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A drinking party in 1963 precipitated a crisis over newly independent Uganda's sovereignty and the respectability of a new postcolonial ruling elite. Under Kampala's multiracial veneer in the early 1960s lurked bawdy British youth culture and radical African youth politics. When Europeans at a party in the elite suburb of Tank Hill allegedly mocked African aspirations for urban respectability and political sovereignty, UPC (Uganda Peoples Congress) Youth Wing activists used the affair to elicit public expressions of anger at the collusion of conservative politicians and racist former colonizers. Prime Minister Milton Obote attempted to channel that anger into nationalist unity but soon found common cause with British diplomats in expelling intemperate youth from Uganda's governing bureaucracy. The affair points to both the power and the limits of the affective politics of decolonization as well as the relationship between youth wings and the politics of respectability in early postcolonial Africa.
Ongoing challenges in maintaining optimum manual cleaning and disinfection of hospital rooms have created increased interest in “no-touch” decontamination technologies including the use of ultraviolet light (UV). Trials have shown that some UV devices can decrease surface contamination and reduce healthcare-associated infections. Despite substantial marketing of these devices for use in healthcare settings, few data are available regarding the doses of UV-C necessary to yield desired reductions in healthcare pathogens and the ability of mobile devices to deliver adequate doses to various surfaces in patient rooms. This review summarizes the physical aspects of UV that affect the doses delivered to surfaces, the UV-C doses needed to yield 3 log10 reductions of several important healthcare-associated pathogens, the doses of UV-C that can be achieved in various locations in patient rooms using mobile UV-C devices, and methods for measuring UV doses delivered to surfaces.
In this paper, we examine some of the physics behind Vertical Take-Off and Landing (VTOL) flying machines, and some of the emerging technologies that are driving the recent upsurge of new VTOL projects. The paper attempts to put these into context by examining some of the projects that have been publicised over the past couple of years, particularly those that transition from hovering into wing-borne flight. Although much progress has been made, there still needs to be significant breakthroughs in technologies, particularly battery technology, before the dream of fast, quiet and environmentally friendly inter-city VTOL aircraft can be realised.
Around 60 000 people in England live in mental health supported accommodation. There are three main types: residential care, supported housing and floating outreach. Supported housing and floating outreach aim to support service users in moving on to more independent accommodation within 2 years, but there has been little research investigating their effectiveness.
A 30-month prospective cohort study investigating outcomes for users of mental health supported accommodation.
We used random sampling, accounting for relevant geographical variation factors, to recruit 87 services (22 residential care, 35 supported housing and 30 floating outreach) and 619 service users (residential care 159, supported housing 251, floating outreach 209) across England. We contacted services every 3 months to investigate the proportion of service users who successfully moved on to more independent accommodation. Multilevel modelling was used to estimate how much of the outcome and cost variations were due to service type and quality, after accounting for service-user characteristics.
Overall 243/586 participants successfully moved on (residential care 15/146, supported housing 96/244, floating outreach 132/196). This was most likely for floating outreach service users (versus residential care: odds ratio 7.96, 95% CI 2.92–21.69, P < 0.001; versus supported housing: odds ratio 2.74, 95% CI 1.01–7.41, P < 0.001) and was associated with reduced costs of care and two aspects of service quality: promotion of human rights and recovery-based practice.
Most people do not move on from supported accommodation within the expected time frame. Greater focus on human rights and recovery-based practice may increase service effectiveness.
Declaration of interest
H.K., S.P., M.K., S.E., P. McCrone, M.A., S.C., G.L. and G.S. report a grant from National Institute of Health Research during the conduct of the study. All other authors report having no conflicts to disclose.
Depression is a heterogeneous disorder with multiple aetiological pathways and multiple therapeutic targets. This study aims to determine whether atypical depression (AD) characterized by reversed neurovegetative symptoms is associated with a more pernicious course and a different sociodemographic, lifestyle, and comorbidity profile than nonatypical depression (nonAD).
