We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The threat of novel pathogens and natural hazards is increasing as global temperatures warm, leading to more frequent and severe occurrences of infectious disease outbreaks and major hurricanes. The COVID-19 pandemic amplified the need to examine how risk perceptions related to hurricane evacuations shift when vaccines become available. This study explores individuals’ expected evacuation plans during the early stages of COVID-19 vaccine availability.
Methods
In March 2021, an online survey was disseminated in Puerto Rico and the US Virgin Islands.
Results
An overwhelming majority (72.6%) of respondents said that their vaccination status would not affect their hurricane evacuation intentions. The unvaccinated were significantly more likely to consider evacuating during a hurricane than the vaccinated. Even with vaccines available, respondents suggested they were less likely to evacuate to a shelter during the 2021 season than prior to the COVID-19 pandemic. Respondents generally believed that the risk of contracting COVID-19 at a shelter was greater than the risk of sheltering-in-place during a hurricane.
Conclusions
Government officials need to develop and communicate clear information regarding evacuation orders for municipalities that may be more impacted than others based on the trajectory of the storm, social determinants of health, and other factors like living in a flood zone.
The diets of children in the UK are suboptimal(1), which may influence their immediate and future health and well-being(2). Schools offer convenient and prolonged access to children from diverse backgrounds, thus interventions within this setting have been suggested as a means to promote diet and health outcomes among this population(3). This study explored the effects of Project Daire(4), a school-based food intervention, on children’s diet diversity and diet quality as well as their attitudes towards health behaviours.
A factorial design cluster randomized controlled trial was conducted. Fifteen primary schools in Northern Ireland were randomized into one of four 6-month intervention arms: Nourish, Engage, Nourish and Engage or Control (Delayed). The Nourish intervention modified the school food environment, provided food-related experiences and increased access to local foods. The Engage intervention included educational activities on nutrition, food and agriculture. Data on food consumption at home, school and/or in total over a 24-hour period were collected using ageappropriate food frequency questionnaires at baseline, with follow-up at 6-months. Diet diversity score (DDS) and diet quality score (DQS) were developed based on adherence to the Eatwell Guide. Additionally, a Health Attitudes and Behaviour measure assessed 10-11 year old children’s attitudes towards importance of various health behaviours at both time points. Linear and logistic regression models were used to examine intervention effects and to account for school clustering.
A total of 445 children aged 6-7 and 458 aged 10-11 years old completed the trial. Results indicated that children aged 10-11 year old who received the Nourish intervention demonstrated higher school DDS (adjusted mean difference=2.79, 95% CI 1.40 – 4.19; p = 0.001) and total DDS (adjusted mean difference=1.55, 95% CI 0.66 – 2.43, p = 0.002) compared to their counterparts who did not. Subgroup analyses revealed that the increases in school DDS among 10-11 year old children in the Nourish group were apparent in both boys and girls (Boys: adjusted mean difference=2.4 95% CI 0.1 – 4.7, p = 0.04; Girls: adjusted mean difference=3.1 95% CI 1.6 – 4.6, p = 0.001). However, the increase in total DDS remained statistically significant only among girls, with an adjusted mean difference of 1.9 (95% CI 1.1-2.7, p<0.001). No statistically significant changes in DQS were detected in either age group. High levels of positive attitudes towards health behaviours were observed at baseline, with no clinically significant effects of either the Nourish or Engage interventions detected during the follow-up period.
The multi-component approach of the Nourish intervention, addressing both food provision and environment, showed promise in promoting diet diversity. Further research is warranted to develop sustainable implementation strategies for Daire, to explore additional intervention components to impact other outcomes, including diet quality, and to evaluate long-term effectiveness.
