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Depuis les années 1990, l’étude des innovations sociales fait l’objet de débats entourant les problèmes de recherche, les approches théoriques et les méthodes. La majorité des recherches ont privilégié les études de cas. Toutefois, plus récemment, des chercheurs ont commencé à réaliser des méta-études à partir de banques de données qualitatives. Cet article examine une démarche novatrice mise en œuvre par le Centre de recherche sur les innovations sociales (CRISES). Partant de centaines d’étude de cas, le CRISES a mis sur pied une base de données sur l’innovation sociale en vue de réaliser des analyses statistiques. Après avoir présenté les tendances en sciences sociales à la constitution de banques de données et à la réalisation de méta-études, nous exposons la méthodologie et les assises épistémologiques du projet afin d’en dégager l’originalité au regard des cartographies d’innovations sociales. L’article se conclut par une évaluation des limites méthodologiques et de la portée analytique du projet.

AbstractObjectives:In Québec, Canada, we evaluated the risk of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection associated with (1) the demographic and employment characteristics among healthcare workers (HCWs) and (2) the workplace and household exposures and the infection prevention and control (IPC) measures among patient-facing HCWs.Design:Test-negative case-control study.Setting:Provincial health system.Participants:HCWs with PCR-confirmed coronavirus disease 2019 (COVID-19) diagnosed between November 15, 2020, and May 29, 2021 (ie, cases), were compared to HCWs with compatible symptoms who tested negative during the same period (ie, controls).Methods:Adjusted odds ratios (aORs) of infection were estimated using regression logistic models evaluating demographic and employment characteristics (all 4,919 cases and 4,803 controls) or household and workplace exposures and IPC measures (2,046 patient-facing cases and 1,362 controls).Results:COVID-19 risk was associated with working as housekeeping staff (aOR, 3.6), as a patient-support assistant (aOR, 1.9), and as nursing staff (aOR, 1.4), compared to administrative staff. Other risk factors included being unexperienced (aOR, 1.5) and working in private seniors’ homes (aOR, 2.1) or long-term care facilities (aOR, 1.5), compared to acute-care hospitals. Among patient-facing HCWs, exposure to a household contact was reported by 9% of cases and was associated with the highest risk of infection (aOR, 7.8). Most infections were likely attributable to more frequent exposure to infected patients (aOR, 2.7) and coworkers (aOR, 2.2). Wearing an N95 respirator during contacts with COVID-19 patients (aOR, 0.7) and vaccination (aOR, 0.2) were the measures associated with risk reduction.Conclusion:In the context of the everchanging SARS-CoV-2 virus with increasing transmissibility, measures to ensure HCW protection, including vaccination and respiratory protection, and patient safety will require ongoing evaluation.

AbstractThe coronavirus disease 2019 (COVID-19) pandemic has placed significant burden on healthcare systems. We compared Clostridioides difficileinfection (CDI) epidemiology before and during the pandemic across 71 hospitals participating in the Canadian Nosocomial Infection Surveillance Program. Using an interrupted time series analysis, we showed that CDI rates significantly increased during the COVID-19 pandemic.

