Medieval London: Collected Papers of Caroline M. Barron

Caroline M. Barron is the world\u27s leading authority on the history of medieval London. For half a century she has investigated London\u27s role as medieval England\u27s political, cultural, and commercial capital, together with the urban landscape and the social, occupational, and religious cultures that shaped the lives of its inhabitants. This collection of eighteen papers focuses on four themes: crown and city; parish, church, and religious culture; the people of medieval London; and the city\u27s intellectual and cultural world. They represent essential reading on the history of one of the world\u27s greatest cities by its foremost scholar.https://scholarworks.wmich.edu/mip_rmemc/1009/thumbnail.jp

TEENAGE PREGNANCY IN BELGIUM: PROTECTIVE FACTORS IN A MIGRANT POPULATION

Background: Teenage pregnancies occur frequently in developing countries and are associated with social issues, including poverty, lower levels of health and educational attainment. Although frequent in European countries in the 20th century today, teenage pregnancies account for only 4% of first children. These pregnancies are usually unplanned and they are considered a vulnerability factor during the pregnancy and the postnatal period, both for the mother and the child. The purpose of our study was to evaluate the evolution of mothers and children of teenage pregnancies, several years after childbirth and to identify factors which may protect or increase the patient’s vulnerability. Subjects and methods: We conducted a retrospective search in our patient database in order to identify all teenage pregnancies between 2010-2014 at CHU Brugmann Hospital. Outcome date data were obtained from the medical files. Mothers were contacted by phone and asked to complete our questionnaire which focused on maternal and paediatric care; and infant and child development after hospitalization. Results: Out of the 342 patients identified, 84 patients were contactable and only 72 patients completed the full questionnaire. With only 4 patients originating from Belgium, our population was largely immigrant. Despite this, obstetrical, maternal and paediatric outcomes were remarkably favorable when compared to other published studies. Conclusion: Our study suggests that some migrant teenage mothers may have a dual advantage in terms of the wealth of a developed country in which have settled and the low social stigma related to their country of origin. More research needs to be done to further investigate this hypothesis

Teachers’ perspectives on communication in the context of supervising learners during telehealth encounters

Background: The COVID-19 pandemic has led to increased use of telehealth for healthcare visits. Telehealth visits have created new communication challenges for clinician-patient encounters and for interactions between health professional learners and clinical teachers, known as preceptors. Little research has explored how teachers can effectively supervise and explicitly emphasize communication skills during telehealth visits. Aim: This study’s purpose was to explore clinical preceptors’ perspectives on effective approaches in precepting telehealth visits with medical residents and students. Methods: An online survey elicited comments from clinical preceptors from two United States medical schools on effective telehealth teaching practices. Thematic analysis identified salient perspectives and overall guidance on precepting telehealth encounters. Results: Survey participants reported varying levels of experience with precepting telehealth visits. Main areas identified as important for effectively supervising telehealth encounters and facilitating effective communication included explicit preparation for preceptors, learners and patients and using educational opportunities, especially observation, during the telehealth encounter. Discussion: This study identifies strategies for maximizing effective communication between preceptors, learners, and patients during supervised telehealth visits. Participants identified potential educational advantages of supervising telehealth visits. Conclusions: Clinical teachers can reinforce effective telehealth communication skills with learner led telehealth patient encounters

Óxido de calcio para mejorar las propiedades físicas y mecánicas del concreto estructural

Esta investigación lleva como título “Óxido de calcio para mejorar las propiedades físicas y mecánicas del concreto estructural”. Tuvo como objetivo principal analizar el óxido de calcio para mejorar las propiedades físicas y mecánicas del concreto estructural. Esta investigación fue documental - bibliográfica, donde la información fue recolectada de investigaciones nacionales e internacionales, tanto como tesis y artículos. Las investigaciones revisadas utilizaron el método deductivo, enfoque cuantitativo, el diseño experimental, longitudinal y estudio de cohorte. Al realizar la adición el óxido de calcio en porcentajes óptimos a una mezcla de concreto, esta mejora sus propiedades físicas y mecánicas como la trabajabilidad, tiempo de fraguado, resistencia a la compresión. Con respecto a la trabajabilidad se determinó que el porcentaje óptimo fue de 4%, con un asentamiento de 11cm. El porcentaje óptimo para aumentar la resistencia a la compresión fue de 4% con una resistencia de 353 kg/cm². Se determinó que la relación a/c de 0.43 con un porcentaje óptimo de óxido de calcio de 4 % en la mezcla de concreto reduce el tiempo de fraguado a 375 minutos. Finalmente, para una mejor mezcla se utilizó del agregado grueso de tamaño máximo nominal de 12.7 mm., con una resistencia máxima de 353 kg/cm²

