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.
Despite considerable academic attention to the role of family caregivers within the general population, little research has been conducted with Indigenous families. This qualitative study aims to fill that gap by focusing on the experiences of Metis caregivers providing care for older Metis adults. Focus groups and interviews were conducted with Metis family caregivers (n = 79), Metis Elders (n = 11) and formal caregivers (n = 8). Although there are considerable parallels in the caregiving experiences identified in this Metis study with those already documented in the literature, there are nonetheless important differences for providing culturally responsive care to Metis seniors.
Describe the epidemiological and molecular characteristics of an outbreak of Klebsiella pneumoniae carbapenemase (KPC)–producing organisms and the novel use of a cohorting unit for its control.
A 566-room academic teaching facility in Milwaukee, Wisconsin.
Solid-organ transplant recipients.
Infection control bundles were used throughout the time of observation. All KPC cases were intermittently housed in a cohorting unit with dedicated nurses and nursing aids. The rooms used in the cohorting unit had anterooms where clean supplies and linens were placed. Spread of KPC-producing organisms was determined using rectal surveillance cultures on admission and weekly thereafter among all consecutive patients admitted to the involved units. KPC-positive strains underwent pulsed-field gel electrophoresis and whole-genome sequencing.
A total of 8 KPC cases (5 identified by surveillance) were identified from April 2016 to April 2017. After the index patient, 3 patients acquired KPC-producing organisms despite implementation of an infection control bundle. This prompted the use of a cohorting unit, which immediately halted transmission, and the single remaining KPC case was transferred out of the cohorting unit. However, additional KPC cases were identified within 2 months. Once the cohorting unit was reopened, no additional KPC cases occurred. The KPC-positive species identified during this outbreak included Klebsiella pneumoniae, Enterobacter cloacae complex, and Escherichia coli. blaKPC was identified on at least 2 plasmid backbones.
A complex KPC outbreak involving both clonal and plasmid-mediated dissemination was controlled using weekly surveillances and a cohorting unit.
As knowledge production has become a more salient part of the economy, intellectual property laws have expanded. From a backwater of specialists in patent, copyright, and trademark law, intellectual property has become linked to trade through successive international agreements, and appreciated as a key to both economic and cultural development. Furthermore, law has begun to engage the interest of economists, political theorists, and human rights advocates. But because each discipline sees intellectual property in its own way, legal scholarship and practice have diverged, and the debate over intellectual property law has become fragmented. This book is aimed at bringing this diverse scholarship and practice together. It examines intellectual property through successive lenses (incentive theory, trade, development, culture, and human rights) and ends with a discussion of whether and how these fragmented views can be reconciled and integrated.
This paper describes the use of a neutron probe to measure detailed stratigraphy in ice and snow. The Wallingford neutron probe, developed for measurement of soil moisture, consists of an annular radioactive source of fast neutrons around the centre of a cylindrical detector for slow (thermal) neutrons. In snow and ice, the fast neutrons lose energy by scattering from hydrogen atoms, and the number of slow neutrons arriving at the detector (the count rate) is related to the density of the medium. Calibration equations for count rate as a function of snow density and borehole diameter have been derived. Snow-density profiles from boreholes obtained using the probe show that, despite the smoothing produced by the neutron-scattering process, annual variations in density can be resolved. The potential contribution of the neutron probe to improvements in mass-balance monitoring is discussed.
Computerised cognitive–behavioural therapy (cCBT) for depression has the potential to be efficient therapy but engagement is poor in primary care trials.
We tested the benefits of adding telephone support to cCBT.
We compared telephone-facilitated cCBT (MoodGYM) (n = 187) to minimally supported cCBT (MoodGYM) (n = 182) in a pragmatic randomised trial (trial registration: ISRCTN55310481). Outcomes were depression severity (Patient Health Questionnaire (PHQ)-9), anxiety (Generalized Anxiety Disorder Questionnaire (GAD)-7) and somatoform complaints (PHQ-15) at 4 and 12 months.
