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We evaluated the added value of infection control-guided, on demand, and locally performed severe acute respiratory coronavirus virus 2 (SARS-CoV-2) genomic sequencing to support outbreak investigation and control in acute-care settings.
Design and setting:
This 18-month prospective molecular epidemiology study was conducted at a tertiary-care hospital in Montreal, Canada. When nosocomial transmission was suspected by local infection control, viral genomic sequencing was performed locally for all putative outbreak cases. Molecular and conventional epidemiology data were correlated on a just-in-time basis to improve understanding of coronavirus disease 2019 (COVID-19) transmission and reinforce or adapt control measures.
Between April 2020 and October 2021, 6 outbreaks including 59 nosocomial infections (per the epidemiological definition) were investigated. Genomic data supported 7 distinct transmission clusters involving 6 patients and 26 healthcare workers. We identified multiple distinct modes of transmission, which led to reinforcement and adaptation of infection control measures. Molecular epidemiology data also refuted (n = 14) suspected transmission events in favor of community acquired but institutionally clustered cases.
SARS-CoV-2 genomic sequencing can refute or strengthen transmission hypotheses from conventional nosocomial epidemiological investigations, and guide implementation of setting-specific control strategies. Our study represents a template for prospective, on site, outbreak-focused SARS-CoV-2 sequencing. This approach may become increasingly relevant in a COVID-19 endemic state where systematic sequencing within centralized surveillance programs is not available.
This chapter addresses how senior managers (executives, directors) and immediate managers (those to whom employees report directly) can protect, if not enhance, employees’ mental health. We begin by defining the broad concept of employee “mental health.” We then review scientific literature addressing senior and immediate managers’ potential roles in supporting employee mental health. Although more has been published on immediate managers, much of that work has failed to provide practically useful insights, because of vague conceptualizations, poorly developed measures, or insufficient integration across related topics of study. To help fill that gap, we propose a comprehensive behavioral taxonomy of mental health–supportive supervision. This taxonomy integrates evidence-based insights on the types of behavior that immediate managers should avoid, those they should display, and helpful actions advocated by mental health first aid training programs. Lastly, we list several pressing avenues for future research.
This innovation in simulation evaluated the effectiveness of a time sensible, low-cost simulation on prelicensure nursing students’ knowledge and confidence in responding to public health emergencies.
One hundred eighty-two nursing students, in groups of 5, participated in a 75-min emergency preparedness disaster simulation. A mixed methods design was used to evaluate students’ knowledge and confidence in disaster preparedness, and satisfaction with the simulation.
Students reported an increase in knowledge and confidence following the disaster simulation and satisfaction with the experience.
Prelicensure nursing programs can replicate this low cost, time sensible disaster simulation to effectively educate students in emergency preparedness.
Youth experiencing socioeconomic deprivation may be exposed to disadvantage in multiple contexts (e.g., neighborhood, family, and school). To date, however, we know little about the underlying structure of socioeconomic disadvantage, including whether the 'active ingredients' driving its robust effects are specific to one context (e.g., neighborhood) or whether the various contexts increment one another as predictors of youth outcomes.
The present study addressed this gap by examining the underlying structure of socioeconomic disadvantage across neighborhoods, families, and schools, as well as whether the various forms of disadvantage jointly predicted youth psychopathology and cognitive performance. Participants were 1,030 school-aged twin pairs from a subsample of the Michigan State University Twin Registry enriched for neighborhood disadvantage.
Two correlated factors underlay the indicators of disadvantage. Proximal disadvantage comprised familial indicators, whereas contextual disadvantage represented deprivation in the broader school and neighborhood contexts. Results from exhaustive modeling analyses indicated that proximal and contextual disadvantage incremented one another as predictors of childhood externalizing problems, disordered eating, and reading difficulties, but not internalizing symptoms.
