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Anatomy museums were thoroughly scrutinised as institutions that potentially perverted public taste, exhibiting specimens of sexual disease, victims of vanity, and monstrous curiosities. Claims that museums might be sites of titillation were not entirely unfounded; visitors to La Specola in Florence were apt to touch the wax genitalia of the anatomical Venus, while Kahn’s Museum peddled quack cures to visitors’ sexual diseases. In an attempt to combat this, anatomy museums foregrounded the moral and educational aspects of their institutions, places that one could visit to ‘know thyself’. Sensation fiction suffered similar imprecations for exhibiting sexualised bodies. Wilkie Collins’s The Law and the Lady (1875) engages with the excesses and order of anatomical, medical, and museum culture, his novel populated by characters that are simultaneously represented as specimens and curators, with clues collected from worryingly instable pathology, collections of female hair, and sexualised objects. Working with nineteenth-century anxieties about the differences between reputable and contentious displays of anatomy, Collins’s textualised and substitute bodies negotiate the tensions of the anatomy museum. This chapter argues that museums and literature shared similar strategies to make these excessive bodies respectable; narrative was used to order anatomy, making displayed specimens educative instead of titillating.
Primary aim – To improve how physical health issues are addressed for inpatients with eating disorders
Secondary aim – To improve efficiency within the MDT
The Yorkshire Centre for Eating Disorders (YCED) is an inpatient unit for the treatment of patients with anorexia and bulimia nervosa. Anorexia nervosa has the highest mortality of all psychiatric disorders with an extensive list of physical manifestations. This project was designed to help better address the physical health concerns of our patients by introducing a primary care style, once weekly clinic that patients could self-refer to.
Questionnaires were designed to assess whether a once weekly physical health clinic would benefit the service.
The clinic was run on a weekly basis from 26th April to 24th June 2019. Follow-up questionnaires were designed and distributed to both patients and staff following this period. Data were analysed with Microsoft Excel to determine if improvement had been made.
N = 12 inpatients responded to the initial questionnaires, n = 2 were discharged during the 8 week period so were included in the analysis but did not complete the follow-up questionnaire.
100% of the staff (n = 8) felt a once weekly clinic would benefit their patients. 62% (n = 5) stated they felt distracted from their other duties with physical health requests.
33% (n = 4) of the inpatient group felt the clinic would benefit them with 67% (n = 8) stating indifference to the idea.
26 appointments were conducted in the physical health clinic with 80% (n = 8) of the service users accessing at least once. 70% (n = 7) stated their physical health concerns had been better addressed since the clinic had been started.
90% (n = 9) of inpatients and 90% (n = 9) of staff responded that the physical health clinic should remain permanent. 90% (n = 9) of staff stated they had more time for their other duties since the introduction of the clinic.
Prior to the clinic 63% (n = 5) of staff responded that in a typical day they were approached between 2-5 times for physical health requests with the other 37% (n = 3) being approached once.
Following the clinic 80% (n = 8) of staff responded that they were approached once in a typical working day.
The qualitative data from the questionnaires indicated success in both improving patient care and reducing nursing workload.
The physical health clinic has been made a permanent feature on the ward and has been continued by the incoming foundation doctor and ward ANP.
The aim of the present study is to determine whether vulnerable non-psychotic clients presenting in court proceedings do not share the same mortality profile as psychotic patients in similar environments. It is hypothesised that the two display quite separate mortality profiles.
The increased mortality of psychiatric patients and prisoners has been documented but less is known of the outcomes among other vulnerable populations .
The population for study is a consecutive series of assessments in court proceedings of carers of children at risk and violent offenders.
Assistants not involved in the initial assessments transferred data from case notes and this material was transferred to computer files. Statistical analysis SPSS19
Formal psychiatric diagnoses were those agreed in court proceedings. National mortality records were searched and copies of death certificates obtained. A small number of cases known to have returned overseas were excluded. 772 cases were studied. One in five were assessed in prison, twice as many gave a history of violent criminal behaviour. Over a half suffered abuse or neglect or admitted to being unhappy in childhood. Three subgroups have been identified: Vulnerable with no psychotic illness(60%), psychosis with no evidence of personality disorder or of mixed psychosis(18%), linked psychosis(22%). It was found that demographic variables , deprivation factors, adverse childhood experiences and outcomes and clinical variables are in excess among linked psychotics compared with other groups. Linear regression of unnatural death among psychotic patients identifies five risk factors. The distribution of high-risk factors among linked psychosis is more than twice that found in other groups.
