It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Thursday, February 09, 2023
Gay men discriminate against feminine gay men, new psychology study finds
University of Sydney psychology study finds both gay men and heterosexual men prefer masculine over feminine gay men for a high-status role, suggesting feminine gay men may face implicit discrimination in the workplace
Psychology study finds both gay men and heterosexual men prefer masculine over feminine gay men for a high-status role, suggesting feminine gay men may face implicit discrimination in the workplace
Key findings
Gay men and heterosexual men prefer masculine-presenting gay men for high-status roles
Masculine presentation was enough to elicit preferential treatment, regardless of qualifications
Gay men are complicit in prejudice against more feminine-presenting gay men
Both gay men and heterosexual men prefer masculine-presenting men for high-status roles, according to a new study from the University of Sydney, leaving more feminine-presenting gay men disadvantaged and facing internal bias, prejudice and potential discrimination in the workplace, including in hiring practices and promotion opportunities.
The research published in the prestigious peer-reviewed journal Sex Roles is believed to be the first experimental study to demonstrate status costs for gay men who present with more feminine than masculine qualities across workplace hierarchies. It also demonstrates implicit bias among gay men as a community.
Ben Gerrard is a researcher in gender and sexuality in the School of Psychology at the University of Sydney. He defines feminine-presenting traits as more feminine, as traditionally understood/defined vocal quality, body language and posture.
Mr Gerrard says the finding that gay men prefer a more “straight-acting” gay man for high-status roles is disappointing and potentially creating a gay glass ceiling in workplaces.
“Gay men are potentially blocking each other from positions of power and leadership due to this implicit bias,” he said. “Men are still expected to conform to more traditional masculine styles of leadership and if they fail to sufficiently project masculine traits they are at risk of status penalites. This is an example of internalised homophobia among the gay community and it impacts opportunities for these gay men.”
Mr Gerrard said while gay men appear to enjoy increasing equality and representation in Western cultures, they are still disadvantaged in pursuing high-status opportunities, compared to heterosexual men. “The findings point to the need for advocacy and training to counter apparent bias against feminine-presenting gay men in a range of professional contexts and populations,” he said.
Testing internal biases against sexuality and gender traits
The researcher created a mock TV commercial casting brief for a campaign promoting tourism in Sydney. The mock campaign aimed to sell Sydney overseas and the casting called for an actor who could be viewed as a leader or someone who would be admired by the audience.
The researcher, (himself a professional actor) created videos of six shortlisted ‘candidates’ using professional actors, all gay men in real-life, who acted the same script in both a feminine-gay and masculine-gay manner (manipulating their voice, mannerisms, and posture but otherwise everything else was kept identical).
A survey of 256 gay and heterosexual men were invited to watch the videos and to look for an actor who could be seen as a “leader” who could represent Australia. They viewed the feminine or masculine version of a particular actor, and placed casting preferences for the role. The researcher found that bothgay men and heterosexual men preferred the more masculine-gay male actor for the advert (discriminating against the feminine-gay actor).
Heterosexual men higher in homonegativity and gay men higher in misogyny both showed a stronger preference for the masculine-gay actor over the feminine-gay actor. These findings hold important implications for implicit bias and hiring practices.
Need for greater acceptance
More work is required to challenge the prevailing association between masculinity and high status, Mr Gerrard says, especially in light of contemporary leadership theories, which suggest traits, traditionally perceived as ‘feminine’, such as warmth, can be more effective in managing modern workplaces.
“We operate in teams-based workplaces now where effective leadership qualities – warmth, empathy and good communication – are all considered feminine traits, and a more feminine-presenting gay man might be an ideal candidate for a leadership role,” Mr Gerrard said. “And yet we still value traditional masculinity at a senior leadership level as a measure of the capacity to lead, because traditional feminine traits are considered too soft or not authoritative enough.”
“This homophobic bias is putting pressure on feminine-presenting gay men to conform so they might be passable as a heterosexual man,” Mr Gerrard said. “What we need is an increase in authentic representation of empowered feminine-presenting gay men - especially in the media: in order to counter misinformed biases regarding their ability to lead. There needs to be education and awareness within the community and in recruitment processes - around the potential to be unconsciously influenced by these unfair biases.”
IMAGE: HUMAN INFANTS AND YOUNG CHILDREN ARE MOST LIKELY TO SURVIVE, GROW AND DEVELOP TO THEIR FULL POTENTIAL WHEN BREASTFED. DESPITE SCIENTIFIC EVIDENCE MORE INFANTS ARE FED FORMULA MILKS TODAY THAN EVER BEFORE.view more
CREDIT: CREDIT: THE LANCET
Peer-reviewed / Literature review, opinion / People
Fewer than half of infants globally are breastfed as recommended by WHO [1], with formula milk sales on the rise despite formula feeding failing to offer the same nutrition, health and development benefits as breastfeeding.
