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To assess the influence of mild behavioral impairment (MBI) on the cognitive performance of older adults who are cognitively healthy or have mild cognitive impairment (MCI).
Methods:
Secondary data analysis of a sample (n = 497) of older adults from the Florida Alzheimer’s Disease Research Center who were either cognitively healthy (n = 285) or diagnosed with MCI (n = 212). Over half of the sample (n = 255) met the operationalized diagnostic criteria for MBI. Cognitive domains of executive function, attention, short-term memory, and episodic memory were assessed using a battery of neuropsychological tests.
Results:
Older adults with MBI performed worse on tasks of executive function, attention, and episodic memory compared to those without MBI. A significant interaction revealed that persons with MBI and MCI performed worse on tasks of episodic memory compared to individuals with only MCI, but no significant differences were found in performance in cognitively healthy older adults with or without MBI on this cognitive domain. As expected, cognitively healthy older adults performed better than individuals with MCI on every domain of cognition.
Conclusions:
The present study found evidence that independent of cognitive status, individuals with MBI performed worse on tests of executive function, attention, and episodic memory than individuals without MBI. Additionally, those with MCI and MBI perform significantly worse on episodic memory tasks than individuals with only MCI. These results provide support for a unique cognitive phenotype associated with MBI and highlight the necessity for assessing both cognitive and behavioral symptoms.
Increasingly, narrative and creative arts approaches are being used to enhance recovery after traumatic brain injury (TBI). Narrative and arts-based approaches congruent with Indigenous storytelling may therefore provide benefit during the transition from hospital to home for some Indigenous TBI patients. This qualitative study explored the use and impact of this approach as part of a larger, longitudinal study of TBI transition with Indigenous Australians.
Method:
A combined narrative and arts-based approach was used with one Indigenous Australian artist to describe his transition experiences following TBI. Together with the researchers and filmmaking team, the artist was involved in aspects of the process. The artist contributed two paintings, detailing the story of his life and TBI. Based on the artworks, a film was co-created. Following the viewing of the film, impacts of the narrative and arts-based process were examined through semi-structured interviews with the artist, a service provider and a family member. Multiple sources of data were used in the final thematic analysis including transcripts of the interviews and filming, paintings (including storylines) and researcher notes.
Results:
Positive impacts from the process for the artist included positive challenge; healing and identity; understanding TBI and raising awareness.
Discussion:
This approach may enable the individual to take ownership over their transition story and to make sense of their life following TBI at a critical point in their recovery. A combined narrative and arts-based approach has potential as a culturally responsive rehabilitation tool for use with Indigenous Australians during the transition period following TBI.
Mental disorders in children and adolescents have an impact on educational attainment.
Aims
To examine the temporal association between attainment in education and subsequent diagnosis of depression or self-harm in the teenage years.
Method
General practitioner, hospital and education records of young people in Wales between 1999 and 2014 were linked and analysed using Cox regression.
Results
Linked records were available for 652 903 young people and of these 33 498 (5.1%) developed depression and 15 946 (2.4%) self-harmed after the age of 12 but before the age of 20. Young people who developed depression over the study period were more likely to have achieved key stage 1 (age 7 years) but not key stage 2 (age 11) (hazard ratio (HR) = 0.79, 95% CI 0.74–0.84) milestones, indicating that they were declining in academic attainment during primary school. Conversely, those who self-harmed were achieving as well as those who did not self-harm in primary school, but showed a severe decline in their attainment during secondary school (HR = 0.72, 95% CI 0.68–0.78).
Conclusions
Long-term declining educational attainment in primary and secondary school was associated with development of depression in the teenage years. Self-harm was associated with declining educational attainment during secondary school only. Incorporating information on academic decline with other known risk factors for depression/self-harm (for example stressful life events, parental mental health problems) may improve risk profiling methods.
Successful man powered aircraft projects may be divided into three main stages:
(a) Design.
(b) Construction.
(c) Operation.
From a purely practical standpoint, this sequence represents the order of increasing difficulty. It is in the later stages of a project that the major problems of team management and of organisation arise. Indeed, many groups, having designed and built a machine, have encountered the utmost difficulty in flying with any regularity. As a result, relatively little has been recorded on the matters of operating methods or handling characteristics, although there has been much discussion on the theoretical aspects of flight under human muscle-power.
