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Michael Bennett provides the first history of the global spread of vaccination during the Napoleonic Wars, offering a new assessment of the cowpox discovery and Edward Jenner's achievement in making cowpox inoculation a viable and universally available practice. He explores the networks that took the vaccine around the world, and the reception and establishment of vaccination among peoples in all corners of the globe. His focus is on the human story of the horrors of smallpox, the hopes invested in vaccination by medical men and parents, the children put arm-to-arm across the world, and the early challenges, successes and disappointments. He presents vaccination as a quiet revolution, genuinely emancipatory, but also the sharp end of growing state power. By the end of the war in 1815, millions of children had been vaccinated. The early success of the war against smallpox paved the way to further advances towards eradication.
Milton J. Bennett sets out by providing an overview of assessing intercultural communicative competence (ICC) through a constructivist lens. Bennett uses the Developmental Model of Intercultural Sensitivity (DMIS) as an example of how constructivist theory and methodology can be applied to assessing ICC.
To determine the prevalence of antibiotic allergy labels (AALs) in Australian aged care residents and to describe the impact of labels on antibiotic prescribing practices.
Australian residential aged care facilities.
We surveyed 1,489 residents in 407 aged care facilities.
Standardized data were collected on a single day between June 1 and August 31, 2018, for residents prescribed an antibiotic. An AAL was reported if it was documented in the resident’s health record. Resident-level data were used to calculate overall prevalence, and antibiotic-level data were used to report relative frequency of AALs for individual antibiotics and classes.
Among 1,489 residents, 356 (24%) had 1 or more documented AALs. The AALs for penicillin (28.3%), amoxicillin or amoxicillin/clavulanic acid (10.5%), cefalexin (7.2%), and trimethoprim (7.0%) were most commonly reported. The presence of an AAL was associated with significantly less prescribing of penicillins (OR, 0.43; 95% CI, 0.31–0.62; P < .001) and significantly more prescribing of lincosamides (OR, 4.81; P < .001), macrolides (OR, 2.03; P = .007), and tetracyclines (OR, 1.54; P = .033). Of residents with AALs, 7 residents (1.9%) were prescribed an antibiotic that was listed on the allergy section of their health record.
A high prevalence of AALs was observed among residents of Australian aged care facilities, comparable to the prevalence of AALs in high-risk hospitalized patients. Significant increases in prescribing of lincosamide, macrolide, and tetracycline agents poses a potential risk to aged populations, and future studies must evaluate the benefits of AAL delabelling programs tailored for aged care settings.
For children with normal hearing (NH), early communication skills predict vocabulary, a precursor to grammar. Growth in early communication skills of infants with cochlear implants (CIs) was investigated using the Early Communication Indicator (ECI), a play-based observation measure. Multilevel linear growth modelling on data from six ECI sessions held at three-monthly intervals revealed significant growth overall, with a non-significant slower growth rate than that of children with NH (comparison age centred at 18 months). Analyses of gesture use and of nonword vocalisations revealed the CI group used significantly more of each, with more rapid growth. In contrast, the CI group used significantly fewer single words and multiword utterances, and with slower growth. Maternal education and time to achieve consistent CI use impacted significantly on growth for the CI sample. The results indicate that progression to vocabulary by young CI users can be supported by encouraging their use of prelinguistic communication.
To compare the microbicidal activity of low-temperature sterilization technologies (vaporized hydrogen peroxide [VHP], ethylene oxide [ETO], and hydrogen peroxide gas plasma [HPGP]) to steam sterilization in the presence of salt and serum to simulate inadequate precleaning.
Test carriers were inoculated with Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, vancomycin-resistant Enterococcus, Mycobacterium terrae, Bacillus atrophaeus spores, Geobacillus stearothermophilus spores, or Clostridiodes difficile spores in the presence of salt and serum and then subjected to 4 sterilization technologies: steam, ETO, VHP and HPGP.
Steam, ETO, and HPGP sterilization techniques were capable of inactivating the test organisms on stainless steel carriers with a failure rate of 0% (0 of 220), 1.9% (6 of 310), and 1.9% (5 of 270), respectively. The failure rate for VHP was 76.3% (206 of 270).
Steam sterilization is the most effective and had the largest margin of safety, followed by ETO and HPGP, but VHP showed much less efficacy.
