The COVID-19 pandemic highlighted gaps in infection control knowledge and practice across health settings nationwide. The Centers for Disease Control and Prevention, with funding through the American Rescue Plan, developed Project Firstline. Project Firstline is a national collaborative aiming to reach all aspects of the health care frontline. The American Medical Association recruited eight physicians and one medical student to join their director of infectious diseases to develop educational programs targeting knowledge gaps. They have identified 5 critical areas requiring national attention.

In 1884, during the period of the Socialist Laws, August Bebel took the time to publish a historical work entitled Die mohamedanisch- arabische Kulturperiode. In it Bebel positioned Islam and the early caliphates as the unacknowledged link between Greco-Roman traditions of knowledge and the blossoming of European culture that, he argued, had occurred since the Renaissance. He also used the book as an opportunity to reject claims that Christianity had played this key role in world historical progress. Through an examination and contextualization of Bebel's writings on Islam, this article shows how he viewed the role of different religious traditions within world history and how his views intersected with contemporary questions regarding the relationship between religion and socialism. The article also examines how Bebel's work fits within a longer tradition of socialist solidarity with the Ottoman Empire.

Via an investigation of the collaboration between banks and foreign offices, this article demonstrates that the restructuring of China’s state debt before and after the revolution of 1911 was not simply a part of Chinese globalisation undertaken under the benign stewardship of foreign banks. Rather, the contest for Chinese loans reflected a power struggle for regional hegemony between expansionist states that hinged on both competition and cooperation, as well as Chinese attempts to preserve their economic and territorial sovereignty. It further shows that the notion that financial institutions operated independently of the state does not reflect the clear record of close coordination between states and financial institutions during loan negotiations.

Canada's experience with the coronavirus disease-2019 (COVID-19) pandemic has been characterized by considerable regional variation, as would be expected in a highly decentralized federation. Yet, the country has been beset by challenges, similar to many of those documented in the severe acute respiratory syndrome outbreak of 2003. Despite a high degree of pandemic preparedness, the relative success with flattening the curve during the first wave of the pandemic was not matched in much of Canada during the second wave. This paper critically reviews Canada's response to the COVID-19 pandemic with a focus on the role of the federal government in this public health emergency, considering areas within its jurisdiction (international borders), areas where an increased federal role may be warranted (long-term care), as well as its technical role in terms of generating evidence and supporting public health surveillance, and its convening role to support collaboration across the country. This accounting of the first 12 months of the pandemic highlights opportunities for a strengthened federal role in the short term, and some important lessons to be applied in preparing for future pandemics.

Introduction: Emergency care serves as an important health resource for First Nations (FN) persons. Previous reporting shows that FN persons visit emergency departments at almost double the rate of non-FN persons. Working collaboratively with FN partners, academic researchers and health authority staff, the objective of this study is to investigate FN emergency care patient visit statistics in Alberta over a five year period. Methods: Through a population-based retrospective cohort study for the period from April 1, 2012 to March 31, 2017, patient demographics and emergency care visit characteristics for status FN patients in Alberta were analyzed and compared to non-FN statistics. Frequencies and percentages (%) describe patients and visits by categorical variables (e.g., Canadian Triage Acuity Scale (CTAS)). Means and standard deviations (medians and interquartile ranges (IQR)) describe continuous variables (e.g., distances) as appropriate for the data distribution. These descriptions are repeated for the FN and non-FN populations, separately. Results: The data set contains 11,686,288 emergency facility visits by 3,024,491 unique persons. FN people make up 4.8% of unique patients and 9.4% of emergency care visits. FN persons live further from emergency facilities than their non-FN counterparts (FN median 6 km, IQR 1-24; vs. non-FN median 4 km, IQR 2-8). FN visits arrive more often by ground ambulance (15.3% vs. 10%). FN visits are more commonly triaged as less acute (59% CTAS levels 4 and 5, compared to non-FN 50.4%). More FN visits end in leaving without completing treatment (6.7% vs. 3.6%). FN visits are more often in the evening – 4:01pm to 12:00am (43.6% vs. 38.1%). Conclusion: In a collaborative validation session, FN Elders and health directors contextualized emergency care presentation in evenings and receiving less acute triage scores as related to difficulties accessing primary care. They explained presentation in evenings, arrival by ambulance, and leaving without completing treatment in terms of issues accessing transport to and from emergency facilities. Many factors interact to determine FN patients’ emergency care visit characteristics and outcomes. Further research needs to separate the impact of FN identity from factors such as reasons for visiting emergency facilities, distance traveled to care, and the size of facility where care is provided.

