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Interpreting and applying macroeconomic analysis to the global economic environment and understanding the tools used to do so is fundamental to making good managerial decisions. Presuming no background in economic theory and prioritizing international application, this textbook introduces macroeconomics to business students. It explains how to understand domestic and global macroeconomic developments, policies, and data, and makes extensive use of case studies and data sets to present modern macroeconomics in a globalized world. Each chapter has several specific data exercises and practices as well as an international application focusing on the global perspective. By providing a host of international material, this book is useful for instructors and students around the globe.
Laser–solid interactions are highly suited as a potential source of high energy X-rays for nondestructive imaging. A bright, energetic X-ray pulse can be driven from a small source, making it ideal for high resolution X-ray radiography. By limiting the lateral dimensions of the target we are able to confine the region over which X-rays are produced, enabling imaging with enhanced resolution and contrast. Using constrained targets we demonstrate experimentally a
X-ray source, improving the image quality compared to unconstrained foil targets. Modelling demonstrates that a larger sheath field envelope around the perimeter of the constrained targets increases the proportion of electron current that recirculates through the target, driving a brighter source of X-rays.
This Element argues that after twenty years of democratization, Indonesia has performed admirably. This is especially so when the country's accomplishments are placed in comparative perspective. However, as we analytically focus more closely to inspect Indonesia's political regime, political economy, and how identity-based mobilizations have emerged, it is clear that Indonesia still has many challenges to overcome, some so pressing that they could potentially erode or reverse many of the democratic gains the country has achieved since its former authoritarian ruler, Soeharto, was forced to resign in 1998.
Background: High volumes, ill patients, and steep learning curves can make neurosurgical rotations challenging for medical students. Furthermore, existing rotations often lack neurosurgery-specific orientation materials and level-appropriate pre-reading resources reducing the educational yield of short rotations. This is compounded by the lack of mandatory neurosurgical rotations across medical schools. We hypothesized that a “Neurosurgery Clerkship Manual” covering key orientation, knowledge, and practical topics would enhance educational experiences and generate sustained knowledge retention. Methods: Students rotating through neurosurgery at three hospitals were randomized to receive(intervention) or not receive(control) free access to the manual before their rotation. Participants completed surveys before, immediately after, and 4-weeks after the rotation assessing expectations, experiences, and clinically-relevant knowledge. Results: 61 participants were randomized between 2014 and 2017 with 43(70.5%) completing all three questionnaires. Baseline demographics, characteristics, and experiences were not significantly different. Those receiving the manual reported increased rotation enjoyment(p=0.02), decreased stress levels (p=0.05), and a greater feeling of being “part of the team”(p=0.01). There were also reductions in feeling like they were “not learning” (p=0.01). Finally, those receiving the manual demonstrated significantly better knowledge after the rotation (91.6%vs80.9%;p=0.04) which was sustained at 4-weeks post-rotation (89.2%vs79.0%;p=0.05). Conclusions: A simple and inexpensive clerkship manual can improve the neurosurgery rotation experience and knowledge retention for medical students.
Introduction: It is critical for planning, clinical care and resource optimization to understand patterns of emergency department (ED) utilization. Individuals who have experienced adverse childhood experiences (ACE) are known to have more unhealthy behaviors and worse health outcomes as adults and therefore may be more frequent ED users. Adverse childhood experiences include physical, sexual and emotional abuse or neglect, substance abuse in the family, witnessing violence, having a parent incarcerated or parents getting divorced or separated. To date there are few studies exploring the relationship between ACE and ED utilization. Methods: This a mixed qualitative and quantitative study. It includes analysis of data collected through a survey, a retrospective chart review and focus group discussions. The survey was administered to a convenience sample of adult patients (CTAS 2 -5) presenting to EDs in Kingston Ontario, and consisted of two validated tools that measured exposure to ACE and resiliency. Demographic data and ED utilization frequency for 12 months prior to the index visit were extracted from an electronic medical record for each patient completing the survey. A sample of participants with a high ACE burden (ACE score > 4) were invited to participate in focus groups to explore their experiences of care in the ED. Demographic, ED utilization and health status data were summarized and statistically significant patterns between high ACE and lower ACE patients were determined using Chi2t or t-tests. Transcripts from the focus groups were thematically analyzed using NVivo software by 2 independent researchers. Results: 1693 surveys were collected, 301 (18%) were deemed to have a high ACE score, data analysis is ongoing. The primary outcome is the relationship between ACE and the frequency of ED utilization among adult patients presenting to EDs in Kingston, ON. Secondary outcomes include evaluating the role of resilience as a potential mitigating factor, describing the demographics of high ACE burden frequent ED visitors, and the experiences of care for individuals with high ACE burden in the ED. These outcomes will be utilized to inform hypotheses for future studies and potential interventions aimed at optimizing ED utilization and patient care experience. Conclusion: This study provides novel insight into the relationship between ACE burden and ED utilization while also describing the demographics and experiences of care for ED patients with a high ACE score. Data analysis is on-going.
Studies have consistently shown that subthreshold depression is associated with an increased risk of developing major depression. However, no study has yet calculated a pooled estimate that quantifies the magnitude of this risk across multiple studies.
We conducted a systematic review to identify longitudinal cohort studies containing data on the association between subthreshold depression and future major depression. A baseline meta-analysis was conducted using the inverse variance heterogeneity method to calculate the incidence rate ratio (IRR) of major depression among people with subthreshold depression relative to non-depressed controls. Subgroup analyses were conducted to investigate whether IRR estimates differed between studies categorised by age group or sample type. Sensitivity analyses were also conducted to test the robustness of baseline results to several sources of study heterogeneity, such as the case definition for subthreshold depression.
Data from 16 studies (n = 67 318) revealed that people with subthreshold depression had an increased risk of developing major depression (IRR = 1.95, 95% confidence interval 1.28–2.97). Subgroup analyses estimated similar IRRs for different age groups (youth, adults and the elderly) and sample types (community-based and primary care). Sensitivity analyses demonstrated that baseline results were robust to different sources of study heterogeneity.
The results of this study support the scaling up of effective indicated prevention interventions for people with subthreshold depression, regardless of age group or setting.
Locomotor stereotypies such as weaving and nodding are commonly observed as pre–feeding activity in stabled horses (Cooper, McDonald and Mills, 2001), whilst oral activities such as crib–biting and woodchewing may be associated with the post–feeding period (McGreevy and Nicol, 1998) particularly in horses fed a low–fibre concentrate (Nicol et al., 2002). In this study, we investigated the effect of increasing the number of meals of concentrate whilst maintaining the same daily concentrate intake, on the behaviour of stabled horses with particular reference to stereotypic activities such as weaving and crib–biting. The study was carried out on a working equestrian yard with stables for up to 50 horses.
A pilot study was used to record incidence of stereotypic behaviour and to select subjects for the main study. In this, the behaviour of 30 warm–blooded horses was recorded during their morning (0830h) and afternoon (1630h) concentrate meals. Each meal consisted of 0.5kg of a commercial feed, mixed with 1kg of soaked sugar beet pulp and 0.5kg of chopped hay and straw mixed in a bucket.
Since the 2008 rice crisis, Malaysia's rice policies have been caught between government efforts to raise production and its support of the country's monopoly rice importer (Bernas). This article argues that when the politics behind the country's policies are revealed, the paradox is more apparent than real. The three principal policy components — gratifying Barisan Nasional's coalition partners in East Malaysia by expanding the acreage devoted to rice; buttressing the rural Malay economy by providing subsidies through a yield-enhancing programme; and relying on big business for financial support (Bernas's new owner is one of Malaysia's richest businessmen) — aim to serve the same end: to perpetuate UMNO's political power amid increasing electoral competition.
We describe the investigation of two temporally coincident illness clusters involving salmonella and Staphylococcus aureus in two states. Cases were defined as gastrointestinal illness following two meal events. Investigators interviewed ill persons. Stool, food and environmental samples underwent pathogen testing. Alabama: Eighty cases were identified. Median time from meal to illness was 5·8 h. Salmonella Heidelberg was identified from 27 of 28 stool specimens tested, and coagulase-positive S. aureus was isolated from three of 16 ill persons. Environmental investigation indicated that food handling deficiencies occurred. Colorado: Seven cases were identified. Median time from meal to illness was 4·5 h. Five persons were hospitalised, four of whom were admitted to the intensive care unit. Salmonella Heidelberg was identified in six of seven stool specimens and coagulase-positive S. aureus in three of six tested. No single food item was implicated in either outbreak. These two outbreaks were linked to infection with Salmonella Heidelberg, but additional factors, such as dual aetiology that included S. aureus or the dose of salmonella ingested may have contributed to the short incubation periods and high illness severity. The outbreaks underscore the importance of measures to prevent foodborne illness through appropriate washing, handling, preparation and storage of food.
