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Anelaphus villosus (Fabricius) and A. parallelus (Newman) are longhorned beetles (Coleoptera: Cerambycidae: Cerambycinae: Elaphidiini) that closely resemble each other in appearance. In practice, if antennomere 3 is distinctly longer than antennomere 4, the specimen is considered to be A. villosus, but the accuracy of this methodology is unknown. Authorities disagree about the ease of separating these two species based on morphological traits, and recent work hypothesises that they should be synonymised due to the difficulty of distinguishing them by either morphology or natural history. Assuming correct initial species determinations of curated specimens, as well as of those determined with DNA barcoding and by the primary author, data from 23 body measurements were collected from 50 A. villosus and 60 A. parallelus specimens. Stepwise discriminant analyses and discriminant functions were used to evaluate the ability to distinguish these species based on morphology. Species assignments from discriminant functions were very accurate and were supported by assignments determined with DNA barcoding. The ability to distinguish A. villosus and A. parallelus based on morphological and molecular differences provides evidence against the taxonomic hypothesis of synonymy under one species. A need for greater ecological understanding of these species remains.
The number of people over the age of 65 attending Emergency Departments (ED) in the United Kingdom (UK) is increasing. Those who attend with a mental health related problem may be referred to liaison psychiatry for assessment. Improving responsiveness and integration of liaison psychiatry in general hospital settings is a national priority. To do this psychiatry teams must be adequately resourced and organised. However, it is unknown how trends in the number of referrals of older people to liaison psychiatry teams by EDs are changing, making this difficult.
We performed a national multi-centre retrospective service evaluation, analysing existing psychiatry referral data from EDs of people over 65. Sites were selected from a convenience sample of older peoples liaison psychiatry departments. Departments from all regions of the UK were invited to participate via the RCPsych liaison and older peoples faculty email distribution lists. From departments who returned data, we combined the date and described trends in the number and rate of referrals over a 7 year period.
Referral data from up to 28 EDs across England and Scotland over a 7 year period were analysed (n = 18828 referrals). There is a general trend towards increasing numbers of older people referred to liaison psychiatry year on year. Rates rose year on year from 1.4 referrals per 1000 ED attenders (>65 years) in 2011 to 4.5 in 2019 . There is inter and intra site variability in referral numbers per 1000 ED attendances between different departments, ranging from 0.1 - 24.3.
To plan an effective healthcare system we need to understand the population it serves, and have appropriate structures and processes within it. The overarching message of this study is clear; older peoples mental health emergencies presenting in ED are common and appear to be increasingly so. Without appropriate investment either in EDs or community mental health services, this is unlikely to improve.
The data also suggest very variable inter-departmental referral rates. It is not possible to establish why rates from one department to another are so different, or whether outcomes for the population they serve are better or worse. The data does however highlight the importance of asking further questions about why the departments are different, and what impact that has on the patients they serve.
The First Episode Rapid Early Intervention for Eating Disorders (FREED) service model is associated with significant reductions in wait times and improved clinical outcomes for emerging adults with recent-onset eating disorders. An understanding of how FREED is implemented is a necessary precondition to enable an attribution of these findings to key components of the model, namely the wait-time targets and care package.
This study evaluated fidelity to the FREED service model during the multicentre FREED-Up study.
Participants were 259 emerging adults (aged 16–25 years) with an eating disorder of <3 years duration, offered treatment through the FREED care pathway. Patient journey records documented patient care from screening to end of treatment. Adherence to wait-time targets (engagement call within 48 h, assessment within 2 weeks, treatment within 4 weeks) and care package, and differences in adherence across diagnosis and treatment group were examined.
There were significant increases (16–40%) in adherence to the wait-time targets following the introduction of FREED, irrespective of diagnosis. Receiving FREED under optimal conditions also increased adherence to the targets. Care package use differed by component and diagnosis. The most used care package activities were psychoeducation and dietary change. Attention to transitions was less well used.
This study provides an indication of adherence levels to key components of the FREED model. These adherence rates can tentatively be considered as clinically meaningful thresholds. Results highlight aspects of the model and its implementation that warrant future examination.
