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To describe the impact of CHD surgery in early childhood on quality of life in children aged 10–16 years with surgically corrected Ventricular Septal Defect, Transposition of the Great Arteries, and Tetralogy of Fallot.
Method:
A cross-sectional survey study of quality of life survey on 161 children and adolescents aged 10–16 years with surgically corrected Ventricular Septal Defect, Transposition of the Great Arteries, and Tetralogy of Fallot. The international Paediatric Quality of Life 4.0 quality of life questionnaires were applied and collected for assessment from patients and parents. The endpoints were total, physical, emotional, social, and school quality of life scores.
Results:
The quality of life total and school scores was significantly lower in children with CHD than their healthy peers. There was no significant difference in quality of life between the three CHD groups. All three CHD groups had a significantly lower total (7.7–13.2%, p<0.001) and school scores (21.1–31.6%, p<0.001) than the control group. The tetralogy of Fallot group was the only group that had significantly lower scores in the physical subscale (p<0.001) than the controls.
Conclusion:
Children and adolescents with surgically corrected CHD show losses in quality of life in total and school scores compared to healthy controls. The tetralogy of Fallot group was the only CHD group that had significantly lower physical score than the controls.
A series of
${\left\hbox[ {{{\left\hbox( {{\rm{SnSe}}} \right\hbox)}_{1 \hbox+ \delta }}} \right\hbox]_m}{\left\hbox[ {{\rm{TiS}}{{\rm{e}}_2}} \right\hbox]_2}$
heterostructure thin films built up from repeating units of m bilayers of SnSe and two layers of TiSe2 were synthesized from designed precursors. The electronic structure of the films was investigated using X-ray photoelectron spectroscopy for samples with m = 1, 2, 3, and 7 and compared to binary samples of TiSe2 and SnSe. The observed binding energies of core levels and valence bands of the heterostructures are largely independent of m. For the SnSe layers, we can observe a rigid band shift in the heterostructures compared to the binary, which can be explained by electron transfer from SnSe to TiSe2. The electronic structure of the TiSe2 layers shows a more complicated behavior, as a small shift can be observed in the valence band and Se3d spectra, but the Ti2p core level remains at a constant energy. Complementary UV photoemission spectroscopy measurements confirm a charge transfer mechanism where the SnSe layers donate electrons into empty Ti3d states at the Fermi energy.
Despite the high prevalence of domestic violence and abuse (DVA) among patients with psychiatric conditions, detection rates are low. Limited knowledge and skills on DVA in mental healthcare (MHC) professionals might contribute to poor identification.
Aims
To assess the level of, and factors associated with, DVA knowledge and skills among MHC professionals.
Method
A total of 278 professionals in Dutch MHC institutions completed a survey assessing factual knowledge, perceived knowledge, perceived skills and attitudes about DVA.
Results
On average, low scores were reported for perceived skills and knowledge. MHC professionals in primary care scored higher than those working with individuals with severe mental illness (P<0.005). Levels of factual knowledge were higher; levels of attitudes moderate. Previous training was positively associated with skills (odds ratios (OR) = 3.0) and attitudes (OR = 2.7). Years of work was negatively associated with factual knowledge (OR = 0.97). Larger case-loads predicted higher scores on skills (OR = 2.1).
Conclusions
Training is needed, particularly for clinicians working with patients with severe mental illness.
The aim of this study was to assess the associations of intake of different types of meat with semen parameters and reproductive hormones in healthy young men. This cross-sectional study included 206 men, 18–23 years, from Southern Spain. All men completed a validated FFQ, underwent a physical examination, and provided blood and semen samples. Multivariable linear regression was used to evaluate the associations between meat intake with semen quality parameters and reproductive hormones. Total meat intake was unrelated to semen quality or reproductive hormone levels. When subgroups of meat were separately considered, however, shellfish intake was positively related to progressive motility. The adjusted percentages of progressively motile spermatozoa for men in increasing quartiles of shellfish intake were 45·2, 42·0, 49·4 and 53·2 % with a significant linear trend across quartiles (Ptrend≤0·001). In contrast, men who consumed organ meats had significantly lower progressive sperm motility (51·5 v. 42·8 %; P = 0·001) and higher luteinising hormone levels (4·0 v. 4·6 IU/l; P = 0·03) compared with men who did not consume organ meats. Intake of shellfish and organ meats was low in this population, however. Given the scarcity of data on the relation between specific types of meat with semen quality and reproductive hormone levels, additional research is needed to confirm or refute these findings.
