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Hand hygiene compliance rates were estimated using direct observations. An AHHMS, installed on 4 nursing units in a sequential manner, determined hand hygiene performance rates, expressed as the number of hand hygiene events performed upon entering and exiting patient rooms divided by the number of room entries and exits. Additional strategies implemented to improve hand hygiene included goal setting, hospital leadership support, feeding AHHMS data back to healthcare personnel, and use of Toyota Kata performance improvement methods. HAIs were defined using National Healthcare Safety Network criteria.
Hand hygiene compliance rates generated by direct observation were substantially higher than performance rates generated by the AHHMS. Installation of the AHHMS without supplementary activities did not yield sustained improvement in hand hygiene performance rates. Implementing several supplementary strategies resulted in a statistically significant 85% increase in hand hygiene performance rates (P < .0001). The incidence density of non–Clostridioies difficile HAIs decreased by 56% (P = .0841), while C. difficile infections increased by 60% (P = .0533) driven by 2 of the 4 study units.
Implementation of an AHHMS, when combined with several supplementary strategies as part of a multimodal program, resulted in significantly improved hand hygiene performance rates. Reductions in non–C. difficile HAIs occurred but were not statistically significant.
In Western countries, an increasing number of companies has difficulties with recruiting and retaining employees, along with growing employer responsibilities in the workplace. Therefore, companies’ interest in disability management programs has increased. This article examines employee perspectives of disability management and how it is related to job satisfaction, physical and mental health, workplace morale and sickness absence. Employees from seven Swiss companies (N=482), from the private and public sector, participated in either an online and paper-and-pencil survey for this present study. The survey asked employees to report their views of how disability management is related to job satisfaction, mental health, physical health, workplace morale and absenteeism. The Swiss employees participating in the study knew about disability management and related programs, which are implemented in their company. They valued them as moderately helpful for a variety of factors related to workplace wellbeing, and regarded the programs generally as high quality and wanted them to continue, because they contribute to job satisfaction, mental health, physical health, workplace morale and reduced sickness absence. However, employees also saw more value in disability prevention (DP) and stay at work (SAW) programs than in return to work (RTW) programs. Male employees and those working for public organisations saw more benefit in disability management programs than female employees and those working in the private sector.
Keto analogues and amino acids (KAAA) supplementation can reduce blood ammonia concentrations in athletes undergoing high-intensity exercise under both ketogenic and thermoneutral conditions. This study evaluated the acute effects of KAAA supplementation on ammonia metabolism during extenuating endurance exercise in rats fed a ketogenic diet. In all, eighty male Fischer rats at 90 d of age were divided into eight groups, and some were trained using a swimming endurance protocol. A ketogenic diet supplemented with keto analogues was administered for 10 d. Administration of the ketogenic diet ended 3 d before the exhaustion test (extenuating endurance exercise). A ketogenic diet plus KAAA supplementation and extenuating endurance exercise (trained ketogenic diet supplemented with KAAA (TKKa)) increased blood ammonia concentrations by approximately 50 % compared with the control diet (trained control diet supplemented with KAAA (TCKa)) and similar training (effect size=1·33; statistical power=0·50). The KAAA supplementation reduced blood urea concentrations by 4 and 18 % in the control and ketogenic diet groups, respectively, compared with the groups fed the same diets without supplementation. The trained groups had 60 % lower blood urate concentrations after TCKa treatment than after TKKa treatment. Our results suggest that KAAA supplementation can reduce blood ammonia concentrations after extenuating endurance exercise in rats fed a balanced diet but not in rats fed a ketogenic diet.
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.
