Changes in antimicrobial use during the pandemic in relation to long-term trends in utilization among different antimicrobial stewardship program models have not been fully characterized. We analyzed data from an integrated health system using joinpoint regression and found temporal fluctuations in prescribing as well as continuation of existing trends.

Dr. Albert Somit recently died at 100 years of age. He was a major figure in the development of biopolitics. This essay reflects on his career and his role in helping others in advancing the study of politics and the life sciences.

Distinguished Oral

Background: Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County, California (SHIELD OC) was a CDC-funded regional decolonization intervention from April 2017 through July 2019 involving 38 hospitals, nursing homes (NHs), and long-term acute-care hospitals (LTACHs) to reduce MDROs. Decolonization in NH and LTACHs consisted of universal antiseptic bathing with chlorhexidine (CHG) for routine bathing and showering plus nasal iodophor decolonization (Monday through Friday, twice daily every other week). Hospitals used universal CHG in ICUs and provided daily CHG and nasal iodophor to patients in contact precautions. We sought to evaluate whether decolonization reduced hospitalization and associated healthcare costs due to infections among residents of NHs participating in SHIELD compared to nonparticipating NHs. Methods: Medicaid insurer data covering NH residents in Orange County were used to calculate hospitalization rates due to a primary diagnosis of infection (counts per member quarter), hospital bed days/member-quarter, and expenditures/member quarter from the fourth quarter of 2015 to the second quarter of 2019. We used a time-series design and a segmented regression analysis to evaluate changes attributable to the SHIELD OC intervention among participating and nonparticipating NHs. Results: Across the SHIELD OC intervention period, intervention NHs experienced a 44% decrease in hospitalization rates, a 43% decrease in hospital bed days, and a 53% decrease in Medicaid expenditures when comparing the last quarter of the intervention to the baseline period (Fig. 1). These data translated to a significant downward slope, with a reduction of 4% per quarter in hospital admissions due to infection (P < .001), a reduction of 7% per quarter in hospitalization days due to infection (P < .001), and a reduction of 9% per quarter in Medicaid expenditures (P = .019) per NH resident. Conclusions: The universal CHG bathing and nasal decolonization intervention adopted by NHs in the SHIELD OC collaborative resulted in large, meaningful reductions in hospitalization events, hospitalization days, and healthcare expenditures among Medicaid-insured NH residents. The findings led CalOptima, the Medicaid provider in Orange County, California, to launch an NH incentive program that provides dedicated training and covers the cost of CHG and nasal iodophor for OC NHs that enroll.

Funding: None

Disclosures: Gabrielle M. Gussin, University of California, Irvine, Stryker (Sage Products): Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Clorox: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Medline: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Xttrium: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes.

This special issue considers the relationship of the life sciences to both public policy and public administration. This makes sense because the bureaucratic process and public administration are deeply involved in the policy process and the development of substantive public policy. The two subjects are intertwined. And a biological perspective can illuminate many aspects of both. That is the focus of this issue.

The Empire of Aksum was one of Africa's most influential ancient civilisations. Traditionally, most archaeological fieldwork has focused on the capital city of Aksum, but recent research at the site of Beta Samati has investigated a contemporaneous trade and religious centre located between Aksum and the Red Sea. The authors outline the discovery of the site and present important finds from the initial excavations, including an early basilica, inscriptions and a gold intaglio ring. From daily life and ritual praxis to international trade, this work illuminates the role of Beta Samati as an administrative centre and its significance within the wider Aksumite world.

Objectives: To evaluate prospective and retrospective memory abilities in Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) Veterans with and without a self-reported history of blast-related mild traumatic brain injury (mTBI). Methods: Sixty-one OEF/OIF/OND Veterans, including Veterans with a self-reported history of blast-related mTBI (mTBI group; n=42) and Veterans without a self-reported history of TBI (control group; n=19) completed the Memory for Intentions Test, a measure of prospective memory (PM), and two measures of retrospective memory (RM), the California Verbal Learning Test-II and the Brief Visuospatial Memory Test-Revised. Results: Veterans in the mTBI group exhibited significantly lower PM performance than the control group, but the groups did not differ in their performance on RM measures. Further analysis revealed that Veterans in the mTBI group with current PTSD (mTBI/PTSD+) demonstrated significantly lower performance on the PM measure than Veterans in the control group. PM performance by Veterans in the mTBI group without current PTSD (mTBI/PTSD-) was intermediate between the mTBI/PTSD+ and control groups, and results for the mTBI/PTSD- group were not significantly different from either of the other two groups. Conclusions: Results suggest that PM performance may be a sensitive marker of cognitive dysfunction among OEF/OIF/OND Veterans with a history of self-reported blast-related mTBI and comorbid PTSD. Reduced PM may account, in part, for complaints of cognitive difficulties in this Veteran cohort, even years post-injury. (JINS, 2018, 24, 324–334)