Disadvantage within the family and disadvantage in the broader context, respectively, appear to represent distinct constructs with additive influence, carrying unique implications for multiple behavioral outcomes during middle childhood.
Understanding spatial variation in origination and extinction can help to unravel the mechanisms underlying macroevolutionary patterns. Although methods have been developed for estimating global origination and extinction rates from the fossil record, no framework exists for applying these methods to restricted spatial regions. Here, we test the efficacy of three metrics for regional analysis, using simulated fossil occurrences. These metrics are then applied to the marine invertebrate record of the Permian and Triassic to examine variation in extinction and origination rates across latitudes. Extinction and origination rates were generally uniform across latitudes for these time intervals, including during the Capitanian and Permian–Triassic mass extinctions. The small magnitude of this variation, combined with the possibility of its attribution to sampling bias, cautions against linking any observed differences to contrasting evolutionary dynamics. Our results indicate that origination and extinction levels were more variable across clades than across latitudes.
Maternal fish consumption exposes the fetus to beneficial nutrients and potentially adverse neurotoxicants. The current study investigated associations between maternal fish consumption and child neurodevelopmental outcomes. Maternal fish consumption was assessed in the Seychelles Child Development Study Nutrition Cohort 1 (n 229) using 4-day food diaries. Neurodevelopment was evaluated at 9 and 30 months, and 5 and 9 years with test batteries assessing twenty-six endpoints and covering multiple neurodevelopmental domains. Analyses used multiple linear regression with adjustment for covariates known to influence child neurodevelopment. This cohort consumed an average of 8 fish meals/week and the total fish intake during pregnancy was 106·8 (sd 61·9) g/d. Among the twenty-six endpoints evaluated in the primary analysis there was one beneficial association. Children whose mothers consumed larger quantities of fish performed marginally better on the Kaufman Brief Intelligence Test (a test of nonverbal intelligence) at age 5 years (β 0·003, 95 % CI (0, 0·005)). A secondary analysis dividing fish consumption into tertiles found no significant associations when comparing the highest and lowest consumption groups. In this cohort, where fish consumption is substantially higher than current global recommendations, maternal fish consumption during pregnancy was not beneficially or adversely associated with children’s neurodevelopmental outcomes.
The first record of the parasite Alebion carchariae in the waters of Ascension Island collected from Galapagos sharks, Carcharhinus galapagensis (Carcharhinidae), is described. No previous record of this parasite exists for Ascension Island, nor have Galapagos sharks previously been listed as a host. Specimens of A. carchariae were identified using morphological techniques and DNA barcoding of the cytochrome c oxidase I subunit (COI) gene. This study provides the first COI barcodes for this species and a brief review of known hosts. We recommend further research to understand the life cycle of this parasite, its plasticity in terms of host/habitat selection, and to determine the implications of its presence on the hosts it inhabits.
While most children with multisystem inflammatory syndrome in children have rapid recovery of cardiac dysfunction, little is known about the long-term outcomes regarding exercise capacity. We aimed to compare the exercise capacity among patients with multisystem inflammatory syndrome in children versus viral/idiopathic myocarditis at 3–6 months after initial diagnosis.
We performed a retrospective cohort study among patients with multisystem inflammatory syndrome in children in June 2020 to May 2021 and patients with viral/idiopathic myocarditis in August 2014 to January 2020. Data from cardiopulmonary exercise test as well as echocardiographic and laboratory data were obtained. Inclusion criteria included diagnosis of multisystem inflammatory syndrome in children or viral/idiopathic myocarditis, exercise test performed within 3–6 months of hospital discharge, and maximal effort on cardiopulmonary exercise test as determined by respiratory exchange ratio >1.10.