Weaning is a time at which many different stressors are imposed on the piglet and poor health and performance are significant commercial problems. It is therefore important to understand which factors influence a piglet's adaptation to weaning, and how this might be improved. UK national recording scheme data demonstrate consistently better post-weaning performance for piglets from outdoor breeding herds than for indoor-bred piglets. There are many differences between the outdoor and indoor situation, and these are being systematically investigated. One potential difference which might influence the response to weaning is the greater degree of environmental and social diversity typically experienced by outdoor piglets during lactation.
Fifty-four sows and their litters were allocated according to farrowing date and parity to one of three enrichment treatments: treatments were (1) Control (C) in which litters remained in fully slatted farrowing pens with crates throughout lactation, (2) Socially enriched (SE) in which two adjacent litters were allowed to co-mingle from 12 days of age by removal of the dividing partition, and (3) Environmentally enriched (EE) in which piglets in similar housing were presented with a variety of small moveable objects and a rooting substrate.
The effect of male hierarchy on the sexual activity of individuals is unclear from the recent scientific literature and a clear distinction between the social and sexual aspects of this hierarchy is lacking. Moreover, the effect of male team size on the extent of sexual competition between individuals has not been examined in the recently developed group mating systems for pigs, such as the Dynamic Service System for gilts (DSS). The main objectives of the present study were therefore to examine the effect of boar sexual status on the sexual activity of individuals and the influence of boar team size on the reproductive output of a DSS.
The closely related actions of cortisol and leptin (Ahima & Flier, 2000) are involved with appetite, tissue growth and maturation, energy balance and weight deposition so that resistance to either may lead to obesity. In normal weight humans, plasma leptin and cortisol exhibit diurnal variation, peaking during darkness and late afternoon (respectively). In sheep, the literature consensus is that plasma cortisol levels are greatest during daylight. Ovine plasma leptin is also reported to vary in response to photoperiod-driven changes (Bocquier et al., 1998) and such as alterations in voluntary feed intake as daylength changes. Daily circadian patterns, however, are thought to be entrained by the time of daily feed presentation (Marie et al., 2001). The aim of the present study was to investigate the diurnal variation in ovine plasma leptin in unrestrained animals with ad-lib access to hay and water in relation to their plasma cortisol profile over the same period. Remote blood sampling was employed in order to reduce sampling stress that would affect the animals’ plasma physiology.
Social facilitation has been observed in the stabled horse with access to forage (Sweeting et al. 1985). Socially facilitated feeding behaviour has not been investigated through the provision of concentrates. It is likely that the motivation to ingest a concentrate feed is different to that of forage. In a variety of species social facilitation will only occur when presented with a novel food. Therefore it has been proposed that a function of social facilitation is to increase the acceptance of novel feeds. The first objective of this study therefore, was to investigate if social facilitation occurs with the horse’s standard concentrate feed and or a standard concentrate feed plus a novel flavour.
Visual contact has been found to be a necessary component in the facilitation of forage ingestion. Increasing visual contact between stables improves awareness of conspecifics, which has been linked to a decrease in abnormal behaviour. There has, however, been limited investigation into the relationship between neighbouring stabled horses especially during potentially stressful periods such as meal times. The second objective of this study was to investigate the effects on behaviour of the presence or absence of a familiar horse during meal times.
The heat period at which gilts are bred affects first reproductive performance and overall sow productivity. However, most studies which have examined this subject have confounded chronological age (i.e. days) with physiological age (i.e. number of heat periods experienced) and the importance of each factor remains unclear. The Dynamic Service System (DSS) is a recently developed variant of group mating and the optimum heat period at which gilts should be bred has never been established. This study tested the hypothesis that the physiological age at which gilts are first mated in a DSS will affect their first reproductive behaviour (i.e. mating frequency and quality) and performance.
The problem of understanding the deformation occurring along the Pacific-North American plate boundary in the western United States depends upon understanding the forces which drive the plates in this region. One of the primary sources of our knowledge concerning these forces lies in their manifestation as relative displacements which occur throughout the broad zone of deformation surrounding the San Andreas fault system. It is information concerning the spatial and temporal distribution of these motions which will be of greatest benefit in helping to determine which of several possible mechanisms is responsible for driving contemporary plate motions in this region.
