Intimate Partner Violence Documentation and Awareness in an Urban Emergency Department.

Background Domestic violence rates in smaller cities have been reported to be some of the highest in Canada. It is highly likely that the staff at emergency departments (ED) will come in contact with victims of intimate partner violence in their daily practice. The purpose of this study is to better understand current practices for detecting intimate partner violence, staff awareness and knowledge regarding intimate partner violence, and barriers to questioning about intimate partner violence in the ED. Methods A standardized retrospective chart review captured domestic violence documentation rates in patients presenting to the ED, and a cross-sectional online survey was distributed to the ED staff. Results We found documentation about intimate partner violence in 4.64% of all included patient charts. No documentation was noted in the domestic violence field. Significantly, 16.4% of the ED staff reported never questioning female patients about intimate partner violence; 83.6% enquired when they thought it appropriate, and none asked routinely. None of the staff used a structured screening tool, and 81.8% of the ED staff had not received any formal training. Partner presence was the most common barrier to asking about intimate partner violence, followed by a lack of access to domestic violence management information, and a lack of knowledge regarding intimate partner violence. Conclusions Our findings suggest that the current documentation tools are not being properly utilized. Low rates of intimate partner violence documentation in high-risk patients and lack of education indicate that there is a need to improve current practices. In order to improve identification of this important problem, appropriate training and education about intimate partner/domestic violence are required to increase staff comfort as well as knowledge about available community resources for the victims

SCUBA noise alters community structure and cooperation at Pederson’s cleaner shrimp cleaning stations

Recreational SCUBA diving is widespread and increasing on coral reefs worldwide. Standard open-circuit SCUBA equipment is inherently noisy and, by seeking out areas of high biodiversity, divers inadvertently expose reef communities to an intrusive source of anthropogenic noise. Currently, little is known about SCUBA noise as an acoustic stressor, and there is a general lack of empirical evidence on community-level impacts of anthropogenic noise on coral reefs. Here, we conducted a playback experiment on Caribbean reefs to investigate impacts of SCUBA noise on fish communities and interspecific cooperation at ecologically important cleaning stations of the Pederson’s cleaner shrimp Ancylomenes pedersoni. When exposed to SCUBA-noise playback, the total occurrence of fishes at the cleaning stations decreased by 7%, and the community and cleaning clientele compositions were significantly altered, with 27% and 25% of monitored species being affected, respectively. Compared with ambient-sound playback, SCUBA-noise playback resulted in clients having to wait 29% longer for cleaning initiation and receiving 43% less cleaning; however, cheating, signalling, posing and time spent cleaning were not affected by SCUBA-noise playback. Our study is the first to demonstrate experimentally that SCUBA noise can have at least some negative impacts on reef organisms, confirming it as an ecologically relevant pollutant. Moreover, by establishing acoustic disturbance as a likely mechanism for known impacts of diver presence on reef animals, we also identify a potential avenue for mitigation in these valuable ecosystems.</p

Contributions and future priorities for soil science: comparing perspectives from scientists and stakeholders

Soils are a fundamental natural resource but intensifying demands and increasing soil degradation necessitate focussed research into the sustainable use of soils. Since soil functioning is critical for the operations and performance of multiple industries, businesses and municipalities, soil scientists need to actively engage with these bodies to orientate research goals towards stakeholder needs. To achieve this, stakeholder views about the current and potential contributions of soil science to different sectors need to be taken into account when setting the future research agenda. Here, we assessed whether the current and future research priorities of soil science match the needs of four major industrial and environmental sectors: agriculture, ecosystem services and natural resources, waste management, and water management. We used an online questionnaire, distributed to 192 organisations and via social media, to compare stakeholders' and scientists' perceptions of (a) the contributions of soil science to date, (b) the areas not currently served by soil science and (c) future research needs in soil science. Stakeholders generally rated the contributions of soil science to date as ‘great’ or ‘fundamental’, but scientists rated the contributions more highly. Respondents identified numerous areas that soil research has not yet sufficiently addressed, which were mostly sector-specific and often overlapped with perceived future research needs. Importantly, stakeholders' and scientists' views of future research priorities differed strongly within sectors, with the notable exception of agriculture, where views were generally consistent. We conclude that soil science may hold unexplored potential in several industrial and environmental sectors. We call for improved research communication and greater stakeholder involvement to shape the future soils research agenda and ensure the sustainable use of soils across multiple areas of society

'She doesn’t want to go to hospital. That’s one thing she hates’: Collective performativity in avoidable nursing home to hospital transfers

