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Public representations of long-term residential care (LTRC) facilities have received limited focus in Canada, although literature from other countries indicates that public perceptions of LTRC tend to be negative, particularly in contexts that prioritize aging and dying in place. Using Manitoba as the study context, we investigate a question of broad relevance to the Canadian perspective; specifically, what are current public perceptions of the role and function of long-term care in the context of a changing health care system? Through critical discourse analysis, we identify four overarching discourses dominating public perceptions of LTRC: the problem of public aging, LTRC as an imperfect solution to the problem, LTRC as ambiguous social spaces, and LTRC as a last resort option. Building on prior theoretical work, we suggest that public perceptions of LTRC are informed by neoliberal discourses that privilege individual responsibility and problematize public care.
The development of user-friendly nutrition resources for pregnant women seldom involves end-users. This qualitative study used a citizens’ jury approach to determine if our modification of a longstanding, frequently used dietitian-informed diet and diabetes booklet was deemed to be a good healthy eating resource for pregnant women.
Design:
Midwives recruited thirteen first-time pregnant women not requiring specialist obstetric care or specialist dietetic advice for any reason. Participants were sent a copy of the modified healthy eating in pregnancy booklet prior to ‘jury day’. Five women were unable to attend the citizens’ jury citing reasons such as early labour. At the jury, five experts presented evidence. Participants adjourned, with an independent facilitator, to ‘deliberate’ as to whether the resource was suitable or not. The verdict was presented, and subsequent discussion was audio-recorded, transcribed and inductively content analysed.
Setting:
Southland, New Zealand.
Participants:
Pregnant women aged 19–35 years (n 8), of whom half had a household income <$NZ30 000.
Results:
The verdict was ‘Yes’; the resource was good. Three themes were derived: communication of health information, resource content and harm reduction in pregnancy. Based on these data, ways to enhance the quality and usability of the booklet were evident.
Conclusions:
Citizens’ juries can be used to obtain an independent assessment by end-users of health resources. Our modified diet and diabetes booklet was considered suitable for providing healthy eating advice to pregnant women. Inclusion of end-users’ perspectives is critical for end-user relevant content, comprehension and resource credibility.
There are no evidence-based treatments for severe and enduring anorexia nervosa.
Objective
To evaluate the relative efficacy of Cognitive Behavioral Therapy (CBT) and Specialist Supportive Clinical Management (SSCM) for adults with severe and enduring anorexia nervosa.
Design
Randomised controlled trial.
Participants
Sixty-three participants aged 18 and over (range 20-62) with a DSM-IV diagnosis of anorexia nervosa with at least a seven year illness history.
Interventions
Thirty outpatient visits over 8 months. Participants were assessed at baseline, end of treatment (EOT), and 6-month and 12-month post-treatment follow-up. At EOP and follow-up, both groups improved significantly on the majority of outcome measures. However, there were no differences between treatment groups at EOT. At 6- and 12-month follow-up, analyses indicate greater improvement for those in CBT compared to SSCM. At 6-month follow-up, CBT participants had higher scores on the social adjustment scale (p = .038), and at 12-month they reported lower eating disorder examination global score (p = .004), and higher readiness for recovery (p = .013) compared to SSCM.
Conclusions
Patients with severe and enduring anorexia nervosa can make significant and meaningful improvements with therapy. CBT shows significant advantage over SSCM in terms of social adjustment, core eating pathology, and readiness for change over time.
Clinical Nursing Skills provides students with a strong, industry-focused foundation in nursing across various clinical settings. It includes the essential theory as well as relevant practical examples, which illustrate the skills required to prepare students for the workplace and help them achieve clinical competence. Each chapter is written by leading academics and based on the registered nurse standards for practice. Pedagogical features include learning objectives, reflective questions, clinical tips, full-colour images, in-situ troubleshooting case studies, skills in practice case studies, keys terms and definitions, and research topics for further study. Clinical Nursing Skills is a highly practical and authoritative resource designed to educate the next generation of nurses. The book comes with free access to the VitalSource etext. This enhanced version of Clinical Nursing Skills houses homework assignments, tutorial assistance, guided solutions and additional content in one convenient resource, which you can download to your computer or mobile device.
