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The diet of most adults is low in fish and, therefore, provides limited quantities of the long-chain, omega-3 fatty acids (LCn-3FAs), eicosapentaenoic and docosahexaenoic acids (EPA, DHA). Since these compounds serve important roles in the brain, we sought to determine if healthy adults with low-LCn-3FA consumption would exhibit improvements in neuropsychological performance and parallel changes in brain morphology following repletion through fish oil supplementation.
In a randomized, controlled trial, 271 mid-life adults (30–54 years of age, 118 men, 153 women) consuming ⩽300 mg/day of LCn-3FAs received 18 weeks of supplementation with fish oil capsules (1400 mg/day of EPA and DHA) or matching placebo. All participants completed a neuropsychological test battery examining four cognitive domains: psychomotor speed, executive function, learning/episodic memory, and fluid intelligence. A subset of 122 underwent neuroimaging before and after supplementation to measure whole-brain and subcortical tissue volumes.
Capsule adherence was over 95%, participant blinding was verified, and red blood cell EPA and DHA levels increased as expected. Supplementation did not affect performance in any of the four cognitive domains. Exploratory analyses revealed that, compared to placebo, fish oil supplementation improved executive function in participants with low-baseline DHA levels. No changes were observed in any indicator of brain morphology.
In healthy mid-life adults reporting low-dietary intake, supplementation with LCn-3FAs in moderate dose for moderate duration did not affect neuropsychological performance or brain morphology. Whether salutary effects occur in individuals with particularly low-DHA exposure requires further study.
Weed management is a major challenge in organic crop production, and organic farms generally harbor larger weed populations and more diverse communities compared with conventional farms. However, little research has been conducted on the effects of different organic management practices on weed communities and crop yields. In 2014 and 2015, we measured weed community structure and soybean [Glycine max (L.) Merr.] yield in a long-term experiment that compared four organic cropping systems that differed in nutrient inputs, tillage, and weed management intensity: (1) high fertility (HF), (2) low fertility (LF), (3) enhanced weed management (EWM), and (4) reduced tillage (RT). In addition, we created weed-free subplots within each system to assess the impact of weeds on soybean yield. Weed density was greater in the LF and RT systems compared with the EWM system, but weed biomass did not differ among systems. Weed species richness was greater in the RT system compared with the EWM system, and weed community composition differed between RT and other systems. Our results show that differences in weed community structure were primarily related to differences in tillage intensity, rather than nutrient inputs. Soybean yield was lower in the EWM system compared with the HF and RT systems. When averaged across all four cropping systems and both years, soybean yield in weed-free subplots was 10% greater than soybean yield in the ambient weed subplots that received standard management practices for the systems in which they were located. Although weed competition limited soybean yield across all systems, the EWM system, which had the lowest weed density, also had the lowest soybean yield. Future research should aim to overcome such trade-offs between weed control and yield potential, while conserving weed species richness and the ecosystem services associated with increased weed diversity.
Negotiating peace in a democratic context where public opinion matters and an international context eschewing the past norm of forgive-and-forget to end conflicts poses new dilemmas for peace negotiators. With both domestic constituents and international law demanding retributive justice for the most egregious human rights abuses, how are negotiators to induce combatants to lay down arms and end a conflict? We examine these dilemmas in the Colombia peace talks of 2012–2016 – a case of a protracted conflict in a democracy with relatively strong rule of law institutions; well-organized civil society, and especially human rights organizations; and a vibrant political dynamic involving both the multi-party Congress and public opinion in the approval and implementation of the negotiated agreement.
Advances in neurosurgery and anesthesia have dramatically reduced intraoperative morbidity and mortality rates over the past several years. A significant part of the care of the neurosurgical patient, however, occurs postoperatively in the neuro-intensive care unit (NICU). The goal of care in a monitored environment during this time is to prevent and treat, in a timely fashion, potential early and often fatal complications of both surgery and anesthesia. This requires a team of highly trained specialists that include neurosurgeons, anesthesiologists, neurointensivists, consultants, nurses, and key roles played by family members. In this chapter we will discuss general concepts that pertain to the neurosurgical patient, as well as particular postoperative intensive care unit (ICU) guidelines for subarachnoid hemorrhage, carotid endarterectomy, craniotomy for tumor, craniotomy for arteriovenous malformation (AVM), epilepsy surgery, and deep brain stimulation.
