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Competing theories on the aetiology of eating disorders originate from a diverse set of disciplines. One such discipline is Evolutionary Psychology which assumes that the human mind has been shaped by natural and sexual selection. Most evolutionary theories on eating disorders limit themselves to the causation of anorexia nervosa only. The Sexual Competition Hypothesis (SCH), based on the Darwinian theory of sexual selection, provides an explanatory framework for the whole spectrum of eating disorders. It contends that intense female intrasexual competition (ISC) is the ultimate cause of eating disorders. The SCH explains the phenomenon of the pursuit of thinness as an adaptation to ISC in the modern environment. It argues that eating disorders are pathological phenomena that arise from the mismatch between the modern environment and the inherited female adaptations for ISC.
To test predictions from a novel evolutionary hypothesis for eating disorders.
i) To examine the relationship between disordered eating behaviour (DEB) and ISC in a sample of female undergraduates.
ii) To establish whether there is any relationship between DEB and Life History (LH) strategy.
A group of 206 female undergraduates were recruited. A structural equation model was constructed to analyse the data.
ISC for mates was significantly associated with DEB, as predicted by the SCH. DEB was found to be predicted by fast LH strategy, which was only partially mediated by the SCH.
The results of this study are supportive of the SCH and justify research on a clinical sample.
To assess the feasibility of non-contrast T2-weighted magnetic resonance imaging as compared to T1-weighted post-contrast magnetic resonance imaging for detecting acoustic neuroma growth.
Adult patients with acoustic neuroma who underwent at least three magnetic resonance imaging scans of the internal auditory canals with and without contrast in the past nine years were identified. T1- and T2-weighted images were reviewed by three neuroradiologists, and tumour size was measured. Accuracy of the measurements on T2-weighted images was defined as a difference of less than or equal to 2 mm from the measurement on T1-weighted images.
A total of 107 magnetic resonance imaging scans of 26 patients were reviewed. Measurements on T2-weighted magnetic resonance imaging scans were 88 per cent accurate. Measurements on T2-weighted images differed from measurements on T1-weighted images by an average of 1.27 mm, or 10.4 per cent of the total size. The specificity of T2-weighted images was 88.2 per cent and the sensitivity was 77.8 per cent.
The T2-weighted sequences are fairly accurate in measuring acoustic neuroma size and identifying growth if one keeps in mind the caveats associated with the tumour characteristics or location.
Community-led total sanitation (CLTS) is an intervention that strives to end the practice of open defaecation. This study measured the effectiveness of CLTS in Nyando District by examining the association between community open defaecation-free (ODF) status and childhood diarrhoeal illness. A cross-sectional study design was used among households with children ⩽5 years old to ascertain information on acute diarrhoea in the past year (outcome), sanitation and health behaviours. Water testing was conducted to determine Escherichia coli and turbidity levels for 55 water sources. Data were obtained from 210 parents or caregivers from an ODF community and 216 parents or caregivers in a non-ODF community. The non-ODF participants reported a non-significant 16% increased risk of diarrhoea compared with the participants from the ODF community. Children's HIV positivity (adjusted prevalence ratio (aPR) = 2.29; 95% CI 2.07–2.53), unsafe child stool disposal (aPR = 1.92; 95% CI 1.74–2.12) and low household income (aPR = 1.93; 95% CI 1.46–2.56) were associated with diarrhoea, in the non-ODF community. The ODF location had a higher percentage of E. coli in the drinking water compared with the non-ODF location (76.7% vs. 60%). Diarrhoeal disease rates in children ⩽5 years old did not differ by whether a latrine intervention was implemented. Water sampling findings suggest water safety may have decreased the effectiveness of the CLTS’ improvement of childhood diarrhoea. Improved water treatment practices, safe stool disposal and education may improve the CLTS intervention in ODF communities and therefore reduced the risk of childhood diarrhoea.
A forward spike attached to a blunt body significantly alters its flow field characteristics and influences aerodynamic characteristics at hypersonic flow due to formation of separated flow and re-circulation region around the spiked body. An experimental investigation was performed to measure aerodynamic forces for spikes blunt bodies with a conical, hemispherical and flat-face spike at Mach 6 and at an angle-of-attack range from 0° to 8° and length-to-diameter L/D ratio of spike varies from 0.5 to 2.0, where L is the length of the spike and D is diameter of blunt body. The shape of the leading edge of the spiked blunt body reveals different types of flow field features in the formation of a shock wave, shear layer, flow separation, re-circulation region and re-attachment shock. They are analysed with the help of schlieren pictures. The shock distance ahead of the hemisphere and the flat-face spike is compared with the analytical solution and is showing satisfactory agreement with the schlieren pictures. The influence of geometrical parameters of the spike, the shape of the spike tip and angle-of-attack on the aerodynamic coefficients are investigated by measuring aerodynamic forces in a hypersonic wind tunnel. It is found that a maximum reduction of drag of about 77% was found for hemisphere spike of L/D = 2.0 at zero angle-of-attack. Consideration for compensation of increased pitching moment is required to stabilise the aerodynamic forces.
