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This Cambridge Companion provides an engaging and expansive overview of gustation, gastronomy, agriculture and alimentary activism in literature from the medieval period to the present day, as well as an illuminating introduction to cookbooks as literature. Bringing together sixteen original essays by leading scholars, the collection rethinks literary food from a variety of critical angles, including gender and sexuality, critical race studies, postcolonial studies, eco-criticism and children's literature. Topics covered include mealtime decorum in Chaucer, Milton's culinary metaphors, early American taste, Romantic gastronomy, Victorian eating, African-American women's culinary writing, modernist food experiments, Julia Child and cold war cooking, industrialized food in children's literature, agricultural horror and farmworker activism, queer cookbooks, hunger as protest and postcolonial legacy, and “dude food” in contemporary food blogs. Featuring a chronology of key publication and historical dates and a comprehensive bibliography of further reading, this Companion is an indispensible guide to an exciting field for students and instructors.
Online self-reported 24-h dietary recall systems promise increased feasibility of dietary assessment. Comparison against interviewer-led recalls established their convergent validity; however, reliability and criterion-validity information is lacking. The validity of energy intakes (EI) reported using Intake24, an online 24-h recall system, was assessed against concurrent measurement of total energy expenditure (TEE) using doubly labelled water in ninety-eight UK adults (40–65 years). Accuracy and precision of EI were assessed using correlation and Bland–Altman analysis. Test–retest reliability of energy and nutrient intakes was assessed using data from three further UK studies where participants (11–88 years) completed Intake24 at least four times; reliability was assessed using intra-class correlations (ICC). Compared with TEE, participants under-reported EI by 25 % (95 % limits of agreement −73 % to +68 %) in the first recall, 22 % (−61 % to +41 %) for average of first two, and 25 % (−60 % to +28 %) for first three recalls. Correlations between EI and TEE were 0·31 (first), 0·47 (first two) and 0·39 (first three recalls), respectively. ICC for a single recall was 0·35 for EI and ranged from 0·31 for Fe to 0·43 for non-milk extrinsic sugars (NMES). Considering pairs of recalls (first two v. third and fourth recalls), ICC was 0·52 for EI and ranged from 0·37 for fat to 0·63 for NMES. EI reported with Intake24 was moderately correlated with objectively measured TEE and underestimated on average to the same extent as seen with interviewer-led 24-h recalls and estimated weight food diaries. Online 24-h recall systems may offer low-cost, low-burden alternatives for collecting dietary information.
Ubisoft's Assassin's Creed series is one the entertainment industry's most popular titles set in the past. With a new game released on an annual basis—each full of distinct historical places, events, and people—the series has unfolded across post-classical history, from the Levant during the Third Crusade to Victorian-era London. The 2017 release of Assassin's Creed: Origins, which entailed a massive reconstruction of Hellenistic Egypt, pushed the series even further back in time. With it, Ubisoft also launched its Discovery Tour, allowing players to explore the game's setting at their leisure and without combat. These trends continued in 2018's Assassin's Creed: Odyssey, set in Greece during the Peloponnesian War. This review discusses the narrative, world, and gameplay of the latest Assassin's Creed within the series more broadly. We provide a critical appraisal of the experience that Odyssey offers and link it to this question: in the Assassin's Creed series, do we engage in meaningful play with the past, or are we simply assassinating our way through history?
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.
The current study explored the experiences and aspirations of a cohort of Aboriginal and Torres Strait Islander adults with neurocognitive disability residing in a homeless shelter in regional Queensland, Australia. Neurocognitive disability (NCD) refers to any acquired disorder or injury to the brain where the primary clinical deficit is in cognitive function.
The data reported on in this paper emerged from a broader study that aimed to understand the extent and nature of neurocognitive disability amongst homeless Aboriginal and Torres Strait Islander people. The broader study found high levels of NCD which impacted on people’s ability to participate in society. As part of the study, qualitative information was sought regarding participant life experiences. A culturally safe and acceptable structure of “past, present and future” was applied to open-ended questions.
Thematic analysis of the data identified four broad themes of i) normalisation of illness and disability; ii) trauma and loss; iii) socioeconomic disadvantage; and iv) hope and disempowerment. This paper reports on these themes and experiences, which occurred across the life span, intersected with NCD, and contributed to what we have termed ‘complex disablement’ amongst this cohort.
