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We conducted a quantitative analysis of the microbial burden and prevalence of epidemiologically important pathogens (EIP) found on long-term care facilities (LTCF) environmental surfaces.
Methods:
Microbiological samples were collected using Rodac plates (25cm2/plate) from resident rooms and common areas in five LTCFs. EIP were defined as MRSA, VRE, C. difficile and multidrug-resistant (MDR) Gram-negative rods (GNRs).
Results:
Rooms of residents with reported colonization had much greater EIP counts per Rodac (8.32 CFU, 95% CI 8.05, 8.60) than rooms of non-colonized residents (0.78 CFU, 95% CI 0.70, 0.86). Sixty-five percent of the resident rooms and 50% of the common areas were positive for at least one EIP. If a resident was labeled by the facility as colonized with an EIP, we only found that EIP in 30% of the rooms. MRSA was the most common EIP recovered, followed by C. difficile and MDR-GNR.
Discussion:
We found frequent environmental contamination with EIP in LTCFs. Colonization status of a resident was a strong predictor of higher levels of EIP being recovered from his/her room.
Ridicule is often understood as an instrument used by an agent to accomplish a goal. This article, however, investigates ridicule as an indexical phenomenon, a social meaning activated for certain participants in particular situations. Through a detailed analysis of interviews with a scientist, this study shows how storytelling, stance-taking, and entitlement practices help shape the experience of ridicule and the situations where it occurs. The scientist experiences a joke about her research as ridicule when it is reported in the news but experiences the same joke as rapport when it is told by colleagues in the lab. The article demonstrates that the meanings and purposes of humor do not inhere in jokes, and joking rights do not inhere in people; they are negotiated and accomplished in interaction. Drawing on an indexical understanding of context, it further shows how the experience of situations shapes and is shaped by discourse. (Narrative, stance, entitlement, indexicality, humor, literacy, scientific popularization)*
Chatbots, conversational agents providing access to information and services through interaction in everyday language, can make essential health information and services more accessible, available, and affordable. Kati Collective, together with Meta, worked to identify, outline, and develop some of the most critical tools and processes required to leverage chatbots for social good with a focus on health. The results of this work are compiled in a comprehensive, modular playbook. We propose to share our learnings and guide participants of our session to explore the existing uses, benefits, trade-offs, and challenges of using chatbots in disaster medicine.
Methods
There are significant challenges and barriers to scale, impact, and sustainability of their chatbot interventions. In response to these challenges, we used a participatory design process, landscape analysis, desk research and interviews with key stakeholders in the digital for development space to inform which content to include and in what format to best connect information to action.
Results
The Playbook contains key information, tools, exercises, and resources organized into four interrelated modules based on barriers and enablers.
Conclusions
This Playbook is particularly relevant in analysis, planning, strategizing and design phases of the chatbot project lifecycle and is highly extensible to disaster medicine.
The past decade has seen mass emigration of Hungarians from Serbia to the kin-state and Western European countries. This has resulted in new ways of understanding what it means to belong to the community, both empirically and in terms of theorizing it, and both for those in Serbia and those abroad. This article claims that there are virtual platforms where members of this ethnic community (re)create their identities, and that this happens through relating to certain common themes. For this reason, I analyze the common themes of two humorous Facebook pages – namely, rurality, food, language use, ethnic others, and crossing borders – popular among Vojvodina Hungarians. The article argues that these elements of identity connect members of the community who live in Vojvodina and those who have emigrated to the kin-state or diaspora. Therefore, in order to unpack the complex dynamics of identification of a national minority community with high diasporic tendencies, an approach that connects the above topics to the concepts of community, nostalgia, home, minority, and borders, and in more general terms the lens of national minority and diaspora studies is needed.
