Strengthening Ontario\u27s System of Housing for People with Serious Mental Illness

This article describes recent work to support recommendations for improving Ontario’s system of housing for people with serious mental illness. This multifaceted project engaged stakeholders in discussions concerning strategies for improving the system based on (a) values that underlie housing programs, (b) evidence of effective housing practices, (c) the current status of the system, and (d) international practices for monitoring community mental health systems. Stakeholders reviewed summaries of the work and discussed implications for improving the provincial system of housing and supports. Recommendations are made for improving the system, focusing on both regional and provincial level actions

Beyond aggression: Androgen-receptor blockade modulates social interaction in wild meerkats

In male vertebrates, androgens are inextricably linked to reproduction, social dominance, and aggression, often at the cost of paternal investment or prosociality. Testosterone is invoked to explain rank-related reproductive differences, but its role within a status class, particularly among subordinates, is underappreciated. Recent evidence, especially for monogamous and cooperatively breeding species, suggests broader androgenic mediation of adult social interaction. We explored the actions of androgens in subordinate, male members of a cooperatively breeding species, the meerkat (Suricata suricatta). Although male meerkats show no rank-related testosterone differences, subordinate helpers rarely reproduce. We blocked androgen receptors, in the field, by treating subordinate males with the antiandrogen, flutamide. We monitored androgen concentrations (via baseline serum and time-sequential fecal sampling) and recorded behavior within their groups (via focal observation). Relative to controls, flutamide-treated animals initiated less and received more high-intensity aggression (biting, threatening, feeding competition), engaged in more prosocial behavior (social sniffing, grooming, huddling), and less frequently initiated play or assumed a ‘dominant’ role during play, revealing significant androgenic effects across a broad range of social behavior. By contrast, guarding or vigilance and measures of olfactory and vocal communication in subordinate males appeared unaffected by flutamide treatment. Thus, androgens in male meerkat helpers are aligned with the traditional trade-off between promoting reproductive and aggressive behavior at a cost to affiliation. Our findings, based on rare endocrine manipulation in wild mammals, show a more pervasive role for androgens in adult social behavior than is often recognized, with possible relevance for understanding tradeoffs in cooperative systems

Wave evolution across the Louisiana shelf

Author Posting. © The Author(s), 2012. This is the author's version of the work. It is posted here by permission of Elsevier B.V. for personal use, not for redistribution. The definitive version was published in Continental Shelf Research 52 (2013): 190-202, doi:10.1016/j.csr.2012.10.005.Observations and third-generation wave model hindcasts of ocean surface gravity waves propagating across the Louisiana shelf show that the effects of the mud environment on wave evolution are complex and episodic. Whereas low-frequency waves (0.04-0.20 Hz) show a consistent decay similar to earlier studies, the presence of mud also appears to suppress the development of short waves (0.20-0.25 Hz) under fetch-limited growth conditions. Significant suppression of wave development under wind-forced conditions is found to occur almost exclusively during easterly winds when satellite images show the Atchafalaya mud plume extends into the study area. These results suggest that episodic sediment suspension events with high mud concentrations in the upper water column can affect the evolution of wind waves.This work is supported by the U.S. Office of Naval Research (Littoral Geosciences and Optics Program, and Physical Oceanography Program), the National Oceanographic Partnership Program, the National Science Foundation, and a National Security Science and Engineering Faculty Fellowship

Bioreactor manufactured cartilage grafts repair acute and chronic osteochondral defects in large animal studies

Objectives Bioreactor‐based production systems have the potential to overcome limitations associated with conventional tissue engineering manufacturing methods, facilitating regulatory compliant and cost‐effective production of engineered grafts for widespread clinical use. In this work, we established a bioreactor‐based manufacturing system for the production of cartilage grafts. Materials & Methods All bioprocesses, from cartilage biopsy digestion through the generation of engineered grafts, were performed in our bioreactor‐based manufacturing system. All bioreactor technologies and cartilage tissue engineering bioprocesses were transferred to an independent GMP facility, where engineered grafts were manufactured for two large animal studies. Results The results of these studies demonstrate the safety and feasibility of the bioreactor‐based manufacturing approach. Moreover, grafts produced in the manufacturing system were first shown to accelerate the repair of acute osteochondral defects, compared to cell‐free scaffold implants. We then demonstrated that grafts produced in the system also facilitated faster repair in a more clinically relevant chronic defect model. Our data also suggested that bioreactor‐manufactured grafts may result in a more robust repair in the longer term. Conclusion By demonstrating the safety and efficacy of bioreactor‐generated grafts in two large animal models, this work represents a pivotal step towards implementing the bioreactor‐based manufacturing system for the production of human cartilage grafts for clinical applications

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment