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There is growing interest in bridging the gap between science and society. Fostering relationships between researchers and practitioners, such as partnering to conduct experiments, is an increasingly popular way to do that. Yet, despite the growing number of such partnerships, academics who are new to them often lack guidance about considerations to keep in mind and the steps involved. This chapter bridges the gap. I discuss the benefits, challenges, and goals of organizational partnerships as well as provide a step-by-step guide for academics beginning new ones. Throughout, I emphasize the fact that such partnerships entail building new working relationships with people who have diverse forms of knowledge. As a result, both a learning mindset as well as a relational mindset are necessary.
The Old Copper Complex (OCC) refers to the production of heavy copper-tool technology by Archaic Native American societies in the Lake Superior region. To better define the timing of the OCC, we evaluated 53 (eight new and 45 published) radiocarbon (14C) dates associated with copper artifacts and mines. We compared these dates to six lake sediment-based chronologies of copper mining and annealing in the Michigan Copper District. 14C dates grouped by archaeological context show that cremation remains, and wood and cordage embedded in copper artifacts have ages that overlap with the timing of high lead (Pb) concentrations in lake sediment. In contrast, dates in stratigraphic association and from mines are younger than those from embedded and cremation materials, suggesting that the former groups reflect the timing of processes that occurred post-abandonment. The comparatively young dates obtained from copper mines therefore likely reflect abandonment and infill of the mines rather than active use. Excluding three anomalously young samples, the ages of embedded organic material associated with 15 OCC copper artifacts range from 8500 to 3580 cal BP, confirming that the OCC is among the oldest known metalworking societies in the world.
In 2018, Minneapolis began phased implementation of an ordinance to increase the local minimum wage to $15/hour. We sought to determine whether the first phase of implementation was associated with changes in frequency of consumption of fruits and vegetables, whole grain-rich foods, and foods high in added sugars among low-wage workers.
The Wages Study is a prospective cohort study of 974 low-wage workers followed throughout the phased implementation of the ordinance (2018-2022). We used difference-in-difference analysis to compare outcomes among workers in Minneapolis, Minnesota, to those in a comparison city (Raleigh, North Carolina). We assessed wages using participants’ pay stubs and dietary intake using the National Cancer Institute Dietary Screener Questionnaire.
Analyses use the first two waves of Wages data (2018 [baseline], 2019) and includes 267 and 336 low-wage workers in Minneapolis and Raleigh (respectively).
After the first phase of implementation, wages increased in both cities, but the increase was $0.82 greater in Minneapolis (p=0.02). However, the first phase of the policy’s implementation was not associated with changes in daily frequency of consumption of fruits and vegetables (IRR=1.03, 95% CI: 0.86-1.24, p=0.73), whole grain-rich foods (IRR=1.23, 95% CI: 0.89-1.70, p=0.20), or foods high in added sugars (IRR=1.13, 95% CI: 0.86-1.47, p=0.38) among workers in Minneapolis compared to Raleigh.
The first phase of implementation of the Minneapolis minimum wage policy was associated with increased wages, but not with changes in dietary intake. Future research should examine whether full implementation is associated dietary changes.
Many people seek to increase practitioners’ use of research evidence in decision making. Two common strategies are dissemination and interaction. Dissemination can reach a wide audience at once, yet interactive strategies can be beneficial because they entail back-and-forth conversations to clarify how research evidence applies in a particular context. To date, however, we lack much direct evidence of the impact of interaction beyond dissemination. Partnering with an international sustainability-oriented NGO, I conducted a field experiment to test the impact of an interactive strategy (i.e., a single conversation) on practitioners’ use of research evidence in a pending decision. I find that the conversation had a substantial impact on research use relative to only receiving disseminated materials, which likely was due to increased self-efficacy. I also provide practical guidance on how researchers can apply this finding close to home by strengthening linkages with local decision makers.
The rapid spread of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) throughout key regions of the United States in early 2020 placed a premium on timely, national surveillance of hospital patient censuses. To meet that need, the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN), the nation’s largest hospital surveillance system, launched a module for collecting hospital coronavirus disease 2019 (COVID-19) data. We present time-series estimates of the critical hospital capacity indicators from April 1 to July 14, 2020.
From March 27 to July 14, 2020, the NHSN collected daily data on hospital bed occupancy, number of hospitalized patients with COVID-19, and the availability and/or use of mechanical ventilators. Time series were constructed using multiple imputation and survey weighting to allow near–real-time daily national and state estimates to be computed.
