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.
Concerns have repeatedly been expressed about the quality of physical healthcare that people with psychosis receive.
To examine whether the introduction of a financial incentive for secondary care services led to improvements in the quality of physical healthcare for people with psychosis.
Longitudinal data were collected over an 8-year period on the quality of physical healthcare that people with psychosis received from 56 trusts in England before and after the introduction of the financial incentive. Control data were also collected from six health boards in Wales where a financial incentive was not introduced. We calculated the proportion of patients whose clinical records indicated that they had been screened for seven key aspects of physical health and whether they were offered interventions for problems identified during screening.
Data from 17 947 people collected prior to (2011 and 2013) and following (2017) the introduction of the financial incentive in 2014 showed that the proportion of patients who received high-quality physical healthcare in England rose from 12.85% to 31.65% (difference 18.80, 95% CI 17.37–20.21). The proportion of patients who received high-quality physical healthcare in Wales during this period rose from 8.40% to 13.96% (difference 5.56, 95% CI 1.33–10.10).
The results of this study suggest that financial incentives for secondary care mental health services are associated with marked improvements in the quality of care that patients receive. Further research is needed to examine their impact on aspects of care that are not incentivised.
We observed the 2 July 2019 total solar eclipse with a variety of imaging and spectroscopic instruments recording from three sites in mainland Chile: on the centerline at La Higuera, from the Cerro Tololo Inter-American Observatory, and from La Serena, as well as from a chartered flight at peak totality in mid-Pacific. Our spectroscopy monitored Fe X, Fe XIV, and Ar X lines, and we imaged Ar X with a Lyot filter adjusted from its original H-alpha bandpass. Our composite imaging has been compared with predictions based on modeling using magnetic-field measurements from the pre-eclipse month. Our time-differenced sites will be used to measure motions in coronal streamers.
We conducted a secondary analysis of data from the National Audit of Psychosis to identify factors associated with use of community treatment orders (CTOs) and assess the quality of care that people on CTOs receive.
Between 1.1 and 20.2% of patients in each trust were being treated on a CTO. Male gender, younger age, greater use of in-patient services, coexisting substance misuse and problems with cognition predicted use of CTOs. Patients on CTOs were more likely to be screened for physical health, have a current care plan, be given contact details for crisis support, and be offered cognitive–behavioural therapy.
CTOs appear to be used as a framework for delivering higher-quality care to people with more complex needs. High levels of variation in the use of CTOs indicate a need for better evidence about the effects of this approach to patient care.
The healthcare environment is recognized as a source for healthcare-acquired infection. Because cleaning practices are often erratic and always intermittent, we hypothesize that continuously antimicrobial surfaces offer superior control of surface bioburden.
To evaluate the impact of a photocatalytic antimicrobial coating at near-patient, high-touch sites in a hospital ward.
The study took place in 2 acute-care wards in a large acute-care hospital.
A titanium dioxide-based photocatalytic coating was sprayed onto 6 surfaces in a 4-bed bay in a ward and compared under normal illumination against the same surfaces in an untreated ward: right and left bed rails, bed control, bedside locker, overbed table, and bed footboard. Using standardized methods, the overall microbial burden and presence of an indicator pathogen (Staphylococcus aureus) were assessed biweekly for 12 weeks.
Treated surfaces demonstrated significantly lower microbial burden than control sites, and the difference increased between treated and untreated surfaces during the study. Hygiene failures (>2.5 colony-forming units [CFU]/cm2) increased 2.6% per day for control surfaces (odds ratio [OR], 1.026; 95% confidence interval [CI], 1.009–1.043; P=.003) but declined 2.5% per day for treated surfaces (OR, 0.95; 95% CI, 0.925–0.977; P<.001). We detected no significant difference between coated and control surfaces regarding S. aureus contamination.
Photocatalytic coatings reduced the bioburden of high-risk surfaces in the healthcare environment. Treated surfaces became steadily cleaner, while untreated surfaces accumulated bioburden. This evaluation encourages a larger-scale investigation to ascertain whether the observed environmental amelioration has an effect on healthcare-acquired infection.
