bluuebunny/crossref_metadata_2025 huggingface dataset:
P01 The increasing incidence of Gram-negative bacteraemias in the UK: confounding effects of the Sepsis 6 campaign
Authors: Baltas Ioannis , Democratis Jane
Published: February 2022

Introduction

The 2019–20 English Surveillance Programme for Antimicrobial Utilisation and Resistance Report (ESPAUR) stated that the incidence of bacteraemias in key bacterial species has increased 17% between 2015 and 2019, continuing the trend observed since mandatory national reporting of Escherichia coli bacteraemias was initiated in 2011. PHE estimates the incidence of infections by calculating the rate of bacteraemias per 100 000 population or per 100 000 bed days for acute Trusts. We hypothesized that the incidence of infections is also affected by the number of blood cultures performed, given that collection of blood cultures for critically unwell patients has been persistently promoted in the UK during the 2010s as part of the Sepsis 6 bundle.

Methods

We compared the incidence of E. coli bacteraemias in an acute NHS Trust from financial year 2012–13 through to 2018–19, with and without adjusting for the number of blood cultures performed, using centrally reported Trust data.

Results

During the study period, the total number of E. coli bacteraemias increased from 375 to 691 (84.3%, Table 1). At the same time, the total number of blood cultures performed increased from 18 956 to 32 283 (70.3%), while the total overnight bed occupancy increased from 377 029 to 453 191 (20.2%, Table 1). The bed occupancy adjusted incidence of E. coli bacteraemias increased from 99.5 E. bacteraemias per 100 000 occupied bed days in financial year 2012–13 to 152.5 bacteraemias per 100 000 occupied bed days in 2018–19 (53.2%, Table 2). The blood culture adjusted incidence of E. coli bacteraemias decreased from 52.5 E. coli bacteraemias per 100 000 bed days per 10 000 blood cultures in 2012–13 to 47.2 E. coli bacteraemias per 100 000 bed days per 10 000 blood cultures in 2018–19 (−10%, Table 2). Even when excluding the 2012–13 financial year, which looks like an outlier, the blood culture adjusted incidence of E. coli bacteraemias only increased by 10% between financial years 2013–14 and 2018–19 (Table 2). Correlation analysis showed a strong and statistically significant association between blood cultures performed and E. coli bacteraemias per 100 000 bed days (R = 0.971, R2 = 0.9428, P<0.001).

Conclusions

The number of blood cultures performed is a potential confounder behind the recent increase in the incidence of E. coli bacteraemias. Regulators should consider adjusting for this factor when reporting incidence of these infections.
P13 Development of a consult and antimicrobial stewardship service in Manchester Foundation Trust
Authors: Devine Karen A. , Ng Wai Kein , Dave Farnaz , Chow Cathy , Emery Darcy , Riste Michael
Published: February 2022

Objectives

To prospectively audit the first year of the North Manchester infectious diseases AMS and Consult service June 2020 to June 2021 to: (i) characterize the number of patients who had antibiotic treatment narrowed, duration reduced and/or switch to oral options; (ii) assess documentation of indication and duration of antibiotic prescriptions; (iii) determine whether or not the appropriate microbiological specimens have been performed and with the lab; (iv) identify the impact on antibiotic consumption measured in defined daily dose (DDDs); and (v) establish whether base teams act on the advice given by the Consult/AMS team (data over a 6 week period).

Methods

On weekdays an electronic prescribing list of all patients prescribed piperacillin/tazobactam, meropenem and ciprofloxacin was generated, and the consults team performed either a bedside or notes review. Data was collected prospectively on 730 patients on which infection was treated, which specialty managed the patient, microbiology samples sent, duration and indication of treatment documentation, and advice given by consults team. Data was then collected over a further 6 weeks looking at whether the base specialty carried out the advice of the AMS team.

Results

The main indication for broad spectrum antibiotic use was urinary tract infection (151/720) and hospital acquired pneumonia (104/720). Poor documentation of antimicrobial indication and duration was observed across all specialties (277/720). Just over 50% of appropriate microbiology samples were sent (422/726). For 42% of cases (311/730), colleagues were advised to stop or reduce antibiotic duration. In 30% of cases (220/730), narrowing of antibiotic spectrum was advised. Thirty percent (219/730) were advised on IV to oral switch. There was a modest reduction in antimicrobial consumption in some specialties comparing the year prior to the introduction of the service 2019–20 to 2020–21; 17.4% reduction respiratory (7810/9137), 0.2% increase in medicine (272698/267351) and 2.1% surgery (68722/67309). In 81 patients reviewed to look at outcomes over 6 weeks, 88% of Consult/AMS team advice was actioned by the lead specialties involved in the patients’ care.