Objectives: Longitudinal research indicates that cognitive load dual-task gait assessment is predictive of cognitive decline and thus might provide a sensitive measure to screen for mild cognitive impairment (MCI). However, research among older adults being clinically evaluated for cognitive concerns, a defining feature of MCI, is lacking. The present study investigated the effect of performing a cognitive task on normal walking speed in patients presenting to a memory clinic with cognitive complaints. Methods: Sixty-one patients with a mean age of 68 years underwent comprehensive neuropsychological testing, clinical interview, and gait speed (simple- and dual-task conditions) assessments. Thirty-four of the 61 patients met criteria for MCI. Results: Repeated measure analyses of covariance revealed that greater age and MCI both significantly associated with slower gait speed, ps<.05. Follow-up analysis indicated that the MCI group had significantly slower dual-task gait speed but did not differ in simple-gait speed. Multivariate linear regression across groups found that executive attention performance accounted for 27.4% of the variance in dual-task gait speed beyond relevant demographic and health risk factors. Conclusions: The present study increases the external validity of dual-task gait assessment of MCI. Differences in dual-task gait speed appears to be largely attributable to executive attention processes. These findings have clinical implications as they demonstrate expected patterns of gait-brain behavior relationships in response to a cognitive dual task within a clinically representative population. Cognitive load dual-task gait assessment may provide a cost efficient and sensitive measure to detect older adults at high risk of a dementia disorder. (JINS, 2017, 23, 493–501)
The stellar occultation technique is a powerful tool to study distant small solar system bodies. Currently, around 2 500 trans-neptunian objects (TNOs) and Centaurs are known. With the astrometry from Gaia and large surveys like the Large Synoptic Survey Telescope (LSST), accurate predictions of occultation events will be available to tens of thousands of TNOs and Centaurs and boost the knowledge of the outer solar system.
Using the example of the PHELIX high-energy short pulse laser we discuss the technical preconditions to investigate ion acceleration with submicrometer thick targets. We show how the temporal contrast of this system was improved to prevent pre-ionization of such targets on the nanosecond timescale. Furthermore the influence of typical fluctuations or uncertainties of the on-target intensity on ion acceleration experiments is discussed. We report how these uncertainties were reduced by improving the assessment and control of the on-shot intensity and by optimizing the positioning of the target into the focal plane. Finally we report on experimental results showing maximum proton energies in excess of 85 MeV for ion acceleration via the target normal sheath acceleration mechanism using target thicknesses on the order of one micrometer.
Previous studies hypothesized that neurodevelopmental risk factors may play a role in the pathogenesis of obsessive-compulsive disorder (OCD). Cortical folding has been shown to be a reliable indicator for normal and altered neurodevelopment, but in OCD it has barely been investigated up to now. The present study investigates whether alterations in gyrification are detectable in OCD and, if so, how these are associated with clinical characteristics.
We compared the local Gyrification Index (lGI) between 75 OCD patients and 75 matched healthy subjects across the whole brain. In addition, for those regions exhibiting an altered lGI in patients we explored a potential relationship to symptom severity, age of onset, and influence of medication.
OCD patients had a significantly decreased lGI in right parietal, precentral but also insula, temporal, pars triangularis and rostral middle frontal regions compared to healthy subjects. A positive association with age of onset was found but no association with symptom severity. There was no effect of co-morbidity or medication.
The reduced gyrification found in OCD confirms previous findings in other psychiatric disorders and suggests that alterations may already occur during early stages of brain development. Our findings support the idea that altered cortical folding might represent a trait characteristic of the disorder although longitudinal studies are needed to clarify the trajectory of this morphological measure in OCD.
