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The COVID-19 pandemic and mitigation measures are likely to have a marked effect on mental health. It is important to use longitudinal data to improve inferences.
To quantify the prevalence of depression, anxiety and mental well-being before and during the COVID-19 pandemic. Also, to identify groups at risk of depression and/or anxiety during the pandemic.
Data were from the Avon Longitudinal Study of Parents and Children (ALSPAC) index generation (n = 2850, mean age 28 years) and parent generation (n = 3720, mean age 59 years), and Generation Scotland (n = 4233, mean age 59 years). Depression was measured with the Short Mood and Feelings Questionnaire in ALSPAC and the Patient Health Questionnaire-9 in Generation Scotland. Anxiety and mental well-being were measured with the Generalised Anxiety Disorder Assessment-7 and the Short Warwick Edinburgh Mental Wellbeing Scale.
Depression during the pandemic was similar to pre-pandemic levels in the ALSPAC index generation, but those experiencing anxiety had almost doubled, at 24% (95% CI 23–26%) compared with a pre-pandemic level of 13% (95% CI 12–14%). In both studies, anxiety and depression during the pandemic was greater in younger members, women, those with pre-existing mental/physical health conditions and individuals in socioeconomic adversity, even when controlling for pre-pandemic anxiety and depression.
These results provide evidence for increased anxiety in young people that is coincident with the pandemic. Specific groups are at elevated risk of depression and anxiety during the COVID-19 pandemic. This is important for planning current mental health provisions and for long-term impact beyond this pandemic.
Background: In spring of 2019, 2 positive sputum cases of Pseudomonas aeruginosa in the cardiac critical care unit (CCU) were reported to the UFHJ infection prevention (IP) department. The initial 2 cases, detected within 3 days of each other, were followed shortly by a third case. Epidemiological evidence was initially consistent with a hospital-acquired infection (HAI): 2 of the 3 patients roomed next to each other, and all 3 patients were ventilated, 2 of whom shared the same respiratory therapist. However, no other changes in routine or equipment were noted. The samples were cultured and processed using Illumina NGS technology, generating 1–2 million short (ie, 250-bp) reads across the P. aeruginosa genome. As an additional positive control, 8 P. aeruginosa NGS data sets, previously shown to be from a single outbreak in a UK facility, were included. Reads were mapped back to a reference sequence, and single-nucleotide polymorphisms (SNPs) between each sample and the reference were extracted. Genetic distances (ie, the number of unshared SNPs) between all UFHJ and UK samples were calculated. Genetic linkage was determined using hierarchical clustering, based on a commonly used threshold of 40 SNPs. All UFHJ patient samples were separated by >18,000 SNPs, indicating genetically distinct samples from separate sources. In contrast, UK samples were separated from each other by <16 SNPs, consistent with genetic linkage and a single outbreak. Furthermore, the UFHJ samples were separated from the UK samples by >17,000 SNPs, indicating a lack of geographical distinction of the UFHJ samples (Fig. 1). These results demonstrated that while the initial epidemiological evidence pointed towards a single HAI, the high-precision and relatively inexpensive (<US$1500) NGS analysis conclusively demonstrated that all 3 CCU P. aeruginosa cases derived from separate origins. The hospital avoided costly and invasive infection prevention interventions in an attempt to track down a single nonexistent source on the CCU, and no further cases were found. This finding supports the conclusion reached from the NGS that this represented a pseudo-outbreak. Furthermore, these genomes serve as an ongoing record of P. aeruginosa infection, providing even higher resolution for future cases. Our study supports the use of NGS technology to develop rational and data-driven strategies. Furthermore, the ability of NGS to discriminate between single-source and multiple-source outbreaks can prevent inaccurate classification and reporting of HAIs, avoiding unnecessary costs and damage to hospital reputations.
Disclosures: Susanna L. Lamers reports salary from BioInfoExperts and contract research for the NIH, the University of California - San Francisco, and UMASS Medical School.
