To send 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 sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.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 sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent 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.
Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care.
The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions.
We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures.
We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.
Implementation of genome-scale sequencing in clinical care has significant challenges: the technology is highly dimensional with many kinds of potential results, results interpretation and delivery require expertise and coordination across multiple medical specialties, clinical utility may be uncertain, and there may be broader familial or societal implications beyond the individual participant. Transdisciplinary consortia and collaborative team science are well poised to address these challenges. However, understanding the complex web of organizational, institutional, physical, environmental, technologic, and other political and societal factors that influence the effectiveness of consortia is understudied. We describe our experience working in the Clinical Sequencing Evidence-Generating Research (CSER) consortium, a multi-institutional translational genomics consortium.
A key aspect of the CSER consortium was the juxtaposition of site-specific measures with the need to identify consensus measures related to clinical utility and to create a core set of harmonized measures. During this harmonization process, we sought to minimize participant burden, accommodate project-specific choices, and use validated measures that allow data sharing.
Identifying platforms to ensure swift communication between teams and management of materials and data were essential to our harmonization efforts. Funding agencies can help consortia by clarifying key study design elements across projects during the proposal preparation phase and by providing a framework for data sharing data across participating projects.
In summary, time and resources must be devoted to developing and implementing collaborative practices as preparatory work at the beginning of project timelines to improve the effectiveness of research consortia.
Research suggests that urbanicity and lower socio-economic status are risk factors for psychosis.
Aims and objectives:
To calculate the incidence and period prevalence of patients admitted with psychosis in Malta, and to examine differences between districts. To date, this is the first study of its kind carried out in the Maltese Islands.
One year prospective cross-sectional study, including all ICD-10 psychosis patients admitted to any one of the three psychiatric hospitals (n = 180).
Incidence of hospital admissions due to psychosis was 26.0 at risk per year per 100, 000 population. Period prevalence for 6 years was 41.9 per 100,000 person-years. Highest incidence: Southern-Harbour area (32.1, CI = 31.9–32.3), and lowest incidence: Western District (20.1, CI = 19.9–20.2). the period prevalence was highest in Gozo District (63.9, CI = 63.2–64.7). 5.2% of participants were irregular migrants, having an approximate estimate for incidence of psychosis of 400 per 100,000 person years at risk.
The high incidence of psychosis may be explained by the fact that Malta is the eighth most densely populated country worldwide. the district with the lowest socio-economic groups were found to have the highest incidence of psychosis, followed by the most densely populated district. Cultural factors, small genetic pool or readily available services could account for the high period prevalence in the Gozo district -a more rural area. Higher education in the Western district area could partially explain the lower incidence. Multiple Stressors and trauma may partially be the reasons for the much higher incidence rate in the irregular immigrant group.
Giant electromagnetic pulses (EMP) generated during the interaction of high-power lasers with solid targets can seriously degrade electrical measurements and equipment. EMP emission is caused by the acceleration of hot electrons inside the target, which produce radiation across a wide band from DC to terahertz frequencies. Improved understanding and control of EMP is vital as we enter a new era of high repetition rate, high intensity lasers (e.g. the Extreme Light Infrastructure). We present recent data from the VULCAN laser facility that demonstrates how EMP can be readily and effectively reduced. Characterization of the EMP was achieved using B-dot and D-dot probes that took measurements for a range of different target and laser parameters. We demonstrate that target stalk geometry, material composition, geodesic path length and foil surface area can all play a significant role in the reduction of EMP. A combination of electromagnetic wave and 3D particle-in-cell simulations is used to inform our conclusions about the effects of stalk geometry on EMP, providing an opportunity for comparison with existing charge separation models.
Domestic kitchen food handling risk factors for sporadic salmonella food poisoning are largely unknown. We compared food consumption and food handling practices, opportunities for cross contamination and refrigerator temperature control, in 99 households in South East Wales in 1997/8 with a case of salmonella food poisoning, and control households matched for electoral ward. On univariate analyses, cases were significantly more likely than control respondents to have purchased free-range eggs in the preceding week, and more likely than control households to have handled frozen whole chicken in the previous week, and to handle raw chicken portions at least weekly. In multivariate analysis, only consumption of raw eggs and handling free-range eggs were significant risk factors, independent of the age structure of the family and of the season.
