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SCN2A encodes a voltage-gated sodium channel (designated NaV1.2) vital for generating neuronal action potentials. Pathogenic SCN2A variants are associated with a diverse array of neurodevelopmental disorders featuring neonatal or infantile onset epilepsy, developmental delay, autism, intellectual disability and movement disorders. SCN2A is a high confidence risk gene for autism spectrum disorder and a commonly discovered cause of neonatal onset epilepsy. This remarkable clinical heterogeneity is mirrored by extensive allelic heterogeneity and complex genotype-phenotype relationships partially explained by divergent functional consequences of pathogenic variants. Emerging therapeutic strategies targeted to specific patterns of NaV1.2 dysfunction offer hope to improving the lives of individuals affected by SCN2A-related disorders. This Element provides a review of the clinical features, genetic basis, pathophysiology, pharmacology and treatment of these genetic conditions authored by leading experts in the field and accompanied by perspectives shared by affected families. This title is also available as Open Access on Cambridge Core.
With increasing numbers of persons living with dementia and their higher rates of hospitalizations, it is necessary to ensure they receive appropriate and effective acute care; yet, acute care environments are often harmful for persons with dementia. There is a lack of dementia education for acute health care providers in Canada. Scotland presently delivers a dementia education program for health care providers, known as the Scottish National Dementia Champions Programme. The objective of this Policy and Practice Note is to present the collaborative work of Scottish experts and Canadian stakeholders to adapt the Dementia Champions Programme for use in Canada. This work to date includes: (a) an environmental scan of Canadian dementia education for acute health care providers; (b) key informant interviews; and, (c) findings from a two-day planning meeting. The results of this collaborative work can and are being used to inform the next steps to develop and pilot a Canadian dementia education program.
Over the past 20 years, collaboration has become an essential aspect of archaeological practice in North America. In paying increased attention to the voices of descendant and local communities, archaeologists have become aware of the persistent injustices these often marginalized groups face. Building on growing calls for a responsive and engaged cultural heritage praxis, this forum article brings together a group of Native and non-Native scholars working at the nexus of history, ethnography, archaeology, and law in order to grapple with the role of archaeology in advancing social justice. Contributors to this article touch on a diverse range of critical issues facing Indigenous communities in the United States, including heritage law, decolonization, foodways, community-based participatory research, and pedagogy. Uniting these commentaries is a shared emphasis on research practices that promote Indigenous sovereignty and self-determination. In drawing these case studies together, we articulate a sovereignty-based model of social justice that facilitates Indigenous control over cultural heritage in ways that address their contemporary needs and goals.
Regular physical activity is safe and effective therapy for adults with CHD and is recommended by European Society of Cardiology guidelines. The COVID-19 pandemic poses enormous challenges to healthcare teams and patients when ensuring guideline compliance. We explored the implications of COVID-19 on physical activity levels in adult CHD patients.
Materials and methods:
A data-based questionnaire was distributed to adult CHD patients at a regional tertiary centre from October to November 2020.
Results:
Prior to the COVID-19 pandemic, 96 (79.3%) of 125 respondents reported participating in regular physical activity, with 66 (52.8%) meeting target levels (moderate physical activity for at least 150 minutes per week). Commonest motivations for physical activity were general fitness (53.6%), weight loss (36.0%), and mental health benefits (30.4%). During the pandemic, the proportion that met target levels significantly decreased from 52.8% to 40.8% (p = 0.03). The commonest reason was fear of COVID-19 (28.0%), followed by loss of motivation (23.2%) and gym/fitness centre closure (15.2%).
Discussion:
The COVID-19 pandemic has negatively impacted exercise levels of adult CHD patients. Most do not meet recommended physical activity levels, mainly attributable to fear of COVID-19. Even before the pandemic, only half of respondents met physical activity guidelines. Availability of online classes can positively impact exercise levels so could enhance guideline compliance. This insight into health perceptions and behaviours of adult CHD patients may help develop quality improvement initiatives to improve physical activity levels in this population.
In 2019, California and Wilmington, Delaware‘ implemented policies requiring healthier default beverages with restaurant kids’ meals. The current study assessed restaurant beverage offerings and manager perceptions.
