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To model the impact of a badge system on hand hygiene and the impact of increased compliance rates on HAIs with the associated cost savings.
Setting:
We consider a variable number of targeted beds within a hospital.
Methods:
Using a Markov chain model, we estimate the effect of hand hygiene compliance on HAI transmission over the course of a year. Based on a given level of compliance, the estimated savings are also calculated.
Results:
With each 10% increment increase in compliance, we estimate a decrease in approximately 7.5 HAIs per year per 100 targeted beds. A 10% increase above baseline in compliance also results in around $100,000 cost savings per year per 100 targeted beds.
Conclusions:
Due to the relative low cost of implementation and upkeep to the badge system, the reduction in HAIs and increase in cost savings make the badge system a worthwhile addition.
We extend the construction of the p-adic L-function interpolating unitary Friedberg–Jacquet periods in previous work of the author to include the p-adic variation of Maass–Shimura differential operators. In particular, we develop a theory of nearly overconvergent automorphic forms in higher degrees of coherent cohomology for unitary Shimura varieties generalising previous work for modular curves. The construction of this p-adic L-function can be viewed as a higher-dimensional generalisation of the work of Bertolini–Darmon–Prasanna and Castella–Hsieh, and the inclusion of this extra variable arising from the p-adic iteration of differential operators will play a key role in relating values of this p-adic L-function to p-adic regulators of special cycles on unitary Shimura varieties.
It is overdue for political science to consider the names of nation-states, the discipline’s primary unit of analysis and the world’s largest, richest, and most powerful actors. I begin this analysis by examining the descriptors used in formal country names, including empire, kingdom, Islamic, republic, democratic, socialist, and people’s. I analyze country names as independent variables, hypothesizing that they have value as signals of political characteristics. To test my hypotheses, I turn to the Varieties of Democracy dataset. I use fixed-effects panel regressions to examine whether countries’ descriptors correlate with the characteristics they name. I find that except for the democratic descriptor, all other descriptors are surprisingly accurate. This is the first step toward developing an understanding of names in political science as well as adding a new tool for comparative politics.
A ‘dialogue model’ of a bill of human rights has been enacted under Australian Human Rights Acts in the Australian Capital Territory, Victoria and Queensland. This model includes obligations imposed on public authorities or public entities to act compatibly with human rights (substantive obligation) and to give proper consideration to relevant human rights (procedural obligation). Reviews of compliance with these ‘conduct obligations’ have proven the most successful avenue in human rights litigation to date. This article examines the conduct obligations through the lens of four recent significant judicial review cases – Thompson v Minogue (2021) 294 A Crim R 216, Davidson v Director-General, Justice and Community Safety Directorate (2022) 18 ACTLR 1, Owen-D’Arcy v Chief Executive, Queensland Corrective Services (2021) 9 QR 250, and Johnston v Carroll; Witthahn v Wakefield; Sutton v Carroll [2024] QSC 2. The article critiques two issues: (1) the substantive obligation and judicial rejection of the concept of weight and latitude being granted to a decision-maker; and (2) the procedural obligation and judicial rejection of proportionality factors as mandatory relevant considerations. It concludes that, despite these contestable issues, the jurisprudence has reached a certain level of maturity and relative consistency.
Hospital epidemiologists and infection prevention professionals are frequently required to make high-stakes decisions in complex clinical scenarios where evidence-based guidance is limited or absent. These decisions often carry significant implications for patient safety, healthcare worker protection, hospital operations, and legal or financial risk. This article presents three challenging cases originally featured during the “Interesting Cases” session at the Society for Healthcare Epidemiology of America (SHEA) Spring 2025 Conference, with the goal of sharing practical lessons learned and contributing to the evolving literature in healthcare epidemiology. The first case describes the intraoperative contamination of a polyethylene liner during emergency revision total hip arthroplasty, highlighting limited data guiding implant salvage and the role of antiseptic decontamination, interdisciplinary communication, and institutional preparedness. The second case examines infection prevention risks associated with a temporary hospital heating, ventilation, and air conditioning (HVAC) shutdown during a COVID-19 surge, emphasizing the use of real-time ventilation assessment tools such as carbon dioxide monitoring to guide mitigation strategies. The third case details the application of failure mode and effect analysis (FMEA) to develop an infection prevention and control policy for the educational use of non-transplant cadaveric tissue in patient care areas—an area with no existing guidelines. Collectively, these cases illustrate the realities of decision-making under uncertainty in hospital epidemiology and demonstrate how structured risk assessment, proactive planning, and cross-disciplinary collaboration can mitigate potential harm. Sharing these experiences provides practical insights and reinforces that, even in the absence of definitive guidance, systematic approaches can support safe infection prevention decision-making.