Conclusions

(i) There is a substantial need for an AMS service within the hospital. (ii) Outcome data shows the ward teams engage with the service and most follow advice. (iii) The service contributed to limiting inappropriate prescribing during the COVID-19 pandemic. There was a modest rise in hospital-wide consumption. (iv) The AMS service needs to be available to provide patient equity across Manchester Foundation Trust, fostering a city-wide AMS strategy that encompasses education, guidelines, audit and quality improvement.
P17 Vancomycin therapeutic drug monitoring—a call for change?
Authors: Payne Lara , Buckingham Christian J. , Wade Paul , Brown Aisling F.
Published: February 2022

Objectives

Despite the widespread use of vancomycin, optimization of dosing can be difficult. Increased vancomycin concentrations are associated with nephrotoxicity, while subtherapeutic levels may lead to inadequate antibacterial therapy and risk development of antimicrobial resistance. Recent guidelines have recommended the use of loading doses and switching to AUC24 TDM, targeting an AUC24:MIC ratio of 400–600 μg·h/mL to minimize toxicity while maintaining similar effectiveness for the treatment of serious infections. We aimed to review adherence to current local vancomycin dosing and conventional trough monitoring guidelines, as well as record time to, and factors related to, achieving target vancomycin troughs.

Methods

Fifty consecutive electronic prescriptions were screened for IV vancomycin use in treatment of active infections in a single acute Trust during April/May 2021. These were cross-referenced with microbiological, clinical and biochemical data from patient records. Variables were analysed by parametric or non-parametric methods on the basis of their normality distribution using GraphPad Prism.

Results

Forty-one patients were included of which 39 had a vancomycin level measured. Mean age was 57 years (range 19–88) and BMI 28 (range 17–44). Nineteen had unstable renal function, including one receiving intermittent haemodialysis. Median CLCR was 95  mL/min (IQR 66–129). Indications were included on the prescription for 26. Median duration of vancomycin was 4 days (range 2–12), and half of patients ultimately switched therapy to an alternate agent . Target troughs were documented in 29 (70%), 9 of which had a target trough ≥15 μg/mL. Twenty-four had positive microbiology samples, 19 of which were organisms against which vancomycin would have expected activity. Five (13%) failed to achieve trough levels >10, 6/39 (15%) achieved troughs of 10–15, 13/39 (33%) 15–20, and 15/39 (38%) had troughs of >20 μg/mL (Figure 1). Where it was achieved, the median time to level ≥10 μg/mL was 46 h (range 11–202) and time to level ≥15 μg/mL was 68 h (range 18–243). Twenty-five (60%) patients required titration above the currently recommended initial dose, and 22 required doses of 1500 mg twice daily or higher. BMI did not correlate with vancomycin level achieved.

Conclusions

A significant proportion of patients with serious infections fail to achieve or have a considerable delay in achieving therapeutic vancomycin trough. An even greater proportion have troughs above target and are at risk of nephrotoxicity. These findings support a potential switch to more personalized regimens using loading doses and AUC24 monitoring where vancomycin is the drug of choice. This would complement other stewardship measures to limit overall vancomycin use, achieve earlier and more complete source control, and optimize use of alternative antimicrobial therapies with more predictable PK/PD.
P21 An assessment of knowledge and hand hygiene practices among healthcare workers at Dodoma Regional Referral hospital
Authors: Venant Erick , Ndesendo Valence , Wiedenmayer Karin , Ombaka Eva M. A.
Published: February 2022

Introduction

The WHO-promoted ‘My 5 moments for hand hygiene’ is designed to prevent the spread of infectious organisms in healthcare settings which occurs mostly via contaminated hands of healthcare workers (HCWs), items/equipment and the environment. Information on its implementation in Tanzania is needed.

Objectives

The main objective of the study was to assess knowledge, availability, and access to facilities for hand hygiene and the adherence to the WHO's five moments of hand hygiene by healthcare workers at Dodoma Regional Referral Hospital. The bacterial content of cell phones of HCWs was assessed as a source of microbial contamination.

Methods

This was a descriptive cross-sectional study. Three sets of data were collected through (i) questionnaires to assess knowledge, attitudes, and barriers to effective hand hygiene; (ii) observation to assess the adherence of five moments of hand hygiene; and (iii) laboratory examination of cell phones for bacterial contamination. Analysis used Statistical Package for Social Science (SPSS).

Results

Over 75% of HCWs had formal training on hand hygiene and had access to handwashing facilities, but only 63% were aware of the WHO five moments. Of 270 doctors, nurses, and healthcare students only 7 (2.6%) complied with expected action with no difference between groups. No hand hygiene was observed after touching cell phones. Thirty-four percent of sampled cell phones were contaminated with staphylococci species, which were resistant to penicillin and had varying resistance to erythromycin, clindamycin and gentamicin.

Conclusions

Hand hygiene is the most effective way to reduce the risk of healthcare-associated infections. However, many healthcare workers do not adhere to recommended hand hygiene despite training and the availability of handwashing facilities. The low practice of hand hygiene means that cell phones of healthcare workers can easily act as a reservoir of transmissible organisms. The use of cell phones as a source of contamination must be included in the interventional training of HCW.
P28 Indications for central venous line access for treating infections and the appropriateness of the antimicrobial therapy: a clinical audit
Authors: Tin Kimberly Chong Shea , Shorten Robert John
Published: February 2022

Introduction

Central venous access devices (CVADs) are used to deliver medications, including antibiotics. CVAD requests should be monitored closely due to the risks associated with insertion and the potential complications of venous thromboembolism and line-associated bloodstream infections. Inappropriate antibiotic use is associated with side effects, including healthcare-associated infections such as Clostridioides difficile infection and the emergence of antimicrobial resistance (AMR).

