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The role that vitamin D plays in pulmonary function remains uncertain. Epidemiological studies reported mixed findings for serum 25-hydroxyvitamin D (25(OH)D)–pulmonary function association. We conducted the largest cross-sectional meta-analysis of the 25(OH)D–pulmonary function association to date, based on nine European ancestry (EA) cohorts (n 22 838) and five African ancestry (AA) cohorts (n 4290) in the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium. Data were analysed using linear models by cohort and ancestry. Effect modification by smoking status (current/former/never) was tested. Results were combined using fixed-effects meta-analysis. Mean serum 25(OH)D was 68 (sd 29) nmol/l for EA and 49 (sd 21) nmol/l for AA. For each 1 nmol/l higher 25(OH)D, forced expiratory volume in the 1st second (FEV1) was higher by 1·1 ml in EA (95 % CI 0·9, 1·3; P<0·0001) and 1·8 ml (95 % CI 1·1, 2·5; P<0·0001) in AA (Prace difference=0·06), and forced vital capacity (FVC) was higher by 1·3 ml in EA (95 % CI 1·0, 1·6; P<0·0001) and 1·5 ml (95 % CI 0·8, 2·3; P=0·0001) in AA (Prace difference=0·56). Among EA, the 25(OH)D–FVC association was stronger in smokers: per 1 nmol/l higher 25(OH)D, FVC was higher by 1·7 ml (95 % CI 1·1, 2·3) for current smokers and 1·7 ml (95 % CI 1·2, 2·1) for former smokers, compared with 0·8 ml (95 % CI 0·4, 1·2) for never smokers. In summary, the 25(OH)D associations with FEV1 and FVC were positive in both ancestries. In EA, a stronger association was observed for smokers compared with never smokers, which supports the importance of vitamin D in vulnerable populations.
The Pueblo population of Chaco Canyon during the Bonito Phase (AD 800–1130) employed agricultural strategies and water-management systems to enhance food cultivation in this unpredictable environment. Scepticism concerning the timing and effectiveness of this system, however, remains common. Using optically stimulated luminescence dating of sediments and LiDAR imaging, the authors located Bonito Phase canal features at the far west end of the canyon. Additional ED-XRF and strontium isotope (87Sr/86Sr) analyses confirm the diversion of waters from multiple sources during Chaco’s occupation. The extent of this water-management system raises new questions about social organisation and the role of ritual in facilitating responses to environmental unpredictability.
Background: Measurement of cognitive behavioural therapy (CBT) competency is often resource intensive. A popular emerging alternative to independent observers’ ratings is using other perspectives for rating competency. Aims: This pilot study compared ratings of CBT competency from four perspectives – patient, therapist, supervisor and independent observer using the Cognitive Therapy Scale (CTS). Method: Patients (n = 12, 75% female, mean age 30.5 years) and therapists (n = 5, female, mean age 26.6 years) completed the CTS after therapy sessions, and clinical supervisor and independent observers rated recordings of the same session. Results: Analyses of variance revealed that therapist average CTS competency ratings were not different from supervisor ratings, and supervisor ratings were not different from independent observer ratings; however, therapist ratings were higher than independent observer ratings and patient ratings were higher than all other raters. Conclusions: Raters differed in competency ratings. Implications for potential use and adaptation of CBT competency measurement methods to enhance training and implementation are discussed.
Flumioxazin and fomesafen are commonly used to control glyphosate-resistant Palmer amaranth in cotton and other crops, thus increasing risk to select for Palmer amaranth biotypes resistant to protoporphyrinogen oxidase (PPO) inhibitors. A field experiment was conducted to determine the potential for fluridone and acetochlor to substitute for soil-applied PPO inhibitors in a Palmer amaranth management system with glufosinate applied twice POST and diuron plus MSMA POST-directed in conservation tillage cotton. Fluridone and flumioxazin applied preplant 23 to 34 d prior to planting were similarly effective. Fluridone and acetochlor plus diuron applied PRE controlled Palmer amaranth as well as fomesafen plus diuron PRE. All systems with preplant and PRE herbicides followed by glufosinate POST and diuron plus MSMA layby controlled Palmer amaranth well. Cotton yield did not differ among herbicide treatments. This research demonstrates that fluridone and acetochlor can substitute for soil-applied PPO-inhibiting herbicides in management systems for Palmer amaranth.
