Examining the role of community resilience and social capital on mental health in public health emergency and disaster response: a scoping review.

The ability of the public to remain psychologically resilient in the face of public health emergencies and disasters (such as the COVID-19 pandemic) is a key factor in the effectiveness of a national response to such events. Community resilience and social capital are often perceived as beneficial and ensuring that a community is socially and psychologically resilient may aid emergency response and recovery. This review presents a synthesis of literature which answers the following research questions: How are community resilience and social capital quantified in research?; What is the impact of community resilience on mental wellbeing?; What is the impact of infectious disease outbreaks, disasters and emergencies on community resilience and social capital?; and, What types of interventions enhance community resilience and social capital?A scoping review procedure was followed. Searches were run across Medline, PsycInfo, and EMBASE, with search terms covering both community resilience and social capital, public health emergencies, and mental health. 26 papers met the inclusion criteria.The majority of retained papers originated in the USA, used a survey methodology to collect data, and involved a natural disaster. There was no common method for measuring community resilience or social capital. The association between community resilience and social capital with mental health was regarded as positive in most cases. However, we found that community resilience, and social capital, were initially negatively impacted by public health emergencies and enhanced by social group activities.Several key recommendations are proposed based on the outcomes from the review, which include: the need for a standardised and validated approach to measuring both community resilience and social capital; that there should be enhanced effort to improve preparedness to public health emergencies in communities by gauging current levels of community resilience and social capital; that community resilience and social capital should be bolstered if areas are at risk of disasters or public health emergencies; the need to ensure that suitable short-term support is provided to communities with high resilience in the immediate aftermath of a public health emergency or disaster; the importance of conducting robust evaluation of community resilience initiatives deployed during the COVID-19 pandemic.

Test, test, test - a complication of testing for coronavirus disease 2019 with nasal swabs.

BACKGROUND: Coronavirus disease 2019, a highly transmissible respiratory infection, has created a public health crisis of global magnitude. The mainstay of diagnostic testing for coronavirus disease 2019 is molecular polymerase chain reaction testing of a respiratory specimen, obtained with a viral swab. As the incidence of new cases of coronavirus disease 2019 increases exponentially, the use of viral swabs to collect nasopharyngeal specimens is anticipated to increase drastically. CASE REPORT: This paper draws attention to a complication of viral swab testing in the nasopharynx and describes the premature engagement of a viral swab breakpoint, resulting in impaction in the nasal cavity. CONCLUSION: This case highlights a possible design flaw of the viral swab when used to collect nasopharyngeal specimens, which then requires an aerosol-generating procedure in a high-risk patient to be performed. The paper outlines a safe technique of nasal foreign body removal in a suspected coronavirus disease 2019 patient and suggests alternative testing materials.

Acute Budd-Chiari syndrome caused by inferior vena cava compression from a congenital diaphragmatic hernia.

Acute Budd-Chiari syndrome is a rare condition characterised by obstruction of hepatic venous outflow. We describe the case of a 52-year-old man, with a congenital Morgagni diaphragmatic hernia, who presented with acute onset abdominal pain, shortness of breath, lactic acidosis, hyperbilirubinaemia and transaminasaemia. Computed tomography revealed strangulation of the diaphragmatic hernia and extrinsic compression of the inferior vena cava from the herniated viscera. Emergency surgery was carried out to repair the hernia with a biosynthetic mesh, with complete resolution of the Budd-Chiari syndrome.

Management of airway obstruction with nebulised adrenaline resulting in takotsubo cardiomyopathy: case report.

BACKGROUND: Takotsubo cardiomyopathy has been associated with the use of catecholamines; however, its development after the use of nebulised adrenaline for the management of acute airway obstruction has not previously been described. CASE REPORT: A 66-year-old man with squamous cell carcinoma of the larynx, with tumour-node-metastasis staging of T3N2cM0, confirmed by biopsy and computed tomography, presented to the emergency department with acute airway obstruction. He was treated twice with nebulised adrenaline and intravenous dexamethasone. After a period of 24 hours, cardiac rhythm changes were noted on telemetry. A 12-lead electrocardiogram showed widespread T-wave inversion and QT prolongation suggestive of an acute coronary syndrome. Coronary angiography demonstrated no coronary artery disease, but left ventricular angiography showed marked apical ballooning and apical wall akinesia consistent with a diagnosis of takotsubo cardiomyopathy. CONCLUSION: Takotsubo cardiomyopathy can mimic true ischaemic heart disease and the diagnosis requires a high index of suspicion in patients managed with nebulised adrenaline.

Clinical trial design in the neurocritical care unit.

