Robert M May

Rationale Non-CF bronchiectasis is associated with recurrent, multi-drug resistant bacterial airway infection, declining lung function, and increased pulmonary exacerbations. This condition is characterized by significant comorbidities and a high treatment burden; however, the prevalence of psychological symptoms in this population remains unreported. Here, we aim to describe the prevalence of anxiety and depression in a non-CF bronchiectasis patient cohort, its association with pulmonary disease severity, and the utilization of algorithmbased intervention tools to coordinate suitable education and treatment responses. Methods Generalized Anxiety Disorder (GAD-7) and Major Depressive Disorder (PHQ-9) questionnaires were electronically administered to sequential adult patients seen in the NIH Clinical Center’s Bronchiectasis Clinic. After summative responses to each questionnaire were scored, ranging …

BackgroundThe majority of children with advanced heart disease in the inpatient setting die in an intensive care unit under 1 year of age following multiple interventions. While pediatric cardiology and palliative care provider attitudes have been described, little is known about pediatric cardiothoracic surgeon attitudes toward palliative care in children with advanced heart disease.ObjectiveTo describe perspectives of pediatric cardiothoracic surgeons regarding palliative care in pediatric heart disease.DesignCross-sectional web-based national survey.ResultsOf the 220 surgeons who were e-mailed the survey, 36 opened the survey and 5 did not meet inclusion criteria (n = 31). Median years of practice was 23.5 (range: 12-41 years), and 87.1% were male. Almost all (90%) reported that they had experience consulting palliative care. While 68% felt palliative care consultation was initiated at the appropriate time, 29 …

E acquainted is an Alien, with a meer your Stranger generous in England, that hath House-keepings; for not been my own part my more particular tyes of service to you my Honoured Lords, have built me up to the height of this Experience, for which this Book now at last dares appear to the World; those times which I tended upon your Honours were those Golden Days of Peace and Hospitality when you enjoyed your own, so as to entertain and releive others.Right Honourable, and Right Worshipful, I have not only been an eyewitness, but interested by my attendance; so as that I may justly acknowledge those Triumphs and magnificent Trophies of Cookery that have adorned your Tables; nor can I but confess to the world, except I should be Guilty of the highest Ingratitude, that the only structure of this my Art and knowledge, I owed to your costs, generous and inimitable Epences; thus not only I have derived my experience, but your Country hath reapt the Plenty of your Humanity and charitable Bounties.

News coverage of the COVID‑19 epidemic makes frequent reference to the reproduction number, R 0, the average number of new cases of a disease that arise from a single case. As well as recognizing its simple mathematical power and the challenges its use poses (see C. Uzoigwe Nature 582, 341; 2020), it is important to understand how it originated.The R 0 concept has been attributed to the late Robert May (1936–2020). Although May championed R 0 and contributed to its application (see RM Anderson and RM May (eds) Population Biology of Infectious Diseases; Springer, 1982), it was first developed more than 60 years ago by the epidemiologist George Macdonald, then director of the Ross Institute of the London School of Hygiene and Tropical Medicine. His aim was to understand quantitatively the transmission of malaria, a mosquito-borne disease (G. Macdonald The Epidemiology and Control of Malaria …

This chapter focuses on “What determines population density?” 1 Ecology is a young science. Arguably the first ecological text is Gilbert White’s Natural History of Selborne, published in 1789. This work goes beyond earlier fascination with descriptive natural history to begin to frame analytical questions about, for instance, what governs the abundance—-and vastly different fluctuations in abundance—of swifts and wasps in Selborne, in the United Kingdom. The nineteenth century saw what I believe to be the most important advance in humanity’s intellectual history, with the advent of Darwin’s and Wallace’s understanding of the basic ideas of evolution by natural selection. But this nineteenth-century advance in our comprehension of the evolutionary drama was not matched by analytical advances in exploration of the ecological stage on which it is played. In describing the “struggle for existence” that underlies evolution, Darwin reached, for instance, for metaphors of wedges in a barrel to illuminate a discussion of what we might call “competition for niche space among species.” But there was, at that time, no attempt—either quantitative or qualitative—to measure the shape and size of the wedges or niches, much less to see if or how they fit together in the barrel. In short, ecological studies lagged behind evolutionary ones in the nineteenth century. All biological populations fluctuate in abundance over time. The degree of fluctuation varies greatly among populations, affected both by their external environment and by other factors, whose effects may or may not depend on population density. The long-term average about which any given population …