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Experts recommend preparedness to manage chronic diseases in case of disaster-related resource disruption. This study’s goal is to identify factors underlying personal medical preparedness (PMP) among participants from a hurricane-prone region.
Methods
A cross-sectional survey was completed during the 2023 Atlantic hurricane season with 120 insured adults age ≥50 in Southeast Louisiana with hypertension and ≥1 regular medication. PMP was measured using the validated Household Emergency Preparedness Instrument Access and Functional Needs Section (HEPI-AFN). Multivariable logistic regression analysis tested associations between PMP and exposure variables, including demographics, health, and hurricane experience.
Results
The sample included 50% women, 43% Black, with mean age 62.6 (SD = 8.1) years and mean 51.3 (SD = 18.1) years living in hurricane-impacted area. Participants were prepared on an average 79% (SD = 21) of applicable HEPI-AFN items; 42 (35%) were prepared on 100% of PMP items. The most missed item was having 2 weeks of extra medication; open-responses noted refill policies as a common barrier to PMP. No factors were associated with increased odds of PMP.
Conclusions
While many participants in this insured, disaster-experienced sample are medically prepared, restrictive pharmaceutical refill policies may be a barrier. Research is needed to understand the impact of prescription refill and other policies on PMP.
Stigma of mental health conditions hinders recovery and well-being. The Honest, Open, Proud (HOP) program shows promise in reducing stigma but there is uncertainty about the feasibility of a randomized trial to evaluate a peer-delivered, individual adaptation of HOP for psychosis (Let's Talk).
Methods
A multi-site, Prospective Randomized Open Blinded Evaluation (PROBE) design, feasibility randomised controlled trial (RCT) comparing the peer-delivered intervention (Let's Talk) to treatment as usual (TAU). Follow-up was 2.5 and 6 months. Randomization was via a web-based system, with permuted blocks of random size. Up to 10 sessions of the intervention over 10 weeks were offered. The primary outcome was feasibility data (recruitment, retention, intervention attendance). Primary outcomes were analyzed by intention to treat. Safety outcomes were reported by as treated status. The study was prospectively registered: https://doi.org/10.1186/ISRCTN17197043.
Results
149 patients were referred to the study and 70 were recruited. 35 were randomly assigned to intervention + TAU and 35 to TAU. Recruitment was 93% of the target sample size. Retention rate was high (81% at 2.5 months primary endpoint), and intervention attendance rate was high (83%). 21% of 33 patients in Let's talk + TAU had an adverse event and 16% of 37 patients in TAU. One serious adverse event (pre-randomization) was partially related and expected.
Conclusions
This is the first trial to show that it is feasible and safe to conduct a RCT of HOP adapted for people with psychosis and individual delivery. An adequately powered trial is required to provide robust evidence.
The so-called “Prakhon Chai Hoard” is one of Southeast Asia’s most infamous cases of looting. The story begins in 1964 when a cache of Buddhist bronzes from Northeast Thailand appeared on the international art market via the auction house Spink & Son, London. They quickly ended up in museums and private collections throughout the US and Europe. The exact findspot was unclear but soon became associated with an unidentified temple in Prakhon Chai district in Buriram province. The moniker “Prakhon Chai Hoard/bronzes” subsequently took hold, becoming commonplace in museum displays, dealer/auction house catalogs, and art historical discourse. However, in 2002, it was revealed the temple in question was Plai Bat II in Lahan Sai district.
This article untangles the many myths and misunderstandings surrounding this act of looting. It does so by reviewing the extant literature in light of information revealed by criminal investigations into the late Douglas Latchford from 2012 onwards, and presenting conclusions drawn from our decade-long documentation of villager testimonies at Plai Bat II (2014–2024).
Calls for the restitution and repatriation of cultural objects continue to escalate. High-profile cases such as the Parthenon Frieze and the Benin Bronzes dominate international news cycles and provoke fierce debate; however, less attention has been paid to items that are quietly returned and to the potential positive outcomes for the institutions on both sides. This article discusses three Southeast Asian case studies to address this lacuna and urges institutions to become more proactive in their engagement with restitution and repatriation claims.
