To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Patients with major depressive disorder (MDD) display cognitive deficits in acutely depressed and remitted states. Childhood maltreatment is associated with cognitive dysfunction in adults, but its impact on cognition and treatment related cognitive outcomes in adult MDD has received little consideration. We investigate whether, compared to patients without maltreatment and healthy participants, adult MDD patients with childhood maltreatment display greater cognitive deficits in acute depression, lower treatment-associated cognitive improvements, and lower cognitive performance in remission.
Healthy and acutely depressed MDD participants were enrolled in a multi-center MDD predictive marker discovery trial. MDD participants received 16 weeks of standardized antidepressant treatment. Maltreatment and cognition were assessed with the Childhood Experience of Care and Abuse interview and the CNS Vital Signs battery, respectively. Cognitive scores and change from baseline to week 16 were compared amongst MDD participants with (DM+, n = 93) and without maltreatment (DM−, n = 90), and healthy participants with (HM+, n = 22) and without maltreatment (HM−, n = 80). Separate analyses in MDD participants who remitted were conducted.
DM+ had lower baseline global cognition, processing speed, and memory v. HM−, with no significant baseline differences amongst DM−, HM+, and HM− groups. There were no significant between-group differences in cognitive change over 16 weeks. Post-treatment remitted DM+, but not remitted DM−, scored significantly lower than HM− in working memory and processing speed.
Childhood maltreatment was associated with cognitive deficits in depressed and remitted adults with MDD. Maltreatment may be a risk factor for more severe and persistent cognitive deficits in adult MDD.
In patients with β-lactam allergies, administration of non–β-lactam surgical prophylaxis is associated with increased risk of infection. Although many patients self-report β-lactam allergies, most are unconfirmed or mislabeled. A quality improvement process, utilizing a structured β-lactam allergy tool, was implemented to improve the utilization of preferred β-lactam surgical prophylaxis.
Angiostrongylus cantonensis is a pathogenic nematode and the cause of neuroangiostrongyliasis, an eosinophilic meningitis more commonly known as rat lungworm disease. Transmission is thought to be primarily due to ingestion of infective third stage larvae (L3) in gastropods, on produce, or in contaminated water. The gold standard to determine the effects of physical and chemical treatments on the infectivity of A. cantonensis L3 larvae is to infect rodents with treated L3 larvae and monitor for infection, but animal studies are laborious and expensive and also raise ethical concerns. This study demonstrates propidium iodide (PI) to be a reliable marker of parasite death and loss of infective potential without adversely affecting the development and future reproduction of live A. cantonensis larvae. PI staining allows evaluation of the efficacy of test substances in vitro, an improvement upon the use of lack of motility as an indicator of death. Some potential applications of this assay include determining the effectiveness of various anthelmintics, vegetable washes, electromagnetic radiation and other treatments intended to kill larvae in the prevention and treatment of neuroangiostrongyliasis.
The flora of Mediterranean ecosystems contains families with species having fully and under-developed embryos in their seeds. After-ripening for physiological dormancy release and smoke influence germination in many species. We investigated how after-ripening and embryo growth interact with smoke to influence the temporal dynamics of seedling emergence among fire ephemerals. Seeds were placed in the field and under standardized (50% relative humidity, 30°C) laboratory conditions to test the effects of summer conditions on physiological dormancy loss. Germination was tested with water or smoke compounds (smoke water, KAR1) at a simulated autumn/winter temperature (18/7°C). The timing and amount of seedling emergence with smoke was observed for seeds exposed to near-natural conditions. During summer, physiological dormancy was broken in all species, enabling germination at autumn/winter but not summer temperatures; no embryo growth occurred in seeds with under-developed embryos. At the start of the wet season, seedling emergence from seeds with fully developed embryos occurred earlier than from seeds with under-developed embryos. In a non-consistent manner among our study species, smoke and smoke compounds influenced the rate of embryo growth and amount of germination. Effects of smoke were noticeable in terms of number of emergents in the first emergence season. Among ecologically similar species, we have shown (1) that both thermal and embryo traits exclude germination in the summer, (2) how embryo size influences the timing of seedling emergence in autumn–winter, and (3) a reduced requirement for smoke in the second emergence season after a fire with a shift to reliance on seasonal cues for emergence.
