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Our pilot study evaluated the feasibility, effectiveness, and implementation of a group-based lifestyle-integrated functional exercise (Mi-LiFE) program for older adults in an interprofessional primary care practice. A physical therapist taught participants how to integrate strength and balance activities into daily routines during one individual and four group sessions, and two follow-up phone calls. Feasibility outcomes were recruitment, adherence, and retention over 6 months. Physical activity (PA) (accelerometer, International Physical Activity Questionnaire [IPAQ]), Short Physical Performance Battery (SPPB), and health-related quality of life (EuroQol Five-Dimensional Questionnaire with 3 Levels [EQ5D-3L]) were evaluated at baseline and 6 months. Of the 123 eligible individuals, 39 per cent participated and 61 per cent were not interested or unreachable. Forty-eight participants (mean ± standard deviation [SD] age = 81 ± 5 years; body mass index [BMI] = 28 ± 5 kg/m2; 60% women; moderate-to-vigorous PA = 49 ± 87 minutes/week) enrolled. Four participants withdrew prior to intervention. Thirty-two participants (67%) were retained at follow-up. Daily diary-documented adherence was 50 per cent at 6 months, and 77 per cent attended more than four sessions. No statistically significant changes in moderate-to-vigorous PA and SPPB outcomes were observed; yet self-reported strength and balance PA and quality of life significantly improved at follow-up. The Mi-LiFE program is feasible with acceptable recruitment and attendance rates alongside modifications to address retention and adherence challenges. These findings inform the feasibility of future pragmatic exercise programs in primary care for older adults.
Formation of a low barrier back contact plays a critical role in improving the photoconversion efficiency of the CdTe solar cells. Incorporating a buffer layer to minimize the band bending at the back of the CdTe device can significantly lower the barrier for the hole current, improving open circuit voltage (VOC) and the fill factor. Over the past years, researchers have incorporated the both ZnTe and Te as buffer layers to improve CdTe device performance. Here we compare device performance using these two materials as buffer layers at the back of CdTe devices. We show that using Te in contact to CdTe results in higher performance than using ZnTe in contact to the CdTe. Low temperature current density-voltage measurements show that Te results is a lower barrier with CdTe than ZnTe, indicating that Te has better band alignment, resulting in less downward bending in the CdTe at the back interface, than ZnTe does.
The timing in which supplements are provided in grazing systems can affect dry matter (DM) intake and productive performance. The objective of this study was to evaluate the effect of timing of corn silage supplementation on ingestive behaviour, DM intake, milk yield and composition in grazing dairy cows. In total, 33 Holstein dairy cows in a randomized block design grazed on a second-year mixed grass–legume pasture from 0900 to 1500 h and received 2.7 kg of a commercial supplement at each milking. Paddock sizes were adjusted to provide a daily herbage allowance of 15 kg DM/cow determined at ground level. The three treatments imposed each provided 3.8 kg DM/day of corn silage offered in a single meal at 0800 h (Treatment AM), equally distributed in two meals 0800 and 1700 h (Treatment AM-PM) or a single meal at 1700 h (Treatment PM). The experiment was carried out during the late autumn and early winter period, with 1 week of adaptation and 6 weeks of measurements. There were no differences between treatments in milk yield, but 4% fat-corrected milk yield tended to be greater in AM-PM than in AM cows, which did not differ from PM (23.7, 25.3 and 24.6±0.84 kg/day for AM, AM-PM and PM, respectively). Fat percentage and yield were greater for AM-PM than for AM cows and intermediate for PM cows (3.89 v. 3.66±0.072% and 1.00 v. 0.92±0.035 kg/day, respectively). Offering corn silage in two meals had an effect on herbage DM intake which was greater for AM-PM than AM cows and was intermediate in PM cows (8.5, 11.0 and 10.3±0.68 kg/day for AM, AM-PM and PM, respectively). During the 6-h period at pasture, the overall proportion of observations on which cows were grazing tended to be different between treatments and a clear grazing pattern along the grazing session (1-h observation period) was identified. During the time at pasture, the proportion of observations during which cows ruminated was positively correlated with the DM intake of corn silage immediately before turn out to pasture. The treatment effects on herbage DM intake did not sufficiently explain differences in productive performance. This suggests that the timing of the corn silage supplementation affected rumen kinetics and likewise the appearance of hunger and satiety signals as indicated by observed changes in temporal patterns of grazing and ruminating activities.