IMPORTANCE: Cardiac implantable electronic device (CIED) infection is a potentially devastating complication with an estimated 12-month mortality of 15% to 30%. The association of the extent (localized or systemic) and timing of infection with all-cause mortality has not been established. OBJECTIVE: To evaluate the association of the extent and timing of CIED infection with all-cause mortality. DESIGN, SETTING, AND PARTICIPANTS: This prospective observational cohort study was conducted between December 1, 2012, and September 30, 2016, in 28 centers across Canada and the Netherlands. The study included 19 559 patients undergoing CIED procedures, 177 of whom developed an infection. Data were analyzed from April 5, 2021, to January 14, 2023. EXPOSURES: Prospectively identified CIED infections. MAIN OUTCOMES AND MEASURES: Time-dependent analysis of the timing (early [≤3 months] or delayed [3-12 months]) and extent (localized or systemic) of infection was performed to determine the risk of all-cause mortality associated with CIED infections. RESULTS: Of 19 559 patients undergoing CIED procedures, 177 developed a CIED infection. The mean (SD) age was 68.7 (12.7) years, and 132 patients were male (74.6%). The cumulative incidence of infection was 0.6%, 0.7%, and 0.9% within 3, 6, and 12 months, respectively. Infection rates were highest in the first 3 months (0.21% per month), reducing significantly thereafter. Compared with patients who did not develop CIED infection, those with early localized infections were not at higher risk for all-cause mortality (no deaths at 30 days [0 of 74 patients]: adjusted hazard ratio [aHR], 0.64 [95% CI, 0.20-1.98]; P = .43). However, patients with early systemic and delayed localized infections had an approximately 3-fold increase in mortality (8.9% 30-day mortality [4 of 45 patients]: aHR, 2.88 [95% CI, 1.48-5.61]; P = .002; 8.8% 30-day mortality [3 of 34 patients]: aHR, 3.57 [95% CI, 1.33-9.57]; P = .01), increasing to a 9.3-fold risk of death for those with delayed systemic infections (21.7% 30-day mortality [5 of 23 patients]: aHR, 9.30 [95% CI, 3.82-22.65]; P < .001). CONCLUSIONS AND RELEVANCE: Findings suggest that CIED infections are most common within 3 months after the procedure. Early systemic infections and delayed localized infections are associated with increased mortality, with the highest risk for patients with delayed systemic infections. Early detection and treatment of CIED infections may be important in reducing mortality associated with this complication.

AbstractWe performed viral culture of nasopharyngeal specimens in individuals aged 79 and older, infected with severe acute respiratory coronavirus virus 2 (SARS-CoV-2), 10 days after symptom onset. A positive viral culture was obtained in 10 (45%) of 22 participants, including 4 (33%) of 12 individuals with improving symptoms. The results of this small study suggest that infectivity may be prolonged among older individuals.

Contexte:La pandémie de COVID-19 a affecté de manière disproportionnée les travailleurs de la santé. Nous avons voulu mesurer la séroprévalence du SRAS-CoV-2 chez les travailleurs de la santé dans les hôpitaux du Québec, au Canada, après la première vague de la pandémie, afin d’explorer les facteurs associés à la SRAS-CoV-2-séropositivité.Méthodes:Entre le 6 juillet et le 24 septembre 2020, nous avons recruté des travailleurs de la santé de 10 hôpitaux, dont 8 d’une région où l’incidence de la COVID-19 était élevée (région de Montréal) et 2 de régions du Québec où l’incidence était faible. Les travailleurs de la santé admissibles étaient des médecins, des infirmières, des préposées aux bénéficiaires et des préposés à l’entretien ménager travaillant dans 4 types d’unité de soins (urgences, soins intensifs, unité hospitalière COVID-19 et unité hospitalière non-COVID-19). Les participants ont répondu à un questionnaire et subi un dépistage sérologique du SRAS-CoV-2. Nous avons identifié les facteurs ayant un lien indépendant avec une séroprévalence plus élevée.Résultats:Parmi les 2056 travailleurs de la santé recrutés, 241 (11,7 %) se sont révélés SRAS-CoV-2-positifs. Parmi eux, 171 (71,0 %) avaient déjà reçu un diagnostic de COVID-19. La séroprévalence a varié d’un hôpital à l’autre, de 2,4 %–3,7 % dans les régions où l’incidence était faible, à 17,9 %–32,0 % dans les hôpitaux ayant connu des éclosions touchant 5 travailleurs de la santé ou plus. La séroprévalence plus élevée a été associée au fait de travailler dans un hôpital où des éclosions sont survenues (rapport de prévalence ajusté 4,16, intervalle de confiance [IC] à 95 % 2,63–6,57), au fait d’être infirmière ou auxiliaire (rapport de prévalence ajusté 1,34, IC à 95 % 1,03–1,74), préposée aux bénéficiaires (rapport de prévalence ajusté 1,49, IC à 95 % 1,12–1,97) et d’ethnicité noire ou hispanique (rapport de prévalence ajusté 1,41, IC à 95 % 1,13–1,76). La séroprévalence moindre a été associée au fait de travailler dans une unité de soins intensifs (rapport de prévalence ajusté 0,47, IC à 95 % 0,30–0,71) ou aux urgences (rapport de prévalence ajusté 0,61, IC à 95 % 0,39–0,98).Interprétation:Les travailleurs de la santé des hôpitaux du Québec ont été exposés à un risque élevé d’infection par le SRAS-CoV-2, particulièrement lors des éclosions. Il faudra travailler à mieux comprendre la dynamique de la transmission du SRAS-CoV-2 dans les milieux de soins.

