To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Australian Property Law: Principles to Practice is an engaging introduction to property law in Australia. Covering substantive law and procedural matters, this textbook presents the law of personal and real property in a contemporary light. Australian Property Law details how property law practice is transformed by technology and provides insights into contemporary challenges and risks. Taking a thematic approach, the text covers possession of goods and land, land tenure, estates and future interests, property registration systems, Indigenous land rights and native title, social housing, Crown land and ethics. Complex concepts are contextualised by linking case law and legislation to practical applications. Each chapter is supported by digital tools including case and legislation boxes with links to the full source online, links to useful online resources, multiple-choice questions, review questions and longer narrative problems.Australian Property Law provides an essential introduction to the principles and practice of property law in an ever-changing technological environment.
An effective hospital response to mass casualty incidents (MCIs) requires rapid mobilization of personnel capable of caring for critically ill trauma patients and availability of resuscitation resources.
Hospitals facing an MCI wrestle with the challenge of immediately adjusting their overextended clinical operations to resuscitate a large number of rapidly arriving patients without compromising the care of existing patients.
Hospitalists are well positioned to add significant value by off-loading the emergency department (ED) given their broad clinical expertise. We describe our institution’s protocol to generate immediate and sustained surge capacity by integrating our hospitalist service into MCI response.
Our protocol details the safe and rapid transfer of care of existing ED patients to hospitalist teams to make ED staff and space available to care for incoming MCI patients.
Relative to other species, human females invest considerable effort in attracting and retaining mates. Stroll the aisles of any bookstore and you may come across titles such as “Get the guy: Learn secrets of the male mind to find the man you want and the love you deserve” (Hussey, 2014), and “Texts so good he can't ignore: Sassy texting secrets for attracting high-quality men” (Bryans, 2018). A desire to attract and retain mates underlies diverse facets of women’s psychology and behavior, including displaying or enhancing aspects of one’s personality and physical appearance. Not surprisingly, these efforts correspond with men’s mate preferences. Human males are unique in their relative choosiness surrounding their mates, especially within the context of long-term pair-bonding. Look further in that bookstore aisle and you might come across a title such as “The man's handbook for choosing the right woman” (Daniels, 2009). In this chapter, we examine the theoretical rationale underlying female intersexual selection. We begin with a discussion of the theory underlying human mate choice, highlighting why men’s choosiness has been selected for, and why this compels women to exert effort toward attracting men. We then discuss specific characteristics of men’s short-term and long-term mate choice, and the multitude of tactics women utilize to better embody those traits. We describe preliminary evidence surrounding how intersexual selection may have shaped some phenotypic traits in women as costly signals of underlying fertility or immunocompetence. Finally, we discuss both individual and contextual differences among women in their mating effort and provide suggestions for future research directions aimed at further understanding how intersexual selection has shaped women’s mating psychology.
We implemented a preoperative staphylococcal decolonization protocol for colorectal surgeries if efforts to further reduce surgical site infections (SSIs).
Retrospective observational study.
Tertiary-care, academic medical center.
Adult patients who underwent colorectal surgery, as defined by National Healthcare Safety Network (NHSN), between July 2015 and June 2020. Emergent cases were excluded.
Simple and multivariable logistic regression were performed to evaluate the relationship between decolonization and subsequent SSI. Other predictive variables included age, sex, body mass index, procedure duration, American Society of Anesthesiology (ASA) score, diabetes, smoking, and surgical oncology service.
In total, 1,683 patients underwent nonemergent NHSN-defined colorectal surgery, and 33.7% underwent the staphylococcal decolonization protocol. SSI occurred in 92 (5.5%); 53 were organ-space infections and 39 were superficial wound infections. We detected no difference in overall SSIs between those decolonized and not decolonized (P = .17). However, superficial wound infections were reduced in the group that received decolonization versus those that did not: 7 (1.2%) of 568 versus 32 (2.9%) of 1,115 (P = .04).
Staphylococcal decolonization may prevent a subset of SSIs in patients undergoing colorectal surgery.
Hospital epidemiologists, infection preventionists, and antimicrobial stewards are integral to the pandemic workforce. However, regardless of pandemic surge or postsurge conditions, their workload remains high due to constant vigilance for new variants, emerging data, and evolving public health guidance. We describe the factors that have led to burnout and suggest strategies to enhance resilience.
