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To describe the genomic analysis and epidemiologic response related to a slow and prolonged methicillin-resistant Staphylococcus aureus (MRSA) outbreak.
Prospective observational study.
Neonatal intensive care unit (NICU).
We conducted an epidemiologic investigation of a NICU MRSA outbreak involving serial baby and staff screening to identify opportunities for decolonization. Whole-genome sequencing was performed on MRSA isolates.
A NICU with excellent hand hygiene compliance and longstanding minimal healthcare-associated infections experienced an MRSA outbreak involving 15 babies and 6 healthcare personnel (HCP). In total, 12 cases occurred slowly over a 1-year period (mean, 30.7 days apart) followed by 3 additional cases 7 months later. Multiple progressive infection prevention interventions were implemented, including contact precautions and cohorting of MRSA-positive babies, hand hygiene observers, enhanced environmental cleaning, screening of babies and staff, and decolonization of carriers. Only decolonization of HCP found to be persistent carriers of MRSA was successful in stopping transmission and ending the outbreak. Genomic analyses identified bidirectional transmission between babies and HCP during the outbreak.
In comparison to fast outbreaks, outbreaks that are “slow and sustained” may be more common to units with strong existing infection prevention practices such that a series of breaches have to align to result in a case. We identified a slow outbreak that persisted among staff and babies and was only stopped by identifying and decolonizing persistent MRSA carriage among staff. A repeated decolonization regimen was successful in allowing previously persistent carriers to safely continue work duties.
Young people with social disability and severe and complex mental health problems have poor outcomes, frequently struggling with treatment access and engagement. Outcomes may be improved by enhancing care and providing targeted psychological or psychosocial intervention.
We aimed to test the hypothesis that adding social recovery therapy (SRT) to enhanced standard care (ESC) would improve social recovery compared with ESC alone.
A pragmatic, assessor-masked, randomised controlled trial (PRODIGY: ISRCTN47998710) was conducted in three UK centres. Participants (n = 270) were aged 16–25 years, with persistent social disability, defined as under 30 hours of structured activity per week, social impairment for at least 6 months and severe and complex mental health problems. Participants were randomised to ESC alone or SRT plus ESC. SRT was an individual psychosocial therapy delivered over 9 months. The primary outcome was time spent in structured activity 15 months post-randomisation.
We randomised 132 participants to SRT plus ESC and 138 to ESC alone. Mean weekly hours in structured activity at 15 months increased by 11.1 h for SRT plus ESC (mean 22.4, s.d. = 21.4) and 16.6 h for ESC alone (mean 27.7, s.d. = 26.5). There was no significant difference between arms; treatment effect was −4.44 (95% CI −10.19 to 1.31, P = 0.13). Missingness was consistently greater in the ESC alone arm.
We found no evidence for the superiority of SRT as an adjunct to ESC. Participants in both arms made large, clinically significant improvements on all outcomes. When providing comprehensive evidence-based standard care, there are no additional gains by providing specialised SRT. Optimising standard care to ensure targeted delivery of existing interventions may further improve outcomes.
We examined whether preadmission history of depression is associated with less delirium/coma-free (DCF) days, worse 1-year depression severity and cognitive impairment.
Design and measurements:
A health proxy reported history of depression. Separate models examined the effect of preadmission history of depression on: (a) intensive care unit (ICU) course, measured as DCF days; (b) depression symptom severity at 3 and 12 months, measured by the Beck Depression Inventory-II (BDI-II); and (c) cognitive performance at 3 and 12 months, measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) global score.
Setting and participants:
Patients admitted to the medical/surgical ICU services were eligible.
