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 firstname.lastname@example.org
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.
Introduction: Intranasal dexmedetomidine (IND) is an emerging agent for procedural distress in children. However, studies to date have been limited by small samples and imprecise estimates of effect size. We sought to summarize the evidence on the effectiveness of IND for procedures associated with distress in children. Methods: We performed electronic searches of MEDLINE (1946-2018), EMBASE (1980-2018), Google Scholar (2018), CINAHL (1981-2018), Cochrane Central Register of Controlled Trials (2018), 6 clinical trials registries and conference proceedings (2010-2018). Title searches, data abstraction, and risk of bias assessments were performed in duplicate. We included all published and unpublished, randomized and quasi-randomized trials of IND for procedures in children younger than 19 years of age without language restriction. The methodological quality of studies was evaluated using the Cochrane Collaboration's Risk of Bias tool. The primary outcome was the proportion of participants that were deemed to be adequately sedated for the procedure. Results: Of 661 studies, 18 met inclusion criteria. Trials involved 2128 participants, age 1 month - 14 years (836, 39.3% females), who received IND 1 - 4 mcg/kg either by drops (n = 12), atomizer (n = 4), or both (n = 2). 12 trials were eligible for meta-analysis. 13 trials used validated instruments to assess sedation. All studies except one were associated with low or moderate risk of bias. For painful procedures (IV insertion; laceration repair; dental extraction), the pooled OR (95% CI) for adequate sedation and need for additional analgesia was non-significant [1.19 (0.53, 2.65)] and [2.16 (0.62, 7.49)], respectively (n = 5). For non-painful procedures (diagnostic imaging), the corresponding pooled OR (95% CI) favored IND [3.04 (1.58, 5.82)] and [4.44 (2.11, 9.35)], respectively (n = 7). Time to onset and duration of sedation ranged from 13-31 minutes and 41-91.5 minutes, respectively. For adverse effects, the pooled OR (95% CI) was not significantly different between IND and comparators [0.58 (0.22, 1.55] and there were no serious adverse events. Conclusion: IND at doses 1 to 4 mcg/kg are safe and adequately sedate children undergoing non-painful procedures, although the ease of administration must be weighed against the risk of prolonged sedation. Additional trials with larger sample sizes and greater methodologic rigor are needed for painful emergency department procedures such as laceration repair and IV insertion.
We observed pediatric S. aureus hospitalizations decreased 36% from 26.3 to 16.8 infections per 1,000 admissions from 2009 to 2016, with methicillin-resistant S. aureus (MRSA) decreasing by 52% and methicillin-susceptible S. aureus decreasing by 17%, among 39 pediatric hospitals. Similar decreases were observed for days of therapy of anti-MRSA antibiotics.
This paper discusses the concept and parameter design of a robust stair-climbing compliant modular robot, capable of tackling stairs with overhangs. Geometry modifications of the periphery of the wheels of our robot helped in tackling overhangs. Along with establishing a concept design, the robust design parameters are set to minimize performance variations. The Grey-based Taguchi method is applied to provide an optimal setting for the design parameters of the robot. The robot prototype is shown to have successfully scaled stairs of varying dimensions, with overhang, thus corroborating the analysis performed.
Echinacea purpurea is one of the most widely used medicinal herbs that is of interest to animal scientists due to its valuable immuno-stimulatory and anti-inflammatory properties. It is thought that it activates the immune system through stimulating T-cell production, lymphocytic activity, phagocytosis, cellular respiration and inhibiting the secretion of the hyaluronidase enzyme. Chicoric acid (CA) is a major active constituent of Echinacea purpurea. The CA content in roots ranges between 16.80-24.30 mg/g which has gained a lot of renown due to its promising bio-activities. CA has shown to simulate growth promoters and have antioxidant, anti-diabetic, anti-inflammatory, anti-HIV, anti-bacterial, hypoglycaemic and hepatocyte protective properties. There have been very few studies relevant to CA and its use in poultry diets. Previously published studies have included pharmacological and nutritional investigations in the poultry industry. CA could be used as an alternative to antibiotics, and may improve meat quality and health status in broiler chickens.