In patients with β-lactam allergies, administration of non–β-lactam surgical prophylaxis is associated with increased risk of infection. Although many patients self-report β-lactam allergies, most are unconfirmed or mislabeled. A quality improvement process, utilizing a structured β-lactam allergy tool, was implemented to improve the utilization of preferred β-lactam surgical prophylaxis.
Archaeological investigations of the age and origins of marine shell beads are important for understanding the emergence and maintenance of long-distance trade networks in prehistory. In this paper we expand upon and re-examine the incremental carbon (14C and δ13C) and oxygen (δ18O) isotope data from two Olivella biplicata shell beads from the LSP-1 Rockshelter, Oregon, USA, to address two common problems in dating marine shell trade goods: (1) the source region is large, adding to uncertainty regarding the appropriate specification of ΔR; and (2) the 14C activity within individual specimens is variable. Although this combination of factors severely limits the dating precision that is possible, we recommend a sampling and calibration approach that accounts for these added sources of uncertainty and minimizes the loss of precision. We recommend (1) sequential sampling in order to quantify the range of variability in 14C within shells; (2) a Bayesian calibration procedure that models the 14C dates as an ontogenetic sequence, in this case constrained by stable isotope sclerochronology; and (3) specifying ΔR in a manner that accounts for the full range of possible reservoir offsets in the source region.
We describe the performance of the Boolardy Engineering Test Array, the prototype for the Australian Square Kilometre Array Pathfinder telescope. Boolardy Engineering Test Array is the first aperture synthesis radio telescope to use phased array feed technology, giving it the ability to electronically form up to nine dual-polarisation beams. We report the methods developed for forming and measuring the beams, and the adaptations that have been made to the traditional calibration and imaging procedures in order to allow BETA to function as a multi-beam aperture synthesis telescope. We describe the commissioning of the instrument and present details of Boolardy Engineering Test Array’s performance: sensitivity, beam characteristics, polarimetric properties, and image quality. We summarise the astronomical science that it has produced and draw lessons from operating Boolardy Engineering Test Array that will be relevant to the commissioning and operation of the final Australian Square Kilometre Array Path telescope.
The aims of the present study were to provide nationally representative data on fruit and vegetable consumption in Vietnam, and to assess the accuracy of the reported numbers of ‘standard servings’ consumed. Data analysed were from a multi-stage stratified cluster survey of 14 706 participants (46·5 % males, response proportion 64·1 %) aged 25−64 years in Vietnam. Measurements were made in accordance with the WHO STEPwise approach to surveillance of non-communicable diseases (STEPS) protocols. Approximately 80 % of Vietnamese people reported having less than five servings of fruit and vegetables daily in a typical week. Fruit and vegetable intake reported in ‘standard serving’ sizes was positively correlated with levels of education completed and household income (P<0·001 for trend). The correlations between summary values for each province reflect some known demographic, geographical and climatic characteristics of the country. For example, provinces at higher latitude had higher mean servings of vegetables (r 0·90), and provinces with higher proportions of urban population had higher mean servings of fruit (r 0·40). In conclusion, about eight in ten Vietnamese people aged 25–64 years did not meet WHO recommendations for daily consumption of at least five servings of fruit and vegetables. On the basis of the consistency of the data collected with other estimates and with physical and demographic characteristics of the country, the WHO STEPS instrument has construct validity for measuring fruit and vegetable intake, but with two issues identified. The issues were seasonal variation in reporting and a limitation on the usefulness of the information for associative analyses.
We prove uniqueness of positive solutions for the boundary value problem
\begin{equation*}\left\{\begin{array}{l}-\Delta u=\lambda f(u)\text{ in }\Omega , \\\ \ \ \ \ \ \ u=0\text{ on }\partial \Omega ,\end{array}\right.\end{equation*}
where Ω is a bounded domain in $\mathbb{R}$n with smooth boundary ∂ Ω, λ is a large positive parameter, f:(0,∞) → [0,∞) is nonincreasing for large t and is allowed to be singular at 0.