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This investigation report describes a case of COVID-19 in a combined military and civilian office workspace and the contact investigation and mitigation efforts that followed. This office space included an embedded public health officer who was able to conduct the contact investigation and advise on the outbreak response. Over a 3-day period, the index case unintentionally exposed 150 coworkers to SARS-CoV-2 through participation in carpools, conferences, and small meetings. Of these exposures 37 were considered medium risk at the time and 113 were considered low risk. A total of 5 contacts reported COVID-like-symptoms at the time of the investigation and another 5 developed symptoms during the 14-day quarantine period and all were directed to self-isolate. None of the contacts required hospitalization and all the symptomatic contacts tested negative for SARS-CoV-2. With the advice and aid of the embedded public health officer, the office authorized telework, conducted thorough cleaning of spaces, distributed informative messaging, conducted virtual question-and-answer forums, and evaluated outbreak policies. This report demonstrates that the close integration of public health and office management can lead to rapid identification of those at risk of infection and implementation of mitigation and control efforts to stop the spread of disease.

The phenomenal growth in the use of social media in the past 10 years has dramatically and irreversibly changed the way individuals communicate and interact with one another. While there are undoubtedly many positives arising out of the use of social media, irresponsible or inappropriate use can have significant negative consequences. In the university setting, comments posted on widely accessible forums such as Facebook, and seen by other students or staff, can damage reputations, create personal distress and compromise academic integrity. So how should universities deal with this problem? This article describes the findings of a research project undertaken in 2011 to address this question. Given that many students would regard their Facebook pages and Facebook groups as their own private space, one of the key goals of the project was to establish appropriate limits for university interference in these matters. Another was to develop a categorisation model for dealing with inappropriate or irresponsible ...

Learning disability is characterized by significant impairment of both intellectual function and social and adaptive function, with onset before adulthood, and yet social and adaptive function is often omitted from assessment processes. This practice analysis explores the feasibility of administering the Assessment of Motor and Process Skills to assess adaptive function (alongside the assessment of intellectual function) as part of the diagnostic process for people with a learning disability. After a 2-year period, scores for the two assessments were correlated and a low level of correlation was found. Findings suggested that the Assessment of Motor and Process Skills should continue to be used as part of the diagnostic process alongside assessments of intellectual function, because assessment of intellectual function alone does not predict adaptive function and cannot be relied on for diagnosis of learning disability; doing so would ensure that practice was evidence based.

Attempts to define children's literature, traces it's history from Victorian roots, and discusses the difficulties of classifying good childrens literature. (RB)

This is an introduction to the work of 19 contemporary English-language writers for children. It consists of critical essays on the works of Joan Aiken, L. M. Boston, H. F. Brinsmead, John Christopher, Helen Cresswell, Meindert DeJong, Eleanor Estes, Paula Fox, Leon Garfield, Alan Garner, Madeleine L'Engle, William Mayne, Andre Norton, Scott O'Dell, Philippa Pearce, K. M.Peyton, Ivan Southall, Rosemary Sutcliff, and Patricia Wrightson. Individual essays on each author consider his work in literary terms, and children's literature is assessed as a part of the whole universe of literature. The book includes brief biographic details about the writers, notes on themselves by the authors, and lists of the authors' books. American, Australian, and British authors are represented. Criteria for judging childrens' literature are given. (MC)

Children's prose literature in Britain is surveyed from the 17th century to the present. The main stream of this development is exemplified by an examination of the lives and works of such authors as (1) John Newbery, whose books for children include "Goody Two-Shoes" (1766), (2) Mrs. Sherwood, whose didactic books contain a moral lesson in every chapter, (3) Lewis Carroll, most famous for "Alice in Wonderland" and "Through the Looking Glass," (4) Robert Louis Stevenson and J. D. Wyss, Victorian adventure writers, (5) Thomas Hughes, creator of the first school story, "Tom Brown's Schooldays" (1857), (6) Francis Hodgson Burnett, who wrote "Little Lord Fauntleroy," (7) Joseph Jacobs and Andrew Lang, who popularized fairy tales in Victorian England, (8) Edith Nesbit, whose book,"The Story of the Treasure Seekers," represents family adventure stories, (9) Anna Sewell, whose "Black Beauty," and Kenneth Grahame, whose "Wind in the Willows," are examples of talking animal stories, (10) A. A. Milne and P. L. Travers, who wrote contemporary fantasy, and (11) the modern authors, William Mayne, John Verney, and Gillian Avery, whose adventure stories appeal to both boys and girls. (JM)

