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As coronavirus disease 2019 (COVID-19) spread, efforts were made to preserve resources for the anticipated surge of COVID-19 patients in British Columbia, Canada. However, the relationship between COVID-19 hospitalizations and access to cancer surgery is unclear. In this project, we analyze the impact of COVID-19 patient volumes on wait time for cancer surgery.
Methods:
We conducted a retrospective study using population-based datasets of regional surgical wait times and COVID-19 patient volumes. Weekly median wait times for urgent, nonurgent, cancer, and noncancer surgeries, and maximum volumes of hospitalized patients with COVID-19 were studied. The results were qualitatively analyzed.
Results:
A sustained association between weekly median wait time for priority and other cancer surgeries and increase hospital COVID-19 patient volumes was not qualitatively discernable. In response to the first phase of COVID-19 patient volumes, relative to pre-COVID-19 pandemic levels, wait time were shortened for urgent cancer surgery but increased for nonurgent surgeries. During the second phase, for all diagnostic groups, wait times returned to pre-COVID-19 pandemic levels. During the third phase, wait times for all surgeries increased.
Conclusion:
Cancer surgery access may have been influenced by other factors, such as policy directives and local resource issues, independent of hospitalized COVID-19 patient volumes. The initial access limitations gradually improved with provincial and institutional resilience, and vaccine rollout.
The unprecedented participation by two Ojibwe-speaking Anishinabek lay delegates in the 1866 meeting of the Electoral Synod of the Anglican Diocese of Toronto garnered a brief flurry of contemporary journalistic coverage across a networked imperial and colonial press. In the most vivid reportage, the two delegates were dehumanized, reduced to the status of ‘Indian nags … becoming inoculated with the ways of Anglicans’. In another more distantly circulated representation, an Indigenous presence at the incipience of Canadian synodality was invested with different rhetorical significance, the unsettling scandal of their voting membership justifying the struggle for self-government in the nascent Anglican Churches of other colonies, thus laying bare anxieties about the precarious situation of colonial Anglicanism. Rather than presuming to interpret the experience and discourse of Indigenous Anglicans, nor simply documenting the first local episode of formal Indigenous involvement in the counsels of Anglicans in Canada, this paper introduces the Electoral Synod, the neglected texts that covered the event, along with the lives of the exoticized churchmen featured in their coverage.
Patients diagnosed with glioblastoma (GBM) are treated with surgery followed by fractionated radiotherapy with concurrent and adjuvant temozolomide. Patients are monitored with serial magnetic resonance imaging (MRI). However, treatment-related changes frequently mimic disease progression. We reviewed a series of patients undergoing surgery for presumed first-recurrence GBM, where pathology reports were available for tissue diagnosis, in order to better understand factors associated with a diagnosis of treatment-related changes on final pathology.
Methods:
Patient records at a single institution between 2005 and 2015 were retrospectively reviewed. Pathology reports were reviewed to determine diagnosis of recurrent GBM or treatment effect. Survival analysis was performed interrogating overall survival (OS) and progression-free survival (PFS). Correlation with radiation treatment plans was also examined.
Results:
One-hundred-twenty-three patients were identified. One-hundred-sixteen patients (94%) underwent resection and seven underwent biopsy. Treatment-related changes were reported in 20 cases (16%). These patients had longer median OS and PFS from the time of recurrence than patients with true disease progression. However, there was no significant difference in OS from the time of initial diagnosis. Treatment effect was associated with surgery within 90 days of completing radiation. In patients receiving radiation at our institution (n = 53), larger radiation target volume and a higher maximum dose were associated with treatment effect.
Conclusion:
Treatment effect was associated with surgery nearer to completion of radiation, a larger radiation target volume, and a higher maximum point dose. Treatment effect was associated with longer PFS and OS from the time of recurrence, but not from the time of initial diagnosis.
We identified a pseudo-outbreak of Mycobacterium avium in an outpatient bronchoscopy clinic following an increase in clinic procedure volume. We terminated the pseudo-outbreak by increasing the frequency of automated endoscope reprocessors (AER) filter changes from quarterly to monthly. Filter changing schedules should depend on use rather than fixed time intervals.
Clinical depression affects approximately 15% of community-dwelling older adults, of which half of these cases present in later life. Falls and depressive symptoms are thought to co-exist, while physical activity may protect an older adult from developing depressive symptoms. This study investigates the temporal relationships between depressive symptoms, falls, and participation in physical activities amongst older adults recently discharged following extended hospitalization.
