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To characterize institutional masking policies for healthcare personnel (HCP) and identify factors informing masking decisions in the post–COVID-19 pandemic era.
Design:
Cross-sectional, survey-based study.
Setting:
Healthcare institutions participating in the Society for Healthcare Epidemiology of America (SHEA) and Association for Professionals in Infection Control and Epidemiology (APIC) Research Networks.
Participants:
One representative per institution, including infection preventionists, hospital epidemiologists, or healthcare administrators, knowledgeable about organizational masking policies.
Methods:
A structured, web-based survey was distributed through the SHEA/APIC Research Networks. Survey domains included institutional characteristics, masking strategies outside of transmission-based precautions, epidemiologic and operational factors influencing masking decisions, and mask types required. Responses were collected anonymously via REDCap over a six-week period and analyzed descriptively.
Results:
A total of 172 unique healthcare institutions completed the survey (41% response rate, n = 172/425). Most respondents were infection preventionists (65%) or hospital epidemiologists (25%). The most common masking approach was a seasonal or situational risk-based strategy (57%), while 7% of institutions reported no formal masking policy. Among institutions using seasonal or situational masking, decisions were most frequently informed by outbreaks or clusters (37%), public health guidance (33%), and HCP illness/absenteeism (27%). Most institutions reported no fixed epidemiologic thresholds for masking decisions. When masking was required, surgical masks were most commonly used (98%).
Conclusions:
Masking policies and decision-making criteria vary widely across healthcare institutions, reflecting a lack of standardized operational guidance. These findings underscore the need for consensus-based, data-driven frameworks to support consistent, transparent, and evidence-informed masking policies in healthcare settings.
Since the late twentieth century, institutional autonomy has become a major issue in the relationship between the government and higher education institutions, with autonomy being presented as a virtuous option that satisfied both government’s regulatory aims and institutional capacities to develop in an increasingly dynamic and complex sector. Due to concerns about the effectiveness of higher education, the development of autonomy was increasingly linked to a market-like logic, with a growing emphasis on competition and efficiency. Thus, what was initially regarded as a path to emancipation of institutions from government’s influence became a mode of relationship that could curtail previous dimensions of autonomy. One of the major regulatory dimensions that helps understand the reversals and nuances of institutional autonomy is funding. Like other regulatory dimensions, recent decades have seen the emergence of new forms of funding that have influenced institutional governance and management. In this text, we analyse these trends in European higher education by mapping changes in governments’ approaches to the sector, specifically the evolution of funding mechanisms and how these highlight a shift in the pendulum between degrees of autonomy and modes of government’s influence in institutions.
Burnout arises from prolonged, unresolved work-related stress and adversely affects professional performance and overall well-being. Resident doctors and medical students are particularly vulnerable because of the demands of balancing clinical, academic and related responsibilities.
Aims
This study aimed to assess self-reported burnout and related stressors among UK resident doctors and medical students, and estimate the economic impact of burnout-related absenteeism among resident doctors.
Method
Self-report questionnaires assessing burnout and related stressors were distributed to UK resident doctors and medical students. A total of 2793 responses were received: 1439 (51.5%) from resident doctors and 1354 (48.5%) from medical students. Economic losses from absenteeism were calculated with a human capital approach.
Results
Burnout was reported by 70% (n = 1008) of resident doctors and 65.7% (n = 889) of medical students. Notably, 56.8% (n = 573) and 79.3% (n = 705) of resident doctors and medical students affected by burnout, respectively, were unaware of available support services. Relocation stress (85.1% of residents and 62.6% of students), financial stress (53.9% of residents and 57.8% of students) and poor work–life balance (32.1% of residents and 20.7% of students) were commonly reported. The annual economic burden of absenteeism related to burnout among resident doctors was estimated to reach £251.5 million.
Conclusions
Burnout among UK resident doctors and medical students may reflect a combination of underlying factors, including financial strain, relocation stress and difficulties with work–life balance. These findings underscore the need for targeted interventions that support well-being and address financial and relocation challenges, which may, in turn, help prevent burnout and improve retention within the medical workforce. Reducing burnout and associated stressors may also help lessen its economic impact, allowing resources to be redirected towards patient care.
Is it permissible to implicate non-epistemic values in the ‘core’ of scientific reasoning? This paper offers an appraisal of Parker’s (2024) Epistemic Projection Approach (EPA) prescribing acceptable relations between epistemic and non-epistemic values in research conduct. Non-epistemic values are granted a role in determining epistemic characteristics for a research project but are meant to be ‘screened off’ from core research decisions via epistemic projection. This discussion takes the EPA for a test drive. We identify three challenges to its conceptual and practical viability and show how EPA currently lacks resources to address them, indicating a need for further development.
