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Students in large cities across the United States can better understand agriculture through their involvement in School-Based Agricultural Education (SBAE). Since the passage of the Smith-Hughes Act in 1917, Agricultural Education has been a pathway that encourages students to continue schooling and connect with future careers. We conducted a descriptive study to explore the involvement of 2021-2022 high school Agricultural Education students in the National FFA Organization. Involvement was calculated through self-reported participation in chapter activities, officer positions, FFA degrees, and contests or events. Additionally, the study evaluated students' curiosity toward stretching or embracing as well as their overall adaptability in different situations. The study occurred in the fall of 2021 with 543 respondents from 18 urban SBAE programs in 12 states completing the online survey. Respondents reported self-perceived moderate curiosity, very strong adaptability, and light involvement in FFA. For urban SBAE students, involvement in FFA was not affected by demographics other than those in the 12th grade were more involved. This could imply study respondents who see the value in the organization's leadership training or college and career readiness are the most curious and adaptable toward being involved in the organization.

School-Based Agricultural Education provides students the opportunity to engage with new and emerging agricultural technologies. Employers value employability skills such as openness, preparedness, and adaptability. However, the Agricultural Education literature is limited on the preparation of students in these skills. We conducted a descriptive study to explore how open and prepared 2020-2021 high school senior members of the National FFA Organization were for 10 selected new and emerging Agriculture, Food, and Natural Resources (AFNR) technologies. Additionally, the study evaluated the methods through which members learned about technology. An overview of students' contact with the 10 selected technologies and their experiences using these technologies contributes to an understanding of methods used in the classroom and how adaptable students may be for emerging technologies in the future. The study occurred in fall 2020 with 1,528 respondents completing the online survey. Almost all respondents reported personal access to a smart phone and computer at home with internet access. Respondents reported use or contact with the 10 selected technologies with that contact most often being in the agriculture classroom/laboratory. Respondents reported self-perceived very strong adaptability, high openness, and average preparedness. This could imply study respondents are open to new and emerging AFNR technologies but not prepared.

Haemophilus influenzae serotype B (Hib) causes a range of clinical syndromes, including pneumonia, primary bacteremia, and meningitis (1,2). Childhood immunization with conjugated Hib vaccines has resulted in dramatic decreases in [...]

This article assesses the constraints and capacities for Canadian state-owned enterprises (SOEs) to enhance economic democracy. Constraints include the democratic deficit produced by the commercialization of SOEs, which shifted away from historically privileging the social outcomes of public enterprise, together with the construction of a global governance architecture with binding and enforceable trade agreements that constrain democratic decision-making and state activity. Capacities include opportunities for SOEs to address deleterious economic outcomes through a rejuvenation of the socially oriented public enterprise tradition in areas of vexing policy concern. The article argues that SOEs can be an important component of enhanced extended state democracy through their redistributive outcomes that provide non-market income support for social infrastructure and services. [ABSTRACT FROM AUTHOR]

Backgrounds: Surgical site infections (SSIs) represent one of the most common and potentially preventable sources of morbidity and healthcare cost escalation associated with skin cancer surgery. There is a lack of data reporting organisms cultured from SSIs in skin surgery, with guidelines for antibiotic prophylaxis based on common skin pathogens rather than actual cultured organisms. In this study, we sought to define the cultured microbiology of SSIs specific to skin cancer surgery and test these against empiric treatment guidelines. Methods: All consenting patients presenting to the Auckland regional skin cancer treatment centre over a 6‐month period were included. Patients receiving any form of antibiotics within a week prior to surgery were excluded. All wounds were assessed postoperatively, with clinically significant infections identified as those with a standardized wound infection score of 4 (range 0–7) and/or prescribed post‐operative antibiotics within 3 weeks of surgery. Wound cultures were recorded. Results: About 104 clinically significant SSIs were identified from 333 lesions treated, with cultures available in 27%. Cultured organisms included MSSA (79%), MRSA (14%), coagulase‐negative Staphylococci (11%), and 'skin flora' (14%). Empiric guidelines inaccurately predicted effective treatment in 14% of cases, exclusively due to MRSA. Conclusion: To our knowledge this is the first comprehensive report of SSI microbiology following skin cancer surgery. The overwhelmingly predominant organisms were Staphylococcus sp. (76%), with the rate of MRSA approaching prevalence warranting empiric first‐line treatment. These data help inform effective rationalized empiric antibiotic treatment, when indicated, for optimal outcome following skin surgery. [ABSTRACT FROM AUTHOR]

Barry Eidlin, Labor and the Class Idea in the United States and Canada (New York: Cambridge University Press 2018) THIS BOOK IS A FINE piece of historical sociology dealing with [...]

