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Time is running out for the earth’s ecosystem as our species has known it and still, in the words of critical race theorist Derrick Bell, “we are not saved.”1 In this afterword, I reflect on the lessons of this volume from a perspective newly emergent in legal scholarship: “law and political economy” (LPE).
Adolescents who hold an entity theory of personality – the belief that people cannot change – are more likely to report internalizing symptoms during the socially stressful transition to high school. It has been puzzling, however, why a cognitive belief about the potential for change predicts symptoms of an affective disorder. The present research integrated three models – implicit theories, hopelessness theories of depression, and the biopsychosocial model of challenge and threat – to shed light on this issue. Study 1 replicated the link between an entity theory and internalizing symptoms by synthesizing multiple datasets (N = 6,910). Study 2 examined potential mechanisms underlying this link using 8-month longitudinal data and 10-day diary reports during the stressful first year of high school (N = 533, 3,199 daily reports). The results showed that an entity theory of personality predicted increases in internalizing symptoms through tendencies to make fixed trait causal attributions about the self and maladaptive (i.e., “threat”) stress appraisals. The findings support an integrative model whereby situation-general beliefs accumulate negative consequences for psychopathology via situation-specific attributions and appraisals.
This SHEA white paper identifies knowledge gaps and challenges in healthcare epidemiology research related to coronavirus disease 2019 (COVID-19) with a focus on core principles of healthcare epidemiology. These gaps, revealed during the worst phases of the COVID-19 pandemic, are described in 10 sections: epidemiology, outbreak investigation, surveillance, isolation precaution practices, personal protective equipment (PPE), environmental contamination and disinfection, drug and supply shortages, antimicrobial stewardship, healthcare personnel (HCP) occupational safety, and return to work policies. Each section highlights three critical healthcare epidemiology research questions with detailed description provided in supplementary materials. This research agenda calls for translational studies from laboratory-based basic science research to well-designed, large-scale studies and health outcomes research. Research gaps and challenges related to nursing homes and social disparities are included. Collaborations across various disciplines, expertise and across diverse geographic locations will be critical.
The COVID-19 pandemic prompted the development and implementation of hundreds of clinical trials across the USA. The Trial Innovation Network (TIN), funded by the National Center for Advancing Translational Sciences, was an established clinical research network that pivoted to respond to the pandemic.
The TIN’s three Trial Innovation Centers, Recruitment Innovation Center, and 66 Clinical and Translational Science Award Hub institutions, collaborated to adapt to the pandemic’s rapidly changing landscape, playing central roles in the planning and execution of pivotal studies addressing COVID-19. Our objective was to summarize the results of these collaborations and lessons learned.
The TIN provided 29 COVID-related consults between March 2020 and December 2020, including 6 trial participation expressions of interest and 8 community engagement studios from the Recruitment Innovation Center. Key lessons learned from these experiences include the benefits of leveraging an established infrastructure, innovations surrounding remote research activities, data harmonization and central safety reviews, and early community engagement and involvement.
Our experience highlighted the benefits and challenges of a multi-institutional approach to clinical research during a pandemic.
The first demonstration of laser action in ruby was made in 1960 by T. H. Maiman of Hughes Research Laboratories, USA. Many laboratories worldwide began the search for lasers using different materials, operating at different wavelengths. In the UK, academia, industry and the central laboratories took up the challenge from the earliest days to develop these systems for a broad range of applications. This historical review looks at the contribution the UK has made to the advancement of the technology, the development of systems and components and their exploitation over the last 60 years.
The Clinical and Translational Science Awards (CTSA) Consortium, a network of academic health care institutions with CTSA hubs, is charged with improving the national clinical and translational research enterprise. The CTSA Consortium and the NIH National Center for Advancing Translational Sciences implemented the Common Metrics Initiative comprised of standardized metrics and a shared performance improvement framework. This article summarizes hubs’ perspectives on its value during the initial implementation.
