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 email@example.com
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.
The general population prevalence and incidence of late-life agoraphobia was estimated and its clinical characteristics and risk factors described using data from the French ESPRIT study. One thousand nine hundred and sixty-eight persons aged 65 and above were randomly recruited from the electoral rolls of the district of Montpellier. Prevalent and incident agoraphobia diagnosed by a standardized psychiatric examination and validated by a clinical panel was assessed at base-line and over 4-year follow-up. The one-month prevalence of agoraphobia was estimated at 10.4% of whom 10.9% reported having the first-episode at age 65 or over. During the 4-year follow-up 11.2% of participants without agoraphobia at base line were classified as cases giving an incident rate of 32 per 1000 person-years. These 132 incident late-onset cases were associated with higher incident rates of anxiety disorders and suicidal ideation. Only two incident cases had past or concurrent panic attacks, which was not significantly different from non-cases. The principal base-line risk factors for incident cases derived from a multivariate model incorporating all significant risk factors were younger age of onset (OR = 0.94; 95% CI 0.90–0.99, P = 0.02), poorer visuospatial memory performance (OR = 1.60; 95% CI 1.02–2.49, P = 0.04), severe depression (OR = 2.62; 95% CI 1.34–5.10, P = 0.005) and trait anxiety (OR = 1.73; 95% CI 1.03–2.90, P = 0.04). No significant association was found with cardiac pathologies. We conclude that agoraphobia has high prevalence in the elderly and unlike younger cases, late-onset cases are not more common in women, and are not associated with panic attacks, suggesting a late-life subtype. Severe depression, trait anxiety and poor visuospatial memory are the principal risk factors for late-onset agoraphobia.
Whereas depression as a risk factor for the incidence of activity limitations in the elderly has been confirmed, little attention has been paid to anxiety, despite its high prevalence, with or without comorbid depression.
In a community-dwelling cohort of 1581 participants aged 65 years and over, the association between trait anxiety symptoms (Spielberger State-Trait Anxiety Inventory, third highest tercile) and current DSM-IV anxiety disorder (GAD, PTSD, OCD, panic disorder, agoraphobia or social phobia) at baseline and 7-year incident activity limitations was determined using mixed logistic regression models. Repeated measures of activity limitations included by increased severity level: social restriction (neighbourhood and house confined), mobility (Rosow and Breslau scale) and limitations in instrumental activities of daily living (IADL).
Of the sample, 42% were male and 14.2% had an anxiety disorder at baseline. Adjusting for socio-demographic and health variables, past and present depression and anxiolytic drugs, trait anxiety symptomatology was associated with increased incidence of social restriction (OR (95% CI): 2.46 (1.45–4.16), p = 0.0008) and current anxiety disorder with an increased risk of incident IADL limitation (OR (95% CI): 1.86 (1.01–3.41), p = 0.046). Associations remained significant in participants free of depressive symptoms at baseline (OR (95% CI): 2.92 (1.41–6.05), p = 0.004; OR (95% CI): 3.21 (1.31–7.89), p = 0.011, respectively).
Despite high comorbidity between depressive and anxiety symptoms, both trait symptomatology and anxiety disorder are independently associated with increased incident dependency with a gradient of severity: trait anxiety symptoms associated with incident social restriction and anxiety disorder with incidence of IADL limitations.
This article describes the development, implementation, and evaluation of a complex methotrexate ethics case used in teaching a Pharmacy Law and Ethics course. Qualitative analysis of student reflective writings provided useful insight into the students’ experience and comfort level with the final ethics case in the course. These data demonstrate a greater student appreciation of different perspectives, the potential for conflict in communicating about such cases, and the importance of patient autonomy. Faculty lessons learned are also described, facilitating adoption of this methotrexate ethics case by other healthcare profession educators.
To explore food perceptions among grandparents and understand the influence of these perceptions on food choice for the younger generations in their family.
Qualitative methodology, thematic analysis of the transcripts from fourteen focus groups.
Grandparents in the southern region of the United States.
