MASK MANDATES REDUCE COVID-19 MORTALITY: Analysis of 37 States and the District of Columbia, with a further analysis of the impact of demographic and medical factors on efficacy.

As the number of COVID-19 deaths in the US increased, various policies were enacted to slow the spread of the pandemic. While the situation has improved in recent months, determining how best to combat the current pandemic is still essential. Failure to do so invites both further resurgences of the current pandemic, and more pandemics in the years to come. As a result of the widespread failure to contain the spread of COVID-19, enough deaths have occurred that the impact of policy on mortality may be statistically evaluated. This paper uses Optimal Discriminant Analysis (ODA) to evaluate the hypothesized ability of limited mask mandates (MM) to reduce the daily number of COVID-19 deaths in the states analyzed. The mandates were found to reduce mortality in half the states analyzed and did not result in increased mortality in any states. A full range of cofactors were analyzed to determine which, if any, influenced the efficacy of the mandates in the states in which mandates had an effect. Institutional Health Subindex of the Social Capital Index, state health score, population density, portion of the population with nongroup health insurance, state GDP, and the rate of pregnancy related diabetes were all correlated with increased mandate efficacy. In contrast, incarceration rate, overcrowded housing, severely overcrowded housing, portion of the population with military provided insurance, portion of the population uninsured, the portion of the population unable to see a doctor due to cost, and the portion of the population who were American Indian/Native Alaskan were all correlated with reduced mandate efficacy.

Emory Roybal Center for Dementia Caregiving Mastery: Diverse Responses to Letter of Intent Call

This new NIA-supported Roybal Center seeks to support Stage 1 pilot clinical trials of programs aimed at promoting caregiving competence and confidence in the great heterogeneity of dementia caregiving contexts. During our first cycle, we received 26 letters of intent (LOI) for full applications. Responses reaffirmed the Center’s premise that dementia caregiving is remarkably varied in nature. While most proposed programs focused on generic caregiving, a number addressed caregiving issues facing specific ethnic/racial groups (African American; Korean American; Native Alaskan/American Indian; Latino), and several focused on specific dementing conditions (MCI, Lewy Body Dementia,TBI-based dementia). Most described programs centered on knowledge development and daily management skill issues (e.g., management of behaviors); others specified development of physical care skills. Decision-making and communication constituted the second most common topic. Over 40% proposed adaptation of existing programs; more than 25% proposed apps or technology interventions. Investigators represented a wide range of disciplines: 45% each from Health sciences (nursing, medicine, and social work) and Social/Behavioral sciences (principally psychology) and the rest from engineering and communications. LOIs varied most in their readiness to complete a clinical trial within a year. About 40% were in very preliminary stages; 25% were clearly poised for a Stage 1 trial; 15% did not sufficiently address the Center’s aims. Key criteria for invitations to submit full applications (n=4) included: specificity of context; clinical trial readiness; reasonableness of proposed adaptation. These criteria should guide future LOIs addressing the diversity of important new research and intervention perspectives on the multifaceted work of caregiving.

Interests and Priorities in Sockeye Salmon Management: How are Policies Enacted and Interpreted on three Alaskan Rivers?

The large export abundance of Alaskan salmon is well documented, and many studies have been performed to assess the economic and environmental viability of the industry and its management. Less research has been done to characterize how state intentions regarding fisheries allocation are conceived of by management or perceived by vulnerable groups in the user pool. This study seeks to qualitatively characterize the disconnect between state and Native Alaskan perceptions of management effectiveness, public interest, and Native Alaskan involvement using interviews. Results showed that Native Alaskan and state manager respondents had very different perceptions of management effectiveness and equity. When asked questions about the goals of policy and public participation in it, Native Alaskan respondents tended to identify issues of over-commercialized fishing and a lack of direct state acknowledgement of tribes while managers repeatedly referenced an equal public voice for all users and a focus on maximum sustainable yield. Results provide insight into the context certain policy decisions by the state of Alaska are received by Native Alaskan groups.

An Integrative Review of the Barriers to Indigenous Peoples Participation in Biobanking and Genomic Research

PURPOSE This investigation was undertaken to define the barriers to Indigenous peoples participating in biobanking and genomic research. METHODS A literature review was conducted to identify studies reporting on the experience of Indigenous peoples with biobanking, tissue banking, and genomic research. Studies pertaining to organ transplantation or blood donation for transfusion were excluded. The databases searched were MEDLINE, EMBASE, PubMed, Web of Science, and Google Scholar, with all literature available until the search date of June 1, 2018, included. The reference lists of all included papers, as well as related review articles, were manually searched to identify additional relevant studies. An inductive approach was used to identify common themes. RESULTS Seventeen publications discussed the experiences of New Zealand Māori (n = 2), Aboriginal and Torres Strait Islanders (n = 3), Native Hawaiian (n = 4), Native Alaskan (n = 2), American First Nation (n = 2), or multiple ethnicities (n = 4). Across all Indigenous peoples, four themes emerged: land, ancestors, culture, and bodily substances are powerfully interconnected and can act on each other; tissue and blood can provide important information (both Western and traditional) about a person; the ownership of specimens—custodians, trustees, or guardians; and the beneficence of the researchers and research team. CONCLUSION Indigenous communities, like Western populations, are concerned with issues pertaining to handling, treatment, and ownership of tissue as well as knowledge gained from specimen analysis. Unlike many Western populations, Indigenous communities have retained a strong sense of cultural connection to ancestors and traditional lands and view biologic specimens as inseparable from these things.

Hitch a Sugar to a Protein

The success of the conjugate Hib vaccines has been spectacular. Prior to their introduction, an estimated 10,000 cases of Hib meningitis occurred annually in the United States, which was approximately 1 in 300 children. It was even higher among native Alaskan and American Indian children. Since the widespread use of the vaccine, the disease has nearly disappeared in the United States, with only 40 cases in children under age 5 years reported by the Centers for Disease Control and Prevention in 2014. Thus, bacterial meningitis, once a scourge that killed and damaged too many American children is, for the most part, now a bad memory.