Antibiotic use plays a major role in the emerging public health crisis of antibiotic resistance. Although the majority of antibiotic use occurs in agricultural settings, relatively little attention has been paid to how antibiotic use in farm animals contributes to the overall problem of antibiotic resistance. The aim of this review is to summarize literature on the role of antibiotics in the development of resistance and its risk to human health. We searched multiple databases to identify major lines of argument supporting the role of agricultural antibiotic use in the development of resistance and to summarize existing regulatory and policy documents. Several lines of reasoning support the conclusion that agricultural antibiotics are associated with resistance, yet most public policy is based on expert opinion and consensus. Finally, we propose strategies to address current gaps in knowledge.

BackgroundHealth care associated infections are more predominant in developing countries where Hand hygiene compliance is associated with so many factors. However, these factors have not been studied so far in the study area. This study sought to determine Hand hygiene compliance and associated factors among health care providers.MethodsInstitution based cross-sectional study was conducted from April to May, 2013 in Gondar University Hospital. Stratified sampling technique was used to select 405 health care providers. Standardized questionnaire and world health organization observational checklist was used to collect the data. Data was entered and analyzed by using SPSS version 20. Descriptive statistics and binary logistic regression model was used to summarize the result.ResultsA total of 405 study participants were interviewed and observed with a response rate of 96.4%. Good Hand hygiene compliance of healthcare providers was found to be 16.5%. Having knowledge about hand hygiene compliance, (AOR = 3.80, 95% CI 1.60, 8.97), getting training (AOR = 2.60, 95% Cl 1.21, 5.62), the presence of individual towel/tissue paper (AOR = 1.91, 95% CI 1.03, 3.56) presence of alcohol based hand rub for Hand hygiene compliance (AOR = 6.58, 95% CI 2.67, 16.22) and knew the presence of infection prevention committees (AOR = 2.6, 95% CI 1.23, 5.37) were significantly associated with hand hygiene compliance.ConclusionsHand hygiene compliance among health care providers in Gondar University Hospital was found to be low. It is better to give training on Hand hygiene compliance and provide Alcohol based hand rub and individual towel or tissue paper for hand hygiene compliance.

Background The Centers for Medicare and Medicaid Services (CMS) promulgated regulations commencing October 1, 2008, which deny payment for selected conditions occurring during the hospital stay and are not present on admission. Three of the 10 hospital-acquired conditions covered by the new CMS policy involve healthcare-associated infections, which are a common, expensive, and often preventable cause of inpatient morbidity and mortality. Objective To outline a research agenda on the impact of CMS’s payment policy on the healthcare system and the prevention of healthcare-associated infections. Methods An invitational daylong conference was convened in April 2009. Including the planning committee and speakers there were 41 conference participants who were national experts and senior researchers. Results Building upon a behavioral model and organizational theory and management research a conceptual framework was applied to organize the wide range of issues that arose. A broad array of research topics was identified. Thirty-two research agenda items were organized in the areas of incentives, environmental factors, organizational factors, clinical outcomes, staff outcomes, and financial outcomes. Methodological challenges are also discussed. Conclusions This policy is a first significant step to move output-based inpatient funding to outcome-based funding, and this agenda is applicable to all hospital-acquired conditions. Studies beginning soon will have the best hope of capturing data for the years preceding the policy change, a key element in nonexperimental research. The CMS payment policy offers an excellent opportunity to understand and influence the use of financial incentives for improving patient safety.

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IntroductionInterdisciplinary research is an approach to advancing scientifi c knowledge, in which researchers from diff erent disciplines work at the borders of those disciplines in order to address complex questions and problems. Th e assumption is sometimes made that anyone can engage in interdisciplinary research should they choose to do so, but it is clear from a considerable body of literature that successful interdisciplinary eff orts require mastery of specific competencies.1-3 It follows, then, that if such competencies are explicated, it might be possible to enhance researchers' abilities to participate in and conduct interdisciplinary scholarship. A number of interdisciplinary programs have emerged in higher education, primarily focused on undergraduates. 4 , 5 Th ose targeted to graduate students are oft en designed to enhance participants' appreciation for crossdisciplinary thinking and models, but not to specifi cally focus on education to develop interdisciplinary research skills. [6][7][8] Th e purpose of this paper is to describe the development and implementation of a course designed for pre-and postdoctoral students and research faculty on models of interdisciplinary research skills. MethodsIn 2004, an interdisciplinary planning center grant (P20 RR020616) was funded as part of the National Institutes of Health (NIH) Roadmap Initiative (which has now evolved into Th e NIH Common Fund, http://nihroadmap.nih.gov/ ). Th e grant funded a portion of the salary for a number of faculty members from more than 10 departments and disciplines across a single University, but it became clear over the 2-year planning process that interest in and skills needed to conduct interdisciplinary research diff ered widely across individuals. Th ere was considerable variation in opinions and beliefs about issues as basic as defi ning interdisciplinarity and understanding competencies needed for interdisciplinary success. As a result, work groups were formed to add clarity and develop a set of shared defi nitions, values, and language about interdisciplinary research. Th e resultant work of the group to defi ne interdisciplinary research is published in Health Services Research . 2 One particular ongoing debate among center participants was whether or not interdisciplinary skills could actually be taught and learned, or whether the abilities and interest in such work were intrinsic to one's personality and value system. Some team members expressed the opinion that interdisciplinary skills could not be formally taught, but rather had to be experienced and learned "on the job." To enhance our understanding of this issue, we conducted a Delphi survey of national experts in interdisciplinary research to determine whether they could identify core competencies necessary for interdisciplinary research. Aft er several rounds in this survey, experts agreed upon 17 competencies that were essential for interdisciplinary research. 3 We concluded from this survey that these competencies could in fact be taught, at least in p...