Culture

In mid-April, as the COVID-19 epidemic roared through the nation, 2,017,105 jobholders were absent from work because they were ill. The April figure was the highest number since at least 1976, and more than double the rate from mid-April 2019, according to a new study from researchers at Harvard Medical School and CUNY's Hunter College. The findings suggest that the official counts of COVID-19 cases greatly understate the number of people sickened by the virus.

The surge in sickness-related work absences was largest for immigrant workers, a group that includes many essential workers at high risk of coronavirus exposure; immigrant jobholders' absence rate rose almost five-fold from 12 months earlier, when their absenteeism rate had been 37% lower than that of native-born jobholders. Workers 55 and older, and those with less education also had larger than average year-over-year increases in sickness-related absences. The research appears Monday, June 27 in the Journal of the American Medical Association (JAMA): Internal Medicine.

Researchers analyzed the Census Bureau's monthly Current Population Survey which tracks U.S. employment. Because the survey asked only about work absence during a single week in mid-April, the figures likely understate the number of jobholders who were out sick during the course of the month.

The share of workers who were out sick was virtually identical in the first two months of 2019 and 2020. As in most years, work absences began dropping in the early spring of 2019, falling to 0.58% of the workforce by April. In contrast, in 2020 the number who were out sick began rising in March as COVID-19 illnesses began spreading, and soared in April, when 1.51% of all job holders were out sick, nearly triple the percentage from a year earlier.

"I've seen firsthand COVID-19's impact on the critically ill patients in our ICU, and we've known that many more were also ill at home," noted lead author Dr. Adam Gaffney, a pulmonary and critical care specialist at Harvard Medical School and the Cambridge Health Alliance, a safety-net hospital system at an epicenter of the pandemic in eastern Massachusetts. "But our study indicates that the pandemic has sickened many more people than we had realized, especially vulnerable employees like immigrants."

"Millions of immigrants and people of color have put themselves in harm's way to keep vital services running during the COVID-19 crisis," said Dr. Steffie Woolhandler, a primary care doctor, Distinguished Professor of Public Health at CUNY's Hunter College, and Lecturer in Medicine at Harvard. Many are uninsured and have no income if they miss work. The least we can do to protect them is to assure paid sick leave and universal health care, benefits that workers in every other wealthy nation already enjoy."

Some smokers might rationalize continuing to smoke because of lower body weight often associated with the habit. However, Vanderbilt University Medical Center investigators have determined that even with a lower body mass index (BMI), smokers have a higher risk of depositing fat in and around organs and tissues compared to those who never smoked.

This is concerning because excess fat, also known as adipose tissue, deposited in the abdomen and around organs such as the liver and non-adipose tissues including muscles, may disrupt their normal functions and cause health problems. This disruption is associated with a higher risk for health complications such as cardiovascular disease and type 2 diabetes.

Investigators used computed tomography (CT) body scans to measure abdominal fat deposited just below the skin's surface (subcutaneous fat), around organs including the intestines (visceral fat) and abdominal muscles (intermuscular fat), and inside the muscles (intramuscular fat) in 3,020 middle-aged participants in the federally funded Coronary Artery Risk Development in Young Adults (CARDIA) study.

"We found that current smokers had abdominal muscles that were significantly higher in fat," said lead author James "Greg" Terry, research programs manager in Radiology and member of Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC). "Smokers also had a higher proportion of visceral fat, the fat around their internal organs, compared to never smokers, whereas those who had quit smoking had intermediate levels of visceral and intramuscular fat. This might contribute to the higher prevalence of cardiovascular disease and age-related physical deconditioning and disability that is well-documented among those who smoke."

Co-author David Jacobs, PhD, professor of Public Health at the University of Minnesota and one of the founding CARDIA investigators, said he considers "cigarette smoking as a weight-loss tool to be a risky strategy. Our data show that the fat deposition pattern apparent in smokers is associated with metabolic damage."

The longitudinal CARDIA study was begun in 1985 with the recruitment of young adult participants (aged 18-30), equally balanced by male and female sex and black and white race, at four locations in the United States. The CT measurements were taken at the 25-year mark. The investigation is published in the online, open access journal PLOS Medicine.

If given the chance, a Kenyan herder is likely to keep a mix of goats and camels. It seems like an irrational economic choice because goats reproduce faster and thus offer higher near-term herd growth. But by keeping both goats and camels, the herder lowers the variability in growth from year to year. All of this helps increase the odds of household survival, which is essentially a gamble that depends on a multiplicative process with no room for catastrophic failure. It turns out, the choice to keep camels also makes evolutionary sense: families that keep camels have a much higher probability of long-term persistence. Unlike businesses or governments, organisms can't go into evolutionary debt -- there is no borrowing one's way back from extinction.

