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We evaluate the utility of the National Surveys of Attitudes and Sexual Lifestyles (Natsal) undertaken in 2000 and 2010, before and after the introduction of the National Chlamydia Screening Programme, as an evidence source for estimating the change in prevalence of Chlamydia trachomatis (CT) in England, Scotland and Wales. Both the 2000 and 2010 surveys tested urine samples for CT by Nucleic Acid Amplification Tests (NAATs). We examined the sources of uncertainty in estimates of CT prevalence change, including sample size and adjustments for test sensitivity and specificity, survey non-response and informative non-response. In 2000, the unadjusted CT prevalence was 4.22% in women aged 18–24 years; in 2010, CT prevalence was 3.92%, a non-significant absolute difference of 0.30 percentage points (95% credible interval −2.8 to 2.0). In addition to uncertainty due to small sample size, estimates were sensitive to specificity, survey non-response or informative non-response, such that plausible changes in any one of these would be enough to either reverse or double any likely change in prevalence. Alternative ways of monitoring changes in CT incidence and prevalence over time are discussed.
The main feature of the epidemiological transition is a shift in the recorded causes of death from infectious diseases to other morbid conditions. This paper outlines modifications made to Omran's original model and stages of transition, and suggests that without a focus on aetiology and morbidity, these have been basically descriptive rather than explanatory, and potentially misleading because infections have been confirmed as causes of various chronic diseases. Common infections and related immune responses or inflammatory processes contribute to the multifactorial aetiology of morbid conditions that together make a substantial contribution to overall mortality, and infectious causation is suspected for many others because of strong evidence of association. Investigation into possible infectious causes of conditions frequently recorded as the underlying cause of death can be integrated into a framework for comparative research on patterns of disease and mortality in support of public health and prevention. A theory of epidemiological transition aimed at understanding changes in disease patterns can encompass the role in different conditions and chronic diseases of infections contracted over the life course, and their contribution to disability, morbidity and mortality relative to other causes and determinants.
Recent research suggests that the genetic makeup of a pig may contribute to the expression of tail biting (Breuer et al., 2002). To date there has been little investigation into the genetics of tail biting. A significant population of tail biters was found at a commercial pig breeding farm at which an experiment on the genetic basis of the expression of harmful social behaviour was being performed. As pedigree data for each pig on the farm were available, the opportunity was taken to investigate the heritability of tail biting by recording the perpetrators of clinical tail biting.
We report the discovery in the Greenland ice sheet of a discrete layer of free nanodiamonds (NDs) in very high abundances, implying most likely either an unprecedented influx of extraterrestrial (ET) material or a cosmic impact event that occurred after the last glacial episode. From that layer, we extracted n-diamonds and hexagonal diamonds (lonsdaleite), an accepted ET impact indicator, at abundances of up to about 5×106 times background levels in adjacent younger and older ice. The NDs in the concentrated layer are rounded, suggesting they most likely formed during a cosmic impact through some process similar to carbon-vapor deposition or high-explosive detonation. This morphology has not been reported previously in cosmic material, but has been observed in terrestrial impact material. This is the first highly enriched, discrete layer of NDs observed in glacial ice anywhere, and its presence indicates that ice caps are important archives of ET events of varying magnitudes. Using a preliminary ice chronology based on oxygen isotopes and dust stratigraphy, the ND-rich layer appears to be coeval with ND abundance peaks reported at numerous North American sites in a sedimentary layer, the Younger Dryas boundary layer (YDB), dating to 12.9 ± 0.1 ka. However, more investigation is needed to confirm this association.
An account is given of how, when accurate topographic maps of a glacier are available, not only the regimen but also the probable response to a change in the firn limit can be calculated from the area distribution. The derivation of the formula used is explained and an account given of its application in suitable areas of Alaska, where recent climatic changes are discussed.
Glaciers in fjords almost always reach standstill positions at the fjord mouths or at changes in their width. Between such positions the terminus is usually advancing or retreating: the advance may be anomalous compared to glaciers on dry land in the vicinity, and the retreat may be catastrophically rapid. These peculiarities of fjord glaciers can be at least partly explained by considering conditions to be expected in an ideal fjord of constant width: the glacier cannot reach equilibrium by changing the extent of its ablation area or its calving terminus, and these cannot change their altitude with respect to sea-level in response to a rise or fall in the firn limit.
The Grinnell and Terra Nivea Ice Caps are the southernmost in eastern North America. The Grinnell Ice Cap reaches an altitude of 870 m. (2854 ft.). The general tendency is for slight retreat, but one large glacier is advancing. The equilibrium line is considerably lower than on the Penny Ice Cap to the north. Both firn and superimposed ice are important in the economy.
Differences by ethnic group in STI diagnosis rates have long been recognized in England. We investigated whether these may be explained by ethnic disparities in socioeconomic deprivation (SED). Data on all diagnoses made in sexual health clinics in England in 2013 were obtained from the mandatory STI surveillance system. Poisson regression was used to calculate incidence rate ratios (IRRs) of STIs, by ethnicity, with and without adjustment for index of multiple deprivation (IMD) a measure of area-level deprivation. Unadjusted IRRs (95% confidence intervals) were highest for gonorrhoea [8·18 (7·77–8·61) and 5·76 (5·28–6·29)] and genital herpes [4·24 (3·99–4·51) and 3·58 (3·23–3·98)] for people of black Caribbean and non-Caribbean/non-African black ethnicity and IRRs were highest for syphilis [8·76 (7·97–9·63)] and genital warts [2·23 (2·17–2·29)] for people of non-British/non-Irish white ethnicity compared to white British ethnicity. After adjustment for IMD, IRRs for gonorrhoea [5·76 (5·47–6·07)] and genital herpes [3·73 (3·50–3·97)] declined but remained highest for black Caribbeans and IRRs for syphilis [7·35 (6·68–8·09)] and genital warts [2·10 (2·04–2·16)] declined but remained highest for non-British/non-Irish white compared to white British. In England, ethnic disparities in STI diagnosis rates are partially explained by SED, but behavioural and contextual factors likely contribute. Clinic and community-based interventions should involve social peer networks to ensure they are targeted and culturally sensitive.
