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.
In 2013, a task force was developed to discuss the future of the Canadian pediatric neurology workforce. The consensus was that there was no indication to reduce the number of training positions, but that the issue required continued surveillance. The current study provides a 5-year update on Canadian pediatric neurology workforce data.
Names, practice types, number of weekly outpatient clinics, and dates of certification of all physicians currently practicing pediatric neurology in Canada were obtained. International data were used to compute comparisons between countries. National data sets were used to provide information about the number of residency positions available and the number of Canadian graduates per year. Models for future projections were developed based on published projected population data and trends from the past decade.
The number of pediatric neurologists practicing in Canada has increased 165% since 1994. During this period, wait times have not significantly shortened. There are regional discrepancies in access to child neurologists. The Canadian pediatric neurology workforce available to see outpatient consultations is proportionally less than that of USA. After accounting for retirements and emigrations, the number of child neurologists being added to the workforce each year is 4.9. This will result in an expected 10-year increase in Canadian pediatric neurologists from 151 to 200.
Despite an increase in the number of Canadian child neurologists over the last two decades, we do not predict that there will be problems with underemployment over the next decade.
Background: Stroke is a rare neurological disease in children, with an annual incidence of 2 - 13/100,000 children per year. Pediatric stroke is associated with significant morbidity and mortality lasting many decades. Diagnosis of pediatric stroke is challenging and often delayed, limiting options for acute intervention, and the pharmacological and mechanical recanalization strategies that have revolutionized adult stroke remain undefined in children. Clinicians are left to draw conclusions from other retrospective cohort studies or case reports and extrapolate adult guidelines to the pediatric population. The TIPS trial eligibility criteria are often used in clinical practice, despite not being validated for this purpose. We present here the case of a healthy 14 year old male who was treated with intravenous tissue plasminogen activator (IV tPA) for a presumed arterial ischemic stroke without large vessel occlusion on neuroimaging. Methods: Retrospective chart review Results: Not applicable Conclusions: Following the administration of IV tPA, the patient made a full recovery. While we do not recommend the routine use of IV tPA for treatment of presumed large vessel or small vessel in children, we suggest that the decision to proceed with IV tPA be considered on a case-by-case basis.
Downy brome (Bromus tectorum L.) is a common impediment to ecological restoration, because its seedbank remains viable after repeated treatment with herbicides. Soil solarization has been used in ecological restoration to control seedbanks of invasive plants. Here we test the efficacy of soil solarization to reduce B. tectorum cover and establish native plants at a site in B. tectorum’s core invasive range with a long history of disturbance and infestation. Solarization raised soil temperatures by as much as 13 C and reduced B. tectorum densities by approximately 20-fold. In 30 plots solarized for 0 to 101 d, B. tectorum emerged in inverse abundance to treatment duration. Broadleaf weeds were less abundant than B. tectorum before treatment, and diminished under solarization, but their response to solarization was weaker than B. tectorum’s, and they emerged in greater numbers than B. tectorum 2 to 3 yr after treatment. When seeded after solarization, a native perennial bunchgrass, squirreltail [Elymus elymoides (Raf.) Swezey], did not differ in abundance between solarized and control plots. Solarization may facilitate B. tectorum control on a small scale without jeopardizing the establishment of native plants, but only if treatment durations are long and subsequent management of broadleaf weeds and remnant B. tectorum is planned.
X-ray fluorescence induced by charged particles has been employed in trace element analysis of both animal and human blood, tissue and bone samples. Preparation techniques included microtome slicing and wet digestion in nitric acid, internal chemical standards being used in the latter case.
Most of the specimens arose from a study of interactions between the toxic elements lead and zinc in growing foals; this was motivated by reports of sickness and death in foals raised near lead-zinc smelters. The cause of toxicity in animals from environmental pollution is often attributed to Single factors, whereas in reality interactions among many factors, including a variety of toxic and nutrient trace elements, should be considered.