Ice-free regions of Antarctica are concentrated along the coastal margins but are scarce throughout the continental interior. Environmental changes, including the introduction of non-indigenous species, increasingly threaten these unique habitats. At the same time, the unique biotic communities subsisting in isolation across the continent are difficult to survey due to logistical constraints, sampling challenges and problems related to the identification of small and cryptic taxa. Baseline biodiversity data from remote Antarctic habitats are still missing for many parts of the continent but are critical to the detection of community changes over time, including newly introduced species. Here we review the potential of standardized (non-specialist) sampling in the field (e.g. from soil, vegetation or water) combined with high-throughput sequencing (HTS) of bulk DNA as a possible solution to overcome some of these problems. In particular, HTS metabarcoding approaches benefit from being able to process many samples in parallel, while workflow and data structure can stay highly uniform. Such approaches have quickly gained recognition and we show that HTS metabarcoding surveys are likely to play an important role in continent-wide biomonitoring of all Antarctic terrestrial habitats.
We study the expected value of the length Ln of the minimum spanning tree of the complete graph Kn when each edge e is given an independent uniform [0, 1] edge weight. We sharpen the result of Frieze  that limn→∞
(Ln) = ζ(3) and show that
The brief life and abortive revolutionary career of William FitzOsbert, alias William Longbeard, came to a sad end, if our sources are to be believed, in a mad insurrection against the royal and municipal authorities in London in April 1196. His brief moment of fame or infamy can be used as a window into many aspects of late twelfth century culture. His life throws light on the experience of crusading and the possibly traumatic effects it could have; on the plight of the poor in a newly urbanized and monetarized society; and on the politics of London and of England as a whole. Indeed, a comparison of the events surrounding the massacre in York in 1190 and the events surrounding FitzOsbert's death provides a window into the tensions of Angevin England. This chapter will therefore consist of three parts. First, I provide a very brief narrative of the events of April 1196. Then I offer an extremely basic compare-and-contrast exercise between FitzOsbert's demise and the events of March 1190; and finally, I suggest what that comparison can say about the nature of English society in the 1190s.
Let me begin with a brief narrative of FitzOsbert's life. William FitzOsbert, the younger son of a rich London family, is first recorded as a participant on the Third Crusade. Following the example of a previous generation of Londoners, he joined with some fellow citizens to fit out a ship as a communal undertaking.
Data are the foundation of modern observational science. High-quality science relies on high quality data. In Antarctica, unlike elsewhere, researchers must disperse data and conduct science differently. They must work within the laws enacted under Antarctic Treaty that defines Antarctica as a continent for peace and science, where data sharing and international collaboration are requisite keystones. Scientists also work under oversight guidance of the Scientific Committee on Antarctic Research (SCAR). In the last decade, rapid technological advances and vast increase in digital data volumes have changed the ways data are acquired, communicated, analysed, displayed and reported. Yet, the underlying science culture in which data are funded, utilised and cared for has changed little. Science-culture changes are needed for greater progress in Antarctic science.
We briefly summarise and discuss aspects of Antarctic ‘data care’, which is a subset of data management. We offer perceptions on how changes to some aspects of current science-culture could inspire greater data sharing and international collaboration, to achieve greater success. The changes would place greater emphasis on data visualisation, higher national priority on data care, implementation of a data-library concept for data sharing, greater individual responsibility for data care, and further integration of cultural arts into data and science presentations.
Much effort has gone into data management in the international community, and there are many excellent examples of successful collaborative Antarctic science programs within SCAR built on existing data sets. Yet, challenges in data care remain and specific suggestions we make deserve attention by the science community, to further promote peace and progress in Antarctic science.
Angiogenesis is important for tumour vascularisation and growth, and is therefore a promising target for cancer therapy. The present study reports inhibition of in vitro angiogenesis in human umbilical vein endothelial cells (HUVEC) as well as in rat aortic rings at physiological concentrations of lycopene, that is, 1–2 μmol/l. At a final concentration of 1·15 μmol/l, a significant reduction (P < 0·05) in network branching, that is, junction numbers, the number of tubules and tubule length, was observed in both HUVEC as well as in the rat aortic rings. The inhibitory effect of lycopene was independent of the presence of the pro-angiogenic agents, vascular endothelial growth factor and TNF-α. The anti-angiogenic effects of lycopene in the present study were shown at a concentration that should be achievable by dietary means. These results extend our knowledge of one of the putative anti-cancer actions of lycopene.
This project sought to evaluate the impact of a hospital-based Palliative Care Consultation (PCC) service utilizing a common practice: the resident mortality review conference.
