A Case of Henoch-Schonlein Purpura Associated with Rotavirus Infection in an Elderly Asian Male and Review of the Literature.

BACKGROUND Henoch-Schönlein purpura (HSP), a small vessel vasculitis mediated by deposition of immune-complexes containing IgA in the skin, gut, and glomeruli, often presents with abdominal pain, purpuric rash in the lower extremities and buttocks, joint pain, and hematuria. The disease most commonly targets children but can affect adults who tend to have a worse prognosis. CASE REPORT We discuss a case of HSP in an elderly Chinese male who presented with severe proximal bowel inflammation, vasculitic rash, and proteinuria; he was found to have positive stool rotavirus and giardia. He improved significantly with high dose steroids. We believe rotavirus may have been a triggering event in this patient. A brief review of the literature is also presented. CONCLUSIONS This is the first case report describing a classic presentation of HSP in an adult following a rotavirus infection. HSP can cause significant morbidity and mortality in adult patients predominantly from progressive renal failure; therefore careful management and monitoring is important. GI infections seem to be a common trigger for HSP and this case report suggests that rotavirus may be part of the spectrum

Luminescence Dating of Sediments from Ancient Irrigation Features, and Associated with Occupation of the Hinterland around Anuradhapura, Sri Lanka

This study supports a new investigation into the development and decline of irrigation and associated human activity in the Anuradhapura Hinterland, Sri Lanka (section 2). Optically stimulated luminescence (OSL) age determinations have been made for a variety of sediments from bund and tank systems, irrigation channels, palaeosols and ceramic scatter horizons in the Anuradhapura hinterland (section 3). The geomorphological and archaeological significance of the age determinations has been reviewed in the light of the luminescence results and the samples’ depositional contexts, to constrain the deposition/formation dates of the sampled sediments integrate the OSL results with independent archaeological and historical expectations (section 6). A total of 26 age determinations were made (section 5.3). Dose rate determinations were made using thick source beta counting, high-resolution gamma spectrometry, field gamma spectrometry, measured water contents and calculated cosmic dose rates (sections 4.2.1, 5.1). Equivalent dose determinations were made (sections 4.2.2, 5.2) using the OSL signals from sand sized grains of quartz separated from each sample. Dose rates ranged from 1.1 to 5.0 mGy/a, equivalent dose values ranged from 0.29 to 33 Gy. Age estimates for these samples ranged from 0.14 to 13 ka, the average being 2.9 ka ± 3.1 (section 5.3). Uncertainties on the age estimates were commonly 7% at one standard error. The OSL age estimates from the largest bund and some ceramic scatter sites were greater than 2000 BC. This is older than expected on archaeological grounds and further investigation of these sites may be warranted. The OSL results from the other samples in the present study date bund construction during the initial urbanisation of Anuradhapura c. 400BC, coincident with the major Nachchaduwa bund construction c. 300AD, and in the Late Iron Age / Early Mediaeval period c. 600AD. They date abandonment of one irrigation channel to the 8th Century AD and its infill up to the late 10th Century when Anuradhapura was finally sacked. A further 8 age estimates, from silts and colluvium, relate to the collapse of infrastructure in the Anuradhapura hinterland during the 10th century and continued landscape response during the 11th century, followed by the lead-in to restoration of the irrigation system during the colonial era

‘Smart Cities’ – Dynamic Sustainability Issues and Challenges for ‘Old World’ Economies: A Case from the United Kingdom

The rapid and dynamic rate of urbanization, particularly in emerging world economies, has resulted in a need to find sustainable ways of dealing with the excessive strains and pressures that come to bear on existing infrastructures and relationships. Increasingly during the twenty-first century policy makers have turned to technological solutions to deal with this challenge and the dynamics inherent within it. This move towards the utilization of technology to underpin infrastructure has led to the emergence of the term ‘Smart City’. Smart cities incorporate technology based solutions in their planning development and operation. This paper explores the organizational issues and challenges facing a post-industrial agglomeration in the North West of England as it attempted to become a ‘Smart City’. In particular the paper identifies and discusses the factors that posed significant challenges for the dynamic relationships residents, policymakers and public and private sector organizations and as a result aims to use these micro-level issues to inform the macro-debate and context of wider Smart City discussions. In order to achieve this, the paper develops a range of recommendations that are designed to inform Smart City design, planning and implementation strategies

The competing dynamics and relationships in corporate and local government agency constructions of place

This is an open-access article distributed under the terms of a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.This paper explores the dynamics of how private sector business entities and local government bodies perceive and interact with the identity of the locality in which they operate. It identifies tensions and differences in, and consequences of, the dynamics and relationships between how private sector business entities view constructions of ‘place’ and how government and publicly-funded place-marketing organisations portray and promote localities. These issues are examined through the phenomenon, brand and slogan of ‘visit, live, invest’ which is gaining credence in the United Kingdom and elsewhere in the world. The paper develops data using in-depth interviews and a smallscale survey set within an overall interpretivistic case study approach. The data and the case-study demonstrate that, despite the rebranding of the local government agencies as a placemarketing organisation committed to the new ‘live, visit, invest’ initiative and brand agenda, there is an ongoing ‘cultural hangover’ from previous place promotion policies. There are also serious impacts and consequences for relationships between the public and private sectors and with other stakeholders. The prevailing image of UKTown (real name anonymised) by business leaders is one that sees this town fundamentally as a historic, traditional and conservative town. This image has been the product of many years of older style promotion in this vein. While such an image may suggest pleasant aspects of the living environment, it has little to do with corporate image, values and concerns and many private sector business entities do not identity with it. In several instances it is even considered by certain business sectors to be ‘detrimental’ to the need for a dynamic business environment and the forms of relationships and activities these necessitate. The paper indicates a number of strategic moves that could be adopted in order to improve this predicament. Keywords: private business entities, local government agency, place identity, place marketing, branding, perceptio

How analysts think: sense-making strategies in the analysis of temporal evolution and criminal network structures and activities

Analysis of criminal activity based on offenders’ social networks is an established procedure in intelligence analysis. The complexity of the data poses an obstacle for analysts to gauge network developments, e.g. detect emerging problems. Visualization is a powerful tool to achieve this, but it is essential to know how the analysts’ sense-making strategies can be supported most efficiently. Based on a think aloud study we identified ten cognitive strategies on a general level to be useful for designers. We also provide some examples how these strategies can be supported through appropriate visualizations

Developing the tissue viability seating guidelines

Background: Costs for the prevention and management of pressure ulcers have increased significantly with limited published advice from health and social care organisations on seating and preventing pressure ulcers. At the request of the UK Tissue Viability Society the aim of the publication was to develop a practical guide for people, carers and health and social care professionals on how the research and evidence base on pressure ulcer prevention and management can be applied to those who remain seated for extended periods of time. Methods and findings: The evidence base informing the guidelines was obtained by applying a triangulation of methods: a literature review, listening event and stakeholder group consultation. The purpose was to engage users and carers, academics, clinicians, inspectorate and charities, with an interest in seating, positioning and pressure management to: gather views, feedback, stories, and evidence of the current practices in the field to create a greater awareness of the issue. Conclusion: The new guidelines are inclusive of all people with short and long-term mobility issues to include all population groups. The document includes evidence on where pressure ulcers develop when seated, risk factors, best possible seated position and what seat adjustments are required, the ideal seating assessment, interventions, self-help suggestions and key seating outcomes. The updated TVS CPGs have been informed by the best available evidence, the insights and wisdom of experts, stakeholders and people who spend extended periods of time sitting

Michael Craton and Gail Saunders - Islanders in the Stream: A History of the Bahamian People.

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