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OBJECTIVES/GOALS: To explore the severity of posttraumatic stress disorder (PTSD) symptoms in association with hippocampal and amygdala volumes in ICU survivors. We hypothesize that the severity of posttraumatic stress symptoms in ICU survivors is associated with lower volumes of both the hippocampus and amygdala. METHODS/STUDY POPULATION: Secondary analysis of the VISIONS study, a prospective sub-study of the BRAIN-ICU cohort, which included survivors of critical illness. Patients were screened for preexisting PTSD before discharge. The PTSD Checklist Specific (PCL-S) was used at 3 and 12 months to evaluate the ICU as a traumatic experience. A score of >30, indicated significant symptoms of PTSD. A Philips Achieva 3T MRI scanner was used to scan patients at both discharge and 3-month follow-up. To compare median brain volumes at discharge and 3 months for those with and without significant PTSD symptomatology (PCL-S ≥30) at 3 and 12 months, we used a Kruskal-Wallis (KW) equality-of-populations rank test. RESULTS/ANTICIPATED RESULTS: The median age for our sample was 58.5 (52.6, 63.7). One-third of the sample was female, and 90% were Caucasian. Fifty-seven percent of individuals (N = 12) had at least one prior mental health diagnosis, with two having a prior history of PTSD. One third of individuals experienced delirium during their critical illness. At 3-month follow up, there were three patients with PTSD symptomatology and one at 12-month follow up. Median brain volumes (hippocampus or amygdala) did not differ between individuals with or without PTSD symptomatology at either 3 or 12 months (p-values for all tests >0.05). DISCUSSION/SIGNIFICANCE OF IMPACT: Although our study did not reveal significant differences in brain volumes between PTSD patients and non-PTSD patients, sample size is a major limitation and larger scale studies should be undertaken to elucidate possible neurobiological markers of PTSD in ICU survivors. CONFLICT OF INTEREST DESCRIPTION: Dr. Wilson would like to acknowledge salary support from the Vanderbilt Faculty Research Scholars Program (1KL2TR002245), HL111111 and GM120484. Drs. Ely and Jackson as well as Mrs. Kiehl all receive funding for their time working on this investigation from AG035117 and HL111111. Dr. Ely would additionally like to acknowledge salary support from the Tennessee Valley Healthcare System Geriatric Research Education and Clinical Center (GRECC). Dr. Ely will also disclose additional funding for his time from AG027472 and having received honoraria from Orion and Hospira for CME activity; he does not hold stock or consultant relationships with those companies. The authors would like to acknowledge the following: this work was conducted in part using the resources of the Center for Computational Imaging at Vanderbilt University Institute of Imaging Science and the Advanced Computing Center for Research and Education at Vanderbilt University, Nashville, TN, and study data were collected and managed using REDCap electronic data capture tools hosted at Vanderbilt University.
Determining best practices for managing free farrowing systems is crucial for uptake. Cross-fostering, the exchange of piglets between litters, is routinely performed amongst crate-housed sows. However, cross-fostering can increase fighting amongst the litter and may be more challenging within free farrowing systems as sows have more freedom to respond to cross-fostered piglets. This study compared the effect of either cross-fostering (FOS), or a control of sham-fostering (CON), of four focal piglets per litter on Day 6 postpartum in crates (CRATE) and free farrowing pens (PEN). The post-treatment behavioural responses of sows were recorded (Day 6 = 60 min; Day 7 = 300 min; n = 48), as were the average daily gain (ADG; g/day), total weight gain (TWG; kg) and body lesion scores of focal piglets and their littermates throughout lactation (Day 6, Day 8, Day 11 and Day 26; n = 539) and the post-weaning period (Day 29, Day 32 and Day 60; n = 108). On Day 6, though post-reunion latency to nursing did not differ, latency to successful nursing was longer amongst FOS than CON litters (P < 0.001), more so amongst CRATE FOS than PEN FOS (P < 0.01). On Day 7, PEN FOS sows had fewer successful nursing bouts (P < 0.05) and exhibited decreased lateral (P < 0.01) and increased ventral lying frequencies (P < 0.01) compared to all other housing and treatment combinations. Focal piglet ADG was lower for FOS than CON in the CRATE during Day 6 to Day 8 (P < 0.01) and lower in the PEN during Day 6 to Day 8 (P < 0.001), Day 8 to Day 11 (P < 0.01) and Day 11 to Day 26 (P < 0.05). The TWG of pre-weaned focal piglets (Day 6 to Day 26) was higher amongst CON than FOS litters (P = 0.01). Post-weaning, piglet ADG was higher for PEN than CRATE during Day 26 to Day 29 (P < 0.01) and higher for FOS than CON during Day 26 to Day 29 (P < 0.05), Day 29 to Day 32 (P < 0.001) and Day 32 to Day 60 (P < 0.01); thus, TWG was higher for FOS than CON during the weaner (P = 0.001) and the combined lactation and weaner periods (P = 0.09). In conclusion, sow behaviour was disrupted by cross-fostering in the crates and pens and continued to be disturbed on the following day amongst penned sows. FOS piglets exhibited reduced ADG after cross-fostering, which extended throughout lactation in the pens. However, the increased post-weaning weight gain of FOS piglets meant that their TWG was higher than CON piglets, irrespective of the farrowing system used.