Abstract:According to a recent study by the Brookings Institution (Reeves & Krause, 2016), vasectomies are safer, more effective, and less expensive than most other voluntary sterilization methods. While the procedure has grown in popularity in recent years, particularly in the United Kingdom and Canada, it is much less common in the United States. This discrepancy can be attributed to both social (a perception that contraception is “women’s work”) and policy-based factors (lack of coverage under the Affordable Care Act). This paper examines the role and extent to which invitational rhetoric could be a useful communicative lens for both partners and providers considering vasectomies, thus increasing access to and utilization of the safe, effective, and affordable procedure. In this policy brief, we suggest strategies for incorporating invitational rhetoric into health professions education curricula, patient counseling literature, and policy language in order to address some of the social stigma around the procedure.

Background:The COVID-19 pandemic has disproportionately affected health care workers. We sought to estimate SARS-CoV-2 seroprevalence among hospital health care workers in Quebec, Canada, after the first wave of the pandemic and to explore factors associated with SARS-CoV-2 seropositivity.Methods:Between July 6 and Sept. 24, 2020, we enrolled health care workers from 10 hospitals, including 8 from a region with a high incidence of COVID-19 (the Montréal area) and 2 from low-incidence regions of Quebec. Eligible health care workers were physicians, nurses, orderlies and cleaning staff working in 4 types of care units (emergency department, intensive care unit, COVID-19 inpatient unit and non-COVID-19 inpatient unit). Participants completed a questionnaire and underwent SARS-CoV-2 serology testing. We identified factors independently associated with higher seroprevalence.Results:Among 2056 enrolled health care workers, 241 (11.7%) had positive SARS-CoV-2 serology. Of these, 171 (71.0%) had been previously diagnosed with COVID-19. Seroprevalence varied among hospitals, from 2.4% to 3.7% in low-incidence regions to 17.9% to 32.0% in hospitals with outbreaks involving 5 or more health care workers. Higher seroprevalence was associated with working in a hospital where outbreaks occurred (adjusted prevalence ratio 4.16, 95% confidence interval [CI] 2.63–6.57), being a nurse or nursing assistant (adjusted prevalence ratio 1.34, 95% CI 1.03–1.74) or an orderly (adjusted prevalence ratio 1.49, 95% CI 1.12–1.97), and Black or Hispanic ethnicity (adjusted prevalence ratio 1.41, 95% CI 1.13–1.76). Lower seroprevalence was associated with working in the intensive care unit (adjusted prevalence ratio 0.47, 95% CI 0.30–0.71) or the emergency department (adjusted prevalence ratio 0.61, 95% CI 0.39–0.98).Interpretation:Health care workers in Quebec hospitals were at high risk of SARS-CoV-2 infection, particularly in outbreak settings. More work is needed to better understand SARS-CoV-2 transmission dynamics in health care settings.

An institution’s marketing materials are an important part of presenting its culture. In 2018, communication professionals in the Office of Faculty Affairs, Professional Development, and Diversity at the Indiana University School of Medicine recognized after reviewing the literature that using images illustrating diversity in marketing materials may have unintended negative consequences and could potentially reflect poorly on the institution. Representations of diversity that are discordant with the actual demographics of an institution can create distrust among faculty, students, and staff who discover an institution is not as diverse or supportive of diversity as their marketing materials suggest. If institutions adopt an aspirational approach to images and depict more diversity than actual demographics reflect, the authors of this Perspective recommend that they both develop marketing materials that present a widely diverse selection of images and demonstrate transparency in their communication strategies.To improve their promotional materials, the authors conducted an analysis of their institution’s strategy for selecting images for these materials, identified institutional goals related to the strategic use of images, created training materials for staff, and drafted a public-facing statement about diversity in images. These measures are a significant step forward in cultivating the ethical use of images illustrating diversity. In the future, institutions should highlight their approaches to using images to portray diversity, as well as photograph and document a wide range of events that represent diverse topics and individuals. When these images are used for marketing purposes, it is also important to ensure that they are used in an appropriate context and not selected with the single goal of presenting diversity. Future research should focus on how underrepresented students and faculty interpret the use of diverse images in marketing, as well as their preferences for the use of their own images in marketing materials portraying diversity.