OBJECTIVES/GOALS: Limited access to medication and poor medication adherence exacerbate chronic diseases following disasters. Experts recommend individuals in disaster-prone areas be prepared to manage their chronic diseases in the event of resource disruption. This study’s goal is to identify factors underlying personal medical preparedness. METHODS/STUDY POPULATION: A cross-sectional survey of 120 insured adults age ≥50 in Southeast Louisiana with hypertension and ≥1 daily medication during the 2023 Atlantic Hurricane Season is underway. The survey includes the Household Emergency Preparedness Index Access and Functional Needs Section (HEPI AFN), a validated measure of medical preparedness that accounts for special circumstances including refrigerated medication and electricity-dependent medical equipment. The mean score of the 9-item tool ranges from 0 to 1, with higher scores indicating more preparedness. The survey also includes 3 open-ended questions where participants can explain difficulties with medication adherence during hurricanes in their own voice. Data collection is ongoing. This interim analysis provides descriptive statistics. RESULTS/ANTICIPATED RESULTS: An interim analysis of the first 50 respondents included 46% women, 52% Black, mean age 61.2 (SD=7.3) years, and mean 52.5 (SD=16.2) years living in a hurricane-impacted area. Participants had a median of 1 comorbid condition; 72% reported taking >5 daily medications. Most respondents (94%) stated their household was at least “somewhat prepared” to handle a disaster and reported medical preparedness on an average of 82% of HEPI-AFN items (mean score = 0.82, SD=0.18); 90% reported that they had never had a healthcare worker talk to them about personal medical preparedness. On open response questions, participants cited insurance restrictions as the primary barrier to having extra medication on hand. In the final sample, regression models will be used to examine factors associated with increased preparedness. DISCUSSION/SIGNIFICANCE: While most participants in this insured, disaster-experienced preliminary sample are medically prepared, few have discussed preparedness with a healthcare provider. Identifying socio-demographic factors associated with preparedness will help to strengthen mitigation strategies addressing widening of health disparities during disasters.
Two introduced carnivores, the European red fox Vulpes vulpes and domestic cat Felis catus, have had extensive impacts on Australian biodiversity. In this study, we collate information on consumption of Australian birds by the fox, paralleling a recent study reporting on birds consumed by cats. We found records of consumption by foxes on 128 native bird species (18% of the non-vagrant bird fauna and 25% of those species within the fox’s range), a smaller tally than for cats (343 species, including 297 within the fox’s Australian range, a subset of that of the cat). Most (81%) bird species eaten by foxes are also eaten by cats, suggesting that predation impacts are compounded. As with consumption by cats, birds that nest or forage on the ground are most likely to be consumed by foxes. However, there is also some partitioning, with records of consumption by foxes but not cats for 25 bird species, indicating that impacts of the two predators may also be complementary. Bird species ≥3.4 kg were more likely to be eaten by foxes, and those <3.4 kg by cats. Our compilation provides an inventory and describes characteristics of Australian bird species known to be consumed by foxes, but we acknowledge that records of predation do not imply population-level impacts. Nonetheless, there is sufficient information from other studies to demonstrate that fox predation has significant impacts on the population viability of some Australian birds, especially larger birds, and those that nest or forage on the ground.
Intertidal biofilms are a diverse mixture of bacteria, algae as well as sporelings of macroalgae embedded in a polysaccharid matrix. As the primary colonisers of newly formed surfaces, biofilms undergo a succession of different microbe assemblage until the mature state is reached. A biofilm can act as primary producers and as such recycle nutrients in a habitat. It will influence macrobiota by providing a food source or sending out cues to settlers. Biofilms themselves will be controlled by these settlers. This interaction between bottom-up and top-down plays a crucial part for the functioning of the rocky shore ecosystems. However, the diversity of biolfilms as well as it nature to react quickly to environmental changes makes identification and quantification of the individual compounds a difficult task. Subsequently, the understanding of biofilms in general and intertidal, rocky shore microbe assemblages has always tied to techniques and methods available at the time of study. This chapter focusses on the techniques that have greatly contributed to increasing knowledge of biofilms and discusses their findings. Nonetheless, newly developed methods promise to further this knowledge of the ecological role of biofilms on rocky coastlines.
The atypical antipsychotics (AAPs) are associated with a recognized class effect of glucose and lipid dysregulation. The use of these medications is rapidly increasing in elderly patients with, and without, dementia. However, the metabolic risks specific to elderly remain poorly studied.
Methods:
Design: A case-control study.
Setting: Psychogeriatric service in Auckland, New Zealand.
Participants: Elderly patients either receiving AAP treatment (cases) or not (controls) between 1 Jan 2008 and 1 Jan 2014.
Main outcome measures: metabolic data of glucose, HbA1c, lipids, and cardiovascular events and death. The data were analyzed using t-tests and linear regression models for each metabolic outcome.
Results:
There were 330 eligible cases and 301 controls from a total study population of 5,307. There was a statistically significant change in the HbA1c over time, within the cases group of −1.14 mmol/mol (p = 0.018, 95% CI −0.19 to −2.09). Also statistically significant was the reduction in total cholesterol of −0.13 mmol/L (p = 0.036, 95% CI −0.008 to −0.245). The only significant difference found between cases and controls was in the change in cholesterol ratio of 0.16 mmol/L between groups (95%CI 0.01–0.31, p = 0.036).
