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To: (i) understand the nutrition attitudes, self-efficacy, knowledge and practices of school food-service personnel (SFP) in Nebraska and (ii) identify potential barriers that schools face in offering healthy school meals that meet the US Department of Agriculture (USDA) nutrition standards.
Convergent parallel mixed-methods study.
Kindergarten–12th grade schools in Nebraska, USA.
SFP (260 survey participants; fifteen focus group participants) working at schools that participate in the USDA National School Lunch Program.
Mixed-methods themes identified include: (i) ‘Mixed attitudes towards healthy meals’, which captured a variety of conflicting positive and negative attitudes depending on the situation; (ii) ‘Positive practices to promote healthy meals’, which captured offering, serving and promotion practices; (iii) ‘Mixed nutrition-related knowledge’, which captured the variations in knowledge depending on the nutrition concept; and (iv) ‘Complex barriers’, which captured challenges with time, support and communication.
The study produced relevant findings to address the barriers identified by SFP. Implementing multicomponent interventions and providing training to SFP may help reduce some of the identified barriers of SFP.
The purpose of this study was to analyse the comparison of intensity-modulated radiation therapy quality assurance (IMRT QA) using Gafchromic® EBT3 film, Electronic portal imaging device (EPID) and MapCHECK®2.
Pretreatment authentication is the main apprehension in advanced radiation therapy treatment plans such as IMRT.
Materials and methods
A total of 20 patients were planned on Eclipse treatment planning system using 6 and 15 MV separately.
Gamma index of EBT3 film results shows the following average passing rates: 97% for 6 MV and 96·6% for 15 MV using criteria of ±5% of 3 mm, ±3% of 3 mm and ±3% of 2 mm for brain. However, by using ±5% of 3 mm and ±3% of 3 mm criteria, the average passing rates were 95·4% on 6 MV and 95·2% on 15 MV for prostate. For EPID, the results show the average passing rates as 97·8% for 6 MV and 97·2% for 15 MV in for brain. In cases in which ±5% of 3 mm and ±3% of 3 mm were used, the average passing rates were 96·6% for 6 MVand 96·1% for 15 MV for prostate. MapCHECK®2 results show average passing rates of 96·4% for 6 and 96·2% for 15 MV, respectively, for brain using criteria of ±5% of 3 mm, ±3% of 3 mm and ±3% of 2 mm, whereas for ±5% of 3 mm and ±3% of 3 mm the average rates are 95·2% for 6 and 94·7% for 15 MV in prostate.
The EPID results are better than the other methods, and hence EPID can be used effectively for IMRT pretreatment verifications.
To investigate the predictive ability of the previously established global cerebrovascular disease (CeVD) burden scale on long-term clinical outcomes in a longitudinal study of Asian elderly participants across the spectrum of cognitive impairment.
A case-control study was conducted over a 2-year period involving participants with no cognitive impairment, cognitive impairment-no dementia (CIND), and Alzheimer's disease (AD). Annually, cognitive function was assessed with a comprehensive neuropsychological battery and the clinical dementia rating (CDR) scale was used to stage disease severity.
Of 314 participants, 102 had none/very mild CeVD, 31 mild CeVD, 94 moderate CeVD, and 87 severe CeVD at baseline. There was a 1.14 and 1.42 units decline per year on global cognitive z-scores in moderate and severe CeVD groups, respectively, compared to none/very mild CeVD. Moderate-severe CeVD predicted significant functional deterioration at year 2 (HR = 2.0, 95% CI = 1.2–3.4), and conversion to AD (HR = 6.3, 95% CI = 1.7–22.5), independent of medial temporal atrophy.
The global CeVD burden scale predicts poor long-term clinical outcome independent of neurodegenerative markers. Furthermore, CeVD severity affects the rate of cognitive and functional deterioration. Hence, cerebrovascular burden, which is potentially preventable, is a strong prognostic indicator, both at preclinical and clinical stages of AD, independent of neurodegenerative processes.
This exploration is intended to measure tissue maximum ratios (TMRs) in smaller fields through CC01 detector and to compare CC01 measured TMRs with Pinnacle treatment planning software (TPS) calculated TMRs.
Materials and methods
CC01 compact chamber detector was used to measure TMR in water phantom for 6 and 18 MV beam delivered from Varian linear accelerator. Pinnacle TPS was employed in this study to calculate TMR from the measured percentage depth doses data. CC01 measured TMR data was compared with the calculated TMR data at depths from 5 to 20 cm for field sizes varying from 1 to 10 cm2.