Between 2000 and 2019, Portugal and Spain adopted divergent youth-oriented active labor market policies (ALMPs) to address rising youth unemployment. Drawing on data from the LABREF database, National Reform Programmes, and key economic indicators, we show that Portugal targeted higher education graduates with internship and innovation schemes aligned with its transition to a knowledge-based economy. In contrast, Spain developed a dual vocational education and training system centered on apprenticeships to support its manufacturing sector. These contrasting approaches reflect distinct national growth strategies and demonstrate how governments shape ALMPs in line with broader economic objectives. The findings offer a comparative perspective on policy divergence in Southern Europe and highlight the role of growth strategies in explaining variation in activation policies, even among countries with similar institutional and macroeconomic conditions.
Expert-produced information and data hold significant potential for adoption by decision-makers; however, this potential can be compromised by barriers related to language, communication channels, and formats. The literature emphasizes the differing languages, timelines, and incentives between specialists and lay decision-makers who seek practical solutions to real-world issues, rather than theoretical dilemmas. We conducted a mixed-method study, based on a survey and interviews with Italian regional lawmakers and local decision-makers in land-use planning. This is an area characterized by high levels of technicality and hence appears challenging to most decision-makers. We discovered that when they easily grasp the meaning and implications of policy documents, their understanding seems more influential in their legislative behavior. Consequently, a key challenge in promoting evidence-informed policy-making seems to translate expert knowledge into accessible languages and codes for laypeople and to present it in practical and concise ways.
Double white dwarf (DWD) binaries are natural outcomes of binary stellar evolution and key sources for future space-based gravitational wave (GW) observatories such as Laser Interferometer Space Antenna (LISA). We investigate how different binary interaction channels shape the physical and orbital properties of DWD systems, focusing on component masses, orbital separations, core compositions, and mass transfer rates. Using the binary population synthesis code COMPAS, we evolve 107 binaries with physically motivated initial distributions of binary parameters. Our simulations reproduce the strong bimodality in the final orbital separations, including a pronounced deficit of systems around 100−500 R⊙, arising from distinct evolutionary pathways: wide DWDs predominantly originate from stable Roche lobe overflow (RLOF), while close DWDs form through unstable RLOF leading to at least one common envelope (CE) phase. Moreover, we show that the core compositions of WDs provide a powerful tracer of evolutionary history: He-core WDs are strongly concentrated in close systems, whereas CO-core WDs span the full separation range and exhibit a small mass gap in wide binaries. We further identify a correlation between the accreted mass and the final orbital separation, highlighting the impact of non-conservative mass transfer on the resulting orbital configuration of DWD systems. These results underscore the links among evolutionary channels, chemical composition, and mass transfer rates; thereby provide a unique framework for interpreting Gaia DWD samples and forecasting the joint electromagnetic and GW population accessible to LISA.
Comment les professionnels du droit et de la médecine construisent-ils, au tribunal, le statut légal et l’état mental des patients, et comment ces derniers participent-ils à ces constructions? Cet article s’appuie sur l’analyse de 300 audiences à Paris et à New York, au cours desquelles des personnes hospitalisées sans consentement demandent leur sortie. Dans les deux villes, les tribunaux rejettent la grande majorité des requêtes. Ils le font en mobilisant, selon des modalités propres à chaque système, des répertoires juridiques et des capacités de contrôle qui transforment les patients en différents types de sujets utilisables: des personnes dont les droits sont formellement pris en compte à l’audience, mais qui sont néanmoins classées comme nécessitant les interventions sans consentement que la psychiatrie a les moyens d’assurer. À Paris, les professionnels du droit insistent sur les garanties procédurales tout en s’en remettant aux évaluations médicales du consentement des patients, entendu comme une disposition sous-jacente à accepter un traitement au long cours. À New York, les avocats contestent plus directement l’expertise psychiatrique, mais négocient avec médecins et patients autour de la compliance, comprise comme une acceptation de court terme de la médication. L’article propose ainsi de déplacer le regard des figures de sujets autonomes que les dispositifs médico-légaux et sociaux hybrides prétendent produire vers des formes plus contingentes et situées de sujets utilisables, qui rendent possible la coopération professionnelle et le traitement institutionnel dans un contexte de ressources limitées et d’extension des droits des patients.
