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Low intensity subsistence agriculture is generally believed to be less damaging to wildlife than intensive farming. As Myanmar is undergoing rapid modernization, subsistence farming may shift to intensive agriculture, resulting in increased threats to species of conservation concern such as the green peafowl Pavo muticus. Here we investigate habitat use of the green peafowl in a low intensity agricultural landscape surrounding a small forest fragment in southern Shan State, Myanmar. The forest belongs to Nan Kone Buddha Monastery and the green peafowl is protected from hunting in the area on the basis of religious beliefs. We established three survey transects with a total length of 3,414 m. During February 2016–January 2017 we conducted surveys twice daily for 4 consecutive days every month, walking all transects in both directions in the mornings and afternoons and recording visual and auditory peafowl encounters. We estimated peafowl density to be 2.63 animals/km2 in the less disturbed western part of the study area and 1.13 animals/km2 in the eastern part, which had higher levels of human disturbance. The peafowl's habitat use was significantly non-random, with forest patches being the most utilized habitat, followed by croplands. Within a 300 m buffer zone around the forest patch, the order of habitat preference was crop > scrub > fallow, with crop significantly preferred over the other two habitats. We conclude that preserved isolated forest blocks adjacent to community-managed agricultural areas are important for green peafowl conservation, and discuss the implications for long-term conservation management of the species.
Thirty-two percent of bird species in South-East Asia are likely to become extinct by the end of this century. However, due to a lack of data this number may be an underestimate. The Chestnut-headed Partridge Arborophila cambodiana found in south-west Cambodia’s Cardamom Mountain range is a largely unknown potentially at-risk species. We used line transects and camera traps to survey A. cambodiana in four protected areas in the Cardamom Mountains to estimate population densities. We also assessed their current distribution range and broad scale habitat changes from 1996 to 2016. We found A. cambodiana in evergreen and semi-evergreen forest at a density of 1.23 calling males/km2, and at altitudes above 400 m and where the slope was between 11 and 43o. From 1996 to 2016 A. cambodiana’s potential habitat decreased by 11%, whilst the total evergreen forest cover in the Cardamom Mountains decreased by 20%. A. cambodiana has a very restricted range within which the habitat has been fragmented. Compounded by human disturbance and development activities that negatively affect the species, we suggest a revision of its IUCN Red List status from ‘Least Concern’ to ‘Near Threatened’ as it partially meets a range of threatened Red List species criteria.
How do people answer polar questions? In this fourteen-language study of answers to questions in conversation, we compare the two main strategies; first, interjection-type answers such as uh-huh (or equivalents yes, mm, head nods, etc.), and second, repetition-type answers that repeat some or all of the question. We find that all languages offer both options, but that there is a strong asymmetry in their frequency of use, with a global preference for interjection-type answers. We propose that this preference is motivated by the fact that the two options are not equivalent in meaning. We argue that interjection-type answers are intrinsically suited to be the pragmatically unmarked, and thus more frequent, strategy for confirming polar questions, regardless of the language spoken. Our analysis is based on the semantic-pragmatic profile of the interjection-type and repetition-type answer strategies, in the context of certain asymmetries inherent to the dialogic speech act structure of question–answer sequences, including sequential agency and thematic agency. This allows us to see possible explanations for the outlier distributions found in ǂĀkhoe Haiǁom and Tzeltal.
The Virtual Personalities Model is a motive-based neural network model that provides both a psychological model and a computational implementation that explicates the dynamics and often large within-person variability in behavior that arises over time. At the same time the same model can produce—across many virtual personalities—between-subject variability in behavior that when factor analyzed yields familiar personality structure (e.g., the Big Five). First, we describe our personality model and its implementation as a neural network model. Second, we focus on detailing the neurobiological underpinnings of this model. Third, we examine the learning mechanisms, and their biological substrates, as ways that the model gets “wired up,” discussing Pavlovian and Instrumental conditioning, Pavlovian to Instrumental transfer, and habits. Finally, we describe the dynamics of how initial differences in propensities (e.g., dopamine functioning), wiring differences due to experience, and other factors could operate together to develop and change personality over time, and how this might be empirically examined. Thus, our goal is to contribute to the rising chorus of voices seeking a more precise neurobiologically based science of the complex dynamics underlying personality.
