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The causes of CHD are complex and often unknown, leading parents to ask how and why this has happened. Genetic counselling has been shown to benefit these parents by providing information and support; however, most parents currently do not receive this service. This study aimed to develop a brochure to determine whether an information resource could improve parents’ knowledge about CHD causation and inheritance and increase psychosocial functioning.
Methods:
In development, the resource was assessed against several readability scales and piloted. Parents of children attending preadmission clinic for surgery were included. Assessments occurred pre- and post-receiving the information resource using a purpose-designed knowledge measure and validated psychological measures.
Results:
Participant’s (n = 52) knowledge scores increased significantly from the pre-questionnaire (
${\overline x}\, = \,5/10$
, sd = 2.086) to post-questionnaire (
$\overline x\, = \,7.88/10$
, sd = 2.094, p < 0.001), with all aware that CHD can be caused by genetic factors after reading the brochure. Perceived personal control also increased from pre- (
$\overline x\, = \,11.856/18$
, sd = 4.339) to post-brochure (
$\overline x\, = \,14.644/18$
, sd = 3.733, p < 0.001), and many reported reduced feelings of guilt. No negative emotional response to the brochure was reported. The information provided was considered relevant (88%), reassuring (86%), and 88% would recommend the brochure to other parents. However, some wanted more emotional support and assistance in what to tell their child.
Conclusions:
Use of the information resource significantly enhanced parents’ knowledge of CHD causation and increased their psychosocial functioning. It is a valuable resource in the absence of genetic counselling; however, it should not replace formal genetic counselling when required.
The north-west European population of Bewick’s Swan Cygnus columbianus bewickii declined by 38% between 1995 and 2010 and is listed as ‘Endangered’ on the European Red List of birds. Here, we combined information on food resources within the landscape with long-term data on swan numbers, habitat use, behaviour and two complementary measures of body condition, to examine whether changes in food type and availability have influenced the Bewick’s Swan’s use of their main wintering site in the UK, the Ouse Washes and surrounding fens. Maximum number of Bewick’s Swans rose from 620 in winter 1958/59 to a high of 7,491 in winter 2004/05, before falling to 1,073 birds in winter 2013/14. Between winters 1958/59 and 2014/15 the Ouse Washes supported between 0.5 and 37.9 % of the total population wintering in north-west Europe (mean ± 95 % CI = 18.1 ± 2.4 %). Swans fed on agricultural crops, shifting from post-harvest remains of root crops (e.g. sugar beet and potatoes) in November and December to winter-sown cereals (e.g. wheat) in January and February. Inter-annual variation in the area cultivated for these crops did not result in changes in the peak numbers of swans occurring on the Ouse Washes. Behavioural and body condition data indicated that food supplies on the Ouse Washes and surrounding fens remain adequate to allow the birds to gain and maintain good body condition throughout winter with no increase in foraging effort. Our findings suggest that the recent decline in numbers of Bewick’s Swans at this internationally important site was not linked to inadequate food resources.
Four substituted pyridazinone compounds inhibited the Hill reaction and photosynthesis in barley (Hordeum vulgare L., var. Dayton C.I. 9517). These inhibitions appeared to account for the phytotoxicity of 5-amino-4-chloro-2-phenyl-3(2H)-pyridazinone (pyrazon). The pyridazinone chemicals were weaker inhibitors than 2-chloro-4-(ethylamino)-6-(isopropylamino)-s-triazine (atrazine). Two substitutions onto the molecular structure of pyrazon result in a new experimental herbicide, 4-chloro-5-(dimethylamino)-2-(α,α,α-trifluoro-m-tolyl)-3(2H)-pyridazinone (hereinafter referred to as 6706), which retains the action mechanism of pyrazon but also has two additional biological properties. It is resistant to metabolic detoxication in plants, and it possesses a second mode of action involving interference with chloroplast development. The second action is like that expressed by 3-amino-s-triazole (amitrole) and by 3,4-dichlorobenzyl methylcarbamate (dichlormate). However, the new chemical is 100 to 1000 times more effective. The trifluoromethyl substitution on the phenyl ring and the dimethyl substitution on the amine are both required to give either of the two additional physiological properties. Analogs with only one of the two substitutions behave like pyrazon rather than like 6706.
