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.
This paper integrates seemingly disjoint studies on consumer behavior in micro and macroanalyses via an intertemporal two-stage budgeting procedure with durable goods and liquidity constraints. The model specifies an indirect utility function as a function of nondurable consumption, commodity (nondurables) prices, and durables stock, and derives the demand functions for nondurable goods. A demand function for durable goods is derived in an adjustment cost framework. The consumption growth equation accounts for relative price effects with precautionary saving, durables stock, and liquidity constraints. The stochastic discount factor is approximated by a time-varying linear function of nondurable consumption growth, commodity price growth, durables stock growth, and disposable income growth. The demand functions for six nondurable goods and services are jointly estimated with the Euler equations for bonds, stocks, and durable goods with allowance for liquidity constraints, using US data. Estimation provides new findings for intertemporal consumption and a multifactor consumption-based capital asset pricing model.
Additive Manufacturing (AM) offers the potential to increase the ability to customise large-scale plastic components. However, a substantial amount of manual work is still required during the customisation process, both in design and manufacturing.
This paper looks into how the additive manufacturing of mass customised large-scale products can be supported. Data was collected through interaction with industrial partners and potential customers in a case study regarding the customisation of kayaks.
As a result, the paper proposes a model-based methodology which combines design automation with a user interface.
The results point to the benefit of the proposed methodology in terms of design efficiency, as well as in terms of displaying results to the end user in an understandable format.
Background: In Alberta in 2016 more people died from an opioid overdose than from motor vehicle crashes. Naloxone is an opioid antagonist - it can reverse an opioid overdose for a period of 30 to 60 minutes. Naloxone kits are available free at emergency departments and community organizations around the province with training provided at the point of pickup. It is possible that training may be refused or may be forgotten and people are often left to rely solely on the instructions included in the kit. Human centred design can improve the way people interact with overdose instructions. Aim Statement: This study will measure the effectiveness and usefulness of prototype community naloxone kit instructions over a six month period of time (2018) in Calgary and Edmonton with the aim to use human centred design principles to improve the way people interpret emergency overdose response directions. Measures & Design: Information design experts engaged people with lived experience to provide a process map outlining the current role that educational materials and instructions for community naloxone kits play in responding to an opioid overdose. Alberta Health Services (AHS) Human Factors, in collaboration with AHS harm reduction developed the protocol and administered pre- and post-questionnaire and specific ‘performance checkpoints’ intended to measure effectiveness and usefulness. A simulated overdose including a mannequin, injection trainer and anatomical paper diagram was designed and a community naloxone kit with instructions setting was provided. Participants were recruited through harm reduction nurses with pre-existing clinical relationships (experienced group), family and friends of people who use opioids and general public (non-experienced) through the University of Alberta Faculty of Art and Design. Evaluation/Results: A total of 30 voluntary participants provided their informed consent and engaged in a simulated overdose scenario using a set of prototype instructions developed by a professional information designer. Through repeated data sampling, the following points were observed and will be integrated in the next iteration of design: It isn't clear to people what opioids are. It isn't clear to people that giving a dose of naloxone will not harm a person, especially if they have not overdosed. Almost none of the participants called 911. People seem to read pictures and text equally in the non-experienced group, but in the experienced group, typically read the pictures. Many participants stated that they knew how to do rescue breaths, but did not perform them correctly. Performing the procedure is a not the same as being asked about how to perform the procedure. Discussion/Impact: Even with new instructional prototypes, many participants identified components that were unclear or confusing. The experienced group made less mistakes than the non-experienced group. They seemed to be more invested or interested in saving a friend's life. These instructions will go through another round of design to incorporate feedback from end users. The final product will be part of a larger provincial emergency medicine initiative that includes participant led design and education around emergency response in opioid overdose settings.
Acute tonsillitis represents a significant proportion of admissions to ENT departments nationally. Given current hospital pressures, it is vital to look for safe alternatives to admission. This study explores the safe management of patients in an ambulatory medical unit, without the need for admission.
A retrospective review of 48 patients’ notes was carried out. Following the development and implementation of a guideline for acute tonsillitis, a prospective re-audit of 41 patients was carried out, measuring length of stay, overnight admissions and re-admissions.
The rate of overnight admission following implementation of the guideline fell from 0.75 to 0.29, and average length of stay dropped from 19.2 to 9.5 hours. There were two re-admissions in each cycle of the audit, which represents a non-significant increase.
The tonsillitis guideline has significantly reduced admissions and length of stay. Re-admissions remain low, demonstrating that this is a safe and cost-effective intervention.
X-ray spectrometric analysis is examined as an analytical tool for elemental determinations of atmospheric aerosols. Contamination levels of the several filters used for collection purposes are examined and the results reported. A calibration technique is described for analysis of several elements in the microgram range based on collection of saturated vapors of aqueous salt solutions. The calibration curves together with an analysis of sensitivity and lower limits of detection are shown. The technique is employed to monitor continuously aerosol content in the atmosphere during passage of a cold front.
