RESUMO
Marine and ice-core records show that the Earth has experienced a succession of glacials and interglacials during the Quaternary (last â¼2.6 million years), although it is often difficult to correlate fragmentary terrestrial records with specific cycles. Aminostratigraphy is a method potentially able to link terrestrial sequences to the marine isotope stages (MIS) of the deep-sea record. We have used new methods of extraction and analysis of amino acids, preserved within the calcitic opercula of the freshwater gastropod Bithynia, to provide the most comprehensive data set for the British Pleistocene based on a single dating technique. A total of 470 opercula from 74 sites spanning the entire Quaternary are ranked in order of relative age based on the extent of protein degradation, using aspartic acid/asparagine (Asx), glutamic acid/glutamine (Glx), serine (Ser), alanine (Ala) and valine (Val). This new aminostratigraphy is consistent with the stratigraphical relationships of stratotypes, sites with independent geochronology, biostratigraphy and terrace stratigraphy. The method corroborates the existence of four interglacial stages between the Anglian (MIS 12) and the Holocene in the terrestrial succession. It establishes human occupation of Britain in most interglacial stages after MIS 15, but supports the notion of human absence during the Last Interglacial (MIS 5e). Suspicions that the treeless 'optimum of the Upton Warren interstadial' at Isleworth pre-dates MIS 3 are confirmed. This new aminostratigraphy provides a robust framework against which climatic, biostratigraphical and archaeological models can be tested.
Assuntos
Arqueologia/métodos , Biodiversidade , Cronologia como Assunto , Fósseis , Gastrópodes , Aminoácidos/análise , Animais , Água Doce , Gastrópodes/química , Gastrópodes/classificação , Humanos , Proteínas/química , Reino UnidoRESUMO
The dispersal of early humans from Africa by 1.75 Myr ago led to a marked expansion of their range, from the island of Flores in the east to the Iberian peninsula in the west. This range encompassed tropical forest, savannah and Mediterranean habitats, but has hitherto not been demonstrated beyond 45 degrees N. Until recently, early colonization in Europe was thought to be confined to the area south of the Pyrenees and Alps. However, evidence from Pakefield (Suffolk, UK) at approximately 0.7 Myr indicated that humans occupied northern European latitudes when a Mediterranean-type climate prevailed. This provided the basis for an 'ebb and flow' model, where human populations were thought to survive in southern refugia during cold stages, only expanding northwards during fully temperate climates. Here we present new evidence from Happisburgh (Norfolk, UK) demonstrating that Early Pleistocene hominins were present in northern Europe >0.78 Myr ago when they were able to survive at the southern edge of the boreal zone. This has significant implications for our understanding of early human behaviour, adaptation and survival, as well as the tempo and mode of colonization after their first dispersal out of Africa.
Assuntos
Clima , Emigração e Imigração/história , Meio Ambiente , Hominidae , Adaptação Fisiológica , Animais , Arqueologia , Ecossistema , Fósseis , Geografia , Sedimentos Geológicos/química , História Antiga , Humanos , Magnetismo , Paleontologia , Rios , Estações do Ano , Sobrevida , Tecnologia/história , Tecnologia/instrumentação , Temperatura , Reino UnidoRESUMO
Aminostratigraphies of Quaternary non-marine deposits in Europe have been previously based on the racemization of a single amino acid in aragonitic shells from land and freshwater molluscs. The value of analysing multiple amino acids from the opercula of the freshwater gastropod Bithynia, which are composed of calcite, has been demonstrated. The protocol used for the isolation of intra-crystalline proteins from shells has been applied to these calcitic opercula, which have been shown to more closely approximate a closed system for indigenous protein residues. Original amino acids are even preserved in bithyniid opercula from the Eocene, showing persistence of indigenous organics for over 30 million years. Geochronological data from opercula are superior to those from shells in two respects: first, in showing less natural variability, and second, in the far better preservation of the intra-crystalline proteins, possibly resulting from the greater stability of calcite. These features allow greater temporal resolution and an extension of the dating range beyond the early Middle Pleistocene. Here we provide full details of the analyses for 480 samples from 100 horizons (75 sites), ranging from Late Pliocene to modern. These show that the dating technique is applicable to the entire Quaternary. Data are provided from all the stratotypes from British stages to have yielded opercula, which are shown to be clearly separable using this revised method. Further checks on the data are provided by reference to other type-sites for different stages (including some not formally defined). Additional tests are provided by sites with independent geochronology, or which can be associated with a terrace stratigraphy or biostratigraphy. This new aminostratigraphy for the non-marine Quaternary deposits of southern Britain provides a framework for understanding the regional geological and archaeological record. Comparison with reference to sites yielding independent geochronology, in combination with other lines of evidence, allows tentative correlation with the marine oxygen isotope record.