Clinical trials provide a robust mechanism to advance science and change clinical practice across the widest possible spectrum. Fundamental in the Neurocritical Care Society's mission is to promote Quality Patient Care by identifying and implementing best medical practices for acute neurological disorders that are consistent with the current scientific knowledge. The next logical step will be to foster rapid growth of our scientific body of evidence, to establish and disseminate these best practices. In this manuscript, five invited experts were impaneled to address questions, identified by the conference organizing committee as fundamental issues for the design of clinical trials in the neurological intensive care unit setting.

Prognostic scoring in necrotising otitis externa.

OBJECTIVE: To collect and analyse data from the published literature concerning the rare condition necrotising otitis externa, in order to formulate a prognostic scoring model based on signs and symptoms. DESIGN: Retrospective data collection from published literature, and binary logistic regression analysis of the effect on outcome of identified signs and symptoms. RESULTS: Six factors were identified as prognostic of a poorer outcome, including facial nerve involvement, additional cranial nerve involvement, non-cranial nerve neurological involvement, extensive granulations (or oedema) in the external auditory canal, bilateral symptoms and aspergillus species as the causative organism. A four-point scoring model based on these findings is presented. CONCLUSIONS: A novel, systematic method of data analysis was utilised to construct a prognostic scoring model for necrotising otitis externa. This will better equip clinicians to treat this potentially fatal condition.

Multiple oesophageal foreign bodies: the importance of two radiological views.

OBJECTIVES: To demonstrate the importance of two radiological views in the assessment of oesophageal foreign bodies. CASE REPORT: The case of a child with multiple oesophageal foreign bodies appearing as a single object on an antero-posterior chest radiograph is used to illustrate the need for two radiological views in the assessment of such cases. CONCLUSIONS: Two radiological views are recommended in the assessment of oesophageal foreign bodies.

Timing of co-phenylcaine administration before rigid nasendoscopy: a randomized, controlled trial.

Rigid nasendoscopy is a commonly used method of examining the nasal cavity and postnasal space. Co-phenylcaine is useful for its vasoconstrictive and anaesthetic properties, but the length of time allowed for it to take effect is variable. We performed a single-blind, randomized, controlled trial to determine whether it was better to allow one or 10 minutes for co-phenylcaine to take effect. Fifty patients were randomized into two groups, 25 in each. Patients in the 10 minute group experienced less discomfort (p=0.02) and less pain (p=0.018) than those in the one minute group. Ease of examination was also greater in the 10 minute group, as was the quality of the image obtained (p<0.001).

Psychiatric side effects of ofloxacin used in the treatment of pelvic inflammatory disease.

The Clinical Effectiveness Group of the Medical Society for the Study of Venereal Diseases and the Association of Genitourinary Medicine published guidelines on the management of pelvic inflammatory disease in 1999. Subsequently, the use of ofloxacin has increased in our department. However, ofloxacin can cause serious psychiatric side effects, particularly in those with a past psychiatric history. This is of relevance to genitourinary medicine (GUM) physicians as there is a high prevalence of psychiatric illness amongst patients attending GUM clinics. We present two cases of ofloxacin causing severe psychiatric symptomatology, in one case causing an acute psychotic reaction. It is recommended a psychiatric history is taken prior to prescribing ofloxacin and that consideration is given to alternative therapy for those with previous psychiatric illness.

Nasotracheal intubation for head and neck surgery.

Nasotracheal intubation offers the head and neck surgeon more scope for surgical manoeuvre in operations of the mouth, pharynx, larynx and also the neck. Concern over the complications of using this route of intubation and lack of training may be limiting its use. A thorough knowledge of the anatomy, benefits of using nasal vasoconstrictors and attention to technique are prerequisites to maintaining the skill. This article reviews each of these topics and aims to encourage the appropriate use of nasotracheal intubation in current practice.

Diminished levels of the putative tumor suppressor proteins EXT1 and EXT2 in exostosis chondrocytes.

The EXT family of putative tumor suppressor genes affect endochondral bone growth, and mutations in EXT1 and EXT2 genes cause the autosomal dominant disorder Hereditary Multiple Exostoses (HME). Loss of heterozygosity (LOH) of these genes plays a role in the development of exostoses and chondrosarcomas. In this study, we characterized EXT genes in 11 exostosis chondrocyte strains using LOH and mutational analyses. We also determined subcellular localization and quantitation of EXT1 and EXT2 proteins by immunocytochemistry using antibodies raised against unique peptide epitopes. In an isolated non-HME exostosis, we detected three genetic hits: deletion of one EXT1 gene, a net 21-bp deletion within the other EXT1 gene and a deletion in intron 1 causing loss of gene product. Diminished levels of EXT1 and EXT2 protein were found in 9 (82%) and 5 (45%) exostosis chondrocyte strains, respectively, and 4 (36%) were deficient in levels of both proteins. Although we found mutations in exostosis chondrocytes, mutational analysis alone did not predict all the observed decreases in EXT gene products in exostosis chondrocytes, suggesting additional genetic mutations. Moreover, exostosis chondrocytes exhibit an unusual cellular phenotype characterized by abnormal actin bundles in the cytoplasm. These results suggest that multiple mutational steps are involved in exostosis development and that EXT genes play a role in cell signaling related to chondrocyte cytoskeleton regulation.

