Educating on democracy in a time of environmental disasters

The recent diffusion of democracy across the globe has led to an increase in the curiosity of scholars, policymakers and the public alike about the main principles and characteristics of democracy. Equally important are concerns over outcomes of democracy, especially responsiveness of democracy to environmental and citizens’ protection in times of disasters. This article aims to answer several questions about the understanding of principles and outcomes of democracy, and the complexity and variability of democracy across countries, which are still unanswered in the literature. Specifically, it adds to the scholarly debates on democracy and environmental disasters in three ways. First, it presents theoretical and empirical debates on definitions and principles of democracy and its progress worldwide. Second, it discusses the effect of democracy on environmental sustainability. Third, it focuses on the pre-eminence of responsiveness of democratic in comparison to non-democratic governments to environmental disasters, and the best pathways to education on democracy in a time of environmental disasters. The article concludes by highlighting the advantage of mechanisms and solutions of democracy in contrast to non-democracy to challenges in times of environmental disasters and to teaching about responses to environmental disasters

Estimating the impact of HIV PrEP regimens containing long-acting injectable cabotegravir or daily oral tenofovir disoproxil fumarate/emtricitabine among men who have sex with men in the United States: a mathematical modelling study for HPTN 083

Background: The HPTN 083 trial demonstrated superiority of HIV pre-exposure prophylaxis (PrEP) containing long-acting injectable cabotegravir (CAB) to daily oral tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) among men who have sex with men (MSM). We compared the potential population-level impact of TDF/FTC and CAB among MSM in Atlanta, Georgia. Methods: An MSM HIV transmission model was calibrated to Atlanta-specific data on HIV prevalence and PrEP usage (percentage of uninfected MSM on PrEP), assuming only PrEP-indicated MSM used PrEP. CAB effectiveness (efficacy × adherence) of 91% was estimated using data from HPTN 083 and previous TDF/FTC trials. We estimated HIV infections averted over 5/10 years if TDF/FTC use were maintained, or if all TDF/FTC users switched to CAB in January 2022 (vs. no PrEP or continued TDF/FTC use). CAB scenarios with 10%/20% more users were also considered. Progress towards Ending the HIV Epidemic (EHE) goals (75%/90% fewer HIV infections in 2025/2030 vs. 2017) was estimated. Findings: We predicted TDF/FTC at current usage (∼28%) would avert 36.3% of new HIV infections (95% credible interval 25.6–48.7%) among all Atlanta MSM over 2022–2026 vs. no PrEP. Switching to CAB with similar usage may prevent 44.6% (33.2–56.6%) infections vs. no PrEP and 11.9% (5.2–20.2%) infections vs. continued TDF/FTC. Increasing CAB usage 20% could increase the incremental impact over TDF/FTC to 30.0% over 2022–2026, getting ∼60% towards reaching EHE goals (47%/54% fewer infections in 2025/2030). Reaching the 2030 EHE goal would require 93% CAB usage. Interpretation: If CAB effectiveness were like HPTN 083, CAB could prevent more infections than TDF/FTC at similar usage. Increased CAB usage could contribute substantially towards reaching EHE goals, but the usage required to meet EHE goals is unrealistic

An Opinion Dynamics Model for the Diffusion of Innovations

We study the dynamics of the adoption of new products by agents with continuous opinions and discrete actions (CODA). The model is such that the refusal in adopting a new idea or product is increasingly weighted by neighbor agents as evidence against the product. Under these rules, we study the distribution of adoption times and the final proportion of adopters in the population. We compare the cases where initial adopters are clustered to the case where they are randomly scattered around the social network and investigate small world effects on the final proportion of adopters. The model predicts a fat tailed distribution for late adopters which is verified by empirical data.Comment: 14 pages, 8 figures, revised text, a new section with empirical evidence has been adde

Moving research into practice: lessons from the US Agency for Healthcare Research and Quality's IDSRN program

BACKGROUND: The U.S. Agency for Healthcare Research and Quality's (AHRQ) Integrated Delivery Systems Research Network (IDSRN) program was established to foster public-private collaboration between health services researchers and health care delivery systems. Its broad goal was to link researchers and delivery systems to encourage implementation of research into practice. We evaluated the program to address two primary questions: 1) How successful was IDSRN in generating research findings that could be applied in practice? and 2) What factors facilitate or impede such success? METHODS: We conducted in-person and telephone interviews with AHRQ staff and nine IDSRN partner organizations and their collaborators, reviewed program documents, analyzed projects funded through the program, and developed case studies of four IDSRN projects judged promising in supporting research implementation. RESULTS: Participants reported that the IDSRN structure was valuable in creating closer ties between researchers and participating health systems. Of the 50 completed projects studied, 30 had an operational effect or use. Some kinds of projects were more successful than others in influencing operations. If certain conditions were met, a variety of partnership models successfully supported implementation. An internal champion was necessary for partnerships involving researchers based outside the delivery system. Case studies identified several factors important to success: responsiveness of project work to delivery system needs, ongoing funding to support multiple project phases, and development of applied products or tools that helped users see their operational relevance. Factors limiting success included limited project funding, competing demands on potential research users, and failure to reach the appropriate audience. CONCLUSION: Forging stronger partnerships between researchers and delivery systems has the potential to make research more relevant to users, but these benefits require clear goals and appropriate targeting of resources. Trade-offs are inevitable. The health services research community can best consider such trade-offs and set priorities if there is more dialogue to identify areas and approaches where such partnerships may have the most promise. Though it has unique features, the IDSRN experience is relevant to research implementation in diverse settings