RESUMO
Darwin was fascinated by the transportation of land snails across great swathes of open ocean by birds--he even immersed snails in sea water to see how long they would survive. Here we follow a molecular phylogenetic trail that reveals the incredible transequatorial dispersal of the land snail Balea from Europe to the Azores and the Tristan da Cunha islands, and back again. This long-distance dispersal is unexpected for what are proverbially considered the most pedestrian of creatures.
Assuntos
Migração Animal , Aves/fisiologia , Geografia , Modelos Biológicos , Caramujos/fisiologia , Animais , DNA Mitocondrial/genética , Europa (Continente) , Islândia , Filogenia , Caramujos/classificação , Caramujos/genéticaRESUMO
The colonization of Eurasia by early humans is a key event after their spread out of Africa, but the nature, timing and ecological context of the earliest human occupation of northwest Europe is uncertain and has been the subject of intense debate. The southern Caucasus was occupied about 1.8 million years (Myr) ago, whereas human remains from Atapuerca-TD6, Spain (more than 780 kyr ago) and Ceprano, Italy (about 800 kyr ago) show that early Homo had dispersed to the Mediterranean hinterland before the Brunhes-Matuyama magnetic polarity reversal (780 kyr ago). Until now, the earliest uncontested artefacts from northern Europe were much younger, suggesting that humans were unable to colonize northern latitudes until about 500 kyr ago. Here we report flint artefacts from the Cromer Forest-bed Formation at Pakefield (52 degrees N), Suffolk, UK, from an interglacial sequence yielding a diverse range of plant and animal fossils. Event and lithostratigraphy, palaeomagnetism, amino acid geochronology and biostratigraphy indicate that the artefacts date to the early part of the Brunhes Chron (about 700 kyr ago) and thus represent the earliest unequivocal evidence for human presence north of the Alps.
Assuntos
Atividades Humanas/história , Animais , Arqueologia , Clima , Europa (Continente)/etnologia , Fósseis , Sedimentos Geológicos/química , História Antiga , Humanos , Insetos/fisiologia , Mamíferos/fisiologia , Chuva , Estações do Ano , Temperatura , Fatores de TempoRESUMO
INTRODUCTION: Providing comprehensive tobacco addiction treatment to smokers admitted to acute care settings represents an opportunity to realise major health resource savings and population health improvements. METHODS: The CURE project is a hospital-wide tobacco addiction treatment service piloted in Wythenshawe Hospital, Manchester, UK. The core components of the project are electronic screening of all patients to identify smokers; the provision of brief advice and pharmacotherapy by frontline staff; opt-out referral of smokers to a specialist team for inpatient behavioural interventions; and continued support after discharge. RESULTS: From 01 October 2018 to 31 March 2019, 92% (13,515/14,690) of adult admissions were screened for smoking status, identifying 2,393 current smokers. Of these, 96% were given brief advice to quit by the admitting team. Through the automated 'opt-out' referral process, 61% patients completed inpatient behavioural interventions with a specialist cessation practitioner (69% within the first 48 hours of admission). Overall, 66% of smokers were prescribed pharmacotherapy. Over one in five of all smokers admitted during this pilot reported that they were abstinent from smoking 12 weeks after discharge (22%) at a cost £183 per quit. DISCUSSION: National implementation of this cost-effective programme would be likely to generate substantial benefits to public health.
Assuntos
Nicotiana , Abandono do Hábito de Fumar , Adulto , Estudos de Viabilidade , Hospitais , Humanos , FumarRESUMO
An outbreak of avian influenza (H7N3) among poultry resulted in laboratory-confirmed disease in 1 of 103 exposed persons. Incomplete use of personal protective equipment (PPE) was associated with conjunctivitis and influenza-like symptoms. Rigorous use of PPE by persons managing avian influenza outbreaks may reduce exposure to potentially hazardous infected poultry materials.