The value was assessed across 58 hubs. Survey items assessed change in perceived ability to manage performance and advance clinical and translational science. Semi-structured interviews elicited hubs’ perspectives on meaningfulness and value-added of the Common Metrics Initiative and hubs’ recommendations.
Hubs considered their abilities to manage performance to have improved, but there was no change in perceived ability to advance clinical and translational science. The initiative added value by providing a formal structured process, enabling strategic conversations, facilitating improvements in processes, providing an external impetus for improvement, and providing justification for funds invested. Hubs were concerned about the usefulness of the metrics chosen and whether the value-added was sufficient relative to the effort required. Hubs recommended useful benchmarking, disseminating best practices and promoting peer-to-peer learning, and expanding the use of data to inform the initiative.
Implementing Common Metrics and a performance improvement framework yielded concrete short-term benefits, but concerns about usefulness remained, particularly considering the effort required. The Common Metrics Initiative should focus on facilitating cross-hub collaboration around metrics that address high-priority impact areas for individual hubs and the Consortium.
Children are important transmitters of infection. Within schools they encounter large numbers of contacts and infections can spread easily causing outbreaks. However, not all schools are affected equally. We conducted a retrospective analysis of school outbreaks to identify factors associated with the risk of gastroenteritis, influenza, rash or other outbreaks. Data on reported school outbreaks in England were obtained from Public Health England and linked with data from the Department for Education and the Office for Standards in Education, Children's Services and Skills (Ofsted). Primary and all-through schools were found to be at increased risk of outbreaks, compared with secondary schools (odds ratio (OR) 5.82, 95% confidence interval (CI) 4.50–7.58 and OR 4.66, 95% CI 3.27–6.61, respectively). School size was also significantly associated with the risk of outbreaks, with higher odds associated with larger schools. Attack rates were higher in gastroenteritis and influenza outbreaks, with lower attack rates associated with rashes (relative risk 0.17, 95% CI 0.15–0.20). Deprivation and Ofsted rating were not associated with either outbreak occurrence or the subsequent attack rate. This study identifies primary and all-through schools as key settings for health protection interventions. Public health teams need to work closely with these schools to encourage early identification and reporting of outbreaks.
This essay explores four key dimensions of political science literature on the U.S. criminal legal system, by way of introducing articles in the special issue on criminal justice featured in the Journal of Racial and Ethnic Politics. We situate police as an institution of social control, rather than providing safety for people vulnerable to crime. The vast array of policy tools to surveil, track, and detain citizens, which lack commensurate restraints on their application, amount to a finely tuned carceral machine that can be deployed against groups newly identified as deviant. We therefore turn attention to this dynamic with our second theme: the criminalization of immigrants, the expansion of interior immigration enforcement, and the consequent targeting of Latinx people. We likewise discuss lessons for reform that can be drawn from research on representation and the political socialization that occurs as a consequence of involuntary contact with the system. We conclude with a brief discussion of directions for future research. The criminal legal system is a key force for persistent racial and class inequality. By turning attention to the politics of the criminal legal system, we forward a critical and understudied facet of American political life that intersects with all corners of the discipline.
Theories concerning the adoption of punitive policies at the state level often cite two dynamics: conservative ideology and racial threat, that punitive policies are more likely in states with Republican politicians and a higher proportion of Black residents. I argue these theories lose their explanatory power in the post-Civil Rights era, and suggest Black political incorporation acts as a powerful antidote to the punitive impulses of government officials. I test my hypotheses on a dataset of state corrections spending from 1983 to 2011 and find evidence for the counterbalancing argument. States with increasing percentages of Black state legislators spend .36 fewer dollars per capita on corrections, suggesting Black political incorporation is an important mediator in the relationship between racial threat and corrections budgets. This paper has implications for the application of the social control theory as descriptive representation grows, but also for the study of the effect of minority politicians on budgets and policy more broadly. The adoption of policies deleterious to certain communities can be mitigated by the presence of representatives who legislate on behalf of those communities.