Studies of extinction typically focus on unintended losses of biodiversity and culture. This study, however, examines an attempt to induce extinction of a parasite: human hookworm (Necator americanus and Ancylostoma duodenale). Our interdisciplinary approach integrates medical history and epidemiology using records created by the Jamaica Hookworm Commission of 1919–1936. We show that the attempt to induce the extinction of hookworms was driven by its perceived effects on labour productivity and consequent status as an ideological and economic threat. We use spatial epidemiology to describe the relationships between parasites, environments and the working conditions of plantation labourers. Using data from 330 locations across Jamaica in which 169,380 individuals were tested for hookworm infection we show that the prevalence of hookworm infection was higher in districts surrounding plantations. Prevalence decreased with the temperature of the coldest month, increased with the amount of rainfall in the driest month, and increased with vegetation quantity (normalised difference vegetation index). Worm burden (and thus pathology) varied greatly between individuals, even those living together; hookworm infection varied between environments, socioeconomic conditions and individuals. Nevertheless, the conditions of labour shaped the distribution of hookworms. Plantations both spread and problematised hookworms, driving efforts to bring it to extinction.
This investigation was designed to integrate the quick-freeze technique for ion diffusion with two computer programs to permit the simultaneous measurement and calculation of the diffus-ivity of a variable number of ions in heteroionic soil system. Kaolinite clay was prepared so as to have the following percentage saturations of the CEC, Sr2+65, Mg2+15, Rb+10, Na+5 and H+5. A quadruplicate radioisotope tag consisting of 85Sr, 28Mg, 86Rb, and 22Na was used to measure the diffusivity of each ion. The complex spectra were resolved by use of Schonfeld’s revised Alpha-M computer program. A probit-transformation procedure was formulated into a computer program to enable the calculation of each diffusion coefficient. These programs are described and illustrated with the diffusivity of 86Rb in kaolinite clay.
Depression is a common mental health disorder that often starts during adolescence, with potentially important future consequences including ‘Not in Education, Employment or Training’ (NEET) status.
Methods
We took a structured life course modeling approach to examine how depressive symptoms during adolescence might be associated with later NEET status, using a high-quality longitudinal data resource. We considered four plausible life course models: (1) an early adolescent sensitive period model where depressive symptoms in early adolescence are more associated with later NEET status relative to exposure at other stages; (2) a mid adolescent sensitive period model where depressive symptoms during the transition from compulsory education to adult life might be more deleterious regarding NEET status; (3) a late adolescent sensitive period model, meaning that depressive symptoms around the time when most adults have completed their education and started their careers are the most strongly associated with NEET status; and (4) an accumulation of risk model which highlights the importance of chronicity of symptoms.
Results
Our analysis sample included participants with full information on NEET status (N = 3951), and the results supported the accumulation of risk model, showing that the odds of NEET increase by 1.015 (95% CI 1.012–1.019) for an increase of 1 unit in depression at any age between 11 and 24 years.
Conclusions
Given the adverse implications of NEET status, our results emphasize the importance of supporting mental health during adolescence and early adulthood, as well as considering specific needs of young people with re-occurring depressed mood.
OBJECTIVES/GOALS: Health care accounts for an estimated 10% of U.S. greenhouse gas (GHG) emissions. Concerted efforts to decrease waste are needed including critical appraisal of single use items. The purpose of this study was to conduct life cycle analyses (LCA) of a pediatric single use laryngoscope to inform environmental impact and identify targets to reduce waste. METHODS/STUDY POPULATION: LCA was used to quantify the environmental impact of a single use pediatric laryngoscope. LCA is an industry standard measure of energy consumption, water consumption, and GHG emissions encompassing a “cradle-to-grave” assessment. The GREET model (Greenhouse gases, Regulated Emissions and Energy use in Technologies) and Open LCA model were used as sources for product/raw material data. Separate analysis was completed for the battery powering the light emitting diode (LED) lights. RESULTS/ANTICIPATED RESULTS: The LCA revealed 598.2 g of CO2 equivalents for the 121g single use pediatric laryngoscope. There were an estimated 26,849 cases that used single use laryngoscope last year at our free-standing children’s hospital resulting in 16.1 metric tons of CO2 equivalents. This is equivalent to 41,273 miles driven by an average gasoline powered vehicle. The 1.5 V battery was the highest contributor to the laryngoscope’s GHG emissions. While the battery has an estimated 2,800 hours of life, single use laryngoscopes are reported in the literature as being used for only an average of 30 seconds to 2 minutes. DISCUSSION/SIGNIFICANCE: Single use laryngoscopes are high contributors to GHGs. Specifically, the batteries contained in the laryngoscopes are wasteful and challenging to remove and recycle. Future efforts to decrease waste in the OR should target use of similar items that have reusable battery components to improve environmental sustainability.
