We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure coreplatform@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The bandwidth theorem of Böttcher, Schacht and Taraz states that any n-vertex graph G with minimum degree
$\big(\tfrac{k-1}{k}+o(1)\big)n$
contains all n-vertex k-colourable graphs H with bounded maximum degree and bandwidth o(n). Recently, a subset of the authors proved a random graph analogue of this statement: for
$p\gg \big(\tfrac{\log n}{n}\big)^{1/\Delta}$
a.a.s. each spanning subgraph G of G(n,p) with minimum degree
$\big(\tfrac{k-1}{k}+o(1)\big)pn$
contains all n-vertex k-colourable graphs H with maximum degree
$\Delta$
, bandwidth o(n), and at least
$C p^{-2}$
vertices not contained in any triangle. This restriction on vertices in triangles is necessary, but limiting. In this paper, we consider how it can be avoided. A special case of our main result is that, under the same conditions, if additionally all vertex neighbourhoods in G contain many copies of
$K_\Delta$
then we can drop the restriction on H that
$Cp^{-2}$
vertices should not be in triangles.
Evidence suggests that increasing the descriptive representation of groups improves their substantive representation. What underpins this link? Many scholars writing on the subject stop short of arguing explicitly that it is “shared experience” within groups. I argue that we should embrace the potential conceptual and empirical benefits of framing representation through experience. To do this, we should think of experience specifically in terms of the epistemic content and capacities gained through subjective experience, which can allow individuals to think about the world in distinct ways. I reframe the idea that experiences might be shared within groups and ameliorate concerns that the concept is essentialist, drawing out the political relevance of my argument. This has the strategic implication that we should be unafraid to argue in favor of political presence on the basis of (shared) experience and the empirical implication that future research should consider subjective experience more closely.
In May 2021, the Scientific Advisory Committee on Nutrition (SACN) published a risk assessment on lower carbohydrate diets for adults with type 2 diabetes (T2D)(1). The purpose of the report was to review the evidence on ‘low’-carbohydrate diets compared with the current UK government advice on carbohydrate intake for adults with T2D. However, since there is no agreed and widely utilised definition of a ‘low’-carbohydrate diet, comparisons in the report were between lower and higher carbohydrate diets. SACN’s remit is to assess the risks and benefits of nutrients, dietary patterns, food or food components for health by evaluating scientific evidence and to make dietary recommendations for the UK based on its assessment(2). SACN has a public health focus and only considers evidence in healthy populations unless specifically requested to do otherwise. Since the Committee does not usually make recommendations relating to clinical conditions, a joint working group (WG) was established in 2017 to consider this issue. The WG comprised members of SACN and members nominated by Diabetes UK, the British Dietetic Association, Royal College of Physicians and Royal College of General Practitioners. Representatives from NHS England and NHS Health Improvement, the National Institute for Health and Care Excellence and devolved health departments were also invited to observe the WG. The WG was jointly chaired by SACN and Diabetes UK.
Delay discounting paradigms have gained widespread popularity across clinical research. Given the prevalence in the field, researchers have set lofty expectations for the importance of delay discounting as a key transdiagnostic process and a ‘core’ process underlying specific domains of dysfunction (e.g. addiction). We believe delay discounting has been prematurely reified as, in and of itself, a core process underlying psychological dysfunction, despite significant concerns with the construct validity of discounting rates. Specifically, high delay discounting rates are only modestly related to measures of psychological dysfunction and therefore are not ‘core’ to these more complex behavioral problems. Furthermore, discounting rates do not appear to be specifically related to any disorder(s) or dimension(s) of psychopathology. This raises fundamental concerns about the utility of discounting, if the measure is only loosely associated with most forms of psychopathology. This stands in striking contrast to claims that discounting can serve as a ‘marker’ for specific disorders, despite never demonstrating adequate sensitivity or specificity for any disorder that we are aware of. Finally, empirical evidence does not support the generalizability of discounting rates to other decisions made either in the lab or in the real-world, and therefore discounting rates cannot and should not serve as a summary measure of an individual's decision-making patterns. We provide recommendations for improving future delay discounting research, but also strongly encourage researchers to consider whether the empirical evidence supports the field's hyper-focus on discounting.
