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Traumatic brain injury (TBI) sustained in childhood is associated with poor social outcomes. This study investigated the role of theory of mind (ToM) as a mediator of the relation between TBI and peer rejection/victimization and reciprocated friendships, as well as the moderating effect of parental nurturance on those relationships.
Participants were children of 8–13 years old (M = 10.45, SD = 1.47), including 13 with severe TBI, 39 with complicated mild/moderate TBI, and 32 children with orthopedic injuries. Data on peer rejection/victimization and friendship were collected in school classrooms using the Extended Class Play and friendship nominations. Parents rated parental nurturance using the Child-Rearing Practices Report. Finally, ToM was measured based on children’s average performance across three tasks measuring different aspects of ToM.
Severe TBI was associated with poorer ToM, greater peer rejection/victimization, and fewer reciprocated friendships. ToM mediated the relation between severe TBI and peer rejection/victimization (i.e., severe TBI predicted poorer ToM, which in turn predicted greater rejection/victimization). Parental nurturance significantly moderated this relation, such that the mediating effect of ToM was significant only at low and average levels of parental nurturance, for both severe and complicated mild/moderate TBI groups. Neither the mediating effect of ToM nor the moderating effect of parental nurturance was significant for reciprocated friendships.
High parental nurturance may mitigate the negative effects of ToM deficits on risk of peer rejection/victimization among children with TBI. Interventions designed to increase parental nurturance or ToM may promote better social outcomes among children with TBI.
This article is an ethnographic investigation of the labours of making art and selling liquid petroleum gas (LPG) in Bulawayo, Zimbabwe. It locates these activities within a shared social world, centred on one of Bulawayo's major art galleries, and it demonstrates that artists and LPG dealers use similar strategies to respond to the political conditions of life in the city. This article frames these conditions as unpredictable, insofar as they change frequently and crystallize in unexpected forms, and it argues that both groups are attempting to act within these conditions and shape them into emergent assemblages. In adopting this term ‘assemblage’, which has been elaborated theoretically by Gilles Deleuze, Félix Guattari and their many interlocutors, this article emphasizes both the mutability and the unpredictability of these formations. The artists who work in the gallery, for their part, make their art by assembling their chosen media. The processes by which they choose their media constitute assemblages as well, in that artists have to adapt their artistic visions to the materials that Zimbabwe's market can provide. Street dealers in gas also produce emergent assemblages against the backdrop of unpredictability. If they want to make natural gas available to consumers, dealers must shepherd their medium through an always emergent process of distribution. They participate in transnational networks of trade, but they also theorize innovative strategies of procurement, develop circuits of trust and loyalty, and conjure up visions of a predatory state. Like artists, they use their work to construct dynamic representations of the world around them. Artists may produce images, and dealers circulate gas, but this article shows that conceptualizing these practices in terms of ‘assemblages’ calls their commonalities into view. In doing so, it also demonstrates that these practices complicate easy distinctions between aesthetics, economics and politics.
The articles that appear in this part issue focus on disparate topics, from rumours of electoral fraud to the production of art, and span the African continent from Guinea and Ghana in the west to Zimbabwe in the south. Despite their evident differences, the contributors see their pieces as united by a common theme: emergence. Elaborating on Simone's influential exploration of the intertwined concepts of emergence and emergency (2004), as well as prior research in Africa on informal economic practices (the exchange of goods and services unregulated by states) (Hart 1973; Piot 2010; Roitman 2004; Weiss 2009), we consider emergence to be the process by which new social formations become thinkable, repeatable, and even – at times – habitual. Although conditions of crisis or precarity or even revolutionary upheaval might be fertile ground for emergence, insofar as these social conditions represent ‘rupture[s] in the organization of the present’ (Simone 2004: 4), the articles here also show that new social practices do not emerge out of nowhere. Rather, these articles demonstrate that attention to quotidian encounters can illuminate how citizens mobilize previously existing norms and patterns of behaviour in response to social change or economic crisis.