Background: The CDC considers methicillin-resistant Staphylococcus aureus (MRSA) one of the most important hospital-acquired infections (HAIs) in the United States. However, infection control departments (ICDs) often rely on subjective data to determine whether multiple MRSA cases are a true outbreak and whether the hospital is responsible (community- vs hospital-acquired). Objective: Our objective was to determine whether whole-genome sequencing (WGS) of MRSA provided new insights into on transmission dynamics at large, inner-city hospital in Jacksonville, Florida. Methods: Over a 4-month period, MRSA samples were obtained from 44 infected patients at 3 campuses within a single hospital system. Limited nonpatient identifying information was obtained, including date of collection, campus, unit, reason for admission, and days post admission (DPA) of MRSA diagnosis. Whole-genome sequences were generated using the Illumina platform. Raw reads were processed, and genetic distances were calculated and used to identify genetically linked bacterial infections using FoxSeq version 1.0 software. Results: Based on their length of stay, 10 patients were reported by the ICD as obtaining an HAI. Three distinct “episodes” were evident in which >5 MRSA cases were observed within a 3–5-day period. Genomic analysis identified 5 clusters of linked infections: 4 clusters contained 2 patients and another contained 3. Of these clusters, only 1 contained multiple cases that were reported as HAIs; however, because these case were separated by 2 weeks, it is unlikely that they came from a source in the hospital. The results suggest that HAIs were overreported and that most MRSA present in the hospital likely came from community sources. Conclusions: WGS provided clear evidence that temporally clustered MRSA cases do not imply an outbreak is occurring. Furthermore, ongoing detection of the same community-acquired infections over several months is indicative of a shared source outside of the hospital, which could be uncovered through examination of clinical records. Considering the implications of HAIs, best approaches to combat them should include identifying their sources. As molecular surveillance approaches to infection control are rapidly becoming easier and less expensive, the methods can be used to bring objective clarity to the ICD.
Disclosures: Susanna L. Lamers reports salary from BioInfoExperts and contract research for the NIH, the University of California - San Francisco, and UMASS Medical School.
Joan Gero argued that archaeological interpretation is not the accumulation of truth but rather an ideological construct. Post-colonial studies building on Gero's work critique notions of universal value, that aspects of human cultural heritage hold value for all peoples. However, these studies are not specific about what a post-colonial analysis of the archaeological record might look like, particularly involving material culture categories. What appear as fundamental artefact classes remain and so appeal to a form of universal value. Here we employ a novel application of the ontological turn, specifically Holbraad's method of ontography, to break away from conventional approaches to stone artefact categorization and interpretation. We use Lucas’ discussion of materialization to develop an alternative approach to artefact categories considering two assemblages of artefacts from the North Island of Aotearoa. Both feature large numbers of obsidian artefacts. The obsidian provides the means to investigate levels of historical use, since the material is identifiable to geological source, analysable technologically and retains traces of use. Using the results of obsidian analyses, we investigate the concepts on which archaeologists have based assessments of the relationships among material culture items, suggesting ways in which archaeologists might consider creating space for post-colonial ontologies.
Amazona lilacina is a threatened species endemic to Ecuador, existing across a patchwork of mangroves, lowland coastal forests, agricultural and community owned land. The species was described in 2014 and listed as ‘Endangered’ on the IUCN Red List, however, full assessment of the population was lacking. Using a combination of field observations, roost surveys and community questionnaires, conducted over the last 20 years, we provide up-to-date information on the species’ Extent of Occurrence, estimate its global population size, and evaluate its level of threat. Our results suggest the species occurs across an area of 19,890 km2 in three distinct geographically isolated subpopulations. Roost surveys across the range estimate the minimum remaining population at 741–1,090 individuals and we present evidence to suggest a 60% decline over the past 19 years in one part of the species’ range. We conducted community questionnaires with 427 people from 52 communities. The presence of pet parrots was reported in 37 communities, including 17 communities which reported pet A. lilacina. From this we predict that over half of all communities within our study area keep parrots as pets and at least 96 communities keep A. lilacina. Our findings justify an IUCN Red Listing of at least ‘Endangered’ for this species and highlight the need for conservation support. In order to assess population health in more detail, further research is required to assess genetic diversity and roost dynamics, and to identify areas that may be important for feeding and nesting throughout the range. As many of these areas are likely to overlap with community owned land, we suggest that future conservation actions should revolve around, and be led by, these communities.