To assess extent of a healthcare-associated outbreak of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) and to evaluate the effectiveness of infection control measures, including universal masking.
Outbreak investigation including 4 large-scale point-prevalence surveys.
Integrated VA healthcare system with 2 facilities and 330 beds.
Index patient and 250 exposed patients and staff.
We identified exposed patients and staff and classified them as probable and confirmed cases based on symptoms and testing. We performed a field investigation and an assessment of patient and staff interactions to develop probable transmission routes. Infection prevention interventions included droplet and contact precautions, employee quarantine, and universal masking with medical and cloth face masks. We conducted 4 point-prevalence surveys of patient and staff subsets using real-time reverse-transcriptase polymerase chain reaction for SARS-CoV-2.
Among 250 potentially exposed patients and staff, 14 confirmed cases of coronavirus disease 2019 (COVID-19) were identified. Patient roommates and staff with prolonged patient contact were most likely to be infected. The last potential date of transmission from staff to patient was day 22, the day universal masking was implemented. Subsequent point-prevalence surveys in 126 patients and 234 staff identified 0 patient cases and 5 staff cases of COVID-19, without evidence of healthcare-associated transmission.
Universal masking with medical face masks was effective in preventing further spread of SARS-CoV-2 in our facility in conjunction with other traditional infection prevention measures.
Coronavirus disease (COVID-19) has been identified as an acute respiratory illness leading to severe acute respiratory distress syndrome. As the disease spread, demands on health care systems increased, specifically the need to expand hospital capacity. Alternative care hospitals (ACHs) have been used to mitigate these issues; however, establishing an ACH has many challenges. The goal of this session was to perform systems testing, using a simulation-based evaluation to identify areas in need of improvement.
Four simulation cases were designed to depict common and high acuity situations encountered in the ACH, using a high technology simulator and standardized patient. A multidisciplinary observer group was given debriefing forms listing the objectives, critical actions, and specific areas to focus their attention. These forms were compiled for data collection.
Logistical, operational, and patient safety issues were identified during the simulation and compiled into a simulation event report. Proposed solutions and protocol changes were made in response to the identified issues.
Simulation was successfully used for systems testing, supporting efforts to maximize patient care and provider safety in a rapidly developed ACH. The simulation event report identified operational deficiencies and safety concerns directly resulting in equipment modifications and protocol changes.
The importance of data science in society today is undeniable, and now is the time to prepare data science talent (National Academies of Sciences, Engineering, and Medicine 2018). Data science demands collaboration, but collaboration within political science departments has been weak in teaching data science. Bridging substantive and methods courses can critically aid in teaching data science because it facilitates this collaboration. Our innovation is to integrate data science into both substantive and methods courses through a dedicated data science course and modules on data science topics taught in substantive courses. This approach allows not only for more opportunities for teaching and practice of data science methods but also helps students to understand how social, economic, and political biases and incentives can affect their data.
Efforts to move community engagement in research from marginalized to mainstream include the NIH requiring community engagement programs in all Clinical and Translational Science Awards (CTSAs). However, the COVID-19 pandemic has exposed how little these efforts have changed the dominant culture of clinical research. When faced with the urgent need to generate knowledge about prevention and treatment of the novel coronavirus, researchers largely neglected to involve community stakeholders early in the research process. This failure cannot be divorced from the broader context of systemic racism in the US that has contributed to Black, Indigenous, and People of Color (BIPOC) communities bearing a disproportionate toll from COVID-19, being underrepresented in COVID-19 clinical trials, and expressing greater hesitancy about COVID-19 vaccination. We call on research funders and research institutions to take decisive action to make community engagement obligatory, not optional, in all clinical and translational research and to center BIPOC communities in this process. Recommended actions include funding agencies requiring all research proposals involving human participants to include a community engagement plan, providing adequate funding to support ongoing community engagement, including community stakeholders in agency governance and proposal reviews, promoting racial and ethnic diversity in the research workforce, and making a course in community engaged research a requirement for Masters of Clinical Research curricula.