Natural mortality is most evident among clients suffering from psychosis without personality disorder or mixed disorder.Unnatural mortality is more than 10 times greater among patients with linked psychosis, compared with those with no psychosis and four times greater than other psychoses. Risk factors for unnatural mortality are: physical illness, stressful relationship, violence to self or others, detained and history of behaviour disorder.
The findings of the present study demonstrate that vulnerable clients without psychosis are less likely to die by unnatural causes than clients who suffer psychosis coexisting with personality disorder or mixed psychosis. The null hypothesis is upheld. The findings suggest that risk assessment of vulnerable populations should take account of risk factors of unnatural death which have been identified in this study.
Within the holdings of the Thomas Fisher Rare Book Library at the University of Toronto there is a curious, rarely examined handwritten book entitled Opera Evangelica, containing translations of several apocryphal works in English. It opens with a lengthy Preface that provides an antiquarian account of Christian apocrypha along with a justification for translating the texts. Unfortunately, the book's title page gives little indication of its authorship or date of composition, apart from an oblique reference to the translator as ‘I. B.’ But citations in the Preface to contemporary scholarship place the volume around the turn of the eighteenth century, predating the first published English-language compendium of Christian apocrypha in print by Jeremiah Jones (1726). A second copy of the book has been found in the Cambridge University Library, though its selection of texts and material form diverges from the Toronto volume in some notable respects. This article presents Opera Evangelica to a modern audience for the first time. It examines various aspects of the work: the material features and history of the two manuscripts; the editions of apocryphal texts that lie behind its translations; the views expressed on Christian apocrypha by its mysterious author; and its place within manuscript publication and English scholarship around the turn of the eighteenth century. Scholars of Christian apocrypha delight in finding ‘lost gospels’ but in Opera Evangelica we have something truly unique: a long-lost collection of Christian apocrypha.
We evaluated adverse drug events (ADEs) by chart review in a random national sample of 428 veterans with coronavirus disease 2019 (COVID-19) who received tocilizumab (n = 173 of 428). ADEs (median time, 5 days) occurred in 51 of 173 (29%) and included hepatoxicity (n = 29) and infection (n = 13). Concomitant medication discontinuation occurred in 22% of ADE patients; mortality was 39%.
This research communication describes the lactating intramammary (IMM) antibiotic formulation most used by Irish dairy farmers at farm level through interviewing 202 dairy farmers. The IMM antibiotic usage data is not easily available to the researcher and farming community. This study determined that three commercial formulations (Synulox ™, Tetra Delta™ and Terrexine) made up 81% of the products used at farm level. The formulation Synulox™ was the most used at 34% first preference and 32% second preference and contains amoxicillin/clavulanic, a standard broad spectrum antibiotic, for which mastitis pathogen resistance remains low. The aminoglycosides were used in four of the IMM formulations analysed, including Tetra Delta™ and Terrexine. Of the 12 antibiotics identified in the IMM formulations studied, three including cefalexin, benzylpenicillin and penethamate are classified as highly important antibiotics (HIA) by the World Health Organisation (WHO) whilst the other 8 (dihydrostreptomycin, streptomycin, neomycin, framycetin, kanamycin, amoxicillin/clavulanic acid, and cefquinome), are considered critically important (CIA) for use in human health. This study has generated knowledge of the preferences of lactating IMM formulations used at farm level.
Factorial experiments were carried out on spring- and winter-sown oat crops in Ireland in 2016–2019 to identify plant responses in yield formation and grain filling procedures. Two cultivars (Husky and Keely), three seed rates (250, 350 and 450 seeds/m2), six applied nitrogen (N) rates (40, 70, 100, 130, 160 and 190 kg N/ha) with a plant growth regulator (PGR) were examined in spring and winter sowings, using the same cultivars at five rates of applied N (80, 110, 140, 170 and 200 kg N/ha). The applied N rate and seed rate significantly (P < 0.05) modified the yield components determining grains/m2 in spring- and winter-sown crops with increases in panicle number of key importance. Increases were also observed in the proportion of primary grain by weight (0.9–1.6%) and number (0.7–1.4%) ratios in spring-sown crops in response to applied N rate, with winter-sown crops exhibiting a more consistent pattern of grain fill. Seed rate and PGR application had minor effects on yield components and panicle conformation. Grain fill procedures played an important role in the maximization of grain yield under seasonal conditions. Significant positive correlations were observed between the number of aborted grain sites and yield under drought conditions (0.22), with negative associations observed in near-optimal conditions (−0.22 to −0.41). Agronomic effects on grain site abortion were minimal in comparison with seasonal effects. In seasons characterized by cool, consistent conditions, grain yield was maximized by the utilization of all available grain sites. Where assimilate shortages were encountered during grain fill the abortion of grains sites was positively associated with grain yield.
