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Using data from a 15-year longitudinal follow-up of a randomized controlled trial of a parenting-focused preventive intervention for divorced families (N = 240) with children aged 9–12, the current study examined alternative cascading pathways through which the intervention led to improvements in offspring’s perceived health problems, BMI, and cigarette smoking in emerging adulthood. It was hypothesized that the program would lead to improvements in these health-related outcomes during emerging adulthood through progressive associations between program-induced changes in parenting and offspring outcomes, including mental health problems, substance use, and competencies. Intervention-induced improvements in positive parenting at posttest led to improvements in mental health problems in late childhood/early adolescence, which led to lower levels of mental health and substance use problems as well as higher levels of competencies in adolescence, which led to improvements in the health-related outcomes. Academic performance predicted all three health-related outcomes and other aspects of adolescent functioning showed different relations across outcomes. Results highlight the potential for intervention effects of preventive parenting interventions in childhood to cascade over time to affect health-related outcomes in emerging adulthood.
Limited data exist on training of European paediatric and adult congenital cardiologists.
Methods:
A structured and approved questionnaire was circulated to national delegates of Association for European Paediatric and Congenital Cardiology in 33 European countries.
Results:
Delegates from 30 countries (91%) responded. Paediatric cardiology was not recognised as a distinct speciality by the respective ministry of Health in seven countries (23%). Twenty countries (67%) have formally accredited paediatric cardiology training programmes, seven (23%) have substantial informal (not accredited or certified) training, and three (10%) have very limited or no programme. Twenty-two countries have a curriculum. Twelve countries have a national training director. There was one paediatric cardiology centre per 2.66 million population (range 0.87–9.64 million), one cardiac surgical centre per 4.73 million population (range 1.63–10.72 million), and one training centre per 4.29 million population (range 1.63–10.72 million population). The median number of paediatric cardiology fellows per training programme was 4 (range 1–17), and duration of training was 3 years (range 2–5 years). An exit examination in paediatric cardiology was conducted in 16 countries (53%) and certification provided by 20 countries (67%). Paediatric cardiologist number is affected by gross domestic product (R2 = 0.41).
Conclusion:
Training varies markedly across European countries. Although formal fellowship programmes exist in many countries, several countries have informal training or no training. Only a minority of countries provide both exit examination and certification. Harmonisation of training and standardisation of exit examination and certification could reduce variation in training thereby promoting high-quality care by European congenital cardiologists.
Astrophysics Telescope for Large Area Spectroscopy Probe is a concept for a National Aeronautics and Space Administration probe-class space mission that will achieve ground-breaking science in the fields of galaxy evolution, cosmology, Milky Way, and the Solar System. It is the follow-up space mission to Wide Field Infrared Survey Telescope (WFIRST), boosting its scientific return by obtaining deep 1–4 μm slit spectroscopy for ∼70% of all galaxies imaged by the ∼2 000 deg2 WFIRST High Latitude Survey at z > 0.5. Astrophysics Telescope for Large Area Spectroscopy will measure accurate and precise redshifts for ∼200 M galaxies out to z < 7, and deliver spectra that enable a wide range of diagnostic studies of the physical properties of galaxies over most of cosmic history. Astrophysics Telescope for Large Area Spectroscopy Probe and WFIRST together will produce a 3D map of the Universe over 2 000 deg2, the definitive data sets for studying galaxy evolution, probing dark matter, dark energy and modifications of General Relativity, and quantifying the 3D structure and stellar content of the Milky Way. Astrophysics Telescope for Large Area Spectroscopy Probe science spans four broad categories: (1) Revolutionising galaxy evolution studies by tracing the relation between galaxies and dark matter from galaxy groups to cosmic voids and filaments, from the epoch of reionisation through the peak era of galaxy assembly; (2) Opening a new window into the dark Universe by weighing the dark matter filaments using 3D weak lensing with spectroscopic redshifts, and obtaining definitive measurements of dark energy and modification of General Relativity using galaxy clustering; (3) Probing the Milky Way’s dust-enshrouded regions, reaching the far side of our Galaxy; and (4) Exploring the formation history of the outer Solar System by characterising Kuiper Belt Objects. Astrophysics Telescope for Large Area Spectroscopy Probe is a 1.5 m telescope with a field of view of 0.4 deg2, and uses digital micro-mirror devices as slit selectors. It has a spectroscopic resolution of R = 1 000, and a wavelength range of 1–4 μm. The lack of slit spectroscopy from space over a wide field of view is the obvious gap in current and planned future space missions; Astrophysics Telescope for Large Area Spectroscopy fills this big gap with an unprecedented spectroscopic capability based on digital micro-mirror devices (with an estimated spectroscopic multiplex factor greater than 5 000). Astrophysics Telescope for Large Area Spectroscopy is designed to fit within the National Aeronautics and Space Administration probe-class space mission cost envelope; it has a single instrument, a telescope aperture that allows for a lighter launch vehicle, and mature technology (we have identified a path for digital micro-mirror devices to reach Technology Readiness Level 6 within 2 yr). Astrophysics Telescope for Large Area Spectroscopy Probe will lead to transformative science over the entire range of astrophysics: from galaxy evolution to the dark Universe, from Solar System objects to the dusty regions of the Milky Way.