In the face of limited carbon budgets, negative emissions technologies (NETs) offer hopes of removing greenhouse gases from the atmosphere. It is difficult to determine whether the prospect of NETs is significantly deterring or delaying timely action to cut emissions. This paper sets out a novel theoretical perspective to this challenge, enabling analysis that accounts for interactions between technologies, society and political and economic power. The paper argues that, seen in this light, the scope of NETs to substitute for mitigation may be easily exaggerated, and thus that the risk of harm from mitigation deterrence should be taken seriously.
Children with intellectual and developmental disabilities (IDD) are likely to receive high-risk prescribing practices, such as polypharmacy, long-term use of psychotropic medications, and overuse of antipsychotics. Behavioural interventions, such as applied behavioural analysis, are evidence-based practices for children with IDD and should be the first-line treatment. Short-term use of psychotropic medications may be helpful in reducing the severity and frequency of challenging behaviours while evidence-based behavioural interventions are pursued. In this essay, we offer practical guidelines for better care.
Grommet insertion is a common surgical procedure in children. Long waiting times for grommet insertion are not unusual. This project aimed to streamline the process by introducing a pathway for audiologists to directly schedule children meeting National Institute for Health and Care Excellence Clinical Guideline 60 (‘CG60’) for grommet insertion.
Method and results
A period from June to November 2014 was retrospectively audited. Mean duration between the first audiology appointment and grommet insertion was 294.5 days (median = 310 days). Implementing the direct-listing pathway reduced the duration between first audiology appointment and grommet insertion (mean = 232 days; median = 231 days). There has been a reduction in the time between the first audiology appointment and surgery (mean difference of 62.5 days; p = 0.024), and a reduction in the time between second audiology appointment and surgery (28 days; p = 0.009).
Direct-listing pathways for grommet insertion can reduce waiting times and expedite surgery. Implementation involves a simple alteration of current practice, adhering to National Institute for Health and Care Excellence Clinical Guideline 60. The ultimate decision regarding surgery still rests with ENT specialists.
Mastitis can prove expensive in sheep reared for meat production due to costs associated with treatment methods, poor lamb growth and premature culling of ewes. The most commonly used method to detect mastitis, in dairy systems, is somatic cell counts. However, in many meat-producing sheep flocks ewes are not routinely handled, thus regular milk sampling is not always possible. It is, therefore, worthwhile to investigate alternative phenotypes, such as those associated with udder conformation and methods of evaluating somatic cell counts in the milk, such as the California Mastitis Test. The main objectives of this study were therefore: (a) to estimate genetic parameters of traits relating to mastitis and udder conformation in a meat sheep breed; (b) estimate the level of association between somatic cell counts and the California Mastitis Test and (c) assess the relationships between mastitis and both udder conformation and lamb live weights. Data were collected from Texel ewes based on 29 flocks, throughout the UK, during 2015 and 2016. The ewes were scored twice each year, at mid- and late-lactation. Eight different conformation traits, relating to udder and teat characteristics, and milk samples were recorded. The data set comprised of data available for 2957 ewes. The pedigree file used contained sire and dam information for 31 775 individuals. The animal models used fitted relevant fixed and random effects. Heritability estimates for traits relating to mastitis (somatic cell score and the California Mastitis Test), ranged from 0.08 to 0.11 and 0.07 to 0.11, respectively. High genetic correlations were observed between somatic cell score and the California Mastitis Test (0.76 to 0.98), indicating the California Mastitis Test to be worthwhile for assessing infection levels, particularly at mid-lactation. The strongest correlations observed between the mastitis traits and the udder conformation traits were associated with udder depth (0.61 to 0.75) also at mid-lactation. Negative phenotypic correlations were estimated between mastitis and the weight of lamb reared by the ewe (−0.15 to −0.23), suggesting that lamb weights fell as infection levels rose. Genetic correlations were not significantly different from zero. Reducing mastitis will lead to improvements in flock productivity and the health and welfare of the animals. It will also improve the efficiency of production and the resilience to disease challenge. The economic benefits, therefore, of these results combined could be substantial not only in this breed but also in the overall meat sheep industry.
The presence of footrot in a flock can have serious implications for animal health, welfare and productivity. Associated increases in treatment and prevention costs, as well as losses in performance, have led to a notable interest in using breeding to control footrot in sheep. Current breeding indexes for UK hill sheep such as the Scottish Blackface, include both lamb and maternal traits, and have led to improvements in economic returns. So that breeding for resistance to footrot can be evaluated in the context of multi-trait selection programmes, the genetic relationships with current breeding goal traits must be quantified. The objective of this study was to identify important environmental factors affecting footrot prevalence and to estimate genetic parameters between footrot severity and other traits used in current UK hill sheep breeding indexes.
