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Much of what we can say about the ebbs and flows of ancient societies comes embedded in and directly from the soil. The soil provides evidence about its past and about the qualities it provided for ecological health and human resources. This is important to the topic of this book because the soil, or the pedosphere, is the ultimate domain of ecosystem services and holds the Earth’s highest biodiversity. In this chapter, we begin with a review of biodiversity and erosion in the underappreciated soil ecosystem and then consider societal collapses, extinctions in a sense, mainly through the lenses of geoarchaeology or archaeology using many tools of the geosciences.
Sediments that accumulate in high-latitude lakes serve as valuable environmental archives of changing conditions in a region currently undergoing rapid change. A previously unexplored sedimentary sequence reaching back 16,000 years from Lakes Peters and Schrader (Neruokpuk Lakes) in the northeastern Brooks Range (69°N), Alaska, shows distinct changes in accumulation rates and biophysical properties including bulk density (BD), organic matter (OM) content, and grain-size distribution at five widely distributed core sites. The oldest sediments contain little OM and accumulated rapidly as glaciers retreated around 15 ka. OM peaked between 12 and 10 ka along with Northern Hemisphere summer insolation. BD increased and OM decreased until around 5 ka, possibly reflecting a decrease in river-transported terrestrial OM. From 5–2 ka, OM consistently increased, suggesting a rise in river discharge, or a rise in summer temperatures, which led to higher productivity, or both. After 2 ka, sediments increased in BD and decreased in OM, suggesting glacier growth. Evidence for glacier expansion late during the Little Ice Age is weak, but increased sedimentation rates may reflect glacier retreat during the last century. This study provides a framework for future paleoenvironmental research of a rare archive in a relatively pristine Arctic setting.
Current healthcare delivery challenges are multi-faceted, requiring multiple perspectives to be addressed using a systems approach. However, a significant amount of healthcare systems design research work is carried out within single disciplines or at best a few disciplines working together. There appears to be little deliberate attempt to draw together a wide range of disciplines committed to working together to overcome differences and tackle some of the complex challenges in healthcare delivery. In this paper, we report on the initial outcomes of such an international initiative that, in the form of a workshop held at the University of Cambridge, brought together researchers and practitioners from a wide range of disciplines to explore the foundations of a community for Healthcare Systems Design Research and Practice.
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.
The aim of the 25 and Up (25Up) study was to assess a wide range of psychological and behavioral risk factors behind mental illness in a large cohort of Australian twins and their non-twin siblings. Participants had already been studied longitudinally from the age of 12 and most recently in the 19Up study (mean age = 26.1 years, SD = 4.1, range = 20–39). This subsequent wave follows up these twins several years later in life (mean age = 29.7 years, SD = 2.2, range = 22–44). The resulting data set enables additional detailed investigations of genetic pathways underlying psychiatric illnesses in the Brisbane Longitudinal Twin Study (BLTS). Data were collected between 2016 and 2018 from 2540 twins and their non-twin siblings (59% female, including 341 monozygotic complete twin-pairs, 415 dizygotic complete pairs and 1028 non-twin siblings and singletons). Participants were from South-East Queensland, Australia, and the sample was of predominantly European ancestry. The 25Up study collected information on 20 different mental disorders, including depression, anxiety, substance use, psychosis, bipolar and attention-deficit hyper-activity disorder, as well as general demographic information such as occupation, education level, number of children, self-perceived IQ and household environment. In this article, we describe the prevalence, comorbidities and age of onset for all 20 examined disorders. The 25Up study also assessed general and physical health, including physical activity, sleep patterns, eating behaviors, baldness, acne, migraines and allergies, as well as psychosocial items such as suicidality, perceived stress, loneliness, aggression, sleep–wake cycle, sexual identity and preferences, technology and internet use, traumatic life events, gambling and cyberbullying. In addition, 25Up assessed female health traits such as morning sickness, breastfeeding and endometriosis. Furthermore, given that the 25Up study is an extension of previous BLTS studies, 86% of participants have already been genotyped. This rich resource will enable the assessment of epidemiological risk factors, as well as the heritability and genetic correlations of mental conditions.
Interest in tactical medicine, the provision of medical support to law enforcement and military special operations teams, continues to grow. The majority of tactical physicians are emergency physicians with additional training and experience in tactical operations. A 2005 survey found that 18% of responding Emergency Medicine (EM) residencies offered their resident physicians structured exposure to tactical medicine at that time.