While causal links between life experience, disability and disablement are not always clear, our findings suggest that attempts to address homelessness must engage with this complexity. The application of holistic, intersectoral supports, which encompass culturally informed, community driven approaches are needed. Understanding the impacts of individual and intergenerational trauma is crucial to safe and effective service provision for this cohort.
Facial transplantation is emerging as a therapeutic option for self-inflicted gunshot wounds. The self-inflicted nature of this injury raises questions about the appropriate role of self-harm in determining patient eligibility. Potential candidates for facial transplantation undergo extensive psychosocial screening. The presence of a self-inflicted gunshot wound warrants special attention to ensure that a patient is prepared to undergo a demanding procedure that poses significant risk, as well as stringent lifelong management. Herein, we explore the ethics of considering mechanism of injury in the patient selection process, referring to the precedent set forth in solid organ transplantation. We also consider the available evidence regarding outcomes of individuals transplanted for self-inflicted mechanisms of injury in both solid organ and facial transplantation. We conclude that while the presence of a self-inflicted gunshot wound is significant in the overall evaluation of the candidate, it does not on its own warrant exclusion from consideration for a facial transplantation.
Lean management and related ideas have had a significant impact on organizations throughout North America and the world. Despite its popularity and impact, I-O psychologists have largely neglected Lean as a research topic and few I-O psychologists engage in applied practice in the area. In this focal article, we provide a working definition of Lean and present examples of Lean’s influence. Next, we outline possible reasons to explain I-O psychologists’ indifference to Lean. Finally, we provide some topic areas that I-O psychologists can use to contribute to the Lean literature. By using I-O psychologists’ skill in measurement and evaluation, along with our considerable organizational theory, we believe that I-O psychology can improve Lean and broaden their impact. We hope this focal article will inspire I-O psychologists to reconsider a research and practice area that they have previously ignored. In addition, we hope that this article causes I-O psychologists to reflect on their role to play in addressing popular management trends.
The purpose of this study was to examine whether vehicle type based on size (car vs. other = truck/van/SUV) had an impact on the speeding, acceleration, and braking patterns of older male and female drivers (70 years and older) from a Canadian longitudinal study. The primary hypothesis was that older adults driving larger vehicles (e.g., trucks, SUVs, or vans) would be more likely to speed than those driving cars. Participants (n = 493) had a device installed in their vehicles that recorded their everyday driving. The findings suggest that the type of vehicle driven had little or no impact on per cent of time speeding or on the braking and accelerating patterns of older drivers. Given that the propensity for exceeding the speed limit was high among these older drivers, regardless of vehicle type, future research should examine what effect this behaviour has on older-driver road safety.
Recognising the significant extent of poor-quality care and human rights issues in mental health, the World Health Organization launched the QualityRights initiative in 2013 as a practical tool for implementing human rights standards including the United Nations Convention on Rights of Persons with Disabilities (CRPD) at the ground level.
To describe the first large-scale implementation and evaluation of QualityRights as a scalable human rights-based approach in public mental health services in Gujarat, India.
This is a pragmatic trial involving implementation of QualityRights at six public mental health services chosen by the Government of Gujarat. For comparison, we identified three other public mental health services in Gujarat that did not receive the QualityRights intervention.
Over a 12-month period, the quality of services provided by those services receiving the QualityRights intervention improved significantly. Staff in these services showed substantially improved attitudes towards service users (effect sizes 0.50–0.17), and service users reported feeling significantly more empowered (effect size 0.07) and satisfied with the services offered (effect size 0.09). Caregivers at the intervention services also reported a moderately reduced burden of care (effect size 0.15).
To date, some countries are hesitant to reforming mental health services in line with the CRPD, which is partially attributable to a lack of knowledge and understanding about how this can be achieved. This evaluation shows that QualityRights can be effectively implemented even in resource-constrained settings and has a significant impact on the quality of mental health services.
Using existing data from clinical registries to support clinical trials and other prospective studies has the potential to improve research efficiency. However, little has been reported about staff experiences and lessons learned from implementation of this method in pediatric cardiology.