The setbacks and frustratons encountered in the desgn and construction of man-powered aircraft are well-known. Many machines have been completed only after the expenditure of several man-years’ effort. Often, groups have reaped little reward in proportion to their labours. The majority of man-powered aircraft have suffered severe damage early in their flight career either from storage accidents, from mismanagement in ground handling, or following loss of control while in flight. The record underlines the vulnerability of these lightweight, flimsy aircraft and emphasises the difficulty in conducting safe operations while simultaneously achieving productive flying.
We describe the use of a multi-aperture Hartmann mask coupled to a slightly out-of-focus focal plane array imager to monitor atmospheric turbulence (‘seeing’) produced by refractive index fluctuations. The imager (a CCD) is located inside or outside the focal surface of the imaging system so that each sub-aperture of the Hartmann mask produces an image well separated from all of the other images produced by the mask. Since the depth of focus of the sub-apertures is an order of magnitude larger than that of the parent optical system, the individual images are still diffraction-limited. We obtain short (10 to 100 msec) exposures and monitor the position fluctuations of the images. Analysis of the position and intensity fluctuations of the images can be used to determine the atmospheric parameter r0, the wind direction and velocity, and, under some circumstances, the distance of the turbulent layer from the observing site.
We describe a system for rapidly screening hundreds of nanoparticle samples using transmission electron microscopy (TEM). The system uses a liquid handling robot to place up to 96 individual samples onto a single standard TEM grid at separate locations. The grid is then transferred into the TEM and automated software is used to acquire multiscale images of each sample. The images are then analyzed to extract metrics on the size, shape, and morphology of the nanoparticles. The system has been used to characterize plasmonically active nanomaterials.
The 2013 Infection Prevention and Control (IP&C) Guideline for Cystic Fibrosis (CF) was commissioned by the CF Foundation as an update of the 2003 Infection Control Guideline for CF. During the past decade, new knowledge and new challenges provided the following rationale to develop updated IP&C strategies for this unique population:
1. The need to integrate relevant recommendations from evidence-based guidelines published since 2003 into IP&C practices for CF. These included guidelines from the Centers for Disease Control and Prevention (CDC)/Healthcare Infection Control Practices Advisory Committee (HICPAC), the World Health Organization (WHO), and key professional societies, including the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). During the past decade, new evidence has led to a renewed emphasis on source containment of potential pathogens and the role played by the contaminated healthcare environment in the transmission of infectious agents. Furthermore, an increased understanding of the importance of the application of implementation science, monitoring adherence, and feedback principles has been shown to increase the effectiveness of IP&C guideline recommendations.
2. Experience with emerging pathogens in the non-CF population has expanded our understanding of droplet transmission of respiratory pathogens and can inform IP&C strategies for CF. These pathogens include severe acute respiratory syndrome coronavirus and the 2009 influenza A H1N1. Lessons learned about preventing transmission of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant gram-negative pathogens in non-CF patient populations also can inform IP&C strategies for CF.
The detonation of a nuclear device in a US city would be catastrophic. Enormous loss of life and injuries would characterize an incident with profound human, political, social, and economic implications. Nevertheless, most responders have not received sufficient training about ionizing radiation, principles of radiation safety, or managing, diagnosing, and treating radiation-related injuries and illnesses. Members throughout the health care delivery system, including medical first responders, hospital first receivers, and health care institution support personnel such as janitors, hospital administrators, and security personnel, lack radiation-related training. This lack of knowledge can lead to failure of these groups to respond appropriately after a nuclear detonation or other major radiation incident and limit the effectiveness of the medical response and recovery effort. Efficacy of the response can be improved by getting each group the information it needs to do its job. This paper proposes a sustainable training strategy for spreading curricula throughout the necessary communities. It classifies the members of the health care delivery system into four tiers and identifies tasks for each tier and the radiation-relevant knowledge needed to perform these tasks. By providing education through additional modules to existing training structures, connecting radioactive contamination control to daily professional practices, and augmenting these systems with just-in-time training, the strategy creates a sustainable mechanism for giving members of the health care community improved ability to respond during a radiological or nuclear crisis, reducing fatalities, mitigating injuries, and improving the resiliency of the community.