Much like nations, the nation-based order and the domestic and international hierarchies it produces are imagined. Benedict Anderson and scholars in Historical International Relations have frequently approached nationalism and nations as a horizontal division of the world. By contrast, this article explores the imagined hierarchies within and between nations during the 1848 Springtime of Nations. Through an examination of fraternal images found in a variety of textual and visual sources, I investigate how the European national imaginary of 1848 translated into the nation-based order and its corresponding domestic and international hierarchies. The collapse of the 1848 Revolutions brought about a crisis in the national imaginary. The revolutionary fraternity was co-opted in a distorted form by dynastic regimes and opposed by socialists advocating for the international brotherhood of workers. The Springtime of Nations, with its successes and failures, was a pivotal chapter in creating, shaping, legitimising, and challenging the nascent nation-based order.
A six-month-old boy with Down syndrome, complete atrioventricular septal defect with intact atrial septum, and moderate left-sided atrioventricular valve regurgitation underwent surgery. The presence of a common atrioventricular junction could not be diagnosed preoperatively. Postoperative left-sided atrioventricular valve regurgitation remained mild by complete cleft closure, direct closure of incised atrial septum, and patch augmentation of the underside of septum primum.
This study analyzes disparities in initial healthcare responses in Turkey and Syria following 2023 earthquakes.
Methods
Using Humanitarian Data Exchange, Crude Mortality Rates (CMR) and injury rates in both countries were calculated, and temporal trends of death tolls and injuries in the first month post- catastrophe were compared. WHO Flash Appeal estimated funding requirements, and ratios of humanitarian aid personnel in Urban Search and Rescue (USAR) teams per population from ReliefWeb and MAPACTION data were used to gauge disparities.
Results
56,051,096 individuals were exposed, with Turkey having 44 million vs 12 in Syria. Turkey had higher CMR in affected areas (10.5 vs 5.0/10,000), while Syria had higher CMR in intensely seismic regions (9.2 vs 7.7/1,000). Turkey had higher injury rates (24.6 vs 9.9/10,000). Death and injury rates plateaued in Syria after three days, but steadily rose in Turkey. Syria allocated more funding for all priorities per population except healthcare facilities’ rehabilitation. Turkey had 219 USAR teams compared to Syria’s six, with significantly more humanitarian aid personnel (23 vs 2/100,000).
Conclusions
Significant disparities in initial healthcare response were observed between Turkey and Syria, highlighting need for policymakers to enhance responses in conflict-affected events to reduce impact on affected populations.
This article analyzes the key factors behind the securitization of Ukraine’s small ethnic Hungarian minority in recent years and how they affect local interethnic as well as interstate relations. It draws on elite interviews conducted in the Ukrainian-Hungarian borderland, and other sources including speech acts. Four underlying factors were identified. The first two are Hungary’s kin-state aid and dual citizenship law, which have empowered Ukraine’s ethnic Hungarians, with the community appearing larger and potentially more threatening in the eyes of the majority population than its mere size justifies. The other two factors are Ukraine’s language policy and Transcarpathia’s future being subject of conspiracy theories in light of Russia’s invasion of eastern Ukraine, which have negatively affected interethnic ties, although somewhat less in the borderland than between Hungary and Ukraine at large. In Transcarpathia, our different informants had diverging perceptions of who is stirring tensions but agreed that actors from outside their region were to blame. Overall, what has emerged is a clash of Hungary’s kin-state politics and Ukraine’s nation-state-building efforts. The article ends with more general implications for kin- and host-state relations in times of conflict.
This study sought to compare terrorist attacks targeting healthcare in two different geographical areas that are economically and culturally similar: North America and Europe.
Methods
The Global Terrorism Database is a database that documents 214,666 worldwide terrorist events from 1970 to 2021. It was searched to identify terrorist attacks against healthcare using keywords. We manually excluded incidents that did not specifically relate to attacks on healthcare. This resulted in 311 and 150 entries in North America and Europe respectively.
Results
The most common method of attack in Europe was bombing (42%) compared to attacks on infrastructure (66%) in North America. The primary target in North America was abortion related (84%). In Europe, the primary target was businesses (37%). In Europe, 18.7% of attacks were assassinations or attempts vs 3% in North America. The total number of fatalities in Europe is 51 vs 3 in North America.