The very large and difficult subject of what standards should be used to judge children's literature is explored at some length. (NH)

PurposeThe purpose of this paper is to critically examine the evidence for the use of on‐line forums within education and their use in working with service users with mental health problems. The paper also outlines the key characteristics of the online facilitator. The authors propose that nurse education is well placed to develop students on‐line forum participation and moderation programme.Design/methodology/approachThe authors reviewed the literature to assess the current evidence.FindingsMuch of the literature was international, mainly from Asia Pacific, the USA and Europe but there was limited research and position papers from the UK. The use of forums was discussed but there is a paucity of research, particularly in relation to the use of on‐line forums within mental health. The literature identifies and gives an insight into the complexities of using on‐line forums.Research limitations/implicationsResearch limitations: this is a systematic literature review but only English language papers were consulted. Also the authors drew on their personal experiences of working with students in an on‐line learning environment to inform this paper. Implications: educators need to develop a change in attitude with regard to the use of on‐line learning. Many are used to face‐to‐face teaching and still regard it as the most stimulating and appropriate way for knowledge development. Specific collaborative and interactive skills are considered to be desirable when engaging in on‐line forums. These have to be learned by both the moderator and the students. Mental health nurses should be encouraged to perceive the skills of forum facilitation in a positive way when engaging with service users and can add to their repertoire of skills.Practical implicationsThe authors suggest that more research is needed within this area on on‐line forums, with particular emphasis on how student nurses engage in on‐line forums. It is felt that nurses, given proper preparation and effective training, are well placed to carry out the role. Partnership working could be developed with universities and NHS Trusts to develop Trust's staff skills and expertise in the moderation of forums, as universities have the skills and experience. However supervision would be essential for moderators to develop appropriate pedagogic tools to facilitate what is a complex process.Social implicationsThe authors suggest making better use of available technology and empowering the service user to take ownership of the way they engage with professionals.Originality/valueThis appears to be an area that is under researched and considering the increasing usage of social networking as a means of peer support, there is scope for this to be transferred to professional practice.

We present derived stellar and disc parameters for a sample of Taurus brown dwarfs both with and without evidence of an associated disc. These parameters have been derived using an online fitting tool (http://bd-server.astro.ex.ac.uk/), which includes a statistically robust derivation of uncertainties, an indication of parameter degeneracies and a complete treatment of the input photometric and spectroscopic observations. The observations of the Taurus members with indications of disc presence have been fitted using a grid of theoretical models including detailed treatments of physical processes accepted for higher mass stars, such as dust sublimation, and a simple treatment of the accretion flux. This grid of models has been designed to test the validity of the adopted physical mechanisms, but we have also constructed models using parametrization, for example semi-empirical dust sublimation radii, for users solely interested in parameter derivation and the quality of the fit. The parameters derived for the naked and disc brown dwarf systems are largely consistent with literature observations. However, our inner disc edge locations are consistently closer to the star than previous results and we also derive elevated accretion rates over non-spectral energy distribution based accretion rate derivations. For inner edge locations, we attribute these differences to the detailed modelling we have performed of the disc structure, particularly at the crucial inner edge where departures in geometry from the often adopted vertical wall due to dust sublimation (and therefore accretion flux) can compensate for temperature (and therefore distance) changes to the inner edge of the dust disc. In the case of the elevated derived accretion rates, in some cases, this may be caused by the intrinsic stellar luminosities of the targets exceeding that predicted by the isochrones we have adopted.