To delineate the timing of, indications for, and assessment of visitor restriction policies and practices (VRPP) in pediatric facilities.
An electronic survey to characterize VRPP in pediatric healthcare facilities.
The Infectious Diseases Society of America Emerging Infections Network surveyed 334 pediatric infectious disease consultants via an electronic link. Descriptive analyses were performed.
A total of 170 eligible respondents completed a survey between 12 July and August 15, 2016, for a 51% response rate. Of the 104 respondents (61%) familiar with their VRPP, 92 (88%) had VRPP in all inpatient units. The respondents reported age-based VRPP (74%) symptom-based VRPP (97%), and outbreak-specific VRPP (75%). Symptom-based VRPP were reported to be seasonal by 24% of respondents and to be implemented year-round according to 70% of respondents. According to the respondents, communication of VRPP to families occurred at admission (87%) and through signage in care areas (64%), while communication of VRPP to staff occurred by email (77%), by meetings (55%), and by signage in staff-only areas (49%). Respondents reported that enforcement of VRPP was the responsibility of nursing (80%), registration clerks (58%), unit clerks (53%), the infection prevention team (31%), or clinicians 16 (16%). They also reported that the effectiveness of VRPP was assessed through active surveillance of hospital acquired respiratory infections (62%), through active surveillance of healthcare worker exposures (28%) and through patient/family satisfaction assessments (29%).
Visitor restriction policies and practices vary in scope, implementation, enforcement, and physician awareness in pediatric facilities. A prospective multisite evaluation of outcomes would facilitate the adoption of uniform guidance.
Large regions of the United States (and the world) face “situational scarcities” of water that arises from energy extraction and use, agricultural practices, expanding urban populations, and poorly integrated water policies.
Creating “fit-for-purpose” water from suboptimal sources will require new materials and a new understanding of the separation of contaminants from complex aqueous media.
We review here scientific, technological, and societal challenges at the nexus of energy, water, and food. We focus on specific examples of energy and water stress in the southwestern United States and technological routes to new sources of water. Situational scarcities of water are increasing worldwide because of the reliance on uncertain water sources, coupled with expanding populations, expanded agricultural uses of water, and water and energy use policies that have not always been effectively integrated. This review is framed using the outcomes of recent National Science Foundation workshops focusing on the Energy/Water/Food Nexus and from other recent U.S. Department of Energy workshops focused on the Energy/Water nexus. Water-stressed regions, even after extensive conservation measures, may need new supplies of water that come from less than optimal sources. A basic understanding of the separation of water from complex aqueous solutions along with new materials, distributed and publically accepted technologies and unit operations, underpin the future production of “fit-for-purpose” water. Regional test beds are required that are small and provide for simultaneous control of a number of variables, yet large enough to approximate real communities. Solutions to these problems represent opportunities for innovation and creation of economically viable, resilient communities.
The objective of this study was to prospectively validate the “Brief Developmental Assessment”, which is a new early recognition tool for neurodevelopmental abnormalities in children with heart disease that was developed for use by cardiac teams.
This was a prospective validation study among a representative sample of 960 pre-school children with heart disease from three United Kingdom tertiary cardiac centres who were analysed grouped into five separate age bands.
The “Brief Developmental Assessment” was successfully validated in the older four age bands, but not in the youngest representing infants under the age of 4 months, as pre-set validation thresholds were met – lower 95% confidence limit for the correlation coefficient above 0.75 – in terms of agreement of scores between two raters and with an external measure the “Mullen Scales of Early Learning”. On the basis of American Association of Pediatrics Guidelines, which state that the sensitivity and specificity of a developmental screening tool should fall between 70 and 80%, “Brief Developmental Assessment” outcome of Red meets this threshold for detection of Mullen scores >2 standard deviations below the mean.
The “Brief Developmental Assessment” may be used to improve the quality of assessment of children with heart disease. This will require a training package for users and a guide to action for abnormal results. Further research is needed to determine how best to deploy the “Brief Developmental Assessment” at different time points in children with heart disease and to determine the management strategy in infants younger than 4 months old.