Plant sterols (PS) lower LDL-cholesterol, an established risk factor for CHD. Endothelial dysfunction and low-grade inflammation are two important features in the development of atherosclerosis. Whether PS affect biomarkers of endothelial function and low-grade inflammation is not well studied. The aim of the present study was to investigate the effect of regular intake of PS on biomarkers of endothelial dysfunction and low-grade inflammation. In a double-blind, randomised, placebo-controlled, parallel-group study, which was primarily designed to investigate the effect of PS intake on vascular function (clinicaltrials.gov: NCT01803178), 240 hypercholesterolaemic but otherwise healthy men and women consumed a low-fat spread with added PS (3 g/d) or a placebo spread for 12 weeks. Endothelial dysfunction biomarkers (both vascular and intracellular adhesion molecules 1 and soluble endothelial-selectin) and low-grade inflammation biomarkers (C-reactive protein, serum amyloid A, IL-6, IL-8, TNF-α and soluble intercellular adhesion molecule-1) were measured using a multi-array detection system based on electrochemiluminescence technology. Biomarkers were combined using z-scores. Differences in changes from baseline between the PS and the placebo groups were assessed. The intake of PS did not significantly change the individual biomarkers of endothelial dysfunction and low-grade inflammation. The z-scores for endothelial dysfunction (−0·02; 95 % CI −0·15, 0·11) and low-grade inflammation (−0·04; 95 % CI −0·16, 0·07) were also not significantly changed after PS intake compared with placebo. In conclusion, biomarkers of endothelial dysfunction and low-grade inflammation were not affected by regular intake of 3 g/d PS for 12 weeks in hypercholesterolaemic men and women.
The reorientation phenomenon of a single red blood cell during sedimentation is simulated using the boundary element method. The cell settles downwards due to a density difference between the internal and external fluids, and it changes orientation toward a vertical orientation regardless of Bond number or viscosity ratio. The reorientation phenomenon is explained by a shape asymmetry caused by the gravitational driving force, and the shape asymmetry increases almost linearly with the Bond number. When velocities are normalised by the driving force, settling/drifting velocities are weak functions of the Bond number and the viscosity ratio, while the angular velocity of the reorientation drastically changes with these parameters: the angular velocity is smaller for lower Bond number or higher viscosity ratio. As a consequence, trajectories of the sedimentation are also affected by the angular velocity, and blood cells with slower reorientation travel longer distances in the drifting direction. We also explain the mechanism of the reorientation using an asymmetric dumbbell. From the analysis, we show that the magnitude of the angular velocity is explained by two main factors: the shape asymmetry and the instantaneous orientation angle.
We present ground-based data of the BL Lac object PKS 2155-305 obtained during a large international campaign spanning the electro–magnetic spectrum from the radio waves to X-rays in November 1991. For the complete description of the observations and data analysis we refer to the paper by Courvoisier et al. 1993, and references therein. The ground-based data include radio, infrared JHKL and UBVRI fluxes as well as optical and near IR polarimetry.
The broad-band optical and near IR data from U to I exhibit the same behaviour in all bands: the flux nearly doubled over the well-covered period of 23 days. The cross-correlation function does not reveal any significant changes in the light-curves. Though significant variations in 24 hours have been recorded, the cumulated Fourier power spectrum drops to the noise level for periods shorter than 2.5 days. The spectral index remained constant.
The polarised flux varied by a larger factor than the total flux and did not follow the same pattern. The degree of polarisation and polarisation angle are nearly independent of the wavelength and are strongly correlated in all filters.
In the radio domain the spectral index increased from −0.1 on November 5 to +0.02 on 25-th.
The absence of the lag between the optical and infrared bands and the polarisation variations are consistent with a model in which the variability is caused by micro-lensing of the source (Stickel, Fried and Kühr 1988). One would, however, expect in this model that the variation in the polarisation and the total flux are tightly correlated contrary to what is observed.
The constant shape of the continuum spectral energy suggests that only the number of electrons whose emission is beamed towards the observer changes, rather than the arrival of fresh electrons that are being accelerated.
The variability of the polarisation may be explained by changes in the geometry of the magnetic field (dominant direction). This is consistent with the observed variations of the polarisation angle.
Sub-fossil sections from a Florida wetland were accelerator mass spectrometry (AMS) dated and the sedimentological conditions were determined. 14C data were calibrated using a combined wiggle-match and 14C bomb-pulse approach. Repeatable results were obtained providing accurate peat chronologies for the last 130 calendar yr. Assessment of the different errors involved led to age models with 3–5 yr precision. This allows direct calibration of paleoenvironmental proxies with meteorological data. The time frame in which 14C dating is commonly applied can possibly be extended to include the 20th century.