Exploration of the use of Bayesian modeling of gradients for censored spatiotemporal data from the Deepwater Horizon oil spill

This paper develops a hierarchical framework for identifying spatiotemporal patterns in data with a high degree of censoring using the gradient process. To do this, we impute censored values using a sampling-based inverse CDF method within our Markov chain Monte Carlo algorithm, thereby avoiding burdensome integration and facilitating efficient estimation of other model parameters. We illustrate use of our methodology using a simulated data example, and uncover the danger of simply substituting a space- and time-constant function of the level of detection for all missing values. We then fit our model to area measurement data of volatile organic compounds (VOC) air concentrations collected on vessels supporting the response and clean-up efforts of the Deepwater Horizon oil release that occurred starting April 20, 2010. These data contained a high percentage of observations below the detectable limits of the measuring instrument. Despite this, we were still able to make some interesting discoveries, including elevated levels of VOC near the site of the oil well on June 26th. Using the results from this preliminary analysis, we hope to inform future research on the Deepwater Horizon study, including the use of gradient methods for assigning workers to exposure categories

Clostridium botulinum type C, D, C/D, and D/C: An update

Clostridium botulinum is the main causative agent of botulism, a neurological disease encountered in humans as well as animals. Nine types of botulinum neurotoxins (BoNTs) have been described so far. Amongst these “toxinotypes,” the A, the B and E are the most frequently encountered in humans while the C, D, C/D and D/C are mostly affecting domestic and wild birds as well as cattle. In France for instance, many cases and outbreaks are reported in these animal species every year. However, underestimation is very likely at least for avifauna species where the detection of dead animals can be challenging. Knowledge about BoNTs C, D, C/D, and D/C and the diseases they cause in animals and humans is still scarce and unclear. Specifically, the potential role of animal botulism outbreaks in cattle and poultry as a source of human illness needs to be further assessed. In this narrative review, we present the current knowledge about toxinotypes C, D, C/D, and D/C in cattle and poultry with, amongst various other aspects, their epidemiological cycles. We also discuss the zoonotic potential of these toxinotypes and some possible ways of risk mitigation. An adapted and effective management of botulism outbreaks in livestock also requires a better understanding of these less common and known toxinotypes

Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19.

Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate parameters independently associated with the primary outcome. Logistic regression was reported as odds ratio (OR) with 95% confidence interval (CI). Results Mean gestational age at diagnosis was 30.6+/-9.5 weeks, with 8.0% of women being diagnosed in the first, 22.2% in the second and 69.8% in the third trimester of pregnancy. There were six miscarriage (2.3%), six intrauterine device (IUD) (2.3) and 5 (2.0%) neonatal deaths, with an overall rate of perinatal death of 4.2% (11/265), thus resulting into 17 cases experiencing and 226 not experiencing composite adverse fetal outcome. Neither stillbirths nor neonatal deaths had congenital anomalies found at antenatal or postnatal evaluation. Furthermore, none of the cases experiencing IUD had signs of impending demise at arterial or venous Doppler. Neonatal deaths were all considered as prematurity-related adverse events. Of the 250 live-born neonates, one (0.4%) was found positive at RT-PCR pharyngeal swabs performed after delivery. The mother was tested positive during the third trimester of pregnancy. The newborn was asymptomatic and had negative RT-PCR test after 14 days of life. At logistic regression analysis, gestational age at diagnosis (OR: 0.85, 95% CI 0.8-0.9 per week increase; pPeer reviewe