“Structural violence” is a term used to describe inflicted systematic violence on a disenfranchised group by an established order, usually framed as a government or the social majority. The disenfranchised groups are marginalized and not provided with the same access to resources such as healthcare or food, the effects of which can be observed directly in their death. Bioarchaeologists often can detect the visible effects of this violence on skeletal remains, which provide a visual representation to and reinforcement of social prejudices inflicted in life and death. Discussed here is how the same concept of structural violence can be inflicted on the landscape through damage to or obliteration of cemeteries. We propose a definition of “landscape structural violence” exhibited through cemetery erasure as a reinforcement of preexisting social prejudices in death where the governments or the social majority, intentionally or passively, destroy, remove, or obscure a cemetery without consultation with the descendant community. This definition is applied to several examples of New Orleans cemeteries to determine the functionality of the definition and what activity is and what is not structural violence inflicted on the landscape.
Violent protests are dramatic political events, yet we know little about the effect of these events on political behavior. While scholars typically treat violent protests as deliberate acts undertaken in pursuit of specific goals, due to a lack of appropriate data and difficulty in causal identification, there is scant evidence of whether riots can actually increase support for these goals. Using geocoded data, we analyze measures of policy support before and after the 1992 Los Angeles riot—one of the most high-profile events of political violence in recent American history—that occurred just prior to an election. Contrary to some expectations from the academic literature and the popular press, we find that the riot caused a marked liberal shift in policy support at the polls. Investigating the sources of this shift, we find that it was likely the result of increased mobilization of both African American and white voters. Remarkably, this mobilization endures over a decade later.
One generation's experience of childhood maltreatment is associated with that of the next. However, whether this intergenerational transmission is specific to distinct forms of maltreatment and what factors may contribute to its continuity remains unclear. Borderline personality pathology is predicted by childhood maltreatment and characterized by features (e.g., dysregulated emotion, relationship instability, impulsivity, and inconsistent appraisals of others) that may contribute to its propagation. Among 364 older adults and 573 of their adult children (total n = 937), self-reported exposure to distinct forms of childhood maltreatment (i.e., emotional, physical, and sexual abuse, and emotional and physical neglect as assessed by the Childhood Trauma Questionnaire) showed homotypic and heterotypic associations across generations with little evidence that latent factors unique to specific forms of maltreatment show generational continuity. General nonspecific indices of childhood maltreatment showed evidence of intergenerational transmission after accounting for demographic factors and parent socioeconomic status (b = 0.126, p = 9.21 × 10−4). This continuity was partially mediated by parental borderline personality pathology (assessed longitudinally through a variety of measures and sources, indirect effect: b = 0.031, 95% confidence interval [0.003, 0.060]). The intergenerational continuity of childhood maltreatment may largely represent general risk for nonspecific maltreatment that may, in part, be propagated by borderline personality pathology and/or shared risk factors.
Many materials systems comprise complex structures where multiple materials are integrated to achieve a desired performance. Often in these systems, it is a combination of both the materials and their structure that dictate performance. Here the authors layout an integrated computational–statistical–experimental methodology for hierarchical materials systems that takes a holistic design approach to both the material and structure. The authors used computational modeling of the physical system combined with statistical design of experiments to explore an activated carbon adsorption bed. The large parameter space makes experimental optimization impractical. Instead, a computational–statistical approach is coupled with physical experiments to validate the optimization results.
