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INTRODUCTION: In neonatal units, Salmonella infections have been attributed to food-borne sources and person to person transmission. METHODS: The outbreak described is the first reported by Salmonella enterica serotype Newport in a neonatal facility in Spain. RESULTS: The index case was an 8-day premature newborn that developed clinical sepsis with positive blood cultures. The outbreak source was the mother of the index case. CONCLUSIONS: It is essential to improve infection control measures taking into account the parents, as they can be an important source of infection.
Assuntos
Portador Sadio/microbiologia , Infecção Hospitalar/transmissão , Doenças do Prematuro/microbiologia , Mães , Infecções por Salmonella/transmissão , Salmonella enterica/isolamento & purificação , Adulto , Doença de Crohn/microbiologia , Infecção Hospitalar/microbiologia , Surtos de Doenças , Feminino , Higiene das Mãos , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Controle de Infecções , Transmissão de Doença Infecciosa do Paciente para o Profissional , Masculino , Leite Humano/microbiologia , Berçários Hospitalares , Recursos Humanos de Enfermagem Hospitalar , Quartos de Pacientes , Infecções por Salmonella/microbiologia , Sepse/etiologiaRESUMO
We study a hybrid system where the demand of customers can be satisfied by both manufacturing new products and remanufacturing used products. To manage the serviceable inventory, we implement a proportional order-up-to (POUT) replenishment policy. In this context, we first analyse the system efficiency by assessing its capacity to meet customer demand in a cost-effective manner. To this end, we consider both inventory performance (i.e., the balance between inventory holding and stock-out costs) and production smoothness (by measuring the Bullwhip effect in the supply chain). Second, we investigate the system resilience to demand volatility. In particular, we explore the impact of demand shocks on the inventory and production of the closed-loop system. Interestingly, we find that tuning the POUT controller to optimise efficiency may be problematic in terms of resilience to demand shocks. In this sense, a key trade-off exists that needs to be carefully considered by supply chain managers. Linking efficiency to resilience in such supply chains thus becomes essential to strengthen the transition towards more circular economic models. All in all, our analysis, via control-theoretic and simulation techniques, provides professionals with valuable insights into how to identify the appropriate 'formula' for building both efficient and resilient closed-loop supply chains.
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BACKGROUND AND AIMS: During the first peak of the COVID-19 pandemic, the Preventive Medicine Department and the Occupational Health Department at Hospital Clinic de Barcelona (HCB), a large Spanish referral hospital, developed an innovative comprehensive SARS-CoV2 Surveillance and Control System (CoSy-19) in order to preserve patients' and health care workers' (HCWs) safety. We aim to describe the CoSy-19 and to assess the impact in the number of contacts that new cases generated along this time. METHODS: Observational descriptive study of the findings of the activity of contact tracing of all cases received at the HCB during the first peak of COVID-19 in Spain (February 25th-May 3rd, 2020). RESULTS: A team of 204 professionals and volunteers performed 384 in-hospital contact-tracing studies which generated contacts, detecting 298 transmission chains which suggested preventive measures, generated around 22 000 follow-ups and more than 30 000 days of work leave. The number of contacts that new cases generated decreased during the study period. CONCLUSION: Coordination between Preventive Medicine and Occupational Health departments and agile information systems were necessary to preserve non-COVID activity and workers safety.