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To characterize nontuberculous mycobacteria (NTM) associated with case clusters at 3 medical facilities.
Retrospective cohort study using molecular typing of patient and water isolates.
Veterans Affairs Medical Centers (VAMCs).
Isolation and identification of NTM from clinical and water samples using culture, MALDI-TOF, and gene population sequencing to determine species and genetic relatedness. Clinical data were abstracted from electronic health records.
An identical strain of Mycobacterium conceptionense was isolated from 41 patients at VA Medical Centers (VAMCs A, B, and D), and from VAMC A’s ICU ice machine. Isolates were initially identified as other NTM species within the M. fortuitum clade. Sequencing analyses revealed that they were identical M. conceptionense strains. Overall, 7 patients (17%) met the criteria for pulmonary or nonpulmonary infection with NTM, and 13 of 41 (32%) were treated with effective antimicrobials regardless of infection or colonization status. Separately, a M. mucogenicum patient strain from VAMC A matched a strain isolated from a VAMC B ICU ice machine. VAMC C, in a different state, had a 4-patient cluster with Mycobacterium porcinum. Strains were identical to those isolated from sink-water samples at this facility.
NTM from hospital water systems are found in hospitalized patients, often during workup for other infections, making attribution of NTM infection problematic. Variable NTM identification methods and changing taxonomy create challenges for epidemiologic investigation and linkage to environmental sources.
The National Visitor Use Monitoring (NVUM) program data underlies estimates of the volume of recreation use of the National Forest System. The data also enable estimation of both the local economic contributions and nonmarket benefits of that visitation. Applications include evaluating the effects of natural disasters, site characteristics, and climate change, as well as expenditure and benefit transfers. This article describes the history and science background of the NVUM program, outlines the methods used in estimating market and nonmarket economic outcomes, and lists some examples of results found in the literature.
Many foreign aid donors brand development interventions. How do citizens in the donor country react to seeing this branding in action? We test the proposition that citizens will express higher levels of support for foreign aid when they see a branded foreign aid project relative to seeing the same project without branding. We present results from a survey-based laboratory experiment conducted in the United Kingdom where subjects learned about a typical foreign aid project and received a randomized UK branding treatment. Our results suggest that the branding treatments increase the likelihood that donor country respondents believe that aid recipients can identify the source of the foreign aid. Only among conservative respondents, however, does the evidence imply that branding increases support for foreign aid. “UK aid” branding increases conservative opinion that aid dollars are well spent and increases support among this group for the expansion of foreign aid.
Research organizations face challenges in creating infrastructures that cultivates and sustains interdisciplinary team science. The objective of this paper is to identify structural elements of organizations and training that promote team science.
We qualitatively analyzed the National Institutes of Health’s Building Interdisciplinary Research Careers in Women’s Health, K12 using organizational psychology and team science theories to identify organizational design factors for successful team science and training.
Seven key design elements support team science: (1) semiformal meta-organizational structure, (2) shared context and goals, (3) formal evaluation processes, (4) meetings to promote communication, (5) role clarity in mentoring, (6) building interpersonal competencies among faculty and trainees, and (7) designing promotion and tenure and other organizational processes to support interdisciplinary team science.
This application of theory to a long-standing and successful program provides important foundational elements for programs and institutions to consider in promoting team science.
The extraordinary projected growth in the elderly population has prompted concern both about their care and about the impact the provision of that care will have on society. In 1900 only 4.1% of the population was 65 and older and only 0.2% was 85 and older. By 2050 an estimated 20.7% will be at least 65 years old and 5.0% at least 85. Thus, the population aged 65 or older increased from approximately 3 million in 1900 to nearly 35 million in 2000 and is projected to reach nearly 90 million in the year 2060.
Families are the most important providers of care for elderly people, with primary caregivers most likely to be immediate family. In fact, 78% of adults receiving care at home rely exclusively on care from family members. It is estimated that 9.4 million people in the United States are providing care to a relative or friend with a chronic health problem. The importance of the family support system on the well-being of patients has been recognized for almost 4 decades. The families who provide such care have been called one of society's great assets.
Seventy three percent of caregivers are spouses or children. Adult daughters make up 29% of caregivers and wives another 23%. Thus, the overwhelming majority of family caregivers are women. Because most elderly men are married and most elderly women are not, men tend to have a spouse for assistance whereas women do not. Thus, husbands constitute only 13% of caregivers.
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