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What does it mean to focus on the decade as a unit of literary history? Emerging from the shadows of iconic Victorian authors such as Eliot and Tennyson, the 1880s is a decade that has been too readily overlooked in the rush to embrace end-of-century decadence and aestheticism. The 1880s witnessed new developments in transatlantic networks, experiments in lyric poetry, the decline of the three-volume novel, and the revaluation of authors, journalists and the reading public. The contributors to this collection explore the case for the 1880s as both a discrete point of literary production, with its own pressures and provocations, and as part of literature's sense of its expanded temporal and geographical reach. The essays address a wide variety of authors, topics and genres, offering incisive readings of the diverse forces at work in the shaping of the literary 1880s.
During the 1940s and 1950s, the Village was the hub of Abstract Expressionism; it was home to Jackson Pollock and Mark Rothko, as well as the New York School of poets, who rubbed shoulders with artists and composers, among them John Cage, Robert Rauschenberg, and Jasper Johns. During the late 1940s and 1950s, the Village, according to the writer Anatole Broyard, was a place brimming with “terrific energy and curiosity,” where the Beat triumvirate – Jack Kerouac, Allen Ginsberg, and William Burroughs – were at the vanguard of the Beat Generation. During the late 1950s and early 1960s, Beat-influenced writers and artists, including the African American poet Ted Joans, were mainstays of coffee houses on McDougal Street and West 3rd and Bleecker Streets. During the 1960s, the Village became an important area for the burgeoning folk music scene, where the likes of Bob Dylan and Dave Van Ronk played in coffee houses and bars.
Hendra virus (HeV) continues to cause fatal infection in horses and threaten infection in close-contact humans in eastern Australia. Species of Pteropus bats (flying-foxes) are the natural reservoir of the virus. We caught and sampled flying-foxes from a multispecies roost in southeast Queensland, Australia on eight occasions between June 2013 and June 2014. The effects of sample date, species, sex, age class, body condition score (BCS), pregnancy and lactation on HeV antibody prevalence, log-transformed median fluorescent intensity (lnMFI) values and HeV RNA status were assessed using unbalanced generalised linear models. A total of 1968 flying-foxes were sampled, comprising 1012 Pteropus alecto, 742 P. poliocephalus and 214 P. scapulatus. Sample date, species and age class were each statistically associated with HeV RNA status, antibody status and lnMFI values; BCS was statistically associated with HeV RNA status and antibody status. The findings support immunologically naïve sub-adult P. alecto playing an important role in maintaining HeV infection at a population level. The biological significance of the association between BCS and HeV RNA status, and BCS and HeV antibody status, is less clear and warrants further investigation. Contrary to previous studies, we found no direct association between HeV infection and pregnancy or lactation. The findings in P. poliocephalus suggest that HeV exposure in this species may not result in systemic infection and virus excretion, or alternatively, may reflect assay cross-reactivity with another (unidentified) henipavirus.
This chapter starts (12.2) by mentioning the drawbacks of the approach conventionally adopted in second language (L2) listening instruction—in particular, its focus on the products of listening rather than the processes that contribute to it. It then offers an overview of our present understanding of what those processes are, drawing upon research findings in psycholinguistics, phonetics, and applied linguistics. section 12.3 examines what constitutes proficient listening and how the performance of an L2 listener diverges from it; and section 12.4 considers the perceptual problems caused by the nature of spoken input. Subsequent sections then cover various areas of research in L2 listening. Section 12.5 provides a brief summary of topics that have been of interest to researchers over the years; and section 12.6 reviews the large body of research into listening strategies. Section 12.7 then covers a number of interesting issues that have come to the fore in recent studies: multimodality; levels of listening vocabulary; cross-language phoneme perception; the use of a variety of accents; the validity of playing a recording twice; text authenticity; and listening anxiety. A final section (12.8) identifies one or two recurring themes that have arisen and considers how listening instruction is likely to develop in the future.
Overweight and obesity may increase risk of disease progression in men with prostate cancer, but there have been few studies of weight loss interventions in this patient group. Based on existing literature and patient preferences we designed a self-help diet and physical activity intervention with telephone-based dietitian support. Men treated for prostate cancer who were overweight or obese were randomised to intervention or wait-list mini-intervention groups. The intervention group had an initial group meeting, a supporting letter from their urological consultant, three telephone dietitian consultations at 4-week intervals, a pedometer and access to web-based diet and physical activity resources. At 12 weeks, men in both groups were given digital scales for providing follow-up weight measurements, and the wait-list group received a mini-intervention of the supporting letter, a pedometer and access to the web-based resources. Sixty-two men were randomised; fifty-four completed baseline and 12-week measurements, and fifty-one and twenty-seven provided measurements at 6 and 12 months, respectively. In a repeated measures model, mean (95 % CI) difference in weight change between groups (wait-list mini-intervention minus intervention) at 12 weeks was −2·13 (−3·44, −0·82) kg (P = 0·002). At 12 months the corresponding value was −2·43 (−4·50, −0·37) kg (P = 0·022). Mean (95 % CI) difference in global QoL score change between groups at 12 weeks was 12·3 (4·93, 19·7) (P = 0·002); at 12 months there were no significant differences between groups. Results suggest the potential of self-help diet and physical activity intervention with trained support for modest but sustained weight loss in this patient group.
Although researchers have described numerous risk factors for salmonellosis and for infection with specific common serotypes, the drivers of Salmonella serotype diversity among human populations remain poorly understood. In this retrospective observational study, we partition records of serotyped non-typhoidal Salmonella isolates from human clinical specimens reported to CDC national surveillance by demographic, geographic and seasonal characteristics and adapt sample-based rarefaction methods from the field of community ecology to study how Salmonella serotype diversity varied within and among these populations in the USA during 1996–2016. We observed substantially higher serotype richness in children <2 years old than in older children and adults and steadily increasing richness with age among older adults. Whereas seasonal and regional variation in serotype diversity was highest among infants and young children, variation by specimen source was highest in adults. Our findings suggest that the risk for infection from uncommon serotypes is associated with host and environmental factors, particularly among infants, young children and older adults. These populations may have a higher proportion of illness acquired through environmental transmission pathways than published source attribution models estimate.
Background: Buprenorphine/naloxone (bup/nal) is a partial opioid agonist/antagonist and recommended first line treatment for opioid use disorder (OUD). Emergency departments (EDs) are a key point of contact with the healthcare system for patients living with OUD. Aim Statement: We implemented a multi-disciplinary quality improvement project to screen patients for OUD, initiate bup/nal for eligible individuals, and provide rapid next business day walk-in referrals to addiction clinics in the community. Measures & Design: From May to September 2018, our team worked with three ED sites and three addiction clinics to pilot the program. Implementation involved alignment with regulatory requirements, physician education, coordination with pharmacy to ensure in-ED medication access, and nurse education. The project is supported by a full-time project manager, data analyst, operations leaders, physician champions, provincial pharmacy, and the Emergency Strategic Clinical Network leadership team. For our pilot, our evaluation objective was to determine the degree to which our initiation and referral pathway was being utilized. We used administrative data to track the number of patients given bup/nal in ED, their demographics and whether they continued to fill bup/nal prescriptions 30 days after their ED visit. Addiction clinics reported both the number of patients referred to them and the number of patients attending their referral. Evaluation/Results: Administrative data shows 568 opioid-related visits to ED pilot sites during the pilot phase. Bup/nal was given to 60 unique patients in the ED during 66 unique visits. There were 32 (53%) male patients and 28 (47%) female patients. Median patient age was 34 (range: 21 to 79). ED visits where bup/nal was given had a median length of stay of 6 hours 57 minutes (IQR: 6 hours 20 minutes) and Canadian Triage Acuity Scores as follows: Level 1 – 1 (2%), Level 2 – 21 (32%), Level 3 – 32 (48%), Level 4 – 11 (17%), Level 5 – 1 (2%). 51 (77%) of these visits led to discharge. 24 (47%) discharged patients given bup/nal in ED continued to fill bup/nal prescriptions 30 days after their index ED visit. EDs also referred 37 patients with OUD to the 3 community clinics, and 16 of those individuals (43%) attended their first follow-up appointment. Discussion/Impact: Our pilot project demonstrates that with dedicated resources and broad institutional support, ED patients with OUD can be appropriately initiated on bup/nal and referred to community care.
Introduction: Canadian undergraduate medical Emergency Medicine (EM) rotations are often completed at either tertiary care centres or regional community hospitals. While the latter offer students exposure to different practice settings and population needs, many students perceive that teaching at tertiary care EM departments is superior to that in community hospitals. At our institution, third year undergraduate medical students complete three-week EM rotation at either a tertiary centre or a community hospital. We compared academic and clinical performance between students trained in tertiary care centres and students trained in community hospitals. Methods: Academic and clinical performance in EM was evaluated based on the results of an EM-specific multiple choice examination (MCQE) and an annual Objective Structured Clinical Exam (OSCE) assessing competency in a broad range of clinical scenarios commonly addressed in EM. The 40-question MCQE is administered quarterly and a mix of old and new questions are used to ensure consistency. The OSCE is administered annually and relies on the same principal to remain consistent. OSCE scores are binary: pass or fail. We reviewed MCQE and OSCE scores from three consecutive cohorts of students. Students were pooled into two groups, tertiary and community, based on the site of their EM rotation. Mean MCQE and OSCE performance were compared between the two groups of students using two-tailed unpaired T tests. Chi squared tests were used to identify significant differences in scores between cohorts. Results: MCQE and OSCE scores from 312 students over three consecutive cohorts were analyzed. Cohorts included 104, 100, and 108 students with 61% trained in tertiary centres (N = 191). Students trained in tertiary centres had a mean MCQE score of 77%. Students from community centres had a mean score of 78%. There was no significant difference in MCQE scores between tertiary- and community-trained students (p = 0.6099). The OSCE pass rate was 97% for students trained in tertiary centres and 98% for students trained in community centres. OSCE pass rates were not significantly different between the two groups (p = 0.8145). Conclusion: Despite student perceptions that training in tertiary care EM centres was superior, objective analysis showed that academic and clinical performance were similar regardless of training site.
Gastrointestinal and mental disorders are highly comorbid, and animal models have shown that both can be caused by early adversity (e.g., parental deprivation). Interactions between the brain and bacteria that live within the gastrointestinal system (the microbiome) underlie adversity–gastrointestinal–anxiety interactions, but these links have not been investigated during human development. In this study, we utilized data from a population of 344 youth (3–18 years old) who were raised with their biological parents or were exposed to early adverse caregiving experiences (i.e., institutional or foster care followed by international adoption) to explore adversity–gastrointestinal–anxiety associations. In Study 1, we demonstrated that previous adverse care experiences were associated with increased incidence of gastrointestinal symptoms in youth. Gastrointestinal symptoms were also associated with concurrent and future anxiety (measured across 5 years), and those gastrointestinal symptoms mediated the adversity–anxiety association at Time 1. In a subsample of children who provided both stool samples and functional magnetic resonance imaging of the brain (Study 2, which was a “proof-of-principle”), adversity was associated with changes in diversity (both alpha and beta) of microbial communities, and bacteria levels (adversity-associated and adversity-independent) were correlated with prefrontal cortex activation to emotional faces. Implications of these data for supporting youth mental health are discussed.
Borsboom et al.’s formulation provides an opportunity for a fundamental rethink about the “brain disease model” of addiction that dominates research, treatment, policy, and lay understanding of addiction. We also demonstrate how the American opioid crisis provides a contemporary example of how “brain disease” is not moderated by the environmental context but is instead crucially dependent upon it.
There is a suicide on the British railways every 36 hours. However, the reasons why people choose to die by train are not well understood.
To explore factors influencing and discouraging the decision to attempt suicide on the railway networks.
We conducted an online survey and qualitative interviews with individuals who had contemplated or attempted suicide by train.
A total of 353 survey responders had considered and 23 had attempted suicide at rail locations (including railways and metro/underground); a third of these cases were impulsive. The most frequently reported motivations for contemplating or attempting suicide were perceptions of quick and certain lethality (54 and 37%, respectively) and easy access to rail settings (33 and 38%, respectively). The main factor discouraging people from rail suicide was its wider impact, especially on train drivers (19%). In qualitative interviews (N = 34) the desire to avoid intervention from others was also a common motivating factor for attempting suicide on the railway networks.
People attempt suicide by train because railway settings are easy to access and because of an inaccurate perception of certain and quick lethality. Tackling exaggerated perceptions of lethality may help reduce suicides by train.
Like many humanists of the late fifteenth century, Cristoforo Landino (1425-1498) came to consider himself not only a rhetorician but a speculative philosopher as well. Like many of these same humanists, Landino would not allow himself to peddle the merely fashionable: he pretended that he had been drinking from philosophical founts since his youth. In his dialogue De anima, completed about 1471, Landino suggested that from the early 1450s he not only was receiving systematic training in natural philosophy from Carlo Marsuppini but also was learning some Plato from the teenager Marsilio Ficino.