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 email@example.com
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.
The preconception, pregnancy and immediate postpartum and newborn periods are times for mothers and their offspring when they are especially vulnerable to major stressors – those that are sudden and unexpected and those that are chronic. Their adverse effects can transcend generations. Stressors can include natural disasters or political stressors such as conflict and/or migration. Considerable evidence has accumulated demonstrating the adverse effects of natural disasters on pregnancy outcomes and developmental trajectories. However, beyond tracking outcomes, the time has arrived for gathering more information related to identifying mechanisms, predicting risk and developing stress-reducing and resilience-building interventions to improve outcomes. Further, we need to learn how to encapsulate both the quantitative and qualitative information available and share it with communities and authorities to mitigate the adverse developmental effects of future disasters, conflicts and migrations. This article briefly reviews prenatal maternal stress and identifies three contemporary situations (wildfire in Fort McMurray, Alberta, Canada; hurricane Harvey in Houston, USA and transgenerational and migrant stress in Pforzheim, Germany) where current studies are being established by Canadian investigators to test an intervention. The experiences from these efforts are related along with attempts to involve communities in the studies and share the new knowledge to plan for future disasters or tragedies.
Lebanon has a need for innovative approaches to increase access to mental health care to meet the country's current high demand. E-mental health has been included in its national mental health strategy while in parallel the World Health Organization has produced an online intervention called ‘Step-by-Step’ to treat symptoms of depression that is being tested in Lebanon over the coming years.
The primary aim of this study is to conduct bottom-up, community-driven qualitative cognitive interviewing from a multi-stakeholder perspective to inform the cultural adaptation of an Internet-delivered mental health intervention based on behavioural activation in Lebanon.
National Mental Health Programme staff conducted a total of 11 key informant interviews with three mental health professionals, six front-line workers in primary health care centres (PHCCs) and two community members. Also, eight focus group discussions, one with seven front-line workers and seven others with a total of 66 community members (Lebanese, Syrians and Palestinians) were conducted in several PHCCs to inform the adaptation of Step-by-Step. Results were transcribed and analysed thematically by the project coordinator and two research assistants.
Feedback generated from the cognitive interviewing mainly revolved around amending the story, illustrations and the delivery methods to ensure relevance and sensitivity to the local context. The results obtained have informed major edits to the content of Step-by-Step and also to the model of provision. Notably, the intervention was made approximately 30% shorter; it includes additional videos of content alongside the originally proposed comic book-style delivery; there is less emphasis on total inactivity as a symptom of low mood and more focus on enjoyable activities to lift mood; the story and ways to contact participants to provide support were updated in line with local gender norms; and many of the suggested or featured activities have been revised in line with suggestions from community members.
These findings promote and advocate the use of community-driven adaptation of evidence-based psychological interventions. Some of the phenomena recorded mirror findings from other research about barriers to care seeking in the region and so changes made to the intervention should be useful in improving utility and uptake of ‘Step-by-Step’.
Antibodies at gastrointestinal mucosal membranes play a vital role in immunological protection against a range of pathogens, including helminths. Gastrointestinal health is central to efficient livestock production, and such infections cause significant losses. Fecal samples were taken from 114 cattle, across three beef farms, with matched blood samples taken from 22 of those animals. To achieve fecal antibody detection, a novel fecal supernatant was extracted. Fecal supernatant and serum samples were then analysed, using adapted enzyme-linked immunosorbent assay protocols, for levels of total immunoglobulin (Ig)A, IgG, IgM, and Teladorsagia circumcincta-specific IgA, IgG, IgM and IgE (in the absence of reagents for cattle-specific nematode species). Fecal nematode egg counts were conducted on all fecal samples. Assays performed successfully and showed that IgA was the predominant antibody in fecal samples, whereas IgG was predominant in serum. Total IgA in feces and serum correlated within individuals (0.581, P = 0.005), but other Ig types did not. Results support the hypothesis that the tested protocols are an effective method for the non-invasive assessment of cattle immunology. The method could be used as part of animal health assessments, although further work is required to interpret the relationship between results and levels of infection and immunity.