Stability of deoxynivalenol in heat-treated foods.

The effects of high-temperature and -pressure processing of foods spiked with deoxynivalenol (DON) were examined. In extruded corn grits, extruded dry dog food, and autoclaved moist dog food, there were no significant reductions (P < 0.05) in DON after processing. Autoclaved cream-style corn showed a reduction in DON of only 12%. Overall, DON was stabile to the high temperature and pressure processes tested. The use of an alpha-amylase in the extraction method for analysis by an enzyme-linked immunosorbant assay (ELISA) improved the recovery of DON from the spiked extruded and autoclaved products by as much as 26% over the standard ELISA method.

Photosynthetic energy storage in aquatic leaves measured by photothermal deflection.

In a study of photosynthetic energy storage efficiency (ES), the adaxial surface of the leaves of Vallisneria americana exhibited the highest ES values (22%) of the four aquatic plants examined. V. americana leaves have a dispersed structure and it was possible to measure the energy storage properties of the epidermal cells independently of the rest of the leaf. The abaxial epidermis had a higher value of ES at zero light fluence than the adaxial epidermis but ES in the abaxial epidermis declined much more rapidly with light fluence. Thus the abaxial epidermis is more suited to lower light fluences than the adaxial epidermis. ES declined as the pH rose from 4.0 to 8.0 at a constant dissolved inorganic carbon concentration. This paralleled the change from carbon dioxide to bicarbonate and suggests that these leaves utilise CO2 more efficiently than bicarbonate. ES increased by about 50% at pH 8.0 as leaf sections further from the leaf tip were examined which demonstrates that the older epidermal cells are less well able to use bicarbonate. Exposure to 30 min of a saturating light fluence caused the epidermal chloroplasts to move from the periclinal walls to the anticlinal walls. This decreased the photothermal signal by increasing the thermal diffusion distance and lowering the light fluence due to greater chloroplast shading. The latter effect increased ES. It appears that chloroplast movement could assist the epidermis to survive harmful light fluences.

Effects of the protein kinase C stimulant bryostatin 1 on the proliferation and colony formation of irradiated human T-lymphocytes.

The protein kinase C stimulant bryostatin 1 (Bryo) was used in examining human peripheral blood T-lymphocyte radiosensitivities in proliferation assays. Bryo was similar to PMA in inducing T-cell proliferation by the CD3, CD28 and CD69 pathways. No difference in radiosensitivities was observed in T-cells stimulated by the three independent surface antigen-mediated activation pathways. CD3 was chosen as the second signal for comparing the potencies of the three different first signals Bryo, phorbol 12-myristate, 13-acetate (PMA), and interleukin 2 (IL-2) in stimulating T-cell proliferation and in maintaining this response after radiation. Though there were radioresponse differences among various individuals, the irradiated lymphocytes consistently showed significantly greater proliferation when treated with Bryo or PMA than with IL-2 (p < 0.05- < 0.005). No difference in proliferative responses was observed in T-cells irradiated between 4 h before and 15 h after the addition of stimulants. Colony forming assays showed higher colony survival for irradiated T-cells stimulated with Bryo than with PMA. These results support the important role of protein kinase C in T-cell radiation responses, and suggest a potential role for Bryo in enhancing T-lymphocyte survival during radiation therapy.

DNA repair in the genomic region containing the beta-actin gene in xeroderma pigmentosum complementation group C and normal human cells.

The limited DNA excision repair in UV-irradiated fibroblasts from xeroderma pigmentosum complementation group C (XP-C) occurs in selected chromatin regions. The small beta-actin gene (3.5 kb) is one of these and is repaired as part of a large region (about 50 kb). We show here that only one of the DNA strands is repaired through this extended region. Several genomic fragments spanning about 70 kb in the beta-actin region have been cloned and mapped and some have been examined for repair activity. Both strands of one fragment (14 kb) in the immediate vicinity of the gene are repaired. Transcripts associated with both strands are detected. In normal cells, both strands of the same fragment are preferentially repaired relative to the genome overall and also associated with transcription. The repair activity in XP-C cells associated with other defined DNA fragments indicates that termini for the repaired regions in either strand can be located. Results are consistent with those of others indicating that transcription promotes repair in XP-C cells and that several levels of repair activity, at least one coupled to transcription, occur in normal cells. We conclude that the beta-actin repair domain, defined in XP-C cells, comprises both strands of a small region (about 14 kb) in the vicinity of the beta-actin gene and a single strand extending through a larger region of about 50 kb. We suggest that a similar genomic organization for repair exists in normal cells.

