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In Canada, recreational use of cannabis was legalized in October 2018. This policy change along with recent publications evaluating the efficacy of cannabis for the medical treatment of epilepsy and media awareness about its use have increased the public interest about this agent. The Canadian League Against Epilepsy Medical Therapeutics Committee, along with a multidisciplinary group of experts and Canadian Epilepsy Alliance representatives, has developed a position statement about the use of medical cannabis for epilepsy. This article addresses the current Canadian legal framework, recent publications about its efficacy and safety profile, and our understanding of the clinical issues that should be considered when contemplating cannabis use for medical purposes.
Patient assessment is a fundamental feature of community paramedicine, but the absence of a recognized standard for assessment practices contributes to uncertainty about what drives care planning and treatment decisions. Our objective was to summarize the content of assessment instruments and describe the state of current practice in community paramedicine home visit programs.
We performed an environmental scan of all community paramedicine programs in Ontario, Canada, and used content analysis to describe current assessment practices in home visit programs. The International Classification on Functioning, Disability, and Health (ICF) was used to categorize and compare assessments. Each item within each assessment form was classified according to the ICF taxonomy.
A total of 43 of 52 paramedic services in Ontario, Canada, participated in the environmental scan with 24 being eligible for further investigation through content analysis of intake assessment forms. Among the 24 services, 16 met inclusion criteria for content analysis. Assessment forms contained between 13 and 252 assessment items (median 116.5, IQR 134.5). Most assessments included some content from each of the domains outlined in the ICF. At the subdomain level, only assessment of impairments of the functions of the cardiovascular, hematological, immunological, and respiratory systems appeared in all assessments.
Although community paramedicine home visit programs may differ in design and aim, all complete multi-domain assessments as part of patient intake. If community paramedicine home visit programs share similar characteristics but assess patients differently, it is difficult to expect that the resulting referrals, care planning, treatments, or interventions will be similar.
There is now widespread agreement on the importance of men's role in reproductive decision-making. Several studies have argued that fertility preferences and their translation into behaviour differ between polygamous and monogamous unions. Studies investigating the dominance of men's preferences over women's preferences, in cases of couple disagreement, found mixed evidence of the effect of polygamy. However, an often cited limitation of these studies has been the inability to link husband's intention with each of his wives in a polygamous union. By adding fertility-intention questions to an on-going Demographic Surveillance Site in Karonga District in northern Malawi the fertility preferences and contraceptive use of husbands and wives were investigated. An analysis of the relationship between the level of agreement and disagreement between husbands' and wives' fertility preferences was then performed to gain insight into the reproductive decision-making process of polygamous couples.
The 3CR catalogue provides a statistical sampling of the most powerful radio galaxies out to z ∼ 0.3. Over the decade and a half of Hubble observations we have amassed a major multi-wavelength dataset on these sources, discovering amongst other things, new jets, hotspots, dust disks, and faint point-like nuclei. We present here the results of our latest snapshot survey, a near-complete sampling of the 3CR host galaxies at z < 0.3 in the near-IR (H-band). This un-extinguished view of the host galaxies has provided us with an accurate measure of the stellar/spheroid masses of the sources, and an unbiased view of their morphologies. We show that they exhibit an identical Kormendy relation to nearby QSO's and the massive Elliptical population, but are distinct from the Brightest Cluster Members, and mergers. We find that while a few sources exhibit signs of a recent or impending major merger, many more sources have remnants consistent with a gas-rich minor merger in their recent history. We detect unresolved nuclear sources in most (∼80%) of FRI, with their IR luminosities correlating linearly with radio core power. This implies that the IR nuclei are synchrotron radiation produced at the base of the relativistic jet, and confirms that no infrared (thermal) radiation in excess to synchrotron is present in FRIs, unlike in other classes of AGN.
Using HST WFPC2 and NICMOS observations, and our 2D image weighting and modelling technique (Floyd et al. 2004), we have reliably disentangled host from nucleus for nine optically matched radio-loud quasars (RLQ) and nine radio-quiet quasars (RQQ) at z = 1&2, in two bands spanning the 4000Å break. The resulting galaxy colours provide the first unbiased estimates of galaxy mass for a statistical sample of quasars at high redshift, and indicates a difference in the evolution of radio-loud and radio-quiet objects.
More than 36000 individuals living in rural Malawi were skin tested with antigens derived from 12 different species of environmental mycobacteria. Most were simultaneously tested with RT23 tuberculin, and all were followed up for both tuberculosis and leprosy incidence. Skin test results indicated widespread sensitivity to the environmental antigens, in particular to Mycobacterium scrofulaceum, M. intracellulare and one strain of M. fortuitum. Individuals with evidence of exposure to ‘fast growers’ (i.e. with induration to antigens from fast growers which exceeded their sensitivity to tuberculin), but not those exposed to ‘slow growers’, were at reduced risk of contracting both tuberculosis and leprosy, compared to individuals whose indurations to the environmental antigen were less than that to tuberculin. This evidence for cross protection from natural exposure to certain environmental mycobacteria may explain geographic distributions of mycobacterial disease and has important implications for the mechanisms and measurement of protection by mycobacterial vaccines.
