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New strain data relating to flexural oscillations of the Erebus Glacier Tongue (EGT), McMurdo Sound, Antarctica, are presented and are analysed in the frequency domain. The data were collected during November 1989, just 3 months prior to the most recent calving of the ice tongue which occurred in March 1990. A broad-band oscillation centred on 50 s is found in both the strain measurements collected on the EGT and those collected on the sea ice nearby. The oscillation is shown, at least in part, to be propagating with a phase velocity of approximately 65 ms−1 in a direction away from the snout towards the grounding line, rather than being wholly due to a standing-wave pattern in the EGT. A coupling model between the sea ice and the EGT is proposed and is shown to compare reasonably well with the data.
To determine the source of a healthcare-associated outbreak of Pantoea agglomerans bloodstream infections.
Epidemiologic investigation of the outbreak.
Oncology clinic (clinic A).
Cases were defined as Pantoea isolation from blood or catheter tip cultures of clinic A patients during July 2012–May 2013. Clinic A medical charts and laboratory records were reviewed; infection prevention practices and the facility’s water system were evaluated. Environmental samples were collected for culture. Clinical and environmental P. agglomerans isolates were compared using pulsed-field gel electrophoresis.
Twelve cases were identified; median (range) age was 65 (41–78) years. All patients had malignant tumors and had received infusions at clinic A. Deficiencies in parenteral medication preparation and handling were identified (eg, placing infusates near sinks with potential for splash-back contamination). Facility inspection revealed substantial dead-end water piping and inadequate chlorine residual in tap water from multiple sinks, including the pharmacy clean room sink. P. agglomerans was isolated from composite surface swabs of 7 sinks and an ice machine; the pharmacy clean room sink isolate was indistinguishable by pulsed-field gel electrophoresis from 7 of 9 available patient isolates.
Exposure of locally prepared infusates to a contaminated pharmacy sink caused the outbreak. Improvements in parenteral medication preparation, including moving chemotherapy preparation offsite, along with terminal sink cleaning and water system remediation ended the outbreak. Greater awareness of recommended medication preparation and handling practices as well as further efforts to better define the contribution of contaminated sinks and plumbing deficiencies to healthcare-associated infections are needed.
Child conduct problems (CP) reflect a heterogeneous collection of oppositional, aggressive, norm-violating, and sometimes violent behaviors, whereas child callous–unemotional (CU) behaviors reflect interpersonal styles of interactions reflecting a lack of guilt and empathy as well as uncaring and shallow emotional responses to others. Taken together, high levels of child CP and CU behaviors are thought to identify a relatively homogenous group of children at elevated risk for persistent and more severe problem behaviors across childhood and into adulthood. Although a large body of research has examined the developmental etiology of CP behaviors, only recently has a developmental psychopathology approach been applied to early CU behaviors. The current study examines multiple levels of contextual influences during the first years of life, including family socioeconomic status, household chaos, and parenting behaviors, on CP and CU behaviors assessed during the first-grade year. Whereas previous studies found associations between parenting behaviors and child problem behaviors moderated by household chaos, the current study found no evidence of moderation. However, path analyses suggest that the associations between child CP and CU behaviors and the contextual variables of socioeconomic status (family income and parental education) and household chaos (disorganization and instability) were mediated by maternal sensitive and harsh–intrusive parenting behavior. Analyses are presented, interpreted, and discussed with respect to both bioecological and family stress models of development.
Our objective was to review how meditation could comfort the terminally ill.
Our methodology was a literature search, which included books, journals, papers in collections, and online databases. The main search engines employed were Google Scholar and the Durham University Library. The main databases consulted were the Christian Meditation Centre, Project Meditation, and Stress-Related Facts and Well-Being at Monash. We were specifically interested in data acquired from clinical and nonclinical trials. The arguments needed to be based on qualitative and quantitative scientific data. Papers were published between 1985 and 2014. We then subdivided the review into three subcategories: physical, emotional, and self-awareness. When reviewing each category, we put our results into tabular form. In each table, we noted the percentage of terminally ill patients (TIPs) and non-terminally ill patients (NTIPs), and whether meditation had comforted them.
Our review demonstrated that there are many areas that have yet to be researched. First, very little work has been done on how meditation affects the physical health of TIPs, including such variables as blood pressure, chronic pain, and sleeping patterns. However, no research has been done on heart disease, hypertension, depression, among others. Second, virtually no research has been conducted on how meditation affects the mental health of TIPs. Notably neglected areas include anxiety, compliance, depression, and stress. Third, no research has been done on whether meditation increases self-awareness in TIPs. In each of these cases, most NTIPs reacted positively; however, no research has been done on why TIPs reacted differently.
Significance of Results:
Our results demonstrate the need for further research on how meditation affects terminally ill patients. In turn, this would enrich the debate on whether meditation should be prescribed for the dying.