It is no exaggeration to say that American health policy is frequently subordinated to budgetary policies and procedures. The Affordable Care Act (ACA) was undeniably ambitious, reaching health care services and underlying health as well as health insurance. Yet fiscal politics determined the ACA’s design and guided its implementation, as well as sometimes assisting and sometimes constraining efforts to repeal or replace it. In particular, the ACA’s vulnerability to litigation has been the price its drafters paid in exchange for fiscal-political acceptability. Future health care reformers should consider whether the nation is well served by perpetuating such an artificial relationship between financial commitments and health returns.
The inclusion of students with autism spectrum disorder (ASD) is increasing, but there have been no longitudinal studies of included students in Australia. Interview data reported in this study concern primary school children with ASD enrolled in mainstream classes in South Australia and New South Wales, Australia. In order to examine perceived facilitators and barriers to inclusion, parents, teachers, and principals were asked to comment on the facilitators and barriers to inclusion relevant to each child. Data are reported about 60 students, comprising a total of 305 parent interviews, 208 teacher interviews, and 227 principal interviews collected at 6-monthly intervals over 3.5 years. The most commonly mentioned facilitator was teacher practices. The most commonly mentioned barrier was intrinsic student factors. Other factors not directly controllable by school staff, such as resource limitations, were also commonly identified by principals and teachers. Parents were more likely to mention school- or teacher-related barriers. Many of the current findings were consistent with previous studies but some differences were noted, including limited reporting of sensory issues and bullying as barriers. There was little change in the pattern of facilitators and barriers identified by respondents over time. A number of implications for practice and directions for future research are discussed.
The principal aim of this study was to optimize the diagnosis of canine neuroangiostrongyliasis (NA). In total, 92 cases were seen between 2010 and 2020. Dogs were aged from 7 weeks to 14 years (median 5 months), with 73/90 (81%) less than 6 months and 1.7 times as many males as females. The disease became more common over the study period. Most cases (86%) were seen between March and July. Cerebrospinal fluid (CSF) was obtained from the cisterna magna in 77 dogs, the lumbar cistern in f5, and both sites in 3. Nucleated cell counts for 84 specimens ranged from 1 to 146 150 cells μL−1 (median 4500). Percentage eosinophils varied from 0 to 98% (median 83%). When both cisternal and lumbar CSF were collected, inflammation was more severe caudally. Seventy-three CSF specimens were subjected to enzyme-linked immunosorbent assay (ELISA) testing for antibodies against A. cantonensis; 61 (84%) tested positive, titres ranging from <100 to ⩾12 800 (median 1600). Sixty-one CSF specimens were subjected to real-time quantitative polymerase chain reaction (qPCR) testing using a new protocol targeting a bioinformatically-informed repetitive genetic target; 53/61 samples (87%) tested positive, CT values ranging from 23.4 to 39.5 (median 30.0). For 57 dogs, it was possible to compare CSF ELISA serology and qPCR. ELISA and qPCR were both positive in 40 dogs, in 5 dogs the ELISA was positive while the qPCR was negative, in 9 dogs the qPCR was positive but the ELISA was negative, while in 3 dogs both the ELISA and qPCR were negative. NA is an emerging infectious disease of dogs in Sydney, Australia.
This essay considers Thomas Elsaesser's debut film, Die Sonneninsel/TheSun Island (Germany, 2017), in particular in light of the concept of ‘tactical compliance’, which Elsaesser himself developed during his keynote paper, reproduced herein, at the Creative Practice Research in the Age of Neoliberal Hopelessness Conference at the University of Bedfordshire on 11 May 2018. The aim is to work through what tactical compliance might mean in the age of neoliberal hopelessness – and in some senses to take issue with the concept. I shall do this by situating The Sun Island within the context of Elsaesser's own theoretical work, in particular his understanding of the so-called Persistenceof Hollywood (2012), which itself springs perhaps from his contribution to Vivian Sobchack's edited collection on The Persistence of History (1997). The aim is not to produce an ad hominem ‘attack’ on Elsaesser and his work, but to understand tactical compliance as a means towards persistence, while also relating persistence to systems of power. In other words, the ideas of Elsaesser will be linked to Elsaesser-as-idea (as author, as filmmaker), with no real concern for Elsaesser-as-man (if that is how he would define himself and/or if that is what Elsaesser is).