We describe the process of using existing registry data in the Pediatric Heart Network Residual Lesion Score Study, report stakeholders’ perspectives, and provide recommendations to guide future studies using this methodology.
The Residual Lesion Score Study, a 17-site prospective, observational study, piloted the use of existing local surgical registry data (collected for submission to the Society of Thoracic Surgeons-Congenital Heart Surgery Database) to supplement manual data collection. A survey regarding processes and perceptions was administered to study site and data coordinating center staff.
Survey response rate was 98% (54/55). Overall, 57% perceived that using registry data saved research staff time in the current study, and 74% perceived that it would save time in future studies; 55% noted significant upfront time in developing a methodology for extracting registry data. Survey recommendations included simplifying data extraction processes and tailoring to the needs of the study, understanding registry characteristics to maximise data quality and security, and involving all stakeholders in design and implementation processes.
Use of existing registry data was perceived to save time and promote efficiency. Consideration must be given to the upfront investment of time and resources needed. Ongoing efforts focussed on automating and centralising data management may aid in further optimising this methodology for future studies.
To investigate whether adherence to the adapted Mediterranean Diet Score for Adolescents (MDS_A) and the adapted Mediterranean Diet Quality Index for Adolescents (KIDMED_A) is associated with better food/nutrient intakes and nutritional biomarkers.
The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study is a cross-sectional study aiming to obtain comparable data on a variety of nutritional and health-related parameters in European adolescents aged 12·5–17·5 years.
Nine European countries.
European adolescents (n 2330) recruited to the HELENA study. Dietary intake was obtained with 24 h dietary recalls, an FFQ and a Food Choices and Preferences questionnaire. MDS_A was calculated as a categorical variable using cut-offs (MDS_A), as a continuous variable (zMDS_A) and with energy adjustments (zEnMDS_A). The KIDMED_A score was also calculated.
Multilevel linear regression analysis showed positive associations for zMDS_A and KIDMED_A with serum levels of vitamin D, vitamin C, plasma folate, holo-transcobalamin, β-carotene and n-3 fatty acids, while negative associations were observed with trans-fatty acid serum levels. For categorical indices, blood biomarkers showed few significant results. zMDS_A and KIDMED_A showed positive associations with vegetables and fruits intake, and negative associations with energy-dense and low-nutritious foods. zMDS_A and KIDMED_A were positively associated with all macronutrients, vitamins and minerals (all P < 0·0001), except with monosaccharides and PUFA for KIDMED_A and cholesterol for both indices (P < 0·05).
zMDS_A and KIDMED_A have shown the strongest associations with the dietary indicators and biomarkers that have been associated with the Mediterranean diet before, and are therefore considered the most appropriate and valid Mediterranean diet scores for European adolescents.
At the first retinal synapse, horizontal cells (HCs) contact both photoreceptor terminals and bipolar cell dendrites, modulating information transfer between these two cell types to enhance spatial contrast and mediate color opponency. The synaptic mechanisms through which these modulations occur are still debated. The initial hypothesis of a GABAergic feedback from HCs to cones has been challenged by pharmacological inconsistencies. Surround antagonism has been demonstrated to occur via a modulation of cone calcium channels through ephaptic signaling and pH changes in the synaptic cleft. GABAergic transmission between HCs and cones has been reported in some lower vertebrates, like the turtle and tiger salamander. In these reports, it was revealed that GABA is released from HCs through reverse transport and target GABA receptors are located at the cone terminals. In mammalian retinas, there is growing evidence that HCs can release GABA through conventional vesicular transmission, acting both on autaptic GABA receptors and on receptors expressed at the dendritic tips of the bipolar cells. The presence of GABA receptors on mammalian cone terminals remains equivocal. Here, we looked specifically for functional GABA receptors in mouse photoreceptors by recording in the whole-cell or amphotericin/gramicidin-perforated patch clamp configurations. Cones could be differentiated from rods through morphological criteria. Local GABA applications evoked a Cl− current in cones but not in rods. It was blocked by the GABAA receptor antagonist bicuculline methiodide and unaffected by the GABAC receptor antagonist TPMPA [(1,2,5,6-tetrahydropyridin-4-yl)methylphosphinic acid]. The voltage dependency of the current amplitude was as expected from a direct action of GABA on cone pedicles but not from an indirect modulation of cone currents following the activation of the GABA receptors of HCs. This supports a direct role of GABA released from HCs in the control of cone activity in the mouse retina.