The present study is the first behavioral genetic investigation of the Dark Triad traits of personality, consisting of Machiavellianism, narcissism, and psychopathy, and the variable of mental toughness, reflecting individual differences in the ability to cope when under pressure. The purpose of this investigation was to explore a potential explanation for the success of individuals exhibiting the Dark Triad traits in workplace and social settings. Participants were adult twins who completed the MACH-IV, the Narcissistic Personality Inventory, and the Self-Report Psychopathy Scale assessing Machiavellianism, narcissism, and psychopathy, respectively, as well as the MT48, measuring mental toughness. Correlational analyses of the data revealed significant positive phenotypic associations between mental toughness and narcissism. Psychopathy and Machiavellianism, however, both showed some significant negative phenotypic correlations with mental toughness. Bivariate behavioral genetic analyses of the data were conducted to assess the extent to which these significant phenotypic correlations were attributable to common genetic and/or common environmental factors. Results indicate that correlations between narcissism and mental toughness were attributable primarily to common non-shared environmental factors, correlations between Machiavellianism and mental toughness were influenced by both common genetic and common non-shared environmental factors, and the correlations between psychopathy and mental toughness were attributable entirely to correlated genetic factors. Implications of these findings in the context of etiology and organizational adaptation are discussed.
The present study investigated the extent to which individual differences in humor styles are attributable to genetic and/or environmental factors in an Australian sample. Participants were 934 same-sex pairs of adult twins from the Australian Twin Registry (546 monozygotic pairs, 388 dizygotic pairs) who completed the Humor Styles Questionnaire (HSQ). The HSQ measures four distinct styles of humor — affiliative, self-enhancing, aggressive, and self-defeating. Results revealed that additive genetic and non-shared environmental factors accounted for the variance in all four humor styles, thus replicating results previously obtained in a sample of twins from the United Kingdom. However, a study conducted with a U.S. sample produced different results and we interpret these findings in terms of cross-cultural differences in humor.
Describe the clinical and molecular epidemiology of incident Clostridium difficile infection (CDI) cases in Chicago area acute healthcare facilities (HCFs).
Design and Setting.
Laboratory, clinical, and epidemiologic information was collected for patients with incident CDI who were admitted to acute HCFs in February 2009. Stool cultures and restriction endonuclease analysis typing of the recovered C. difficile isolates was performed.
Two hundred sixty-three patients from 25 acute HCFs.
Acute HCF rates ranged from 2 to 7 patients with CDI per 10,000 patient-days. The crude mortality rate was 8%, with 20 deaths occurring in patients with CDI. Forty-two (16%) patients had complications from CDI, including 4 patients who required partial, subtotal, or total colectomy, 3 of whom died. C. difficile was isolated and typed from 129 of 178 available stool specimens. The BI strain was identified in 79 (61%) isolates. Of patients discharged to long-term care who had their isolate typed, 36 (67%) had BI-associated CDI.
Severe disease was common and crude mortality was substantial among patients with CDI in Chicago area acute HCFs in February 2009. The outbreak-associated BI strain was the predominant endemic strain identified, accounting for nearly two-thirds of cases. Focal HCF outbreaks were not reported, despite the presence of the BI strain. Transfer of patients between acute and long-term HCFs may have contributed to the high incidence of BI cases in this investigation.
GaAs layers were grown directly on misoriented (2° off (100)→) Si substrates by Metalorganic Chemical Vapor Deposition. The threading dislocation density at the surface of 4 μm thick layers was typically 108cm−2, as determined by both preferential etching and transmission electron microscopy. Rapid thermal annealing (900°C, 10s) improved the crystalline quality of the GaAs near the heterointerface while allowing no detectable Si diffusion into this layer. Two deep electron traps were observed in the undoped GaAs, but were present at a low concentration (∼ 1013 cm−3 ). The (400) x-ray diffraction peak width from the GaAs was significantly reduced with increasing GaAs layer thickness, indicating improved material quality. This is supported by Si implant activation data, which shows higher net donor activity in thicker layers.
Hunter ‘crippling losses’, or unretrieved kill, probably range from 20% to 40% of all ducks hit by gunfire. However, this major mortality factor in duck populations has been largely ignored by waterfowl policymakers and managers. An economic analysis of ‘crippling losses’ for prairie Canada and the USA was conducted, based on 1992 harvest statistics. The analysis is based on current levels of spending on habitat programmes designed to bolster declining North American duck populations, with reference to the North American Waterfowl Management Plan.
To determine whether a multimodal intervention could improve adherence to hand hygiene and glove use recommendations and decrease the incidence of antimicrobial resistance in different types of healthcare facilities.