For the smallest given field size of 1 cm2, CCO1 measured 13·95% higher TMR value for 18 MV beam than that for 6 MV beam. At 20 cm depth for 1 cm2 field size, TMR due to 18 MV beam was 52·4% higher than the TMR due to 6 MV beam. For 6 MV beam, the maximum difference appeared between the measured TMR and pinnacle calculated TMR was 2·8% and for 18 MV beam, the maximum difference was 4%.
For both 6 and 18 MV beam, there was good agreement between CC01 measured and Pinnacle calculated TMRs for the field sizes ranging from 1 to 10 cm2. This exploration can be extended to the determination of other dosimetric parameters like TARs, TPRs in small fields.
This study aimed to examine the dosimetric properties of Gafchromic® EBT3 film and intensity-modulated radiation therapy quality assurance (IMRT QA).
Materials and methods
Beams characteristics dosimetric properties and 20 IMRT plans were created and irradiated on Varian dual-energy DHX-S Linac for 6 and 15 MV energies. EBT3 films were analysed using ‘film Pro QA 2014’ software.
The dosimetric comparison of EBT3 film (for red channel dosimetry) and ionisation ion chamber measurement showed that average deviations of symmetry, flatness, central axis, penumbra (left) and penumbra (right) of dose profile were 0·18, 1·34, 0·49%, 3·68 and 3·61 mm for 6 MV and 0·10, 1·3, 0·45, 2·65 and 2·71 mm for 15 MV, respectively. The blue and green channels dosimetry showed greater dose deviation as compared with red channel. IMRT QA verification plan complied about 95% at all different criteria. Reproducibility, stability and face orientation of film were within 1·4% for red channel.
The results advocate that the film can be used not only for dosimetric assessment but also as a reliable IMRT QA tool.
Small field dosimetry is complicated and accuracy in the measurement of total scatter factor (TSF) is crucial for dosimetric calculations, in making optimum intensity-modulated radiotherapy plans for treating small target volumes. In this study, we intended to determine the TSF measuring properties of CC01 and CC04 detectors for field sizes ranging from sub-centimetre to the centimetre fields.
Material and methods
CC01 and CC04 chamber detectors were used to measure TSF for 6 and 18 MV photon beam delivered from the linear accelerator, through small fields in a water phantom. Small fields were created by collimator jaws and multi-leaf collimators separately, with field sizes ranging from 0·6 to 10 cm2 and 0·5 to 20 cm2, respectively.
CC01 measured TSF at all the given field sizes created by jaws and multi-leaf collimators for both 6 and 18 MV beams whereas CC04 could not measure TSF for field sizes <1 cm2 due to volume averaging and perturbation effects.
CC01 was shown to be effective for measurement of TSF in sub-centimetre field sizes. CC01 can be employed to measure other dosimetric quantities in small fields using different energy beams.
To investigate the presence of neuropsychiatric symptoms (NPS) and sub-syndromes in elderly community-dwelling Asians with varying severity of cognitive impairment.
Chinese and Malay participants (n = 613) from the Epidemiology of Dementia in Singapore (EDIS) Study aged ≥ 60 years underwent clinical examination, neuropsychological testing, and NPS assessment using the Neuropsychiatric Inventory (NPI). Diagnosis of no cognitive impairment (NCI), cognitive impairment-no dementia (CIND), including CIND-mild and CIND-moderate, and dementia were made using established criteria.
A significant increase in the numbers of NPS was observed accompanying with increasing severity of cognitive impairment (p < 0.001). Compared to those with NCI/CIND-mild, participants with CIND-moderate [Odds ratio (OR): 4.2, 95% confidence interval (CI): 1.8–10.0] or dementia [OR: 9.2, 95% CI: 2.3–36.0] were more likely to have two or more neuropsychiatric sub-syndromes. Participants with CIND-moderate were more likely to have hyperactivity [OR: 2.0, 95% CI: 1.0–3.8] and apathy [OR: 2.9, 95% CI: 1.0–8.4] sub-syndromes, whereas patients with dementia were more likely to have psychosis [OR: 6.9, 95% CI: 2.4–20.1], affective (OR: 8.7, 95% CI: 1.8–42.9), and hyperactivity (OR: 5.4, 95% CI: 1.8–16.1). Furthermore, executive dysfunction and visual memory impairment were associated with the presence of three neuropsychiatric sub-syndromes; whist language and visuomotor speed impairment were related to the presence of two sub-syndromes. By contrast, impairment in attention, verbal memory, and visuoconstruction were not associated with any of the sub-syndromes.
The presence of NPS and sub-syndromes increase with increasing severities of cognitive impairment, and different neuropsychiatric syndromes are associated with specific impairment on cognitive domains in community-dwelling Asian elderly.