Of 821 subjects eligible at enrollment, 261 (33%) had preadmission history of depression. After adjusting for covariates, preadmission history of depression was not associated with less DCF days (OR 0.78, 95% CI, 0.59–1.03 p = 0.077). A prior history of depression was associated with higher BDI-II scores at 3 and 12 months (3 months OR 2.15, 95% CI, 1.42–3.24 p = <0.001; 12 months OR 1.89, 95% CI, 1.24–2.87 p = 0.003). We did not observe an association between preadmission history of depression and cognitive performance at either 3 or 12 months (3 months beta coefficient −0.04, 95% CI, −2.70–2.62 p = 0.97; 12 months 1.5, 95% CI, −1.26–4.26 p = 0.28).
Patients with a depression history prior to ICU stay exhibit a greater severity of depressive symptoms in the year after hospitalization.
In the interest of promoting open and reproducible science, the Journal of Experimental Political Science editorial team will pilot the pre-acceptance of preregistered reports. We note that the launch of this new submission option is a complement to, and does not replace, the option to submit other types of manuscripts. JEPS remains open to receiving and reviewing high quality manuscripts regardless of whether they are based on preregistered studies.
We are excited and honored to be the editorial team for JEPS. We are indebted to Eric Dickson for his efforts as the journal's previous editor. He set a high bar for JEPS as an outlet for high quality experimental research. Lucky for us, the healthy state of experimental research means that we will continue to have a deep pool of well-crafted and important work. We also thank Nick Haas, who deftly guided us through the transition as Editorial Assistant. Without his help, it would have been a near impossible task to get up to speed.
The ultimatum game is a standard instrument for laboratory experimentalists. It has been replicated in a large number of environments and points to special considerations for fairness. Although it has been popular in the experimental community, researchers have not harnessed all the statistical power they should to evaluate the dynamics at work in this type of a bargaining game. This research uses two planned treatments, the first involving a signaling condition concerning a subject's “type”, and the second a price effect built into the structure of the game. We find that there are no significant main effects as a result of the signaling condition of a subject's type, but that there are strong effects as a result of the different payoff parameters. Using a variety of multivariate models we find important, nonobvious interactions with the gender of the subjects. The lesson that we take away from this research is that experimentalists can learn more from data collected in the tightly controlled laboratory environment by using statistical techniques that complement their research designs.
Digital signal processing is one of many valuable tools for suppressing unwanted signals or inter-ference. Building hardware processing engines seems to be the way to best implement some classes of interference suppression but is, unfortunately, expensive and time-consuming, especially if several miti-gation techniques need to be compared. Simulations can be useful, but are not a substitute for real data. CSIRO’s Australia Telescope National Facility has recently commenced a ‘software radio telescope’ project designed to fill the gap between dedicated hardware processors and pure simulation. In this approach, real telescope data are recorded coherently, then processed offline. This paper summarises the current contents of a freely available database of base band recorded data that can be used to experiment with signal processing solutions. It includes data from the following systems: single dish, multi-feed receiver; single dish with reference antenna; and an array of six 22 m antennas with and without a reference antenna. Astronomical sources such as OH masers, pulsars and continuum sources subject to interfering signals were recorded. The interfering signals include signals from the US Global Positioning System (GPS) and its Russian equivalent (GLONASS), television, microwave links, a low-Earth-orbit satellite, various other transmitters, and signals leaking from local telescope systems with fast clocks. The data are available on compact disk, allowing use in general purpose computers or as input to laboratory hardware prototypes.
Peer review is central to political science. In this article we collect the ideas of journal editors in political science and several recent PhDs, who met as a panel at the 2011 American Political Science Association Annual Meeting to discuss the principles of the review process. This includes why reviewing is important to the development of one's own scholarship but also offers some nuts and bolts on reviewing.
To develop alternative and low cost photovoltaic technologies we have synthesized CuInS2 nanocrystals with tunable optical properties and characterization was carried out thoroughly with TEM, SEM, EDAX and XRD. Furthermore large self-organized arrays of TiO2 nanotubes were fabricated on Ti foil followed by simple electrochemical anodization technique and characterized their structure by SEM and then for the first time coupled both the nanocrystals and nanotubes to form a p-n junction type photovoltaic device. The current-voltage (I-V) characteristics of photovoltaic cells were measured to test the proof of concept. Some preliminary experiments showed that device generates some current upon illumination. However, in our case we fabricated a device without sandwiching any buffer or barrier layers in between nanocrystals and nanotube arrays. We have been optimizing our solar cells efficiency by improving quality of nanotubes and nanocrystals. Some of the interesting finding are presented and discussed.
