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Using a series of laboratory experiments in the context of bilateral bargaining over whether and how to engage in a joint venture, this paper shows that fairness concerns result in failures to undertake profitable joint production opportunities. We find that framing an opportunity as an employment relationship rather than as a partnership significantly reduces these inefficiencies and increases subjects’ welfare. Consistent with the theoretical model developed in the paper, text analysis and a follow-up experiment demonstrate that the lower likelihood of an efficient outcome in the partnership frame is driven primarily by a concern for fairness generated by the perceived social relationship associated with partnerships, and not by differences in the economic structure, cognition, subject motivation, or changes in relative bargaining power.
Team Methods to Advance Processes and Performance in Science (TeamMAPPS) is an evidence-based Team Science competency model and intervention. TeamMAPPS was developed by experts in the Science of Team Science with translational teams in mind. TeamMAPPS focuses on three core teamwork competencies: (1) psychological safety, (2) awareness and exchange, and (3) self-correction and adaptation. In 2023, the TeamMAPPS framework was operationalized into five online training modules that can be used to train whole teams or individuals, with or without facilitation, in any order. This article reports formative findings from the pre-implementation stage of the TeamMAPPS Dissemination and Implementation (D&I) study.
Methods:
We conducted 27 interviews and participant-observation fieldwork with 23 individuals involved in the conceptualization, design, or implementation of TeamMAPPS (four were interviewed twice). All implementers were affiliated with a Clinical and Translational Science Award (CTSA) hub. Data were collected during pre-implementation, when modules were being tested and early-stage implementers were being trained. We used D&I theories and frameworks to structure the study, analyze interview data, and recommend implementation strategies.
Findings:
“Adoption,” “reach,” and “effectiveness” emerged as key implementation outcomes. TeamMAPPS was perceived to be evidence-based, highly adaptable, and a Team Science intervention offering unique benefits. We draw on participants’ responses and expert recommendations to suggest implementation strategies.
Conclusions:
CTSAs and other organizations can use varied strategies to implement TeamMAPPS. The flexibility of the intervention and its rootedness in an evidence-base synthesized by Team Science leaders make TeamMAPPS appealing for CTSAs seeking to enhance their team training offerings.
The gospel of Mark quickly introduces both human and superhuman characters who engage each other in consequential words and actions as they move through time and space, with geographical movement from the wilderness to Galilee and through Judea towards Jerusalem, and back towards Galilee again.
In this paper, we present a standardized approach for using cancer incidence and survival data to account for the timing between a reduction in carcinogen exposure and the subsequent reduction in cancer risk and fatality. While the estimates for this timing between a reduction in carcinogen exposure and reduced cancer risk would ideally come from high-quality studies specifically examining this question, very few such studies are available. Thus, we designed an approach to account for this timing when sufficient data are not available elsewhere. Our approach can be used in estimating monetized values for achieving small reductions in the risks for many common specific types of cancer in benefit–cost analyses of regulatory and non-regulatory policies in the United States that achieve cancer risk reductions by reducing carcinogen exposures. We provide estimated values for 108 different cancer sites and for all cancer sites combined. We accompany this paper with a spreadsheet-based tool that presents our results separately for non-fatal and fatal risks so that results can easily be calculated using different combinations of discount rates, latency between carcinogen exposure and cancer diagnosis, values for the willingness-to-pay to avoid fatal and non-fatal cancer risks, and potentially affected populations.
To evaluate the clinical impact and features associated with repeat tracheal aspirate (TA) cultures in children admitted to the intensive care unit.
Design:
Retrospective cohort study.
Setting:
A 338-bed freestanding, tertiary pediatric academic medical center with pediatric medical intensive care unit (PICU) and cardiac intensive care units (CICU).
Patients:
Children ≤18 years of age who were admitted to either the PICU or CICU who had ≥2 TA cultures in a single intensive care admission.
Methods:
Patients with ≥2 TA cultures between 2018 and 2019 were included in this study. The following information was collected: patient demographics, clinical data summarizing patient condition at the time of culture collection, number of TA cultures per patient, antibiotic usage, and microbiologic data. Descriptive statistics established the frequency of TA collection, time between culturing, clinical reasoning for collection, antibiotic exposure, and development of multidrug-resistant organisms (MDRO).
