Background: Cervical spondylotic myelopathy (CSM) is the leading cause of spinal cord impairment. In a public healthcare system, wait times to see spine specialists and eventually access surgical treatment for CSM can be substantial. The goals of this study were to determine consultation wait times (CWT) and surgical wait times (SWT), and identify predictors of wait time length. Methods: Consecutive patients enrolled in the Canadian Spine Outcomes and Research Network (CSORN) prospective and observational CSM study from March 2015 to July 2017 were included. A data-splitting technique was used to develop and internally validate multivariable models of potential predictors. Results: A CSORN query returned 264 CSM patients for CWT. The median was 46 days. There were 31% mild, 35% moderate, and 33% severe CSM. There was a statistically significant difference in median CWT between moderate and severe groups; 207 patients underwent surgical treatment. Median SWT was 42 days. There was a statistically significant difference in SWT between mild/moderate and severe groups. Short symptom duration, less pain, lower BMI, and lower physical component score of SF-12 were predictive of shorter CWT. Only baseline pain and medication duration were predictive of SWT. Both CWT and SWT were shorter compared to a concurrent cohort of lumbar stenosis patients (p <0.001). Conclusions: Patients with shorter duration (either symptoms or medication) and less neck pain waited less to see a spine specialist in Canada and to undergo surgical treatment. This study highlights some of the obstacles to overcome in expedited care for this patient population.

Around the beginning of the 3rd millennium cal bc a cremation cemetery was established at Forteviot, central Scotland. This place went on to become one of the largest monument complexes identified in Mainland Scotland, with the construction of a palisaded enclosure, timber structures, and a series of henge monuments and other enclosures. The cemetery was established between 3080 and 2900 cal bc, probably in the 30th century cal bc, which is contemporary with the cremation cemetery at Stonehenge. Nine discrete deposits of cremated bone, representing the remains of at least 18 people, were identified. In most instances they were placed within cut features and, in one case, a series of cremation deposits was associated with a broken standing stone. This paper includes the first detailed assessment of the cremated remains at Forteviot and the features associated with the cemetery, and explores how the establishment of this cemetery may have been both a catalyst and inspiration for the elaborate monument building and prolonged acts of remembrance that occurred at this location over a period of almost 1000 years. The paper also outlines the parallels for Forteviot across Britain and, for the first time, draws together the dating evidence (including Bayesian modelling) for this major category of evidence for considering the nature of late 4th/early 3rd millennium cal bc society. The results and discussion have wide implications and resonances for contemplating the establishment and evolution of monument complexes in prehistoric Britain and beyond.

This article is an ecumenical conversation between Pentecostal and Anabaptist-Pietist traditions. Emerging out of this will be a suggestion that the Christian worship practice of footwashing may provide a means to share Christian love and fellowship that is inclusive of all Christian traditions. In this article we will addresses important points of theological intersection of these two storied traditions, specifically soteriology as a ‘Christian synergism’ and ecclesiology as an ‘alternative society’. These traditions approach ecclesiology through soteriology with a conscientious concern to form eschatological communities. We believe that these traditions must engage in ecumenical dialogue for mutual theological support in forming and sustaining ‘alternative Christian communities’ while continuing to participate in ecumenical dialogue with other traditions.

Background: This paper describes an innovative education program for the management of mental health problems in long-term care (LTC) homes and the evaluation of its longer-term sustainability. Since 1998, the [ldquor]Putting the P.I.E.C.E.S. Together[rdquor] learning initiative has been providing education sessions and related learning strategies aimed at developing the knowledge and skills of health professionals who care for older persons with complex physical and mental health needs and associated behaviors, in Ontario, Canada. A major focus of this province-wide initiative was the development of in-house Psychogeriatric Resource Persons (PRPs).

Methods: Evaluation of this initiative included the completion of pre- and post-education questionnaires (over three data collection time periods) assessing learner confidence (N = 1,024 and 792, for pre- and post-education, respectively) and session evaluation questionnaires gathering feedback on the session (N = 2,029 across all sessions). A survey of LTC homes in Ontario (N = 439, 79% of the homes in the province) was conducted to assess longer-term sustainability.

Results: Ratings of the sessions indicated that they were relevant to learners' clinical practice. There were significant increases in ratings of ability to recognize and understand challenging behaviors and mental health problems, and in ability to use a variety of assessment tools. Few homes (15%) do not have a PRP; over 50% of the staff who completed the first session in 1999 continue to serve as a PRP and to apply learned skills.

Conclusions: A learning initiative with supportive and reinforcing strategies can develop in-house PRPs to enhance the care of the elderly in LTC. Incorporation of PRP functions into job descriptions and management support contributed to the success of this initiative. This study highlights the importance of work environments that support and reinforce the use of learned skills to the success of continuing education and quality improvement initiatives in LTC.

This paper reports on the second season of the new fieldwork at Euesperides (Benghazi). Excavations continued in Areas P (a large building with early Hellenistic mosaics) and Q (an area of streets and buildings built against the line of the Archaic period city wall), and were commenced at a site in the Lower City (Area R), where evidence for purple dye production from the Murex trunculus shellfish was found. In addition, a programme of machine-cut evaluation trenching was carried out in an area to the south of the Sidi Abeid mound to determine the limits of the archaeological area; this showed that occupation deposits continued for some distance to the south-east of the zone formerly considered to have encompassed the city. Geophysical prospection was completed in the Lower City, giving a fuller understanding of the city plan and of manufacturing activities. Preliminary quantification of the fine pottery suggests heavy reliance on imported wares (some 90%) to meet demand for tablewares, and carries important implications for the volume of ancient shipping and trade reaching Euesperides.

This paper reports on the first season of a new project at Euesperides (Benghazi) aimed at studying the urban development and economy of the city. Two area excavations were started, the first on the site of early Hellenistic pebble and tessellated mosaics discovered in 1998, and the second in what appears to be an area of houses and workshops built against the city wall on the east side of the mound of Sidi Abeid. Geophysical survey and surface prospection was also undertaken; it appears that the lower-lying extension to the city was much larger than previously thought, and several modifications are necessary to previously published plans of the site. Much of the lower city is covered with large spreads of deliberately crushed shells of Murex trunculus, indicating the production of purple dye on a significant scale. Other evidence of urban production was also recovered, notably metal-working, while study of the ceramic assemblage shows widespread trading connections, with significant imports of coarsewares besides the expected fineware and amphora imports.