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.
Describe and validate the CHROME (CHemical Restraints avOidance MEthodology) criteria.
Observational prospective longitudinal study.
Single nursing home in Las Palmas de Gran Canaria, Spain.
288 residents; mean age: 81.6 (SD 10.6). 77.4% had dementia.
Multicomponent training and consultancy program to eliminate physical and chemical restraints and promote overall quality care. Clinicians were trained in stringent diagnostic criteria of neuropsychiatric syndromes and adequate psychotropic prescription.
Psychotropic prescription (primary study target), neuropsychiatric syndromes, physical restraints, falls, and emergency room visits were semi-annually collected from December 2015 to December 2017. Results are presented for all residents and for those who had dementia and participated in the five study waves (completer analysis, n=107).
For the study completers, atypical neuroleptic prescription dropped from 42.7% to 18.7%, long half-life benzodiazepines dropped from 25.2% to 6.5%, and hypnotic medications from 47.7% to 12.1% (p<0.0005). Any kind of fall evolved from 67.3 to 32.7 (number of falls by 100 residents per year). Physicians’ diagnostic confidence increased, while the frequency of diagnoses of neuropsychiatric syndromes decreased (p<0.0005).
Implementing the CHROME criteria reduced the prescription of the most dangerous medications in institutionalized people with dementia. Two independent audits found no physical or chemical restraint and confirmed prescription quality of psychotropic drugs. Adequate diagnosis and independent audits appear to be the keys to help and motivate professionals to optimize and reduce the use of psychotropic medication. The CHROME criteria unify, in a single compendium, neuropsychiatric diagnostic criteria, prescription guidelines, independent audit methodology, and minimum legal standards. These criteria can be easily adapted to other countries.
To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and the INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in 14 intensive care units (ICUs) in Argentina from January 2014 to April 2017.
This prospective, pre–post surveillance study of 3,940 ICU patients was conducted in 11 hospitals in 5 cities in Argentina. During our baseline evaluation, we performed outcome and process surveillance of CLABSI applying Centers for Disease Control and Prevention/National Health Safety Network (CDC/NHSN) definitions. During the intervention, we implemented the IMA through ISOS: (1) a bundle of infection prevention practice interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on CLABSI rates and consequences, and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using a logistic regression model to estimate the effect of the intervention on the CLABSI rate.
During the baseline period, 5,118 CL days and 49 CLABSIs were recorded, for a rate of 9.6 CLABSIs per 1,000 central-line (CL) days. During the intervention, 15,659 CL days and 68 CLABSIs were recorded, for a rate of 4.1 CLABSIs per 1,000 CL days. The CLABSI rate was reduced by 57% (incidence density rate: 0.43; 95% confidence interval, 0.34–0.6; P<.001).
Implementing IMA through ISOS was associated with a significant reduction in the CLABSI rate in ICUs in Argentina.
This study aimed to assess the risks and opportunities associated with Facebook usage and to explore the moderating role of psychosocial (mal)adjustment, nationality and age in these relationships. This correlational study involved a sample of 452 Brazilian and 500 Portuguese youths, aged between 14 and 20 years. Results showed that these youths spent a daily average of 61-120 minutes on Facebook, three to four times per week, displaying a positive attitude towards its use. These characteristics were most notable in the Brazilian youths [t(950) = 5.64, p < .001; t(950) = –5.07, p < .001; and t(950) = – 6.85, p < .001, respectively]. The Portuguese youths ran more risks than the Brazilians [t(950) = 6.36, p < .001], but both youths equally enjoyed the opportunities. In the case of the Portuguese youths, the risks and opportunities were moderated by the frequency of use, in other words “the higher the usage, the more risks and opportunities” (β = –.235 p < .001and β = –.167, p < .001, respectively). The psychosocial adjustment indicators did not moderate the effects of Facebook usage habits in risks and opportunities. The less psychosocially adjusted youths were those who ran more risks and also made the most of the opportunities. The results are discussed in light of the role of psychological, socio-cultural and developmental factors.
