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Presented is an approach to support margin allocation and management via a graph-theoretical network of assumptions. In contrast to the document-centric approach, the network captures assumptions dependencies, and enables an algorithmic process supporting margin allocation and management. Ultimately, this methodology is intended to assist decision-makers in managing assumptions and examining their impact on an architecture. Explicitly linking margins to assumptions allows to support mitigating their risk of invalidity. The approach is demonstrated with a conceptual aircraft design example.
Antisocial behaviour is common among patients with severe mental illness (SMI) requiring hospitalisation.
To determine whether differential treatments and services are provided to patients with SMI who engage in antisocial behaviour.
A random sample of 161 inpatients with SMI were recruited from general adult wards and assessed at baseline and two years later. Information on symptoms, aggressive behaviour, substance misuse, and service use was obtained from patients and clinical files.
Past antisocial behaviours were not associated with type or intensity of treatments and services. Severity of positive symptoms, aggressive behaviour, and illicit drug use were positively associated with the frequency of CMHT contact, but not with the type of CMHT, type of medication, or other treatments and benefits.
While the frequency of meetings with CMHTs increased with the severity of antisocial behaviours, no specific treatments were provided to patients with SMI engaging in antisocial behaviours.
This study tested the hypothesis that among patients with schizophrenia the risk and correlates of aggressive behavior differ depending on the level of positive symptoms. Two hundred and fifty-one adults with schizophrenia who were living in the community were assessed by psychiatrists using validated instruments. Patients and collaterals reported aggressive behavior. In a final multivariate model, aggressive behavior was significantly and positively associated with childhood conduct disorder, current use of illicit drugs, positive, threat-control-override (TCO), and depression symptoms. While 16% of the patients with two or fewer positive symptoms engaged in aggressive behavior in the previous six months, this was true of 28.4% of those with three or more positive symptoms (X2(n = 251,1) = 5.48, P = 0.019). Among patients with high positive symptoms, even univariate analyses failed to detect any factors associated with aggressive behavior other than medication non-compliance, typical antipsychotic medication, and clozapine. By contrast, among patients with few positive symptoms, aggressive behavior was associated with TCO and depression symptoms, young age, male sex, the number of childhood conduct disorder symptoms, prior aggressive behavior, and current illicit drug use. In phases of illness characterized by different levels of positive symptoms, the risk of aggressive behavior and the associated factors differ.
Agomelatine is a novel antidepressant which was licensed in the United Kingdom in February 2009, but has not yet been included in national prescribing guidelines in the UK. The cost of Agomelatine and the need for monitoring of liver function during treatment have informed the development of strict local guidelines in respect of the initiation of Agomelatine.
To assess the use of Agomelatine following introduction in a district general hospital outpatient setting.
To determine whether Agomelatine use is in accordance with recently formulated local guidelines and to explore prescribing patterns for Agomelatine.
Case notes were reviewed for consecutive patients prescribed Agomelatine over a 3 month study period. Using a specifically designed proforma, prescribing data, laboratory indices, outcome data and patient feedback were assessed against standards derived by consensus based on new prescribing guidelines.
27 patients were studied. Agomelatine was initiated in 93% of cases for major depressive disorder as third-line treatment. 89% of patients completed baseline liver function tests and 63% had these reviewed at all of 3 time-points as recommended. 14% did not require an increment to the 50mg dose. 33% discontinued Agomelatine. 44% experienced mild side-effects such as headaches and nausea. 56% did not require an additional anxiolytic and 14% were successfully discharged. Positive feedback was obtained verbally and with rating scales.
Initiation of agomelatine in accordance with recommended standards proved possible in a district general hospital setting. Agomelatine was well tolerated and positive patient feedback was received.
An audit was designed to compare 3 ethnic groups(White British(WB), South Asian(SA) and Other (Black and others) to identify trends in Diagnosis, Length of admission, No. of admissions, Status on admission, Services on Discharge. The initial cycle was commenced in 2009,data were collected for 1 year. More people from ethnic minorities were detained, had longer hospitalstay,were diagnosed with psychosis more than WB.
Observe outcome of assessment and treatment of patients from different ethnic background,after recommendations of the 2009 audit were implemented (better use of intrepreting services, educational events for carers and patients, effective discharge planning)
repeat the auditcycle to close the loop
data were collected, covering a period of 1 year (1/4/12-31/3/13). Number of patients:241
Diagnosis: 47% of SA were diagnosed with psychotic disorder compared to 18% of WB,more depressive disorders recorded in SA(16%) compared to previous audit(3%)
Length of admission: similar length of stay in SA(69%) and WB(71%)for admission < 28 days, similar results for admission >28 days
Number of admissions: 18% of WB have > 2 admissions compared to 9% of SA
Status on admission: 41% of SA are detained compared to 21% of WB.