Conclusion
Even though there were significantly more attacks in North America, there were far fewer total fatalities compared to Europe. Attacks in North America appear to be ideological, targeting infrastructure to send a message. Whereas, in Europe, the targets and methods used are more targeted towards the individual and their property.
The international solidarity movement for the East Timorese was developed in Southeast Asian nations during the 1990s as ‘the issue of East Timor’ became a primary concern for the ASEAN countries’ civil society. Proponents of liberal democracy have assumed that international solidarity movements for human rights and democracy during the 1990s resulted from the powerful momentum of liberal democracy that universally linked foreign people. However, Michael Hardt, Antonio Negri and their marxist followers have explained these transnational movements as a transnational network that overcomes national borders against the capitalist Empire. Nevertheless, the political history of transnational solidarity movements from East Timor to Southeast Asia in the post-Cold War 1990s makes clear that nationalism has continued to be an ideological driver to link people from different nations.
Focusing on the international solidarity for the East Timorese independence struggle, this paper demonstrates a transnational function of nationalism through which international solidarity movements are created, resonate and function. The East Timor international solidarity struggle successfully created a transnational platform through the APCET conferences held in the Philippines, Malaysia and Thailand in the 1990s. Socio-historical analysis of APCET reveals that nationalists in Southeast Asia shared collective memories of national struggles beyond their spaces and times to create a transnational force to support self-determination for the East Timorese. Through its analysis, this article extends the theoretical framework of nationalism that has explained nationalist movements to serve as a more powerful tool to explain international solidarity in the age of globalisation. (247 words)
High-Fidelity training in triage for Mass Casualty Incidents (MCI) is resource intensive and therefore limited in frequency despite knowing that this skill degrades with time. Didactic classroom materials offer a non-resource-intensive introduction to foundational concepts, but the extent to which it can prepare providers for real world scenarios is limited. Virtual reality (VR) is an effective training alternative, but in its infancy of development and accessibility. To bridge the gap between these modalities, we propose a video-enhanced method to didactic training.
Methods
During Uniformed Service University’s (USU) annual Operation Bushmaster field exercise we produced video footage of individual casualties along with multiple casualty scenes consisting of several 5-15 second videos capturing various elements of a primary survey.
Results
The videos offer a higher-fidelity alternative to written casualty descriptions allowing the learner to visually process casualty presentation that is more representative of reality. The video segments facilitate thinking through specific points in the decision-making process for triage and life saving interventions.
Conclusions
Video enhanced didactic training offers a bridge between written didactic training and exercise or VR training for MCI triage skills acquisition and sustainment. Assessment and validation of this training methodology with various MCI responders is recommended.
The twenty-first century COVID-19 epidemic revealed a U.S. public health system that countenanced health inequities and a U.S. public that resisted disease containment policies. This crisis, however, was only the most recent chapter in a longer struggle in the United States to institutionalize public health. We focus on two early twentieth-century public health campaigns in the American South, the unhealthiest U.S. region at the time. Black southerners—denied basic health, political, economic, and social rights under a rising Jim Crow regime—self-organized health services networks, including through the Tuskegee Woman’s Club, the Negro Organization Society of Virginia, and the Moveable School (1890s–1915). Around the same time, a philanthropic project, the Rockefeller Sanitary Commission (RSC, 1909–1914), seeded state-level public health agencies in eleven southern states, thereby installing public health in a top-down manner. We use archival data sources to explore key similarities and differences in the public health concerns and coalition-building approaches of each campaign and southern resistance to their efforts. We find Black-led campaigns often blurred the color line to form coalitions that provided services to the underserved while tackling environmental health risks at the community level. In contrast, RSC affiliates in southern states, as directed by RSC administrators, provided health services as short-term public dispensaries. Services reached Black and White communities willing to participate but in a manner that did not overtly challenge Jim Crow-era practices. Southern resistance to public health expansion persisted under each approach. The legacies of these struggles remain; the political-economic and ideological forces that limited public health expansion while marginalizing Black community health efforts reverberate in public health inequities today.
