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Physical activity is increasingly positioned as playing an important role in preventing and mitigating many of the decrements associated with biological ageing. As a result, public health messages encourage older people to remain active in later life. Despite this, physical activity participation rates among older adults are low. This may be in part related to the conventional approach to understanding physical activity participation as a product of motivation. We contend that this approach does not allow for a deeper exploration of the wider structural, historical and discursive contexts in which physical activity participation occurs. Therefore, we propose that physical activity can be reconceptualised as a career. Through a synthesis of findings from four studies exploring physical activity experiences in later life, we demonstrate that beginning and maintaining a physical activity career requires a disposition towards physical activity, the legitimation of physically active practices and dealing with contingencies. In addition, we demonstrate that maintaining a physical activity career requires investment and deliberation to adapt physical activity practices continually within an individual's own personal biography. As such, we conclude that current strategies to promote physical activity to older adults are unlikely to result in increased levels of participation. To promote physical activity to older adults an understanding of how structural, cultural and historical contexts influence participation is needed.
Primary care practitioners (PCPs) do not routinely promote dementia risk reduction. The purpose of this study was to map the published literature on the views of PCPs about dementia risk reduction, in order to identify implementation constructs and strategies crucial to the development of an implementation intervention to support dementia risk reduction in primary care. We undertook a scoping review of the PCPs’ views about promoting brain health for reducing dementia risk. We searched MEDLINE, PsycINFO, CINAHL, and Embase for English-language articles published between 1995 and December 2017. We then applied the Consolidated Framework for Implementation Research (CFIR) and matched Expert Recommendations for Implementing Change to the scoping review findings in order to develop a preliminary implementation model. Eight articles reported views of PCPs about dementia prevention. Study findings were mapped to 5 of the 39 CFIR constructs: (i) knowledge and beliefs about dementia risk reduction, (ii) evidence strength and quality, (iii) relative priority, (iv) available resources, and (v) external policy and incentives. The findings suggest implementation strategies to consider in our preliminary model include (i) educational meetings, (ii) identifying and preparing champions, (iii) conducting local consensus discussions, (iv) altering incentive structures, and (v) capturing and sharing local knowledge. There have been few studies about the views of PCPs about dementia risk reduction. Implementation in the primary care setting is fundamental to early identification of risk and supporting preventive practices, but it needs to focus on more than just education for PCPs. We need more up-to-date and in-depth data on the views of PCPs about dementia risk reduction and context-specific analyses of implementation needs. Further research into effective primary care interventions to reduce dementia risk is expected to support implementation efforts.
The thymus undergoes a critical period of growth and development early in gestation and, by mid-gestation, immature thymocytes are subject to positive and negative selection. Exposure to undernutrition during these periods may permanently affect phenotype. We measured thymulin concentrations, as a proxy for thymic size and function, in children (n = 290; aged 9–13 years) born to participants in a cluster-randomized trial of maternal vitamin A or β-carotene supplementation in rural Nepal (1994–1997). The geometric mean (95% confidence interval) thymulin concentration was 1.37 ng/ml (1.27, 1.47). A multivariate model of early-life exposures revealed a positive association with gestational age at delivery (β = 0.02; P = 0.05) and higher concentrations among children born to β-carotene-supplemented mothers (β = 0.19; P < 0.05). At ∼9–12 years of age, thymulin was positively associated with all anthropometric measures, with height retained in our multivariate model (β = 0.02; P < 0.001). There was significant seasonal variation: concentrations tended to be lower pre-monsoon (β = −0.13; P = 0.15), during the monsoon (β = −0.22; P = 0.04), and pre-harvest (β = −0.34; P = 0.01), relative to the post-harvest season. All early-life associations, except supplementation, were mediated in part by nutritional status at follow-up. Our findings underscore the known sensitivity of the thymus to nutrition, including potentially lasting effects of early nutritional exposures. The relevance of these findings to later disease risk remains to be explored, particularly given the role of thymulin in the neuroendocrine regulation of inflammation.