The perception and production of emotional and linguistic (focus) prosody were compared in children with cochlear implants (CI) and normally hearing (NH) peers. Thirteen CI and thirteen hearing-age-matched school-aged NH children were tested, as baseline, on non-verbal emotion understanding, non-word repetition, and stimulus identification and naming. Main tests were verbal emotion discrimination, verbal focus position discrimination, acted emotion production, and focus production. Productions were evaluated by NH adult Dutch listeners. All scores between groups were comparable, except a lower score for the CI group for non-word repetition. Emotional prosody perception and production scores correlated weakly for CI children but were uncorrelated for NH children. In general, hearing age weakly predicted emotion production but not perception. Non-verbal emotional (but not linguistic) understanding predicted CI children's (but not controls’) emotion perception and production. In conclusion, increasing time in sound might facilitate vocal emotional expression, possibly requiring independently maturing emotion perception skills.
This article discusses the way development-led archaeology in the Netherlands disseminates archaeological knowledge to and with the public using the way archaeological projects were designed in Dalfsen (Netherlands) as a case study. In the early days of contract archaeology, which in the Netherlands was designed after the Valetta Convention, archaeologists were primarily concerned with the financial and planning aspects of projects, and there was little room for public archaeology. We suggest that this caused archaeologists to forget to involve the public in their projects. In time, it became almost impossible to rectify this mistake because archaeological contractors became extremely bureaucratic. In the case of Dalfsen, a spectacular project was needed to change this situation. The project, and especially its media value, inspired the municipality to invest in community archaeology and make choices that an archaeologist would not primarily be concerned with. Thus, we discuss the effects of these choices and archaeologists’ actions in this process. We conclude that it is important for archaeologists to act as facilitators because it improves the success rate of community archaeology projects.
In the past, several empirical firn-densification models have been developed fitted to measured density–depth profiles from Greenland and Antarctica. These models do not specifically deal with refreezing of meltwater in the firn. Ice lenses are usually indirectly taken into account by choosing a suitable value of the surface snow density. In the present study, a simple densification model is developed that specifically accounts for the content of ice lenses in the snowpack. An annual layer is considered to be composed of an ice fraction and a firn fraction. It is assumed that all meltwater formed at the surface in one year will refreeze in the corresponding annual layer, and that no additional melting or refreezing occurs in deeper layers. With this assumption, further densification is solely controlled by compaction of the firn fraction of the annual layer. Comparison of modelled and observed depth–density profiles from Canadian Arctic ice-core sites with large melting–refreezing percentages shows good agreement. The model is also used to estimate the long-term surface elevation change in interior Greenland that will result from temperature-driven changes of density–depth profiles. These surface elevation changes reflect a volume change of the ice sheet with no corresponding change of mass, i.e. a volume change that does not influence global sea level.
A 100 m long ice core was retrieved from the coastal area of Dronning Maud Land (DML), Antarctica, in the 2000/01 austral summer. The core was dated to AD 1737 by identification of volcanic horizons in dielectrical profiling and electrical conductivity measurement records in combination with seasonal layer counting from high-resolution oxygen isotope (δ18O) data. A mean long-term accumulation rate of 0.29 ma–1w.e. was derived from the high-resolution δ18O record as well as accumulation rates during periods in between the identified volcanic horizons. A statistically significant decrease in accumulation was found from about 1920 to the present. A comparison with other coastal ice cores from DML suggests that this is a regional pattern.
The geometry of the ice sheets during the Pliocene to early Pleistocene is not well constrained. Here we apply an ice-flow model in the study of the Greenland ice sheet (GIS) during three extreme intervals of this period constrained by geological observations and climate reconstructions. We study the extent of the GIS during the Mid-Pliocene Warmth (3.3–3.0 Ma), its advance across the continental shelf during the late Pliocene to early Pleistocene glaciations (3.0–2.4 Ma) as implied by offshore geological studies, and the transition from glacial to interglacial conditions around 2.4 Ma as deduced from the deposits of the Kap København Formation, North Greenland. Our experiments show that no coherent ice sheet is likely to have existed in Greenland during the Mid-Pliocene Warmth and that only local ice caps may have been present in the coastal mountains of East Greenland. Our results illustrate the variability of the GIS during the Pliocene to early Pleistocene and underline the importance of including independent estimates of the GIS in studies of climate during this period. We conclude that the GIS did not exist throughout the Pliocene to early Pleistocene, and that it melted during interglacials even during the late Pliocene climate deterioration.
