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Analysis of human remains and a copper band found in the center of a Late Archaic (ca. 5000–3000 cal BP) shell ring demonstrate an exchange network between the Great Lakes and the coastal southeast United States. Similarities in mortuary practices suggest that the movement of objects between these two regions was more direct and unmediated than archaeologists previously assumed based on “down-the-line” models of exchange. These findings challenge prevalent notions that view preagricultural Native American communities as relatively isolated from one another and suggest instead that wide social networks spanned much of North America thousands of years before the advent of domestication.
Most of the existing literature on inclusion and exclusion among older adults focuses on community-dwelling individuals. In this article, we draw on the results of a comparative case study to explore how older adults in two assisted living settings experience inclusion and exclusion. One site was a low-income facility and the other a higher-end facility in a mid-sized Canadian city. Bridging together geographies of encounter and gerontological approaches on social inclusion, we analyse interviews with tenants and key informants to explore when, where and in what ways these groups experience inclusion and exclusion in these particular settings. Tenants’ narratives reveal how their encounters, and in turn their experiences of exclusion and inclusion are shaped by experiences throughout their lifecourse, the organisation of assisted living spaces, communities beyond the facility, and pervasive discourses of ageism and ‘dementiaism’. We argue that addressing experiences of exclusion for older adults within these settings involves making more time and space for positive encounters and addressing pervasive discourses around ageism and ‘dementiaism’ among tenants and staff.
Focused electron beam-induced deposition (FEBID) is capable of producing metal-containing nanostructures with lateral resolution on the sub-nanometer scale. Practical application of this nanofabrication technique has been hindered by ligand-derived contamination from precursors developed for thermal deposition methods. Mechanistic insight into FEBID through surface science studies and gas-phase electron–molecule interactions has begun to enable the design of custom FEBID precursors. These studies have shown that precursors designed to decompose under electron irradiation can produce high-purity FEBID deposits. Herein, we highlight the progress in FEBID precursor development with several examples that incorporate this mechanism-based design approach.
To reduce inappropriate antimicrobial prescribing across ambulatory care, understanding the patient-, provider-, and practice-level characteristics associated with antibiotic prescribing is essential. In this study, we aimed to elucidate factors associated with inappropriate antimicrobial prescribing across urgent care, family medicine, and pediatric and internal medicine ambulatory practices.
DESIGN, SETTING, AND PARTICIPANTS
Data for this retrospective cohort study were collected from outpatient visits for common upper respiratory conditions that should not require antibiotics. The cohort included 448,990 visits between January 2014 and May 2016. Carolinas HealthCare System urgent care, family medicine, internal medicine and pediatric practices were included across 898 providers and 246 practices.
Prescribing rates were reported per 1,000 visits. Indications were defined using the International Classification of Disease, Ninth and Tenth Revisions, Clinical Modification (ICD-9/10-CM) criteria. In multivariable models, the risk of receiving an antibiotic prescription was reported with adjustment for practice, provider, and patient characteristics.
The overall prescribing rate in the study cohort was 407 per 1,000 visits (95% confidence interval [CI], 405–408). After adjustment, adult patients seen by an advanced practice practitioner were 15% more likely to receive an antimicrobial than those seen by a physician provider (incident risk ratio [IRR], 1.15; 95% CI, 1.03–1.29). In the pediatric sample, older providers were 4 times more likely to prescribe an antimicrobial than providers aged ≤30 years (IRR, 4.21; 95% CI, 2.96–5.97).
Our results suggest that patient, practice, and provider characteristics are associated with inappropriate antimicrobial prescribing. Future research should target antibiotic stewardship programs to specific patient and provider populations to reduce inappropriate prescribing compared to a “one size fits all” approach.
Cyg X-3 underwent a series of giant radio outbursts beginning on September 28, 1982 (Geldzahler et al. 1983). The flux densities at 2.7 and 8.1 GHz (11.1, 3.71 cm respectively, see Figure 1) were measured with the 2.4 km baseline of the Green Bank interferometer once every three days before October 5, 1982 (= JD 244 5248) and three times daily thereafter.