A variety of spectra are presented and elemental concentrations derived. Agreement between the X-ray data and atomic absorption spectrophotometry is encouraging. The results demonstrate the potential of particle-excited X-ray fluorescenee as a broad-range analytical technique for the study of trace element interactions.
For livestock production systems to play a positive role in global food security, the balance between their benefits and disbenefits to society must be appropriately managed. Based on the evidence provided by field-scale randomised controlled trials around the world, this debate has traditionally centred on the concept of economic-environmental trade-offs, of which existence is theoretically assured when resource allocation is perfect on the farm. Recent research conducted on commercial farms indicates, however, that the economic-environmental nexus is not nearly as straightforward in the real world, with environmental performances of enterprises often positively correlated with their economic profitability. Using high-resolution primary data from the North Wyke Farm Platform, an intensively instrumented farm-scale ruminant research facility located in southwest United Kingdom, this paper proposes a novel, information-driven approach to carry out comprehensive assessments of economic-environmental trade-offs inherent within pasture-based cattle and sheep production systems. The results of a data-mining exercise suggest that a potentially systematic interaction exists between ‘soil health’, ecological surroundings and livestock grazing, whereby a higher level of soil organic carbon (SOC) stock is associated with a better animal performance and less nutrient losses into watercourses, and a higher stocking density with greater botanical diversity and elevated SOC. We contend that a combination of farming system-wide trials and environmental instrumentation provides an ideal setting for enrolling scientifically sound and biologically informative metrics for agricultural sustainability, through which agricultural producers could obtain guidance to manage soils, water, pasture and livestock in an economically and environmentally acceptable manner. Priority areas for future farm-scale research to ensure long-term sustainability are also discussed.
To develop sustainable grazing systems, an understanding of the complex interactions between competing plant species and grazing herbivores is needed. An understanding of dietary preference is a prerequisite to predicting how much and from which plant species animals select. This work initially concentrated on dietary preferences of sheep grazing perennial ryegrass and white clover swards and was then extended to other animal species to test the generality of our findings.
Previous research has shown relatively diminished medial prefrontal cortex activation and heightened psychophysiological responses during the recollection of personal events in post-traumatic stress disorder (PTSD), but the origin of these abnormalities is unknown. Twin studies provide the opportunity to determine whether such abnormalities reflect familial vulnerabilities, result from trauma exposure, or are acquired characteristics of PTSD.
In this case–control twin study, 26 male identical twin pairs (12 PTSD; 14 non-PTSD) discordant for PTSD and combat exposure recalled and imagined trauma-unrelated stressful and neutral life events using a standard script-driven imagery paradigm during functional magnetic resonance imaging and concurrent skin conductance measurement.
Diminished activation in the medial prefrontal cortex during Stressful v. Neutral script-driven imagery was observed in the individuals with PTSD, relative to other groups.
Diminished medial prefrontal cortex activation during Stressful v. Neutral script-driven imagery may be an acquired characteristic of PTSD. If replicated, this finding could be used prospectively to inform diagnosis and the assessment of treatment response.
Simultaneous observations of 8 Seyfert 1 type AGN (Fairall-9, Mrk 590, NGC 4051, 3C 273, NGC 5548, Mrk 841, Q 1821+643 and 3C 390.3) obtained with ROSAT and IUE (RIASS program), and for 5 sources (Fairall-9, NGC 4051, 3C 273, Mrk 841 and Q 1821+643) with Ginga, have been analysed with the aim of describing the UV to soft X-ray spectral component in these sources.