We sought to determine the frequency with which hospice and palliative social workers encounter patients, family caregivers, and other clients at risk of suicide, and to discover the extent to which hospice and palliative social workers feel prepared to address issues related to suicide in their professional practice.
We conducted a cross-sectional survey of hospice and palliative social workers, recruiting a convenience sample of volunteer respondents through advertisements at professional conferences and listservs, and via social media accounts associated with national organizations, state hospice and palliative care associations, and individual healthcare professionals.
Most respondents reported having worked with patients, family caregivers, or other clients who had exhibited warning signs of suicide during the previous year. Fewer respondents indicated that they had worked with patients and family members who had attempted or died by suicide. While the majority of respondents believed they possessed sufficient knowledge and skills to intervene effectively with individuals at risk of suicide, they indicated that additional education on this topic would be valuable for their professional practice.
Significance of results:
These study results suggest that suicide-related competencies are important in the practice of hospice and palliative social work. Future education and training efforts should include skill development in addition to knowledge building.
We describe a versatile infrared camera/spectrograph, IRIS, designed and constructed at the Anglo-Australian Observatory for use on the Anglo-Australian Telescope. A variety of optical configurations can be selected under remote control to provide several direct image scales and a few low-resolution spectroscopic formats. Two cross-dispersed transmission echelles are of novel design, as is the use of a modified Bowen-Burch system to provide a fast f/ratio in the widest-field option. The drive electronics includes a choice of readout schemes for versatility, and continuous display when the array is not taking data, to facilitate field acquisition and focusing.
The linearity of the detector has been studied in detail. Although outwardly good, slight nonlinearities prevent removal of fixed-pattern noise from the data without application of a cubic linearising function.
Specific control and data-reduction software has been written. We describe also a scanning mode developed for spectroscopic imaging.
Residual herbicides are routinely recommended to aid in control of glyphosate-resistant (GR) Palmer amaranth in cotton. Acetochlor, a chloroacetamide herbicide, applied PRE, controls Palmer amaranth. A microencapsulated (ME) formulation of acetochlor is now registered for PRE application in cotton. Field research was conducted in North Carolina to evaluate cotton tolerance and Palmer amaranth control by acetochlor ME alone and in various combinations. Treatments, applied PRE, consisted of acetochlor ME, pendimethalin, or no herbicide arranged factorially with diuron, fluometuron, fomesafen, diuron plus fomesafen, and no herbicide. The PRE herbicides were followed by glufosinate applied twice POST and diuron plus MSMA directed at layby. Acetochlor ME was less injurious to cotton than pendimethalin. Acetochlor ME alone or in combination with other herbicides reduced early season cotton growth 5 to 8%, whereas pendimethalin alone or in combinations injured cotton 11 to 13%. Early season injury was transitory, and by 65 to 84 d after PRE treatment, injury was no longer noticeable. Before the first POST application of glufosinate, acetochlor ME and pendimethalin controlled Palmer amaranth 84 and 64%, respectively. Control by acetochlor ME was similar to control by diuron plus fomesafen and greater than control by diuron, fluometuron, or fomesafen alone. Greater than 90% control was obtained with acetochlor ME mixed with diuron or fomesafen. Palmer amaranth control was similar with acetochlor ME plus a full or reduced rate of fomesafen. Acetochlor ME controlled large crabgrass and goosegrass at 91 and 100% compared with control at 83 and 91%, respectively, by pendimethalin. Following glufosinate, applied twice POST, and diuron plus MSMA, at layby, 96 to 99% control was obtained late in the season by all treatments, and no differences among herbicide treatments were noted for cotton yield. This research demonstrated that acetochlor ME can be safely and effectively used in cotton weed management programs.
Influenza A (H1N1) pdm09 became the predominant circulating strain in the United States during the 2013–2014 influenza season. Little is known about the epidemiology of severe influenza during this season.