The unprecedented occurrence of a global pandemic is accompanied by both physical and psychological burdens that may impair quality of life. Research relating to COVID-19 aims to determine the effects of the pandemic on vulnerable populations who are at high risk of developing negative health or psychosocial outcomes. Having an ongoing medical condition during a pandemic may lead to greater psychological distress. Increased psychological distress may be due to preventative public health measures (e.g. lockdown), having an ongoing medical condition, or a combination of these factors.
This study analyses data from an online cross-sectional national survey of adults in Ireland and investigates the relationship between comorbidity and psychological distress. Those with a medical condition (n = 128) were compared to a control group without a medical condition (n = 128) and matched according to age, gender, annual income, education, and work status during COVID-19. Participants and data were obtained during the first public lockdown in Ireland (27 March 2020–8 June 2020).
Individuals with existing medical conditions reported significantly higher levels of anxiety (p < .01) and felt less gratitude (p ≤ .001). Exploratory analysis indicated that anxiety levels were significantly associated with illness perceptions specific to COVID-19. Post hoc analysis revealed that psychological well-being was not significantly related to condition type (e.g. respiratory disorders).
This research supports individualised supports for people with ongoing medical conditions during the COVID-19 pandemic, and has implications for the consideration of follow-up care specifically for mental health. Findings may also inform future public health policies and post-vaccine support strategies for vulnerable populations.
The United States Constitution requires the government “to provide for the common defense.” As a prime topic featured prominently throughout the legislative blueprint of American society, the “common defense” is conspicuously uncommon in today’s policy scholarship and education. Ironically, the policy discipline largely ignores defense issues despite defense serving as the catalyst for establishing policy studies as an academic field in the 1940s. Through decades of military conflict since and obvious relevance to practitioner behavior, defense issues remain ironically absent the public policy scholarly landscape and are instead hosted primarily within strategic and security studies mediums. This article offers an historical examination of the evolution, development, and scholarly shifts in defense policy over time. It also presents perceived reasons for the lack of defense policy dialogue, recommends approaches to reintegrate the topic back into the scholarly discourse, and concludes arguing defense policy warrants greater attention in academic scholarship and teaching.
Divine hiddenness in the Hebrew Bible is widely construed as the conceptual equivalent to divine absence. This article challenges this influential account in light of Psalm 88—where the hidden God is hostilely present, not absent—and reevaluates divine hiddenness. Divine hiddenness is not conterminous with divine absence. Rather, with its roots in the ancient Near Eastern idea of the royal and cultic audience, the meaning of “hide the face” (סתר + פנים) may be construed as a refusal of an audience with the divine king YHWH. Building on this insight, I argue that divine hiddenness possesses a petitionary logic and develop a distinction between the experiential and petitionary inaccessibility of salvific divine presence. Divine absence and hostile divine presence denote the former, while divine hiddenness the latter. I probe the relationships between divine hiddenness, divine absence, and hostile divine presence, concluding that the absent or hostilely present God is not ipso facto hidden.
Sex-related differences in psychopathology are known phenomena, with externalizing and internalizing symptoms typically more common in boys and girls, respectively. However, the neural correlates of these sex-by-psychopathology interactions are underinvestigated, particularly in adolescence.
Participants were 14 years of age and part of the IMAGEN study, a large (N = 1526) community-based sample. To test for sex-by-psychopathology interactions in structural grey matter volume (GMV), we used whole-brain, voxel-wise neuroimaging analyses based on robust non-parametric methods. Psychopathological symptom data were derived from the Strengths and Difficulties Questionnaire (SDQ).
We found a sex-by-hyperactivity/inattention interaction in four brain clusters: right temporoparietal-opercular region (p < 0.01, Cohen's d = −0.24), bilateral anterior and mid-cingulum (p < 0.05, Cohen's d = −0.18), right cerebellum and fusiform (p < 0.05, Cohen's d = −0.20) and left frontal superior and middle gyri (p < 0.05, Cohen's d = −0.26). Higher symptoms of hyperactivity/inattention were associated with lower GMV in all four brain clusters in boys, and with higher GMV in the temporoparietal-opercular and cerebellar-fusiform clusters in girls.