Prospective, observational study performed from October 1, 1999, through December 31, 2002. We monitored adherence to hand hygiene and glove use recommendations and the incidence of antimicrobial-resistant bacteria among isolates from clinical cultures. We evaluated trends in and predictors for adherence and preferential use of alcohol-based hand rubs, using multivariable analyses.
Three intervention hospitals (a 660-bed acute and long-term care hospital, a 120-bed community hospital, and a 600-bed public teaching hospital) and a control hospital (a 700-bed university teaching hospital).
At the intervention hospitals, we introduced or increased the availability of alcohol-based hand rub, initiated an interactive education program, and developed a poster campaign; at the control hospital, we only increased the availability of alcohol-based hand rub.
We observed 6,948 hand hygiene opportunities. The frequency of hand hygiene performance or glove use significantly increased during the study period at the intervention hospitals but not at the control hospital; the maximum quarterly frequency of hand hygiene performance or glove use at intervention hospitals (74%, 80%, and 77%) was higher than that at the control hospital (59%). By multivariable analysis, preferential use of alcohol-based hand rubs rather than soap and water for hand hygiene was more likely among workers at intervention hospitals compared with nonintervention hospitals (adjusted odds ratio, 4.6 [95% confidence interval, 3.3-6.4]) and more likely among physicians (adjusted odds ratio, 1.4 [95% confidence interval, 1.2-1.8]) than among nurses at intervention hospitals. A significantly reduced incidence of antimicrobial-resistant bacteria among isolates from clinical culture was found at a single intervention hospital, which had the greatest increase in the frequency of hand hygiene performance.
During a 3-year period, a multimodal intervention program increased adherence to hand hygiene recommendations, especially to the use of alcohol-based hand rubs. In one hospital, a concomitant reduction was found in the incidence of antimicrobial-resistant bacteria among isolates from clinical cultures.
We developed criteria for justifiable CVC use and evaluated CVC use in a public hospital. Unjustified CVC-days were more common for non-ICU patients compared with ICU patients. Also, insertion-site dressings were less likely to be intact on non-ICU patients. Interventions to reduce CVC-associated bloodstream infections should include non-ICU patients.
We observed adherence with hand hygiene in 14 units at 4 hospitals with varying sink-to-bed ratios (range, 1:1 to 1:6). Adherence was less than 50% in all units and there was no significant trend toward improved hand hygiene with increased sink-to-bed ratios.
Lipogenesis occurs in all vertebrate species and has a critical role in energy balance, providing a means whereby excess energy can be stored as a fat. The metabolic pathways involved and their tissue distribution in different species, including man, are well known. The responses of lipogenesis to diet and to physiological and pathological states have been the subject of many studies. At a molecular level the major rate-controlling enzymes have been identified and their acute, and to a lesser extent chronic, control by hormones have been investigated extensively. However, there is no reason to suppose that all factors regarding lipogenesis have been identified (e.g. the recent discovery of acylation-stimulating protein). Little is known about the movement of newly-synthesized triacylglycerols in cells, either for secretion or storage. The production of leptin and tumour necrosis factor α by adipocytes provides a novel means of feedback control of triacylglycerol production, leptin by decreasing appetite and tumour necrosis factor α by inducing insulin resistance. The synthesis of these peptides appears to vary with the amount of triacylglycerol in adipocytes, but the molecular basis of this process is unknown. Elucidation of the signalling systems involved in the acute and chronic regulation of lipogenesis is also important, both with respect to some homeorhetic adaptations and also in some pathological conditions (e.g. non-insulin-dependent diabetes). Finally, molecular biology is revealing unexpected complexities, such as multiple promoters and different isoforms of enzymes (e.g. acetyl-CoA carboxylase; EC 188.8.131.52) exhibiting tissue specificity. Molecular biology, through transgenesis, also offers novel and powerful means of manipulating lipogenesis.
Recent studies suggest that dexfenfluramine (D-fenfluramine), because of its pure serotonergic effect, may be a more potent anti-obesity agent, associated with fewer side-effects than the racemate DL-fenfluramine. The effect of dexfenfluramine on gastric emptying of a mixed solid and liquid meal was assessed with a double-isotope scintigraphic technique in eleven obese patients. Each subject took a placebo capsule on the morning and evening of the day before, and on the morning of the first gastric emptying measurement. Dexfenfluramine was then taken at a dose of 15 mg twice daily and gastric emptying measurements were performed at 5 and at 29 d after the initiation of active treatment. Dexfenfluramine significantly slowed gastric emptying of the solid meal at both 5 and 29d when compared with the placebo (P < 0.05) and also delayed emptying of solid food from the proximal stomach (P < 0.01), but no significant effect on liquid emptying was observed. No significant side-effects were reported and there was a marginal weight loss (P< 0.005) during treatment. We conclude that inhibition of gastric emptying may contribute to the efficacy of dexfenfluramine in the treatment of obesity.