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To estimate the impact of California’s antimicrobial stewardship program (ASP) mandate on methicillin-resistant Staphylococcus aureus (MRSA) and Clostridioides difficile infection (CDI) rates in acute-care hospitals.
Centers for Medicare and Medicaid Services (CMS)–certified acute-care hospitals in the United States.
2013–2017 data from the CMS Hospital Compare, Provider of Service File and Medicare Cost Reports.
Difference-in-difference model with hospital fixed effects to compare California with all other states before and after the ASP mandate. We considered were standardized infection ratios (SIRs) for MRSA and CDI as the outcomes. We analyzed the following time-variant covariates: medical school affiliation, bed count, quality accreditation, number of changes in ownership, compliance with CMS requirements, % intensive care unit beds, average length of stay, patient safety index, and 30-day readmission rate.
In 2013, California hospitals had an average MRSA SIR of 0.79 versus 0.94 in other states, and an average CDI SIR of 1.01 versus 0.77 in other states. California hospitals had increases (P < .05) of 23%, 30%, and 20% in their MRSA SIRs in 2015, 2016, and 2017, respectively. California hospitals were associated with a 20% (P < .001) decrease in the CDI SIR only in 2017.
The mandate was associated with a decrease in CDI SIR and an increase in MRSA SIR.
We are asked to answer a seemingly simple question certified by the US District Court for the District of New Hampshire – namely: “Is a child conceived after her father’s death via artificial insemination eligible to inherit from her father as his surviving issue under New Hampshire intestacy law?” Majority Opinion at 1181 (emphasis added).
How would judicial opinions change if the judges were to use feminist methods and perspectives when deciding cases? That is the question that various groups of scholars, working around the globe and mostly independently of each other, have taken up in a series of books of “shadow opinions” – literally, rewritten judicial decisions – using precedents, authorities, theories, and approaches that were in existence at the time of the original decision to reach radically different outcomes and often using saliently different reasoning. This global sociolegal movement toward critical opinion writing originated when a group of lawyers and law professors who called themselves the Women’s Court of Canada published a series of six rewritten decisions in 2008 in the Canadian Journal of Women and the Law. Inspired by that project, scholars have produced similar projects in the United Kingdom, Australia, the United States, Ireland, and New Zealand/Aotearoa. There is an international law feminist judgments project and a Scottish project. Other feminist judgments projects are underway in India, Africa, and Mexico.
Reece v. Elliott involved the enforceability of an antenuptial agreement that Bonnie Reece signed prior to her marriage to Eugene Reece. Under the provisions of the agreement, the real and personal property that Bonnie and Eugene had acquired before they were married would be classified as separate property.
For women and other marginalized groups, the reality is that the laws regulating estates and trusts may not be treating them fairly. By using popular feminist legal theories as well as their own definitions of feminism, the authors of this volume present rewritten opinions from well-known estates and trust cases. Covering eleven important cases, this collection reflects the diversity in society and explores the need for greater diversity in the law. By re-examining these cases, the contributors are able to demonstrate how women's property rights, as well as the rights of other marginalized groups, have been limited by the law.
This chapter examines the field’s double-sided struggle for relevance: How media studies gets lost among academic disciplines, on one side, and how it fails to connect with publics, on the other. Seth Lewis scrutinizes the disconnect between the field of media studies and people’s deeply mediated lived experience. He approaches the topic three ways: First, conceptually, considering what questions scholars are asking and not asking as a way to explore the assumptions, worldviews, and theories driving the research that does and does not get done. Second, methodologically, delving into how scholars ask questions, to which groups of people, and gathering what kinds of data. Third, communicatively, asking for whom scholars undertake their work, looking particularly at how research is being communicated to multiple audiences and with what normative aims. Lewis highlights sources of disconnection by exploring well-researched media topics of central concern to publics – media bias, information inequality, and religious faith. He demonstrates the field’s failure to provide the public with satisfactory responses.
