“Social isolation among older adults is associated with increased change of premature death; depression; dementia, disability from chronic diseases; poor mental health; increased use of health and support services; reduced quality of life; poor general health; and an increased number of falls.” (National Academies of Sciences, Engineering, and Medicine (2020).

Without question, the global pandemic has significantly exacerbated both the prevalence and awareness of social isolation and loneliness as a growing health and societal challenge for older populations.

“Because of growing calls for Canada’s health-care systems to identify, prevent and mitigate loneliness as part of COVID-19-related public health efforts, there is a unique opportunity to build capacity to identify and intervene with older adults who are experiencing social isolation or loneliness.” National Institute on Aging (2022).

Over the past two decades, the Canadian Coalition for Seniors’ Mental Health (CCSMH) has developed a number of internationally recognized clinical guidelines in support of mental health for older adults. CCSMH is responding to the growing mental health crisis of isolation and loneliness with the development of evidence-based guidelines, to support the vital work of health and social service providers across Canada. The focus of these guidelines is to develop a broad range of evidence-based, manageable, and stepped care approaches to identify and address social isolation and loneliness in older adults. It is recognized that this topic is extremely complex and vast in potential scope. Through the guidance of a national working group of experts, these guidelines will draw upon both academic and grey literature, as well as on the experience of a diversity of health and social service providers, older adults, and their caregivers. This project will also provide guidance, promoting wellness and reducing the risk of social isolation with targeted messaging, knowledge translation and useful tools for supporting social connection among those at highest risk.

This presentation will share the Guidelines’ preliminary recommendations, as well as data from two national surveys alongside other insights gained from ongoing research and stakeholder engagement.

The Hierarchical Taxonomy of Psychopathology (HiTOP) has emerged out of the quantitative approach to psychiatric nosology. This approach identifies psychopathology constructs based on patterns of co-variation among signs and symptoms. The initial HiTOP model, which was published in 2017, is based on a large literature that spans decades of research. HiTOP is a living model that undergoes revision as new data become available. Here we discuss advantages and practical considerations of using this system in psychiatric practice and research. We especially highlight limitations of HiTOP and ongoing efforts to address them. We describe differences and similarities between HiTOP and existing diagnostic systems. Next, we review the types of evidence that informed development of HiTOP, including populations in which it has been studied and data on its validity. The paper also describes how HiTOP can facilitate research on genetic and environmental causes of psychopathology as well as the search for neurobiologic mechanisms and novel treatments. Furthermore, we consider implications for public health programs and prevention of mental disorders. We also review data on clinical utility and illustrate clinical application of HiTOP. Importantly, the model is based on measures and practices that are already used widely in clinical settings. HiTOP offers a way to organize and formalize these techniques. This model already can contribute to progress in psychiatry and complement traditional nosologies. Moreover, HiTOP seeks to facilitate research on linkages between phenotypes and biological processes, which may enable construction of a system that encompasses both biomarkers and precise clinical description.

Interactions with parents are integral in shaping the development of children’s emotional processes. Important aspects of these interactions are overall (mean level) affective experience and affective synchrony (linkages between parent and child affect across time). Respectively, mean-level affect and affective synchrony reflect aspects of the content and structure of dyadic interactions. Most research on parent–child affect during dyadic interactions has focused on infancy and early childhood; adolescence, however, is a key period for both normative emotional development and the emergence of emotional disorders. We examined affect in early to mid-adolescents (N = 55, Mage = 12.27) and their parents using a video-mediated recall task of 10-min conflict-topic discussions. Using multilevel modeling, we found evidence of significant level-2 effects (mean affect) and level-1 effects (affective synchrony) for parents and their adolescents. Level-2 and level-1 associations were differentially moderated by adolescent age and adolescent internalizing and externalizing symptoms. More specifically, parent–adolescent synchrony was stronger when adolescents were older and had more internalizing problems. Further, more positive adolescent mean affect was associated with more positive parent affect (and vice versa), but only for dyads with low adolescent externalizing problems. Results underscore the importance of additional research examining parent–child affect in adolescence.

