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Presenteeism, or working while ill, by healthcare personnel (HCP) experiencing influenza-like illness (ILI) puts patients and coworkers at risk. However, hospital policies and practices may not consistently facilitate HCP staying home when ill.
Objective and methods:
We conducted a mixed-methods survey in March 2018 of Emerging Infections Network infectious diseases physicians, describing institutional experiences with and policies for HCP working with ILI.
Of 715 physicians, 367 (51%) responded. Of 367, 135 (37%) were unaware of institutional policies. Of the remaining 232 respondents, 206 (89%) reported institutional policies regarding work restrictions for HCP with influenza or ILI, but only 145 (63%) said these were communicated at least annually. More than half of respondents (124, 53%) reported that adherence to work restrictions was not monitored or enforced. Work restrictions were most often not perceived to be enforced for physicians-in-training and attending physicians. Nearly all (223, 96%) reported that their facility tracked laboratory-confirmed influenza (LCI) in patients; 85 (37%) reported tracking ILI. For employees, 109 (47%) reported tracking of LCI and 53 (23%) reported tracking ILI. For independent physicians, not employed by the facility, 30 (13%) reported tracking LCI and 11 (5%) ILI.
More than one-third of respondents were unaware of whether their institutions had policies to prevent HCP with ILI from working; among those with knowledge of institutional policies, dissemination, monitoring, and enforcement of these policies was highly variable. Improving communication about work-restriction policies, as well as monitoring and enforcement, may help prevent the spread of infections from HCP to patients.
Do state-level exams in civics have a positive impact on young people's civic knowledge? We hypothesize that civics exams have the biggest effect in states where they are a requirement for high school graduation—the incentive hypothesis. We further hypothesize that civics requirements have the biggest effect on young people with less exposure to information about the U.S. political system at home, specifically Latinos and, especially, immigrants—the compensation hypothesis. We test these hypotheses with the 2006 and 2010 National Assessment of Educational Progress (NAEP) civics test administered to high school students, and with a large national survey of 18–24 year-olds. Across the two datasets, we find modest support for the incentive hypothesis and strong support for the compensation hypothesis.
Background: The diagnosis of a sports-related concussion is often dependent on the athlete self-reporting their symptoms. It has been suggested that improving youth athlete knowledge and attitudes toward concussion may increase self-reporting behaviour. The objective of this study was to determine if a novel Concussion-U educational program improves knowledge of and attitudes about concussion among a cohort of elite male Bantam and Midget AAA hockey players. Methods: Fifty-seven male Bantam and Midget AAA-level hockey players (mean age=14.52±1.13 years) were recruited from the local community. Each participant completed a modified version of the Rosenbaum Concussion Knowledge and Attitudes Survey–Student Version immediately before and after a Concussion-U educational presentation. Follow-up sessions were arranged 4 to 6 months after the presentation, and assessed retention of knowledge and attitude changes. Results: Forty-three players completed all three surveys. Concussion knowledge and attitude scores significantly (p<0.01) increased from pre- to post-presentation by 12.79 and 8.41%, respectively. At long-term follow-up, knowledge levels remained significantly (p<0.01) higher than baseline by 8.49%. Mean attitude scores were also increased at follow-up; however, this increase was not statistically significant. Conclusions: A Concussion-U educational program led to an immediate improvement in concussion knowledge and attitudes among elite male Bantam and Midget AAA hockey players. Increased knowledge was maintained at long-term follow-up, but improved attitude was not. Future studies should investigate whether similar educational programs influence symptom reporting and concussion incidence. In addition, they should focus on how to maintain improved concussion attitudes.
This symposium examines the politics of religious alliances. While the literature on religion and politics generally focuses on differences across individuals, congregations, denominations, or traditions, these articles instead ask how, when, and why religious groups do — and do not — form alliances with other organizations, both religious and secular. Specifically, this collection of original research examines the formation of multi-denominational coalitions among party activists, litigants, and religious leaders. These varied articles arose from a workshop at Oxford University in March 2015, an event hosted and funded by the Rothermere American Institute. The collection explores the impact of religious coalitional activity upon political attitudes, decision-making, and public policy development. It is wide-ranging, extending our understanding of religious coalitional activity beyond the United States and dealing with topics of vital current significance, including the swiftly changing landscape of school voucher and tax credit expansion, same-sex marriage, healthcare, and abortion advocacy.
To determine the effect of interhospital patient sharing via transfers on the rate of Clostridium difficile infections in a hospital.