The Lancet 2023 Series on Breastfeeding argues that formula milk companies exploit parent’s emotions and manipulate scientific information to generate sales at the expense of the health and rights of families, women, and children.
The Series highlights the economic and political power of the dominant formula milk companies and the public policy failures which mean millions of women are prevented from breastfeeding as recommended.
The authors stress that breastfeeding is a collective responsibility of society and call for more effective promotion, support and protection for breastfeeding, including a much better trained healthcare workforce and an international legal treaty to end exploitative formula milk marketing and prohibit political lobbying.
Formula milk marketing tactics are exploitative, and regulations need to be urgently strengthened and properly implemented according to a new three paper Series publish in The Lancet. Experts call for an international legal treaty to end irresponsible formula milk marketing and political lobbying, accompanied by more effective breastfeeding support worldwide.
Series co-author, Professor Nigel Rollins, WHO, says “The sale of commercial milk formula is a multi-billion-dollar industry which uses political lobbying alongside a sophisticated and highly effective marketing playbook to turn the care and concern of parents and caregivers into a business opportunity. It is time for this to end. Women should be empowered to make choices about infant feeding which are informed by accurate information free from industry influence.”
He continues, “Our Series finds society, politics, and economics all contribute to why fewer than half of infants globally are breastfed as recommended [1]. Breastfeeding should be considered society’s collective responsibility, not the sole concern of women. We need to see wide-ranging actions across different areas of society to better support mothers to breastfeed for as long as they want.” [2]
“Babies are most likely to survive and grow to their full potential when breastfed. [3] Breastfeeding promotes brain development, protects infants against malnutrition, infectious diseases, and death, while also reducing risks of obesity and chronic diseases in later life. Yet, globally, many women who wish to breastfeed face multiple barriers, including insufficient parental leave and lack of support in healthcare systems and at the workplace, in the context of exploitative marketing tactics of the commercial milk formula industry”, says Series co-author Professor Rafael Pérez-Escamilla, Yale University School of Public Health, US. [2]
In a novel analysis, the Series describes how profits made by the formula milk industry benefit companies located in high-income countries while the social, economic and environmental harms are widely distributed and most harmful in low and middle income countries.
An exploitative marketing playbook
Triggered by The Baby Killer investigative report into Nestle’s marketing of formula milk in the Global South in the 1970s, the World Health Assembly developed the voluntary International Code of Marketing of Breast-milk Substitutes and subsequent resolutions (the Code) in 1981 [4]. However, the powerful influence of the milk formula industry and the marketing of their products in violation of the Code continues, with sales from commercial formula milk having rapidly increased over the past twenty years and now at more than $55 billion a year.
The Series outlines the exploitative tactics used by formula milk companies to sell their products, including taking advantage of parents’ worries about their child’s health and development. One common reason women introduce formula milk is interpretating unsettled baby behaviour, especially disrupted sleep and persistent crying, as a sign that breast milk is insufficient. [5,6] However, sleep patterns of babies are not the same as for adults and unsettled baby behaviours are common. When mothers are appropriately supported, concerns can be addressed successfully without the use of formula milk.
“The formula milk industry uses poor science to suggest, with little supporting evidence, that their products are solutions to common infant health and developmental challenges. Adverts claim specialised formulas alleviate fussiness, help with colic, prolong night-time sleep, and even encourage superior intelligence. Labels use words like ‘brain’, ‘neuro’ and ‘IQ’ with images highlighting early development, but studies show no benefit of these product ingredients on academic performance or long-term cognition. This marketing technique violates the 1981 Code, which says labels should not idealise the use of formula, and exploits poor science to create an untrue story to sell more product,” says Professor Linda Richter, Wits University, South Africa. [2] (For artwork illustrative of formula packaging see figure 3 and 4 in paper 2 of the Series. For a direct link to the images, please see notes to editors).
The Series explains how formula milk marketing exploits the lack of support for breastfeeding by governments and society to use gender politics to sell its products. The authors describe how the formula milk industry frames breastfeeding advocacy as a moralistic judgment that is anti-feminist and damaging to women, while presenting milk formula as a convenient and empowering solution for working mothers.
