Defining a Civil War battlefield: recent archaeological investigations at the Pickett\u27s Mill State Historic Site, Paulding County, Georgia.

Recent investigations at the Pickett\u27s Mill State Historic Site have yielded new insights into the Civil War battle that occurred in May 1864. Military and historical sources have documented that the major battle took place in a ravine, but that skirmishes also occurred in adjacent areas, including a large, open wheat field. Some reports have suggested that Confederate soldiers had forced Union troops out of the ravine into this field where they became exposed. In the summer of 2006 a variety of different archaeological techniques were employed to determine what role the wheat field played in the battle. This paper describes the archaeological techniques that were used and their effectiveness in identifying and recovering military items associated with the battle. Among them, metal detectors proved to be the most effective tool with hundreds of artifacts being recovered from the site

Characteristics associated with quality of life among people with drug-resistant epilepsy

Quality of Life (QoL) is the preferred outcome in non-pharmacological trials, but there is little UK population evidence of QoL in epilepsy. In advance of evaluating an epilepsy self-management course we aimed to describe, among UK participants, what clinical and psycho-social characteristics are associated with QoL. We recruited 404 adults attending specialist clinics, with at least two seizures in the prior year and measured their self-reported seizure frequency, co-morbidity, psychological distress, social characteristics, including self-mastery and stigma, and epilepsy-specific QoL (QOLIE-31-P). Mean age was 42 years, 54% were female, and 75% white. Median time since diagnosis was 18 years, and 69% experienced ≥10 seizures in the prior year. Nearly half (46%) reported additional medical or psychiatric conditions, 54% reported current anxiety and 28% reported current depression symptoms at borderline or case level, with 63% reporting felt stigma. While a maximum QOLIE-31-P score is 100, participants’ mean score was 66, with a wide range (25–99). In order of large to small magnitude: depression, low self-mastery, anxiety, felt stigma, a history of medical and psychiatric comorbidity, low self-reported medication adherence, and greater seizure frequency were associated with low QOLIE-31-P scores. Despite specialist care, UK people with epilepsy and persistent seizures experience low QoL. If QoL is the main outcome in epilepsy trials, developing and evaluating ways to reduce psychological and social disadvantage are likely to be of primary importance. Educational courses may not change QoL, but be one component supporting self-management for people with long-term conditions, like epilepsy

Progress in evaluation of radionuclide geochemical information developed by DOE high-level nuclear waste repository site projects. Annual report, October 1984-September 1985. Volume 4

Information pertaining to the potential geochemical behavior of radionuclides at candidate sites for a high-level radioactive waste repository, which is being developed by projects within the Department of Energy (DOE), is being evaluated by Oak Ridge National Laboratory for the Nuclear Regulatory Commission (NRC). During this report period, emphasis was placed on the evaluation of information pertinent to the Hanford site in southeastern Washington. Results on the sorption/solubility behavior of technetium, neptunium, and uranium in the basalt/water geochemical system are summarized and compared to the results of DOE. Also, summaries of results are reported from two geochemical modeling studies: (1) an evaluation of the information developed by DOE on the native copper deposits of Michigan as a natural analog for the emplacement of copper canisters in a repository in basalt, and (2) calculation of the solubility and speciation of radionuclides for representative groundwaters from the Yucca Mountain site in Nevada

Delivery of antimicrobial stewardship competencies in UK pre-registration nurse education programmes: a national cross-sectional survey

Background: Registered nurses perform numerous functions critical to the success of antimicrobial stewardship but only 63% of pre-registration nursing programmes include any teaching about stewardship. Updated nursing standards highlight nurses require antimicrobial stewardship knowledge and skills. Aim: To explore the delivery of key antimicrobial stewardship competencies within updated pre-registration nursing programmes. Method: A cross-sectional survey design. Data was collected between March and June 2021. Findings: Lecturers from 35 universities responsible for teaching antimicrobial stewardship participated. The provision of antimicrobial stewardship teaching and learning was inconsistent across programmes with competencies in infection prevention and control, patient centred care, and interprofessional collaborative practice taking precedent over those pertaining to the use, management, and monitoring of antimicrobials. On-line learning and teaching surrounding hand hygiene, personal protective equipment, and immunisation theory was reported to have increased during the pandemic. Only a small number of respondents reported that students shared taught learning with other healthcare professional groups. Conclusion: There is a need to ensure consistency in antimicrobial stewardship across programmes, and greater knowledge pertaining to the use, management and monitoring of antimicrobials should be included. Programmes need to adopt teaching strategies and methods that allow nurses to develop interprofessional skill in order to practice collaboratively

Arctic quaternary ostracods and their use in paleoreconstructions

The paper deals with original and published data on fossil ostracodal assemblages from the Eurasian Arctic Kara, Laptev and Chuckchi seas. As a whole, six ecologically different assemblages were distinguished (freshwater, brackish water, marine of the inner, middle and outer shelves and upper continental slope), they replace each other upcore reflecting a gradual increase in water depth and distance from the coast. These assemblages are stable in the entire Arctic region and can be used for interpretation of environments in different Arctic areas

An overview of the cutaneous porphyrias

This is an overview of the cutaneous porphyrias. It is a narrative review based on the published literature and my personal experience; it is not based on a formal systematic search of the literature. The cutaneous porphyrias are a diverse group of conditions due to inherited or acquired enzyme defects in the porphyrin–haem biosynthetic pathway. All the cutaneous porphyrias can have (either as a consequence of the porphyria or as part of the cause of the porphyria) involvement of other organs as well as the skin. The single commonest cutaneous porphyria in most parts of the world is acquired porphyria cutanea tarda, which is usually due to chronic liver disease and liver iron overload. The next most common cutaneous porphyria, erythropoietic protoporphyria, is an inherited disorder in which the accumulation of bile-excreted protoporphyrin can cause gallstones and, rarely, liver disease. Some of the porphyrias that cause blistering (usually bullae) and fragility (clinically and histologically identical to porphyria cutanea tarda) can also be associated with acute neurovisceral porphyria attacks, particularly variegate porphyria and hereditary coproporphyria. Management of porphyria cutanea tarda mainly consists of visible-light photoprotection measures while awaiting the effects of treating the underlying liver disease (if possible) and treatments to reduce serum iron and porphyrin levels. In erythropoietic protoporphyria, the underlying cause can be resolved only with a bone marrow transplant (which is rarely justifiable in this condition), so management consists particularly of visible-light photoprotection and, in some countries, narrowband ultraviolet B phototherapy. Afamelanotide is a promising and newly available treatment for erythropoietic protoporphyria and has been approved in Europe since 2014