The United States Centers for Disease Control and Prevention and the World Health Organization broadly categorize mass gathering events as high risk for amplification of coronavirus disease 2019 (COVID-19) spread in a community due to the nature of respiratory diseases and the transmission dynamics. However, various measures and modifications can be put in place to limit or reduce the risk of further spread of COVID-19 for the mass gathering. During this pandemic, the Johns Hopkins University Center for Health Security produced a risk assessment and mitigation tool for decision-makers to assess SARS-CoV-2 transmission risks that may arise as organizations and businesses hold mass gatherings or increase business operations: The JHU Operational Toolkit for Businesses Considering Reopening or Expanding Operations in COVID-19 (Toolkit). This article describes the deployment of a data-informed, risk-reduction strategy that protects local communities, preserves local health-care capacity, and supports democratic processes through the safe execution of the Republican National Convention in Charlotte, North Carolina. The successful use of the Toolkit and the lessons learned from this experience are applicable in a wide range of public health settings, including school reopening, expansion of public services, and even resumption of health-care delivery.

Rock debris covers ~30% of glacier ablation areas in the Central Himalaya and modifies the impact of atmospheric conditions on mass balance. The thermal properties of supraglacial debris are diurnally variable but remain poorly constrained for monsoon-influenced glaciers over the timescale of the ablation season. We measured vertical debris profile temperatures at 12 sites on four glaciers in the Everest region with debris thickness ranging from 0.08 to 2.8 m. Typically, the length of the ice ablation season beneath supraglacial debris was 160 days (15 May to 22 October)—a month longer than the monsoon season. Debris temperature gradients were approximately linear (r2 > 0.83), measured as −40°C m–1 where debris was up to 0.1 m thick, −20°C m–1 for debris 0.1–0.5 m thick, and −4°C m–1 for debris greater than 0.5 m thick. Our results demonstrate that the influence of supraglacial debris on the temperature of the underlying ice surface, and therefore melt, is stable at a seasonal timescale and can be estimated from near-surface temperature. These results have the potential to greatly improve the representation of ablation in calculations of debris-covered glacier mass balance and projections of their response to climate change.

Background: When control mechanisms such as water temperature and biocide level are insufficient, Legionella, the causative bacteria of Legionnaires’ disease, can proliferate in water distribution systems in buildings. Guidance and oversight bodies are increasingly prioritizing water safety programs in healthcare facilities to limit Legionella growth. However, ensuring optimal implementation in large buildings is challenging. Much is unknown, and sometimes assumed, about whether building and campus characteristics influence Legionella growth. We used an extensive real-world environmental Legionella data set in the Veterans Health Administration (VHA) healthcare system to examine infrastructure characteristics and Legionella positivity. Methods: VHA medical facilities across the country perform quarterly potable water sampling of healthcare buildings for Legionella detection as part of a comprehensive water safety program. Results are reported to a standardized national database. We did an exploratory univariate analysis of facility-reported Legionella data from routine potable water samples taken in 2015 to 2018, in conjunction with infrastructure characteristics available in a separate national data set. This review examined the following characteristics: building height (number of floors), building age (reported construction year), and campus acreage. Results: The final data set included 201,936 water samples from 819 buildings. Buildings with 1–5 floors (n = 634) had a Legionella positivity rate of 5.3%, 6–10 floors (n = 104) had a rate of 6.4%, 11–15 floors (n = 36) had a rate of 8.1%, and 16–22 floors (n = 9) had a rate of 8.8%. All rates were significantly different from each other except 11–15 floors and 16–22 floors (P < .05, χ2). The oldest buildings (1800s) had significantly less (P < .05, χ2) Legionella positivity than those built between 1900 and 1939 and between 1940 and 1979, but they were no different than the newest buildings (Fig. 1). In newer buildings (1980–2019), all decades had buildings with Legionella positivity (Fig. 1 inset). Campus acreage varied from ~3 acres to almost 500 acres. Although significant differences were found in Legionella positivity for different campus sizes, there was no clear trend and campus acreage may not be a suitable proxy for the extent or complexity of water systems feeding buildings. Conclusions: The analysis of this large, real-world data set supports an assumption that taller buildings are more likely to be associated with Legionella detection, perhaps a result of more extensive piping. In contrast, the assumption that newer buildings are less associated with Legionella was not fully supported. These results demonstrate the variability in Legionella positivity in buildings, and they also provide evidence that can inform implementation of water safety programs.

