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Since the COVID-19 outbreak was declared a global pandemic, public health messages have emphasised the importance of frequent handwashing in limiting the transmission of the virus. Whilst crucial in controlling transmission, such messaging may have an adverse effect on individuals with OCD. The primary aim of this study was to investigate any significant changes to handwashing behaviour, as well as other related hygiene behaviours, across all symptom dimensions of OCD. The frequency of engaging with pandemic-related media coverage was also considered across all symptom subtypes.
A cross-sectional study was conducted, with a total of 332 participants recruited. Participants who scored above the optimal cut-off score on the Obsessive-Compulsive Inventory Revised edition (OCI-R) were included in the analysis (n = 254). Scores on the six subscales of the OCI-R were correlated with responses to a COVID-19 Impact measure.
Factor analysis of the COVID-19 Impact measure revealed that items loaded on two components of the measure (handwashing and distress-avoidance). A significant correlation was revealed between the handwashing component and the OCI-R washing subscale (rs = 0.523, p = 0.0001), as well as between distress-avoidance and the OCI-R washing and ordering subscales (s = −0.227, p = 0.0001; rs = −0.159, p = 0.006). Content analysis revealed disruption to treatment delivery and worsening symptom severity in participants with contamination-related OCD.
The pandemic has had a significant impact on individuals with contamination-related OCD symptoms, in relation to symptom severity and treatment disruption. Consideration should be given to targeted support tailored to patients with this subtype of OCD.
This chapter provides an overview of teaching methods and second language acquisition theories, assessing the strengths and weaknesses of particular methods in revitalization contexts. Revitalizers must consider community desires and resources, as well as traditional worldviews and lifeways in choosing appropriate approaches. 8 case studies present practical applications of specific teaching methods: grammar-translation and a radically input-based approach in Potawatomi; reclaiming domains and ‘language nesting’ in Lushootseed; Accelerated Second Language Acquisition (ASLA), reclaiming domains and the master-apprentice method in Tolowa Deeni’; how Sámi language and culture can meaningfully shape education in the classroom; homeschooling activities and strategies for elementary age learners in Tolowa Dee-ni’; and how teachers with limited fluency teach language-rich lessons within their own level of proficiency in Chinuk Wawa, where immersion models are unrealistic. The capsules exemplify immersion programmes, culture place-based learning and other approaches in 8 languages: Hawai’ian, Kristang, Wym, Lemko, Chinuk Wawa, Sámi, Cherokee and Anishinaabemowin.
Point-prevalence surveys for infection or colonization with methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae (CREs), and for Clostridium difficile infection (CDI) were conducted in Canadian hospitals in 2010 and 2012 to better understanding changes in the epidemiology of antimicrobial-resistant organisms (AROs), which is crucial for public health and care management.
A third survey of the same AROs in adult inpatients in Canadian hospitals with ≥50 beds was performed in February 2016. Data on participating hospitals and patient cases were obtained using standard criteria and case definitions. Associations between ARO prevalence and institutional characteristics were assessed using logistic regression models.
In total, 160 hospitals from 9 of the 10 provinces with 35,018 adult inpatients participated in the survey. Median prevalence per 100 inpatients was 4.1 for MRSA, 0.8 for VRE, 1.1 for CDI, 0.8 for ESBLs, and 0 for CREs. No significant change occurred compared to 2012. CREs were reported from 24 hospitals (15%) in 2016 compared to 10 hospitals (7%) in 2012. Routine universal or targeted admission screening for VRE decreased from 94% in 2010 to 74% in 2016. Targeted screening for MRSA on admission was associated with a lower prevalence of MRSA infection. Large hospitals (>500 beds) had higher prevalences of CDI.
This survey provides national prevalence rates for AROs in Canadian hospitals. Changes in infection control and prevention policies might lead to changes in the epidemiology of AROs and our capacity to detect them.
The origins of agriculture in South-west Asia is a topic of continued archaeological debate. Of particular interest is how agricultural populations and practices spread inter-regionally. Was the Arabian Neolithic, for example, spread through the movement of pastoral groups, or did ideas perhaps develop independently? Here, the authors report on recent excavations at Alshabah, one of the first Neolithic sites discovered in Northern Arabia. The site’s material culture, environmental context and chronology provide evidence suggesting that well-adapted, seasonally mobile, pastoralist groups played a key role in the Neolithisation of the Arabian Peninsula.
To determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile infection (CDI) in Canadian hospitals.
National point prevalence survey in November 2010.
Canadian acute care hospitals with at least 50 beds.
Adult inpatients colonized or infected with MRSA or VRE or with CDI.
The prevalence (per 100 inpatients) of MRSA, VRE, and CDI was determined. Associations between prevalence and institutional characteristics and infection control policies were evaluated.
One hundred seventy-six hospitals (65% of those eligible) participated. The median (range) prevalence rates for MRSA and VRE colonization or infection and CDI were 4.2% (0%–22.1%), 0.5% (0%–13.1%), and 0.9% (0%–8.6%), respectively. Median MRSA and VRE infection rates were low (0.3% and 0%, respectively). MRSA, VRE, and CDI were thought to have been healthcare associated in 79%, 96%, and 84% of cases, respectively. In multivariable analysis, routine use of a private room for colonized/infected patients was associated with lower median MRSA infection rate (prevalence ratio [PR], 0.44 [95% confidence interval (CI), 0.22–0.88]) and VRE prevalence (PR, 0.26 [95% CI, 0.12–0.57]). Lower VRE rates were also associated with enhanced environmental cleaning (PR, 0.52 [95% CI, 0.36–0.75]). Higher bed occupancy rates were associated with higher rates of CDI (PR, 1.02 [95% CI, 1.01–1.03]).
These data provide the first national prevalence estimates for MRSA, VRE, and CDI in Canadian hospitals. Certain infection prevention and control policies were found to be associated with prevalence and deserve further investigation.
There are several studies in which a correlation between maternal vitamin D deficiency and serum mineral disorders in the mother and the newborn has been reported. The present randomised clinical trial was designed to investigate the effect of vitamin D administration on maternal and fetal Ca and vitamin D status. The trial was carried out on 160 pregnant women. Vitamin D-deficient (25-hydroxyvitamin D (25(OH)D) < 30 ng/ml) pregnant women were recruited at 26–28 weeks of pregnancy. In the control group, a multivitamin supplement containing 400 IU vitamin D3/d was given. Patients in the treatment group were treated with 50 000 IU vitamin D3 weekly for a total duration of 8 weeks. At delivery, maternal and fetal Ca and 25(OH)D levels in both groups were compared. In total, 81 % of pregnant women were vitamin D deficient. At the time of delivery, Ca and vitamin D levels were higher in the treatment group compared with the control group (92 (sd 3) v. 85 (sd 4) mg/l, respectively, P= 0·001 for serum Ca; 47·8 (sd 11·1) v. 15·9 (sd 6·6) ng/ml, respectively, P< 0·001 for vitamin D). At the time of delivery, 32·7 % of women in the control group had hypocalcaemia, while no hypocalcaemic case was detected in the vitamin D-treated group. Mean neonatal serum 25(OH)D was higher in the treatment group compared with the control group (27·7 (sd 5·2) v.10·9 (sd 4·4) ng/ml, respectively, P< 0·01). The neonatal Ca level in the treatment group was significantly higher than that of the control group (99 (sd 3) v. 91 (sd 3) mg/l, respectively, P< 0·001). The administration of vitamin D to pregnant women with vitamin D deficiency improves both maternal and neonatal Ca levels.