In recent years, digital communications have greatly increased the reach of marketing in ways that blur the difference between advertising and the provision of nutrition and care advice. The Series highlights examples of digital marketing such as industry-paid influencers sharing the difficulties of breastfeeding as preludes to formula milk marketing, and industry sponsored parenting apps with 24/7 chat services that enable product placement, offer free samples or deals, and promote online sales. The authors argue there is very little regulation of the formula milk industry online and there are regular violations of the Code.
A new review, conducted for the Series, of 153 studies details how marketing practices in violation of the Code have continued in nearly 100 countries and in every region of the world since its adoption more than forty years ago [7]. The Series says voluntary uptake of the Code is not enough and calls for an international legal treaty on the commercial marketing of food products for babies to protect the health and wellbeing of mothers and families.
The formula milk lobby
The Series also draws attention to the power of the milk formula industry to influence national political decisions and interfere with international and national regulatory processes. The formula industry has established a network of trade associations and front groups that lobby against the Code and other breastfeeding protection measures. For example, in 2012, South Africa passed new national legislation to implement The Code into law, however, this took nine years with many setbacks resulting from industry lobbying. Formula milk manufacturers formed a new lobby group, the Infant Feeding Association, which applied pressure for amendments to the regulations.
This outsourcing of lobbying allows the corporations themselves to project an image of benevolence and corporate social responsibility, suggesting that they can adequately self-regulate through corporate policies on responsible marketing. However, their self-regulation falls far short of compliance to the Code.
As well as influencing political organisations, the authors argue formula milk companies also draw on the credibility of science by sponsoring professional organisations, publishing sponsored articles in scientific journals, and inviting leaders in public health onto advisory boards and committees, leading to unacceptable conflicts of interest within public health.
“The voluntary Code is not working – formula milk companies chose to disregard the guidance and lobby at every opportunity to weaken regulation. We need a stricter international legal treaty on the marketing of milk formula which is incorporated into law across the world. The treaty must protect policymaking from industry influence, with obligations for senior public officials to divulge meetings with lobbyists and requirements for scientific organisations to disclose funding sources and members of expert advisory groups. This would regulate the commercial milk formula industry while not restricting the sale of the products to those who need or want them. More generally, the global and public health community must also be much more critical about public-private partnerships that enable or tolerate conflicts of interest” says Professor David McCoy. [2]
Society-wide changes needed
In addition to ending the marketing tactics and industry influence of formula milk companies, broader actions across workplaces, healthcare, governments, and communities are needed to more effectively support women who want to breastfeed.
Half a billion working women globally are not entitled to adequate maternity protection. A systematic review of studies found women with a minimum of three months maternity leave, paid or unpaid, were at least 50% more likely to continue breastfeeding compared to women returning to work within three months of giving birth [8]. The authors call for governments and workplaces to recognise the value of breastfeeding and care work, by actions such as extending paid maternity leave duration to align with the six month WHO recommended duration of exclusive breastfeeding.
Women also face a lack of breastfeeding promotion, protection and support within healthcare systems due to limited public budgets, skilled support by health workers, influence from milk formula industry and an absence of care that is culturally appropriate and led by the needs of women. Authors argue that breastfeeding outcomes improve when health systems actively empower women and enable experienced peers to support women during pregnancy, childbirth and onwards. Healthcare providers should offer skilled counselling before and after birth to all mothers to enable them to address unsettled baby behaviours whilst continuing to breastfeed if they wish to do so.
Sonia Hernández-Cordero, Universidad Iberoamericana, Mexico City says, “We are seeing improvements in some countries. A case study which we commissioned for the Series found that, despite lacking federally mandated paid maternity leave, the US continues to recognise an increasing number of Baby-Friendly [9] hospitals each year, and the National Supplemental Nutrition Program for Women, Infants and Children (WIC), which reaches half of annual births in the US, is increasingly providing breastfeeding counselling as it continues to support more women to choose breastfeeding.” [2]
“Many governments fail to protect mothers and children from unethical marketing practices because of the economic and political power of trans-national companies. The extreme power of corporations relative to public-interest bodies must be re-balanced. Anti-trust legislation and the ending of corporate tax abuse would help reverse the favouring of private financial interests at the expense of the rights of mothers and infants”, says Professor David McCoy, United Nations University. [2]
“Advice that breastfeeding is best for their babies' health is no use if women are not supported to understand and manage unsettled baby behaviours, or if mothers without maternity leave or pay are forced to go back to work out of financial necessity”, says Dr Julie Smith, Australian National University. [2]
A large expansion in health professional training on breastfeeding, as well as statutory paid maternity leave and other protections are vital. This requires changing the way society views breastfeeding as the sole responsibility of individual women and putting the onus across all levels of society,” says Professor Rafael Pérez-Escamilla, Yale School of Public Health. [2]
A linked Editorial published in The Lancet says, “Some women choose not to breastfeed, or are unable to. Perceived pressure, or inability, to breastfeed—especially if it is at odds with a mother’s wishes—can have a detrimental effect on mental health, and systems should be in place to fully support all mothers in their choices. Women and families make decisions about infant feeding based on the information they receive, and a criticism of the CMF industry’s predatory marketing practices should not be interpreted as a criticism of women. All information that families receive on infant feeding must be accurate and independent of industry influence to ensure informed decision making.”