We implemented a guideline for appropriate acid suppressant use in hematology-oncology patients. This intervention resulted in a sustained reduction in proton pump inhibitor (PPI) use without an increase in rates of gastrointestinal bleeding. Practice guidelines are effective in reducing PPI use, which is associated with risk of Clostridioides difficile infection.
Cascading effects of high trophic levels onto lower trophic levels have been documented in many ecosystems. Some studies also show evidence of extended trophic cascades, in which guilds dependent on lower trophic levels, but uninvolved in the trophic cascade themselves, are affected by the trophic cascade due to their dependence on lower trophic levels. Top-down effects of large mammals on plants could lead to a variety of extended trophic cascades on the many guilds dependent on plants, such as pollinators. In this study, floral-visitor and floral abundances and assemblages were quantified within a series of 1-ha manipulations of large-mammalian herbivore density in an African savanna. Top-down effects of large mammals on the composition of flowers available for floral visitors are first shown, using regressions of herbivore activity on metrics of floral and floral-visitor assemblages. An extended trophic cascade is also shown: the floral assemblage further altered the assemblage of floral visitors, according to a variety of approaches, including a structural equation modelling approach (model with an extended trophic cascade was supported over a model without, AICc weight = 0.984). Our study provides support for extended trophic cascades affecting floral visitors, suggesting that trophic cascades can have impacts throughout entire communities.
This research investigates two factors influencing the ability of tree-ring data to provide accurate 14C calibration information: the fitness and rigor of the statistical model used to combine the data into a curve; and the accuracy, precision and reproducibility of the component 14C data sets. It presents a new Bayesian spline method for calibration curve construction and tests it on extant and new Southern Hemisphere (SH) data sets (also examining their dendrochronology and pretreatment) for the post-Little Ice Age (LIA) interval AD 1500–1950. The new method of construction allows calculation of component data offsets, permitting identification of laboratory and geographic biases. Application of the new method to the 10 suitable SH 14C data sets suggests that individual offset ranges for component data sets appear to be in the region of ± 10 yr. Data sets with individual offsets larger than this need to be carefully assessed before selection for calibration purposes. We identify a potential geographical offset associated with the Southern Ocean (high latitude) Campbell Island data. We test the new methodology for wiggle-matching short tree-ring sequences and use an OxCal simulation to assess the likely precision obtainable by wiggle-matching in the post-LIA interval.
Considerable attention has focused on tactics firms use when building their sustainability platforms. Less is known, however, about how sustainability goal setting varies globally, especially in developing economies. Accordingly, we examined sustainability goals of 21 of the 50 largest Indian firms and compared them with similar data from a published study that examined 22 of the 50 largest U.S. firms. In total, 679 sustainability goals were analyzed using a triple bottom line framework. We found U.S. firms set more sustainability goals than Indian firms. Firms from both samples set similar numbers of people goals but U.S. firms set more diversity goals. Indian firms were more inclined to set economic and community development goals. We also detected differences across the samples in planet goals associated with emissions and water. Especially significant, Indian firms were much more likely than U.S. firms to specify profit goals. Implications for research and practice are discussed.
A pinhole camera has been used to record low-energy x rays produced from CD2 microsphere irradiation with Sandia Laboratories four-beam, pulsed laser system. Camera useful energy range, spatial resolution, and x-ray energy sensitivity are discussed. Camera x-ray energy sensitivity which was determined by laboratory calibration is compared with measurements obtained with a multi-channel x-ray spectrometer. X-ray photographs of laser-irradiated microspheres are presented. Spatial information about the x-ray source derived from these photographs is discussed.
