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We implemented universal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing of patients undergoing surgical procedures as a means to conserve personal protective equipment (PPE). The rate of asymptomatic coronavirus disease 2019 (COVID-19) was <0.5%, which suggests that early local public health interventions were successful. Although our protocol was resource intensive, it prevented exposures to healthcare team members.
The practice of extended family and friends helping to care for children when their parents are unable to is an enduring tradition in many cultures. Kinship care provides the largest proportion of out of home care in Western society but many of these carers experience poverty and deprivation, and do not receive comparable levels of support, financial or professional, to other placement types. This study provides UK evidence for the relationship between kinship care and deprivation and examines how the welfare state frames kinship care in policy and practice.
There is an increasing interest in divesting activities, giving rise to several initiatives both academic and governmental to identify and address one of the problems of health systems. In 2013 the Spanish Atlas of Variability in Clinical Practice (VPM) in collaboration with the Spanish Network of Health Technology Assessment (HTA) Agencies started a project with the purpose of providing elements to support a national strategy aimed at minimizing the use of doubtful procedures in the Spanish National Health System (1).
The identification, selection and definition of low added value procedures and the determination of the most cost-effective alternatives were carried out jointly between the AtlasVPM group and the HTA agencies of Andalusia (AETSA), Catalonia (AQUAS), Galicia (Avalia-t), Basque Country (Osteba), Madrid (UETS) and Aragon (IACS). The process consisted of the following phases: (i) Literature review; (ii) Preliminary list of procedures of dubious value; (iii) Analysis of feasibility and construction of the indicators (variability); and (iv) Empirical validation of the defined indicators. Different lists and sources of evidence were used to identify the procedures and evidence that support their low-value.
The synthesis of the evidence gave rise to an initial list of fifty-nine procedures of doubtful value that could be classified as: obsolete or outdated procedures in comparison to more effective / cost-effective alternatives (n = 31), procedures of doubtful value when used outside their main indication (n = 17) and procedures for which the evidence around effectiveness was still insufficient (n = 11). With the advice of clinical experts and coders, the original list was reduced to seventeen procedures and after some adjustments to thirteen.
Identifying procedures of low-added value is a complex task and is context dependent. Literature could be useful to identify a preliminary list but the analysis of the clinical practice, its variability and reasons that justify it are required to determine which procedures are good candidates for disinvestment.
The focus of this work is on back contact improvement for sputtered CZTS thin film solar cells. Three methods have been investigated including a thin Ag coating, a thin ZnO coating on the Mo back contact and rapid thermal annealing of the back contact. All of these methods have been found to reduce defects such as voids as well as secondary phases at the back contact region and inhibit the formation of MoS2. Consequently all the mothods effectively enhances Voc, Jsc, FF and therefore efficiency significantly.
Due to rising rates of obesity globally, the present study aimed to examine differences in overweight and underweight prevalence in Western Australian schoolchildren in 2008 compared with 2003.
Cross-sectional study at two time points; using two-stage stratified sampling, primary and secondary schools in both metropolitan and non-metropolitan Western Australia; sample selected was representative of the State's population figures.
Seventeen primary and thirteen secondary (2008) and nineteen primary and seventeen secondary (2003) schools. Government and non-government funded schools in metropolitan and non-metropolitan (regional/rural) Western Australia were recruited.
Height and weight were measured for 1708 (961 primary and 747 secondary) students in 2008 and 1694 (876 primary and 817 secondary) students in 2003.
Overweight and obesity prevalence in primary students was similar in 2008 (22·9 %) to 2003 (23·2 %; P > 0·05). In secondary girls overweight and obesity prevalence dropped from 23·1 % (2003) to 15·9 % (2008; P = 0·002). Secondary boys showed a slight decrease in overweight and obesity prevalence; however, this was not statistically significant (P = 0·102). Higher proportions of underweight in primary girls were observed in 2008 (9·9 %) compared with 2003 (4·2 %; P < 0·001) and in secondary girls in 2008 (9·4 %) compared with 2003 (5·5 %; P < 0·001).
Prevalence of overweight and obesity in Western Australian primary students was stable; however, it declined in secondary students. Both primary and secondary girls showed an increase in underweight prevalence. Public health interventions are needed for the high percentage of youth still overweight, whereas the observed increase in underweight girls warrants attention and further investigation.
An up-converter (UC) absorbs two or more low-energy photons and emits a single high-energy photon. A down-converter (DC) absorbs a single high-energy photon and emits two or more low energy photons. The current work extends previous limiting efficiency analysis to a combination of UC and DC; an up converter with two levels; and to compare analyses using real air mass data with that modelling the sun as a blackbody. Analysis has been carried out both with the band gap of the cell as an optimized parameter and at a fixed value of 1.1eV. All of UC, DC and two level UC are shown to improve efficiencies for both spectra. Combined UC/DC improves the efficiency further for the 1.1eV band gap but gives a lower efficiency for the optimised band gap. The explanation for this unexpected result is presented based on the small coupling losses that result from absorption/re-emission in the DC. The limiting efficiencies of such an approach are very similar to several other third generation concepts such as impurity PV, Intermediate Band solar cells or three level tandems. However in practice the UC (or DC) approach has the advantage that the optical properties of the UC are decoupled from the electrical properties of the PV cell, and hence each can be optimised independently. This means that it may be the simplest third generation approach to implement using existing PV cells, if a reasonable UC efficiency can be obtained. Nonetheless experimental work on realising UC is at an early stage. Some of the work on rare earth doped UC is reviewed together with the potential to improve the spectral sensitivity to below band gap radiation.