Methods:
A prospective cohort study in which 311 older adults surveyed prior to hospital discharge were assessed monthly post-discharge for six months. N = 218 completed the six-month follow-up. Participants were recruited from hospitals in Melbourne, Australia. The survey instrument used was designed based on Fiske's behavioral model depicting onset and maintenance of depression. The baseline survey collected data on self-reported falls, physical activity levels, and depressive symptoms. The monthly follow-up surveys repeated measurement of these outcomes.
Results:
At any assessment point, falls were positively associated with depressive symptoms; depressive symptoms were negatively associated with physical activity levels; and, physical activity levels were negatively associated with falls. When compared with data in the subsequent assessment point, depressive symptoms were positively associated with falls reported over the next month (unadjusted OR: 1.20 (1.12, 1.28)), and physical activity levels were negatively associated with falls reported over the next month (unadjusted OR: 0.97 (0.96, 0.99) household and recreational), both indicating a temporal relationship.
Conclusion:
Falls, physical activity, and depressive symptoms were inter-associated, and depressive symptoms and low physical activity levels preceded falls. Clear strategies for management of these interconnected problems remain elusive.
Heritage, memory, community archaeology and the politics of the past form the main strands running through the papers in this volume. The authors tackle these subjects from a range of different philosophical perspectives, with many drawing on the experience of recent community, commercial and other projects. Throughout, there is a strong emphasis on both the philosophy of engagement and with its enactment in specific contexts; the essays deal with an interest in the meaning, value and contested nature of the recent past and in the theory and practice of archaeological engagements with that past.
Chris Dalglish is a lecturer in archaeology at the University of Glasgow. Contributors: Julia Beaumont, David Bowsher, Terry Brown, Jo Buckberry, Chris Dalglish, James Dixon, Audrey Horning, Robert Isherwood, Robert C Janaway, Melanie Johnson, Siân Jones, Catriona Mackie, Janet Montgomery, Harold Mytum, Michael Nevell, Natasha Powers, Biddy Simpson, Matt Town, Andrew Wilson
This volume publishes a selection of the papers first presented during the Society for Post-Medieval Archaeology's conference Engaging the Recent Past in 2010. This introductory paper seeks to situate the other contributions, placing them in the context of wider processes including the rise of Community Archaeology and the development of an explicit political consciousness in archaeology. Concepts of multivocality and memory are discussed, as are the practices of public participation. The paper argues that a more critical stance needs to be taken towards public engagement in archaeology, and this is discussed in relation to concepts of power and social learning. The paper advocates a move beyond limited participation (confined to particular activities, such as participatory site identification and recording, and to the context of particular projects) and it advocates a move towards participatory governance. Here, the archaeological professional is repositioned as a collaborator engaging with others, including relevant public constituencies and the relevant authorities, in the social process of creating knowledge about the past and defining how historic environments and relationships will be protected, managed or transformed in the future.
INTRODUCTION
This volume arises from the Society for Post-Medieval Archaeology conference Engaging the Recent Past: Public, Political Post-Medieval Archaeology (Glasgow, September 2010). The focus of the conference was the contemporary context of post-medieval archaeology: the values, politics and ethics associated with the recent past, and the practices through which we engage with and construct that past. Contributors to the conference considered these issues in relation to the post-medieval and contemporary archaeologies of the U.K., Ireland and a number of other countries, and they promoted positions founded in a variety of philosophical, political and practice traditions.
This paper will demonstrate, through recent fieldwork and political engagements in Bristol, UK, the potential for a new kind of political archaeology, not based around supporting political parties or facilitating community engagement as ends in themselves, but around creating new kinds of knowledge that can be used to influence politics and politicians at the highest levels.
INTRODUCTION: BIG P, SMALL p
The phrase ‘archaeology is a political act’ is oft repeated, but as with any such definitive phrase when used in academia each word of it has multiple meanings. For instance ‘is’. Well, it is not always. Archaeology can be a political act and archaeology sometimes is a political act, but this is not a universal truth. Likewise, the word archaeology can be taken different ways itself. There is academic archaeology, private sector archaeology, public archaeology, uses of archaeology in the heritage industry and so on, all intrinsically connected, but each with nuances different enough to render universality meaningless.
