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.
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.
Introduction: Identification of latent safety threats (LSTs) in the emergency department is an important aspect of quality improvement that can lead to improved patient care. In situ simulation (ISS) takes place in the real clinical environment and multidisciplinary teams can participate in diverse high acuity scenarios to identify LSTs. The purpose of this study is to examine the influence that the profession of the participant (i.e. physician, registered nurse, or respiratory therapist) has on the identification of LSTs during ISS. Methods: Six resuscitation- based adult and pediatric simulated scenarios were developed and delivered to multidisciplinary teams in the Kingston General Hospital ED. Each ISS session consisted of a 10- minute scenario, followed by 3-minutes of individual survey completion and a 7- minute group debrief led by ISS facilitators. An objective assessor recorded LSTs identified during each debrief. Surveys were completed prior to debrief to reduce response bias. Data was collected on participant demographics and perceived LSTs classified in the following categories: medication; equipment; resources and staffing; teamwork and communication; or other. Two reviewers evaluated survey responses and debrief notes to formulate a list of unique LSTs across scenarios and professions. The overall number and type of LSTs from surveys was identified and stratified by health care provider. Results: Thirteen ISS sessions were conducted with a total of 59 participants. Thirty- four unique LSTs (8 medication, 15 equipment, 5 resource, 4 communication, and 2 miscellaneous issues) were identified from surveys and debrief notes. Overall, MDs (n = 12) reported 19 LSTss (n = 41) reported 77 LSTs, and RTs (n = 6) reported 4 LSTs based on individual survey data. The most commonly identified category of LSTs reported by MDs (36.8%) and RTs (75%) was equipment issues while RNs most commonly identified medication issues (36.4%). Participants with □5 years of experience in their profession, on average identified more LSTs in surveys than participants with >5 years experience (1.9 LSTs vs 1.5 LSTs respectively). Conclusion: Nursing staff identified the highest number of LSTs across all categories. There was fairly unanimous identification of major LSTs across professions, however each profession did identify unique perspectives on LSTs in survey responses. ISS programs with the purpose of LST identification would benefit from multidisciplinary participation.
This Research Communication describes an investigation of the nutritional depletion of total mixed rations (TMR) by pest birds. We hypothesized that species-specific bird depredation of TMR can alter the nutritional composition of the ration and that these changes can negatively impact the performance of dairy cows. Blackbirds selected the high energy fraction of the TMR (i.e., flaked corn) and reduced starch, crude fat and total digestible nutrients during controlled feeding experiments. For Holsteins producing 37·1 kg of milk/d, dairy production modeling illustrated that total required net energy intake (NEI) was 35·8 Mcal/d. For the reference TMR unexposed to blackbirds and the blackbird-consumed TMR, NEI supplied was 41·2 and 37·8 Mcal/d, and the resulting energy balance was 5·4 and 2·0 Mcal/d, respectively. Thus, Holsteins fed the reference and blackbird-consumed TMR were estimated to gain one body condition score in 96 and 254 d, and experience daily weight change due to reserves of 1·1 and 0·4 kg/d, respectively. We discuss these results in context of an integrated pest management program for mitigating the depredation caused by pest birds at commercial dairies.