Colleges and universities around the world engaged diverse strategies during the COVID-19 pandemic. Baylor University, a community of ˜22,700 individuals, was 1 of the institutions which resumed and sustained operations. The key strategy was establishment of multidisciplinary teams to develop mitigation strategies and priority areas for action. This population-based team approach along with implementation of a “Swiss Cheese” risk mitigation model allowed small clusters to be rapidly addressed through testing, surveillance, tracing, isolation, and quarantine. These efforts were supported by health protocols including face coverings, social distancing, and compliance monitoring. As a result, activities were sustained from August 1 to December 8, 2020. There were 62,970 COVID-19 tests conducted with 1435 people testing positive for a positivity rate of 2.28%. A total of 1670 COVID-19 cases were identified with 235 self-reports. The mean number of tests per week was 3500 with approximately 80 of these positive (11/d). More than 60 student tracers were trained with over 120 personnel available to contact trace, at a ratio of 1 per 400 university members. The successes and lessons learned provide a framework and pathway for similar institutions to mitigate the ongoing impacts of COVID-19 and sustain operations during a global pandemic.
Throughout their 250 Myr history, archosaurian reptiles have exhibited a wide array of body sizes, shapes, and locomotor habits, especially in regard to terrestriality. These features make Archosauria a useful clade with which to study the interplay between body size, shape, and locomotor behavior, and how this interplay may have influenced locomotor evolution. Here, digital volumetric models of 80 taxa are used to explore how mass properties and body proportions relate to each other and locomotor posture in archosaurs. One-way, nonparametric, multivariate analysis of variance, based on the results of principal components analysis, shows that bipedal and quadrupedal archosaurs are largely distinguished from each other on the basis of just four anatomical parameters (p < 0.001): mass, center of mass position, and relative forelimb and hindlimb lengths. This facilitates the development of a quantitative predictive framework that can help assess gross locomotor posture in understudied or controversial taxa, such as the crocodile-line Batrachotomus (predicted quadruped) and Postosuchus (predicted biped). Compared with quadrupedal archosaurs, bipedal species tend to have relatively longer hindlimbs and a more caudally positioned whole-body center of mass, and collectively exhibit greater variance in forelimb lengths. These patterns are interpreted to reflect differing biomechanical constraints acting on the archosaurian Bauplan in bipedal versus quadrupedal groups, which may have shaped the evolutionary histories of their respective members.
Clinical intuition suggests that personality disorders hinder the treatment of depression, but research findings are mixed. One reason for this might be the way in which current assessment measures conflate general aspects of personality disorders, such as overall severity, with specific aspects, such as stylistic tendencies. The goal of this study was to clarify the unique contributions of the general and specific aspects of personality disorders to depression outcomes.
Methods
Patients admitted to the Menninger Clinic, Houston, between 2012 and 2015 (N = 2352) were followed over a 6–8-week course of multimodal inpatient treatment. Personality disorder symptoms were assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition Axis II Personality Screening Questionnaire at admission, and depression severity was assessed using the Patient Health Questionnaire-9 every fortnight. General and specific personality disorder factors estimated with a confirmatory bifactor model were used to predict latent growth curves of depression scores in a structural equation model.
Results
The general factor predicted higher initial depression scores but not different rates of change. By contrast, the specific borderline factor predicted slower rates of decline in depression scores, while the specific antisocial factor predicted a U shaped pattern of change.
Conclusions
Personality disorder symptoms are best represented by a general factor that reflects overall personality disorder severity, and specific factors that reflect unique personality styles. The general factor predicts overall depression severity while specific factors predict poorer prognosis which may be masked in prior studies that do not separate the two.