What follows will nonetheless seem to conflate the personal with the political because The Sun Island is in some senses a deeply personal film. The film is primarily about the rehabilitation of the reputation of the filmmaker’s grandfather, Martin Elsaesser, an architect who played a significant role in the design of Frankfurt between 1925 and 1932, and whose most famous work, the city's Grosmarkthalle, or Central Market, was to be destroyed to make way for the new headquarters of the European Central Bank in the first part of the twenty-first century. However, the film also is a consideration of the Elsaessers's family history – including perhaps most significantly the relationship between the filmmaker's grandmother, Liesel, and landscape designer Leberecht Migge. Migge, whom Elsaesser has referred to elsewhere as ‘something like the Grandfather of the German Green movement’ (Elsaesser 2009a: 47) is the person mainly responsible for the titular Sun Island, which started out in 1932 as a kind of project for sustainable living, where inhabitants would be able to survive without the interference of the modern world.
In this essay, I shall describe the content and the delivery of a module (referred to in some institutions as a course or a unit) that I designed at my institution, called Guerrilla Filmmaking. The reasons for doing this are several. Since the module springs in some senses from my own theoretical research into and practice as a zero-budget filmmaker, Guerrilla Filmmaking exemplifies how to bridge practice and theory in the classroom, or, to put it in the language of this edited collection, how to teach practice-research. As the making of zero-budget films springs from the development of readily available digital technologies, the module also allows students themselves to bridge practice as research, in that the module involves the adoption of new media technologies in order to explore their expressive possibilities, which also means that practice (for example, making films with smartphones) involves research (working out what sorts of film a smartphone can help to produce), which in turn helps to generate a theoretical understanding of what (in this example) smartphones mean. As we shall see, by exploring the expressive possibilities of new media technologies, students (and teachers) on the module begin to understand that they are not ‘inferior’ to conventional cinematic technologies, but simply different – a shift in outlook/theoretical thinking that the module conscientiously ties to a history of ‘imperfect’ cinema (both as a theory and as a practice), which shift itself is linked to a ‘decolonisation’ or a ‘liberation’ of thought in relation to film and perhaps to the world more generally. In order to understand how Guerrilla Filmmaking does this, though, let us begin with an overview of the module.
THE PRAGMATICS OF GUERRILLA FILMMAKING
Guerrilla Filmmaking is a module in which, over the course of an eleven- or twelve-week semester, students are invited to make a portfolio of three to five short films (typically I ask them to have a duration of between one and three minutes, although some can be slightly shorter and some longer). The three highest scoring of these films are carried forward as the first of two assignments that students complete for the module. Each of the films involves a formal and a thematic ‘constraint’, in that students must make a film on a certain topic, or which answers a certain question (about which more below), while at the same time only using certain filmmaking techniques.
The conopid fly Stylogaster neglecta Williston (Diptera: Conopidae) is a parasitoid with no known host. We report this species as the first recorded dipteran parasitoid of Oecanthus nigricornis Walker (Orthoptera: Gryllidae) (black-horned tree crickets). We reared field-collected O. nigricornis juveniles over several months in 2017 and found that larval S. neglecta emerged from them during late July into August. We estimated the incubation period for S. neglecta larvae to be around 30 days based on the length of time it took for them to emerge from the host and pupate (subsequently all hosts died). We documented several cases of multiple parasitism. In 2018, we dissected O. nigricornis sampled from four sites across southern Ontario, Canada and upstate New York, United States of America and found that the percentage of juvenile O. nigricornis parasitised ranged 2–39%. Further sampling will be necessary to determine whether this variation represents consistent population differences or between-year variation in parasitism.