Kummerite, ideally Mn2+Fe3+A1(PO4)2(OH)2.8H2O, is a new secondary phosphate mineral belonging to the laueite group, from the Hagendorf-Süd pegmatite, Hagendorf, Oberpfalz, Bavaria, Germany. Kummerite occurs as sprays or rounded aggregates of very thin, typically deformed, amber yellow laths. Cleavage is good parallel to ﹛010﹜. The mineral is associated closely with green Zn- and Al-bearing beraunite needles. Other associated minerals are jahnsite-(CaMnMn) and Al-bearing frondelite. The calculated density of kummerite is 2.34 g cm 3. It is optically biaxial (-), α= 1.565(5), β = 1.600(5) and y = 1.630(5), with weak dispersion. Pleochroism is weak, with amber yellow tones. Electron microprobe analyses (average of 13 grains) with H2O and FeO/Fe2O3 calculated on structural grounds and normalized to 100%, gave Fe2O3 17.2, FeO 4.8, MnO 5.4, MgO 2.2, ZnO 0.5, Al2O3 9.8, P2O5 27.6, H2O 32.5, total 100 wt.%. The empirical formula, based on 3 metal apfu is (Mn2+0.37Mg0.27Zn0.03Fe2+0.33)Σ1.00(Fe3+1.06Al0. 94)Σ2.00PO4)1.91(OH)2.27(H2O)7.73. Kummerite is triclinic, P1̄, with the unit-cell parameters of a = 5.316(1) Å, b =10.620(3) Å , c = 7.118(1) Å, α = 107.33(3)°, β= 111.22(3)°, γ = 72.22(2)° and V= 348.4(2) Å3. The strongest lines in the powder X-ray diffraction pattern are [dobs in Å(I) (hkl)] 9.885 (100) (010); 6.476 (20) (001); 4.942 (30) (020); 3.988 (9) (̄110); 3.116 (18) (1̄20); 2.873 (11) (1̄21). Kummerite is isostructural with laueite, but differs in having Al and Fe3+ ordered into alternate octahedral sites in the 7.1 Å trans-connected octahedral chains.
Childhood adversity predicts adolescent suicidal ideation but there are few studies examining whether the risk of childhood adversity extends to suicidal ideation in midlife. We hypothesized that childhood adversity predicts midlife suicidal ideation and this is partially mediated by adolescent internalizing disorders, externalizing disorders and adult exposure to life events and interpersonal difficulties.
At 45 years, 9377 women and men from the UK 1958 British Birth Cohort Study participated in a clinical survey. Childhood adversity was prospectively assessed at the ages of 7, 11 and 16 years. Suicidal ideation at midlife was assessed by the depressive ideas subscale of the Revised Clinical Interview Schedule. Internalizing and externalizing disorders were measured by the Rutter scales at 16 years. Life events, periods of unemployment, partnership separations and alcohol dependence were measured through adulthood.
Illness in the household, paternal absence, institutional care, parental divorce and retrospective reports of parental physical and sexual abuse predicted suicidal ideation at 45 years. Three or more childhood adversities were associated with suicidal ideation at 45 years [odds ratio (OR) 4.31, 95% confidence interval (CI) 2.67–6.94]. Psychological distress at 16 years partially mediated the associations of physical abuse (OR 3.41, 95% CI 2.29–5.75), sexual abuse (OR 4.99, 95% CI 2.90–11.16) with suicidal ideation. Adult life events partially mediated the association of parental divorce (OR 6.34, 95% CI −7.16 to 36.75) and physical (OR 9.59, 95% CI 4.97–27.88) and sexual abuse (OR 6.59, 95% CI 2.40–38.36) with suicidal ideation at 45 years.
Adversity in childhood predicts suicidal ideation in midlife, partially mediated by adolescent internalizing and externalizing disorders, adult life events and interpersonal difficulties. Understanding the pathways from adversity to suicidal ideation can inform suicide prevention and the targeting of preventive interventions.
We describe the design and current status of the Degree Angular Scale Interferometer (DASI), a compact cm-wave interferometer operating at the Amundsen-Scott South Pole research station. With 20-cm diameter primary antenna elements operating over the frequency range 26 − 36 GHz, DASI is optimized to measure the power spectrum of the cosmic microwave background radiation (CMBR) over the multipole range 140 − 920, (corresponding to scales of 25′ − 2°.6), as well as make high-sensitivity maps of the microwave sky. The telescope was built at the University of Chicago and deployed at the South Pole during the 1999-2000 austral summer.