Urban flooding in Britain:An approach to comparing ancient and contemporary flood exposure

Using modified UK Environment Agency Flood Estimation Handbook techniques, inundation extent and likely flood hydrographs for 0.1% probability annual return periods are compared for twelve Roman town sites in the UK, both at the present day and for simulated Roman catchment conditions. Eight of the study sites appear to have suffered minimal urban flood liability as occupied in the Roman period. The exceptions were Canterbury, York, Leicester, and Chichester. It is reasonable to expect flood characteristics to have changed subsequently in response to transformations in catchment land use, urban expansion, wetland reclamation, and floodway engineering. However, modelling results suggest limited differences in flood flows attributable to such factors. Greater present-day urban damage liability essentially results from floodplain urban extension. There are also contrasts between sites: those Roman towns lying on floodplains themselves, rather than on slightly elevated terraces (Canterbury, Chichester), are dominated by groundwater regimes with attenuated flood peaks. Taken together, these results suggest some Roman awareness of the actualities of urban flood liability at the time. Site sensitivity has not been carried forward as urban expansion has flourished, especially from the nineteenth century with suburban and industrial expansion. The straightforward mapping approach here suggested should in future take account of multiple century-scale hydroclimatic changes, morphological river channel and floodplain transformations over similar time periods, and on-going improvements to inundation modelling

Infectious disease outbreaks and increased complexity of care

Aim: This study examined the effects of healthcare-associated infectious disease outbreaks on nurses’ work in a large acute care hospital in Ontario, Canada. Background: The incidence of healthcare-associated infections has increased. Previous research focuses on epidemiology, healthcare systems, and the economic burden of outbreaks. Few published studies focus on the impact of outbreaks on nurses’ work in acute care facilities. Introduction: Since the severe acute respiratory syndrome epidemic in 2003, combating infectious diseases has become a key issue. Hospitals have implemented measures related to healthcare-associated infections. However, nurses experience challenges in preventing, controlling, and contending with outbreaks. Methods: A retrospective exploratory case study approach was used. Data were collected over a 4-month period in 2012. The incidence rates of site-specific HAIs were analysed, and individual interviews were held with 23 bedside nurses and five nurse managers. Findings: Five themes emerged from the interviews: comparison of healthcare-associated infections outbreaks; the nature of nurses’ work; impact of outbreaks on patient care; innovation and quality control in clinical practice; and increased and expanded IPAC measures. The incidence rates of methicillin-resistant Staphylococcus aureus, Clostridium difficile and vancomycin-resistant enterococci at the study site decreased, but remained above provincial benchmarks. Nurses experienced workload challenges, time pressures and psychological effects stemming from outbreaks and developed various innovations in response. Patient care was also affected. Conclusion: Nurses’ work has been impacted by healthcare-associated infectious disease outbreaks. Nursing workloads should be quantified to facilitate the development of guidelines for optimum nurse–patient ratio during outbreaks. Implications for Nursing and/or Health Policy: A strong evidence-based policy framework is required to address healthcare-associated infectious disease outbreaks. Infection prevention and control guidelines and procedures should be established provincially and nationally. An interdisciplinary approach is essential for the creation of comprehensive and innovative strategies. Nursing research has increased understanding of the implications of infectious diseases in hospitals. Building on the literature, findings from this study can be used to influence policies on the care of patients who have secondary infections. Nurse-driven protocols are important and can lead to the creation of best practice guidelines that can be implemented across settings

Prevalence and morphological types of anaemia and hookworm infestation in the medical emergency ward, Mulago Hospital, Uganda

Introduction. Anaemia is common worldwide, although the burden is highest in developing countries where nutrient deficiencies and chronic infections are prevalent.Objective. To determine the prevalence and morphologicaltypes of anaemia and assess the hookworm burden among patients in the medical emergency ward at Mulago national referral hospital, Uganda.Methods. In a cross-sectional descriptive study 395 patients were recruited by systematic random sampling and their socio-demographic characteristics and clinical details collected. A complete blood count and peripheral film examination were done and stool examined for hookworm ova.Statistical analysis. Data were processed using Epi-Info version 6 and Stata version 9. The chi-square test was used for categorical variables and Student’s t-test for non-categorical variables. Multiple logistic regression was used to determine factors predictive of anaemia.Results. Of the patients 255 (64.6%) had anaemia. The prevalence was higher among males (65.8%) than females (63.7%). Fatigue (odds ratio (OR) 2.1, confidence interval (CI) 1.37 - 3.24), dizziness (OR 1.64, CI 1.07 - 2.44), previous blood transfusion (OR 2.83, CI 1.32 - 6.06), lymphadenopathy (OR 2.99, CI 1.34 - 6.66) and splenomegaly (OR 5.22, CI 1.78 - 15.28) were significantly associated with anaemia.Splenomegaly, low body mass index (BMI)

Genetic counseling and testing practices for late-onset neurodegenerative disease: a systematic review