Results:
Sixty-three patients had repeat TA cultures and accounted for 252 TA cultures during the study period. Most patients with repeat TA cultures were admitted to the PICU (71%) and were male (65%). A median of 3 TA cultures per patient were obtained with 50% of repeat cultures occurring within 7 days from the previous culture. Sixty-six percent of patients had the same organism cultured on ≥2 TA cultures. Most antibiotics were not modified or continued to treat the results of the TA culture.
Conclusions:
Repeat TA cultures frequently show the same pathogens, and results do not often influence antibiotic selection or usage. Repeat TA cultures did demonstrate the development of MDROs.
OBJECTIVES/GOALS: We are using ethnographic methods and Dissemination and Implementation (D&I) frameworks to study barriers and facilitators to implementing ‘TeamMAPPS: Team Methods to Advance Processes and Performance in Science.’ TeamMAPPS is an evidence-based Team Science curriculum deployed as five online modules and being implemented across CTSA hubs. METHODS/STUDY POPULATION: For this pre-implementation study, we used the Implementation Mapping framework to understand likely barriers and facilitators, with the aim of designing implementation strategies and long-term outcome measures. Data included field notes from a two-day train-the-trainer, one visit to a key implementing site, and 27 interviews. Participants were four TeamMAPPS conceptualizers, four module designers, and 15 implementers from seven implementing sites, each with a CTSA hub (four were interviewed twice). We coded transcripts using the Consolidated Framework for Implementation Research (CFIR) to identify contextual barriers and facilitators to D&I, the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) D&I outcomes framework, and target competencies of TeamMAPPS. RESULTS/ANTICIPATED RESULTS: Priority D&I outcomes that emerged were adoption, reach, and effectiveness. Potential barriers/facilitators to “adoption” included institutional willingness to incentivize scientists to utilize TeamMAPPS, support for Team Science at CTSAs, and systems of rewards for scientists to undergo trainings. Anticipated barriers/facilitators for “reach” were closely tied to adoption, such as institutions’ ability to persuade or require scientists to take trainings. Other issues relevant to reach included the time it takes to time to complete TeamMAPPS and potentially fraught intra-team dynamics arising if modules are implemented as a whole-team intervention. Anticipated barriers/facilitators for “effectiveness” included having adequate tools to assess actual impact. DISCUSSION/SIGNIFICANCE: TeamMAPPS has the potential to accelerate advances in translational sciences across the CTSA consortium. As this D&I study proceeds we will continue Implementation Mapping and use the Expert Recommendations for Implementing Change (ERIC) to develop bundles of implementer-informed strategies to the effectively deliver TeamMAPPS among CTSAs.
I-InTERACT-North is a stepped-care telepsychological parenting intervention designed to promote positive parenting skills and improve child behaviour. Initially developed for children with traumatic brain injury, our pilot study has shown efficacy in increasing positive parenting skills and reducing problem behaviours for children with early brain injury (e.g., stroke, encephalopathy). Recently, the program has expanded to include children with neurodevelopmental disorders, including Autism Spectrum Disorder. Although positive parenting programs (e.g., Parent-Child Interaction Therapy) can be effective for autistic children, it is unknown whether the goals most important to these families can be addressed with IInTERACT-North program. An examination of suitability and preliminary efficacy was conducted.
Participants and Methods:
Parent participants of autistic children between 3 and 9 years (n= 20) were recruited from the neonatal, neurology, psychiatry, or cardiology clinics at The Hospital for Sick Children and the Province of Ontario Neurodevelopmental Disorders (POND) Network. Top problems, as reported by parents at baseline, were analyzed qualitatively through a cross-case analysis procedure in order to identify common themes and facilitate generalizations surrounding concerning behaviours. Parent-reported intensity of their children’s top problem behaviours on a scale from 1 (“not a problem”) to 8 (“huge problem”) were quantified. To explore preliminary program efficacy, t-tests were used to compare pre- and post-intervention problems and intensity on the Eyberg Child Behavior Inventory (ECBI) (n=16).
