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During October 2021, the County of San Diego Health and Human Services Agency identified five cases of shigellosis among persons experiencing homelessness (PEH). We conducted an outbreak investigation and developed interventions to respond to shigellosis outbreaks among PEH. Confirmed cases occurred among PEH with stool-cultured Shigella sonnei; probable cases were among PEH with Shigella-positive culture-independent diagnostic testing. Patients were interviewed to determine infectious sources and risk factors. Fifty-three patients were identified (47 confirmed, 6 probable); 34 (64%) were hospitalised. None died. No point source was identified. Patients reported inadequate access to clean water and sanitation facilities, including public restrooms closed because of the COVID-19 pandemic. After implementing interventions, including handwashing stations, more frequent public restroom cleaning, sanitation kit distribution, and isolation housing for ill persons, S. sonnei cases decreased to preoutbreak frequencies. Improving public sanitation access was associated with decreased cases and should be considered to prevent outbreaks among PEH.
Forty-eight Large White x Landrace multiparous sows were mixed into twelve groups of four animals after their piglets were weaned. These groups were defined as static, with no animals being added to or removed from the groups after their formation. Aggressive and submissive behaviours were recorded continuously for 9 h after the sows were mixed, and the sows were assigned high or low social status on the basis of their relative aggressiveness and success in aggressive interactions. After five weeks, each static group was mixed into a dynamic group of 40 ±2 sows for an 11-week period. Three static groups (ie 12 animals) at a time were added to the dynamic group at three-week intervals; the same number of animals was removed at these time-points in order to maintain the group number at 40 ± 2. Injury levels increased significantly with the transition from static groups to the dynamic group (P < 0.001). Sows with low social status had lower bodyweights (P < 0.001) and higher injury levels one week after mixing into static and dynamic groups (P < 0.01). Social status did not significantly affect salivary Cortisol levels. Sows with low social status were positioned lower in the feed order, determined using an electronic feeder (P < 0.001), and tended to be displaced from the feeder queue more often (P < 0.1) in the dynamic group. Sows with low social status were also displaced from the drinker more often than highranking sows in the dynamic group (P < 0.01). This may have led to the greater frequency of drinking behaviour shown by low-ranking sows (P < 0.05). Sows with low social status were observed less often in the kennel areas than were the high-ranking sows in the dynamic group (P < 0.05), suggesting that they were denied access to the prime lying areas. The results suggest that the welfare of sows is negatively affected by low social status in both small static and large dynamic groups.
This study examined the effects of enriching the environment on the behaviour and productivity of pigs, in an attempt to assess changes in welfare. A total of 102 pigs were housed in either barren or enriched housing from birth to slaughter. The barren environments were defined as intensive housing and the enriched environments incorporated extra space, an area which contained peat and straw in a rack. Enriching the environment reduced both the amount of time pigs spent inactive and the time involved in harmful social and aggressive behaviour. Tail biting was absent from the enriched environment but four pigs were removed from barren pens with severe tail damage. Pigs housed in enriched environments spent longer durations in exploratory behaviour than those in barren housing, and young pigs in enriched environments performed locomotory behaviour more frequently than their counterparts in barren environments. Overall growth rates were similar in both treatments. These results indicate that welfare is improved by enrichment with substrates and suggest that barren pens should be modified to provide these facilities.
The preferences of growing pigs for substrates were investigated by giving small groups of pigs a choice between two substrates in each test. The seven substrates examined were concrete, mushroom compost (spent), peat, sand, sawdust, straw and woodbark. Thirteen comparisons of pairs of substrates were tested with four replicates of each comparison. Eleven-week-old pigs (in groups of six) were placed in specially designed choice pens where they had access to two different substrates. The pigs were allowed to habituate to the pen for 1 week and at the end of week 2 the substrates were swapped. In weeks 2 and 3 the time spent by the pigs in each substrate was recorded. Peat, mushroom compost and sawdust were preferred most, with sand next and woodbark and straw being preferred only to concrete. It is suggested that growing pigs may be attracted to substrates which are similar in texture to earth.