Participants were fifty-eight Black, Hispanic, and White grandparents, predominantly women (72%), ranging in age from 44–86 years (mean age = 65·4 (sd 9·97) years).
Grandparents’ perceptions related to personal food choice were related to health issues and the media. Grandparents’ perceived influence on their children’s and grandchildren’s food choices was described through the themes of proximity and power (level of influence based on an interaction of geographic proximity to grandchildren and the power given to them by their children and grandchildren to make food decisions), healthy v. unhealthy spoiling, cultural food tradition, and reciprocal exchange of knowledge.
Our results highlight areas for future research including nutrition interventions for older adults as well as factors that may be helpful to consider when engaging grandparents concerning food decisions for younger generations to promote health. Specifically, power should be assessed as part of a holistic approach to addressing dietary influence, the term ‘healthy spoiling’ can be used to reframe notions of traditional spoiling, and the role of cultural food tradition should be adapted differently by race.
TAOS II is a next-generation occultation survey with the goal of measuring the size distribution of the small end of the Kuiper Belt (objects with diameters 0.5–30 km). Such objects have magnitudes r > 30, and are thus undetectable by direct imaging. The project will operate three telescopes at San Pedro Mártir Observatory in Baja California, México. Each telescope will be equipped with a custom-built camera comprised of a focal-plane array of CMOS imagers. The cameras will be capable of reading out image data from 10,000 stars at a cadence of 20 Hz. The telescopes will monitor the same set of stars simultaneously to search for coincident occultation detections, thus minimising the false-positive rate. This talk described the project, and reported on the progress of the development of the survey infrastructure.
Pain-related conditions have been reported to play a key role among risk factors for suicide. Headache in particular has been repeatedly associated with suicidal thoughts and behaviors. The aims of this study were: 1) to assess the association between lifetime headache (both non-migrainous headache and migraine) and lifetime suicide attempts (SA); 2) to differentiate, within subjects with lifetime SA, patients with and without lifetime headache in terms of socio-demographic and clinical features.
We studied 1965 subjects from a cohort of community-dwelling persons aged 65 years and over without dementia (the ESPRIT study), divided in two groups: those with (n = 75), and those without a lifetime SA (n = 1890). Logistic regression analyses were used to compare these groups according to lifetime headache status.
After adjusting for gender, living alone, tobacco and alcohol consumption, and depressive, manic/hypomanic and anxiety disorders, lifetime headache frequency was significantly higher in subjects with a lifetime SA compared with controls (OR = 1.92 [1.17–3.15]). Additionally, different factors were identified as being associated with lifetime SA in participants with lifetime headache (female gender, a lower level of high-density lipoprotein cholesterol, insomnia, lifetime major depression) versus participants without headache (glycemia and lifetime major depression).
Lifetime headache was associated with lifetime SA. Subjects who are women and report the co-occurrence of headache and insomnia as well as lifetime major depression require higher attention and a careful screening for suicidal thoughts and behaviors.
Background: Cerebral Palsy (CP) is a neurological condition arising from a perinatal or intra-uterine stroke. In the past 25 years there has been a revolution in neonatal care. For over 40 years children with CP in and around Saskatoon have been treated through the Kinsman Childrens’ Centre (KCC). This is a unique population database covering all CP patients in the region. We analyzed the KCC database to determine if the recent changes in neonatal care were correlated with the incidence of CP co-morbidities. Methods: A retrospective study using a Saskatchewan database of cerebral palsy data from the last four decades. Results: Over the last 40 years the incidence of visual disturbance and diagnoses of epilepsy in children with CP have remained stable regardless of advances in neonatal care. However, incidences of spine and hip issues requiring orthopedic intervention have halved. Conclusions: We hypothesize that advances in neonatal care have been successful in decreasing the incidence of gross motor impairments however have yet to significantly impact impairments relating to cortical network function. Although improvements in care have resulted in a decreased burden of disability, there remains opportunity for further improvements, especially in the settings of epilepsy and long-term visual function.