BlumethalD, BaderJ, ChristensenD, KoernerJ, CuellarJ, HindsS, CrapoJ, GlassmanES, PotterAB, SingletaryL. A Sustainable Training Strategy for Improving Health Care Following a Catastrophic Radiological or Nuclear Incident. Prehosp Disaster Med. 2014;29(1):80-86.
Edited by
A. M. Viens, Queen Mary University of London,John Coggon, University of Southampton,Anthony S. Kessel, London School of Hygiene and Tropical Medicine
Many older women reduce the amount of cooking and food preparation they do in later life. While cooking may be seen as traditionally associated with women's family roles, little is known about the impact of such reduced engagement with food on their lives. This paper presents the findings from a one-year qualitative study (Changes Around Food Experience, CAFE) of the impact of reduced contact with preparing and cooking meals from scratch for 40 women, aged 65–95 years, living in Norfolk, United Kingdom. Data were collected through semi-structured interviews, focus groups and observations. Women's reasons for reducing food-related activities included changes in health, loss of a partner or a caring role, and new patterns of socialising. Disengagement from cooking and shopping was not found to entail predominantly negative feelings, passive acceptance or searching for forms of support to re-enable more cooking from scratch. Accounts evidenced the dynamic adaptability of older women in actively managing changed relationships with food. In exploring new meal options, older women were not simply disengaging from their environments. CAFE findings linked women's engagement with their environments to how they were using formal services and, even more, to the value they placed on social engagement and being out and about. Through the connections they fostered with friends, family and community, older women actively enabled their continued involvement in their social, public and family spheres. Reduced contact with preparing and cooking meals from scratch, therefore, did not induce or imply passivity or debility in the CAFE cohort. By contrast, it involved their exploring new means of retaining what was important to them about food in the context of their lived situation and social connections with friends, family, the community and public spheres.
SNR 1987A is the expanding remnant from the brightest supernova since the invention of the telescope. The remnant has been monitored extensively in the radio at variety of wavelengths and provides a wealth of data on which to base a simulation. Questions to be answered include estimating the efficiency of particle acceleration at shock fronts, determining the cause of the one-sided radio morphology for SNR 1987A and investigating the gas properties of the pre-supernova environment. We attempt to address these questions using a fully three-dimensional model of SNR 1987A.
The Duke Twins Study of Memory in Aging is an ongoing, longitudinal study of cognitive change and dementia in the population-based National Academy of Sciences-National Research Council (NAS-NRC) Twin Registry of World War II Male Veterans. The primary goal of this study has been to estimate the overall genetic and environmental contributions to dementia with a specific focus on Alzheimer's disease. An additional goal has been to examine specific genetic and environmental antecedents of cognitive decline and dementia. Since 1989, we have completed 4 waves of data collection. Each wave included a 2-phase telephone cognitive screening protocol, followed by an in-home standardized clinical assessment for those with suspected dementia. For many participants, we have obtained postmortem neuro-pathological confirmation of the diagnosis of dementia. In addition to data on cognition, we have also collected information on occupational history, medical history, medications and other lifetime experiences that may influence cognitive function in late life. We provide an overview of the study's methodology and describe the focus of recent research.
Web-based studies have become increasingly common in the social sciences, but have been rare in genetic epidemiology in general and twin studies in particular. We here review the methods, validity checks and preliminary correlational data from an on-line questionnaire collected from 2005–2008. During this time period, 44,112 individuals completed the questionnaire. This sample was 65.3% female, 85.4% 18 years or older, 72.0% Caucasian and had a mean educational level of 12.2 years. The sample included 609 twin, 333 sibling and 201 parent-offspring pairs as well as 342 dating partners, 313 ‘significant other’ pairs, 327 spouses and 2,316 friend pairs. A range of checks suggested low levels of invalid data. Correlations for personality, substance use and misuse, lifetime major depression, social attitudes, educational status, and height and weight were broadly similar to those obtained previously using conventional assessment methods. Web-based studies are a relatively easy and inexpensive way to ascertain large numbers of individuals, although obtaining twin pairs is more difficult, and female and monozygotic pairs are overrepresented. The sample is diverse and pair resemblance is generally similar to that obtained using interviews or mailed questionnaires.