Services on discharge: More SA(13%) are now referred to IHBT (Intensive Home Base treatment) compared to previously(2%) and is comparable to WB(12%)
Better use of interpreting services improved communication, timely assessment and lead to reduced length of stay. Better liasion with community/crisis services lead to effective discharge planning, reduced length of stay. In-depth audit of pathway leading to MHA admission is needed.
•Pilot project similar to “Enhancing pathways into care” done in Sheffield. It was used to describe different types of initiatives that have been established in health to improve patient pathways and access to services.
To observe outcome of assessment and treatment of patients from different ethnic background.
Compare 3 ethnic groups (White British(WB), South Asian(SA) and Black Caribbean & Others) and identify trends in the following categories: Diagnosis, No. of Admissions, Status on Admission, Length of Admission, Services on Discharge.
Collected information from relevant resources covering a period of 1 year (1/4/09 – 31/03/10) •Information transferred onto spreadsheet •The findings were presented in forms of graphs and pie charts. •Number of patients: 194.
72% of SA were diagnosed with psychotic disorder compared to 32% of WB. 36%of WB have depressive disorder compared to 3% of SA.
Length of admission:
53% of SA stay in hospital > 28 days compared to 33% of WB.
Number of admissions:
31% of SA and 19% of WB have more than 2 admissions.
Status on admission:
60% of SA are admitted under section of MHA compared to 19% of WB.
Services on discharge:
Only 2% of SA are referred to CHTT(Crisis and home base treatment team) compared to 14.5% in WB and 29% of SA are discharged to AOT(Assertive Outreach Team).
People from ethnic minorities present to services with severe symptomatology. We need to look at service user's engagement with community services.
There is an urgent need for new therapeutic options to treat muscle cramps; however, no patient-reported measures exist that capture the entire cramp experience. We conducted a qualitative study to assess the experience of patients suffering muscle cramps, aiming to understand what factors determine the impact cramps have in patients’ lives to guide the development of a patient-centered outcome measure of cramp severity and impact.
We enrolled patients with cramps due to several etiologies, including motor neuron disease, pregnancy-induced cramps, cirrhosis and hemodialysis, and idiopathic and exercise-induced cramps. Patients participated in semistructured interviews about their experiences with muscle cramps and their responses were recorded and transcribed. Data were analyzed with content analysis using data saturation to determine the sample size. We subsequently developed a conceptual framework of cramp severity and overall cramp impact.
Ten patients were interviewed when data saturation was reached. The cramp experience was similar across disease and physiological states known to cause muscle cramps. The main themes that compose the overall cramp impact are cramp characteristics, sleep interference, daytime activities interference, and the effect on mental health.
This framework will be used to develop a patient-reported outcome of cramp severity and impact.
We present a method for measuring the shear complex modulus of hydrogels by oscillatory nanoindentation, with unprecedented attention to procedure and uncertainty analysis. The method is verified by testing a typical low-molecular-weight gelator formed from the controlled hydrolysis of glucono-δ-lactone. Nanoindentation results are compared with those obtained by rheometry using both vane-in-cup and parallel-plate fixtures. At 10 Hz, the properties measured by oscillatory nanoindentation were G′ = 38.1 ± 2.8 kPa, tan δ = 0.22 ± 0.02. At the same frequency, the properties measured by rheometry were G′ = 15.3 ± 2.9 kPa, tan δ = 0.11 ± 0.016 (vane-in-cup) and G′ = 7.9 ± 1.1 kPa, tan δ = 0.05 ± 0.004 (parallel-plate). The larger shear modulus measured by nanoindentation is due to the scale of testing. Whereas rheometry characterizes the bulk material response, nanoindentation probes the fibrous network of the gel. The procedure and analysis presented here are valuable for nanoindentation testing of other compliant materials such as hydrogels, soft biological tissue, and food products.
