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The early intervention service (EIS) approach is based on therapeutic interactions, which promote service user recovery from first episode psychosis. Collaborative therapeutic work between the service user and case manager depends on good communication. This can be a challenge for people with psychosis as the process of thought can be disrupted or stimulus misinterpreted leading to communication errors.
The objective is to develop an interactive tool that can assist service user's communication of distress, whilst employing a psychoeducational approach to the use of an informal therapeutic measurement scale; subjective units of distress (SUDs) and early warning signs (EWS). The ApTiC mobile intervention will include ten numerically graded emoticons from low to extreme distress. Each emoticon is associated with specific individualised service user descriptors and linked to an individually agreed action plan and level of response to be offered by a staff member.
The aim of the present study will be to examine the feasibility and acceptability of the ApTic mobile intervention in preparation for a larger randomised controlled trial.
Phase one: qualitative research to inform the development of the complimentary tool and mobile app (qualitative). Phase two: a 12-week rater-blinded randomized control trial of ApTiC compared to routine EIS case management (quantitative).
The qualitative data will be presented.
It is expected that once validated, the SUDs based ApTiC will enhance rapport and understanding thus improving the recovery approach to well-being and hopefully preventing relapse or the involvement of the crisis team or hospital admissions.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Glaciers depicted on old maps reveal their historical extents, before the advent of aerial and satellite remote sensing. Digital glacier inventories produced from these maps can be employed in assessments of centennial-scale glacier change. This study reconstructs the ~1899 (covering the period 1882–1916) glacier extent in Nordland, northern Norway, from historical gradteigskart maps, with an emphasis on examining the accuracy of the mapped glaciers. Glacier outlines were digitised from georectified scans of the analogue maps in a raster graphics editor and were subsequently inventoried in a GIS. The accuracy of the historical glacier extent was established from written descriptions and landscape photographs created during the original field surveys, and further validated against independent glacier outlines of (1) the maximum Little Ice Age extent derived from geomorphological evidence, and (2) the 1945 extent derived from vertical aerial photographs. An overall uncertainty of ±17% is associated with our inventory. Nordland's glaciers covered an area of 1712 ± 291 km2 in 1899. By 2000, total ice cover had decreased by 47% (807 ± 137 km2) at a rate of 6% 10 a−1 (80 ± 14 km2 10 a−1). The approach presented here may serve as a blueprint for future studies intending to derive glacier inventories from historical maps.
The majority of self-management interventions are designed with a narrow focus on patient skills and fail to consider their potential as “catalysts” for improving care delivery. A project was undertaken to develop a patient self-management resource to support evidence-based, person-centered care for cancer pain and overcome barriers at the levels of the patient, provider, and health system.
The project used a mixed-method design with concurrent triangulation, including the following: a national online survey of current practice; two systematic reviews of cancer pain needs and education; a desktop review of online patient pain diaries and other related resources; consultation with stakeholders; and interviews with patients regarding acceptability and usefulness of a draft resource.
Findings suggested that an optimal self-management resource should encourage pain reporting, build patients’ sense of control, and support communication with providers and coordination between services. Each of these characteristics was identified as important in overcoming established barriers to cancer pain care. A pain self-management resource was developed to include: (1) a template for setting specific, measureable, achievable, relevant and time-bound goals of care, as well as identifying potential obstacles and ways to overcome these; and (2) a pain management plan detailing exacerbating and alleviating factors, current strategies for management, and contacts for support.
Significance of results
Self-management resources have the potential for addressing barriers not only at the patient level, but also at provider and health system levels. A cluster randomized controlled trial is under way to test effectiveness of the resource designed in this project in combination with pain screening, audit and feedback, and provider education. More research of this kind is needed to understand how interventions at different levels can be optimally combined to overcome barriers and improve care.
Collaborative care can support the treatment of depression in people with long-term conditions, but long-term benefits and costs are unknown.
To explore the long-term (24-month) effectiveness and cost-effectiveness of collaborative care in people with mental-physical multimorbidity.