Introduction: Acute bloody diarrhea obligates rapid and accurate diagnostic evaluation; few studies have described such cohorts of children. Methods: We conducted a planned secondary analysis employing the Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE) acute gastroenteritis study cohort to describe the characteristics of children with acute bloody diarrhea, compared to a cohort of children without hematochezia. Children <18 years of age presenting to 2 pediatric tertiary care emergency departments (EDs) in Alberta, with ≥3 episodes of diarrhea and/or vomiting in the preceding 24 hours and <7 days of symptoms were consecutively recruited. Stools were tested for 17 viruses, bacteria and parasites. Primary outcomes were clinical characteristics and pathogens identified. Secondary outcomes included interventions and resource utilization. Results: Of 2257 children enrolled between October 2015 and August 2018, hematochezia before or at the index ED visit was reported in 122 (5.4%). Compared to children with nonbloody diarrhea, children with hematochezia had longer illness duration [59.5 vs. 41.5 hrs, difference 10.6, 95% CI 3.5, 19.9], more diarrheal episodes in a 24-hour period [8 vs. 5, difference 3, 95% CI 2, 4], and less vomiting [55.7% vs. 91.1%; difference -35.3%; 95% CI -44.7, -26.3]. They received more intravenous fluids [32.0% vs. 18.3%; difference 13.7%, 95% CI 5.5, 23.0], underwent non-study stool testing [53.7% vs. 4.8%; difference 49.0%, 95% CI 39.6, 58.0], experienced longer ED visits [4.1 vs. 3.3 hours, difference 0.9, 95% CI 0.3, 1.0] and were more likely to have repeat healthcare visits within 14 days [54.8% vs. 34.2%; difference 20.6%, 95% CI 10.8, 30.1]. A bacterial enteric pathogen was found in 31.9% of children with hematochezia versus 6.6% without bloody diarrhea (difference 25.4%, 95% CI 17.2, 34.7). In children with hematochezia, the most commonly detected bacteria were Salmonella spp. (N = 15), Shiga toxin-producing E. coli (N = 9), Campylobacter spp. (N = 7), and Shigella spp. (N = 5). Viruses were detected in 32.8% of children with bloody diarrhea, most commonly adenovirus (N = 15), norovirus (N = 14), sapovirus (N = 8) and rotavirus (N = 7). Conclusion: Children with hematochezia differed clinically from those without hematochezia and required more healthcare resources. While bacterial etiologies are common, several viruses were also detected.

