We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Decentralized research has many advantages; however, little is known about the representativeness of a source population in decentralized studies. We recruited participants aged 18-64 years from four states from June to December 2022 for a prospective cohort study to assess viral epidemiology. Our aim was to determine the association between age, gender, race/ethnicity, rurality, and socioeconomic status (SES) on study participation in a decentralized prospective cohort study.
Methods:
We consented 9,286 participants from 231,099 (4.0%) adults with the mean age of 45.6 years (±12.0). We used an electronic decentralized approach for recruitment. Consented participants were more likely to be non-Hispanic White, female, older, urban residents, have more health conditions, and possessed higher socioeconomic status (SES) compared to those non-consented.
Results:
We observed an interaction between SES and race-ethnicity on the odds of consent (P = 0.006). Specifically, SES did not affect non-Hispanic white participation rates(OR 1.24 95% CI 1.16 – 1.32] for the highest SES quartile compared to those with the lowest SES quartile) as much as it did participants combined across the other races (OR 1.73; 95% CI 1.45 – 2.98])
Conclusion:
The relationship between SES and consent rates might be disproportionately greater in historically disadvantaged groups, compared to non-Hispanic White. It suggests that instead of focusing on enrollment of specific minority groups in research, there is value in future research exploring and addressing the diversity of barriers to trials within minority groups. Our study highlights that decentralized studies need to address social determinants of health, especially in under-resourced populations.
Limited academic career prospects are pushing PhD graduates in political science and other disciplines to nonacademic careers. Understanding the mismatch between student and supervisor perceptions of doctoral career training is a starting point for suggesting program reforms. This research note examines the perceptions of PhD students and supervisors on doctoral career training. We compare results from two surveys of English-speaking Canadian universities on doctoral political science programs; one surveys PhD students and the other surveys supervisors. These survey results suggest that 1) students are more aware of the limited academic job market and interested in nonacademic careers than supervisors realize; 2) supervisors are unaware of the sunk costs PhD students face; 3) supervisors and students have different preferences for change in doctoral programs; and 4) students overestimate supervisors’ confidence in preparing them for nonacademic careers. Changes in program design can better meet student needs in these PhD programs.
During the COVID-19 pandemic, research organizations accelerated adoption of technologies that enable remote participation. Now, there’s a pressing need to evaluate current decentralization practices and develop appropriate research, education, and operations infrastructure. The purpose of this study was to examine current adoption of decentralization technologies in a sample of clinical research studies conducted by academic research organizations (AROs).
Methods:
The setting was three data coordinating centers in the U.S. These centers initiated coordination of 44 clinical research studies during or after 2020, with national recruitment and enrollment, and entailing coordination between one and one hundred sites. We determined the decentralization technologies used in these studies.
Results:
We obtained data for 44/44 (100%) trials coordinated by the three centers. Three technologies have been adopted across nearly all studies (98–100%): eIRB, eSource, and Clinical Trial Management Systems. Commonly used technologies included e-Signature (32/44, 73%), Online Payments Portals (26/44, 59%), ePROs (23/44, 53%), Interactive Response Technology (22/44, 50%), Telemedicine (19/44, 43%), and eConsent (18/44, 41%). Wearables (7/44,16%) and Online Recruitment Portals (5/44,11%) were less common. Rarely utilized technologies included Direct-to-Patient Portals (1/44, 2%) and Home Health Nurse Portals (1/44, 2%).
Conclusions:
All studies incorporated some type of decentralization technology, with more extensive adoption than found in previous research. However, adoption may be strongly influenced by institution-specific IT and informatics infrastructure and support. There are inherent needs, responsibilities, and challenges when incorporating decentralization technology into a research study, and AROs must ensure that infrastructure and informatics staff are adequate.
COVID-19 had the potential to dramatically increase public support for welfare. It was a time of apparent increased solidarity, of apparently deserving claimants, and of increasingly widespread exposure to the benefits system. However, there are also reasons to expect the opposite effect: an increase in financial strain fostering austerity and self-interest, and thermostatic responses to increasing welfare generosity. In this paper, we investigate the effects of the pandemic on attitudes towards working-age unemployment benefits in the UK using a unique combination of data sources: (i) temporally fine-grained data on attitudinal change over the course of the pandemic; and (ii) a novel nationally representative survey contrasting attitudes towards pandemic-era and pre-pandemic claimants (including analysis of free-text responses). Our results show that the pandemic prompted little change in UK welfare attitudes. However, we also find that COVID-era unemployment claimants were perceived as substantially more deserving than those claiming prior to the pandemic. This contrast suggests a strong degree of ‘COVID exceptionalism’ – with COVID claimants seen as categorically different from conventional claimants, muting the effect of the pandemic on welfare attitudes overall.