X-ray fluorescence spectroscopy is usually not considered a surface technique in the same sense as ESCA or Auger spectroscopies. However, it can be a useful tool in studying the “surface” and bulk concentrations of elements in heterogeneous catalysts. The “surface” is defined by the effective penetration depth of the analyte line of the element of interest in a specific matrix. In the example which is presented, silver on alumina, the “surface” using the Ag KB1,3 is defined by a shell 3000 microns deep while for the Ag LAI it is 15 microns. Two methods of sample preparation are discussed and data obtained using three different calculation methods is presented. Data from the x-ray fluorescence method is compared to the silver depth profile in the alumina pellets obtained by electron microprobe analysis. The XRFS method allows rapid screening of many catalyst samples for the fraction of the cost of the microprobe technique.
22q11.2 deletion syndrome (22q11DS), one of the most common recurrent copy number variant disorders, is associated with dopaminergic abnormalities and increased risk for psychotic disorders.
Given the elevated prevalence of substance use and dopaminergic abnormalities in non-deleted patients with psychosis, we investigated the prevalence of substance use in 22q11DS, compared with that in non-deleted patients with psychosis and matched healthy controls.
This cross-sectional study involved 434 patients with 22q11DS, 265 non-deleted patients with psychosis and 134 healthy controls. Psychiatric diagnosis, full-scale IQ and COMT Val158Met genotype were determined in the 22q11DS group. Substance use data were collected according to the Composite International Diagnostic Interview.
The prevalence of total substance use (36.9%) and substance use disorders (1.2%), and weekly amounts of alcohol and nicotine use, in patients with 22q11DS was significantly lower than in non-deleted patients with psychosis or controls. Compared with patients with 22q11DS, healthy controls were 20 times more likely to use substances in general (P < 0.001); results were also significant for alcohol and nicotine use separately. Within the 22q11DS group, there was no relationship between the prevalence of substance use and psychosis or COMT genotype. Male patients with 22q11DS were more likely to use substances than female patients with 22q11DS.
The results suggest that patients with 22q11DS are at decreased risk for substance use and substance use disorders despite the increased risk of psychotic disorders. Further research into neurobiological and environmental factors involved in substance use in 22q11DS is necessary to elucidate the mechanisms involved.
Whitehouse's article posits several plausible hypotheses, but suffers from an unwarranted reliance on the importance of distinct social groups in the causation of self-sacrificing behavior. A focus on relationships between individual kin is better able to account for both the evolution of self-sacrifice and present forms of self-sacrifice. The practical importance of this point is discussed.
Despite aspirations to be a world-class national curriculum, the Australian Curriculum (AC) has been criticised as ‘manifestly deficient’ (Australian Government Department of Education and Training, 2014 p. 5) as an inclusive curriculum, failing to meet the needs of all students with disabilities (SWD) and their teachers. There is a need for research into the daily attempts of educators to navigate the tension between a ‘top-down’ system-wide curriculum and a ‘bottom-up’ regard for individual student needs, with a view to informing both policy and practice. This article is the first of two research papers in which we report the findings from a national online Research in Special Education (RISE) Australian Curriculum Survey of special educators in special schools, classes, and units regarding their experience using the AC to plan for and teach SWD. Survey results indicated (a) inconsistent use of the AC as the primary basis for developing learning objectives and designing learning experiences, (b) infrequent use of the achievement standards to support assessment and reporting, and (c) considerable supplementation of the AC from other resources when educating SWD. Overall, participants expressed a lack of confidence in translating the AC framework into a meaningful curriculum for SWD. Implications for policy, practice, and future research are discussed.
Identifying factors that influence the functional outcome is an important goal in schizophrenia research. The 22q11.2 deletion syndrome (22q11DS) is a unique genetic model with high risk (20–25%) for schizophrenia. This study aimed to identify potentially targetable domains of neurocognitive functioning associated with functional outcome in adults with 22q11DS.