The new accelerator mass spectrometry (AMS) Radiocarbon Analysis Laboratory in Jena is described. The laboratory developed a combustion system for solid samples and a CO2 extraction system for air samples. Thus far, sample preparation, including graphitization, was performed in the laboratory, and the samples were measured subsequently by other AMS facilities. Currently, the laboratory owns a 3MV AMS system from HVEE (Netherlands) that has passed the acceptance tests and will be used for routine 14C determinations in the near future. The AMS system is equipped with 2 ion sources, one suitable for graphite targets and the second for both graphite and CO2 targets.
Child conduct problems (CP) reflect a heterogeneous collection of oppositional, aggressive, norm-violating, and sometimes violent behaviors, whereas child callous–unemotional (CU) behaviors reflect interpersonal styles of interactions reflecting a lack of guilt and empathy as well as uncaring and shallow emotional responses to others. Taken together, high levels of child CP and CU behaviors are thought to identify a relatively homogenous group of children at elevated risk for persistent and more severe problem behaviors across childhood and into adulthood. Although a large body of research has examined the developmental etiology of CP behaviors, only recently has a developmental psychopathology approach been applied to early CU behaviors. The current study examines multiple levels of contextual influences during the first years of life, including family socioeconomic status, household chaos, and parenting behaviors, on CP and CU behaviors assessed during the first-grade year. Whereas previous studies found associations between parenting behaviors and child problem behaviors moderated by household chaos, the current study found no evidence of moderation. However, path analyses suggest that the associations between child CP and CU behaviors and the contextual variables of socioeconomic status (family income and parental education) and household chaos (disorganization and instability) were mediated by maternal sensitive and harsh–intrusive parenting behavior. Analyses are presented, interpreted, and discussed with respect to both bioecological and family stress models of development.
This paper briefly describes the principle of operation and science goals of the AMANDA high energy neutrino telescope located at the South Pole, Antarctica. Results from an earlier phase of the telescope, called AMANDA-BIO, demonstrate both reliable operation and the broad astrophysical reach of this device, which includes searches for a variety of sources of ultrahigh energy neutrinos: generic point sources, Gamma-Ray Bursts and diffuse sources. The predicted sensitivity and angular resolution of the telescope were confirmed by studies of atmospheric muon and neutrino backgrounds. We also report on the status of the analysis from AMANDA-II, a larger version with far greater capabilities. At this stage of analysis, details of the ice properties and other systematic uncertainties of the AMANDA-II telescope are under study, but we have made progress toward critical science objectives. In particular, we present the first preliminary flux limits from AMANDA-II on the search for continuous emission from astrophysical point sources, and report on the search for correlated neutrino emission from Gamma Ray Bursts detected by BATSE before decommissioning in May 2000. During the next two years, we expect to exploit the full potential of AMANDA-II with the installation of a new data acquisition system that records full waveforms from the in-ice optical sensors.
Blazar OJ 287 is one of the best observed extragalactic objects. It's historical light curve goes back to 1890′s. Based on the historical behaviour Sillanpää et al. (1988) showed that OJ 287 displays large periodic outbursts, with a period of 11.7 years. We have monitored OJ 287 intensively for two years, during the OJ-94 project. This project was created for monitoring OJ 287 during its predicted new outburst in 1994. In the data archive we have over 7000 observations on OJ 287, in the radio, infrared and optical bands. This data archive contains the best ever obtained light curves for any extragalactic object. The optical light curve shows continuous variability down to time scales of tens of minutes. The variability observed in OJ 287 can be broken down to (at least) four different categories:
Patients with psychosis display the so-called ‘Jumping to Conclusions’ bias (JTC) – a tendency for hasty decision-making in probabilistic reasoning tasks. So far, only a few studies have evaluated the JTC bias in ‘at-risk mental state’ (ARMS) patients, specifically in ARMS samples fulfilling ‘ultra-high risk’ (UHR) criteria, thus not allowing for comparisons between different ARMS subgroups.