Anecdotal evidence suggests the use of bolus tube feeding is increasing in the long-term home enteral tube feed (HETF) patients. A cross-sectional survey to assess the prevalence of bolus tube feeding and to characterise these patients was undertaken. Dietitians from ten centres across the UK collected data on all adult HETF patients on the dietetic caseload receiving bolus tube feeding (n 604, 60 % male, age 58 years). Demographic data, reasons for tube and bolus feeding, tube and equipment types, feeding method and patients’ complete tube feeding regimens were recorded. Over a third of patients receiving HETF used bolus feeding (37 %). Patients were long-term tube fed (4·1 years tube feeding, 3·5 years bolus tube feeding), living at home (71 %) and sedentary (70 %). The majority were head and neck cancer patients (22 %) who were significantly more active (79 %) and lived at home (97 %), while those with cerebral palsy (12 %) were typically younger (age 31 years) but sedentary (94 %). Most patients used bolus feeding as their sole feeding method (46 %), because it was quick and easy to use, as a top-up to oral diet or to mimic mealtimes. Importantly, oral nutritional supplements (ONS) were used for bolus feeding in 85 % of patients, with 51 % of these being compact-style ONS (2·4 kcal (10·0 kJ)/ml, 125 ml). This survey shows that bolus tube feeding is common among UK HETF patients, is used by a wide variety of patient groups and can be adapted to meet the needs of a variety of patients, clinical conditions, nutritional requirements and lifestyles.
Caribou (tuktuit) are embedded in northern life, and have been part of Inuit culture and seasonal rounds for generations. In Inuit Nunangat (Inuit homelands), tuktuit are the most prevalent of country foods consumed, and remain interconnected with Inuit values, beliefs and practices. Despite co-management mandates to consider Inuit and scientific knowledge equally, the intertwined colonial legacies of research and wildlife management render this challenging. In Uqsuqtuuq (Gjoa Haven, Nunavut), community members identified the importance of documenting Inuit knowledge in order to be taken more seriously by researchers and government managers. To address this priority we worked with Uqsuqtuurmiut (people of Uqsuqtuuq) to articulate which types of tuktuit are found on or near Qikiqtaq (King William Island), provide a historical perspective of tuktuit presence/absence in the region, and describe seasonal movements of tuktuit on and off the island. In reflecting on potential intersections of our work with the Government of Nunavut strategy “Working Together for Caribou”, we identify several considerations in support of Qanuqtuurniq (information and knowledge acquisition): defining information needs, recognising and valuing Inuit knowledge, and developing and implementing credible research. By sharing lessons from our collaborative process we aim to contribute to broader cross-cultural research and co-management efforts in Nunavut.
We present Phantom, a fast, parallel, modular, and low-memory smoothed particle hydrodynamics and magnetohydrodynamics code developed over the last decade for astrophysical applications in three dimensions. The code has been developed with a focus on stellar, galactic, planetary, and high energy astrophysics, and has already been used widely for studies of accretion discs and turbulence, from the birth of planets to how black holes accrete. Here we describe and test the core algorithms as well as modules for magnetohydrodynamics, self-gravity, sink particles, dust–gas mixtures, H2 chemistry, physical viscosity, external forces including numerous galactic potentials, Lense–Thirring precession, Poynting–Robertson drag, and stochastic turbulent driving. Phantom is hereby made publicly available.
‘Cracked trials’, where defendants enter a late guilty plea after a trial date has been set, are considered a societal problem because public resources set aside for trials are wasted. Various government reports attribute the main cause to tactical defendants playing the system, and reforms have been initiated to encourage early guilty pleas and strongly discourage late ones. The aim of the present study is to investigate the reasons for cracked trials in the Hong Kong context, insofar as the reasons for late guilty pleas can be investigated without the influence of reforms seen in other jurisdictions used to discourage late pleas. A mixed methods approach of courtroom observations and interviews with defendants was adopted. We find that defendants who were represented by publicly-funded lawyers or who were in prolonged pre-trial detention were more disposed to changing their pleas. Subsequent interviews illustrate why these factors are salient. The findings support the notion that it is the pressures of the criminal justice process that lead defendants to ‘crack’ and highlight the costs to defendants for decisions on how to plead that are influenced by considerations other than actual culpability.
Not enough is known in the UK about how economic phenomena and policy changes have impacted families’ ability to feed themselves. This article employs a novel way of identifying the types of UK families at risk of food poverty over time. Applying a relative deprivation approach, it asks what counts in the UK as a socially acceptable diet that meets needs for health and social participation and how much this costs. Comparing this to actual food expenditure by different family types, between 2005 and 2013, it identifies which are spending less than expected and may be at risk of food poverty. The analysis finds the proportion has increased over time for most family types and for lone parents and large families in particular. The discussion considers findings in light of changing economic and policy contexts and the implications for policy responses of how food poverty is defined and measured.
