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This article describes priority areas for research on the impact of the Covid-19 pandemic on older adults that have been identified by the CIHR Institute of Aging (CIHR-IA). The process used by CIHR-IA consists of several iterative phases and thus far has resulted in identification of three key areas for Covid-19 research needs and four cross-cutting thematic areas. The key research priority areas are as follows: response of older adults to disease, vaccination, and therapeutics; mental health and isolation; and supportive care environments. The four cross-cutting themes are equity, diversity, and inclusion (EDI); ethical/moral considerations; evidence-informed practices; and digital health technologies. The priorities outlined in this article will inform CIHR-IA’s responses to Covid-19 research needs.
Hookworms are some of the most widespread of the soil-transmitted helminths (STH) with an estimated 438.9 million people infected. Until relatively recently Ancylostoma ceylanicum was regarded as a rare cause of hookworm infection in humans, with little public health relevance. However, recent advances in molecular diagnostics have revealed a much higher prevalence of this zoonotic hookworm than previously thought, particularly in Asia. This study examined the prevalence of STH and A. ceylanicum in the municipalities of Palapag and Laoang in the Philippines utilizing real-time polymerase chain reaction (PCR) on stool samples previously collected as part of a cross-sectional survey of schistosomiasis japonica. Prevalence of hookworm in humans was high with 52.8% (n = 228/432) individuals positive for any hookworm, 34.5% (n = 149/432) infected with Necator americanus, and 29.6% (n = 128/432) with Ancylostoma spp; of these, 34 were PCR-positive for A. ceylanicum. Considering dogs, 12 (n = 33) were PCR-positive for A. ceylanicum. This is the first study to utilize molecular diagnostics to identify A. ceylanicum in the Philippines with both humans and dogs infected. Control and elimination of this zoonotic hookworm will require a multifaceted approach including chemotherapy of humans, identification of animal reservoirs, improvements in health infrastructure, and health education to help prevent infection.
Rapid detection and isolation of COVID-19 patients is the only means of reducing hospital transmission. We describe the impact of implementation of on-site SARS-CoV-2 RT-PCR testing on reduction in result turnaround time, isolation duration, pathology test ordering and antibiotic use in patients who do not have COVID-19.
Purpose: The novel coronavirus (severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)) first appeared in Wuhan, China, in December 2019, and rapidly spread across the globe. Since most respiratory viruses are known to show a seasonal pattern of infection, it has been hypothesised that SARS-CoV-2 may be seasonally dependent as well. The present study looks at a possible effect of atmospheric temperature, which is one of the suspected factors influencing seasonality, on the evolution of the pandemic. Basic procedures: Since confirming a seasonal pattern would take several more months of observation, we conducted an innovative day-to-day micro-correlation analysis of nine outbreak locations, across four continents and both hemispheres, in order to examine a possible relationship between atmospheric temperature (used as a proxy for seasonality) and outbreak progression. Main findings: There was a negative correlation between atmospheric temperature variations and daily new cases growth rates, in all nine outbreaks, with a median lag of 10 days. Principal conclusions: The results presented here suggest that high temperatures might dampen SARS-CoV-2 propagation, while lower temperatures might increase its transmission. Our hypothesis is that this could support a potential effect of atmospheric temperature on coronavirus disease progression, and potentially a seasonal pattern for this virus, with a peak in the cold season and rarer occurrences in the summer. This could guide government policy in both the Northern and Southern hemispheres for the months to come.
Little is known internationally about return to prison from in-patient psychiatric services, including: circumstances leading to return, aftercare services and subsequent patient outcomes.
To examine and describe: (a) circumstances leading to return to prison from medium secure services; (b) available aftercare and early outcomes of returned persons; and (c) implications for policy development.
Prospective cohort design with all patients (n = 96) returned to prisons from 33 National Health Service (NHS) medium secure services over a 6-month period in England and Wales. Follow-up was conducted for 1 year post-remittal, across 60 prisons.