A numerical model, based on the two-phase incompressible Navier–Stokes equations, is used to study transmission of regular water waves by a thin floating plate in two dimensions. The model is shown to capture the phenomenon of waves overwashing the plate, and the generation of turbulent bores on the upper plate surface. It is validated against laboratory experimental measurements, in terms of the transmitted wave field and overwash depths, for a set of incident wave periods and steepness values. Corresponding simulations are performed for a thick plate that does not experience overwash, which are validated using experiments where an edge barrier prevents thin-plate overwash. The model accurately reproduces (i) the linear relationship between the transmitted and incident amplitudes for the thick plate, and (ii) the decrease in proportion of incident-wave transmission for the thin plate, as incident steepness increases. Model outputs are used to link the decreasing transmission to wave-energy dissipation in the overwash, particularly where bores collide, and in the surrounding water, particularly at the plate ends. It is shown that most energy dissipation occurs in the overwash for the shortest incident waves tested, and in the surrounding water for the longer incident waves. Further, evidence is given that overwash suppresses plate motions, and causes asymmetry in plate rotations.
In the event of a Legionnaires' disease outbreak, rapid location and control of the source of bacteria are crucial for outbreak management and regulation. In this paper, we describe an enhancement of the traditional wind rose for epidemiological use; shifting the focus of measurement from relative frequency of the winds speeds and directions to the relative volume of air carried, whilst also incorporating probability distributions of disease incubation periods to refine identification of the important wind directions during a cases window of exposure, i.e. from which direction contaminated aerosols most likely originated. The probability-weighted wind rose offers a potential improvement over the traditional wind rose by weighting the importance of wind measurements through incorporation of probability of exposure given an individual's time of symptom onset (obtained through knowledge of the incubation period), and by instead focusing on the volume of carrying air which offers better insight into the most probable direction of the source. This then provides a probabilistic distribution of which direction the wind was blowing around the time of infection. We discuss how the probability-weighted wind rose can be implemented during a Legionnaires' disease outbreak, and how outbreak control teams might use it as supportive evidence to identify the most likely direction of the contaminated source from the presumed site of exposure. In addition, this paper discusses how minor adjustments can be made to the method allowing the probability-weighted wind rose to be applied to other non-communicable airborne diseases, providing the disease's probability distribution for the incubation period distribution is well known.
The Berlin ecclesiastical historian, August Neander (1789–1850), developed a religiously driven conception of history which excited contemporaries across the Protestant world. This article reconstructs the impetus which Neander gave to the creation of a religiously cosmopolitan historical imagination in Germany, Britain, and the United States. At a time when Hegelian and ‘scientific’ models of historical progress foretold a post-Christian future for civilization, Neander's alternative idea of world history, centred on the leavening spread of the invisible church through contrasting forms of Christianity and culture, exercised a powerful sway over Protestant historians everywhere. His universalizing historical philosophy offered an appealing mode of self-understanding to the networks which translated his ideas into new settings. Appearing to afford a mode of securing Protestantism from the twin dangers of sectarianism and unbelief, Neander's ‘unpartisan’ philosophy simultaneously became an important instrument of Protestant nation-building in the hands of the historians drawn towards it. By considering the interaction between universal and national aspirations in the development and dissemination of Neander's historical philosophy, the article examines the practical implications of historical thought, and connections between national and transnational scales of analysis, in modern religious and intellectual history.
Shanidar Cave in Iraqi Kurdistan became an iconic Palaeolithic site following Ralph Solecki's mid twentieth-century discovery of Neanderthal remains. Solecki argued that some of these individuals had died in rockfalls and—controversially—that others were interred with formal burial rites, including one with flowers. Recent excavations have revealed the articulated upper body of an adult Neanderthal located close to the ‘flower burial’ location—the first articulated Neanderthal discovered in over 25 years. Stratigraphic evidence suggests that the individual was intentionally buried. This new find offers the rare opportunity to investigate Neanderthal mortuary practices utilising modern archaeological techniques.
In 2011, Operation Nightingale was established to promote archaeology as a means to support the wellbeing and recovery of serving military personnel and veterans. Since then, the number of opportunities for participation has increased enormously. This article seeks to contextualise the current landscape of ‘rehabilitation archaeology’ for military personnel and veterans, through the presentation of data from the largest service evaluation to be based on standardised psychological measures undertaken to date. The results demonstrate improvements in wellbeing among veterans participating in fieldwork in 2018, including a reduction in the occurrence of anxiety, depression and feelings of isolation, and a greater sense of being valued.
The mammalian kidney is a complex organ, requiring the concerted function of up to millions of nephrons. The number of nephrons is constant after nephrogenesis during development, and nephron loss over a life span can lead to susceptibility to acute or chronic kidney disease. New technologies are under development to count individual nephrons in the kidney in vivo. This review outlines these technologies and highlights their relevance to studies of human renal development and disease.