The Paleozoic represents a key time interval in the origins and early diversification of chondrichthyans (cartilaginous fishes), but their diversity and macroevolution are largely obscured by heterogenous spatial and temporal sampling. The predominantly cartilaginous skeletons of chondrichthyans pose an additional limitation on their preservation potential and hence on the quality of their fossil record. Here, we use a newly compiled genus-level dataset and the application of sampling standardization methods to analyze global total-chondrichthyan diversity dynamics through time from their first appearance in the Ordovician through to the end of the Permian. Subsampled estimates of chondrichthyan genus richness were initially low in the Ordovician and Silurian but increased substantially in the Early Devonian. Richness reached its maximum in the middle Carboniferous before dropping across the Carboniferous/Permian boundary and gradually decreasing throughout the Permian. Sampling is higher in both the Devonian and Carboniferous compared with the Silurian and most of the Permian stages. Shark-like scales from the Ordovician are too limited to allow for some of the subsampling techniques. Our results detect two Paleozoic radiations in chondrichthyan diversity: the first in the earliest Devonian, led by acanthodians (stem-group chondrichthyans), which then decline rapidly by the Late Devonian, and the second in the earliest Carboniferous, led by holocephalans, which increase greatly in richness across the Devonian/Carboniferous boundary. Dispersal of chondrichthyans, specifically holocephalans, into deeper-water environments may reflect a niche expansion following the faunal displacement in the aftermath of the Hangenberg extinction event at the end of the Devonian.
FoodRx is a 12-month healthy food prescription incentive program for people with type 2 diabetes (T2DM) and experiences of household food insecurity. In this study, we aimed to explore potential users’ prospective acceptability (acceptability prior to program use) of the design and delivery of the FoodRx incentive and identify factors influencing prospective acceptability.
Design:
We used a qualitative descriptive approach and purposive sampling to recruit individuals who were interested or uninterested in using the FoodRx incentive. Semi-structured interviews were guided by the theoretical framework of acceptability, and corresponding interview transcripts were analysed using differential qualitative analysis guided by the socioecological model.
Setting:
Individuals living in Alberta, Canada.
Participants:
In total, fifteen adults with T2DM and experiences of household food insecurity.
Results:
People who were interested in using the FoodRx incentive (n 10) perceived it to be more acceptable than those who were uninterested (n 5). We identified four themes that captured factors that influenced users’ prospective acceptability: (i) participants’ confidence, views and beliefs of FoodRx design and delivery and its future use (intrapersonal), (ii) the shopping routines and roles of individuals in participants’ social networks (interpersonal), (iii) access to and experience with food retail outlets (community), and (iv) income and food access support to cope with the cost of living (policy).
Conclusion:
Future healthy food prescription programs should consider how factors at all levels of the socioecological model influence program acceptability and use these data to inform program design and delivery.
Data compilations expand the scope of research; however, data citation practice lags behind advances in data use. It remains uncommon for data users to credit data producers in professionally meaningful ways. In paleontology, databases like the Paleobiology Database (PBDB) enable assessment of patterns and processes spanning millions of years, up to global scale. The status quo for data citation creates an imbalance wherein publications drawing data from the PBDB receive significantly more citations (median: 4.3 ± 3.5 citations/year) than the publications producing the data (1.4 ± 1.3 citations/year). By accounting for data reuse where citations were neglected, the projected citation rate for data-provisioning publications approached parity (4.2 ± 2.2 citations/year) and the impact factor of paleontological journals (n = 55) increased by an average of 13.4% (maximum increase = 57.8%) in 2019. Without rebalancing the distribution of scientific credit, emerging “big data” research in paleontology—and science in general—is at risk of undercutting itself through a systematic devaluation of the work that is foundational to the discipline.