During the pandemic’s April peak in the United States, among an estimated 431,000 total inpatients, 84,000 (19%) had COVID-19. Although the number of inpatients with COVID-19 decreased from April to July, the proportion of occupied inpatient beds increased steadily. COVID-19 hospitalizations increased from mid-June in the South and Southwest regions after stay-at-home restrictions were eased. The proportion of inpatients with COVID-19 on ventilators decreased from April to July.
The NHSN hospital capacity estimates served as important, near–real-time indicators of the pandemic’s magnitude, spread, and impact, providing quantitative guidance for the public health response. Use of the estimates detected the rise of hospitalizations in specific geographic regions in June after they declined from a peak in April. Patient outcomes appeared to improve from early April to mid-July.
Immigration is a highly polarized issue in the United States, and negative attitudes toward immigrants are common. Yet, almost all Americans are descended from people who originated outside the country, a narrative often evoked by the media and taught in school curricula. Can this narrative increase inclusionary attitudes toward migrants? We draw from scholarship showing that perspective-taking decreases prejudice toward out-groups to investigate whether reminding Americans about their own immigration history increases support for immigrants and immigration. We propose that priming family experiences can indirectly stimulate perspective-taking and induce empathy toward the out-group, which we test with three separate survey experiments conducted over two years. Our findings show that priming family history generates small but consistent inclusionary effects. These effects occur even among partisan subgroups and Americans who approve of President Trump. We provide evidence that increased empathy for immigrants constitutes one mechanism driving these effects.
To investigate associations between healthcare-associated Clostridioides difficile infection and patient demographics at an urban safety-net hospital and compare findings with national surveillance statistics.
Study participants were selected using a case-control design using medical records collected between August 2014 and May 2018 at Hahnemann University Hospital in Philadelphia. Controls were frequency matched to cases by age and length of stay. Final sample included 170 cases and 324 controls. Neighborhood-level factors were measured using American Community Survey data. Multilevel models were used to examine infection by census tract, deprivation index, race/ethnicity, insurance type, referral location, antibiotic use, and proton-pump inhibitor use.
Patients on Medicare compared to private insurance had 2.04 times (95% CI, 1.31–3.20) the odds of infection after adjusting for all covariables. Prior antibiotic use (2.70; 95% CI, 1.64–4.46) was also associated with infection, but race or ethnicity and referral location were not. A smaller proportion of hospital cases occurred among white patients (25% vs 44%) and patients over the age of 65 (39% vs 56%) than expected based on national surveillance statistics.
Medicare and antibiotics were associated with Clostridioides difficile infection, but evidence did not indicate association with race or ethnicity. This finding diverges from national data in that infection is higher among white people compared to nonwhite people. Furthermore, a greater proportion of hospital cases were aged <65 years than expected based on national data. National surveillance statistics on CDI may not be transportable to safety-net hospitals, which often disproportionately serve low-income, nonwhite patients.
Nearly 1 in 5 children in the United States lives in a household whose income is below the official federal poverty line, and more than 40% of children live in poor or near-poor households. Research on the effects of poverty on children's development has been a focus of study for many decades and is now increasing as we accumulate more evidence about the implications of poverty. The American Academy of Pediatrics recently added “Poverty and Child Health” to its Agenda for Children to recognize what has now been established as broad and enduring effects of poverty on child development. A recent addition to the field has been the application of neuroscience-based methods. Various techniques including neuroimaging, neuroendocrinology, cognitive psychophysiology, and epigenetics are beginning to document ways in which early experiences of living in poverty affect infant brain development. We discuss whether there are truly worthwhile reasons for adding neuroscience and related biological methods to study child poverty, and how might these perspectives help guide developmentally based and targeted interventions and policies for these children and their families.
Conflicts between humans and bears have occurred since prehistory. Through time, the catalogue of human–bear conflicts (HBC) has been changing depending on the values and needs of human societies and their interactions with bears. Even today, conflict situations vary among the eight species of bears and geographically across these species’ ranges. This results in a broad range of interactions between bears and humans that may be considered as conflicts, including: (1) predation of domestic or semiwild animals, including bees, hunting dogs, and pet animals; (2) damage due to foraging on cultivated berries, fruits, agricultural products, and the tree bark in forest plantations; (3) economic loss due to destruction of beehives, fences, silos, houses, and other human property; (4) bear attacks on humans causing mild or fatal trauma; (5) bluff charges, bear intrusions into residential areas; and (6) vehicle collisions with bears and traffic accidents. In this chapter we aim to outline the principal types of HBC and geographical differences in the occurrence of conflicts and the coexistence between people and bears.