Conclusions:
AAP use was not associated with any clinically significant change in metabolic outcomes in this study population.
Screening for organ and tissue donation is an essential skill for emergency physicians. In 2015, 4,631 Canadians were on a waiting list for a transplant, and 262 died while waiting. Canada’s donation rates are less than half of comparable countries, so it is essential to explore strategies to improve the referral of donors. Poisoned patients may be one such underutilized source for donation. This study explores physician practices and perceptions regarding the referral of poisoned patients as donors.
Methods
In this cross-sectional unidirectional survey, 1,471 physician members of the Canadian Association of Emergency Physicians were invited to participate. Physicians were presented with 20 scenarios and asked whether they would refer the patient as a potential organ or tissue donor. Results were reported descriptively, and associations between demographics and referral patterns were assessed.
Results
Physicians totalling 208 participated in the organ or tissue donation scenarios (14.1%); 75% of scenarios involving poisoning were referred for organ or tissue donation, compared with 92% in a non-poisoning scenario. Poisons associated with lower referrals included sedatives, acetaminophen, chemical exposure, and organophosphates. A total of 175 physicians completed the demographic survey (11.9%). Characteristics associated with increased referrals included previous referral experience, donation training, donation support, >10 years of service, urban practice, emergency medicine certification, and male gender.
Conclusions
Scenarios involving poisoning were referred less often when compared with an ideal scenario. Because poisoning is not a contraindication for referral, this represents a potential source of donors. Targeted training and referral support may help improve donation rates in this demographic.
In the early 1830s and 1840s, a British colonial official by the name of Colonel James Low uncovered evidence for an early culture with Indic traits in a river system known as the Bujang Valley. On the west coast of the Thai-Malay peninsula, the Bujang Valley is today located in the Malaysian state of Kedah. However, it wasn't until just before World War II that excavations took place, conducted by H. G. Quaritch Wales and his wife Dorothy. Their discoveries and subsequent publications led to the first real attempts to explain the origins and extent of this civilisation and its place within the larger South and Southeast Asian world. In the intervening years between Quaritch Wales's excavations and the present day, considerably more research has taken place within the Bujang Valley, though this has not been without controversy. Recently claims and counter-claims regarding the antiquity of Hinduism and Buddhism at the site have arisen in some quarters within Malaysia. It therefore seems pertinent that this material be re-evaluated in light of new scholarship and discoveries as well as the prevailing paradigms of interactions between South and Southeast Asia. This paper presents an updated reading of this material and argues that the Bujang Valley should be seen as a cosmopolitan trading port with substantive evidence for the presence of Hinduism and Buddhism.
Weed seed return and seedbank composition, with particular reference to common lambsquarters, were studied in four tillage systems established on a site near Fingal, Ontario. The tillage treatments were moldboard plow, chisel plow, ridge-till, and no-till. The cropping system was a cornsoybean rotation. Tillage effects on weed population composition were assessed after all weed control measures had been implemented. More than 60% of the weed seedbank was concentrated in the upper 5 cm of soil in chisel plow and no-till. The seedbank of the moldboard plow system was more uniformly distributed over depth and larger than the other systems. Common lambsquarters comprised more than 50% of the seedbank in all systems except ridge-till, but only dominated the aboveground weed population in chisel plow. Seedbank populations of common lambsquarters with moldboard plowing were greater than those with ridge-till and no-till, and chisel plow seedbank populations were greater than those in ridge-till. Chisel and moldboard plow systems generally had higher aboveground plant populations of common lambsquarters than the other two systems. Seed production per plant by common lambsquarters was equivalent among the four systems, but estimated seed production per unit area was higher in moldboard plow and chisel plow systems than in the other systems. Populations of common lambsquarters and similar species may produce more seeds and persist in moldboard plow and chisel plow systems; these weeds may produce fewer seeds per unit area and be easier to manage in no-till and ridge-till systems.
DPX-79406 was evaluated for POST annual grass weed control in both controlled environment and field experiments. In controlled environment experiments, green foxtail was most susceptible to DPX-79406; whereas yellow foxtail was least susceptible of the species evaluated. DPX-79406 at 12 g/ha completely controlled six leaf black-seeded proso millet, yellow foxtail, green foxtail, and barnyardgrass. In the field, DPX-79406 at 3.0 to 25.0 g/ha effectively controlled annual grass weeds without injury to three- to six-leaf corn. There was more variation in the effectiveness of DPX-79406 applied in the field. Early POST applications provided less weed control than the late application, especially for barnyardgrass, because of weeds emerging after application. As a result, higher doses were sometimes needed for effective control. In weed-free field trials at two sites in 1990 and 1991, corn tolerated doses up to 75 g/ha of DPX-79406 applied at the three- to six-leaf growth stage. However, doses as low as 18.8 g/ha applied at the six- to nine-leaf growth stage reduced grain yield. In 1991, corn tillering increases and height and yield reductions were related linearly to the dose of DPX-79406 applied during later growth stages. DPX-79406 should be applied early POST in order to avoid crop injury while providing effective weed control.
