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Among 353 healthcare personnel in a longitudinal cohort in 4 hospitals in Atlanta, Georgia (May–June 2020), 23 (6.5%) had severe acute respiratory coronavirus virus 2 (SARS-CoV-2) antibodies. Spending >50% of a typical shift at the bedside (OR, 3.4; 95% CI, 1.2–10.5) and black race (OR, 8.4; 95% CI, 2.7–27.4) were associated with SARS-CoV-2 seropositivity.
The Burnout Syndrome Study screened for burnout in psychiatric trainees in 22 countries, along with associated factors. This paper reports the results of the PHQ-9 depression screen that formed part of the study.
It is well documented that physicians have higher rates of mental illness compared to the general population. Post-graduate medical trainees may work long hours and be exposed to stressful or saddening situations regularly. Their environment and workload means they may not exhibit appropriate help-seeking behaviours and be at significant risk of depression.
The study used a cross sectional, multi-country online survey. Participants were asked to participate via an email invitation. The participants were asked to complete the PHQ-9 questionnaire, which is validated as a primary care self-administered screen for depression. Mixed methodology was used when recruiting trainees to obtain the most representative sample possible from each country. Statistical analysis was performed using SPSS.
Complete data was obtained from 1980 trainees with an average age of 31.9 years and with 2.8 years of training. The prevalence of depression in psychiatric trainees varied by country from 50% in Latvia to 7.1% in Belarus. The average rate of depression was 20.8%.
Prevalence of depression in the US general population is estimated at 6.7%, making the prevalence of depression in trainees of 20.8% a sign that action needs to be taken to reduce depression rates in trainees.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Horseweed is one of Kentucky’s most common and problematic weeds in no-till soybean production systems. Emergence in the fall and spring necessitates control at these times because horseweed is best managed when small. Control is typically achieved through herbicides or cover crops (CCs); integrating these practices can lead to more sustainable weed management. Two years of field experiments were conducted over 2016 to 2017 and 2017 to 2018 in Versailles, KY, to examine the use of fall herbicide (FH; namely, saflufenacil or none), spring herbicide (SH; namely, 2,4-D; dicamba; or none), and CC (namely, cereal rye or none) for horseweed management prior to soybean. Treatments were examined with a fully factorial design to assess potential interactions. The CC biomass in 2016 to 2017 was higher relative to 2017 to 2018 and both herbicide programs reduced winter weed biomass in that year. The CC reduced horseweed density while growing and after termination in 1 yr. The FH reduced horseweed density through mid-spring. The FH also killed winter weeds that may have suppressed horseweed emergence; higher horseweed density resulted by soybean planting unless the CC was present to suppress the additional spring emergence. If either FH or CC was used, SH typically did not result in additional horseweed control. The SH killed emerged plants but did not provide residual control of a late horseweed flush in 2017 to 2018. These results suggest CCs can help manage spring flushes of horseweed emergence when nonresidual herbicide products are used, though this effect was short-lived when less CC biomass was present.
Horseweed, also known as marestail, is a problematic weed for no-till soybean producers that can emerge from late summer through the following spring. Overwintering cover crops can reduce both the density and size of fall-emerged weeds such as horseweed and reduce further spring emergence, although typically cover crops do not provide complete control. Cover crops may be integrated with additional spring herbicide applications to control emerged horseweed, and selective herbicides such as 2,4-D may be used to target horseweed while maintaining small grain cover crop growth. However, cover crops may affect herbicide deposition, which could reduce their efficacy to control weeds. The objective of this study was to determine how the amount and variability of 2,4-D ester spray solution deposition, measured with water-sensitive paper, was affected by a cereal rye cover crop and fall-applied saflufenacil. We also examined deposition at the soil surface relative to the cereal rye row position. In a year with greater cereal rye biomass accumulation, there was 44% less coverage and average deposit size was 45% smaller immediately adjacent to cereal rye rows compared with between rows and areas without cereal rye. Greater variability in these measurements was also noted in this position. Percent spray solution coverage was also 22% greater in plots that received saflufenacil in the fall, and deposits were 28% larger. In a year with less cover crop and winter weed biomass, no differences in spray deposition were observed. This suggests that small horseweed plants and other weeds immediately adjacent to cereal rye cover crop rows may be more likely to survive early spring herbicide applications, though the suppressive effects of cover crops may mitigate this concern.