Do all PhD students aspire to an academic career? Do PhD programs appropriately prepare students for the realities of the job market? There is a well-established gap between political science PhD graduates and tenure-track academic postings. The mismatch between PhD graduates and academic positions may point to alternative models of doctoral education as a possible solution. However, the survey of Canadian and Australian PhD students described in this article suggests that issues and challenges are common regardless of the model of doctoral education. Canadian PhDs report more mentoring activity, but they also are more fixated on securing academic positions. However, we find important gender differences across countries: men are more interested in an academic career and only a (disproportionately male) minority is confident that they will succeed in securing a faculty career. This raises questions about diversity in the future of the profession. This research suggests that although students have different experiences under different doctoral models, issues of academic jobs and a mismatch are common in both systems.
Post-traumatic stress disorder occurs in parents of infants with CHD, contributing to psychological distress with detrimental effects on family functioning and well-being. We sought to determine the prevalence and factors associated with post-traumatic stress disorder symptoms in parents whose infants underwent staged palliation for single ventricle heart disease.
Materials and methods:
A large longitudinal multi-centre cohort study evaluated 215 mothers and fathers for symptoms of post-traumatic stress disorder at three timepoints, including post-Norwood, post-Stage II, and a final study timepoint when the child reached approximately 16 months of age, using the self-report questionnaire Impact of Event Scale – Revised.
Results:
The prevalence of probable post-traumatic stress disorder post-Norwood surgery was 50% of mothers and 39% of fathers, decreasing to 27% of mothers and 24% of fathers by final follow-up. Intrusive symptoms such as flashbacks and nightmares and hyperarousal symptoms such as poor concentration, irritability, and sudden physical symptoms of racing heart and difficulty breathing were particularly elevated in parents. Higher levels of anxiety, reduced coping, and decreased satisfaction with parenting were significantly associated with symptoms of post-traumatic stress disorder in parents. Demographic and clinical variables such as parent education, pre-natal diagnosis, medical complications, and length of hospital stay(s) were not significantly associated with symptoms of post-traumatic stress disorder.
Discussion:
Parents whose infants underwent staged palliation for single ventricle heart disease often reported symptoms of post-traumatic stress disorder. Symptoms persisted over time and routine screening might help identify parents at-risk and prompt referral to appropriate supports.
Supervisors shape the PhD student experience and play a critical role in students’ development. To what extent and in what ways are faculty engaged in mentorship? Are faculty mentoring more or differently now than in the past? This study of political science faculty from political science departments offering PhD programs in the English language finds that graduate supervision is changing over time, with mentorship practices becoming both more common and more varied. Supervisors do not appear to be simply replicating their own limited experience of mentorship as a PhD student. Instead, supervisors are becoming more actively and directly involved in their students’ research careers in ways that increase their students’ career opportunities. There is opportunity for institutions, at both the university and department level, to further invest in building the capacity and ability of supervisors to be effective mentors.
The rapid spread of coronavirus disease 2019 (COVID-19) required swift preparation to protect healthcare personnel (HCP) and patients, especially considering shortages of personal protective equipment (PPE). Due to the lack of a pre-existing biocontainment unit, we needed to develop a novel approach to placing patients in isolation cohorts while working with the pre-existing physical space.
Objectives:
To prevent disease transmission to non–COVID-19 patients and HCP caring for COVID-19 patients, to optimize PPE usage, and to provide a comfortable and safe working environment.
Methods:
An interdisciplinary workgroup developed a combination of approaches to convert existing spaces into COVID-19 containment units with high-risk zones (HRZs). We developed standard workflow and visual management in conjunction with updated staff training and workflows. The infection prevention team created PPE standard practices for ease of use, conservation, and staff safety.
Results:
The interventions resulted in 1 possible case of patient-to-HCP transmission and zero cases of patient-to-patient transmission. PPE usage decreased with the HRZ model while maintaining a safe environment of care. Staff on the COVID-19 units were extremely satisfied with PPE availability (76.7%) and efforts to protect them from COVID-19 (72.7%). Moreover, 54.8% of HCP working in the COVID-19 unit agreed that PPE monitors played an essential role in staff safety.