Background Periprosthetic joint infection (PJI) is a devastating condition and there is a lack of evidence to guide its management. We hypothesized that treatment success is independently associated with modifiable variables in surgical and antibiotic management. Methods The is a prospective, observational study at 27 hospitals across Australia and New Zealand. Newly diagnosed large joint PJIs were eligible. Data were collected at baseline and at 3, 12, and 24 months. The main outcome measures at 24 months were clinical cure (defined as all of the following: alive, absence of clinical or microbiological evidence of infection, and not requiring ongoing antibiotic therapy) and treatment success (clinical cure plus index prosthesis still in place). Results Twenty-four-month outcome data were available for 653 patients. Overall, 449 patients (69%) experienced clinical cure and 350 (54%) had treatment success. The most common treatment strategy was debridement and implant retention (DAIR), with success rates highest in early postimplant infections (119 of 160, 74%) and lower in late acute (132 of 267, 49%) and chronic (63 of 142, 44%) infections. Selected comorbidities, knee joint, and Staphylococcus aureus infections were independently associated with treatment failure, but antibiotic choice and duration (including rifampicin use) and extent of debridement were not. Conclusions Treatment success in PJI is associated with (1) selecting the appropriate treatment strategy and (2) nonmodifiable patient and infection factors. Interdisciplinary decision making that matches an individual patient to an appropriate management strategy is a critical step for PJI management. Randomized controlled trials are needed to determine the role of rifampicin in patients managed with DAIR and the optimal surgical strategy for late-acute PJI. [ABSTRACT FROM AUTHOR]

School-Based Agricultural Education provides students the opportunity to engage with new and emerging agricultural technologies. Employers value employability skills such as openness, preparedness, and adaptability. However, the Agricultural Education literature is limited on the preparation of students in these skills. We conducted a descriptive study to explore how open and prepared 2020-2021 high school senior members of the National FFA Organization were for 10 selected new and emerging Agriculture, Food, and Natural Resources (AFNR) technologies. Additionally, the study evaluated the methods through which members learned about technology. An overview of students' contact with the 10 selected technologies and their experiences using these technologies contributes to an understanding of methods used in the classroom and how adaptable students may be for emerging technologies in the future. The study occurred in fall 2020 with 1,528 respondents completing the online survey. Almost all respondents reported personal access to a smart phone and computer at home with internet access. Respondents reported use or contact with the 10 selected technologies with that contact most often being in the agriculture classroom/laboratory. Respondents reported self-perceived very strong adaptability, high openness, and average preparedness. This could imply study respondents are open to new and emerging AFNR technologies but not prepared. [ABSTRACT FROM AUTHOR]

Numerous studies have revealed a relationship between unemployment and various other social ills. These include poverty, negative shifts in self-esteem for affected individuals and their families, increased anxiety, stress, and associated increases in physical and mental illness, alcoholism, drug abuse, child abuse and family breakdown. Others have linked unemployment to increased racism and discrimination, suicide rates and crime rates. For much of the post-war period the stresses associated with unemployment were mitigated by a social policy net and a programme of unemployment insurance that, by 1971, covered the great majority of the workforce and provided a significant cushion against the immediate effect of job loss. Since the mid-1970s the social supports available to the unemployed have been eroded by government and, in the mid-1990s, major alterations were made to the programmes. The Employment Insurance reforms of 1996, the replacement of the Canadian Assistance Plan by a Canada Health and Social Transfer that permits workfare as a condition of social assistance, and the devolution of training and active employment measures to the provincial level receive detailed analysis. In a context where a world of work is undergoing rapid change and partial attachments to the labour force- part-time, temporary and individual self-employment- are more common, the effect of Unemployment Insurance and social reforms, combined with an overall economic strategy that privileges inflation and deficit control over employment creation, means that permanent insecurity is replacing the relative social security of an earlier era. The social impact of this situation will be traced.