Methods

An audit was performed to investigate the appropriateness of requests for CVAD insertion and the antimicrobials prescribed. In total, 52 patient records were analysed over a 1 month period.

Results

There was good evidence of infection requiring IV antibiotics in 49/52 cases. Antibiotic selection was in line with guidelines in 71.4% of cases, and the vast majority of the exceptions had been discussed with a microbiologist. Good compliance was seen with guidelines for requesting CVAD access, but poor online documentation meant that it was not possible to confirm this in all cases.

Conclusions

Despite some minor anomalies detected in this small patient size, there was an overall prominent demonstration of proficiency in clinical judgement by the central venous access team and microbiology team. The CVAD requests made by the clinical teams had definite indications and were predominantly appropriate. This highlights the importance of a multidisciplinary approach, particularly the microbiologist, when considering antimicrobial therapy via CVAD, in view of the risks associated with antibiotic misuse. In addition, patients undergoing CVAD placement should be closely monitored, and thus online record-keeping and documentation should be better improved to ensure quality healthcare practice and patient safety.
P45 Antimicrobial activity of ruthenium-based metallo-therapeutics against Pseudomonas aeruginosa
Authors: Britten Nicole S. , Butler Jonathan A.
Published: February 2022

Background

Pseudomonas aeruginosa is a Gram-negative opportunistic pathogen that is highly resistant to antibiotics and biocidal products used in both medical and industrial environments respectively. Metal-based compounds have been used as antimicrobial agents throughout history for a broad range of applications. More recently, it has been shown that ruthenium (Ru)-based compounds have potent antimicrobial properties and, in contrast to traditional antibiotics, these are thought to elicit antibacterial activity at multiple sites within the bacterial cell, which will undoubtedly reduce the possibility of resistance evolution.

Methods

MIC and MBC assays coupled with disc diffusion assays were used to screen a library of Ru-based compounds.

Results

One lead compound was identified that was highly active at inhibiting growth of multiple strains of P. aeruginosa at ≤32 mg/L. Crystal violet biofilm assays were performed, which showed a decrease in biomass following exposure over a 24 h period. Scanning electron microscopy was used to reveal morphological changes in the bacterial cell ultrastructure when exposed to the Ru-based compound, with evidence of membrane perturbation that supported a proposed mechanism of antimicrobial activity.

Conclusions

These findings make a significant contribution towards the search for novel bactericidal agents and further research is now focused on determining the potential for use as novel adjuvants within medicinal applications such as wound care management.
In an Era of Enhanced Cybersecurity: The Effect of Disclosing a Third Party’s Role in Confidentiality Pledges on Response Propensity
Authors: Redline Cleo , Tuttle Alfred D
Published: February 2022

Federal surveys often pledge that personally identifiable information (PII) will be used for statistical purposes only and that the willful disclosure of PII by employees who have been sworn to confidentiality is subject to penalties. In 2015, the passing of the Cybersecurity Enhancement Act required the Department of Homeland Security (DHS) to monitor federal computers for cyber threats. Since DHS personnel are not bound to the confidentiality pledges used by the statistical agencies, the question became how to inform respondents about these changes without alarming them and harming response rates. This paper reports on an experiment conducted in a survey of public-school principals with a simple random sample (n = 4,122). The experiment examined differences in response rates across three versions of pledges disclosing the cybersecurity monitor: one pledge specified explicitly the role of DHS, one referred to the monitors as “Federal employees and contractors,” and a control version referred implicitly to DHS monitors via a legal citation. Half of the pledges included the penalty language, and the other half did not. There were no statistically significant differences between any of the experimental comparisons. We conclude that, of the pledges studied, the DHS version of the pledge with penalty language provides respondents with the most accurate information for deciding whether to participate in the survey without harming response rates.
Sex Differences in Susceptibility to Coccidioidomycosis
Authors: McHardy Ian , Reagan Krystle L , Sebastian Jamie F , Barker Bridget , Bays Derek J , Dandekar Satya , Cohen Stuart H , Jennings Kathleen E , Sykes Jane , Thompson George R
Published: February 2022

To assess sex-specific differences in coccidioidomycosis, a retrospective analysis of human patients, nonhuman primates, and veterinary patients (including the neutered status of the animal) was performed. We found higher rates of infection and severity in males. This observed increased infection risk suggests deeper biological underpinnings than solely occupational/exposure risks.
“A Secluded Nordic Castle”
Authors: Ben-Ami Shlomo
Published: February 2022

