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Psychological interventions that are brief, acceptable, effective and can be delivered by non-specialists are especially necessary in low- and middle-income countries, where mental health systems are unable to address the high level of psychosocial needs. Problem Management Plus (PM+) is a five-session intervention designed for those impaired by psychological distress while living in communities affected by adversity. Individual PM+ has demonstrated effectiveness in reducing distress in Kenya and Pakistan, and a group version of PM+ (Group PM+) was effective for conflict-affected women in Pakistan. This paper describes a feasibility and acceptability trial of locally adapted Group PM+ for women and men in an earthquake-affected region of rural Nepal.
In this feasibility cluster randomised controlled trial, participants in the experimental arm were offered five sessions of Group PM+ and participants in the control arm received enhanced usual care (EUC), which entailed brief psycho-education and providing referral options to primary care services with health workers trained in the mental health Gap Action Programme Intervention Guide (mhGAP-IG). A mixed-methods design was used to assess the feasibility and acceptability of Group PM+. Feasibility was assessed with criteria including fidelity and retention of participants. Acceptability was assessed through in-depth interviews with participants, family members, programme staff and other stakeholders. The primary clinical outcome was depression symptoms assessed using the Patient Health Questionnaire (PHQ-9) administered at baseline and 8–8.5 weeks post-baseline (i.e. after completion of Group PM+ or EUC).
We recruited 121 participants (83% women and 17% men), with equal allocation to the Group PM+ and EUC arms (1:1). Group PM+ was delivered over five 2.5–3 hour sessions by trained and supervised gender-matched local non-specialists, with an average attendance of four out of five sessions. The quantitative and qualitative results demonstrated feasibility and acceptability for non-specialists to deliver Group PM+. Though the study was not powered to assess for effectiveness, for all five key outcome measures, including the primary clinical outcome, the estimated mean improvement was larger in the Group PM+ arm than the EUC arm.
The intervention and trial procedures were acceptable to participants, family members, and programme staff. The communities and participants found the intervention to be beneficial. Because feasibility and acceptability were established in this trial, a fully powered randomised controlled trial will be conducted for larger scale implementation to determine the effectiveness of the intervention in Nepal.
Much of suicide research focuses on suicide attempt (SA) survivors. Given that more than half of the suicide decedent population dies on their first attempt, this means a significant proportion of the population that dies by suicide is overlooked in research. Little is known about persons who die by suicide on their first attempt–and characterizing this understudied population may improve efforts to identify more individuals at risk for suicide.
Data were derived from the National Violent Death Reporting System, from 2005 to 2013. Suicide cases were included if they were 18–89 years old, with a known circumstance leading to their death based on law enforcement and/or medical examiner reports. Decedents with and without a history of SA were compared on demographic, clinical, and suicide characteristics, and circumstances that contributed to their suicide.
A total of 73 490 cases met criteria, and 57 920 (79%) died on their first SA. First attempt decedents were more likely to be male, married, African-American, and over 64. Demographic-adjusted models showed that first attempt decedents were more likely to use highly lethal methods, less likely to have a known mental health problem or to have disclosed their intent to others, and more likely to die in the context of physical health or criminal/legal problem.
First attempt suicide decedents are demographically different from decedents with a history of SA, are more likely to use lethal methods and are more likely to die in the context of specific stressful life circumstances.
This paper summarises developments in understanding sea level change during the Quaternary in Scotland since the publication of the Quaternary of Scotland Geological Conservation Review volume in 1993. We present a review of progress in methodology, particularly in the study of sediments in isolation basins and estuaries as well as in techniques in the field and laboratory, which have together disclosed greater detail in the record of relative sea level (RSL) change than was available in 1993. However, progress in determining the record of RSL change varies in different areas. Studies of sediments and stratigraphy offshore on the continental shelf have increased greatly, but the record of RSL change there remains patchy. Studies onshore have resulted in improvements in the knowledge of rock shorelines, including the processes by which they are formed, but much remains to be understood. Studies of Late Devensian and Holocene RSLs around present coasts have improved knowledge of both the extent and age range of the evidence. The record of RSL change on the W and NW coasts has disclosed a much longer dated RSL record than was available before 1993, possibly with evidence of Meltwater Pulse 1A, while studies in estuaries on the E and SW coasts have disclosed widespread and consistent fluctuations in Holocene RSLs. Evidence for the meltwater pulse associated with the Early Holocene discharge of Lakes Agassiz–Ojibway in N America has been found on both E and W coasts. The effects of the impact of storminess, in particular in cliff-top storm deposits, have been widely identified. Further information on the Holocene Storegga Slide tsunami has enabled a better understanding of the event, but evidence for other tsunami events on Scottish coasts remains uncertain. Methodological developments have led to new reconstructions of RSL change for the last 2000 years, utilising state-of-the-art GIA models and alongside coastal biostratigraphy to determine trends to compare with modern tide gauge and documentary evidence. Developments in GIA modelling have provided valuable information on patterns of land uplift during and following deglaciation. The studies undertaken raise a number of research questions which will require addressing in future work.