NOTES TO EDITORS
The Global Series launch is on Wednesday 8th February at 12:30 – 14:00 UK time. It will be livestreamed here. This Series received funding from BMGF for the research but not to authors for their time or writing. For a full list of researchers see the three papers.
[1] UNICEF. Global database 2021. Available from: https://data.unicef.org/topic/nutrition/breastfeeding/ [2] Quote direct from author and cannot be found in the text of the Article. [3] Victora CG, Bahl R, Barros AJ, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet 2016; 387(10017): 475-90. [4] https://www.who.int/publications/i/item/9241541601 [5] Vilar-Compte M, Pérez-Escamilla R, Orta-Aleman D, Cruz-Villalba V, Segura-Pérez S, Nyhan K, Richter LM. Impact of baby behaviour on caregiver's infant feeding decisions during the first 6 months of life: A systematic review. Matern Child Nutr. 2022 May;18 Suppl 3(Suppl 3):e13345. doi: 10.1111/mcn.13345. [6] Segura-Pérez S, Richter L, Rhodes EC, Hromi-Fiedler A, Vilar-Compte M, Adnew M, Nyhan K, Pérez-Escamilla R. Risk factors for self-reported insufficient milk during the first 6 months of life: A systematic review. Matern Child Nutr. 2022 May;18 Suppl 3(Suppl 3):e13353. doi: 10.1111/mcn.13353. [7] Becker GE, Zambrano P, Ching C, et al. Global evidence of persistent violations of the International Code of Marketing of Breast-milk Substitutes: A systematic scoping review. Maternal & child nutrition 2022; 18(S3): e13335. [8] Navarro-Rosenblatt D, Garmendia ML. Maternity Leave and Its Impact on Breastfeeding: A Review of the Literature. Breastfeed Med 2018; 13(9): 589-97. [9] https://www.unicef.org.uk/babyfriendly/
Paper 1: NR received grants from the Bill & Melinda Gates Foundation during the conduct of this study. All other authors declare no competing interests. Paper 2: PB reports receiving funds from WHO to undertake research on the political economy of infant and young child feeding, which included research on CMF marketing. PB also reports funding from the Australian Research Council, UNICEF, The World Bank, and WHO to undertake research, prepare policy reviews, write reports, or attend meetings, outside the submitted work. GK was employed by M&C Saatchi World Services, which was commissioned by UNICEF and WHO to design and implement a multicountry study examining the scope and influence of CMF marketing. GH and DM report receiving funds from WHO to undertake qualitative and secondary research on the political economy of breastfeeding and other research describing the nature of CMF marketing. KR reports receiving a research grant from Alive & Thrive and FHI360 that supported earlier research that is now cited in this Series paper. Paper 3: PB and DM report funding from the WHO Department of Maternal, Newborn, Child and Adolescent Health and Ageing for conducting reviews and specific analyses in preparation of this paper. All other authors declare no competing interests. The findings reported in this manuscript reflect the viewpoints and findings of the authors only, and do not necessarily represent those of the study funder.
Cannabis has same effect on adolescents and adults, and CBD doesn’t dampen effects
The short-term effects of vaporised cannabis do not differ between adolescents and adults, while cannabidiol (CBD) does not dampen the effects of the drug, finds a new study led by UCL and King’s College London researchers.
For the experimental study published in Addiction, the researchers measured how regular cannabis users of different ages responded to inhaling cannabis with differing levels of CBD.
The study participants included 24 adolescents (16-17 years old) and 24 adults (26-29 years old), all of whom were already regular users of cannabis (0.5 to three days per week, averaging 1.5 days of cannabis use per week).
In a clinical research facility (Invicro), the participants inhaled three types of vaporised cannabis under close medical supervision. On three separate weeks, participants were given either a placebo, or a strain of cannabis high in delta-9-tetrahydocannabinol (THC, the main psychoactive component, which typically predominates in both illegal and legal markets), or a high-CBD and high-THC version (consisting of the same level of THC, and also containing CBD)*. There were administered in doses comparable to typical recreational use.