A cluster randomised trial compared collaborative care (integrated physical and mental healthcare) with usual care for depression alongside diabetes and/or coronary heart disease. Depression symptoms were measured by the symptom checklist-depression scale (SCL-D13). The economic evaluation was from the perspective of the English National Health Service.
191 participants were allocated to collaborative care and 196 to usual care. At 24 months, the mean SCL-D13 score was 0.27 (95% CI, −0.48 to −0.06) lower in the collaborative care group alongside a gain of 0.14 (95% CI, 0.06-0.21) quality-adjusted life-years (QALYs). The cost per QALY gained was £13 069.
In the long term, collaborative care reduces depression and is potentially cost-effective at internationally accepted willingness-to-pay thresholds.
We present results from a multiwavelength study of the blazar PKS 1954–388 at radio, UV, X-ray, and gamma-ray energies. A RadioAstron observation at 1.66 GHz in June 2012 resulted in the detection of interferometric fringes on baselines of 6.2 Earth-diameters. This suggests a source frame brightness temperature of greater than 2 × 1012 K, well in excess of both equipartition and inverse Compton limits and implying the existence of Doppler boosting in the core. An 8.4-GHz TANAMI VLBI image, made less than a month after the RadioAstron observations, is consistent with a previously reported superluminal motion for a jet component. Flux density monitoring with the Australia Telescope Compact Array confirms previous evidence for long-term variability that increases with observing frequency. A search for more rapid variability revealed no evidence for significant day-scale flux density variation. The ATCA light-curve reveals a strong radio flare beginning in late 2013, which peaks higher, and earlier, at higher frequencies. Comparison with the Fermi gamma-ray light-curve indicates this followed ~ 9 months after the start of a prolonged gamma-ray high-state—a radio lag comparable to that seen in other blazars. The multiwavelength data are combined to derive a Spectral Energy Distribution, which is fitted by a one-zone synchrotron-self-Compton (SSC) model with the addition of external Compton (EC) emission.
People with a life-limiting physical illness experience high rates of significant psychological and psychiatric morbidity. Nevertheless, psychiatrists often report feeling ill-equipped to respond to the psychiatric needs of this population. Our aim was to explore psychiatry trainees’ views and educational needs regarding the care of patients with a life-limiting physical illness.
Using semistructured interviews, participants’ opinions were sought on the role of psychiatrists in the care of patients with a life-limiting illness and their caregivers, the challenges faced within the role, and the educational needs involved in providing care for these patients. Interviews were audiotaped, fully transcribed, and then subjected to thematic analysis.
A total of 17 psychiatry trainees were recruited through two large psychiatry training networks in New South Wales, Australia. There were contrasting views on the role of psychiatry in life-limiting illness. Some reported that a humanistic, supportive approach including elements of psychotherapy was helpful, even in the absence of a recognizable mental disorder. Those who reported a more biological and clinical stance (with a reliance on pharmacotherapy) tended to have a nihilistic view of psychiatric intervention in this setting. Trainees generally felt ill-prepared to talk to dying patients and felt there was an educational “famine” in this area of psychiatry. They expressed a desire for more training and thought that increased mentorship and case-based learning, including input from palliative care clinicians, would be most helpful.
Significance of Results:
Participants generally feel unprepared to care for patients with a life-limiting physical illness and have contrasting views on the role of psychiatry in this setting. Targeted education is required for psychiatry trainees in order to equip them to care for these patients.
To improve wildlife conservation incentives in community-based natural resource management programs, a better understanding of rural communities' willingness to engage in wildlife conservation jobs is needed. We implement a discrete choice model explaining reservation wages for nine conservation jobs using contingent behavior data from rural Botswana residents. We present a model in which the conditional indirect utility function incorporates a more general value of time than has previously been used, and this specification outperforms the standard model. Sample estimates indicate that reservation wages are modestly higher for women than for men, and that residents have higher reservation wages for jobs requiring more exertion or involving more danger.