The Reformation in Ireland has traditionally been seen as an unmitigated failure. This article contributes to current scholarship that is challenging this perception by conceiving the sixteenth-century Irish Church as part of the English Church. It does so by examining the episcopal career of John Bale, bishop of Ossory, County Kilkenny, 1552–3. Bale wrote an account of his Irish experience, known as the Vocacyon, soon after fleeing his diocese upon the accession of Queen Mary to the English throne and the subsequent restoration of Roman Catholicism. The article considers Bale's episcopal career as an expression of the relationship between Church and state in mid-Tudor England and Ireland. It will be shown that ecclesiastical reform in Ireland was complemented by political subjugation, and vice versa. Having been appointed by Edward VI, Bale upheld the royal supremacy as justification for implementing ecclesiastical reform. The combination of preaching the gospel and enforcing the 1552 Prayer Book was, for Bale, the best method of evangelism. The double effect was to win converts and align the Irish Church with the English form of worship. Hence English reformers exploited the political dominance of England to export their evangelical faith into Ireland.
This study determines the prevalence of inadequate micronutrient intakes consumed by long-term care (LTC) residents. This cross-sectional study was completed in thirty-two LTC homes in four Canadian provinces. Weighed and estimated food and beverage intake were collected over 3 non-consecutive days from 632 randomly selected residents. Nutrient intakes were adjusted for intra-individual variation and compared with the Dietary Reference Intakes. Proportion of participants, stratified by sex and use of modified (MTF) or regular texture foods, with intakes below the Estimated Average Requirement (EAR) or Adequate Intake (AI), were identified. Numbers of participants that met these adequacy values with use of micronutrient supplements was determined. Mean age of males (n 197) was 85·2 (sd 7·6) years and females (n 435) was 87·4 (sd 7·8) years. In all, 33 % consumed MTF; 78·2 % (males) and 76·1 % (females) took at least one micronutrient pill. Participants on a MTF had lower intake for some nutrients (males=4; females=8), but also consumed a few nutrients in larger amounts than regular texture consumers (males=4; females =1). More than 50 % of participants in both sexes and texture groups consumed inadequate amounts of folate, vitamins B6, Ca, Mg and Zn (males only), with >90 % consuming amounts below the EAR/AI for vitamin D, E, K, Mg (males only) and K. Vitamin D supplements resolved inadequate intakes for 50–70 % of participants. High proportions of LTC residents have intakes for nine of twenty nutrients examined below the EAR or AI. Strategies to improve intake specific to these nutrients are needed.
The low (high) abnormal returns of stocks with high (low) beta, which we refer to as the beta anomaly, is one of the most persistent anomalies in empirical asset pricing research. This article demonstrates that investors’ demand for lottery-like stocks is an important driver of the beta anomaly. The beta anomaly is no longer detected when beta-sorted portfolios are neutralized to lottery demand, regression specifications control for lottery demand, or factor models include a lottery demand factor. The beta anomaly is concentrated in stocks with low levels of institutional ownership and it exists only when the price impact of lottery demand is concentrated in high-beta stocks.