Negotiations in broad daylight in Tel Aviv hotels soon shifted to secret talks in Harpsund, the summer residence of Sweden’s prime minister. A meeting with Arafat in Ramallah, ahead of our Swedish trip, reaffirmed the utter lack of trust between him and Prime Minister Barak. Still in Israel, a meeting with the military high command revealed how Barak was still within his comfort zone, with wishful desires that the Palestinians could never accept. Conversely, in Sweden, Abu Ala and his team member Hassan Asfour were surprisingly creative, not ruling out border changes and Israel’s annexation of the Jewish neighborhoods in East Jerusalem. Unfortunately, the Swedish track died once it was leaked to the press, and Arafat lost interest. We, on our part, failed to offer a package of proposals that could have sustained the momentum. The Nakba Day riots in mid-May 2000 were a warning about the future: negotiations were under fire.
Oh Jerusalem! (and Its Lies)
Authors: Ben-Ami Shlomo
Published: February 2022

The backchannel, Barak preferred to belittle it as “the intellectual exercise” and called for collective team reflection on our capacity to make further progress on Jerusalem. We all departed from our comfort zone on Jerusalem, not enough though to meet Arafat’s resilient requirements. Barak liked such brainstorming sessions, which he could sum up with inspiring rhetoric, but alas, he was always hesitant to translate it into concrete policy moves. Such moves were necessary now not just because we were in the defining moments of a peace summit, but also because of the yawning gap that existed between the Jerusalem of our imagination and the real one. While we were still hesitantly considering ceding functions and rights to the Palestinians in the Holy City, Jerusalem was already, for all practical purposes, a divided city.
Our Faintest Hour
Authors: Ben-Ami Shlomo
Published: February 2022

Other than release his anger at Arafat, Clinton engaged in a desperate, last-ditch attempt to break the unbreakable code of the Jerusalem imbroglio. The last day of the summit was marked by a long, dramatic discussion into the night between me and Saeb Erakat under the president’s aegis, and Arafat’s heroic, albeit self-defeating resilience; he turned down each and every idea on Jerusalem that emerged from the meeting. To help Barak survive the political fallout of the summit’s failure, and in contradiction to the agreed rules of engagement, Clinton publicly laid the blame on Arafat for the summit’s failure. But the specter of a descent into violence would encourage the parties not to upset the apple cart yet. They, therefore, left the summit with a determination to pursue the negotiations. The Palestinians were right: Camp David was only one phase of a longer journey.
Arafat: “Barak Has Gone beyond My Partner Rabin”
Authors: Ben-Ami Shlomo
Published: February 2022

The immediate aftermath of Camp David was a tale of ambivalent news and events. Promising changes in the Israeli public’ attitude to the price of peace, and second thoughts among the Palestinians, who moved from a sense of relief for their escape from the summit’s trap to an appreciation of its many achievements, combined to enhance our commitment to pursuing the talks and looking for new ideas. Arafat remained, however, in his own bubble, still pursuing his inherently unachievable historic mission. Our attempt to rekindle the talks was seriously stymied by a surprising fact: the Americans had no written records of the summit, and no agreed-upon premises upon which we could move forward. This allowed the Palestinians, now also hoping that our domestic political distress would work in their favor, to wriggle out of previous understandings, which, inevitably, brought us again to a dead end.
Moments of Grace on the Precipice’s Edge
Authors: Ben-Ami Shlomo
Published: February 2022

Paradoxically, the dramatic improvement in Israel’s international standing, as it was reflected in the UN Millennium General Assembly of late September 2000, brought us closer to an all-out war. An Israel that was courted and hailed in international fora, while the Palestinians were being put in the dock as peace refuseniks, was a reversal of roles that Arafat could not stomach. He lost his temper and looked desperately for ways to recover the right order of things in which he, the icon of an ever immaculate national cause, stood at the center. Barak, always oscillating between believing in direct negotiations and, in moments of despair, asking for an American definitive peace offer, made his peace with Arafat and sent us to yet one more futile round of talks in Washington. We landed back in Israel right into the Al-Aqsa Intifada . . .
“With Our Soul and Blood We’ll Redeem Palestine”
Authors: Ben-Ami Shlomo
Published: February 2022

The Palestinians’ Second Intifada was a page from the classical theory of anti-colonial revolutionary struggle. It was written into the genetic code of the Palestinian movement of national liberation that, as soon as it became apparent that diplomacy had not produced results, the resort to armed struggle would be a natural option. Arafat did not initiate it, but he surfed on it as a way to regain for his cause the global prominence and political support it had lost to Israel in the wake of Camp David. Israel failed in mitigation, though. Its army defeated the government’s containment strategy and released a disproportionate response that increased popular support for the Intifada. Arafat’s monumental strategic blunder lay in his failure to gauge how the Intifada pushed the Israeli electorate radically to the right and killed the chances of peace.
Barak in a Cage of Doves
Authors: Ben-Ami Shlomo
Published: February 2022