Hurricanes can interrupt communication, exacerbate attrition, and disrupt participant engagement in research. We used text messaging and disaster preparedness protocols to re-establish communication, re-engage participants, and ensure retention in a human immunodeficiency virus (HIV) self-test study.
Participants were given HIV home test kits to test themselves and/or their non-monogamous sexual partners before intercourse. A daily text message-based short message service computer-assisted self-interview (SMS-CASI) tool reminded them to report 3 variables: (1) anal sex without a condom, (2) knowledge of partners’ testing history, and (3) proof of partners’ testing history. A disaster preparedness protocol was put in place for hurricanes in Puerto Rico. We analyzed 6315 messages from participants (N = 12) active at the time of Hurricanes Irma and Maria. Disaster preparedness narratives were assessed.
All participants were able to communicate sexual behavior and HIV testing via SMS-CASI within 30 days following María. Some participants (n = 5, 42%) also communicated questions. Re-engagement within 30 days after the hurricane was 100% (second week/89%, third week/100%). Participant re-engagement ranged from 0–16 days (average = 6.4 days). Retention was 100%.
Daily SMS-CASI and disaster preparedness protocols helped participant engagement and communication after 2 hurricanes. SMS-CASI responses indicated high participant re-engagement, retention, and well-being.
Bridget Jones's Baby (2016) continues the account of the life of the eponymous diarist, as the film opens with Bridget (Renée Zellweger) turning forty-three, having aged only eleven years in the fifteen-year period since the franchise's first film, Bridget Jones's Diary (2001), in which Bridget was thirty-two. Single once again, Bridget none the less becomes pregnant after two one-night stands, one with American internet dating tycoon Jack Qwant (Patrick Dempsey) and another with childhood friend and old flame Mark Darcy (Colin Firth). Uncertain as to who the father is, Bridget allows both men to believe the child to be theirs, with both happy to prepare for parenting duties even after Bridget explains to both men her confusion over the father's identity at a meal at Gianni’s, an Italian restaurant near Bridget's flat. A rivalry develops between Jack and Mark, with the former eventually losing out to the latter when Bridget grabs Mark's hand during the delivery of her child – a clear sign that he is the man for her rather than the result of pain-induced confusion. Although Jack is present at their wedding and clearly now a close friend, the film ends with Bridget marrying Mark, who also turns out to be the father of their son, William Jones-Darcy.
There have been Anglo-American relationships in all three of the Bridget Jones films. In the first film, for example, Mark is initially going out with American lawyer Natasha (Embeth Davitz), with whom he moves to New York, before returning to London to be with Bridget. In Bridget Jones: The Edge of Reason (2004), meanwhile, Mark is again associated with an American, Rebecca (Jacinda Barrett), who turns out to be obsessed with Bridget, as opposed to being her rival. What is more, Renée Zellweger, who plays Bridget, is of course an American actress playing a British woman – an idea to which I shall return – while all of the films are also international co-productions involving British and American funding. None the less, where, in the earlier films, Bridget had to choose between Mark and playboy Daniel Cleaver (Hugh Grant) – who, in the third film, is supposedly dead after a plane crash, although a newspaper headline seen in the final moments suggests that he has been found alive (opening up the possibility for more sequels) – here she has to choose between British Mark and American Jack.
Genomic imprinting is genotype-independent parent-of-origin gene expression. It is a well-understood example of epigenetic inheritance, as the environment (i.e., whether a gene resided in the egg or sperm in the previous generation) leaves a reversible mark on offspring DNA. These marks are erased when the offspring produces its own gametes (i.e., sperm or egg), so that new parent-of-origin marks can be placed. The phenotypic effects of imprinted genes are significant, especially in terms of growth and neurobiology. Imprinted genes are rare in mammalian genomes, but here I make the case for the idea that they are critically important for our understanding of how natural selection shaped functional adaptations. There are approximately 100 imprinted genes in humans that have differentially methylated regions by parent of origin. The effects of imprinted genes are species, isoform (i.e., alternative transcripts), tissue, and developmentally dependent.
