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To investigate whether a small regional memory clinic would benefit from engaging with a structured external audit process such as the Royal College of Psychiatrists’ Memory Service National Accreditation Program (MSNAP).
The Psychiatry of Old Age service in Navan operates a public cognitive clinic. Despite the publication of the 2014 National Dementia Strategy, there are currently no national standards for memory clinics in Ireland. It may be beneficial to link in with an external quality control system as part of routine clinical governance.
Published data from the MSNAP group was reviewed and a set of audit materials extrapolated to replicate the MSNAP self-review process. The audit cycle involved (1) retrospective case review, (2) institution of a range of interventions and (3) a prospective audit, which included service user feedback.
Overall the results demonstrated a high standard of service, especially in the areas of accessibility, assessment and communication of diagnosis. The clinic performed well against MSNAP key performance indicators. Patient and carer satisfaction with the service was very high. Clinic policies needed further development, particularly in the areas of referral, consent and data protection.
The process was useful, providing clear pointers for action. It highlighted the need to formalise organisational and practice policies, patient support and education, audit and outreach. Although accreditation is a laborious process requiring financial investment, it provides a strong scaffold to maintain and improve standards and is likely to be a valuable learning experience, where national guidelines are lacking.
To examine the delivery and assessment of psychiatry at undergraduate level in the six medical schools in the Republic of Ireland offering a medical degree programme.
A narrative description of the delivery and assessment of psychiatry at undergraduate level by collaborative senior faculty members from all six universities in Ireland.
Psychiatry is integrated to varying degrees across all medical schools. Clinical experience in general adult psychiatry and sub-specialities is provided by each medical school; however, the duration of clinical attachment varies, and the provision of some sub-specialities (i.e. forensic psychiatry) is dependent on locally available resources. Five medical schools provide ‘live’ large group teaching sessions (lectures), and all medical schools provide an array of small group teaching sessions. Continuous assessment encompasses 10–35% of the total assessment marks, depending on the medical school. Only one medical school does not provide a clinical examination in the form of an Objective Structured Clinical Examination with viva examinations occurring at three medical schools.
Many similarities exist in relation to the delivery of psychiatry at undergraduate level in Ireland. Significant variability exists in relation to assessment with differences in continuous assessment, written and clinical exams and the use of vivas noted. The use of e-learning platforms has increased significantly in recent years, with their role envisaged to include cross-disciplinary teaching sessions and analysis of examinations and individual components within examinations which will help refine future examinations and enable greater sharing of resources between medical schools.
High-redshift quasars are unique probes of the evolution of supermassive black holes and the intergalactic medium at the end of the epoch of reionization. We present the optical spectra of eight new z ~ 6 quasars selected from the Panoramic Survey Telescope & Rapid Response System 1 (Pan-STARRS1). Details of the selection strategy can be found in Bañados et al. (2014). With this work we increase the number of known quasars at z < 5.7 by more than 10%. The quasars discovered here span a large range of luminosities (19.6 ≤ zP1 ≤ 21.2) and are remarkably heterogeneous in their spectral features: half of them show bright emission lines whereas the other half show weak or no Lyα emission line. We find a larger fraction of weak–line emission quasars than in lower redshift studies, although still based on low number statistics, this may imply that the quasar population could be more diverse than previously thought.
Genetic (or ‘genomic’) imprinting, a feature of approximately 100 mammalian genes, results in monoallelic expression from one of the two parentally inherited chromosomes. To date, most studies have been directed on imprinted genes in murine or human models; however, there is burgeoning interest in the effects of imprinted genes in domestic livestock species. In particular, attention has focused on imprinted genes that influence foetal growth and development and that are associated with several economically important production traits in cattle, sheep and pigs. We have re-sequenced regions in 20 candidate bovine imprinted genes in order to validate single nucleotide polymorphisms (SNPs) that may influence important production traits in cattle. Putative SNPs detected via re-sequencing were subsequently re-formatted for high-throughput SNP genotyping in 185 cattle samples comprising 138 performance-tested European Bos taurus (all Limousin bulls), 29 African B. taurus and 18 Indian B. indicus samples. Analysis of the resulting genotypic data identified 117 validated SNPs. Preliminary genotype–phenotype association analyses using 83 SNPs that were polymorphic in the Limousin samples with minor allele frequencies ⩾0.05 revealed significant associations between two candidate bovine imprinted genes and a range of important beef production traits: average daily gain, average feed intake, live weight, feed conversion ratio, residual feed intake and residual gain. These genes were the Ras protein-specific guanine nucleotide releasing factor gene (RASGRF1) and the zinc finger, imprinted 2 gene (ZIM2). Despite the relatively small sample size used in these analyses, the observed associations with production traits are supported by the purported biological function of the RASGRF1 and ZIM2 gene products. These results support the hypothesis that imprinted genes contribute significantly to important complex production traits in cattle. Furthermore, these SNPs may be usefully incorporated into future marker-assisted and genomic selection breeding schemes.