To investigate the feasibility of a national audit of epistaxis management led and delivered by a multi-region trainee collaborative using a web-based interface to capture patient data.
Six trainee collaboratives across England nominated one site each and worked together to carry out this pilot. An encrypted data capture tool was adapted and installed within the infrastructure of a university secure server. Site-lead feedback was assessed through questionnaires.
Sixty-three patients with epistaxis were admitted over a two-week period. Site leads reported an average of 5 minutes to complete questionnaires and described the tool as easy to use. Data quality was high, with little missing data. Site-lead feedback showed high satisfaction ratings for the project (mean, 4.83 out of 5).
This pilot showed that trainee collaboratives can work together to deliver an audit using an encrypted data capture tool cost-effectively, whilst maintaining the highest levels of data quality.
Most research on interventions to counter stigma and discrimination has
focused on short-term outcomes and has been conducted in high-income
To synthesise what is known globally about effective interventions to
reduce mental illness-based stigma and discrimination, in relation first
to effectiveness in the medium and long term (minimum 4 weeks), and
second to interventions in low- and middle-income countries (LMICs).
We searched six databases from 1980 to 2013 and conducted a
multi-language Google search for quantitative studies addressing the
research questions. Effect sizes were calculated from eligible studies
where possible, and narrative syntheses conducted. Subgroup analysis
compared interventions with and without social contact.
Eighty studies (n = 422 653) were included in the
review. For studies with medium or long-term follow-up (72, of which 21
had calculable effect sizes) median standardised mean differences were
0.54 for knowledge and −0.26 for stigmatising attitudes. Those containing
social contact (direct or indirect) were not more effective than those
without. The 11 LMIC studies were all from middle-income countries.
Effect sizes were rarely calculable for behavioural outcomes or in LMIC
There is modest evidence for the effectiveness of anti-stigma
interventions beyond 4 weeks follow-up in terms of increasing knowledge
and reducing stigmatising attitudes. Evidence does not support the view
that social contact is the more effective type of intervention for
improving attitudes in the medium to long term. Methodologically strong
research is needed on which to base decisions on investment in
(See the commentary by Van Schooneveld and Rupp, on pages1100–1102.)
Although prior authorization and prospective audit with feedback are both effective antimicrobial stewardship program (ASP) strategies, the relative impact of these approaches remains unclear. We compared these core ASP strategies at an academic medical center.
We compared antimicrobial use during the 24 months before and after implementation of an ASP strategy change. The ASP used prior authorization alone during the preintervention period, June 2007 through May 2009. In June 2009, many antimicrobials were unrestricted and prospective audit was implemented for cefepime, piperacillin/tazobactam, and vancomycin, marking the start of the postintervention period, July 2009 through June 2011. All adult inpatients who received more than or equal to 1 dose of an antimicrobial were included. The primary end point was antimicrobial consumption in days of therapy per 1,000 patient-days (DOT/1,000-PD). Secondary end points included length of stay (LOS).
In total, 55,336 patients were included (29,660 preintervention and 25,676 postintervention). During the preintervention period, both total systemic antimicrobial use (−9.75 DOT/1,000-PD per month) and broad-spectrum anti-gram-negative antimicrobial use (−4.00 DOT/1,000-PD) declined. After the introduction of prospective audit with feedback, however, both total antimicrobial use (+9.65 DOT/1,000-PD per month; P < .001) and broad-spectrum anti-gram-negative antimicrobial use (+4.80 DOT/1,000-PD per month; P < .001) increased significantly. Use of cefepime and piperacillin/tazobactam both significantly increased after the intervention (P = .03). Hospital LOS and LOS after first antimicrobial dose also significantly increased after the intervention (P = .016 and .004, respectively).
Significant increases in antimicrobial consumption and LOS were observed after the change in ASP strategy.
Infect Control Hosp Epidemiol 2014;35(9):1092-1099
To investigate whether inadequate dose to Point-A necessitates treatment plan changes in a time of computed tomography (CT)-image-guided brachytherapy treatment planning for cervix cancer.
Materials and methods
A total of 125 tandem and ovoid insertions from 25 cervix patients treated were reviewed. CT-image-based treatment planning was carried out for each insertion. Point-A is identified and the dose documented; however, dose optimisation in each plan was based on covering target while limiting critical organ doses (PlanTarget). No attempts were made to equate prescription and Point-A dose. For each insertion, a second hypothetical treatment plan was generated by prescribing dose to Point-A (PlanPoint-A). Plans were inter-compared using dose–volume histogram analyses.
A total of 250 treatment plans were analysed. For the study population, the median cumulative dose at Point-A was 80 Gy (range 70–95) for PlanTarget compared with 84·25 Gy for PlanPoint-A. Bladder and rectal doses were higher for PlanPoint-A compared with PlanTarget (p < 0·0001). Target D90 did not correlate with Point-A dose (p = 0·60).
Depending on applicator geometry, tumour size and patient anatomy, Point-A dose may vary in magnitude compared with prescription dose. Treatment plan modifications purely based on inadequate Point-A dose are unnecessary, as these may result in higher organ-at-risk doses and not necessarily improve target coverage.
The present paper presents oil flow visualisations and pressure measurements over a hemisphere-cylinder body attached with a forward facing spike at Mach 6 and Reynolds number of 1·38 × 108 at 0° and 5° angle-of-attack. The oil flow pictures depict the separation region in the vicinity of the spike on the hemisphere-cylinder body. The oil flow visualisations will help to locate the reattachment shock wave on the hemisphere-cylinder body and also understand the flow field behavior on the blunt-nosed spike configuration. The pressure measurements over the hemisphere-cylinder body depend on the shape and the length of the spike. The pressure distributions over the blunt-nosed body show significant influence of the angle-of-attack. The maximum pressure coefficient on the hemisphere-cylinder body is a function of the spike length, shape of the aerodisk and angle-of-attack. The windward and leeward sides pressure variations show dependence of the geometrical parameters of the spike and shape of the spike. The hemisphere and the flat-faced aerodisk cause considerable reduction of pressure leading to decrease of aerodynamic drag compared to the conical spike.
A forward facing spike attached to a hemispherical body significantly changes its flow field and influences aerodynamic drag and wall heat flux in a high speed flow. The dynamic pressure in the recirculation area is highly reduced and this leads to the decrease in the aerodynamic drag and heat load on the surface. Consequently, the geometry, that is, the length and shape of the spike, has to be simulated in order to obtain a large conical recirculation region in front of the blunt body to get beneficial drag reduction. It is, therefore, a potential candidate for aerodynamic drag reduction for a future high speed vehicle. Axisymmetric compressible laminar Navier-Stokes equations are solved using a finite volume discretisation in conjunction with a multistage Runge-Kutta time stepping scheme. The effect of the spike length and shape, and the spike nose configuration on the reduction of drag is numerically evaluated at Mach 6 at a zero angle-of-attack. The computed density contours agree well with the schlieren images. Additional modification to the tip of the spike to get different types of flow field such as the formation of a shock wave, separation area and reattachment point are examined. The spike geometries include the conical spike, the flat-disk spike and the hemispherical disk spike of different length to diameter ratios attached to the blunt body.
In 1978, 22 staff members of the National Institute of Virology, Pune, India, were given two doses of human diploid cell antirabies vaccine (HDCV) for primary pre-exposure prophylactic immunization; the interval between the two doses being approximately 4 weeks. Eighteen of these 22 vaccinees were given a booster dose 1 year later. All 18 vaccinees developed protective levels of antibody; most of them had antibody levels exceeding 10 IU/ml.
In 1984, 5 years after the booster dose, 11 (79·0%) of 14 vaccinees tested still possessed neutralizing antibody levels ranging from 0·5 IU/ml to 10 IU/ml. Fourteen days after the administration of a booster dose, the antibody levels ranged from 10 to ≥ 100 IU/ml for all except one vaccinee (5·2 IU/ml). These findings demonstrate that the majority of vaccinees retained detectable neutralizing antibody after pre-exposure prophylaxis for as long as 5 years and that a single booster dose thereafter evoked a good antibody response.
A spike attached to a hemispherical body drastically changes its flowfield and influences aerodynamic drag in a hypersonic flow. It is, therefore, a potential candidate for drag reduction of a future high-speed vehicle. The effect of the spike length, shape, spike nose configuration and angle-of-attack on the reduction of the drag is experimentally studied with use of hypersonic wind-tunnel at Mach 6. The effects of geometrical parameters of the spike and angle-of-attack on the aerodynamic coefficient are analysed using schlieren picture and measuring aerodynamic forces. These experiments show that the aerodisk is superior to the aerospike. The aerodisk of appropriate length, diameter and nose configuration may have the capability for the drag reduction. The inclusion of an aero disk at the leading edge of the spike has an advantage for the drag reduction mechanism if it is at an angle-of-attack, however consideration to be given for increased moment resulting from the spike is required.
