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In the Netherlands, we started in 2016 with a new procedure for large scale medical assistance during a crisis. The normal daily assistance in the Netherlands is organized on a regional level, and we have 25 regions. These regions are far too small to handle big incidents, and cooperation is needed on a higher level to generate enough capacity. However, the Aim is that most emergency workers continue to do their own work in standard procedures, we also need more coordination, information management, transition of “stay and play” to “scoop and run” and deploying volunteers and citizens.
We developed the model practice-based, however, we have little big incidents. We feel the urgency to compare this practice to international knowledge.
The goal is twofold: validation of the starting points of our model, but also further improvement: speeding up the transport and treatment of patients, improvement of capacity, safety of the ambulance staff – especially with terrorist attacks or contamination, civil participation. We held the first survey on scientific literature in English, related to items in our prehospital assistance model. (the article is not yet published).
The conclusion was, that scientific articles are rare, however, a lot of information is given about the practical course of incidents. Scientific research to explore these experiences is rare, partly due to a missing universal terminology on disaster medicine.
We want to contribute to enlarging the scientific knowledge on large scale prehospital assistance. We expect that a lot of practical experience can be unlocked by bringing together experts in this field. We want to present the Dutch model, with a focus and invitation to compare this with the models in other countries, to compare experiences, to deepen them and to stimulate international research. We want to commit ourselves to facilitate this.
Textural, mineralogical and chemical characterization of archaeological ceramics (zellige) from El Badi Palace (Marrakech, Morocco), the main Islamic monument from the Saadian period (sixteenth century), has been performed to enhance restoration and to determine the technology of manufacturing. A multi-analytical approach based on optical and scanning electron microscopy, cathodoluminescence, X-ray fluorescence and X-ray diffraction was used. Re-firing tests on ceramic supports were also performed to determine the firing temperatures used by the Saadian artisans. A calcareous clay raw material was used to manufacture these decorative ceramics. The sherds were fired at a maximum temperature of 800°C in oxidizing atmosphere. The low firing temperature for ‘zellige’ facilitates cutting of the pieces, but also causes fragility in these materials due to the absence of vitreous phases.
To explore the correlations between observer ratings and instrumental parameters across domains of psychomotor functioning in depression.
In total, 73 patients with major depressive disorder underwent extensive psychomotor and clinical testing. Psychomotor functioning was assessed with (i) an observer-rated scale (the CORE measure) and also objectively with (ii) 24-h actigraphy, and (iii) a fine motor drawing task.
Observer ratings of retardation correlated with instrumental assessments of fine and gross motor functioning. In contrast, observer ratings of agitation did not correlate with observer ratings of retardation or with the instrumental measures. These associations were partly influenced by age and, to a lesser extent, by depression severity.
Psychomotor disturbance is a complex concept with different manifestations in depressed patients. Although observer ratings of retardation correspond well with instrumental measures of the motor domains, objective measurement of agitation and other aspects of psychomotor disturbance require further research.
While a long history of experimental data shows that aerial thermal images can reveal a wide range of both surface and subsurface archaeological features, technological hurdles have largely prevented more widespread use of this promising prospecting method. However, recent advances in the sophistication of thermal cameras, the reliability of commercial drones, and the growing power of photogrammetric software packages are revolutionizing archaeologists' ability to collect, process, and analyze aerial thermal imagery. This paper provides an overview of the theory behind aerial thermography in archaeology, as well as a discussion of an emerging set of methods developed by the authors for undertaking successful surveys. Summarizing investigations at archaeological sites in North America, the Mediterranean, and the Near East, our results illustrate some contexts in which aerial thermography is very effective, as well as cases in which ground cover, soil composition, or the depth and character of archaeological features present challenges. In addition, we highlight novel approaches for filtering out noise caused by vegetation, as well as methods for improving feature visibility using radiometric thermal imagery.
Anoplolepis gracilipes is one of the six most widespread and pestiferous invasive ant species. Populations of this invader in Arnhem Land, Australia have been observed to decline, but the reasons behind these declines are not known. We investigated if there is evidence of a pathogen that could be responsible for killing ant queens or affecting their reproductive output. We measured queen number per nest, fecundity and fat content of queens from A. gracilipes populations in various stages of decline or expansion. We found no significant difference in any of these variables among populations. However, 23% of queens were found to have melanized nodules, a cellular immune response, in their ovaries and fat bodies. The melanized nodules found in dissected queens are highly likely to indicate the presence of pathogens or parasites capable of infecting A. gracilipes. Queens with nodules had significantly fewer oocytes in their ovaries, but nodule presence was not associated with low ant population abundances. Although the microorganism responsible for the nodules is as yet unidentified, this is the first evidence of the presence of a pathogenic microorganism in the invasive ant A. gracilipes that may be affecting reproduction.
