To save 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 saving content to .
To save 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 saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved 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.
Colleges and universities around the world engaged diverse strategies during the COVID-19 pandemic. Baylor University, a community of ˜22,700 individuals, was 1 of the institutions which resumed and sustained operations. The key strategy was establishment of multidisciplinary teams to develop mitigation strategies and priority areas for action. This population-based team approach along with implementation of a “Swiss Cheese” risk mitigation model allowed small clusters to be rapidly addressed through testing, surveillance, tracing, isolation, and quarantine. These efforts were supported by health protocols including face coverings, social distancing, and compliance monitoring. As a result, activities were sustained from August 1 to December 8, 2020. There were 62,970 COVID-19 tests conducted with 1435 people testing positive for a positivity rate of 2.28%. A total of 1670 COVID-19 cases were identified with 235 self-reports. The mean number of tests per week was 3500 with approximately 80 of these positive (11/d). More than 60 student tracers were trained with over 120 personnel available to contact trace, at a ratio of 1 per 400 university members. The successes and lessons learned provide a framework and pathway for similar institutions to mitigate the ongoing impacts of COVID-19 and sustain operations during a global pandemic.
The vagus nerve performs many different functions in the human body. Understanding these functions helps inform the potential side effects of vagus nerve stimulation (VNS). The nerve consists of 80% afferent fibres [1,2]. These include visceral sensory and taste fibres which travel primarily to the nucleus of the tractus solitarius, as well as cutaneous sensation fibres from the external auditory meatus which project to the spinal nucleus of the trigeminal nerve. The efferent component includes branchial motor fibres from the nucleus ambiguus, parasympathetic fibres primarily from the dorsal nucleus of the vagus and parasympathetic fibres from the nucleus ambiguus to the heart. The motor fibres innervate skeletal muscles in the head and neck involved in speech production and swallowing, while the parasympathetic fibres innervate most of the viscera serving to control heart rate, respiration, gastrointestinal motility and many other autonomic functions. The majority of fibres in the vagus nerve consist of unmyelinated C fibres, but commensurate with its wide variety of functions, it also contains larger and faster-conducting A- and B-type fibres. The brainstem nuclei that receive vagal inputs integrate homeostatic information, provide commensurate adjustments to autonomic functions and also send this information to other brainstem nuclei projecting widely throughout the brain.
Fifty million people worldwide have epilepsy and yet up to 35% of patients experience seizures that are resistant to anti-epileptic drugs. Patients with medication-resistant epilepsy have increased risks of premature death, psychosocial dysfunction and a reduced quality of life. This key resource delivers guidance for all clinicians involved in caring for patients with medication-resistant epilepsy in order to reduce these risks. Covering the epidemiology, biology, causes and potential treatments for medication-resistant epilepsy, this definitive and focused text reviews the clinical care needs of patients. Guidance is practical and includes treatment for specialized groups including pediatric patients and those with psychiatric comorbidities. Several promising non-pharmacologic interventions available for patients, such as surgery, neuromodulation diet therapy and botanical treatment are explored in detail. Leading international figures from a range of disciplines bring their expertise together holistically in this essential manual.
Work–life balance facilitates positive affect, happiness, and satisfaction [1–4]; absence of it contributes to depression and anxiety . However, achieving a “balance” is easier said than done. Strategies to increase positive affect, happiness, and quality of life have often been simplistic.
For example, some suggestions to enhance work–life balance include “learn to say no if you are too busy,” “practice self-care,” “don’t take work home with you,” “make time for friends and family outside of work,” and “reduce work email and work phone access” . In contrast, our chapter focuses on how to increase well-being. Well-being and positive affect are well described in the positive psychology literature [6, 7].
The science of studying diamond inclusions for understanding Earth history has developed significantly over the past decades, with new instrumentation and techniques applied to diamond sample archives revealing the stories contained within diamond inclusions. This chapter reviews what diamonds can tell us about the deep carbon cycle over the course of Earth’s history. It reviews how the geochemistry of diamonds and their inclusions inform us about the deep carbon cycle, the origin of the diamonds in Earth’s mantle, and the evolution of diamonds through time.
Simulation plays an integral role in the Canadian healthcare system with applications in quality improvement, systems development, and medical education. High-quality, simulation-based research will ensure its effective use. This study sought to summarize simulation-based research activity and its facilitators and barriers, as well as establish priorities for simulation-based research in Canadian emergency medicine (EM).
Simulation-leads from Canadian departments or divisions of EM associated with a general FRCP-EM training program surveyed and documented active EM simulation-based research at their institutions and identified the perceived facilitators and barriers. Priorities for simulation-based research were generated by simulation-leads via a second survey; these were grouped into themes and finally endorsed by consensus during an in-person meeting of simulation leads. Priority themes were also reviewed by senior simulation educators.