The Learning Health System Network clinical data research network includes academic medical centers, health-care systems, public health departments, and health plans, and is designed to facilitate outcomes research, pragmatic trials, comparative effectiveness research, and evaluation of population health interventions.
The Learning Health System Network is 1 of 13 clinical data research networks assembled to create, in partnership with 20 patient-powered research networks, a National Patient-Centered Clinical Research Network.
Results and Conclusions
Herein, we describe the Learning Health System Network as an emerging resource for translational research, providing details on the governance and organizational structure of the network, the key milestones of the current funding period, and challenges and opportunities for collaborative science leveraging the network.
In August 2015 a gastroenteritis outbreak occurred following a wedding. An outbreak investigation was undertaken and a cohort study was conducted using an online survey. Of 140 guests, 134 received the survey and 113 responded (84·3% response rate). Seventy respondents met the case definition of vomiting and/or diarrhoea within 72 h of the wedding (61·9% attack rate). Fifteen exposures were associated with illness; on stratification, all were confounded by the ham hock starter. Multivariable analysis showed a significant association with exposure to ham hock (risk ratio 6·62, 95% confidence interval 2·19–20·03). Eight guests and two catering staff submitted stool samples. All tested positive for norovirus GI-6 infection, including a food handler who had vomiting less than 48 h before the wedding. A single genotype was detected among all samples, suggesting a single source of contamination. The transmission pattern suggested point-source exposure. The most plausible cause of the outbreak was transmission from an infected food handler via contaminated food. This highlights the importance of appropriate exclusions for symptomatic food handlers. Additionally, the food handler's stool sample was submitted 7 days after symptom resolution. The potential for extended viral excretion, and the extremely low infective dose of norovirus, may mean that current exclusion guidelines are not of sufficient duration.
Experiments on the National Ignition Facility show that multi-dimensional effects currently dominate the implosion performance. Low mode implosion symmetry and hydrodynamic instabilities seeded by capsule mounting features appear to be two key limiting factors for implosion performance. One reason these factors have a large impact on the performance of inertial confinement fusion implosions is the high convergence required to achieve high fusion gains. To tackle these problems, a predictable implosion platform is needed meaning experiments must trade-off high gain for performance. LANL has adopted three main approaches to develop a one-dimensional (1D) implosion platform where 1D means measured yield over the 1D clean calculation. A high adiabat, low convergence platform is being developed using beryllium capsules enabling larger case-to-capsule ratios to improve symmetry. The second approach is liquid fuel layers using wetted foam targets. With liquid fuel layers, the implosion convergence can be controlled via the initial vapor pressure set by the target fielding temperature. The last method is double shell targets. For double shells, the smaller inner shell houses the DT fuel and the convergence of this cavity is relatively small compared to hot spot ignition. However, double shell targets have a different set of trade-off versus advantages. Details for each of these approaches are described.
“Solar X-ray Spectrometer (SOXS)” mission on-board GSAT-2 Indian spacecraft was launched on 08 May 2003 by GSLV-D2 and deployed in geostationery orbit to study the X-ray emission from solar flares with high spectral and temporal resolution. The SOXS consists of two independent payloads viz. SOXS Low Energy Detector (SLD) payload, and SOXS High Energy Detector (SHD) payload. The SLD consists of two solid state detectors Si PIN and CZT, which cover the energy range from 4-60 keV, while the SHD has NaI(Tl)/CsI(Na) sandwiched phoswich detector that covers energy range from 20 keV to 10 MeV. We present very briefly the science objectives and instrumentation of SLD payload. After the successful In-orbit Tests (IOT), the first light was fed into SLD payload on 08 June 2003 when the solar flare was already in progress. We briefly present the first results from the SLD payload.
This paper discusses the development of an optimal wheel-torque controller for a compliant modular robot. The wheel actuators are the only actively controllable elements in this robot. For this type of robots, wheel-slip could offer a lot of hindrance while traversing on uneven terrains. Therefore, an effective wheel-torque controller is desired that will also improve the wheel-odometry and minimize power consumption. In this work, an optimal wheel-torque controller is proposed that minimizes the traction-to-normal force ratios of all the wheels at every instant of its motion. This ensures that, at every wheel, the least traction force per unit normal force is applied to maintain static stability and desired wheel speed. The lower this is, in comparison to the actual friction coefficient of the wheel-ground interface, the more margin of slip-free motion the robot can have. This formalism best exploits the redundancy offered by a modularly designed robot. This is the key novelty of this work. Extensive numerical and experimental studies were carried out to validate this controller. The robot was tested on four different surfaces and we report an overall average slip reduction of 44% and mean wheel-torque reduction by 16%.