Using data from the Healthcare Cost and Utilization Project California State Inpatient Database, 2005–2011, we identified 2,752,639 transfers. We then constructed a series of networks detailing the connections formed by hospitals. We computed 2 measures of connectivity, indegree and weighted indegree, measuring the number of hospitals from which transfers into a hospital arrive, and the total number of incoming transfers, respectively. Next, we estimated a multivariate model of C. difficile infection cases using the log-transformed network measures as well as covariates for hospital fixed effects, log median length of stay, log fraction of patients aged 65 or older, and quarter and year indicators as predictors.
We found an increase of 1 in the log indegree was associated with a 4.8% increase in incidence of C. difficile infection (95% CI, 2.3%–7.4%) and an increase of 1 in log weighted indegree was associated with a 3.3% increase in C. difficile infection incidence (1.5%–5.2%). Moreover, including measures of connectivity in our models greatly improved their fit.
Our results suggest infection control is not under the exclusive control of a given hospital but is also influenced by the connections and number of connections that hospitals have with other hospitals.
Infect. Control Hosp. Epidemiol. 2015;36(9):1031–1037
Variation in human cognitive ability is of consequence to a large number of health and social outcomes and is substantially heritable. Genetic linkage, genome-wide association, and copy number variant studies have investigated the contribution of genetic variation to individual differences in normal cognitive ability, but little research has considered the role of rare genetic variants. Exome sequencing studies have already met with success in discovering novel trait-gene associations for other complex traits. Here, we use exome sequencing to investigate the effects of rare variants on general cognitive ability. Unrelated Scottish individuals were selected for high scores on a general component of intelligence (g). The frequency of rare genetic variants (in n = 146) was compared with those from Scottish controls (total n = 486) who scored in the lower to middle range of the g distribution or on a proxy measure of g. Biological pathway analysis highlighted enrichment of the mitochondrial inner membrane component and apical part of cell gene ontology terms. Global burden analysis showed a greater total number of rare variants carried by high g cases versus controls, which is inconsistent with a mutation load hypothesis whereby mutations negatively affect g. The general finding of greater non-synonymous (vs. synonymous) variant effects is in line with evolutionary hypotheses for g. Given that this first sequencing study of high g was small, promising results were found, suggesting that the study of rare variants in larger samples would be worthwhile.
This is a book about Mormons and American politics, a religious community and a subject that frequently elicit strong reactions. Some readers will have a negative perception of Mormons, others will have a positive view, and some will be Mormons themselves. Still others will not have a prior opinion one way or the other and are reading this book out of curiosity (or perhaps because it was assigned in a class). Since our readers will come to this subject with different backgrounds, let us explain ours.
We recognize that it is unusual to highlight authors’ personal, especially religious, backgrounds in a work of empirical social science. But owing to the fervent opinions Mormonism can engender, many readers will undoubtedly wonder about our connections to the faith. Readers who would rather not know our religious perspectives should stop reading this and skip to Chapter 1. Perhaps, upon finishing the book, they can try to guess our religions and then come back to find out whether they are right.
In the fall of 2012, Hurricane Sandy devastated parts of New York and surrounding areas. Within a few days of the hurricane, Mormon volunteers donned yellow vests with a “Mormon Helping Hands” logo and divided into small teams to help local residents begin to clean up. For the next several months, they spent weekends in “chainsaw brigades,” clearing fallen trees, removing mud and debris from homes, tearing out damaged walls and carpet, and disinfecting what remained (Trapasso 2012). The LDS Church estimates that 28,000 Mormons logged more than 275,000 hours of labor – a remarkable figure given that Mormons make up a very small share of the population in the region (Church of Jesus Christ of Latter-day Saints 2012a).
This vast volunteer effort was led and coordinated by the regional and local LDS leadership. Recall that in Chapter 1 we described the importance of religious authority within Mormonism. With authority comes hierarchy, which means a clear “chain of command” for activating Church members. For example, volunteers from the Princeton First Ward responded to a call from their stake president that was delivered through the ward’s bishop and other ward-level leaders such as the “Elders Quorum President” (the leader of a ward’s priesthood organization for men). Within a week of the hurricane, ward members were asked to attend or participate via conference call in an “all hands” training session to learn the basics of participating in the Mormon Helping Hands program. As part of ten- to twelve-person teams, the typical active ward member spent two or three weekends working from late October to late December. Nor was the volunteer effort limited to Mormons in storm-ravaged communities. Mormons from less-affected areas traveled to New York and the New Jersey shore, camping at LDS ward buildings while they worked for the weekend (Snell 2013).
