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Despite the frequency that refugees suffer bereavement, there is a dearth of research into the prevalence and predictors of problematic grief reactions in refugees. To address this gap, this study reports a nationally representative population-based study of refugees to determine the prevalence of probable prolonged grief disorder (PGD) and its associated problems.
This study recruited participants from the Building a New Life in Australia (BNLA) prospective cohort study of refugees admitted to Australia between October 2013 and February 2014. The current data were collected in 2015–2016, and comprised 1767 adults, as well as 411 children of the adult respondents. Adult refugees were assessed for trauma history, post-migration difficulties, probable PGD, post-traumatic stress disorder (PTSD) and mental illness. Children were administered the Strengths and Difficulties Questionnaire.
In this cohort, 38.1% of refugees reported bereavement, of whom 15.8% reported probable PGD; this represents 6.0% of the entire cohort. Probable PGD was associated with a greater likelihood of mental illness, probable PTSD, severe mental illness, currently unemployed and reported disability. Children of refugees with probable PGD reported more psychological difficulties than those whose parents did not have probable PGD. Probable PGD was also associated with the history of imprisonment, torture and separation from family. Only 56.3% of refugees with probable PGD had received psychological assistance.
Bereavement and probable PGD appear highly prevalent in refugees, and PGD seems to be associated with disability in the refugees and psychological problems in their children. The low rate of access to mental health assistance for these refugees highlights that there is a need to address this issue in refugee populations.
In March 2017, the New Jersey Department of Health received reports of 3 patients who developed septic arthritis after receiving intra-articular injections for osteoarthritis knee pain at the same private outpatient facility in New Jersey. The risk of septic arthritis resulting from intra-articular injection is low. However, outbreaks of septic arthritis associated with unsafe injection practices in outpatient settings have been reported.
An infection prevention assessment of the implicated facility’s practices was conducted because of the ongoing risk to public health. The assessment included an environmental inspection of the facility, staff interviews, infection prevention practice observations, and a medical record and office document review. A call for cases was disseminated to healthcare providers in New Jersey to identify patients treated at the facility who developed septic arthritis after receiving intra-articular injections.
We identified 41 patients with septic arthritis associated with intra-articular injections. Cultures of synovial fluid or tissue from 15 of these 41 case patients (37%) recovered bacteria consistent with oral flora. The infection prevention assessment of facility practices identified multiple breaches of recommended infection prevention practices, including inadequate hand hygiene, unsafe injection practices, and poor cleaning and disinfection practices. No additional cases were identified after infection prevention recommendations were implemented by the facility.
Aseptic technique is imperative when handling, preparing, and administering injectable medications to prevent microbial contamination.
This investigation highlights the importance of adhering to infection prevention recommendations. All healthcare personnel who prepare, handle, and administer injectable medications should be trained in infection prevention and safe injection practices.
A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.
This study considers the relationships between first-year law students' admission credentials, the amount of time they spend in study, and the grades they receive on examination. Findings include that there is a significant drop in effort during the first year, that while effort invested in study pays off in improved grades this effort is much less significant in explaining grades than is student ability as measured by LSAT and undergraduate grades, that students in the middle and bottom of the class are helped more by substantial study than are those in the top, that class attendance is much more valuable in raising grades than is equivalent time in other study, and that none of the various study techniques examined could be linked with major differences in results.
Objectives: Caregivers of youth with heavy prenatal alcohol exposure report impaired communication, which can significantly impact quality of life. Using data collected as part of the Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD), we examined whether cognitive variables predict communication ability of youth with histories of heavy prenatal alcohol exposure. Methods: Subjects (ages 10–16 years) comprised two groups: adolescents with heavy prenatal alcohol exposure (AE) and non-exposed controls (CON). Selected measures of executive function (NEPSY, Delis-Kaplan Executive Function System), working memory (CANTAB), and language were tested in the child, while parents completed communication ratings (Vineland Adaptive Behavior Scales – Second Edition). Separate multiple regression analyses determined which cognitive domains predicted communication ability. A final, global model of communication comprised the three cognitive models. Results: Spatial Working Memory and Inhibition significantly contributed to communication ability across groups. Twenty Questions performance related to communication ability in the CON group only while Word Generation performance related to communication ability in the AE group only. Effects remained significant in the global model, with the exception of Spatial Working Memory. Conclusions: Both groups displayed a relation between communication and Spatial Working Memory and Inhibition. Stronger communication ability related to stronger verbal fluency in the AE group and Twenty Questions performance in the CON group. These findings suggest that alcohol-exposed adolescents may rely more heavily on learned verbal storage or fluency for daily communication while non-exposed adolescents may rely more heavily on abstract thinking and verbal efficiency. Interventions aimed at aspects of executive function may be most effective at improving communication ability of these individuals. (JINS, 2018, 24, 1026–1037)
Palaeoecology has been prominent in studies of environmental change during the Holocene epoch in Scotland. These studies have been dominated by palynology (pollen, spore and related bio-and litho-stratigraphic analyses) as a key approach to multi- and inter-disciplinary investigations of topics such as vegetation, climate and landscape change. This paper highlights some key dimensions of the pollen- and vegetation-based archive, with a focus upon woodland dynamics, blanket peat, human impacts, biodiversity and conservation. Following a brief discussion of chronological, climatic, faunal and landscape contexts, the migration, survival and nature of the woodland cover through time is assessed, emphasising its time-transgressiveness and altitudinal variation. While agriculture led to the demise of woodland in lowland areas of the south and east, the spread of blanket peat was especially a phenomenon of the north and west, including the Western and Northern Isles. Almost a quarter of Scotland is covered by blanket peat and the cause(s) of its spread continue(s) to evoke recourse to climatic, topographic, pedogenic, hydrological, biotic or anthropogenic influences, while we remain insufficiently knowledgeable about the timing of the formation processes. Humans have been implicated in vegetational change throughout the Holocene, with prehistoric woodland removal, woodland management, agricultural impacts arising from arable and pastoral activities, potential heathland development and afforestation. The viability of many current vegetation communities remains a concern, in that Scottish data show reductions in plant diversity over the last 400 years, which recent conservation efforts have yet to reverse. Palaeoecological evidence can be used to test whether conservation baselines and restoration targets are appropriate to longer-term ecosystem variability and can help identify when modern conditions have no past analogues.