Adrenal gland-induced hypertension, also known as secondary hypertension, is a medical condition caused by an underlying adrenal pathology, most typically adrenocortical adenomas. Current clinical practices involve pharmacotherapy or surgical resection to treat adrenal gland diseases that cause hypertension. However, due to the limitations of these treatment options, microwave ablation (MWA) has emerged as a promising minimally invasive alternative. An accurate understanding of the dielectric properties of adrenal glands would support the further development and optimization of MWA technology for treating adrenal tumors. Only a few studies have examined the dielectric properties of both human and animal adrenal glands, and the sample sizes of these studies have been relatively small. Therefore, further dielectric data of human and animal adrenal glands are warranted. This paper presents the ex vivo dielectric properties of the ovine adrenal glands (medulla and cortex) and summarizes the published literature on dielectric data of adrenal glands from porcine, bovine, ovine, and human samples in the microwave frequency range to analyze the consistency and reliability of the reported data. The dielectric properties of the ovine adrenal glands (N = 8) were measured using an open-ended coaxial probe measurement technique at frequencies ranging from 0.5 to 8.5 GHz. This study also investigated the temperature-dependent dielectric properties of the ovine adrenal medulla ranging from 37 to 64°C at frequencies ranging from 0.5 to 8.5 GHz. The dielectric properties of the ovine adrenal medulla measured in this study were found to be consistent with the literature. Moreover, the review suggests that variations exist in the dielectric properties of the adrenal medulla and cortex among species. The study also found that the dielectric properties of the adrenal medulla decrease with increasing temperature, similar to other tissues for which temperature-dependent dielectric data have been reported. This summary of dielectric data of adrenal glands and the temperature-dependent dielectric properties of the ovine adrenal medulla will accelerate the development of MWA technologies for hypertension treatment.
The central argument set out in this Element is that the combination of a perceived radical change in the threat environment post 9/11, and the new capabilities afforded by the long silent reach of the drone, have put pressure on the previously accepted legal frameworks justifying the use of force. This has resulted in disagreements - both articulated and unarticulated - in how the Western allies should respond to both the legal and operational innovations in the use of force that drones have catalysed. The Element focuses on the responses of the UK, France, and Germany to these developments in the context of the changing US approach to the use of force. Locating itself at the interface of international law and politics, this is the first attempt to look at the interplay between technological innovations, legal justifications, and inter-alliance politics in the context of the use of armed drones.
Many social interventions have been developed with the hopes of reducing and preventing social isolation among older people (e.g., recreation, arts-based programs and social prescription). Friendly visiting programs, also known as befriending schemes, have been a mainstay in this area for decades and are largely thought to be effective at reconnecting older people (≥ 60 years of age) experiencing isolation. Research and evaluations have yet to determine, however, how and why these programs may be most successful, and under what conditions. This article presents the findings of a realist synthesis aimed at identifying the critical mechanisms and contextual factors that lead to successful outcomes in friendly visiting programs. Seven studies are synthesized to inform a friendly visiting program theory accounting for key mechanisms (e.g., provision of informal support) and underlying contexts (e.g., training of volunteers) that can be used to inform future programs. Recommendations for future research are also presented.