Cryptosporidium is a protozoan parasite that causes the diarrhoeal disease, cryptosporidiosis. Although many species have been identified, the majority of human disease worldwide is caused by two species; Cryptosporidium parvum and Cryptosporidium hominis. In Australia, data from the National Notifiable Diseases Surveillance System (NNDSS) show that cryptosporidiosis outbreaks occur every few years. To better understand the transmission, trends and nature of cryptosporidiosis outbreaks in Western Australia, epidemiological and genomic data from three cryptosporidiosis outbreaks in 2003, 2007 and 2011 were reviewed. The 2007 outbreak was the largest (n = 607) compared with the outbreaks in 2003 (n = 404) and 2011 (n = 355). All three outbreaks appeared to have occurred predominantly in the urban metropolitan area (Perth), which reported the highest number of case notifications; increases in case notifications were also observed in rural and remote areas. Children aged 0–4 years and non-Aboriginal people comprised the majority of notifications in all outbreaks. However, in the 2003 and 2007 outbreaks, a higher proportion of cases from Aboriginal people was observed in the remote areas. Molecular data were only available for the 2007 (n = 126) and 2011 (n = 42) outbreaks, with C. hominis the main species identified in both outbreaks. Subtyping at the glycoprotein 60 (gp60) locus identified subtype IbA10G2 in 46.3% and 89.5% of C. hominis isolates typed, respectively, in the 2007 and 2011 outbreaks, with the IdA15G1 subtype was identified in 33.3% of C. hominis isolates typed in the 2007 outbreak. The clustering of cases with the IdA15G1 subtype in the remote areas suggests the occurrence of a concurrent outbreak in remote areas during the 2007 outbreak, which primarily affected Aboriginal people. Both the C. hominis IbA10G2 and IdA15G1 subtypes have been implicated in cryptosporidiosis outbreaks worldwide; its occurrence indicates that the mode of transmission in both the 2007 and 2011 outbreaks was anthroponotic. To better understand the epidemiology, sources and transmission of cryptosporidiosis in Australia, genotyping data should routinely be incorporated into national surveillance programmes.
To identify predominant dietary patterns in four African populations and examine their association with obesity.
We used data from the Africa/Harvard School of Public Health Partnership for Cohort Research and Training (PaCT) pilot study established to investigate the feasibility of a multi-country longitudinal study of non-communicable chronic disease in sub-Saharan Africa. We applied principal component analysis to dietary intake data collected from an FFQ developed for PaCT to ascertain dietary patterns in Tanzania, South Africa, and peri-urban and rural Uganda. The sample consisted of 444 women and 294 men.
We identified two dietary patterns: the Mixed Diet pattern characterized by high intakes of unprocessed foods such as vegetables and fresh fish, but also cold cuts and refined grains; and the Processed Diet pattern characterized by high intakes of salad dressing, cold cuts and sweets. Women in the highest tertile of the Processed Diet pattern score were 3·00 times more likely to be overweight (95 % CI 1·66, 5·45; prevalence=74 %) and 4·24 times more likely to be obese (95 % CI 2·23, 8·05; prevalence=44 %) than women in this pattern’s lowest tertile (both P<0·0001; prevalence=47 and 14 %, respectively). We found similarly strong associations in men. There was no association between the Mixed Diet pattern and overweight or obesity.
We identified two major dietary patterns in several African populations, a Mixed Diet pattern and a Processed Diet pattern. The Processed Diet pattern was associated with obesity.
Family-based strategies to reduce the risk of overweight in childhood are needed in the Caribbean.
To investigate the associations between parental characteristics and risk of overweight and explore possible mechanisms.
Data from a parenting intervention were analysed. Parental characteristics were obtained by questionnaire at enrolment. At 18 months, 501 infants (82.9% of cohort) had weight and length measured using standardized methods. The association of parents’ characteristics with risk of infant overweight was assessed using random-effects logistic regression. Four focus groups among mothers in Jamaica were conducted to explore mechanisms.
Overall, 20.6% of infants were ‘at risk of overweight’. Fathers were present in 52% of households. Fathers’ presence [OR (95% CI) 0.60 (0.37–0.96)] was associated with reduced risk of overweight independent of socioeconomic status. Mothers reported that fathers encouraged healthier practices.
Fathers may be important agents of change in intervention strategies to prevent childhood overweight.
In sub-Saharan Africa, there are limited data on burden of non-alcohol substance abuse (NAS) and depressive symptoms (DS), yet potential risk factors such as alcohol and intimate partner violence (IPV) are common and NAS abuse may be the rise. The aim of this study was to measure the burden of DS and NAS abuse, and determine whether alcohol use and IPV are associated with DS and/or NAS abuse. We conducted a cross-sectional study at five sites in four countries: Nigeria (nurses), South Africa (teachers), Tanzania (teachers) and two sites in Uganda (rural and peri-urban residents). Participants were selected by simple random sampling from a sampling frame at each of the study sites. We used a standardized tool to collect data on demographics, alcohol use and NAS use, IPV and DS and calculated prevalence ratios (PR). We enrolled 1415 respondents and of these 34.6% were male. DS occurred among 383 (32.3%) and NAS use among 52 (4.3%). In the multivariable analysis, being female (PR = 1.49, p = 0.008), NAS abuse (PR = 2.06, p = 0.02) and IPV (PR = 2.93, p < 0.001) were significantly associated with DS. Older age [odds ratio (OR) = 0.31, p < 0.001)], female (OR = 0.48, p = 0.036) were protective of NAS but current smokers (OR = 2.98, p < 0.001) and those reporting IPV (OR = 2.16, p = 0.024) were more likely to use NAS. Longitudinal studies should be done to establish temporal relationships with these risk factors to provide basis for interventions.