Background: Methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization has been a well-established risk for developing MRSA pneumonia. In previous studies, the MRSA nasal screening test has shown an excellent negative predictive value (NPV) for MRSA pneumonia in patients without exclusion criteria such as mechanical ventilation, hemodynamic instability, cavitary lesions, and underlying pulmonary disease. MRSA nasal screening can be used as a stewardship tool to de-escalate broad antibiotic coverage, such as vancomycin. Objective: The purpose of this study was to determine whether implementation of a MRSA nasal screening questionnaire improves de-escalation of vancomycin for patients with pneumonia. Methods: A retrospective review was performed on 250 patients from October 2018 to January 2019 who received MRSA nasal screening due to their prescriber choosing only “respiratory” on the vancomycin dosing consult form. Data obtained included demographics and clinical outcomes. Statistical analyses were performed, and P < .05 was considered significant. Results: Of the 250 patients screened, only 19 patients (8%) were positive for MRSA. Moreover, 40% of patients met exclusion criteria. In 149 patients without exclusion criteria, the MRSA nasal swab had a 98% NPV. Although not statistically significant, vancomycin days of therapy (DOT) based on MRSA nasal swab result was 1 day shorter in those with negative swabs (3.49 days negative vs 4.58 days positive; P = .22). Vancomycin DOT was significantly reduced in pneumonia patients without exclusion criteria (3.17 days “no” vs 4.17 days “yes”; P = .037). Conclusions: The implementation of an electronic MRSA nasal screening questionnaire resulted in reduced vancomycin DOT in pneumonia patients at UAB Hospital. The MRSA nasal swab is an effective screening tool for antibiotic de-escalation based on its 98% NPV for MRSA pneumonia if utilized in the correct patient population.
Funding: None
Disclosures: Rachael Anne Lee reports a speaker honoraria from Prime Education, LLC.
In an r-uniform hypergraph on n vertices, a tight Hamilton cycle consists of n edges such that there exists a cyclic ordering of the vertices where the edges correspond to consecutive segments of r vertices. We provide a first deterministic polynomial-time algorithm, which finds a.a.s. tight Hamilton cycles in random r-uniform hypergraphs with edge probability at least C log3n/n.
Our result partially answers a question of Dudek and Frieze, who proved that tight Hamilton cycles exist already for p = ω(1/n) for r = 3 and p = (e + o(1))/n for $r \ge 4$ using a second moment argument. Moreover our algorithm is superior to previous results of Allen, Böttcher, Kohayakawa and Person, and Nenadov and Škorić, in various ways: the algorithm of Allen et al. is a randomized polynomial-time algorithm working for edge probabilities $p \ge {n^{ - 1 + \varepsilon}}$, while the algorithm of Nenadov and Škorić is a randomized quasipolynomial-time algorithm working for edge probabilities $p \ge C\mathop {\log }\nolimits^8 n/n$.
To investigate the association between energy drink (ED) use and sleep-related disturbances in a population-based sample of young adults from the Raine Study.
Design:
Analysis of cross-sectional data obtained from self-administered questionnaires to assess ED use and sleep disturbance (Epworth Sleepiness Scale, Functional Outcomes of Sleep Questionnaire (FOSQ-10) and the Pittsburgh Sleep Symptoms Questionnaire–Insomnia (PSSQ-I)). Regression modelling was used to estimate the effect of ED use on sleep disturbances. All models adjusted for various potential confounders.
Setting:
Western Australia.
Participants:
Males and females, aged 22 years, from Raine Study Gen2–22 year follow-up.
Results:
Of the 1115 participants, 66 % were never/rare users (i.e. <once/month) of ED, 17·0 % were occasional users (i.e. >once/month to <once/week) and 17 % were frequent users (≥once/week). Compared with females, a greater proportion of males used ED occasionally (19 % v. 15 %) or frequently (24 % v. 11 %). Among females, frequent ED users experienced significantly higher symptoms of daytime sleepiness (FOSQ-10: β = 0·93, 95 % CI 0·32, 1·54, P = 0·003) and were five times more likely to experience insomnia (PSSQ-I: OR = 5·10, 95 % CI 1·81, 14·35, P = 0·002) compared with never/rare users. No significant associations were observed in males for any sleep outcomes.
Conclusions:
We found a positive association between ED use and sleep disturbances in young adult females. Given the importance of sleep for overall health, and ever-increasing ED use, intervention strategies are needed to curb ED use in young adults, particularly females. Further research is needed to determine causation and elucidate reasons for gender-specific findings.