Experimental transmission of bovine viral diseases by insemination with contaminated semen or during embryo transfer.

Three experimental approaches were used to study transmission of blue tongue (BT), infectious bovine rhinotracheitis (IBR) and bovine virus diarrhoea (BVD) viruses. These were insemination with contaminated semen, experimental infection of embryo donor cows, or transfer of embryos experimentally exposed to virus in vitro to normal recipients. Parameters assessed included number and quality of embryos produced, virus detection (isolation and electron microscopy), serology and histopathology. All superovulated sesceptible cows inseminated with semen containing blue tongue virus (BTV) (n = 2) or infectious bovine rhinotracheitis virus (IBRV) (n = 2) became infected. One cow inseminated with semen containing BTV produced seven virus-free seven-day-old embryos; the second cow failed to produce any embryos. One of two cows inseminated with semen containing IBRV produced two underdeveloped, virus-free embryos while no embryos were produced by the second cow. One of two cows inseminated with semen containing bovine viral diarrhoea virus (BVDV) became infected. Two poorly developed, virus-free seven-day-old embryos were recovered from one of these cows. Superovulated susceptible cows inoculated either intramuscularly with BTV (n = 3) or intranasally with IBR virus (n = 2) became infected. Virus was isolated from some tissues of two BTV-infected cows, neither of which produced embryos. A third BTV-infected cow produced two virus-free embryos collected at necropsy five days after inoculation. One of two cows experimentally infected with IBR virus, produced three embryos but virus was not detected either by electron microscopy (1 embryo) or in cell culture by cytopathic alterations (1 embryo).(ABSTRACT TRUNCATED AT 400 WORDS)

Effect of pregnancy on the immune response of cattle to a Brucella vaccine.

An experiment was performed to determine whether humoral- or cell-mediated immune responses of cattle to a Brucella abortus vaccine were influenced by the stage of gestation. Heifers were vaccinated 2 mth before and 2 mth after breeding with cell envelopes of B. abortus in an oil adjuvant containing trehalose dimycolate and muramyl dipeptide. Control groups received adjuvant alone or no vaccine. Following breeding, vaccinated animals were divided into pregnant and nonpregnant subgroups. Immune responses to two outer membrane proteins were measured at monthly intervals by ELISA and lymphocyte blastogenesis tests. Skin tests were performed during the ninth month of gestation. Vaccination induced sustained immune responses, but few differences were detected between pregnant and non-pregnant animals. The relative increase in IgA antibodies to group 3 protein in nonpregnant heifers exceeded that in pregnant heifers during months 4 and 6 of gestation (P less than 0.05). Dermal hypersensitivity, measured by changes in double skin thickness, was significantly greater in nonpregnant heifers to porin (P less than 0.01) and group 3 (P less than 0.05) antigens at 24 h post-injection, but no significant differences in skin thicknesses or in the nature of the lesions were observed at 48 h. Animals which received adjuvant alone demonstrated negligible responses. Pregnancy had no significant effect on the responses of lymphocytes to phytohemagglutinin (PHA) or Concanavalin A (Con A). However, plasmas from nonvaccinated pregnant heifers taken during the sixth and seventh (but not eight or ninth) months of pregnancy decreased responses of normal donor cells to PHA and Con A when compared with those in autologous plasma (P less than 0.05).

Hypertensive potency of 18-oxocortisol in the rat.

The hypertensogenic effect of 18-oxocortisol, an aldosterone analogue possessing both mineralocorticoid and glucocorticoid properties, was studied at the same dosage but under different experimental conditions in two experiments. Under experimental conditions conducive to the development of mineralocorticoid hypertension (i.e., rats with a single kidney on a high NaCl intake), there was an extremely rapid onset of saline polydipsia and hypertension accompanied by cardiac and renal enlargement, marked thymic involution without adrenal atrophy, cardiovascular lesions, and hypokalemia. With the exception of the thymic changes, the same changes occurred in rats given the biologically equivalent dose of deoxycorticosterone acetate. Under circumstances favoring the development of glucocorticoid hypertension (i.e., intact rats on a normal sodium intake), the same dose had only a transient blood pressure-elevating effect, attaining prehypertensive levels at most, and caused neither chronic hypertension nor hypokalemia. The biologically equivalent glucocorticoid dosage of cortisol was similarly ineffective. Under these circumstances, both steroids caused thymus involution but only 18-oxocortisol caused kidney enlargement.