The measurement of inequality from a human development perspective is fundamental. We start this chapter by briefly introducing the human development approach and its main conceptual basis: the capability approach. We note that inequality should preferably be assessed in the space of functionings, requiring the assessment methods to use multidimensional techniques. We then present the primary challenges inherent to multidimensional inequality measurement that are related to two types of distributional changes: one is concerned with the dispersions within distributions that are analogous to the unidimensional framework and the other, unlike the unidimensional framework, is concerned with the association between distributions. We next present a succinct review of the most prominent measures proposed in the literature within a unifying framework and review the empirical applications surrounding these measures. We note that while multidimensional inequality measures have a great potential to contribute to the monitoring of human development, there are some challenges to overcome in order to fulfil this potential.
To test the effects of talker variability and explicit instruction on the statistical learning of lexical tone, 80 monolingual English listeners were taught an artificial language that mimicked Mandarin’s asymmetric distribution of syllable-tone co-occurrences. Training stimuli consisted of either speech from one talker or speech from four talkers. Participants were either never instructed or explicitly taught associations between phonemes (CVs), tones, and nonce symbols across four consecutive days. Learning was assessed by the accuracy of mouse clicks and eye movements to visual nonce symbols. Critical trials induced competition between the target symbol, which matched the acoustic input, and a competitor symbol that had a statistically more probable tone (but mismatched the acoustic input). Eye fixations indicated that participants were sensitive to syllable-tone co-occurrence probabilities even without explicit instruction of tone. The degree to which statistical knowledge was used to recognize words appeared to increase when participants processed more variable speech.
Many believe primary elections distort representation in American legislatures because unrepresentative actors nominate extremist candidates. Advocates have reformed primaries to broaden voter participation and increase representation. Empirical evidence, however, is quite variable on the effects of reform. I argue that when institutional reform narrows one pathway of political influence, aggrieved actors take political action elsewhere to circumvent reform. I use a difference-in-differences design in the American states and find that although changing primary rules increases primary turnout, campaign contributions also increase with reform. Implementing nonpartisan primaries and reforming partisan primaries lead to estimated 9 and 21 percent increases in individual campaign contributions per cycle. This suggests actors substitute action across avenues of political influence to limit effects of institutional reform.
Besides a global health crisis, the COVID-19 pandemic has potential to have a severe and long-lasting psychological impact on frontline healthcare workers such as paramedics. It is imperative to shed light on these mental health issues and employ interventions to protect the mental wellness of this vulnerable group of healthcare workers.
Inadequate iodine intake during pregnancy increases the risk of neonatal morbidity and mortality. We aimed to evaluate whether prenatal supplements containing iodine affect urinary iodine concentrations (UIC) of pregnant women in Malawi.
A randomised controlled trial. Pregnant women (n 1391) were assigned to consume 60 mg/d Fe and 400 µg/d folic acid (IFA) or 18 vitamins and minerals including 250 µg/d iodine (MMN) or 20 g/d small-quantity lipid-based nutrient supplements (SQ-LNS) with similar nutrient contents as MMN group, plus macronutrients (LNS) until childbirth. In a sub-study (n 317), we evaluated group geometric mean urinary iodine concentration (UIC) (µg/L) at 36 weeks of gestation controlling for baseline UIC and compared median (baseline) and geometric mean (36 weeks) UIC with WHO cut-offs: UIC < 150, 150–249, 250–499 and ≥500 reflecting insufficient, adequate, above requirements and excessive iodine intakes, respectively.
Mangochi District, Malawi.
Women ≤20 weeks pregnant.
Groups had comparable background characteristics. At baseline, overall median (Q1, Q3) UIC (319 (167, 559)) suggested iodine intakes above requirements. At 36 weeks, the geometric mean (95 % CI) UIC of the IFA (197 (171, 226)), MMN (212 (185, 243)) and LNS (220 (192, 253)) groups did not differ (P = 0·53) and reflected adequate intakes.
In this setting, provision of supplements containing iodine at the recommended dose to pregnant women with relatively high iodine intakes at baseline, presumably from iodised salt, has no impact on the women’s UIC. Regular monitoring of the iodine status of pregnant women in such settings is advisable. Clinicaltrials.gov identifier: NCT01239693.
New evidence allows us to demonstrate that a regional trade connected North Syria with both central Anatolia and Babylonia well into the 17th-Century bc. Archaeological evidence indicates that a specific type of vessel, the globular flask, was produced at Zincirli Höyük in the mid-17th century for the purpose of storing and transporting wine. The simultaneous appearance of these vessels as far afield as Kültepe and Sippar-Amnānum lines up with Late Old Babylonian attestations of alluḫarum-pots in 17th-c. texts from Sippar, Babylon, and Dūr-Abiešuḫ. These, we argue, must refer to the same vessels called aluārum in earlier Old Assyrian texts from Kültepe from the 19th century. Taken together, this evidence points towards the existence of a previously unsuspected trade network centered on the ancient Syrian state of Mamma that thrived in the decades between the collapse of the Old Assyrian Trade Network and the accession of Hattušili I. Through a dialogue between textual and archaeological materials, we are not only able to reveal the persistence of long-distance exchange for a century previously believed to lack it, but provide more context for the political transformations taking place at the end of the Middle Bronze Age.