How biological survival relates to economic choice is the crux of a new paper published in Evolutionary Human Sciences, co-authored by Michael Price, an anthropologist and Applied Complexity Fellow at the Santa Fe Institute, and James Holland Jones, a biological anthropologist and associate professor at Stanford's Earth System Science department.

"People have wanted to make this association between evolutionary ideas and economic ideas for a long time," Price says, and "they've gone about it quite a lot of different ways." One is to equate the economic idea of maximizing utility -- the satisfaction received from consuming a good -- with the evolutionary idea of maximizing fitness, which is long-term reproductive success. "That utility equals fitness was simply assumed in a lot of previous work," Price says, but it's "a bad assumption." The human brain evolved to solve proximate problems in ways that avoid an outcome of zero. In the Kenyan example, mixed herding diversifies risk. But more importantly, the authors note, the growth of these herds, like any biological growth process, is multiplicative and the rate of increase is stochastic.

As Jones explains, most economics is additive -- adding value, adding utility. But evolutionary fitness is multiplicative, so it can't tolerate zero. The size of the Kenyan's herd next year is essentially the size of the herd this year times the net birth rate. If there is ever a zero in that equation - a drought kills the whole herd of goats - it becomes a catastrophic loss that the herder can't overcome.

"These multiplicative factors influence variables that matter for evolutionary fitness," Price says. In the herder scenario, the decision to diversify ultimately benefits fertility and the long-term survival of the family. The two liken major life decisions -- diversifying the herd, buying a house, having more kids -- to lotteries with inherent risks and uncertain payoffs. They theorize that evolution strongly favors "pessimistic probability weighting" - choosing lower-profit camels despite the immediate potential payoff of goats. In the long run, Jones says, this may "leave money on the table" but it keeps people in the evolutionary game.

Price gives another example: climate change. From a purely economic standpoint, he says, one could argue it would be cheaper to do nothing now and wait until geoengineering offers a solution however many years down the road. But we don't know all the risks and potential consequences of multiplicative factors like Arctic permafrost thaws and oceanic circulation changes coming together at once. "We should probably deal with climate change," Price says, because "the success of our species is probably way more important than eking out a little bit more efficiency over the next five years of economic growth."

Price also hopes to apply these ideas to archaeology. "I am interested in pushing this perspective into the past." He aims to study the problems and decision-making patterns that preceded the Maya collapse.

The element phosphorus (P) is central to life, agriculture, and food security. Approximately 90% of global phosphate rock demand is for food production. Access to P is put under pressure by population growth, limited P recycling and reuse, and finite P mining resources. In addition to access, the network resilience of P cycling (that is, a system attribute that ensures continuous access of P within the network and is critical for sustainable P management) is vulnerable to socio-environmental shocks and disturbances. To eradicate hunger and achieve food security, it is essential to better understand the metabolic network of P flows.

A study recently published on Nature food evaluates the evolution of the resilience of the P cycling network in China over four centuries (1600-2012), as well as its underlying determinants. "Our results reveal that, in the most recent decades, the network resilience of the P cycling in China has declined", commented Ali Kharrazi, CMCC researcher at ECIP - Economic analysis of Climate Impacts and Policy Division. Dr. Kharrazi is a Marie Curie Research Fellow at Ca' Foscari University and CMCC Foundation Euro-Mediterranean Center on Climate Change in Venice, Italy; his research focuses on examining the resilience of food trade networks under climate change.

"The key factors underlying this trend include the growth of food demand and the changes of the food structure from a modest, mostly vegetarian-based diet to a more complex diet (that is, more animal-based foods with higher P content). This is because, after the year 2000, urbanization accelerated in China and higher living standards were adopted.

Should this trend persist, China's food security shall be increasingly vulnerable to P availability under socio-environmental shocks and disturbances to its P cycling network. Moreover, the P declining trend observed in China it's definitely a global trend", he adds.

The resilience of the P cycling network is influenced by human food demand/fertilizer P proportion: to meet this demand, the animal husbandry and aquaculture sectors expanded their production, subsequently increasing the demand for agricultural products such as grains and beans and P fertilizer use in the cultivation sector.

So, how we can satisfy the increasing food demand and guarantee sustainable development?

The authors tried to give some suggestions to increase the resilience of the P cycling network while guaranteeing food security.

The first suggestion is to reduce food loss and food waste. The second one, to improve the 'farm to fork efficiency' (that is, P productivity) in food supply chains. Possible measures in this avenue include setting guidance limits and standards for P fertilizer use, promoting advanced technologies to reduce food loss during food processing, and reducing food wastage during food consumption through education and public awareness campaigns.

The third suggestion is to reduce fertilizer use. A potential measure to achieve this is developing technologies to enhance fertilizer use efficiency.

Approaches to increase fertilizer use efficiency range from high-tech solutions (for example, precision agriculture, e.g. hydroponics) to organic farming techniques aimed at optimizing soil conditions to increase the P availability of soil. Other approaches focus on the addition of microbial inoculants to increase the P availability of soil. An obstacle in spreading these approaches is the fact that poorest countries in the world may be not able to adopt these options because they don't have the necessary know-how.