One of the primary objectives of adult social work is to support and safeguard adults in order to promote individual autonomy, increase and maximise individual choice, and enhance people's health and wellbeing while ensuring their safety and protection. Adults who access services are often challenged by complex needs and burdened by social stereotypes and stigma that aggravate their difficulties; these include individual vulnerability and human frailty, isolation, social exclusion, social stereotypes and stigma, and so on. These and other challenges may influence people's identity or their ability to meet their own needs, maintain their independence, exercise control, achieve their goals and priorities, and lead healthy and rewarding lives with dignity and integrity. Social media present a host of opportunities to address these and other challenges and to support people in a powerful, transformative and person-centred manner.
This chapter presents a glimpse of some of the applications and transformational implications of digital and social media technologies. It begins by briefly examining adults’ use of social media and some of the misconceived assumptions and stereotypes about older adults’ use of digital and social media technologies. Challenging Prensky's (2001) notion of digital natives and digital immigrants, it highlights the need for a more critical view and awareness of intersectionality within society (intersectionality refers to interconnected nature of social categorisations such as race, class, gender, ethnicity, religion, age and so on that create overlapping and interdependent experiences and systems of discrimination, oppression, exclusion and disadvantage within society). The chapter then considers the ‘social’ in health and social care, followed by a discussion of social media and its impact on social capital and relationships. It then offers a brief note about digital storytelling followed by a discussion of social media and people with disabilities with specific focus on social media and autism. This is to demonstrate the transformative power of social media in challenging stigmatising notions of vulnerability and in reframing and repositioning the identity narratives of people who experience difficulties and vulnerabilities or those who may have different modes of information processing. Finally, it presents an example of coproduction and the use of social media to meet an older person's needs, followed by examples of some helpful apps and concludes with a few suggestions for social work and social care practice and education.
Social media: our modern social and emotional environment
The relationship between social media and mental health is often dominated by a discourse of risk and negative outcomes. From the mental health consequences of ‘overuse’ of social media (Pantic et al, 2012), to the potential psychological and emotional consequences of ‘cyberbullying’ and ‘trolling’ of adults and children and young people, to the risks associated with online sites that promote self-harm or suicide (Guardian, 2014; Jenaro, 2018; Popovac, 2017) or other forms of abuse (Kloess et al, 2014), debates around the risks of harm associated with social media are widespread in popular culture and by politicians and often overlook its potential benefits.
Much academic research into online and social media activity has also tended to focus on the risks of negative impacts on mental wellbeing. This includes the suggestion that internet and social media communications reduce face-to-face interactions, causing isolation and vulnerability to online abuse and predators, and increasing levels of loneliness (Primack et al, 2017; Yao and Zhong, 2014).
However, as research in this field develops, more recent studies suggest that interactive social media and online resources have mixed effects (for a brief overview of research in respect of adolescents see Durbin et al, 2018), highlighting potential benefits as well as negative outcomes. Studies indicate that impact and experiences depend on many factors, including the nature and patterns of usage, specific online content, the pre-existing mental health and wellbeing of the individual, psychological factors and the meanings associated with online interactions, and the degree to which people can control their experience and communications with others.
Social media plays an important role in everyday communication and social relationships and is a growing feature of social work and mental health practice. Therefore, as in all areas of practice, social workers in mental health need to be open-minded and reflective about social media and its impact and should develop their knowledge in this area and use it effectively in the complexities of their work. The British Association of Social Workers (BASW) provides ethical and practice guidance for all social workers on social media (BASW, 2018) to support this.
Image feature points are detected as pixels which locally maximise a detector function, two commonly used examples of which are the (Euclidean) image gradient and the Harris–Stephens corner detector. A major limitation of these feature detectors is that they are only Euclidean-invariant. In this work, we demonstrate the application of a 2D equi-affine-invariant image feature point detector based on differential invariants as derived through the equivariant method of moving frames. The fundamental equi-affine differential invariants for 3D image volumes are also computed.
