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Colleges and universities around the world engaged diverse strategies during the COVID-19 pandemic. Baylor University, a community of ˜22,700 individuals, was one of the institutions which resumed and sustained operations. The key strategy was establishment of multidisciplinary teams to develop mitigation strategies and priority areas for action. This population-based team approach along with implementation of a “Swiss Cheese” risk mitigation model allowed small clusters to be rapidly addressed through testing, surveillance, tracing, isolation, and quarantine. These efforts were supported by health protocols including face coverings, social distancing, and compliance monitoring. As a result, activities were sustained from 1 August to 8 December 2020. There were 62,970 COVID-19 tests conducted with 1,435 people testing positive for a positivity rate of 2.28%. A total of 1,670 COVID-19 cases were identified with 235 self-reports. The mean number of tests per week was 3,500 with approximately 80 of these positive (11 per day). More than 60 student tracers were trained with over 120 personnel available to contact trace, at a ratio of one per 400 university members. The successes and lessons learned provide a framework and pathway for similar institutions to mitigate the ongoing impacts of COVID-19 and sustain operations during a global pandemic.
Background: Carbapenemase-producing Enterobacterales (CPE) have rapidly become a global health concern and are associated with substantial morbidity and mortality due to limited treatment options. Travel to endemic areas, especially healthcare exposure in these areas, is an important risk factor for acquisition. We describe the evolving epidemiology, molecular features, and outcomes of CPE in Canada through surveillance by the Canadian Nosocomial Infection Surveillance Program (CNISP). Methods: CNISP has conducted surveillance for CPE among inpatients and outpatients of all ages since 2010. Participating acute-care facilities submit eligible specimens to the National Microbiology Laboratory for detection of carbapenemase production, and epidemiological data are collected. Incidence rates per 10,000 patient days are calculated based on inpatient data. Results: In total, 59 CNISP hospitals in 10 Canadian provinces representing 21,789 beds and 6,785,013 patient days participated in this surveillance. From 2010 to 2018, 118 (26%) CPE-infected and 547 (74%) CPE-colonized patients were identified. Few pediatric cases were identified (n = 18). Infection incidence rates remain low and stable (0.02 per 10,000 patient days in 2010 to 0.03 per 10,000 patient days in 2018), and colonization incidence rates have increased by 89% over the surveillance period. Overall, 92% of cases were acquired in a healthcare facility: 61% (n = 278) in a Canadian healthcare facility and 31% (n = 142) in a healthcare facility outside Canada. Of the 8% of cases not acquired in a healthcare facility, 50% (16 of 32) reported travel outside of Canada in the 12 months prior to positive culture. The distribution of carbapenemases varied by region; New Delhi metallo-B-lactamase (NDM) was dominant (59%) in western Canada and Klebsiella pneumoniae carbapenemase (KPC) (66%) in central Canada. NDM and class D carbapenemase OXA-48 were more commonly identified among those who traveled outside of Canada, whereas KPC was more commonly identified among patients without travel. In addition, 30-day all-cause mortality was 14% (25 of 181) among CPE infected patients and 32% (14 of 44) among those with bacteremia. Conclusions: CPE rates remain low in Canada; however, national surveillance data suggest that the increase in CPE in Canada is now being driven by local nosocomial transmission as well as travel and healthcare within endemic areas. Changes in screening practices may have contributed to the increase in colonizations; however, these data are currently lacking and will be collected moving forward. These data highlight the need to intensify surveillance and coordinate infection control measures to prevent further spread of CPE in Canadian acute-care hospitals.
Susy Hota reports contracted research for Finch Therapeutics. Allison McGeer reports funds to her institution for projects for which she is the principal investigator from Pfizer and Merck, as well as consulting fees from the following companies: Sanofi-Pasteur, Sunovion, GSK, Pfizer, and Cidara.
Resilience is a cross-disciplinary concept that is relevant for understanding the sustainability of the social and environmental conditions in which we live. Most research normatively focuses on building or strengthening resilience, despite growing recognition of the importance of breaking the resilience of, and thus transforming, unsustainable social-ecological systems. Undesirable resilience (cf. lock-ins, social-ecological traps), however, is not only less explored in the academic literature, but its understanding is also more fragmented across different disciplines. This disparity can inhibit collaboration among researchers exploring interdependent challenges in sustainability sciences. In this article, we propose that the term lock-in may contribute to a common understanding of undesirable resilience across scientific fields.
First investigated archaeologically in 1963, it is only with the recent publication of the 2006–2008 excavations that the nature of the Early Bronze Age sanctuary and settlement on Keros is becoming clear. Further investigations – a survey in 2012–2013 and excavations in 2016–2018 – have expanded our knowledge of the sanctuary. This paper sets out the interdisciplinary nature of the research on Keros, highlighting the contribution of a panoply of environmental techniques built into the project methodology from its inception, with all sampling taking place during the excavation itself. In addition, compositional and microscopic analyses of materials such as ceramics, metals and marble contribute to understanding their manufacture and provenance. Finally, taphonomic analyses include micromorphological and soil-chemistry studies, both of which are the largest of their kind yet undertaken in the Aegean. The reflexive contribution of all these specialisms to the ongoing study and publication of the site is described.
The origins of religion and ritual in humans have been the focus of centuries of thought in archaeology, anthropology, theology, evolutionary psychology and more. Play and ritual have many aspects in common, and ritual is a key component of the early cult practices that underlie the religious systems of the first complex societies in all parts of the world. This book examines the formative cults and the roots of religious practice from the earliest times until the development of early religion in the Near East, in China, in Peru, in Mesoamerica and beyond. Here, leading prehistorians and other specialists bring a fresh approach to the early practices that underlie the faiths and religions of the world. They demonstrate the profound role of play ritual and belief systems and offer powerful new insights into the emergence of early civilization.