Recent work has pioneered the use of expert surveys to estimate cross-national party positions in a common ideological space. In this paper, we report findings from an original dataset designed to evaluate bridging strategies between European and American party placements. Specifically, we compare the use of “anchoring vignettes” (fictional party platforms) with an alternative approach that asks comparativist scholars who live in the US (whom we call transatlantic or TA experts) to place parties and parties in their country of expertise on a series of issues scales. The results provide an optimistic assessment of the ability of TA experts to serve as valid bridges across the Atlantic. The resulting cross-comparable estimates of party positions show instances of both convergence and divergence between American and European party systems, including parallels between systems on the cross-cutting issue of international economic integration.
A 2018 workshop on the White Mountain Apache Tribe lands in Arizona examined ways to enhance investigations into cultural property crime (CPC) through applications of rapidly evolving methods from archaeological science. CPC (also looting, graverobbing) refers to unauthorized damage, removal, or trafficking in materials possessing blends of communal, aesthetic, and scientific values. The Fort Apache workshop integrated four generally partitioned domains of CPC expertise: (1) theories of perpetrators’ motivations and methods; (2) recommended practice in sustaining public and community opposition to CPC; (3) tactics and strategies for documenting, investigating, and prosecuting CPC; and (4) forensic sedimentology—uses of biophysical sciences to link sediments from implicated persons and objects to crime scenes. Forensic sedimentology served as the touchstone for dialogues among experts in criminology, archaeological sciences, law enforcement, and heritage stewardship. Field visits to CPC crime scenes and workshop deliberations identified pathways toward integrating CPC theory and practice with forensic sedimentology’s potent battery of analytic methods.
Although shyness is a ubiquitous phenomenon with early developmental origins, little research has examined the influence of prenatal exposures on the developmental trajectory of shyness. Here, we examined trajectories of shyness from childhood to adulthood in three groups (N = 254), with varying degrees of prenatal adversity as indicated by the number of stressful exposures: extremely low birth weight (ELBW; <1000 g) survivors prenatally exposed to exogenous corticosteroids (ELBW+S, n = 56); ELBW survivors not prenatally exposed to exogenous corticosteroids (ELBW+NS, n = 56); and normal birth weight (NBW, n = 142) controls. Multilevel modeling revealed that the ELBW+S individuals exhibited the highest levels of childhood shyness, which remained stable into adulthood. The ELBW+NS and NBW controls had comparably low levels of childhood shyness; however, the ELBW+NS individuals experienced patterns of increasing shyness, while NBW controls displayed decreases in shyness into adulthood. We speculate that individuals exposed to multiple prenatal stressors (i.e., ELBW+S) may be developmentally programmed to be more sensitive to detecting social threat, with one manifestation being early developing, stable shyness, while increasing shyness among ELBW+NS individuals may reflect a later developing shyness influenced by postnatal context. We discuss the implications of these findings for understanding the developmental origins and developmental course of human shyness from childhood through adulthood.
We sought to define the prevalence of echocardiographic abnormalities in long-term survivors of paediatric hematopoietic stem cell transplantation and determine the utility of screening in asymptomatic patients. We analysed echocardiograms performed on survivors who underwent hematopoietic stem cell transplantation from 1982 to 2006. A total of 389 patients were alive in 2017, with 114 having an echocardiogram obtained ⩾5 years post-infusion. A total of 95 patients had echocardiogram performed for routine surveillance. The mean time post-hematopoietic stem cell transplantation was 13 years. Of 95 patients, 77 (82.1%) had ejection fraction measured, and 10/77 (13.0%) had ejection fraction z-scores ⩽−2.0, which is abnormally low. Those patients with abnormal ejection fraction were significantly more likely to have been exposed to anthracyclines or total body irradiation. Among individuals who received neither anthracyclines nor total body irradiation, only 1/31 (3.2%) was found to have an abnormal ejection fraction of 51.4%, z-score −2.73. In the cohort of 77 patients, the negative predictive value of having a normal ejection fraction given no exposure to total body irradiation or anthracyclines was 96.7% at 95% confidence interval (83.3–99.8%). Systolic dysfunction is relatively common in long-term survivors of paediatric hematopoietic stem cell transplantation who have received anthracyclines or total body irradiation. Survivors who are asymptomatic and did not receive radiation or anthracyclines likely do not require surveillance echocardiograms, unless otherwise indicated.
