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Vaccine hesitancy among health care workers poses significant challenges to public health, particularly during times of crisis. This study investigates the factors influencing vaccine hesitancy among health care workers at Montefiore Medical Center, NY, with the aim of providing valuable insights to help shape and enhance future public health vaccination campaigns.
Methods
Utilizing Montefiore’s HER (Epic system) data from 2021–2023, linear logistic and multiple regression analyses were performed to assess correlations between demographic variables—such as age, race/ethnicity, job category, and county of residence—and vaccine uptake for both influenza and COVID-19 vaccines. Data were sourced from EPIC and Cority employee datasets. Missing demographic data were imputed where possible. The study population comprises a diverse workforce of 21 331 health care workers, encompassing a wide range of clinical and non-clinical roles.
Results
Key predictors of vaccine hesitancy included prior influenza vaccination status, age, race/ethnicity, job title, and county of residence. Workers vaccinated against influenza were 6.2% more likely to receive the COVID-19 vaccine. Younger health care workers and racial groups like Black and biracial employees demonstrated higher levels of hesitancy, while Asian workers exhibited higher rates of vaccine acceptance.
Conclusions
Tailored communication strategies and educational programs are critical for addressing vaccine hesitancy, particularly among younger health care workers and specific racial groups. Building trust and improving transparency will be essential to increasing vaccine uptake and achieving broader public health objectives.
Although much is known about psychopathology such as post-traumatic stress disorder (PTSD) and depression following bushfire (also known as wildfire), little is known about prevalence, trajectory and impacts for those experiencing general adjustment difficulties following exposure to these now-common events.
Aims
This was an exploratory analysis of a large cohort study that examined the prevalence, trajectory and risk factors of probable adjustment disorder over a 10-year period following bushfire exposure.
Method
The Beyond Bushfires study assessed individuals exposed to a large and deadly bushfire across three time points spanning 10 years. Self-report survey data from participants from areas with moderate and high levels of fire-affectedness were analysed: n = 802 participants at Wave 1 (3–4 years post-fires), n = 596 at Wave 2 (5 years post-fires) and n = 436 at Wave 3 (10 years post-fires). Surveys indexed fire-related experiences and post-fire stressors, and comprised the six-item Kessler Psychological Distress Scale (probable adjustment disorder index), four-item Posttraumatic Stress Disorder Checklist (probable fire-related PTSD) and nine-item Patient Health Questionnaire (probable major depressive episode).
Results
Prevalence of probable adjustment disorder was 16% (Wave 1), 15% (Wave 2) and 19% (Wave 3). Probable adjustment disorder at 3–4 years post-fires predicted a five-fold increase in risk for escalating to severe psychiatric disorder (i.e. probable fire-related PTSD/major depressive episode) at 10 years post-fires, and was associated with post-fire income and relationship stressors.
Conclusions
Adjustment difficulties are prevalent post-disaster, many of which are maintained and exacerbated over time, resulting in increased risk for later disorder and adaptation difficulties. Psychosocial interventions supporting survivors with adjustment difficulties may prevent progression to more severe disorder.
INDUCT (Interdisciplinary Network for Dementia Using Current Technology), and DISTINCT (Dementia Inter-sectorial strategy for training and innovation network for current technology) are two Marie Sklodowska-Curie funded International Training Networks that aimed to develop a multi-disciplinary, inter-sectorial educational research framework for Europe to improve technology and care for people with dementia, and to provide the evidence to show how technology can improve the lives of people with dementia.
Methods:
In INDUCT (2016-2020) 15 Early Stage Researchers worked on projects in the areas of Technology to support everyday life; technology to promote meaningful activities; and healthcare technology. In DISTINCT (2019-2023) 15 Early Stage Researchers worked on technology to promote Social health in three domains: fulfilling ones potential and obligations in society, managing one’s own life, and participation in social and other meaningful activities.
Both networks adopted three transversal objectives: 1) To determine practical, cognitive and social factors needed to make technology more useable for people with dementia; 2) To evaluate the effectiveness of specific contemporary technology; 3) To trace facilitators and barriers for implementation of technology in dementia care.
Results:
The main recommendations resulting from all research projects are integrated in a web-based digital Best Practice Guidance on Human Interaction with Technology in Dementia which was recently updated (Dec 2022 and June 2023) and will be presented at the congress. The recommendations are meant for different target groups, i.e. people in different stages of dementia, their (in)formal carers, policy makers, designers and researchers, who can easily find the recommendations relevant to them in the Best Practice Guidance by means of a digital selection tool.
