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This study aimed to evaluate the influence of lower limb loss (LL) on mental workload by assessing neurocognitive measures in individuals with unilateral transtibial (TT) versus those with transfemoral (TF) LL while dual-task walking under varying cognitive demand.
Electroencephalography (EEG) was recorded as participants performed a task of varying cognitive demand while being seated or walking (i.e., varying physical demand).
The findings revealed both groups of participants (TT LL vs. TF LL) exhibited a similar EEG theta synchrony response as either the cognitive or the physical demand increased. Also, while individuals with TT LL maintained similar performance on the cognitive task during seated and walking conditions, those with TF LL exhibited performance decrements (slower response times) on the cognitive task during the walking in comparison to the seated conditions. Furthermore, those with TF LL neither exhibited regional differences in EEG low-alpha power while walking, nor EEG high-alpha desynchrony as a function of cognitive task difficulty while walking. This lack of alpha modulation coincided with no elevation of theta/alpha ratio power as a function of cognitive task difficulty in the TF LL group.
This work suggests that both groups share some common but also different neurocognitive features during dual-task walking. Although all participants were able to recruit neural mechanisms critical for the maintenance of cognitive-motor performance under elevated cognitive or physical demands, the observed differences indicate that walking with a prosthesis, while concurrently performing a cognitive task, imposes additional cognitive demand in individuals with more proximal levels of amputation.
Equitable access to mental healthcare is a priority for many countries. The National Health Service in England uses a weighted capitation formula to ensure that the geographical distribution of resources reflects need.
To produce a revised formula for estimating local need for secondary mental health, learning disability (intellectual disability) and psychological therapies services for adults in England.
We used demographic records for 43 751 535 adults registered with a primary care practitioner in England linked with service use, ethnicity, physical health diagnoses and type of household, from multiple data-sets. Using linear regression, we estimated the individual cost of care in 2015 as a function of individual- and area-level need and supply variables in 2013 and 2014. We sterilised the effects of the supply variables to obtain individual-need estimates. We aggregated these by general practitioner practice, age and gender to derive weights for the national capitation formula.
Higher costs were associated with: being 30–50 years old, compared with 20–24; being Irish, Black African, Black Caribbean or of mixed ethnicity, compared with White British; having been admitted for specific physical health conditions, including drug poisoning; living alone, in a care home or in a communal environment; and living in areas with a higher percentage of out-of-work benefit recipients and higher prevalence of severe mental illness. Longer distance from a provider was associated with lower cost.
The resulting needs weights were higher in more deprived areas and informed the distribution of some 12% (£9 bn in 2019/20) of the health budget allocated to local organisations for 2019/20 to 2023/24.
Changes in positive and negative symptom profiles during acute psychotic episodes may be key drivers in the pathway to violence. Acute episodes are often preceded by fluctuations in affect before psychotic symptoms appear and affective symptoms may play a more important role in the pathway than previously recognised.
We carried out a prospective cohort study of 409 male and female patients discharged from medium secure services in England and Wales to the community. Measures were taken at baseline (pre-discharge), 6 and 12 months post-discharge using the Positive and Negative Syndrome Scale. Information on violence was obtained using the McArthur Community Violence Instrument and Police National Computer.
The larger the shift in positive symptoms the more likely violence occurred in each 6-month period. However, shifts in angry affect were the main driving factor for positive symptom shifts associated with violence. Shifts in negative symptoms co-occurred with positive and conveyed protective effects, but these were overcome by co-occurring shifts in anger. Severe but stable delusions were independently associated with violence.
Intensification of angry affect during acute episodes of psychosis indicates the need for interventions to prevent violence and is a key driver of associated positive symptoms in the pathway to violence. Protective effects against violence exerted by negative symptoms are not clinically observable during symptom shifts because they are overcome by co-occurring anger.
Early findings from a national study of discharges from 32 National
Health Service medium secure units revealed that nearly twice as many
patients than expected were discharged back to prison.
To compare the characteristics of those discharged back to prison with
those discharged to the community, and consider the implications for
ongoing care and risk.
Prospective cohort follow-up design. All forensic patients discharged
from 32 medium secure units across England and Wales over a 12-month
period were identified. Those discharged to prison were compared with
those who were discharged to the community.
Nearly half of the individuals discharged to prison were diagnosed with a
serious mental illness and over a third with schizophrenia. They were a
higher risk, more likely to have a personality disorder, more symptomatic
and less motivated than those discharged to the community.
Findings suggest that alternative models of prison mental healthcare
should be considered to reduce risks to the patient and the public.
Several studies have suggested that dairy food may reduce the risk of obesity and metabolic abnormalities but few have been able to conclusively demonstrate that it reduces the risk of diabetes. The aim of the present analysis was to investigate if dairy food intake independently reduces the risk of diabetes.
The Australian Diabetes Obesity and Lifestyle Study (AusDiab) is a national, population-based, prospective survey conducted over 5 years. Baseline measurements included a 121-item FFQ, anthropometrics and an oral glucose tolerance test.