Does attending communal religious services heighten the tendency to express exclusionary attitudes? Drawing on responses from thousands of Muslims, we identify how the ritual Friday Prayer systematically influences congregants' political and social attitudes. To isolate the independent role of this religious behavior, we exploit day-of-the-week variation in survey enumeration, which we assume to be plausibly uncorrelated with likely confounders, including self-reported religiosity. In our primary analysis, six variables charting various modes of intolerance each indicate that frequent attenders interviewed on Fridays (that is, proximate to the weekly communal prayer) were significantly more likely to express sectarian and antisecular attitudes than their counterparts. To test the potential mechanism behind this tendency, we rely on a controlled comparison between Egyptian and Algerian subgroups, as well as an original survey experiment in Lebanon. Evidence from both analyses is consistent with arguments that elite political messaging embedded in religious rituals spurs much of the observed variation.
The Hierarchical Taxonomy of Psychopathology (HiTOP) has emerged out of the quantitative approach to psychiatric nosology. This approach identifies psychopathology constructs based on patterns of co-variation among signs and symptoms. The initial HiTOP model, which was published in 2017, is based on a large literature that spans decades of research. HiTOP is a living model that undergoes revision as new data become available. Here we discuss advantages and practical considerations of using this system in psychiatric practice and research. We especially highlight limitations of HiTOP and ongoing efforts to address them. We describe differences and similarities between HiTOP and existing diagnostic systems. Next, we review the types of evidence that informed development of HiTOP, including populations in which it has been studied and data on its validity. The paper also describes how HiTOP can facilitate research on genetic and environmental causes of psychopathology as well as the search for neurobiologic mechanisms and novel treatments. Furthermore, we consider implications for public health programs and prevention of mental disorders. We also review data on clinical utility and illustrate clinical application of HiTOP. Importantly, the model is based on measures and practices that are already used widely in clinical settings. HiTOP offers a way to organize and formalize these techniques. This model already can contribute to progress in psychiatry and complement traditional nosologies. Moreover, HiTOP seeks to facilitate research on linkages between phenotypes and biological processes, which may enable construction of a system that encompasses both biomarkers and precise clinical description.
Background: The COVID-19 pandemic has made a significant impact on antimicrobial use patterns across health systems. We have described antibiotic use patterns at an academic medical center in Richmond, Virginia, before and after the onset of COVID-19. We also examined the impact on the proportional consumption of carbapenems (PoCC) metric. PoCC represents meropenem utilization relative to the narrower-spectrum antipseudomonal agents cefepime and piperacillin-tazobactam. Our institution practices antimicrobial restriction for meropenem. All other antibiotics included in the study data can be freely ordered by any provider. Methods: We evaluated antimicrobial use data from September 2018 through August 2021 using days of therapy (DOT) per 1,000 patient days. We included 18 months of data before and after the first recorded COVID-19 admission at our institution in March 2020. Mean comparisons were performed using the Welch 2-sample t test. The Bonferonni correction for multiple comparisons was utilized to determine significance with an initial baseline α of 0.05. All data analyses were performed using R software (R Foundation for Statistical Computing, Vienna, Austria, 2021). Results: Normality was evaluated with QQ-plots and all data demonstrated normality. Bonferroni correction produced an adjusted α value of 0.007. We detected significant increases in the use of cefepime, piperacillin-tazobactam, ceftriaxone, and azithromycin following the onset of the COVID-19 pandemic. We noted a significant decrease in the PoCC metric during this period. No significant change was noted for levofloxacin or meropenem. Conclusions: The COVID-19 pandemic produced significant changes in antimicrobial use patterns at our institution. We noted statistically significant increases in bacterial community-acquired pneumonia-focused antibiotics (ceftriaxone and azithromycin). We observed significant increases for cefepime and piperacillin-tazobactam. Interestingly, relative utilization of carbapenems as measured by the PoCC metric continued to decrease during this time. This trend was primarily driven by increases in cefepime and piperacillin-tazobactam utilization while meropenem utilization remained relatively constant. This study highlights the importance of looking at normalized antibiotic consumption data and not relative-use data alone.
Background: Over-testing for Clostridioides difficile infection outside acute diarrheal illness without a clear alternative cause can lead to inappropriate diagnosis and treatment with antibiotic therapy. Preanalytical interventions such as education, order restriction, and electronic order assistance are common but are limited in effectiveness. As an alternative approach, our antibiotic stewardship program (ASP) implemented prospective audit and feedback (PAF) on C. difficile PCR orders to reduce inappropriate testing.