Using a large, sex-balanced and community-based sample, our study lends support to the idea that externalizing symptoms of hyperactivity/inattention may be associated with different neural structures in male and female adolescents. The brain regions we report have been associated with a myriad of important cognitive functions, in particular, attention, cognitive and motor control, and timing, that are potentially relevant to understand the behavioural manifestations of hyperactive and inattentive symptoms. This study highlights the importance of considering sex in our efforts to uncover mechanisms underlying psychopathology during adolescence.
The systems ecology paradigm (SEP) emerged in the late 1960s at a time when societies throughout the world were beginning to recognize that our environment and natural resources were being threatened by their activities. Management practices in rangelands, forests, agricultural lands, wetlands, and waterways were inadequate to meet the challenges of deteriorating environments, many of which were caused by the practices themselves. Scientists recognized an immediate need was developing a knowledge base about how ecosystems function. That effort took nearly two decades (1980s) and concluded with the acceptance that humans were components of ecosystems, not just controllers and manipulators of lands and waters. While ecosystem science was being developed, management options based on ecosystem science were shifting dramatically toward practices supporting sustainability, resilience, ecosystem services, biodiversity, and local to global interconnections of ecosystems. Emerging from the new knowledge about how ecosystems function and the application of the systems ecology approach was the collaboration of scientists, managers, decision-makers, and stakeholders locally and globally. Today’s concepts of ecosystem management and related ideas, such as sustainable agriculture, ecosystem health and restoration, consequences of and adaptation to climate change, and many other important local to global challenges are a direct result of the SEP.
ABSTRACT IMPACT: The potential to use vaginal pH as a low cost, non-invasive diagnostic test at the point of CIN2 diagnosis to predict worsening of cervical disease. OBJECTIVES/GOALS: We previously reported that persistence/progression of cervical intraepithelial neoplasia-2 (CIN2) was uncommon in women living with HIV (WLH) from the Women’s Interagency HIV Study (WIHS, now MWCCS). Here we examined additional factors that may influence CIN2 natural history. METHODS/STUDY POPULATION: A total of 337 samples from 94 WLH with a confirmed CIN2 diagnosis were obtained from the MWCCS. 42 cervicovaginal HPV types and 34 cervicovaginal cytokines/chemokines were measured at CIN2 diagnosis (94 samples) and 6-12 months prior to CIN2 diagnosis (79 samples). Covariates, including CD4 count and vaginal pH, were abstracted from core MWCCS visits. Logistic regression models were used to explore CIN2 regression (CIN1, normal) vs. persistence/progression (CIN2, CIN3). Log rank tests, Kaplan Meier method, and Cox regression modeling were used to determine CIN2 regression rates. RESULTS/ANTICIPATED RESULTS: The most prevalent HPV types were HPV54 (21.6%) and 53 (21.3%). 33 women (35.1%) had a subsequent CIN2/CIN3 diagnosis (median 12.5 years follow-up). Each additional hr-HPV type detected at the pre-CIN2 visit associated with increased odds of CIN2 persistence/progression (OR 2.27, 95% CI 1.15, 4.50). Higher vaginal pH (aOR 2.27, 95% CI 1.15, 4.50) and bacterial vaginosis (aOR 5.08, 95% CI 1.30, 19.94) at the CIN2 diagnosis visit associated with higher odds of CIN2 persistence/progression. Vaginal pH >4.5 at CIN2 diagnosis also associated with unadjusted time to CIN2 persistence/progression (log rank p=0.002) and a higher rate of CIN2 persistence/progression (adjusted hazard ratio [aHR] 3.37, 95% CI 1.26, 8.99). Cervicovaginal cytokine/chemokine levels were not associated with CIN2 persistence/progression. DISCUSSION/SIGNIFICANCE OF FINDINGS: We found relatively low prevalence of HPV16/18 in this cohort. Elevated vaginal pH at the time of CIN2 diagnosis may be a useful indicator of CIN2 persistence/progression and the rate of persistence/progression.