Several temporal and event classifications are used for the Quaternary glacial and interglacial record in the Great Lakes region of North America. Although based on contrasting principles, the classifications, as practiced, are similar to one another in most respects and they differ little from the classification proposed by Chamberlin a century ago. All are based on stratigraphic units having time-transgressive boundaries; thus the associated time spans and events are diachronous. Where application of geochronologic classification based on isochronous boundaries is not practical or useful, we advocate the use of diachronic principles to establish local and regional temporal and event classifications. Diachronic and event classifications based on such principles are proposed herein for the Great Lakes region. Well-established names, including Wisconsin, Sangamon, and Illinois, are used at the episode (or glaciation/interglaciation) rank without significant redefinition. The Hudson Episode (Interglaciation) is introduced for postglacial time, the current interglacial interval. The Wisconsin Episode is divided into the Ontario, Elgin, and Michigan Subepisodes in the eastern and northern parts of the Great Lakes region and into the Athens and Michigan Subepisodes in the southern and western parts of the Great Lakes region.
Qualitative samples of ‘opisthobranchs’ were collected from different beaches and estuaries in Ceará State, North-east Brazil. Further species distributions from the literature were used to infer patterns of distribution and to analyse faunal similarity among Atlantic biogeographic areas, Brazilian zones and the Ceará State. A total of 35 new records are reported for the Ceará State, including 19 new records from the North-east Brazilian Shelf (NBS), 12 new from the Brazilian Province and two new records from the South Atlantic. More than half of the species in this area are common between the Caribbean and Brazilian provinces, which demonstrates their capacity for crossing the Amazon–Orinoco barrier. The high percentage of occurrence in the NBS and the South Brazilian Bight, when compared to neighbouring zones, may be attributed to the poor knowledge of the Brazilian ‘opisthobranch’ fauna.
It has been suggested that childhood obsessive-compulsive disorder (OCD) may be a risk factor for the development of an eating disorder (ED) later in life, but prospective studies are lacking. We aimed to determine the prevalence of ED at follow-up and clinical predictors in a longitudinal clinical sample of adolescents/young adults diagnosed with OCD in childhood.
Method
All contactable (n=231) young people with OCD assessed over 9 years at a national and specialist paediatric OCD clinic were included in this study. At follow-up, 126 (57%) young people and parents completed the ED section of the Developmental and Well-being Assessment. Predictors for ED were investigated using logistic regression.
Results
In total, 16 participants (12.7%) had a diagnosis of ED at follow-up. Having an ED was associated with female gender and persistent OCD at follow-up. There was a trend for family history of ED being predictive of ED diagnosis. Five (30%) of those who developed an ED at follow-up had ED symptoms or food-related obsessions/compulsions at baseline. A difference in predictors for an ED versus other anxiety disorders at follow-up was identified.
Conclusions
This study provides initial evidence that baseline clinical predictors such as female gender and family history of ED might be specific to the later development of ED in the context of childhood OCD. Clinicians should be alert to ED subthreshold symptoms in young girls presenting with OCD. Future longitudinal studies are needed to clarify the relationship between childhood OCD and later ED.
Obsessive–compulsive disorder (OCD) often starts in childhood and adolescence and can be a chronic disorder with high persistence rates. There are few prospective long-term follow-up studies.
Aims
To follow up young people with OCD to clarify persistence rates and relevant predictors, presence of other psychiatric disorders, functional impairment, service utilisation and perceived treatment needs.
Method
All young people with OCD assessed over 9 years at the National and Specialist Paediatric OCD clinic, Maudsley Hospital, London, were included. Sixty-one per cent (142 of 222) of all contactable young people and parents completed computerised diagnostic interviews and questionnaires.
Results
We found a persistence rate of OCD of 41%; 40% of participants had a psychiatric diagnosis other than OCD at follow-up. The main predictor for persistent OCD was duration of illness at assessment. High levels of baseline psychopathology predicted other psychiatric disorders at follow-up. Functional impairment and quality of life were mildly to moderately affected. Approximately 50% of participants were still receiving treatment and about 50% felt a need for further treatment.
Conclusions
This study confirms that paediatric OCD can be a chronic condition that persists into adulthood. Early recognition and treatment might prevent chronicity. Important challenges for services are ensuring adequate treatment and a smooth transition from child to adult services.