We present techniques for obtaining large (∼100 L STP) samples of ancient air for analysis of 14C of methane (14CH4)and other trace constituents. Paleoatmospheric 14CH4 measurements should constrain the fossil fraction of past methane budgets, as well as provide a definitive test of methane clathrate involvement in large and rapid methane concentration ([CH4]) increases that accompanied rapid warming events during the last deglaciation. Air dating to the Younger Dryas–Preboreal and Oldest Dryas–Bølling abrupt climatic transitions was obtained by melt extraction from old glacial ice outcropping at an ablation margin in West Greenland. The outcropping ice and occluded air were dated using a combination of δ15N of N2, δ18O of O2, δ18Oice and [CH4] measurements. The [CH4] blank of the melt extractions was <4 ppb. Measurements of δ18O and δ15N indicated no significant gas isotopic fractionation from handling. Measured Ar/N2, CFC-11 and CFC-12 in the samples indicated no significant contamination from ambient air. Ar/N2, Kr/Ar and Xe/Ar ratios in the samples were used to quantify effects of gas dissolution during the melt extractions and correct the sample [CH4]. Corrected [CH4] is elevated over expected values by up to 132 ppb for most samples, suggesting some in situ CH4 production in ice at this site.
The error box of the unusual Gamma-Ray Burst of March 5, 1979 falls completely inside the optical and radio image of the Supernova Remnant N49 in the Large Magellanic Cloud. This region was observed twice in x-rays with the High Resolution Imager of the Einstein Observatory, six weeks and nearly two years after the Gamma-Ray Burst. We show the comparison between the two observations.
Recent genetic, isotopic and linguistic research has dramatically changed our understanding of how the Corded Ware Culture in Europe was formed. Here the authors explain it in terms of local adaptations and interactions between migrant Yamnaya people from the Pontic-Caspian steppe and indigenous North European Neolithic cultures. The original herding economy of the Yamnaya migrants gradually gave way to new practices of crop cultivation, which led to the adoption of new words for those crops. The result of this hybridisation process was the formation of a new material culture, the Corded Ware Culture, and of a new dialect, Proto-Germanic. Despite a degree of hostility between expanding Corded Ware groups and indigenous Neolithic groups, stable isotope data suggest that exogamy provided a mechanism facilitating their integration. This article should be read in conjunction with that by Heyd (2017, in this issue).
Transmission electron microscopy is a powerful technique for the analysis of solid samples, but it can also be used to image in liquid environments, gaining a unique view of processes and structures in liquids. Here, we describe recent developments in electron microscopy of liquids and discuss applications in several areas. We first describe closed-liquid-cell microscopy with its opportunities for visualizing electrochemical processes. We then discuss imaging of low-vapor-pressure liquids relevant to the operation of rechargeable batteries. Finally, we describe imaging of thick biological materials to obtain information on membrane proteins in intact mammalian cells that cannot be observed classically under dry or frozen conditions. Electron microscopy in liquid environments is developing rapidly and has the potential to solve key problems in materials science, physics, chemistry, and biology.
The San Francisco Fire Department’s (SFFD; San Francisco, California USA) Homeless Outreach and Medical Emergency (HOME) Team is the United States’ first Emergency Medical Services (EMS)-based outreach effort using a specially trained paramedic to redirect frequent users of EMS to other types of services. The effectiveness of this program at reducing repeat use of emergency services during the first seven months of the team’s existence was examined.
Methods
A retrospective analysis of EMS use frequency and demographic characteristics of frequent users was conducted. Clients that used emergency services at least four times per month from March 2004 through May 2005 were contacted for intervention. Patterns for each frequent user before and after intervention were analyzed. Changes in EMS use during the 15-month study interval was the primary outcome measurement.
Results
A total of 59 clients were included. The target population had a median age of 55.1 years and was 68% male. Additionally, 38.0% of the target population was homeless, 43.4% had no primary care, 88.9% had a substance abuse disorder at time of contact, and 83.0% had a history of psychiatric disorder. The HOME Team undertook 320 distinct contacts with 65 frequent users during the study period. The average EMS use prior to HOME Team contact was 18.72 responses per month (SD=19.40), and after the first contact with the HOME Team, use dropped to 8.61 (SD=10.84), P<.001.
Conclusion
Frequent users of EMS suffer from disproportionate comorbidities, particularly substance abuse and psychiatric disorders. This population responds well to the intervention of a specially trained paramedic as measured by EMS usage.
TangherliniN, VillarJ, BrownJ, RodriguezRM, YehC, FriedmanBT, WadaP. The HOME Team: Evaluating the Effect of an EMS-based Outreach Team to Decrease the Frequency of 911 Use Among High Utilizers of EMS. Prehosp Disaster Med. 2016;31(6):603–607.
Several new AMS 14C dates on shells from the Fossvogur sea sediments in southern Iceland are reported. Up till now, researchers have assumed that the Fossvogur sediments formed during the last interglacial period (Eem), some 100,000 years ago. However, a recent 14C determination from this location yielded an age of ca 11,000 yr. Because of the importance of these sediments for the Quaternary chronology of Iceland, further sampling for 14C dating was subsequently initiated. The present results on several shell samples collected from the Fossvogur layers strongly indicate that these sediments were formed during the warm Allerød period toward the end of the last glaciation.