The purpose of this work was to study the relationship between self-focused
attention and mindfulness in participants prone to hallucinations and others who
were not. A sample of 318 healthy participants, students at the universities of
Sevilla and Almería, was given the Launay-Slade Hallucinations
Scale-revised (LSHS-R, Bentall & Slade, 1985). Based on this sample, two groups were formed:
participants with high (n = 55) and low proneness
(n = 28) to hallucinations. Participants with a
score higher than a standard deviation from the mean in the LSHS-R were included
in the high proneness group, participants with a score lower than a standard
deviation from the mean in the LSHR-R were included in the second one. All
participants were also given the Self-Absorption Scale (SAS, McKenzie
& Hoyle, 2008) and the
Southampton Mindfulness Questionnaire (SMQ, Chadwick et al., 2008). The results showed that
participants with high hallucination proneness had significantly higher levels
of public (t(80) = 6.81, p
< .001) and private (t(77) = 7.39,
p < .001) self-focused attention and lower levels
of mindfulness (t(81) = -4.56, p
< .001) than participants in the group with low hallucination
proneness. A correlational analysis showed a negative association between
self-focused attention (private and public) and mindfulness (r
= -0.23, p < .001; r
= -0.38, p < .001 respectively). Finally,
mindfulness was found to partly mediate between self-focused attention and
hallucination proneness. The importance of self-focused attention and
mindfulness in understanding the etiology of hallucinations discussed and
suggest some approaches to their treatment.
The genus Megasyllis is herein reorganized excluding the size from the diagnosis, since it is not a characteristic of all the species of the genus. We provide here a taxonomic account of all known species and a key to species identification. Seven species are new combinations, and re-descriptions of the four latter are included: Megasyllis nipponica (Imajima, 1966) and M. multiannulata (Aguado, San Martín & Nishi, 2008) from Japan; Megasyllis procera (Hartman, 1965) from the Atlantic; Megasyllis pseudoheterosetosa (Böggemann & Westheide, 2004) from the Indian Ocean. Megasyllis glandulosa (Augener, 1913), from Australia; Megasyllis marquesensis (Monro, 1939) from the Marquesas Islands, Micronesia and Megasyllis subantennata (Hartmann-Schröder, 1984) from Australia. Four new species from the Pacific Ocean namely Megasyllis tigrina sp. nov., Megasyllis mariandreworum sp. nov. (both from Australia), Megasyllis chrissyae sp. nov. (from the Philippines) and Megasyllis eduardoi sp. nov. (from New Zealand) are described.
Export decisions depend on a wide variety of information stimuli. The current research focuses on the attention that international entrepreneurs (IEs) dedicate to different information stimuli relating to how the firm operates internationally, and examines whether the IE's attention varies in function of their experience and knowledge. For their empirical analysis, the authors study the information interests of the IEs in the Spanish natural stone industry. They identify three centres of interest: the strategic attractiveness of the foreign markets, barriers to exporting, and support programmes for exporters. The results show that the IEs are most interested in information about support programmes, and that is due to IEs with scant knowledge about the export markets. As the IEs accumulate knowledge about which are the main export markets, they become more interested in information about the strategic attractiveness of these markets. The authors conclude that a trade-off exists between the information about market attractiveness and the information about support programmes in the IE's attention. In contrast, attention towards export barriers behaves independently and depends on the IE's experience.
Elongated embryos provide a unique source of information about trophoblastic differentiation, gene expression and maternal-embryonic interactions; however they are difficult and costly to obtain, especially elongated cloned embryos. One alternative is their production in heterologous temporary recipients such as sheep and goats. We aimed to produce elongated bovine cloned embryos using heterologous transfer to temporary recipients. Day-7 cloned cattle blastocysts were transferred to the uteri of ewes and goats and recovered as elongated structures at day 17. We evaluated elongation, length, presence of embryonic disc and expression of several important genes for embryonic development. We also produced homologous (cloned cattle embryos transferred into cattle uteri). Cloned bovine blastocysts were able to proceed with preimplantation development through elongation with high efficiency despite the species to which they were transferred. In qualitative and quantitative RT-PCR experiments we found differences in the pattern of gene expression among embryos recovered from different species. Sox2, Nanog and FGF-4 were markedly deregulated. No previous reports about the expression pattern of the studied genes had been published for elongated bovine cloned embryos produced in intermediate recipients, furthermore, the pattern of expression of Nanog, Oct4, Eomes, Cdx2, IFN-tau, Dicer, FGF-4 and Sox2 shown here are novel for elongated cloned bovine embryos created by hand-made cloning. Our data confirmed that sheep and goats can be used as temporary recipients. This model could serve as a basis for further research on gene expression and cellular changes during bovine peri-implantation development.