The participants were asked to report how the drug was affecting them at regular intervals, and completed tests assessing their verbal memory and the psychotic-like effects of the drug (such as delusions, cognitive disorganisation or paranoia).
The researchers found all the expected effects of cannabis in the THC and THC+CBD conditions, among the participants’ responses: feeling high, feeling anxious, having mild transient psychotic-like experiences, and memory impairment.
However, crucially there was no evidence that adolescents differed from adults in their responses to cannabis, while under the influence.
Lead author, psychology lecturer Dr Will Lawn, who conducted the study at UCL before moving to King’s College London, said: “Immediately following consumption, cannabis can elicit psychotic-like effects, and impair verbal memory, and adolescents in our study who regularly smoke cannabis were just as vulnerable to this as the adults were. Adolescence is a key developmental stage of life, when people are at an increased risk of developing mental health problems.
“Regularly producing transient psychotic-like effects and memory impairments through cannabis use is likely to augment the risk of psychological distress, especially in those who are vulnerable to these harms. However, critically, our results also indicate that 16- to 17-year-old cannabis users were not more sensitive to the acute harmful effects of cannabis than adults.”
In recent years, there has been growing concern about the impact of cannabis on young people, as well as hope that CBD may protect against some cannabis harms. A recent long-term, observational study by the same authors found that adolescents are more vulnerable to cannabis addiction, compared to adult users, but they are not more vulnerable to depression and anxiety.**
Cannabis has natural variation in CBD, which is a non-intoxicating constituent of the drug, as well as the relative levels of THC, which is psychoactive and gets people high.
CBD has rapidly grown as an over-the-counter wellness supplement in recent years, and previously CBD in cannabis had been thought to mitigate against some of the unpleasant effects of THC.
For the latest study, in testing the impact of differing CBD levels, the researchers found that CBD levels did not impact the subjective feel of the drug, and it also did not affect memory impairment or psychotic-like effects.
The researchers say their study does not address high-dose CBD’s potential medical benefits when administered by itself, but the findings do cast doubt on popular suggestions that these lower doses of CBD found in cannabis may protect against THC’s acute effects on memory and psychotic-like experiences.
Dr Lawn said: “Adding a moderate dose of vaporised CBD, about 25mg, to cannabis that is already high in THC does not alter the subjective experience, nor does it protect from effects such as paranoia or memory impairment. However, we have not investigated the long-term effects of low-dose CBD nor the therapeutic effects of high-dose pharmaceutical CBD here.”
Senior author Professor Val Curran (UCL Clinical Psychopharmacology Unit, UCL Psychology & Language Sciences) commented: “Cannabis is the world’s most commonly used internationally controlled drug. It is particularly popular among adolescents, with over 15% of 15-year-olds in England and 28% of those in the US reporting usage in the last year. As cannabis laws are rapidly changing around the globe, it is vital that we understand whether the adolescent brain is more vulnerable, in order to inform regulations and accurate, evidence-based harm reduction messaging. Here, we have found that adolescents are neither more resilient nor more vulnerable to the immediate effects of cannabis.”
The research formed part of the Medical Research Council-funded CannTeen study***, involved researchers at UCL, King’s College London, the University of Bath and Invicro llc, and received full ethical approval from the UCL Ethics Committee. As all participants were over 16 years old, everyone consented as a legal adult. All participants were already cannabis users and the study was completed safely without issues, with medical professionals present at all times.
The researchers say that strengths of this randomised, double-blind, placebo-controlled experiment are the tight experimental controls and that participants in the adult and adolescent groups were carefully matched on their natural cannabis use. The researchers caution that their study does not shed light on long-term impacts of cannabis.
* For a 75kg person, the “THC” condition had 8mg of THC, and the “THC+CBD” condition had 8mg of THC + 24mg of CBD. This dose of THC reflects approximately one quarter of a joint, and a moderate dose of CBD that was thought might influence the drug’s effects. The placebo consisted of a product using cannabis as the starting material, but with all cannabinoids (including THC and CBD) removed.