In an era of globalization, increasingly interconnected labor markets have intensified competition for skilled talent, particularly among countries in the Global North such as Canada. While Canada’s immigration policy prioritizes education and professional experience, these same credentials are often devalued upon arrival, as systemic barriers limit access to commensurate employment. This study examines the employment experiences of skilled, racialized immigrants in British Columbia, exploring how institutional narratives of meritocracy conceal exclusion, credential systems reinforce epistemic hierarchies, and settlement services pathologize migrant experiences. Using a qualitative design with four focus group discussions (n = 18), the study integrates critical migration theory, intersectionality, and decolonial social work to analyze the structural marginalization of skilled, racialized immigrants. Findings reveal a central paradox: the very system that celebrates global talent simultaneously erodes its value through credential gatekeeping, discriminatory hiring practices, and labor market practices that privilege local over global expertise. By situating these barriers within broader colonial and epistemic hierarchies, the study argues that integration must be understood not as individual adaptation but as institutional transformation. It contributes to critical debates on skilled migration, equity, and the reproduction of colonial logics within Canada’s labor market.
One third of greenhouse gas emissions comes from the production, distribution and disposal of food. Animal products generally have a higher environmental footprint than plant-based foods, with grains, fruits and vegetables having the lowest impact and ruminant meat having the highest. Reducing meat consumption benefits the environment – but also improves health outcomes; for example, reducing the risk of cardiovascular disease and cancer. Consumers have some degree of freedom in their daily behaviour and can contribute to both planetary sustainability and personal health through their food choices. In this article, we focus on consumers as key actors in the food system and propose a framework for communication goals to stimulate changes in food choices. We argue that communication efforts need to (1) frame food choices as both healthy and sustainable (‘dualistic framing’), and (2) inform about the health and sustainability consequences of food choices. Moreover, we argue that communication efforts also need to (3) support the socio-emotional readiness to make healthy and sustainable food choices, for example by emphasizing the hedonic value of plant-based foods. The conceptual framework will be useful both to inspire future research and guide practical campaign work.
This paper presents the design and evaluation of reflectarray antennas at spherical surfaces aimed at achieving an optimal compromise between electrical performance and mechanical deployability for satellite antenna solutions based on offset reflector configurations. By implementing printed reflectarray elements on a spherical surface, the phase-shifting elements mitigate spherical aberration, leading to enhanced focusing capabilities comparable to those of parabolic reflectors. The spherical geometry inherently simplifies the folding mechanism due to the rotational symmetry of the reflecting surface and minimizes the differential spatial phase delay, improving the reflectarray in-band performance. Simulation results demonstrate that large-aperture spherical reflectarrays can replicate the gain and beam quality of parabolic reflectors with smoother phase distributions than flat or multifaceted reflectarrays. The integration of spherical reflectarrays in dual-antenna configurations is evaluated to realize compact and efficient antenna systems for next-generation satellites.
The COVID-19 pandemic caused by the SARS-CoV-2 virus was the biggest global health emergency in the past century. The impact of the pandemic on society, and demand for health services, especially mental health services is not fully understood.
Aims
We describe the change in activity in a single UK NHS mental health trust during and following the pandemic.
Method
We conducted a retrospective service evaluation using a population-based referral rates and clinical activity for mental health disorders in Cambridgeshire over the period 1 January 2017 to 31 December 2023. We divided the time period into pre-pandemic period, during the pandemic, and post-pandemic months. A negative binomial regression model was fitted to the monthly rates to yield incidence rate ratios. Subgroup analyses were performed by age, gender, ethnicity, and level of deprivation.
Results
There was a steep decline in both referrals and clinical contacts during the lockdowns with a subsequent and steep increase in these measures during the immediate post-pandemic period. Increased numbers of referrals and contacts have been sustained well into the post-pandemic period.