Conclusions:
The INDUCT/DISTINCT Best Practice Guidance informs on how to improve the development, usage, impact and implementation of technology for people with dementia in various technology areas. This Best Practice Guidance is the result of intensive collaborative partnership of INDUCT and DISTINCT with academic and non-academic partners as well as the involvement of representatives of the different target groups throughout the projects.
Scholars have long recognized that interpersonal networks play a role in mobilizing social movements. Yet, many questions remain. This Element addresses these questions by theorizing about three dimensions of ties: emotionally strong or weak, movement insider or outsider, and ingroup or cross-cleavage. The survey data on the 2020 Black Lives Matter protests show that weak and cross-cleavage ties among outsiders enabled the movement to evolve from a small provocation into a massive national mobilization. In particular, the authors find that Black people mobilized one another through social media and spurred their non-Black friends to protest by sharing their personal encounters with racism. These results depart from the established literature regarding the civil rights movement that emphasizes strong, movement-internal, and racially homogenous ties. The networks that mobilize appear to have changed in the social media era. This title is also available as Open Access on Cambridge Core.
Most neuropsychological tests were developed without the benefit of modern psychometric theory. We used item response theory (IRT) methods to determine whether a widely used test – the 26-item Matrix Reasoning subtest of the WAIS-IV – might be used more efficiently if it were administered using computerized adaptive testing (CAT).
Method:
Data on the Matrix Reasoning subtest from 2197 participants enrolled in the National Neuropsychology Network (NNN) were analyzed using a two-parameter logistic (2PL) IRT model. Simulated CAT results were generated to examine optimal short forms using fixed-length CATs of 3, 6, and 12 items and scores were compared to the original full subtest score. CAT models further explored how many items were needed to achieve a selected precision of measurement (standard error ≤ .40).
Results:
The fixed-length CATs of 3, 6, and 12 items correlated well with full-length test results (with r = .90, .97 and .99, respectively). To achieve a standard error of .40 (approximate reliability = .84) only 3–7 items had to be administered for a large percentage of individuals.
Conclusions:
This proof-of-concept investigation suggests that the widely used Matrix Reasoning subtest of the WAIS-IV might be shortened by more than 70% in most examinees while maintaining acceptable measurement precision. If similar savings could be realized in other tests, the accessibility of neuropsychological assessment might be markedly enhanced, and more efficient time use could lead to broader subdomain assessment.
Over the past two decades, the Church of Jesus Christ of Latter-Day Saints, the University of Alabama, the University of Texas at Arlington, and the Universidad de Yucatán have produced microfilm copies of primary source materials in the Yucatán. While their films only begin to tap the rich documentary resources of the peninsula, the combined holdings put a large corpus of materials for reconstructing the Yucatecan past within the reach of scholars in the United States. This brief essay will describe the four microfilm collections as they existed in the fall of 1984 as well as the finding aids that have been developed to assist researchers in accessing them.
These contrasting pronouncements on Christopher Columbus's transatlantic navigation in 1492 crystalize the extreme division of opinion that characterized the recent quincentennial. The five-hundredth anniversary of Columbus's first voyage inspired among other things a world's fair, several replicas of the Niña, the Pinta, and the Santa María, two feature films, and an opera. Commemoration of the event also inspired, in time-honored tradition, the publication of thousands of works dedicated to this major event. Thus although publishing technology is speeding along toward electronic rather than printed images, the fifth centennial of Columbus's voyage has been marked most significantly by the rolling of the presses.
This chapter returns to a long-standing issue in in language and identity research based on life story interviews - the need for theoretical and methodological rigour (Pavlenko, 2007). It begins with background: first a brief discussion of identity that highlights those aspects of the construct that later come to the fore, and second, presentation of a version of positioning theory (PT) recently developed by the author (Block, 2017). This version draws on the original PT model developed by Rom Harré and his associates but importantly, it expands on this model with the addition of constructs taken from sociolinguistics, sociology and social theory, including authenticity and authentication (Bucholtz, 2003), belonging (Guibernau, 2013), field and habitus (Bourdieu, 1993, 2000), discourse formations and gaze (Foucault, 1989, 2003) and resistance (Seymour, 2006). The second half of the chapter examines an excerpt from an interview with an English-medium instruction lecturer, drawing on constructs developed in the first part. The aim is to show how the version of PT presented can lead to a detailed and nuanced interpretation of the construction of identity, turn by turn, in an interaction.
On March 11, 2020, the World Health Organization declared an outbreak of a new viral entity, coronavirus 2019 (COVID-19), to be a worldwide pandemic. The characteristics of this virus, as well as its short- and long-term implications, are not yet well understood. The objective of the current paper was to provide a critical review of the emerging literature on COVID-19 and its implications for neurological, neuropsychiatric, and cognitive functioning.