Older people who live with a combination of conditions experience fluctuations over time, which others may interpret as a need for medical attention. For some nursing home residents, this results in transitions in and out of hospital. Such transfers may be arranged without expectation ofimproved quality of life, can be associated with significant morbidity and mortality, and may preclude end-of-life preferences. Factors affecting avoidable hospitalisation for nursing home residents are not well understood. I aim to explore potential drivers, moving beyond deficit explanations relating to funding, training and resources. I use a framework of analysis that firstly considers medicalisation of frailty, as a state of vulnerability that provides focus for others’ action. I then draw on Judith Butler’s theory of performativity, to explore nursing homes as sites of identify work for staff, residents and families. I consider ways subjectivities can be effected through reiterative practice that is compelled by normative conventions. Trouble may arise when citational practice of healthcare staff, and performative acquiescence of residents and families, culminate in an inevitability of hospitalisation when navigating grey areas of assumed clinical risk. Principles of coproduction could present a disruptive opening, to rework power asymmetries and move toward aspirations for residents and their relatives to be at the centre of decisions about care

HIV-TRACE (Transmission Cluster Engine):A tool for large scale molecular epidemiology of HIV-1 and other rapidly evolving pathogens

In modern applications of molecular epidemiology, genetic sequence data are routinely used to identify clusters of transmission in rapidly evolving pathogens, most notably HIV-1. Traditional 'shoe-leather' epidemiology infers transmission clusters by tracing chains of partners sharing epidemiological connections (e.g., sexual contact). Here, we present a computational tool for identifying a molecular transmission analog of such clusters: HIV-TRACE (TRAnsmission Cluster Engine). HIV-TRACE implements an approach inspired by traditional epidemiology, by identifying chains of partners whose viral genetic relatedness imply direct or indirect epidemiological connections. Molecular transmission clusters are constructed using codon-aware pairwise alignment to a reference sequence followed by pairwise genetic distance estimation among all sequences. This approach is computationally tractable and is capable of identifying HIV-1 transmission clusters in large surveillance databases comprising tens or hundreds of thousands of sequences in near real time, that is, on the order of minutes to hours. HIV-TRACE is available at www.hivtrace.org and from www.github.com/veg/hivtrace, along with the accompanying result visualization module from www.github.com/veg/hivtrace-viz. Importantly, the approach underlying HIV-TRACE is not limited to the study of HIV-1 and can be applied to study outbreaks and epidemics of other rapidly evolving pathogens

Growth, profits and technological choice: The case of the Lancashire cotton textile industry

Using Lancashire textile industry company case studies and financial records, mainly from the period just before the First World War, the processes of growth and decline are re-examined. These are considered by reference to the nature of Lancashire entrepreneurship and the impact on technological choice. Capital accumulation, associated wealth distributions and the character of Lancashire business organisation were sybiotically linked to the success of the industry before 1914. However, the legacy of that accumulation in later decades, chronic overcapacity, formed a barrier to reconstruction and enhanced the preciptious decline of a once great industry

Cyclicity and Connectivity in Nez Perce Relative Clauses

This article studies two aspects of movement in relative clauses, focusing on evidence from Nez Perce. First, I argue that relativization involves cyclic Ā-movement, even in monoclausal relatives: the relative operator moves to Spec, CP via an intermediate position in an Ā outer specifier of TP. The core arguments draw on word order, complementizer choice, and a pattern of case attraction for relative pronouns. Ā cyclicity of this type suggests that the TP sister of relative C constitutes a phase—a result whose implications extend to an ill-understood corner of the English that-trace effect. Second, I argue that Nez Perce relativization provides new evidence for an ambiguity thesis for relative clauses, according to which some but not all relatives are derived by head raising. The argument comes from connectivity and anticonnectivity in morphological case. A crucial role is played by a pattern of inverse case attraction, wherein the head noun surfaces in a case determined internal to the relative clause. These new data complement the range of existing arguments concerning head raising, which draw primarily on connectivity effects at the syntax-semantics interface

Genetic Sharing with Cardiovascular Disease Risk Factors and Diabetes Reveals Novel Bone Mineral Density Loci.

Bone Mineral Density (BMD) is a highly heritable trait, but genome-wide association studies have identified few genetic risk factors. Epidemiological studies suggest associations between BMD and several traits and diseases, but the nature of the suggestive comorbidity is still unknown. We used a novel genetic pleiotropy-informed conditional False Discovery Rate (FDR) method to identify single nucleotide polymorphisms (SNPs) associated with BMD by leveraging cardiovascular disease (CVD) associated disorders and metabolic traits. By conditioning on SNPs associated with the CVD-related phenotypes, type 1 diabetes, type 2 diabetes, systolic blood pressure, diastolic blood pressure, high density lipoprotein, low density lipoprotein, triglycerides and waist hip ratio, we identified 65 novel independent BMD loci (26 with femoral neck BMD and 47 with lumbar spine BMD) at conditional FDR < 0.01. Many of the loci were confirmed in genetic expression studies. Genes validated at the mRNA levels were characteristic for the osteoblast/osteocyte lineage, Wnt signaling pathway and bone metabolism. The results provide new insight into genetic mechanisms of variability in BMD, and a better understanding of the genetic underpinnings of clinical comorbidity

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms