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Secure forensic mental health services treat patients with high rates of treatment-resistant psychoses. High rates of obesity and medical comorbidities are common. Population-based studies have identified high-risk groups in the event of SARS-CoV-2 infection, including those with problems such as obesity, lung disease and immune-compromising conditions. Structured assessment tools exist to ascertain the risk of adverse outcome in the event of SARS-CoV-2 infection.
To assess risk of adverse outcome in the event of SARS-CoV-2 infection in a complete population of forensic psychiatry patients using structured assessment tools.
All patients of a national forensic mental health service (n = 141) were rated for risk of adverse outcome in the event of SARS-CoV-2 infection, using two structured tools, the COVID-Age tool and the COVID-Risk tool.
We found high rates of relevant physical comorbidities. Mean chronological age was 45.5 years (s.d. = 11.4, median 44.1), mean score on the COVID-Age tool was 59.1 years (s.d. = 19.4, median 58.0), mean difference was 13.6 years (s.d. = 15.6), paired t = 10.9, d.f. = 140, P < 0.001. Three patients (2.1%) were chronologically over 70 years of age, compared with 43 (30.5%) with a COVID-Age over 70 (χ2 = 6.99, d.f. = 1, P = 0.008, Fisher's exact test P = 0.027).
Patients in secure forensic psychiatric services represent a high-risk group for adverse outcomes in the event of SARS-COV-2 infection. Population-based guidance on self-isolation and other precautions based on chronological age may not be sufficient. There is an urgent need for better physical health research and treatment in this group.
To determine risk factors for carbapenemase-producing organisms (CPOs) and to determine the prognostic impact of CPOs.
A retrospective matched case–control study.
Inpatients across Scotland in 2010–2016 were included. Patients with a CPO were matched with 2 control groups by hospital, admission date, specimen type, and bacteria. One group comprised patients either infected or colonized with a non-CPO and the other group were general inpatients.
Conditional logistic regression models were used to identify risk factors for CPO infection and colonization, respectively. Mortality rates and length of postisolation hospitalization were compared between CPO and non-CPO patients.
In total, 70 CPO infection cases (with 210 general inpatient controls and 121 non-CPO controls) and 34 CPO colonization cases (with 102 general inpatient controls and 60 non-CPO controls) were identified. Risk factors for CPO infection versus general inpatients were prior hospital stay (adjusted odds ratio [aOR], 4.05; 95% confidence interval [CI], 1.52–10.78; P = .005), longer hospitalization (aOR, 1.07; 95% CI, 1.04–1.10; P < .001), longer intensive care unit (ICU) stay (aOR, 1.41; 95% CI, 1.01–1.98; P = .045), and immunodeficiency (aOR, 3.68; 95% CI, 1.16–11.66; P = .027). Risk factors for CPO colonization were prior high-dependency unit (HDU) stay (aOR, 11.46; 95% CI, 1.27–103.09; P = .030) and endocrine, nutritional, and metabolic (ENM) diseases (aOR, 3.41; 95% CI, 1.02–11.33; P = .046). Risk factors for CPO infection versus non-CPO infection were prolonged hospitalization (aOR, 1.02; 95% CI, 1.00–1.03; P = .038) and HDU stay (aOR, 1.13; 95% CI, 1.02–1.26; P = .024). No differences in mortality rates were detected between CPO and non-CPO patients. CPO infection was associated with longer hospital stay than non-CPO infection (P = .041).
A history of (prolonged) hospitalization, prolonged ICU or HDU stay; ENM diseases; and being immunocompromised increased risk for CPO. CPO infection was not associated with increased mortality but was associated with prolonged hospital stay.
Computability is discussed here at length, being the prime example of what Gödel calls formalism independence in his 1946 Princeton Bicentennial Lecture. The emergence of the concept of human effective calculability and of its formal counterpart---simply computability---is traced in the work of Gödel, Chucrh, Hilbert and Bernays, and finally Turing. The reception of Turing’s work on the part of Church and Kleene as well as on the part of Gödel is chronicled.
The philosophical stance of the book is laid out: it is a form of the semantic point of view. The philosophcal morals of the various mathematical stories told in the book are drawn. A final plea to naturalise, historicise and to take, in the end, the side of natural language, is put forward.
Gödel’s suggestion in his 1946 Princeton Bicentennial Lecture, to extend what he characterises as the formalism independence of the concept of computability to definability and provability, are discussed and implenented. The implementation for the concept of definability takes the form of extended constructibility. Possible implementations having to do with provability are also discussed, mainly in connection with informal proof systems involving Gödel’s so-called large cardinal program.
Formalism freeness and logical entanglement are precisely defined. Anticipations of these concepts are cited in the work of Post and Brouwer, as well as in early work of Gödel. Varieties of entanglement and formalism freeness are given, with specific examples taken from set theory: extended constructibility and games; and model theory. Semantic characterisations of metamathematical concepts are discussed at length.