This study sought to assess interval changes in tactical medicine exposure during EM residency and Emergency Medical Services (EMS) fellowship training. A secure online survey was distributed electronically to all 212 EM residency programs and 44 EMS fellowship programs in the United States.
Responses were received from 99 (46%) EM residency and 40 (91%) EMS fellowship programs. Results showed that 52 (53%) of the responding residencies offered physician trainees formal exposure to tactical medicine as part of their training (P < .0001 compared to 18% in 2005). In addition, 32 (72%) of the 40 responding EMS fellowships (newly established since the initial survey) offered this opportunity. Experiences ranged from observation to active participation during tactical training and call-outs. The EM residents and EMS fellows provide support to local, state, and federal law enforcement agencies. A small number of programs (six residencies and four fellowships) allowed a subset of qualified trainees to be armed during tactical operations.
Overall, training opportunities in tactical medicine have grown significantly over the last decade from 18% to 53% of responding EM residencies. In addition, 72% of responding EMS fellowships incorporate tactical medicine in their training program.
Petit NP, Stopyra JP, Padilla RA, Bozeman WP. Resident involvement in tactical medicine: 12 years later. Prehosp Disaster Med. 2019;34(2):217–219
This paper reviews several procedures for the removal of instrumental contributions from measured x-ray diffraction profiles, including: direct convolution, unconstrained and constrained deconvolution, an iterative technique, and a maximum entropy method (MEM) which we have adapted to x-ray diffraction profile analysis. Decorevolutions using the maximum entropy approach were found to be the most robust with simulated profiles which included Poisson-distributed noise and uncertainties in the instrument profile function (IPF). The MEM procedure is illustrated by application to the analysis for domain size and microstrain carried out on the four calcined α-alumina candidate materials for Standard Reference Material (SRM) 676 (a quantitative analysis standard for I/Ic determinations), along with the certified material. Williamson-Hall plots of these data were problematic with respect to interpretation of the microstrain, indicating that the line profile standard, SRM 660 (LaB6), exhibits a small amount of strain broadening, particularly at high 2θ angle. The domain sizes for all but one of the test materials were much smaller than the crystallite (particle) size; indicating the presence of low angle grain boundaries.
The Rietveld method entails the calculation of a powder diffraction pattern from crystallographic, microstructural and equipment characteristics. These characteristics are related to the form of the pattern through a series of model functions. The difference between an observed and calculated pattern is then minimized by sequentially refining the physical parameters contained within the mode) functions to obtain an accurate and precise description of the specimen. A powder diffraction pattern from a specimen exhibiting cry stallo graphic texture, or preferred orientation, will display intensity values which differ systematically from those calculated for a specimen of random orientation. This systematic discrepancy can be addressed by incorporating into the Rietveld refinement a model function for sample texture. A successful model for texture will accurately assess the phase abundance and degree of texture from both oriented and randomized specimens. In this study we use the March-Dollase model function to characterize texture development in sintered alumina with respect to processing variables and sintering time.
The Research Domain Criteria initiative was launched by the US National Institute of Mental Health to establish a multi-level framework for understanding psychological constructs relevant to human psychiatric disorders, and identified ‘effort valuation/willingness to work’ as a clinically useful construct worthy of further study. This construct encompasses the processes by which the cost(s) of obtaining an outcome are calculated, and the tendency to overcome response costs to obtain a reinforcer. The current study aims to examine effort valuation as a correlate of psychopathology in children and adults, and the moderating effects of sex on this relationship.
Participants were 1215 children aged 6–12 and their parents (n = 1044). All participants completed the Effort Expenditure for Rewards Task as a measure of effort expenditure. Child psychopathology was measured via the Child Behavior Checklist, while adult psychopathology was measured via the Adult Self Report. Additionally, the Social Adjustment Inventory for Children and Adolescents and Injury Behavior Checklist were used to examine child social impairments/problem behaviors.
In children, significant interactions between reward sensitivity and sex were observed in association with anxiety and thought problems, specifically at low reward sensitivity levels. In adults, main effects of effort expenditure were seen in drug and alcohol abuse, where higher effort was associated with higher degrees of abuse.