We compared rotavirus detection patterns before (2001–2006) and after (2008–2015) rotavirus vaccine introduction. We also compared rotavirus detection patterns in odd (2009, 2011, 2013, 2015) and even (2008, 2010, 2012, 2014) years post-vaccine separately. Results of stool rotavirus antigen testing from inpatient, outpatient and emergency department encounters from July 2000 to July 2015 at two paediatric hospital laboratories in Atlanta, Georgia were reviewed. Post-vaccine, rotavirus detection declined (30.2% vs. 13.7% (overall 54.6% decline, P <0.001)), occurred more frequently outside the rotavirus season (19.8% vs. 3.5%; P < 0.001), and was more common among older children (26 vs. 13 median months of age; P < 0.001). During odd years post-vaccine, rotavirus detection was significantly higher than even years (20.2% vs. 6.4%; P < 0.001). Rotavirus detection declined substantially and developed a biennial pattern in the post-vaccine era. The intensity and temporality of rotavirus detection in odd years post-vaccine resembled that observed pre-vaccine, although considerably reduced in magnitude.
The Mediterranean fan worm, Sabella spallanzanii (Gmelin, 1791), is a highly invasive pest species introduced to Australia and New Zealand, with the ability to alter marine ecosystems by outcompeting native species for food and space. Sabella spallanzanii has been established in southern Australia for decades, but was discovered in Botany Bay (NSW, eastern Australia) in 2013. In New Zealand, S. spallanzanii was first detected in March 2008. Using cytochrome c oxidase subunit 1 (COI) sequences, we investigate the phylogeography of the Australian and New Zealand populations of S. spallanzanii, including the possible origins of the recent incursions in both countries. Australian and New Zealand S. spallanzanii show minimal genetic diversity (0.2% divergence) and were dominated by two main haplotypes suggesting a commonality. Our molecular data are insufficient by themselves to identify fine-scale invasion pathways in antipodean S. spallanzanii, but the similar, minimal haplotype diversity in combination with well-constrained field survey data suggests that the New Zealand incursion originated from southern Australia, rather than as a new incursion from the Mediterranean Sea. This highlights the importance of ongoing marine biosecurity surveillance and monitoring as well as improvements to biosecurity protocols for international and domestic vessels. The origin of the eastern Australian (Botany Bay) incursion is plausibly derived from either southern Australia or as a ‘return’ from New Zealand, and requires further, more detailed investigation.
A subset of Post-AGB (PAGB) objects are the highly luminous RV Tauri variables that show similarities to Type-II Cepheids. By using a sample of known RV Tauri stars from the Magellanic Clouds we are able to determine period luminosity relationships (PLRs) in various bands that have been used to determine the luminosities of their Galactic counterparts. We have gathered all available photometry in order to generate an SED for each object and determine the total integrated flux. This total flux combined with a calculated or inferred intrinsic luminosity leads to a distance (Vickers et al. 2015). This distance catalogue has allowed us to begin to constrain the physical parameters of this poorly understood evolutionary phase and to determine links between these physical characteristics as a function of their stellar population.
This special issue of the European journal of applied mathematics features research articles that involve the application of mathematical methodologies to the modelling of a broad range of problems related to crime and security. Some specific topics in this issue include recent developments in mathematical models of residential burglary, a dynamical model for the spatial spread of riots initiated by some triggering event, the analysis and development of game-theoretic models of crime and conflict, the study of statistically based models of insurgent activity and terrorism using real-world data sets, models for the optimal strategy of police deployment under realistic constraints, and a model of cyber crime as related to the study of spiking behaviour in social network cyberspace communications. Overall, the mathematical and computational methodologies employed in these studies are as diverse as the specific applications themselves and the scales (spatial or otherwise) to which they are applied. These methodologies range from statistical and stochastic methods based on maximum likelihood methods, Bayesian equilibria, regression analysis, self-excited Hawkes point processes, agent-based random walk models on networks, to more traditional applied mathematical methods such as dynamical systems and stability theory, the theory of Nash equilibria, rigorous methods in partial differential equations and travelling wave theory, and asymptotic methods that exploit disparate space and time scales.
