We retrospectively reviewed the records of 136 veterans with a penicillin allergy label during a quality improvement initiative. We identified 82 inpatients eligible for removal of penicillin allergy by oral amoxicillin challenge, including 40 out of 82 (48%) still eligible after accounting for other limiting factors.

An outpatient parenteral antimicrobial therapy team from a Veterans Affairs facility managed patients discharged from their own facility and neighboring community hospitals. There were no significant differences in adverse outcomes between the groups, but a majority of regimens were modified from those initially proposed by community providers.

The presence of a penicillin allergy label in a patient’s medical chart is associated with negative clinical and economic outcomes. Given that less than 10% of reported reactions are truly immunoglobulin E-mediated, removal of unverified penicillin allergy labels is a public health priority and an area of ongoing implementation research. The Veterans Health Administration (VHA) is the largest integrated healthcare system in the United States, with almost 9 million veterans currently enrolled. However, studies analyzing the impact of the penicillin allergy label in this population are limited to single facilities and largely focus on short-term outcomes of allergy documentation correction, usage of β-lactams, and avoidance of antibiotic-related side effects. Broader, national VHA studies focusing on health outcomes and costs are lacking. As with non-VHA facilities, penicillin allergy evaluations are limited owing to the absence of formal allergy/immunology services at most VHA facilities. Pharmacy-driven screening and referral for clinic-based penicillin skin testing is a promising and frequently discussed modality in the literature, but its scalability within the VHA is not yet proven. Broader, evidence-based strategies that can be adapted to the available resources of individual VHA facilities, including those without on-site access to allergy providers, are needed.

Rural areas tend to be inhabited by more older people and thus have a higher prevalence of dementia. Combined with lower population densities and more sparse geography, rural areas pose numerous barriers and costs relating to support and resource provision. This may leave people with dementia in rural places at a significant disadvantage, leading to a heavy reliance on informal support networks. The present study explores the personal experiences of people living with dementia and carers living in rural areas, seeking to discover both benefits and challenges, as well as recommendations within the literature for improving the lives of those affected by dementia in rural areas. A scoping review following the framework of Arksey and O'Malley identified 60 studies that describe or discuss the personal experience of dementia (either by the person with dementia or carer), in relation to living in rural or remote geographical areas. Four overarching themes were derived, namely the possible benefits of living in a rural community (supportive rural communities), sources of strength described by people affected by dementia in rural areas (managing and coping), detrimental aspects of living in a rural community (rural community challenges) and difficulties with dementia care services. Three further themes yielded recommendations for improving the experience of dementia in rural areas. This review highlights some potential opportunities related to living in rural areas for people living with dementia. These often come with parallel challenges, reflecting a delicate balance between being well-supported and being in crisis for those living in rural areas. Given the limited access to formal services, supporting people with dementia in rural areas requires input and innovation from the people, organisations and services local to those communities.

The city of Teotihuacan (AD 1–550) was a major multiethnic urban center that attracted migrants from as far away as west Mexico and the Maya region. Past research in the Tlajinga district at Teotihuacan using oxygen isotopes from human remains estimated that nearly 30% of the population of Tlajinga 33, a single apartment compound, were migrants. This study takes a dual-isotope approach (87Sr/86Sr and δ18Op) to reevaluate the proportion of in-migration at Tlajinga and includes data from two additional apartment compounds, Tlajinga 17 and 18 (n = 23). New results indicate that migrants comprised ~45% of the Tlajinga population. Previously acquired radiocarbon dates combined with mortuary and isotope data suggest that immigration to Tlajinga was highest during the first centuries of compound occupation. Nevertheless, migration was a continual process throughout its history. Additionally, a new finding suggests that residents of Tlajinga 33 ingested foods with higher 87Sr/86Sr ratios than did those of Tlajinga 17 and 18. We hypothesize that the incorporation of imported lime for the nixtamalization process skewed the 87Sr/86Sr ratios of human remains, a potentially important finding for future studies at Teotihuacan.