To predict weed emergence and help farmers make weed management decisions, we constructed a mathematical model of seed germination for green and redroot pigweed based on temperature and water potential (moisture) and expressing cumulative germination in terms of thermal time (degree days). Empirical observations indicated green pigweed germinated at a lower base temperature than redroot pigweed but the germination rate of redroot pigweed is much faster as mean temperature increases. Moisture limitation delayed seed germination until 23.8 C (green pigweed) or 27.9 (redroot pigweed); thereafter, germination was independent of water potential as mean temperatures approached germination optima. Our germination model, based on a cumulative normal distribution function, accounted for 80 to 95% of the variation in seed germination and accurately predicted that redroot pigweed would have a faster germination rate than green pigweed. However, the model predicted that redroot pigweed would germinate before green pigweed (in thermal time) and was generally less accurate during the early period of seed germination. The model also predicted that moisture limitation would increase, rather than delay, seed germination. These errors were related to the mathematical function chosen and analyses used, but an explicit interaction term for water potential and temperature is also needed to produce an accurate model. We also tested the effect of mean temperature on shoot elongation (emergence) and described the relationship by a linear model. Base temperatures for shoot elongation were higher than for seed germination. Shoot elongation began at 15.6 and 14.4 C for green and redroot pigweed, respectively; they increased linearly with temperature until the optimum of 27.9 C was reached. Elongation was dependent on completion of the rate-limiting step of radicle emergence and was sensitive to temperature but not moisture; hence, elongation was sensitive to a much smaller temperature range. Beyond mathematical changes, we are testing our model in the field and need to link it to ecophysiological, genetic, and spatially explicit population processes for it to be useful in decision support for weed management.
We studied the effect of no-till, chisel, and moldboard plow and the presence or absence of corn on soil temperature, moisture and, subsequently, the emergence phenology and density of pigweed seedlings at 2 sites from 1993 to 1995 inclusively. Tillage significantly affected the phenology of pigweed seedling emergence only during a June drought at one site in 1994. Soil temperature and moisture, measured at 2.5-cm depths, also were unaffected by tillage. Weed phenology is usually earlier in no-till because more seeds are located closer to the surface (< 5 cm deep) in no-till, thereby reducing the delay in penetrating through the soil, and because soil temperatures and moisture are nearer the germination and emergence optima. However, pigweed seedlings are already physiologically restricted to germination depths of less than 2.5 cm regardless of tillage; therefore, this prior constraint eliminated any potential differences in emergence phenologies caused by tillage. The presence or absence of corn also did not affect soil temperatures, soil moisture, or pigweed seedling emergence phenologies. Pigweed seedling density was significantly higher in no-till; this may have been caused by increased numbers of seeds near the soil surface in no-till. The presence or absence of corn did not affect pigweed seedling density; the lack of a significant effect probably reflects high variances in density. Although necessary for most weed species, tillage may be a less important factor to consider in predicting pigweed population dynamics and subsequent management recommendations.
On-farm implementation of IWM includes the biological and economic rationalization of weed management decisions. This, in turn, requires the ability to predict how weed populations and pressures will change with farm management options such as tillage method. We have developed a set of algorithms that simulate seedling emergence of mixed populations of green and redroot pigweed on the basis of the ecophysiological responses of seed germination and shoot elongation to temperature and, for germination, to moisture. The algorithms were calibrated using field data from 1993 and evaluated with data from two locations in 1994 and 1995. Over both sites and years, for four tillage systems, cumulative emergence was predicted with an overall root mean square error of 1.7%. Overprediction in one year was attributed to moisture shortage. Errors were greater for moldboard plowed plots than for those no-tilled. This decreased ability to predict emergence with increased tillage (soil disturbance) suggests that the algorithms should be modified to account for increased heterogeneity in weed seed distribution and soil moisture within disturbed soil. The algorithms, which were explicitly designed for incorporation within a crop growth model (e.g., CROPSIM), could become a useful part of a decision support system to rationalize weed management. Importantly, they could help predict changes in weed populations as farm management is adjusted, thereby reducing economic and environmental risk in agroecosystems.