Bill Clinton convinced Arafat to engage personally in last-moment negotiations for a final settlement. At the Erez crossing in Gaza, we got from the Palestinians the fullest, official version of how total was their rejection of the Clinton Parameters. In a truly surrealistic telephone conversation, Arafat assured me that his intention was to reach a final agreement even before the end of Clinton’s presidency. Once Barak’s gut instinct to disengage from the process was repressed by his peace cabinet, he assimilated that negotiations could help him gain time ahead of the general elections. I differed, and suggested to the Chairman that the same energy could be used to wrap up a full agreement. With this purpose in mind, I traveled to Egypt for a meeting with President Mubarak and then with Arafat and his top ministers. I agreed with Arafat to resume the talks not before we got entangled in a long, typically convoluted conversation where he complained of Israel’s unfulfilled obligations. Intelligence reports indicated now that Arafat was interested in an agreement. A political solution, a respected Palestinian pollster argued then, had become vital to the salvation of the national movement from the chaos of the revolutionary militias. Barak sent us to a last-ditch attempt to save in Taba a peace that is “painful, but not humiliating.”
Taba: “The Boss Doesn’t Want an Agreement”
Authors: Ben-Ami Shlomo
Published: February 2022

At Taba, the Israelis wanted an agreement that translated the Clinton parameters into a peace settlement; the Palestinians wanted negotiations free of Clinton’s straitjacket. Yet progress was made; Abu Ala assured Arafat that the Israeli proposals guaranteed that the Palestinian state will consist of fully contiguous territories. An Israeli Solomonic proposal of splitting the Jerusalem question, with each party getting two of the four bones of contention solved in line with its interest was turned down. The pressure around us—the Intifada’s unabated fire, and the electoral campaign back home—was mounting daily. Until the very last breath of this meeting we tried and tried, but the “boss,” as the Palestinians admitted, was no longer interested in a settlement. He just wanted to register Israeli concessions. The eternal Palestinian delusion about some friendlier American administration, now presumably George W. Bush’s, was again on full display.
Post-Mortem
Authors: Ben-Ami Shlomo
Published: February 2022

The Camp David experience should not be seen in a simple binary way as a failure or a success. Its taboo-breaking talks and the hopes it raised nurtured future peace endeavors, and the Clinton peace parameters, an integral legacy of the Camp David process, remain to this day the most equitable peace plan on Palestine ever to be produced. Arafat missed an historic opportunity for his nation, but he was a shrewder negotiator than Barak, for the Clinton peace parameters were a considerable improvement on the summit’s offers, for whose rejection he had been universally condemned. Camp David failed because of the two sides’ conflicting interpretations of the terms of reference of the peace process, a lesson that future negotiators would embrace in their quest for such terms. Barak’s inadequate political gifts and Clinton’s inefficient mediation should share with Arafat the blame for the consequences.
Introduction
Authors: Larson Kate Clifford
Published: February 2022

SHE WORE A BORROWED dress, one suitable for such an important occasion. A Mississippi sharecropper, she never had new things. Used, reused, patched, and patched again—these defined the fabric of her everyday existence. Someone loaned her white shoes and a white purse, too. From her seat at the table at the front of a packed hearing room, she scanned the faces of the men and women waiting to hear her testimony. The din of conversations and rustling papers and creaking chairs muffled the noise of whirring television cameras. She folded her hands to steady herself. A man to her right gave her the cue to start....
One Man, One Vote
Authors: Larson Kate Clifford
Published: February 2022

This chapter studies the Student Non-Violent Coordinating Committee's (SNCC) One Man, One Vote Campaign. Fannie Lou Hamer spent the last days of 1963 and first days of the New Year attending meetings, giving speeches, teaching citizenship classes, and encouraging people to register to vote. She shined so brightly-in song, speech, and simple presence-during the SNCC convention in December that SNCC leaders believed she could convince influential people to cast their support behind the movement, and raise awareness of what was happening in Mississippi. Of particular concern was the unchecked violence against Blacks and civil rights workers in Mississippi and other southern states. The chapter then looks at the success of Hattiesburg Freedom Day. Over the next few months, hundreds of Forrest County Black citizens, inspired by the protest, tried to register to vote.
“Mississippi Goddam”
Authors: Larson Kate Clifford
Published: February 2022

This chapter charts the time when after Fannie Lou Hamer lost her primary election bid for Congress she traveled to Washington D.C. for a hearing on voter-registration efforts and more generally on the violence and intimidation Black Mississippians were facing every day. Hamer was among the dozen or more Mississippi residents and activists who gave statements in front of a panel of experts that included prominent authors, lawyers, doctors, sociologists, as well as New York Democratic Congressman William Fitts Ryan who listened to their testimony and asked questions. They hoped their testimonies would move President Lyndon B. Johnson to provide protection for Freedom Summer workers and pressure the Senate to vote in favor of a major civil rights bill. Ultimately, the testimonies made clear that white supremacy was flourishing in Mississippi. When Congressman Fitts Ryan submitted the recorded testimonies to the House of Representatives for inclusion in the Congressional Record, he formally requested that Attorney General Robert Kennedy send Federal marshals to Mississippi to protect the summer project workers.
Keep Your Eyes on the Prize
Authors: Larson Kate Clifford
Published: February 2022