Globalisation and the mixing of people, cultures, religions and languages fuels pressing healthcare, educational, political and other complex sociocultural issues. Many of these issues are driven by society's struggle to find ways to facilitate deeper and more emotionally meaningful ways to help people connect and overcome the empathy gap which keeps various groups of people apart. This paper presents a process to design for empathy – as an outcome of design. This extends prior work which typically looks at empathy for design – as a part of the design process, as is common in inclusive design and human centered design process. We reflect on empathy in design and challenge the often internalised role of the designer to be more externalised, to shift from an empathiser to become an empathy generator. We develop and demonstrate the process to design for empathy through a co-creation case study aiming to bring empathy into politics. The ongoing project is set in the Parliament of Finland, and involves co- creation with six Members of the Parliament from five political parties. Outcomes of the process and case study are discussed, including design considerations for future research.
Nurse sow strategies are used to manage large litters on commercial pig farms. However, new-born piglets transferred to nurse sows in late lactation might be compromised in terms of growth and survival. We investigated the effects of two nurse sow strategies on piglet growth, suckling behaviour and sow nursing behaviour. At 1-day post-farrowing, the four heaviest piglets from large litters were transferred to a nurse sow either 21 (1STEP21, n=9 litters) or 7 (2STEP7, n=10 litters) days into lactation. The remainder of the litter remained with their mother and was either kept intact (remain intact (RI), n=10 litters) or had some piglets cross-fostered to equalise birth weights (remain equalised (RE), n=9 litters). The 7-day-old piglets from 2STEP7 were transferred onto a sow 21 days into lactation (2STEP21, n=10 litters). The growth of new-born piglets on 1STEP21 and 2STEP7 nurse sows was initially lower than in RI litters (F3,33.8=4.61; P<0.01), but weaning weights did not significantly differ (F4,32.7=0.78; P>0.5). After the 1st week of lactation, the weights and growth rates did not differ between treatments. Fighting behaviour during nursing bouts decreased over time. The frequency of fights was higher in 1STEP21 and 2STEP21 litters compared with RI litters (t122=3.06 and t123=3.00, respectively, P<0.05). The 2STEP21 litters had shorter nursing bouts than RI and 1STEP21 litters (t107=−2.81 and t81.7=2.8, respectively, P<0.05), which were more frequently terminated by 2STEP21 than RI sows (t595=2.93; P<0.05). Transferring heaviest piglets from RI and RE litters to nurse sows reduced the percentage of teat changes during nursing bouts (RI: F1,275=16.61; RE: F1,308=43.59; P<0.001). In conclusion, nurse sow strategies do not appear to compromise piglet growth. However, new-born piglets transferred onto sows in late lactation experienced more competition at the udder, suggesting that the sows’ stage of lactation is of importance to how achievable nurse sow strategies are. Thus, the two-step nurse sow strategy is likely the best option (in relation to growth and suckling behaviour), as it minimises the difference between piglet age and sow stage of lactation.
