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To assess the effect of rural-to-urban migration on nutrition transition and overweight/obesity risk among women in Kenya.
Secondary analysis of data from nationally representative cross-sectional samples. Outcome variables were women’s BMI and nutrition transition. Nutrition transition was based on fifteen different household food groups and was adjusted for socio-economic and demographic characteristics. Stepwise backward multiple ordinal regression analysis was applied.
Kenya Demographic and Health Survey 2014.
Rural non-migrant, rural-to-urban migrant and urban non-migrant women aged 15–49 years (n 6171).
Crude data analysis showed rural-to-urban migration to be associated with overweight/obesity risk and nutrition transition. After adjustment for household wealth, no significant differences between rural non-migrants and rural-to-urban migrants for overweight/obesity risk and household consumption of several food groups characteristic of nutrition transition (animal-source, fats and sweets) were observed. Regardless of wealth, migrants were less likely to consume main staples and legumes, and more likely to consume fruits and vegetables. Identified predictive factors of overweight/obesity among migrant women were age, duration of residence in urban area, marital status and household wealth.
Our analysis showed that nutrition transition and overweight/obesity risk among rural-to-urban migrants is apparent with increasing wealth in urban areas. Several predictive factors were identified characterising migrant women being at risk for overweight/obesity. Future research is needed which investigates in depth the association between rural-to-urban migration and wealth to address inequalities in diet and overweight/obesity in Kenya.
Peter Hill, one of the leading British pianists and musicologists of his generation.,
Thalia Myers, association with the music of Howard Skempton dates from 1995, when she commissioned Cantilena for the first Spectrum (for the ABRSM, the Associated Board of the Royal Schools of Music).,
John Tilbury, Polish government scholarship where he studied with Zbigniew Drzewiecki and co-founded the Warsaw Music Workshop group with Zygmunt Krause.,
James Weeks, published by University of York Music Press.,
Howard Skempton, none
This chapter captures the voices of some leading performers of Howard Skempton's music: Peter Hill (PH), Thalia Myers (TM), John Tilbury (JT), James Weeks (JW), interviewed by Cavett (EC) and collated by Head. The chapter concludes with a few words from Skempton (HS). For details of Skempton pieces see the Authorized Worklist (Appendix One). For information about recordings, see the Discography (Appendix Two). Author-date references in the transcripts below are to items in the select bibliography, unless they are further annotated ‘Discography’.
“SIMPLICITY ABOUT HIM”: FIRST ENCOUNTERS WITH SKEMPTON
PH: I got to know Howard in the early 1970s through my sister who worked at Faber Music, as did Howard. The first time we met was at a supper party for my sister's colleagues and for composers associated with Faber. Howard at once impressed me as a person of complete artistic integrity, and when he talked about his music he had a sincerity that made a refreshing change from the relentlessly competitive and over-professionalized ambience of the Royal College of Music where I was then a student. He was engaged in writing miniatures, many of them for piano, each of which was a distillation of weeks or even months of thought. Indeed, Howard told me he liked the mundane office work he did at Faber since it left his mind free to concentrate on his music. I had the impression of someone who thought very deeply about very simple things, and he explained that for him composition involved paring his ideas down to their essentials. The appeal of his music to me was that it embodied the principle of “less is more,” in which every sound mattered, instead of being lost in a maze of complexity. Although his manner was serious, Howard was not solemn. I can still recall from that evening that he amused us all with a lengthy saga of the accumulated mishaps that had befallen him on a trip to the launderette – making us laugh through his ability to look at the everyday in a quirky way that brought out the unexpected in things we take for granted.
What Howard was writing at that time was so at odds with the world of contemporary music, as it then was, that one didn't think of him as a “career” composer.
The rotation rate of a planet is a fundamental parameter, no less than its mass or composition, and planetary investigators require this rate to assess various other phenomena such as planetary wind speeds, internal and atmospheric models, ring dynamics and so forth. Saturn presents a conundrum, however, because none of its various planetary periods indicates the “true” rotation of the planet. Thus, although the planet displays an abundance of periodicities near 10.7 hours, the exact rotation period of Saturn is unknown. In the magnetosphere, “planetary-period oscillations” (PPOs) appear in charged particles, magnetic fields, energetic neutral atoms, radio emissions and motions of the plasma sheet and magnetopause. In Saturn’s rings, the spoke phenomenon can exhibit periodicities near 10.7 hours, and ring phenomena themselves may be related to the interior rotation of the planet. In the high-latitude ionosphere, modulations near this period appear in auroral motions and intensities. In the upper atmosphere, some cloud features rotate near this period, although wind speeds are generally faster, and the well-known polar hexagon rotates with a period close to 10.7 hours. Some of the magnetospheric/ionospheric oscillations differ in the northern and southern hemispheres and their periods do not remain constant, sometimes varying on long time scales of a year or longer and sometimes on much shorter time scales. These variations in the period argue against a cause related to changes interior to Saturn, and because the magnetic and spin axes of Saturn are reported to be axisymmetric (unlike those of any other known planet), Saturn’s periodicities cannot be explained as “wobble” caused by a geometric tilt or by a nondipolar magnetic anomaly. Several models have been proposed to account for the observed periodicities, including rotating atmospheric vortices, periodic plasma releases and a flapping magnetodisk, but none can satisfactorily explain all of Saturn’s periodicities nor their common origin, and none can determine the exact rotation rate of the planet. This chapter reviews Saturn’s periodicities, theories thereof, and how they might be used to determine the elusive rotation rate of the planet.