Oswald Spengler’s Der Untergang des Abendlandes (The Decline of the West) gave expression to a pervasive feeling of cultural crisis in early twentieth-century European intellectual life. Perhaps unsurprisingly given his reactionary politics and nationalist sympathies, Spengler’s work met with a muted reception in metropolitan France. More open to his message were members of imperial France’s modest colonial intelligentsia; Spengler’s French translator was Mohand Tazerout (1893–1973), an Algerian-born World War I veteran, schoolteacher, and aspiring sociologist. This article tells the story of The Decline of the West’s initial appearance in French before exploring Tazerout’s own intellectual project, which both built on and reached beyond Spengler’s thinking. Contemporary and subsequent North African intellectuals were no less drawn to themes of cultural decline and renewal; however, the unique circumstances that pushed Tazerout to embrace Spengler’s ideas were quickly swept away in a vortex of postcolonial contention.
During the past few decades, higher-education and research systems have been experiencing profound waves of reformed governance and organization resulting in a stronger emphasis on hierarchy, more well-defined boundaries between universities as organizational actors and their environments, more rigorous performance measurements at the organization level and a changed political control. Administration has been centralized and relations between academic and administrative staff have been transformed. Changes in university governance are sometimes described as a shift from collegiality to enterprise management. However, in previous studies we have found that this development could rather be described as a remixed governance. Universities are subject to mixed modes of governance related to the many tasks and missions they are expected to fulfil. Mixed modes of governance also stem from reforms based on widely held ideals of governance and organization. Much previous research has analysed the changing roles and influence of faculty and leadership that follow on these reforms. The diverse modes of governance also imply diverse roles for administration. Furthermore, with mixed modes of governance, the roles of administrators and their relations with academic faculty may vary depending on issues and situations. Based on observations of the governance mix of universities, in this article I ask: administration for what, how and by whom?
While immigration status is often arbitrarily ascribed, the moral meanings of undocumented status are central in the growing polarization and punitiveness of immigration politics in the United States. How do political actors construct the moral meanings of undocumented status and reason their preferred redresses? Existing substantialist approach’s search for a coherent list of moral traits is unable to locate the basis of such construction. Through interviews with a multiracial group of 65 Democratic and Republican activists, this paper identifies the relational meaning-making process underlying the construction of migrant morality, which I label as “Folk Durkheimian.” I find that, like Durkheim, activists believe that law exists to uphold social solidarities and therefore legal categories mark people as belonging or threatening to the social body. I further find that activists construct belonging and threat along two axes: similarity and division of labor. As both Democratic and Republican activists construct migrants as simultaneously belonging and threatening on different axes, both prefer the ambivalent redress of pathways to citizenship for a limited subset of migrants. This Folk Durkheimian understanding advances a relational and integrated framework for understanding morality, group politics, and punitive attitudes.
Can feelings of loneliness and depression be adaptive for adolescents? Yes, suggests the Evolutionary Theory of Loneliness: initially, loneliness activates depressive responses for self-preservation. In turn, these feelings prepare adolescents for reaffiliation, thereby reducing loneliness (H1a: short-term balancing feedback loop). If this fails, loneliness and depressive symptoms may become long-term traits that exacerbate each other over time (H1b: long-term reinforcing feedback loop). Therefore, the short-term balancing feedback loop between loneliness and depressive symptoms may buffer against their long-term increases (H2: across-timescale influence). We tested these hypotheses in Dutch adolescents (Mage_Wave1 = 12.9, SDage_Wave1 = 0.7, 53% female) using six-wave, half-yearly panel data (N = 774; 2017–2021) and 7-day, 1.5-hourly experience sampling data (nsubsample = 84; mid-2021). Residual dynamic structural equation modeling revealed reinforcing feedback loops at both short-term (1.5-hourly) and long-term (half-yearly), supporting H1b but not H1a. Bayesian latent change score modeling supported H2: Adolescents who felt more depressed an hour after heightened loneliness showed smaller half-yearly increases in trait loneliness. However, this buffering effect was not predicted by the hourly depressed-to-loneliness relation, nor did either hourly relations predict half-yearly changes in depressive symptoms. Our findings suggest that feeling depressed shortly after loneliness may protect adolescents from long-term loneliness.
We assessed if supplementation of an obese-inducing diet with yellow pea fibre throughout pre-pregnancy (PP), gestation, and lactation could influence maternal gut microbiome composition and improve metabolic health and liver steatosis in newly weaned rat male and female offspring. Forty female Sprague-Dawley rats were fed a low (CON) or high (HC) calorie diet for a 6-week PP period. At the end of PP, HC animals were randomly assigned to either remain on the HC diet or the HC diet with yellow pea fibre (HC + FBR) for an additional 4-weeks prior to mating and throughout gestation and lactation. At the end of lactation, caecal microbiome profile was evaluated in mothers with shotgun metagenomic sequencing, and newly weaned male and female pups were assessed for serum biochemistry and hepatic fat outcomes. Maternal obesity reduced the beta-diversity of the maternal microbiome and lowered total caecal short-chain fatty acid (SCFA) concentration. HC + FBR consumption increased caecal SCFA concentration and differentially altered the maternal caecal microbiome profile of several species that have been linked with hepatic steatosis including Bifidobacterium pseudolongum, Porphyromonas gingivalis, and several Provetella species. Newly weaned offspring from HC mothers exhibited hepatic steatosis; however, male and female pups from HC + FBR mothers demonstrated normalised liver lipid concentrations (cholesterol and triglyceride) and an increase in caecal acetate and propionate concentrations. Findings suggest that maternal obesity enhances the risk of liver steatosis in offspring and that maternal dietary fibre supplementation may have a protective influence that is partly mediated through changes in the caecal microbiome profile and activity.