The acute effects of cannabis with and without cannabidiol in adults and adolescents: a randomised, double-blind, placebo-controlled, crossover experiment
ARTICLE PUBLICATION DATE
7-Feb-2023
Scientists develop new index based on functional morphology to understand how ancestors of modern birds used their wings
IMAGE: SCIENTISTS DEVELOP NEW INDEX TO UNDERSTAND HOW ANCESTORS OF MODERN BIRDS USED THEIR WINGS BASED ON THE STRENGTH OF THE CORACOID BONE (SHOWN IN RED) AND THE ANIMAL’S BODY MASSview more
CREDIT: REIKO MATSUSHITA
Scientists at Nagoya University in Japan have developed an index to estimate how a bird uses its wings for flight or other locomotion by measuring the strength of the coracoid bone and the animal’s body mass. It should improve our understanding of how extinct animals used their wings and the different patterns of wing-propelled locomotion that emerged as birds evolved. Their findings were published in the Journal of Anatomy.
The presence of a wing alone does not tell us whether an animal can fly. For example, penguins evolved wings to propel them through water whereas feathered dinosaurs may have used their wings for other purposes, such as thermoregulation and intraspecific display. Therefore, to better understand how animals evolved the ability to fly, an index must take into account both the presence of wings and the ability to perform powerful wing-beats.
“We wanted to create a new index because people think that if an animal has wings, then it can fly”, said the study’s second author, Assistant Professor Shin-ichi Fujiwara. “But this is not always true. An animal can also use its wings for other purposes, such as thermal insulation in flightless animals. Our research team focused on how changes in skeletal morphology can lead to changes in locomotion. Subsequently, these changes can lead to major ecological transitions such as a shift in lifestyle from a terrestrial environment to an aerial, aquatic, arboreal, or subterranean environment. The origin of flight in birds has been an important topic in this field. We, therefore, needed to develop an alternative index, based on biomechanics, to determine the flapping ability of birds and which we could also use to measure skeletal remains.”
To create this index, the researchers used the avian coracoid bone. The coracoid bone acts as a strut to prevent the thoracic skeleton from deforming when an animal’s powerful flight muscles, which connect the wings to the sternum, contract. Doctoral student Takumi Akeda of the Department of Earth and Planetary Sciences, Graduate School of Environmental Studies, at Nagoya University, and Fujiwara of the Nagoya University Museum, measured the size of a cross section of the coracoid bone in relation to the body mass of 220 bird specimens. Their sample of 209 species included extinct birds such as the dodo and the great auk.
The researchers then divided the birds into four groups based on how they used their wings. These groups were those that used flapping flight (e.g., pigeons); those that used wing-propelled diving (e.g., penguins); those that were flightless with no flapping ability (e.g., ostriches); and those that used thermal and dynamic soaring (e.g., albatrosses and vultures). Based on the strength of the coracoid bone and flapping ability, the researchers could create a new index to analyze flight patterns.
They found that the strength of the coracoid in relation to body mass may reflect the force exerted by the flight muscles, which counteract the lifting force on the wings. This helps to estimate how a bird uses propulsion. Soaring birds had increased coracoid strength, probably to enable them to withstand the greater bending forces caused by the contraction of the flapping muscles. In contrast, non-flapping birds had lower coracoid strength. These findings show that coracoid strength in relation to body mass reflects the lifting force on the wings, therefore, it is a useful tool for reconstructing the type of propulsion used by the animal.
Akeda and Fujiwara’s index should allow future researchers to assess the flight styles and flapping abilities of not only extinct birds but also other flying animals, including the Pteranodon and Quetzalcoatlus of “Jurassic World” fame. The index could also allow them to estimate the origin of flight in winged theropods, the ancestors of birds.
“The use of coracoid strength is a powerful theoretical framework for reconstructing the origins of pre-flight flapping ability and powered flight,” said Fujiwara. “It seems appropriate to first apply our new index to the extinct taxa in the theropod bird lineage, which includes feathered dinosaurs such as Archaeopteryx and Confuciusornis. We also believe that coracoid bones of Pteranodon and Quetzalcoatlus functioned as struts against the contraction of the flapping muscles. Therefore, our index can potentially reconstruct their flight ability and help answer controversial questions such as whether Quetzalcoatlus could flap its wings to fly.”
Coracoid strength as an indicator of wing-beat propulsion in birds
Can I come, too? How tourism can include people whose health conditions usually keep them at home
Around 20 per cent of the world’s population suffer from chronic diseases such as diabetes, heart disease, cancer, or mental disorders — a group of people the travel industry needs to accommodate
Following the disruption of COVID-19, the global tourism industry has largely opened up again; however, travelling remains a serious challenge for a large group of people.
The World Health Organization estimates 20 per cent of the world’s population suffer from non-communicable chronic diseases such as diabetes, heart disease, cancer, or mental disorders.