An alternative for decreasing the proportion of mineral P fertilizer use is to increase the P recycling rate: there are lots of other measures to recover and reuse P, such as ploughing crop residues back into the soil; composting food waste; and P recovery from sewage sludge, steelmaking slags and wastewater.

"P geographical distribution and availability is very limited", Kharrazi explains; "it is in fact located in few countries, such as Morocco, Australia and China; other countries, and especially European countries, don't have great stocks of P and import this key chemical element from other countries. Another problem is that P is not adequately recycled: we use an increasing amount of fertilizers in the agricultural sector but all the data indicate that the current P cycling network is actually a 'one-way journey', where the majority of the P is directly deposited in the soil or discharged in solid wastes and water bodies causing critical environmental problems, such as algae blooms and eutrophication. We should not only rely on P rocks to maintain the high efficiency of P cycling, but also improve the network resilience through P recycling and P productivity improvement in food supply chains. In our study, we proposed some ideas to solve this well-know, critical issue."

Children, and especially boys, show stronger stereotyping about masculine and feminine jobs than previously suspected, an innovative study by the University of Sussex reveals.

New research reveals the extent to which girls exaggerated their gendered voices to imitate workers in different professions dropped off at around seven but continues to increase beyond that age with boys.

Boys also used an overtly masculine voice even when imitating workers in gender-neutral roles, the study found.

Research in the field of gender stereotypes usually involves asking study participants what they think about men and women doing different jobs, but there are concerns this can mask people's true beliefs because their answers may be biased by their desire to conform.

So instead, University of Sussex psychologists tapped into children's unconscious stereotypes by asking them to speak in the voices of people with different occupations.

The research found that for stereotypically male jobs, both sexes spontaneously masculinised their voices, by lowering pitch and resonance, and they also feminised their voices for stereotypically female occupations, by raising their pitch and resonance.

The academics are advising authors and children's TV writers to be extra vigilant about associating job roles too strongly with a specific gender, to avoid children associating certain jobs exclusively with a given gender. They also call attention to the voice as an untapped resource to monitor and potentially challenge implicit stereotypes in children.

Dr Valentina Cartei, research fellow at the University of Sussex's School of Psychology, said: "Our study found that boys were especially likely to accentuate the vocal masculinity or femininity of people doing different jobs. This pattern suggests that children have differential evaluations of males and females engaging in stereotypical and counter-stereotypical occupations."

In the study, children between the ages of five and ten took part in a voice production task where they were provided with descriptions of traditionally male, female and gender neutral professions and asked to give voices to people in each of those jobs.

In order to measure children's beliefs about gender stereotypes using the more conventional approach, the researchers also asked them to complete a questionnaire which asked them directly about men and women carrying out particular job roles.

The researchers created a simple Index of Stereotypicality which they believe could be used to quantify implicit occupational stereotyping in children.

Used alongside software that can extract pitch from the recording of children's voices, the academics believe the index could be a useful tool for teachers and practitioners interested in challenging stereotypes.

Professor Jane Oakhill said: "The strength of stereotypicality based on vocal pitch revealed stereotypes that were not found in children's direct responses to the conventional questions about men and women doing different jobs. This suggests that children continue to entertain gender stereotypes even if they are not prepared to say so explicitly.

"If we are to successfully challenge these occupational stereotypes, then as well as having depictions of both male and female nurses, we need occupational role models who vary in vocal masculinity and femininity, such as male nurses with both low and high vocal pitch, Unconscious bias training should also include voice cues to help teachers and parents become aware of and challenge biases about gender stereotypes in relation to particular jobs."

A new study, which analyzed 40 years of Framingham Heart Study data, found an association between lowered rates of hip fractures and decreases in smoking and heavy drinking.The rates of hip fractures in the United States have been declining over the past few decades. Although some experts attribute this change primarily to improved treatments for bone health, a new National Institutes of Health-supported study suggests other factors. These results indicate that modifiable lifestyle factors, along with treatments, may be beneficial to bone health. The findings appear July 27, 2020 in JAMA Internal Medicine.

Timothy Bhattacharyya, M.D., a researcher with the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), part of NIH, led the analysis to determine what may be causing the drop in hip fracture rates. The research team included scientists from NIH's National Cancer Institute, the Hinda and Arthur Marcus Institute for Aging Research, part of the Hebrew SeniorLife, Beth Israel Deaconess Medical Center, Boston, and Harvard Medical School, Boston.

The analysis included information from 4,918 men and 5,634 women who participated in the Framingham Study. These individuals were followed for a first hip fracture between Jan. 1, 1970, and Dec. 31, 2010. The rates for hip fractures, which were adjusted for age, dropped by 4.4% each year across the 40-year study period. The decrease was seen in both men and women.