SS433 has been under intensive study for the past five years in almost all wavelength bands of the electromagnetic spectrum. This peculiar object is generally regarded (Beer 1981) as being a binary system composed of a main sequence star losing mass via Roche lobe overflow to a massive accretion disk associated with a compact object, probably a neutron star. The binary period is 13.1 days. Supercritical accretion onto the disk causes about 10−6 M⊙/year of ionised matter to be ejected in the form of jets with a relatively constant velocity of 0.26 c along the disk axis. The disk (or the inner part of it) precesses with a period of about 164 days, although there is evidence that this may not be constant. The half angle of the precession cone is ~20° and its axis lies at an angle of ~80° to the line of sight. The main sequence star loses mass at a rate of 10−4 to 10−6 M⊙/yr into a stellar wind with the result that a relatively dense environment surrounds the binary system.
In Table I we present the list of 38 celestial objects that have been observed since January 1978 at 2.7 and 8.1 GHz with the Green Bank interferometer. The sources fall naturally into three categories: radio stars, possibly Galactic sources, and extragalactic sources. SS433, Cyg X-3, and each extrgalactic source is measured several times per day while the other sources are measured once every three days. Reports on the entire program will be found in Geldzahler et al. (1983a), and on specific sources: SS433—Johnston et al. (1983a), BL Lac—Johnston et al. (1983b), Cyg X-3—Geldzahler et al. (1983b) and elsewhere in this volume), and CTA 26—Spencer et al. (1983).
At the lowest radio frequencies (≤30 MHz), the Earth's ionosphere transmits poorly or not at all. This relatively unexplored region of the electromagnetic spectrum is thus an area where high resolution, high sensitivity observations can open a new window for astronomical investigations. Also, extending observations down to very low frequencies brings astronomy to a fundamental physical limit where the Milky Way becomes optically thick over relatively short path lengths due to diffuse free-free absorption.
The WAIS (West Antarctic Ice Sheet) Divide deep ice core was recently completed to a total depth of 3405 m, ending 50 m above the bed. Investigation of the visual stratigraphy and grain characteristics indicates that the ice column at the drilling location is undisturbed by any large-scale overturning or discontinuity. The climate record developed from this core is therefore likely to be continuous and robust. Measured grain-growth rates, recrystallization characteristics, and grain-size response at climate transitions fit within current understanding. Significant impurity control on grain size is indicated from correlation analysis between impurity loading and grain size. Bubble-number densities and bubble sizes and shapes are presented through the full extent of the bubbly ice. Where bubble elongation is observed, the direction of elongation is preferentially parallel to the trace of the basal (0001) plane. Preferred crystallographic orientation of grains is present in the shallowest samples measured, and increases with depth, progressing to a vertical-girdle pattern that tightens to a vertical single-maximum fabric. This single-maximum fabric switches into multiple maxima as the grain size increases rapidly in the deepest, warmest ice. A strong dependence of the fabric on the impurity-mediated grain size is apparent in the deepest samples.
Narrow-band photometric surveys, such as the Javalambre Photometric Local Universe Survey (J-PLUS), provide not only a means of pre-selection for high-resolution follow-up, but open a new era of precision photometric stellar parameter determination. Using a family of machine learning algorithms known as Artificial Neural Networks (ANNs), we have obtained photometric estimates of effective temperature (Teff) and metallicity ([Fe/H]) across a wide parameter range of temperature and metallicity (4000 < Teff <7000 K; −3.5 <[Fe/H]<0.0) for a number of stars in the J-PLUS Early Data Release. With this methodology, we expect to increase the number of known Carbon-enhanced Metal-poor (CEMP; [C/Fe]>+0.7) stars by several orders of magnitude, as well as constrain the metallicity distribution function of the Milky Way Halo system.