Funding: None

Disclosures: Chetan Jinadatha, principal Investigator/Co-I: Research: NIH/NINR, AHRQ, NSF principal investigator: Research: Xenex Healthcare Services. Funds provided to institution. Inventor: Methods for organizing the disinfection of one or more items contaminated with biological agents. Owner: Department of Veterans Affairs. Licensed to Xenex Disinfection System, San Antonio, TX.

Chronic kidney disease continues to be under recognised and is associated with a significant global health burden and costs. An adverse intrauterine environment may result in a depleted nephron number and an increased risk of chronic kidney disease. Antenatal ultrasound was used to measure the foetal renal parenchymal thickness (RPT), as a novel method to estimate nephron number. Foetal renal artery blood flow was also assessed. This prospective, longitudinal study evaluated the foetal kidneys of 102 appropriately grown and 30 foetal growth-restricted foetuses between 20 and 37 weeks gestational age (GA) to provide vital knowledge on the influences foetal growth restriction has on the developing kidneys. The foetal RPT and renal artery blood flow were measured at least every 4 weeks using ultrasound. The RPT was found to be significantly thinner in growth-restricted foetuses compared to appropriately grown foetuses [likelihood ratio (LR) = 21.06, P ≤ 0.0001] and the difference increases with GA. In foetuses with the same head circumference, a growth-restricted foetus was more likely to have a thinner parenchyma than an appropriately grown foetus (LR = 8.9, P = 0.0028), supporting the principle that growth-restricted foetuses preferentially shunt blood towards the brain. No significant difference was seen in the renal arteries between appropriately grown and growth-restricted foetuses. Measurement of the RPT appears to be a more sensitive measure than current methods. It has the potential to identify infants with a possible reduced nephron endowment allowing for monitoring and interventions to be focused on individuals at a higher risk of developing future hypertension and chronic kidney disease.

The elimination of unwanted catch in mixed species fisheries is technically challenging given the complexity of fish behaviour within nets. Most approaches to date have employed technologies that modify the nets themselves or use physical sorting grids within the gear. There is currently increasing interest in the use of artificial light to either deter fish from entering the net, or to enhance their escapement from within the net. Here, we evaluated the differences in catch retained in a standard otter trawl, relative to the same gear fitted with a square mesh panel, or a square mesh panel fitted with LEDs. We found that the selectivity of the gear differed depending on water depth. When using a square mesh panel in shallow depths of 29–40 m the unwanted bycatch of whiting and haddock was reduced by 86% and 58% respectively. In deep, darker water (45–95 m), no change in catch was observed in the square-mesh panel treatment, however when LEDs were added to the square-mesh panel, haddock and flatfish catches were reduced by 47% and 25% respectively. These findings demonstrate the potential to improve the performance of bycatch reduction devices through the addition of light devices to enhance selectivity. The results also highlight species-specific and site-specific differences in the performance of bycatch reduction devices, and hence a more adaptive approach to reduce bycatch is probably required to maximize performance.

Short-term feeding studies have highlighted a phenomenon in Ca regulation that raises concerns around Ca absorption in dogs that may make an impact on commercial diets near to the maximum recommended level. A recent study to determine responses in dogs fed one of two diets differing in dietary Ca over 40 weeks found no evidence to suggest a concern across a range of biological parameters hypothesised to be affected by Ca. Unforeseen consequences of dietary Ca could have occurred and metabolic profiling was deemed a suitable data-driven approach to identify effects of dietary Ca. The objectives were to compare the fasted plasma metabolome (sampled at 8-week intervals over 40 weeks) of dogs fed one of two diets, near to the minimum and maximum recommended levels of dietary Ca. Comparisons with the control diet were also investigated across the postprandial time course (1–4 h) following acute (1 d) and long-term (24 weeks) feeding of the test diet. Comparing fasted plasma samples at each time point, no significant effect (adjusted P < 0·05) of diet on metabolites was observed. In the postprandial state, only phosphate was consistently different between diets and was explained by additional dietary P to maintain Ca:P. Metabolic profiling analysis supports the view that the dietary Ca upper limit is safe. Additionally, the canine plasma metabolome was characterised, providing insights into the stability of individual profiles across 40 weeks, the response to consumption of a nutritionally complete meal over a 4 h postprandial time course and different kinetic categories of postprandial absorption.