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Systematic, national surveillance of outbreaks of intestinal infectious disease has been undertaken by Public Health England (PHE) since 1992. Between 1992 and 2002, there were 19 outbreaks linked to raw drinking milk (RDM) or products made using raw milk, involving 229 people; 36 of these were hospitalised. There followed an eleven-year period (2003–2013) where no outbreaks linked to RDM were reported. However, since 2014 seven outbreaks of Escherichia coli O157:H7 (n = 3) or Campylobacter jejuni (n = 4) caused by contaminated RDM were investigated and reported. Between 2014 and 2017, there were 114 cases, five reported hospitalisations and one death. The data presented within this review indicated that the risk of RDM has increased since 2014. Despite the labelling requirements and recommendations that children should not consume RDM, almost a third of outbreak cases were children. In addition, there has been an increase in consumer popularity and in registered RDM producers in the UK. The Food Standards Agency (FSA) continue to provide advice on RDM to consumers and have recently made additional recommendations to enhance existing controls around registration and hygiene of RDM producers.
To investigate the relative importance of 10 attributes identified in prior studies as essential for effective disaster medical responders and leaders.
Emergency and disaster medical response personnel (N=220) ranked 10 categories of disaster worker attributes in order of their importance in contributing to the effectiveness of disaster responders and leaders.
Attributes of disaster medical leaders and responders were rank ordered, and the rankings differed for leaders and responders. For leaders, problem-solving/decision-making and communication skills were the highest ranked, whereas teamwork/interpersonal skills and calm/cool were the highest ranked for responders.
The 10 previously identified attributes of effective disaster medical responders and leaders include personal characteristics and general skills in addition to knowledge of incident command and disaster medicine. The differences in rank orders of attributes for leaders and responders suggest that when applying these attributes in personnel recruitment, selection, and training, the proper emphasis and priority given to each attribute may vary by role. (Disaster Med Public Health Preparedness. 2019;13:700–703)
Mobile ultraviolet-C (UV-C) light room decontamination devices are frequently used as an adjunct to standard cleaning in healthcare facilities, but their efficacy in killing Candida species is not clear. In laboratory testing, the emerging multidrug-resistant Candida auris and 2 other Candida species were significantly less susceptible to killing by UV-C than methicillin-resistant Staphylococcus aureus.
Contaminated surfaces are a suspected source for dissemination of the globally emerging pathogen Candida auris. In laboratory testing, sporicidal and improved hydrogen peroxide disinfectants were highly effective against C. auris, C. glabrata, and C. albicans. The widely used quaternary ammonium disinfectants exhibited relatively poor activity against all of the Candida species.
To identify key attributes of effective disaster/mass casualty first responders and leaders, thereby informing the ongoing development of a capable disaster health workforce.
We surveyed emergency response practitioners attending a conference session, the EMS State of the Science: A Gathering of Eagles. We used open-ended questions to ask participants to describe key characteristics of successful disaster/mass casualty first responders and leaders.
Of the 140 session attendees, 132 (94%) participated in the survey. All responses were categorized by using a previously developed framework. The most frequently mentioned characteristics were related to incident command/disaster knowledge, teamwork/interpersonal skills, performing one’s role, and cognitive abilities. Other identified characteristics were related to communication skills, adaptability/flexibility, problem solving/decision-making, staying calm and cool under stress, personal character, and overall knowledge.
The survey findings support our prior focus group conclusion that important characteristics of disaster responders and leaders are not limited to the knowledge and skills typically included in disaster training. Further research should examine the extent to which these characteristics are consistently associated with actual effective performance of disaster response personnel and determine how best to incorporate these attributes into competency models, processes, and tools for the development of an effective disaster response workforce. (Disaster Med Public Health Preparedness. 2016;page 1 of 4)
People with dementia may benefit from palliative care which specifically addresses the needs of patients and families affected by this life-limiting disease. On behalf of the European Association for Palliative Care (EAPC), we recently performed a Delphi study to define domains for palliative care in dementia and to provide recommendations for optimal care. An international panel of experts in palliative care, dementia care or both, achieved consensus on almost all domains and recommendations, but the domain concerning the applicability of palliative care to dementia required revision.