Formal thought disorder (FTD) is a highly disabling transdiagnostic feature that impedes communication and social ties. Progress in understanding and treating FTD has been hampered by the uncertainties in its assessment.
Aims
We examined if a short 3–5min assessment of transcribed speech can capture the latent dimensions and network structure of FTD and predict functional outcomes.
Method
In a transdiagnostic sample (N = 666) with a single longitudinal follow-up over 3–12 months (n = 244), we administered the short form of the Thought and Language Index to measure eight individual features of FTD. We determined the baseline factor structure of FTD, its temporal invariance at follow-up, and the predictive validity of FTD dimensions on the global single-item Social and Occupational Functioning Assessment Scale scores at baseline and follow-up. We identified the most influential and putative primary phenomena within the FTD syndrome, using network analysis.
Results
Factor analyses revealed a stable three-factor model of FTD: impoverishment (poverty of speech, weakening of goal), loosening (looseness, illogicality) and peculiarities (peculiar words, peculiar sentences), with excellent fit (Comparative Fit Index: 0.997, root mean square error of approximation: 0.040) and metric invariance over time. Impoverishment and peculiarities predicted functioning at baseline and 3–12 months later (cross-sectional: β = –0.196, p < 0.001 and β = –0.298, p = 0.001, respectively; longitudinal: β = –0.201, p = 0.037 and β = –0.336, p = 0.042, respectively). Looseness and poverty of speech were putative primary features influencing other FTD phenomena. Weakening of goal and peculiar sentences were the most connected phenomena.
Conclusions
By integrating latent variable and network approaches, we provide a unified, empirically grounded framework to interpret FTD assessed using a brief speech task. We report a replicable three-dimensional structure, identify central symptoms that may maintain the FTD syndrome, and the specific dimensions that influence functional disability. These findings clarify the prognostically valuable features of FTD for future mechanistic and interventional research.
A cosmopolis may be understood as a durable, cross–regional cultural–political order in which a prestigious bridge language provides the central anchor and the shared medium for knowledge, cultural authority and institutional practice across multilingual settings. In this article I hypothesise that, in the early 21st century, English in international employ is beginning to occupy a socio–cultural position comparable in certain respects to that of the pre‑modern formations associated with Sanskrit, Latin and Classical Arabic. To examine this possibility, I begin with a deliberately broad, first‑pass identification of the most salient cosmopolis features, limiting the analysis to the characteristic profile of the prestige bridge language that underwrites each cosmopolis. I then consider whether a comparable profile plausibly holds for global modern English, drawing on existing research on its global role. The results are preliminary, but they suggest that this perspective may offer a useful analytical lens for investigating English in its present sociolinguistic position, and that it merits more systematic follow‑up work.
People with severe mental illness (SMI) are more likely to develop long-term physical health conditions compared with those without SMI, contributing to an inequality in life expectancy. Chronic kidney disease (CKD) is a growing global health concern set to be the fifth leading cause of life-years lost by 2040. Although people with SMI may have a higher risk of CKD, there is limited research exploring the relationship between CKD and SMI.
Aims
This review aimed to examine the prevalence, incidence and risk of CKD among people with SMI.
Method
We searched Medline, Embase, PsycINFO, CINAHL, Scopus and Web of Science for epidemiological research reporting the prevalence of CKD (of any stage according to Kidney Disease Improving Global Outcomes guidelines) among people with SMI. Records were imported into Covidence and screened by two reviewers. Meta-analyses were conducted using random-effects models to examine the prevalence, incidence and risk of CKD among people with SMI.
Results
Forty-eight studies were included in the review. The pooled prevalence of CKD was 8% in studies of people with SMI (95% CI 5%, 18%) and was highest in studies focused only on participants with bipolar disorder (95% CI 0.15 (0.06, 0.26)). The pooled incidence rate of CKD was 26.83 cases (95% CI 18.66, 38.58) per 1000 person-years. People with SMI had significantly higher odds of CKD compared with those without SMI (odds ratio 2.33 [95% CI 1.70, 3.21]).
Conclusion
People with SMI are at a significantly higher risk of having CKD compared with those without SMI. Although psychiatric medication and high rates of diabetes may play a role, the drivers of this inequality are under-researched.