Obesity is a growing problem in India, the dietary determinants of which have been studied using an ‘individual food/nutrient’ approach. Examining dietary patterns may provide more coherent findings, but few studies in developing countries have adopted this approach. The present study aimed to identify dietary patterns in an Indian population and assess their relationship with anthropometric risk factors.
FFQ data from the cross-sectional sib-pair Indian Migration Study (IMS; n 7067) were used to identify dietary patterns using principal component analysis. Mixed-effects logistic regression was used to examine associations with obesity and central obesity.
The IMS was conducted at four factory locations across India: Lucknow, Nagpur, Hyderabad and Bangalore.
The participants were rural-to-urban migrant and urban non-migrant factory workers, their rural and urban resident siblings, and their co-resident spouses.
Three dietary patterns were identified: ‘cereals–savoury foods’ (cooked grains, rice/rice-based dishes, snacks, condiments, soups, nuts), ‘fruit–veg–sweets–snacks’ (Western cereals, vegetables, fruit, fruit juices, cooked milk products, snacks, sugars, sweets) and ‘animal-food’ (red meat, poultry, fish/seafood, eggs). In adjusted analysis, positive graded associations were found between the ‘animal-food’ pattern and both anthropometric risk factors. Moderate intake of the ‘cereals–savoury foods’ pattern was associated with reduced odds of obesity and central obesity.
Distinct dietary patterns were identified in a large Indian sample, which were different from those identified in previous literature. A clear ‘plant food-based/animal food-based pattern’ dichotomy emerged, with the latter being associated with higher odds of anthropometric risk factors. Longitudinal studies are needed to further clarify this relationship in India.
“While the FBI possesses no information indicating that violent or terrorist activities are being planned as part of these protests, the possibility exists that elements of the activist community may attempt to engage in violent, destructive, or dangerous acts.”
– New York Times Bulletin October 15, 2003
“‘Anti-terrorist’ legislation has been adopted in a number of western countries which allows for the arrest and detention without charge of alleged terrorists, including leaders of so-called ‘domestic radical groups’ (meaning antiwar activists), who are now categorized as a threat to Homeland Security.”
– Michel Chossudovsky Professor of Economics, University of Ottawa December 21, 2005
The above passages illustrate how the focus of the government’s antiterrorism activities included political activist groups, who were being considered as a threat to national security. Documented cases of government surveillance and infiltration of nonviolent activist groups, including the Occupy movement, and the dragnet monitoring of Americans revealed by Edward Snowden (as detailed in Chapter 2) substantiate concern that the USA PATRIOT Act is being used to infringe on the privacy and due process rights of citizens, including political activists who may stake out extreme positions on issues but are not suspected of criminal activities.
Public response to this range of government surveillance activities is likely to be shaped by how they are portrayed by the media. We argue that the nature of news coverage about civil liberties controversies has the potential to sway individuals’ security concerns and social tolerance judgments. Our theory builds on past research that finds contemporary information works in combination with citizens’ political predispositions to shape the level of support for civil liberties (Marcus et al., 1995). However, this past research focused only on how individuals respond when confronted with disliked groups, arguing that it is under these conditions that the limits of tolerance are best understood (Sullivan and Marcus, 1988; Sullivan et al., 1979). An unintended consequence of this focus on disliked groups has been a dearth of research on how individuals make these judgments when they confront efforts to restrict the civil liberties of groups whose causes they support, but whose tactics they may oppose. The decision to defend the civil liberties of radicals, even if only for targets toward which one feels some latent sympathy, is a meaningful test of tolerance in the political climate created after 9/11 and typified by the Snowden revelations.
“Our enemies operate secretly and they seek to attack us from within. In this new kind of war, it is both necessary and appropriate for us to take all possible steps to locate our enemy and know what they are plotting before they strike.”