Trust and its complement, trustworthiness, are key concepts in political science. Trust is seen as critical for the existence of stable political institutions, as well as for the formation of social capital and civic engagement (Putnam 1993, 2000; Stolle 1998). It also serves as a social lubricant that reduces the cost of exchange, whether in reaching political compromise (Fenno 1978; Bianco 1994) or in daily market and nonmarket exchange (Lupia and McCubbins 1998; Sztompka 1999; Knight 2001). Researchers in this area face three key challenges. First, the concept of trust has been used in a multiplicity of ways, leaving its meaning unclear. Second, it is used to refer both to trust in government and trust among individuals (interpersonal trust). Third, it is sometimes seen as a cause and sometimes as an effect of effective political institutions, leaving the causal relationship between trust and institutions unclear.
The definition of trust is muddied by the fact that two distinct research methods have been used to explore it. Early research treats trust as a perception of norms in a society, assessed using survey questions about the trustworthiness or fairness of others. For forty years, the General Social Survey (GSS), World Values Survey (WVS), and American National Election Studies (ANES) have relied on the same questions to evaluate trust. In contrast, recent research has turned to behavioral assessments of trust using incentivized, economics-style laboratory experiments; this work is the focus of this chapter.
Nutrigenomics is the study of how constituents of the diet interact with genes, and their products, to alter phenotype and, conversely, how genes and their products metabolise these constituents into nutrients, antinutrients, and bioactive compounds. Results from molecular and genetic epidemiological studies indicate that dietary unbalance can alter gene–nutrient interactions in ways that increase the risk of developing chronic disease. The interplay of human genetic variation and environmental factors will make identifying causative genes and nutrients a formidable, but not intractable, challenge. We provide specific recommendations for how to best meet this challenge and discuss the need for new methodologies and the use of comprehensive analyses of nutrient–genotype interactions involving large and diverse populations. The objective of the present paper is to stimulate discourse and collaboration among nutrigenomic researchers and stakeholders, a process that will lead to an increase in global health and wellness by reducing health disparities in developed and developing countries.
The willingness to trust strangers has been associated with a variety of public benefits, from greater civic-mindedness and more honest government to higher rates of economic growth, and more. But a growing body of research finds that such generalized trust is far more common in ethnically homogeneous than in more diverse societies. Ethnic difference is believed to breed more particularistic, ingroup ties, thus undermining both generalized and cross-ethnic trust. We argue that this image is too narrow, and we propose a broader model to identify the factors that give rise to cross-ethnic trust. Using data from two minority regions of Russia, we find considerable support for the model. We also find that high ingroup or particularistic trust is no barrier to faith in another ethnic group.
In a study of plasma amino acids in psychiatric patients, serine to cysteine (S/C) ratio was higher (S/C = 1.57±0.28) in 57 psychotics compared to 27 nonpsychotics (S/C = 1.06±0.23). This difference was highly significant at P <0.001. Psychotic patients were given a psychosis score (p score) of 1–4, The S/C ratios of individual patients were significantly correlated to their p scores (r = 0.65, P <0.001). S/C ratios were not related to diagnosis, age, sex, food intake and medications. When the initial S/C ratio and p scores of 22 patients were compared to their S/C ratio and p score at the time when they were improved and ready to be discharged, there was a concomitant fall both in S/C ratios and p scores suggesting the high S/C ratios may be indicative of a state rather than a trait characteristic. Our findings lead us to the conclusion that S/C ratios may provide a marker for the presence of psychosis and an index of its severity.
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