These results establish effort valuation as a relevant psychological construct for understanding psychopathology, but with different profiles of associated psychopathology across sex in children and adults.
A fine-grained, up to 3-m-thick tephra bed in southwestern Saskatchewan, herein named Duncairn tephra (Dt), is derived from an early Pleistocene eruption in the Jemez Mountains volcanic field of New Mexico, requiring a trajectory of northward tephra dispersal of ~1500 km. An unusually low CaO content in its glass shards denies a source in the closer Yellowstone and Heise volcanic fields, whereas a Pleistocene tephra bed (LSMt) in the La Sal Mountains of Utah has a very similar glass chemistry to that of the Dt, supporting a more southerly source. Comprehensive characterization of these two distal tephra beds along with samples collected near the Valles caldera in New Mexico, including grain size, mineral assemblage, major- and trace-element composition of glass and minerals, paleomagnetism, and fission-track dating, justify this correlation. Two glass populations each exist in the Dt and LSMt. The proximal correlative of Dt1 is the plinian Tsankawi Pumice and co-ignimbritic ash of the first ignimbrite (Qbt1g) of the 1.24 Ma Tshirege Member of the Bandelier Tuff. The correlative of Dt2 and LSMt is the co-ignimbritic ash of Qbt2. Mixing of Dt1 and Dt2 probably occurred during northward transport in a jet stream.
Movement disorders associated with exposure to antipsychotic drugs are common and stigmatising but underdiagnosed.
To develop and evaluate a new clinical procedure, the ScanMove instrument, for the screening of antipsychotic-associated movement disorders for use by mental health nurses.
Item selection and content validity assessment for the ScanMove instrument were conducted by a panel of neurologists, psychiatrists and a mental health nurse, who operationalised a 31-item screening procedure. Interrater reliability was measured on ratings for 30 patients with psychosis from ten mental health nurses evaluating video recordings of the procedure. Criterion and concurrent validity were tested comparing the ScanMove instrument-based rating of 13 mental health nurses for 635 community patients from mental health services with diagnostic judgement of a movement disorder neurologist based on the ScanMove instrument and a reference procedure comprising a selection of commonly used rating scales.
Interreliability analysis showed no systematic difference between raters in their prediction of any antipsychotic-associated movement disorders category. On criterion validity testing, the ScanMove instrument showed good sensitivity for parkinsonism (90%) and hyperkinesia (89%), but not for akathisia (38%), whereas specificity was low for parkinsonism and hyperkinesia, and moderate for akathisia.
The ScanMove instrument demonstrated good feasibility and interrater reliability, and acceptable sensitivity as a mental health nurse-administered screening tool for parkinsonism and hyperkinesia.
High-residue cover crops can facilitate organic no-till vegetable production when cover crop biomass production is sufficient to suppress weeds (>8000 kg ha−1), and cash crop growth is not limited by soil temperature, nutrient availability, or cover crop regrowth. In cool climates, however, both cover crop biomass production and soil temperature can be limiting for organic no-till. In addition, successful termination of cover crops can be a challenge, particularly when cover crops are grown as mixtures. We tested whether reusable plastic tarps, an increasingly popular tool for small-scale vegetable farmers, could be used to augment organic no-till cover crop termination and weed suppression. We no-till transplanted cabbage into a winter rye (Secale cereale L.)-hairy vetch (Vicia villosa Roth) cover crop mulch that was terminated with either a roller-crimper alone or a roller-crimper plus black or clear tarps. Tarps were applied for durations of 2, 4 and 5 weeks. Across tarp durations, black tarps increased the mean cabbage head weight by 58% compared with the no tarp treatment. This was likely due to a combination of improved weed suppression and nutrient availability. Although soil nutrients and biological activity were not directly measured, remaining cover crop mulch in the black tarp treatments was reduced by more than 1100 kg ha−1 when tarps were removed compared with clear and no tarp treatments. We interpret this as an indirect measurement of biological activity perhaps accelerated by lower daily soil temperature fluctuations and more constant volumetric water content under black tarps. The edges of both tarp types were held down, rather than buried, but moisture losses from the clear tarps were greater and this may have affected the efficacy of clear tarps. Plastic tarps effectively killed the vetch cover crop, whereas it readily regrew in the crimped but uncovered plots. However, emergence of large and smooth crabgrass (Digitaria spp.) appeared to be enhanced in the clear tarp treatment. Although this experiment was limited to a single site-year in New Hampshire, it shows that use of black tarps can overcome some of the obstacles to implementing cover crop-based no-till vegetable productions in northern climates.