CdSe and CdTe nanoparticles dispersed in silicon dioxide films have been grown by magnetron sputtering technique followed by thermal annealing. Effect of thermal annealing conditions on the structural and optical properties of CdTe and CdSe nanoparticles has been studied. Glancing angle x-ray diffraction (GAXRD), optical absorption (OA), transmission electron microscope (TEM) and spectroscopic ellipsometry (SE) techniques have been used to study the crystal structure, particle size and dielectric function spectra of nanoparticles. ε2 spectra of CdTe nanoparticles show a decrease in dielectric constant values in comparison to bulk CdTe. ε2″ spectrum of CdTe nanoparticles show four critical points in the electronic band structure of CdTe. Optical absorption studies in the case of CdTe and CdSe nanoparticles clearly show the blue shift of fundamental absorption edge due to quantum confinement effect.
To test the effect of dietary nutrients on oral precancerous lesions in a reverse-smoking (i.e. smoking with the glowing end inside the mouth) population in South India.
Case–control. Cases with precancerous lesions were matched to an equal number of lesion-free controls matched on age (±5 years), sex and village. All subjects used tobacco in some form. Dietary data were obtained using an interviewer-administered food-frequency questionnaire, designed for use in this population. All interviews were conducted blinded to the disease status of the subject. Data were analysed using logistic regression.
Nineteen rural villages in Srikakulam District, Andhra Pradesh.
From a survey of 6007 tobacco users, 485 (79% women) were found to have precancerous, mostly palatal, lesions (cases), and 487 lesion-free subjects were selected as controls.
All eligible subjects consented to participate and nearly all (>99%) had complete data for analyses. Reverse smoking was the most common form of tobacco use among cases (81.9%) and controls (73.5%), and reverse smokers were 5.19 times more likely than chewers to have these lesions (95% confidence interval = 1.35, 19.9). After controlling for relevant covariates, including the type of tobacco use, protective linear effects were observed for zinc (70% reduction across the interquartile range, P<<0.002 ), calcium (34% reduction, P<0.002 ), fibre (30% reduction, P<0.009 ), riboflavin (22% reduction, P<0.03 ) and iron (17% reduction, P<0.05 ).
Several dietary nutrients appear to protect against oral precancerous lesions that are strongly associated with reverse smoking. The results of this study indicate scope for targeting dietary factors in preventing oral cancer, which should be coupled with aggressive anti-tobacco use efforts.
To develop and test a quantitative, interviewer-administered food frequency questionnaire (FFQ) to ascertain nutrient intakes of individuals in northern India.
A 92-item FFQ was developed based on food use and market surveys of the study area. A validation study was conducted consisting of 24-h diet recalls (24HR) administered on 6 randomly selected days over 1 year. Two FFQs were administered, one each at the beginning and end of the 1-year period. FFQ and 24HR-derived nutrient scores were compared using correlation and regression analyses and by computing differences between nutrient intakes estimated by the two methods.
Rural villages in Bhavnagar District, Gujarat, North India.
60 individuals who agreed to provide all necessary data.
Pearson (parametric) correlation coefficients averaged 0.69 in comparing nutrient scores derived from the 24HR with those from the first FFQ and 0.72 in comparing the second FFQ (P < 0.0001). Spearman correlation coefficients were virtually identical to the Pearson correlations, averaging 0.68 and 0.72, respectively. In regression analyses, most coefficients were close to 1.0 (perfect linear association). Nutrient scores were significantly and consistently higher on both FFQs relative to the 24HR.
This FFQ produces results broadly comparable, and superior in some respects, to those commonly used in the West. Higher than average measures of association indicate its suitability for comparing exposures within this study population in reference to health-related endpoints.
To develop and test a food frequency questionnaire (FFQ) for use in rural areas of Kerala, India.
Based on food use and market surveys of the study area, a quantitative 81-item interviewer-administered FFQ was developed. A validation study was conducted consisting of 24-h diet recalls (24HR) administered on 8 days randomly selected over an entire year and two administrations of the FFQ, one at the beginning of the l-year period and the other at the end. FFQ and 24HR-derived nutrient scores were compared using correlation and regression analyses and by examining differences in the nutrient scores.
Rural villages in Ernakulum district, Kerala, South India.
In each of 30 households, the male head of household and female food preparer were enrolled.
Pearson (parametric) correlation coefficients (rp) averaged about 0.50 in comparing nutrient scores derived from the 24HR with those from the first FFQ and about 0.55 in comparing the second FFQ. On average, Spearman correlation coefficients (rs) were slightly lower than the rp in comparing the scores derived from the first FFQ, but virtually identical for the second FFQ. Regression analyses indicated better agreement in the comparison of the 24HR-derived scores with the first FFQ than the second FFQ. Difference scores, however, tended to be larger in comparing the first FFQ scores with the 24HR.
This FFQ produces results broadly comparable to those used in Europe and North America, indicating its suitability for comparing exposures within a study population in reference to health-related endpoints.