Method:
A critical review of recently published empirical research, case studies, and reviews pertaining to central nervous system (CNS) complications of COVID-19 was conducted by searching PubMed, PubMed Central, Google Scholar, and bioRxiv.
Results:
After considering the available literature, areas thought to be most pertinent to clinical and research neuropsychologists, including CNS manifestations, neurologic symptoms/syndromes, neuroimaging, and potential long-term implications of COVID-19 infection, were reviewed.
Conclusion:
Once thought to be merely a respiratory virus, the scientific and medical communities have realized COVID-19 to have broader effects on renal, vascular, and neurological body systems. The question of cognitive deficits is not yet well studied, but neuropsychologists will undoubtedly play an important role in the years to come.
This paper examines the emergent identities of three STEM (science, technology, engineering and mathematics) lecturers, focusing especially on how they construct themselves with regard to their disciplines and how researchers construct them as potential English language teachers. It begins with essential background information before discussing identity as a key construct. The paper then moves to the presentation of a Foucauldian-inflected version of positioning theory which is employed as a means of understanding the construction of English-medium instruction (EMI) STEM lecturer identities. In the second half of the paper, there is a discussion of three case-studies of EMI STEM lecturers, which shows how each orientates to his or her subject discipline, and the prospect of acting, on occasion, as an English language teacher. Specifically, there is a detailed consideration of how EMI lecturers position themselves in their contacts with researchers and in their teaching; how their self-positionings are consistent or not with how researchers position them; and how self-positionings are similar or different across EMI lecturers. The paper ends with a discussion of what conclusions can be drawn from the research findings.
To develop and evaluate a program to presvent hospital-acquired pneumonia (HAP).
Design:
Prospective, observational, surveillance program to identify HAP before and after 7 interventions. An order set automatically triggered in programmatically identified high-risk patients.
Setting:
All 21 hospitals of an integrated healthcare system with 4.4 million members.
Patients:
All hospitalized patients.
Interventions:
Interventions for high-risk patients included mobilization, upright feeding, swallowing evaluation, sedation restrictions, elevated head of bed, oral care and tube care.
Results:
HAP rates decreased between 2012 and 2018: from 5.92 to 1.79 per 1,000 admissions (P = .0031) and from 24.57 to 6.49 per 100,000 members (P = .0014). HAP mortality decreased from 1.05 to 0.34 per 1,000 admissions and from 4.37 to 1.24 per 100,000 members. Concomitant antibiotic utilization demonstrated reductions of broad-spectrum antibiotics. Antibiotic therapy per 100,000 members was measured as follows: carbapenem days (694 to 463; P = .0020), aminoglycoside days (154 to 61; P = .0165), vancomycin days (2,087 to 1,783; P = .002), and quinolone days (2,162 to 1,287; P < .0001). Only cephalosporin use increased, driven by ceftriaxone days (264 to 460; P = .0009). Benzodiazepine use decreased between 2014 to 2016: 10.4% to 8.8% of inpatient days. Mortality for patients with HAP was 18% in 2012% and 19% in 2016 (P = .439).
Conclusion:
HAP rates, mortality, and broad-spectrum antibiotic use were all reduced significantly following these interventions, despite the absence of strong supportive literature for guidance. Most interventions augmented basic nursing care. None had risks of adverse consequences. These results support the need to examine practices to improve care despite limited literature and the need to further study these difficult areas of care.
Disasters pose a documented risk to mental health, with a range of peri- and post-disaster factors (both pre-existing and disaster-precipitated) linked to adverse outcomes. Among these, increasing empirical attention is being paid to the relation between disasters and violence.
Aims
This study examined self-reported experiences of assault or violence victimisation among communities affected by high, medium, and low disaster severity following the 2009 bushfires in Victoria, Australia. The association between violence, mental health outcomes and alcohol misuse was also investigated.
Method
Participants were 1016 adults from high-, medium- and low-affected communities, 3–4 years after an Australian bushfire disaster. Rates of reported violence were compared by areas of bushfire-affectedness. Logistic regression models were applied separately to men and women to assess the experience of violence in predicting general and fire-related post-traumatic stress disorder, depression and alcohol misuse.
Results
Reports of experiencing violence were significantly higher among high bushfire-affected compared with low bushfire-affected regions. Analyses indicated the significant relationship between disaster-affectedness and violence was observed for women only, with rates of 1.0, 0 and 7.4% in low, medium and high bushfire-affected areas, respectively. Among women living in high bushfire-affected areas, negative change to income was associated with an increased likelihood of experiencing violence (odds ratio, 4.68). For women, post-disaster violence was associated with more severe post-traumatic stress disorder and depression symptoms.