In the framework of the PREVENT (secondary prevention of schizophrenia) study, a JTC task was applied to 188 patients either fulfilling UHR criteria or presenting with cognitive basic symptoms (BS). Similar data were available for 30 healthy control participants matched for age, gender, education and premorbid verbal intelligence. ARMS patients were identified by the Structured Interview for Prodromal Symptoms (SIPS) and the Schizophrenia Proneness Instrument – Adult Version (SPI-A).
The mean number of draws to decision (DTD) significantly differed between ARM -subgroups: UHR patients made significantly less draws to make a decision than ARMS patients with only cognitive BS. Furthermore, UHR patients tended to fulfil behavioural criteria for JTC more often than BS patients. In a secondary analysis, ARMS patients were much hastier in their decision-making than controls. In patients, DTD was moderately associated with positive and negative symptoms as well as disorganization and excitement.
Our data indicate an enhanced JTC bias in the UHR group compared to ARMS patients with only cognitive BS. This underscores the importance of reasoning deficits within cognitive theories of the developing psychosis. Interactions with the liability to psychotic transitions and therapeutic interventions should be unravelled in longitudinal studies.
On May 22, 1989 the Japanese Ginga Team discovered a new X-ray source that was cataloged as GS 2023+338. This source was subsequently identified as coincident in position with a previously known nova cataloged as V404 Cygni. Its last recorded outburst was in 1938 when it rose to about 12th mag. Spectroscopic data were obtained and confirmed the nature of the outburst. Additional ground based data were obtained by us at CTIO and the VLA. The X-ray behavior of this object has been reported to be very unusual and it reached a peak of about 17 crab about one week after discovery. Since then it has varied widely in magnitude at all wavelengths at which it has been studied. We present a brief summary of the observations that have been obtained up to the time of the meeting and shortly thereafter.
Phanerozoic trends in shell and life habit traits linked to postmortem durability were evaluated for the most common fossil brachiopod, gastropod, and bivalve genera in order to test for changes in taphonomic bias. Using the Paleobiology Database, we tabulated occurrence frequencies of genera for 48 intervals of ∼11 Myr duration. The most frequently occurring genera, cumulatively representing 40% of occurrences in each time bin, were scored for intrinsic durability on the basis of shell size, reinforcement (ribs, folds, and spines), life habit, and mineralogy.
Shell durability is positively correlated with the number of genera in a time bin, but durability traits exhibit different temporal patterns across higher taxa, with notable offsets in the timing of changes in these traits. We find no evidence for temporal decreases in durability that would indicate taphonomic bias at the Phanerozoic scale among commonly occurring genera. Also, all three groups show a remarkable stability in mean shell size through the Phanerozoic, an unlikely pattern if strong size-filtering taphonomic megabiases were affecting the fossil record of shelly faunas. Moreover, small shell sizes are attained in the early Paleozoic in brachiopods and in the latest Paleozoic in gastropods but are steady in bivalves; unreinforced shells are common to all groups across the entire Phanerozoic; organophosphatic and aragonitic shells dominate only the oldest and youngest time bins; and microstructures having high organic content are most common in the oldest time bins.
In most cases, the timing of changes in durability-related traits is inconsistent with a late Mesozoic Marine Revolution. The post-Paleozoic increase in mean gastropod reinforcement occurs in the early Triassic, suggesting either an earlier appearance and expansion of durophagous predators or other drivers. Increases in shell durability hypothesized to be the result of increased predation in the late Mesozoic are not evident in the common genera examined here. Infaunal life habit does increase in the late Mesozoic, but it does not become more common than levels already attained during the Paleozoic, and only among bivalves does the elevated late Mesozoic level persist through the Holocene.
These temporal patterns suggest control on the occurrence of durability-related traits by individual evolutionary histories rather than taphonomic megabiases. Our findings do not mean taphonomic biases are absent from the fossil record, but rather that their effects apparently have had little net effect on the relative occurrence of shell traits generally thought to confer higher preservation potential over long time scales.