Defining the causal relationship between a microbe and encephalitis is complex. Over 100 different infectious agents may cause encephalitis, often as one of the rarer manifestations of infection. The gold-standard techniques to detect causative infectious agents in encephalitis in life depend on the study of brain biopsy material; however, in most cases this is not possible. We present the UK perspective on aetiological case definitions for acute encephalitis and extend them to include immune-mediated causes. Expert opinion was primarily used and was supplemented by literature-based methods. Wide usage of these definitions will facilitate comparison between studies and result in a better understanding of the causes of this devastating condition. They provide a framework for regular review and updating as the knowledge base increases both clinically and through improvements in diagnostic methods. The importance of new and emerging pathogens as causes of encephalitis can be assessed against the principles laid out here.
Increasingly serious shortages of water make it imperative to improve the efficiency of irrigation in agriculture, horticulture and in the maintenance of urban landscapes. The main aim of the current review is to identify ways of meeting this objective. After reviewing current irrigation practices, discussion is centred on the sensitivity of crops to water deficit, the finding that growth of many crops is unaffected by considerable lowering of soil water content and, on this basis, the creation of improved means of irrigation scheduling. Subsequently, attention is focused on irrigation problems associated with spatial variability in soil water and the often slow infiltration of water into soil, especially the subsoil. As monitoring of soil water is important for estimating irrigation requirements, the attributes of the two main types of soil water sensors and their most appropriate uses are described. Attention is also drawn to the contribution of wireless technology to the transmission of sensor outputs. Rapid progress is being made in transmitting sensor data, obtained from different depths down the soil profile across irrigated areas, to a PC that processes the data and on this basis automatically commands irrigation equipment to deliver amounts of water, according to need, across the field. To help interpret sensor outputs, and for many other reasons, principles of water processes in the soil–plant system are incorporated into simulation models that are calibrated and tested in field experiments. Finally, it is emphasized that the relative importance of the factors discussed in this review to any particular situation varies enormously.
We give some sufficient conditions for an (S, U)-outline T-factorization of Kn to be an (S, U)-amalgamated T-factorization of Kn. We then apply these to give various necessary and sufficient conditions for edge coloured graphs G to have recoverable embeddings in T-factorized Kn's.
AuTiAlTi, AuPdAlTi and AuAlTi ohmic contacts to AlGaN/GaN layers rapid thermal annealed at temperatures up to 950°C have been characterised using conventional and chemical transmission electron microscopy techniques. The relationship between the as-deposited metallic structure, annealing temperature, post-anneal interfacial microstructure and contact resistance is examined.
The presence of a TiN interfacial layer is found to correlate with the onset of ohmic behaviour. Ti and Pd barrier layers are found to be ineffective at stopping the diffusion of Au to the interface. Au is implicated in the development of the inclusions, which are associated with threading dislocations. Once activated, the presence of the inclusions has little influence on the ohmic behaviour of the sample.
We report on the in-situ measurement of temperature, i.e., self-heating effects, in multi-finger AlGaN/GaN HFETs grown on SiC substrates. Optical micro-spectroscopy was used to measure temperature with 1m spatial resolution. Thermal resistance (temperature rise per W/mm) was measured as a function of device pitch and gate finger width. There is significant thermal cross talk in multi-finger AlGaN/GaN HFETs and this needs to be seriously considered for device performance and ultimately device reliability. A comparison with theoretical modeling is presented. Uncertainties in modeling parameters currently make modeling less reliable than experimental temperature assessment of devices.
The commercial introduction of high-count-rate, near-room-temperature silicon drift detectors (presently available) and high-energy-resolution cryogenic microcalorimeters (forthcoming) is an exciting development in x-ray microanalysis, in which detector choices and capabilities have been essentially stable for many years. Both of these new energy-dispersive detectors promise improved capabilities for specific applications, e.g., faster EDS mapping (silicon drift detectors) and nanoscale particle analysis (microcalorimeters). In this paper, we briefly examine some of the important benefits and drawbacks of microcalorimeter EDS (μcal EDS) for x-ray microanalysis.
The primary benefit of μcal EDS over conventional semiconductor EDS is the factor of ∼ 20 improvement in energy resolution (∼ 4 eV, real-time analog signal processing), as shown in Figure 1.