The commissioning and operation of apparatus for neutron diffraction at simultaneous high temperatures and pressures is reported. The basic design is based on the Paris-Edinburgh cell using opposed anvils, with internal heating. Temperature is measured using neutron radiography. The apparatus has been shown in both on-line and off-line tests to operate to a pressure of 7 GPa and temperature of 1700°C. The apparatus has been used in a neutron diffraction study of the crystal structure of deuterated brucite, and results for 520°C and 5.15 GPa are presented. The diffraction data that can be obtained from the apparatus are of comparable quality to previous high-pressure studies at ambient temperatures, and are clearly good enough for Rietveld refinement analysis to give structural data of reasonable quality.
Recreational saltwater anglers from the mid-Atlantic through the Gulf of Mexico commonly target red drum. Due to concerns about overharvesting within South Carolina coupled with regional management actions, South Carolina explored the technical feasibility of stocking hatchery-produced juvenile red drum as a technique to augment the abundance of South Carolina stock. In order to assess a continued program, in 2005 a mail survey was used to collect data for estimating the economic benefits with the contingent valuation method. The theoretical validity of willingness to pay was assessed by comparison to the value of a change in red drum fishing trips that would result from the program. Benefits were compared to estimated, explicit stocking costs. We illustrate how a certainty recode approach can be used in sensitivity analysis. The net present values (NPVs) for the stocking program are positive suggesting that the program would have been economically efficient relative to no program.
Pneumonia is a leading cause of mortality and morbidity worldwide with radiographically confirmed pneumonia a key disease burden indicator. This is usually determined by a radiology panel which is assumed to be the best available standard; however, this assumption may introduce bias into pneumonia incidence estimates. To improve estimates of radiographic pneumonia incidence, we applied Bayesian latent class modelling (BLCM) to a large database of hospitalized patients with acute lower respiratory tract illness in Sa Kaeo and Nakhon Phanom provinces, Thailand from 2005 to 2010 with chest radiographs read by both a radiology panel and a clinician. We compared these estimates to those from conventional analysis. For children aged <5 years, estimated radiographically confirmed pneumonia incidence by BLCM was 2394/100 000 person-years (95% credible interval 2185–2574) vs. 1736/100 000 person-years (95% confidence interval 1706–1766) from conventional analysis. For persons aged ⩾5 years, estimated radiographically confirmed pneumonia incidence was similar between BLCM and conventional analysis (235 vs. 215/100 000 person-years). BLCM suggests the incidence of radiographically confirmed pneumonia in young children is substantially larger than estimated from the conventional approach using radiology panels as the reference standard.
Acinetobacter is a well-recognized nosocomial pathogen. Previous reports of community-associated Acinetobacter infections have lacked clear case definitions and assessment of healthcare-associated (HCA) risk factors. We identified Acinetobacter bacteraemia cases from blood cultures obtained <3 days after hospitalization in rural Thailand and performed medical record reviews to assess HCA risk factors in the previous year and compare clinical and microbiological characteristics between cases with and without HCA risk factors. Of 72 Acinetobacter cases, 32 (44%) had no HCA risk factors. Compared to HCA infections, non-HCA infections were more often caused by Acinetobacter species other than calcoaceticus–baumannii complex species and by antibiotic-susceptible organisms. Despite similar symptoms, the case-fatality proportion was lower in non-HCA than HCA cases (9% vs. 45%, P < 0·01). Clinicians should be aware of Acinetobacter as a potential cause of community-associated infections in Thailand; prospective studies are needed to improve understanding of associated risk factors and disease burden.