Management strategies are needed to optimise the number of piglets weaned from hyper-prolific sows. Nurse sow strategies involve transferring supernumerary new-born piglets onto a sow whose own piglets are either weaned or fostered onto another sow. Such ‘nurse sows’ have extended lactations spent in farrowing crates, which could have negative implications for their welfare. This study used 47 sows, 20 of which farrowed large litters and had their biggest piglets fostered onto nurse sows which were either 1 week (2STEP7, n=9) or 3 weeks into lactation (1STEP21, n=10). Sows from which piglets were removed (R) were either left with the remainder of the litter intact (I) (remain intact (RI) sows, n=10), or had their litters equalised (E) for birth weight using piglets of the same age from non-experimental sows (remain equalised (RE) sows, n=9). Piglets from 2STEP7 were fostered onto another nurse sow which was 3 weeks into lactation (2STEP21, n=9). Back-fat thickness was measured at entry to the farrowing house, at fostering (nurse sows only) and weaning. Sows were scored for ease of locomotion and skin and claw lesions at entry to the farrowing house and weaning. Salivary cortisol samples were collected and tear staining was scored at 0900 h weekly from entry until weaning. Saliva samples were also taken at fostering. Data were analysed using GLMs with appropriate random and repeated factors, or non-parametric tests were applied where appropriate. Back-fat thickness decreased between entry and weaning for all sows (F1,42=26.59, P<0.001) and tended to differ between treatments (F4,16=2.91; P=0.06). At weaning RI sows had lower limb lesion scores than 2STEP7 and RE sows (χ24=10.8, P<0.05). No treatment effects were detected on salivary cortisol concentrations (P>0.05) and all nurse sows had a higher salivary cortisol concentration at fostering, compared with the other days (F10,426=3.47; P<0.05). Acute effects of fostering differed between nurse sow treatments (F2,113=3.45, P<0.05); 2STEP7 sows had a higher salivary cortisol concentration than 1STEP21 and 2STEP21 sows on the day of fostering. 2STEP7 sows had a higher salivary cortisol concentration at fostering, compared with 1STEP21 and 2STEP21 sows. Tear staining scores were not influenced by treatment (P>0.05). In conclusion, no difference was detected between nurse sows and non-nurse sows in body condition or severity of lesions. Although some nurse sows experienced stress at fostering, no long-term effect of the nurse sow strategies was detected on stress levels compared with sows that raised their own litter.
There is currently a lack of research investigating the effectiveness of commercial broiler enrichments, and in particular the ability of these additions to create opportunities for positive welfare. One aim of this study was to investigate whether offering broiler chickens enrichments that have recently been found to be preferred leads to increased levels of activity. A second aim was to investigate the emotional effects of provision of these enrichments by assessing levels of fearfulness and play-like activity. Commercially housed broilers were assigned to treatment houses containing either: (1) platform perches, (2) platform perches+peat dust baths, (3) no enrichment (control). Activity levels and play behaviours in unenriched areas of the house were measured in weeks 3, 4 and 5. Levels of active behaviours, such as foraging and locomotion, were determined from video recordings of undisturbed birds in unenriched areas of the house. To stimulate play-like behaviours an observer walked through the birds, displacing them and creating a space. The broilers using the space were then filmed for 5 min and the occurrences of frolicking, sparring and food-running were recorded. Fearfulness of broilers in unenriched areas of the house, and also when using enrichments, was measured using observer avoidance tests in week 5. We found that creating space among the broilers was a successful method of stimulating play (largely sparring and frolicking), with play being observed in 93% of videos, however the presence of enrichments did not have an effect on the level of play recorded (P>0.05). There was also no treatment effect on activity levels of broilers in unenriched areas (P>0.05), however levels of overall activity decreased as broilers aged. Compared with the control, flight distances in unenriched areas were significantly lower in the perches+dust bath treatment (P=0.026), and were numerically lower in the perches treatment. This suggests a reduction in fearfulness with increased environmental complexity, and thus possible welfare benefits. It is suggested that further research should investigate whether increasing the level of provision of these enrichments leads to more marked improvements in welfare.