Breast cancer is a major global health issue, especially among women. Previous research has indicated a possible association between psychiatric conditions, particularly schizophrenia, and an increased risk of breast cancer. However, the specific risk of breast cancer in women with schizophrenia, compared with those with other psychiatric disorders and the general population, remains controversial and needs further clarification.
Aims
To estimate the risk of breast cancer among people with schizophrenia compared with people with other psychiatric disorders and people in the general population.
Method
We utilised medical claims data of women aged 18 to 80 years in the Korean National Health Information Database from 2007 to 2018. Individuals with schizophrenia were defined as women with ICD-10 codes F20 or F25 (n = 224 612). The control groups were defined as women with other psychiatric disorders (n = 224 612) and women in the general Korean population (n = 449 224). Cases and controls were matched by index date and age, in a 1:1:2 ratio. We estimated the hazard of breast cancer using the Cox proportional hazards model, adjusting for insurance premiums and medical comorbidities. Among the people with schizophrenia, we used the landmark method to estimate the association between duration of antipsychotic medication use and the incidence of breast cancer.
Results
In multivariable Cox regression models, the hazard rate of breast cancer was 1.26 times higher in the people with schizophrenia than in the general population (95% CI: 1.20–1.32). In comparison with the psychiatric patient group, the hazard ratio was 1.17 (95% CI: 1.11–1.28). Among women with schizophrenia, the hazard of breast cancer was greater among those who took antipsychotic medications for 1 year or more compared with those who took antipsychotics for less than 6 months.
Conclusions
Women with schizophrenia have an elevated risk of breast cancer, and long-term use of antipsychotics is associated with an increased risk of breast cancer.
Across the globe, people who mobilize to protect their rights in highly oppressive contexts may have to navigate government institutions that not only fail to implement protections but also engage in discriminatory practices. This article introduces the term “circumventive legal resistance” to describe practices of making legally grounded claims but facilitating relief through processes of expression and negotiation that are distinct from explicit mechanisms of legal enforcement. Based upon a study of twenty-seven rural, semi-rural, and urban areas across the north and north-west regions of India, this article documents how Dalit women—from the most marginalized groups at the base of the caste pyramid—mobilize to protect their rights in contexts where local institutions do not enforce laws prohibiting caste discrimination and instead perpetrate caste-based forced labor practices. In particular, I focus on a campaign to end manual scavenging—a form of caste-based forced labor that is one of the worst surviving symbols of untouchability. With local channels to legal relief largely foreclosed, Dalit women who leave manual scavenging engage in circumventive legal resistance: they draw on law to make claims but win relief through avenues distinct from those envisioned within the parameters of the law.
Sergei Rachmaninoff is widely regarded as one of the great pianists of the twentieth century. In a research project that has stretched over two decades, I have compiled data on Rachmaninoff’s performance career, comprising research in archives as well as published sources in Russian and English languages. The resulting Rachmaninoff Performance Diary has been publicly available online since 2011. A missing link in the data has been the complete programmatic details of over 1,080 solo recitals. In 2006, I discovered research that was apparently unrecognized in its completeness in an archive of the Library of Congress, undertaken and donated by Rachmaninoff’s sister-in-law, Dr Sophia Satina. In this article, I examine the details of the 1924/25 season, which was a critical time for Rachmaninoff: after the collapse of his personal fortune caused by the Russian Revolution, he at last had achieved sufficient success and financial security from his hectic touring to allow him to return to composition the following year, his ‘sabbatical’ break of 1926. From the data, a clearer picture emerges of how Rachmaninoff varied his repertoire in his many concert appearances and recording sessions, showing how frequency of performance and, in instances, apparent self-assessment of his own music, were key factors.