We argue here that Tarski’s conception of “the mathematical” is paradigmatic for model theory, moving foward from Tarski’s work into contemporary practice. The question of when a piece of natural language mathematics has a natural syntax or a natural logic is considered, also in the context of Shelah’s Presentation Theorem. The possibility of laying down a methodology providing a mathematically direct conceptualisation of mathematical content is argued for. The seocnd order logic vs set theory debate is considered, especially focussing on previous attempts to separate the two. Symbiosis is discussed at length as providing a solution to the problem of the entaglement of second order logic with set theory.
Tarski’s conception of what he calls “the mathematical” is analysed at length. We carve out what we see as the philosophy of the logical work, going on to categorise this philosophical position as a form of naturalism. We suggest that the logic-philosohical framework underpinning Tarski’s approach to metamathematics can take the form of squeezing arguments. We then take up the contemporary debate on logicality, inspired as it was by Tarski’s invariance criterion. Gil Sagi’s work on logicality is discussed as well that that of Feferman, McGee and others. An improvement of McGee's theorem is presented.
The central concepts of the book are introduced: formalism freeness and logical entanglement. The stability of the syntax/semantics distinction is discussed, as is J. Burgess’s distinction between formal and linguistic semantics. A special kind of logical pluralism is introduced, and likened to the theme of multi-scalarity as defined in Mark Wilson’s work.
This Element examines an increasingly important community crime prevention strategy - focused deterrence. This strategy seeks to change offender behavior by understanding underlying crime-producing dynamics and conditions that sustain recurring crime problems, and implementing a blended set of law enforcement, community mobilization, and social service actions. The approach builds on recent theorizing on optimizing deterrence, mobilizing informal social control, enhancing police legitimacy, and reducing crime opportunities through situational crime prevention. There are three main types of focused deterrence strategies: group violence intervention programs, drug market intervention programs, and individual offender programs. A growing number of rigorous program evaluations find focused deterrence to be an effective crime prevention strategy. However, a number of steps need to be taken to ensure focused deterrence strategies are implemented properly. These steps include creating a network of capacity through partnering agencies, conducting upfront and ongoing problem analysis, and developing accountability structures and sustainability plans.
To describe epidemiologic and genomic characteristics of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in a large skilled nursing facility (SNF), and the strategies that controlled transmission.
Design, Setting, and Participants:
Cohort study during March 22–May 4, 2020 of all staff and residents at a 780-bed SNF in San Francisco, California.
Contact tracing and symptom screening guided targeted testing of staff and residents; respiratory specimens were also collected through serial point prevalence surveys (PPS) in units with confirmed cases. Cases were confirmed by real-time reverse transcription–polymerase chain reaction testing for SARS-CoV-2; whole genome sequencing (WGS) characterized viral isolate lineages and relatedness. Infection prevention and control (IPC) interventions included restricting from work any staff who had close contact to a confirmed case; restricting movements between units; implementing surgical face masking facility-wide; and recommended PPE (isolation gown, gloves, N95 respirator and eye protection) for clinical interactions in units with confirmed cases.
Of 725 staff and residents tested through targeted testing and serial PPS, twenty-one (3%) were SARS-CoV-2-positive; sixteen (76%) staff and 5 (24%) residents. Fifteen (71%) were linked to a single unit. Targeted testing identified 17 (81%) cases; PPS identified 4 (19%). Most (71%) cases were identified prior to IPC intervention. WGS was performed on SARS-CoV-2 isolates from four staff and four residents; five were of Santa Clara County lineage and the three others were distinct lineages.
Early implementation of targeted testing, serial PPS, and multimodal IPC interventions limited SARS-CoV-2 transmission within the SNF.
The two key aspects of water infrastructure – engineered and human – in mid-nineteenth-century Rio de Janeiro are the foci of this article. On the one hand, gravity flow engineering brought fresh water from the Tijuca Forest to the fountains in the city, but on the other, hundreds of slaves carried heavy jugs of water from the fountains though the streets to residences. Using the account of Thomas Ewbank (1856), georeferenced historical maps and a field study, this article first reconstructs the route of the Carioca Aqueduct, then, using the accounts of Ewbank and other travellers, turns to the delivery of water in the city by enslaved water carriers.
In this chapter I summarize sociological literature on sustainable consumption. This review showcases, in public discourse, the prominence of consumer-focussed solutions and, in academic research, the predominance of relatively individualistic theories of engagement in sustainable consumption practices. Regarding public discourse, I note that despite compelling evidence that environmental issues from climate change to biodiversity loss are shaped by cultural and institutional dynamics like norms, state policy, and urban design, individual consumption choices are subject to much scrutiny in the public sphere. Regarding academic research, I suggest that social practice theories offer a valuable alternative to understand individual motivations in the context of broader social structures. Relatedly, I outline two related problems with mainstream, contemporary sustainable consumption. The material problem is that individual sustainable consumption activities like buying a hybrid car are largely unrelated to individuals’ environmental impact. This is closely tied to the second, symbolic, challenge—like any social practice, sustainable consumption is built upon class, gender, and race inequality. Inattention to these axioms of inequality constitutes a threat to the pursuit of a just sustainability. The chapter concludes with a discussion of future research directions on sustainable consumption, a rich and timely area of environmental sociological scholarship.