Among 157 366 adults who completed the UK Biobank Mental Health Questionnaire (MHQ), N = 37 434 (24%) met the DSM-5 criteria for probable lifetime major depressive disorder (MDD) based on the Composite International Diagnostic Interview Short Form. Participants reporting both hypersomnia and weight gain were classified as AD cases (N = 2305), and the others as nonAD cases (N = 35 129). Logistic regression analyses were conducted to examine differences between AD and nonAD in depression features, sociodemographic and lifestyle factors, lifetime adversities, psychiatric and physical comorbidities.
Persons with AD experienced an earlier age of depression onset, longer, more severe and recurrent episodes, and higher help-seeking rates than nonAD persons. AD was associated with female gender, unhealthy behaviours (smoking, social isolation, low physical activity), more lifetime deprivation and adversity, higher rates of comorbid psychiatric disorders, obesity, cardiovascular disease (CVD), and metabolic syndrome. Sensitivity analyses comparing AD persons with those having typical neurovegetative symptoms (hyposomnia and weight loss) revealed similar results.
These findings highlight the clinical and public health significance of AD as a chronic form of depression, associated with high comorbidity and lifetime adversity. Our findings have implications for predicting depression course and comorbidities, guiding research on aetiological mechanisms, planning service use and informing therapeutic approaches.
The US, as well as many countries, are being beseeched by more natural and man-made events; both small (e.g., shootings) and geographically vast (e.g., floods). Due to a myriad of issues, traditional first responders i.e., EMS, fire department, and police cannot be expected to be the only trained lifesavers on the scene. In the US (as in many countries), it is imperative to begin the discussion to better understand the role of the “injured” and “immediate” responders and how they interact with the “first” responders.
To open a discussion amongst disaster experts about the merits of training and subsequent promotion of a curriculum for “immediate” responders.
After recent evaluations of events, it is postulated that there are three categories of responders: the injured, the immediate, and the first (EMS, fire department, police). The premise upon which disaster risk reduction and building community resilience are achieved begin with strengthening, empowering, and equipping local populations with the appropriate tools. This would involve education, skills, and training. With the average general public trained, and if they are one of the first two categories, then the community would not only be better able to assist themselves, but also be able to integrate into the recovery process much more quickly and fully. By doing this, they will be empowered to take care of themselves, neighbors, and community, which in turn increases local resilience.
Introduction: Intravenous insertion (IVI) is identified by children as extremely painful and the resultant distress can have lasting negative consequences. There is an urgent need to effectively manage such procedures. Our primary objective was to compare the pain and distress of IVI with the addition of humanoid robot-based distraction to standard care, versus standard care alone. Methods: This two-armed randomized controlled trial (RCT) was conducted from April 2017 to May 2018 at the Stollery Children's Hospital emergency department (ED). Children aged 6 to 11 years who required IVI were included. Exclusion criteria included hearing or visual impairments, neurocognitive delays, sensory impairment to pain, previous enrolment, and discretion of the ED clinical staff. Primary outcomes were measured using the Observational Scale of Behavioural Distress-Revised (OSBD-R) (distress) and the Faces Pain Scale-Revised (FPS-R) (pain). A total of 426 pediatric patients were screened and 340 were excluded. Results: We recruited 86 children, of which 55% (47/86) were male; 9% (7/82) were premature at birth; 82% (67/82) had a previous ED visit; 30% (25/82) required previous hospitalization; 78% (64/82) had previous IV placement and 96% (78/81) received topical anesthesia. The mean total OSBD-R score was 1.49 ± 2.36 (standard care) compared to 0.78 ± 1.32 (robot group) (p = 0.047). The median FPS-R during the IV procedure was 4 (IQR 2,6) in the standard care group alone, compared to 2 (IQR 0,4) with the addition of humanoid robot-based distraction (p = 0.10). Change in parental state anxiety pre-procedure versus post-procedure was not significantly different between groups (p = 0.49). Parental satisfaction with the IV start was 93% (39/42) in the robot arm compared to 74% (29/39) in the standard care arm (p = 0.03). Parents were also more satisfied with management of their child's pain in the robot group (95% very satisfied) compared with standard care (72% very satisfied) (p = 0.002). Conclusion: A statistically significant reduction in distress was observed with the addition of robot-based distraction to standard care. Humanoid robot-based distraction therapy reduces distress and to a lesser extent, pain, in children undergoing IVI in the ED. Further trials are required to confirm utility in other age groups and settings.