Background: Treatment regimens requiring multiple daily dosing for enterococcal endocarditis are challenging to deliver in the outpatient setting. Continuous-infusion benzylpenicillin via a 24 h elastomeric infusor, combined with either once-daily gentamicin or ceftriaxone, requires only one nursing encounter daily and is commonly used in New Zealand.Objectives: To assess the therapeutic success and adverse antibiotic effects of these regimens.Methods: A retrospective observational case series from multiple hospitals of patients aged 15 years or over with enterococcal endocarditis diagnosed between July 2013 and June 2019 who received at least 14 days of outpatient continuous-infusion benzylpenicillin combined with either gentamicin or ceftriaxone for synergy.Results: Forty-three episodes of enterococcal endocarditis in 41 patients met inclusion criteria. The primary synergy antibiotic was gentamicin in 20 episodes and ceftriaxone in 23 episodes. For the 41 initial treatment courses, 31 (76%) patients were cured, 3 (7%) patients developed relapsed endocarditis during or following antibiotic treatment and 7 (17%) patients continued with long-term suppressive oral amoxicillin following IV antibiotic treatment. There was no difference in the relapse rate between the two groups (P = 0.59). Seven (35%) adverse antibiotic effects were documented in the gentamicin group and none in the ceftriaxone group (P < 0.01). Two deaths (5%) occurred within the 6 month follow-up period.Conclusions: Outpatient treatment of enterococcal endocarditis with continuous-infusion benzylpenicillin combined with either once-daily gentamicin or ceftriaxone following a period of inpatient treatment is usually effective. A significantly higher rate of adverse effects was seen with gentamicin, favouring ceftriaxone as the initial synergy antibiotic. [ABSTRACT FROM AUTHOR]

Background Periprosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. Most observational studies of PJI are retrospective or single-center, and reported management approaches and outcomes vary widely. We hypothesized that there would be substantial heterogeneity in PJI management and that most PJIs would present as late acute infections occurring as a consequence of bloodstream infections. Methods The Prosthetic joint Infection in Australia and New Zealand, Observational (PIANO) study is a prospective study at 27 hospitals. From July 2014 through December 2017, we enrolled all adults with a newly diagnosed PJI of a large joint. We collected data on demographics, microbiology, and surgical and antibiotic management over the first 3 months postpresentation. Results We enrolled 783 patients (427 knee, 323 hip, 25 shoulder, 6 elbow, and 2 ankle). The mode of presentation was late acute (>30 days postimplantation and <7 days of symptoms; 351, 45%), followed by early (≤30 days postimplantation; 196, 25%) and chronic (>30 days postimplantation with ≥30 days of symptoms; 148, 19%). Debridement, antibiotics, irrigation, and implant retention constituted the commonest initial management approach (565, 72%), but debridement was moderate or less in 142 (25%) and the polyethylene liner was not exchanged in 104 (23%). Conclusions In contrast to most studies, late acute infection was the most common mode of presentation, likely reflecting hematogenous seeding. Management was heterogeneous, reflecting the poor evidence base and the need for randomized controlled trials. [ABSTRACT FROM AUTHOR]