In 785 mother–child (50% male) pairs from a longitudinal epidemiological birth cohort, we investigated associations between inflammation-related epigenetic polygenic risk scores (i-ePGS), environmental exposures, cognitive function, and child and adolescent internalizing and externalizing problems. We examined prenatal and postnatal effects. For externalizing problems, one prenatal effect was found: i-ePGS at birth associated with higher externalizing problems (ages 7–15) indirectly through lower cognitive function (age 7). For internalizing problems, we identified two effects. For a prenatal effect, i-ePGS at birth associated with higher internalizing symptoms via continuity in i-ePGS at age 7. For a postnatal effect, higher postnatal adversity exposure (birth through age 7) associated with higher internalizing problems (ages 7–15) via higher i-ePGS (age 7). Hence, externalizing problems were related mainly to prenatal effects involving lower cognitive function, whereas internalizing problems appeared related to both prenatal and postnatal effects. The present study supports a link between i-ePGS and child and adolescent mental health.
Emerging research in epigenetics has shown that there is variability in how environmental exposures “get under the skin” through mechanisms like DNA methylation to influence gene expression that may lead to differential adaptations to stress. This is the first study to examine prospectively the relationship between DNA methylation at birth and resilience to prenatal environmental stressors in several domains (conduct, hyperactivity, emotional problems, and global symptomatology) in middle childhood. We focused on DNA methylation in the vicinity of the oxytocin receptor (OXTR) gene as it has been previously associated with impairments in social–cognitive processes that may underlie a wide range of childhood psychopathology. Participants were 91 youth exposed to pre- and postnatal adversity with established conduct problem trajectories drawn from the Avon Longitudinal Study of Parents and Children. Consistent with our hypothesis, OXTR DNA methylation was predictive of resilience in the conduct problems domain in middle childhood. DNA methylation profiles did not predict resilience in domains of emotional, hyperactivity, and global symptomatology, suggesting a potential role for OXTR in the development of conduct problems in particular. However, individuals who were resilient to conduct problems were also broadly resilient across multiple domains. Therefore, future research should elucidate the biological pathways between OXTR DNA methylation and gene expression and its relation to impairments in social behavior.
The immediate postweaning period in pigs is often characterised by a reduced and variable food intake, digestive disorders and poor growth and development. Historically such effects were reduced by the use of in-feed antibiotic growth promoters (AGPs), copper sulphate and zinc oxide to enhance the efficiency of feed conversion and hence maximise nutrient capture. However from January 2006 the routine use of in-feed AGPs was banned and, due to concern over environmental pollution, levels of inclusion of heavy metals are limited by regulation and likely to be further reduced in the future. Weaning pigs at a later age has been suggested as an approach to reduce the potentially negative effects of the AGP ban on the national herd. The objective of the AGEWEAN programme of research was to investigate the effects of weaning age (4, 6 and 8 weeks) in both an indoor and outdoor lactation environment on the biological and economic efficiency of production where diets contain no AGPs and lower levels of copper (<25ppm added) and zinc (<100ppm added).
There is a need to identify finishing systems for pigs that meet the requirements of both pig producers and society. These require that a system is economically efficient, but also takes due account of animal welfare, food safety and environmental considerations. As part of an integrated investigation, this study assessed the health and welfare implications of giving pigs either dry or liquid feed when housed in either fully-slatted or straw-based accommodation.