Service providers in Western welfare states have to engage with an increasingly differentiated citizenry. The arrival of new migrant communities triggers debates, negotiations and struggles over the needs of these communities and how service providers can engage with them. In this paper, we look at these processes of developing local social inclusion policies that target migrant communities through the perspective of Nancy Fraser's ‘politics of need interpretation’. More specifically, we analyse Roma engagement strategies in Manchester. We do so by reconstructing how the presence of Romanian Roma emerged as a public issue leading to various engagement strategies and how different actors competed over the interpretation of the needs of the Roma community and the best ways to respond to them. We use Fraser's notion of ‘parity of participation’ to draw attention to the position of the Roma community itself in the process of interpreting needs.
Bookstart is a universal programme and the books given through the scheme are carefully chosen to ensure wide appeal. However, some children may benefit from a different type of book, an alternative format or other ways of engaging with it. This chapter explores how and why the UK programme was successfully expanded to include packs for children who are visually impaired, deaf or have conditions affecting their fine motor skills. The chapter will explore the kinds of books that would particularly benefit these audiences as well as others. It introduces strategies and resources which may suit different audiences and offers advice on ways to identify books offering different forms of accessibility, as well as on the value of stories and pictures that include all children.
Supporting every child through Bookstart
Any child – indeed every child – can enjoy books and stories from a very young age. Every child can also reap prodigious benefits from books. And that is the simple – but highly effective – principle behind Bookstart.
Bookstart is all about encouraging and enabling every child to enjoy books, from a very early age. The original Bookstart concept is generally cited as having been conceived in 1992 (Bookstart, 2016). It grew from a simple pilot project involving just 300 babies, to a national programme. And it is a model which has proved so effective that it has been replicated in numerous countries around the world.
Part of the beauty of Bookstart lies in its simplicity. It takes the form of a pack, usually a cloth bag containing two books and some accompanying materials and advice for parents or carers. The initial Bookstart pack is given to babies who have not yet reached their first birthday and is distributed to families through libraries, health centres and early years settings. Librarians and health professionals are crucial partners and supporters of this work with very young children. However, the books given are not just any books.
The Bookstart book is a very special book. It may be the first book that a baby has actually owned. It may be the first book that this baby has ever actually held. And this may even be the first time that the parent or carer has really thought about sitting down to share books together.
Depression is one of the most common and debilitating non-motor symptoms of Parkinson's disease (PD). The neurocognitive mechanisms underlying depression in PD are unclear and treatment is often suboptimal.
We investigated the role of striatal dopamine in reversal learning from reward and punishment by combining a controlled medication withdrawal procedure with functional magnetic resonance imaging in 22 non-depressed PD patients and 19 PD patients with past or present depression.
PD patients with a depression (history) exhibited impaired reward v. punishment reversal learning as well as reduced reward v. punishment-related BOLD signal in the striatum (putamen) compared with non-depressed PD patients. No effects of dopaminergic medication were observed.
The present findings demonstrate that impairments in reversal learning from reward v. punishment and associated striatal signalling depend on the presence of (a history of) depression in PD.
Pertussis is a vaccine-preventable respiratory infection caused by Bordetella pertussis which can be fatal in infants. Although high vaccine coverage led to prolonged disease control in England, a national outbreak of pertussis in 2011 led to the largest increase in over two decades, including a marked increase in cases aged ⩾15 years. A case-control study in four regions of England was undertaken to investigate risk factors for pertussis in adolescents and adults, specifically employment type and professional and household contact with children. Pertussis cases were laboratory-confirmed and aged ⩾15 years. Controls were recruited through general practitioner nomination. Demographic and risk factor information were collected using an online survey. Multivariable logistic regression was used to estimate independent associations with outcome. Two hundred and thirty-one cases and 190 controls were recruited. None of the four employment variables (social care, education, health sector, patient contact) were significantly associated with pertussis. Professional contact with children aged < 1 year was associated with a significantly reduced odds of pertussis [odds ratio (OR) 0·25, 95% confidence interval (CI) 0·08–0·78, P = 0·017]. Household contact with ⩾1 child aged 10–14 years was associated with significantly increased odds of pertussis (OR 2·61, 95% CI 1·47–4·64, P = 0·001). Occupational contact with very young children was associated with reduced odds of pertussis, probably due to immune boosting by low-level exposures to B. pertussis. Sharing a household with a young adolescent was a significant risk factor for pertussis in adults and older teenagers. The primary focus of the childhood pertussis vaccination programmes is to prevent infant disease. Although evidence is emerging that adolescent vaccination does not provide indirect protection to infants, our results highlight the importance of children aged 10–14 years in pertussis transmission to older adolescents and adults.