In this group, the rate of smoking decreased from 38% in the 1970s to 15% in the period from 2006 to 2010. During the same period, heavy drinking (defined as three or more drinks per day) fell from 7% to 4.5%. The rates of other risk factors for hip fracture, such as underweight and early menopause, did not change over the study period.

"This study points to the continued need for public health interventions to target modifiable lifestyle factors such as smoking and drinking, in addition to considering osteoporosis treatments in individuals at risk of hip fractures," said Bhattacharyya.

"As we learn more about lifestyle factors that impact bone health, we continue to conduct research aimed at understanding all the factors that contribute to reducing fractures, including both lifestyle and medications, so that we can all live longer lives without disability," Robert H. Carter, M.D., acting director of NIAMS, added.

The Framingham Heart Study launched in 1948 to determine factors that contribute to cardiovascular disease. The National Heart, Lung, and Blood Institute, assumed responsibility for the project in 1949. Though many of the original participants have passed away, the study continues to examine another two generations of residents in and near Framingham, Massachusetts.

The study authors note that because the data was exclusively from white individuals, it is unclear whether other populations might show a similar correlation based on lifestyle factors. Another limiting factor was that Framingham participants had lower rates of obesity than the national average. Additionally, the study did not include measurements of bone mineral density, because such testing was not available until the 1990s.

Medical and non-medical prescription stimulant use is higher in states without medical cannabis laws (MCLs) than in states with MCLs among heterosexuals and among certain lesbian, gay and bisexual (LGB) subpopulations. The study led by Columbia University Mailman School of Public Health researchers is published in the International Journal of Drug Policy.

Based on an analysis of data from the National Survey on Drug Use and Health between 2015 and 2017, the researchers found that bisexual men self-reported higher medical and non-medical prescription stimulant use than heterosexual men. Bisexual women self-reported higher non-medical prescription stimulant use than heterosexual women. Female and male heterosexuals in MCL states had lower odds of medical stimulant use than their female and male counterparts in non-MCL states; bisexual men in MCL states also reported a lower odds of medical stimulant use than their counterparts in non-MCL states. Female and male heterosexuals living in MCL states also reported lower odds of non-medical prescription stimulant use than their counterparts living in non-MCL states; similar patterns emerged for bisexual men and women. These associations were not significant among lesbian/gay adults.

This study is cross-sectional and thus only shows associations, not causality. Several factors may explain the link between medical and non-medical stimulant use and state MCL status. First, MCL states may have other common characteristics that existed prior to MCL enactment compared to non-MCL states, including lower rates of medical and non-medical prescription stimulant use. Second, MCL states might have different stimulant prescribing regulations that may drive prescribing patterns and thus the amount of prescription stimulants in circulation. In 2016, half of the states above the median in per capita (mg/person) of amphetamine prescriptions were non-MCL states, while only one-third of states that were below the median in prescriptions were non-MCL states. "This suggests that the volume of prescription stimulants may be higher in non-MCL as compared to MCL states, which previous research suggests can lead to diversion, whereby stimulants that were medically prescribed are used non-medically," the authors write.

The study findings are in keeping with research finding elevated rates of stimulant use among LGB individuals--a pattern that may be linked to minority stress, meaning the discrimination, rejection, identity concealment, harassment, and maltreatment these individuals experience.

"Our findings support the need for multi-level approaches to address higher levels of prescription stimulant among LGB adults compared to their heterosexual counterparts," the study authors write. "At a structural level, states should ensure that public health campaigns incorporate information about stimulant use and target LGB individuals, reduce unnecessary stimulant prescriptions to help limit [non-medical-use of these drugs], and offer non-stigmatizing and affordable treatment when clinically indicated. At a community level, harm reduction and medication disposal should be readily accessible."

Researchers from North Carolina State University have identified a microRNA (miRNA) that could promote hair regeneration. This miRNA – miR-218-5p – plays an important role in regulating the pathway involved in follicle regeneration, and could be a candidate for future drug development.

Hair growth depends on the health of dermal papillae (DP) cells, which regulate the hair follicle growth cycle. Current treatments for hair loss can be costly and ineffective, ranging from invasive surgery to chemical treatments that don’t produce the desired result. Recent hair loss research indicates that hair follicles don’t disappear where balding occurs, they just shrink. If DP cells could be replenished at those sites, the thinking goes, then the follicles might recover.A research team led by Ke Cheng, Randall B. Terry, Jr. Distinguished Professor in Regenerative Medicine at NC State’s College of Veterinary Medicine and professor in the NC State/UNC Joint Department of Biomedical Engineering, cultured DP cells both alone (2D) and in a 3D spheroid environment. A spheroid is a three-dimensional cellular structure that effectively recreates a cell’s natural microenvironment.In a mouse model of hair regeneration, Cheng looked at how quickly hair regrew on mice treated with 2D cultured DP cells, 3D spheroid-cultured DP cells in a keratin scaffolding, and the commercial hair loss treatment Minoxidil. In a 20-day trial, mice treated with the 3D DP cells had regained 90% of hair coverage at 15 days.