As part of a project to investigate the flow of ice at low effective stress, two independent strain-gauge systems were used to measure vertical strain rate as a function of depth and time at Siple Dome, Antarctica. The measurements were made from January 1998 until January 2002 at the ice divide and a site 7km to the northeast on the flank. The strain-rate profiles place constraints on the rheology of ice at low stress, show the expected differences between divide and flank flow (with some structure due to firn compaction and probably ice stratigraphy), and suggest that the flow of the ice sheet has not changed much in the last 8.6 kyr. The strain rates show an unexpected time dependence on scales ranging from several months to hours, including discrete summer events at the divide. Time dependence in strain rate, water pressure, seismicity, velocity and possibly basal motion has been seen previously on the Siple Coast ice streams, but it is especially surprising on Siple Dome because the bed is cold.
The properties of ultraviolet interstellar extinction in and near the core of the 30 Doradus Nebula are studied. The pair method is employed using nine reddened stars from within 5′ (80pc) of the core and nine unreddened stars from a variety of locations in the large Magellanic Cloud. All of the 30 Doradus stars examined appear to be reddened by E(B-V) ⋍ 0.12 with an extinction law similar in wavelength dependence to those derived for the LMC by Koornneef and Code (1981) and Nandy et al. (1981). Several of the stars, including R136a, R145 and R147, are found to be additionally reddened by E(B-V) ⋍ 0.18 with an extinction law qualitatively similar in wavelength dependence to the law found in the Orion region. A two-component model, featuring a layer of “LMC foreground dust” which affects all of the stars and a deeper layer of “nebular dust” which affects some of the stars, provides the simplest explanation of the extinction properties. The 2200 Å extinction bump is present in both curves. The wavelength positions of the bump and the bump profiles, when normalized to a linear “background extinction”, are indistinguishable from the average Galactic bump. The strengths of the bumps, relative to E(B-V), are 20–30% weaker than for the Milky Way Curve.
An antenna in geostationary orbit was used for VLBI observations at 2.3 GHz, in combination with ground antennas in Australia and Japan. 23 of the 25 observed sources were detected on orbiter-ground baselines, with baseline lengths as large as 2.15 earth diameters. Brightness temperatures between 1012 K and 4 × 1012 K were measured for 10 sources.
Early-onset conduct problems (CP) are a key predictor of adult criminality and poor mental health. While previous studies suggest that both genetic and environmental risks play an important role in the development of early-onset CP, little is known about potential biological processes underlying these associations. In this study, we examined prospective associations between DNA methylation (cord blood at birth) and trajectories of CP (4–13 years), using data drawn from the Avon Longitudinal Study of Parents and Children. Methylomic variation at seven loci across the genome (false discovery rate < 0.05) differentiated children who go on to develop early-onset (n = 174) versus low (n = 86) CP, including sites in the vicinity of the monoglyceride lipase (MGLL) gene (involved in endocannabinoid signaling and pain perception). Subthreshold associations in the vicinity of three candidate genes for CP (monoamine oxidase A [MAOA], brain-derived neurotrophic factor [BDNF], and FK506 binding protein 5 [FKBP5]) were also identified. Within the early-onset CP group, methylation levels of the identified sites did not distinguish children who will go on to persist versus desist in CP behavior over time. Overall, we found that several of the identified sites correlated with prenatal exposures, and none were linked to known genetic methylation quantitative trait loci. Findings contribute to a better understanding of epigenetic patterns associated with early-onset CP.
We present results from a multiwavelength study of the blazar PKS 1954–388 at radio, UV, X-ray, and gamma-ray energies. A RadioAstron observation at 1.66 GHz in June 2012 resulted in the detection of interferometric fringes on baselines of 6.2 Earth-diameters. This suggests a source frame brightness temperature of greater than 2 × 1012 K, well in excess of both equipartition and inverse Compton limits and implying the existence of Doppler boosting in the core. An 8.4-GHz TANAMI VLBI image, made less than a month after the RadioAstron observations, is consistent with a previously reported superluminal motion for a jet component. Flux density monitoring with the Australia Telescope Compact Array confirms previous evidence for long-term variability that increases with observing frequency. A search for more rapid variability revealed no evidence for significant day-scale flux density variation. The ATCA light-curve reveals a strong radio flare beginning in late 2013, which peaks higher, and earlier, at higher frequencies. Comparison with the Fermi gamma-ray light-curve indicates this followed ~ 9 months after the start of a prolonged gamma-ray high-state—a radio lag comparable to that seen in other blazars. The multiwavelength data are combined to derive a Spectral Energy Distribution, which is fitted by a one-zone synchrotron-self-Compton (SSC) model with the addition of external Compton (EC) emission.
EURO-GANEX aims to recycle both major and minor actinides. As the final waste
composition is free from actinides, adapted immobilization matrices should be
developed. Synroc is a potential wasteform that has proven itself to be
efficient in immobilizing high-level wastes (HLW). In this study, a new
composition of Synroc, Synroc-Z, is designed and characterized. The key
modification is in decreasing the amount of zirconolite phase, which is the main
host phase for actinides and increasing the amount of other phases (hollandite
and perovskite). As designed the obtained amount of zirconolite is lower than in
Synroc-C compositions. Synroc-Z samples were synthesized with a waste loading of
20 wt.% at various temperatures and pressures via hot-pressing to determine the
optimum process parameters, which were determined to be 1150-1200°C and
20 MPa, respectively.