Antibiotic resistance is a growing crisis across the globe. With the use of antibiotics in heathcare settings in an ever-growing population, the growth of antibiotic resistance has been named a top 10 global public health threat by the World Health Organization. Through an analysis of 6 countries; Mexico, China, the United States, India, Saudi Arabia, and Ethiopia, I look at the current implementation of policy and contributing factors to the use and abuse of antibiotics within the country. Through my research, I was able to find knowledge, behaviors, and a lack of enforcement to be the main contributors to the growing antibiotic crisis. Based on the evidence, I suggested three policies that focused on treatment, prevention, or economic assistance in an effort to combat the antibiotic crisis on a global scale. With socio-economic factors in mind as well as sustainability of policy, the evidence pointed in the direction of a three-pronged approach on prevention with education, policy enforcement, and a global database to minimize the growth of antibiotic resistance as well as improve public health at a global level.

COVID-19 has been challenging for nearly everyone in different ways. Healthcare organizations have had to quickly change policy, modify operations, reorganize facilities, hire, and train staff to overcome COVID-19 related challenges to be able to still provide care for patients, all while being mindful of the protection of their staff. Some healthcare organizations have responded particularly well, perhaps due to preparedness, planning, or exceptional leadership in times of crisis. To explore this, we invited seven healthcare system leaders from three different organizations in Arizona to talk about how they overcame challenges at the beginning of this pandemic with effective strategies and any leadership tips they had for the future. After the interviews were conducted, the interviews were transcribed, coded qualitatively, and separated into themes and categories to analyze their answers to the questions asked. The results and conclusions included strategies such as having open and honest communication, teamwork, rapidly developing communicating policies, and widely adopting new work practices like Telemedicine, Zoom, and working at home as crucial. This report is designed to assist in aiding and inspiring future or other leaders to be better prepared for solving various challenges with other emergencies that arise in the future.

As much as SARS-CoV-2 has altered the way humans live since the beginning of 2020, this virus's deadly nature has required clinical testing to meet 2020's demands of higher throughput, higher accuracy and higher efficiency. Information technology has allowed institutions, like Arizona State University (ASU), to make strategic and operational changes to combat the SARS-CoV-2 pandemic. At ASU, information technology was one of the six facets identified in the ongoing review of the ASU Biodesign Clinical Testing Laboratory (ABCTL) among business, communications, management/training, law, and clinical analysis. The first chapter of this manuscript covers the background of clinical laboratory automation and details the automated laboratory workflow to perform ABCTL’s COVID-19 diagnostic testing. The second chapter discusses the usability and efficiency of key information technology systems of the ABCTL. The third chapter explains the role of quality control and data management within ABCTL’s use of information technology. The fourth chapter highlights the importance of data modeling and 10 best practices when responding to future public health emergencies.

Developing a vaccine during the midst of a pandemic requires a careful balance between <br/>speed, safety, and efficacy. For the COVID-19 pandemic, the U.S. implemented Operation Warp Speed to accelerate the timeline for vaccine development. The FDA also imposed specific guidelines for granting Emergency Use Authorization (EUA). As of April 1st, 2021, Operation Warp Speed resulted in three different vaccines receiving EUA, all of which are currently being administered to the public. However, the rapid production and changes in the approval process intensified public scrutiny on the safety and efficacy of the vaccine. This thesis analyzes the differences in fast-tracking a vaccine, which consolidated the authorization process into months rather than years, and delineates the main concerns of the public regarding the COVID-19 vaccine through a media analysis. Although the EUA raised questions about the safety of the vaccine, polls indicate that most Americans would still be willing to receive the vaccine.

Chronic diseases place a financial burden on the United States and claim the lives of nearly 2 million Americans every year. Among the chronic diseases that plague American people, type 2 diabetes is particularly prevalent and injurious. Thus, action is warranted to improve prevention and management of this disease. Nutrition plays a significant role in prevention and management of type 2 diabetes and other chronic diseases. Registered dietitians, as nutrition experts, are qualified to use medical nutrition therapy as a method of prevention and treatment for chronic diseases using a nutritional approach. However, there is no consensus as to which eating pattern is the most efficacious. The aim of this review of research was to examine how plant-based eating patterns impact chronic disease conditions, with an emphasis on type 2 diabetes mellitus, as compared to omnivorous eating patterns. A literature search was conducted through the ASU Library, PubMed, and CINAHL using terms related to plant-based diets and chronic diseases, such as type 2 diabetes. The results revealed that a plant-based eating pattern may be beneficial in the prevention and treatment of certain chronic diseases, such as type 2 diabetes. Specifically, adults who have type 2 diabetes and consume a plant-based diet may exhibit enhanced glycemic control as evidenced by less insulin resistance, increased incretin and insulin secretion, greater insulin sensitivity, and improved HbA1c levels. There is sufficient evidence for registered dietitians to recommend a plant-based approach to patients with type 2 diabetes who would like to achieve enhanced glycemic control.