We used comprehensive neurocognitive test data available for 99 adults with 22q11DS (n = 43 with schizophrenia) and principal component analysis to derive four domains of neurocognition (Verbal Memory, Visual and Logical Memory, Motor Performance, and Executive Performance). We then investigated the association of these neurocognitive domains with adaptive functioning using Vineland Adaptive Behavior Scales data and a linear regression model that accounted for the effects of schizophrenia status and overall intellectual level.
The regression model explained 46.8% of the variance in functional outcome (p < 0.0001). Executive Performance was significantly associated with functional outcome (p = 0.048). Age and schizophrenia were also significant factors. The effects of Executive Performance on functioning did not significantly differ between those with and without psychotic illness.
The findings provide the impetus for further studies to examine the potential of directed (early) interventions targeting Executive Performance to improve long-term adaptive functional outcome in individuals with, or at high risk for, schizophrenia. Moreover, the neurocognitive test profiles may benefit caregivers and clinicians by providing insight into the relative strengths and weaknesses of individuals with 22q11DS, with and without psychotic illness.
In September 2015, an outbreak of Escherichia coli Phage Type 32 with an indistinguishable multi locus variable number tandem repeat analysis profile was identified in Scotland. Twelve cases were identified; nine primary cases, two secondary and one asymptomatic case. Extensive food history investigations identified venison products containing wild venison produced by a single food business operator as the most likely source of the outbreak. Of the nine primary cases, eight had consumed venison products, and one case had not eaten venison themselves but had handled and cooked raw venison in the household. This was the first reported outbreak of Shiga toxin-producing Escherichia coli (STEC) linked to venison products in the UK, and was also notable due to the implicated products being commercially produced and widely distributed. In contrast, previous venison outbreaks reported from other countries have tended to be smaller and related to individually prepared carcases. The outbreak has highlighted some important knowledge gaps in relation to STEC in venison that are currently been investigated via a number of research studies.
Here gelatin biotemplated platinum aerogels were prepared from gelatin hydrogels equilibrated in K2PtCl4 solutions ranging from 1-250 mM and reduced with sodium borohydride before supercritical drying in liquid CO2. Scanning electron microscopy revealed an average ligament diameter of 40.6 ± 9.7 nm and a pore size range of ∼10 – 200 nm. Thermogravimetric analysis correlated the ratio of metal content to biotemplate mass as a function of equilibrated platinum ion solution, and X-ray diffractometry indicated platinum metal with no detectable oxide phases. Electrochemical impedance spectroscopy indicated a specific capacitance of 1.92 F/g, with a corresponding specific electrochemical accessible surface area of 6.39 m2/g. Cyclic voltammetry performed in H2SO4 demonstrated biotemplated platinum aerogel potential for catalytic and energy storage applications.
Gary P. Baker, Research Associate at the University of East Anglia, and a Researcher at the University of Groningen in the Netherlands.,
Craig L. Lambert, Lecturer in Maritime History at the University of Southampton.,
David Simpkin, Teacher of History at Birkenhead Sixth-Form College.,
J. J. N. Palmer
Given the contribution Andrew Ayton has made to the study of late medieval military history we hope he is not surprised by the production of a Festschrift in his honour. All the editors of this volume were supervised by Andrew for their doctoral studies, and all no doubt thrashed out the general outlines to their theses in one of the infamous ‘Ayton’ meetings that regularly ran into the late evening. Andrew's enthusiasm for his subject was infectious and it is to his credit that many of his former students have gone on to publish contributions on late medieval military and naval history. The papers featured in the present volume highlight the important international impact Andrew's work has had on his students and academic colleagues.
Andrew, a native of Dorset, is in his own words ‘a country dweller at heart’ but has spent much of his working life in the big city. He studied as an undergraduate at the University of Hull in the early 1980s, during which time he undertook several modules taught by Professor John Palmer. John's module on the Hundred Years’ War in particular seems to have kindled Andrew's interest in medieval military history and military communities; it certainly began a fruitful association between two like-minded scholars which was to span some three decades until John's retirement in 2002. Andrew often visited John's home to discuss their latest research and he will be pleased to know he is remembered with some affection by John's children.