Producers are interested in utilising farrowing systems with reduced confinement to improve sow welfare. However, concerns of increased mortality may limit commercial uptake. Temporary confinement systems utilise a standard crate which is opened 3 to 7 days postpartum, providing protection for neonatal piglets at their most vulnerable age and later increased freedom of movement for sows. However, there is anecdotal evidence that piglet mortality increases immediately after the temporary crate is opened. The current study aims were to determine if piglet mortality increases post-opening, to trial different opening techniques to reduce post-opening piglet mortality and to identify how the different opening techniques influence sow behaviour. Three opening treatments were implemented across 416 sows: two involved opening crates individually within each farrowing house when each litter reached 7 days of age, in either the morning or afternoon (AM or PM), with a control of the standard method used on the farm to open all crates in each farrowing house simultaneously once the average litter age reached 7 days (ALL). Behavioural observations were performed on five sows from each treatment during the 6 h after crate opening, and during the same 6 h period on the previous and subsequent days. Across all treatments, piglet mortality was significantly higher in the post-opening than pre-opening period (P<0.0005). Between opening treatments, there were significant differences in piglet mortality during the 2 days after crate opening (P<0.05), whilst piglet mortality also tended to differ from crate opening until weaning (P=0.052), being highest in ALL and lowest in PM. Only sows in the PM treatment showed no increase in standing behaviour but did show an increased number of potentially dangerous posture changes after crate opening (P=0.01), which may be partly attributed to the temporal difference in observation periods. Sow behaviour only differed between AM and ALL on the day before crate opening, suggesting the AM treatment disrupted behaviour pre-opening. Sows in AM and PM treatments showed more sitting behaviour than ALL, and therefore may have been more alert. In conclusion, increases in piglet mortality after crate opening can be reduced by opening crates individually, more so in the afternoon. Sow habituation to disturbance before crate opening may have reduced post-opening piglet mortality, perhaps by reducing the difference in pre- and post-opening sow behaviour patterns.
Global interest in alternative indoor farrowing systems is increasing, leading to a growing number of farms utilising such systems alongside standard crates. There is evidence that interchanging sows between different farrowing systems affects maternal behaviour, whilst the subsequent effect of this on piglet mortality is unknown. The current study hypothesised that second parity piglet mortality would be higher if a sow farrowed in a different farrowing system to that of her first parity. Retrospective farm performance records were used from 753 sows during their first and second parities. Sows farrowed in either standard crates (crates), temporary crates (360s) or straw-bedded pens (pens), with mortality recorded as occurring either pre- or post-processing. Inter- and intra-parity sow consistency in performance were also investigated. Overall, total piglet mortality reduced from the first to the second parity, being significantly higher in the crates and higher in the 360s during the first or second parity, respectively. In the second parity, an interaction of the current and previous farrowing systems resulted in the lowest incidence of crushing for sows housed in the same system as their first parity for the crates and pens, but not the 360s. Post-processing mortality was significantly higher in the crates if a sow previously farrowed in the 360s and vice versa. Sows which previously farrowed in a pen had a significantly larger litter size and lower pre-processing mortality from crushing in their second parity than sows previously housed in the crates or the 360s. No inter-parity consistency of sow performance was found, whilst intra-parity consistency was found in the first but not second parity. In conclusion, returning sows to the same farrowing system appears to reduce piglet mortality, whilst farrowing in a pen during the first parity significantly increased second parity litter size without increasing piglet mortality.
Provision of an appropriate dustbathing substrate may allow broiler chickens to satisfy a natural motivation and give them an opportunity to exercise. The main aim of this study was to evaluate the extent to which different substrates promote dustbathing behaviour in broilers. The trial was replicated over three production cycles in one commercial broiler house, with ~22 000 Ross broilers housed per cycle. The birds were provided with access to five experimental substrates from day 10 of the 6-week production cycle. The substrates included the following: (1) peat (P), (2) oat hulls (OH), (3) straw pellets (SP), (4) clean wood shavings (WS), and (5) litter control (C). The substrates were provided in 15 steel rings (1.1 m in diameter, three rings per substrate) dispersed throughout the house. The level of occupancy of the rings, behaviours performed in each substrate, and the effect of ring position (central or edge of house) were assessed in weeks 3, 4, 5 and 6 using scan sampling from video footage. Where substrates successfully promoted dustbathing, the length and components of the bouts (including number of vertical wing shakes and ground pecks) were also assessed. Results showed that birds used P significantly more than the remaining substrates for dustbathing (P<0.001). Oat hulls were the second most preferred substrate for dustbathing, with significantly more birds dustbathing in the OH compared with SP, WS and C (P<0.001). The least sitting inactive was also seen in the P and OH rings compared with the SP, WS and C (P<0.001). The highest levels of foraging were recorded in the P, OH and WS compared with SP and the C. Position of the rings did not affect the types of behaviours performed in any substrate, although overall more birds were counted in the central compared with edge rings (P=0.001). More detailed information on dustbathing behaviour was only recorded in the P and OH treatments, and there were no differences in the length of dustbathing bout, or components of the bout between them (P>0.05). The use of OH is likely to be more environmentally sustainable than that of P, and our results suggest that this substrate is relatively successful in promoting dustbathing. However, a preference was still observed for P and further work should investigate whether other suitable substrates could better reflect its qualities.