The Val158Met polymorphism of the catechol-O-methyltransferase (COMT) gene may be related to individual differences in cognition, likely via modulation of prefrontal dopamine catabolism. However, the available studies have yielded mixed results, possibly in part because they do not consistently account for other genes that affect cognition. We hypothesized that COMT Met allele homozygosity, which is associated with higher levels of prefrontal dopamine, would predict better executive function as measured using standard neuropsychological testing, and that other candidate genes might interact with COMT to modulate this effect. Participants were 95 healthy, right-handed adults who underwent genotyping and cognitive testing. COMT genotype predicted executive ability as measured by the Trail-Making Test, even after covarying for demographics and Apolipoprotein E (APOE), brain-derived neurotrophic factor (BDNF), and ankyrin repeat and kinase domain containing 1 (ANKK1) genotype. There was a COMT-ANKK1 interaction in which individuals having both the COMT Val allele and the ANKK1 T allele showed the poorest performance. This study suggests the heterogeneity in COMT effects reported in the literature may be due in part to gene–gene interactions that influence central dopaminergic systems. (JINS, 2011, 17, 1–7)
Exposure to otolaryngology is currently minimal in the UK undergraduate medical curriculum. This may lead to difficulties in attracting graduates into higher ENT surgical training and in ensuring a reasonable standard of ENT knowledge amongst primary care practitioners.
A recent innovation, of which many ENT units may be unaware, is the introduction to the undergraduate curriculum of ‘student-selected components’. Like the traditional elective, this allows students to undertake an attachment to a speciality and department of their choice. Units which do not regularly teach medical students but which have a welcoming and enthusiastic approach to undergraduate training may well be ideal hosts.
This paper introduces the concepts underlying student-selected components, outlines the preparation required and offers a template for such an attachment, for which ENT is ideally suited.
We compared helminth communities in spiny mice (Acomys dimidiatus) from 4 wadis in the arid montane region of the southern Sinai in Egypt, in a 4-week period in late summer. Total helminth species richness was 14 (8 nematodes, 5 cestodes and 1 acanthocephalan) with 94% of mice carrying at least 1 species and an overall mean species richness of 1·85. The most prevalent parasites were Protospirura muricola (47·8%) and Dentostomella kuntzi (46·3%). One larval cestode, Joyeuxiella rossicum, represents a new host record. The helminth community was dominated by intestinal nematodes (88·7%) of which 58·2% were arthropod-transmitted heteroxenic species. At the component community level, 70% of the worms were recovered from mice in just two wadis (Gharaba and Tlah) and 48·6% of intestinal nematodes were from Wadi Gharaba. Although only 7 species of helminths were recorded from Wadi Gharaba, this site gave the highest Berger-Parker dominance index because of P. muricola. P. muricola was also dominant in Wadi El Arbaein whilst Syphacia minuta was the dominant species in Wadis Gebal and Tlah. At the infracommunity level, mean species richness and Brillouin's index of diversity were highest in Wadi Tlah and lowest in Wadi Gebal, and the former was age dependent. Whilst mice from different wadis differed in the nematodes that were most common, those from Wadi Gharaba carried the highest mean number of worms/mouse. The abundance of P. muricola in particular varied markedly between sites: Wadi Gharaba was distinct as the site showing the highest mean worm burden whereas mice from Wadi Gebal were uninfected. None of the directly transmitted oxyuroid nematodes showed significant variation in abundance between wadis, or host sex or age classes. Overall, the single extrinsic factor in the study, site of capture, was more important than the intrinsic factors in explaining variation in helminth communities in the region. We conclude that in the high mountains of southern Sinai, each wadi is distinct in terms of its rodent parasites, and hence we expect spatially different coevolutionary pressures on their hosts, with resultant variation in life-histories.
