To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Neonates and infants who undergo congenital cardiac surgery frequently have difficulty with feeding. The factors that predispose these patients to require a gastrostomy tube have not been well defined. We aimed to report the incidence and describe hospital outcomes and characteristics in neonates and infants undergoing congenital cardiac surgery who required gastrostomy tube placement.
Materials and method:
A retrospective review was performed on patients undergoing congenital cardiac surgery between October 2015 and December 2020. Patients were identified by International Classification of Diseases 10th Revision codes, utilising the performance improvement database Vizient® Clinical Data Base, and stratified by age at admission: neonates (<1 month) and infants (1–12 months). Outcomes were compared and comparative analysis performed between admissions with and without gastrostomy tube placement.
There were 11,793 admissions, 3519 (29.8%) neonates and 8274 (70.2%) infants. We found an increased incidence of gastrostomy tube placement in neonates as compared to infants following congenital cardiac surgery (23.1% versus 6%, p = <0.001). Outcomes in neonates and infants were similar with increased length of stay and cost in those requiring a gastrostomy tube. Gastrostomy tube placement was noted to be more likely in neonates and infants with upper airway anomalies, congenital abnormalities, hospital infections, and genetic abnormalities.
Age at hospitalisation for congenital cardiac surgery is a definable risk factor for gastrostomy tube requirement. Additional factors contribute to gastrostomy tube placement and should be used when counselling families regarding the potential requirement of a gastrostomy tube.
Visual experiences such as hallucinations are commonly reported by people with psychosis, psychological trauma and dissociative states, although questions remain about their similarities and differences. For diagnostic and therapeutic purposes, clinical research must better delineate and compare the characteristics of these experiences in post-traumatic stress disorder (PTSD) and in schizophrenia.
To compare visual phenomena and dissociation in participants with a primary psychotic illness and those with a trauma diagnosis.
A quantitative group design study comparing visual phenomena in three participant groups who also have a history of hearing voices: schizophrenia and no trauma history (n = 19), PTSD with dissociation (n = 17) and comorbid schizophrenia and PTSD (n = 20). Validated clinical measures included the North-East Visual Hallucination Interview, PTSD Symptoms Scale Interview, Clinician Administered Dissociative States Scale, Psychotic Symptoms Rating Scales and Positive and Negative Syndrome Scale.
There was a remarkable similarity in visual experiences, including rates of complex visual hallucinations, between the three diagnostic groups. There were no significant differences in the severity or components of distress surrounding the visual experiences. Dissociation predicted visual hallucination severity for the comorbid schizophrenia and PTSD group, but not for PTSD or schizophrenia alone.
Visual experiences in PTSD can include visual hallucinations that are indistinguishable from those experienced in schizophrenia. Multimodal hallucinations are frequently observed in both schizophrenia and PTSD. A model for visual hallucinations in PTSD is suggested, following two separate neurobiological pathways based on distinct responses to trauma.
This position paper aims to increase awareness among primary care practitioners and policymakers about the specific and complex health needs of people who experience incarceration. We focus on the importance of primary care and of continuity of care between prison and community. We highlight what is known from the literature on the health of people who experience incarceration, on the organisation of prison health care, and on the role of primary care both during and after detention. We present three case descriptions of detainees’ encounters with the organisation of prison health care in three European countries. Finally, we describe the position that the European Forum for Primary Care takes. Prisoners and ex-prisoners have a worse physical and mental health compared with a cross-section of the population. However, access to good quality treatment and care is often worse than in the outside situation. In particular, well-organised primary care in the prison context could benefit prisoners and, indirectly, society at large. Moreover, continuity of care between the community and the prison situation needs improvement.
Children born very preterm (VP) are susceptible to a range of cognitive impairments, yet the effects of VP birth on long-term, episodic, and prospective memory remains unclear. This study examined episodic and prospective memory functioning in children born VP compared with their term-born counterparts at 13 years.