Altica is a rare first-farming village site in the Basin of Mexico that has survived to modern times. Thus, it provides a glimpse into life during the Early–Middle Formative period. While valuable archaeological information on the village was recovered in excavation, only four burials comprising four individuals were recovered, a very small sample. Two individuals are older-aged females; the third, a middle-aged male, was accompanied by prestigious nonperishable goods and indicates that there are status differences even at this early date. The final individual was a young male buried in a deviant manner, suggesting possible foul play. While all individuals have indicators of periods of poor health, stable isotopes of carbon and nitrogen paint a more complete picture of the types of foods these individuals consumed over their lifetime. Radiogenic strontium isotopes of tooth enamel identify one individual, the young male buried in a deviant manner, as non-native to the Altica region. Thus, there is mystery in the manner of death, but even in this small sample, the wider connections Altica had that are so evident in the artefactual analysis are found in the skeletons. In addition, accelerator mass spectrometry radiocarbon dating provides a chronology of occupation through the people.

Skeletal remains from Tlajinga 33 (33:S3W1) have been the focus of research in the southern sector of Teotihuacan since excavations took place in the 1980s. Recent excavations in Tlajinga Compounds 17 and 18 (17:S3E1 and 18:S3E1, respectively), located along the southern Street of the Dead, recovered nine additional skeletons. This article is a description of the burials from Compounds 17 and 18 and a comparative analysis of health, diet, and chronology across all three compounds (Compounds 17, 18, and 33). Here, we test the hypothesis that individuals between residential compounds at Tlajinga lived similar lives and that health and biogeochemical markers of individuals will reflect these similarities. Although the sample size is small, the paleopathological analysis of individuals at Compounds 17 and 18 indicates morbidity patterns similar to Tlajinga 33, but also that these residents were perhaps less susceptible to stressors during periods of juvenile growth. Stable carbon and nitrogen isotopes suggest that, overall, diets were analogous across compounds, but Compounds 17 and 18 were able to supplement their diet with a greater variety of plant resources. There were no clear dietary differences between higher and lower status individuals, however. Finally, accelerated mass spectrometry radiocarbon (AMS 14C) dates indicate that residential living may have occurred later at Compound 18 than at Compound 17 and Tlajinga 33.

A survey was conducted at 88 sites in Montana in 1984 and 1985 to determine the distribution of Urophora affinis Frauenfeld and U. quadrifasciata (Meigen), two seed head flies released on spotted knapweed (Centaurea maculosa Lam. # CENMA) in North America. U. affinis, released in Montana during 1973 to 1977, was found at 40 of the 88 sites. The fly was concentrated within a short radius (about 5 to 8 km) of release sites, even at sites having well-established populations. U. quadrifasciata, released in British Columbia in 1972, but not in the United States, was found at 84 sites. The data suggest that the fly entered the state in the northwest corner and dispersed in a southeasterly direction. There was a strong positive relationship between mean number of galls per seed head and percent infestation for both fly species.

Leafy spurge (Euphorbia spp.), an aggressive noxious perennial weed of North America, is a complex group that has been designated as several different species, including E. esula L. (# EPHES) and E. virgata Wald. & Kit. [E. waldsteinii (Sojak) Radcliffe-Smith]. Current classification keys are unsatisfactory in assigning plants in the field to specific taxa (or to a single taxon). These keys rely heavily upon morphological characteristics of leaves, but great variation in the leaves has been noted by us and previously reported by others. In this study we demonstrate qualitatively and quantitatively that the within-plant, within-clone, among-clone, and among-site variation in leaf morphology and triterpenoid content of the latex of leafy spurge is inherently high. Leaf characters were of little value in separating any of the accessions considered in our study. Latex triterpenoid profiles were useful in distinguishing E. lucida W. & K. × salicifolia Host. and E. salicifolia from European E. esula, E. waldsteinii, and E. sequieriana Neck. ssp. seguieriana, and all Montana accessions previously described from morphological studies. We concluded that Montana leafy spurge and the European E. esula, E. waldsteinii, and E. sequieriana belong to a single taxon: Euphorbia esula L.

Spotted knapweed (Centaurea maculosa Lam. # CENMA) communities were sampled to determine the relationship between age and the number of root rings, and the population age structure. Spotted knapweed taproots add one ring of secondary xylem annually. In 1984, populations were expanding with high densities of individuals in the early age classes, followed by a steady decline in the older classes. In 1985, the majority of the individuals in knapweed populations were in the older age classes. This change in the population age structure was attributed to high mortality among the young age classes due to a drought in 1985. The maximum age class at the sites ranged from 5 to 9 yr. The percentage of plants with floral stalks increased with age to a peak of 75% in the fifth year in 1984 and in the seventh year in 1985.