“The 3D cells in a keratin scaffold performed best, as the spheroid mimics the hair microenvironment and the keratin scaffold acts as an anchor to keep them at the site where they are needed,” Cheng says. “But we were also interested in how DP cells regulate the follicle growth process, so we looked at the exosomes, specifically, exosomal miRNAs from that microenvironment.” Exosomes are tiny sacs secreted by cells that play an important role in cell to cell communication. Those sacs contain miRNAs.

MiRNAs are small molecules that regulate gene expression. Cheng and his team measured miRNAs in exosomes derived from both 3D and 2D DP cells. In the 3D DP cell-derived exosomes, they pinpointed miR-218-5p, a miRNA that enhances the molecular pathway responsible for promoting hair follicle growth. They found that increasing miR-218-5p promoted hair follicle growth, while inhibiting it caused the follicles to lose function.

“Cell therapy with the 3D cells could be an effective treatment for baldness, but you have to grow, expand, preserve and inject those cells into the area,” Cheng says. “MiRNAs, on the other hand, can be utilized in small molecule-based drugs. So potentially you could create a cream or lotion that has a similar effect with many fewer problems. Future studies will focus on using just this miRNA to promote hair growth.”

LOS ANGELES -- For many with end-stage lung disease, lung transplantation has become a viable option to extend lives and improve the quality of life.

However, once lung transplant recipients leave the hospital, they may experience complications, such as an infection or organ rejection, that can result in unplanned hospital readmissions and other poor outcomes.

One of the many challenges patients face is managing their health from home and adhering to medication schedules.

To provide another layer of support for lung transplant recipients, the Keck Medicine of USC lung transplant team launched a two-year observational pilot study to monitor patients post-discharge using Bluetooth-enabled devices and computer tablets. The devices measured blood pressure, heart rate, weight, blood glucose, oxygen saturation and pulmonary function.

The researchers discovered that monitored patients had 44% fewer hospital readmissions and spent 54% fewer days in the hospital when they were readmitted.

"This study is significant because it is the first to use Bluetooth technology to comprehensively monitor transplant patients," says Felicia Schenkel, MSN, lung transplant manager and lead author of the study. "Lung transplant recipients are a high-risk patient population, and we're happy to see that this program worked so well to improve patients' lives."

The study appeared in the American Journal of Transplantation.

Twenty-eight lung transplant patients received the two-year remote tracking and 28 matched control patients did not. With the exception of remote monitoring, all patients received the same level of post-surgical care, which included regular in-person visits and lung function check-ups. The two groups of patients were also similar in respect to demographics, diagnosis and pre-transplant clinical characteristics.

Monitored patients used computer tablets to report symptoms, track appointments and medication compliance, conduct videoconferences with staff and access educational videos along with other materials.

Patients were asked to measure their vital signs and report symptoms daily for the first three months and after that time, three times a week. The results were sent in real time to the transplant team and triggered alerts if out of normal range.

Patients with high compliance rates on reporting vital signs and symptoms received incentives such as badges and humorous memes. Patients with marginal compliance received encouraging reminders and periodic calls from the transplant team.

At the end of the two years, the tracked patients were readmitted to the hospital 66 times versus 112 for the control group. They were less likely to be admitted for infections and non-organ rejection/non-infection causes such as shortness of breath or hypertension. They also had a lower but not statistically significant readmission for organ rejection and for death.

In addition, when monitored patients were readmitted to the hospital, they spent an average of 12 fewer days per patient per year compared to the control group (approximately 10 days versus 22). Hospital costs were also dramatically cut by 48%, translating to a $132,000 reduction in hospital charges per patient per year.

The at-home tracking worked for two reasons, according to Schenkel. "With constant monitoring, we were able to react to data sooner and take intervening steps before a patient's condition worsened," she says. "In addition, because we incentivized data reporting, patients were more likely to check in with us about their health and report symptoms."

Post-surgical remote monitoring is now standard protocol for all lung transplant recipients at Keck Medicine. The department averages between 30 - 40 lung transplants per year.

In the future, study authors hope other medical teams will follow their lead.

"Real-time remote monitoring of patients is not only beneficial to lung transplant patients but can easily be transferred to other types of transplant or critical care patients," Schenkel says. "This program should be a model for how telemedicine can be used in the future, especially as the need for remote monitoring technology has increased due to the COVID-19 pandemic."