Laboratory identification of carbapenem-resistant Enterobacteriaceae (CRE) is a key step in controlling its spread. Our survey showed that most Veterans Affairs laboratories follow VA guidelines for initial CRE identification, whereas 55.0% use PCR to confirm carbapenemase production. Most respondents were knowledgeable about CRE guidelines. Barriers included staffing, training, and financial resources.
Cyber Operational Risk: Cyber risk is routinely cited as one of the most important sources of operational risks facing organisations today, in various publications and surveys. Further, in recent years, cyber risk has entered the public conscience through highly publicised events involving affected UK organisations such as TalkTalk, Morrisons and the NHS. Regulators and legislators are increasing their focus on this topic, with General Data Protection Regulation (“GDPR”) a notable example of this. Risk actuaries and other risk management professionals at insurance companies therefore need to have a robust assessment of the potential losses stemming from cyber risk that their organisations may face. They should be able to do this as part of an overall risk management framework and be able to demonstrate this to stakeholders such as regulators and shareholders. Given that cyber risks are still very much new territory for insurers and there is no commonly accepted practice, this paper describes a proposed framework in which to perform such an assessment. As part of this, we leverage two existing frameworks – the Chief Risk Officer (“CRO”) Forum cyber incident taxonomy, and the National Institute of Standards and Technology (“NIST”) framework – to describe the taxonomy of a cyber incident, and the relevant cyber security and risk mitigation items for the incident in question, respectively.Summary of Results: Three detailed scenarios have been investigated by the working party:
∙Employee leaks data at a general (non-life) insurer: Internal attack through social engineering, causing large compensation costs and regulatory fines, driving a 1 in 200 loss of £210.5m (c. 2% of annual revenue).
∙Cyber extortion at a life insurer: External attack through social engineering, causing large business interruption and reputational damage, driving a 1 in 200 loss of £179.5m (c. 6% of annual revenue).
∙Motor insurer telematics device hack: External attack through software vulnerabilities, causing large remediation / device replacement costs, driving a 1 in 200 loss of £70.0m (c. 18% of annual revenue).
Limitations: The following sets out key limitations of the work set out in this paper:
∙While the presented scenarios are deemed material at this point in time, the threat landscape moves fast and could render specific narratives and calibrations obsolete within a short-time frame.
∙There is a lack of historical data to base certain scenarios on and therefore a high level of subjectivity is used to calibrate them.
∙No attempt has been made to make an allowance for seasonality of renewals (a cyber event coinciding with peak renewal season could exacerbate cost impacts)
∙No consideration has been given to the impact of the event on the share price of the company.
∙Correlation with other risk types has not been explicitly considered.
Conclusions: Cyber risk is a very real threat and should not be ignored or treated lightly in operational risk frameworks, as it has the potential to threaten the ongoing viability of an organisation. Risk managers and capital actuaries should be aware of the various sources of cyber risk and the potential impacts to ensure that the business is sufficiently prepared for such an event. When it comes to quantifying the impact of cyber risk on the operations of an insurer there are significant challenges. Not least that the threat landscape is ever changing and there is a lack of historical experience to base assumptions off. Given this uncertainty, this paper sets out a framework upon which readers can bring consistency to the way scenarios are developed over time. It provides a common taxonomy to ensure that key aspects of cyber risk are considered and sets out examples of how to implement the framework. It is critical that insurers endeavour to understand cyber risk better and look to refine assumptions over time as new information is received. In addition to ensuring that sufficient capital is being held for key operational risks, the investment in understanding cyber risk now will help to educate senior management and could have benefits through influencing internal cyber security capabilities.
To examine variation in antibiotic coverage and detection of resistant pathogens in community-onset pneumonia.
A total of 128 hospitals in the Veterans Affairs health system.
Hospitalizations with a principal diagnosis of pneumonia from 2009 through 2010.
