Current evidence underscores a need to transform how we do clinical research, shifting from academic-driven priorities to co-led community partnership focused programs, accessible and relevant career pathway programs that expand opportunities for career development, and design of trainings and practices to develop cultural competence among research teams. Failures of equitable research translation contribute to health disparities. Drivers of this failed translation include lack of diversity in both researchers and participants, lack of alignment between research institutions and the communities they serve, and lack of attention to structural sources of inequity and drivers of mistrust for science and research. The Duke University Research Equity and Diversity Initiative (READI) is a program designed to better align clinical research programs with community health priorities through community engagement. Organized around three specific aims, READI-supported programs targeting increased workforce diversity, workforce training in community engagement and cultural competence, inclusive research engagement principles, and development of trustworthy partnerships.

Recent changes to US research funding are having far-reaching consequences that imperil the integrity of science and the provision of care to vulnerable populations. Resisting these changes, the BJPsych Portfolio reaffirms its commitment to publishing mental science and advancing psychiatric knowledge that improves the mental health of one and all.

Signs of distress in dogs during veterinary visits are often normalised rather than viewed as welfare concerns. Interventions designed to reduce fear during veterinary visits were evaluated to see if they affected dogs’ behaviours compared to dogs without interventions. Twenty-eight dogs were examined at four visits across eight weeks. Dogs were randomised into intervention (distress reduction/adaptive care) and control groups (standard care) and evaluated via the Working Dog Questionnaire – Pet Dog Version (WDQ-Pet). At visit 1 (baseline) all dogs received the control protocol. Homework was assigned following visit 1 to practice collaborative examination (intervention) or to pet the dog (control) for the same allotted time. At each visit, behaviours were scored (clinical stress score) via video and in-person observations when dogs entered the hospital, stepped onto a scale to be weighed, entered the exam room, at the beginning and end of examination, and after venipuncture. There were no differences between groups at visit 1, or across visits entering the hospital or exam room. At visit 4, intervention scores either decreased or remained low when weighed, and at the beginning and end of the physical exam. Control scores were significantly higher than the intervention scores during these periods. Reduced clinical stress scores indicate intervention dogs had improved care experience compared to the control. The study results highlight the value of applying simple and adaptable interventions, ultimately leading to improved animal care and welfare.

Background: Previous analyses describing the relationship between SARS-CoV-2 infection and Staphylococcus aureus have focused on hospital-onset S. aureus infections occurring during COVID-19 hospitalizations. Because most invasive S. aureus (iSA) infections are community-onset (CO), we characterized CO iSA cases with a recent positive SARS-CoV-2 test (coinfection). Methods: We analyzed CDC Emerging Infections Program active, population- and laboratory-based iSA surveillance data among adults during March 1–December 31, 2020, from 11 counties in 7 states. The iSA cases (S. aureus isolation from a normally sterile site in a surveillance area resident) were considered CO if culture was obtained <3 days after hospital admission. Coinfection was defined as first positive SARS-CoV-2 test ≤14 days before the initial iSA culture.  We explored factors independently associated with SARS-CoV-2 coinfection versus no prior positive SARS-CoV-2 test among CO iSA cases through a multivariable logistic regression model (using demographic, healthcare exposure, and underlying condition variables with P<0.25 in univariate analysis) and examined differences in outcomes through descriptive analysis. Results: Overall, 3,908 CO iSA cases were reported, including 138 SARS-CoV-2 coinfections (3.5%); 58.0% of coinfections had iSA culture and the first positive SARS-CoV-2 test on the same day (Fig. 1). In univariate analysis, neither methicillin resistance (44.2% with coinfection vs 36.5% without; P = .06) nor race and ethnicity differed significantly between iSA cases with and without SARS-CoV-2 coinfection (P = .93 for any association between race and ethnicity and coinfection), although iSA cases with coinfection were older (median age, 72 vs 60 years , P<0.01) and more often female (46.7% vs 36.3%, P=0.01).  In multivariable analysis, significant associations with SARS-CoV-2 coinfection included older age, female sex, previous location in a long-term care facility (LTCF) or hospital, presence of a central venous catheter (CVC), and diabetes (Figure 2).  Two-thirds of co-infection cases had ≥1 of the following characteristics: age > 73 years, LTCF residence 3 days before iSA culture, and/or CVC present any time during the 2 days before iSA culture. More often, iSA cases with SARS-CoV-2 coinfection were admitted to the intensive care unit ≤2 days after iSA culture (37.7% vs 23.3%, P<0.01) and died (33.3% vs 11.3%, P<0.01). Conclusions: CO iSA patients with SARS-CoV-2 coinfection represent a small proportion of CO iSA cases and mostly involve a limited number of factors related to likelihood of acquiring SARS-CoV-2 and iSA. Although CO iSA patients with SARS-CoV-2 coinfection had more severe outcomes, additional research is needed to understand how much of this difference is related to differences in patient characteristics.

Disclosures: None

Settlement scaling theory predicts that higher site densities lead to increased social interactions that, in turn, boost productivity. The scaling relationship between population and land area holds for several ancient societies, but as demonstrated by the sample of 48 sites in this study, it does not hold for the Northern Maya Lowlands. Removing smaller sites from the sample brings the results closer to scaling expectations. We argue that applications of scaling theory benefit by considering social interaction as a product not only of proximity but also of daily life and spatial layouts.