In test-negative study of residents exposed to viral respiratory infection (VRI), odds of VRI (excluding SARS-CoV-2) was higher with shared room (OR = 2.28, 95% CI, 1.53–3.40) and shared adjoining washroom (OR = 1.65, 95% CI, 1.03–2.64) than neighboring rooms. Measures recommended for exposed residents in shared rooms should be considered for shared washrooms.

Post-traumatic stress disorder (PTSD) and complex-PTSD (cPTSD) can be experienced following experiences of domestic abuse (DA). People who have experienced DA are likely to face re-victimisation, especially when the threat of DA is ongoing. Trauma-focused cognitive behavioural therapy (TF-CBT) is recommended for PTSD. However, there are often concerns about offering this intervention where there is ongoing threat due to fears of desensitisation to risk and lack of stability. Recent reviews have illustrated that, on the contrary, TF-CBT can be effective at reducing PTSD and does not necessarily increase risk. However, research is lacking in community settings. The present case study utilised a single-case experimental design to measure the assessment (Phase A) and treatment (Phase B) of PTSD in response to DA using a TF-CBT model in a community NHS setting where there was a threat of further DA due to ongoing contact with the perpetrator. PTSD, anxiety, and depression scores reduced, and improvements were seen in idiosyncratic measures. Results are discussed in line with ongoing debates regarding offering TF-CBT to those at risk of ongoing threat.

Despite the growing body of research on the intergenerational transmission of problem behavior, there is a need for more integrative approaches that consider the interplay between genetic and environmental factors. This study uses unique longitudinal data from TRAILS (analytic sample n = 2202), a prospective multiple-generation cohort study in the Netherlands to examine whether parents’ problem behavior (parents’ self-reported lifetime antisocial behavior and substance use, reported at mean age 40 years) predicts offspring problem behavior nearly two decades later (offspring self-reported aggression and delinquency at mean ages 29 and 32 years). In path analyses, independent and relative contributions of genetic (polygenic scores of parents and offspring) and environmental (harsh parenting) pathways were tested. Results confirm intergenerational transmission and consistently point to genetic nurture whereby genetic predisposition predicts parental problem behavior, which in turn predicts harsh parenting, which in turn predicts offspring problem behavior, all while accounting for offspring genetic predisposition, sex and family socioeconomic position. Though these findings are surprising in light of genetic contributions to behavior, they allow for tentative considerations regarding implication for practice to help reduce the continuation of problem behaviors across generations.

Although depression can be transmitted across generations, less is known about how this cycle can be interrupted. This study examines whether the multilevel Fast Track intervention (clinicaltrials.gov, NCT01653535) disrupts intergenerational transmission of depression. Children at high risk for aggression were randomly assigned to a 10-year control group or intervention targeting parenting and children’s intrapersonal, interpersonal, and academic skills. The original sample included 891 first-generation (G1) participants who reported on their depression and their children’s (second-generation; G2) internalizing problems. At age 34, 374 G2 participants (n = 191 intervention, n = 183 control) reported on their and their children’s (third-generation; G3) emotional difficulties. Mediated path models showed that a cascading model where higher G1 depressive symptoms influence higher G2 childhood depressive symptoms, leading to higher G2 adulthood depressive symptoms, which in turn is connected with greater G3 emotional difficulties, emerged only in the control group. The Fast Track intervention disrupted the pathways from G1 depressive symptoms to G3 emotional difficulties, from G2 childhood depressive symptoms to G2 adulthood depressive symptoms, and from G2 adulthood depressive symptoms to G3 emotional difficulties, highlighting the importance of preventive interventions in altering developmental trajectories of psychopathology.

This paper describes subgroup analyses of a recent real-world study examining the impact of esketamine nasal spray combined with a newly initiated oral antidepressant (OAD) on quality-of-life and depression severity in participants with treatment-resistant depression (TRD). Patients with TRD, defined as major depressive disorder in adults who have not responded adequately to ≥2 different OADs of adequate dose and duration to treat the current depressive episode, were recruited from the esketamine early access program in Australia and New Zealand. Subgroups were defined by prior antidepressant medications received in the current depressive episode (2, 3–5, or ≥6) and post-traumatic stress disorder (PTSD) or anxiety disorder comorbidity (with or without). Comorbid PTSD or anxiety disorder was identified by treating psychiatrists. Outcome measurements included Assessment of Quality-of-Life (AQoL-8D) and Hamilton Depression Rating (HAM-D) scales. From baseline to Week 16, all subgroups saw significant improvements in AQoL-8D and HAM-D. There was no statistical difference between outcome improvements for participants with or without comorbid anxiety or PTSD. When separated by prior therapy, participants with 2 prior therapies demonstrated the greatest outcome improvements. Real-world esketamine treatment in conjunction with a newly initiated OAD benefits real-world participants with TRD and comorbid anxiety or PTSD, regardless of previously failed treatments.