The vast majority of stars will become white dwarfs at the end of the stellar life cycle. These remnants are precise cosmic clocks owing to their well constrained cooling rates. Gaia Data Release 2 is expected to discover hundreds of thousands of white dwarfs, which can then be observed spectroscopically with WEAVE and 4MOST. By employing spectroscopically derived atmospheric parameters combined with Gaia parallaxes, white dwarfs can constrain the stellar formation history in the early developing phases of the Milky Way, the initial mass function in the 1.5 to 8 M⊙ range, and the stellar mass loss as well as the state of planetary systems during the post main-sequence evolution.
High-resolution (or “cross-correlation”) electron backscatter diffraction analysis (HR-EBSD) utilizes cross-correlation techniques to determine relative orientation and distortion of an experimental electron backscatter diffraction pattern with respect to a reference pattern. The integrity of absolute strain and tetragonality measurements of a standard Si/SiGe material have previously been analyzed using reference patterns produced by kinematical simulation. Although the results were promising, the noise levels were significantly higher for kinematically produced patterns, compared with real patterns taken from the Si region of the sample. This paper applies HR-EBSD techniques to analyze lattice distortion in an Si/SiGe sample, using recently developed dynamically simulated patterns. The results are compared with those from experimental and kinematically simulated patterns. Dynamical patterns provide significantly more precision than kinematical patterns. Dynamical patterns also provide better estimates of tetragonality at low levels of distortion relative to the reference pattern; kinematical patterns can perform better at large values of relative tetragonality due to the ability to rapidly generate patterns relating to a distorted lattice. A library of dynamically generated patterns with different lattice parameters might be used to achieve a similar advantage. The convergence of the cross-correlation approach is also assessed for the different reference pattern types.
Biogenic nitrogen (N2) and nitrous oxide (N2O) accumulations were measured in groundwater, streams and the vadose zone of small agricultural watersheds in the Mid-Atlantic USA. In general, N2 and N2O in excess of atmospheric equilibrium were found in groundwater virtually everywhere that was sampled. Excess N2 in groundwater ranged from undetectable to 616 μmol N2-N/l, the latter representing c. 50% of background N2. The N2O-N concentrations varied from undetectable to 75 μm, and usually greatly exceeded values at atmospheric equilibrium (25–30 nM); however, N2O was generally 1–10% of excess N2. Intermediate levels of deficit and excess N2 in flowing streams (−65 to +250 μmol N2-N/L) resulting from both abiotic and biotic processes were also measured. In vadose zone gases, multiple N2/Ar gas profiles were measured which exhibited seasonal variations with below atmospheric values when the soil was warming in spring/summer and above atmospheric values when groundwater was cooling in fall/winter. Both abiotic and biotic processes contributed to the excess N2 and N2O that was observed. The current data indicate that large concentrations of excess N gases can accumulate within soil, groundwater, and streams of agriculturally dominated watersheds. When excess N gases are exchanged with the atmosphere, the net fluxes to the atmosphere may represent an important loss term for watershed N budgets.