These conditions can make travelling difficult, while some people may even avoid taking holidays altogether.
A cross-disciplinary research project from Edith Cowan University has highlighted the impacts this decision can have on people with these health challenges, and outlined the future repercussions for the industry as a whole.
Through collaboration between ECU’s School of Business and Law and its Centre for Precision Health, the project has put forth the concept of ‘travel therapy’, which sees tourism as a means of improving mental health and wellbeing.
Researcher Dr Jun Wen said it is vital the tourism industry catered more to vulnerable people with physical or psychological disorders, a market he described as important but too often overlooked.
“Most are able to travel but remain vulnerable during trips and need intensive services,” he said.
“The world has an ageing population, so there will be more and more people dealing with the challenges that brings, like dementia, physical limitations and so on.
“There are also more people being diagnosed with mental health issues, such as depression and anxiety.
“Tourism needs to be able to accommodate vulnerable travellers such as these for the industry’s survival — but also because health is important and as our previous work has shown, tourism can help support health.”
What the industry can do
Dr Wen said there are numerous initiatives which could make destinations more accessible for vulnerable people.
Strategies could be implemented throughout the tourism industry chain (food, accommodation, transportation, travel, shopping, and entertainment) and could include considerations or allowances for caregivers who may need to accompany travellers.
Dr Wen said education was critical.
“Staff and stakeholders need training to be made aware of vulnerable travellers’ needs and demands,” he said.
“This can include developing manuals to standardise services for vulnerable travellers, enhancing accessible infrastructure and equipping professional emergency and care facilities appropriately, such as with first-aid tools.
“The industry can also customise services for different traveller segments, such as people with dementia, depression or anxiety.”
Dr Wen said technological advances could also play a great role in bringing the benefits of tourism to more people.
“Not everyone can take physical trips,” he said.
“The tourism industry should develop virtual products that enable all travellers to be present in a destination and to enjoy fun and health-related benefits.”
Five medical organizations are recommending updated best practices for hand hygiene to protect patients and staff in healthcare settings. The recommendations emphasize the importance of healthy skin and nails and easy access to alcohol-based hand sanitizers.
Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene: 2022 Update, one in a series of expert guidance documents known collectively as the Compendium, was published today in the journal Infection Control & Hospital Epidemiology.
“Hand hygiene is a basic function of healthcare safety,” said lead author Janet Glowicz, PhD, RN, CIC, with the Centers for Disease Control and Prevention. “By engaging healthcare personnel and establishing reliable processes described in the Compendium, we can achieve effective, consistent hand hygiene. Commitment by healthcare leadership is also necessary to establishing a culture of safety.”
The document addresses how facilities can train healthcare personnel in proper technique, monitor their compliance, engage them in the selection of products to keep their skin healthy, and properly use gloves. It also discusses where facilities should place and how they should maintain alcohol-based sanitizer dispensers and sinks.
The guidance reviews the evidence around nail polish, gel, and shellac, which shows that short, natural nails with standard polish or no polish are easiest to clean. The authors found no new evidence specific to chipped nail polish and artificial nails but note previous findings that they can harbor germs. The guidance leaves specific policies about nail polish, gels, shellac, and artificial nail extenders to the discretion of infection prevention programs at each facility, with the exception of policies for those who scrub for surgery or work in high-risk areas. These personnel should maintain short, natural fingernails free of polish and nail extenders.
Citing research that shows only 7% of healthcare personnel effectively clean the entire surface of their hands, the guidance recommends ongoing training in handwashing and proper use of sanitizer. Thumbs and fingertips were most frequently missed.
The authors recommend that healthcare personnel not be provided with individual, pocket-sized hand sanitizers in lieu of wall-mounted sanitizer dispensers and emphasize that hand sanitizer dispensers always be widely available and never prohibited, even in situations when washing with soap and water are indicated. When healthcare personnel suspect organisms that are difficult to remove, such as C. difficile and noroviruses, healthcare personnel should wear gloves and follow structured techniques for hand washing and hand sanitizing. In addition, facilities should not top-off sanitizer dispensers meant for single use or provide antimicrobial soaps that contain Triclosan. Facilities also should discourage the use of double gloves, except in certain circumstances.
To encourage compliance and to support healthy skin and nails, facilities should include healthcare personnel in the selection of hand sanitizers and moisturizers, while ensuring the products are compatible with antiseptics and gloves used on site. Maintaining healthy skin is a crucial element of hand hygiene.
Surgical settings require special care, but waterless hand hygiene with surgical hand rubs is acceptable, especially as it improves compliance. Brushes should be avoided in surgery prep due to their negative impact on skin health.