An overview of some of the problems, which have to be overcome in the design of hypersonic missiles or projectiles, is given. In the main, these are connected with the high levels of heat transfer rate suffered by such vehicles, particularly those induced by aerodynamic control surfaces. Some of the aspects of heat transfer, induced by, and suffered by such controls are presented. Data are presented and discussed, regarding the effects of flow separation due to flaps or flares, the effects of sharp and bluff fins (both swept and unswept). Finally, the aerodynamic interactions and heat transfer rates induced by reaction control jets are presented.
Obliteration of persistently discharging open mastoid cavities is one surgical option to achieve a dry ear. All the currently described techniques involve the use of random pattern local tissue flaps or free grafts. Ten patients have undergone obliteration procedures using the vascularized temporoparietal fascia flap. This resulted in rapid epithelialization by six weeks in seven out of 10 cases. The remaining three patients have persistent non healed areas over the medial attic wall, but are not troubled by otorrhoea. The indications, technique and complications of mastoid obliteration by this axial pattern flap are described.
Experimental and theoretical, small and large amplitude stability data are presented for a pointed and a 0.2 bluntness ratio, 10° semi-angle cone performing pitching oscillations in hypersonic flow at a Mach number of 6.85. Analysis identifies that large amplitude model motion time histories cannot be predicted from a knowledge of small amplitude oscillation stability derivatives data. At the Reynolds numbers of the experiments the pointed and blunted cone are subject to significant hypersonic flow viscous phenomena, which are proposed as the cause of the small to large amplitude stability prediction being invalid.
A lifting line theory of flapping wings in steady forward flight is presented in which the unsteady features of the flow are modelled. A detailed three-dimensional model of the vortex wake is used to evaluate the unsteadiness to first order. The method gives satisfactory agreement with well-known limiting cases. Relationships between the geometric and the kinematic parameters, and the forces and the power are predicted which are compatible with the limited experimental evidence. The theory is applied to the calculation of the power curve of specific birds. Important similarities and differences are observed between the present results and those of Pennycuick (1975) and Rayner (1979c).
Heat-transfer rates from a non-equilibrium hypersonic air flow to flat plates at zero and 12° incidence have been measured in a free piston shock tunnel at stagnation enthalpy levels up to 51 MJ kg−1. Nozzle flow conditions resulted in test section velocities up to 8·1 km 8−1 and in an experimental regime in which the free stream was chemically frozen and the flat-plate boundary layer was laminar. Estimates of the gas-phase and surface-reaction Damkohler numbers have been made and the heat-transfer results are discussed in this context. At the highest test-section densities non-equilibrium endothermic gas phase reactions involving oxygen atoms in the boundary layer are suggested as a possible mechanism for the observed low heattransfer rates.
Using a perturbation method, the formulae for the pitching stability derivatives of sharp wedges at zero incidence in viscous hypersonic flow are obtained in closed form. The results include the effect of unsteady reflected waves from the bow shock and may be applied to any wedge provided that the bow shock is attached. The effect of viscosity of the gas is included in two parts: first, it thickens the wedge, thus introducing the concept of an effective wedge, thicker than the original wedge by a semi-vertex angle equal to the average inclination of the displacement boundary layer; secondly, it makes this effective wedge deformable. Comparison with previous theories is given.
The back fat thickness of 77 live pigs has been measured with an ultrasonic instrument. The method is simple to use and the ultrasonic waves do not harm the pigs. For measurement of a pig on one day, 95% of the mean ultrasonic readings are within ±13·2% of the mean measurements on the carcass.
Evidence for variations between the breeds examined or between sexes is doubtful. By taking repeated measurements on a large number of days, the accuracy of the mean readings for a pig would approach the limit inherent in the method. This limit is determined by small differences between pigs and is estimated to be within ±4·2% for 95% of pigs.
The apparent lytic effect of a newly formed (‘nascent’) streptococcal bacteriophage on streptococcal strains not normally lysed by the phage was shown to be actually an inhibitory action produced by high concentrations of the phage. The inhibitory effect was exhibited by stock preparations of the phage, used in sufficient concentration, and there was no need to postulate a special potency for the phage in its ‘nascent’ form. The inhibitory effect of phages on heterologous organisms was found to be a widespread phenomenon among strains of Streptococcus cremoris and Str. lactis. It became apparent only when larger proportions of phage than the traces normally used for lytic tests were employed.