– U.S. Attorney General Alberto Gonzalez Testimony before the U.S. Senate Judiciary Committee February 6, 2006
“I know for an absolute fact that we have not been involved in anything related to promoting terrorism, and yet the government has collected almost 1,200 pages on our activities. Why is the ACLU now the subject of scrutiny from the FBI?”
– Anthony. D. Romero ACLU Executive Director July 16, 2005
As the United States government took actions to engage in surveillance of activist groups, the discourse surrounding this action straddled both sides of the national security/civil liberties dichotomy. Some officials, such as Attorney General Alberto Gonzalez (quoted above), made the argument that such government activities are necessary to protect the safety and security of the American public. On the other hand, civil rights advocates such as Anthony Romero, the ACLU’s Executive Director, questioned whether activist group surveillance wasn’t motivated by political rather than security concerns. As discussed earlier, this national security/civil liberties debate was played out for public consumption through the mass media. Audience members seeking to understand the debate over government surveillance activities had to make judgments about what was happening on the basis of information reported in the media. This led us to ask questions about how the audience would make sense of this controversy in response to the news stories that they encounter.
In this chapter, we examine how different frames used to construct such new stories affect audience understanding and cognitions. As we noted in Chapter 1, frames are likely to affect people differently according to the predispositions that they bring to the processing of news stories. As such, this chapter examines the interplay of news frames and political predispositions on audience reactions to news stories. For this analysis, we used data from the Activist Study in which research participants read news stories about the surveillance of political advocacy groups under the USA PATRIOT Act.
“The consciousness of being at war, and therefore in danger, makes the handing-over of all power to a small caste seem the natural, unavoidable condition of survival.”
– George Orwell in 1984
“There are many other things that are excluded from the official framing of the ‘global war on terror,’ such as oil, the economy, the deficit, health care, jobs, education, taxes, and the effects of global trade. The implication is that none of these things matter if every American is in mortal danger, even those in the swing states where there’s little to no chance of a terrorist strike. But rationality is not at issue here. People think in terms of frames.”
– George Lakoff Professor of Linguistics at U. of California – Berkeley August 31, 2004
Framing that enhances a sense of danger and threat is a potent tool in the hands of powerholders. If the research presented in this book is any indication, this influence is bestowed by the factors that shape the production of news, not the least of which are the codes and practices of the journalistic profession. When covering the tension between national security and civil liberties – that is, reporting on the government’s massive surveillance powers – journalists tended to construct news reports on that basis of these conventions, emphasizing the conflict between these contending values while trying to find ways to personify and personalize the policy debate. Framing coverage around principled conflicts and individual instances are longstanding news values (Price and Tewksbury, 1997). Although framing news around “rights talk” has been well studied (Shah et al., 1996; Brewer, 2007), in this book we find it is this personification – framing stories in individual as opposed to collective terms – that plays such an important role in shaping the responses of audiences, their thought processes, their mental sophistication, their social tolerance, and their political expression. Such individual framing is a fixture of news construction, particularly when covering “Big Brother.”
According to the coding scheme, coders focused exclusively on manifest content in order to establish a high degree of reliability in coding three factors: the degrees of differentiation (i.e., the number of discrete cognitive categories mentioned), the average elaboration (i.e., the extent of detail provided for each mentioned category), and integration (i.e., the interconnectedness of the various cognitive categories mentioned) in the answers provided by respondents.
The coding instrument asked coders to focus on nine conceptual categories that had been identified from a preliminary examination of the open-ended responses. To establish differentiation, coders were asked to judge which constructs were present in an explicit fashion in each answer. For example, if a respondent mentioned in her answer the “importance of ensuring due process for all,” this would have been coded as one construct (category #6: rights/constitution/freedoms). If in addition to mentioning due process, the respondent wrote about the threats posed to national security by the activities of certain groups and the need to ensure public safety, the coder, recognizing the presence of a second construct (category #5: national security/safety), would give this response a value of 2 in terms of construct differentiation.
In addition to the number of constructs present in the answer, coders were asked to rate the degree of elaboration for each concept that was present. Following the example given, just mentioning the importance of due process would have been coded as low in elaboration. A one-sentence explanation of due process would have received a medium elaboration grade, while an extended explanation of due process (two sentences or more on the subject) would have been coded as high on elaboration.