This chapter details Fannie Lou Hamer's experiences during a trip to the newly established nation of Guinea in Africa along with other civil rights activists. Hamer felt a particular kinship with African women, most of whom wore "their heads tied up" with brightly colored scarves. She recalled how her mother would do the same thing. Guinea's education system, expanded and made available to all citizens after the French left, also impressed the Student Non-Violent Coordinating Committee (SNCC) activists. While Hamer was in Africa, those who had counseled compromise at the Atlantic City convention assembled in New York City to discuss strategies moving forward. When Hamer returned from Africa, a deluge of requests for appearances poured in. She was a fresh and authentic face of struggle who breathed new life into a movement dominated by men. When she was not traveling out-of-state to raise money for the Mississippi Freedom Democratic Party (MFDP) and SNCC, she was giving speeches in Mississippi, drumming up interest in the November Freedom Vote.
Defining the Deficit
Authors: Salomone Rosemary
Published: February 2022

This chapter examines the “foreign language deficit” in the United States. It begins with the failure of the government to address the problem beyond isolated programs and intermittent “calls to action” in response to crises. It considers the country’s history as a “settler nation” and its conflicted views on language in attempting to preserve a national identity in the face of successive waves of newcomers. It looks at declining numbers in foreign language programs and enrollments from elementary school through university while recognizing the rising popularity of Korean as a culturally driven phenomenon and the growing interest in streaming foreign language media. It uncovers concerns that affect access and opportunity tied to social capital and systemic exclusion. The chapter notes the potential of students from immigrant families who could meet the demand for bilingual service providers in immigrant communities. It further underscores the risks of monolingualism to foreign diplomacy.
Suspending the Hustle
Authors: Ticona Julia
Published: February 2022

Chapter 4 compares how high- and low-wage workers both used and refused to use their digital technologies in strategies to resist work. While both groups of workers talked about digital technologies in their efforts to resist work and carve out spaces of autonomy for themselves, they did so in very different ways, depending on the forms of managerial control they faced. Low-wage workers resisted direct control over their bodies and attention by diving into their phones to create a kind of absent presence. By contrast, high-wage workers refused to use their digital technologies to limit their affective commitment to jobs that demanded their devotion. However, this chapter also explores how these strategies weren’t available to all workers in the same ways. This chapter explains how race, sexuality, and gender constrained workers’ strategies to use their digital technologies to resist work.
Christianity, Scripture, and “Reading” the World, from Augustine to Bishop Berkeley
Authors: Cassedy Steven
Published: February 2022

To get to the idea that we can find meanings not just in conventional signifying objects (words, stories) but in the world and hence envision a “book of nature,” we need to reimagine signification itself. This chapter examines how, beginning with St. Augustine, Christian thinkers proposed various schemes for seeking and discovering meanings in nature just as we do in Holy Scripture. This is because, as Augustine explains, signs are things that “point beyond themselves,” and natural objects can function as signs. Accepting that natural signs point beyond themselves to something else requires accepting a form of idealism according to which there are truths and qualities that dwell in a realm removed from that of direct experience. The “book of nature” conceit was temporarily brought to an end by the Protestant Reformation and the rise of modern science—the former through the motto “sola scriptura” (by Scripture alone), which pushed readers to seek fixed meanings in the holy texts, and the latter through its insistence that natural objects possess not metaphysical meanings but only empirically discoverable properties. Then the “book of nature” conceit returned in the work of George Berkeley (1685–1753) and his philosophy of immaterialism, according to which we lack all direct perceptual access to objects in the world, and so those supposed objects are equivalent to the “meanings” that lie behind our perceptions.
Two Russian Titans Weigh In
Authors: Cassedy Steven
Published: February 2022

This chapter examines the contribution that two Russian literary greats, Lev Tolstoy and Fedor Dostoevsky, made to the evolution of meaning in its metaphysical senses. The Russian word commonly translated as “meaning” is smysl and is connected through its etymological root with thought and thus carries such sub-definitions as “comprehension,” “sense” (the sense of a word), “reason,” and, of course, “meaning.” Smysl zhizni (the meaning of life) and smysl by itself appear in Tolstoy’s writings innumerable times. Smysl appears to have a range of senses: “meaning,” “aim,” “goal,” “purpose.” In the author’s two lengthy novels, it represents the end of a personal quest, but an end that is elusive, as neither the hero of War and Peace nor the hero of Anna Karenina truly uncovers the “meaning” he seeks. Dostoevsky turned his attention to “the meaning of life” relatively late in life, when he came to associate it with what he regarded as an epidemic of suicide in his homeland: young people take their lives upon losing “the highest meaning of life,” which he equated with belief in the immortality of the soul. And yet “the meaning of life” takes on an odd resonance in Dostoevsky’s writing, where it serves as a kind of bridge phrase, whose ambiguity allows skeptics and believers to refer to a religious concept that the former reject and the latter embrace.
Julius Caesar in Britain
Authors: Hingley Richard
Published: February 2022