Landraces (including heritage varieties) are an important agrobiodiversity resource offering considerable value as a buffer against crop failures, as a crop for niche markets, and as a source of diversity for crop genetic improvement activities underpinning future food security. Home gardens are reservoirs of landrace diversity, but some of the accessions held in them are vulnerable or threatened with extinction. Those associated with seed saving networks have added security, for example, ca. 800 varieties are stored in the Heritage Seed Library (HSL) of Garden Organic, UK. In this study, Amplified Fragment Length Polymorphisms-based genetic analysis of accessions held in the HSL was used to (a) demonstrate the range of diversity in the collection, (b) characterize accessions to aid collection management and (c) promote broader use of the collection. In total, 171 accessions were included from six crops: Vicia faba L., Pisum sativum L., Daucus carota L., Cucumis sativus L., Lactuca sativa L. and Brassica oleracea L. var. acephala (DC.) Metzq. Average expected heterozygosity ranged from 0.18 to 0.28 in D. carota; 0.02–0.18 in P. sativum; 0.05–0.18 in L. sativa; 0.15–0.26 in B. oleracea var. acephala; 0.15–0.37 in C. sativus and 0.07–0.36 in V. faba. Genetic diversity and Fst values generally reflected the breeding system and cultivation history of the different crops. Comparisons of the diversity found in heritage varieties with that found in commercial varieties did not show a consistent pattern. Principal coordinates analysis and Unweighted Pair Group Method with Arithmetic Mean cluster analysis were used to identify four potential duplicate accession pairs.
This paper presents the results of investigations at the ancient Maya site of Margarita in south-central Quintana Roo, Mexico, and relates them to documented patterns at neighboring centers. Following initial settlement of the region in the Middle Preclassic, settlement hierarchies topped by large centers with monumental architecture, carved monuments, and associations with sites to the south emerged in the Late Preclassic to Early Classic periods. In the Late Classic, several primary centers declined and there was a proliferation of affluent urban populations—evidenced by construction of elaborate residential groups—at smaller centers like Margarita. Long-distance cultural affiliations shifted as well, with ceramic and architectural links to western and northern Yucatán becoming pronounced. Many settlements were abandoned in the Terminal Classic, but there is also evidence of the formation of “post-collapse” communities at Margarita and other neighboring sites during the same period.
We examined psychological outcomes in a sample of participants who evacuated from the World Trade Center towers on September 11, 2011. This study aimed to identify risk factors for psychological injury that might be amenable to change, thereby reducing adverse impacts associated with emergency high-rise evacuation.
We used data from a cross-sectional survey conducted 2 years after the attacks to classify 789 evacuees into 3 self-reported psychological outcome categories: long-term psychological disorder diagnosed by a physician, short-term psychological disorder and/or memory problems, and no known psychological disorder.
After nonmodifiable risk factors were controlled for, diagnosed psychological disorder was more likely for evacuees who reported lower “emergency preparedness safety climate” scores, more evacuation challenges (during exit from the towers), and evacuation-related physical injuries. Other variables associated with increased risk of psychological disorder outcome included gender (female), lower levels of education, preexisting physical disability, preexisting psychological disorder, greater distance to final exit, and more information sources during egress.