Oregon's Fort Rock Cave is iconic in respect to both the archaeology of the northern Great Basin and the history of debate about when the Great Basin was colonized. In 1938, Luther Cressman recovered dozens of sagebrush bark sandals from beneath Mt. Mazama ash that were later radiocarbon dated to between 10,500 and 9350 cal B.P. In 1970, Stephen Bedwell reported finding lithic tools associated with a date of more than 15,000 cal B.P., a date dismissed as unreasonably old by most researchers. Now, with evidence of a nearly 15,000-year-old occupation at the nearby Paisley Five Mile Point Caves, we returned to Fort Rock Cave to evaluate the validity of Bedwell's claim, assess the stratigraphic integrity of remaining deposits, and determine the potential for future work at the site. Here, we report the results of additional fieldwork at Fort Rock Cave undertaken in 2015 and 2016, which supports the early Holocene occupation, but does not confirm a pre–10,500 cal B.P. human presence.
Children and adolescents make up almost a quarter of the world's population with 85% living in low- and middle-income countries (LMICs). Globally, mental (and substance use) disorders are the leading cause of disability in young people; however, the representativeness or ‘coverage’ of the prevalence data is unknown. Coverage refers to the proportion of the target population (ages 5–17 years) represented by the available data.
Prevalence data for conduct disorder (CD), attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorders (ASDs), eating disorders (EDs), depression, and anxiety disorders were sourced from systematic reviews conducted for the Global Burden of Disease Study 2010 (GBD 2010) and 2013 (GBD 2013). For each study, the location proportion was multiplied by the age proportion to give study coverage. Location proportion was calculated by dividing the total study location population by the total country population. Age proportion was calculated by dividing the population of the country aged within the age range of the study sample by the country population aged 5–17 years. If a study only sampled one sex, study coverage was halved. Coverage across studies was then summed for each country to give coverage by country. This method was repeated at the region and global level, and separately for GBD 2013 and GBD 2010.
Mean global coverage of prevalence data for mental disorders in ages 5–17 years was 6.7% (CD: 5.0%, ADHD: 5.5%, ASDs: 16.1%, EDs: 4.4%, depression: 6.2%, anxiety: 3.2%). Of 187 countries, 124 had no data for any disorder. Many LMICs were poorly represented in the available prevalence data, for example, no region in sub-Saharan Africa had more than 2% coverage for any disorder. While coverage increased between GBD 2010 and GBD 2013, this differed greatly between disorders and few new countries provided data.
The global coverage of prevalence data for mental disorders in children and adolescents is limited. Practical methodology must be developed and epidemiological surveys funded to provide representative prevalence estimates so as to inform appropriate resource allocation and support policies that address mental health needs of children and adolescents.
Children and youth have tended to be under-reported in the historical scholarship. This collection of essays recasts the historical narrative by populating premodern Scottish communities from the thirteenth to the late eighteenth centuries with their lively experiences and voices. By examining medieval and early modern Scottish communities through the lens of age, the collection counters traditional assumptions that young people are peripheral to our understanding of the political, economic, and social contexts of the premodern era. The topics addressed fall into three main sections: theexperience of being a child/adolescent; representations of the young; and the construction of the next generation. The individual essays examine the experience of the young at all levels of society, including princes and princesses, aristocratic and gentry youth, urban young people, rural children, and those who came to Scotland as slaves; they draw on evidence from art, personal correspondence, material culture, song, legal and government records, work and marriage contracts, and literature.
Janay Nugent is an Associate Professor of History and a founding member of the Institute for Child and Youth Studies at the University of Lethbridge, Alberta, Canada; Elizabeth Ewan is University Research Chair and Professor of History and Scottish Studies at the Centre for Scottish Studies, University of Guelph, Ontario, Canada.
Contributors: Katie Barclay, Stuart Campbell, Mairi Cowan, Sarah Dunnigan, Elizabeth Ewan, Anne Frater, Dolly MacKinnon, Cynthia J. Neville, Janay Nugent, Heather Parker, Jamie Reid Baxter, Cathryn R. Spence, Laura E. Walkling, Nel Whiting.