The objective of the present study was to investigate the relationship between rooting behaviour and foraging in growing pigs. In study 1, forty-eight 11-week-old pigs were housed in eight groups of six with access to a rooting substrate in the form of spent mushroom compost. In half of the groups the rooting substrate contained food rewards, and in the other half of the groups it did not. All pigs had ad libitum access to feed. In study 2, one hundred and ninety-two 11-week-old pigs were housed in thirty-two groups of six, all with access to spent mushroom compost, and eight groups were each fed to 70, 80, 90 or 100% appetite. Treatments were applied over a two-week period in both studies. The number of pigs involved in active rooting (rooting in substrate while standing), inactive rooting (rooting in substrate while sitting or lying) or non-rooting activity (standing in substrate area and involved in any activity except rooting) was recorded by scan sampling. These behaviours tended to reach a peak in the morning and again in the afternoon. Inactive rooting was not significantly affected by treatments in study 1 or study 2. Food rewards in the rooting substrate led to a significant reduction in active rooting behaviour and in non-rooting activity during peak periods of the day (P < 0.05). It is suggested that learned associations between rooting behaviour and acquisition of food caused the pigs to stop rooting when all the food rewards had been consumed. The fact that rooting was performed in the absence of nutritive feedback suggests that this behaviour is performed independently of its appetitive foraging function. Restricting feed levels to 70 or 80% of appetite led to a significant increase in active rooting and in non-rooting activity during peak periods (P < 0.05). The relationship between feed restriction and active rooting behaviour tended to be linear (P < 0.08). This suggests that levels of rooting behaviour are flexible in response to nutritional needs.
This study examined the effects of environmental enrichment on aggressive behaviour and dominance relationships in growing pigs. Three hundred and twenty pigs were reared from birth to 15 weeks of age in either barren or enriched environments. The barren environments were defined by common intensive housing conditions (ie with slatted floors and in terms of recommended space allowances), while the enriched environments incorporated extra space and substrates for manipulation. Aggressive behaviour was observed in a social confrontation test during the suckling period and dominance relationships were assessed from a food competition test at 12 weeks of age. Animals were weighed at regular intervals throughout the experiment. Environmental enrichment reduced the expression of aggressive behaviour. Pigs from enriched rearing environments fought significantly less with unfamiliar animals than those from barren environments when tested under standard conditions (mean of 1.46 vs 2.75 fights per 30min test for enriched vs barren environments; SEM 0.20, P < 0.001). The nature of dominance relationships also appeared to differ between barren and enriched environments. In barren environments, dominance among pen mates was correlated with aggression (r = 0.33, P < 0.01), whereas in enriched environments it was correlated with body weight (r = 0.24, P < 0.01). Correlations between behaviour in the social confrontation and food competition tests suggested that dominance characteristics were established early in life and remained stable through the growing period.
The effects of enrichment and floor type on the behaviour and welfare of cubicle loose-housed dry sows were investigated in a 2x2 factorial design with four replicates. Sixty-four dry sows were housed in groups of four in pens containing a communal exercise area and four feeding stalls. Pens were either enriched (using spent mushroom compost on suspended wood and wire flat racks) or barren (containing either a solid or part-slatted floor). Enrichment reduced aggressive behaviour, injuries, nosing the ground and lying with eyes open and led to an increase in lying with eyes closed. Floor type had no overall significant effect on sow behaviour. Presentation of spent mushroom compost on suspended racks was found to be a cheap and practical form of enrichment. Incorporation of this system into the design of cubicle loose housing could reduce many of the problems associated with this type of housing and improve the welfare of the sows.
Six pairs of steers were allowed to choose between two types of floors in a paired choice test. The four floors tested were a fully slatted floor, a fully slatted floor covered with rubber mats, a solid floor with sawdust bedding, and a solid floor with straw bedding. All combinations of floor types were tested and the choices were repeated eight times, using naïve animals. The animals were allowed 17 days to habituate, and on days 18-21 their behaviour was recorded by video for 72 hours. Straw was the most preferred floor type, followed by sawdust, then mats, and finally slats. During a second test period, rubber mats were compared with rubber strips, and no significant preferences were found.