Less than 20% of patients with legal entitlement to section 117 aftercare under the Mental Health Act 1983 were receiving care managed/delivered via the care programme approach. Subsequent pathways included: inter-prison transfer (30%), use of the Assessment, Care in Custody and Teamwork process (49%), referral to secure services (21%) and community release (30%). Less than half of community releases were referred to a community mental health team.
Findings suggest that persons returned to prison are a vulnerable group of patients, many of whom require intervention (e.g. enhanced monitoring, admission to a healthcare wing, readmission to secure mental health services) on return to prison in the absence of targeted aftercare services. More robust guidance for discharge and aftercare planning procedures for persons remitted to prison should be developed to ensure that the benefits of in-patient admission are maintained and that individuals’ legal rights to ongoing aftercare are upheld.
The Kilmaluag Formation on the Isle of Skye, Scotland, provides one of the richest Mesozoic vertebrate fossil assemblages in the UK, and is among the richest globally for Middle Jurassic tetrapods. Since its discovery in 1971, this assemblage has predominantly yielded small-bodied tetrapods, including salamanders, choristoderes, lepidosaurs, turtles, crocodylomorphs, pterosaurs, dinosaurs, non-mammalian cynodonts and mammals, alongside abundant fish and invertebrates. It is protected as a Site of Special Scientific Interest and by Nature Conservancy Order. Unlike contemporaneous localities from England, this assemblage yields associated partial skeletons, providing unprecedented new data. We present a comprehensive updated overview of the Kilmaluag Formation, including its geology and the fossil collections made to date, with evidence of several species occurrences presented here for the first time. We place the vertebrate faunal assemblage in an international context through comparisons with relevant contemporaneous localities from the UK, Europe, Africa, Asia and the US. This wealth of material reveals the Kilmaluag Formation as a vertebrate fossil assemblage of global significance, both in terms of understanding Middle Jurassic faunal composition and the completeness of specimens, with implications for the early evolutionary histories of mammals, squamates and amphibians.
Synthetic cationic polymer-mediated synthesis of silver nanoparticles and selective antimicrobial activity of the same were demonstrated. Polyethyleneimine (PEI)-coated silver nanoparticles showed antimicrobial activity against Acinetobacter baumannii as a function of the polymeric molecular weight (MW) of PEI. Silver nanoparticles were coated with PEI of three different MWs: Ag-NP-1 with PEI exhibiting a MW of 750,000, Ag-NP-2 with PEI exhibiting a MW of 1300, and Ag-NP-3 with PEI exhibiting a MW of 60,000. These nanoparticles showed a particle size distribution of 4–20 nm. The nanoparticles exhibited potent antimicrobial activity against A. baumannii, with the minimum inhibitory concentration of Ag-NP-1, Ag-NP-2, and Ag-NP-3 on the order of 5, 10, and 5 μg/mL, respectively, and minimum bactericidal concentration of Ag-NP-1, Ag-NP-2, and Ag-NP-3 on the order of 10, 20, and 10 μg/mL, respectively. Fluorescence imaging of Ag-NPs revealed selective transfusion of Ag-NPs across the cell membrane as a function of the polymeric MW; differential interaction of the cytoplasmic proteins during antimicrobial activity was observed.
Maltreatment adversely impacts the development of children across a host of domains. One way in which maltreatment may exert its deleterious effects is by becoming embedded in the activity of neurophysiological systems that regulate metabolic function. This paper reviews the literature regarding the association between childhood maltreatment and the activity of three systems: the parasympathetic nervous system, the sympathetic nervous system, and the hypothalamic–pituitary–adrenal axis. A particular emphasis is placed on the extent to which the literature supports a common account of activity across these systems under conditions of homeostasis and stress. The paper concludes with an outline of directions for future research and the implications of the literature for policy and practice.