An alternative amplification technique to detect SARS-CoV-2 RNA could offer a way to rapidly test large numbers of people for COVID-19, although the technique is not as sensitive as quantitative RT-PCR, the current standard method for COVID-19 testing. Faster and less complicated testing could aid in the rapid isolation of infected people and could help to identify and prevent new outbreaks of the disease until a vaccine becomes available. Quantitative RT-PCR can successfully detect viral RNA but requires expensive machinery and chemical reagents that can sometimes be in short supply. The standard method also depends on time-consuming temperature cycling steps to amplify enough RNA from a patient sample for detection, resulting in a processing time between 3 and 24 hours in most clinical laboratories. Viet Loan Dao Thi and colleagues instead propose using a technique called reverse transcription loop-mediated isothermal amplification (RT-LAMP), which can be carried out at a constant temperature using simple equipment and a different set of reagents. In their tests of RNA isolated from 768 nasopharyngeal swabs from individuals tested for COVID-19, Dao Thi et al. determined that RT-LAMP was less sensitive than quantitative RT-PCR but could be used to evaluate large groups of people, with an average test processing times of 30 minutes. The researchers concluded that RT-LAMP works best for identifying people with moderate to high amounts of SARS-CoV-2 virus in their bodies, but is not sensitive enough to identify infection in people with a low viral load - such as those at the beginning or end of the illness. The researchers also tested the possibility of using RT-LAMP directly on nasopharyngeal swabs - without the need for RNA isolation - but concluded this technique was less sensitive than using isolated RNA.

INFORMS Journal Management Science Study Key Takeaways:

Organizations that provide a safe workplace have significantly lower odds of survival.

Organizations that would typically have better survival odds, benefit most from not providing a safe workplace.

CATONSVILLE, MD, July 27, 2020 - There are conflicting predictions on the relationship between worker safety and organization survival. New research in the INFORMS journal Management Science finds organizations that provide a safe workplace have a significantly lower chance of survival because it costs to be safe.

The study, "The Tension Between Worker Safety and Organization Survival," conducted by Mark Pagell, Mary Parkinson, Michalis Louis and Brian Fynes of University College Dublin, Ireland, Anthony Veltri of Oregon State University, John Gray of The Ohio State University and Frank Wiengarten of Universitat Ramon Llull in Spain, looked at 100,000 organizations across 25 years in the state of Oregon.

"A safe workforce is burdensome and costly for employers," said Veltri, a professor in the College of Public Health and Human Sciences at Oregon State. "As the amount of work increases and buffers or slack decreases, productivity increases, but so does the likelihood of accidents and other harm to workers. Organizations that do not provide a safe workplace gain an economic advantage by avoiding burdensome costs and being more productive."

Classical economics suggests that safety regulations exists because organizations would not provide a safe workplace on their own volition. Organizations that do get inspected could conclude that the fines for noncompliance are miniscule compared to what it costs to have a safe environment. Safety regulations and policies are intended to prevent harm at work. But the implications are whether it is profitable to provide a safe workplace.

"Workers in unsafe environments engage in self-protection and are not motivated to improve the organization's operations," said Veltri. "While workers in safe environments do not have to dedicate resources to self-protection and can be motivated to engage in improving the organization's operations."

This shows that safety provides a necessary condition to leverage human capital into the development of unique capabilities and long-term competitive advantage. This research linking regulation to proven safety indicates that the impact of an inspection is short-term and that inspections do not improve safety in the long term.

Short-term survival or survival in the immediate future may be enhanced by not taking on the costs of providing a safe workplace. For instance, decreasing costs by eliminating safety training. However, over the long-term, the same organizational conduct could increase the severity and frequency of claims, and destroy rather than build human capital.

"The results predict that for most organizations, enhanced survival will conflict with the goal of protecting the workforce," concluded Veltri.

University of Hawai'i (UH) at Mānoa researchers and Sumida Farm farmers published a study this week detailing their collaboration to study the past, present and future of the multigenerational farm which produces 70 percent of Hawai'i's watercress. The study highlights that relationships with the broader community have enhanced Sumida Farm's ability to adapt and innovate their farm practices in response to challenges and changing conditions. 

Once a preferred swimming pool of Hawaiian ali'i, the Kalauao Spring on the island of O'ahu today continues to supply millions of gallons of clean, fresh water to the Pearl Harbor region. But changes to the environment, climate and continued development of the surrounding areas has put into question its sustainability.

Third-generation farmers, siblings Barbara and David Sumida had been running the farm for decades, and were starting to wonder if the clean fresh spring water that was the source of their livelihood was experiencing pollution from the surrounding urban development; if the springs were getting saltier from sea level rise; and why the crops were dying off during the hottest summer months.

In 2017, the Sumida family began to collaborate with members of UH Mānoa's 'Ike Wai research group. A team of UH earth scientists, economists, geographers and Hawaiian language experts, and the Sumida family used novel research methods to study this dynamic and fragile resource and investigate changes they were observing in the crops.

The team pursued an approach that included interviews about farm history and harvests; place name searches to research the mo'olelo of Kalauao (Kahuawai) Spring; a 25-year retrospective analysis of harvests, groundwater pumping, Oceanic Niño Index, and temperature to identify trends in productivity; a one-year intensive study of the freshwater springs at the farm to identify any seasonal, tidal and climate-induced changes to water quality, as well as pollution from agriculture or cesspools; and an analysis of local and national press to determine the community's valuation of the farm over its 90-year history.