Thirty-one patients with multisystem inflammatory syndrome in children and 25 with viral/idiopathic myocarditis were included. The mean percent predicted peak VO2 was 90.84% for multisystem inflammatory syndrome in children patients and 91.08% for those with viral/idiopathic myocarditis (p-value 0.955). There were no statistically significant differences between the groups with regard to percent predicted maximal heart rate, metabolic equivalents, percent predicted peak VO2, percent predicted anerobic threshold, or percent predicted O2 pulse. There was a statistically significant correlation between lowest ejection fraction during hospitalisation and peak VO2 among viral/idiopathic myocarditis patients (r: 0.62, p-value 0.01) but not multisystem inflammatory syndrome in children patients (r: 0.1, p-value 0.6).
Patients with multisystem inflammatory syndrome in children and viral myocarditis appear to, on average, have normal exercise capacity around 3–6 months following hospital discharge. For patients with viral/idiopathic myocarditis, those with worse ejection fraction during hospitalisation had lower peak VO2 on cardiopulmonary exercise test.
To investigate the relationship between lean muscle mass and treatment response in treatment-resistant late-life depression (TR-LLD). We hypothesized that lower lean muscle mass would be associated with older age, higher physical comorbidities, higher depressive symptom severity, and poorer treatment response.
Secondary analysis of a randomized, placebo-controlled trial.
Three academic hospitals in the United States and Canada.
Adults aged 60+ years with major depressive disorder who did not remit following open treatment with venlafaxine extended-release (XR) (n = 178).
We estimated lean muscle mass using dual-energy X-ray absorptiometry (DEXA) scans prior to and following randomized treatment with aripiprazole or placebo added to venlafaxine XR. Multivariate regressions estimated influence of demographic and clinical factors on baseline lean muscle mass, and whether baseline lean muscle mass was associated with treatment response, adjusted for treatment arm.
Low lean muscle mass was present in 22 (12.4%) participants. Older age and female sex, but not depressive symptom severity, were independently associated with lower lean muscle mass at baseline. Marital status, baseline depressive symptom severity, and treatment group were associated with improvement of depressive symptoms in the randomized treatment phase. Baseline lean muscle mass was not associated with improvement, regardless of treatment group.
As expected, older age and female sex were associated with lower lean muscle mass in TR-LLD. However, contrary to prior results in LLD, lean muscle mass was not associated with depression severity or outcome. This suggests that aripiprazole augmentation may be useful for TR-LLD, even in the presence of anomalous body composition.
Studies have reported that minorities are disproportionately impacted by the COVID-19 pandemic. Few studies have elucidated the lived experiences of African American older adults, and the resiliency displayed in combatting the COVID-19 pandemic and other disasters.
This study used 4 recorded focus groups with 26 African American older adults who have spent most of their lives living in Houston, Texas to assess safety, economic, and health concerns related to the pandemic and similarities or differences with other types of disasters that are specific to Houston/ the Gulf Region of Texas, such as Hurricane Harvey.
Key themes emerged from the thematic analysis: 1) previous disasters provided important coping and preparation skills, although each occurrence was still a major stressor, 2) while telehealth was a significant benefit, regular health maintenance and chronic disease management were not completed during the COVID-19 pandemic, 3) information from the federal and state authorities were inconsistent and spurred fear and anxiety, 4) participants experienced few to no disruptions to their income but were heavily called on to support family members, and 5) participants experienced anxiety and isolation, but many used existing social connections to cope.
These findings demonstrate how African American older adults navigate disaster response and recovery through experience and community. Providing unambiguous information to older adults could prove useful in preparing for future disaster events and coping with disasters.