Background: Healthcare-associated infections (HAIs) are a serious threat to patient safety; they account for substantial morbidity, mortality, and healthcare costs. Healthcare practices, such as inappropriate use of antimicrobials, can also amplify the problem of antimicrobial resistance. Data collected to target HAI prevention and antimicrobial stewardship efforts and measure progress are an important resource for assuring transparency and accountability in healthcare, tracking adverse outcomes, investigating healthcare practices that may spread or protect against disease, detecting and responding to the spread of resistant pathogens, preventing infections, and saving lives. Methods: We discuss 3 healthcare-associated infection and antimicrobial Resistant infection (HAI-AR) reporting types: NHSN HAI-AR reporting, reportable diseases, and nationally notifiable diseases. HAI-AR reporting requirements outline facilities and data to report to NHSN and the health department to comply with state laws. Reportable diseases are those that facilities, providers, and laboratories are required to report to the health department. Nationally notifiable diseases are those reported by health departments to the CDC for nationwide surveillance and analysis as determined by Council of State and Territorial Epidemiologists (CSTE) and the CDC. Data presented are based on state and federal policy; NHSN data are based on CDC reporting statistics. Results: Since the 2005 launch of the CDC NHSN and publication of federal advisory committee HAI reporting guidance, most states have established policies stipulating healthcare facilities in their jurisdiction report HAIs and resistant infections to the NHSN to gain access to those data, increasing from 2 states in 2005, to 18 in 2010, and to 36 states, Washington, DC, and Philadelphia in 2019. Reporting policies and NHSN participation expanded greatly following the 2011 inception of CMS HAI quality reporting requirements, with several states aligning state requirements with CMS reporting. States listing carbapenem-resistant Enterobacteriaceae (CRE) as a reportable disease increased from 7 in 2013 to 41 states and the District of Columbia in 2019. Vancomycin-intermediate and vancomycin-resistant Staphylococcus aureus (VISA/VRSA) was added as a nationally notifiable disease in 2004, carbapenemase-producing CRE (CP-CRE) was added in 2018, and Candida auris clinical infections were added in 2019. The CDC and most jurisdictions with HAI reporting mandates issue public reports based on aggregate state data and/or facility-level data. States may also alert healthcare providers and health departments of emerging threats and to assist in notifying patients of potential exposure. Conclusions: Through efforts by health departments, facilities, patient advocates, partners, the CDC, and other federal agencies, HAI-AR reporting has steadily increased. Although reporting laws and data uses vary between jurisdictions, data provided serves as valuable tools to inform prevention.
Background: Methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization has been a well-established risk for developing MRSA pneumonia. In previous studies, the MRSA nasal screening test has shown an excellent negative predictive value (NPV) for MRSA pneumonia in patients without exclusion criteria such as mechanical ventilation, hemodynamic instability, cavitary lesions, and underlying pulmonary disease. MRSA nasal screening can be used as a stewardship tool to de-escalate broad antibiotic coverage, such as vancomycin. Objective: The purpose of this study was to determine whether implementation of a MRSA nasal screening questionnaire improves de-escalation of vancomycin for patients with pneumonia. Methods: A retrospective review was performed on 250 patients from October 2018 to January 2019 who received MRSA nasal screening due to their prescriber choosing only “respiratory” on the vancomycin dosing consult form. Data obtained included demographics and clinical outcomes. Statistical analyses were performed, and P < .05 was considered significant. Results: Of the 250 patients screened, only 19 patients (8%) were positive for MRSA. Moreover, 40% of patients met exclusion criteria. In 149 patients without exclusion criteria, the MRSA nasal swab had a 98% NPV. Although not statistically significant, vancomycin days of therapy (DOT) based on MRSA nasal swab result was 1 day shorter in those with negative swabs (3.49 days negative vs 4.58 days positive; P = .22). Vancomycin DOT was significantly reduced in pneumonia patients without exclusion criteria (3.17 days “no” vs 4.17 days “yes”; P = .037). Conclusions: The implementation of an electronic MRSA nasal screening questionnaire resulted in reduced vancomycin DOT in pneumonia patients at UAB Hospital. The MRSA nasal swab is an effective screening tool for antibiotic de-escalation based on its 98% NPV for MRSA pneumonia if utilized in the correct patient population.
Disclosures: Rachael Anne Lee reports a speaker honoraria from Prime Education, LLC.