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Chorioamnionitis and intrauterine growth retardation (IUGR) are risk factors for cerebral palsy (CP). Common bacteria isolated in chorioamnionitis include group B Streptococcus (GBS) serotypes Ia and III. Little is known about the impact of placental inflammation induced by different bacteria, including different GBS strains. We aimed to test the impact of chorioamnionitis induced by two common GBS serotypes (GBSIa and GBSIII) on growth and neuromotor outcomes in the progeny. Dams were exposed at the end of gestation to either saline, inactivated GBSIa or GBSIII. Inactivated GBS bacteria invaded placentas and triggered a chorioamnionitis featured by massive polymorphonuclear cell infiltrations. Offspring exposed to GBSIII – but not to GBSIa – developed IUGR, persisting beyond adolescent age. Male rats in utero exposed to GBSIII traveled a lower distance in the Open Field test, which was correlating with their level of IUGR. GBSIII-exposed rats presented decreased startle responses to acoustic stimuli beyond adolescent age. GBS-exposed rats displayed a dysmyelinated white matter in the corpus callosum adjacent to thinner primary motor cortices. A decreased density of microglial cells was detected in the mature corpus callosum of GBSIII-exposed males – but not females – which was correlating positively with the primary motor cortex thickness. Altogether, our results demonstrate a causal link between pathogen-induced acute chorioamnionitis and (1) IUGR, (2) serotype- and sex-specific neuromotor impairments and (3) abnormal development of primary motor cortices, dysmyelinated white matter and decreased density of microglial cells.
Memory and Agency in Ancient China offers a novel perspective on China's material culture. The volume explores the complex 'life histories' of selected objects, whose trajectories as ginle objects ('biographies') and object types ('lineages') cut across both temporal and physical space. The essays, written by a team of international scholars, analyse the objects in an effort to understand how they were shaped by the constraints of their social, political and aesthetic contexts, just as they were also guided by individual preference and capricious memory. They also demonstrate how objects were capable of effecting change. Ranging chronologically from the Neolithic to the present, and spatially from northern to southern mainland China and Taiwan, this book highlights the varied approaches that archaeologists and art historians use when attempting to reconstruct object trajectories. It also showcases the challenges they face, particularly with the unearthing of objects from archaeological contexts that, paradoxically, come to represent the earliest known point of their 'post-recovery lives'.
The aim of this study was to assess the impact of a urinary tract infection (UTI) management bundle to reduce the treatment of asymptomatic bacteriuria (AB) and to improve the management of symptomatic UTIs.
Before-and-after intervention study.
Consecutive sample of inpatients with positive single or mixed-predominant urine cultures collected and reported while admitted to the hospital.
The UTI management bundle consisted of nursing and prescriber education, modification of the reporting of positive urine cultures, and pharmacists’ prospective audit and feedback. A retrospective chart review of consecutive inpatients with positive urinary cultures was performed before and after implementation of the management bundle.
Prior to the implementation of the management bundle, 276 patients were eligible criteria for chart review. Of these 276 patients, 165 (59·8%) were found to have AB; of these 165 patients with AB, 111 (67·3%) were treated with antimicrobials. Moreover, 268 patients met eligibility criteria for postintervention review. Of these 268, 133 patients (49·6%) were found to have AB; of these 133 with AB, 22 (16·5%) were treated with antimicrobials. Thus, a 75·5% reduction of AB treatment was achieved. Educational components of the bundle resulted in a substantial decrease in nonphysician-directed urine sample submission. Adherence to a UTI management algorithm improved substantially in the intervention period, with a notable decrease in fluoroquinolone prescription for empiric UTI treatment.
A UTI management bundle resulted in a dramatic improvement in the management of urinary tract infection, particularly a reduction in the treatment of AB and improved management of symptomatic UTI.
This article draws on the concept of “identity interests” to explain why commitment to the territorial integrity norm in the context of African peace processes has persisted over such a long period of time, even as continental and international contexts have changed. One major implication of this commitment to the territorial integrity norm is that third parties involved in peacemaking in Africa have consistently refrained from promoting a negotiated settlement that might pave the way for independence; they have only pushed for a territorial revision in a few instances. The role of major powers has been crucial with regard to the few successful territorial changes in Africa since 1960. An overview of all outcomes of mediation in territorial intrastate conflicts in Africa—as well as seven case studies—support this argument.
I contrast two perspectives adopted to theorize political authorities. The first is the modern perspective. It conceives of political society as a civic union of free and equal citizens and regards the state as the political organization of this society. This perspective is primarily concerned with the principles that should govern the use of state power. The second is the political pluralist perspective. It recognizes a multiplicity of normative orders as equally legitimate. The focus is put on the civic processes by which a diverse citizenry should negotiate its interactions. I illustrate these perspectives by considering how they approach diversity, and more specifically the political claims of indigenous peoples. The pluralist perspective is argued to be normatively motivated by a consideration for the actual freedom of citizens to sustain diverse normative orders, to negotiate the structure of political society, and to jointly search for justice.