Results:
A total of 56 top problem data units were examined, with convergent thematic coding on 53 of 56 (94.6% inter-coder reliability). Four prevalent, high-agreement themes were retained: emotion dysregulation (19; 33.9%), non-compliance (12; 21.4%), sibling conflict (7; 12.5%), and inattention and hyperactivity (7; 12.5%). Average problem intensity for these themes ranged from 5.85 to 6.53 (where 8 is greatest impairment) with emotion dysregulation having the highest intensity (6.53) compared to the others. Scores on the ECBI were lower post-intervention (Intensity scale: M= 59.06, SD= 8.1; Problem scale: M= 60.69, SD= 11.5) compared to pre-intervention (Intensity scale: M= 61.19, SD= 10.4; Problem scale: M= 64.31, SD= 11.7), but small sample size precluded detecting statistical significance (p’s = .16 and .07, respectively).
Conclusions:
Thematic analysis of top problems identified by parents of autistic children suggested that concerns were transdiagnostic in nature, and represent common treatment targets of the I-InTERACTNorth program. Though challenging behaviours related to restricted interests or repetitive behaviours may exist in our sample, parental behavioural goals appeared to align with the types of concerns traditionally raised by participants of the program, supporting a transdiagnostic approach. Preliminary data point to positive treatment outcomes in these families.
To characterize and compare severe acute respiratory coronavirus virus 2 (SARS-CoV-2)–specific immune responses in plasma and gingival crevicular fluid (GCF) from nursing home residents during and after natural infection.
Design:
Prospective cohort.
Setting:
Nursing home.
Participants:
SARS-CoV-2–infected nursing home residents.
Methods:
A convenience sample of 14 SARS-CoV-2–infected nursing home residents, enrolled 4–13 days after real-time reverse transcription polymerase chain reaction diagnosis, were followed for 42 days. After diagnosis, plasma SARS-CoV-2–specific pan-Immunoglobulin (Ig), IgG, IgA, IgM, and neutralizing antibodies were measured at 5 time points, and GCF SARS-CoV-2–specific IgG and IgA were measured at 4 time points.
Results:
All participants demonstrated immune responses to SARS-CoV-2 infection. Among 12 phlebotomized participants, plasma was positive for pan-Ig and IgG in all 12 participants. Neutralizing antibodies were positive in 11 participants; IgM was positive in 10 participants, and IgA was positive in 9 participants. Among 14 participants with GCF specimens, GCF was positive for IgG in 13 participants and for IgA in 12 participants. Immunoglobulin responses in plasma and GCF had similar kinetics; median times to peak antibody response were similar across specimen types (4 weeks for IgG; 3 weeks for IgA). Participants with pan-Ig, IgG, and IgA detected in plasma and GCF IgG remained positive throughout this evaluation, 46–55 days after diagnosis. All participants were viral-culture negative by the first detection of antibodies.
Conclusions:
Nursing home residents had detectable SARS-CoV-2 antibodies in plasma and GCF after infection. Kinetics of antibodies detected in GCF mirrored those from plasma. Noninvasive GCF may be useful for detecting and monitoring immunologic responses in populations unable or unwilling to be phlebotomized.
Parent-Child interaction therapy (PCIT) has been shown to improve positive, responsive parenting and lower risk for child maltreatment (CM), including among families who are already involved in the child welfare system. However, higher risk families show higher rates of treatment attrition, limiting effectiveness. In N = 120 child welfare families randomized to PCIT, we tested behavioral and physiological markers of parent self-regulation and socio-cognitive processes assessed at pre-intervention as predictors of retention in PCIT. Results of multinomial logistic regressions indicate that parents who declined treatment displayed more negative parenting, greater perceptions of child responsibility and control in adult–child transactions, respiratory sinus arrhythmia (RSA) increases to a positive dyadic interaction task, and RSA withdrawal to a challenging, dyadic toy clean-up task. Increased odds of dropout during PCIT's child-directed interaction phase were associated with greater parent attentional bias to angry facial cues on an emotional go/no-go task. Hostile attributions about one's child predicted risk for dropout during the parent-directed interaction phase, and readiness for change scores predicted higher odds of treatment completion. Implications for intervening with child welfare-involved families are discussed along with study limitations.
To assess the relationship between food insecurity, sleep quality, and days with mental and physical health issues among college students.
Design:
An online survey was administered. Food insecurity was assessed using the ten-item Adult Food Security Survey Module. Sleep was measured using the nineteen-item Pittsburgh Sleep Quality Index (PSQI). Mental health and physical health were measured using three items from the Healthy Days Core Module. Multivariate logistic regression was conducted to assess the relationship between food insecurity, sleep quality, and days with poor mental and physical health.
Setting:
Twenty-two higher education institutions.