A retrospective cohort study of severely ill patients with influenza infection in intensive care units in 33 US hospitals from September 1, 2013, through April 1, 2014, was conducted to determine risk factors for mortality present on intensive care unit admission and to describe patient characteristics, spectrum of disease, management, and outcomes.
A total of 444 adults and 63 children were admitted to an intensive care unit in a study hospital; 93 adults (20.9%) and 4 children (6.3%) died. By logistic regression analysis, the following factors were significantly associated with mortality among adult patients: older age (>65 years, odds ratio, 3.1 [95% CI, 1.4–6.9], P=.006 and 50–64 years, 2.5 [1.3–4.9], P=.007; reference age 18–49 years), male sex (1.9 [1.1–3.3], P=.031), history of malignant tumor with chemotherapy administered within the prior 6 months (12.1 [3.9–37.0], P<.001), and a higher Sequential Organ Failure Assessment score (for each increase by 1 in score, 1.3 [1.2–1.4], P<.001).
Risk factors for death among US patients with severe influenza during the 2013–2014 season, when influenza A (H1N1) pdm09 was the predominant circulating strain type, shifted in the first postpandemic season in which it predominated toward those of a more typical epidemic influenza season.
Infect. Control Hosp. Epidemiol. 2015;36(11):1251–1260
Interference for 40 d after emergence (DAE) of corn, cotton, peanut, and snap bean by four glyphosate-resistant (GR) and four glyphosate-susceptible (GS) Palmer amaranth populations from Georgia and North Carolina was compared in the greenhouse. Greater interference from Palmer amaranth, measured as crop height and fresh weight reduction, was noted in cotton and peanut compared with corn or snap bean. Crop height 15 to 40 DAE was reduced similarly by GR and GS populations. Crop fresh weight, however, was reduced 25 and 19% in the presence of GS and GR populations, respectively. Measured as percent reduction in fresh weight, GR and GS populations of Palmer amaranth were controlled similarly by glufosinate, lactofen, paraquat, and trifloxysulfuron applied POST. Atrazine and dicamba controlled GR populations more effectively than GS populations.
Glyphosate-resistant Palmer amaranth is a serious problem in southern cropping systems. Much phenotypic variation is observed in Palmer amaranth populations with respect to plant growth and development and susceptibility to herbicides. This may be related to levels of genetic diversity existing in populations. Knowledge of genetic diversity in populations of Palmer amaranth may be useful in understanding distribution and development of herbicide resistance. Research was conducted to assess genetic diversity among and within eight Palmer amaranth populations collected from North Carolina and Georgia using amplified fragment length polymorphism (AFLP) markers. Pair-wise genetic similarity (GS) values were found to be relatively low, averaging 0.34. The highest and the lowest GS between populations were 0.49 and 0.24, respectively, while the highest and the lowest GS within populations were 0.56 and 0.36, respectively. Cluster and principal coordinate (PCO) analyses grouped individuals mostly by population (localized geographic region) irrespective of response to glyphosate or gender of individuals. Analysis of molecular variance (AMOVA) results when populations were nested within states revealed significant variation among and within populations within states while variation among states was not significant. Variation among and within populations within state accounted for 19 and 77% of the total variation, respectively, while variation among states accounted for only 3% of the total variation. The within population contribution towards total variation was always higher than among states and among populations within states irrespective of response to glyphosate or gender of individuals. These results are significant in terms of efficacy of similar management approaches both in terms of chemical and biological control in different areas infested with Palmer amaranth.
Tactical emergency medical services (TEMS) bring immediate medical support to the inner perimeter of special weapons and tactics team activations. While initially envisioned as a role for an individual dually trained as a police officer and paramedic, TEMS is increasingly undertaken by physicians and paramedics who are not police officers. This report explores the ethical underpinnings of embedding a surgeon within a military or civilian tactical team with regard to identity, ethically acceptable actions, triage, responsibility set, training, certification, and potential future refinements of the role of the tactical police surgeon.
KaplanLJ, SiegelMD, EastmanAL, FlynnLM, RosenbaumSH, ConeDC, BlakeDP, MulhernJ. Ethical Considerations in Embedding a Surgeon in a Military or Civilian Tactical Team. Prehosp Disaster Med. 2012;27(6):1-6.