Encoding and maintenance of information in working memory, followed by internal manipulation of that information for planning adaptive behavior, are two key components of working-memory systems. Both processes have been reported to be impaired in schizophrenia, but few studies have directly compared the relative severity of these abnormalities, or the degree to which manipulation deficits might be secondary to alterations in maintenance processes.
Clinically stable schizophrenia patients (n=25) and a demographically similar healthy comparison group (n=24) were administered a verbal span task with three levels of working-memory load. Maintenance was assessed using sequential position questions. Manipulation processes were assessed by requiring comparison of the relative sequential position of test items, which entailed simultaneous serial search strategies regarding item order.
Both groups showed reduced accuracy and increased reaction time for manipulation compared with maintenance processing. There were significant patient impairments across working-memory loads. There was no differential deficit in manipulation processing, and effect sizes of relative deficit in the patient group were higher for maintenance than manipulation processing.
The strong correlation for maintenance and manipulation deficits suggest that impairments in the ability to internally manipulate information stored in working-memory systems are not greater than alterations in the encoding and maintaining of information in working memory and that disturbances in maintenance processing may contribute to deficits in higher-order working-memory operations.
A 2 ✕ 2 factorial arrangement of treatments used 280 growing pigs and 240 finishing pigs to examine the main effects and interactions between two levels of stocking density (0·75 m2 v. 0·45 m2 per growing pig and 0·88 m2 v. 0·53 m2 per finishing pig) and grouping (static groups v. regrouped) on pig growth performance, carcass characteristics, nutrient digestibility and measurements of physiological indicators of stress responses. Regrouping was achieved by moving four unfamiliar pigs between replicate groups every 14 days. Average daily gain (ADG) and average daily food intake (ADFI) were reduced by an additive interaction between high density and regrouping in growing pigs (P < 0·01). In finishing pigs, regrouping reduced ADG (P 0·05) and carcass weight (P 0·05). Regrouping reduced apparent dry matter and gross energy digestibility in finishing pigs (P 0·05). Rectal temperature increased 3 h after mixing finishing pigs (P 0·05), but not growing pigs. In growing pigs, the neutrophil: lymphocyte ratio tended to increase (P 0·1) after regrouping, although plasma cortisol concentration was unaffected. In finishing pigs, the response to a Newcastle disease virus antigen challenge tended to decrease at high stocking density (P 0·1), although total IgG concentration was unaffected. In conclusion, the growth performance of growing and finishing pigs was affected by social stressors. However, effects on the physiological measurements did not concur with effects on growth performance.
The linear stability of tearing modes in a cylindrical plasma subject to a sub-Alfvénic equilibrium shear flow along the equilibrium magnetic field is considered. The equations in the resistive boundary layer at the rational surface are solved numerically using a Fourier transform combined with a finite-element approach. The behaviour of the growth rate as a function of the flow and the various parameters (including a perpendicular fluid viscosity) is obtained. Marginal stability curves showing the dependence of the familiar matching parameter $\Delta'$ with flow and shear are also given.
The Royal College of Anaesthetist requires that trainees wishing to specialise in Anaesthesia register with the College and keep a logbook documenting their experience and training in clinical anaesthesia. There are a number of advantages if such logbooks are kept in an electronic format. For the first time in the United Kingdom, we have evaluated the usefulness in a district general hospital of introducing a computerized system of record keeping based on a portable palm top computer. This has enabled the careful analysis of the individual work load of each trainee in the department by means of a specific program designed to generate a comprehensive report after the information from each individual has been downloaded on to a standard desk top computer. We have found a number of interesting and unexpected results and have highlighted ways in which the system may be improved.
We investigate strain and composition of epitaxial single layers of wurtzite InxGa1−xN (0<x<0.25) grown by MOCVD on top of GaN/Al203 substrates. It is shown that significant inaccuracies may arise in composition assessments if strain in InxGa1−xN/GaN heterostructures is not properly taken into account. Rutherford backscattering spectrometry (RBS) measures composition, free from the effects of strain and with depth resolution. Using X-ray diffraction (XRD) we measure both a- and c- parameters of the strained wurtzite films. By measuring both lattice parameters and solving Hooke's equation, a good estimation for composition can be obtained from XRD data. The agreement between RBS and XRD data for composition allows reliable values for perpendicular (εzz) and parallel strain components ( (εxx) to be determined. RBS and depth resolved cathodoluminescence (CL) measurements further indicate that the indium content is not uniform over depth in some samples. This effect occurs for the most strained layers, suggesting that strain is the driving force for compositional pulling.
Five samples from tested pig herds (Large White 1972, 1975, and 1976, British Landrace 1976 and Welsh 1976) were used to estimate the current rate of inbreeding in British pig testing herds. The annual rates of inbreeding (%) were estimated at 0·32, 0·19, 0·24, 0·33 and 0·34 respectively in the five samples. Overall average estimates of 0·49 to 0·52% per generation are similar to estimates from other pig populations reported in the literature. Coefficients of relationship within farms were calculated for various sib and non-sib groups and these were used to estimate the genetic contributions to the variance components in the analysis of variance of test records.
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