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Previously reported associations between hospital-level antibiotic use and hospital-onset Clostridioides difficile infection (HO-CDI) were reexamined using 2012–2018 data from a new cohort of US acute-care hospitals. This analysis revealed significant positive associations between total, third-generation, and fourth-generation cephalosporin, fluoroquinolone, carbapenem, and piperacillin-tazobactam use and HO-CDI rates, confirming previous findings.
Maternal depression and anxiety are potential risk factors to children's language environments and development. Though existing work has examined relations between these constructs, further work is needed accounting for both depression and anxiety and using more direct measures of the home language environment and children's language development. We examined 265 mother-infant dyads (49.6% female, Mage = 17.03 months) from a large city in the Western United States to explore the relations between self-reports of maternal depression and anxiety and observational indices of the home language environment and expressive language as captured by Language Environment Analysis (LENA) and parent-reported language comprehension and production. Results revealed maternal depressive symptoms to be negatively associated with home language environment and expressive language indices. Maternal anxiety symptoms were found to be negatively associated with children's parent-reported language production. These findings provide further evidence that maternal mental health modulates children's home language environments and expressive language.
This article presents a study of the discursive politics of the COVID-19 outbreak in the United States and Russia from its early onset to 30 April 2020. We examine how official securitisation discourses in the two countries draw on gendered constructions of national identity and discuss what linkages and potential implications they have for the state, its policy, and its society. Our analysis shows that both the US President Donald Trump and Russia's President Vladimir Putin instrumentalise hierarchical gendered identities to securitise COVID-19. They mobilise gendered narratives, imageries, and practices to affirm particular understandings of the threat and create a homogeneous national ‘we’, portraying themselves as its guardians.
This is the first report on the association between trauma exposure and depression from the Advancing Understanding of RecOvery afteR traumA(AURORA) multisite longitudinal study of adverse post-traumatic neuropsychiatric sequelae (APNS) among participants seeking emergency department (ED) treatment in the aftermath of a traumatic life experience.
We focus on participants presenting at EDs after a motor vehicle collision (MVC), which characterizes most AURORA participants, and examine associations of participant socio-demographics and MVC characteristics with 8-week depression as mediated through peritraumatic symptoms and 2-week depression.
Eight-week depression prevalence was relatively high (27.8%) and associated with several MVC characteristics (being passenger v. driver; injuries to other people). Peritraumatic distress was associated with 2-week but not 8-week depression. Most of these associations held when controlling for peritraumatic symptoms and, to a lesser degree, depressive symptoms at 2-weeks post-trauma.
These observations, coupled with substantial variation in the relative strength of the mediating pathways across predictors, raises the possibility of diverse and potentially complex underlying biological and psychological processes that remain to be elucidated in more in-depth analyses of the rich and evolving AURORA database to find new targets for intervention and new tools for risk-based stratification following trauma exposure.
We report two cases of respiratory toxigenic Corynebacterium diphtheriae infection in fully vaccinated UK born adults following travel to Tunisia in October 2019. Both patients were successfully treated with antibiotics and neither received diphtheria antitoxin. Contact tracing was performed following a risk assessment but no additional cases were identified. This report highlights the importance of maintaining a high index of suspicion for re-emerging infections in patients with a history of travel to high-risk areas outside Europe.
A combination of ground-penetrating radar surveys, physical sedimentology and ice composition measurements has been used to characterize ice and sediment accreted to the southern margin of the McMurdo Ice Shelf, Antarctica. The radar data and surface observations show that the ice-shelf margin consists of strongly layered debris-rich ice that contains marine sediment and fossils. A modified Rayleigh-based distillation system has been used to model the isotopic fractionation from sea water to ice in a closed system. The model of ice formation is consistent with formation during almost complete freezing of a sea-water reservoir. By contrast, ice on the upstream side of the grounding line has formed during the early stages of freezing in which a small fraction of the sea-water reservoir has frozen. The model results and the presence of delicate, well-preserved marine fossils are interpreted as evidence of anchor ice formation on the seabed, and rafting of glaciomarine sediment into the bottom of the ice shelf. We argue that repeated accretion of sea water and marine sediment has produced a stacked sequence of ice and glaciomarine debris that forms shore-parallel ice-cored moraines.
Reattribution is frequently taught to general practitioners (GPs) as a structured consultation that provides a psychological explanation for medically unexplained symptoms.
To determine if practice-based training of GPs in reattribution changes doctor–patient communication, thereby improving outcomes in patients with medically unexplained symptoms of 3 months' duration.
Cluster randomised controlled trial in 16 practices, 74 GPs and 141 patients with medically unexplained symptoms of 6 hours of reattribution training v. treatment as usual.
With training, the proportion of consultations mostly consistent with reattribution increased (31 v. 2%, P=0.002). Training was associated with decreased quality of life (health thermometer difference −0.9, 95% CI −1.6 to −0.1; P=0.027) with no other effects on patient outcome or health contacts.
Practice-based training in reattribution changed doctor–patient communication without improving outcome of patients with medically unexplained symptoms.
To determine the prevalence and risk factors for bloodborne exposure and infection in correctional healthcare workers (CHCWs).
Cross-sectional risk assessment study with a confidential questionnaire and serological testing performed during 1999-2000.
Correctional systems in 3 states.
Among 310 participating CHCWs, the rate of percutaneous injury (PI) was 32 Pis per 100 person-years overall and 42 Pis per 100 person-years for CHCWs with clinical job duties. Underreporting was common, with only 25 (49%) of 51 Pis formally reported to the administration. Independent risk factors for experiencing PI included being age 45 or older (adjusted odds ratio [aOR], 2.41 (95% confidence interval (CI), 1.31-4.46]) and having job duties that involved needle contact (aOR, 3.70 [95% CI, 1.28-10.63]) or blood contact (aOR, 5.05 [95% CI, 1.45-17.54]). Overall, 222 CHCWs (72%) reported having received a primary hepatitis В vaccination series; of these, 150 (68%) tested positive for anti-hepatitis B surface antigen, with negative results significantly associated with receipt of last dose more than 5 years previously. Serologic markers of hepatitis В virus infection were identified in 31 individuals (10%), and the prevalence of hepatitis B virus infection was 2% (n = 7). The high hepatitis B vaccination rate limited the ability to identify risk factors for infection, but hepatitis C virus infection correlated with community risk factors only.
Although the wide coverage with hepatitis B vaccination and the decreasing rate of hepatitis C virus infection in the general population are encouraging, the high rate of exposure in CHCWs and the lack of exposure documentation are concerns. Continued efforts to develop interventions to reduce exposures and encourage reporting should be implemented and evaluated in correctional healthcare settings. These interventions should address infection control barriers unique to the correctional setting.