Methods for culling wild red deer (Cervus elaphus) were compared by observing behaviour and collecting post mortem samples from wild deer shot: (i) by a single stalker during daytime; (ii) by more than one stalker during daytime; (iii) by using a helicopter for the deployment of stalkers and carcase extraction; or (iv) by a single stalker at night, and compared with farmed red deer shot in a field or killed at a slaughterhouse. Culling by a single stalker during the day and shooting in a field were the most accurate in achieving placement of a shot in a target area, but when compared across all methods, there were no significant differences in the percentages of deer that were either wounded or appeared to have died immediately after the first shot. Plasma cortisol concentrations in deer shot using helicopter assistance were similar to those in deer at the slaughterhouse, but higher than deer shot at night or during the day by a single stalker, or in a field. Deer shot using helicopter assistance and also deer culled by a collaborative and single stalking during the day had lower muscle glycogen concentrations than those culled by a single stalker at night. There was no evidence that a particular culling method was associated with an increased risk of accidental or pre-culling injury. If a helicopter is used to assist culling, the deer are more likely to be disturbed before they are shot and therefore, measures should be taken to minimise the disturbance to the deer.
Previous research has established that higher levels of trait Honesty-Humility (HH) are associated with less dishonest behavior in cheating paradigms. However, only imprecise effect size estimates of this HH-cheating link are available. Moreover, evidence is inconclusive on whether other basic personality traits from the HEXACO or Big Five models are associated with unethical decision making and whether such effects have incremental validity beyond HH. We address these issues in a highly powered reanalysis of 16 studies assessing dishonest behavior in an incentivized, one-shot cheating paradigm (N = 5,002). For this purpose, we rely on a newly developed logistic regression approach for the analysis of nested data in cheating paradigms. We also test theoretically derived interactions of HH with other basic personality traits (i.e., Emotionality and Conscientiousness) and situational factors (i.e., the baseline probability of observing a favorable outcome) as well as the incremental validity of HH over demographic characteristics. The results show a medium to large effect of HH (odds ratio = 0.53), which was independent of other personality, situational, or demographic variables. Only one other trait (Big Five Agreeableness) was associated with unethical decision making, although it failed to show any incremental validity beyond HH.
Economic games offer a convenient approach for the study of prosocial behavior. As an advantage, they allow for straightforward implementation of different techniques to reduce socially desirable responding. We investigated the effectiveness of the most prominent of these techniques, namely providing behavior-contingent incentives and maximizing anonymity in three versions of the Trust Game: (i) a hypothetical version without monetary incentives and with a typical level of anonymity, (ii) an incentivized version with monetary incentives and the same (typical) level of anonymity, and (iii) an indirect questioning version without incentives but with a maximum level of anonymity, rendering responses inconclusive due to adding random noise via the Randomized Response Technique. Results from a large (N = 1,267) and heterogeneous sample showed comparable levels of trust for the hypothetical and incentivized versions using direct questioning. However, levels of trust decreased when maximizing the inconclusiveness of responses through indirect questioning. This implies that levels of trust might be particularly sensitive to changes in individuals’ anonymity but not necessarily to monetary incentives.
Recent studies have identified the uncertainty effect (UE), whereby risky prospects (e.g., a binary lottery that offers either a $50 or $100 gift certificate) are valued less than their worst possible outcome (a $50 certificate). This effect has been proposed to result from “direct risk-aversion” which posits that the mere uncertainty of a lottery directly decreases its value. However, this effect may also be driven by the potential disappointment inherent in not receiving the better of the two outcomes (disappointment aversion), or the mere fact that the risky prospect is referred to as a “lottery”. The results of two experiments do not support either of these two alternatives. Specifically, the results of Experiment 1 indicate that the UE is observed even when the values of the two lottery outcomes are similar, or even identical. Experiment 2 further replicates the UE in a context in which the word “lottery” is never used (a company promotional). These results are consistent with a direct risk-aversion mechanism (Gneezy et al., 2006; Simonsohn, 2009) and suggest that the UE obtains across a number of different contexts.
Abnormal tau, a hallmark Alzheimer’s disease (AD) pathology, may appear in the locus coeruleus (LC) decades before AD symptom onset. Reports of subjective cognitive decline are also often present prior to formal diagnosis. Yet, the relationship between LC structural integrity and subjective cognitive decline has remained unexplored. Here, we aimed to explore these potential associations.