We examined proportions of hospitalizations with empiric antibiotic coverage for methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PAER) and with initial detection in blood or respiratory cultures. We compared lowest- versus highest-decile hospitals, and we estimated adjusted probabilities (AP) for patient- and hospital-level factors predicting coverage and detection using hierarchical regression modeling.
Among 38,473 hospitalizations, empiric coverage varied widely across hospitals (MRSA lowest vs highest, 8.2% vs 42.0%; PAER lowest vs highest, 13.9% vs 44.4%). Detection rates also varied (MRSA lowest vs highest, 0.5% vs 3.6%; PAER lowest vs highest, 0.6% vs 3.7%). Whereas coverage was greatest among patients with recent hospitalizations (AP for anti-MRSA, 54%; AP for anti-PAER, 59%) and long-term care (AP for anti-MRSA, 60%; AP for anti-PAER, 66%), detection was greatest in patients with a previous history of a positive culture (AP for MRSA, 7.9%; AP for PAER, 11.9%) and in hospitals with a high prevalence of the organism in pneumonia (AP for MRSA, 3.9%; AP for PAER, 3.2%). Low hospital complexity and rural setting were strong negative predictors of coverage but not of detection.
Hospitals demonstrated widespread variation in both coverage and detection of MRSA and PAER, but probability of coverage correlated poorly with probability of detection. Factors associated with empiric coverage (eg, healthcare exposure) were different from those associated with detection (eg, microbiology history). Providing microbiology data during empiric antibiotic decision making could better align coverage to risk for resistant pathogens and could promote more judicious use of broad-spectrum antibiotics.
Objectives: The current study examines whether psychosocial outcomes following pediatric traumatic brain injury (TBI) vary as a function of children’s rejection sensitivity (RS), defined as their disposition to be hypersensitive to cues of rejection from peers. Methods: Children ages 8–13 with a history of severe TBI (STBI, n=16), complicated mild/moderate TBI (n=35), or orthopedic injury (OI, n=49) completed measures assessing self-esteem and RS on average 3.28 years post-injury (SD=1.33, range=1.25–6.34). Parents reported on their child’s emotional and behavioral functioning and social participation. Results: Regression analyses found moderation of group differences by RS for three outcomes: social participation, self-perceptions of social acceptance, and externalizing behavior problems. Conditional effects at varying levels of RS indicated that externalizing problems and social participation were significantly worse for children with STBI at high levels of RS, compared to children with OI. Social participation for the STBI group remained significantly lower than the OI group at mean levels of RS, but not at low levels of RS. At high levels of RS, self-perceptions of social acceptance were lower for children with moderate TBI compared to OI, but group differences were not significant at mean or low levels of RS. No evidence of moderation was found for global self-worth, self-perceptions of physical appearance or athletic ability, or internalizing problems. Conclusions: The findings highlight the salient nature of social outcomes in the context of varying levels of RS. These findings may have implications for the design of interventions to improve social outcomes following TBI. (JINS, 2017, 23, 451–459)
Objectives: This study examined whether children with distinct brain disorders show different profiles of strengths and weaknesses in executive functions, and differ from children without brain disorder. Methods: Participants were children with traumatic brain injury (N=82; 8–13 years of age), arterial ischemic stroke (N=36; 6–16 years of age), and brain tumor (N=74; 9–18 years of age), each with a corresponding matched comparison group consisting of children with orthopedic injury (N=61), asthma (N=15), and classmates without medical illness (N=68), respectively. Shifting, inhibition, and working memory were assessed, respectively, using three Test of Everyday Attention: Children’s Version (TEA-Ch) subtests: Creature Counting, Walk-Don’t-Walk, and Code Transmission. Comparison groups did not differ in TEA-Ch performance and were merged into a single control group. Profile analysis was used to examine group differences in TEA-Ch subtest scaled scores after controlling for maternal education and age. Results: As a whole, children with brain disorder performed more poorly than controls on measures of executive function. Relative to controls, the three brain injury groups showed significantly different profiles of executive functions. Importantly, post hoc tests revealed that performance on TEA-Ch subtests differed among the brain disorder groups. Conclusions: Results suggest that different childhood brain disorders result in distinct patterns of executive function deficits that differ from children without brain disorder. Implications for clinical practice and future research are discussed. (JINS, 2017, 23, 529–538)
