to win traffic from road and air? Although officially there are no formal plans to unravel the tangle to give a simpler and more manageable structure, sooner or later reform is inevitable. This is bound to take time because of the need for legislation, and further reorganisation will not be welcomed by all parties in the industry.Sir Alastair Morton said in June that ’since our railways are in trouble, we shall not get it right by putting too much pressure on a structure already in trouble’. He called for the industry ’to consider solutions either confirming or modifying the existing structure of relationships.’ Wholesale renationalisation is not on the agenda, but at the very least, some form of consolidation to reduce the number of companies running the business would seem likely. One obstacle to restructuring is the government’s desire for quick political benefits, although how it expects these to be achieved in an industry where it took a year for Virgin Trains to get three clocks installed at London’s Euston station remains a mystery.The freight business, while not immune from the troubles afflicting the passenger operators, has reasonable prospects for growth (p601), subject to the vicissitudes of the economy and Railtrack’s co-operation.Except on inter-city routes, passenger traffic has shown remarkable resilience in the face of poor performance, and this summer has seen a drive to win back lost business with the first national rail advertising campaign supported by all train operators since privatisation. The annual count of London commuters in December and January showed that an average of 466920 passengers arrived in London between 07.00 and 09.59 on weekdays, the highest figure since the late 1980s. Whether this growth will continue depends on the country’s ability to weather economic recession.Despite the government’s failure to provide clear targets or leadership, and even in the face of the policy vacuum caused by Byers’ decision to concentrate on the short term, the resilience of freight and passenger customers suggests that huge growth could be achieved if performance and service levels could be significantly bettered. For the moment, the railway can only muddle on in the hope that a policy uniting the industry towards a common goal will emerge in the course of time.CAPTION: Prospects for augmenting or replacing GNER’s IC225 fleet have diminished, following the government’s decision to delay the award of a 20-year franchise to operate inter-city services on the East Coast Main LinePhoto: Quintus VosmanCAPTION: Despite investing £150m in a network of new terminals and trains, Royal Mail is considering whether to abandon rail for all postal services, due to its inability to achieve the required 95% of arrivals within 10 min of scheduled timePhoto:EWSCAPTION: Hopes for recovering lost inter-city business on the West Coast Main Line are pinned on Virgin Trains’ Pendolino fleet, due to enter service from March next yearFor detailed coverage of what is happening on Britain’s railways, subscribe to our specialist fortnightly newsletterRail Business IntelligenceCall +44 1444 475630 or fax +44 1444 445447The end of the experiment When Transport Secretary Stephen Byers announced in July that the Strategic Rail Authority should concentrate on short-term franchises, it signalled the collapse of investment plans pinned on a long-term refranchising programme. Railtrack’s inability to manage major projects or provide accurate costings for infrastructure improvements, plus the chaos that followed the Hatfield derailment last October, suggest that the structure of Britain’s privatised railway is deeply flawed. Although unravelling the complex legal tangle governing relationships within the industry is not on the official agenda, it is clear that a simpler structure is needed. Passenger and freight operators are meanwhile striving to raise performance and service standardsLa fin de l’expérience?Lorsque le Secrétaire aux Transports Stephen Byers annonçait en juillet que la Strategic Rail Authority devait se concentrer sur les franchises de courte durée, il signalait l’effondrement des plans d’investissement attachés au programme d’attribution des nouvelles franchises de longue durée. L’incapacité de Railtrack à mener des projets importants ou à fournir des chiffres précis pour ce qui concerne les améliorations de l’infrastructure, le tout ajouté au chaos qui a suivi le déraillement de Hatfield en octobre dernier, sont autant d’éléments qui laissent à penser que la structure des chemins de fer privatisés de Grande-Bretagne est profondément imparfaite. Bien que démêler l’imbroglio juridique complexe qui régit les relations au sein même de l’activité ferroviaire ne figure pas sur l’agenda officiel, il est clair que l’on a besoin d’une structure plus simple. Pendant ce temps, les opérateurs voyageurs et fret se démènent afin d’améliorer le niveau des performances et du serviceDas Ende des Experiments?Als Stephen Byers, Sekretär für Verkehr, im Juli ankündigte, dass die Strategic Rail Authority sich auf Kurzzeit-Franchisen konzentrieren sollte, war dies das Zeichen für das Ende von auf einem langfristigen Refranchisierungsprogramm basierenden Investitionsplänen. Die Unfähigkeit von Railtrack, Grossprojekte abzuwickeln oder genaue Kosten für Infrastrukturverbesserungen anzugeben, sowie das letzten Oktober der Entgleisung in Hatfield folgende Chaos zeigen deutlich, dass die Strukturen der privatisierten britischen Eisenbahnen schwerwiegende Fehler aufweisen. Obwohl ein Entwirren der komplexen rechtlichen Verflechtungen der Beziehungen zwischen den Unternehmungen in der Branche nicht auf der Tagesordnung steht, ist es klar, dass einfachere Stukturen notwendig sind. In der Zwischenzeit bemühen sich die Personen- und Güterverkehrsgesellschaften, ihre Leistung und Angebotsqualität zu steigern?€El fin del experimento?Cuando el Secretario de Transportes britlast_img read more

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TouringPlans Best of YouTube 2018 (Part 2)

first_imgShare This!We’re back with a look at some more of the YouTube videos that you loved for 2018.You can’t go wrong with food. Looking at the best use of snack credits at Magic Kingdom is sure to make you hungry! And, last but not least, one of my favorite videos of the year was this demo of the “Popin Cookin’ DIY Candy Kit” from the Japan pavilion in Epcot. Hint — it didn’t turn out that well. And keeping with the snack theme, when it comes to Dole Whip versus Citrus Swirl, who wins in that ultimate frozen treat showdown?TouringPlans provides a wealth of resources for dealing with crowds, and some of the most intense crowds of the years can appear during Food and Wine. Here’s a video about how to manage the crowds and build a plan for Food and Wine. We’ll be back in 2019 with a variety of new videos — if you have any ideas for things to add to our list, let us know in the comments! Another popular video of the year was this one on packing tips for the family. I don’t know about the rest of you, but it certainly can be a major logistics effort to get everything packed.last_img read more

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