Importance: Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is associated with mortality of more than 20%. Combining standard therapy with a β-lactam antibiotic has been associated with reduced mortality, although adequately powered randomized clinical trials of this intervention have not been conducted.Objective: To determine whether combining an antistaphylococcal β-lactam with standard therapy is more effective than standard therapy alone in patients with MRSA bacteremia.Design, Setting, and Participants: Open-label, randomized clinical trial conducted at 27 hospital sites in 4 countries from August 2015 to July 2018 among 352 hospitalized adults with MRSA bacteremia. Follow-up was complete on October 23, 2018.Interventions: Participants were randomized to standard therapy (intravenous vancomycin or daptomycin) plus an antistaphylococcal β-lactam (intravenous flucloxacillin, cloxacillin, or cefazolin) (n = 174) or standard therapy alone (n = 178). Total duration of therapy was determined by treating clinicians and the β-lactam was administered for 7 days.Main Outcomes and Measures: The primary end point was a 90-day composite of mortality, persistent bacteremia at day 5, microbiological relapse, and microbiological treatment failure. Secondary outcomes included mortality at days 14, 42, and 90; persistent bacteremia at days 2 and 5; acute kidney injury (AKI); microbiological relapse; microbiological treatment failure; and duration of intravenous antibiotics.Results: The data and safety monitoring board recommended early termination of the study prior to enrollment of 440 patients because of safety. Among 352 patients randomized (mean age, 62.2 [SD, 17.7] years; 121 women [34.4%]), 345 (98%) completed the trial. The primary end point was met by 59 (35%) with combination therapy and 68 (39%) with standard therapy (absolute difference, -4.2%; 95% CI, -14.3% to 6.0%). Seven of 9 prespecified secondary end points showed no significant difference. For the combination therapy vs standard therapy groups, all-cause 90-day mortality occurred in 35 (21%) vs 28 (16%) (difference, 4.5%; 95% CI, -3.7% to 12.7%); persistent bacteremia at day 5 was observed in 19 of 166 (11%) vs 35 of 172 (20%) (difference, -8.9%; 95% CI, -16.6% to -1.2%); and, excluding patients receiving dialysis at baseline, AKI occurred in 34 of 145 (23%) vs 9 of 145 (6%) (difference, 17.2%; 95% CI, 9.3%-25.2%).Conclusions and Relevance: Among patients with MRSA bacteremia, addition of an antistaphylococcal β-lactam to standard antibiotic therapy with vancomycin or daptomycin did not result in significant improvement in the primary composite end point of mortality, persistent bacteremia, relapse, or treatment failure. Early trial termination for safety concerns and the possibility that the study was underpowered to detect clinically important differences in favor of the intervention should be considered when interpreting the findings.Trial Registration: ClinicalTrials.gov Identifier: NCT02365493. [ABSTRACT FROM AUTHOR]

Background Native joint septic arthritis (NJSA) is poorly studied. We describe the epidemiology, treatment, and outcomes of large joint NJSA (LNJSA) and small joint NJSA (SNJSA) in adults at Middlemore Hospital, Auckland, New Zealand. Methods This was a coding-based retrospective study of patients ≥16 years old admitted between 2009 and 2014. Prosthetic joint infections were excluded. Results Five hundred forty-three NJSA episodes were included (302 LNJSA, 250 SNJSA). Only 40% had positive synovial fluid culture. Compared to SNJSA, LNJSA has higher incidence (13 vs 8/100 000 person-years [PY]), occurs in older, more comorbid patients, and is associated with greater rates of treatment failure (23% vs 12%) and mortality, despite longer antibiotic treatment. Total incidence is higher than previously reported (21/100 000 PY), with marked interethnic variation. Incidence rises with age (LNJSA only) and socioeconomic deprivation (LNJSA and SNJSA). Tobacco smokers and males are overrepresented. The most commonly involved joints were knee (21%) and hand interphalangeal (20%). Staphylococcus aureus was the most common pathogen (53%). Mean antibiotic duration was 25 days for SNJSA and 40 days for LNJSA, and the mean number of surgical procedures was 1.5 and 1.6, respectively. Treatment failure was independently associated with LNJSA, age, intra-articular nonarthroplasty prosthesis, and number of surgical procedures. Conclusions This is the largest contemporary series of adult NJSA. SNJSA has better outcomes than LNJSA and may be able to be safely treated with shorter antimicrobial courses. Incidence is high, with significant ethnic and socioeconomic variation. Microbiological NJSA case ascertainment underestimates case numbers as it frequently excludes SNJSA. [ABSTRACT FROM AUTHOR]

This article analyses the documents released by the OECD at the end of May 2018 launching a revised Jobs Strategy. The analysis frames the new initiative in the context of the two previous Jobs Strategies of 1994 and 2006. We pose the general question of whether continuity or discontinuity is the prevailing theme, along with a specific question concerning the significance of new themes of job quality and inclusive growth, given the documents' simultaneous endorsement of the older theme of flexibility-enhancing policies to ensure a labour market functioning without rigidities. Flexibility had been the central feature of previous Jobs Strategies, although there was also a nod in the direction of an alternative route to better employment performance in the 2006 revision. The 2018 documents assert that the new strategy represents a significant departure from the previous iterations. This article provides a critical evaluation of this claim. [ABSTRACT FROM AUTHOR]