To examine in detail, the opinions of the international panel of 64 experts around the applicability of palliative care, we explored feedback they provided in the Delphi process. To examine which experts found it less important or less applicable, ordinal regression analyses related characteristics of the panelists to ratings of overall importance of the applicability domain, and to agreement with the domain's four recommendations.
Some experts expressed concerns about bringing up end-of-life issues prematurely and about relabeling dementia care as palliative care. Multivariable analyses with the two outcomes of importance and agreement with applicability indicated that younger or less experienced experts and those whose expertise was predominantly in dementia care found palliative care in dementia less important and less applicable.
Benefits of palliative care in dementia are acknowledged by experts worldwide, but there is some controversy around its early introduction. Further studies should weigh concerns expressed around care receiving a “palliative” label versus the benefits of applying palliative care early.
We present first results from the Intermediate Redshift OSIRIS Chemo-Kinematic Survey (IROCKS) of z ∼ 1 star forming galaxies (Mieda et al. in prep). We have targeted Hα and [NII] emission lines in J-band and have spatially resolved the galaxies at sub-kilo parsec scale. We have combined our sample with deep HST continuum images, and are able to reveal the dynamics, morphologies, metallicity distribution, emission-line diagnostics, and star formation rates of galaxies spanning this crucial z ∼ 1 epoch.
A number of studies have demonstrated the anti-aggressive properties of clozapine in schizophrenia and its positive effect in borderline personality disorder. There is no published literature on the treatment of antisocial personality disorder (ASPD) with clozapine. We present a case series of 7 patients with primary ASPD and high psychopathic traits treated with clozapine, having a significant history of serious violence and currently detained in a UK based high-security hospital.
A retrospective review of case notes was carried out to formulate Clinical Global Impression (CGI) scores and record incidents of violence and aggression. Effect on specific symptom domains (cognitive-perceptual, impulsive-behavioural dyscontrol, affective dysregulation) was also noted. Metabolic parameters and serum clozapine levels were also sampled.
All 7 patients showed significant improvement on clozapine. It was shown to benefit all symptom domains, especially impulsive behavioral dyscontrol and anger. The number of violent incidents committed by 6 of the 7 patients reduced significantly, and all patients’ risk of violence reduced. Clozapine serum levels for 6 of the 7 patients were in the range 150–350 ng/mL.
Clozapine is of benefit in reducing the clinical severity of ASPD. It improved all symptom domains, especially impulsive-behavioral dyscontrol and anger, and reduced levels of aggression and violence, especially at lower doses (serum levels <350 ng/m). To our knowledge, this is the first account of clozapine treatment in patients with ASPD and high psychopathy.
Despite recent advances in measuring and compensating for environmental damages, several challenges remain. States have a vested interest in claiming economic damages, especially those that reduce the value of investments. Because place-brand values are considered personal property, Florida may seek additional compensation from the Deepwater Horizon oil spill.
The biology, ecology, disease etiology, and biological control potential of different members of the Entomophaga grylli species complex are discussed. This complex is represented by several pathotypes that include members that produce both conidia and resting spores within a single season, and members that produce only resting spores. This complex is known as a major pathogen of acridids from most areas of the world where populations of these insects are found, including Africa, Asia, Australia, Europe, North America, and South America. Pathogens from this species complex commonly cause disease epizootics in their host populations and are known to reduce significantly outbreaks of grasshoppers, particularly following periods of rain or high humidity. Specific factors that either limit or enhance disease processes and host mortality are discussed in relation to both epizootiology and biological control programmes. Recent biological control efforts are discussed and the potential of using members of the E. grylli species complex in both augmentation and introduction programmes is considered.