The Millimetre Astronomy Legacy Team 90 GHz (MALT90) survey aims to characterise the physical and chemical evolution of high-mass star-forming clumps. Exploiting the unique broad frequency range and on-the-fly mapping capabilities of the Australia Telescope National Facility Mopra 22 m single-dish telescope1, MALT90 has obtained 3′ × 3′ maps towards ~2 000 dense molecular clumps identified in the ATLASGAL 870 μm Galactic plane survey. The clumps were selected to host the early stages of high-mass star formation and to span the complete range in their evolutionary states (from prestellar, to protostellar, and on to
regions and photodissociation regions). Because MALT90 mapped 16 lines simultaneously with excellent spatial (38 arcsec) and spectral (0.11 km s−1) resolution, the data reveal a wealth of information about the clumps’ morphologies, chemistry, and kinematics. In this paper we outline the survey strategy, observing mode, data reduction procedure, and highlight some early science results. All MALT90 raw and processed data products are available to the community. With its unprecedented large sample of clumps, MALT90 is the largest survey of its type ever conducted and an excellent resource for identifying interesting candidates for high-resolution studies with ALMA.
Integration of nanomaterials into composite systems is the next evolutionary step in nanoscale science. Until recently nanocomposites are formed by embedding nanomaterial components into matrices, through chemical bonding or with various wrapping agents. We seek to show that through directed self assembly nanomaterials can be coupled with photosensitizing ruthenium complexes while avoiding chemical augmentation and insulating effects from polymer, surfactant or DNA wrapping. We have synthesized dinuclear ruthenium complexes (dimers) possessing rigid conjugated π-electron systems that form a nanoscale pocket. The pocket is dimensionally suited to interact strongly with nanomaterials forming an architecture that could facilitate photon collection and charge transfer across the interaction. This study explores the binding interaction of our ruthenium dimers with SWNTs. The binding strength varies relative to the magnitude of formal charge which trends with DFT simulations that predict SWNT dimer interactions. SWNT surface saturation by ruthenium dimers can be observed using UV-visible spectroscopy and characterized with adsorption isotherms. We also explore a new technique to measure nanomaterial interactions, isothermal titration calorimetry (ITC). We show that ITC can be used to directly measure the binding enthalpy of nano material surface interactions in solution.
Bioimpedance spectroscopy (BIS) has been used to track changes in total body water (TBW). Accurate TBW estimations can be influenced by both methodological and biological factors. One methodological variation that contributes to BIS TBW errors is the electrode placement. The purpose of the present study was to compare the reproducibility and validity of fixed-distance electrode placements (5 cm) with the standard single-site electrode placements. Twenty-nine subjects (fifteen men and fourteen women) participated in the reproducibility study, while sixty-nine subjects (thirty-three men and thirty-six women) participated in the validity study. The reproducibility study included two measurements that were taken 24 h apart, while the validity study consisted of a 12-week exercise intervention with measurements taken at weeks 1 and 12. TBW was estimated using BIS and 2H techniques. Reproducibility results indicated that fixed-distance electrodes reduced the day-to-day standard error of the measurement in men (from 1·13 to 0·81 litres) but not in women (0·47 litres). sem values were lower for women than for men, suggesting that BIS TBW estimates are sex dependent. Validity results produced similar accurate findings (mean difference < 0·21 litres). However, fixed-distance electrodes improved delta TBW errors (mean difference improvements>0·04 litres in men, women, and men and women combined). When tracking changes in TBW, fixed-distance electrodes may reduce reproducibility errors and allow for smaller changes to be detected. However, the reduction of reproducibility errors may be greater for men than for women. Therefore, reproducibility calculations should be based on the sex of the sample population.
Glancing-incidence X-ray diffraction (GIXRD) has been applied to the investigation of depth-dependent stress distributions within electroplated Cu films due to overlying capping layers. 0.65 μm thick Cu films plated on conventional barrier and seed layers received a CVD SiCxNyHz cap, an electrolessly-deposited CoWP layer, or a CoWP layer followed by a SiCxNyHz cap. GIXRD and conventional X-ray diffraction measurements revealed that strain gradients were created in Cu films possessing a SiCxNyHz cap, where a greater in-plane tensile stress was generated near the film / cap interface. The constraint imposed by the SiCxNyHz layer during cooling from the cap deposition temperature led to an increase in the in-plane stress of approximately 180 MPa from the value measured in the bulk Cu. However, Cu films possessing a CoWP cap without a SiCxNyHz layer did not exhibit depth-dependent stress distributions. Because the CoWP capping deposition temperature was much lower than that employed in SiCxNyHz deposition, the Cu experienced elastic deformation during the capping process. Cross-sectional transmission electron microscopy indicated that the top surface of the Cu films exhibited extrusions near grain boundaries for the samples undergoing the thermal excursion during SiCxNyHz deposition. The conformal nature of these caps confirmed that the morphological changes of the Cu film surface occurred prior to capping and are a consequence of the thermal excursions associated with cap deposition.