Conclusions:
The HRZ model of containment unit is an effective method to prevent the spread of COVID-19 with several benefits. It is easily implemented and scaled to accommodate census changes. Our experience suggests that other institutions do not need to modify existing physical structures to create similarly protective spaces.
This chapter aims to describe the psychology of nonbelonging through co-constructed accounts by informal settlement residents who belong – yet also struggle to not belong – to ‘non-places’ such as the informal settlement. It illustrates how (non)belonging is performed as unspoken affective senses of place that are resonant in narratives. Using Lacanian psychoanalytic insights, the chapter contributes to an expanded conceptualisation of ‘senses of place’ by showing that we also perform place belonging in an ‘unconscious’ sense – beyond our discursive performances (place identity) or expressed feeling states (place attachment). This epistemological stance highlights senses of place belonging as coordinated via an unspoken social contract with the hovering interlocutor (Other), who offers the navigational cues to situate where we are (place) and to define who we are (identity).
ABSTRACT IMPACT: Use of this novel murine model of inflammatory bowel disease (IBD) and C. difficile infection (CDI) will aid in developing new clinical approaches to predict, diagnose, and treat CDI in the IBD population. OBJECTIVES/GOALS: IBD is associated with intestinal inflammation and alterations of the gut microbiota, both of which can diminish colonization resistance to C. difficile. Here, we sought to determine if IBD is sufficient to render mice susceptible to C. difficile colonization and infection in the absence of other perturbations, such as antibiotic treatment. METHODS/STUDY POPULATION: C57BL/6 IL-10-/- mice were colonized with Helicobacter hepaticus to trigger colonic inflammation akin to human IBD. Control mice, not colonized with H. hepaticus, were pretreated with the antibiotic cefoperazone to render the gut microbiota susceptible to CDI. Mice were then gavaged with spores of the toxigenic C. difficile strain VPI 10463 and monitored for C. difficile colonization and disease. The fecal microbiota at the time of C. difficile exposure was profiled by 16S rRNA gene sequencing and analyzed using mothur. Statistical analyses were performed using R. RESULTS/ANTICIPATED RESULTS: Mice with IBD harbored significantly distinct intestinal microbial communities compared to non-IBD controls at the time of C. difficile spore exposure (14 days post-IBD trigger). Mice with IBD were susceptible to persistent C. difficile colonization, while genetically identical non-IBD controls were resistant to C. difficile colonization. Concomitant IBD and CDI was associated with significantly worse clinical and intestinal disease than unaccompanied IBD. DISCUSSION/SIGNIFICANCE OF FINDINGS: Patients with IBD who develop concurrent CDI experience increased morbidity and mortality. These studies in a novel mouse model of IBD and CDI emphasize the dual importance of host responses and alterations of the gut microbiota in susceptibility to C. difficile colonization and infection in the setting of IBD.
To characterize postextraction antibiotic prescribing patterns, predictors for antibiotic prescribing and the incidence of and risk factors for postextraction oral infection.
Design:
Retrospective analysis of a random sample of veterans who received tooth extractions from January 1, 2017 through December 31, 2017.
Setting:
VA dental clinics.
Patients:
Overall, 69,610 patients met inclusion criteria, of whom 404 were randomly selected for inclusion. Adjunctive antibiotics were prescribed to 154 patients (38.1%).
Intervention:
Patients who received or did not receive an antibiotic were compared for the occurrence of postextraction infection as documented in the electronic health record. Multivariable logistic regression was performed to identify factors associated with antibiotic receipt.
Results:
There was no difference in the frequency of postextraction oral infection identified among patients who did and did not receive antibiotics (4.5% vs 3.2%; P = .59). Risk factors for postextraction infection could not be identified due to the low frequency of this outcome. Patients who received antibiotics were more likely to have a greater number of teeth extracted (aOR, 1.10; 95% CI, 1.03–1.18), documentation of acute infection at time of extraction (aOR, 3.02; 95% CI, 1.57–5.82), molar extraction (aOR, 1.78; 95% CI, 1.10–2.86) and extraction performed by an oral maxillofacial surgeon (aOR, 2.29; 95% CI, 1.44–3.58) or specialty dentist (aOR, 5.77; 95% CI, 2.05–16.19).
Conclusion:
Infectious complications occurred at a low incidence among veterans undergoing tooth extraction who did and did not receive postextraction antibiotics. These results suggest that antibiotics have a limited role in preventing postprocedural infection; however, future studies are necessary to more clearly define the role of antibiotics for this indication.