Participants:
College students (n 17 686) enrolled at one of twenty-two participating universities.
Results:
Compared with food-secure students, those classified as food insecure (43·4 %) had higher PSQI scores indicating poorer sleep quality (P < 0·0001) and reported more days with poor mental (P < 0·0001) and physical (P < 0·0001) health as well as days when mental and physical health prevented them from completing daily activities (P < 0·0001). Food-insecure students had higher adjusted odds of having poor sleep quality (adjusted OR (AOR): 1·13; 95 % CI 1·12, 1·14), days with poor physical health (AOR: 1·01; 95 % CI 1·01, 1·02), days with poor mental health (AOR: 1·03; 95 % CI 1·02, 1·03) and days when poor mental or physical health prevented them from completing daily activities (AOR: 1·03; 95 % CI 1·02, 1·04).
Conclusions:
College students report high food insecurity which is associated with poor mental and physical health, and sleep quality. Multi-level policy changes and campus wellness programmes are needed to prevent food insecurity and improve student health-related outcomes.
The health and economic outcomes of the COVID-19 pandemic will in part be determined by how effectively experts can communicate information to the public and the degree to which people follow expert recommendation. Using a survey experiment conducted in May 2020 with almost 5,000 respondents, this paper examines the effect of source cues and message frames on perceptions of information credibility in the context of COVID-19. Each health recommendation was framed by expert or nonexpert sources, was fact- or experience-based, and suggested potential gain or loss to test if either the source cue or framing of issues affected responses to the pandemic. We find no evidence that either source cue or message framing influence people’s responses – instead, respondents’ ideological predispositions, media consumption, and age explain much of the variation in survey responses, suggesting that public health messaging may face challenges from growing ideological cleavages in American politics.
We examined associations between preschool children's cumulative risk exposure, dyadic interaction patterns, and self-control abilities in 238 mother–child dyads. Positive interactive synchrony, relationship ruptures, and latency to repair were micro-coded during a 3–5 minute joint challenge task. Children's self-control was assessed via two laboratory tasks and by parent report. Structural equation modeling and mediation analyses were utilized to examine the direct and indirect effects of cumulative risk on children's observed and parent-reported self-control abilities. Parent–child interactive processes of dyadic synchrony and latency to repair ruptures in synchrony were examined as mediators. Dyadic synchrony and latency to repair ruptures were found to mediate associations between cumulative risk exposure and children's behavioral and parent-reported self-control. Children exposed to more cumulative risk engaged in less dyadic synchrony and experienced longer latencies to repair ruptures with their caregiver, which in turn was associated with lower child self-control. Though cross-sectional, findings suggest dyadic synchrony and repair processes may represent viable mechanistic pathways linking cumulative risk exposure and deficits in child self-control. However, independent replications using longitudinal and experimental intervention designs are needed to determine causal pathways and inform new approaches for targeting the effects of early risk exposure through a focus on two-generational interventions.
Healthcare personnel (HCP) were recruited to provide serum samples, which were tested for antibodies against Ebola or Lassa virus to evaluate for asymptomatic seroconversion.
Setting:
From 2014 to 2016, 4 patients with Ebola virus disease (EVD) and 1 patient with Lassa fever (LF) were treated in the Serious Communicable Diseases Unit (SCDU) at Emory University Hospital. Strict infection control and clinical biosafety practices were implemented to prevent nosocomial transmission of EVD or LF to HCP.
Participants:
All personnel who entered the SCDU who were required to measure their temperatures and complete a symptom questionnaire twice daily were eligible.
Results:
No employee developed symptomatic EVD or LF. EVD and LF antibody studies were performed on sera samples from 42 HCP. The 6 participants who had received investigational vaccination with a chimpanzee adenovirus type 3 vectored Ebola glycoprotein vaccine had high antibody titers to Ebola glycoprotein, but none had a response to Ebola nucleoprotein or VP40, or a response to LF antigens.
Conclusions:
Patients infected with filoviruses and arenaviruses can be managed successfully without causing occupation-related symptomatic or asymptomatic infections. Meticulous attention to infection control and clinical biosafety practices by highly motivated, trained staff is critical to the safe care of patients with an infection from a special pathogen.
