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Suicide is a major concern among active-duty military personnel. Aggression represents a salient risk factor for suicide among civilians, yet is relatively understudied among military populations. Although several theories posit a relation between aggression and suicide with putative underlying mechanisms of social isolation, access to firearms, and alcohol use, researchers have yet to test these potential mediators. This study uses rich, longitudinal data from the Army Study to Assess Risk and Resilience (STARRS) Pre/Post Deployment Study (PPDS) to examine whether aggression longitudinally predicts suicide attempts and to identify mediators of this association.
Methods
Army soldiers (N = 8483) completed assessments 1 month prior to deployment and 1, 2–3, and 9–12 months post-deployment. Participants reported on their physical and verbal aggression, suicide attempts, social network size, firearm ownership, and frequency of alcohol use.
Results
As expected, pre-deployment aggression was significantly associated with suicide attempts at 12-months post-deployment even after controlling for lifetime suicide attempts. Social network size and alcohol use frequency mediated this association, but firearm ownership did not.
Conclusions
Findings further implicate aggression as an important suicide risk factor among military personnel and suggest that social isolation and alcohol use may partially account for this association.
To evaluate the impact of a diagnostic stewardship intervention on Clostridioides difficile healthcare-associated infections (HAI).
Design:
Quality improvement study.
Setting:
Two urban acute care hospitals.
Interventions:
All inpatient stool testing for C. difficile required review and approval prior to specimen processing in the laboratory. An infection preventionist reviewed all orders daily through chart review and conversations with nursing; orders meeting clinical criteria for testing were approved, orders not meeting clinical criteria were discussed with the ordering provider. The proportion of completed tests meeting clinical criteria for testing and the primary outcome of C. difficile HAI were compared before and after the intervention.
Results:
The frequency of completed C. difficile orders not meeting criteria was lower [146 (7.5%) of 1,958] in the intervention period (January 10, 2022–October 14, 2022) than in the sampled 3-month preintervention period [26 (21.0%) of 124; P < .001]. C. difficile HAI rates were 8.80 per 10,000 patient days prior to the intervention (March 1, 2021–January 9, 2022) and 7.69 per 10,000 patient days during the intervention period (incidence rate ratio, 0.87; 95% confidence interval, 0.73–1.05; P = .13).
Conclusions:
A stringent order-approval process reduced clinically nonindicated testing for C. difficile but did not significantly decrease HAIs.
Correctly spelling an English word requires a high-quality orthographic representation. When faced with spelling a complex word without a high-quality representation, spellers often rely on other knowledge sources (e.g., incomplete stored orthographic forms, phonological to orthographic relationships) to spell it. For bilinguals, another potentially facilitative source is knowledge of a word's lexical and sublexical representations in another language. In the current study we considered simultaneous effects of word-level (e.g., frequency, cognate status) and person-level (e.g., English spelling skill, prompting, bilingual status) predictors on college students’ complex English word spelling. Monolinguals (English; n = 42) significantly outperformed bilinguals (Spanish and English; n = 76) on non-cognate spelling; no group differences emerged for cognate spelling accuracy. Within bilinguals, significantly higher spelling performance on cognates compared to non-cognates suggests cognate facilitation, with no prompting effects. Findings expand an interdisciplinary framework of understanding bilinguals’ activation and use of cross-linguistic representations in spelling.
To determine the proportion of hospitals that implemented 6 leading practices in their antimicrobial stewardship programs (ASPs). Design: Cross-sectional observational survey.
Setting:
Acute-care hospitals.
Participants:
ASP leaders.
Methods:
Advance letters and electronic questionnaires were initiated February 2020. Primary outcomes were percentage of hospitals that (1) implemented facility-specific treatment guidelines (FSTG); (2) performed interactive prospective audit and feedback (PAF) either face-to-face or by telephone; (3) optimized diagnostic testing; (4) measured antibiotic utilization; (5) measured C. difficile infection (CDI); and (6) measured adherence to FSTGs.
Results:
Of 948 hospitals invited, 288 (30.4%) completed the questionnaire. Among them, 82 (28.5%) had <99 beds, 162 (56.3%) had 100–399 beds, and 44 (15.2%) had ≥400+ beds. Also, 230 (79.9%) were healthcare system members. Moreover, 161 hospitals (54.8%) reported implementing FSTGs; 214 (72.4%) performed interactive PAF; 105 (34.9%) implemented procedures to optimize diagnostic testing; 235 (79.8%) measured antibiotic utilization; 258 (88.2%) measured CDI; and 110 (37.1%) measured FSTG adherence. Small hospitals performed less interactive PAF (61.0%; P = .0018). Small and nonsystem hospitals were less likely to optimize diagnostic testing: 25.2% (P = .030) and 21.0% (P = .0077), respectively. Small hospitals were less likely to measure antibiotic utilization (67.8%; P = .0010) and CDI (80.3%; P = .0038). Nonsystem hospitals were less likely to implement FSTGs (34.3%; P < .001).