Introduction: NSAIDS offer more effective analgesia than opioids, require less rescue medication, and decrease the incidence of nausea and vomiting in renal colic patients. Alpha blockers and Opioids are also prescribed frequently, but doses used and treatment durations are not well described. Our objective was to investigate ED prescribing decisions and medication compliance by patients with acute renal colic. Methods: In this prospective two-city cohort study, we invited patients with a first ED visit for image-confirmed 2-10 mm ureteric stones to consent to a telephone survey 10 days after their ED visit. During follow-up interviews, patients were asked what drugs they were prescribed and how many doses they required. This study was REB approved. Results: A convenience sample of 224 patients, including 152 males (67.9%) and 72 females (median age= 52.4 years) completed 10-day surveys. NSAIDS were prescribed for 48.7%, tamsulosin for 65.2% and opioids for 81.7%. One-third received a tamsulosin-NSAID combination, 40% an opioid-NSAID combination and 28% a tamsulosin-NSAID-opioid combination. Of 109 patients prescribed an NSAID, only 70 (64.2%) took 1 dose/day; however an additional 28 who were not prescribed NSAIDs took 1 NSAID dose/day. Mean (sd) NSAID intake in the overall study group was 1.1 (1.5) doses/day from day 1-5 and 0.6 (1.1) doses/day on days 6-10, with 90%ile values of 3.0 and 2.0 doses/day. NSAID compliance was more common in patients who stated they received high quality discharge instructions (63.8% vs. 32.6%; RR=1.95; 95% CI 1.47-2.60). Mean opioid intake in the overall study group was 1.2 (1.7) doses/day from day 1-5 and 0.5 (1.3) doses/day on days 6-10, with 90%ile values of 4.0 and 2.0 doses/day. Among patients prescribed tamsulosin, the average was 4.0 days of compliance (sd=4.3), with a 90%ile value of 10 days. Conclusion: This study provides estimates for the amount of drug actually used by renal colic patients during the 10-days after their ED visit. Patients used fewer opioid doses than expected, and NSAID and tamsulosin compliance appears relatively poor. NSAID compliance was better in patients who perceived high quality discharge instructions. This study suggests there is room for improvement in medication prescribing and discharge instructions for ED patients with an acute episode of ureteral colic.
A key to long-term sustainable enhancement of viable livestock production is the introduction of genetic traits that ensure that fertility and meat quality characteristics are compatible with farming environments and market needs. For example, the sheep industry could benefit if daughters of hill-breed ewes were of a crossbred genotype that enhances both carcass characteristics and fertility traits. Use of sires that confer better conformation is an option but does not significantly boost prolificacy. Introduction of the ‘Inverdale’ fecundity gene could change this. On a flock basis in the Romney breed, mean ovulation is increased by 1.0 and litter size by 0.6 in adult ewes carrying a single copy of this gene (designated as FecXI because it is on the X chromosome; Davis et al. 1992). Carrier males transmit it to all of their female offspring, these being heterozygous carriers of the gene unless it also is maternally inherited. In the latter instance, young would be infertile the homozygous genotype confers an undesirable ‘streak ovary’ phenotype. Although a number of sheep breeds world-wide exhibit significant ‘single gene’ effects on ovulation and litter size (Montgomery et al. 2001), Scottish hill sheep breeds show no evidence of this. Consequently, all ewe lambs generated by crossing these hill ewes with a ram carrying the Inverdale gene should be heterozygous. To ascertain whether such animals exhibit enhanced fecundity, an on-farm study investigated ovulation incidence in cyclic ewe lambs born to Cheviot or Scottish Blackface ewes that had been bred to Texel rams carrying a single copy of the ‘Inverdale’ gene.