This paper briefly describes the principle of operation and science goals of the AMANDA high energy neutrino telescope located at the South Pole, Antarctica. Results from an earlier phase of the telescope, called AMANDA-BIO, demonstrate both reliable operation and the broad astrophysical reach of this device, which includes searches for a variety of sources of ultrahigh energy neutrinos: generic point sources, Gamma-Ray Bursts and diffuse sources. The predicted sensitivity and angular resolution of the telescope were confirmed by studies of atmospheric muon and neutrino backgrounds. We also report on the status of the analysis from AMANDA-II, a larger version with far greater capabilities. At this stage of analysis, details of the ice properties and other systematic uncertainties of the AMANDA-II telescope are under study, but we have made progress toward critical science objectives. In particular, we present the first preliminary flux limits from AMANDA-II on the search for continuous emission from astrophysical point sources, and report on the search for correlated neutrino emission from Gamma Ray Bursts detected by BATSE before decommissioning in May 2000. During the next two years, we expect to exploit the full potential of AMANDA-II with the installation of a new data acquisition system that records full waveforms from the in-ice optical sensors.
In late February and early March 2002, an archaeological watching brief at Lynford Quarry, Mundford, Norfolk revealed a palaeochannel with a dark organic fill containing in situ mammoth remains and associated Mousterian stone tools and debitage buried under 2–3 m of bedded sands and gravels. Well-preserved in situ Middle Palaeolithic open air sites are very unusal in Europe and exceedingly rare within a British context. As such, the site was identified as being of national and international importance, and was subsequently excavated by the Norfolk Archaeological Unit with funding provided by English Heritage through the Aggregates Levy Sustainability Fund.
This report presents some of the initial results of the excavation. It sets out how the site was excavated, outlines the stratigraphic sequence for the site, and presents some provisional findings of the excavation based on the results of the assessment work carried out by project specialists and Norfolk Archaeological Unit staff.
The susceptibility to develop coeliac disease (CD) has a strong genetic component, which is not
entirely explained by HLA associations. Two previous genome wide linkage studies have been
performed to identify additional loci outside this region. These studies both used a sib-pair design
and produced conflicting results.
Our aim is to identify non-MHC genetic loci contributing to coeliac disease using a family based
linkage study. We performed a genome wide search in 16 highly informative multiply affected
pedigrees using 400 microsatellite markers with an average spacing of 10 cM. Linkage analysis was
performed using lod score and model free methods.
We identified two new potential susceptibility loci with lod scores of 1.9, at 10q23.1, and 16q23.3.
Significant, but lower lod scores were found for 6q14 (1.2), 11p11 (1.5), and 19q13.4 (0.9), areas
implicated in a previous genome wide study. Lod scores of 0.9 were obtained for both D7S507, which
lies 1 cM from the γT-cell receptor gene, and for D2S364, which lies 12 cM from the CTLA4 gene.
We present a mathematical model which is used to interpret the
dynamics of the immunological response of a mouse host
to infection with the filarial worm Onchocerca lienalis. The
model mimics changes in worm burden over time post-infection
and after reinfection and its behaviour provides a good description of
experimental results. Measured production of T-cells and eosinophils
is also compared with the predictions of the model. Our results show
that the immune response
mechanism proposed on the basis of experimental results, involving
CD4+ T-cells and eosinophil destruction of the
parasite, is supported by the insights gained from the mathematical
model. Also, using the parameters estimated to describe
the primary infection dynamics, the degree of acquired immunity to
secondary infection is also well described by the
model. Our analysis highlights the importance of obtaining
quantitative measures of the many rate parameters involved
in even the simplest interpretations of immunological responses to
parasitic infection.
The Medium-l Program of the Michelson Doppler Imager (MDI) instrument on board SOHO provides continuous observations of oscillation modes of angular degree, l, from 0 to ∼ 300. The initial results show that the noise in the Medium-l oscillation power spectrum is substantially lower than in ground-based measurements. This enables us to detect lower amplitude modes and, thus, to extend the range of measured mode frequencies. The MDI observations also reveal the asymmetry of oscillation spectral lines. The line asymmetries agree with the theory of mode excitation by acoustic sources localized in the upper convective boundary layer. The sound-speed profile inferred from the mean frequencies gives evidence for a sharp variation at the edge of the energy-generating core. In a thin layer just beneath the convection zone, helium appears to be less abundant than predicted by theory. Inverting the multiplet frequency splittings from MDI, we detect significant rotational shear in this thin layer.