After graduating, Andrew spent a brief spell in a ‘real’ job, before returning to Hull to study for his Ph.D. under John Palmer – ‘The Warhorse and Military Service under Edward III’ – and from 1985 to 1987 Andrew was employed, alongside Virginia Davis, on John's Domesday Project. This was a role for which Andrew was particularly well equipped. He had taken John Palmer's special subject on the Domesday Book as an undergraduate, which had provided him with the essential background plus the basic computing skills – in particular related to databases – needed for the research: rare qualifications in the mid-1980s. This period, of course, included the 900th anniversary of Domesday Book, which for Andrew and Virginia entailed a frenetic year, giving lectures and demonstrations around the UK while trying to keep to a research schedule and do some work on their own account.
Bathing intensive care unit (ICU) patients with 2% chlorhexidine gluconate (CHG)–impregnated cloths decreases the risk of healthcare-associated bacteremia and multidrug-resistant organism transmission. Hospitals employ different methods of CHG bathing, and few studies have evaluated whether those methods yield comparable results.
To determine whether 3 different CHG skin cleansing methods yield similar residual CHG concentrations and bacterial densities on skin.
Prospective, randomized 2-center study with blinded assessment.
PARTICIPANTS AND SETTING
Healthcare personnel in surgical ICUs at 2 tertiary-care teaching hospitals in Chicago, Illinois, and Boston, Massachusetts, from July 2015 to January 2016.
Cleansing skin of one forearm with no-rinse 2% CHG-impregnated polyester cloth (method A) versus 4% CHG liquid cleansing with rinsing on the contralateral arm, applied with either non–antiseptic-impregnated cellulose/polyester cloth (method B) or cotton washcloth dampened with sterile water (method C).
In total, 63 participants (126 forearms) received method A on 1 forearm (n=63). On the contralateral forearm, 33 participants received method B and 30 participants received method C. Immediately and 6 hours after cleansing, method A yielded the highest residual CHG concentrations (2500 µg/mL and 1250 µg/mL, respectively) and lowest bacterial densities compared to methods B or C (P<.001).
In healthy volunteers, cleansing with 2% CHG-impregnated cloths yielded higher residual CHG concentrations and lower bacterial densities than cleansing with 4% CHG liquid applied with either of 2 different cloth types and followed by rinsing. The relevance of these differences to clinical outcomes remains to be determined.
The agricultural industry, particularly the livestock section, has been beset by difficulties in recent years, with the wettest year since 1776, the lowest commodity prices since the 1930's in many sectors, and by the widespread outbreak of ‘foot and mouth’ disease (F&M). This epidemic renewed fears for the future in an industry that was just beginning to see a glimmer of hope for better times ahead after many years of depression, with the OECD forecasting in early 2001 that world agricultural markets were poised for a ‘significant recovery‘.
Following what with hindsight can be thought of as a ‘golden period’ in the early 1990's, things began to go really wrong in the livestock sector after the BSE crisis in 1996. The problems were exacerbated by many other ‘external economic’ pressures in the late 1990's - in particular the high value of the pound and its effect on trade and market prices, the economic problems in other parts of the world (particularly in South East Asia and the former Eastern bloc), and an oversupplied European food market (particularly for meat and dairy products). By the late 1990's these ‘macro’ pressures were affecting all livestock sectors and if things were not bad enough, the spectre of ‘disease’ was about to make matters worse, beginning with the outbreak of classical swine fever in the pig industry in 2000.
The downward pressure on market prices and the monetary losses have also brought into focus the structural changes that are sorely needed throughout the livestock production, and meat processing/marketing supply chains in Britain. It has been apparent (ignoring the international situation) since the late 1980's, following the more rapid changes that have occurred in the final domestic consumer market, that these have been needed and they are now essential if the industry is to remain competitive in the 21st century.