For over a century, scholars have traced higher levels of serious crime in minority compared to White neighborhoods to stark socioeconomic inequality. Yet, this research is largely cross-sectional and does not assess how ethnoracial differences in crime patterns evolve over time in response to shifting structural conditions. The new century witnessed substantial changes to the circumstances that undergird the ethnoracial divide in neighborhood crime as well as a national crime decline. How are the changing dynamics of urban inequality reinforcing or diminishing racial and ethnic disparities in neighborhood crime in the context of the “Great American Crime Decline”? We address this question by first identifying distinct paths of violent and property crime change between 1999 and 2013 for almost 2700 neighborhoods across eighteen cities. We then assess how initial and changing levels of disadvantage, housing instability, and demographics explain divergent crime trajectories within neighborhoods. We find that most neighborhoods have lower levels of homicide and burglary than fifteen years ago. However, homicide and burglary increased in some neighborhoods, and this trend is largely limited to Black neighborhoods. Disadvantage and the housing crisis are critical in accounting for the heightened risk of neighborhoods having increasing rather than decreasing crime trends. In contrast, immigration is linked with declining and stable trends in violent and property crime. Overall, results indicate a widening of the racial-spatial divide for the most marginalized communities in the United States.
The objective of the study was to determine the effect of task-specific self-efficacy on stages of readiness for change among people with substance abuse problems. Participants were 140 men and 33 women with substance abuse problems receiving services in outpatient therapeutic community service programs. The Stages of Change Scale-Substance Abuse (SCS-SA) was the outcome measure. People with substance abuse problems receiving outpatient treatment services can be meaningfully classified into four stages of change groups: (1) Precontemplation, (2) Inactive, (3) Ambivalent-Conforming, and (4) Participation. Readiness for change is related to self-efficacy in work-related skills and risk-avoidance skills. Task-specific self-efficacy is related to stages of change. The findings of this study suggested that providing skill training to enhance task specific self-efficacy can help people with substance abuse problems progress from lower level to higher level of stages of change.
Understanding the genetic and environmental contributions to measures of brain structure such as surface area and cortical thickness is important for a better understanding of the nature of brain-behavior relationships and changes due to development or disease. Continuous spatial maps of genetic influences on these structural features can contribute to our understanding of regional patterns of heritability, since it remains to be seen whether genetic contributions to brain structure respect the boundaries of any traditional parcellation approaches. Using data from magnetic resonance imaging scans collected on a large sample of monozygotic and dizygotic twins in the Vietnam Era Twin Study of Aging, we created maps of the heritability of areal expansion (a vertex-based area measure) and cortical thickness and examined the degree to which these maps were affected by adjustment for total surface area and mean cortical thickness. We also compared the approach of estimating regional heritability based on the average heritability of vertices within the region to the more traditional region-of-interest (ROI)-based approach. The results suggested high heritability across the cortex for areal expansion and, to a slightly lesser degree, for cortical thickness. There was a great deal of genetic overlap between global and regional measures for surface area, so maps of region-specific genetic influences on surface area revealed more modest heritabilities. There was greater inter-regional variability in heritabilities when calculated using the traditional ROI-based approach compared to summarizing vertex-by-vertex heritabilities within regions. Discrepancies between the approaches were greatest in small regions and tended to be larger for surface area than for cortical thickness measures. Implications regarding brain phenotypes for future genetic association studies are discussed.
Despite the continued importance of discrimination for racial labor market inequality, little research explores the process by which workers name potentially negative experiences as race discrimination. Drawing on the legal consciousness literature and organizational approaches to employment discrimination, we assess the effect of social status, job characteristics, and workplace context on the likelihood that workers perceive race discrimination at work. Analyzing data from the Multi-City Study of Urban Inequality, we find that ascriptive status is associated with perceptions of discrimination, with African Americans, Hispanics, and women more likely to perceive racial discrimination, net of job and organizational controls. Results also suggest that workers with a greater sense of entitlement (as indicated by job authority, promotion experience, and union membership) and knowledge of legal entitlements (as indicated by education level and age) are more likely to perceive workplace racial discrimination. Other workplace conditions can signal fairness and decrease perceptions of racial bias, such as formalized screening practices and having nonwhite supervisors, whereas working among predominantly nonwhite coworkers increases the likelihood of perceiving discrimination. These findings suggest that personal attributions of discrimination vary across social groups and their environments, and demonstrate the importance of workplace context for understanding how individuals apply legal concepts, such as discrimination, to their experiences.