In Pakistan, although the sea cucumber fishery has not yet been developed, Holothuria arenicola is abundant on its coast. Nineteen months of sampling was carried out to study the population structure, allometric relationships and reproductive status of H. arenicola stocks in Manora and Buleji rocky shores. All measured biometric characters showed significant temporal variations and width/length, weight/length, gutted weight/length and gutted weight/weight relationships followed negative allometry, indicating a change in body shape as the animal grows. Length-frequency distribution analysis was bimodal in both summer and autumn consisting of small-sized and medium-sized individuals while in winter and spring three modes were found at Manora. At Buleji, the population was unimodal in all seasons consisting of small-sized individuals. Sex in H. arenicola cannot be determined externally but can be identified on examination of gonad colour which is orange-like in females and creamy yellow in males. The sex was further confirmed on histological examination and maturation was divided into five stages, i.e. undetermined, early developing, late developing, mature and partially spawned. The sex ratio in H. arenicola was approximately 1:1 and increase in gonad index was observed during spring and early summer, followed by a decrease in GI in autumn and winter, which showed the spawning followed by resting phase. The GI showed a significant negative correlation with salinity and non-significant correlation with temperature. There is a need to undertake more biological/ecological studies on H. arenicola in order to take effective measures for its management.
Background: Cognitive Behaviour Therapy for Psychosis (CBTp) has a strong evidence base and is practised widely in the Western World. Psycho-social interventions, on the other hand, including Cognitive Behaviour Therapy (CBT) are hardly used in the low and middle income countries for psychosis. It has been suggested that adaptations in content, format and delivery are needed before CBT can be used outside the Western cultures. We describe preliminary evaluation of Culturally Adapted Cognitive Behaviour Therapy for Psychosis (CaCBTp) in in-patient settings in Lahore, Pakistan. Aims: We aimed to evaluate the efficacy of culturally adapted CBT for psychosis (CaCBTp) in Pakistan in a pilot project. Method: In a randomized controlled trial we tested CaCBTp against treatment as usual (TAU) in in-patient settings in Pakistan. Those diagnosed with schizophrenia according to the DSM-IV-TR, and who fulfilled the inclusion criteria, were recruited into the study. Patients (n = 42) were randomized into two equal groups, i.e. CaCBTp and TAU. Assessments were carried out both at the baseline and then at the end of the therapy by raters blind to the groupings. Psychopathology was measured using PANSS (Positive and Negative Syndrome Scale of Schizophrenia), PSYRATS (Psychotic Symptom Rating Scales), and the Insight Scale. Results: Patients receiving CaCBTp showed statistically significant improvement on measures of positive symptoms (p = .000), negative symptoms (p = .000), overall psychotic symptoms (p = .000), hallucinations (p = .000), delusions (p = .000) and insight (p = .000) at the end of the therapy. Conclusions: The CaCBTp was effective in reducing symptoms of psychosis and in improving insight in in-inpatient settings in Pakistan.
This article examines a previously overlooked publication titled The Indian Voice of British East Africa, Uganda and Zanzibar. Printed in Nairobi between 1911 and 1913, the Indian Voice has been dismissed by some scholars as “insignificant” in the wider context of Kenya’s militant press. As an important tool for discovering, exploring and analyzing the nature of racial hierarchies, diasporic identity and belonging, this article argues that the Indian Voice can be used to understand how “new kinds of self-representation” both emerged and dissolved in early twentieth-century East Africa. By contextualizing the historical significance of the newspaper, it demonstrates how the Indian Voice offers an invaluable means of generating new insights into the complex cultural and political formulations of Indian identities in diaspora. In doing so, this article contributes to remapping the historical perspective of East African Indians within the early colonial period.
We examined the discriminant validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in detecting multiple-domain mild cognitive impairment (md-MCI) in a Chinese sub-sample drawn from elderly population-based study.
This study included Chinese participants from the Epidemiology of Dementia in Singapore (EDIS) study aged ≥ 60 years who underwent cognitive screening with the Abbreviated Mental Test and Progressive Forgetfulness Questionnaire. Screen-positive participants subsequently underwent MoCA, MMSE, and a comprehensive formal neuropsychological battery. MCI was defined by Petersen's criteria and further classified into single-domain MCI (sd-MCI) and md-MCI. Area under the receiver operating characteristic curve (AUC) with 95% confidence intervals (CIs) was computed for the MoCA and the MMSE in detecting md-MCI.