In this paper, the Lewis base character of 3-aminopropyltrimethoxysilane (3-APTMS), an imine derivative of siloxane, and an indole monomer were shown to enable the reduction of gold cations in acetone. The Lewis acid–base adduct of indole monomers and gold formed a polyindole–gold nanoparticle sol. Similarly, the Lewis acid–base adduct of 3-APTMS and gold enabled the formation of gold nanoparticles in the presence of acetone. The polyindole–gold nanoparticle sol and siloxane–gold nanoparticles underwent self-assembly into a polymeric nanofluid that was suitable for casting membranes. The use of these membranes as a potentiometric ion sensor for both cations and anions was considered; a common nonspecific ion exchange molecule, sodium tetraphenylborate, and the polymeric nanofluid were used to prepare an anion sensor and a cation sensor.
THE ST OMER CHRONICLE, the focus of this study, is an anonymous contemporary narrative of around 21,000 words that deals almost exclusively with the conduct of the Hundred Years’ War in the period 1342–47. During these five years, the English enjoyed an astounding degree of military success. Although France had triple the population and wealth of England, a high martial reputation, and the aid of Scotland, Edward III and his lieutenants were victorious in every theater. In the southwest of France, Henry of Lancaster crushed two French field armies, at Bergerac and Auberoche; captured dozens of magnates whose ransoms, collectively, far exceeded the peacetime annual revenues of the English crown; seized control of 136 castles and towns, including major centers like La Réole, Bergerac, and Poitiers, strategically crucial places like Aiguillon, and exceptionally strong fortresses like Lusignan; and won his reputation as “one of the best warriors in the world.” In Brittany, Edward III pushed the zone of English control, which at one point hardly extended past the walls of Quimperlé, as far east as the vicinity of Vannes. His lieutenant Sir Thomas Dagworth, with small forces at his disposal, was nonetheless able to more than hold his own against a major French counter- thrust. First, he won a small engagement at Restellou near Kergadoret that Sir Thomas Gray considered the most marvelous victory of the Breton Wars. Then he triumphed in a much more significant battle at La Roche Derrien, where the pro-Valois claimant to the duchy, Charles of Blois, was captured. On the Scottish front, the English thoroughly defeated a royal army led by David II, and brought the wounded king of Scots himself to the Tower of London as a prisoner. Meanwhile Edward III ravaged Normandy from the Cotentin to the Seine, sacked the large city of Caen and dozens of smaller towns, burned the royal palace of Montjoye outside Paris, and won the great battle of Crécy. Then, after keeping an army on French soil for over a year, he captured the key strategic port of Calais, so that, as Froissart put it, thereafter the English considered that “the keys to the kingdom of France hung at their belt.”
The St Omer Chronicle is an important source for nearly all of these major operations – but then, so are several other chronicles.
There are only a few known gunpowder recipes securely datable to fourteenth- century Europe. All of them have been published, but most of the texts have been misread, misprinted, or misunderstood. This article offers a corrected transcription and translation of the group of three recipes in the Breviarium Bartholomei of John of Mirfield (c.1380–95), and sets it in the context of other late-fourteenth to early-fifteenth century recipes.
Few technological innovations have been as momentous as the development of gunpowder. Gunpowder was the first major harnessing of chemical energy by humans since the mastery of fire, and the development of gunpowder artillery has been commonly used since the eighteenth century as the original and archetypical example of a “military revolution.” Whether cannon actually did “revolutionize” warfare is a debated subject, but most of those who argue that it did do so date the Artillery Revolution to some time in the first half of the fifteenth century. By then, however, gunpowder artillery had been in use for around a century. Our sources allow us a reasonably good understanding of the development of guns during the fifteenth century, but our information about the fourteenth century (especially in the first fifty years, from c.1326 to c.1375) is relatively thin.