Superburst oscillations are high frequency X-ray variations observed during hours’ long superbursts on accreting neutron stars. We investigate a potential mechanism to explain these observations; a buoyant r-mode, excited in the ocean layers of the star. These modes are affected by ash composition in the ocean so are a good probe of nuclear burning processes. The phenomenon could be used in pulse profile modelling as a way of measuring neutron star mass and radius, and so the dense matter equation of state.
In this study the onset of stress-free Boussinesq thermal convection in rotating spherical shells with aspect ratio η = rinner/router = 0.9, Prandtl numbers Pr ∈ [10−4, 10−1], and Taylor numbers Ta ∈ [104, 1012] is considered. We focus on the form of the convective cell pattern that develops, and on its time scales, since this may have observational consequences for thermonuclear burning and the development of burst oscillations in the exploding oceans of accreting neutron stars (Watts (2012)).
We present the recent results of a magnetometry survey of the Spring Lake Tract conducted during the summer of 2015 at Cahokia Mounds State Historic Site located along the Mississippi River Floodplain in southern Illinois. This tract, located southeast of Woodhenge and west of the Grand Plaza, is situated north of two known borrow pits and includes an additional, previously unidentified borrow pit. Through comparing our gradiometer results with our subsequent test excavations, we argue that this area of Cahokia potentially demonstrates an increase in building density at the Spring Lake Tract during the transition between the Terminal Late Woodland and Lohmann phases. In addition, our survey and exaction results demonstrate that this area was densely occupied between the Lohmann and Stirling phases. During the Moorehead phase, we identify a possible increase in habitation based on hypothesized structure density using statistical analyses of length and width ratios (m) and structure area (m2). Our preliminary results suggest that the Spring Lake Tract saw an increase in habitation during the Moorehead phase, a new perspective on the density and use of domestic space during Cahokia's late occupational history.
Objectives: This study examines the selective, sustained, and executive attention abilities of very preterm (VPT) born children in relation to concurrent structural magnetic resonance imaging (MRI) measures of regional gray matter development at age 12 years. Methods: A regional cohort of 110 VPT (≤32 weeks gestation) and 113 full term (FT) born children were assessed at corrected age 12 years on the Test of Everyday Attention-Children. They also had a structural MRI scan that was subsequently analyzed using voxel-based morphometry to quantify regional between-group differences in cerebral gray matter development, which were then related to attention measures using multivariate methods. Results: VPT children obtained similar selective (p=.85), but poorer sustained (p=.02) and executive attention (p=.01) scores than FT children. VPT children were also characterized by reduced gray matter in the bilateral parietal, temporal, prefrontal and posterior cingulate cortices, bilateral thalami, and left hippocampus; and increased gray matter in the occipital and anterior cingulate cortices (family-wise error–corrected p<.05). Poorer sustained auditory attention was associated with increased gray matter in the anterior cingulate cortex (p=.04). Poor executive shifting attention was associated with reduced gray matter in the right superior temporal cortex (p=.04) and bilateral thalami (p=.05). Poorer executive divided attention was associated with reduced gray matter in the occipital (p=.001), posterior cingulate (p=.02), and left temporal (p=.01) cortices; and increased gray matter in the anterior cingulate cortex (p=.001). Conclusions: Disturbances in regional gray matter development appear to contribute, at least in part, to the poorer attentional performance of VPT children at school age. (JINS, 2017, 23, 539–550)
This paper reports three cases of severe post-stapedectomy granuloma, emphasising the variable presentation of this devastating complication and the challenges of its management.
A retrospective review was conducted of three cases of post-stapedectomy granuloma requiring surgical debulking between 2010 and 2015. Clinical symptoms, serial imaging, histopathology and post-operative outcomes were considered.