Conclusions:
Significant variation exists in the adoption of ASP leading practices. A minority of hospitals have taken action to optimize diagnostic testing and measure adherence to FSTGs. Additional efforts are needed to expand adoption of leading practices across all acute-care hospitals with the greatest need in smaller hospitals.
Since 2015, institutions across the land we now call Canada have been increasingly engaged in reconciliation efforts as laid out in Canada's Truth and Reconciliation Commission's Calls to Action. While only three of the 94 Calls to Action are directed at libraries, the overarching theme of educational change resonates within all library sectors. Academic libraries are uniquely positioned both to engage in their own decolonising and Indigenising initiatives and to support those of their parent institutions. Caution should be taken, though, since often people and institutions seem to want to move quickly to reconciliation, as if it were a destination and not a journey. As Rhiannon Bennett [Musqueam] said during a panel discussion at Kwantlen Polytechnic University on 25 November 2020, you need to learn the truth before you can work on reconciliation.
This chapter presents some of that truth by providing a brief background on the colonisation of the country known today as Canada and how that colonisation was carried out through education. Part of this is learning what we mean by Indigenous, and who the three Indigenous Peoples in Canada are. We also share our learning on what reconciliation means, and how legal documents set up a framework to support our work. Complementing this, we unpack decolonising and Indigenising in relation to each other. This leads to a section on education, imparting why Indigenisation initiatives are important both within post-secondary institutions and in the libraries that serve them. We conclude our chapter by sharing our stories as Indigenous academic librarians contributing towards Indigenising our institutions.
Before we begin
Following the government definition and current practice (Joseph [Gwawaenuk], 2018; Justice [Cherokee Nation], 2018; Vowel [Métis], 2016; Younging [Opaskwayak Cree], 2018), the term Indigenous will be used when discussing First Nations, Métis and Inuit. Older and outdated terms may be used in context when discussing practices or as used by an author. Additionally, where possible, the name of an author's community or Nation has been included the first time we cite them. We are responsible for any omissions or mistakes and apologise in advance for them. We have used Gregory Younging's 2018 work Elements of Indigenous Style (EIS) to compose this chapter; where there are discrepancies in publication styles, we have followed EIS.
A 136-m-long drill core of sediments was recovered from tropical high-altitude Lake Titicaca, Bolivia-Peru, enabling a reconstruction of past climate that spans four cycles of regional glacial advance and retreat and that is estimated to extend continuously over the last 370,000 yr. Within the errors of the age model, the periods of regional glacial advance and retreat are concordant respectively with global glacial and interglacial stages. Periods of ice advance in the southern tropical Andes generally were periods of positive water balance, as evidenced by deeper and fresher conditions in Lake Titicaca. Conversely, reduced glaciation occurred during periods of negative water balance and shallow closed-basin conditions in the lake. The apparent coincidence of positive water balance of Lake Titicaca and glacial growth in the adjacent Andes with Northern Hemisphere ice sheet expansion implies that regional water balance and glacial mass balance are strongly influenced by global-scale temperature changes, as well as by precessional forcing of the South American summer monsoon.
Agricultural lenders have a stake in and are in a position to influence their borrowers' management decisions. Risk management practice adoption is an area in which lenders might want to exercise this influence. This study employs logistic statistical models to estimate lenders' influence on crop producers' decisions regarding use of three alternative risk management practices: federal multiple-peril crop insurance, crop hail and fire insurance, and forward contracting. Results suggest lenders can exert significant influence on these decisions but that poor communication between lenders and borrowers likely reduces this influence.
Our knowledge of the universe comes from recording the photon and particle fluxes incident on the Earth from space. We thus require sensitive measurement across the entire energy spectrum, using large telescopes with efficient instrumentation located on superb sites. Technological advances and engineering constraints are nearing the point where we are recording as many photons arriving at a site as is possible. Major advances in the future will come from improving the quality of the site. The ultimate site is, of course, beyond the Earth’s atmosphere, such as on the Moon, but economic limitations prevent our exploiting this avenue to the degree that the scientific community desires. Here we describe an alternative, which offers many of the advantages of space for a fraction of the cost: the Antarctic Plateau.
Additive-abrasive interactions in chemical-mechanical planarization (CMP) slurries are investigated using fluorescence correlation spectroscopy (FCS). The FCS technique provides quantitative determinations of the interaction between additives and abrasive particles by characterizing the competitive adsorption of the additive and a fluorescent probe molecule by an abrasive particle. Adsorption of the CMP additives glycine and benzotriazole (BTA) on precipitated and sol-gel colloidal silica abrasives are characterized. Significant differences in the fluorescent probe’s adsorption to the different silica abrasives in the presence of the additives suggest surface chemistry differences between the different types of silica. Extensions of the analysis of FCS data are proposed for improving the quantitative determination of the competitive adsorption of fluorescent probe dyes and CMP additives on abrasive particles.