This chapter is an exploration of the two campaigns led by the great Roman commander in 55 and 54 bce. Caesar left a vitally important account of his invasions of south-eastern Britain which provides information about his campaigns and addresses the Iron Age peoples of Britain. Significant archaeological discoveries have supplemented, and often challenged, this narrative. These include the recent discovery of Caesar’s probable landing site from his second campaign (at Ebbsfleet, Kent) and the uncovering of a high-status Iron Age warrior burial at North Bersted (West Sussex). Caesar brought around 20,000 soldiers to Britain during his second campaign and forced the surrender of several of the kings of south-eastern Britain, including a great warrior named Cassivellaunus, who attempted to unite the opposition to Rome. Caesar described the martial valour of the Britons he fought, including their use of slingshots and chariots. Departing from Britain to return to Gaul, he took hostages and slaves, imposing a tribute on the kings of Britain. Commius was a Gallic ally of Caesar who assisted him during his invasions of Britain and eventually appears to have settled to rule over a people living to the south of the Thames. He was the first of a series of friendly kings established by Roman rulers in Britain. The North Bersted warrior may have been a member of a retinue of cavalry soldiers who accompanied Commius to Britain after Caesar had withdrawn.
Subduing Ocean
Authors: Hingley Richard
Published: February 2022

When the emperor Claudius succeeded Caligula, he needed a significant victory to secure his rule and he chose to invade Britain. Claudius instructed the commander Aulus Plautius to lead the initial invasion in 43 and arrived in person to lead the campaign after the collapse of the main opposition. He arrived at the oppidum of Camulodunum in time to receive the submission of several British kings and then returned to Rome to receive a victory. Southern Britain was conquered by Plautius within four years, building on the establishment of six friendly kingdoms. The friendly rulers, including Togidubnus, Cartimandua, and Prasutagus (the partner of Boudica), enabled Rome to direct its military might against the peoples of the south who did not immediately surrender. The future emperor Vespasian played a significant role in these campaigns. After Plautius was replaced as provincial governor by Ostorius Scapula in 47, Roman attention turned to the conquest of Wales, which was to take many decades, as the result of sustained resistance from the Iron Age peoples, including the Silures. Even the defeat and capture of Caratacus, widely famed for his resistance, during the ninth year of the conquest (51) did not defeat the resistance, which continued for another three decades. When Claudius died in 54, the conquest of Britain, portrayed as the subduing of Ocean, was viewed as the most important achievement of his reign.
Rebellion
Authors: Hingley Richard
Published: February 2022

The initial years of the emperor Nero’s reign witnessed the expansion of Roman territory in Britain, as campaigns extended the province into south-western, western, and central Britain. One notable event was a marital dispute between the friendly queen Cartimandua of the Brigantes and her husband, Venutius. Roman troops marched to the north to defend her from the uprising against her rule. The provincial governor, Suetonius Paulinus, was campaigning in north-west Wales to conquer the island of Anglesey in 60 when a serious uprising broke out in eastern Britain as Boudica led the Iceni and the Trinovantes in an attempt to drive the Romans out of Britain. The Britons burnt the newly established colony at Camulodunum and its temple of Claudius and then turned their ire on the populations of the newly established port town of London and the pro-Roman oppidum at Verulamium. For a while it looked as if Rome might have to withdraw from Britain, although Paulinus won a significant battle against far larger numbers of Britons, and Boudica died. Not all the Britons turned against Rome, and the support of the friendly king Togidubnus was a vital factor in Rome’s recovery of the province. Paulinus embarked on severe retribution against the Britons who had rebelled and had to be replaced by a governor who followed a more diplomatic path. By the time Nero committed suicide in Rome in 68, southern Britain was again fully under Roman control.
Introduction: High Expectations
Authors: Shneiderman Ben
Published: February 2022

This book proposes a new synthesis in which AI-based intelligent algorithms are combined with human-centered thinking to make HCAI. This approach will increase the chance that technology will empower rather than replace people. In the past, researchers and developers focused on building AI algorithms and systems, stressing machine autonomy and measuring algorithm performance. The new synthesis gives equal attention to human users and other stakeholders by raising the value of user experience design and by measuring human performance. Researchers and developers for HCAI systems value meaningful human control, putting people first by serving human values such as rights, justice, and dignity, and supporting goals such as self-efficacy, creativity, responsibility, and social connections.
Defining Reliable, Safe, and Trustworthy Systems
Authors: Shneiderman Ben
Published: February 2022

While machine autonomy remains a popular goal, the goal of human autonomy should remain equally strong in designers’ minds. Machine and human autonomy are both valuable in certain contexts, but a combined strategy uses automation when it is reliable and human control when it is necessary. To guide design improvements it will be helpful to focus on the attributes that make HCAI systems reliable, safe, and trustworthy. Designers of reliable, safe, and trustworthy systems will also promote resilience, clarify responsibility, increase quality, and encourage creativity. Still broader goals are to ensure privacy, increase cybersecurity, support social justice, and protect the environment.
Design Guidelines and Examples
Authors: Shneiderman Ben
Published: February 2022