We have completed a Chandra snapshot survey of 54 radio jets that are extended on arcsec scales. These are associated with flat spectrum radio quasars spanning a redshift range z=0.3 to 2.1. X-ray emission is detected from the jet of approximately 60% of the sample objects. We assume minimum energy and apply conditions consistent with the original Felten-Morrison calculations in order to estimate the Lorentz factors and the apparent Doppler factors. This allows estimates of the enthalpy fluxes, which turn out to be comparable to the radiative luminosities.
Interstellar scintillation (ISS) has been shown to be primarily responsible for the short term intraday variability (IDV) exhibited by extragalactic sources at centimeter wavelengths (e.g. Bignall et al. 2006 and references therein). For a source to scintillate its angular size must be comparable to that of the first Fresnel zone (Narayan 1992) which implies microarcsecond angular sizes for screen distances of tens to hundreds of parsecs. This has the potential to probe within a few light months of the central black hole (Bignall et al. 2006). The aim of the Microarcsecond Scintillation-Induced Variability (MASIV) survey was to provide a catalogue of at least a hundred AGNs that vary on timescales of hours to days to provide the basis of detailed studies of the IDV population drawn from a well-defined sample.
We are undertaking an observational program using the ATCA to monitor the intraday variability (IDV) of a sample of sources at 4.8 and 8.6 GHz. The sources were selected to include the known strong southern IDV sources plus a number of sources whose IDV was recently discovered. The present monitoring program will extend over a full year in order to search for any annual cycle that may be present in the long-term IDV characteristics of these sources. In this paper we discuss the observing strategy and data analysis, and present the first results from our observations.
Flux density monitoring data at 2.3 and 8.4 GHz is presented for a sample of 33 southern hemisphere GPS sources, drawn from the 2.7 GHz Parkes survey. This monitoring data, together with VLBI monitoring data, shows that a small fraction of these sources, ∼10%, vary. Their variability falls into several categories: sources whose spectral classification is, at best, ephemeral on a timescale of years; sources with a stable GPS classification that vary, but retain their classification; and a small number of sources that exhibit interstellar scintillation, but that maintain a mean GPS spectrum. Existing data on GPS sources with higher frequency peaks, ≥3 GHz, reveals that many such sources vary. However, the majority of these sources possess a GPS spectrum only during outbursts, and hence should perhaps be classified as ephemeral GPS sources. In addition, significant levels of circular polarisation have been found in a number of GPS sources, both amongst the variables and non-variables. Remarkable amongst these is PKS 1519–273, which possesses strong and variable circular polarisation, and which exhibits IDV in all Stokes parameters.
The future of centimetre and metre-wave astronomy lies with the Square Kilometre Array (SKA), a telescope under development by a consortium of 17 countries that will be 50 times more sensitive than any existing radio facility. Most of the key science for the SKA will be addressed through large-area imaging of the Universe at frequencies from a few hundred MHz to a few GHz. The Australian SKA Pathfinder (ASKAP) is a technology demonstrator aimed in the mid-frequency range, and achieves instantaneous wide-area imaging through the development and deployment of phased-array feed systems on parabolic reflectors. The large field-of-view makes ASKAP an unprecedented synoptic telescope that will make substantial advances in SKA key science. ASKAP will be located at the Murchison Radio Observatory in inland Western Australia, one of the most radio-quiet locations on the Earth and one of two sites selected by the international community as a potential location for the SKA. In this paper, we outline an ambitious science program for ASKAP, examining key science such as understanding the evolution, formation and population of galaxies including our own, understanding the magnetic Universe, revealing the transient radio sky and searching for gravitational waves.
Of 22 strains of Salmonella gallinarum isolated from recent outbreaks of infection in poultry in Greece (15), Amman (3), Kenya (2), Lebanon (1) and Yemen (1), 20 were more resistant to furazolidone in vitro than 6 strains that had been isolated in the U.K. in the 1950s; the minimum inhibitory concentration of furazolidone was approximately 0·3 μg/ml for the sensitive strains and 1·3 or 2·5 μg/ml for the more resistant strains.