Design:
Pre-post menu observations were conducted in California and Wilmington. Observations of cashiers/servers during orders were conducted pre-post implementation in California and post-implementation in Wilmington. Changes in California were compared using multilevel logistic regression and paired t tests. Post-implementation, managers were interviewed.
Setting:
Inside and drive-through ordering venues in a sample of quick-service restaurants in low-income California communities and all restaurants in Wilmington subject to the policy, the month before and 7–12 months after policy implementation.
Participants:
Restaurant observations (California n 110; Wilmington n 14); managers (California n 75; Wilmington n 15).
Results:
Pre-implementation, the most common kids’ meal beverages on California menus were unflavoured milk and water (78·8 %, 52·0 %); in Wilmington, juice, milk and sugar-sweetened beverages were most common (81·8 %, 66·7 % and 46·2 %). Post-implementation, menus including only policy-consistent beverages significantly increased in California (9·7 % to 66·1 %, P < 0·0001), but remained constant in Wilmington (30·8 %). During orders, cashiers/servers offering only policy-consistent beverages significantly decreased post-implementation in California (5·0 % to 1·0 %, P = 0·002). Few managers (California 29·3 %; Wilmington 0 %) reported policy knowledge, although most expressed support. Most managers wanted additional information for customers and staff.
Conclusions:
While the proportion of menus offering only policy-consistent kids’ meal default beverages increased in California, offerings did not change in Wilmington. In both jurisdictions, managers lacked policy knowledge, and few cashiers/servers offered only policy-consistent beverages. Additional efforts are needed to strengthen implementation of kids’ meal beverage policies.
In coastal and island archaeology, carbonate mollusk shells are often among the most abundant materials available for radiocarbon (14C) dating. The marsh periwinkle (Littorina irrorata) is one of these such species, ubiquitously found along the Atlantic and Gulf coasts of the United States in both modern and archaeological contexts. This paper presents a novel approach to dating estuarine mollusks where rather than attempting to characterize the size and variability of reservoir effects to “correct” shell carbonate dates, we describe a compound-specific approach that isolates conchiolin, the organic matter bound with the shell matrix of the L. irrorata. Conchiolin typically constitutes <5% of shell weight. In L. irrorata, it is derived from the snail’s terrestrial diet and is thus not strongly influenced by marine, hardwater, or other carbon reservoir effects. We compare the carbon isotopes (δ13C and Δ14C) of L. irrorata shell carbonate, conchiolin, and bulk soft tissue from six modern, live-collected specimens from Apalachicola Bay, Florida, with samples that represent possible sources of carbon within their environment including surface sediments, marsh plant tissues, and dissolved inorganic carbon (DIC) in water. Ultimately, this paper demonstrates that samples obtained from wet chemical oxidation of L. irrorata conchiolin produces accurate 14C dates.
Over the past 30 years, the number of US doctoral anthropology graduates has increased by about 70%, but there has not been a corresponding increase in the availability of new faculty positions. Consequently, doctoral degree-holding archaeologists face more competition than ever before when applying for faculty positions. Here we examine where US and Canadian anthropological archaeology faculty originate and where they ultimately end up teaching. Using data derived from the 2014–2015 AnthroGuide, we rank doctoral programs whose graduates in archaeology have been most successful in the academic job market; identify long-term and ongoing trends in doctoral programs; and discuss gender division in academic archaeology in the US and Canada. We conclude that success in obtaining a faculty position upon graduation is predicated in large part on where one attends graduate school.
Asynchronous coupling schemes between ice sheet and atmospheric forcing models are evaluated for use in long-term ice-age simulations. In these schemes the ice sheet and atmospheric forcing are run together for short synchronous periods (Ts), alternating with longer asynchronous periods (TA) during which the ice sheet is run with atmospheric information extrapolated from the previous synchronous period(s). Two simple ice-sheet models are used that predict ice thickness as a function of latitude, and the atmosphere is represented by a prescribed pattern of net annual accumulation minus ablation. The pattern is shifted vertically to represent long-term orbital variations, stochastic inter-annual weather variability and ice-sheet albedo feedback.