The purpose of this study is to examine the perceptions of nurses of the suffering of the healer. Twenty-five registered nurses (RNs) were interviewed about their experiences. Most reported that they had experienced suffering. The most common threats that gave rise to suffering were reverberations with the past, expectations, vulnerability, guilt, and the high cost of empathy. Strategies used to cope with their suffering included talking about it with colleagues, friends, and family, placing it in perspective, and prayer.

As community care has become embedded in the UK as in much of the western world, more responsibility for psychosocial care has been placed on family carers. A systematic review of the literature about the role of family carers upporting a relative with severe mental illness and their relationships and engagement with professionals was carried out. The review aimed to find out what professionals expected of family carers and what family carers expected of themselves. Themes were identified: the distinct and personal nature of family caring, potentially effective family caring, barriers to effective caring and ways to overcome barriers. There were expectations that family carers were obligated to help support effective care, but that the rights to enable carers to fulfil these obligations were not consistently upheld. Barriers to upholding rights include: types of service provision, professional attitudes to communication and engagement with carers, and carer ability to cope. Recommendations for practice included: service provision aimed at including carers, more empathic communication by professionals, and a covenant between mental health services and people who depend on them. The idea of a covenant requires more discussion and research is needed into what is expected of family carers.

In the UK, community care has led to more complex relationships for mental health nurses. They need to respect the rights of service users to confidentiality while also respecting the rights of family caregivers to information that directly affects them. An unsatisfactory situation has arisen in which utilitarian and legally driven motives have seen family caregivers’ interests become subsidiary to those of service users and providers. An ethical case is made for sharing information with family caregivers, even against the wishes of service users. Through the use of a conceptual framework based on elements proposed by Thiroux — value of life, goodness or rightness, justice or fairness, truth-telling or honesty, and individual freedom — the article concludes that there is an ethical argument for sharing some information with family caregivers and that nurses should respect caregivers’ rights through their actions. Nurses’ actions are a commitment to seeking what is ‘good’ by making judgements based on what matters. It is argued that people and their relationships matter more than strict adherence to laws and codes.

Despite the large number of children that the Surgeon General of the United States estimated to be suffering from a mental disorder (Office of the Surgeon General, 2000), the majority of childhood disorders are undiagnosed and untreated. The negative effect of childhood disorders on a child's academic, social, and psychological development can be devastating. The child's teacher is often the 1st person to identify that there is a problem and the 1st person to suggest referrals. The teacher is also often able to make adjustments in the classroom that can enable the child to be successful academically, minimize the negative effects of the illness on the child's development, and manage the child's behaviors that can disrupt the classroom. The author describes the most common disorders that teachers have observed in the classroom, including major depressive disorder, attention deficit hyperactivity disorder, post-traumatic stress disorder, and conduct disorder. The author presents the effects of chil...

Summary Much is known about the purpose of practice educators in the United Kingdom, but how their role is implemented is subject to conflicting expectations, partly created by the structure in which they work. Joint appointments between universities and practice are an opportunity for both organisations to collaborate in a partnership to enhance practice learning and fulfill one of the main aims of the practice educator role: to narrow the theory-practice gap. However tensions exist. This paper advocates a national (UK) job description for practice educators to reduce some of the tensions and conflict between the expectations of collaborating partners in practice learning. This would enable practice educators to concentrate on their obligations while employers concentrate on enabling practice educators to fulfill their obligations by upholding their rights to proper preparation, support and career structure.

Knowing how fathers contribute to child outcomes is critical in the clinical management of children who have type 1 diabetes. The purposes of this review were to synthesize what is known about the role of fathers and to determine directions for future research. Research studies that reported findings that encompassed fathers' perceptions, knowledge, coping and adjustment, and behavior in relation to their children with type 1 diabetes were reviewed. Research suggests that, although fathers are usually not the primary caregiver or manager of the routine day-to-day care, their contribution to the family through perceptions, knowledge, adjustment, and behavior may be associated with important disease management outcomes.