The primary goal for all involved in the care of women in labor is a healthy mother and baby after delivery. For most pregnancies, which are low risk, delivery by cesarean section appears to pose greater risk of maternal morbidity and mortality than vaginal delivery and can have significant implications for future pregnancies.
To investigate the feasibility of a national audit of epistaxis management led and delivered by a multi-region trainee collaborative using a web-based interface to capture patient data.
Six trainee collaboratives across England nominated one site each and worked together to carry out this pilot. An encrypted data capture tool was adapted and installed within the infrastructure of a university secure server. Site-lead feedback was assessed through questionnaires.
Sixty-three patients with epistaxis were admitted over a two-week period. Site leads reported an average of 5 minutes to complete questionnaires and described the tool as easy to use. Data quality was high, with little missing data. Site-lead feedback showed high satisfaction ratings for the project (mean, 4.83 out of 5).
This pilot showed that trainee collaboratives can work together to deliver an audit using an encrypted data capture tool cost-effectively, whilst maintaining the highest levels of data quality.
In the orthodox, “Whig” interpretations of the history of education of nineteenth-century France the focus of attention has traditionally been on the triumph of free, obligatory and secular education. In recent years historians have attempted to provide a more balanced picture by also chronicling the activities of the “losers” in this confrontation — the defenders of religious education. But one group has been left out of both accounts—the propagandists for a working-class education free of the interference of both the Catholic Church and the capitalist state. Of this latter group of thinkers the most interesting was Paul Robin, not simply because his views were the most radical, but because for over a decade this educational anarchist controlled an institution in which he could test his theories in practice. The purpose of the following account of Robin's work is first to illustrate the links that bound together the sexual, political and educational concerns of the libertarian left and secondly to show how deeply rooted in the past century are the current debates regarding the education of women and workers.
Green galenia is a South African woody prostrate perennial that was first recorded in Australia in the early 1900s and has since become a serious threat to indigenous temperate grasslands and surrounding agricultural areas. Laboratory and field based experiments were conducted to examine the effect of environmental factors on the germination and viability of green galenia seed. It was shown that green galenia was able to germinate over a broad range of temperatures, but short bursts (5 min) of high temperatures (80 C to 120 C replicating possible exposures to a fire) reduced seed germination. Seed germination was positively favored by light, declined rapidly in darkness, and decreased by > 80% at a depth of only 0.5 cm in soil. Water stress greatly reduced seed germination (45% germination at osmotic potentials below −0.2 MPa). Germination was completely inhibited at water potentials of −0.4 to −1.0 MPa. This species is moderately tolerant to salinity, with over 50% of seeds germinating at low levels of salinity (60 mM NaCl), and moderate germination (49%) occurring at 120 mM NaCl, it can germinate well in both alkaline (pH 10–83%) and acidic (pH 4–80%) conditions. The results of this study have contributed to our understanding of the germination and emergence of green galenia, and this will assist in developing tools and strategies for the long term management of this noxious weed in Victoria and other parts of Australia.
Living alone is a risk factor for depressive symptoms among older adults, although it is unclear if it is a risk factor for older gay men. A sense of belonging to the gay community is protective and might compensate for living alone. This research investigated whether a sense of belonging with gay friends weakened the relationship between living alone and depressive symptoms among older gay men.
A community sample of 160 Australian gay men aged 65–92 years completed the Center for Epidemiologic Studies Depression Scale and two visual analogue scales assessing a sense of belonging with gay friends.
Results supported the moderation model, with increasing levels of belonging with gay friends weakening the relationship between living alone and depressive symptoms.
Results imply that enhancing a sense of belonging with gay friends among older gay men who live alone is likely to be a protective factor in relation to depressive symptoms.
Since graduating from library school I have worked as a “small press” micropublisher, issuing microfilm editions of newspapers and serials relating to Canadian social and political history. My interests include art and architecture, the ethnic press (especially that of the pre-World War II period), labour history, women’s history, and the alternative press including gay and lesbian periodicals.
The Transitions of Care from Child and Adolescent Mental Health Services to Adult Mental Health Services (TRACK) study was a multistage, multicentre study of adolescents' transitions between child and adult mental health services undertaken in England. We conducted a secondary analysis of the TRACK study data to investigate healthcare provision for young people (n = 64) with ongoing mental health needs, who were not transferred from child and adolescent mental health services (CAMHS) to adult mental health services mental health services (AMHS).
The most common outcomes were discharge to a general practitioner (GP; n =29) and ongoing care with CAMHS (n = 13), with little indication of use of third-sector organisations. Most of these young people had emotional/neurotic disorders (n = 31, 48.4%) and neurodevelopmental disorders (n = 15, 23.4%).
GPs and CAMHS are left with the responsibility for the continuing care of young people for whom no adult mental health service could be identified. GPs may not be able to offer the skilled ongoing care that these young people need. Equally, the inability to move them decreases the capacity of CAMHS to respond to new referrals and may leave some young people with only minimal support.