The current assays to confirm herbicide resistance can be time- and labor-intensive (dose–response) or require a skill set/technical equipment (genetic sequencing). Stakeholders could benefit from a rapid assay to confirm herbicide-resistant weeds to ensure sustainable crop production. Because protoporphyrinogen oxidase (PPO)-inhibiting herbicides rapidly interfere with chlorophyll production/integrity; we propose a new, rapid assay utilizing spectral reflectance to confirm resistance. Leaf disks were excised from two PPO-inhibiting herbicide-resistant (target-site [TSR] and non–target site [NTSR]) and herbicide-susceptible redroot pigweed (Amaranthus retroflexus L.) populations and placed into a 24-well plate containing different concentrations (0 to 10 mM) of fomesafen for 48 h. A multispectral sensor captured images from the red (668 nm), green (560 nm), blue (475 nm), and red edge (717 nm) wavebands after a 48-h incubation period. The green leaf index (GLI) was utilized to determine spectral reflectance ratios of the treated leaf disks. Clear differences of spectral reflectance were observed in the red edge waveband for all populations treated with the 10 mM concentration in the dose–response assays. Differences of spectral reflectance were observed for the NTSR population compared with the TSR and susceptible populations treated with the 10 mM concentration in the green waveband and the GLI in the dose–response assay. Leaf disks from the aforementioned A. retroflexus populations and two additional susceptible populations were subjected to a similar assay with the discriminating concentration (10 mM). Spectral reflectance was different between the PPO-inhibiting herbicide-resistant and herbicide-susceptible populations in the red, blue, and green wavebands. Spectral reflectance was not distinctive between the populations in the red edge waveband and the GLI. The results provide a basis for rapidly (∼48 h) detecting PPO-inhibiting herbicide-resistant A. retroflexus via spectral reflectance. Discrimination between TSR and NTSR populations was possible only in the dose–response assay, but the assay still has utility in distinguishing herbicide-resistant plants from herbicide-susceptible plants.
ENT specialty trainees are invited to national bootcamps to prepare for critical events to which they may have never been exposed. Here, we evaluate the frequency of out-of-hours ENT operations and the level of supervision provided to inform aspiring trainees and the national bootcamps.
Methods
Information on all ENT operations performed out-of-hours was prospectively recorded by trainees in Kent, Surrey and Sussex over seven months.
Results
There was a 100 per cent response rate. The trainee was the most senior surgeon present for 48.4 per cent of out-of-hours operations. Four of the six most frequently performed out-of-hours operations are not included in the ENT indicator procedures, and two are not included in the national ENT bootcamps.
Conclusion
Trainees should be aware of the most common procedures they may be expected to perform out-of-hours. Training in these should be provided prior to the commencement of specialty training. The audit design can be replicated across surgical specialties.
Complaints of control failures with acetolactate synthase (ALS)- and protoporphyrinogen oxidase (PPO)-inhibiting herbicides on redroot pigweed (Amaranthus retroflexus L.) were reported in conventional soybean [Glycine max (L.) Merr.] fields in North Carolina. Greenhouse dose–response assays confirmed that the Camden County and Pasquotank County populations were less sensitive to ALS- and PPO-inhibiting herbicides compared with susceptible A. retroflexus populations, suggesting the evolution of resistance to these herbicides. Sanger sequencing of target genes determined the Camden County population carried a Trp-574-Leu mutation in the ALS gene and an Arg-98-Gly mutation in the PPX2 gene, while the Pasquotank County population carried a His-197-Pro mutation in the ALS gene (first documentation of the mutation in the Amaranthus genus), but no mutation was detected in the PPX2 gene. Single-nucleotide polymorphism (SNP) genotyping assays were developed to enable efficient screening of future control failures in order to limit the spread of these herbicide-resistant populations. In addition, preliminary testing of these assays revealed the three mutations were ubiquitous in the respective populations. These two populations represent the first confirmed cases of PPO-inhibiting herbicide-resistant A. retroflexus in the United States, as well as the first confirmed cases of this particular herbicide-resistance profile in A. retroflexus inhabiting North America. While no mutation was found in the PPX2 gene of the Pasquotank County population, we suggest that this population has evolved resistance to PPO-inhibiting herbicides, but the mechanism of resistance is to be determined.