Chemically defended benthic macroalgae that dominate shallow, hard bottom communities along the western Antarctic Peninsula support very high densities of mesograzers, particularly amphipods but also small gastropods. Previous studies have demonstrated that the macroalgae and amphipods form a mutualistic relationship. The chemically defended macroalgae provide the amphipods with a refuge from predation while the macroalgae benefit from the amphipods greatly reducing surface fouling by smaller algae. One of the three most important macroalgae in terms of overstory cover, Himantothallus grandifolius, forms huge blades that can carpet the benthos. Field observations suggest that gastropods may be higher in relative abundance in proportion to amphipods on H. grandifolius than on other overstory macroalgae. The present study documents the finding that natural abundances of gastropods on H. grandifolius maintained in mesocosms reduce fouling by microscopic algae, primarily diatoms. However, amphipods are probably also important in keeping the macroalga clean of diatoms in nature. In a smaller scale experiment, three gastropod species were differentially effective at reducing diatom coverage on H. grandifolius. The hypothesis that gastropods benefit from associating with H. grandifolius in potentially gaining a refuge from sea-star predation was also tested but not supported by the experimental results.
OBJECTIVES/SPECIFIC AIMS: Our objective was to assess and compare the attitudes of patients with head and neck cancer and their clinicians regarding the commercialization of genetic research data. We explored whether such opinions changed when profits from such transactions were used to fund 1) cancer research, 2) academic research generally, or 3) if patients were given personalized genetic information in return. METHODS/STUDY POPULATION: This qualitative analysis was nested within a prospective precision oncology genomic sequencing study in an NCI-designated cancer center. We conducted paired, semi-structured interviews with enrolled participants with head & neck cancer and with their doctors (medical oncologists, surgical oncologists, and radiation oncologists). Interviews were recorded, transcribed, and coded for analysis. Codes were developed through an iterative process until saturation was reached, and all transcripts were double-coded (and discrepancies reconciled) to ensure reliability. RESULTS/ANTICIPATED RESULTS: We identified three main themes from the patients and clinicians: (1) Both clinicians and their patients were unclear about how the study protocol and informed consent form authorized patients’ genetic data to be used and commercialized in the future. (2) Patients with cancer were generally more comfortable than their clinician thought they were regarding the ongoing research use of their genetic data and commercialization thereof. (3) There is a strong interest among patients and clinicians in focusing academic medical center profits from commercialization back into the research program from which the data was acquired, rather than being invested into academic research more broadly. DISCUSSION/SIGNIFICANCE OF IMPACT: Given patients’ strong feelings about the commercialization of their data, our results highlight the need for greater transparency—both with patients and with their clinicians—about potential future use of research data. Clinicians appear inclined to be particularly cautious regarding access to and commercialization of patients’ data, however patients generally hope that their data may be used to help future cancer patients. Explicit discussions with patients about specific future uses of profits derived from commercialization of research data can ensure both transparency and participation in future primary and secondary precision health research programs.
We investigated the impact of discontinuation of contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus infected or colonized patients on central-line associated bloodstream infection rates at an academic children’s hospital. Discontinuation of contact precautions with a bundled horizontal infection prevention platform resulted in no adverse impact on CLABSI rates.
Interaction between the peoples of northern Africa has thrived for millennia; isotopic analysis of skeletal remains is an excellent method to examine this interface and better understand the associated social implications. Here, we discuss the applicability of strontium (87Sr/86Sr) and oxygen (δ18O) isotope analysis to osteological specimens. These elements, characterised by geological, locale-specific, atomic ratios, are incorporated into human dental enamel during young adulthood and into bone continuously via food and/or water. This information can then be compared to the individual’s place of burial and, thus, can infer mobility and identity.
Specifically, we address migration between Egypt and Nubia during various periods. The Upper Nubian archaeological site of Tombos, located on the Third Cataract of the Nile in modern Sudan (Fig. 7.1), functioned as an Egyptian colonial outpost during the New Kingdom Period (1550–1069 BC).