Methods: The study was conducted at a 399-bed, tertiary-care, Veterans’ Affairs Medical Center and included adult inpatients and outpatients for whom C. difficile PCR testing was ordered. In the preintervention period from June through September 2019, the ASP was alerted to C. difficile PCR tests and collected data but did not intervene. From October 2019 to January 2020, the ASP performed real-time PAF at the time of ordering. Appropriateness of testing was determined based on whether there was a negative result in the prior 7 days and a 3-step review of clinical factors (Fig. 1). When possible, a direct conversation took place with the ordering provider. If not possible, a general note delineating appropriate clinical criteria for testing was generated. No PAF was done outside standard hours. The ASP recommended cancelling tests deemed inappropriate. Monthly test rates during the pre- and postintervention periods were compared using the Student t test with α = .05, and test appropriateness was compared using the χ2 test. All analyses were conducted using Microsoft Excel software. Results: During the preintervention period, a total of 418 tests were ordered (104.5 per month). This number decreased to 276 (69 per month) during the intervention period. (p Conclusions: Direct PAF at the time of C. difficile PCR ordering may increase test appropriateness and is associated with a reduction in overall testing, primarily by reducing the number of tests that are considered not appropriate on clinical grounds. PAF is effective but requires significant time investment by ASP staff and may not be a sustainable intervention over time.
OBJECTIVES/GOALS: The present study investigated contextual factors linking rural Black American mens experiences of racial discrimination to their COVID vaccine hesitancy. Specifically, we investigated two potential mediators of the link between racial discrimination and COVID vaccine hesitancy: (1) medical mistrust, and (2) COVID conspiratorial beliefs. METHODS/STUDY POPULATION: Hypotheses were tested using structural equation modeling with 7 waves of data from 504 Black American men participating in a longitudinal study of risk behavior and substance use during young adulthood. At baseline, mens mean age was ~20. Data were collected before and during the COVID pandemic. The COVID pandemic began after Wave 4 data had been collected. A series of 3 online surveys, at 3-month intervals, were conducted to examine acute COVID-related stressors and impacts. RESULTS/ANTICIPATED RESULTS: The dual mediation model fit the data as follows: Ï‡2(7) = 19.00, p < .008; Ï‡2/ df = 2.71; RMSEA = 0.06; CFI = 0.95; SRMR= 0.04. Results indicated that racial discrimination was directly associated with increases in COVID conspiratorial beliefs (B = .14, p<.05) and medical mistrust (B = .22, p<.001). COVID conspiratorial beliefs was directly associated with increases in COVID vaccine hesitancy (B = .11, p<.05). Indirect effects were detected whereby racial discrimination was associated with increases COVID vaccine hesitancy indirectly via increases in COVID conspiratorial beliefs (B = 0.016; 95% CI [0.001, 0.048]). DISCUSSION/SIGNIFICANCE: Investigating race-related factors in the context of vaccine hesitancy is a novel area of inquiry that could facilitate the development of targeted interventions for Black Americans to increase their vaccine uptake. Future research is needed to more thoroughly examine the relationship between racial discrimination and conspiratorial beliefs.
To describe the use of artificial intelligence (AI)-enabled dark nudges by leading global food and beverage companies to influence consumer behaviour.
The five most recent annual reports (ranging from 2014 to 2018 or 2015 to 2019, depending on the company) and websites from twelve of the leading companies in the global food and beverage industry were reviewed to identify uses of AI and emerging technologies to influence consumer behaviour. Uses of AI and emerging technologies were categorised according to the Typology of Interventions in Proximal Physical Micro-Environments (TIPPME) framework, a tool for categorising and describing nudge-type behaviour change interventions (which has also previously been used to describe dark nudge-type approaches used by the alcohol industry).
Twelve leading companies in the global food and beverage industry.
Text was extracted from fifty-seven documents from eleven companies. AI-enabled dark nudges used by food and beverage companies included those that altered products and objects’ availability (e.g. social listening to inform product development), position (e.g. decision technology and facial recognition to manipulate the position of products on menu boards), functionality (e.g. decision technology to prompt further purchases based on current selections) and presentation (e.g. augmented or virtual reality to deliver engaging and immersive marketing).
Public health practitioners and policymakers must understand and engage with these technologies and tactics if they are to counter industry promotion of products harmful to health, particularly as investment by the industry in AI and other emerging technologies suggests their use will continue to grow.