Since the establishment of the Portable Antiquities Scheme, the systematic
reporting of metal-detected finds in England and Wales has increased our
knowledge of distribution patterns and complemented the evidence from
assemblages uncovered by conventional excavation. The large number of Roman
metal small finds documented, particularly brooches, now allows for a
quantitative comparison between those recovered through excavation and those
discovered by metal-detecting. This study shows that certain artefact
morphologies are more easily detected than others, resulting in differential
rates of representation in the archaeological record. It is suggested that
similar biases can be seen in artefacts from other periods. This has
important consequences for anyone wishing to use metal-detected material in
We investigated the epidemiology and characterization of isolates of Staphylococcus aureus within the Yorkshire and Humber (YH) region in the UK. In July 2015, each laboratory within YH (n = 14) was assigned two consecutive days during which all clinical isolates of S. aureus were collected. Isolates were tested for antibiotic susceptibilities and the presence of genes encoding methicillin resistance (mecA and mecC), Panton–Valentine leukocidin (PVL) (lukS-PV), and efflux-mediated chlorhexidine resistance (qacA); isolates were also characterized by spa-types. Minimum inhibitory concentrations (MICs) to chlorhexidine were determined by the broth dilution method. Of 520 isolates collected, 6·2% were methicillin-resistant S. aureus (MRSA, all mecA-positive) and mupirocin resistance was low [0·8%, 95% confidence interval (CI) 0·3–2·0] and only found in MRSA. Carriage of the qacA gene was identified in 1·7% (95% CI 0·8–3·3) of isolates and 3·5% (95% CI 2·2–5·4) had a chlorhexidine MIC of 4 mg/l. The PVL gene was infrequent (3·7%, 95% CI 2·4–5·6). Genotyping identified 234 spa-types that mapped to 22 clonal complexes. Comparison of these current data with previous work suggest that the widespread use of staphylococcal decolonization regimens over the past decade or more has not had an adverse impact on resistance rates, PVL carriage or the prevalence of specific S. aureus lineages.
This case report describes intestinal angiodysplasias as a cause of persisting anaemia in a 16-year-old girl with a failing Fontan circulation. Although this is a very rare cause of anaemia, we highlight the importance of video capsule endoscopy in such patients to initiate a life-saving treatment.
This paper considers the small glass objects often called counters, which are common finds at Pompeii, and normally thought to have been used in playing games. An assemblage of over 500 stratigraphically dated examples from Insula VI.1 are examined, and the colour and size of this group are compared to a dataset of first-century ad glass counters found in graves where they can be shown with certainty to be part of gaming sets. The comparisons show that the bulk of the Pompeii counters are very unlikely to have been used in gaming, a conclusion that is supported by the types of counters that would have been necessary to play games such as ludus latrunculorum and ludus duodecim scriptorum. Other functions are considered and it is suggested that many of the Pompeiian counters might have been used for interior decoration. The rise of a specialist production of counters that could have been used in gaming is demonstrated, and it is suggested this might have implications for the development of craft specialization and demonstrate the rise of leisure time in the first century ad.
HST makes it possible for the first time to study nearly the entire mass range of globular-cluster main sequences, from the turnoff down almost to the theoretical limit for hydrogen ignition. We present main-sequence luminosity functions (LFs) for four clusters that include stars with M < 0.15M⊙ in all cases. We compare these and other LFs that have been obtained with HST for a total of five globulars to date. Two of the three clusters in the sample that have similar metallicities have nearly identical LFs, while the third is relatively deficient in low mass stars. Possible implications of this finding are briefly discussed. Inferred mass functions vary significantly depending on the mass-luminosity relations that are adopted.