Improving the “emergency preparedness safety climate” of high-rise business occupancies and reducing the number of egress challenges are potential strategies for reducing the risk of adverse psychological outcomes of high-rise evacuations. Focused safety training for individuals with physical disabilities is also warranted. (Disaster Med Public Health Preparedness. 2017;11:326–336)
Menu labelling has been identified as a potential strategy to help individuals make healthier choices when eating out. Although adolescents eat out often, little research involving menu labelling has been conducted with this population. The objectives of the present study were to: (i) gather qualitative information from adolescents regarding use of menu labels when eating out; (ii) gather adolescents’ suggestions for optimal ways to design menu labels; and (iii) examine differences between adolescents living in communities of different socio-economic status.
Qualitative. Five focus groups of five to ten participants.
Austin, TX, USA, 2012.
Forty-one adolescents living in diverse communities recruited using a snowballing technique at public and private recreation centres (twenty-four females; twenty-two African American).
Participants reported that menu labelling, in general, does not influence food selections when eating out. Among participants living in low-income communities, food purchases were based on price, taste and familiarity. Among participants living in high-income areas, food purchases were based on quality and ability to satiate (among boys). According to participants, effective ways to present menu labels are by matching calorie levels with physical activity equivalents or through simple graphics.
For adolescents, providing menu labels in their current format may not be an effective strategy to increase healthy food selection. Given that the current menu label format has been set by federal policy in the USA cannot be easily changed, research to determine how this format can be best presented or enhanced so that it can have an impact on all US sub-populations is warranted.
To determine the prospective relationship between changes in sugar-sweetened beverage (SSB) intake and central adiposity in older children.
Dietary intakes of children were obtained by 3 d food records at ages 10 and 13 years. Waist circumference (WC) and weight and height to determine BMI were measured at 10 and 13 years and total body fat mass (TBFM) at 13 years by dual-energy X-ray absorptiometry. Analyses were conducted using multivariable linear regression. Reporting errors were measured and participants were categorized as under-, plausible and over-reporters of dietary intakes.
Community-based British cohort of children participating in the Avon Longitudinal Study of Parents and Children.
Among 2455 older children, increased SSB consumption from ages 10 to 13 years was associated with higher WC (standardized β=0·020, P=0·19), BMI (β=0·028, P=0·03) and TBFM (β=0·017, P=0·20) at 13 years. Effects were strengthened among plausible dietary reporters (n 1059): WC (β=0·097, P<0·001), BMI (β=0·074, P<0·001) and TBFM (β=0·065, P=0·003). The association between change in SSB and WC was weakened, but remained statistically significant after accounting for BMI (β=0·042, P=0·02) and TBFM (β=0·048, P=0·01).
Higher consumption of SSB from ages 10 to 13 years was associated with a larger WC at age 13 years independent of differences in total adiposity. Accounting for dietary reporting errors strengthened associations. Our findings further support recommendations to limit intakes of SSB to reduce excess weight gain in children and suggest that SSB have an additional deleterious effect on central adiposity.
Corner stores, also known as bodegas, are prevalent in low-income urban areas and primarily stock high-energy foods and beverages. Little is known about individual-level purchases in these locations. The purpose of the present study was to assess corner store purchases (items, nutritional characteristics and amount spent) made by children, adolescents and adults in a low-income urban environment.
Evaluation staff used 9238 intercept surveys to directly examine food and beverage purchases.
Intercepts were collected at 192 corner stores in Philadelphia, PA, USA.
Participants were adult, adolescent and child corner store shoppers.
Among the 9238 intercept surveys, there were 20 244 items. On average, at each corner store visit, consumers purchased 2·2 (sd 2·1) items (1·3 (sd 2·0) foods and 0·9 (sd 0·9) beverages) that cost $US 2·74 (sd $US 3·52) and contained 2786·5 (sd 4454·2) kJ (666·0 (sd 1064·6) kcal). Whether the data were examined as a percentage of total items purchased or as a percentage of intercepts, the most common corner store purchases were beverages, chips, prepared food items, pastries and candy. Beverage purchases occurred during 65·9 % of intercepts and accounted for 39·2 % of all items. Regular soda was the most popular beverage purchase. Corner store purchases averaged 66·2 g of sugar, 921·1 mg of sodium and 2·5 g of fibre per intercept. Compared with children and adolescents, adults spent the most money and purchased the most energy.