OBJECTIVES/SPECIFIC AIMS: This research project envisions the integration of Homeless Management Information System (HMIS) and UI Health Cerner electronic medical record (EMR) system with the following goals: (1) enable sharing of data about the status of the housing insecure and homeless. (2) Identify and match patient record accurately. (3) Record housing insecurity or homelessness information with structured data elements in the EMR. METHODS/STUDY POPULATION: We created a Master Person Index (MPI) of the homeless individuals from HMSI using OpenEMPI software package, which is an open source implementation of an Enterprise Master Patient Index (EMPI). An entity model was generated based on the selective data elements from HMIS database, which were relevant for the patient identity management and healthcare service management. An automated script was implemented to extract data from HMIS and load it into OpenEMPI to build the MPI. Once the MPI is setup, the Emergency Department users were able to perform patient identity matching and confirm housing insecure or homeless status of their patients by querying the index using the web-based tool. We developed structured data elements to record homelessness information, which will allow us to measure the prevalence of this risk among patients. We are also exploring the possibility to integrate the systems the using the IHE PIX/PDQ profile, which provides ways for healthcare applications to query a patient information server for a patient based on user-defined search criteria, and retrieve a patient’s information directly into the application. RESULTS/ANTICIPATED RESULTS: We implemented a MPI of homeless individuals, which would allow the emergency department users to perform patient identity matching of housing insecure or homeless patients, without undue privacy intrusions. We are confident that IHE PIX/PDQ profile is able to support the integration of healthcare and housing and homeless services systems and enable the data sharing in an efficient way. DISCUSSION/SIGNIFICANCE OF IMPACT: The project addressed the gap in the sharing of data about housing insecure or homeless persons between healthcare and housing and social services that will result in improvements in coordination of care, reduce the cycle time from recognition of risk to the referral to housing and services and improve health outcomes and residential stability. Successful completion of this integration project will give us a model that we can scale to many other communities.
The South-East Asian ranges of two narrow-geographical range species, Germain’s Peacock Pheasant Polyplectron germaini (GPP) and Orange-necked Partridge Arborophila davidi (ONP) have been shrinking due to pressures from anthropogenic activities. To improve our knowledge of population densities of Germain’s Peacock Pheasant and the Orange-necked Partridge in their remaining habitats, their current and historical distribution range, and the contraction of their distribution range as a surrogate for population declines, we carried out line and point transect surveys in protected areas in southern Vietnam to estimate their density and subsequently model their habitat associations. Our results consistently showed that the density of the GPP was not significantly different among mosaic, evergreen, or mixed deciduous forests, but appeared to be notably lower in bamboo forest, while the density of the ONP was highest in evergreen and mosaic forests and lower in bamboo, with no detections in mixed-deciduous forest. GPP was mostly found close to water sources in mosaic, evergreen and mixed-deciduous forests. The presence of ONP was positively associated with elevation, evergreen and mosaic forest. Primary forest loss, mainly in the lowlands, within the ranges of both species was at least 70% over the last 70 years, suggesting that suitable habitats within the range of both species may have shrunk by at least 60–70%. In addition, a number of threats still occur in their remaining suitable habitats, making them increasingly vulnerable in the long-term, if conservation interventions, such as increased protection, are not implemented.
In Thailand, as for most of South-East Asia, large vertebrates are declining rapidly due to habitat degradation and increasing hunting pressure. Once relatively common in the evergreen forest of Southern Thailand, the Great Argus Argusianus argus is currently limited to a few populations, whose status is currently unknown. In this study we investigated changes in Great Argus abundance over the past 13 years in Hala-Bala Wildlife Sanctuary. Our aim was to estimate and compare the abundance and density of this species from an earlier two-year survey in 2001–2002 and ours in 2014, and to assess the effect of landscape change on its status of the species. We conducted surveys from March to August 2014 during the breeding season. We placed point counts that overlapped the line transects from the 2001–2002 survey. The results indicated a decline of > 35% in mean abundance from 2001 to 2014. In addition, male abundance has shifted and is now positively related to distance from the forest edge. High levels of human disturbance close to the forest edge may have resulted in the birds moving to the core of the forest, suggesting a need to increase protection and management of forest edge areas. In common with other studies of large vertebrates, our results confirm the importance of long-term studies to highlight the negative effects of human disturbance.
New paediatric cardiology trainees are required to rapidly assimilate knowledge and gain clinical skills to which they have limited or no exposure during residency. The Pediatric Cardiology Fellowship Boot Camp (PCBC) at Boston Children’s Hospital was designed to provide incoming fellows with an intensive exposure to congenital cardiac pathology and a broad overview of major areas of paediatric cardiology practice.