Progress in the neurobiology of childhood anxiety has recently focused on the effects of rearing and environment in the progression of anxiety states. Convergence of evidence from both child studies of stress and trauma (Pfefferbaum, 1997; Pynoos, Steinberg & Wrath, 1995) as well as primate rearing and deprivation studies (Coplan et al., 1996; Higley, Suomi & Linnoila, 1992) illustrate that the effects of stress in the genesis of anxiety disorder can be profound. Anxiety disorders are now viewed from a developmental perspective (Ollendick, 1998; Rosenberg & Keshavan, 1998) in which an individual's history of exposure to threat and that threat's developmental and cognitive context are interwoven with internal factors (e.g. genetic and neurophysiological) as keys to the individual's ‘stress-response system’. Later in this chapter, neuroanatomical and information processing models of panic and childhood obsessive–compulsive disorders (OCD) are discussed in their developmental context in order to shed light on both the development of anxiety disorder and its frequent association with comorbid conditions, such as attention-deficit hyper-activity disorder (ADHD), in child psychiatry. The implication is clear: anxiety disorders, now viewed across the life span (Ballenger, 1997; Lydiard & Brawman-Mintzer, 1997), require treatments that reflect both the developmental stage and context of anxiety disorder genesis and maintenance.
Our understanding of the neurobiology of anxiety has been propelled by new pharmacological therapeutic tools specific in their impact on certain central nervous system (CNS) receptors within the ‘stress-response system’.
A telephone survey of Montana residents was undertaken to determine their knowledge of noxious weeds, their attitudes toward noxious weeds, how they use the outdoors with respect to spreading noxious weeds, and the best methods to distribute information to those most unaware about noxious weeds. Most Montanans (76%) thought that noxious weeds were a serious or very serious problem. Respondents from central (67%) and southwestern (59%) Montana were more likely to evaluate the noxious weed problem as serious than respondents from western (37%) or southeastern (33%) Montana. Most Montanans (80%) could name a problem associated with noxious weed invasion. Farmers and operators of non-farm machinery knew more problems associated with weeds than people not involved in these activities. Respondents knew ways weeds spread (89%) but many could not think of ways to prevent weed spread (70%) or identify activities they participate in that might spread weeds (64%). Television (89%) and newspaper stories (85%) were mentioned most often as the most effective ways to distribute information about noxious weeds.
Prominent aeromagnetic anomalies around Ballantrae in southwest Scotland have long been associated with extensive outcrops of basic/ultrabasic igneous rocks in the Midland Valley terrane. However, recent reprocessing of data from a 1978 detailed aeromagnetic survey has demonstrated excellent correlation between discrete aeromagnetic features and certain magnetic greywacke formations within the early Caradoc Tappins Group. This heterogeneous unit forms the oldest and most northwesterly tectonostratigraphic tract in the Southern Uplands terrane and is characterized by relatively high detrital magnetite(and serpentinite) content and elevated values for Cr and Ni. This suggests original close sedimentary links with an ophiolitic terrane not unlike the presently adjacent Ballantrae Complex (or its extensive along-strike correlatives), a consideration which has important implications for terrane reconstructions in this region.
The meta-igneous greenschists of the Start Complex, SouthDevon, are composed of a mineralogically uniform, but texturally variable, actinolite-epidote-albite assemblage with retrogressed variants containing chlorite, muscovite, sphene, carbonate and oxidized opaque minerals. Geochemically they represent a suite of relatively primitive tholeiites, exhibiting mild differentiation, depleted incompatible element abundances, and variable light rare-earth-element-depletion patterns comparable to modern basalts from normal spreading ridge segments (N-MORB). As the Start greenschistsexhibit a number of chemical similarities to the nearby Upper Palaeozoic Lizard ophiolite, and MORB-type clasts within the Rhenohercynian Zone generally, they may also represent local Variscan ocean crust, which floored smalloceanic basins that separated the Old Red Sandstone continent from the Armorican microplate to the south. The Start Complex could thus represent a previously unrecognized oceanic component to the Variscan orogenic belt (Rhenohercynian Zone) of Northwest Europe.
We conducted a prospective environmental study for Legionella pneumophila in 15 hospitals in Pennsylvania. Hot water tanks, cold water sites, faucets, and show-erheads were surveyed four times over a one-year period. Sixty percent (9/15) of hospitals surveyed were contaminated with L pneumophila. Although contamination could not be linked to a specific municipal water supplier, most of the contaminated supplies came from rivers. Parameters found to be significantly associated with contamination included elevated hot water temperature, vertical configuration of the hot water tank, older tanks, and elevated calcium and magnesium concentrations of the water (P < 0.05). This study suggests that L pneumophila contamination could be predicted based on design of the distribution system, as well as physicochemical characteristics of the water.
Immunology and ear diseases finally have met each other. There are several ear diseases associated with hearing loss, vertigo, tinnitus. These include Menière's Disease, otosclerosis and autoimmune sensorineural hearing loss. These diseases have immunologic manifestations.
Nodulation and N2-fixation of groundnut were investigated in sole and intercropping systems. Intercropping with pearl millet, maize, or sorghum reduced nodulation and N2-fixation. This effect is ascribed to the shading of groundnut by the cereal component and the consequent decrease in photosynthesis of the legume canopy.
Just as the colonial trade created commercial elites in Spain, so, too, did businessmen rise to economic and social importance in the New World. In Central America, for example, the marketers of indigo played an especially significant role.
Prehistoric human and nonhuman feces from alcoves in the Glen Canyon region of southern Utah are a rich source of pollen and spores. The dominant pollen types (determined in a 200-grain pollen count) vary greatly from sample to sample, making stratigraphic and climatic interpretation very difficult. The record of economic plant pollen appears to reflect the prehistoric Pueblo diet. Cleome, Zea, Cucurbita, and Opuntia are the most abundant economic pollen types. Long-distance transport of pollen from distant montane forests will account for the presence of occasional pollen grains of spruce, fir, and alder in certain samples. The salvage and study of ancient human feces promises to reveal new information about the environment and diet of prehistoric man in the Southwest, a development of interest to both the ecologist and the ethnobotanist.