Detailed study of subsurface deposits in the Polish Sudeten Foreland, particularly with reference to provenance data, has revealed that an extensive preglacial drainage system developed there in the Pliocene–Early Pleistocene, with both similarities and differences in comparison with the present-day Odra (Oder) system. This foreland is at the northern edge of an intensely deformed upland, metamorphosed during the Variscan orogeny, with faulted horsts and grabens reactivated in the Late Cenozoic. The main arm of preglacial drainage of this area, at least until the early Middle Pleistocene, was the Palaeo–Nysa Kłodzka, precursor of the Odra left-bank tributary of that name. Significant preglacial evolution of this drainage system can be demonstrated, including incision into the landscape, prior to its disruption by glaciation in the Elsterian (Sanian) and again in the early Saalian (Odranian), which resulted in burial of the preglacial fluvial archives by glacial and fluvioglacial deposits. No later ice sheets reached the area, in which the modern drainage pattern became established, the rivers incising afresh into the landscape and forming post-Saalian terrace systems. Issues of compatibility of this record with the progressive uplift implicit in the formation of conventional terrace systems are examined, with particular reference to crustal properties, which are shown to have had an important influence on landscape and drainage evolution in the region.
What impact do local candidates have on elections in single member district plurality electoral systems? We provide new evidence using data from a large election study carried out during the 2015 Canadian federal election. We improve on the measurement of local candidate effects by asking over 20,000 survey respondents to rate the candidates in their constituency directly. We present three estimates. We find that when all voters are considered together, local candidate evaluations are decisive for approximately 4 per cent of voters. Second, these evaluations are decisive for the outcome of 10 per cent of constituency contests. Third, when models are estimated for each constituency, we find significant evaluation effects for 14 per cent of candidates.
OBJECTIVES/SPECIFIC AIMS: To create a searchable public registry of all Quality Improvement (QI) projects. To incentivize the medical professionals at UF Health to initiate quality improvement projects by reducing startup burden and providing a path to publishing results. To reduce the review effort performed by the internal review board on projects that are quality improvement Versus research. To foster publication of completed quality improvement projects. To assist the UF Health Sebastian Ferrero Office of Clinical Quality & Patient Safety in managing quality improvement across the hospital system. METHODS/STUDY POPULATION: This project used a variant of the spiral software development model and principles from the ADDIE instructional design process for the creation of a registry that is web based. To understand the current registration process and management of quality projects in the UF Health system a needs assessment was performed with the UF Health Sebastian Ferrero Office of Clinical Quality & Patient Safety to gather project requirements. Biweekly meetings were held between the Quality Improvement office and the Clinical and Translational Science – Informatics and Technology teams during the entire project. Our primary goal was to collect just enough information to answer the basic questions of who is doing which QI project, what department are they from, what are the most basic details about the type of project and who is involved. We also wanted to create incentive in the user group to try to find an existing project to join or to commit the details of their proposed new project to a data registry for others to find to reduce the amount of duplicate QI projects. We created a series of design templates for further customization and feature discovery. We then proceed with the development of the registry using a Python web development framework called Django, which is a technology that powers Pinterest and the Washington Post Web sites. The application is broken down into 2 main components (i) data input, where information is collected from clinical staff, Nurses, Pharmacists, Residents, and Doctors on what quality improvement projects they intend to complete and (ii) project registry, where completed or “registered” projects can be viewed and searched publicly. The registry consists of a quality investigator profile that lists contact information, expertise, and areas of interest. A dashboard allows for the creation and review of quality improvement projects. A search function enables certain quality project details to be publicly accessible to encourage collaboration. We developed the Registry Matching Algorithm which is based on the Jaccard similarity coefficient that uses quality project features to find similar quality projects. The algorithm allows for quality investigators to find existing or previous quality improvement projects to encourage collaboration and to reduce repeat projects. We also developed the QIPR Approver Algorithm that guides the investigator through a series of questions that allows an appropriate quality project to get approved to start without the need for human intervention. RESULTS/ANTICIPATED RESULTS: A product of this project is an open source software package that is freely available on GitHub for distribution to other health systems under the Apache 2.0 open source license. Adoption of the Quality Improvement Project Registry and promotion of it to the intended audience are important factors for the success of this registry. Thanks goes to the UW-Madison and their QI/Program Evaluation Self-Certification Tool (https://uwmadison.co1.qualtrics.com/SE/?SID=SV_3lVeNuKe8FhKc73) used as example and inspiration for this project. DISCUSSION/SIGNIFICANCE OF IMPACT: This registry was created to help understand the impact of improved management of quality projects in a hospital system. The ultimate result will be to reduce time to approve quality improvement projects, increase collaboration across the UF Health Hospital system, reduce redundancy of quality improvement projects and translate more projects into publications.