Objective: To estimate the heritability of ambulatory blood pressure (BP), heart rate (HR), and beat-to-beat office BP and HR in an isolated, environmentally and genetically homogeneous Omani Arab population. Methods: Ambulatory BP measurements were recorded in 1,124 subjects with a mean age of 33.8 ± 16.2 years, using the auscultatory mode of the validated Schiller ambulatory BP Monitor. Beat-to-beat BP and HR were recorded by the Task Force Monitor. Heritability was estimated using quantitative genetic analysis. This was achieved by applying the maximum-likelihood-based variance decomposition method implemented in SOLAR software. Results: We detected statistically significant heritability estimates for office beat-to-beat, 24-hour, daytime, and sleep HR of 0.31, 0.21, 0.20, and 0.07, respectively. Heritability estimates in the abovementioned conditions for systolic BP (SBP)/diastolic BP (DBP)/mean BP (MBP) were all significant and estimated at 0.19/0.19/0.19, 0.30/0.44/0.41, 0.28/0.38/0.39, and 0.21/0.18/0.20, respectively. Heritability estimates for 24-hour and daytime ambulatory SBP, DBP, and MBP ranged from 0.28 to 0.44, and were higher than the heritability estimates for beat-to-beat recordings and sleep periods, which were estimated within a narrow range of 0.18–0.21. Conclusion: In this cohort, because shared environments are common to all, the environmental influence that occurs is primarily due to the variation in non-shared environment that is unique to the individual. We demonstrated significant heritability estimates for both beat-to-beat office and ambulatory BP and HR recordings, but 24-hour and daytime ambulatory heritabilities are higher than those from beat-to-beat resting levels and ambulatory night-time recordings.
Background: We performed a genome-wide scan in a homogeneous Arab population to identify genomic regions linked to blood pressure (BP) and its intermediate phenotypes during mental and physical stress tests. Methods: The Oman Family Study subjects (N = 1277) were recruited from five extended families of ~10 generations. Hemodynamic phenotypes were computed from beat-to-beat BP, electrocardiography and impedance cardiography. Multi-point linkage was performed for resting, mental (word conflict test, WCT) and cold pressor (CPT) stress and their reactivity scores (s), using variance components decomposition-based methods implemented in SOLAR. Results: Genome-wide scans for BP phenotypes identified quantitative trait loci (QTLs) with significant evidence of linkage on chromosomes 1 and 12 for WCT-linked cardiac output (LOD = 3.1) and systolic BP (LOD = 3.5). Evidence for suggestive linkage for WCT was found on chromosomes 3, 17 and 1 for heart rate (LOD = 2.3), DBP (LOD = 2.4) and left ventricular ejection time (LVET), respectively. For △WCT, suggestive QTLs were detected for CO on chr11 (LOD = 2.5), LVET on chr3 (LOD = 2.0) and EDI on chr9 (LOD = 2.1). For CPT, suggestive QTLs for HR and LVET shared the same region on chr22 (LOD 2.3 and 2.8, respectively) and on chr9 (LOD = 2.3) for SBP, chr7 (LOD = 2.4) for SV and chr19 (LOD = 2.6) for CO. For △CPT, CO and TPR top signals were detected on chr15 and 10 (LOD; 2.40, 2.08) respectively. Conclusion: Mental stress revealed the largest number of significant and suggestive loci for normal BP reported to date. The study of BP and its intermediate phenotypes under mental and physical stress may help reveal the genes involved in the pathogenesis of essential hypertension.
This paper presents the concept of using cylindrical pins as short protuberances for trajectory control of a blunted cone in the supersonic and hypersonic regimes. Supersonic and hypersonic flow interactions for cylindrical protuberances, installed on a blunt cone are studied for their aerodynamic effects. The utility of these protuberances for aerodynamic control and trajectory shaping of a re-entry cone are explored. Static aerodynamic coefficients in the Mach range of 2–9·7 at various incidences are computed. The pressure distribution along the vehicle longitudinal axis in the presence of the pin-protuberance is studied using CFD analysis. With the altered pressure distribution, a net increase in the aerodynamic force is obtained which can be actively utilised for flight control and maneuvering of the vehicle during re-entry. After quantifying the aerodynamic effects of the protuberance, it is modelled and used as an effective actuation mechanism for flight feedback control. It is shown that this can work as an effective control device for Mach numbers less than five. An actuator design for insertion/retraction of the protuberance is presented and modelled, and a robust controller is synthesised which can in real time govern the position of the protuberance to control the flight attitude angle to achieve a desired trajectory. The controller takes in measurements of the vehicle’s pitch angle and actuates the pin height continuously to control the pitch angle to a desired value. The control performance is demonstrated on a high fidelity six degrees-of-freedom (6-DOF) nonlinear flight simulation.