ABSTRACTA hybrid finite element/volume model that captures the flow and pressure drop characteristics in highly porous woven matrix media is developed. It is demonstrated that the characteristics of flow through a woven matrix composed of fibers with circular cross-section can be modeled using the finite element method with an equivalent woven matrix system composed of fibers with square cross-section. From simulations of fluid flow in a range of models with varying sizes, it is demonstrated that changes in the thickness of the finite element model in the fluid flow direction and defects in the lay-up of the woven matrix layers have significant effects on the pressure drops. Higher defect densities result in greater pressure drops as they disrupt the steady flow of fluid in the through-thickness direction. The pressure drops obtained in the finite element model simulations of thick models that contained some defective layers match well with experimental observations.

AbstractWe performed viral culture of respiratory specimens in 118 severe acute respiratory coronavirus virus 2 (SARS-CoV-2)–infected healthcare workers (HCWs), ∼2 weeks after symptom onset. Only 1 HCW (0.8%) had a positive culture. No factors for prolonged viral shedding were identified. Infectivity is resolved in nearly all HCWs ∼2 weeks after symptom onset.

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RÉSUMÉCet article présente une analyse du discours du Conseil civique des organisations populaires et indigènes du Honduras (COPINH), une fédération lenca du Honduras mobilisée autour de conflits socioenvi-ronnementaux liés à l’extraction minière, l’exploitation forestière, l’accès aux terres communales et la privatisation de l’eau et dont les membres font face à la répression et la criminalisation de leurs actions. En mettant en scène la défense du territoire, le discours du COPINH oppose le caractère sacré, inviolable et digne de la vie humaine et naturelle à la condition de la vie nue, c’est-à-dire à l’abandon à la mort en toute impunité. Ce faisant, à travers les significations associées à la vie et à la mort, ce discours participe à la mise en circulation d’un imaginaire qui déplace le sens attribué aux projets de barrages hydroélectriques et d’extraction minière affectant des communautés, qualifiés de « projets de mort » détruisant les espaces naturels sacrés.

IMPORTANCE: Clostridium difficile infection (CDI) is a major cause of health care–associated infection worldwide, and new preventive strategies are urgently needed. Current control measures do not target asymptomatic carriers, despite evidence that they can contaminate the hospital environment and health care workers’ hands and potentially transmit C difficile to other patients. OBJECTIVE: To investigate the effect of detecting and isolating C difficile asymptomatic carriers at hospital admission on the incidence of health care–associated CDI (HA-CDI). DESIGN, SETTING, AND PARTICIPANTS: We performed a controlled quasi-experimental study between November 19, 2013, and March 7, 2015, in a Canadian acute care facility. Admission screening was conducted by detecting the tcdB gene by polymerase chain reaction on a rectal swab. Carriers were placed under contact isolation precautions during their hospitalization. MAIN OUTCOMES AND MEASURES: Changes in HA-CDI incidence level and trend during the intervention period (17 periods of 4 weeks each) were compared with the preintervention control period (120 periods of 4 weeks each) by segmented regression analysis and autoregressive integrated moving average (ARIMA) modeling. Concomitant changes in the aggregated HA-CDI incidence at other institutions in Québec City, Québec (n = 6) and the province of Québec (n = 94) were also examined. RESULTS: Overall, 7599 of 8218 (92.5%) eligible patients were screened, among whom 368 (4.8%) were identified as C difficile carriers. During the intervention, 38 patients (3.0 per 10 000 patient-days) developed an HA-CDI compared with 416 patients (6.9 per 10 000 patient-days) during the preintervention control period (P < .001). There was no immediate change in the level of HA-CDIs on implementation (P = .92), but there was a significant decrease in trend over time of 7% per 4-week period (rate ratio, 0.93; 95% CI, 0.87-0.99 per period; P = .02). ARIMA modeling also detected a significant effect of the intervention, represented by a gradual progressive decrease in the HA-CDI time series by an overall magnitude of 7.2 HA-CDIs per 10 000 patient-days. We estimated that the intervention had prevented 63 of the 101 (62.4%) expected cases. By contrast, no significant decrease in HA-CDI rates occurred in the control groups. CONCLUSIONS AND RELEVANCE: Detecting and isolating C difficile carriers was associated with a significant decrease in the incidence of HA-CDI. If confirmed in subsequent studies, this strategy could help prevent HA-CDI.