"This deep dive into the history of the farm uncovered some very surprising insights," said Jennifer Engels, affiliate researcher with the UH Mānoa School of Ocean and Earth Science and Technology (SOEST) and lead author of the study. "The close partnership between the UH Mānoa team and the Sumidas resulted in a great synergy of ideas and information that would never have been possible without their generational accounts of lived experiences on the farm."

The team sought to gain insight into the resilience of the Sumidas' watercress farm despite the pressures of urbanization that have made other small farms obsolete around the islands.

It turns out that thousands of community members, from school children to senior citizens to celebrity chefs, have been welcomed to Sumida farm over the past several decades--creating deep and meaningful connections. Furthermore, as far back as the 1800's, hundreds of Hawaiian language newspaper reports indicate how valuable and useful the spring and the surrounding areas were for the community.

As urban areas expand around the world, there are growing efforts to restore and protect natural and agricultural systems for the services they provide to urban communities, such as crop production, flood prevention and nutrient retention.

"Hawai'i has ambitious goals around food sustainability by 2050, and yet small farms around the state have struggled or failed over the last several decades," said Engels. "Sumida Farm has survived and thrived despite multiple challenges throughout its history, from pests, to urbanization, to climate change. Their example can serve as a model for other small farms."

In an unfortunate and heartbreaking turn of events, Barbara Sumida passed away in February of this year. Although her presence is deeply missed, her spirit and legacy remain strong. Her brother David, and now the fourth generation of Sumida farmers, Emi and Kyle, are continuing their partnership with UH Mānoa's research team. Their goal is to adapt and evolve the farm in response to changing environmental and social needs so they can continue to nourish the islands and serve the community.

Below please find a summary and link(s) of new coronavirus-related content published today in Annals of Internal Medicine. The summary below is not intended to substitute for the full article as a source of information. A collection of coronavirus-related content is free to the public at http://go.annals.org/coronavirus.

1. Opinion: During the COVID-19 pandemic, the public must be protected from research without consent

The COVID-19 pandemic demands a sweeping public health response, however, preventing unnecessary sacrifice of fundamental human rights under the pretext of public health is critical, according to a team of bioethicists from Johns Hopkins University. One area where this concern arises is differentiating public health activities classified as surveillance from those that constitute research. Defining activities as public health surveillance has profound implications, because there is then no further ethical oversight, no legal requirement in the United States for informed consent, and no specific protection for vulnerable participants or communities. The ethical basis for using surveillance data without consent, particularly in emergency situations, is that it serves a compelling common good. While public health activities should proceed without informed consent when it is not possible or would undermine effective public health response. However, researchers should not invoke the Common Rule's public health surveillance exclusion, under questionable pretenses, when there is clearly also a research intent, whether extant or downstream. Storage of data and biological specimens for future research should occur with informed consent. Activities that are truly research should be regulated as such, and public health surveillance should be done with consent if possible. According to the authors, we must execute good governance of the public health surveillance and emergency response infrastructure to maintain the public trust and avoid repeating research abuses of the past. Read the full text: https://www.acpjournals.org/doi/10.7326/M20-4631.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. The lead author, Mary Catherine Beach, MD, MPH, can be reached at mcbeach@jhmi.edu.

2. Occupational Health: A Key to the Control of COVID-19 in Correctional Facilities

COVID-19 has swept through prisons in much the same way it has nursing homes: after being introduced by staff or newly arrived residents, it spreads efficiently, including to many with medical vulnerabilities. Yet, many correctional workers lack basic protections. The authors from Amend at UCSF: Changing Correctional Culture and University of California believe that ensuring community-standard occupational health for correctional staff during COVID-19 will protect prison residents, staff, and their communities. Read the full text: https://www.acpjournals.org/doi/10.7326/M20-4543.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. The lead author, David Sears, MD, can be reached through Daryl Norcott at daryl.norcott@ucsf.edu.

Scientists have discovered a unique enzyme responsible for the pungent characteristic smell we call body odour or BO.

Researchers from the University of York have previously shown that only a few bacteria in your armpit are the real culprits behind BO. Now the same team, in collaboration with Unilever scientists, has gone a step further to discover a unique "BO enzyme" found only within these bacteria and responsible for the characteristic armpit odour.

This new research highlights how particular bacteria have evolved a specialised enzyme to produce some of the key molecules we recognise as BO.

Co-first author Dr Michelle Rudden from the group of Prof. Gavin Thomas in the University of York's Department of Biology, said: "Solving the structure of this 'BO enzyme' has allowed us to pinpoint the molecular step inside certain bacteria that makes the odour molecules. This is a key advancement in understanding how body odour works, and will enable the development of targeted inhibitors that stop BO production at source without disrupting the armpit microbiome."