The same is true of the development of gunpowder. All gunpowder includes a mix of saltpeter, sulfur, and charcoal. Nineteenth-century gunpowder was typically mixed with ratios of around 75:10:15 (in that order), i.e. with a saltpeter:sulfur ratio of 7.5:1 and a saltpeter content of 75%. Several early fifteenth-century recipes come fairly close to that mix, though some have significantly more sulfur content. A recipe from Montauban of the turn of the fifteenth century calls for 22:4:5 (71%/13%/16%). One of the two Frankfurter Büchsenmeisterblätter recipes (c.1400) gives a ratio 5:1:1 (71%/14%/14%). The 1405 manuscript of Bellifortis includes a 4:1:0.5 (73%/18%/9%) mix; the Büchsenmeisterbuch (composed at an uncertain date before 1411, probably around 1400) recommends the same mixture with small additions of salarmoniac (ammonium chloride) and salpracticum (a mix of saltpeter and salarmoniac), or 3.5:1:0.5 (70%/20%/10%) without those extra ingredients. Abundant evidence shows a shift towards – or back towards – somewhat lower saltpeter content in later fifteenth-century recipes, including those edited by Trevor Russell Smith in the following article in this volume of the Journal of Medieval Military History.
The COVID-19 pandemic is exerting major pressures on society, health and social care services and science. Understanding the progression and current impact of the pandemic is fundamental to planning, management and mitigation of future impact on the population. Surveillance is the core function of any public health system, and a multi-component surveillance system for COVID-19 is essential to understand the burden across the different strata of any health system and the population. Many countries and public health bodies utilise ‘syndromic surveillance’ (using real-time, often non-specific symptom/preliminary diagnosis information collected during routine healthcare provision) to supplement public health surveillance programmes. The current COVID-19 pandemic has revealed a series of unprecedented challenges to syndromic surveillance including: the impact of media reporting during early stages of the pandemic; changes in healthcare-seeking behaviour resulting from government guidance on social distancing and accessing healthcare services; and changes in clinical coding and patient management systems. These have impacted on the presentation of syndromic outputs, with changes in denominators creating challenges for the interpretation of surveillance data. Monitoring changes in healthcare utilisation is key to interpreting COVID-19 surveillance data, which can then be used to better understand the impact of the pandemic on the population. Syndromic surveillance systems have had to adapt to encompass these changes, whilst also innovating by taking opportunities to work with data providers to establish new data feeds and develop new COVID-19 indicators. These developments are supporting the current public health response to COVID-19, and will also be instrumental in the continued and future fight against the disease.
The social needs of frail or isolated older people are sometimes aided by referrals to day centres in the United Kingdom. Since the late 1940s, day centres have had a role to play promoting socialisation in later life. Additionally, attendance at day centres is often open ended, with participants only leaving due to moving to a nursing home or dying. In this study, the views of those attending time-limited day centre programmes in seven day centres in Northern Ireland have been sought in relation to their thoughts about the service as well as how they feel when it ends. Seventeen participants completed diaries for the programme duration and/or engaged in an interview process. Participants reflected on the social and educational benefits of attending but also recognised impositions in the centres that impinged upon individual choices and also the length of time they could remain. This study reveals that, in order to maintain socialisation, time-limited programmes must have clear follow-on strategies for participants. Additionally, respondents’ experiences reflect that a paternalistic model of care delivery remains in place that, whilst restrictive, reveals that access to the service is more specialised and not universal. Nevertheless, should day centres wish to remain relevant, it is important that service users are fully consulted about their desires and choices within the setting.
The purpose of this study was to investigate differences in the perception of disaster issues between disaster directors and general health care providers in Gyeonggi Province, South Korea.
The Gyeonggi provincial committee distributed a survey to acute care facility personnel. Survey topics included awareness of general disaster issues, hospital preparedness, and training priorities. The questionnaire comprised multiple choices and items scored on a 10-point Likert scale. We analyzed the discrepancies and characteristics of the responses.
Completed surveys were returned from 43 (67%) of 64 directors and 145 (55.6%) of 261 health care providers. In the field of general awareness, the topic of how to triage in disaster response showed the greatest discrepancies. In the domain of hospital level disaster preparedness, individual opinions varied most within the topics of incident command, manual preparation. The responses to “accept additional patients in disaster situation” showed the biggest differences (> 21 versus 6~10).
In this study, there were disaster topics with discrepancies and concordances in perception between disaster directors and general health care providers. The analysis would present baseline information for the development of better training programs for region-specific core competencies, knowledge, and skills required for the effective response.