The Common Metrics Initiative aims to develop and field metrics to improve research processes within the national Clinical and Translational Science Award (CTSA) Consortium. A Median Accrual Ratio (MAR) common metric was developed to assess the results of efforts to increase subject accrual into a set of clinical trials within the expected time period. A pilot test of the MAR was undertaken at Tufts Clinical and Translational Science Institute (CTSI) with eight CTSA Consortium hubs. Post-pilot interviews were conducted with 9 CTSA Principal Investigators (PIs) and 23 pilot team members. Over three-quarters (78%) of respondents reported that the MAR could be useful for performance improvement, but also described limitations or concerns. The most commonly cited barrier to MAR use for performance improvement was difficulty in interpreting the single value that is produced. Most respondents were interested in using the MAR to assess recruitment at an individual trial level. Majority of respondents (63%) had mixed opinions about aggregating metric results across the CTSA Consortium for comparison or benchmarking. Collecting data about additional contextual factors, and comparing accrual between subgroups, were cited as potentially helping address concerns about aggregation. Significant challenges remain in ensuring that the MAR can be sufficiently useful for collaborative process improvement. We offer recommendations to potentially improve metric usefulness.
What explains why some Latinos feel strongly tied to their coethnics while others do not? Demographic context is one of the most cited predictors of identity strength, but the size and direction of its effects are disputed. Geographic differences in policy environments may explain the phenomenon. We argue that high levels of immigration enforcement indirectly lead to increased feelings of ethnic linked fate by determining where and how demographic context—in this case, the size of the immigrant population—will be salient. To test this, we combine information from local immigration-enforcement data (obtained via Freedom of Information Act requests) with the Latino Decisions' 2016 Collaborative Multiracial Post-Election Survey. The results suggest native-born Latinos have a stronger sense of ethnic linked fate when they live near large immigrant populations and rates of enforcement are high. When enforcement is low, the presence of immigrants has a negligible effect on native-born attitudes. Foreign-born Latinos' sense of linked fate is unaffected by policy context. These results suggest that as immigration enforcement becomes intensifies, conservative politicians may see increased backlash, at least in certain communities, from native-born Latinos. This is because feelings about ethnic linked fate correlate with increased participation and more proimmigrant policy stances.
Failure to accrue participants into clinical trials incurs economic costs, wastes resources, jeopardizes answering research questions meaningfully, and delays translating research discoveries into improved health. This paper reports the results of a pilot test of the Median Accrual Ratio (MAR) metric developed as a part of the Common Metrics Initiative of the NIH’s National Center for Advancing Translational Science (NCATS) Clinical and Translational Science Award (CTSA) Consortium. Using the metric is intended to enhance the ability of the CTSA Consortium and its “hubs” to increase subject accrual into trials within expected timeframes. The pilot test was undertaken at Tufts Clinical and Translational Science Institute (CTSI) with eight CTSA Consortium hubs. We describe the pilot test methods, and results regarding feasibility of collecting metric data and the quality of data that was collected. Participating hubs welcomed the opportunity to assess accrual efforts, but experienced challenges in collecting accrual metric data due to insufficient infrastructure and inconsistent implementation of electronic data systems and lack of uniform data definitions. Also, the metric could not be constructed for all trial designs, particularly those using competitive enrollment strategies. We offer recommendations to address the identified challenges to facilitate progress to broad accrual metric data collection and use.
To characterize associations between exposures within and outside the medical workplace with healthcare personnel (HCP) SARS-CoV-2 infection, including the effect of various forms of respiratory protection.
We collected data from international participants via an online survey.
In total, 1,130 HCP (244 cases with laboratory-confirmed COVID-19, and 886 controls healthy throughout the pandemic) from 67 countries not meeting prespecified exclusion (ie, healthy but not working, missing workplace exposure data, COVID symptoms without lab confirmation) were included in this study.