Conclusions
In a single county-wide mental health service in the UK, the prolonged and sustained increase in both referrals and activity post-pandemic was not matched by equal increase in resource to meet demand. Our findings may be useful to effectively plan mental health services before, during and after any future pandemics.
This essay develops the notion of Dark Pedagogy as a framework for responding to climate and ecological disruption. It begins with the claim that climate breakdown exemplifies the metacrisis: a structural condition in which the very knowledge of ecological catastrophe coexists with inaction, denial, or disavowal. Climate disruptions thus reflect not only material devastation but also the erosion of social, political and cognitive frameworks that normally enable collective response. Dark Pedagogy foregrounds the parallel between the metacrisis and the psychological dynamics of disavowal, showing how familiar narratives of progress, harmony and control both obscure ecological realities and perpetuate ineffective responses. Against educational approaches that rely on hope or reassurance, Dark Pedagogy emphasises dwelling with unsettling affects as a means of confronting the uncanny instability of the world, using Giacomo Leopardi’s reflections on nature as an exemplary case. Anguish, in this context, is treated not as a symptom to be overcome but as a critical signal: it reveals the fragility of our assumptions, alerts us to the limitations of familiar frameworks and opens a horizon for education rooted in reflection, ethical engagement and attentiveness to the unpredictable, often hostile realities of the current geological era.
On July 11, 1924, the Lincoln reached Angel Island, the desolate and remote location of the infamous immigration station in California. Aboard the ship were nine Chinese wives, hopeful that they would soon reunite with their spouses who had preceded them to the United States. Until then, despite harsh immigration laws, many Chinese women had been admitted to the country because they were married to noncitizen merchants or to American citizens. Building on coverture principles that a man’s care and comfort were so important that his wife’s status should follow his, Chinese husbands had often argued successfully that their right to reunite with their families took precedence over existing immigration laws, which excluded Chinese immigrants because of their race. It was these laws, they contended, that had forced many Chinese migrants into transnational marriages in the first place. Despite these precedents, the immigration officers who inspected the women on the Lincoln rejected them all, regardless of their age, education, and class.
Managers confronting important strategic decisions often receive diagnostic information sequentially over time. As new information becomes available, they may need to update their understanding of the situation and possibly revise their preferences. During a decision, as a preference develops for one alternative course of action, a nonconscious goal of maintaining consistency between that preference, however tentative, and the new information can lead to an interpretation of that information so as to support the current preference. This tendency to bias or distort information to support the currently preferred option can in turn lead to even greater confidence in that leading option, despite the increase in confidence being unwarranted by the information itself. The result of such a biased decision process can be overconfidence in the chosen course of action. To show this, in the current work, experienced managers engaged in a realistic business decision task with their levels of information distortion and confidence tracked throughout the decision. Over the course of the decision, confidence in the leading action increased as a function of distortion. The results confirmed that distortion-driven confidence can develop even when decision makers have no prior preference for one of the outcomes.
The effect of a smooth surface hump on laminar–turbulent transition over a swept wing is investigated using direct numerical simulation (DNS), and results are compared with wind tunnel measurements. When the amplitude of incoming crossflow (CF) perturbation is relatively low, transition in the reference (without hump) case occurs near $53\,\%$ chord, triggered by the breakdown of type I secondary instability. Under the same conditions, no transition is observed in the hump case within the DNS domain, which extends to $69\,\%$ chord. The analysis reveals a reversal in the CF velocity component downstream of the hump’s apex. Within this region, the structure and orientation of CF perturbations are linearly altered, particularly near the wall. These perturbations gradually recover their original state further downstream. During this recovery phase, the lift-up mechanism is weakened, reducing linear production, which stabilises the stationary CF perturbations and weakens spanwise gradients. Consequently, the neutral point of high-frequency secondary CF instability modes shifts downstream relative to the reference case, leading to laminar–turbulent transition delay in the presence of the surface hump. In contrast, when the amplitude of the incoming CF perturbation is relatively high, a pair of stationary counter-rotating vortices forms downstream of the hump. These vortices locally deform the boundary layer and generate regions of elevated spanwise shear. The growth of secondary instabilities in these high-shear regions leads to a rapid advancement of transition towards the hump, in agreement with experimental observations.