Bees (Hymenoptera: Apoidea, Apiformes) are taxonomically and ecologically diverse, with a wide range of social complexity, nesting preferences, floral associations, and biogeographic restrictions. A Canadian bee checklist, greatly assisted by the gene-assisted approach of DNA barcoding, is nearing completion. Previous evaluation of bee diversity in Canada, assisted by DNA barcoding, was restricted to Nova Scotia, which contains about 25% of the bee species in the country. Here, we summarise efforts to date to build a comprehensive DNA barcode library supporting bee taxonomic studies in Canada, consisting of more than 12 500 barcode-compliant sequences yielding 811 distinct barcode index numbers (BINs). This appears to represent ~95% of the 856 bee species presently recorded from Canada, but comparison with known morphological species in each genus shows that some genera are still under-sampled or may contain cryptic taxa, with much taxonomic work still to be done on bees in Canada. This is particularly true within the taxonomically difficult genera Andrena Fabricius (Andrenidae), Hylaeus Fabricius (Colletidae), Melissodes Latreille (Apidae), Nomada Scopoli (Apidae), Osmia Panzer (Megachilidae), and Sphecodes Latreille (Halictidae). DNA analysis will likely be a key asset in resolving bee taxonomic issues in Canada in the future, and to date has even assisted studies of well-known bee taxa. Here we present summaries of our results, and discuss the use of DNA barcoding to assist future taxonomic work, faunal lists, and ecological studies.
Hemihedrite from the Florence Lead-Silver mine in Pinal County, Arizona, USA
was first described and assigned the ideal chemical formula
based upon a variety of chemical and crystal-structure analyses. The primary
methods used to determine the fluorine content for hemihedrite were
colorimetry, which resulted in values of F that were too high and
inconsistent with the structural data, and infrared (IR) spectroscopic
analysis that failed to detect OH or H2O. Our reinvestigation
using electron microprobe analysis of the type material, and additional
samples from the type locality, the Rat Tail claim, Arizona, and Nevada,
reveals the absence of fluorine, while the presence of OH is confirmed by
Raman spectroscopy. These findings suggest that the colorimetric
determination of fluorine in the original description of hemihedrite
probably misidentified F due to the interferences from PO4 and
SO4, both found in our chemical analyses. As a consequence of
these results, the study presented here proposes a redefinition of the
chemical composition of hemihedrite to the ideal chemical formula
Hemihedrite is isotypic with iranite with substitution of Zn for Cu, and
raygrantite with substitution of Cr for S. Structural data from a sample
from the Rat Tail claim, Arizona, indicate that hemihedrite is triclinic in
space group P1, a = 9.4891(7),
b = 11.4242(8), c = 10.8155(7) Å, α =
120.368(2)°, β = 92.017(3)°, γ = 55.857(2)°, V = 784.88(9)
Å3, Z= 1, consistent with previous
investigations. The structure was refined from singlecrystal X-ray
diffraction data to R1 = 0.022 for 5705 unique observed reflections, and the ideal
was assumed during the refinement. Electron microprobe analyses of this
sample yielded the empirical chemical formula
6.00 Si1.97O34H2.16 based on 34 O
atoms and six (Cr + S + P) per unit cell.
We present subarcsecond observations at 2.7 and 1.4 mm of a sample of massive young stellar objects made with the BIMA millimetre array. For most sources the continuum emission on the smallest scales at 2.7 mm is dominated by free-free emission from the stellar wind or jet. Strong emission at 1.4 mm shows the presence of significant dust associated with Cep A and GL 490 but our resolution is not sufficient to resolve any structure. The 2.7-mm emission from GL 490 is resolved but it is not clear whether we are seeing a single circumstellar disk or a secondary companion, although near-infrared data support the disk hypothesis. Estimates of the dust mass yield values of ∼1–4 M⊙ within radii of 150 to 1000 AU.