Introduction: The Cunningham reduction method for anterior shoulder dislocation offers an atraumatic alternative to traditional reduction techniques without the inconvenience and risk of procedural sedation and analgesia (PSA). Unfortunately, success rates as low as 27% have limited widespread use of this method. Inhaled methoxyflurane (I-MEOF) offers a rapidly administered, minimally invasive option for short-term analgesia. We conducted a pilot study to evaluate the feasibility of studying whether I-MEOF increased success rates for atraumatic reduction of anterior shoulder dislocation. Methods: A convenience sample of 20 patients with uncomplicated anterior shoulder dislocations were offered the Cunningham reduction method supported by methoxyflurane analgesia under the guidance of an advanced care paramedic. Operators were instructed to limit their attempt to the Cunningham method. Outcomes included success rate without the requirement for PSA, time to discharge, and operator and patient satisfaction with the procedure. Results: 20 patients received I-MEOF and an attempt at Cunningham reduction. 80% of patients were male, median age was 38.6 (range 18-71), and 55% were first dislocations of that joint. 35% (8/20 patients) had reduction successfully achieved by the Cunningham method under I-MEOF analgesia. The remainder proceeded to closed reduction under PSA. All patients had eventual successful reduction in the ED. 60% of operators reported good to excellent satisfaction with the process, with inadequate muscle relaxation being identified as the primary cause of failed initial attempts. 80% of patients reported good to excellent satisfaction. Conclusion: Success with the Cunningham technique was marginally increased with the use of I-MEOF, although 65% of patients still required PSA to facilitate reduction. The process was generally met with satisfaction by both providers and patients, suggesting that early administration of analgesia is appreciated. Moreover, one-third of patients had reduction achieved atraumatically without need for further intervention. A larger, randomized study may identify patient characteristics which make this reduction method more likely to be successful.

Decolonizing history and anthropology is often presented as a theoretical enterprise, through which a more rigorous and inclusive framing of historical precepts will deliver a clearer and less Eurocentric understanding of the past. Yet it is arguably necessary to decouple decolonization from the broader practices of anti-Eurocentric historiography. Via an empirical assessment of the legacy of Hermann Klaatsch, a German anthropologist working on the colonial frontier, this article examines the possibilities and limitations of a decolonizing approach to settler colonial history. The article reflects upon its own study of colonial anthropology and the historical complexity of the repatriation of Indigenous human remains, and suggests that not all anti-Eurocentric interrogations of the colonial past are synonymous with decolonization.

Discovered in 1857, the site of La Tène, in Switzerland, played an important role in the rapid development of European prehistory in the mid-nineteenth century including the adoption of the three-age system in which it was named as the type site for the later Iron Age. The finds from it are now scattered across museums in Europe and America, and those in London are published here as part of a project to locate and publish all the finds from the site. The discovery of the site and the dispersal of its finds are discussed in the context of contemporary understandings of the past and collecting practices. Usually seen as votive offerings placed in a river, the finds have been re-interpreted recently as the remains of a trophy that displayed the bodies and equipment of an army defeated in c 220–200 bc.

In the past two decades, colonial studies, the postcolonial turn, the new imperial history, as well as world and global history have made serious strides toward revising key elements of German history. Instead of insisting that German modernity was a fundamentally unique, insular affair that incubated authoritarian social tendencies, scholars working in these fields have done much to reinsert Germany into the broader logic of nineteenth-century global history, in which the thalassocratic empires of Europe pursued the project of globalizing their economies, populations, and politics. During this period, settler colonies, including German South West Africa, were established and consolidated by European states at the expense of displaced, helotized, or murdered indigenous populations. Complementing these settler colonies were mercantile entrepôts and plantation colonies, which sprouted up as part of a systematic, global attempt to reorient non-European economies, work patterns, and epistemological frameworks along European lines. Although more modestly than some of its European collaborators and competitors, Germany joined Britain, France, the Netherlands, and the United States in a largely liberal project of global maritime imperialism.

Research at the Chelechol ra Orrak rockshelter in Palau has revealed an extensive cemetery with at least 50 interred individuals, their graves overlain by later occupational deposits. Previous radiocarbon dating placed this sequence of burial and occupation at c. 3000 cal BP, making it one of the earliest Pacific Island cemetery sites. To provide a more robust chronological framework, Bayesian modelling was applied to construct probability ranges for the date and duration of activity at the site, assisted by a suite of new 14C determinations. The results provide more secure evidence for burial activity dating back to c. 3000 cal BP, thus confirming Chelechol ra Orrak as one of the only cemeteries in Remote Oceania that dates to the earliest, known stages of island colonisation.