A major challenge in addressing the loss of benefits and services provided by the natural environment is that it can be difficult to find ways for those who benefit from them to pay for their preservation. We examine one such context in Malawi, where erosion from soils disturbed by agriculture affects not only farmers’ incomes, but also damages aquatic habitat and inhibits the storage and hydropower potential of dams downstream. We demonstrate that payments from hydropower producers to farmers to maintain land cover and prevent erosion can have benefits for all parties involved.
The molecular, neurobiological, and physical health impacts of child maltreatment are well established, yet mechanistic pathways remain inadequately defined. Telomere length (TL) decline is an emerging molecular indicator of stress exposure with definitive links to negative health outcomes in maltreated individuals. The multiple confounders endemic to human maltreatment research impede the identification of causal pathways. This study leverages a unique randomized, cross-foster, study design in a naturalistic translational nonhuman primate model of infant maltreatment. At birth, newborn macaques were randomly assigned to either a maltreating or a competent control mother, balancing for sex, biological mother parenting history, and social rank. Offspring TL was measured longitudinally across the first 6 months of life (infancy) from peripheral blood. Hair cortisol accumulation was also determined at 6, 12, and 18 months of age. TL decline was greater in animals randomized to maltreatment, but also interacted with biological mother group. Shorter TL at 6 months was associated with higher mean cortisol levels through 18 months (juvenile period) when controlling for relevant covariates. These results suggest that even under the equivalent social, nutritional, and environmental conditions feasible in naturalistic translational nonhuman primate models, early adverse caregiving results in lasting molecular scars that foreshadow elevated health risk and physiologic dysregulation.
We present multi–epoch VLBI observations of the methanol and water masers in the high–mass star formation region G 339.884−1.259, made using the Australian Long Baseline Array (LBA). Our sub–milliarcsecond precision measurements trace the proper motions of individual maser features in the plane of the sky. When combined with the direct line–of–sight radial velocity (vlsr), these measure the 3 D gas kinematics of the associated high–mass star formation region, allowing us to probe the dynamical processes to within 1000 AU of the core.
We are currently performing a monitoring program of the 1612 MHz OH maser emission of several dozen Galactic disk OH/IR stars with the Nancay Radio Telescope (NRT). They are complemented by several OH/IR stars toward the Galactic center, which were monitored with the Hartebeesthoek radio telescope. We use the maser variations to probe the underlying stellar variability. As early monitoring programs already have shown, some stars are large amplitude variables with periods up to 7 years, others show small or even no amplitude variations. This dichotomy in the variability behaviour is assumed to mark the border between the AGB and the post-AGB stages. With the current program, we wish to find objects in transition and to describe their variability properties. We consider the fading out of pulsations with steadily declining amplitudes as a viable process. Promising candidates in the disk are the small-amplitude variables OH 138.0+7.2 and OH 51.8−0.2. ’Non-variable’ OH/IR stars in the Galactic center region may be as frequent as in the disk.
In the current paper we describe results of an extensive and refined analysis which shows that the beaming leads to considerable changes in the model line ratios and brightness estimates. For example, beaming shifts the locus of the brightest masers to the lower values of the gas densities. Recent theoretical paper by Leurini et al. (2016) presented extensive consideration of the Class I methanol maser (MMI) pumping. Their study allowed to distinguish only 3 of 4 MMI pumping regimes found in Sobolev et al. (2005) and Sobolev et al. (2007) on the basis of analysis of observational data combined with theoretical considerations. The regime when the line from the J−2 − (J − 1)−1E series is the brightest was missing in Leurini et al. (2016) results. This may be explained by considering the fact that the authors did not take into account considerable beaming effects.