The PCBC curriculum was designed by core faculty in cardiac pathology, echocardiography, electrophysiology, interventional cardiology, exercise physiology, and cardiac intensive care. Individual faculty contributed learning objectives, which were refined by fellowship directors and used to build a programme of didactics, hands-on/simulation-based activities, and self-guided learning opportunities.
A total of 16 incoming fellows participated in the 4-week boot camp, with no concurrent clinical responsibilities, over 2 years. On the basis of pre- and post-PCBC surveys, 80% of trainees strongly agreed that they felt more prepared for clinical responsibilities, and a similar percentage felt that PCBC should be offered to future incoming fellows. Fellows showed significant increase in their confidence in all specific knowledge and skills related to the learning objectives. Fellows rated hands-on learning experiences and simulation-based exercises most highly.
We describe a novel 4-week-long boot camp designed to expose incoming paediatric cardiology fellows to the broad spectrum of knowledge and skills required for the practice of paediatric cardiology. The experience increased trainee confidence and sense of preparedness to begin fellowship-related responsibilities. Given that highly interactive activities were rated most highly, boot camps in paediatric cardiology should strongly emphasise these elements.
Neuropsychiatric Symptoms (NPS) are ubiquitous in dementia and are often treated pharmacologically. The objectives of this study were to describe the use of psychotropic, anti-cholinergic, and deliriogenic medications and to identify the prevalence of polypharmacy and psychotropic polypharmacy, among older hospitalized patients in Ireland, with and without dementia.
All older patients (≥ 70 years old) that had elective or emergency admissions to six Irish study hospitals were eligible for inclusion in a longitudinal observational study. Of 676 eligible patients, 598 patients were recruited and diagnosed as having dementia, or not, by medical experts. These 598 patients were assessed for delirium, medication use, co-morbidity, functional ability, and nutritional status. We conducted a retrospective cross-sectional analysis of medication data on admission for 583/598 patients with complete medication data, and controlled for age, sex, and co-morbidity.
Of 149 patients diagnosed with dementia, only 53 had a previous diagnosis. At hospital admission, 458/583 patients experienced polypharmacy (≥ 5 medications). People with dementia (PwD) were significantly more likely to be prescribed at least one psychotropic medication than patients without dementia (99/147 vs. 182/436; p < 0.001). PwD were also more likely to experience psychotropic polypharmacy (≥ two psychotropics) than those without dementia (54/147 vs. 61/436; p < 0.001). There were no significant differences in the prescribing patterns of anti-cholinergics (23/147 vs. 42/436; p = 0.18) or deliriogenics (79/147 vs. 235/436; p = 0.62).
Polypharmacy and psychotropic drug use is highly prevalent in older Irish hospitalized patients, especially in PwD. Hospital admission presents an ideal time for medication reviews in PwD.
Healthcare provider hands are an important source of intraoperative bacterial transmission events associated with postoperative infection development.
To explore the efficacy of a novel hand hygiene improvement system leveraging provider proximity and individual and group performance feedback in reducing 30-day postoperative healthcare-associated infections via increased provider hourly hand decontamination events.
Randomized, prospective study.
Dartmouth-Hitchcock Medical Center in New Hampshire and UMass Memorial Medical Center in Massachusetts.
Patients undergoing surgery.
Operating room environments were randomly assigned to usual intraoperative hand hygiene or to a personalized, body-worn hand hygiene system. Anesthesia and circulating nurse provider hourly hand decontamination events were continuously monitored and reported. All patients were followed prospectively for the development of 30-day postoperative healthcare-associated infections.
A total of 3,256 operating room environments and patients (1,620 control and 1,636 treatment) were enrolled. The mean (SD) provider hand decontamination event rate achieved was 4.3 (2.9) events per hour, an approximate 8-fold increase in hand decontamination events above that of conventional wall-mounted devices (0.57 events/hour); P<.001. Use of the hand hygiene system was not associated with a reduction in healthcare-associated infections (odds ratio, 1.07 [95% CI, 0.82–1.40], P=.626).