There are multiple recent reports of an association between anxious/depressed (A/D) symptomatology and the rate of cerebral cortical thickness maturation in typically developing youths. We investigated the degree to which anxious/depressed symptoms are tied to age-related microstructural changes in cerebral fiber pathways. The participants were part of the NIH MRI Study of Normal Brain Development. Child Behavior Checklist A/D scores and diffusion imaging were available for 175 youths (84 males, 91 females; 241 magnetic resonance imagings) at up to three visits. The participants ranged from 5.7 to 18.4 years of age at the time of the scan. Alignment of fractional anisotropy data was implemented using FSL/Tract-Based Spatial Statistics, and linear mixed model regression was carried out using SPSS. Child Behavior Checklist A/D was associated with the rate of microstructural development in several white matter pathways, including the bilateral anterior thalamic radiation, bilateral inferior longitudinal fasciculus, left superior longitudinal fasciculus, and right cingulum. Across these pathways, greater age-related fractional anisotropy increases were observed at lower levels of A/D. The results suggest that subclinical A/D symptoms are associated with the rate of microstructural development within several white matter pathways that have been implicated in affect regulation, as well as mood and anxiety psychopathology.
Head lice (Pediculus humanus capitis) infestations are a public health concern. The insecticidal properties of the Australian native plant Kunzea ambigua (commonly known as tick bush) have been documented. In this study, we tested activity of kunzea oil (KO) against head lice through in vitro bioassays. Head lice were exposed to filter paper treated with either KO, as either a 5 or 100% oil, or commercial formulations containing either permethrin or tea tree oil (TTO) for 120 min. Head lice exposure to KO, both as a 5 and 100% solution oil, resulted in 100% mortality within 120 min with a mean survival times of 17·1 and 34·8 min, respectively. There was no significant difference between the mean mortality of head lice exposed to 5% KO (17·1 ± 1·0; 95% CI: 115·2–19·0) and 5% TTO (21·2 ± 1·9; 95% CI: 17·4–25·1). This study revealed, for the first time, that KO holds great potential as an effective alternative to current active ingredients contained within commercial pediculicide formulations.
Discovery of the non-native Anoplophora glabripennis Motschulsky (Coleoptera: Cerambycidae) in Ontario, Canada, in 2003 led to the implementation of an eradication programme. The plan consisted of removing all infested trees and all trees belonging to a genus considered suitable for complete development of this wood-borer that were found within 400 m of an infested tree; however, many of the trees within that 400 m belonged to genera for which suitability for development of A. glabripennis was questionable or unknown. We visually inspected over 3000 such trees annually for the three years following removal of infested trees. All but one tree were unattacked: an ash (Fraxinus excelsior Linnaeus (Oleaceae)) tree had signs of oviposition and early-instar development, but not of adult emergence. Before that survey, we had found only one other species with questionable suitability, a little leaf linden (Tilia cordata Miller (Malvaceae)) that had many signs of oviposition, but no evidence of full development, suggesting resistance to A. glabripennis. Both of these trees were within 200 m of the most heavily infested maple (Acer platanoides Linnaeus (Sapindaceae)) tree found in that infestation, suggesting that colonisation of trees with questionable or unknown suitability might occur mostly where population pressure is high.
Background: Little knowledge exists on the availability of academic and community paediatric neurology positions. This knowledge is crucial for making workforce decisions. Our study aimed to: 1) obtain information regarding the availability of positions for paediatric neurologists in academic centres; 2) survey paediatric neurology trainees regarding their perceptions of employment issues and career plans; 3) survey practicing community paediatric neurologists 4) convene a group of paediatric neurologists to develop consensus regarding how to address these workforce issues. Methods: Surveys addressing workforce issues regarding paediatric neurology in Canada were sent to: 1) all paediatric neurology program directors in Canada (n=9) who then solicited information from division heads and from paediatric neurologists in surrounding areas; 2) paediatric neurology trainees in Canada (n=57) and; 3) community paediatric neurologists (n=27). A meeting was held with relevant stakeholders to develop a consensus on how to approach employment issues. Results: The response rate was 100% from program directors, 57.9% from residents and 44% from community paediatric neurologists. We found that the number of projected positions in academic paediatric neurology is fewer than the number of paediatric neurologists that are being trained over the next five to ten years, despite a clinical need for paediatric neurologists. Paediatric neurology residents are concerned about job availability and desire more career counselling. Conclusions: There is a current and projected clinical demand for paediatric neurologists despite a lack of academic positions. Training programs should focus on community neurology as a viable career option.