In this synthesis, we hope to accomplish two things: 1) reflect on how the analysis of the new archaeological cases presented in this special feature adds to previous case studies by revisiting a set of propositions reported in a 2006 special feature, and 2) reflect on four main ideas that are more specific to the archaeological cases: i) societal choices are influenced by robustness–vulnerability trade-offs, ii) there is interplay between robustness–vulnerability trade-offs and robustness–performance trade-offs, iii) societies often get locked in to particular strategies, and iv) multiple positive feedbacks escalate the perceived cost of societal change. We then discuss whether these lock-in traps can be prevented or whether the risks associated with them can be mitigated. We conclude by highlighting how these long-term historical studies can help us to understand current society, societal practices, and the nexus between ecology and society.

For at least the past 8000 years, small-scale farmers in semi-arid environments have had to mitigate shortfalls in crop production due to variation in precipitation and stream flow. To reduce their vulnerability to a shortfall in their food supply, small-scale farmers developed short-term strategies, including storage and community-scale sharing, to mitigate inter-annual variation in crop production, and long-term strategies, such as migration, to mitigate the effects of sustained droughts. We use the archaeological and paleoclimatic records from A.D. 900-1600 in two regions of the American Southwest to explore the nature of variation in the availability of water for crops, and the strategies that enhanced the resilience of prehistoric agricultural production to climatic variation. Drawing on information concerning contemporary small-scale farming in semi-arid environments, we then suggest that the risk coping and mitigation strategies that have endured for millennia are relevant to enhancing the resilience of contemporary farmers’ livelihoods to environmental and economic perturbations.

The value of “diversity” in social and ecological systems is frequently asserted in academic and policy literature. Diversity is thought to enhance the resilience of social-ecological systems to varied and potentially uncertain future conditions. Yet there are trade-offs; diversity in ecological and social domains has costs as well as benefits. In this paper, we examine social diversity, specifically its costs and benefits in terms of decision making in middle range or tribal societies, using archaeological evidence spanning seven centuries from four regions of the U.S. Southwest. In these nonstate societies, social diversity may detract from the capacity for collective action. We ask whether as population density increases, making collective action increasingly difficult, social diversity declines. Further, we trace the cases of low diversity and high population density across our long-temporal sequences to see how they associate with the most dramatic transformations. This latter analysis is inspired by the claim in resilience literature that reduction of diversity may contribute to reduction in resilience to varied conditions. Using archaeological data, we examine social diversity and conformity through the material culture (pottery styles) of past societies. Our research contributes to an enhanced understanding of how population density may limit social diversity and suggests the role that this association may play in some contexts of dramatic social transformation.

What relationships can be understood between resilience and vulnerability in social-ecological systems? In particular, what vulnerabilities are exacerbated or ameliorated by different sets of social practices associated with water management? These questions have been examined primarily through the study of contemporary or recent historic cases. Archaeology extends scientific observation beyond all social memory and can thus illuminate interactions occurring over centuries or millennia. We examined trade-offs of resilience and vulnerability in the changing social, technological, and environmental contexts of three long-term, pre-Hispanic sequences in the U.S. Southwest: the Mimbres area in southwestern New Mexico (AD 650–1450), the Zuni area in northern New Mexico (AD 850–1540), and the Hohokam area in central Arizona (AD 700–1450). In all three arid landscapes, people relied on agricultural systems that depended on physical and social infrastructure that diverted adequate water to agricultural soils. However, investments in infrastructure varied across the cases, as did local environmental conditions. Zuni farming employed a variety of small-scale water control strategies, including centuries of reliance on small runoff agricultural systems; Mimbres fields were primarily watered by small-scale canals feeding floodplain fields; and the Hohokam area had the largest canal system in pre-Hispanic North America. The cases also vary in their historical trajectories: at Zuni, population and resource use remained comparatively stable over centuries, extending into the historic period; in the Mimbres and Hohokam areas, there were major demographic and environmental transformations. Comparisons across these cases thus allow an understanding of factors that promote vulnerability and influence resilience in specific contexts.

With the recent rise in opioid overdose and death1<br/><br/>, chronic opioid therapy (COT) programs using<br/>Center of Disease Control (CDC) guidelines have been implemented across the United States8<br/>.<br/>Primary care clinicians at Mayo Clinic initiated a COT program in September of 2017, during the<br/>use of Cerner Electronic Health Record (EHR) system. Study metrics included provider<br/>satisfaction and perceptions regarding opioid prescription. Mayo Clinic transitioned its EHR<br/>system from Cerner to Epic in October 2018. This study aims to understand if provider perceptions<br/>about COT changed after the EHR transition and the reasons underlying those perceptions.