Reward Deficiency Syndrome (RDS) is an umbrella term for all drug and nondrug addictive behaviors, due to a dopamine deficiency, “hypodopaminergia.” There is an opioid-overdose epidemic in the USA, which may result in or worsen RDS. A paradigm shift is needed to combat a system that is not working. This shift involves the recognition of dopamine homeostasis as the ultimate treatment of RDS via precision, genetically guided KB220 variants, called Precision Behavioral Management (PBM). Recognition of RDS as an endophenotype and an umbrella term in the future DSM 6, following the Research Domain Criteria (RDoC), would assist in shifting this paradigm.
We implemented universal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing of patients undergoing surgical procedures as a means to conserve personal protective equipment (PPE). The rate of asymptomatic coronavirus disease 2019 (COVID-19) was <0.5%, which suggests that early local public health interventions were successful. Although our protocol was resource intensive, it prevented exposures to healthcare team members.
We have previously shown that higher intake of cruciferous vegetables is inversely associated with carotid artery intima-media thickness. To further test the hypothesis that an increased consumption of cruciferous vegetables is associated with reduced indicators of structural vascular disease in other areas of the vascular tree, we aimed to investigate the cross-sectional association between cruciferous vegetable intake and extensive calcification in the abdominal aorta. Dietary intake was assessed, using a FFQ, in 684 older women from the Calcium Intake Fracture Outcome Study. Cruciferous vegetables included cabbage, Brussels sprouts, cauliflower and broccoli. Abdominal aortic calcification (AAC) was scored using the Kauppila AAC24 scale on dual-energy X-ray absorptiometry lateral spine images and was categorised as ‘not extensive’ (0–5) or ‘extensive’ (≥6). Mean age was 74·9 (sd 2·6) years, median cruciferous vegetable intake was 28·2 (interquartile range 15·0–44·7) g/d and 128/684 (18·7 %) women had extensive AAC scores. Those with higher intakes of cruciferous vegetables (>44·6 g/d) were associated with a 46 % lower odds of having extensive AAC in comparison with those with lower intakes (<15·0 g/d) after adjustment for lifestyle, dietary and CVD risk factors (ORQ4 v. Q1 0·54, 95 % CI 0·30, 0·97, P = 0·036). Total vegetable intake and each of the other vegetable types were not related to extensive AAC (P > 0·05 for all). This study strengthens the hypothesis that higher intake of cruciferous vegetables may protect against vascular calcification.
In 2017, transgender woman Danica Roem stunned political observers in Virginia by unseating a long-time anti-LGBTQ legislator from a conservative district in the Virginia House of Delegates.1 She was the first openly transgender person elected and seated to a state legislature. Delegate Roem’s election was historic in LGBTQ political representation, but it also occurred in a period when backlash against the LGBTQ community seemed to be growing (Taylor, Lewis, and Haider-Markel 2018). These two threads led us to ask: How are LGBTQ candidates achieving historic successes even as forces seem mobilized against them?
The development of childhood anxiety disorders (CADs) is likely to depend on pathways that can be programmed by early-life risk factors. We test the hypothesis that early-life maternal factors can predict this programming effect on CAD.
Data were obtained from 198 women and children from the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS), a cohort study with data collected across pregnancy, postpartum and until 4 years of age. Maternal antenatal depression was measured using the Structured Clinical Interview for DSM-IV (SCID-IV), together with antenatal hair cortisol concentrations, maternal childhood trauma and parenting stress at 6 months postpartum. CAD was assessed with the Preschool Age Psychiatric Assessment and the Child Behaviour Checklist.
Antenatal depression, a history of maternal childhood trauma and lower gestational age at birth were each associated with anxiety disorders at 4 years of age in their children. A multivariate binary logistic model with these early predictors explained approximately 9% of variance in CAD outcome at 4 years of age; however, only maternal trauma and gestational age were significant predictors in the model. The effect of early parenting stress on CAD was found to vary by the concentration of maternal antenatal hair cortisol, whereby postpartum parenting stress was associated with CAD only when there were higher maternal antenatal cortisol levels.
This study suggests the importance of maternal factors pre-conception, pregnancy and in the postnatal period, which predict CADs and this is consistent with a developmental programming hypothesis for CAD.