Banwari Trace, a well-stratified shell midden located in southeastern Trinidad, provides the oldest known archaeological evidence of human settlement in the West Indies and has been crucial to our understanding of the initial peopling of the greater Caribbean region. Detailed excavation profile descriptions, soil and faunal analyses, accelerator mass spectrometry radiocarbon and optically stimulated luminescence dating, and stable carbon isotope analyses provide an accurate chronology and paleoenvironmental framework for the natural and anthropogenic depositional history of this significant archaeological site. Our findings support the recognition of three Middle Holocene strata at Banwari Trace, which represent significant periods of midden deposition and environmental change at: ~7800–7900 cal BP (Level 3); ~6900–7400 cal BP (Level 2); and ~5500–6200 cal BP (Level 1). Stable carbon isotope analyses show the landscape was dominated by C3 vegetation throughout the Middle Holocene with a possible drying episode near the end of the Middle Holocene climatic optimum. Cedrosan potsherds discovered in the uppermost 25 cm (Level 0) suggest that a Late Holocene radiocarbon age of ~2770–2200 cal BP for charcoal from this stratum is valid and possibly contemporary with an apparently intrusive human burial recovered in 1971 at a depth of ~20 cm.
We sought to assess the universal salt iodization (USI) strategy in Armenia by characterizing dietary iodine intake from naturally occurring iodine, salt-derived iodine in processed foods and salt-derived iodine in household-prepared foods.
Using a cross-sectional cluster survey model, we collected urine samples which were analysed for iodine and sodium concentrations (UIC and UNaC) and household salt samples which were analysed for iodine concentration (SI). SI and UNaC data were used as explanatory variables in multiple linear regression analyses with UIC as dependent variable, and the regression parameters were used to estimate the iodine intake sources attributable to native iodine and iodine from salt in processed foods and household salt.
Armenia is naturally iodine deficient; in 2004, the government mandated a USI strategy.
We recruited school-age children (SAC), pregnant women (PW) and non-pregnant women of reproductive age (WRA).
From thirteen sites covering all provinces, sufficient urine and table salt samples were obtained from 312 SAC, 311 PW and 332 WRA. Findings revealed significant differences between groups: contribution of native iodine ranged from 81% in PW to 46% in SAC, while household salt-derived iodine contributed from 19% in SAC to 1% in PW.
Differences between groups may reflect differences in diet. In all groups, household and processed food salt constituted a significant part of total iodine intake, highlighting the success and importance of USI in ensuring iodine sufficiency. There appears to be leeway to reduce salt intake without adversely affecting the iodine status of the population in Armenia.
Balloon atrial septostomy is performed in infants with dextro-transposition of the great arteries to improve oxygenation before surgery. It is performed in the catheterisation laboratory with fluoroscopy or at the bedside using echocardiography. It is unclear whether procedural safety and efficacy is superior in one location versus the other, although the bedside procedure may improve resource utilisation and present an opportunity for reducing cost. This study compares safety and efficacy of atrial septostomy performed at the patient’s bedside versus the catheterisation laboratory.
Neonates with dextro-transposition of the great arteries who underwent balloon atrial septostomy from October, 2000 to January, 2014 were included. Medical and procedural records, echocardiograms, and catheterisation data were reviewed. Comparisons between the two procedural locations included patient demographics, pre- and post-procedure oxygen saturations, and outcomes. Complications reviewed included bleeding, arrhythmia, cardiac trauma, stroke, and death. Coronary artery evaluations were recorded. T-tests were used for continuous variables, and Fisher’s exact tests were used for all categorical variables. Wilcoxon rank sum and analysis of covariance modelling were used for time variables and oxygen saturation, respectively.
A total of 88 infants met the inclusion criteria. Among them, 53 underwent septostomy at the bedside and 35 underwent septostomy in the catheterisation laboratory. No safety or outcome benefit was identified between the two procedural locations.
Septostomy performed at the bedside and in the catheterisation laboratory had similar outcomes and efficacy. Further, bedside septostomy has the advantage of no radiation exposure, and obviating risks with patient transfer from the ICU to the catheterisation laboratory.