The organization of early Paleoindian economies in the western Great Lakes.

The organization of early Paleoindian economies in the western Great Lakes

New Evidence of the Earliest Domestic Dogs in the Americas

The domestication of dogs likely occurred in Eurasia by 16,000 years ago, and the initial peopling of the Americas potentially happened around the same time. Dogs were long thought to have accompanied the first migrations into the Americas, but conclusive evidence for Paleoindian dogs is lacking. In this study, the direct dating of two dogs from the Koster site (Greene County, Illinois) and a newly described dog from the Stilwell II site (Pike County, Illinois) to between 10,190 and 9,630 cal BP represents the earliest confirmed evidence of domestic dogs in the Americas and individual dog burials anywhere in the world. Analysis of these animals shows Early Archaic dogs were medium sized, lived active lifestyles, and exhibited significant morphological variation. Stable isotope analyses suggest diets dominated by terrestrial C3 resources and substantial consumption of riverine fish

Creating ophthalmology experiences in undergraduate medical education: pilot of a cased-based learning ophthalmology tool

Abstract Purpose To evaluate medical student perceptions of a novel ophthalmology resource delivered through facilitated workshops in the core clerkship curriculum. Methods We created www.2020sim.com, a free case-based learning (CBL) ophthalmology tool, adapted from NephSIM (www.nephsim.com). The tool was first piloted with the internal medicine (IM) residents. After confirming a need, we focused on undergraduate medical education (UME) by expanding the 20/20 SIM content and partnering with the neurology (pilot academic year [AY] 2020-2021) and pediatric clerkships (pilot AY 2021-2022) to deliver a facilitated one-hour ophthalmology workshop within each clerkship’s didactic curriculum. We evaluated the tool using pre- and post-surveys and knowledge assessments. Results Of 80 IM residents, 33 (41.3%) completed the needs assessment. Of the 25 residents who attended the workshop, 23 (92.0%) completed the exit survey. IM residents reported discomfort in several ophthalmology domains (9 of 14 rated mean score < 3.0), confirming a need. Most (n = 21/23, 91.3%) rated the tool as good/excellent. Of 145 neurology clerkship students, 125 (86.2%) and at least 88 (60.7%) students completed the pre- and post-test/exit surveys, respectively. On average, participants highly rated the tool, perceiving 20/20 SIM to be relevant to their education [4.1 (0.8)]. Mean pre- to post-test knowledge scores increased from 7.5 to 8.5/10.0 points (p < 0.001). Of the 136 pediatric clerkship students, 67 (49.3%) and 51 (37.5%) completed the pre- and post-surveys, respectively. Respondents perceived increased comfort with ophthalmology topics after the facilitated workshop [3.8 (0.8)]. Mean pre- to post-test knowledge scores trended from 1.8 to 2.0/5.0 points (p = 0.30). Collectively, 20/139 (14.4%) of exit survey respondents visited www.2020sim.com within 1 month after the workshop. Conclusion After identifying areas of greatest need with residents, we partnered with core clerkships to deliver cross-disciplinary ophthalmology content in UME. We found high engagement with 20/20 SIM, with trends toward increased knowledge

West London first-episode study of schizophrenia - clinical correlates of duration of untreated psychosis

Background: Studies in schizophrenia suggest that a longer initial period of untreated illness is associated with a poorer clinical outcome. Aims: To determine whether, in first-episode schizophrenia, a longer duration of untreated psychosis (DUP) or of untreated illness (DUI) (DUP plus any prodrome) is associated with clinical variables that could mediate a poor prognosis. Method: Clinical, social, neuropsychological and oculomotor function data on 53 patients with first-episode schizophrenia were related to the DUP and DUI. Results: Comparing short and long DUP groups split around the median showed no statistically significant differences (except age); patients in the latter group tended to perform worse on an executive attentional set-shifting task, and were more likely to be unemployed, and living alone or homeless. Conclusions: There was little evidence of any association between either DUP or DUI and progressive deterioration in the schizophrenic illness or the development of resistance to initial drug treatment. Social variables that augur a poor prognosis may be associated with delayed presentation of schizophrenia to psychiatric services. Declaration of interest: Supported by the Wellcome Trust