Intra-operatively, extensive granulation tissue with erosion of the otic capsule was found. There was spread along the VIIth and VIIIth cranial nerves to the cochlear nucleus in one patient. Post-operative clinical improvement was demonstrable, corroborated by diminution of contrast enhancement on serial magnetic resonance imaging. Facial nerve function recovered, tinnitus amelioration was variable and some otalgia persisted. Post-operative complications included grade IV facial weakness and late Pseudomonas aeruginosa meningitis, which all resolved.
To the authors’ knowledge, this paper reports the only case of post-stapedectomy granuloma tracking to the brainstem. Otalgia was present in all our cases, and may be deemed a red flag symptom of progressive bony destruction and otic capsule involvement. Although granuloma remains rare, it should be considered in any patient with worsening otological symptoms following stapes surgery.
A new method of electromagnetic sounding in resistive electrical environments has been developed for use in lunar exploration. It is applicable to the study of terrestrial glaciers and ice sheets. A horizontal electric dipole antenna on the ground is used to transmit power at frequencies of 1, 2, 4, 8, 16 and 32 MHz. A set of orthogonal receiving coils is mounted on a vehicle which traverses away from the transmitter. Field strength is recorded as a function of distance. Waves which travel above the surface interfere with waves from the subsurface, generating interference patterns which can be used to determine the dielectric constant, the loss tangent, and depth to reflecting horizons.
The technique was tested on the Athabasca Glacier in western Canada. At 1, 2 and 4 MHz the ice was found to have a dielectric constant of about 3.3, a loss tangent (tan δ) which is roughly inversely proportional to frequency giving values of f tan δ in the range 0.25 to 0.35 (where f is in MHz). These values correspond well with the known properties of ice near 0° C, which is a temperature typical of temperate glaciers. It has been possible to determine the depth of the ice but results are not always consistent with previous seismic and gravity surveys and with drilling. At frequencies of 16 and 32 MHz, scattering is the dominant feature of the results. At 8 MHz there is a transition from clear-cut interference patterns to the scattering patterns. From these findings, we suggest that the Athabasca Glacier has a large number of dielectric scatterers with dimensions less than about 35 m, probably due in large part to crevasses.
A C14-dating installation was operated in the Physics Department, Trinity College, Dublin, from early 1958 until early 1960, by I. R. McAulay. Construction and testing of the apparatus had occupied 15 months previous to this. Material for dating was selected and pretreated by W. A. Watts, who also collected and submitted the samples and carried out pollen analyses except where the contrary is stated in the text. The project was a short-term one with two main aims; to obtain a few key archaeologic dates, particularly in the Neolithic, to help orientate chronologic discussion; and to test the validity of the pollen zonation for the post-Atlantic of Mitchell (1956).
The University of Tasmania balloon-borne large area X-ray telescope was flown from Alice Springs on 20 November 1978. A number of known X-ray sources were observed and a transient increase believed to be a gamma ray burst was detected.
La centralisation au Bureau international de l’Heure des résultats d’observations de l’Opération internationale de 1933 a été très lente, puisque les dernières données attendues ont été reçues vers la fin de 1937.
Le nombre des stations ayant coopéré à l’Opération internationale et ayant transmis leurs observations à l’organisme centralisateur s’élève à soixante et onze. Ainsi qu’il a été expliqué à notre Commission mixte, lors du Congrès de l’Union géodésique et géophysique internationale tenu à Édimbourg en 1936, ces stations ont été réparties en trois groupes:
Le Ier comprenant vingt Observatoires, disposant chacun de plusieurs horloges de première classe (soit à poids sous pression et à température constantes, soit à quartz piézoélectrique);
A complete orbital light-curve of V2051 Oph in the IR H band is presented, together with a second eclipse in the J band. Simultaneous Rc band data were obtained. Eclipse depths in Rc, J and H are 1.8 mag, 1.0 mag and 0.8 mag respectively. No evidence for ellipsoidal variations due to the secondary was seen and constraints on the secondary are discussed.