The dwarf galaxies in the Local Group (LG) reveal a surprising amount of spatial structuring. In particular, almost all non-satellite dwarfs belong to one of two planes that show a very pronounced symmetry. In order to determine if these structures in the LG are dynamically stable or, alternatively, if they only represent transient alignments, proper motion measurements of these galaxies are required. A viable method to derive proper motions is offered by VLBI studies of 22-GHz water (and 6.7-GHz methanol) maser lines in star-forming regions.
In 2016, in the framework of the Early Science Program of the Sardinia Radio Telescope (SRT), we have conducted an extensive observational campaign to map the entire optical body of all the LG dwarf galaxies that belong to the two planes, at C and K band, in a search for methanol and water maser emission.
Here, we outline the project and present its first results on 3 targets, NGC 6822, IC 1613, and WLM. While no luminous maser emission has been detected in these galaxies, a number of interesting weaker detections has been obtained, associated with particularly active star forming regions. In addition, we have produced deep radio continuum maps for these galaxies, aimed at investigating their star forming activity and providing an improved assessment of star formation rates in these galaxies.
Variable OH/IR stars are Asymptotic Giant Branch (AGB) stars with an optically thick circumstellar envelope that emit strong OH 1612 MHz emission. They are commonly observed throughout the Galaxy but also in the LMC and SMC. Hence, the precise inference of the distances of these stars will ultimately result in better constraints on their mass range in different metallicity environments. Through a multi-year long-term monitoring program at the Nancay Radio telescope (NRT) and a complementary high-sensitivity mapping campaign at the eMERLIN and JVLA to measure precisely the angular diameter of the envelopes, we have been re-exploring distance determination through the phase-lag method for a sample of stars, in order to refine the poorly-constrained distances of some and infer the currently unknown distances of others. We present here an update of this project.
We present Kitty, an unprecedented and near simultaneous flaring event in ten transitions (6 hydroxyl, 1 water and 3 methanol), that began on 1 January 2015 in the massive star-forming region NGC6334F located in the Cat’s Paw Nebula. The brightest components in each transition increased by factors of 20 to 70 in line with a factor of ~70 increase in dust emission luminosity for the source MM1. We also report the detection of only the fifth known 4.660 GHz hydroxyl maser and that it varied in a correlated fashion with 1.720, 6.031, and 6.035 GHz hydroxyl counterparts. We postulate that if Kitty, and two historical flares in 1965 & 1999, are accretion events and are caused by the successive passages of a secondary star disrupting the accretion disk, where the frequency of occurrence is cycling down at a rate of ~2.2, it is possible another event will occur in 2022.
The first periodic Class II methanol maser was reported on in 2003. Since that time, a number of different monitoring programmes have found periodic masers, as well as other modes of variability. In a few cases, periodicity has been found in other maser species such as formaldehyde and water. Several distinct characteristics of light curves have been noted, possibly pointing to different underlying mechanisms for periodicity if one assumes a linear response to incoming radiation. I will give a brief overview of the known periodic sources, discuss current theories, and present new results obtained from monitoring mainline hydroxyl masers using the seven-element Karoo Array Telescope (KAT-7) during its science verification phase.
The Central Molecular Zone (CMZ), the inner 450 pc of our Galaxy, is an exceptional region where the volume and column densities, gas temperatures, velocity dispersions, etc. are much higher than in the Galactic plane. It has been suggested that the formation of stars and clusters in this area is related to the orbital dynamics of the gas. The complex kinematic structure of the molecular gas was revealed by spectral line observations. However, these results are limited to the line-of-sight-velocities. To fully understand the motions of the gas within the CMZ, we have to know its location in 6D space (3D location + 3D motion). Recent orbital models have tried to explain the inflow of gas towards and its kinematics within this region. With parallax and proper motion measurements of masers in the CMZ we can discriminate among these models and constrain how our Galactic Center is fed with gas.