ABSTRACT IMPACT: It is our hope that a better understanding of the relationship between genetic variants that influence heart failure precursor traits will not only inform clinical care, but enable better assessment of inherited risk and will identify new biological targets for drug development. OBJECTIVES/GOALS: In this project, using a large-scale human genomic dataset with extensive phenotype data available, we intend to interrogate the known MTSS1 variants that have been associated with heart failure (HF) in previous GWAS studies in order to understand the directionality and mechanisms of their effects. METHODS/STUDY POPULATION: Data was obtained from the UK Biobank, a large prospective cohort of ˜500,000 patients across the United Kingdom with extensive phenotype data, including ˜50,000 patients with cardiac MRI and ˜200,000 with whole exome sequencing. We test for associations between genetic variants at the MTSS1 locus and HF precursor traits using logistic regression or linear regression, adjusting for age, gender, and principal components (PCs) of ancestry. For rare variant analyses we ‘bin’ rare variants (MAF < 0.01) using the software tool BioBin to aggregate low frequency genetic variants into single genetic units. RESULTS/ANTICIPATED RESULTS: Preliminary data have shown that variants in the known MTSS1 enhancer region which reduce MTSS1 expression are associated with smaller, more contractile hearts. We anticipate that common variants known to reduce enhancer activity will attenuate heart failure precursor traits, will be associated with a reduced risk clinical heart failure, and will favorably impact clinical outcomes once HF is established. We also anticipate that rare exonic variants predicted to impair MTSS1 function will attenuate heart failure precursor traits. DISCUSSION/SIGNIFICANCE OF FINDINGS: Through this work, we intend to take advantage of multiple novel approaches to better understand a complex disease process, identify a new potential therapeutic target (namely one that targets cardiac function), and to determine which patient subgroups will benefit from this our therapeutic interventions and why.
ABSTRACT IMPACT: This work will inform the ongoing development of adaptive capacity and preparedness of the CTSA Program and other clinical and translational research organizations in their quest of improving processes that drive outcomes and impacts, shaping effective programs and services, and strengthening their emergency readiness and sustainability. OBJECTIVES/GOALS: -Share the progress and preliminary findings of an ‘Adaptive Capacity and Preparedness of CTSA Hubs’ CTSA Working Group; -Improve our awareness and understanding of the efficient and effective changes helping CTSA hubs build robust capacity to address METHODS/STUDY POPULATION: A multi-case study including: - Triangulating multiple sources of information and mixed methods (survey/interviews of research administrators, researchers, evaluators, and other key stakeholders), literature review, document and M&E system information analysis, and expert review; - Describing CTSA hubs’ experiences as related to research implementation, translation, and support during the time of emergency; - Administering a comprehensive survey of the CTSAs addressing their challenges, lessons learned, and practices that work in various program components/areas. Data collection includes aggregate and cross-sectional data, with representation based on CTSA size, maturity, and population density. RESULTS/ANTICIPATED RESULTS: The described approach shows sound promise to investigate and share strategies and best practices for building adaptive capacity and preparedness of CTSAs -- across various scientific sectors, translational research spectrum, and the goals outlined by NCATS for the CTSA program. The anticipated results of this research will include the identified/shared innovative solutions and lessons learned for this rapidly emerging, high-priority clinical and translational science issue. ‘High-quality lessons learned’ are those that represent principles extrapolated from multiple sources and triangulated to increase transferability to new contexts and situations. DISCUSSION/SIGNIFICANCE OF FINDINGS: The project provides useful knowledge and tools to research organizations and stakeholders across multiple disciplines -- for mitigating the impact of the COVID-19 disaster via effective adjusting programs, practices, and processes, and building capacity for future successful, ‘emergency ready and responsive’ research and training.
Individuals with mental illness have poorer physical health, nutritional status, and lowered life expectancy. Optimising their physical and nutritional status has become an increasingly important therapeutic goal. Current experience with COVID-19 has further emphasised the susceptibility to physical illness and poorer outcomes amongst individuals with mental illness and those who are nutritionally compromised. Although life as we knew it has been suspended until the widespread roll-out of a vaccine, individuals can take immediate action to improve physical and mental health by attending to and optimising their nutritional well-being. Clinicians within mental health services have a crucial role to play in assisting such change, and reminding their patients of the importance of pursuing a healthy and balanced diet.
5. Competition and Emulation: The Amorite Koine from Dilmun to Avaris, 1800–1550 BC
The establishment of an Amorite koine culture during the second half of the Middle Bronze Age is articulated in the context of intensive and long-distance exchanges of personnel through trade, warfare, and land tenure. Both competition between Amorite dynasties as well as the emulation of elites are discussed as the principal means by which a wide range of traditions were embraced across the Near East in the construction of an Amorite social identity.