Objectives: Huntington’s disease (HD) is a debilitating genetic disorder characterized by motor, cognitive and psychiatric abnormalities associated with neuropathological decline. HD pathology is the result of an extended chain of CAG (cytosine, adenine, guanine) trinucleotide repetitions in the HTT gene. Clinical diagnosis of HD requires the presence of an otherwise unexplained extrapyramidal movement disorder in a participant at risk for HD. Over the past 15 years, evidence has shown that cognitive, psychiatric, and subtle motor dysfunction is evident decades before traditional motor diagnosis. This study examines the relationships among subcortical brain volumes and measures of emerging disease phenotype in prodromal HD, before clinical diagnosis. Methods: The dataset includes 34 cognitive, motor, psychiatric, and functional variables and five subcortical brain volumes from 984 prodromal HD individuals enrolled in the PREDICT HD study. Using cluster analyses, seven distinct clusters encompassing cognitive, motor, psychiatric, and functional domains were identified. Individual cluster scores were then regressed against the subcortical brain volumetric measurements. Results: Accounting for site and genetic burden (the interaction of age and CAG repeat length) smaller caudate and putamen volumes were related to clusters reflecting motor symptom severity, cognitive control, and verbal learning. Conclusions: Variable reduction of the HD phenotype using cluster analysis revealed biologically related domains of HD and are suitable for future research with this population. Our cognitive control cluster scores show sensitivity to changes in basal ganglia both within and outside the striatum that may not be captured by examining only motor scores. (JINS, 2017, 23, 159–170)
Four ice cores from the Ross Sea drainage, Antarctica, show patterns of δ18O variations on a time scale of decades to centuries over the last 1400 years without change in the long-term average δ18O. Century scale δ18O fluctuations in the two cores drilled in the Ross Ice Shelf at Station J-9 (82°23′S, 168°38′W, elevation 60 m) are highly correlated (P < 2 × 10−4). The long isotope record (>30 000 a) of the 1978 J-9 core thus represents local conditions over at least 102 m and on time scales of 100 years and longer.
Regional correlations between the J-9 δ18O records and those from Ridge BC (82°54′S, 136°40′W, elevation 509 m) and the Dominion Range (85°15′S, 166°10′E, elevation 2700 m) are barely significant (P ≈ 0.05 for J-9 '76 and Dominion Range, 580 to 1400 years ago) or absent. The failure to find clear regional isotope trends related to climate fluctuations may reflect the finding that between 1957 and 1982 the area was in the transition zone between areas with opposite temperature trends, and showed little or no temperature change. The fact that the records nevertheless show significant δ18O fluctuations highlights the need to base regional climate reconstructions on a regional suite of ice-core records.
Patterns of dental service use can be described using a range of approaches including measures related to first dental visit, usual dental visit pattern, and the most recent dental visit. First dental visit is considered important as it represents first contact with the dental system. The usual dental visit pattern of children is also of interest as it can reflect long-term attendance patterns. The most recent dental visit is considered important as it reflects current health behaviour.
In this chapter, measures related to first dental visit will be presented for: first making a dental visit before the age of 5 years, having a check-up as the reason for the first dental visit, and reporting having never made a dental visit. Information will also be presented related to usual dental visiting using the measure of irregular usual visit pattern. For the most recent dental visit: making a dental visit within the last 12 months, having a check-up as the reason for last dental visit, attending a private dental clinic at the last dental visit, whether parents or guardians attended with the child at their last dental visit, and rating of the last dental visit by the parent/guardian.
Frequency of dental visits and the reason for dental visits are key aspects related to access to dental care (Roberts-Thomson et al. 1995). Making a recent dental visit is indicative of access to the dental care system while visiting for the reason of a check-up is considered more likely to be associated with better health outcomes than visiting for a dental problem such as relief of pain (Crocombe et al. 2012). Hence, the dental profession tends to advocate a visit pattern of attending for annual dental check-ups to access preventive dental care or allow diagnosis of dental problems at an early stage, which can facilitate treatment before the disease progresses (Riley et al. 2013). For children, there are recommendations in relation to the desirability of making dental visits at an early age (Jones & Tomar 2005). While children who have not made a dental visit or report an irregular dental visit pattern could reflect a lack of perceived need, these measures could also reflect barriers to dental care that inhibit dental visiting or reflect problem-based attendance patterns.
In consequence of the decision made by the Fifth General Assembly of the I.A.U. I have been entrusted, from January 1936, with the direction of the Central Bureau for the International Service of Latitudes.
I am much indebted to Prof. Kimura, who preceded me as Director and to Prof. Kohlschütter, Director of the Geodetic Institute of Potsdam, for information and advice, which has been of great assistance to me; therefore I desire to acknowledge to them my deep gratitude.