Forty-two randomly selected clusters across Australia.
Adults aged ≥25 years who participated in the baseline survey and returned to follow-up 5 years later.
A total of 5582 participants with complete data were eligible for analysis, 209 of whom had incident diabetes. Compared with men in the first tertile of dairy food intake, men in the third tertile had a significantly reduced risk of developing diabetes after adjustment for age, sex, total energy intake, family history of diabetes, education, physical activity, smoking status, fasting serum TAG and HDL cholesterol, systolic blood pressure, waist circumference and hip circumference (OR = 0·53, 95 % CI 0·29, 0·96; P = 0·033). A similar non-significant association was observed in women.
Dietary patterns that incorporate high intakes of dairy food may reduce the risk of diabetes among men. Further investigation into the relationship between dairy food intake and diabetes needs to be undertaken to fully understand the potential mechanism of this observation.
The teeth of the marine mollusk Acanthopleura hirtosa are an excellent example of a complex, organic, matrix-mediated biomineral, with the fully mineralized teeth comprising layers of iron oxide and iron oxyhydroxide minerals around a calcium apatite core. To investigate the relationship between the various mineral layers and the organic matrix fibers on which they grew, sections have been prepared from specific features in the teeth at controlled orientations using focused ion beam processing. Compositional and microstructural details of heterophase interfaces, and the fate of the organic matrix fibers within the mineral layers, can then be analyzed by a range of transmission electron microscopy (TEM) techniques. Energy-filtered TEM highlights the interlocking nature of the various mineral phases, while high-angle annular dark-field scanning TEM imaging demonstrates that the organic matrix continues to exist in the fully mineralized teeth. These new insights into the structure of this complex biomaterial are an important step in understanding the relationship between its structural and physical properties and may help explain its high strength and crack-resistance behavior.
When it comes to mineral synthesis, there is a lot we can learn from nature. Although we can synthesize a range of materials in the laboratory, the experimental conditions are often constrained to particular ranges of temperature, pH, etc. Biological systems, on the other hand, seem to be able to produce individual minerals and complex composite mineral structures under a variety of conditions, many of which are far from those applied to create their synthetic counterparts. Understanding how nature does this could provide a means to produce novel biomimetic materials with potential applications in a diverse range of fields from medicine to materials engineering.
The cusp epithelium is a specialized branch of the superior epithelium that surrounds the developing teeth of chitons and is responsible for delivering the elements required for the formation of biominerals within the major lateral teeth. These biominerals are deposited within specific regions of the tooth in sequence, making it possible to conduct a row by row examination of cell development in the cusp epithelium as the teeth progress from the unmineralized to the mineralized state. Cusp epithelium from the chiton Acanthopleura hirtosa was prepared using conventional chemical and microwave assisted tissue processing, for observation by light microscopy, conventional transmission electron microscopy (TEM) and energy filtered TEM. The onset of iron mineralization within the teeth, initiated at row 13, is associated with a number of dramatic changes in the ultrastructure of the apical cusp cell epithelium. Specifically, the presence of ferritin containing siderosomes, the position and number of mitochondria, and the structure of the cell microvilli are each linked to aspects of the mineralization process. These changes in tissue development are discussed in context with their influence over the physiological conditions within both the cells and extracellular compartment of the tooth at the onset of iron mineralization.
Eight species of polydorid polychaetes were found to inhabit mollusc shells from south-western Australian waters. Numerous individuals of Polydora uncinata were extracted for the first time from the shells of both land-based cultured abalone Haliotis laevigata and H. roei, as well as from natural subtidal H. roei and Chlamys australis. Shells of the oyster Saccostrea commercialis cultured in sea-based systems were infested by Boccardia knoxi which was first recorded in these waters. Polydora aura, Dipolydora giardi, D. armata, D. aciculata and Boccardia proboscidea were common among shells of various natural intertidal and subtidal molluscs. A small number of P. haswelli were extracted from their self-excavated burrows in shells of cultured oysters. Boccardia knoxi and D. aciculata were redescribed based on the newly collected materials. Polydora uncinata and B. knoxi exhibited similar larval development patterns (exolecithotrophy and adelphophagy), iteroparity and longer life span, suggesting a high reproductive potential. This study suggests that further monitoring of polydorid species is needed not only from the viewpoint of marine biology but also to survey the risk invasive species pose to commercially important molluscs in this region and worldwide.
In April 2000 a massive recruitment of the barnacle Semibalanus balanoides was observed in the Clyde Sea. At one location 700 cyprids 1−1 of this species were recorded. This is ∼3500 times more abundant than previously recorded, and resulted in metamorphosis of some cyprids whilst still in the plankton, as well as massive settlement, with recruits found on adults and in the splash zone. The maximum density recorded was 109 settlers cm−2. Over the next 60 d mortality averaged 85%, resulting in a mean density of 8.4 recruits cm−2 in June 2000. Recruitment varied spatially at the km and m scale (site, shore height) but there was no evidence that it was affected by the presence of adult conspecifics.
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