Dendritic cells (DC) are central regulators of immune responses and professional antigen-presenting cells (APCs) with the unique ability to induce both innate immune responses and a highly specific acquired immunity. DC communicates through chemical and mechanical signals in the initiation and maintenance of immune responses. DC forms immunological synapses with T-cells thus pulling T-cells strings and leading to activation of T-cells. Owing to their properties, DC are often called ‘nature's adjuvants’ and thus have become an important component of any vaccination strategy. Coccidiosis is a major intestinal disease caused by Eimeria spp., affecting economically valuable livestock animals such as chickens and turkeys. Economic losses are associated with decreased productivity in afflicted poultry. Vaccination strategies involving DC have been developed owing to the special properties of these cells in coordinating innate and adaptive immune responses. Vaccination of chickens with exosomes isolated from DC containing parasite antigens (Ags) represents a promising alternative strategy to control avian coccidiosis. In recent years, emergence of new chicken DC has opened a new horizon for the development of new vaccines and DC derived vaccine could be a possible strategy to control coccidiosis in field. This review summarises the current state of knowledge of DC and their specific functions in immunity against avian coccidiosis.
Dendritic cells (DCs) are antigen-presenting cells (APCs) with the unique ability to induce both innate immune responses and a highly specific acquired immunity. DCs are crucial to induce immunity, and their maturation and functions are influenced by microbial and environmental stimuli. Chicken DCs are composed of several subtypes including bursal secretory dendritic cells (BSDCs), follicular dendritic cells (FDCs), and thymic dendritic cells (TDCs). DC maturation depends on the nature of the perturbation and permits unique and efficient immune responses for each pathogen. DCs differentially recognise the viruses, bacteria, parasite and fungi and specifically regulate the immune response. Dendritic cells (DCs) are ‘nature's adjuvants’ and, as such represent an essential component of any vaccination strategy. The understanding of DC regulatory mechanisms opens a new horizon for the development of new vaccines and their targeting with the vaccination for elicitation of better immunity levels. The following review summarises the current state of knowledge of DCs and their specific functions during host pathogens interaction.
The Endangered Indian pangolin Manis crassicaudata, a burrowing, armoured mammal, plays an important role in the food web by consuming insects and termites. In Pakistan the species’ range includes the 22,000 km2 Potohar Plateau, where it is under pressure from illegal hunting for its scales and requires conservation attention. We used a geographical information system to quantify the range of the Indian pangolin on the Plateau and to compare this with the range estimated in the IUCN Red List assessment of the species. We found that the species occupies c. 89% of the Plateau, in eight of the 10 protected areas, compared with the IUCN estimate of 71%, and we recorded the species at 40 locations on the Plateau outside the range predicted by the IUCN assessment. We collected data on the illegal capture and killing of the species, recording 412 individuals that had been killed at 48 locations between January 2011 and the end of April 2013. The highest number of killings was recorded in Chakwal District (n = 156, at 13 sites) followed by the Attock District (n = 149, at eight sites). Although the Indian pangolin's range on the Potohar Plateau is c. 18% larger than that estimated in the IUCN assessment, the species is under pressure from illegal killing and requires urgent conservation measures to save the small remaining population and avoid the extirpation of this vital insectivorous predator from the area.
The poultry industry is currently facing a serious problem of controlling coccidiosis, owing to the development of drug resistance against commonly available anticoccidials. Furthermore, an increasing demand in the consumers for drug residue free poultry and poultry products has led to the development of alternative strategies for the treatment and control of avian coccidiosis. In response to the invasion of Eimeria species in coccidiosis, oxidative stress is created by host cellular response which imparts pathology to the host tissue besides damaging the parasite. Hence, in order to alleviate the damage caused by oxidative stress during coccidiosis, the use of essential oils (EOs) rich in antioxidant compounds is being considered as an appealing approach. However, results are very divergent and often not as satisfactory as expected. Essential oils, as natural products, obtained from aromatic plants have the potential to serve as an alternate to anticoccidials. The present work aims to review the current state of knowledge, informative collection of results obtained over the years and to attain a critical decision in aspects of the use of EOs as anticoccidials.
TiO2 nanofibers (TNFs) with different anatase/rutile phase ratios were fabricated using electrospinning technique followed by the annealing at different temperatures. The effect of annealing temperatures on their morphology, structural, and optical properties and photocatalytic activity was investigated. The photocatalytic performance of TNFs was evaluated by degradation of methyl orange (MO) in aqueous solution under the irradiation of simulated solar light. Annealing temperature significantly influenced photocatalytic degradation of MO due to the incorporation of rutile phase which suppresses recombination of photoactivated electron and hole pairs. Turnover frequency (TOF) of MO degradation was introduced to describe the intrinsic activity of TNFs. TNFs acquired best anatase/rutile phase ratio (A/R = 83/17) when annealed at 650 °C, resulting in highest TOF value 2394 h−1, two times higher as compared to P25 with similar anatase/rutile phase ratio (A/R = 85/15). Appropriate crystalline structure could be the reason for good photocatalytic activity as well as intrinsic activity of TNFs.