Mormons have long had an outsized presence in American culture and politics, but they remain largely unknown to most Americans. Recent years have seen the political prominence of Mormons taken to a new level - including the presidential candidacy of Republican Mitt Romney, the prominent involvement of Mormons in the campaign for California's Proposition 8 (anti-gay marriage), and the ascendancy of Democrat Harry Reid to the position of Senate Majority Leader. This book provides the most thorough examination ever written of Mormons' place in the American political landscape - what Mormons are like politically and how non-Mormons respond to Mormon candidates. However, this is a book about more than Mormons. As a religious subculture in a pluralistic society, Mormons are a case study of how a religious group balances distinctiveness and assimilation - a question faced by all faiths.
On March 8, 2013, Dieter F. Uchtdorf, Second Counselor in the First Presidency of the LDS Church, joined a group of religious leaders in a meeting with President Barack Obama to discuss immigration reform. Upon leaving the meeting, Uchtdorf said that what the president said “was totally in line with our values.” While not endorsing any specific proposal, the LDS Church also issued a statement supportive of immigration reform that sounded a lot more like the platform of the Democratic than the Republican Party. “Public officials should create and administer laws that reflect the best of our aspiration as a just and caring society. Such laws will properly balance love for neighbors, family cohesion, and the observance of just and enforceable laws” (Canham 2013).
Some observers might be surprised at the common ground between LDS leaders and the Obama administration on immigration. As we have seen in Chapter 4, Mormons are more heavily Republican than any other religious group. Furthermore, Mitt Romney, President Obama’s opponent in the 2012 election, is a devout Mormon who took a hard line on immigration, even endorsing a policy of “self-deportation” for undocumented immigrants. Yet Uchtdorf, and the LDS leadership more generally, are more in step with Mormons’ attitudes on immigration than Romney – notwithstanding Mormons’ overall conservatism and support of the Republican Party.
Just as the 2012 presidential race was heating up, the Pew Mormons in America Survey found that 68 percent of Mormons thought their fellow Americans did not consider Mormonism “mainstream.” But a nearly identical number, 63 percent, also indicated that their fellow citizens were becoming more accepting of Mormons. And 56 percent of Mormons said Americans were ready to elect a Mormon president. Simultaneously believing that they are viewed with suspicion and that the suspicion is waning reflects the Mormon paradox of being a self-consciously peculiar people who are also quintessential Americans. The belief that full acceptance by society will come one day undoubtedly stems from the optimistic spirit of the proselytizing people Mormons are.
Mormons have long sought their own promised land, where they can be both clearly distinctive and fully at peace with their neighbors. Or, as Mormons themselves often put it, they want to be in the world, not of the world – yet also accepted by the world. They would like to be counted among the “mainstream” faiths, grouped in the public mind with Protestants, Catholics, and Jews rather than, say, Scientologists or Wiccans. Mormons have earned a measure of such acceptance in many other venues, including business, sports, entertainment, literature, and academia. But in a democratic society, a key measure of acceptance is politics – an area that has produced mixed results for the Latter-day Saints. Old secular and religious tensions persist, even with new allies, and a Mormon has yet to break the stained-glass ceiling to win the White House.
This book employed several special surveys conducted by the authors as well as secondary analysis of other data sets. The details are listed below. All links were live as of October 7, 2013.
Special Surveys Conducted by Authors
Peculiar People Survey 2012. Self-identified Mormons; YouGov online panel; N = 500; http://csed.byu.edu/Research/PeculiarPeopleSurvey.aspx.
Mormon Perceptions Study 2012. General population, pre- and post-election interviews; YouGov online panel; N = 1,349; http://csed.byu.edu/Research/MormonPerceptionsSurvey.html.
YouGov Daily Omnibus Survey 2014 (replication of feeling thermometer from Mormon Perceptions Survey). General population; YouGov online panel; N = 1,000; http://csed.byu.edu/Research/MormonPerceptionsSurvey.aspx.
Cooperative Congressional Election Study 2012. Akron, BYU, and Notre Dame pre-election modules; YouGov online panel; N = 3,000; http://projects.iq.harvard.edu/cces/data.
Cooperative Campaign Analysis Project 2008. Akron, BYU, and Notre Dame January modules 2008; YouGov online panel; N = 3,000; http://ccap.yougov.com/.
Methodological Note: YouGov online panel surveys employ a matching procedure to representative samples; see Jackman and Vavreck (2010) for the details of matching process, and Vavreck and Rivers (2008) on the representativeness of the samples drawn using this method. Overall, the results of these surveys are consistent with findings from telephone surveys.