Glufosinate is an effective postemergence herbicide, and overreliance on this herbicide for weed control is likely to increase and select for glufosinate-resistant weeds. Common assays to confirm herbicide resistance are dose–response and molecular sequencing techniques; both can require significant time, labor, unique technical equipment, and a specialized skillset to perform. As an alternative, we propose an image-based approach that uses a relatively inexpensive multispectral sensor designed for unmanned aerial vehicles to measure and quantify surface reflectance from glufosinate-treated leaf disks. Leaf disks were excised from a glufosinate-resistant and glufosinate-susceptible corn (Zea mays L.), cotton (Gossypium hirsutum L.), and soybean [Glycine max (L.) Merr.] varieties and placed into a 24-well plate containing eight different concentrations (0 to 10 mM) of glufosinate for 48 h. Multispectral images were collected after the 48-h incubation period across five discrete wave bands: blue (475 to 507 nm), green (560 to 587 nm), red (668to 682 nm), red edge (717 to 729 nm), and near infrared (842 to 899 nm). The green leaf index (GLI; a metric to measure chlorophyll content) was utilized to determine relationships between measured reflectance from the tested wave bands from the treated leaf disks and the glufosinate concentration. Clear differences of spectral reflectance were observed between the corn, cotton, and soybean leaf disks of the glufosinate-resistant and glufosinate-susceptible varieties at the 10 mM concentration for select wave bands and GLI. Leaf disks from two additional glufosinate-resistant and glufosinate-susceptible varieties of each crop were subjected to a similar assay with two concentrations: 0 and 10 mM. No differences of spectral reflectance were observed from the corn and soybean varieties in all wave bands and the GLI. The leaf disks of the glufosinate-resistant and glufosinate-susceptible cotton varieties were spectrally distinct in the green, blue, and red-edge wave bands. The results provide a basis for rapidly detecting glufosinate-resistant plants via spectral reflectance. Future research will need to determine the glufosinate concentrations, useful wave bands, and susceptible/resistant thresholds for weeds that evolve resistance.
Infection by parasites or pathogens can have marked physiological impacts on individuals. In birds, infection may affect moult and feather growth, which is an energetically demanding time in the annual cycle. Previous work has suggested a potential link between clinically visible Trichomonas gallinae infection and wing length in turtle doves Streptopelia turtur arriving on breeding grounds. First, T. gallinae infection was characterized in 149 columbids from 5 species, sampled on turtle dove wintering grounds in Senegal during the moulting period, testing whether infection by T. gallinae is linked to moult. Trichomonas gallinae prevalence was 100%, so rather than testing for differences between infected and uninfected birds, we tested for differences in moult progression between birds infected by different T. gallinae strains. Twelve strains of T. gallinae were characterized at the internal transcribed spacer 1 (ITS1)/5.8S/ITS2 region, of which 6 were newly identified within this study. In turtle doves only, evidence for differences in wing length by strain was found, with birds infected by strain Tcl-1 having wings nearly 6 mm longer than those infected with strain GEO. No evidence was found for an effect of strain identity within species on moult progression, but comparisons between infected and uninfected birds should be further investigated in species where prevalence is lower.
Global biodiversity is at a heightened risk of extinction and we are losing species faster than at any other time. It is important to understand the threats that drive a species towards extinction in order to address those drivers. In this paper, we assess our knowledge of the threats faced by 24 Himalayan Galliformes species by undertaking a review of the threats reported in the published literature and the supporting evidence that the threat is having an impact on the species’ populations. Only 24 papers were deemed suitable to be included in the study. We found that biological resource use and agriculture and aquaculture are the predominant threats to the Galliformes in the Greater Himalaya but the evidence available in the studies is quite poor as only one paper quantified the impact on species. This study shows that major gaps exist in our understanding of threats to species, and it is imperative to fill those gaps if we want to prevent species from going extinct.
Written for an audience of students, general readers, and economists alike, this Element is a primer on the field of the economics of conflict and peace. It offers a reasonably comprehensive, systematic, and detailed overview - even if in broad strokes - of the field's orthodox and heterodox history of thought and current theories and evidence. The authors view this Element as a baseline account on which to build a future, separate and more fully developed, work on the economics of peace, economic growth, and human development. Altogether, the Element contextualizes the field of conflict and peace economics, outlines its history of thought, highlights examples of current theoretical and empirical scholarship in the field, and maps trajectories for further research.