The purpose of this paper is to build on personal engagement and role theory to develop a conceptual definition of engagement to different organizational roles (job, organization, supervisor, and coworkers) and create and validate the Role-Based Engagement Scale (RBES). Data were collected from four samples (n = 1,302) of employees, including three from multiple organizations and one from an aircraft manufacturer. Results across three studies consistently support the four dimension structure of the RBES, its internal consistency, convergent, discriminant, and predictive validity based on a series of confirmatory factor analyses. The RBES is a psychometrically sound instrument that measures engagement to job, organization, supervisor, and coworkers. This instrument will provide more targeted information for human resource management (HRM) professionals tasked with developing training methods and processes to improve low-scoring dimensions of engagement, optimizing HRM interventions.
To develop a regional antibiogram within the Chicagoland metropolitan area and to compare regional susceptibilities against individual hospitals within the area and national surveillance data.
Design:
Multicenter retrospective analysis of antimicrobial susceptibility data from 2017 and comparison to local institutions and national surveillance data.
Setting and participants:
The analysis included 51 hospitals from the Chicago–Naperville–Elgin Metropolitan Statistical Area within the state of Illinois. Overall, 18 individual collaborator hospitals provided antibiograms for analysis, and data from 33 hospitals were provided in aggregate by the Becton Dickinson Insights Research Database.
Methods:
All available antibiogram data from calendar year 2017 were combined to generate the regional antibiogram. The final Chicagoland antibiogram was then compared internally to collaborators and externally to national surveillance data to assess its applicability and utility.
Results:
In total, 167,394 gram-positive, gram-negative, fungal, and mycobacterial isolates were collated to create a composite regional antibiogram. The regional data represented the local institutions well, with 96% of the collaborating institutions falling within ±2 standard deviations of the regional mean. The regional antibiogram was able to include 4–5-fold more gram-positive and -negative species with ≥30 isolates than the median reported by local institutions. Against national surveillance data, 18.6% of assessed pathogen–antibiotic combinations crossed prespecified clinical thresholds for disparity in susceptibility rates, with notable trends for resistant gram-positive and gram-negative bacteria.
Conclusions:
Developing an accurate, reliable regional antibiogram is feasible, even in one of the largest metropolitan areas in the United States. The biogram is useful in assessing susceptibilities to less commonly encountered organisms and providing clinicians a more accurate representation of local antimicrobial resistance rates compared to national surveillance databases.
In face of the ongoing discrepancy between the number of political science PhD graduates and the availability of permanent academic positions, in this article we consider attitudes of faculty members towards options to address this issue. Based on a survey of faculty members in PhD-granting political science programs at English-speaking Canadian universities, we find considerable support for both reducing the number of PhD students admitted and reforming curriculum to ensure graduates cultivate skills transferable to non-academic environments. At the same time, faculty members are inclined to believe that PhD students themselves should shoulder the greatest responsibility for career preparation.
Australia is a federation. The division of powers set out in the Australian Constitution between the federal government and the state and territory governments is such that the legal relationship between adults and children is partly governed by federal law and partly by state law. Broadly speaking, the federal government has exclusive power in relation to the formation of marriage (and de facto relationships), divorce, parenting disputes and all maintenance obligations, with states retaining all residual jurisdiction (e.g. care and protection matters, adoption, surrogacy, artificial reproduction etc.). Having said that, as this chapter shows, there are complex interactions at times between state and federal law.
CHANGES IN THE TRADITIONAL FAMILY
A. MOTHERS
1. Is maternity automatically established by the birth certificate?
Leaving aside artificial reproductive situations and adoption (which have their own rules and are discussed at Q. 17 and 32), a woman who gives birth to a child is the legal mother of the child in Australia. This is because parenthood is – legally – dependent solely on biology. Under s 69R of the Family Law Act 1975 (Cth) (FLA) a person named on the birth certificate is presumed to be the parent of the child, so in a sense maternity is legally proved by being named on the birth certificate, because being named as a parent on a birth certificate raises a legal presumption of parenthood. However, this is only a presumption, which means that a person seeking to disprove parenthood of a person on the register bears the legal onus of proof. Thus, the birth certificate is relevant from an evidentiary point of view, though of course is regularly provided as proof of parenthood. Each state has its own birth registration legislation.
The presumption of parenthood can be rebutted by showing through a DNA test that the woman is not biologically the mother.
If a woman's name is not on the register, she is still legally the mother if she is the biological mother, but she will need to prove it if questioned.