Several asynchronous schemes are evaluated by comparing results with those from fully synchronous runs. The best overall results are obtained using a scheme in which the forcing during each asynchronous period is linearly extrapolated from its means in the previous two synchronous periods. Differences from the synchronous results are caused primarily by poor sampling of the stochastic forcing component, which exaggerates the stochastic ice-sheet fluctuations. We examine how these errors depend on Ts and TA, and outline implications for GCM ice-age simulations.
Edited by
Jean Andrews, Associate Professor in the Department of Spanish, Portuguese and Latin American Studies, University of Nottingham,Isabel Torres, Professor of Spanish Golden Age Literature at Queen's University, Belfast
Edited by
Jean Andrews, Associate Professor in the Department of Spanish, Portuguese and Latin American Studies, University of Nottingham,Isabel Torres, Professor of Spanish Golden Age Literature at Queen's University, Belfast
Edited by
Jean Andrews, Associate Professor in the Department of Spanish, Portuguese and Latin American Studies, University of Nottingham,Isabel Torres, Professor of Spanish Golden Age Literature at Queen's University, Belfast
Edited by
Jean Andrews, Associate Professor in the Department of Spanish, Portuguese and Latin American Studies, University of Nottingham,Isabel Torres, Professor of Spanish Golden Age Literature at Queen's University, Belfast
Edited by
Jean Andrews, Associate Professor in the Department of Spanish, Portuguese and Latin American Studies, University of Nottingham,Isabel Torres, Professor of Spanish Golden Age Literature at Queen's University, Belfast
Edited by
Jean Andrews, Associate Professor in the Department of Spanish, Portuguese and Latin American Studies, University of Nottingham,Isabel Torres, Professor of Spanish Golden Age Literature at Queen's University, Belfast
Edited by
Jean Andrews, Associate Professor in the Department of Spanish, Portuguese and Latin American Studies, University of Nottingham,Isabel Torres, Professor of Spanish Golden Age Literature at Queen's University, Belfast
Edited by
Jean Andrews, Associate Professor in the Department of Spanish, Portuguese and Latin American Studies, University of Nottingham,Isabel Torres, Professor of Spanish Golden Age Literature at Queen's University, Belfast
The fourteen essays of this volume engage in distinct ways with the matter of motion in early modern Spanish poetics, without limiting the dialectic of stasis and movement to any single sphere or manifestation. Interrogation of the interdependence of tradition and innovation, poetry, power and politics, shifting signifiers, the intersection of topography and deviant temporalities, the movement between the secular and the sacred, tensions between centres and peripheries, issues of manuscript circulation and reception, poetic calls and echoes across continents and centuries, and between creative writing and reading subjects, all demonstrate that Helgerson's central notion of conspicuous movement is relevant beyond early sixteenth-century secular poetics, By opening it up we approximate a better understanding of poetry's flexible spatio-temporal co-ordinates in a period of extraordinary historical circumstances and conterminous radical cultural transformation. Los catorce ensayos de este volumen conectan de una manera perceptible con el tema del movimiento en la poesía española del siglo de oro, sin limitar la dialéctica de la estasis y movimiento a una sola esfera o manifestación única. Entre los multiples enfoques cabe destacar: el cuestionamiento de la interdependencia de la tradición e inovación, de la poesía, del poder y la política, de los significantes que se transforman, de los espacios que conectan y cruzan con los tiempos 'desviados'; análisis de las tensiones entre lo sagrado y lo secular, del conflicto centro-periferia y del complejo sistema de producción, circulación y recepción de los manuscritos; el diálogo con el eco poético a través de los siglos y de los continentes y la construcción creativa del sujeto escritor y/o lector. Al abrir la noción central de Helgerson del "movimiento conspicuo" más allá de la poesía nueva secular, este libro propone un entendimiento más completo de las coordinadas espacio-temporales de la poesía en un periodo de circunstancias históricas extrao. Jean Andrews is Associate Professor in the Department of Spanish, Portuguese and Latin American Studies, University of Nottingham. Isabel Torres is Professor of Spanish Golden Age Literature at Queen's University, Belfast. Contributors: Jean Andrews, Dana Bultman, Noelia Cirnigliaro, Marsha Collins, Trevor J. Dadson, Aurora Egido, Verónica Grossi, Anne Holloway, Mark J. Mascia, Terence O'Reilly, Carmen Peraita, Amanda Powell, Colin Thompson, Isabel Torres.