A policy consensus has not been reached regarding discontinuing contact precautions in patients with a history of methicillin-resistant Staphylococcus aureus (MRSA). We found that as many as 72% of outpatients flagged for past MRSA were no longer carriers, and a single nasal PCR test provided a reasonable negative predictive value for removing contact precautions.
Exceptional biotas—those in which the non-biomineralized tissues of organisms are preserved—are an important record of the evolutionary biology of the late Neoproterozoic—early Phanerozoic interval. Most of these biotas exhibit one of four modes of preservation: preservation of either 1) internal and external detail (Doushantuo-type preservation) or, 2) external cuticles (Orsten-type preservation) in calcium phosphate; 3) coating in pyrite films and infills (Beecher's Bed-type preservation); and 4) preservation of organic remains (Burgess Shale-type preservation). The global environmental and temporal distribution of each mode of preservation is reasonably well constrained, but not why these taphonomic windows existed when they did. The late Neoproterozoic – early Phanerozoic interval is characterized by complex, interlinked, physical, geochemical and biological changes to the Earth's biosphere and geosphere. The changing ecology of marine environments (from matground to mixgrounds: the ‘Agronomic Revolution’) occurred via an intermediate phase of stiffened, but not microbially bound sediments that extended the interval over which exceptional preservation occurred. Prolonged eustatic sea-level rise across flat-lying continental platforms ensured environments conducive to exceptional preservation were developed and, critically, sustained over large contiguous areas. During this, regolith on continental surfaces was recycled, providing an integral source of sediment and ions relevant to mineral authigenesis. Superimposed on these broad-scale changes are specific drivers that controlled the duration of individual taphonomic windows; elucidating these requires a better understanding of the environmental context and diagenetic history of fossiliferous successions at the intra-basinal scale.
Throughout much of the nineteenth century relations between Britain and Germany were blessed not only by the absence of any fundamental conflicts of national interest, but also by positive factors tending to encourage friendly ties. Memories of the common struggle against Napoleon, the predominantly Protestant character of tioth countries, and the marriage of Queen Victoria to a German prince all suggested a natural affinity between them. German liberals and conservatives alike found much to admire in English political institutions, while Englishmen in turn approved the steps, however halting, by which many of the German states adopted constitutions and representative institutions.
During the late 1840s British statesmen did appear to have recognized the benefits that would accrue for Britain through consolidation of the German Confederation, and there was also some discussion regarding the prospect of an Anglo-Prussian alliance. After 1846, thanks to Palmerston's stridency in the affair of the Spanish marriages, Britain lost the good will of France and thus remained diplomatically isolated in the face of the powerful conservative coalition of Austria, Prussia, and Russia.
Background: Video feedback (VF) interventions effectively reduce social anxiety symptoms and negative self-perception, particularly when they are preceded by cognitive preparation (CP) and followed by cognitive review. Aims: In the current study, we re-examined data from a study on the efficacy of a novel VF intervention for individuals high in social anxiety to test the hypothesis that physical appearance anxiety would moderate the effects of VF. Method: Data were analyzed from 68 socially anxious participants who performed an initial public speech, and were randomly assigned to an Elaborated VF condition (VF plus cognitive preparation and cognitive review), a Standard VF condition (VF plus cognitive preparation) or a No VF condition (exposure alone), and then performed a second speech. Results: As hypothesized, when appearance concerns were low, both participants who received Elaborated and Standard VF were significantly less anxious during speech 2 than those in the No VF condition. However, when levels of appearance concern were high, neither Elaborated nor Standard VF reduced anxiety levels during speech 2 beyond the No VF condition. Conclusions: Results from our analog sample suggest the importance of tailoring treatment protocols to accommodate the idiosyncratic concerns of socially anxious patients.