De-implementation of established practices is a common challenge in infection prevention and antimicrobial stewardship and a necessary part of the life cycle of healthcare quality improvement programs. Promoting de-implementation of ineffective antimicrobial use and increasingly of low-value diagnostic testing are cornerstones of stewardship practice. Principles of de-implementation science and the interplay of implementation and de-implementation are discussed in part I of this Society for Healthcare Epidemiology of America White Paper Series.In this second part of the series, we discuss a process for applying principles of de-implementation science in infection prevention and stewardship and then review some real-world examples and case studies, including a national blood culture shortage, contact precautions, and surgical and dental prophylaxis. We use these examples to demonstrate how barriers and facilitators can be mapped to evidence-informed implementation/de-implementation strategies to promote efforts to reduce low-value, ineffective, or out-of-date practices. These real-world examples highlight the need for infection prevention and stewardship programs to adapt to changing evidence, contexts, and conditions. Although barriers to practice change are often a bit different, de-implementation can sometimes be thought of as the implementation of a new program—but the new program aims to stop rather than start doing something.

As the saying goes, sometimes less really is more. Medicine and public health have a strong action bias and a strong aversion to risk and uncertainty. Although our best intentions may point us to implementing more interventions, often, the best medicine instead dictates that we do less, or nothing at all. Leveraging principles of de-implementation science can help move healthcare in the right direction when interventions are low-value, ineffective, or no longer needed.

The Digital Services Act (DSA) is a critical piece of the procedural puzzle of generating a safe social media environment. This article highlights how the DSA’s ambitious provisions regarding content moderation rely on psychological assumptions and inferences about behaviour, yet do so in the absence of extensive empirical behavioural evidence. The difference between how individuals are assumed to behave and evidence on how they actually behave is a crucial element in the complex landscape of effectively moderating content on social media. For this reason, the article sheds light on the value of behavioural research in understanding preferences, incentives and decisions, and the role of such information in interpreting and developing legal provisions. Specifically, through explaining the results of a novel experimental study designed with the DSA in mind, the article offers insights on certain decision-making processes, and how this evidence can steer away from unfounded suppositions to help interpret and apply the DSA against the reality of behaviour.

This response to Robert Gerwarth and Gwendal Piégais’s special issue on humanitarianism and civil wars in Europe has three parts. First, it aims to situate the authors’ findings in the broader context of what might be termed the ‘dialectic of humanitarianism’ – namely the reciprocal tendency of the violence of war, and notably civil war, and the mobilisation of humanitarian aid for its victims, to reinforce each other. Second, it considers in more detail some of the implications of the findings of all of the authors on the specific challenges posed by civil wars for ‘humanitarianism’ and for the ways in which we might write the history of the latter in the future. Finally, it reflects briefly on one key aspect of that history, namely the politicisation of humanitarian aid.

The Duke Research Equity and Diversity Initiative (READI) was established in 2021 to engage Durham and surrounding communities in clinical research and build capacity to promote equitable access to research participation. Within READI, a voucher program was launched with the goals of increasing diverse participation in clinical research, improving community-partnered research, and enhancing community engagement. The vouchers leveraged a stand-alone, community-centered, outpatient research clinic, the Duke Research at Pickett (R@P) facility, which was originally opened to support COVID-19 trials. A formative evaluation of the voucher program was conducted with 3 voucher-awarded teams, READI personnel, and R@P staff. Data included 18 semi-structured interviews (n = 14) over two timepoints (Spring 2023, 2024). A rapid response analysis approach was used. Data indicate that READI voucher-awarded services were useful for voucher teams, with value for supporting community-engaged efforts, making research participation accessible, creating a community-centered and streamlined service facility, and personnel development benefits. Communication and flexibility of support services facilitated program implementation. Challenges occurred in service utilization logistics and incorporating community engagement into research support services. Ultimately, we find that a research support program with embedded community engagement support is feasible; this type of support can be integral in normalizing community-engaged research.