Background: Mobile phone apps have been shown to enhance guideline adherence by prescribers, but have not been widely evaluated for their impact on guideline adherence by prescribers caring for inpatients with infections. Objectives: To determine whether providing the Auckland City Hospital (ACH) antibiotic guidelines in a mobile phone app increased guideline adherence by prescribers caring for inpatients with community acquired pneumonia (CAP) or urinary tract infections (UTIs). Methods: We audited antibiotic prescribing during the first 24 hours after hospital admission in adults admitted during a baseline and an intervention period to determine whether provision of the app increased the level of guideline adherence. To control for changes in prescriber adherence arising from other factors, we performed similar audits of adherence to antibiotic guidelines in two adjacent hospitals. Results: The app was downloaded by 145 healthcare workers and accessed a total of 3985 times during the three month intervention period. There was an increase in adherence to the ACH antibiotic guidelines by prescribers caring for patients with CAP from 19% (37/199) to 27% (64/237) in the intervention period (p = 0.04); but no change in guideline adherence at an adjacent hospital. There was no change in adherence to the antibiotic guidelines by prescribers caring for patients with UTI at ACH or at the two adjacent hospitals. Conclusions: Provision of antibiotic guidelines in a mobile phone app can significantly increase guideline adherence by prescribers. However, providing an app which allows easy access to antibiotic guidelines is not sufficient to achieve high levels of prescriber adherence. [ABSTRACT FROM AUTHOR]

The rationale for this study is to explore whether or not the Winnicottian concept of primary maternal preoccupation fits into the identities and features in what male group analysts reflect on and resonate with upon ‘giving birth to’ and conducting a group. A qualitative, individual case-study approach was employed to attempt to discover and understand how male group analysts make sense of Winnicott’s fundamental concept. Wondering and thinking about how a male group analyst ‘holds’ both the maternal and paternal function in a group is also being thought about to ascertain the impact of these features on clinical practice. Exploring the concept of primary maternal preoccupation lends towards a strong focus on the relationship between mother and baby, mirrored in and seen as a metaphor for the relationship between the group analyst and the group members. Doron argues that in disclosing her depth of feeling towards the changing group membership in the group she was conducting, she identified strongly with the state of primary maternal preoccupation. This study will explore the range of feelings associated with the primary maternal preoccupation male group analysts associate with. Three qualified group analysts with five years’ minimum post-qualification experience, with whom there were no boundary issues, were interviewed in a semi-structured interview format to ascertain and develop this understanding. A phenomenological research method was chosen to analyse the collated data from the three individual interviews. Following completion of the three interviews, the participants’ texts were analysed resulting in five overall themes being developed. Potential wider scopes and application of the question, potential clinical implications of the topic under discussion and the potential for developing a theoretical discussion in group analysis on what might be coined ‘paternal preoccupation’ were illuminated and discussed. [ABSTRACT FROM AUTHOR]

Introduction: Patients presenting to emergency departments (ED) are often screened for suicidality, even when their chief complaint does not involve mental health concerns. Patient receptiveness to ED based mental health screening and intervention is unknown, particularly among patients with low-acuity chief complaints, who often prioritize rapid evaluation and discharge. Methods: This cross-sectional study included adults with low-acuity chief complaints presenting to an urban, academic ED in the Northeastern United States during daytime and evening hours, from 2015 to 2016. Participants completed validated mental health screening instruments, including the Suicide Behaviors Questionnaire-Revised and the Patient Health Questionnaire-4. Participants were also asked to rate the importance of addressing mental health concerns during their ED visit. Results: We approached 1,688 patients, and 816 (48.4%) consented to participate in the study. Of these, 27% screened positive for anxiety and 25% screened positive for depression. Even among patients with no prior depression history, 17% were at high risk of depression. Eleven percent of participants were at high risk for suicidal behavior, including 5% of those with no reported history of depression or bipolar disorder. Thirty-five percent of patients at risk for suicide and 53% of those at high risk of depression thought it was important or very important to address these issues during the ED visit. Conclusion: Symptoms of mental health disorders were common among this group of ED patients presenting with low-acuity chief complaints. Patients often desired to address these mental health concerns as part of their ED visit. [ABSTRACT FROM AUTHOR]