Conclusions
Women residing within high bushfire-affected communities experienced the highest levels of violence. These post-disaster experiences of violence are associated with post-disaster changes to income and with post-traumatic stress disorder and depression symptoms among women. These findings have critical implications for the assessment of, and interventions for, women experiencing or at risk of violence post-disaster.
In 2018, the Clostridium difficile LabID event methodology changed so that hospitals doing 2-step tests, nucleic acid amplification test (NAAT) plus enzyme immunofluorescence assay (EIA), had their adjustment modified to EIA-based tests, and only positive final tests (eg, EIA) were counted in the numerator. We report the immediate impact of this methodological change at 3 Milwaukee hospitals.
This state-of-the-art review is based on the fundamental idea that political economy should be adopted as a frame for research and discussion in applied linguistics as part of a general social turn which has taken hold in the field over the past three decades. It starts with Susan Gal's (1989) early call for such a move in sociolinguistics and linguistic anthropology, that is, for ‘investigations of the links among language structure, language use, and political economy’ (Gal 1989: 346), and moves from a consideration of theoretical bases to the discussion and critique of concrete examples of research. Thus, after a fairly detailed discussion of political economy and the key constructs neoliberalism and social class, the paper moves to a review of research in three broad areas. First, it focuses on how issues and constructs from political economy have been incorporated into discussions of education, work and leisure by a growing number of sociolinguists. This is followed by a review of research which has focused specifically on social class as a central organising construct and then a third section on political economy in language teaching and learning research. The review ends with a consideration of the future of political economy in applied linguistics research.
Social class is a curious construct. In the discipline where it has traditionally been most at home, sociology, there has been a constant flow of commentary on its demise and, indeed, its death over the years. In applied linguistics, the situation is somewhat different in that there has been a degree of social class denial, but more importantly, there has been social class erasure in that the construct has tended to receive little or no attention in publications that deal with language and identity and social life. Where social class is introduced into research, it is almost always done in a very cursory, partial, and superficial way. Still, there has been some research examining the interrelationship between social class and language over the years, and in this article, I provide a review of that research, focusing primarily on the period 2000–2014. First, however, I include a discussion of what social class means in 21st-century societies and a short review of class-based research carried out from the 1960s to the 1990s, the inclusion of the latter being necessary to an understanding of research after 2000. I conclude the article with some thoughts about future directions.
From ‘language learning’ and ‘language use’ to ‘becoming multilingual’ and ‘being multilingual’
There is a long-standing issue in second language acquisition (SLA) and educational bilingualism studies of how to describe individuals in terms of their language-mediated identities. In Block ( 2003 ), I discuss a distinction made by researchers such as Susan Gass ( 1998 ) between language ‘learners’ and language ‘users’, the argument being, in effect, that researchers can and should distinguish between individuals when they are in language learning mode and when they are in language using mode. In making this distinction, Gass was making a programmatic statement about SLA as a field of inquiry in the larger field of what she called ‘second language studies’. She was also responding to Alan Firth and Johannes Wagner's ( 1997 ) prescient and oft-cited call for a broadening of SLA to take on frameworks and methodologies used in discourse analysis. She stated her position as follows:
the goal of my work (and the work of others within the input/interaction framework …) has never been to understand language use per se … but rather to understand what types of interaction might bring about what types of changes in linguistic knowledge … Nevertheless, it is true that in order to examine these changes, one must consider language use in context. But in some sense this is trivial; the emphasis in input and interaction studies is on the language used and not on the act of communication. This may appear to be a small difference, but to misunderstand the emphasis and the research questions … can result … in fundamental misinterpretations and naïve criticism. In fact, the result is the proverbial (and not very useful) comparison between apples and oranges.
(Gass, 1998 : 84)
This perspective, eminently linguistic at the expense of a broader view of SLA which would include communication writ large, is represented in Figure 11.1 below.
In this case, SLA is understood as ‘linguistic-cognitive’ (Ortega, 2013 ), as exclusively about linguistic development and the cognitive processes leading to it. Two statements made by Gass in her 1998 article make this case clearly.
This paper elucidates a theory of identity formation and applies it to the study of international negotiation. The theory acknowledges that actors/agents can adopt a multiplicity of identities, and it treats changes in the salience of identities as endogenous to the contextually dependent processes of interpersonal and intergroup interactions. Typically, strong identities are viewed as encouraging conflict and exacerbating interstate disputes. Our theory, however, suggests a palliative role for identity: third-party mediation can more effectively resolve conflicts when it enhances shared, if initially less salient, aspects of the disputants’ identities. We discuss several causal pathways through which the process of enhancing identity salience can increase the likelihood of successful conflict resolution, providing a complementary mechanism for the effectiveness of mediation to those extant in the literature. The paper concludes with a practical method for applying the theory's insights to the choice of mediator and the mediator's technique.