Background:The clinical and molecular epidemiology of health care–associated Clostridium difficileinfection in nonepidemic settings across Canada has evolved since the first report of the virulent North American pulsed-field gel electrophoresis type 1 (NAP1) strain more than 15 years ago. The objective of this national, multicentre study was to describe the evolving epidemiology and molecular characteristics of health care–associated C. difficileinfection in Canada during a post-NAP1-epidemic period, particularly patient outcomes associated with the NAP1 strain.Methods:Adult inpatients with C. difficileinfection were prospectively identified, using a standard definition, between 2009 and 2015 through the Canadian Nosocomial Infection Surveillance Program (CNISP), a network of 64 acute care hospitals. Patient demographic characteristics, severity of infection and outcomes were reviewed. Molecular testing was performed on isolates, and strain types were analyzed against outcomes and epidemiologic trends.Results:Over a 7-year period, 20 623 adult patients admitted to hospital with health care–associated C. difficileinfection were reported to CNISP, and microbiological data were available for 2690 patients. From 2009 to 2015, the national rate of health care–associated C. difficileinfection decreased from 5.9 to 4.3 per 10 000 patient-days. NAP1 remained the dominant strain type, but infection with this strain has significantly decreased over time, followed by an increasing trend of infection with NAP4 and NAP11 strains. The NAP1 strain was significantly associated with a higher rate of death attributable to C. difficileinfection compared with non-NAP1 strains (odds ratio 1.91, 95% confidence interval [CI] 1.29–2.82). Isolates were universally susceptible to metronidazole; one was nonsusceptible to vancomycin. The proportion of NAP1 strains within individual centres predicted their rates of health care–associated C. difficileinfection; for every 10% increase in the proportion of NAP1 strains, the rate of health care–associated C. difficileinfection increased by 3.3% (95% CI 1.7%–4.9%).Interpretation:Rates of health care–associated C. difficileinfection have decreased across Canada. In nonepidemic settings, NAP4 has emerged as a common strain type, but NAP1, although decreasing, continues to be the predominant circulating strain and remains significantly associated with higher attributable mortality.

ABSTRACTThe impact of Clostridium difficilefecal loads on diagnostic test results is poorly understood, but it may have clinical importance. In this study, we investigated the relationship between C. difficilefecal load and the results of four assays: a glutamate dehydrogenase (GDH) enzyme immunoassay (EIA), a toxin A/B antigen EIA (ToxAB), a cell culture cytotoxicity assay (CCA), and PCR targeting the tcdBgene. We also compared the PCR cycle threshold (CT) with the results of quantitative culture using Spearman's rank correlation coefficient. Finally, we sequenced the genomes of 24 strains with different detection profiles. A total of 203 clinical samples harboring toxigenic C. difficilewere analyzed and sorted into one of four groups: 17 PCR+(group 1), 37 PCR+GDH+(group 2), 24 PCR+GDH+CCA+(group 3), and 125 PCR+GDH+ToxAB+(group 4). The overall median fecal load in log10CFU/g was 6.67 (interquartile range [IQR], 5.57 to 7.54). The median fecal bacterial load of groups 1, 2, 3, and 4 were 4.15 (IQR, 3.00 to 4.98), 5.74 (IQR, 4.75 to 6.16), 6.20 (IQR, 5.23 to 6.80), and 7.08 (IQR, 6.35 to 7.83), respectively. Group 1 samples had lower fecal loads than those from each of the other groups (P< 0.001). Group 2 samples had lower fecal loads than those from groups 3 and 4 (P< 0.001). There was a significant correlation between PCR CTand fecal loads (? = -0.697; P< 0.001). NAP1 strains were associated with the detection of toxins by EIA or CCA (P= 0.041). This study demonstrates an association between C. difficilefecal load and the results of routinely used diagnostic tests.

