Vancomycin-resistant enterococci (VRE) are an important cause of nosocomial infections in acute-care hospitals (ACHs), intermediate-care facilities (ITCFs), and long-term care facilities (LTCFs). This study contemporaneously compared the epidemiology and risk factors for VRE colonization in different care settings in a health care network. We conducted a serial cross-sectional study in a 1,700-bed ACH and its six closely affiliated ITCFs and LTCFs in June and July of 2014 to 2016. Rectal swab or stool specimens were cultured for VRE. Multivariable logistic regression was used to assess for independent risk factors associated with VRE colonization. Of 5,357 participants, 523 (9.8%) were VRE colonized. VRE prevalence was higher in ACHs (14.2%) than in ITCFs (7.6%) and LTCFs (0.8%). Common risk factors between ACHs and ITCFs included prior VRE carriage, a longer duration of antibiotic therapy, surgery in the preceding 90 days, and the presence of a skin ulcer. Independent risk factors specific to ACH-admitted patients were prior methicillin-resistant carriage, a higher number of beds per room, prior proton pump inhibitor use, and a length of stay of>14 days. For ITCFs, a length of stay of >14 days was inversely associated with VRE colonization. Similarities and differences in risk factors for VRE colonization were observed between health care settings. VRE prevention efforts should target the respective high-risk patients.

Procrastination has been found to negatively impact academic and job performance. However, little attention has been given to the effect of procrastination on creative performance. Moreover, past studies have mainly focused on the antecedent role of anxiety in procrastination. The impact of procrastination on anxiety is not clear, though literature has suggested that procrastination may induce anxiety. The primary question addressed in the present study is whether and how procrastination influences creativity. Some exceptional studies have indicated that procrastination allows incubation and hence is conducive to creativity. However, on the basis of the literature, we argued and hypothesized that procrastination may impair creativity through state anxiety. A total of 218 Malaysian undergraduate students were recruited via social networking sites and responded to a packet of online survey questionairres, including self-report of procrastination tendency, state and trait anxiety, and creativity. Results showed that procrastination was positively associated with state and trait anxiety and negatively correlated with creativity. A negative relationship was also observed between state and trait anxiety and creativity. In addition, mediation analysis supported our hypothesis that state anxiety mediates the relationship between procrastination and creativity after controlling for the effect of trait anxiety. Specifically, people tend to experience feeling anxious when they postpone task completion. The high level of anxiety, in turn, is negatively associated with creative performance. As a whole, the findings not only offer the first empirical evidence supportive of the detrimental effect of procrastination on creativity, but also reveal the underlying process. Future directions and limitations are also explored.

treat MDRGNB infections. This finding pointed that strict antibiotic policies were required to work out the issue of emerging MDR-GNB infections.

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