Internal Medicine residents used a revised chart audit tool during the mortality review conference, which included domains described in the Clinical Practice Guidelines for Quality Palliative Care (2004). This study attempted to transform the common practice into a methodology for collecting data that could be used as a platform to assess the quality of hospital care near the end of life. In this review, the residents were asked not only “what care was delivered appropriately?” but “what could we have done?” to relieve the patient's and family's suffering.
The results showed that the mortality review process could be used to assess care at the end of life. It also showed that those patients who received a PCC received better care. Symptoms were addressed at a significantly higher rate for those patients who received a PCC than for those who did not. Specifically, these were symptoms of pain (75% vs. 51%, p <.0001), dyspnea (75% vs. 59%, p < 0.0001), nausea (28% vs. 18%, p < 0.0001), and agitation (53% vs. 33%, p < 0.0001).
Significance of results:
The mortality review process was found to be valuable in assessing care delivery for patients near the end of life. The tool yielded results that were consistent with findings of other studies looking at pain and symptom management, advance care planning, and the rate of palliative care consults across major diagnostic categories, supporting the face validity of the mortality review process.
A hawaiite dyke dated at 3.88 ± 0.05 Ma from the Mount Morning eruptive centre intrudes a diamictite deposit at Gandalf Ridge in the southern Ross Sea. The dyke has been dextrally offset up to 6 m horizontally by faults interpreted as the onshore continuation of the West Antarctic rift system (WARS) fault array. Felsic dykes emplaced during the Miocene are also present at Gandalf Ridge. The offset of the Miocene dykes is equivalent to the offset on the hawaiite dyke, suggesting that at this locality movement on faults within WARS has been restricted to a period more recent than c. 3.88 Ma. Over this period the minimum average rate of movement on these faults within WARS is 0.0015 mm yr-1.
We analyze relationships among a range of ecological and biological traits—geographic range size, body size, life mode, larval type, and feeding type—in order to identify those traits that are associated significantly with species duration in New Zealand Cenozoic marine molluscs, during a time of background extinction. Using log-linear modeling, we find that bivalves have only a small number of simple, two-way associations between the studied traits and duration. In contrast, gastropods display more complex interactions involving three-way associations between traits, a pattern that suggests greater macroecological complexity of gastropods. This is not an artifact caused by the larger number of gastropods than bivalves in our data set. We used stratified randomized resampling of families to test for associations between traits that might result from shared inheritance rather than ecological trait interactions; we found no evidence of phylogenetic effects in any associations examined. The relationships revealed by our study should serve to constrain the range of possible biological mechanisms that underlie these relationships. As previously observed, two-way associations are present between large geographic range and increased duration, and between large geographic range and large body size, in both bivalves and gastropods. In gastropods, planktotrophic larval type is associated with large range size through a three-way interaction that also involves duration; there is no direct association of larval type and geographic range. Gastropods also display two-way associations between duration and life mode, and duration and feeding type. We note that in gastropods, an infaunal life mode is associated with large range size, whereas in bivalves infaunality is associated with reduced range size.
Geographic range and taxonomic duration are known to be positively correlated in a number of biologic groups; this is usually attributed to the influence of range upon duration rather than the other way about. Here we analyze two distinct components of this correlation within species and genera of marine invertebrates and microfossils by partitioning the total duration into two parts: the time it takes a taxon to attain its maximum geographic range, and the time a taxon persists after attaining its peak range. We find that the longer it takes a taxon to attain its maximum geographic range, the wider is that range. We also find that the broader the maximum range, the greater is the duration after this maximum is attained. These two correlations are equally strong on average. There is thus a reciprocal relationship between duration and geographic range, and there is no compelling evidence that range generally determines duration more or less than duration determines range.
Children of mothers with eating disorders are at increased risk of developmental disturbance, but there has been little research in middle childhood, when disturbed eating habits tend to emerge.
To examine whether maternal eating disorders identified in the postnatal year are associated with the development of disturbed eating habits and attitudes in children at 10 years of age.
Follow-up comparative study of 56 families (33 mothers with eating disorders and 23 controls). Psychopathology of children, mothers and fathers was assessed by interview, and mother-child interaction observed.
The index group of children scored higher than controls on three of four domains of eating disorder psychopathology and on a global score. Children's eating disturbance was associated with length of exposure to mothers' eating disorder and mother-child mealtime conflict at 5 years. There was some evidence of increased emotional problems in index children.
The children of mothers with eating disorders manifested disturbed eating habits and attitudes compared with controls, and may be at heightened risk of developing frank eating disorder psychopathology.