The ability to create dynamic deformations of micron-sized structures is relevant to a wide variety of applications such as adaptable optics, soft robotics and reconfigurable microfluidic devices. In this work, we examine non-uniform lubrication flow as a mechanism to create complex deformation fields in an elastic plate. We consider a Kirchhoff–Love elasticity model for the plate and Hele-Shaw flow in a narrow gap between the plate and a parallel rigid surface. Based on linearization of the Reynolds equation, we obtain a governing equation which relates elastic deformations to gradients in non-homogeneous physical properties of the fluid (e.g. body forces, viscosity and slip velocity). We then focus on a specific case of non-uniform Helmholtz–Smoluchowski electro-osmotic slip velocity, and provide a method for determining the zeta-potential distribution necessary to generate arbitrary static and quasi-static deformations of the elastic plate. Extending the problem to time-dependent solutions, we analyse transient effects on asymptotically static solutions, and finally provide a closed form solution for a Green’s function for time periodic actuations.
This date list contains the results of measurements made during 1961, 1962 and 1963. The method of counting, utilizing acetylene gas, remains essentially unchanged, except for the addition of some solid state electronics. The method of computation, using the Libby half-life of 5568 ± 30 yr, is continued. The error listed is always larger than the one-sigma statistical counting error commonly used, and takes into account known uncertainty laboratory factors, and does not include external (field or atmospheric) variations.
Unless otherwise stated, collectors of all samples are members of the U. S. Geological Survey.
An MP tandem Van de Graaff accelerator at the University of Rochester has been employed since May 1977 to detect 14C in various terrestrial samples. The carbon sample sizes required are 1mg or less. Dating accuracies based on reproducibility now approach (± 80 years). Measurements have been made on 1850 wood, Australian sucrose, a carbon sample from Mt Shasta, a baby woolly mammoth, and an Egyptian bull mummy wrapping.
We present new far-infrared line observations of the planetary nebulae (PNs) NGC 7027, NGC 7009, NGC 6210, NGC 6543, and IC 4997 obtained with the Kuiper Airborne Observatory (KAO). The bulk of our data are for NGC 7027 and NGC 7009, including [Ne V] 24 μm, [O IV] 26 μm, [O III] (52, 88μm), and [Nm] 57 μm. Our data for [O III] (52, 88) and [N III] 57 in NGC 7027 represent the first measurements of these lines in this source. The large [O III] 52/88 flux ratio implies an electron density (cm–3) of log Ne[O III] = 4.19, the largest Ne ever inferred from these lines. We derive N++/O++ = 0.394±0.062 for NGC 7027 and 0.179±0.043 for NGC 6210. We are able to infer the O+3/O++ ionic ratio from our data. As gauged by this ionic ratio, NGC 7027 is substantially higher ionization than is NGC 7009 – consistent with our observation that the former produces copious [Ne V] emission while the latter does not. These data help characterize the stellar ionizing radiation field.
The Medium-l Program of the Michelson Doppler Imager (MDI) instrument on board SOHO provides continuous observations of oscillation modes of angular degree, l, from 0 to ∼ 300. The initial results show that the noise in the Medium-l oscillation power spectrum is substantially lower than in ground-based measurements. This enables us to detect lower amplitude modes and, thus, to extend the range of measured mode frequencies. The MDI observations also reveal the asymmetry of oscillation spectral lines. The line asymmetries agree with the theory of mode excitation by acoustic sources localized in the upper convective boundary layer. The sound-speed profile inferred from the mean frequencies gives evidence for a sharp variation at the edge of the energy-generating core. In a thin layer just beneath the convection zone, helium appears to be less abundant than predicted by theory. Inverting the multiplet frequency splittings from MDI, we detect significant rotational shear in this thin layer.