This study examined the effects of enriching the environment on the learning abilities of growing pigs. Eighty-four pigs were housed in either barren or enriched environments from birth to 14 weeks. The barren environments were defined as intensive housing and the enriched environments incorporated extra space, including areas which contained peat and straw in a rack. The learning abilities of pigs from both environments were tested at 15-17 weeks using an operant task which involved pigs learning to push a panel for a reward and a maze test which involved spatial learning. Pigs from enriched environments learned both the operant task and the maze task more rapidly than their counterparts from barren environments. These results suggest that the cognitive development of pigs may be impaired in intensive housing systems.
Over the last 25 years, radiowave detection of neutrino-generated signals, using cold polar ice as the neutrino target, has emerged as perhaps the most promising technique for detection of extragalactic ultra-high energy neutrinos (corresponding to neutrino energies in excess of 0.01 Joules, or 1017 electron volts). During the summer of 2021 and in tandem with the initial deployment of the Radio Neutrino Observatory in Greenland (RNO-G), we conducted radioglaciological measurements at Summit Station, Greenland to refine our understanding of the ice target. We report the result of one such measurement, the radio-frequency electric field attenuation length $L_\alpha$. We find an approximately linear dependence of $L_\alpha$ on frequency with the best fit of the average field attenuation for the upper 1500 m of ice: $\langle L_\alpha \rangle = ( ( 1154 \pm 121) - ( 0.81 \pm 0.14) \, ( \nu /{\rm MHz}) ) \,{\rm m}$ for frequencies ν ∈ [145 − 350] MHz.
In recent years, a variety of efforts have been made in political science to enable, encourage, or require scholars to be more open and explicit about the bases of their empirical claims and, in turn, make those claims more readily evaluable by others. While qualitative scholars have long taken an interest in making their research open, reflexive, and systematic, the recent push for overarching transparency norms and requirements has provoked serious concern within qualitative research communities and raised fundamental questions about the meaning, value, costs, and intellectual relevance of transparency for qualitative inquiry. In this Perspectives Reflection, we crystallize the central findings of a three-year deliberative process—the Qualitative Transparency Deliberations (QTD)—involving hundreds of political scientists in a broad discussion of these issues. Following an overview of the process and the key insights that emerged, we present summaries of the QTD Working Groups’ final reports. Drawing on a series of public, online conversations that unfolded at www.qualtd.net, the reports unpack transparency’s promise, practicalities, risks, and limitations in relation to different qualitative methodologies, forms of evidence, and research contexts. Taken as a whole, these reports—the full versions of which can be found in the Supplementary Materials—offer practical guidance to scholars designing and implementing qualitative research, and to editors, reviewers, and funders seeking to develop criteria of evaluation that are appropriate—as understood by relevant research communities—to the forms of inquiry being assessed. We dedicate this Reflection to the memory of our coauthor and QTD working group leader Kendra Koivu.1
Behavioral and psychological symptoms of dementia (BPSD) are very prevalent among individuals with dementia living in residential aged care. The development and implementation of new non-pharmacological interventions to reduce BPSD requires knowledge on the current perception and clinical practice of the care staff. We analyzed clinical care notes to examine the way residential aged care staff reported and managed BPSD in their daily clinical practice.
Methods:
We examined semi-structured care notes relating to the presentation and management of behaviors of 76 older residents (67% female; aged 67-101; 75% with formal dementia diagnosis) prior to participating in the Australian BPSDPLUS Program. As part of standard clinical practice in three residential aged care facilities, staff document the presentation and management of behaviors amongst residents. Using an inductive thematic analytical approach, we analyzed the reported data in the one and a half months prior to commencing participation in the BPSDPLUS Program. Care notes were coded and analyzed by two independent assessors and they discussed themes until consensus was reached.
Results:
A total of 465 behavior charts were completed in the one and a half months prior to the commencement of the BPSDPLUS Program. The number of behavioral charts varied widely across residents (Mean=7.3, range 0–93). Behaviors such as refusal of care, repetitive verbal behaviors, and wandering were most often mentioned, while apathy and affective and psychotic symptoms were seldomly reported. When confronted with BPSD, the clinical care notes indicated that care staff tend to respond in a reactive manner by reassuring, redirecting, or distracting the resident. Furthermore, it seems that staff did not routinely investigate potential underlying causes of the BPSD.