Objectives. The study investigated executive function in adults with Down's syndrome. Design. Participants with Down's syndrome (N=26) were compared with non-Down syndrome learning disabled participants (N=26). Method. The two group's performance on a range of tests of executive function were compared. Groups were matched on age and a measure of vocabulary. Results. The Down's syndrome group performed at a significantly lower level on a number of tests of executive function. Conclusion. It is suggested that impaired executive function in Down's syndrome is due to abnormal development of the prefrontal cortex in Down's syndrome. Tests of executive function may be sensitive to cognitive changes with the onset of dementia in people with Down's syndrome. Longitudinal studies examining changes in executive function in people with Down's syndrome are recommended.

Dystonia is a movement disorder considered to result from basal ganglia dysfunction. The aim of this study was to investigate the functional significance of frontal hyperactivity demonstrated in dystonia in imaging studies by examining executive function and working memory, in which the prefrontal cortex is known to be involved. We assessed 10 patients with idiopathic dystonia and 12 age- and IQ-matched normal controls. All subjects completed tests of first letter, category, and alternating category word fluency, the Wisconsin Card Sorting Test, the Stroop Colour Word Naming Test, the Missing Digit Test of working memory, a test of random number generation, a test requiring generation of self-ordered random number sequences, the Paced Serial Addition Test, a test of conditional associative learning, and finger tapping and peg insertion under unimanual, bimanual, and dual task conditions. The patients with dystonia did not differ significantly from controls on any measures of executive function or working memory used other than category word fluency and the extent of decline in tapping with one hand under dual task conditions when simultaneously inserting pegs with the other hand. For this small sample, the results suggest that unlike other movement disorders associated with fronto-striatal dysfunction such as Parkinson's disease or Huntington's disease, dystonia was not associated with deficits on the tests of executive function or working memory used. A more detailed investigation of cognitive function in a larger sample of patients is required.

TOPIC The severe distress sometimes experienced by nurses in their role as healer. PURPOSE To identify the sources that give rise to the suffering of the healer, describe the responses of healers to their suffering, and make recommendations on how to prepare nurses to cope with suffering. SOURCES The concept of the suffering of the healer is derived from the work of Erik Cassell; the framework for understanding responses to suffering from the work of Dorothy Solle. CONCLUSIONS Nurses need to be aware that practice in health care can give rise to the suffering of the healer. Nursing education and administration need to help nurses learn to cope.

We present an isochrone server for semi-empirical pre-main-sequence model isochrones in the following systems: Johnson-Cousins, Sloan Digital Sky Survey, Two-Micron All-Sky Survey, Isaac Newton Telescope (INT) Wide-Field Camera, and INT Photometric H$\alpha$ Survey (IPHAS)/UV-Excess Survey (UVEX). The server can be accessed via the Cluster Collaboration webpage {http://www.astro.ex.ac.uk/people/timn/isochrones/}. To achieve this we have used the observed colours of member stars in young clusters with well-established age, distance and reddening to create fiducial loci in the colour-magnitude diagram. These empirical sequences have been used to quantify the discrepancy between the models and data arising from uncertainties in both the interior and atmospheric models, resulting in tables of semi-empirical bolometric corrections (BCs) in the various photometric systems. The model isochrones made available through the server are based on existing stellar interior models coupled with our newly derived semi-empirical BCs. As part of this analysis we also present new cluster parameters for both the Pleiades and Praesepe, yielding ages of $135^{+20}_{-11}$ and $665^{+14}_{-7}\,\rm{Myr}$ as well as distances of $132 \pm 2$ and $184 \pm 2\,\rm{pc}$ respectively (statistical uncertainty only)., Comment: Accepted for publication in MNRAS; 18 pages, 8 figures and 7 tables. Tables 3, 4, 6 and 7 (for which only samples are given in the paper) are available in full at the Cluster Collaboration homepage {http://www.astro.ex.ac.uk/people/timn/Catalogues/paper3.html}