VP (n = 81: born <30 weeks’ gestation) and term (n = 26) groups were aged between 12 and 14 years. Children completed: (i) standardized verbal and visuospatial episodic memory tests; and (ii) an experimental time- and event-based prospective memory test that included short-term (within assessment session) and long-term (up to 1-week post-session) tasks. Parents completed a questionnaire assessing memory functions in everyday life.
The VP group performed worse on all measures of verbal and visuospatial episodic memory than the term group. While there were no group differences in event-based or long-term prospective memory, the VP group performed worse on time-based and short-term prospective memory tasks than term-born counterparts. Parents of children born VP reported more everyday memory difficulties than parents of children born at term, with parent-ratings indicating significantly elevated rates of everyday memory challenges in children born VP.
Children born VP warrant long-term surveillance, as challenges associated with VP birth include memory difficulties at 13 years. This study highlights the need for greater research and clinical attention into childhood functional memory outcomes.
OBJECTIVES/GOALS: To describe and evaluate an innovative university-community vaccination and food access model for minority, immigrant, and underserved individuals experiencing food insecurity during a global pandemic. METHODS/STUDY POPULATION: The Purdue University Center for Health Equity and Innovation (CHEqI) partnered with the two largest food banks in the Midwest and Walgreens to offer free COVID-19 and Flu vaccinations alongside food distribution. Goals included addressing food insecurity, increasing vaccine access, and decreasing vaccine hesitancy. CHEqI acquired funding, recruited volunteers and interpreters, assessed interest and addressed vaccine hesitancy. Food bank/pantry partners distributed food and provided access to clientele and marketing assistance. Walgreens procured, administered, and documented vaccinations. The Model accommodated drive-through and indoor processes. Unidentifiable observational and self-report data were collected. Descriptive statistics were computed to characterize program outcomes. RESULTS/ANTICIPATED RESULTS: A total of 11 vaccination events occurred between June and October 2021 at three food bank/pantry locations. Of these 11 events, nine (82%) were drive-through and two (18%) took place indoors, eight (72%) offered COVID-19 vaccinations only, and three (27%) offered both COVID-19 and Flu vaccinations. Food was distributed to a total of 5,108 families and 416 vaccines (314 COVID, 102 Flu) were administered. Of the 396 individuals who received at least one vaccine, 20 (5%) received both a COVID and Flu vaccine. Of the 386 individuals who received at least one vaccine and reported their sex, 194 (50%) identified as female and the average age of those who received at least one vaccine was 45 years old. Of those who reported race (N = 228) or ethnicity (N = 253), 43% identified as Black or African American and 53% identified as LatinX. DISCUSSION/SIGNIFICANCE: Findings offer an innovative vaccination and food access model for diverse individuals experiencing food insecurity during a global pandemic. By drawing on cost effective, accessible, and culturally contextualized practices to optimize the reach and quality of vaccination services we can improve access barriers and mitigate health disparities.
Chukchansi belongs to the Yokuts language family (ISO 639 code: yok) ancestrally spoken in the San Joaquin valley of Central California and in the adjacent foothills of the Sierra Nevada. The headquarters of the Chukchansi tribe is located in Coarsegold and many members of the tribe live in and around Madera and Fresno counties. As shown in the map in Figure 1, there are three major territories of the Yokuts: Northern Valley Yokuts, Foothill Yokuts, and Southern Valley Yokuts. While the territory of the Chukchansi is in the foothills area, the dialect is linguistically Northern Valley (Whistler & Golla 1986), as shown in Figure 2. Yawelmani, a Yokuts language that has been a subject of extensive linguistic research (e.g. Newman 1944, Archangeli 1983, Weigel 2005), is a dialect of the Southern Valley Yokuts. It is unclear to what extent Yokuts varieties are mutually intelligible. Yokuts is often considered to be a part of a larger Penutian language family (e.g. Dixon & Kroeber 1913, Sapir 1921, DeLancey & Golla 1997). While the status of Penutian as a macro-family is disputed, Yokuts is very likely related to the Miwok and Costanoan language families of California (Callaghan 1997).