Surveys have found that otherwise well individuals report delusional experiences. Previous studies have shown an association between psychotic symptoms and exposure to trauma.
To explore the association between trauma and delusional experiences in a community sample.
Respondents (n = 10 641) were assessed for delusional experiences, exposure to various types of traumatic experiences and the presence of post-traumatic stress disorder (PTSD). The endorsement of delusional items was examined in people exposed to traumatic events who did or did not have PTSD.
Exposure to any traumatic event but without the development of PTSD was associated with increased endorsement of delusional experiences (relative risk 2.68, 95% CI 2.18–3.30) and there was a significant dose–response relationship between the number of types of traumatic events and endorsement of such experiences (χ2 =26.74, d.f. =2, P < 0.001). A diagnosis of PTSD further increased endorsement of delusional experiences (RR = 9.24, 95% CI 6.95–12.27). The association between PTSD and delusional experiences remained significant after adjusting for factors associated with psychotic symptoms.
Further investigation into the pathways between trauma, delusions and psychosis may provide insights into shared aetiological mechanisms underpinning these conditions.
Diagnosis of a major depressive episode by the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association requires 5 out of 9 symptoms to be present. Therefore, individuals may differ in the specific symptoms they experience and reach a diagnosis of depression via different pathways. It has been suggested that depressed women more often report symptoms of sleep disturbance, appetite or weight disturbance, fatigue, feelings of guilt/worthlessness and psychomotor retardation than depressed men. In the current study, we investigate whether depressed men and women differ in the symptoms they report. Two samples were selected from a sample of Dutch and Australian twins and siblings. First, Dutch and Australian unrelated depressed individuals were selected. Second, a matched epidemiological sample was created consisting of opposite-sex twin and sibling pairs in which both members were depressed. No sex differences in prevalence rates for symptoms were found, with the exception of decreased weight in women in the sample of unrelated individuals. In general, the similarities in symptoms seem to far outweigh the differences in symptoms between men and women. This signifies that men and women are alike in their symptom profiles for major depression and genes for depression are probably expressed in the same way in the two sexes.
The aim of this study was to investigate familial influences and their dependence on sex for panic disorder and/or agoraphobia, social phobia, generalized anxiety disorder and major depression. Data from Australian (N = 2287) and Dutch (N = 1185) twins and siblings who were selected for a linkage study and participated in clinical interviews to obtain lifetime Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) diagnoses were used. In a liability model, tetrachoric correlations were estimated in sibling pairs and sex differences between sibling correlations were tested. For each diagnosis, the sibling correlations could be constrained to be equal across the Australian and Dutch samples. With the exception of panic disorder and/or agoraphobia, all sibling correlations were the same for brother, sister and opposite-sex sibling pairs and were around .20. For panic disorder and/or agoraphobia, the correlation was .23 in brother and sister pairs, but absent in opposite-sex sibling pairs. From these results it can be concluded that upper heritability estimates, based on twice the correlations in the sibling pairs, vary between 36% (major depression) and 50% (social phobia). Furthermore, different genetic risk factors appear to contribute to the vulnerability for panic disorder and/or agoraphobia in men and women. No other sex differences were found.
Multivariate modelling of anxiety and depression data in twins has suggested that the two phenotypes are largely underpinned by one genetic factor, while other studies have indicated a relationship between these disorders and the neuroticism personality trait. As part of a study to identify quantitative trait loci for anxiety and depression, questionnaire responses and interviews of 15 027 Australian twins and 11 389 of their family members conducted during the past 20 years were reviewed to identify individuals with neuroticism, anxiety and depression scores in the upper or lower deciles of the population. This information was then used to identify extreme discordant and concordant (EDAC) sib pairs. 1373 high-scoring and 1571 low-scoring subjects (2357 sib pairs) were selected for participation, and extremely high participation rates were achieved, with over 90% of contactable prospective participants completing the interview phase, and over 90% of these providing blood or buccal samples. Participation bias arising from the nature of the selection variables was minimal, with only a small difference between rates of interview participation among prospective participants with high and low selection scores (89.4% vs 91.6%). The interview permitted the diagnosis of depression and several anxiety disorders (OCD, agoraphobia, panic disorder, generalised anxiety disorder) in this sample according to DSM-IV criteria. The methodology for selection of prospective subjects was demonstrated to be extremely successful, with highly significant differences in depression and anxiety disorder prevalence rates between individuals in the two selection groups. The success of this EDAC sampling scheme will enhance the power for QTL linkage and association analysis in this sample. Twin Research (2000) 3, 299–309.
The CV PQ Gem is thought by many to be the first truly ‘Intermediate’ Polar in that it displays characteristics typical of the synchronous and high magnetic field strength (B ~10–230MG) AM Her systems as well as those of the asynchronous (and much weaker magnetic field strength) Intermediate Polar systems. Here we present the results of quasi-simultaneous optical photopolarimetric and EUVE observations.
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