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.

Coinfection with human immunodeficiency virus (HIV) and viral hepatitis is associated with high morbidity and mortality in the absence of clinical management, making identification of these cases crucial. We examined characteristics of HIV and viral hepatitis coinfections by using surveillance data from 15 US states and two cities. Each jurisdiction used an automated deterministic matching method to link surveillance data for persons with reported acute and chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections, to persons reported with HIV infection. Of the 504 398 persons living with diagnosed HIV infection at the end of 2014, 2.0% were coinfected with HBV and 6.7% were coinfected with HCV. Of the 269 884 persons ever reported with HBV, 5.2% were reported with HIV. Of the 1 093 050 persons ever reported with HCV, 4.3% were reported with HIV. A greater proportion of persons coinfected with HIV and HBV were males and blacks/African Americans, compared with those with HIV monoinfection. Persons who inject drugs represented a greater proportion of those coinfected with HIV and HCV, compared with those with HIV monoinfection. Matching HIV and viral hepatitis surveillance data highlights epidemiological characteristics of persons coinfected and can be used to routinely monitor health status and guide state and national public health interventions.

As part of further investigations into three linked haemorrhagic fever with renal syndrome (HFRS) cases in Wales and England, 21 rats from a breeding colony in Cherwell, and three rats from a household in Cheltenham were screened for hantavirus. Hantavirus RNA was detected in either the lungs and/or kidney of 17/21 (81%) of the Cherwell rats tested, higher than previously detected by blood testing alone (7/21, 33%), and in the kidneys of all three Cheltenham rats. The partial L gene sequences obtained from 10 of the Cherwell rats and the three Cheltenham rats were identical to each other and the previously reported UK Cherwell strain. Seoul hantavirus (SEOV) RNA was detected in the heart, kidney, lung, salivary gland and spleen (but not in the liver) of an individual rat from the Cherwell colony suspected of being the source of SEOV. Serum from 20/20 of the Cherwell rats and two associated HFRS cases had high levels of SEOV-specific antibodies (by virus neutralisation). The high prevalence of SEOV in both sites and the moderately severe disease in the pet rat owners suggest that SEOV in pet rats poses a greater public health risk than previously considered.

Recent cases of acute kidney injury due to Seoul hantavirus infection from exposure to wild or pet fancy rats suggest this infection is increasing in prevalence in the UK. We conducted a seroprevalence study in England to estimate cumulative exposure in at-risk groups with contact with domesticated and wild rats to assess risk and inform public health advice. From October 2013 to June 2014, 844 individual blood samples were collected. Hantavirus seroprevalence amongst the pet fancy rat owner group was 34.1% (95% CI 23·9–45·7%) compared with 3·3% (95% CI 1·6–6·0) in a baseline control group, 2·4% in those with occupational exposure to pet fancy rats (95% CI 0·6–5·9) and 1·7% with occupational exposure to wild rats (95% CI 0·2–5·9). Variation in seroprevalence across groups with different exposure suggests that occupational exposure to pet and wild rats carries a very low risk, if any. However incidence of hantavirus infection among pet fancy rat owners/breeders, whether asymptomatic, undiagnosed mild viral illness or more severe disease may be very common and public health advice needs to be targeted to this at-risk group.

The alternate Mediterranean diet (aMED) score is an adaptation of the original Mediterranean diet score. Raw (aMED) and energy-standardised (aMED-e) versions have been used. How the diet scores and their association with health outcomes differ between the two versions is unclear. We examined differences in participants’ total and component scores and compared the association of aMED and aMED-e with all-cause, CVD and cancer mortality. As part of the Multiethnic Cohort, 193 527 men and women aged 45–75 years from Hawaii and Los Angeles completed a baseline FFQ and were followed up for 13–18 years. The association of aMED and aMED-e with mortality was examined using Cox’s regression, with adjustment for total energy intake. The correlation between aMED and aMED-e total scores was lower among people with higher BMI. Participants who were older, leaner, more educated and consumed less energy scored higher on aMED-e components compared with aMED, except for the red and processed meat and alcohol components. Men reporting more physical activity scored lower on most aMED-e components compared with aMED, whereas the opposite was observed for the meat component. Higher scores of both aMED and aMED-e were associated with lower risk of all-cause, CVD and cancer mortality. Although individuals may score differently with aMED and aMED-e, both scores show similar reductions in mortality risk for persons scoring high on the index scale. Either version can be used in studies of diet and mortality. Comparisons can be performed across studies using different versions of the score.

The Dark Energy Survey is undertaking an observational programme imaging 1/4 of the southern hemisphere sky with unprecedented photometric accuracy. In the process of observing millions of faint stars and galaxies to constrain the parameters of the dark energy equation of state, the Dark Energy Survey will obtain pre-discovery images of the regions surrounding an estimated 100 gamma-ray bursts over 5 yr. Once gamma-ray bursts are detected by, e.g., the Swift satellite, the DES data will be extremely useful for follow-up observations by the transient astronomy community. We describe a recently-commissioned suite of software that listens continuously for automated notices of gamma-ray burst activity, collates information from archival DES data, and disseminates relevant data products back to the community in near-real-time. Of particular importance are the opportunities that non-public DES data provide for relative photometry of the optical counterparts of gamma-ray bursts, as well as for identifying key characteristics (e.g., photometric redshifts) of potential gamma-ray burst host galaxies. We provide the functional details of the DESAlert software, and its data products, and we show sample results from the application of DESAlert to numerous previously detected gamma-ray bursts, including the possible identification of several heretofore unknown gamma-ray burst hosts.