Whether contact precautions (CP) are required to control the endemic transmission of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) in acute care hospitals is controversial in light of improvements in hand hygiene, MRSA decolonization, environmental cleaning and disinfection, fomite elimination, and chlorhexidine bathing.
To provide a framework for decision making around use of CP for endemic MRSA and VRE based on a summary of evidence related to use of CP, including impact on patients and patient care processes, and current practices in use of CP for MRSA and VRE in US hospitals.
A literature review, a survey of Society for Healthcare Epidemiology of America Research Network members on use of CP, and a detailed examination of the experience of a convenience sample of hospitals not using CP for MRSA or VRE.
Hospital epidemiologists and infection prevention experts.
No high quality data support or reject use of CP for endemic MRSA or VRE. Our survey found more than 90% of responding hospitals currently use CP for MRSA and VRE, but approximately 60% are interested in using CP in a different manner. More than 30 US hospitals do not use CP for control of endemic MRSA or VRE.
Higher quality research on the benefits and harms of CP in the control of endemic MRSA and VRE is needed. Until more definitive data are available, the use of CP for endemic MRSA or VRE in acute care hospitals should be guided by local needs and resources.
Infect Control Hosp Epidemiol 2015;36(10):1163–1172
To investigate the associations of household and neighbourhood socio-economic position (SEP) with indicators of both under- and overnutrition in adolescents and to explore sex differences.
Analysis of anthropometric, household and neighbourhood SEP data from the Birth to Twenty Plus cohort born in 1990. Anthropometric outcomes were BMI (thinness, overweight and obesity) and percentage body fat (%BF; low, high). Associations between these and the household wealth index, caregiver education and neighbourhood SEP tertile measures were examined using binary logistic regression.
Johannesburg–Soweto, South Africa.
Adolescents aged 17–19 years (n 2019; 48·2 % men).
Women had a significantly higher combined prevalence of overweight/obesity (26·2 %) than men (8·2 %) whereas men had a significantly higher prevalence of thinness than women (22·2 % v. 10·6 %, respectively). Having a low neighbourhood social support index was associated with higher odds of high %BF in women (OR=1·59; 95 % CI 1·03, 2·44). A low household wealth index was associated with lower odds of both overweight (OR=0·31; 95 % CI 0·12, 0·76) and high %BF in men (OR=0·28; 95 % CI 0·10, 0·78). A low or middle household wealth index was associated with higher odds of being thin in men (OR=1·90; 95 % CI 1·09, 3·31 and OR=1·80; 95 % CI 1·03, 3·15, respectively). For women, a low household wealth index was associated with lower odds of being thin (OR=0·49; 95 % CI 0·25, 0·96).
The study highlights that even within a relatively small urban area the nutrition transition manifests itself differently in men and women and across SEP indicators. Understanding the challenges for different sexes at different ages is vital in helping to plan public health services.
Recent research has shown that many students continue to understand phenomena in simplified or unproductive ways, even after those understandings are directly contradicted in educational settings (Hake, 1998; Miller et al., 2006). In the context of engineering education, many engineering graduates still do not understand the foundational concepts of solid and fluid mechanics, physics, thermodynamics, digital logic, or other fields. The study of conceptual change and misconceptions is one attempt to understand and address this issue.
Because this field of study is fractious and diverse, we briefly establish some shared vocabulary and understanding of the fundamental processes underlying conceptual change and misconceptions. The following section introduces three primary theories of conceptual change: curriculum, measurement, and theory-focused efforts in engineering education. The chapter concludes with a brief summary and discussion of future directions for research.
We must define conceptual understanding somewhat carefully for our terminology to be useful across the various theoretical frameworks discussed in this chapter. An individual’s conceptual understanding of a topic is the collection of his or her concepts, beliefs, andmental models, where the following definitions apply:
Concepts are pieces or clusters of knowledge, for example, “force,” “mass,” “causation,” and “acceleration.”
Beliefs Concepts are pieces or clusters of knowledge, for example, “force,” “mass,” “causation,” and “acceleration.”
Mental models are groups of meaningfully related beliefs and concepts that allow people to explain phenomena and make predictions; for example, an expert dynamics instructor would use her mental model of Newtonian physics to predict an object’s motion.