A simple, portable capillary refill time (CRT) simulator is not commercially available. This device would be useful in mass-casualty simulations with multiple volunteers or mannequins depicting a variety of clinical findings and CRTs. The objective of this study was to develop and evaluate a prototype CRT simulator in a disaster simulation context.
A CRT prototype simulator was developed by embedding a pressure-sensitive piezo crystal, and a single red light-emitting diode (LED) light was embedded, within a flesh-toned resin. The LED light was programmed to turn white proportionate to the pressure applied, and gradually to return to red on release. The time to color return was adjustable with an external dial. The prototype was tested for feasibility among two cohorts: emergency medicine physicians in a tabletop exercise and second year medical students within an actual disaster triage drill. The realism of the simulator was compared to video-based CRT, and participants used a Visual Analog Scale (VAS) ranging from “completely artificial” to “as if on a real patient.” The VAS evaluated both the visual realism and the functional (eg, tactile) realism. Accuracy of CRT was evaluated only by the physician cohort. Data were analyzed using parametric and non-parametric statistics, and mean Cohen’s Kappas were used to describe inter-rater reliability.
The CRT simulator was generally well received by the participants. The simulator was perceived to have slightly higher functional realism (P=.06, P=.01) but lower visual realism (P=.002, P=.11) than the video-based CRT. Emergency medicine physicians had higher accuracy on portrayed CRT on the simulator than the videos (92.6% versus 71.1%; P<.001). Inter-rater reliability was higher for the simulator (0.78 versus 0.27; P<.001).
A simple, LED-based CRT simulator was well received in both settings. Prior to widespread use for disaster triage training, validation on participants’ ability to accurately triage disaster victims using CRT simulators and video-based CRT simulations should be performed.
ChangTP, SantillanesG, Claudius I, PhamPK, KovedJ, CheyneJ, Gausche-HillM, KajiAH, SrinivasanS, DonofrioJJ, BirC. Use of a Novel, Portable, LED-Based Capillary Refill Time Simulator within a Disaster Triage Context. Prehosp Disaster Med. 2017;32(4):451–456.
The linear polarization of the Crab pulsar as a function of pulse phase was observed by the High Speed Photometer on the Hubble Space Telescope in March, 1993. Observations were obtained in a bandpass centered on 2770 A using a 0.25 ms sample time, corresponding to a time resolution of 0.0075 in pulse phase. The UV polarization of the pulsar [Fig. 1] is strikingly similar to that observed in the visible (cf. Smith et al. 1988). The same values of polarization and the same swing of position angle occur through the main and secondary pulses. The polarization pulse profile must be essentially wavelength independent at frequencies above the infrared.
Legislative actions and advanced technologies, particularly dissemination of safety-engineered devices, have aided in protecting healthcare personnel from occupational blood and body fluid exposures (BBFE).
To investigate the trends in BBFE among healthcare personnel over 15 years and the impact of safety-engineered devices on the incidence of percutaneous injuries as well as features of injuries associated with these devices.
Retrospective cohort study at University of North Carolina Hospitals, a tertiary care academic facility. Data on BBFE in healthcare personnel were extracted from Occupational Health Service records (2000–2014). Exposures associated with safety-engineered and conventional devices were compared. Generalized linear models were applied to measure the annual incidence rate difference by exposure type over time.
A total of 4,300 BBFE, including 3,318 percutaneous injuries (77%), were reported. The incidence rate for overall BBFE was significantly reduced during 2000–2014 (incidence rate difference, 1.72; P=.0003). The incidence rate for percutaneous injuries was also dramatically reduced during 2001–2006 (incidence rate difference, 1.37; P=.0079) but was less changed during 2006–2014. Percutaneous injuries associated with safety-engineered devices accounted for 27% of all BBFE. BBFE was most commonly due to injecting through skin, placing intravenous catheters, and blood drawing.
Our study revealed significant overall reduction in BBFE and percutaneous injuries likely due in part to the impact of safety-engineered devices but also identified that a considerable proportion of percutaneous injuries is now associated with these devices. Additional prevention strategies are needed to further reduce percutaneous injuries and improve design of safety-engineered devices.
Indoor localisation has always been a challenging problem due to poor Global Navigation Satellite System (GNSS) availability in such environments. While inertial measurement sensors have become popular solutions for indoor positioning, they suffer large drifts after initialisation. Collaborative positioning enhances positioning robustness by integrating multiple localisation information, especially relative ranging measurements between local users and transmitters. However, not all ranging measurements are useful throughout the whole positioning process and integrating too much data will increase the computation cost. To enable a more reliable positioning system, an adaptive collaborative positioning algorithm is proposed which selects units for the collaborative network and integrates ranging measurement to constrain inertial measurement errors. The algorithm selects the network adaptively from three perspectives: the network geometry, the network size and the accuracy level of the ranging measurements between the units. The collaborative relative constraint is then defined according to the selected network geometry and anticipated measurement quality. In the case of trials with real data, the positioning accuracy is improved by 60% by adjusting the range constraint adaptively according to the selected network situation, while also improving the system robustness.