Acetylcholine (ACh) enhances the preferred direction responses of directionally selective ganglion cells (DS GCs; Ariel & Daw, 1982; Ariel & Adolph, 1985) through the activation of nicotinic acetylcholine receptors (nAChRs; Ariel & Daw, 1982; Massey et al., 1997; Kittila & Massey, 1997). DS GCs appear to express at least two types of nAChRs, those that are sensitive to the partially subtype-specific antagonist methyllycaconitine (MLA), and those that are MLA-insensitive (Reed et al., 2002). Our purpose was to confirm the expression of α7 nAChRs by DS GCs and to assess the contributions of other nAChR subtypes to DS GC responses. Using choline as a nAChR partially subtype-specific agonist, we found that the majority of DS GCs demonstrated responses to choline while under synaptic blockade. The blockade or reduction of choline-induced responses by bath application of nanomolar (nM) concentrations of MLA provided direct evidence that the choline responses were mediated by α7 nAChRs. Because choline is a partial agonist for α3β4 nAChRs (Alkondon et al., 1997), the residual choline responses are consistent with mediation by α3β4 nAChRs. Additionally, a subset of DS GCs responded to nicotine but not to choline, indicating the expression of a third nAChR subtype. The pharmacological results were supported by single cell reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry experiments. The expression of α7 and specific non-α7 nAChR subtypes was correlated with the preferred direction. This indicates the possibility of differential responses to ACh depending on the direction of movement. This is the first description of differential expression of multiple nAChR subtypes by DS GCs.
Small-scale dairy farming has been suggested as a rural development option for Mexican campesino communities. However, there is a lack of information on how dairy farming systems operate. The objective of this paper is to analyse the social, productive and economic characteristics of small-scale dairy production systems in the central highlands in the northwest of the State of Mexico. These three characteristics were analysed on 69 farms using factor and cluster analysis. Five factors accounted for 68% of cumulative variance. Cluster analysis yielded three well-defined groups. A Kruskal–Wallis test was performed on the arable land area and the number of animals, and analysis of variance for milk yield. Economic analysis was undertaken using activity budgets. Results showed the relationships between scale and management methods and their effects on the income for the family. Families in only one of the three groups receive incomes from dairying that were above all Mexican poverty indices. This outcome is explained by the intensification in the management of their herds, which is reflected in higher milk yields, higher incomes and better access to government support schemes. Enhancement of milk production in the area studied needs differential policies which take in to account differences between the groups identified.
Gene therapy is being studied for the treatment of a variety of acquired and inherited disorders. Retroviruses, adeno-viruses, poxviruses, adeno-associated viruses, herpesviruses, and others are being engineered to transfer genes into humans. Treatment protocols using recombinant viruses are being introduced into clinical settings. Infection control professionals will be involved in reviewing the safety of these agents in their clinics and hospitals. To date, only a limited number of articles have been written on infection control in gene therapy, and no widely available recommendations exist from federal or private organizations to guide infection control professionals. The goals of the conference were to provide a forum where gene therapy experts could share their perspectives and experience with infection control in gene therapy and to provide an opportunity for newcomers to the field to learn about issues specific to infection control in gene therapy. Recommendations for infection control in gene therapy were proposed.
Stereotypes of older people suggest that they are depressed.
To examine depression symptoms among people aged ⩾65 in the general population and to ask the following questions. Are there high proportions of depressive symptoms among otherwise well people? Do these levels reflect the prevalence of depression? Do key symptoms vary with age and do they confirm stereotypes?
Nine centres contributed data from community-based random samples, using standardised methods (GMS–AGECAT package)
Proportions of depressive symptoms varied between centres. Some often associated with ageing were rare. Many were more common in women. Low-prevalence centres tended to have fewer symptoms among ‘well’ people, but there were inconsistencies. Low levels of symptoms among the well population of a centre did not necessarily predict lower levels in the depressed.
Variations in the prevalence of depressive symptoms occurred between centres, not always related to levels of illness. There was no consistent relationship between proportions of symptoms in well persons and cases for all centres. Few symptoms were present in > 60% of the older population – stereotypes of old age were not upheld.