Use of cCBT increased by a factor of between 1.5 and 2 with telephone facilitation. At 4 months PHQ-9 scores were 1.9 points lower (95% CI 0.5–3.3) for telephone-supported cCBT. At 12 months, the results were no longer statistically significant (0.9 PHQ-9 points, 95% CI −0.5 to 2.3). There was improvement in anxiety scores and for somatic complaints.
Telephone facilitation of cCBT improves engagement and expedites depression improvement. The effect was small to moderate and comparable with other low-intensity psychological interventions.
This study examined teachers’ perceptions of the role of teacher aides in mathematics classrooms in rural and remote Indigenous communities. Twelve teachers from three schools in rural and remote Queensland participated in the study. The results from the first year of the project indicated that there were differences in how these teachers worked with their teacher aides, particularly the specific roles assigned to them in the mathematics classroom, with non-Indigenous teacher aides being given greater responsibilities for student learning and Indigenous teacher aides for behavioural management. As a result of teacher aide in-service on mathematics learning, teachers’ perception of the Indigenous teacher aides changed, resulting in each being given greater responsibility for student learning.
Studies on the role of diet in the development of chronic diseases often rely on self-report surveys of dietary intake. Unfortunately, many validity studies have demonstrated that self-reported dietary intake is subject to systematic under-reporting, although the vast majority of such studies have been conducted in industrialised countries. The aim of the present study was to investigate whether or not systematic reporting error exists among the individuals of African ancestry (n 324) in five countries distributed across the Human Development Index (HDI) scale, a UN statistic devised to rank countries on non-income factors plus economic indicators. Using two 24 h dietary recalls to assess energy intake and the doubly labelled water method to assess total energy expenditure, we calculated the difference between these two values ((self-report − expenditure/expenditure) × 100) to identify under-reporting of habitual energy intake in selected communities in Ghana, South Africa, Seychelles, Jamaica and the USA. Under-reporting of habitual energy intake was observed in all the five countries. The South African cohort exhibited the highest mean under-reporting ( − 52·1 % of energy) compared with the cohorts of Ghana ( − 22·5 %), Jamaica ( − 17·9 %), Seychelles ( − 25·0 %) and the USA ( − 18·5 %). BMI was the most consistent predictor of under-reporting compared with other predictors. In conclusion, there is substantial under-reporting of dietary energy intake in populations across the whole range of the HDI, and this systematic reporting error increases according to the BMI of an individual.
Credit is due a great many individuals for sustained, serious and heartbreaking efforts to achieve successful dance productions within the organization of the Federal Theatre Project in New York, but there is one person who has practically given all her life to it for the past three years and has repeatedly and consistently identified her own career with it. She has been responsible for four productions and has done more than any other one person to hold the whole project together and keep it going. Without her tremendous creative enthusiasm and energy, her personal and artistic integrity, her sense of social responsibility, I doubt if this project could ever have endured. I doubt it could have been organized in the first place.… I am speaking of Tamiris.
The history of the Works Progress Administration's short-lived Federal Dance Theatre embodies many of the aspirations, achievements, ambiguities, handicaps and frustrations of Franklin Delano Roosevelt's New Deal. Like the other Works Progress Administration (WPA) relief programs, the Federal Dance Theatre (FDT) was created with federal funds to help alleviate the hardships brought on by the Great Depression. The FDT was established in January 1936 as a distinct artistic entity within the WPA relief organization. It employed professional dancers, choreographers, musicians, designers, and technicians, and set before them the task of producing socially relevant dance pieces for the American people, in particular, audiences that had not previously had access to the theatre. That the Federal Dance Theatre came into existence at all and managed to stay afloat and produce a few critically acclaimed productions of social portent and artistic merit was largely due to the perseverance of modern dance maverick, Helen Tamiris (1905–1966).