Objectives: Previous studies have shown that a majority of patients cite altruistic motives, such as contributing to generalisable medical knowledge, as factors motivating clinical trial participation. We sought to examine the impact of making trial results publicly available on patients' willingness to participate in clinical research. Design: Cross-sectional analysis using a questionnaire developed by a panel with expertise in publication bias, informed consent and survey design. Setting: A single urban, academic emergency department (ED) in the Northeastern USA. Participants: 799 ED patients. Outcome Measures: We assessed (1) participants' attitudes towards clinical trial participation, and (2) the impact of whether study results would eventually be made publicly available or not on willingness to participate in a trial. Results: Of 799 patients surveyed, 36% (95% CI 32% to 39%) reported that they would generally like to participate in a trial, and another 50% (95% CI 47% to 54%) reported that they would consider participation depending on study details. For the majority of participants, the publication of trial results was either important (36%; 95% CI 33% to 40%) or very important (48%; 95% CI 44% to 51%). Most (63%; 95% CI 59% to 66%) reported they would be less likely to participate in a trial if investigators had not publicly released results from a prior study. Additionally, 85% (95% CI 82% to 87%) felt that it was important or very important to receive information about the publication track record of sponsors and investigators during the informed consent process. Conclusions: The majority of patients in this sample would consider participation in a clinical trial. Patients value the public release of trial results, and believe that the informed consent process should address the possibility of non-publication. [ABSTRACT FROM AUTHOR]

Background The aims of this paper were to review our experience with necrotizing fasciitis at Middlemore Hospital and to define the trends in incidence, inpatient mortality and microbiological profile. Methods A computerized search of the electronic medical records was undertaken to identify adult patients with a diagnosis of necrotizing fasciitis between January 2000 and December 2010. A retrospective review of the clinical records was performed. Results Of the 138 patients with necrotizing fasciitis identified, 129 had their diagnosis confirmed at operation. The mortality at 30 days was 20.3% (95% confidence interval ( CI) 13.9%-28.0%). There was a significant reduction in hospital mortality in each successive year of the study period with an odds ratio of 0.84 (95% CI 0.71-0.98, P = 0.03). A pattern of increasing incidence was noted until February 2004 (95% CI September 2002- July 2005). This was followed by a significant decrease in incidence. The empirical antibiotic regime of clindamycin, gentamicin and penicillin provides satisfactory cover against 95% of the causative pathogens. Conclusion This represents the largest single-centre published case series in New Zealand. Despite concerns of increasing incidence and mortality associated with necrotizing fasciitis in New Zealand, the experience in South Auckland shows a decrease in incidence of necrotizing fasciitis since 2004 and a statistically significant decreasing trend in hospital mortality. [ABSTRACT FROM AUTHOR]

Nothwithstanding their failure to achieve stated objectives, austerity policies have been pursued with persistence. Rather than failures prompting reconsideration, there is a clear trend to render austerity policies a permanent, constitutionalized response to economic challenges 'for all seasons'. This article links the drive to austerity with the 'new constitutionalism' literature which depicts procedurally the removal of important decisions from the realm of liberal democratic politics and their re-location behind impenetrable and unaccountable barriers; and, in terms of content, embed neoliberal practices and policies, and the power relations that underpin them, as 'normal'. This takes the public out of public policy making with negative consequences for democratic governance. [ABSTRACT FROM AUTHOR]

The existence of a low wage sector is nothing new, nor are efforts to resist the conditions experienced by people whose incomes typically fall below the poverty line. In recent decades, under the rubric of neoliberalism structural and political factors in many western states have combined to expand the low wage sector. In policy terms this is represented by intensified efforts toflexibilize the labour market and to impose conditionality for the receipt of social benefits. Various social and political forces have pushed for policies to address issues of low wages and poverty. The paper recognizes the intersection of social and labour market policies but focuses on the latter. It opens with an historical overview of efforts to address low wages that touches on sectoral councils in the U.K, and the Awards system in Australia. It then moves on to analyze contemporary minimum wage policy and campaigns for a living wage. We then turn to the discourses/argumentation associated with these initiatives, and those employed by opposition to them. Our goal is to understand and evaluate the arguments advanced but move beyond discourse to identify the conditions in which particular means of addressing low wages can succeed. [ABSTRACT FROM AUTHOR]