Porphyrins are vital pigments involved in biological energy transduction processes. Their abilities to absorb light, then convert it to energy, have raised the interest of using porphyrin nanoparticles as photosensitizers in photodynamic therapy. A recent study showed that self- assembled porphyrin-silica composite nanoparticles can selectively destroy tumor cells, but detection of the cellular uptake of porphyrin-silica composite nanoparticles was limited to imaging microscopy. Here we developed a novel method to rapidly identify porphyrin-silica composite nanoparticles using Atmospheric Solids Analysis Probe-Mass Spectrometry (ASAP-MS). ASAP-MS can directly analyze complex mixtures without the need for sample preparation. Porphyrin-silica composite nanoparticles were vaporized using heated nitrogen desolvation gas, and their thermo-profiles were examined to identify distinct mass- to-charge (M/Z) signatures. HeLa cells were incubated in growth media containing the nanoparticles, and after sufficient washing to remove residual nanoparticles, the cell suspension was loaded onto the end of ASAP glass capillary probe. Upon heating, HeLa cells were degraded and porphyrin-silica composite nanoparticles were released. Vaporized nanoparticles were ionized and detected by MS. The cellular uptake of porphyrin-silica composite nanoparticles was identified using this ASAP-MS method.
Why is it that ruling parties with origins as rebel movements fighting against perceived injustices and exclusion often abandon the ideas and visions of state transformation that they had articulated when they were fighting? Using the case of the Conseil National pour la Défense de la Démocratie–Forces pour la Défense de la Démocratie (CNDD-FDD) in Burundi, this article shows that rather than experiencing an abrupt ideological change when the CNDD-FDD became a ruling party, there had always been ideological divergence within the movement. Over time, progressive ideas of inclusive state transformation were repeatedly sidelined in favour of a focus on resistance, and then state capture. Paradoxically, then, once it became a ruling party the CNDD-FDD reverted to governance practices that were akin to those that had led it to take up arms in the first place. This is not because of an absence of commitment to progressive ideas among some CNDD-FDD members, but because the internal dynamics of the CNDD-FDD meant that those factions relying on power politics eventually gained the upper hand over those that articulated a more progressive, inclusive vision, due in part to their ability to back their ideas with force.
Christian scripture provides good reason to think that Christ's redemptive work has cosmic scope (cf. Colossians 1:19–20). Explanations of how Christ's work might extend to all creation (including any sufficiently human-like extraterrestrials) have not, however, received significant sustained attention in theology. In this article, I consider two attempts to explain the cosmic scope of redemption, and after identifying shortcomings with each explanation, I offer a philosophical anthropology (hylemorphic animalism), which when combined with a principle of soteriology due to Gregory of Nazianzus provides a full explanation for how Christ's redemptive work might extend to all creation.
We describe the production of photovoltaic modules with high-quality large-grain copper indium gallium selenide (CIGS) thin films obtained with the unique combination of low-cost ink-based precursors and a reactive transfer printing method. The proprietary metal-organic inks contain a variety of soluble Cu-, In- and Ga- multinary selenide materials; they are called metal-organic decomposition (MOD) precursors, as they are designed to decompose into the desired precursors. Reactive transfer is a two-stage process that produces CIGS through the chemical reaction between two separate precursor films, one deposited on the substrate and the other on a printing plate in the first stage. In the second stage, these precursors are rapidly reacted together under pressure in the presence of heat. The use of two independent thin films provides the benefits of independent composition and flexible deposition technique optimization, and eliminates pre-reaction prior to the synthesis of CIGS. In a few minutes, the process produces high quality CIGS films, with large grains on the order of several microns, and preferred crystallographic orientation, as confirmed by compositional and structural analysis by XRF, SIMS, SEM and XRD. Cell efficiencies of 14% and module efficiencies of 12% were achieved using this method. The atmospheric deposition processes include slot die extrusion coating, ultrasonic atomization spraying, pneumatic atomization spraying, inkjet printing, direct writing, and screen printing, and provide low capital equipment cost, low thermal budget, and high throughput.