Spotted knapweed is an important weed of rangeland in the northwestern United States. A study was conducted near Corvallis, MT, during 1992 to 1994 in order to assess the relationship among the growth attributes of spotted knapweed to identify a minimum set of measurable plant characteristics that are representative of spotted knapweed vigor. Spotted knapweed growth attributes that were examined included plant age, root diameter, plant height, number of stems per plant, aboveground biomass, number of capitula (seed heads) per plant, and number of capitula per stem. Spotted knapweed age was positively correlated with root diameter, number of stems per plant, aboveground biomass, and proportion of bolted plants. Most spotted knapweed plants did not bolt until the third or fourth year. Although plant age is not measured easily in the field, it may be useful as a covariate in an analysis of experiments involving plant competition or nonlethal biological control agents. Root diameter can be used as a nondestructive measure of approximate plant age, especially for the first 5 yr of growth. Root diameter was also highly correlated with many growth measurements, including number of capitula per plant and aboveground biomass, which are most relevant to assessing overall plant vigor. Plant height was positively correlated with aboveground biomass, number of capitula per plant, and mean number of capitula per stem. Number of stems per plant was positively correlated with plant height, aboveground biomass, and number of capitula per plant. Aboveground biomass was positively correlated to number of capitula per plant and mean number of capitula per stem. Measurements of root diameter, plant height, and number of stems are easy to perform and should provide a good indication of plant vigor.

The Antarctic Roadmap Challenges (ARC) project identified critical requirements to deliver high priority Antarctic research in the 21st century. The ARC project addressed the challenges of enabling technologies, facilitating access, providing logistics and infrastructure, and capitalizing on international co-operation. Technological requirements include: i) innovative automated in situ observing systems, sensors and interoperable platforms (including power demands), ii) realistic and holistic numerical models, iii) enhanced remote sensing and sensors, iv) expanded sample collection and retrieval technologies, and v) greater cyber-infrastructure to process ‘big data’ collection, transmission and analyses while promoting data accessibility. These technologies must be widely available, performance and reliability must be improved and technologies used elsewhere must be applied to the Antarctic. Considerable Antarctic research is field-based, making access to vital geographical targets essential. Future research will require continent- and ocean-wide environmentally responsible access to coastal and interior Antarctica and the Southern Ocean. Year-round access is indispensable. The cost of future Antarctic science is great but there are opportunities for all to participate commensurate with national resources, expertise and interests. The scope of future Antarctic research will necessitate enhanced and inventive interdisciplinary and international collaborations. The full promise of Antarctic science will only be realized if nations act together.

We describe the performance of the Boolardy Engineering Test Array, the prototype for the Australian Square Kilometre Array Pathfinder telescope. Boolardy Engineering Test Array is the first aperture synthesis radio telescope to use phased array feed technology, giving it the ability to electronically form up to nine dual-polarisation beams. We report the methods developed for forming and measuring the beams, and the adaptations that have been made to the traditional calibration and imaging procedures in order to allow BETA to function as a multi-beam aperture synthesis telescope. We describe the commissioning of the instrument and present details of Boolardy Engineering Test Array’s performance: sensitivity, beam characteristics, polarimetric properties, and image quality. We summarise the astronomical science that it has produced and draw lessons from operating Boolardy Engineering Test Array that will be relevant to the commissioning and operation of the final Australian Square Kilometre Array Path telescope.

Adequate plans for the examination of the language and place-names of the Island were conceived only three years ago; it will not, therefore, be surprising if this interim report is a more or less inadequate sketch which may at times dwell more on what needs to be done rather than on what has actually been accomplished.

Some of the difficulties we are having to take into account result from the fact that toponymy and linguistic research are not altogether autonomous disciplines. Properly viewed they impinge on such studies as cartography, geography, history, social anthropology and folklore. One of the most encouraging recent developments in Newfoundland has been the lively interest in the inheritance of the Island, and the formulation of a programme of research for its adequate exploration.