Twenty simulation-leads representing all 14 invited institutions participated in the study between February and May, 2018. Sixty-two active, simulation-based research projects were identified (median per institution = 4.5, IQR 4), as well as six common facilitators and five barriers. Forty-nine priorities for simulation-based research were reported and summarized into eight themes: simulation in competency-based medical education, simulation for inter-professional learning, simulation for summative assessment, simulation for continuing professional development, national curricular development, best practices in simulation-based education, simulation-based education outcomes, and simulation as an investigative methodology.
This study summarized simulation-based research activity in EM in Canada, identified its perceived facilitators and barriers, and built national consensus on priority research themes. This represents the first step in the development of a simulation-based research agenda specific to Canadian EM.
We study the implications of patents in an overlapping generations model with horizontal innovation of differentiated physical capital. We show that within this demographic structure of finitely lived agents, weakening patent protection generates two contradicting effects on innovation and growth. Weakening patent protection lowers the (average) price of patented machines, thereby increasing machine utilization, output, aggregate saving, and investment. However, a higher demand for machines shifts investment away from the R&D activity aimed at inventing new machine varieties toward the formation of physical capital. The growth-maximizing level of patent protection is incomplete. Shortening patent length is more effective than loosening patent breadth in spurring growth, due to an additional positive effect on growth, that is decreasing investment in old patents. Welfare can be improved by weakening patent protection beyond the growth-maximizing level.
Objective: To determine whether volumetric measures of the hippocampus, entorhinal cortex, and other cortical measures can differentiate between cognitively normal individuals and subjects with mild cognitive impairment (MCI). Method: Magnetic resonance imaging (MRI) data from 46 cognitively normal subjects and 50 subjects with MCI as part of the Boston University Alzheimer’s Disease Center research registry and the Alzheimer’s Disease Neuroimaging Initiative were used in this cross-sectional study. Cortical, subcortical, and hippocampal subfield volumes were generated from each subject’s MRI data using FreeSurfer v6.0. Nominal logistic regression models containing these variables were used to identify subjects as control or MCI. Results: A model containing regions of interest (superior temporal cortex, caudal anterior cingulate, pars opercularis, subiculum, precentral cortex, caudal middle frontal cortex, rostral middle frontal cortex, pars orbitalis, middle temporal cortex, insula, banks of the superior temporal sulcus, parasubiculum, paracentral lobule) fit the data best (R2 = .7310, whole model test chi-square = 97.16, p < .0001). Conclusions: MRI data correctly classified most subjects using measures of selected medial temporal lobe structures in combination with those from other cortical areas, yielding an overall classification accuracy of 93.75%. These findings support the notion that, while volumes of medial temporal lobe regions differ between cognitively normal and MCI subjects, differences that can be used to distinguish between these two populations are present elsewhere in the brain.
Anorexia nervosa is an eating disorder, which is associated with many different medical complications as a result of the weight loss and malnutrition that characterise this illness. It has the highest mortality rate of any psychiatric disorder. A large portion of deaths are attributable to the cardiac abnormalities that ensue as a result of the malnutrition associated with anorexia nervosa. In this review, the cardiac complications of anorexia nervosa will be discussed.
A comprehensive literature review on cardiac changes in anorexia nervosa was carried out.
There are structural, functional, and rhythm-type changes that occur in patients with anorexia nervosa. These become progressively significant as ongoing weight loss occurs.
Cardiac changes are inherent to anorexia nervosa and they become more life-threatening and serious as the anorexia nervosa becomes increasingly severe. Weight restoration and attention to these cardiac changes are crucial for a successful treatment outcome.
The integration of women and African Americans into the politically active southern electorate in the 1960s and the 1970s was a turning point in the rise of the “New South” and essential to the establishment of a democratic political process in the region. Whereas there are numerous studies of the reenfranchisement of African Americans in the South in the literature, temporal changes in the gender gap in southern political participation have received less attention. Gender inequality in voting has historically been greatest in the South and was more resistant to change over time. This study is the first to examine the intersection of gender and racial inequality in political participation in the South over a period spanning several decades. Building on previous theories of political participation, including the civic voluntarism model and the strategic mobilization perspective, we develop and test a conceptual model based on the interplay between individual characteristics and the broader institutional context. Using data from the American National Election Studies, we examine racial differences in the gender gap in southern political participation over time using hierarchical age-period-cohort analysis. We conclude with a discussion of the theoretical implications for the study of gender and racial inequality in political participation.
Although attention has been given to how broadband access is related to economic development in rural areas, scant consideration has been given to how it may be associated with voluntary participation. This issue is important in that numerous studies have shown how much more vital community participation is in rural areas as compared to suburban and urban places. Drawing on three diverse data sets, we examine the influence of broadband access on community participation. In addition, we explore whether broadband access exerts its influence through, in conjunction with, or independent of social networks. The results suggest that broadband access and social network size have independent effects on volunteering in rural places.