Dicamba-resistant (DR) kochia is an increasing concern for growers in the US Great Plains, including Kansas. Greenhouse and field experiments (Garden City and Tribune, KS, in the 2014 to 2015 growing season) were conducted to characterize the dicamba resistance levels in two recently evolved DR kochia accessions collected from fallow fields (wheat–sorghum–fallow rotation) near Hays, KS, and to determine the effectiveness of various PRE herbicide tank mixtures applied in fall or spring prior to the fallow year. Dicamba dose–response studies indicated that the KS-110 and KS-113 accessions had 5- to 8-fold resistance to dicamba, respectively, relative to a dicamba-susceptible (DS) accession. In separate field studies, atrazine-based PRE herbicide tank mixtures, dicamba + pendimethalin + sulfentrazone, and metribuzin + sulfentrazone when applied in the spring had excellent kochia control (85% to 95%) for 3 to 4 mo at the Garden City and Tribune sites. In contrast, kochia control with those PRE herbicide tank mixtures when applied in the fall did not exceed 79% at the later evaluation dates. In conclusion, the tested kochia accessions from western Kansas had evolved moderate to high levels of resistance to dicamba. Growers should utilize these effective PRE herbicide tank mixtures (multiple sites of action) in early spring to manage kochia seed bank during the summer fallow phase of this 3-yr crop rotation (wheat–corn/sorghum–fallow) in the Central Great Plains.
Schizophrenia and anorexia nervosa were recently added to the list of conditions for which whole genome sequencing might be indicated as part of the 100 000 Genomes Project, reflecting the remarkable recent progress in findings emerging from psychiatric genetics research. Genetic testing methods may offer increased opportunities for diagnosis and estimation of familial risk and could have implications for management and treatment options. They also present ethical and philosophical questions about the role of testing and storage of genetic information. Mental health professionals will need to have a good understanding of this area in order for patients to fully realise the benefits of these advances.
Declaration of Interest
K.S.B. is Editor of the British Journal of Psychiatry.
Chemically defended benthic macroalgae that dominate shallow, hard bottom communities along the western Antarctic Peninsula support very high densities of mesograzers, particularly amphipods but also small gastropods. Previous studies have demonstrated that the macroalgae and amphipods form a mutualistic relationship. The chemically defended macroalgae provide the amphipods with a refuge from predation while the macroalgae benefit from the amphipods greatly reducing surface fouling by smaller algae. One of the three most important macroalgae in terms of overstory cover, Himantothallus grandifolius, forms huge blades that can carpet the benthos. Field observations suggest that gastropods may be higher in relative abundance in proportion to amphipods on H. grandifolius than on other overstory macroalgae. The present study documents the finding that natural abundances of gastropods on H. grandifolius maintained in mesocosms reduce fouling by microscopic algae, primarily diatoms. However, amphipods are probably also important in keeping the macroalga clean of diatoms in nature. In a smaller scale experiment, three gastropod species were differentially effective at reducing diatom coverage on H. grandifolius. The hypothesis that gastropods benefit from associating with H. grandifolius in potentially gaining a refuge from sea-star predation was also tested but not supported by the experimental results.
Poly(ethylene glycol) (PEG)-based materials can potentially be used as biomechanical matrices in regenerative medicine and tissue engineering implants including the replacement of intervertebral (IV) disks. Glycerol and other generally recognized as safe (GRAS) plasticizers (low-MW PEG, propylene glycol, and sorbitol) were added to the bulk PEG matrix and gelled using chemical and photochemical methods at different temperatures (21, 37, 59, and 80 °C) and pressures (0 and 90 MPa gauge) settings, and their compression testing properties were acquired and analyzed. Surface incorporation of custom-made bioactive glass particles shortened the blood clotting time (78% compared to no glass particles), while alginate and laponite additives improved the gel’s mechanical properties to 645 kPa compressive modulus, 12% yield strain, and 79 kPa yield strength. This IV disk-modeled hydrogel system endured the cyclic loading and unloading tests at 4% compressive strain indicative of an elastic response, but required improvement to its biomechanical tolerance for downstream bioengineering applications.