The Cultural Evolution of Democracy: Saltational Changes in A Political Regime Landscape

Transitions to democracy are most often considered the outcome of historical modernization processes. Socio-economic changes, such as increases in per capita GNP, education levels, urbanization and communication, have traditionally been found to be correlates or ‘requisites’ of democratic reform. However, transition times and the number of reform steps have not been studied comprehensively. Here we show that historically, transitions to democracy have mainly occurred through rapid leaps rather than slow and incremental transition steps, with a median time from autocracy to democracy of 2.4 years, and overnight in the reverse direction. Our results show that autocracy and democracy have acted as peaks in an evolutionary landscape of possible modes of institutional arrangements. Only scarcely have there been slow incremental transitions. We discuss our results in relation to the application of phylogenetic comparative methods in cultural evolution and point out that the evolving unit in this system is the institutional arrangement, not the individual country which is instead better regarded as the ‘host’ for the political system

An embedded longitudinal multi-faceted qualitative evaluation of a complex cluster randomized controlled trial aiming to reduce clinically important errors in medicines management in general practice

<p>Abstract</p> <p>Background</p> <p>There is a need to shed light on the pathways through which complex interventions mediate their effects in order to enable critical reflection on their transferability. We sought to explore and understand key stakeholder accounts of the acceptability, likely impact and strategies for optimizing and rolling-out a successful pharmacist-led information technology-enabled (PINCER) intervention, which substantially reduced the risk of clinically important errors in medicines management in primary care.</p> <p>Methods</p> <p>Data were collected at two geographical locations in central England through a combination of one-to-one longitudinal semi-structured telephone interviews (one at the beginning of the trial and another when the trial was well underway), relevant documents, and focus group discussions following delivery of the PINCER intervention. Participants included PINCER pharmacists, general practice staff, researchers involved in the running of the trial, and primary care trust staff. PINCER pharmacists were interviewed at three different time-points during the delivery of the PINCER intervention. Analysis was thematic with diffusion of innovation theory providing a theoretical framework.</p> <p>Results</p> <p>We conducted 52 semi-structured telephone interviews and six focus group discussions with 30 additional participants. In addition, documentary data were collected from six pharmacist diaries, along with notes from four meetings of the PINCER pharmacists and feedback meetings from 34 practices. Key findings that helped to explain the success of the PINCER intervention included the perceived importance of focusing on prescribing errors to all stakeholders, and the credibility and appropriateness of a pharmacist-led intervention to address these shortcomings. Central to this was the face-to-face contact and relationship building between pharmacists and a range of practice staff, and pharmacists’ explicitly designated role as a change agent. However, important concerns were identified about the likely sustainability of this new model of delivering care, in the absence of an appropriate support network for pharmacists and career development pathways.</p> <p>Conclusions</p> <p>This embedded qualitative inquiry has helped to understand the complex organizational and social environment in which the trial was undertaken and the PINCER intervention was delivered. The longitudinal element has given insight into the dynamic changes and developments over time. Medication errors and ways to address these are high on stakeholders’ agendas. Our results further indicate that pharmacists were, because of their professional standing and skill-set, able to engage with the complex general practice environment and able to identify and manage many clinically important errors in medicines management. The transferability of the PINCER intervention approach, both in relation to other prescribing errors and to other practices, is likely to be high.</p

Cottrell Scholars Collaborative New Faculty Workshop: Professional Development for New Chemistry Faculty and Initial Assessment of Its Efficacy

The Cottrell Scholars Collaborative New Faculty Workshop (CSC NFW) is a professional development program that was initiated in 2012 to address absences in the preparation of chemistry faculty at research universities as funded researchers and educators (i.e., teacher–scholars). The primary focus of the workshop is an introduction to evidence-based teaching methods; other topics including mentoring, work–life balance, time management, and grant writing are also addressed. A longer-term aim of the workshop is to develop lifelong teacher–scholars by encouraging workshop participants to engage with teaching-focused faculty learning communities through the CSC NFW and at their institutions. The workshop also provides a platform to investigate the adoption of student-centered pedagogies among new faculty, and a study of that process was initiated concurrently. Thus, the aim of the workshop program is to address professional development needs as well as understand the efficacy of that effort

Financing Student Migration: Evidence for a Commitment Problem

This paper develops and tests a model of profit-sharing arrangement over returns to a student migration investment. Taking advantage of a unique dataset on Cameroonian students, I find evidence of non-commitment bargaining between student, parents and an outside helper. The commitment problem arises because the coalition of parents and student has strong incentives not to abide by the outcome of the ex ante negotiation with the helper. This finding suggests some inefficiency of the decision process, in that students from credit-constrained families might not benefit from the support of a helper, even though the returns to their migration can be significant