Your armpit hosts a diverse community of bacteria that is part of your natural skin microbiome. This research highlights Staphylococcus hominis as one of the main microbes behind body odour.

Furthermore, the researchers say that this "BO enzyme" was present in S. hominis long before the emergence of Homo sapiens as a species, suggesting that body odour existed prior to the evolution of modern humans, and may have had an important role in societal communication among ancestral primates.

This research represents an important discovery for Unilever R&D, made possible by its long-standing academic-industry collaboration with the University of York. Unilever co-author Dr Gordon James said: "This research was a real eye-opener. It was fascinating to discover that a key odour-forming enzyme exists in only a select few armpit bacteria - and evolved there tens of millions of years ago."

A new study has found that men are more likely than women to endorse coronavirus (COVID-19) related conspiracy theories.

The study, published in early July in Politics and Gender, builds upon research from earlier this year that revealed Republicans were more likely than Democrats to believe COVID-19 conspiracies.

The partisan split - shown in a previous study by University of Delaware professor Joanne Miller - makes sense, given that one of the reasons people believe conspiracy theories is to protect their political worldviews.

The current political context is one in which the Republican president is being widely criticized for his handling of the pandemic. So Republicans are more likely to believe that, for example, scientists or the media are exaggerating the seriousness of the virus. If the United States had a Democratic president who was being criticized for his/her handling of the pandemic, more Democrats would believe these COVID-19 conspiracy theories, said Miller, a professor in the University of Delaware's Department of Political Science and International Relations.

But the new research, co-authored by Miller, fellow University of Delaware professor Erin Cassese and Christina Farhart from Carleton College, shows that gender is more of a factor than party affiliation.

The COVID-19 pandemic is an easy target for conspiracy theories. Most of us are engulfed in worries over health, finances, jobs or our childrens' education and feel a lack of control, the authors say.

"During a global pandemic, it's kind of the perfect storm of uncertainty," Miller said. "And so when we feel a lack of control, uncertainty or powerlessness, we seek out explanations for why the event occurred that's causing us to feel that way. And what this can do is it can lead us to connect dots that shouldn't be connected because we're trying to seek out answers. And sometimes those answers are conspiracy theories."

Working with Farhart, Miller and Cassese used previous research as a jumping off point: Men and women are experiencing the pandemic differently. For example, men are more vulnerable to the virus, but women are more likely to be frontline workers and experience more of a burden as the primary caregivers at home.

Those findings raised questions as to whether gender also influenced conspiracy theory beliefs.

To find out, the team ran a survey of 3,000 people in April using 11 popular conspiracy theories, including claims that China or the U.S. accidentally released the virus; that 5G cell towers are causing the virus; that Bill Gates is plotting to somehow inject us with a vaccine; and that scientists are trying to make Donald Trump look bad by exaggerating the seriousness of the pandemic.

Among Democrats, there were statistically significant gender gaps for all 11 conspiracy theories; among Republicans, there were gender gaps for nine of the 11. The average gender gap among Democrats was 10.18% points (32.45% males to 22.27% females endorsed the theories), compared to 10.09% points among Republicans (48.9% males vs. 38.81% females). The gender differences were notable, researchers said, given that gender gaps in public opinion tend to be much smaller in magnitude, and the results were surprising, given that past work has not found a consistent association between gender and conspiracy theory beliefs.

So why men? Two dispositional factors are connected to the gender gap. Learned helplessness, which is a feeling like everything's out of your control and any actions that you try to take are basically pointless; and conspiratorial thinking, which is a tendency to think about major political events and problems in conspiratorial terms without having any connection to, in this case, COVID-19.

The key factor is learned helplessness, which is experienced by both men and women. Miller described the process: Some people, when faced with repeated failures at trying to affect positive change in their lives, come to believe that they are helpless to control the things that they want to control.

The resulting general sense of learned helplessness can lead to conspiracy theory beliefs, Miller said.

"What we're finding in this research is that men are more likely to score higher on learned helplessness," Miller said. "And that might be a boost that's happening just as a result of the pandemic itself, that they're feeling more of this because they can't control what's going on right now. That leads to these beliefs that, well, maybe there's a secret group of people controlling these things behind the scenes."

Cassese added, "It's something that both men and women can experience, but in our study we're finding that it's men who are really feeling this more at this moment, and it's influencing how they feel about COVID. Learned helplessness and a predisposition toward conspiratorial thinking explain about half of the gender difference that we find. But there's still more for us to do to try to understand this phenomenon."

Miller and Cassese said they hope to use their findings to affect positive change in public health. Recent research has found that women were more likely than men to engage in protective behaviors that have been recommended by scientists and health officials, such as wearing masks and social distancing.

"So there may be some connection here between engaging in those activities and belief in conspiracy theories that we plan on exploring in future research," Miller said.