Rates of primary infertility worldwide are in the region of one to five per cent, with higher rates found in central Africa, while rates of secondary infertility range from seven to 33 per cent. This paper is about research carried out since the late 1970s by the Special Programme of Research, Development and Research Training in Human Reproduction on clinical aspects of infertility, with an emphasis on developing countries, particularly sub-Saharan Africa, where prevalence has been the highest in recent decades. Clinical studies have shown that prior pelvic inflammatory disease resulting from lower genital tract infection was the cause of primary infertility in women in sub-Saharan Africa in up to two-thirds of cases. Many tertiary health care facilities in developing countries are overwhelmed by demand for attention to infertility problems. In the 1990s, the Special Programme's research has focused on the ways in which health care services in developing country settings can respond to these problems through improving the prevention, diagnosis and treatment of infertility at primary, secondary and tertiary levels of care, and through the use of management guidelines appropriate to national and local settings.

SUMMARY Palaeomagnetic analysis of six orientated hematite samples from the Florence Mine, Egremont, west Cumbria is described. A total of 21 specimens were subjected to incremental thermal demagnetization and the components of magnetization isolated by principal components analysis. All the specimens displayed a single component of magnetization with no evidence of either multicomponent magnetizations or significant low-temperature secondary magnetic components. The mean direction of the characteristic remanence based on the isolated components has a declination of 203°, and an inclination of −13° (α 95 = 10°, k = 12) with the corresponding pole position at 38.6°S, 333.5°E ( D p = 5.2, D m = 10.3). A single primary component is responsible for the characteristic remanent magnetism (ChRM) directions. The initial susceptibilities and magnetic intensities are compatible with petrographic observations that the samples comprise virtually pure hematite. The ChRM originated as chemical remanent magnetism when the hematite precipitated at temperatures over 100°C. Comparison of the calculated pole position for the west Cumbrian hematite deposits with the apparent polar wander path for Britain south of the Iapetus Suture reveals that the ore deposits formed during the Late Carboniferous and Early Permian. The west Cumbrian hematite deposits therefore are not precipitates of a brine expelled from the Triassic sediments of the East Irish Sea Basin. The hematite may have precipitated from a brine expelled from older sediments (Devonian?), a fluid associated with igneous activity resulting from Permian rifting in the Irish Sea area, or they may be associated with ingress of surface-derived fluids during the Permian.

This issue of the NCMJ addresses the problem of chronic pain in North Carolina; its diagnosis and management in primary and specialty care; and the need to balance efficacy and safety when prescribing opioid medications, as these drugs are associated with significant potential for misuse and abuse. The commentaries in this issue not only address the use of opioids for the management of chronic pain but also explore various alternatives, including medical marijuana, epidural and other injections, surgery, acupuncture, and other integrative therapies. Articles in this issue also describe the management of chronic pain in palliative care, the ways in which mental health affects pain, and the unintended consequences of chronic pain management. Finally, this issue describes several initiatives across the state that are addressing the epidemic of prescription drug abuse; these initiatives are effecting systematic changes in clinical practice to more effectively manage chronic pain, protect patients, and minimize the negative impact of prescription drug abuse on communities.

The rapid growth in the number of trucks on the nation's highways combined with the fact that safety violation rates have not declined significantly have created an urgency to increase the efficiency of heavy-truck inspections. At the same time, the growing number of on-board electronic systems are delivering more information than ever before about key components of vehicle operation. The objective of this study is to determine whether it would be feasible to standardize electronic diagnostic interface systems and use them to help make roadside inspection faster, more accurate, and less constrained by shortages of qualified inspection personnel. The study found that electronics has made significant inroads into components of heavy-duty commercial vehicles. In addition to widely adopted systems, such as electronically controlled engines, transmissions, and antilock brakes, the technology exists for a number of new applications. The heavy-duty Class 8 truck of the year 2000 and beyond could be equipped with as many as 50 electronic systems but more likely with three to seven intelligent control devices for the engine, transmission, brakes, retarder, instrument cluster, trip recorder, and off-board communications. There is potential for using these electronics in roadside inspections as standardization efforts by the Society of Automotive Engineers and The Maintenance Council successfully continue if the proper on-board parameters are made available to inspectors.