ObjectiveTo understand contemporary genetic counseling and testing practices for late-onset neurodegenerative diseases (LONDs), and identify whether practices address the internationally accepted goals of genetic counseling: interpretation, counseling, education, and support.MethodsFour databases were systematically searched for articles published from 2009 to 2020. Peer-reviewed research articles in English that reported research and clinical genetic counseling and testing practices for LONDs were included. A narrative synthesis was conducted to describe different practices and map genetic counseling activities to the goals. Risk of bias was assessed using the Qualsyst tool. The protocol was registered with PROSPERO (CRD42019121421).ResultsSixty-one studies from 68 papers were included. Most papers focused on predictive testing (58/68) and Huntington's disease (41/68). There was variation between papers in study design, study population, outcomes, interventions, and settings. Although there were commonalities, novel and inconsistent genetic counseling practices were identified. Eighteen papers addressed all four goals of genetic counseling.ConclusionContemporary genetic counseling and testing practices for LONDs are varied and informed by regional differences and the presence of different health providers. A flexible, multidisciplinary, client- and family-centered care continues to emerge. As genetic testing becomes a routine part of care for patients (and their relatives), health providers must balance their limited time and resources with ensuring clients are safely and effectively counseled, and all four genetic counseling goals are addressed. Areas of further research include diagnostic and reproductive genetic counseling/testing practices, evaluations of novel approaches to care, and the role and use of different health providers in practice

Improving the scalability of parallel N-body applications with an event driven constraint based execution model

The scalability and efficiency of graph applications are significantly constrained by conventional systems and their supporting programming models. Technology trends like multicore, manycore, and heterogeneous system architectures are introducing further challenges and possibilities for emerging application domains such as graph applications. This paper explores the space of effective parallel execution of ephemeral graphs that are dynamically generated using the Barnes-Hut algorithm to exemplify dynamic workloads. The workloads are expressed using the semantics of an Exascale computing execution model called ParalleX. For comparison, results using conventional execution model semantics are also presented. We find improved load balancing during runtime and automatic parallelism discovery improving efficiency using the advanced semantics for Exascale computing.Comment: 11 figure

Ultrashort-pulse laser with an intracavity phase shaping element

A novel ultrashort-pulse laser cavity configuration that incorporates an intracavity deformable mirror as a phase control element is reported. A user-defined spectral phase relation of 0.7 radians relative shift could be produced at around 1035 nm. Phase shaping as well as pulse duration optimization was achieved via a computer-controlled feedback loop

Peer support for patients with type 2 diabetes: cluster randomised controlled trial

Objective To test the effectiveness of peer support for patients with type 2 diabetes

Intramolecular vibronic dynamics in molecular solids: C60

Vibronic coupling in solid C60 has been investigated with a combination of resonant photoemission spectroscopy (RPES) and resonant inelastic x-ray scattering (RIXS). Excitation as a function of energy within the lowest unoccupied molecular orbital resonance yielded strong oscillations in intensity and dispersion in RPES, and a strong inelastic component in RIXS. Reconciling these two observations establishes that vibronic coupling in this core hole excitation leads to predominantly inelastic scattering and localization of the excited vibrations on the molecule on a femtosecond time scale. The coupling extends throughout the widths of the frontier valence bands.

Two-hit model of brain damage in the very preterm newborn: small for gestational age and postnatal systemic inflammation

Background: We sought to disentangle the contributions of perinatal systemic inflammation and small for gestational age (SGA) to the occurrence of low Bayley Mental Development Indices (MDIs) at age 2 years. Method We measured the concentration of 25 inflammation-related proteins in blood obtained during the first 2 postnatal weeks from 805 infants who were born before the 28th week of gestation and who had MDI measurements at age 2 years and were able to walk independently. Results: SGA newborns who did not have systemic inflammation (a concentration of an inflammation-related protein in the top quartile for gestational age on 2 days a week apart) were at greater risk of an MDI < 55, but not 55–69, than their peers who had neither SGA nor systemic inflammation. SGA infants who had elevated blood concentrations of IL-1beta, TNF-alpha, or IL-8 during the first two postnatal weeks were at even higher risk of an MDI < 55 than their SGA peers without systemic inflammation and of their non-SGA peers with systemic inflammation. Conclusion: SGA appears to place very preterm newborns at increased risk of a very low MDI. Systemic inflammation adds considerably to the increased risk

Observation and Modeling of the Solar Transition Region: II. Solutions of the Quasi-Static Loop Model

In the present work we undertake a study of the quasi-static loop model and the observational consequences of the various solutions found. We obtain the most general solutions consistent with certain initial conditions. Great care is exercised in choosing these conditions to be physically plausible (motivated by observations). We show that the assumptions of previous quasi-static loop models, such as the models of Rosner, Tucker and Vaiana (1978) and Veseckey, Antiochos and Underwood (1979), are not necessarily valid for small loops at transition region temperatures. We find three general classes of solutions for the quasi-static loop model, which we denote, radiation dominated loops, conduction dominated loops and classical loops. These solutions are then compared with observations. Departures from the classical scaling law of RTV are found for the solutions obtained. It is shown that loops of the type that we model here can make a significant contribution to lower transition region emission via thermal conduction from the upper transition region.Comment: 30 pages, 3 figures, Submitted to ApJ, Microsoft Word File 6.0/9