Yellow starthistle is the most widespread broadleaf invasive plant in the western United States, and it is particularly prevalent in California. Prior to the registration of aminopyralid in 2005, the standard for chemical control of yellow starthistle was the herbicide clopyralid. We report on a compilation of several independent trials comparing the efficacy of aminopyralid and clopyralid on yellow starthistle. Treatments were applied at several rates and timings at 11 locations in four states between 2001 and 2007. Treatments were made pre-emergence and postemergence at the seedling and rosette stages of yellow starthistle. Results showed that aminopyralid, even at the low rate of 18 g ae ha−1, provided nearly complete control of yellow starthistle when treatments were made at the seedling stage. However, less consistent control (80 to 100%) resulted with applications made at the pre-emergence and rosette stages. At the seedling stage, aminopyralid is about four times more effective on yellow starthistle compared to clopyralid, based on the rate of acid equivalent. In the Central Valley of California, complete control was obtained at the lowest registered rate (53 g ae ha−1) when applications were made from December through February. At two locations we also evaluated control of the poisonous native plant coast fiddleneck. Although clopyralid does not adequately control coast fiddleneck, aminopyralid provided almost complete control when applied in the winter growing season. Applications of aminopyralid at the rosette stage resulted in a two-fold increase in annual forage grass biomass the following year. These results indicate that aminopyralid is a valuable tool for land managers and can play an important role in integrated management strategies for yellow starthistle and coast fiddleneck.

Russian knapweed is an invasive weed of rangeland, pasture, and natural areas throughout western North America. Aminopyralid is a new pyridine carboxylic acid herbicide that has activity on Russian knapweed at lower use rates than current standard treatments. The objectives of this study were to compare aminopyralid efficacy at the bud to early flower timing and the fall timing with commercial standards for Russian knapweed control. Studies were conducted at five locations in California, Utah, and Wyoming in heavily infested pastures or rangeland. When applied in summer at the bud to early flower timing, aminopyralid at 0.07 kg ae/ha controlled Russian knapweed effectively and was comparable to picloram + 2,4-D amine (0.56 + 1.12 kg ae/ha) at 12 and 24 months after treatment (MAT). The addition of 2,4-D with lower rates of aminopyralid did not improve control. When applied after seed set at the fall timing, control from aminopyralid at 0.05 kg ae/ha and higher was also comparable to picloram (0.56 kg ae/ha) and better than clopyralid (0.42 kg ae/ha) and imazapic (0.18 and 0.21 kg ae/ha) 12 and 21 MAT. Aminopyralid controlled Russian knapweed effectively at lower use rates than current commercial standards and good control lasted for at least 21 to 24 MAT.

Nursing home residents are at risk for acquiring and transmitting MDROs. A serial point-prevalence study of 605 residents in 3 facilities using random sampling found MDRO colonization in 45% of residents: methicillin-resistant Staphylococcus aureus (MRSA, 26%); extended-spectrum β-lactamase–producing Enterobacteriaceae (ESBL, 17%); vancomycin-resistant Enterococcus spp. (VRE, 16%); carbapenem-resistant Enterobacteriaceae (CRE, 1%). MDRO colonization was associated with history of MDRO, care needs, incontinence, and catheters.

Infect Control Hosp Epidemiol 2016;1485–1488

So that the reader can better adjudge possible disagreements, we would like to begin by stating, at the very outset, the thesis argued in our book, Darwinism, Dominance, and Democracy (Somit and Peterson, 1997). As Peter Corning correctly reports in his commentary (2000), we contend that “the most important reason for the rarity of democracy is that evolution has endowed our species, as it has other primates, with a predisposition for hierarchically structured social and political systems” (1997: 1). In short, we argue that Homo sapiens has a “genetic bias” toward authoritarian political societies characterized by hierarchy, dominance, and submission.

Health status has been held to affect people's political orientations and behavior. Using the 1987 National Opinion Research Center General Social Survey, this paper tests for the existence of that relationship. Results suggest that healthier people are more likely to be conservative and status quo oriented, somewhat more politicized, less alienated, and more active in politics. Results, although modest, support the thesis that health status has an effect on political orientations and behavior.

IQ and Global Inequality is a sequel to the authors' earlier IQ and the Wealth of Nations wherein they argued that “… national differences in intelligence are an important factor contributing to differences in national wealth and rates of economic growth” (p. 2). Or, later more precisely stated, that “… national IQ is the single most powerful explanatory variable, but because the explained part of the variation does not rise higher than 40–60 percent, this explanation leaves room for other explanatory factors”(p. 13). Not surprisingly, even so qualified, this thesis triggered a “mixed reception.” As the authors relate with refreshing candor, some of the reviewers denounced them for “jumping to conclusions,” took issue with their “relatively weak statistical evidence and dubious presumptions,” found the study “neither methodologically nor theoretically convincing,” and dismissed the evidence as “virtually meaningless” (p. 3).

In accordance with the principle of full disclosure, we believe we should inform the reader about several matters. First, as associate book review editors of the Journal of Social and Evolutionary Systems, we recommended for publication (but did not commission) a review by Frederic Townsend of Born to Rebel (Townsend, 1997). That recommendation was accepted, and the review appeared in the journal's Volume 2, Issue 2 in 1997.

In this bibliographic essay, we continue our annual updating of the biopolitics literature (see Somit et al., 1980; Peterson, Somit, and Slagter, 1982; Peterson, Somit, and Brown, 1983). We have identified 81 items appearing in 1983 (down a bit from last year's total of 93): 2 books (Corning, 1983b; Flohr and Tbnnesmann, 1983a), 22 full articles published in journals, 18 chapters in books (excluding reprints of previously published materials), 25 conference presentations, 4 master's theses and doctoral dissertations, and 10 commentaries, review essays, etc. It seems worth noting that 12 of the 80 works appearing in 1983 were published in the journal of the Association for Politics and the Life Sciences, Politics and the Life Sciences.