When this story began more than a decade ago in the early fall of 2001, we were relatively new professors at the University of Wisconsin. We were in the process of launching a research collaboration that has lasted to this day. We were on our way to work when a report came over the radio that a second plane had struck the World Trade Center. Within the hour, we were both at work watching CNN in a conference room along with other faculty, staff, and students. Like everyone else in the room – and so many others across the country – we sensed that the world was about to change.
What we didn’t know was how profound this change would be, nor that we would spend the next decade writing this book that focuses on one particular aspect of this change, the War on Terror, how it was covered in the media, and the effects that this coverage had on the public. But we did know that the public opinion survey that we were planning was going to have to be redesigned to deal with public reactions to the 9/11 attacks. As the ensuing weeks unfolded, we read news reports about the federal government’s reorganization of its various intelligence agencies, as well as proposed legislation that would allow them to fight terrorism more effectively. This legislation, dubbed the PATRIOT Act, was passed overwhelmingly by both the House and Senate and signed into law by President Bush on October 26, 2001, only 45 days after the 9/11 terrorist attacks.
“Ever since the 1970s, when Army intel agents were caught snooping on antiwar protesters, military intel agencies have operated under tight restrictions inside the United States. But the new provision (Senate Bill S.2386, Sec. 502), approved in closed session last month by the Senate Intelligence Committee, would eliminate one big restriction: that they comply with the Privacy Act, a Watergate-era law that requires government officials seeking information from a resident to disclose who they are and what they want the information for.”
– Michael Isikoff Newsweek Magazine June 21, 2004
“Among the Americans who complain about the Patriot Act, Mohammad Junaid Babar probably dislikes it more than most. Absent that often-criticized federal statute, Babar still might stroll the sidewalks of New York, gathering money and equipment for al Qaeda. According to the unsealed transcript of his June 3 appearance before U.S. District Judge Victor Marrero, Babar pleaded guilty to five counts of furnishing ‘material support or resources to a foreign terrorist organization.’”
– Deroy Murdock The National Review October 25, 2004
Both of these passages from magazine articles – the first from Newsweek and the second from the National Review – discuss the implications of domestic surveillance activities by U.S. government agencies. But this is where the similarity ends. These two excerpts represent two very different ways of telling a story about government surveillance. One obvious difference is that the first excerpt emphasizes the issue of civil liberties, while the second emphasizes the issue of national security. In addition, the stories illustrate two different common targets of government scrutiny: activist groups and Arab groups. But a more subtle difference is that the first story addresses the broader policy implications of surveillance in relation to large groups, while the second focuses on a single, potentially dangerous individual.
The differences in these stories raise a number of questions: Would audience members react differently depending on which of these stories they encountered about the debate over domestic security and civil liberties? How would the frame of the news story, whether it organized the issue around individuals or collectives, shape reactions of audience members? Are audience members more likely to favor national security over personal freedoms when seeing individuals or collectives targeted under the PATRIOT Act?
Tolerance toward extreme groups was measured by asking respondents for their level of agreement with the following statements: “I feel sorry for groups that are the targets of FBI surveillance,” “the media should give extremist groups the opportunity to express their views,” “a group that is targeted by the FBI probably deserves the treatment it gets” (reverse-coded), and “the media should not encourage extremist groups by providing news coverage” (reverse-coded). Tolerance toward extreme groups was constructed by averaging respondents’ answers on a 10-point scale (Cronbach’s alpha = .75, M = 6.00, SD = 1.77).
Tolerance for Targeted Group Index
Tolerance for the targeted group was operationalized with an additive index of four statements taken from Marcus et al. (1995), but modified to fit the current social context. Subjects were asked how they felt about a set of statements regarding the treatment of the hypothetical group that had appeared on the manipulation stories: group members should be allowed to work as a teacher in public schools, hold public rallies, broadcast public access cable programs, and share their views over the Internet. Items were measured on 10-point scales from “strongly disagree” to “strongly agree.” Responses were used to create an index averaging the scores from these items (Cronbach’s α = .77, M = 7.12, SD = 1.86).