The hand hygiene system evaluated in this study increased the frequency of hand decontamination events without reducing 30-day postoperative healthcare-associated infections. Future work is indicated to optimize the efficacy of this hand hygiene improvement strategy.
Introduction: Common short screening measures of dependence that use number of cigarettes per day may not be appropriate for use in populations of occasional smokers.
Aims: In this study, we investigate whether perceived addiction (PA) predicts quit attempts and successful cessation among occasional smokers.
Methods: Current occasional smokers (18+) in the Ontario Tobacco Survey (OTS) longitudinal cohort study followed up every six months for up to three years. Respondents rated their self-perceived level of addiction (very vs. somewhat or not very addicted). Generalised Estimating Equation models and proportional hazard models were used to test the predictive ability of PA.
Results/Findings: Occasional smokers with very high PA had a higher likelihood of reporting a quit attempt (RR: 2.49; 95% CI: 1.88, 3.30) after adjusting for demographics. Given an incident quit attempt, occasional smokers who reported being very addicted were 2.93 times more likely to relapse (95%: 2.01, 4.28). The effect of PA was independent of other predictors of smoking behaviour.
Conclusions: For some, occasional smokers, smoking cessation is a difficult process that may require significant support. Asking occasional smokers about PA is an effective way to predict likely success in quitting smokers that may be easily assessed in population based, as well as in community and clinical, settings.
To analyze antipsychotic prescribing patterns in a UK high security hospital (HSH) that treats seriously violent men with either schizophrenia or personality disorder and examine how different groups consented to treatment and prescribing for metabolic conditions. We hypothesized that there would be high prevalence of antipsychotic polypharmacy, and high-dose antipsychotic and clozapine prescribing.
HSHs treat seriously violent, mentally disordered offenders, and the extant literature on prescribing patterns in forensic settings is sparse.
Prescribing and clinical data on all 189 patients in a UK HSH were collected from the hospital’s databases. Data were analyzed using SPSS.
The population was split into the following groups: schizophrenia spectrum disorder (SSD-only), personality disorder (PD-only), and comorbid schizophrenia spectrum disorder and PD. The majority (93.7%) of all patients were prescribed at least one antipsychotic, and (27.5%) were on clozapine. Polypharmacy was prevalent in 22.2% and high-dose antipsychotic in 27.5%. Patients on clozapine were more likely to be prescribed antidiabetic, statins, or antihypertensive medication. Patients in the PD-only group were more likely to be deemed to have the capacity to consent to treatment and be prescribed clozapine in contrast to the SSD-only group.
Rates of clozapine and high-dose antipsychotic prescribing were higher than in other psychiatric settings, while polypharmacy prescribing rates were lower. Higher clozapine prescribing rates may be a function of a treatment-resistant and aggressive population. A higher proportion of PD-only patients consented to treatment and received clozapine compared with in-house SSD-only as well as other psychiatric settings. Implications of the findings are discussed.
Parasites are considered to be an important selective force in host evolution but ecological studies of host-parasite systems are usually short-term providing only snap-shots of what may be dynamic systems. We have conducted four surveys of helminths of bank voles at three ecologically similar woodland sites in NE Poland, spaced over a period of 11 years, to assess the relative importance of temporal and spatial effects on helminth infracommunities. Some measures of infracommunity structure maintained relative stability: the rank order of prevalence and abundance of Heligmosomum mixtum, Heligmosomoides glareoli and Mastophorus muris changed little between the four surveys. Other measures changed markedly: dynamic changes were evident in Syphacia petrusewiczi which declined to local extinction, while the capillariid Aonchotheca annulosa first appeared in 2002 and then increased in prevalence and abundance over the remaining three surveys. Some species are therefore dynamic and both introductions and extinctions can be expected in ecological time. At higher taxonomic levels and for derived measures, year and host-age effects and their interactions with site are important. Our surveys emphasize that the site of capture is the major determinant of the species contributing to helminth community structure, providing some predictability in these systems.