The aims of this study were to define the basic epidemiology of serologically confirmed acute Q fever in patients tested via the Townsville Hospital laboratory from 2000 to 2010 and to determine the impact of geographical location and seasonality on the incidence of acute cases in the Townsville region. Seven Statistical Local Areas (SLA) were identified as having an incidence higher than the average Queensland incidence over the study period. The SLA with the highest incidence was Woodstock-Ross with 24·9 cases/100 000. A clear seasonal peak was found, with the greatest number of cases observed in May, 3 months following the peak in rainfall in February. We hypothesize that an increase in wildlife numbers and drier conditions seen immediately following the wet season is the reason for the seasonal peak of human acute Q fever cases in Townsville.
Sunspot observations inspired solar dynamo theory and continue to do so. Simply counting them established the sunspot cycle and its period. Latitudinal distributions introduced the tough constraint that the source of sunspots moves equator-ward as the cycle progresses. Observations of Hale's polarity law mandated hemispheric asymmetry. How much more can sunspots tell us about the solar dynamo? We draw attention to a few outstanding questions raised by inherent sunspot properties. Namely, how to explain sunspot rotation rates, the incoherence of follower spots, the longitudinal spacing of sunspot groups, and brightness trends within a given sunspot cycle. After reviewing the first several topics, we then present new results on the brightness of sunspots in Cycle 24 as observed with the Helioseismic Magnetic Imager (HMI). We compare these results to the sunspot brightness observed in Cycle 23 with the Michelson Doppler Imager (MDI). Next, we compare the minimum intensities of five sunspots simultaneously observed by the Hinode Solar Optical Telescope Spectropolarimeter (SOT-SP) and HMI to verify that the minimum brightness of sunspot umbrae correlates well to the maximum field strength. We then examine 90 and 52 sunspots in the north and south hemisphere, respectively, from 2010 - 2012. Finally, we conclude that the average maximum field strengths of umbra 40 Carrington Rotations into Cycle 24 are 2690 Gauss, virtually indistinguishable from the 2660 Gauss value observed at a similar time in Cycle 23 with MDI.
The effect of elevated carbon dioxide (CO2) concentration on greenhouse gas (GHG) emission from semi-arid cropping systems is poorly understood. Closed static chambers were used to measure the fluxes of nitrous oxide (N2O), CO2 and methane (CH4) from a spring wheat (Triticum aestivum L. cv. Yitpi) crop-soil system at the Australian grains free-air carbon dioxide enrichment (AGFACE) facility at Horsham in southern Australia in 2009. The targeted atmospheric CO2 concentrations (hereafter CO2 concentration is abbreviated as [CO2]) were 390 (ambient) and 550 (elevated) μmol/mol for both rainfed and supplementary irrigated treatments. Gas measurements were conducted at five key growth stages of wheat. Elevated [CO2] increased the emission of N2O and CO2 by 108 and 29%, respectively, with changes being greater during the wheat vegetative stage. Supplementary irrigation reduced N2O emission by 36%, suggesting that N2O was reduced to N2 in the denitrification process. Irrigation increased CO2 flux by 26% at ambient [CO2] but not at elevated [CO2], and had no impact on CH4 flux. The present results suggest that under future atmospheric [CO2], agricultural GHG emissions at the vegetative stage may be higher and irrigation is likely to reduce the emissions from semi-arid cropping systems.
We evaluated A/H1N1 influenza in healthcare workers (HCWs) and in a flu room during the 2009 pandemic. The flu room aided HCW care and management by facilitating rapid diagnosis and treatment. Absence of fever was common, and symptoms were nonspecific. A higher rate of H1N1 occurred in HCWs deployed in acute services.
