We describe a large outbreak of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) involving an acute-care hospital emergency department during December 2020 and January 2021, in which 27 healthcare personnel worked while infectious, resulting in multiple opportunities for SARS-CoV-2 transmission to patients and other healthcare personnel. We provide recommendations for improving infection prevention and control.

A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.

Tools applied at the point of care can provide valuable prognostic information for practitioners. In this one-year, prospective observational study, we examined the association of the short performance physical battery (SPPB) and one-year emergency department (ED) visits and hospitalizations. Overall, 191 new referrals attending an outpatient geriatric clinic in Hamilton, Ontario, were approached, and 120 were enrolled. SPPB and other assessments were completed during the routine clinical visit. ED visits and hospitalizations within one year of the baseline assessment were abstracted from electronic medical records. Logistic regression analyses were used to determine ED visits and hospitalization predictors. The mean SPPB score in the study cohort (mean age 80.6, SD 6.3 years; 53% female) was 6.3 (SD 3.2). SPPB score was associated with a one-year ED visit (OR = 0.90 [0.78–1.03]) and hospitalization (OR = 0.84 [0.72–0.97]) after adjusting for age, sex, and co-morbidities.

Childhood obesity is a common concern across global cities and threatens sustainable urban development. Initiatives to improve nutrition and encourage physical exercise are promising but are yet to exert significant influence on prevention. Childhood obesity in London is associated with distinct ethnic and socio-economic patterns. Ethnic inequalities in health-related behaviour endure, underpinned by inequalities in employment, housing, access to welfare services, and discrimination. Addressing these growing concerns requires a clearer understanding of the socio-cultural, environmental and economic contexts of urban living that promote obesity. We explore opportunities for prevention using asset based-approaches to nutritional health and well-being, with a particular focus on adolescents from diverse ethnic backgrounds living in London. We focus on the important role that community engagement and multi-sectoral partnership play in improving the nutritional outcomes of London's children. London's children and adolescents grow up in the rich cultural mix of a global city where local streets are characterised by diversity in ethnicities, languages, religions, foods, and customs, creating complex and fluid identities. Growing up with such everyday diversity we argue can enhance the quality of life for London's children and strengthen their social capital. The Determinants of young Adult Social well-being and Health longitudinal study of about 6500 of London's young people demonstrated the positive impact of cultural diversity. Born to parents from over a hundred countries and exposed to multi-lingual households and religious practices, they demonstrated strong psychological resilience and sense of pride from cultural straddling, despite material disadvantage and discrimination. Supporting the potential contribution of such socio-cultural assets is in keeping with the values of social justice and equitable and sustainable development. Our work signals the importance of community engagement and multisectoral partnerships, involving, for example, schools and faith-based organisations, to improve the nutrition of London's children.

Few of the marine terraces along the Pacific coast of North America have been dated using uranium-series techniques. Ten terrace sequences from southern Oregon to southern Baja California Sur have yielded fossil corals in quantities suitable for U-series dating by alpha spectrometry. U-series-dated terraces representing the ∼80,000 yr sea-level high stand are identified in five areas (Bandon, Oregon; Point Arena, San Nicolas Island, and Point Loma, California; and Punta Banda, Baja California); terraces representing the ∼125,000 yr sea-level high stand are identified in eight areas (Cayucos, San Luis Obispo Bay, San Nicolas Island, San Clemente Island, and Point Loma, California; Punta Bands and Isla Guadalupe, Baja California; and Cabo Pulmo, Baja California Sur). On San Nicolas Island, Point Loma, and Punta Bands, both the ∼80,000 and the ∼125,000 yr terraces are dated. Terraces that may represent the ∼105,000 sea-level high stand are rarely preserved and none has yielded corals for U-series dating. Similarity of coral ages from midlatitude, erosional marine terraces with coral ages from emergent, constructional reefs on tropical coastlines suggests a common forcing mechanism, namely glacioeustatically controlled fluctuations in sea level superimposed on steady tectonic uplift. The low marine terrace dated at ∼125,000 yr on Isla Guadalupe, Baja California, presumed to be tectonically stable, supports evidence from other localities for a +6-m sea level at that time. Data from the Pacific Coast and a compilation of data from other coasts indicate that sea levels at ∼80,000 and ∼105,000 yr may have been closer to present sea level (within a few meters) than previous studies have suggested.

Cretaceous and early Tertiary Pholadidae (Mollusca: Bivalvia) from the Pacific Slope of North America are rare and only poorly known. Three new species, each the earliest known Pacific Slope representative of its respective genus, are described: Barnea (Anchomasa) saulae n. sp. (Pholadinae) from the Upper Cretaceous (Coniacian and Santonian) Redding Formation near Redding, uppermost Sacramento Valley, Shasta County, northern California; Chaceia fulcherae n. sp. (Martesiinae) from three widely separated areas of outcrop represented by 1) the middle Miocene (“Temblor”) Temblor Formation near Oil City and in Jasper Canyon, western Fresno County, central California, 2) the middle Miocene (“Temblor”) Topanga(?) Group in the northern Santa Ana Mountains, Orange County, southern California, and 3) the upper Miocene (Wishkahan) Montesano Formation on the Middle Fork of the Satsop River, Mason County, western Washington; and Netastoma squiresi n. sp. (Jouannetiinae) from the lowest Eocene (uppermost “Meganos”) part of the Santa Susana Formation north of Simi Valley in the Santa Susana Mountains, Ventura County, southern California.

We examine producer behavior, resistance evolution, and returns under alternative refuge requirements in an eastern North Carolina region with multiple corn, cotton, and soybean fields infested by a mobile pest. Returns are highest, pyrethroid sprays occur least frequently, and pyrethroid resistance evolution is delayed most effectively with no refuge requirement. Complying with the current 20% refuge requirement costs the producer $8.67 per cotton acre, or $34.21 per non-transgenic insecticidal (Bt) cotton acre. Returns are highest under each refuge requirement when one-toxin Bt cotton is not phased out; however, removal of the technology at the earliest phase-out date minimizes regional pyrethroid sprays.

This study described prescribing trends before and after implementing a provincial strategy aimed at improving osteoporosis and fracture prevention in Ontario long-term care (LTC) homes. Data were obtained from a pharmacy provider for 10 LTC homes in 2007 and 166 homes in 2012. We used weighted, multiple linear regression analyses to examine facility-level changes in vitamin D, calcium, and osteoporosis medication prescribing rates between 2007 and 2012. After five years, the estimated increase in vitamin D, calcium, and osteoporosis medication prescribing rates, respectively, was 38.2 per cent (95% confidence interval [CI]: 29.0, 47.3; p < .001), 4.0 per cent (95% CI: –3.9, 12.0; p = .318), and 0.2 per cent (95% CI: –3.3, 3.7; p = .91). Although the study could not assess causality, findings suggest that wide-scale knowledge translation activities successfully improved vitamin D prescribing rates, although ongoing efforts are needed to target homes with low uptake.