Neither of the two general councils of the western Church held between the Second and Third Lateran (1139, 1179) produced a large body of legislation: the genuine canons of the Council of Rheims (1148) number eighteen; those of Tours (1163) about ten. But in the great collection of Mansi this meagre store is eked out by an equal weight of additional canons, sixteen for Rheims and ten for Tours. Mansi looked on them with no great favor, but offered no criterion by which their validity and value might be judged. The Rheims canons, so far as I am aware, have never been submitted to critical study. The Tours canons, on the other hand, were examined and shown to be spurious by Seckel in a valuable appendix to his article on the sources of the canons of the English council of 1175, which he published in the Deutsche Zeitschrift für Kirchenrecht in 1899.

The members of some newly formed academic societies peer forward into the future with a nice mixture of enthusiasm and uncertainty: enthusiasm for a subject in which they are so fanatically interested that they have dared to found yet another society; uncertainty whether the world at large will admit that the subject exists, whether it will be accorded proper academic respectability. We share, I hope, this enthusiasm; but we have no grounds for uncertainty. It was the study of the Church’s history, from within, which did more than anything else to lay the foundations for the critical study of historical sources, most notably in the work of Mabillon and the Maurists. The study of the Church’s history, and most particularly the history of its founder, rocked the world in the nineteenth century, and played a large part in providing the intellectual grounds both for modern belief and for modern disbelief. The Church’s history has, in the past, provided the locus classicus of the problem of historical bias: is it possible, the question has been asked times out of number, for historians of different persuasions to agree in the study of the early Church, or of the Reformation? The question is a real one; we cannot confidently say more than that they can, without much difficulty, talk the same language; that true scholars nowadays will not think of not talking the same language. And this fact reveals the extraordinary power of reconciliation which the study of the Church’s history has had. It does not always reconcile; the common pursuit of truth did little to foster good relations between Coulton and Gasquet. But this spirit of reconciliation is clearly a feature of our age. It is part of a much larger movement, of which we are all witnesses. I have seen with my own eyes a Jesuit father give a public lecture in Winchester College; I have not seen, but millions of my fellow-countrymen have, Catholic and Anglican metropolitans sitting side by side in cosy amity in a television studio. We all know how limited, in terms of visible reunion, is the significance of these events; but the movement towards reunion among Protestant churches and towards better relations among all the sane branches of the Christian family is one of the striking historical phenomena of our age; and a movement (if I may strike a personal note) of hope and joy. Beyond doubt the study of the Church’s history and the dominance of the historical outlook over the last century and a half have much to do with this.

Few incidents in thirteenth-century history have been more often described than the story of the Christmas crib at Greccio. Not long before his death St Francis arranged with a noble layman called John of Greccio to prepare a crib for midnight mass at Christmas, with plenty of hay and real animals, ox and ass, in attendance. Crowds flocked to the place and ‘the whole night resounded with jubilation’. Mass was celebrated over the crib. But not by Francis, for he was not a priest but a deacon; and he put on the deacon’s vestments, sang the gospel and preached. Strange as it may seem, it is only from this story in the First Life by Thomas of Celano, confirmed by some shreds of other evidence, that we know that Francis was in deacon’s orders. No explanation is given, no contemporary commentary expounds the fact. Yet it is abundantly clear that his deacon’s orders had some profound significance related to his conception of his Order and its members, and their relations one to another. It is a curious puzzle to discover what it was.

The wide span of years which I have boldly claimed in my title is intended to enmesh and hold together for our inspection the first great age of the medieval city, the tenth and eleventh centuries, when the medieval Church first faced the problem of evangelism in growing mercantile communities, and the age when it deployed in the cities and towns of Europe a new army of missionaries in the persons of the friars. The missionary techniques of the friars are familiar and comparatively well documented; the evangelism of the tenth and eleventh centuries is scarcely documented at all. In recent years the dramatic nature of urban history in this early period has been becoming increasingly apparent; and it was in the conviction that the Church’s hand in it could not wholly escape detection that I chose the title for this lecture. Many aspects of this problem have been traced with the closest care; but I justify the breadth and cloudiness of my theme by a conviction that it has rarely been looked at quite from this point of view.

The history of women in the middle ages is difficult to write. Few women were literate; their opportunities to record their own thoughts and feelings and attitudes were restricted; the bulk of medieval records were written by men for men. Yet twelfth-century literature would be much impoverished in personal interest, and in human and intellectual content, if we lacked the writings of Heloïse and Hildegarde; and I remain stubbornly unconvinced that the letters of Heloïse were written by a man. Some of the best poetry of this and other centuries was written by women; and the cult of womankind is the essential centre and focus of the whole romantic, courtly tradition. At the other extreme White Annays and her colleagues figure in innumerable court records. A part of the relative neglect of medieval women has been due to the neglect of the history of marriage. This is now past: the academic world is full of the sound of symposia and conferences on matrimony; and a much better balance of interests between the sexes is one evident result. Catherine Morland’s gay jibe at history—’the men all so good-for-nothing and hardly any women at all’—had an edge to it in Jane Austen’s day and in the early and mid-twentieth century; it will hardly be so true of the history we study in the 1990s.