From 1924–1928, Gertrude Caton-Thompson and Elinor Gardner surveyed and excavated Epipalaeolithic and Neolithic sites across the Fayum north shore in Egypt, publishing a volume entitled The Desert Fayum (1934). Since then, a number of researchers have worked in the Fayum (e.g. Wendorf & Schild 1976; Hassan 1986; Wenke et al. 1988; Kozłowski & Ginter 1989), and most recently the UCLA/RUG/UOA Fayum Project. The long history of research in the area means that the Fayum is a testament to changing archaeological approaches, particularly regarding the Neolithic. Caton-Thompson and Gardner's study is recognised as one of the most progressive works on Egyptian prehistory, and their research provided the foundation for many subsequent studies in the region (e.g. Wendrich & Cappers 2005; Holdaway et al. 2010, 2016; Shirai 2010, 2013, 2015, 2016a; Emmitt 2011; Emmitt et al. 2017; Holdaway & Wendrich 2017). A recent article in Antiquity, however, uses Caton-Thompson and Gardner's preliminary interpretations of their excavations at a stratified deposit in the Fayum, Kom W, to generate a series of speculative statements concerning agricultural origins in the region (Shirai 2016b). The majority of these statements are very similar to conclusions initially made by Caton-Thompson and Gardner in the first half of the twentieth century, and new data and theory needed to reassess earlier conclusions are not considered. Recently published studies concerning the Fayum north shore and adjacent regions provide a different view of the state of research in this region and the Egyptian Neolithic in general. Here we acquaint Antiquity readers with current archaeological approaches to the Fayum north shore Neolithic, with the intent of stimulating academic debate.
Recent evidence suggests that exercise plays a role in cognition and that the posterior cingulate cortex (PCC) can be divided into dorsal and ventral subregions based on distinct connectivity patterns.
To examine the effect of physical activity and division of the PCC on brain functional connectivity measures in subjective memory complainers (SMC) carrying the epsilon 4 allele of apolipoprotein E (APOE 4) allele.
Participants were 22 SMC carrying the APOE ɛ4 allele (ɛ4+; mean age 72.18 years) and 58 SMC non-carriers (ɛ4–; mean age 72.79 years). Connectivity of four dorsal and ventral seeds was examined. Relationships between PCC connectivity and physical activity measures were explored.
ɛ4+ individuals showed increased connectivity between the dorsal PCC and dorsolateral prefrontal cortex, and the ventral PCC and supplementary motor area (SMA). Greater levels of physical activity correlated with the magnitude of ventral PCC–SMA connectivity.
The results provide the first evidence that ɛ4+ individuals at increased risk of cognitive decline show distinct alterations in dorsal and ventral PCC functional connectivity.
Families express a need for information to support people with severe anorexia nervosa.
To examine the impact of the addition of a skills training intervention for caregivers (Experienced Caregivers Helping Others, ECHO) to standard care.
Patients over the age of 12 (mean age 26 years, duration 72 months illness) with a primary diagnosis of anorexia nervosa and their caregivers were recruited from 15 in-patient services in the UK. Families were randomised to ECHO (a book, DVDs and five coaching sessions per caregiver) or treatment as usual. Patient (n=178) and caregiver (n=268) outcomes were measured at discharge and 6 and 12 months after discharge.
Patients with caregivers in the ECHO group had reduced eating disorder psychopathology (EDE-Q) and improved quality of life (WHO-Quol; both effects small) and reduced in-patient bed days (7–12 months post-discharge). Caregivers in the ECHO group had reduced burden (Eating Disorder Symptom Impact Scale, EDSIS), expressed emotion (Family Questionnaire, FQ) and time spent caregiving at 6 months but these effects were diminished at 12 months.
Small but sustained improvements in symptoms and bed use are seen in the intervention group. Moreover, caregivers were less burdened and spent less time providing care. Caregivers had most benefit at 6 months suggesting that booster sessions, perhaps jointly with the patients, may be needed to maintain the effect. Sharing skills and information with caregivers may be an effective way to improve outcomes. This randomised controlled trial (RCT) was registered with Current Controlled Trials ISRCTN06149665.