We examined 381 community-dwelling men (mean age = 67.58; SD = 2.62) in the Vietnam Era Twin Study of Aging who underwent LC-sensitive magnetic resonance imaging and completed the Everyday Cognition scale to measure subjective cognitive decline along with their selected informants. Mixed models examined the associations between rostral-middle and caudal LC integrity and subjective cognitive decline after adjusting for depressive symptoms, physical morbidities, and family. Models also adjusted for current objective cognitive performance and objective cognitive decline to explore attenuation.
For participant ratings, lower rostral-middle LC contrast to noise ratio (LCCNR) was associated with significantly greater subjective decline in memory, executive function, and visuospatial abilities. For informant ratings, lower rostral-middle LCCNR was associated with significantly greater subjective decline in memory only. Associations remained after adjusting for current objective cognition and objective cognitive decline in respective domains.
Lower rostral-middle LC integrity is associated with greater subjective cognitive decline. Although not explained by objective cognitive performance, such a relationship may explain increased AD risk in people with subjective cognitive decline as the LC is an important neural substrate important for higher order cognitive processing, attention, and arousal and one of the first sites of AD pathology.
Data from neurocognitive assessments may not be accurate in the context of factors impacting validity, such as disengagement, unmotivated responding, or intentional underperformance. Performance validity tests (PVTs) were developed to address these phenomena and assess underperformance on neurocognitive tests. However, PVTs can be burdensome, rely on cutoff scores that reduce information, do not examine potential variations in task engagement across a battery, and are typically not well-suited to acquisition of large cognitive datasets. Here we describe the development of novel performance validity measures that could address some of these limitations by leveraging psychometric concepts using data embedded within the Penn Computerized Neurocognitive Battery (PennCNB).
We first developed these validity measures using simulations of invalid response patterns with parameters drawn from real data. Next, we examined their application in two large, independent samples: 1) children and adolescents from the Philadelphia Neurodevelopmental Cohort (n = 9498); and 2) adult servicemembers from the Marine Resiliency Study-II (n = 1444).
Our performance validity metrics detected patterns of invalid responding in simulated data, even at subtle levels. Furthermore, a combination of these metrics significantly predicted previously established validity rules for these tests in both developmental and adult datasets. Moreover, most clinical diagnostic groups did not show reduced validity estimates.
These results provide proof-of-concept evidence for multivariate, data-driven performance validity metrics. These metrics offer a novel method for determining the performance validity for individual neurocognitive tests that is scalable, applicable across different tests, less burdensome, and dimensional. However, more research is needed into their application.
Avian influenza (AI) is an important disease that has significant implications for animal and human health. High pathogenicity AI (HPAI) has emerged in consecutive seasons within the UK to cause the largest outbreaks recorded. Statutory measures to control outbreaks of AI virus (AIV) at poultry farms involve disposal of all birds on infected premises. Understanding of the timing of incursions into the UK could facilitate decisions on improved responses. During the autumnal migration and wintering period (autumn 2019– spring 2020), three active sampling approaches were trialled for wild bird species considered likely to be involved in captive AI outbreaks with retrospective laboratory testing undertaken to define the presence of AIV.
Faecal sampling of birds (n = 594) caught during routine and responsive mist net sampling failed to detect AIV. Cloacal sampling of hunter-harvested waterfowl (n = 146) detected seven positive samples from three species with the earliest detection on the 17 October 2020. Statutory sampling first detected AIV in wild and captive birds on 3 November 2020. We conclude that hunter sourced sampling of waterfowl presents an opportunity to detect AI within the UK in advance of outbreaks on poultry farms and allow for early intervention measures to protect the national poultry flock.
We describe the association between job roles and coronavirus disease 2019 (COVID-19) among healthcare personnel. A wide range of hazard ratios were observed across job roles. Medical assistants had higher hazard ratios than nurses, while attending physicians, food service workers, laboratory technicians, pharmacists, residents and fellows, and temporary workers had lower hazard ratios.