Monoclonal antibody therapeutics to treat coronavirus disease (COVID-19) have been authorized by the US Food and Drug Administration under Emergency Use Authorization (EUA). Many barriers exist when deploying a novel therapeutic during an ongoing pandemic, and it is critical to assess the needs of incorporating monoclonal antibody infusions into pandemic response activities. We examined the monoclonal antibody infusion site process during the COVID-19 pandemic and conducted a descriptive analysis using data from 3 sites at medical centers in the United States supported by the National Disaster Medical System. Monoclonal antibody implementation success factors included engagement with local medical providers, therapy batch preparation, placing the infusion center in proximity to emergency services, and creating procedures resilient to EUA changes. Infusion process challenges included confirming patient severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity, strained staff, scheduling, and pharmacy coordination. Infusion sites are effective when integrated into pre-existing pandemic response ecosystems and can be implemented with limited staff and physical resources.
Attentional bias toward health-threat may theoretically contribute to the development and maintenance of health anxiety, but the empirical findings have been controversial. This study aimed to synthesize and explore the heterogeneity in a health-threat related attentional bias of health-anxious individuals, and to determine the theoretical model that better represents the pattern of attentional bias in health anxiety. Four databases (Web of Science, PubMed, PsycINFO, and Scopus) were searched for relevant studies, with 17 articles (N = 1546) included for a qualitative review and 16 articles (18 studies) for a three-level meta-analysis (N = 1490). The meta-analytic results indicated that the health anxiety group, compared to the control group, showed significantly greater attentional bias toward health-threat (g = 0.256). Further analyses revealed that attentional bias type, paradigm, and stimuli type were significant moderators. Additionally, compared to the controls, health-anxious individuals displayed significantly greater attention maintenance (g = 0.327) but nonsignificant attention vigilance to health-threat (g = −0.116). Our results provide evidence for the attention maintenance model in health-anxious individuals. The implications for further research and treatment of elevated health anxiety in the context of coronavirus disease-2019 (COVID-19) were also discussed.
Approximately one-third of individuals in a major depressive episode will not achieve sustained remission despite multiple, well-delivered treatments. These patients experience prolonged suffering and disproportionately utilize mental and general health care resources. The recently proposed clinical heuristic of ‘difficult-to-treat depression’ (DTD) aims to broaden our understanding and focus attention on the identification, clinical management, treatment selection, and outcomes of such individuals. Clinical trial methodologies developed to detect short-term therapeutic effects in treatment-responsive populations may not be appropriate in DTD. This report reviews three essential challenges for clinical intervention research in DTD: (1) how to define and subtype this heterogeneous group of patients; (2) how, when, and by what methods to select, acquire, compile, and interpret clinically meaningful outcome metrics; and (3) how to choose among alternative clinical trial design options to promote causal inference and generalizability. The boundaries of DTD are uncertain, and an evidence-based taxonomy and reliable assessment tools are preconditions for clinical research and subtyping. Traditional outcome metrics in treatment-responsive depression may not apply to DTD, as they largely reflect the only short-term symptomatic change and do not incorporate durability of benefit, side effect burden, or sustained impact on quality of life or daily function. The trial methodology will also require modification as trials will likely be of longer duration to examine the sustained impact, raising complex issues regarding control group selection, blinding and its integrity, and concomitant treatments.
In this article, we focus on data trust and data privacy, and how attitudes may be changing during the COVID-19 period. On balance, it appears that Australians are more trusting of organizations with regards to data privacy and less concerned about their own personal information and data than they were prior to the spread of COVID-19. The major determinant of this change in trust with regards to data was changes in general confidence in government institutions. Despite this improvement in trust with regards to data privacy, trust levels are still low.
Challenges for infection prevention and antimicrobial stewardship programs have arisen with the fourth wave of the coronavirus disease 2019 (COVID-19) pandemic, fueled by the delta variant. These challenges include breakthrough infections in vaccinated individuals, decisions to re-escalate infection prevention measures, critical medication shortages, and provider burnout. Various strategies are needed to meet these challenges.
As Ngāi Tahu (southern Maori), we take issue with widespread reference in scholarly publication to Polynesian voyagers reaching the Antarctic, an idea that originated in the translation of Rarotongan traditions in the nineteenth century. Analysis of those indicates that they contain no plausible reference to Antarctic seafaring. Southern Māori interests have extended into the Subantarctic Islands for 800 years but there is no reference to Antarctica in our historical traditions. Our archaeology and history document a southern boundary to Māori occupation at Port Ross (Auckland Islands), despite habitable islands existing further south. We think it is very unlikely that Māori or other Polynesian voyaging reached the Antarctic.