Respondents were queried regarding workplace exposures, respiratory protection, and extra-occupational activities. Odds ratios for HCP infection were calculated using multivariable logistic regression and sensitivity analyses controlling for confounders and known biases.
HCP infection was associated with non–aerosol-generating contact with COVID-19 patients (adjusted OR, 1.4; 95% CI, 1.04–1.9; P = .03) and extra-occupational exposures including gatherings of ≥10 people, patronizing restaurants or bars, and public transportation (adjusted OR range, 3.1–16.2). Respirator use during aerosol-generating procedures (AGPs) was associated with lower odds of HCP infection (adjusted OR, 0.4; 95% CI, 0.2–0.8, P = .005), as was exposure to intensive care and dedicated COVID units, negative pressure rooms, and personal protective equipment (PPE) observers (adjusted OR range, 0.4–0.7).
COVID-19 transmission to HCP was associated with medical exposures currently considered lower-risk and multiple extra-occupational exposures, and exposures associated with proper use of appropriate PPE were protective. Closer scrutiny of infection control measures surrounding healthcare activities and medical settings considered lower risk, and continued awareness of the risks of public congregation, may reduce the incidence of HCP infection.
Evidence that racial minorities are targeted for searches during police traffic stops is widespread, but observed differences in outcomes following a traffic stop between white drivers and people of color could potentially be due to factors correlated with driver race. Using a unique dataset recording over 5 million traffic stops from 90 municipal police departments, we control for and evaluate alternative explanations for why a driver may be searched. These include: (1) the context of the stop itself, (2) the characteristics of the police department including the race of the police chief, and (3) demographic and racial composition of the municipality within which the stop occurs. We find that the driver's race remains a robust predictor: black male drivers are consistently subjected to more intensive police scrutiny than white drivers. Additionally, we find that all drivers are less likely to be subject to highly discretionary searches if the police chief is black. Together, these findings indicate that race matters in multiple and varied ways for policing outcomes.
This paper provides evidence of racial variation in traffic enforcement responses to local government budget stress using data from policing agencies in the state of Missouri from 2001 through 2012. Like previous studies, we find that local budget stress is associated with higher citation rates; we also find an increase in traffic-stop arrest rates. However, we find that these effects are concentrated among White (rather than Black or Latino) drivers. The results are robust to the inclusion of a range of covariates and a variety of model specifications, including a regression discontinuity examining bare budget shortfalls. Considering potential mechanisms, we find that targeting of White drivers is higher where the White-to-Black income ratio is higher, consistent with the targeting of drivers who are better able to pay fines. Further, the relative effect on White drivers is higher in areas with statistical over-policing of Black drivers: when Black drivers are already getting too many fines, police cite White drivers from whom they are presumably more likely to be able to raise the needed extra revenue. These results highlight the relationship between policing-as-taxation and racial inequality in policing outcomes.
A growing body of research suggests that proximal exposure to immigration enforcement can have important social and health-related consequences. However, there is little research identifying the impact of proximal contact with immigration policy on political attitudes and behaviors, and still less investigating the underlying mechanisms that might connect contact and political dispositions. Drawing on insights from criminal justice, we argue that proximal immigration contact influences political behavior via a sense of injustice with respect to the discriminatory application of immigration enforcement. The impact of a sense of injustice should primarily hold among Latinos, who are targeted on the basis of race, ethnicity, accent, and skin color. Nevertheless, it may also hold among Blacks, whose communities are targeted more generally, and Asians, to whom issues related to immigration are likewise important. In order to assess this theory, we leverage a survey with nationally representative samples of four different racial groups. We find that proximal contact motivates participation in protests, and does so indirectly via a sense of injustice for white and Asian respondents. Latino and Black respondents are primarily motivated by injustice irrespective of contact. In sum, the results suggest that immigration enforcement and non-immigration-related criminal justice policies may have similar political effects on those who are proximately affected.