We updated a descriptive analysis of national outpatient antibiotic prescribing during the COVID-19 pandemic. Prescribing volume was lower during 2020 and January–June in 2021 and 2022 compared to corresponding baseline months in 2019. Prescribing approached or exceeded baseline during July–December of 2021 and 2022 for all antibiotics, especially for azithromycin.

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.

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.

First-of-a-kind engineered systems often burst with complexity – a major cause of project budget and time overruns. Our particular concern is the structural complexity of nuclear fusion devices, which is determined by the amount and entanglement of components. We seek to understand how this complexity rises during the development phase and how to manage it. This paper formulates a theory around the interplay between a problem-solving design process and an evolving design model. The design process introduces new elements that solve problems but also increase the quantifiable complexity of the model. Those elements may lead to new problems, extending the design process. We capture these causal effects in a hierarchy of problems and introduce two metrics of the impact of design decisions on complexity. By combining and incorporating the Function-Behavior-Structure (FBS) paradigm, we create a new problem-solving method. This method frames formulation, synthesis and analysis activities as transitions from problems to solutions. We demonstrate our method for a nuclear fusion measurement system. Exploring different design trajectories leads to alternative design models with varying degrees of complexity. Furthermore, we visualize the time-evolution of complexity during the design process. Analysis of individual design decisions emphasizes the high impact of early design decisions on the final system complexity.