The fall of kinship - towards an epidemiological explanation

Kinship used to be described as what anthropologists do. Today, many might well say that it is what anthropologists do not do. One possible explanation is that the notion of kinship fell off anthropology's radar due to the criticisms raised by Needham and Schneider among others, which supposedly demonstrated that kinship is not a sound theoretical concept. Drawing inspiration from epidemiological approaches to cultural phenomena, this article aims to enrich this explanation. Kinship became an unattractive theoretical concept in the subculture of anthropology not simply because of problems with kinship theory per se, but also on account of fundamental changes in the very conception of anthropological knowledge and the impact of these changes on the personal identity of anthropologists.

The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration

Systematic reviews and meta-analyses are essential to summarize evidence relating to efficacy and safety of health care interventions accurately and reliably. The clarity and transparency of these reports, however, is not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users. Since the development of the QUOROM (QUality Of Reporting Of Meta-analysis) Statement-a reporting guideline published in 1999-there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realizing these issues, an international group that included experienced authors and methodologists developed PRISMA ( Preferred Reporting Items for Systematic reviews and Meta-Analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions. The PRISMA Statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this Explanation and Elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA Statement, this document, and the associated Web site (http://www.prisma-statement.org/) should be helpful resources to improve reporting of systematic reviews and metaanalyses.

Effect of a multifaceted intervention on adherence to hand hygiene among healthcare workers:A cluster-randomized trial

OBJECTIVES. Adherence to hand hygiene among healthcare workers (HCWs) is widely believed to be a key factor in reducing the spread of healthcare-associated infection. The objective of this study was to evaluate the impact of a multifaceted intervention to increase rates of adherence to hand hygiene among HCWs and to assess the effect on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) colonization. DESIGN. Cluster-randomized controlled trial. SETTING. Thirty hospital units in 3 tertiary care hospitals in Hamilton, Ontario, Canada. INTERVENTION. After a 3-month baseline period of data collection, 15 units were randomly assigned to the intervention arm (with performance feedback, small-group teaching seminars, and posters) and 15 units to usual practice. Hand hygiene was observed during randomly selected 15-minute periods on each unit, and the incidence of MRSA colonization was measured using weekly surveillance specimens from June 2007 through May 2008. RESULTS. We found that 3,812 (48.2%) of 7,901 opportunities for hand hygiene in the intervention group resulted in adherence, compared with 3,205 (42.6%) of 7,526 opportunities in the control group (P <.001; independent t test). There was no reduction in the incidence of hospital-acquired MRSA colonization in the intervention group. CONCLUSION. Among HCWs in Ontario tertiary care hospitals, the rate of adherence to hand hygiene had a statistically significant increase of 6% with a multifaceted intervention, but the incidence of MRSA colonization was not reduced.

Off-center explosions of Chandrasekhar-mass white dwarfs:An explanation of super-bright type la supernovae?

Context. The recent discovery of a very bright type la supernova, SNLS-03D3bb (=SN 2003fg), in the Supernova Legacy Survey (SNLS) has raised the question of whether super-Chandrasekhar-mass white-dwarf stars are needed to explain such bright explosions. Progenitors of this sort could form by mergers of pairs of rather massive white dwarfs. Binary systems of two white dwarfs in close orbit, where their total mass significantly exceeds the Chandrasekhar mass, have not yet been found. Therefore SNLS-03D3bb could establish the first clear case of a double-degenerate progenitor of a (peculiar) type la supernovae. Moreover, if this interpretation is correct, it casts some doubt on the universality of the calibration relations used to make SNe la distance indicators for cosmology. Aims. We aim to evaluate the case for a super-Chandrasekhar-mass progenitor for SNLS-03D3bb in light of previous theoretical work on super-Chandrasekhar-mass explosions. Furthermore, we propose an alternative scenario involving only a Chandrasekhar-mass progenitor. Methods. We present a theoretically motivated critical discussion of the expected observational fingerprints of super-Chandrasekharmass explosions. As an alternative, we describe a simple class of aspherical Chandrasekhar-mass models in which the products of nuclear burning are displaced from the center. We then perform simple radiative transfer calculations to predict synthetic lightcurves for one such off-center explosion model. Results. In important respects, the expected observational consequences of super-Chandrasekhar-mass explosions are not consistent with the observations of SNLS-03D3bb. We demonstrate that the lopsided explosion of a Chandrasekhar-mass white dwarf could provide a better explanation. © ESO 2007.

Effect of a multifaceted intervention on number of antimicrobial prescriptions for suspected urinary tract infections in residents of nursing homes:Cluster randomised controlled trial

Objective: To assess whether a multifaceted intervention can reduce the number of prescriptions for antimicrobials for suspected urinary tract infections in residents of nursing homes. Design: Cluster randomised controlled trial. Setting: 24 nursing homes in Ontario, Canada, and Idaho, United States. Participants: 12 nursing homes allocated to a multifaceted intervention and 12 allocated to usual care. Outcomes were measured in 4217 residents. Interventions: Diagnostic and treatment algorithm for urinary tract infections implemented at the nursing home level using a multifaceted approach-small group interactive sessions for nurses, videotapes, written material, outreach visits, and one on one interviews with physicians. Main outcome measures: Number of antimicrobials prescribed for suspected urinary tract infections, total use of antimicrobials, admissions to hospital, and deaths. Results: Fewer courses of antimicrobials for suspected urinary tract infections per 1000 resident days were prescribed in the intervention nursing homes than in the usual care homes (1.17 v 1.59 courses; weighted mean difference -0.49, 95% confidence intervals -0.93 to -0.06). Antimicrobials for suspected urinary tract infection represented 28.4% of all courses of drugs prescribed in the intervention nursing homes compared with 38.6% prescribed in the usual care homes (weighted mean difference -9.6%, -16.9% to -2.4%). The difference in total antimicrobial use per 1000 resident days between intervention and usual care groups was not significantly different (3.52 v 3.93; weighed mean difference -0.37, -1.17 to 0.44). No significant difference was found in admissions to hospital or mortality between the study arms. Conclusion: A multifaceted intervention using algorithms can reduce the number of antimicrobial prescriptions for suspected urinary tract infections in residents of nursing homes.