Conclusions:
These results suggest that the residential care staff primarily detected and responded to externalizing behaviors, while more internalizing behaviors were not reported. Potential underrecognition of internalizing behaviors, as well as the fact that the staff did not routinely examine causes of BPSD are vital observations for the development and implementation of nonpharmacological interventions and care programs targeting BPSD in residential aged care.
This research addresses dementia and driving cessation, a major life event for affected individuals, and an immense challenge in primary care. In Australia, as with many other countries, it is primarily general practitioners (GPs) who identify changes in cognitive functioning and monitor driving issues with their patients with dementia. Qualitative evidence from studies with family members and other health professionals shows it is a complicated area of practice. However we still know little from GPs about how they manage the challenges with their patients and the strategies that they use to facilitate driving cessation.
Methods:
Data were collected through five focus groups with 29 GPs at their primary care practices in metropolitan and regional Queensland, Australia. A semi-structured topic guide was used to direct questions addressing decision factors and management strategies. Discussions were audio recorded, transcribed verbatim and thematically analyzed.
Results:
Regarding the challenges of raising driving cessation, four key themes emerged. These included: (i) Considering the individual; (ii) GP-patient relationships may hinder or help; (iii) Resources to support raising driver retirement; and (iv) Ethical dilemmas and ethical considerations. The impact of discussing driving cessation on GPs is discussed.
Conclusions:
The findings of this study contribute to further understanding the experiences and needs of primary care physicians related to managing driving retirement with their patients with dementia. Results support a need for programs regarding identification and assessment of fitness to drive, to upskill health professionals and particularly GPs to manage the complex issues around dementia and driving cessation, and explore cost-effective and timely delivery of such support to patients.
To examine similarities and differences in the demographic and clinical profiles of young people (15–25 years of age) referred between the mental health services (MHS) and Jigsaw Galway.
Methods
A retrospective chart review was conducted of clinical files of individuals attending secondary MHS who had been referred to or from Jigsaw Galway over a 5-year period. Differences in demographic and clinical data between individuals referred to or from Jigsaw Galway were compared.
Results
A recent act of self-harm was more prevalent in individuals referred from Jigsaw to the adult MHS (p=0.02). No other demographic or clinical differences were detected between individuals attending Jigsaw Galway and the MHS.
Conclusions
Education sessions for clinical staff working in primary care, Jigsaw Galway and the MHS are suggested to support clinicians in choosing the best referral pathway, which may more optimally address young people’s mental health difficulties.
Introduction: The diagnosis of Salter-Harris Type 1 fractures in the Emergency Department (ED) is primarily clinical, as radiographs are usually unrevealing. We hypothesize that bilateral asymmetry of the growth plate, detected using bedside ultrasound (US), could improve the accuracy of this diagnosis in the ED. This study seeks to determine growth plate size according to age, and to establish normal variation in bilateral symmetry of growth plate cartilage, for the ulna, radius, tibia, and fibula, using bedside US in normal healthy children. Methods: This prospective observational study was conducted in a convenience sample of children ages 0-17 during planned visits to an elementary school, high school, and an outpatient pediatric clinic. A sample size of 177 was determined with a linear regression model using previously published data on the subject. The study was approved by the hospital and universitys ethics board. After a medical questionnaire with a research nurse, the participants underwent ultrasound evaluation of bilateral ulnae, radii, fibulae, and tibiae, to obtain still images of the physes from two orthogonal views. The evaluations were performed by 3 medical residents, 1 medical student, and by the supervising emergency physician. All ultrasonographers were EDE1 certified and specifically trained for growth plate imagery. The still images were evaluated ulteriorly and measurements taken of the physeal cartilage. Ten percent of the patients had their images re-evaluated by the supervising physician to determine inter-rater reliability. Results: A total of 227 patients were recruited. The median age was 8 years old with an interquartile range of (3;14). Mean growth plate size by age was determined, confirming decreasing growth plate size with advancing age for all articulations. The percentage of absolute difference between right and left, for all growth plates together, was a mean of 17% with a 95% CI of 16-19%. The overall inter-rater reliability was excellent at 0.84. Conclusion: This study establishes a reproducible technique of measuring growth plates with ultrasound. We suspect that increased asymmetry at the growth plate, beyond this established normal variation, may signify a physis widening or hematoma consistent with a Salter-Harris Type 1 fracture; this will be evaluated in a second study.