This replication study was invited by the Editor in Chief of Management and Organization Review, Arie Y. Lewin. The original study by Judge, Fainshmidt, and Brown (2014) spanned the global financial crisis (2005–2010), and as such, this anomalous time period may not have been representative of most economies, or even the overall global economy. In this replication study we refine and extend Judge et al. (2014) which explored the provocative question – which form of capitalism works best in terms of ‘equitable wealth creation’? Similar to the earlier study, we find that there are multiple paths to macro-economic success. Notably, effective institutional configurations tend to combine high-quality regulatory institutions, effective skill development systems, and social cultures largely unaffected by corruption so there is some commonality amongst effective configurations. In contrast, ineffective institutional configurations tend to be relatively weak in one or several of these three critical sets of institutions. Importantly, we find some novel patterns emerging from the most recent data, including potentially new forms of capitalism associated with equitable wealth creation. In addition, we find that effective credit market institutions are more important, and collective bargaining institutions are less important than the original study suggested. We discuss implications for the comparative capitalism literature, policy makers, and the future of capitalism in the global economy.
The dystopian scenario of an ‘artificial intelligence takeover’ imagines artificial intelligence (AI) becoming the dominant form of intelligence on Earth, rendering humans redundant. As a society we have become increasingly familiar with AI and robots replacing humans in many tasks, certain jobs and even some areas of medicine, but surely this is not the fate of psychiatry?
Here a computational neuroscientist (Janaina Mourão-Miranda) and psychiatrist (Justin Taylor Baker) suggest that psychiatry as a profession is relatively safe, whereas psychiatrists Christian Brown and Giles William Story predict that robots will be taking over the asylum.
Much of the pivotal debate concerning the validity of affirmative action is situated in a legal context of defending or challenging claims that there may be broad societal gains from increased diversity. Race-conscious affirmative action policies originally advanced legal sanctions to promote racial equity in the United States. Today, increasingly detached from its historical context, defense or rejection of affirmative action is otherwise upheld to achieve diversity. A “diversity” rationale for affirmative action calls for increasing tolerance of the “other,” reducing negative stereotypes, and moderating prejudice as goals—all objectives that deviate from the former aim of race-targeted inclusion intended to resolve racial discrimination in employment and college admissions. Diversity policy provides a tapered defense for affirmative action, one detached from principles of justice and equity. The current article suggests that, despite the fact that the ostensible benefits of “racial inclusion as diversity” may be the remaining legal prop for affirmative action in the U.S., there is a need to consider whether diversity intrinsically can engender the benefits that affirmative action policy seeks to provide.
The initial classic Fontan utilising a direct right atrial appendage to pulmonary artery anastomosis led to numerous complications. Adults with such complications may benefit from conversion to a total cavo-pulmonary connection, the current standard palliation for children with univentricular hearts.
A single institution, retrospective chart review was conducted for all Fontan conversion procedures performed from July, 1999 through January, 2017. Variables analysed included age, sex, reason for Fontan conversion, age at Fontan conversion, and early mortality or heart transplant within 1 year after Fontan conversion.
A total of 41 Fontan conversion patients were identified. Average age at Fontan conversion was 24.5 ± 9.2 years. Dominant left ventricular physiology was present in 37/41 (90.2%) patients. Right-sided heart failure occurred in 39/41 (95.1%) patients and right atrial dilation was present in 33/41 (80.5%) patients. The most common causes for Fontan conversion included atrial arrhythmia in 37/41 (90.2%), NYHA class II HF or greater in 31/41 (75.6%), ventricular dysfunction in 23/41 (56.1%), and cirrhosis or fibrosis in 7/41 (17.1%) patients. Median post-surgical follow-up was 6.2 ± 4.9 years. Survival rates at 30 days, 1 year, and greater than 1-year post-Fontan conversion were 95.1, 92.7, and 87.8%, respectively. Two patients underwent heart transplant: the first within 1 year of Fontan conversion for heart failure and the second at 5.3 years for liver failure.
Fontan conversion should be considered early when atrial arrhythmias become common rather than waiting for severe heart failure to ensue, and Fontan conversion can be accomplished with an acceptable risk profile.