Graphene and graphene oxide are being investigated for use in drug delivery systems, bioimaging, and antimicrobial applications. However, their effects, if any, on healthy cells need to be established before they can be deemed safe for therapeutic use. This research tested whether graphene oxide (GO) and/or partially reduced graphene oxide (pRGO) exhibit antimicrobial properties on Staphylococcus aureus; and also examined the growth and proliferation of dermal fibroblasts and keratinocytes in media modified with graphene oxide or partially reduced graphene oxide. Staphylococcus aureus was able to proliferate in both GO and pRGO- modified growth media as well as on gelatin made with GO and pRGO solutions. Both GO and pRGO increased dermal fibroblast doubling time and displayed lower cell counts compared to the control, with pRGO exerting a more pronounced effect than GO. After 4 days of keratinocyte incubation, GO and pRGO showed cell counts 75-80% less than the control. Cell counts of test samples dropped even lower by day 5 while the control cell count increased, suggesting that more investigation into the properties as well as the safety of graphene and its derivatives needs to be done before it is implemented for medical applications.
Dental pulp stem cells (DPSCs) can differentiate into bone cells when provided the correct environment, potentially generating cells to repair non-union fractures. Polylactic Acid (PLA) is a biocompatible polymer for 3-D printing of scaffolds, but DPSCs do not proliferate well on PLA. With the goal of making PLA more conducive for DPSC growth, Graphene Oxide (GO); partially reduced Graphene Oxide (pRGO); GO with iron nanoparticles (FeGO) or Fe-pRGO were incorporated into PLA and spun cast as thin films onto silicon wafers for DPSC plating. DPSCs on Fe-pRGO displayed the fastest doubling time and the highest cell modulus; Fe-pRGO with exterior magnets produced high cell density. SEM demonstrated DPSC mineralization, whereas PLA-only DPSC cultures showed none. Results suggest that PLA/Fe-pRGO and PLA/pRGO enhance DPSC proliferation and possibly differentiation with the potential for use as a 3-D printed scaffold for tissue engineering.
The Taipan galaxy survey (hereafter simply ‘Taipan’) is a multi-object spectroscopic survey starting in 2017 that will cover 2π steradians over the southern sky (δ ≲ 10°, |b| ≳ 10°), and obtain optical spectra for about two million galaxies out to z < 0.4. Taipan will use the newly refurbished 1.2-m UK Schmidt Telescope at Siding Spring Observatory with the new TAIPAN instrument, which includes an innovative ‘Starbugs’ positioning system capable of rapidly and simultaneously deploying up to 150 spectroscopic fibres (and up to 300 with a proposed upgrade) over the 6° diameter focal plane, and a purpose-built spectrograph operating in the range from 370 to 870 nm with resolving power R ≳ 2000. The main scientific goals of Taipan are (i) to measure the distance scale of the Universe (primarily governed by the local expansion rate, H0) to 1% precision, and the growth rate of structure to 5%; (ii) to make the most extensive map yet constructed of the total mass distribution and motions in the local Universe, using peculiar velocities based on improved Fundamental Plane distances, which will enable sensitive tests of gravitational physics; and (iii) to deliver a legacy sample of low-redshift galaxies as a unique laboratory for studying galaxy evolution as a function of dark matter halo and stellar mass and environment. The final survey, which will be completed within 5 yrs, will consist of a complete magnitude-limited sample (i ⩽ 17) of about 1.2 × 106 galaxies supplemented by an extension to higher redshifts and fainter magnitudes (i ⩽ 18.1) of a luminous red galaxy sample of about 0.8 × 106 galaxies. Observations and data processing will be carried out remotely and in a fully automated way, using a purpose-built automated ‘virtual observer’ software and an automated data reduction pipeline. The Taipan survey is deliberately designed to maximise its legacy value by complementing and enhancing current and planned surveys of the southern sky at wavelengths from the optical to the radio; it will become the primary redshift and optical spectroscopic reference catalogue for the local extragalactic Universe in the southern sky for the coming decade.
Partially reduced graphene oxide functionalized with Fe nanoparticles alone or combined with Au and Pt nanoparticles is synthesized and characterized, and their effects on Polymer Electrolyte Membrane Fuel Cell (PEMFC) power output and carbon monoxide resistance are tested. Samples were prepared with various combinations of metal nanoparticles to create a cost-effective catalyst. Transmission and scanning electron microscopy revealed metal nanoparticles embedded on graphene sheets, some with magnetic susceptibility. PEMFC tests exhibited power output that was >180% of the control in a pure H2 gas feed and 250% of the control in a H2 gas feed with 1000 ppm of CO.