Transport contributes around 11% of greenhouse gas emissions and the sector is also vulnerable to climate change. High temperatures can melt roads and distort rail lines while sea-level rise can disrupt coastal transport infrasructure. At the community level, cities and precincts can help mitigate climate change and adapt to changes by promoting active lifestyles with walking and bicyling replacing powered transport for short-distance travel and making cities more compact. Significant cost and health benefits can accrue from reduction of diseases associated with low physical activity and air pollution can also be mitigated. Increased provision and electrification of public transport based on renewable energy can decarbonise these services. The electification of sea and air transport present challenges but significant development work is underway with expected early availability of electrically powered short-haul aircraft. Phase-out of internal combustion engine cars and other vehicles is scheduled in several countries as battery-electric and hydrogen cars, buses and heavy transport vehicles emerge. Governments can help the transition with a range of policy initiatives.
This chapter outlines the case for the global green building movement to embrace integrated ‘climate-smart’ green building design, construction and operation, which optimises new and existing buildings to achieve both mitigation and adaptation goals synergistically and cost-effectively. The climate-smart building agenda is a high priority for this sector because it can help improve the well-being, productivity and health of occupants, and provide other social equity benefits, thus helping, simultaneously, to achieve other UN Sustainable Development Goals. Focus extends to precincts, the building blocks of cities, interfacing Building and Precinct Information Modelling. Overview is provided of leading sustainability assessment and rating tools for design of buildings and precincts. The chapter identifies key stakeholders and decision makers, and how each can best play their part to enable needed changes in this sector to achieve a net zero-carbon resilient future. It examines the role of governments in addressing major market and informational failures and what policies are needed to underpin efforts by all these key actors to achieve decarbonisation of the built environment sector.
Industry is a major contributor to climate change. Many industrial sites, supply chains and customers are vulnerable to climate change and policy and consumer responses to climate change. Profits from industrial production depend on consumer demand, and how products are provided. Powerful forces such as digitalisation, dematerialisation, decentralisation, electrification, efficiency improvement and circular economies influence production and emissions Industrial firms face pressure from regulators, investors and customers. However, there is enormous potential to capture multiple benefits through aggressive, innovative decarbonisation strategies that target growth markets and involve cooperation along supply chains. Economic productivity and business competitiveness improvement can cut business costs and reduce extreme weather risk exposure, whilst positioning manufacturing companies for fast-growing markets in low-carbon resilient products and services. The chapter overviews policies national and subnational government policymakers can consider to support transition to a zero-carbon resilient industrial sector.
The Introduction highlights the opportunities for a healthier and wealthier society following a transition to a low-carbon economy but also notes the serious consequences of inaction. It outlines the aim of the book to help policy-makers with practical guidance and summarises the various sections of the book including: the technologies available, economic projections for a low-carbon Australian economy and comparisons with two emerging giants – Indonesia and India, the sectoral analysis encompassing cities and their precincts, industry and manufacturing, tranportation and regional environments, land use, forestry and agriculture.
The transition to a low-carbon economy will increase mineral commodity demands by up to tenfold by 2050. Improving the quality of lives in developing countries will further increase resource demands. Mineral ores are critical for manufacturing low-carbon technologies. The projected increase in demand provides a major business opportunity, in turn providing a driver for the required investment to move to low-carbon mining, processing and recycling. To improve efficiency and reduce the carbon footprint of mining and metals recycling, the industry can take advantage of solar photovoltaics, wind and batteries, and renewable energy power purchase agreements, and reduce flaring, venting and fugitive emissions. Adaptation to cope with extreme weather events is critical to ensure materials can be delivered to low-carbon technology producers. Reducing exposure to climate risks through an integrated adaptation–mitigation approach lessens operational, maintenance and insurance costs. This chapter reviews tools to help the sector simultaneously achieve both climate mitigation and adaptation cost-effectively.