Assuntos
Surtos de Doenças , Vírus da Influenza A/isolamento & purificação , Influenza Aviária/epidemiologia , Influenza Aviária/transmissão , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Equipamentos de Proteção/estatística & dados numéricos , Animais , Anticorpos Antivirais/sangue , Antivirais/uso terapêutico , Controle de Doenças Transmissíveis/métodos , Conjuntivite Viral/diagnóstico , Conjuntivite Viral/prevenção & controle , Conjuntivite Viral/virologia , Humanos , Vírus da Influenza A/imunologia , Influenza Aviária/virologia , Influenza Humana/fisiopatologia , Influenza Humana/virologia , Oseltamivir/uso terapêutico , Aves Domésticas/virologia , Inquéritos e QuestionáriosRESUMO
Multidisciplinary investigations of the vegetational, faunal and sea-level history inferred from the infills of buried channels on the coast of eastern Essex have a direct bearing on the differentiation of MIS 11 and MIS 9 in continental records. New data are presented from Cudmore Grove, an important site on Mersea Island that can be linked to the terrace sequence of the River Thames. The vegetational history has been reconstructed from a pollen sequence covering much of the interglacial represented. The temperate nature of the climate is apparent from a range of fossil groups, including plant remains, vertebrates (especially the rich herpetofauna), molluscs and beetles, which all have strong thermophilous components. The beetle data have been used to derive a Mutual Climatic Range reconstruction, suggesting that mean July temperatures were about 2 degrees C warmer than modern values for southeast England, whereas mean January temperatures may have been slightly colder. The sea-level history has been reconstructed from the molluscs, ostracods and especially the diatoms, which indicate that the marine transgression occurred considerably earlier in the interglacial cycle than at the neighbouring Hoxnian site at Clacton. There are a number of palynological similarities between the sequence at Cudmore Grove and Clacton, especially the presence of Abies and the occurrence of Azolla filiculoides megaspores. Moreover, both sites have yielded Palaeolithic archaeology, indeed the latter is the type site of the Clactonian (flake-and-core) industry. However, the sites can be differentiated on the basis of mammalian biostratigraphy, new aminostratigraphic data, as well as the differences in the sea-level history. The combined evidence suggests that the infill of the channel at Cudmore Grove accumulated during MIS 9, whereas the deposits at Clacton formed during MIS 11. The infill of a much later channel, yielding non-marine molluscs and vertebrates including Hippopotamus, appears to have formed during the Ipswichian (MIS 5e). This evidence is compared with other important sites of late Middle Pleistocene age in Britain and elsewhere on the continent and the importance of a multidisciplinary approach is stressed.
Assuntos
Neoplasias Pulmonares/epidemiologia , Modelos Organizacionais , Abandono do Hábito de Fumar , Fumar Tabaco/terapia , Canadá/epidemiologia , Terapia Cognitivo-Comportamental , Assistência Integral à Saúde , Tratamento Farmacológico , Humanos , Neoplasias Pulmonares/prevenção & controle , Programas Nacionais de Saúde , Transtornos Relacionados ao Uso de Substâncias , Fumar Tabaco/efeitos adversos , Resultado do Tratamento , Reino Unido/epidemiologiaRESUMO
Long-term sickness absence and incapacity benefits (disability pension) rates have increased across industrialised countries. Effective measures are needed to support return to work. The recommendations of this guidance were informed by the most appropriate available evidence of effectiveness and cost-effectiveness. Public health evidence was provided by research using a variety of study designs that attempted to determine the outcome of a particular intervention by evaluating status before and after the intervention had been effected, and was not limited to randomised control trials. Where the evidence base was depleted or underdeveloped, expert witnesses were called to give their opinion on the best available evidence and emerging interventions. The process enabled challenge and contestability from stakeholder groups at different points as the guidance was developed. Forty-five heterogeneous studies were included in the review of interventions to reduce long-term sickness absence and transitions from short-term to long-term absence (mainly covering the former and also mainly examining musculoskeletal conditions). The analysis of evidence was restricted to descriptive synthesis. Three general themes emerged from an analysis of the studies that were more likely to report positive results: early interventions; multidisciplinary approaches; and interventions with a workplace component. Two further reviews were undertaken, one on interventions to reduce the re-occurrence of sickness absence, which identified seven studies on lower back pain, and concluded that early intervention and direct workplace input are important factors. The final evidence review focused on six studies of interventions for those in receipt of incapacity benefit. The evidence was that work-focused interviews coupled with access to tailored support are effective and cost-effective interventions. Practitioners should consider the impact of interventions and management options on work ability for patients of working age. Work ability should be considered a key outcome for future intervention studies.
Assuntos
Doenças Profissionais/reabilitação , Guias de Prática Clínica como Assunto , Licença Médica/estatística & dados numéricos , Europa (Continente) , Feminino , Órgãos Governamentais , Humanos , Masculino , Doenças Profissionais/economia , Licença Médica/economia , Reino Unido , Local de TrabalhoRESUMO
BACKGROUND: Clinical governance has been introduced into health care in the United Kingdom as a means to improve quality. At present there is no legal duty for commercial occupational providers to implement this model. AIM: This preliminary study examined how commercial occupational health providers had implemented clinical governance. METHODS: The senior clinical manager of commercial occupational health providers completed a questionnaire. RESULTS: Fourteen of 17 organizations asked to participate completed the survey. Most of these had implemented some form of clinical governance. Patient and public involvement was attributed the least importance of potential components of clinical governance. Organizations were more likely to have systems to address poor clinical performance than encourage excellent performance. CONCLUSIONS: Commercial occupational health providers have implemented clinical governance. Its focus appears to be avoidance of failures rather than clinical excellence and patients. However, further work is needed to explore this more fully.