Urban corner store shoppers spent almost $US 3·00 for over 2700 kJ (650 kcal) per store visit. Obesity prevention efforts may benefit from including interventions aimed at changing corner store food environments in low-income, urban areas.
To analyse trends in two-week rule referrals for head and neck cancer over 10 years.
Data from two-week referrals received by the Wirral University Hospital NHS Trust between 1 January and 30 June 2012 were compared with similar data from 2002.
A total of 357 referrals were received during the 6-month audit period, compared with 149 during the whole of 2002. Cancer pick-up rates were 9 per cent and 5 per cent in the first and second cycles, respectively.
The annual number of two-week referrals made to our department increased by over 450 per cent in 10 years, but the resulting cancer pick-up rate fell by nearly 50 per cent. Whilst cancer patients need to be seen quickly, the current system is inefficient in parts. Modifications to the treatment pathway should be considered to improve patient care quality and reduce pressure on ENT departments.
In situ Pleistocene reefs form a gently sloping nearshore terrace around the island of Oahu. TIMS Th–U ages of in situ corals indicate that most of the terrace is composed of reefal limestones correlating to Marine Oxygen Isotope Stage 7 (MIS 7, ~ 190–245 ka). The position of the in situ MIS 7 reef complex indicates that it formed during periods when local sea level was ~ 9 to 20 m below present sea level. Its extensiveness and geomorphic prominence as well as a paucity of emergent in situ MIS 7 reef-framework deposits on Oahu suggest that much of MIS 7 was characterized by regional sea levels below present. Later accretion along the seaward front of the terrace occurred during the latter part of MIS 5 (i.e., MIS 5a–5d, ~ 76–113 ka). The position of the late MIS 5 reefal limestones is consistent with formation during a period when local sea level was below present. The extensiveness of the submerged Pleistocene reefs around Oahu compared to the relative dearth of Holocene accretion is due to the fact that Pleistocene reefs had both more time and more accommodation space available for accretion than their Holocene counterparts.
Anomalously broad diffuse interstellar bands (DIBs) at 5780.5, 5797.1, 6196.0, and 6613.6 Å are found in absorption along the line of sight to Herschel 36, an O star system next to the bright Hourglass nebula of the Hii region Messier 8. Excited lines of CH and CH+ are seen as well. We show that the region is very compact and itemize other anomalies of the gas. An infrared-bright star within 400 AU is noted. The combination of these effects produces anomalous DIBs, interpreted by Oka et al. (2013, see also this volume) as being caused predominantly by infrared pumping of rotational levels of relatively small molecules.
Beginning with the 1972 presidential election and for each election thereafter Harvard University's Institute of Politics in the John F. Kennedy School of Government has held a post-election symposium where all of the campaign managers, pollsters, political consultants and media advisors for all of the primary and general election candidates come together with leading journalists, electronic and print, and political commentators and pundits to discuss and dialogue about what occurred during the election among the candidates, nominees, and the winner and losers. The symposia have allowed campaign managers to describe what happened and forecast for the forthcoming presidential election. After the multi-day symposium a book length transcript is published. In 1992 the Annenberg School of Communication at the University of Pennsylvania launched its own symposia where the campaign managers of the Democratic and Republican nominees in the general election are invited to discuss what happened and forecast for the next presidential election. The ten books in the Harvard series and the three books in the Pennsylvania series are used as data sources in this article to determine if any of the campaign managers forecasted and/or predicted an African American presidential candidate, even when such candidates had appeared in previous years. While our findings uncover some of the interests and concerns of presidential campaign managers and advisors since 1972, the overriding focus of the symposia has been on the nature, scope, and significance of the African American electorate.