Excavations in the late-glacial Presumpscot Formation at Portland, Maine, uncovered tree remains and other terrestrial organics associated with marine invertebrate shells in a landslide deposit. Buds of Populus balsamifera (balsam poplar) occurred with twigs of Picea glauca (white spruce) in the Presumpscot clay. Tree rings in Picea logs indicate that the trees all died during winter dormancy in the same year. Ring widths show patterns of variation indicating responses to environmental changes. Fossil mosses and insects represent a variety of species and wet to dry microsites. The late-glacial environment at the site was similar to that of today's Maine coast. Radiocarbon ages of 14 tree samples are 11,907 ± 31 to 11,650 ± 50 14C yr BP. Wiggle matching of dated tree-ring segments to radiocarbon calibration data sets dates the landslide occurrence at ca. 13,520 + 95/−20 cal yr BP. Ages of shells juxtaposed with the logs are 12,850 ± 65 14C yr BP (Mytilus edulis) and 12,800 ± 55 14C yr BP (Balanus sp.), indicating a marine reservoir age of about 1000 yr. Using this value to correct previously published radiocarbon ages reduces the discrepancy between the Maine deglaciation chronology and the varve-based chronology elsewhere in New England.
Crop bioengineering provides unique and dramatic opportunities for international agricultural development. However, we consider the technology not as a ‘silver bullet’ or panacea for crop improvement in the developing world but as an increasingly important tool that can be used to complement conventional methods of crop improvement. The number of bioengineered crops ready for commercial release in developing countries is expected to expand considerably in the next few years. But the multi-national life sciences companies that are leading the research, development and commercialization of bioengineered crops focus primarily on major crops that have high commercial value and extensive international markets. These companies also hold proprietary gene technology for many other crops of extreme importance to subsistence and resource-poor farmers but do not pursue product development and commercialization because of low anticipated returns. Such crops have traditionally been overlooked and are sometimes referred to as ‘orphan crops’ because of the relative lack of research and development applied to them. We propose a strategy for the development and delivery of bioengineered crops, including orphan crops, for developing countries. Consulting local public and private sector stakeholders to determine their highest priority needs for agricultural products is the first step. This ensures local stakeholder buy-in and that we do not invest in technology that is unlikely to be adopted. Next, the feasibility of developing and delivering the product is assessed. If the result is positive, the work is organized into ‘product commercialization packages’ (PCPs) that integrate all elements of the research, development and commercialization processes. The main elements of each PCP include (i) technology development; (ii) policy-related issues such as intellectual property and licensing, as well as gaining regulatory approval by the relevant national authorities; (iii) providing public information to producers and consumers about the benefits, risks and correct management of these new products; and (iv) establishing, or verifying, the existence of marketing and distribution mechanisms to provide farmers access to planting material. Our strategy involves integration of needs-based capacity building, socio-economic impact studies and product stewardship into each PCP. Whenever appropriate, opportunities are sought to create public–private partnerships to help leverage public funds, help absorb development costs and provide a broader distribution channel. To illustrate how our strategy is being translated into action we include, as a case study, examples of work by the US Agency for International Development-funded, Cornell University-led Agricultural Biotechnology Support Project II on the research, development and delivery of bioengineered fruit and shoot-borer-resistant eggplant varieties (Solanum melanogena) for South and Southeast Asia.
Highly conducting and transparent Al-doped ZnO (AZO) thin films, which are oriented along c-axis and have wurtzite structure, were grown on quartz substrate at low temperature by pulsed laser deposition. The techniques of x-ray diffraction (XRD), Raman spectroscopy, atomic force microscopy (AFM), optical transmission spectroscopy (OTS), electrical resistivity, and Hall Effect were used to study the effect of growth temperature and oxygen pressure on the structural, electrical transport, and optical properties of these films. The optical transparency in all the films is high and does not change much with oxygen pressure and growth temperature. However, electrical parameters such as resistivity, carrier concentration, and mobility strongly depend on both oxygen pressure and growth temperature. The temperature dependence resistivity measurement indicates semiconducting behavior of all the films. A detailed study indicates that the films which are highly conducting and transparent correspond to an optimum temperature of 200 °C and an oxygen pressure of 5 × 10−7 bar. Higher transmittance of the AZO films compared with pure ZnO and ITO and comparable mobility make us to suggest that Al-doped ZnO is an excellent material for optoelectronic applications.