Both Holmberg (1961) and de Vaucouleurs (1963, 1973) found a significant difference between the mean velocities of the different morphological types in the Virgo cluster of galaxies. To check on any dependence of this result upon spatial distribution, Lewis (1975) plotted the position of every object in the compilation of de Vaucouleurs (1961) as a function of its type. Figure 1 is the resulting plot for the elliptical galaxies, which appear to lie within two well-defined and well-separated groups. The principal parameters of these groups are listed in Table I. Arp (1967) briefly noted the linear form of the northern group centred on NGC 4486. This paper examines the evidence for the physical existence of these groups.
During the first half of the twentieth century, Shaw became one of the most celebrated, commented on, and quoted literary figures of the age. In the public domain and in theatrical circles he was widely regarded as a major contributor to the English dramatic tradition, and as belonging to the international company of playwrights such as Ibsen, Strindberg, Wilde, Chekhov, and Pirandello as creators of some of the classics of modern drama. In the sub-title of his third large-scale biographical work on Shaw, published in 1956, Archibald Henderson boldly, if controversially, named him ‘man of the century’. But the recognition and acclaim accorded to Shaw in the outside world was not widely echoed in the groves of academe. On the contrary, Shaw was largely ignored in the dominant critical discourses of the mid-twentieth-century. In the introduction to his 1953 collection of essays on Shaw, Louis Kronenberger justifiably remarked that ‘what stands forth glaringly is the extent to which Shaw has not been written about – that is to say, by the most influential of our serious critics’.
Mid-twentieth-century Anglophone literary criticism was a high culture, the boundaries of which were jealously protected by its academic exponents. In England and the British Commonwealth, and in many leading universities in America, the core subject of study comprised authors judged to be the major figures in the English literary tradition. Several departments of drama had been established in England and North America. But in departments of English, partly because of concerns about study of works in translation, modern drama was a neglected field. University English syllabuses in the 1950s rarely included study of Shaw, and hostility towards him was common in academic circles.
The Cambridge critic F. R. Leavis, an influential and, to many teachers and students, inspiring figure, did not write any extensive essays on Shaw. But in 1956 he used the occasion of reviewing a collection of essays by D. H. Lawrence, including ‘A Propos of Lady Chatterley's Lover’, to launch a fierce attack on Shaw, in which he wrote: ‘What repels Lawrence in Shaw is what [one of the editors] Mr. [H. F.] Rubinstein acclaims as the triumph of reason. It is the automatism, the emptiness and the essential irreverence – all that makes Shaw boring and cheap; the emotional nullity’.
Different front-of-pack (FOP) labelling systems have been developed in Europe by industry and organisations concerned with health promotion. A study (n 2068) was performed to establish the extent to which inclusion of the most prevalent FOP systems – guideline daily amounts (GDA), traffic lights (TL), GDA+TL hybrid (HYB) and health logos (HL) – impact consumer perceptions of healthiness over and above the provision of a FOP basic label (BL) containing numerical nutritional information alone. The design included within- and between-subjects factors. The within-subjects factors were: food (pizzas, yogurts and biscuits), healthiness of the food (high health, medium health and low health) and the repeated measurements under BL and test FOP label conditions. The between-subjects factors were: the system (GDA, TL, GDA+TL hybrid, HL), portion size (typical portion size and a 50 % reduction of a typical portion) and country (the UK, Germany, Poland and Turkey). Although the FOP systems tested did result in small improvements for objective understanding under some conditions, there was little difference between the provision of an FOP label containing basic numerical nutritional information alone or between the various systems. Thus, any structured and legible presentation of key nutrient and energy information on the FOP label is sufficient to enable consumers to detect a healthier alternative within a food category when provided with foods that have distinctly different levels of healthiness. Future research should focus on developing greater understanding of the psychological and contextual factors that impact motivation and the opportunity to use the various FOP systems in real-world shopping settings.
To identify clinical signs and symptoms (ie, “terms”) that accurately predict laboratory-confirmed influenza cases and thereafter generate and evaluate various influenza-like illness (ILI) case definitions for detecting influenza. A secondary objective explored whether surveillance of data beyond the chief complaint improves the accuracy of predicting influenza.
Retrospective, cross-sectional study.
Large urban academic medical center hospital.