BACKGROUNDPolymerase chain reaction (PCR) assays based on the detection of the toxin B gene are replacing enzyme-linked immunosorbent assay (ELISA)–based toxin production detection or cell cytotoxicity assay in most laboratories.OBJECTIVETo determine the proportion of pediatric patients diagnosed withClostridium difficileinfection by PCR who would have also been diagnosed by ELISA and to compare the clinical characteristics of PCR+/ELISA+ vs PCR+/ELISA− patients.METHODSUsing the microbiology laboratory information system, stool samples positive for C. difficileby PCR between October 2010 and July 2014 were identified. Using frozen stool specimens, an ELISA for toxin A and B was performed. A retrospective medical chart review was conducted to obtain demographic and clinical data. Duplicate samples were excluded.RESULTSA total of 136 PCR-positive samples underwent ELISA testing: 54 (40%) were positive for toxin A or B. The mean (SD) age of the entire cohort was 8.5 (6.2) years. There was no difference in age, gender, clinical manifestation, previous medical problems, and management between patients positive or negative by ELISA. However, patients positive by ELISA were more likely to have had a recent exposure to antibiotics (67.9% vs 50%; crude odds ratio, 2.1 [95% CI, 1.03–4.28]).CONCLUSIONIn our pediatric population, 60% of patients with C. difficilediagnosed by PCR had no toxin detectable by ELISA. ELISA-negative patients were less likely to have received an antibiotic recently compared with ELISA-positive patients. These results highlight the need to standardize laboratory criteria for the diagnosis of C. difficileinfections in children.Infect Control Hosp Epidemiol2016;37:1087–1093

BACKGROUNDThe degree of bacterial contamination of stethoscopes can vary significantly following a physical examination.OBJECTIVETo conduct a prospective study to investigate the impact of various environmental and patient characteristics on stethoscope contamination.METHODSFollowing a standardized examination, the levels of bacterial contamination of 4 regions of the physicians’ hands and 2 sections of the stethoscopes, and the presence of different pathogenic bacteria, were assessed. Predictors of heavy stethoscope contamination were identified through multivariate logistic regression.RESULTSIn total, 392 surfaces were sampled following examination of 56 patients. The microorganisms most frequently recovered from hands and stethoscopes were Enterococcusspp. (29% and 20%, respectively) and Enterobacteriaceae (16% and 7%, respectively). Staphylococcus aureus(either methicillin susceptible or resistant), extended-spectrum β-lactamase–producing Enterobacteriaceae, and Acinetobacter baumanniiwere recovered from 4%-9% of the samples from either hands or stethoscopes. There was a correlation between the likelihood of recovering these pathogens from the stethoscopes vs from the physicians’ hands (ρ=0.79; P=.04). The level of patient’s skin contamination was an independent predictor of contamination of the stethoscope diaphragm (adjusted odds ratio [aOR], 1.001; P=.007) and tube (aOR, 1.001; P=.003). Male sex (aOR, 28.24; P=.01) and reception of a bed bath (aOR, 7.52; P=.048) were also independently associated with heavy tube contamination.CONCLUSIONSStethoscope contamination following a single physical examination is not negligible and is associated with the level of contamination of the patient’s skin. Prevention of pathogen dissemination is needed.Infect Control Hosp Epidemiol2016;37:673–679