This document updates the 2014 Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene. The Compendium, first published in 2008, is sponsored by the Society for Healthcare Epidemiology (SHEA). It is the product of a collaborative effort led by SHEA, with the Infectious Diseases Society of America, the Association for Professionals in Infection Control and Epidemiology, the American Hospital Association, and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The Compendium is a multiyear, highly collaborative guidance-writing effort by over 100 experts from around the world.
Upcoming Compendium updates will include strategies to prevent catheter-associated urinary tract infections, Clostridium difficile infections, methicillin-resistant Staphylococcus aureus infections, and surgical site infections. Strategies for preventing central line-associated bloodstream infections and pneumonia were updated earlier in 2022. Each Compendium article contains infection prevention strategies, performance measures, and example implementation approaches. Compendium recommendations are derived from a synthesis of systematic literature review and evaluation of the evidence, practical and implementation-based considerations, and expert consensus.
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About ICHE Published through a partnership between the Society for Healthcare Epidemiology of America and Cambridge University Press, Infection Control & Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 24th out of 94 Infectious Disease Journals in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.
The Society for Healthcare Epidemiology of America (SHEA)is a professional society representing more than 2,000 physicians and other healthcare professionals around the world who possess expertise and passion for healthcare epidemiology, infection prevention, and antimicrobial stewardship. The society’s work improves public health by establishing infection-prevention measures and supporting antibiotic stewardship among healthcare providers, hospitals, and health systems. This is accomplished by leading research studies, translating research into clinical practice, developing evidence-based policies, optimizing antibiotic stewardship, and advancing the field of healthcare epidemiology. SHEA and its members strive to improve patient outcomes and create a safer, healthier future for all. Visit SHEA online atshea-online.org,facebook.com/SHEApreventingHAIsandtwitter.com/SHEA_Epi.
JOURNAL
Infection Control and Hospital Epidemiology
SUBJECT OF RESEARCH
Not applicable
ARTICLE TITLE
Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene: 2022 Update
The divergent goals of two opponents—whether they are individual people or entire nations—can be thought of as two points in a multi-dimensional space of possibilities, and the ensuing battle of wills can be described in terms of a ball bouncing around in this same space. When one party gains temporary control of the ball, they move it closer to where they want to to be, but their opponent is then liable to seize control and move the ball in the opposite direction. The focus of this paper is on conflicts that are of interest to evolutionary biologists—including those occurring between genes, between individuals, between the sexes, and between the generations. The geometric approach reveals that not only are these conflicts liable to continue indefinitely through evolutionary time, but that they are also able to spill out from the initial battleground and cause extensive collateral damage in areas where there is no actual disagreement. The damage is particularly devastating to complex organisms and social structures, and so conflict places an important barrier to the evolution of complexity. The geometric analysis finds that such collateral damage is greatly reduced if organisms and their societies embody the principle of modular design, which constrains the bouncing ball to move only in certain directions at any given time. This suggests that modularity is a crucial—and previously unappreciated—enabler of complex adaptation and transformative changes in social organisation, from the evolution of multicellular life to the emergence of superorganismal insect societies.
JOURNAL
Proceedings of the Royal Society B Biological Sciences
A recent study examined patients’ outcomes after receiving care based on scientific and clinical evidence. The work, which is published in Worldviews on Evidence-Based Nursing, also reviewed the extent and type of evidence-based practices (EBPs) performed across clinical settings.
A total of 636 published articles addressing EBP and patient outcomes met investigators’ inclusion criteria. There were many differences in approaches, designs, and outcomes measured among the articles included in the review.
Most articles (63.3%) were published in the United States, and 90% took place in the acute care setting. Various EBPs were implemented, with just over a third including some aspect of infection prevention, and most (91.2%) linked to reimbursement. The two most reported outcomes were length of stay (15%), followed by mortality (12%).
“Although our study revealed that EBP improves patient outcomes and reduces costs for healthcare systems, there is much opportunity to improve healthcare quality and safety with EBP as healthcare executives still do not invest enough in their budgets to ensure that all clinicians take this approach to care and that all care is evidence-based, not steeped in tradition, or outdated policies or procedures,” said corresponding author Linda Connor, PhD, RN, CPN, of The Ohio State University.
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About the Journal Worldviews on Evidence-Based Nursing is a peer-reviewed journal and top information resource from The Honor Society of Nursing, Sigma Theta Tau International, that uniquely bridges knowledge and application, taking a global approach in its presentation of research, policy and practice, education and management, and its link to action in real world settings.
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