Although moving from institutional to home-like long-term care (LTC) settings can promote and sustain the health and wellbeing of older adults, there has been little research examining how home is perceived by older adults when moving between care settings. A qualitative study was conducted over a two-year period during the relocation of residents and staff from an institutional LTC home to a purpose-built LTC home in Western Canada. The study explored perceptions of home amongst residents, family members and staff. Accordingly, 210 semi-structured interviews were conducted at five time-points with 35 residents, 23 family members and 81 staff. Thematic analyses generated four superordinate themes that are suggestive of how to create and enhance a sense of home in LTC settings: (a) physical environment features; (b) privacy and personalisation; (c) autonomy, choice and flexibility; and (d) connectedness and togetherness. The findings reveal that the physical environment features are foundational for the emergence of social and personal meanings associated with a sense of home, and highlight the impact of care practices on the sense of home when the workplace becomes a home. In addition, tension that arises between providing care and creating a home-like environment in LTC settings is discussed.
The family physician is key to facilitating access to psychiatric treatment for young people with first-episode psychosis, and this involvement can reduce aversive events in pathways to care. Those who seek help from primary care tend to have longer intervals to psychiatric care, and some people receive ongoing psychiatric treatment from the family physician.
Our objective is to understand the role of the family physician in help-seeking, recognition and ongoing management of first-episode psychosis.
We will use a mixed-methods approach, incorporating health administrative data, electronic medical records (EMRs) and qualitative methodologies to study the role of the family physician at three points on the pathway to care. First, help-seeking: we will use health administrative data to examine access to a family physician and patterns of primary care use preceding the first diagnosis of psychosis; second, recognition: we will identify first-onset cases of psychosis in health administrative data, and look back at linked EMRs from primary care to define a risk profile for undetected cases; and third, management: we will examine service provision to identified patients through EMR data, including patterns of contacts, prescriptions and referrals to specialised care. We will then conduct qualitative interviews and focus groups with key stakeholders to better understand the trends observed in the quantitative data.
These findings will provide an in-depth description of first-episode psychosis in primary care, informing strategies to build linkages between family physicians and psychiatric services to improve transitions of care during the crucial early stages of psychosis.
Most previous research on changes in weed abundance and community composition in cropping systems has focused on field crops. The study presented here examined changes in the weed seedbank and aboveground biomass in four organic vegetable cropping systems over a 10-yr period. The systems included an Intensive system with six crops per 4-yr rotation, an Intermediate system with one cash crop per year, a Bio-extensive system with alternating cash crop and tilled fallow years plus prevention of seed rain, and a Ridge-tillage system with one cash crop per year. Systems also differed in the types and number of cover crops between cash crops. During the course of the experiment, the weed community shifted from one dominated by summer annual broadleaf species that reproduce at the end of their lives to a community dominated by summer and winter annuals that mature rapidly. This shift in community composition can be attributed to the change in land use from conventionally managed corn (Zea mays L.) and alfalfa (Medicago sativa L.) to organic vegetable production. In particular, crop rotations with diverse preplantings and postharvest tillage dates interrupted the life cycle of common lambsquarters (Chenopodium album L.) and pigweed species (Amaranthus spp.: mostly Powell amaranth [Amaranthus powellii S. Watson], with small numbers of redroot pigweed [Amaranthus retroflexus L.] and smooth pigweed [Amaranthus hybridus L.]), while favoring a diverse assemblage of quickly maturing species. The study thus demonstrates that an appropriate crop rotation can control the seedbank of weeds like C. album that potentially persist well in the soil. The Ridge-tillage system greatly reduced the frequency and depth of tillage relative to other systems while effectively suppressing perennial weeds. The early-reproducing annuals, however, became more abundant in the Ridge-tillage system than in the other systems, primarily due to escapes along the edge of the scraped ridges. The tilled fallow periods coupled with prevention of seed rain in the Bio-extensive system substantially reduced weed abundance through time and relative to the other systems.