The paper presents data on the snow cover in the Cairngorm Mountains, Scotland, and compares typical Scottish snow profiles with those measured in alpine, continental, and polar areas. The paper shows that in the Cairngorms snow temperatures are higher and as a result densities and ram penetration resistances are also higher. Typical densities are between 350 and 500 kg m−3 and ram resistances are frequently above 50 or even 100 kg. Typical profiles show large masses of windslab above an equigranular basal layer of old snow, and ice layers are common throughout the profile. Avalanche activity is related to two types of profile both of which share low ram resistance in common. Dry-slab avalanches release when densities are of the order of 250 kg m−3 or less and snow temperatures down to – 10° C in the upper layers. Wet slabs and sluffs fall when the snow is isothermal at the melting point. Densities are usually over 450 kg m−3 and may reach over 600 kgm−3 in slush layers supported by ice lenses.
Memory is an integral part of language processing. Given this, a better understanding of how people learn, represent and process language requires considerations of the principles of memory that support language comprehension. Cunnings’ paper (Cunnings, 2016) does just this. The core of his proposal is that second language (L2) processing that is non-target like can be explained in terms of memory operations rather than by invoking a shallow processor (cf. Clahsen & Felser, 2006).
A new dromomerycine palaeomerycid artiodactyl, Surameryx acrensis new genus new species, from upper Miocene deposits of the Amazon Basin documents the first and only known occurrence of this Northern Hemisphere group in South America. Osteological characters place the new taxon among the earliest known dromomerycine artiodactyls, most similar to Barbouromeryx trigonocorneus, which lived in North America during the early to middle Miocene, 20–16 Ma. Although it has long been assumed that the Great American Biotic Interchange (GABI) began with the closure of the Isthmus of Panama in the late Pliocene, or ca. 3.0–2.5 Ma, the presence of this North American immigrant in Amazonia is further evidence that terrestrial connections between North America and South America through Panama existed as early as the early late Miocene, or ca. 9.5 Ma. This early interchange date was previously indicated by approximately coeval specimens of proboscideans, peccaries, and tapirs in South America and ground sloths in North America. Although palaeomerycids apparently never flourished in South America, proboscideans thrived there until the end of the Pleistocene, and peccaries and tapirs diversified and still live there today.
To determine the frequency of multiple pathology [Alzheimer Disease (AD) plus Vascular Dementia and/or Dementia with Lewy Bodies] in patients enrolled in clinical trials of AD therapy, and to compare the cognitive and functional assessments between patients with pure AD and AD with multiple pathology.
Methods:
We conducted a retrospective analysis of patients with a clinical diagnosis of AD who were enrolled in AD therapy clinical trials and subsequently received an autopsy for confirmation of their diagnosis from 2000 to 2009. Performance on cognitive screening tests, namely Modified Mini Mental state (3MS) exam, Mini Mental state Exam (MMSE) and Functional Rating Scale (FRS) were compared between patients with pure AD and multiple pathology.
Results:
Autopsy reports were available for 16/47 (34%) of deceased patients. Of these 16 patients, 5 (31%) had pure AD pathology, 10 (63%) had AD with other pathology, and 1 (6%) had non-AD pathology. Compared to patients with pure AD, patients with AD mixed with other pathology had poorer baseline FRS in problem-solving (p<0.01) and community affairs (p<0.02).
Conclusion:
While the strict enrollment criteria for clinical trials identified the presence of AD pathology in the majority of cases (15/16), multiple pathology was more common than pure AD in our series of autopsied patients. Premortem biomarkers that can distinguish between pure AD and AD with multiple pathology will be beneficial in future clinical trials and dementia patient management.