Different farmers require different compensation payments to be incentivized to participate in water quality improvement-related agri-environmental schemes (AESs) and payment for ecosystem services (PESs). This is because they differ in their farm management practices, cost structures and attitudinal characteristics. However, these differences are rarely characterized in the design and implementation of AESs and PESs in the Global South. Using a discrete choice experiment, we investigate farmers’ willingness to accept compensation to control agricultural nonpoint source pollution in the Limpopo River Basin of South Africa to observe whether these differences matter. Conditional, random parameter and latent class logit models are estimated. Our latent class logit model identified one random choice class (farmers making random responses) and three preference classes of farmers (low-, moderate- and high-resistance) with dissimilar compensation requirements to alter their status quo farm management practices to improve water quality. Gender, age, education, farming experience and secure tenure rights are key drivers of preference heterogeneity.

Nationalist historiography portrays interwar protest in South Asia as predominantly Gandhian, non-militaristic, and non-violent. This portrayal is at odds with the experience of other parts of the world, which were shaped by a “violent peace” in the form of small wars, armed insurgencies, the mobilization of paramilitaries, and the increased prominence of the army in the public sphere in a context of the mass demobilization of military personnel. This article asks how South Asia’s interwar labour movement was shaped by a world marked by the experience of World War I and its aftermath. Through a study of labour “volunteer movements” or paramilitaries and military-related claims-making by labour leaders on the colonial state, it argues that “militarization” was an important aspect of labour politics in interwar South Asia. Volunteer movements were a widespread form of mobilization deployed by labouring populations. Labouring communities with historical connections to military service made claims on the colonial state’s patronage during industrial conflict by appealing to their past military service or official status as “martial races”. While this article studies these phenomena among Bombay’s textile and Dalit workers, it references analogous processes that occurred elsewhere on the subcontinent. Using a unique source base of the speeches and writings of labour leaders, publications of volunteer movements, workers’ court depositions, Marathi-language memoirs, strike enquiry committees, and newspaper material, it unearths a world of militaristic ideas and action seldom explored in the context of interwar South Asian labour.

Higher-order constructs enable more expressive and concise code by allowing procedures to be parameterized by other procedures. Assertions allow expressing partial program specifications, which can be verified either at compile time (statically) or run time (dynamically). In higher-order programs, assertions can also describe higher-order arguments. While in the context of (constraint) logic programming ((C)LP), run-time verification of higher-order assertions has received some attention, compile-time verification remains relatively unexplored. We propose a novel approach for statically verifying higher-order (C)LP programs with higher-order assertions. Although we use the Ciao assertion language for illustration, our approach is quite general, and we believe is applicable to similar contexts. Higher-order arguments are described using predicate properties – a special kind of property which exploits the (Ciao) assertion language. We refine the syntax and semantics of these properties and introduce an abstract criterion to determine conformance to a predicate property at compile time, based on a semantic order relation comparing the predicate property with the predicate assertions. We then show how to handle these properties using an abstract interpretation-based static analyzer for programs with first-order assertions by reducing predicate properties to first-order properties. Finally, we report on a prototype implementation and evaluate it through various examples within the Ciao system.

Generative AI (GenAI) offers potential for English language teaching (ELT), but it has pedagogical limitations in multilingual contexts, often generating standard English forms rather than reflecting the pluralistic usage that represents diverse sociolinguistic realities. In response to mixed results in existing research, this study examines how ChatGPT, a text-based generative AI tool powered by a large language model (LLM), is used in ELT from a Global Englishes (GE) perspective. Using the Design and Development Research approach, we tested three ChatGPT models: Basic (single-step prompts); Refined 1 (multi-step prompting); and Refined 2 (GE-oriented corpora with advanced prompt engineering). Thematic analysis showed that Refined Model 1 provided limited improvements over Basic Model, while Refined Model 2 demonstrated significant gains, offering additional affordances in GE-informed evaluation and ELF communication, despite some limitations (e.g., defaulting to NES norms and lacking tailored GE feedback). The findings highlight the importance of using authentic data to enhance the contextual relevance of GenAI outputs for GE language teaching (GELT). Pedagogical implications include GenAI–teacher collaboration, teacher professional development, and educators’ agentive role in orchestrating diverse resources alongside GenAI.

Using Danish register data, we study whether individuals save enough to maintain almost all (90%) of their pre-retirement consumption. We find that 85 percent do, largely due to mandatory labour market pension contributions. The remaining 15 percent are less likely to have mandatory pension schemes and do not compensate for the lack thereof via voluntary private savings. However, mandatory contributions come at the cost of lower consumption and non-retirement savings during working years. Individuals experiencing the largest increases in mandatory pension contributions accumulate less non-retirement wealth and consume less before retirement compared to those with small increases.