Traditional ambulatory rhythm monitoring in children can have limitations, including cumbersome leads and limited monitoring duration. The ZioTM patch ambulatory monitor is a small, adhesive, single-channel rhythm monitor that can be worn up to 2 weeks. In this study, we present a retrospective cross-sectional analysis of the ZioTM monitor’s impact in clinical practice. Patients aged 0–18 years were included in the study. A total of 373 studies were reviewed in 332 patients. In all, 28.4% had structural heart disease, and 16.9% had a prior surgical, catheterisation, or electrophysiology procedure. The most common indication for monitoring was tachypalpitations (41%); 93.5% of these patients had their symptoms captured during the study window. The median duration of monitoring was 5 days. Overall, 5.1% of ZioTM monitoring identified arrhythmias requiring new intervention or increased medical management; 4.0% identified arrhythmias requiring increased clinical surveillance. The remainder had either normal-variant rhythm or minor rhythm findings requiring no change in management. For patients with tachypalpitations and no structural heart disease, 13.2% had pathological arrhythmias, but 72.9% had normal-variant rhythm during symptoms, allowing discharge from cardiology care. Notably, for patients with findings requiring intervention or increased surveillance, 56% had findings first identified beyond 24 hours, and only 62% were patient-triggered findings. Seven studies (1.9%) were associated with complications or patient intolerance. The ZioTM is a well-tolerated device that may improve what traditional Holter and event monitoring would detect in paediatric cardiology patients. This study shows a positive clinical impact on the management of patients within a paediatric cardiology practice.
Brandãoite, [BeAl2(PO4)2(OH)2(H2O)4](H2O), is a new Be–Al phosphate mineral from the João Firmino mine, Pomarolli farm region, Divino das Laranjeiras County, Minas Gerais State, Brazil, where it occurs in an albite pocket with other secondary phosphates, including beryllonite, atencioite and zanazziite, in a granitic pegmatite. It occurs as colourless acicular crystals <10 µm wide and <100 µm long that form compact radiating spherical aggregates up to 1.0–1.5 mm across. It is colourless and transparent in single crystals and white in aggregates, has a white streak and a vitreous lustre, is brittle and has conchoidal fracture. Mohs hardness is 6, and the calculated density is 2.353 g/cm3. Brandãoite is biaxial (+), α = 1.544, β = 1.552 and γ = 1.568, all ± 0.002; 2Vobs = 69.7(10)° and 2Vcalc = 71.2°. No pleochroism was observed. Brandãoite is triclinic, space group P
, a = 6.100(4), b = 8.616(4), c = 10.261(5) Å, α = 93.191(11), β = 95.120(11), γ = 96.863(11)°, V = 532.1(8) Å3 and Z = 2. Chemical analysis of a 4 µm wide needle-shaped crystal by electron microprobe and secondary-ion mass spectrometry gave P2O5 = 28.42, Al2O3 = 20.15, BeO = 4.85, H2O = 21.47 and sum = 74.89 wt.%. The empirical formula, normalised on the basis of 15 anions pfu with (OH) = 2 and (H2O) = 5 apfu (from the crystal structure) is Be0.98Al1.99P2.02H12O15. The crystal structure was solved by direct methods and refined to an R1 index of 7.0%. There are two P sites occupied by P5+, two Al sites occupied by octahedrally coordinated Al3+, and one Be site occupied by tetrahedrally coordinated Be2+. There are fifteen anions, two of which are (OH) groups and five of which are (H2O) groups. The simplified ideal formula is thus [BeAl2(PO4)2(OH)2(H2O)4](H2O) with Z = 2. Beryllium and P tetrahedra share corners to form a four-membered ring. Aluminium octahedra share a common vertex to form an [Al2φ11] dimer, and these dimers are cross-linked by P tetrahedra to form a complex slab of polyhedra parallel to (001). These slabs are cross-linked by BeO2(OH)(H2O) tetrahedra, with interstitial (H2O) groups in channels that extend along .