A total of 1,581 emergency department (ED) patients who received a nasopharyngeal swab followed by rRT-PCR testing between August 30, 2009, and January 2, 2010, and between November 28, 2010, and March 26, 2011.
An electronic surveillance system (GUARDIAN) scanned the entire electronic medical record (EMR) and identified cases containing 29 clinical terms relevant to influenza. Analyses were conducted using logistic regressions, diagnostic odds ratio (DOR), sensitivity, and specificity.
The best predictive model for identifying influenza for all ages consisted of cough (DOR=5.87), fever (DOR=4.49), rhinorrhea (DOR=1.98), and myalgias (DOR=1.44). The 3 best case definitions that included combinations of some or all of these 4 symptoms had comparable performance (ie, sensitivity=89%–92% and specificity=38%–44%). For children <5 years of age, the addition of rhinorrhea to the fever and cough case definition achieved a better balance between sensitivity (85%) and specificity (47%). For the fever and cough ILI case definition, using the entire EMR, GUARDIAN identified 37.1% more influenza cases than it did using only the chief complaint data.
A simplified case definition of fever and cough may be suitable for implementation for all ages, while inclusion of rhinorrhea may further improve influenza detection for the 0–4-year-old age group. Finally, ILI surveillance based on the entire EMR is recommended.
A time-honoured convention in accounting has been that accounts should be based on historic cost, with all items being recorded in terms of the purchasing power of the pound at the date of each transaction. In a period of rapid inflation, accounts on the traditional basis become distorted and dangerously misleading. The authors describe the theory and practice of the proposals of the Accounting Standards Steering Committee for current purchasing power accounting and examine replacement cost accounting, comprehensively applied, as an alternative. They point out the advantages, despite somewhat greater practical difficulties, of current value accounting. A sample of large United Kingdom companies is analysed and the effect on their earnings of the A.S.S.C.'s proposals is estimated where these figures are not already published. Share price movements by different industry sectors over the last five years are examined in relation to changes in earnings on inflation accounting principles. It is stressed that gaining from inflation accounting is not the same as gaining from inflation, and that liquidity is a separate question. Problems of taxation (notably on stock appreciation) are discussed and practice in other countries is mentioned, as are the implications for price controls, trade unions, and indexation. The authors hope that the Sandilands Committee on Company Accounts and Inflation will find a convincing case for inflation-adjusted accounts to form the basis for taxation and price controls. They look forward to the gradual abandonment of historiccost accounts, regarding the proposals of the A.S.S.C. as a desirable but imperfect first step, and urge that meantime investors and creditors should make their own estimates of the impact of inflation on particular companies.
Central line-associated bloodstream infection (CLABSI) is a national target for mandatory reporting and a Centers for Medicare and Medicaid Services target for value-based purchasing. Differences in chart review versus claims-based metrics used by national agencies and groups raise concerns about the validity of these measures.
Evaluate consistency and reasons for discordance among chart review and claims-based CLABSI events.
We conducted 2 multicenter retrospective cohort studies within 6 academic institutions. A total of 150 consecutive patients were identified with CLABSI on the basis of National Healthcare Safety Network (NHSN) criteria (NHSN cohort), and an additional 150 consecutive patients were identified with CLABSI on the basis of claims codes (claims cohort). Ail events had full-text medical record reviews and were identified as concordant or discordant with the other metric.
In the NHSN cohort, there were 152 CLABSIs among 150 patients, and 73.0% of these cases were discordant with claims data. Common reasons for the lack of associated claims codes included coding omission and lack of physician documentation of bacteremia cause. In the claims cohort, there were 150 CLABSIs among 150 patients, and 65.3% of these cases were discordant with NHSN criteria. Common reasons for the lack of NHSN reporting were identification of non-CLABSI with bacteremia meeting Centers for Disease Control and Prevention (CDC) criteria for an alternative infection source.
Substantial discordance between NHSN and claims-based CLABSI indicators persists. Compared with standardized CDC chart review criteria, claims data often had both coding omissions and misclassification of non-CLABSI infections as CLABSI. Additionally, claims did not identify any additional CLABSIs for CDC reporting. NHSN criteria are a more consistent interhospital standard for CLABSI reporting.