This book offers innovative tips and tried-and-tested best practice to enable library and knowledge workers to take control of professional development regardless of the budget and time available to them. Continuing professional development (CPD) is a key component of a successful and satisfying career. Part of the Practical Tips for Library and Information Professionals series, this book offer a wide range of ideas and methods for all library and information professionals to manage the development of those who work for and with them.
Background: Transdiagnostic psychotherapies are designed to apply the same underlying treatment principles across a set of psychiatric disorders, without significant tailoring to specific diagnoses. Several transdiagnostic psychotherapy protocols have been developed recently, each of which has its own strengths and weaknesses. One promising treatment is Transdiagnostic Behaviour Therapy (TBT), in that it is one of the few transdiagnostic treatments to date shown to be effective in patients with depressive and anxiety disorders. However, TBT has only been investigated via individual psychotherapy. Aims: The present study investigated the effectiveness of a group protocol for TBT, compared with disorder-specific group psychotherapies, in a naturalistic setting. Method: 109 participants with various diagnoses of affective disorders completed either group TBT (n = 37) or a disorder-specific group psychotherapy (n = 72). Measures included assessments of psychiatric symptomatology and transdiagnostic impairment at baseline and post-treatment. Results: Overall, participants in the TBT group demonstrated significant improvements across all measures. When compared with disorder-specific groups, no statistical differences were observed between groups across symptoms; however, participants in the TBT group demonstrated roughly twice the treatment effect sizes in transdiagnostic impairment compared with participants in the disorder-specific groups. In addition, when participants from the most well-represented diagnosis and disorder-specific treatment (social anxiety disorder) were investigated separately, participants in the TBT group demonstrated significantly larger improvements in comorbid depressive symptoms than participants in the disorder-specific treatment. Conclusions: Pending replication and additional comparison studies, group TBT may provide an effective group treatment option for patients with affective disorders.
Field experiments were conducted over 3 yr at three locations in Illinois to evaluate the efficacy of glyphosate in glyphosate-resistant soybean planted in rows spaced 19, 38, and 76 cm. Minimal soybean injury (less than 10%) was observed from any glyphosate treatment. Glyphosate treatments controlled 82 to 99% of giant foxtail. Common waterhemp control was increased as soybean row spacing was decreased. Applying sequential glyphosate applications or increasing the glyphosate rate from 420 g ae/ha to 840 g/ha frequently increased common waterhemp control in 76-cm rows. Velvetleaf control with glyphosate was variable, ranging from 48 to 99%. Decreasing soybean row spacing, utilizing sequential glyphosate applications, or increasing the glyphosate rate improved velvetleaf control in at least four of eight site-years. Glyphosate treatments generally resulted in weed control and soybean yield equal to or greater than the standard herbicide treatments. However, glyphosate treatments yielded less than the hand-weeded control in four of eight site-years, suggesting that weed control from glyphosate treatments was sometimes inadequate.
YOUNG (2013, 14) defines projects as ‘Temporary endeavours to achieve some specific objectives in a defined time’. This means that projects are not something which are part of the day-to-day operation of a service, or business as usual. They are a one-off occurrence which is unique and will ultimately result in a change to your service, whether by changing a process, introducing a new product or creating an innovative service. Projects can vary in size and scope, will be of different timescales and will require additional resources, whether financial or human. Projects can range from large-scale national programmes of interconnected projects, interdepartmental working groups or smaller project groups.
You and your teams will be involved in a number of projects, whether local, for example to implement a new library management system, or a national programme of work, such as the Knowledge for Healthcare Programme (Health Education England, 2014) in the UK. This programme incorporates a number of workstreams, each with a number of smaller task and finish groups which are responsible for delivering specific outcomes. Each task and finish group comprises health library staff from different organizations across England, who are working together to deliver their smaller project outcomes. Your team members may be involved purely in library-based projects, but can also bring their unique specialist skills in knowledge management, evidence or information to interdepartmental organizational projects involving a number of staff from different teams.
Tools
Newton (2013) defines a project as having a number of stages, including defining the project, planning the project, identifying resource requirements, delivering the project, managing risks, evaluation and learning lessons. There are a number of tools which can be used to manage projects and whichever you choose is likely to depend on the complexity of the project and your requirements. Check out Tip 73 (p. 190) for more information about project management tools. Project definition and planning are central to ensuring that everyone understands what the project aims to deliver, the resources required and individual roles, and this is discussed in more detail in Tip 100 (p. 266).