Frequent Undetected Ward-Based Methicillin-Resistant Staphylococcus aureus Transmission Linked to Patient Sharing Between Hospitals.

Background: Recent evidence suggests that hospital transmission of methicillin-resistant Staphylococcus aureus (MRSA) is uncommon in UK centers that have implemented sustained infection control programs. We investigated whether a healthcare-network analysis could shed light on transmission paths currently sustaining MRSA levels in UK hospitals. Methods: A cross-sectional observational study was performed in 2 National Health Service hospital groups and a general district hospital in Southeast London. All MRSA patients identified at inpatient, outpatient, and community settings between 1 November 2011 and 29 February 2012 were included. We identified genetically defined MRSA transmission clusters in individual hospitals and across the healthcare network, and examined genetic differentiation of sequence type (ST) 22 MRSA isolates within and between hospitals and inpatient or outpatient and community settings, as informed by average and median pairwise single-nucleotide polymorphisms (SNPs) and SNP-based proportions of nearly identical isolates. Results: Two hundred forty-eight of 610 (40.7%) MRSA patients were linked in 90 transmission clusters, of which 27 spanned multiple hospitals. Analysis of a large 32 patient ST22-MRSA cluster showed that 26 of 32 patients (81.3%) had multiple contacts with one another during ward stays at any hospital. No residential, outpatient, or significant community healthcare contacts were identified. Genetic differentiation between ST22 MRSA inpatient isolates from different hospitals was less than between inpatient isolates from the same hospitals (P ≤ .01). Conclusions: There is evidence of frequent ward-based transmission of MRSA brought about by frequent patient admissions to multiple hospitals. Limiting in-ward transmission requires sharing of MRSA status data between hospitals

Planetary health: from concept to decisive action.

Planetary health sets the ambitious task of understanding the dynamic and systemic relationships between global environmental changes, their effects on natural systems, and how changes to natural systems affect human health and wellbeing at multiple scales: global (eg, climate), regional (eg, transboundary fire emissions), and local (eg, persistent organic pollutants). By emphasising interconnections between human health and environmental changes and enabling holistic thinking about overlapping challenges and integrated solutions for present and future generations, the concept of planetary health offers an opportunity to advance the 2030 Agenda for Sustainable Development, including identification of co-benefits across targets, encouraging effective cross-sector action and partnerships, and ensuring policy coherence. In turn, the agenda of the Sustainable Development Goals (SDGs) offers substantial opportunities to advance planetary health. As the scientific evidence strengthens and public appreciation of humanity's dependence on the state of natural systems increases, now is the time to move from concept to decisive action to protect planetary health

HIV Risk among MSM in Senegal: A Qualitative Rapid Assessment of the Impact of Enforcing Laws That Criminalize Same Sex Practices

Men who have sex with men (MSM) are at high risk for HIV in Senegal, with a prevalence of 21.5%. In December 2008, nine male HIV prevention workers were imprisoned for “acts against nature” prohibited by Senegalese law. This qualitative study assessed the impact of these arrests on HIV prevention efforts. A purposive sample of MSM in six regions of Senegal was recruited by network referral. 26 in-depth interviews (IDIs) and 6 focus group discussions (FGDs) were conducted in July–August 2009. 14 key informants were also interviewed. All participants reported pervasive fear and hiding among MSM as a result of the December 2008 arrests and publicity. Service providers suspended HIV prevention work with MSM out of fear for their own safety. Those who continued to provide services noticed a sharp decline in MSM participation. An effective response to the HIV epidemic in Senegal should include active work to decrease enforcement of this law

Insights into the accuracy of social scientists' forecasts of societal change

How well can social scientists predict societal change, and what processes underlie their predictions? To answer these questions, we ran two forecasting tournaments testing the accuracy of predictions of societal change in domains commonly studied in the social sciences: ideological preferences, political polarization, life satisfaction, sentiment on social media, and gender–career and racial bias. After we provided them with historical trend data on the relevant domain, social scientists submitted pre-registered monthly forecasts for a year (Tournament 1; N = 86 teams and 359 forecasts), with an opportunity to update forecasts on the basis of new data six months later (Tournament 2; N = 120 teams and 546 forecasts). Benchmarking forecasting accuracy revealed that social scientists’ forecasts were on average no more accurate than those of simple statistical models (historical means, random walks or linear regressions) or the aggregate forecasts of a sample from the general public (N = 802). However, scientists were more accurate if they had scientific expertise in a prediction domain, were interdisciplinary, used simpler models and based predictions on prior data

An examination of Downtown Vancouver streets: does pedestrian-oriented design actually foster increased pedestrian usage?

This research paper examines and compares Downtown Vancouver’s premier streets and the relationship between pedestrian-oriented design and pedestrian use. This study aims to determine whether streets that possess more pedestrian-oriented design features result in higher pedestrian counts than streets with fewer such features. In addition, the study tries to determine what specific types of pedestrian-oriented features are present on streets with higher pedestrian counts that were not present on streets with lower counts. Data were collected by conducting pedestrian counts for the streets studied and by an observational checklist of pedestrian-oriented design features present on each street. The results of this study provide insight on the relationship between street character and pedestrian-oriented amenities and how this relationship influences pedestrian use. The research determined that the quantity of amenities is not important but the types of amenities available in relation to the role of the street were important factors

Covid-19 as a long multiwave event: implications for responses to safeguard younger generations

Mandeep Dhaliwal and colleagues call for urgent correction of the response to covid-19 to safeguard the development of children and young peopl