There is an established disparity between physical and mental healthcare. Parity of research outputs has not been assessed internationally across influential medical journals.
To assess parity of publication between physical and mental health, and within psychiatry.
Four major medical disciplines were identified and their relative burden estimated. All publications from the highest-impact general medical journals in 2001, 2006 and 2011 were categorised accordingly. The frequency of psychiatry, cardiology, oncology and respiratory medicine articles were compared with the expected proportion (given illness burdens). Six subspecialties within psychiatry were also compared.
Psychiatry was consistently and substantially underrepresented; other specialties were overrepresented. Dementia and psychosis demonstrated overrepresentation, with addiction and anxiety disorders represented proportionately and other disorders underrepresented. The underrepresentation of mood disorders increased more recently.
There appears to be an important element of disparity of esteem; further action is required to achieve equivalence between mental and physical health research publications.
As talk of “crisis” justifies suspension of established legal orders, we are only beginning to understand the far-reaching impact of these suspensions under law's increasingly global purview. But while many scholars in the social sciences have embraced Agamben's critical perspective on the “state of exception” (2005), lawyers and legal educators have been slower to do so. We still proceed largely as though our profession is charged with accretion and application of sound principles and not also with increasingly frequent derogation of those under declarations of “crisis.”
For at least this reason, legal realism has never been a more important tool for students of professional law. And as I will suggest in this brief essay, a highly effective way to develop this tool is through careful, well-directed legal ethnography – also known as participant-observation. Legal ethnography offers an empirical method by which students can leave “law in books” to observe and document “law in action” in the complicated social environments in which they reside. In this piece, I justify the value of this method, first by demonstrating how adopting social science in law teaching helps students address general legal problems in more sophisticated ways, and second by conveying my own experience using ethnographic assignments as a law professor in first-year doctrinal and upper-division courses. There, over several years of crafting, administering, and assessing such assignments, I have developed what I believe to be a streamlined approach to the employment of social science theory and method complementary to law pedagogy.
Ethnography is subject to several variations in interpretation and practice. For some, it is simply a research methodology defined by long-term, embedded qualitative data collection. It places the researcher “on the ground” within a community whose boundary formations are often themselves one of the objects of study. Its output consists of meticulous field notes and informant interviews capturing the symbols, practices, and narratives by which people make sense of their universe. For others, ethnography is far more than this; it is an outlook placing the researcher's own cultural assumptions in productive tension with those of her environment, and one attuned especially to the ongoing fabrication of “reality” through meaning-making. Under both views, ethnography attends more than any other approach to the cultural thread of which social fabric – law included – is woven.
Tribological performance of industrial applications involving boundary lubrication regime can be improved by depositing surface coatings such as diamond-like carbon (DLC) on the interacting surfaces. DLCs are considered as hard coatings with unique combination of properties which results in minimizing the friction induced energy and material losses especially under starved lubrication conditions. In spite of high wear-resistance and ultralow friction coefficients, there are a lot of factors that can directly influence the tribological characteristics of DLC coatings. Although, many studies were conducted to comprehend the effects of intrinsic/extrinsic conditions on tribological behavior of these coatings, still there is a lack of understanding due to contradictory remarks. Therefore, there is a need to rearrange the published data in an organized manner for logical continuation of research. In this paper, a brief introduction of DLC coatings is presented followed by detailed discussion on conditions that can directly influence their tribological properties.
Stripe rust, caused by Puccinia striiformis f. sp. tritici (Pst), is one of the most important diseases affecting wheat. In this study, seven gene-linked markers were used to identify the presence of stripe rust resistant genes in 51 accessions of synthetic hexaploid of wheat which were found to be resistant at seedling plant stage. Molecular marker-based gene identification showed the presence of Yr5, Yr10 and Yr15 in three accessions, Yr36 in three accessions, Yr48 in seven accessions, YrR61 in four accessions, and YrTP1 in ten accessions of resistant hexaploid of wheat. These gene-linked markers were also used for the detection of genetic diversity. A total of 68 alleles were detected by these seven gene-linked markers. The mean number of allele was 11.3 alleles per locus. Genetic diversity values ranged from 0.34 to 0.93, with highest genetic diversity value of 0.93 detected for marker Xwm477. The lowest genetic diversity value was observed for marker Xbarc167. The polymorphic information content value ranged from 0.33 to 0.92 with an average of 0.54. The highest number of alleles (n= 24) were detected for marker Xwmc477. The evidence in this study on the basis of genetic diversity and presence of Yr genes in synthetic hexaploid wheat accessions will be useful in further breeding programmes.