The recent decline in cardiovascular disease mortality in Western countries has been linked with changes in life style and treatment. This study considers periods of decline before effective medical interventions or knowledge about risk factors. Trends in annual age-standardized death rates from cerebrovascular disease, heart disease and circulatory disease, and all cardiovascular disease are reviewed for three phases, 1881–1916, 1920–1939, and 1940–2000. There was a consistent decline in the cerebrovascular disease death rate between 1891 and 2000, apart from brief increases after the two world wars. The heart disease and circulatory disease death rate was declining between 1891 and 1910 before cigarette smoking became prevalent. The early peak in cardiovascular mortality in 1891 coincided with an influenza pandemic and a peak in the death rate from bronchitis, pneumonia and influenza. There is also correspondence between short-term fluctuations in the death rates from these respiratory diseases and cardiovascular disease. This evidence of ecological association is consistent with the findings of many studies that seasonal influenza can trigger acute myocardial infarction and episodes of respiratory infection are followed by increased risk of cardiovascular events. Vaccination studies could provide more definitive evidence of the role in cardiovascular disease and mortality of influenza, other viruses, and common bacterial agents of respiratory infection.
Patterns of sexual mixing are major determinants of sexually transmitted infection (STI) transmission, in particular the extent to which high-risk populations mix with low-risk populations. However, patterns of mixing in the general population are poorly understood. We analysed data from a national probability sample survey of households, the Health Survey for England 2010. A total of 943 heterosexual couples living together, where at least one partner was aged between 16–44 years, were included. We used correlation coefficients to measure the strength of similarities between partners with respect to demographic characteristics, general health, health behaviours and sexual history. Males were on average 2 years older than their female partners, although this age difference ranged from a median of 0 years in men aged 16–24 years to a median of 2 years in men aged 35–44 years. A positive correlation between partners was found for all demographic characteristics. With respect to general health and health behaviours, a strongly positive correlation was found between men and women in reporting alcohol consumption at ⩾3 days a week and smoking. Men typically reported greater numbers of sexual partners than their female partner, although men and women with more partners were more likely to mix with each other. We have been able to elucidate the patterns of sexual mixing between men and women living together in England. Mixing based on demographic characteristics was more assortative than sexual characteristics. These data can better inform mathematical models of STI transmission.
Multimorbidity - the co-occurrence of two or more long-term conditions in an individual - is highly relevant to psychiatry. Changes to training and a more integrated model of psychiatric and physical healthcare are needed in the future if we are to improve the long-term health of our patients.
Remoras (echeneid fish) reversibly attach and detach to marine hosts, almost instantaneously, to “hitchhike” and feed. The adhesion mechanisms that they use are remarkably insensitive to substrate topology and quite different from the latching and suction cup-based systems associated with other species at similar length scales. Remora adhesion is also anisotropic; drag forces induced by the swimming host increase adhesive strength, while rapid detachment occurs when the remora reverses this shear load. In this work, an investigation of the adhesive system’s functional morphology and tissue properties was carried out initially through dissection and x-ray microtomographic analyses. Resulting finite element models of these components have provided new insights into the adaptive, hierarchical nature of the mechanisms and a path toward a wide range of engineering applications.
Current agricultural practices rely on crops with developmental phenologies adapted to local climate, photoperiods and soils; however, global climate change will alter some abiotic factors (e.g. temperature and precipitation). Previously adapted varieties may be poorly prepared for these changing conditions, if such conditions induce mismatched phenologies. Crops that depend on cross-pollination and synchronous flowering may be most susceptible, e.g. monoecious plants have separate male and female flowers, and changes in flowering synchrony may alter yield. Using genetically diverse (open-pollinated (OP)) and genetically homogeneous (hybrid) varieties of a monoecious crop, courgette, also known as zuchinni (Cucurbita pepo), phenological responses to experimentally manipulated moisture conditions were explored in an agricultural context. Under drier and wetter conditions, the hybrid courgette plants shifted towards a male-biased floral sex ratio due to the reduced production of female flowers. However, flowering synchrony and fruit production were unaffected by moisture treatment in both varieties. The hybrid and OP varieties differed in many traits related to floral sex ratios, phenology, synchrony and fruit production. Further, the OP variety displayed more phenotypic variation than the hybrid in many traits. Being in a population context rather than relying on self-pollination increased the availability of potential mates for a given female flower in both the hybrid and, particularly, the OP variety. Thus, the increased genetic diversity found in OP v. hybrid varieties may buffer the possible environmental effects on flowering synchrony within a cropping context. Finally, the likelihood of female flowers setting fruit increased with the number of male flowers within a population, and the rate of increase was higher in the hybrid variety. In summary, climate change is predicted to reduce investment in female function in some monoecious crops and genetically diverse varieties may play an important role in maintaining reproductive synchrony in altered environments.
Every schoolboy knows that a large fraction of the American public domain was granted to pioneer railroads in the nineteenth century. But was the federal land-grant policy socially beneficial? Professor Mercer provides one imaginative answer based upon an analysis of the economic issues involved and estimates of the private and social rates of return on the investment in the subsidized railroads.