Furazolidone given continuously in the food did not control experimental infections in chickens caused by most of the strains that had been classed as more resistant by the in vitro tests. Chloramphenicol, trimethoprim and sulphadiazine or mixtures of the latter two were the best antibiotics for treating these infections, but they were less satisfactory than furazolidone for treating infections caused by the furazolidone-sensitive strains.
As a group, the furazolidone-resistant strains and furazolidone-resistant mutants of one of the sensitive strains were less virulent for chickens than the sensitive strains.
Compared with a similar survey conducted ten years previously, a survey conducted in 1982, eleven years after the implementation of legislation forbidding the routine use of feeds containing ‘therapeutic’ antibiotics, revealed a decreased incidence of resistance to tetracyclines, furazolidone and sulphonamides in Escherichia coli strains causing generalized infections in chickens in the UK; the decrease was particularly marked in the case of tetracycline resistance, 17·9% of strains in 1982 being resistant to this antibiotic compared with 31·2% in 1972.
Giving furazolidone to groups of chickens inoculated intramuscularly with O2:K1 strains of E. coli of differing degrees of furazolidone sensitivity indicated that great care is required in the performance and interpretation of laboratory tests for sensitivity to this antibiotic. Infections caused by strains that required as little as 1·25 μg/ml of furazolidone to inhibit their multiplication in laboratory tests responded poorly to furazolidone treatment; those that were inhibited by less responded well, better than to treatment with tetrac3rcline, chloramphenicol. ampicillin or trimethoprim.
A series of six bones from samples of mice from eleven inbred strains and one F1 hybrid were measured using a simple apparatus. The bones examined were the mandible, os coxae, femur, tibia–fibula, scapula and humerus. Considerable variation in the shape of each bone was found and successful discrimination between the strains was obtained. Correct strain classification ranged from 87% for the scapula to 98% for the os coxae. Gross abnormalities and quantitative variants were identified.
As the pattern of discrimination is different for each bone, the use of other bones in addition to the mandible may improve resolution in the identification and quality control of mouse stocks. The objective and precise identification of abnormal and variant bones suggests that the method may be useful for population studies and for the detection of induced skeletal abnormalities in toxicological investigations.
The shape of the mandible of the mouse can be described by a series of discriminant functions which have been used to discriminate between and investigate relationships among strains of mice. The effect of sex and variation in age of the animal on the results obtained from these functions has been investigated. Significant sex differences in mandible shape were detected, but these were considerably smaller than the differences found between two inbred strains. A simple correction for expressing each measure as a proportion of the sum of the measures on each bone removes the effects of overall size. Significant age effects were found, but these were only large in animals under seven weeks of age where considerable changes are taking place in the relative lengths of bone measurements. Routine testing for genetic authenticity using the shape of the mandible is possible over a wide age range and may be an efficient method for monitoring genotypes at the end of long-term experiments.
We report the synthesis of nanostructured stage-2 potassium graphite, KC24, by intercalation of turbostratic graphite nanofibers produced from an electrospun polymer, and compare its properties with exfoliated graphite-based KC24. The nanostructured KC24 sample has low crystalline order and slightly increased interlayer spacing of 8.76 Å, compared with 8.65 Å in the bulk sample, indicating minimal registration of the graphite planes. Time-resolved time-of-flight neutron diffraction on both nanostructured and bulk KC24 under ammoniation is suggestive of a more homogeneous and faster pressure-modulated phase transition to the ternary ammoniated potassium-graphite in the nanostructured material. Following ammoniation, negligible hydrogen uptake is observed at 50 K.
The costs of living with wildlife are assessed using Namibian subsistence farmers' willingness to pay (WTP) for deterrents to attacks on crops and livestock. A utility-theoretic approach jointly estimates household WTP for deterrent programs in two ‘currencies’: maize and cash. This has a double payoff. Use of a non-cash staple increases respondent comprehension and provides more information about preferences, improving the accuracy of results. The household shadow value of maize is also identified. Significant costs from living with elephants and other types of wildlife are demonstrated. Compensation for farmers may be warranted on equity and efficiency grounds. Uncontrolled domestic cattle generate even higher costs to farmers than wildlife, highlighting the need to clarify property rights among these farmers.