Salmonella enterica serovar Typhimurium definitive phage type (DT) 8 is uncommon in humans in the UK. In July 2010, the Health Protection Agency reported an excess isolation rate of pan-susceptible S. Typhimurium DT8 in England and Northern Ireland. By the end of October, this amounted to 81 laboratory-confirmed human cases for all regions of England and Northern Ireland in 2010, an increase of 26% and 41% on 2009 and 2008, respectively. Descriptive epidemiological investigation found a strong association with infection and consumption of duck eggs. Duck eggs contaminated with S. Typhimurium DT8 were collected from a patient's home and also at farms in the duck-egg supply chain. Although duck eggs form a small part of total UK eggs sales, there has been significant growth in sales in recent years. This is the first known outbreak of salmonellosis linked to duck eggs in the UK since 1949 and highlighted the impact of a changing food source and market on the re-emergence of salmonellosis linked to duck eggs. Control measures by the duck-egg industry should be improved along with a continued need to remind the public and commercial caterers of the potential high risks of contracting salmonellosis from duck eggs.
Many studies on the adoption of precision technologies have generally used logit models to explain the adoption behavior of individuals. This study investigates factors affecting the intensity of precision agriculture technologies adopted by cotton farmers. Particular attention is given to the role of spatial yield variability on the number of precision farming technologies adopted, using a count data estimation procedure and farm-level data. Results indicate that farmers with more within-field yield variability adopted a higher number of precision agriculture technologies. Younger and better educated producers and the number of precision agriculture technologies used were significantly correlated. Finally, farmers using computers for management decisions also adopted a higher number of precision agriculture technologies.
The low pressure chemical vapor deposition (LPCVD) of silicon carbide from (CH3)HSiCH2SiCH2 (CH3)CH2 SiH2 (CH 3) on Si(100) has been investigated between 700 and 1100°C at ca. 1.0 torr total pressure using a flow of argon as a carrier gas in a cold-wall LPCVD system. The gaseous byproducts were determined using quadrupole mass spectrometry (QMS) and gas chromatography - Fourier transform IR (FTIR) spectroscopy. The coating surface morphology varied from smooth to a columnar structure with increasing substrate temperature. Film composition and crystallinity were monitored as a function of deposition temperature using Auger electron spectroscopy (AES) and powder XRD.
A collagenous scar capsule forms around biomaterial implants and for deformable implants such as a breast prosthesis, this phenomenon of capsular scar contracture may lead to deformation and hardening of the implant. Relaxin, a peptide hormone of pregnancy which is known to affect collagen rich tissues, was given to mice in an attempt to eliminate or lessen this contracture. A short (8 day) study was performed to observe the effects of relaxin and estrogen on the mechanical properties of Skin and the interpubic ligament. A longer (27 day) study observed the effects of relaxin in estrogen primed mice containing implants. Changes in skin, interpubic ligament, scar capsule and contracture phenomenon were noted. Stress-strain characterization, dynamic mechanical spectroscopy and light microscopy were used to characterize the effects of relaxin and estradiol on the contracture phenomenon. Qualitatively, relaxin given to estrogen primed mice was shown to lessen implant contracture and deformability. Administration of relaxin produced the documented changes in the interpubic ligament, but differences were noted between the 8 and 27 day studies. Differences in the failure stress and strain and modulus for the long implant and short non-implant study were noted for the relaxin treated mice.
The use of cyclic organometallic molecules as single-source MOCVD precursors is illustrated by means of examples taken from our recent work on SiC and AlN deposition, with particular focus on SiC. Molecules containing (SiC)2 and (AlN)3 rings as the “core structure” were employed as the source materials for these studies. The organoaluminum amide, [Me2AlNH2]3, was used as the AlN source and has been studied in a molecular beam sampling apparatus in order to determine the gas phase species present in a hot-wall CVD reactor environment. In the case of SiC CVD, a series of disilacyclobutanes, [Si(XX′)CH2]2 (with X and X′ - H, CH3 , and CH2 SiH2CH3), were examined in a cold-wall, hot-stage CVD reactor in order to compare their relative reactivities and prospective utility as single-source CVD precursors. The parent compound, disilacyclobutane, [SiH2 CH2]2, was found to exhibit the lowest deposition temperature (ca. 670 °C) and to yield the highest purity SiC films. This precursor gave a highly textured, polycrystalline film on the Si(100) substrates (70% with a SiC<lll> orientation).