In this paper, I wish to put forward the possibility that contemporary forms of archaeological thought and investigation can play a role in redefining the ways in which politicians engage with ordinary people and everyday situations. Rather than limiting themselves to facilitating community engagement or lobbying politicians in relation to heritage legislation, I will suggest that archaeologists can move towards using their unique perspectives on contemporary and historic environments to change the very way in which the connection between archaeology and politics is conceived, using archaeological investigation to understand the nature of contemporary politics and feeding this back into the wider system of policy making instead of merely working within the confines of existing heritage legislation.
Recent developments in the realm of public and community archaeologies have stressed the need for plurality, diversity, and a lessening of archaeological authority. The mandate for such community engagement is often the well-meaning desire to redress historical imbalances and injustices through prioritising the interests of certain constituencies. Yet the ethics of deciding what history will be prioritised and whose voice should be heard are often left unconsidered in our haste to demonstrate the social value of archaeology. In Northern Ireland, a host of anniversaries relating to the still contested past of the early 17th-century Plantation period lend an unavoidable immediacy to archaeological engagements. Drawing from several recent fieldwork projects, the parameters of a critical, publically-engaged Plantation-period archaeology are considered. The challenges of developing public archaeology in Northern Ireland, where both communities (Catholic and Protestant) have equal voices if oppositional historical memories, has the potential to critically inform the practice of ethical community engagement in other locales.
INTRODUCTION: THE PAST IN THE PRESENT
Public and community archaeologies clearly have their deepest roots in places characterised by structural, societal inequities, and in situations where archaeologists have sought to be inclusive. As such, community archaeology has been generally theorised within a postcolonial, post-processual framework whereby we as scholars and trained professionals question our own position and our right to talk about the past of ‘other people’, often disenfranchised people.
Community archaeology is a rapidly expanding approach to archaeological research. Whilst the archaeology itself is central to individual projects, issues of community' may be heavily implicated within the agendas of many project partners. In this paper, I will argue that community archaeology projects are complex arenas in which a variety of agendas are interwoven within both the planned activities and the unplanned outcomes that occur during the life of a project. Drawing on ethnographic evidence of community archaeology from my recently completed doctoral research as well as from recent experience of the proactive delivery of community archaeology I will focus on the role of memory in relation to both the initial design of community archaeology projects and also the ways in which projects come to be understood and valued by those who have supported and/or participated in them. I will identify projects as being arenas in which aspects of social memory can be central to much that is both planned for and experienced by participants. The rediscovery of lost memories, the preserving of fragile memories and the making of new memories will be shown to be especially significant within the narratives aggregating around individual community projects. I identify ‘living memory'sites as being especially meaningful and effective for community archaeology and argue that the event of a community archaeology project can serve as an arena for the construction of community in the present.
Research reveals mixed results regarding the utility of standardized cognitive and academic tests to predict educational outcomes in youth following a traumatic brain injury (TBI). Yet, deficits in everyday school-based outcomes are prevalent after pediatric TBI. The current study used path modeling to test the hypothesis that parent ratings of adolescents’ daily behaviors associated with executive functioning (EF) would predict long-term functional educational outcomes following pediatric TBI, even when injury severity and patient demographics were included in the model. Furthermore, we contrasted the predictive strength of the EF behavioral ratings with that of a common measure of verbal memory. A total of 132 adolescents who were hospitalized for moderate to severe TBI were recruited to participate in a randomized clinical intervention trial. EF ratings and verbal memory were measured within 6 months of the injury; functional educational outcomes were measured 12 months later. EF ratings and verbal memory added to injury severity in predicting educational competence post injury but did not predict post-injury initiation of special education. The results demonstrated that measurement of EF behaviors is an important research and clinical tool for prediction of functional outcomes in pediatric TBI. (JINS, 2013, 19, 1–9)
This unique collection presents texts in international relations from Ancient Greece to the First World War. Major writers such as Thucydides, Augustine, Aquinas, Machiavelli, Grotius, Kant and John Stuart Mill are represented by extracts of their key works; less well-known international theorists including John of Paris, Cornelius van Bynkershoek and Friedrich List are also included. Fifty writers are anthologised in what is the largest such collection currently available. The texts, most of which are substantial extracts, are organised into broadly chronological sections, each of which is headed by an introduction that places the work in its historical and philosophical context. Ideal for both students and scholars, the volume also includes biographies and guides to further reading.