We prove several stability results for Atkinson linear relations under additive perturbation by small norm, strictly singular and strictly cosingular multivalued linear operators satisfying some additional conditions.
We introduce the notion of hereditarily indecomposable normed space and we prove that this class of normed spaces may be characterised by means of F+ and strictly singular linear relations. We also show that if X is a complex hereditarily indecomposable normed space then every partially continuous linear relation in X with dense domain can be written as λI + S, where λ ∈ ℂ and S is a strictly singular linear relation.
The diversity within 20 rice varieties used as progenitors in Cuban rice breeding programmes was analysed with respect to agro-morphological traits, pedigree and DNA markers. Eleven agro-morphological traits were scored, and phenotypic (Euclidian) distances between the rice varieties were calculated. Sixty random amplified polymorphism DNA (RAPD) and 115 amplified fragment length polymorphism (AFLP) bands served to determine Dice's distance estimates. Cluster analyses were performed based on genetic distance matrices using the unweighted pair-group method of arithmetical means (UPGMA) as the clustering method. This analysis showed five phenotypic, six genealogical, five RAPD and six AFLP diversity groups. Genetic diversity estimates based on RAPD data, but not on AFLP, efficiently represented the genetic parentage and phenotypic diversity between rice varieties. Combined diversity estimates allowed the identification of 11 different genetic pools and permitted a more effective separation of the progenitor set than those obtained solely by phenotypic and genealogical information. The results of this study stress the necessity to diversify rice parental stocks for further breeding purposes.
In this paper various conditions are given under which the strict singularity (respectively, strict cosingularity) of a linear relation implies the strict singularity (respectively, strict cosingularity) of its conjugate.
Certain norm related functions of linear operators are considered in the very general setting of linear relations in normed spaces. These are shown to be closely related to the theory of strictly singular, strictly cosingular, F+ and F− linear relations. Applications to perturbation theory follow.
Abnormal regulation of the adipocyte-derived hormone leptin could play a role in body weight gain induced by antipsychotics.
To study the effects of long-term antipsychotic treatment on leptin levels in patients with schizophrenia.
Serum leptin levels were determined in 59 out-patients with chronic schizophrenia and in the same number of healthy subjects controlled by gender, age and body mass index.
Leptin levels did not differ between patients and controls. Leptin levels in patients with schizophrenia correlated with weight gain, even after controlling for current weight, but did not show any association with clinical variables. Antipsychotic class tended to exert different effects over leptin levels (among atypicals, olanzapine induced a greater increase).
Elevation of leptin levels induced by chronic antipsychotic treatment can be attributed to weight gain, but other mechanisms could be involved.
Sinking of particles was measured at a coastal site near La Coruña (north-western Spain) using sedimentation traps placed at the base of the euphotic zone during four short periods between March and June 1995. In addition, measurements of water column properties and particles were made at five stations. The cases studied were representative of the main oceanographic situations that occur in this area and were related to the wind-induced upwelling. Phytoplankton blooms (> 100 mg chlorophyll−a m−2) were observed on two occasions in April and June, both during favourable upwelling conditions. The two other cases were studied during low phytoplankton biomass concentrations in the water column.
We study a concept of stability under the gap of isomorphic properties of Banach spaces and apply it to obtain some results of stability under compact or small norm perturbation for non-semi-Fredholm operators with closed range.
Email your librarian or administrator to recommend adding this to your organisation's collection.