We report a new methodology based on glancing angle deposition (GLAD) of an organic molecule in combination with perpendicular growth of a second inorganic material. The resulting thin films retain a very well-defined tilted columnar microstructure characteristic of GLAD with the inorganic material embedded inside the columns. We refer to this new methodology as growth assisted by glancing angle deposition or GAGLAD, since the material of interest (here, the inorganic) grows in the form of tilted columns, though it is deposited under a nonglancing configuration. As a “proof of concept”, we have used silver and zinc oxide as the perpendicularly deposited material since they usually form ill-defined columnar microstructures at room temperature by GLAD. By means of our GAGLAD methodology, the typical tilted columnar microstructure can be developed for materials that otherwise do not form ordered structures under conventional GLAD. This simple methodology broadens significantly the range of materials where control of the microstructure can be achieved by tuning the geometrical deposition parameters. The two examples presented here, Ag/Alq3 and ZnO/Alq3, have been deposited by physical vapor deposition (PVD) and plasma enhanced chemical vapor deposition (PECVD), respectively: two different vacuum techniques that illustrate the generality of the proposed technique. The two type of hybrid samples present very interesting properties that demonstrate the potentiality of GAGLAD. On one hand, the Ag/Alq3 samples present highly optical anisotropic properties when they are analyzed with linearly polarized light. To our knowledge, these Ag/Alq3 samples present the highest angular selectivity reported in the visible range. On the other hand, ZnO/Alq3 samples are used to develop highly porous ZnO thin films by using Alq3 as sacrificial material. In this way, antireflective ZnO samples with very low refractive index and extinction coefficient have been obtained.

Abstract:We used a combination of molecular and morphological tools to determine whether mucilage ducts are a useful taxonomic character for species differentiation in the genera Laminariaand Saccharinain the North Atlantic and to verify the taxonomic status of Saccharina groenlandicaand the genetic species currently attributed to it in North America (NAGenSp). Microscopic examination of genetically verified Laminaria digitata, Laminaria hyperborea, Saccharina latissimaand the NAGenSp determined that the presence/absence of mucilage ducts in the blade is not a useful taxonomic character. However, the presence/absence and location of mucilage ducts in the stipe were useful for species differentiation. Laminaria digitataand S. latissimalacked mucilage ducts in the stipe, while the NAGenSp had mucilage ducts in the cortex, and L. hyperboreahad mucilage ducts in the medulla. Microscopic examination of the type material of S. groenlandicadetermined that S. groenlandicais synonymous with S. latissimaand that the reportedly diagnostic appearance of mucilage ducts in the stipe and blade of type material were the result of pseudo-mucilage ducts (putative infections). Microscopic examination of the type material of Laminaria nigripesrevealed a combination of mislabelled L. digitataand a single specimen that matched the type description, as well as northern individuals of the NAGenSp necessitating the combination Saccharina nigripes(J. Agardh) Longtin et G.W. Saunders comb. nov. Saccharina nigripesis distributed throughout the Northeast Pacific, Canadian Arctic, Northwest Atlantic, and Northern Europe (Greenland, Iceland, and Scandinavia).

Academic health centers (AHCs) are under unprecedented pressure, making strong leadership during these challenging times critical. Department chairs have tremendous influence in their AHCs, yet data indicate that—despite outstanding academic credentials—they are often underprepared to take on these important leadership roles. The authors sought to improve the approach to recruiting, developing, and giving feedback to department chairs at their institution, the Indiana University School of Medicine (IUSM), by reorganizing these processes around six key leadership competencies: leadership and team development, performance and talent management, vision and strategic planning, emotional intelligence, communication skills, and commitment to the tripartite mission. Over a two-year period (2009–2011), IUSM faculty and administrators developed standardized recruitment procedures to assess potential chairs based on the six leadership domains, and searches are now streamlined through centralized staff support in the dean’s office. Additionally, IUSM offers a chair development series to support learning around these leadership competencies and to meet the stated professional development needs of the chairs. Finally, chairs receive structured feedback regarding their leadership (among other considerations) through two different assessment instruments, IUSM’s Department Chair 360° Leadership Survey and IUSM’s Faculty Vitality Survey—both of which the dean reviews annually. Strategically attending to the way that chairs are selected, developed, and given feedback has tremendous potential to increase the success of chairs and, in turn, to constructively shape the culture of AHCs.