Successful designs are comprehensible, predictable, and controllable, thereby increasing the users’ self-efficacy, leading to reliable, safe, and trustworthy systems. These successes require careful design of the fine structure of interaction, which emerges from validated theories, clear principles, and actionable guidelines. In turn, this knowledge becomes easy to apply when it is embedded in programming tools that favor human control. The examples clarify the key ideas of supporting users to express their intent through visual interfaces (although auditory and haptic interfaces are also valuable in many situations and for users with disabilities). These designs give users informative feedback about the machine state, with progress indicators and completion reports, thereby giving users meaningful control.
Trustworthy Certification by Independent Oversight
Authors: Shneiderman Ben
Published: February 2022

The key to independent oversight is to support the legal, moral, and ethical principles of human or organizational responsibility and liability for their products and services. Three common forms of independent oversight are planning oversight, continuous monitoring, and retrospective analysis of disasters. These may be carried out by accounting firms, insurance companies, non-governmental and civil society organizations, and professional organizations and research institutes. Skeptics delight in pointing out that each of these approaches is imperfect, but the evidence shows that overall they are helpful in promoting trustworthy systems by way of continuous improvement to methods and improved training for leaders and staff members. Use of these approaches can be a competitive advantage that is featured in marketing new products and services.
Caring for and Learning from Older Adults
Authors: Shneiderman Ben
Published: February 2022

Caring for older adult parents, grandparents, family members, and friends is a virtue that can be an enriching experience for all. However, it requires a serious commitment if the older adult needs help to maintain independent living, which often leads to the older adult moving to a facility that will provide support for the activities of daily life. But caregivers and others can gain and learn from older adults, who are often eager to teach, mentor, advise, and coach others. Older adults have many needs that could be served by appropriate technologies that supported their self-efficacy and independence. Examples include wheelchair design, dining table with a dishwasher built in, and yoga instruction.
Dickens and Democracy in the Age of Paper
Authors: Berman Carolyn Vellenga
Published: February 2022

This book examines Charles Dickens’s fiction alongside publications emanating from Parliament. It argues that Dickens and Parliament were engaged in competitive efforts to represent the People at a crucial moment in the history of representative democracy—when the British government was under enormous political pressure to expand the franchise beyond a narrow band of male landowners. Contending that fiction and the literature of Parliament interacted at a host of levels—jostling one another in the same bookshops—it reads Dickens’s novels in tandem with blue books, the practice texts of shorthand manuals, and Dickens’s journalism. It shows how his fiction mocks parliamentary form (as in The Pickwick Papers ), canvasses the history of parliamentary representation (as in Bleak House), and depicts the relation of the People to the state as well as commerce (as in Little Dorrit). It thus rethinks the history of the Victorian novel by examining its rivalry with Parliament in the expanding world of print publication.
Christian Practices, Islamic Contexts
Authors: Rassi Salam
Published: February 2022

Chapter 5 examines ʿAbdīshōʿ’s justification of Christian devotional practice. It focuses on his discussion of the veneration of the Cross and the striking of a wooden percussion instrument known as the clapper in times of prayer. ʿAbdīshōʿ’s explanation of Christian cult affirms its validity in a socio-cultural environment that was sometimes at odds with it. The chapter situates ʿAbdīshōʿ’s apology within a contested visual and acoustic environment shared in by Muslims and Christians. In particular, Christian writers in the Islamic World contended with the accusation that the veneration and public display of the Cross constituted yet another form of idolatry, and that the sound of the clapper was offensive to Muslims and inferior to the call of the muʾadhdhin. In addition to providing scriptural testimony for the veneration of the Cross, our author appeals to a kalām-inflected language to explain the salvific nature of the Crucifixion and the cosmological significance of the Cross’s four points. Similarly, he invokes an instance where the call of the clapper features positively in a poetic sermon attributed to ʿAlī ibn Abī Ṭālib (d. 661), thereby invoking a common lettered tradition to legitimate an otherwise marginal practice. ʿAbdīshōʿ employs this sermon to illustrate how Christian sacred tradition is consonant with Muslim models of piety and repentance. ʿAlī’s importance in the Christian imaginary reveals how this shared lettered tradition was also trans-linguistic, since many of the ethical and moralizing themes of his sermon also emerge in ʿAbdīshōʿ’s Syriac poetry.
Prologue
Authors: Cohn, Jr. Samuel K.
Published: February 2022

The prologue investigates popular protest from the end of the late medieval zenith of revolt c. 1425, to when this book’s focus begins with Charles VIII’s crossing the Alps into Italy in 1494, igniting the Italian wars and foreign military occupation that endured for the next sixty-five years. I have gathered these protests from two samples, first from reviewing the secondary literature of popular revolt in fifteenth-century Florence and then by surveying contemporary edited chronicles from the mid-fourteenth to the early sixteenth century in the region of the Marche, where historians have yet to explore popular insurrection. Despite the preponderance of chronicles on the fifteenth century, overwhelmingly these revolts in the Marche concentrate in the fourteenth century and then re-emerge with the sixteenth century. Moreover, those from the fourteenth century reveal sophisticated organization of the popolo in small cities such as Fermo and Jesi, which overthrew rule by the papacy, condottieri, and larger city-states to extend constitutionally political representation across classes. The chapter ends by speculating on the reasons for the decline in popular revolt in fifteenth-century Italy.