A total of 300 participants were recruited: 128 (42.7%) were diagnosed with no cognitive impairment (NCI), 47 (15.7%) with sd-MCI, and 83 (28.0%) with md-MCI. Forty-one participants were excluded, 7 (2.3%) had dementia, and 34 (11.3%) had only objective cognitive impairment without subjective complaints. Although the MoCA had a significantly larger AUC than the MMSE (0.94 (95% CI = 0.91–0.97) vs. 0.91 (95% CI = 0.86–0.95), p= 0.04), at optimal cut-off points, the MoCA (19/20) was equivalent to the MMSE (25/26) in detecting md-MCI (sensitivity: 0.80 vs. 0.87, specificity: 0.92 vs. 0.80).
Both screening tests had good discriminant validity and can be used in detecting md-MCI in a sub-sample of Chinese drawn from a population-based study.
A variety of skeletal abnormalities can be seen in the newborn period as the result of a myriad of underlying disease processes that affect bone development. These include metabolic, genetic, endocrine, and infectious etiologies. The metabolic differential is vast, but most common are the bone changes associated with prematurity. In addition, fractures either due to underlying bony insufficiency or due to trauma can be seen.
Radiology plays an important role in the investigation of all skeletal abnormalities in the newborn period. The primary imaging modality is x-ray. CT and MRI may be indicated in special circumstances. Ultrasound is a very useful supplementary imaging modality.
Metabolic bone disease
Osteopenia of prematurity
Poor mineral stores in the preterm infant result from the loss of the normal third trimester accretion of minerals. This may then be compounded by increased mineral demands and decreased activity and tone in the sick preterm. Finally, if there is inadequate vitamin D supplementation, further demineralization ensues. Collectively, this may result in metabolic bone disease of the preterm, known as osteopenia of prematurity.
The first radiological signs are usually seen between 6 and 12 weeks of post-natal life. Biochemical investigations, such as serum calcium and alkaline phosphatase, correlate poorly with bone mineralization. This is often noted on x-rays performed for other reasons, most oft en a CXR. Hence, it is important to ensure that all images for preterms include an interpretation of the bones.
Electrically conducting fibers of polyaniline doped with Camphorsulfonic acid PAn.HCSA in the Polyethylene Oxide (PEO) matrix were prepared using the non-mechanical electrospinning technique. The morphology of the fibers was studied using the scanning electron microscope (SEM) and Transmission electron microscope (TEM), showing a uniform thickness along the fiber length. The fibers had a diameter ranging from 800nm to 2μm. The electrical conductivity of the non-woven fibrous mat and the cast film was measured using the four-point probe method, for different concentrations of Pan.HCSA in the blend. Some possible factors affecting the electrical conductivity of the fibers/films were discussed.
Silicon Carbide (SiC) nanofibers were synthesized from SiC powder dispersed in polyethylene oxide (PEO) solution in Chloroform using the electrospinning technique. The as-spun fibers were then annealed at 1000ËC to 7 hours. The average diameter of the annealed fibers is 500 nm while the length of the annealed fibers is about 50 Âµm. The fibers were characterized using scanning electron microscope (SEM), X-ray diffraction (XRD) and Cathodoluminescence (CL). PL spectra from the annealed SiC fibers show a broad emission in the red-infrared spectral regime. The main peak is centered at 774 nm while the shoulder on the left is at 740 nm
Using the electrospinning technique, we have prepared [Ru (pic) 2 (dmso) 2] doped-polyethylene oxide nanofibers for ultraviolet sensing. The diameter of the as-prepared fibers is in the range of 1μm-100nm. These fibers change color from pale yellow to orange when exposed to ultraviolet light (wavelength∼350nm) and return to their original color after approximately 2-3 days. The intensity of the color increases with an increased time of exposure to UV. The color changing behavior in the nanofibrous mat is almost the same as that in cast films prepared from the same solutions. The scanning electron microscope (SEM) studies of the fibers show that the morphology of the fibers remains unchanged after exposure to UV.
ZnO nanofibers doped with Ga, In and Er metals have been fabricated by electrospinning technique. The diameter of the fibers was in the range of 0.5-2 μm and the length can be up to several feet. After spinning fabrication step the samples were dried out and annealed at 900 °C in air. Room temperature photoluminescence (PL) spectra measured for undoped and In- and Ga-doped ZnO fiber samples exhibit only a strong near band edge (NBE) emission at ∼380 nm with very weak green band at 525 nm. In contrary, the PL spectrum of Er-doped ZnO fibers shows a very weak NBE and strong green emission band at ∼550 nm at 300 K. The electrospinning mechanism used for the fabrication of nanofibers was found to be productive, simple and easy to implement disregarding of the doping type and concentration.