In the United States alone, ∼14,000 children are hospitalised annually with acute heart failure. The science and art of caring for these patients continues to evolve. The International Pediatric Heart Failure Summit of Johns Hopkins All Children’s Heart Institute was held on February 4 and 5, 2015. The 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children’s Heart Institute was funded through the Andrews/Daicoff Cardiovascular Program Endowment, a philanthropic collaboration between All Children’s Hospital and the Morsani College of Medicine at the University of South Florida (USF). Sponsored by All Children’s Hospital Andrews/Daicoff Cardiovascular Program, the International Pediatric Heart Failure Summit assembled leaders in clinical and scientific disciplines related to paediatric heart failure and created a multi-disciplinary “think-tank”. The purpose of this manuscript is to summarise the lessons from the 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children’s Heart Institute, to describe the “state of the art” of the treatment of paediatric cardiac failure, and to discuss future directions for research in the domain of paediatric cardiac failure.
We investigate the mechanics of a nano logic gate, comprising a metallofullerene which is located inside a square-shaped single-walled carbon nanotorus involving non-metallic, single-walled carbon nanotubes with perfect nanotoroidal corners. These are highly novel and speculative nanodevices whose construction, no doubt, involves many technical challenges. The energy for the system is obtained from the 6–12 Lennard-Jones potential with the continuous approximation. Our approach shows that there is not much difference between the energy when the metallofullerene is located in the tubes compared to when it is at the corners, and therefore the metallofullerene may be controlled by a small voltage. By applying two voltage inputs to produce external electric fields, one for the left–right motion and the other for the top–bottom motion, the metallofullerene can be moved to one of the four corners. Assuming that at the four corners there are charge detectors, the proposed device can be designed as a logic gate with different signals corresponding to particular gates.
Emergency department (ED) patients with symptoms of cardiac ischemia often require a second cardiac troponin (cTn) measurement to rule out non–ST elevation myocardial infarction. We measured the total turnaround time and the component event times following the ordering of the second cTn level to ED discharge to identify root causes of delays.
We reviewed a random sample of ED discharges following a second normal cTn measurement and recorded associated event times. The central tendency of time intervals is reported as median and mean number of minutes with interquartile ranges (IQRs) and 95% confidence intervals, respectively.
From 9,656 eligible cases, we randomly selected 226 for data collection. The median number of minutes for each event are as follows: from ordering the second cTn measurement to the time of ED discharge was 90 minutes (IQR 65–120); for blood collection from the time the collection was ordered for was 0 minutes (IQR 212–0); from blood collection to the time the blood was transported to the laboratory was 9 minutes (IQR 2–19); laboratory process duration was 44 minutes (IQR 39–52); from when the results were available to the time the patient was discharged was 30 minutes (IQR 15–52).
For ED patients discharged following two normal cTn levels, the laboratory processing time and time from the result being available to the time of ED discharge represent the longest modifiable time periods to reduce ED length of stay.
Research was conducted to determine the efficacy of aminocyclopyrachlor in comparison to glyphosate, clopyralid, fluroxypyr, and triclopyr for silk tree (commonly known as mimosa) control. In the greenhouse, aminocyclopyrachlor was applied at 8.75, 17.5, 35, and 70 g ha−1 with and without methylated seed oil (MSO) at 0.5% v/v. Efficacy of these treatments was compared to glyphosate and triclopyr at 1,350 g ha−1, fluroxypyr at 103 g ha−1, and clopyralid at 100 g ha−1. Few differences in silk tree control were detected by 28 d after treatment (DAT), as aminocyclopyrachlor with MSO controlled silk tree 87 to 100% compared to 53 to 100% for aminocyclopyrachlor without MSO. Aminocyclopyrachlor at 35 g ha−1 provided silk tree control similar to glyphosate, triclopyr, clopyralid, and fluroxypyr regardless of adjuvant. Inclusion of MSO enhanced initial activity of aminocyclopyrachlor after application. At 7 DAT, 8.75 g ha−1 of aminocyclopyrachlor plus MSO controlled silk tree similar to aminocyclopyrachlor alone at 70 g ha−1. In laboratory studies, absorption of 14C-aminocyclopyrachlor 2 h after treatment (HAT) with MSO measured 93% compared to only 62% for 14C-aminocyclopyrachlor without MSO. By 24 HAT, absorption of 14C-aminocyclopyrachlor measured 99 and 71% for applications with and without MSO, respectively. Increased foliar absorption with MSO may explain enhanced activity observed 7 DAT in greenhouse studies, as no effects in 14C-aminocyclopyrachlor translocation due to adjuvant were observed. Responses suggest MSO increased the speed of silk tree control with aminocyclopyrachlor and may also improve rainfastness of aminocyclopyrachlor applications for control of silk tree and other woody species.