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Hand hygiene is effective to prevent transmission of pathogens and healthcare-associated infections. Despite efforts by hospitals to improve hand hygiene adherence among healthcare practitioners (HCP), adherence in neonatology wards is often limited.
Objective:
Identifying determinants, i.e., facilitators and barriers, to hand hygiene adherence among frontline HCP in neonatology.
Design:
Qualitative implementation research study.
Setting:
Department of Neonatology of the University Hospital Zurich, Switzerland.
Methods:
Semi-structured interviews with frontline HCP and Infection Prevention and Control (IPC) experts were conducted in November 2022. Interviews were coded deductively according to the Theoretical Domains Framework (TDF) and the Capability, Opportunity, Motivation and Behavior model (COM-B), and inductively to capture nuances in the data. Determinants whose addressing was perceived to likely improve hand hygiene adherence in the current setting were rated as “high priority”.
Results:
A total of 42 interviews were conducted, 27 (64%) with nurses, six (14%) with physicians, four (10%) with other professions, and five (12%) with IPC experts. Sixteen determinants were identified, twelve of which were high-priority, four in each COM-B domain. Knowledge, attention control, planning workflows, and habits & automatisms were found in “Capability,” workload & emergencies, invisibility of germs, role models, and being observed in “Opportunity,” and bad conscience, experience consequences of (non-) adherence, self-reflection, and intention to adhere to hand hygiene in “Motivation.”
Discussion/Conclusion:
Facilitators from all COM-B domains and barriers from “Capability” and “Opportunity” influence hand hygiene behavior in neonatology settings. Our findings can now inform interventions to improving hand hygiene adherence in neonatal settings.
The COVID-19 pandemic has had a significant impact on the health of millions of people worldwide, and many manifest new or persistent symptoms long after the initial onset of the infection. One of the leading symptoms of long-COVID is cognitive impairment, which includes memory loss, lack of concentration, and brain fog. Understanding the nature and underlying mechanisms of cognitive impairment in long-COVID is important for developing preventive and therapeutic interventions.
Methods
Our present study investigated functional connectivity (FC) changes in patients with long-COVID and their associations with cognitive impairment. Resting-state functional MRI data from 60 long-COVID patients and 52 age- and sex-matched healthy controls were analyzed using seed-based functional connectivity analysis.
Results
We found increased FC between the right caudate nucleus and both the left and right precentral gyri in long-COVID patients compared with healthy controls. In addition, elevated FC was observed between the right anterior globus pallidus and posterior cingulate cortex as well as the right temporal pole in long-COVID patients. Importantly, the magnitude of FC between the caudate and the left precentral gyrus showed a significant negative correlation with Montreal Cognitive Assessment (MoCA) scores and a negative correlation with Trail Making Test B performance in the patient group.
Conclusion
Patients with long-COVID present enhanced FC between the caudate and the left precentral gyrus. Furthermore, those FC alterations are related to the severity of cognitive impairment, particularly in the domain of executive functions.
Validated yes/no vocabulary tests that measure bilinguals’ language proficiency based on vocabulary knowledge have been widely used in psycholinguistic research. However, it is unclear what aspects of test takers’ vocabulary knowledge are employed in these tests, which makes the interpretation of their scores problematic. The present study investigated the contribution of bilinguals’ form-meaning knowledge to their item accuracy on a Malay yes/no vocabulary test. Word knowledge of Malay first- (N = 80) and second-language (N = 80) speakers were assessed using yes/no, meaning recognition, form recognition, meaning recall and form recall tests. The findings revealed that 59% of the variance in the yes/no vocabulary test score was explained by the accuracy of the meaning recognition, form recognition and meaning recall tests. Importantly, the item analysis indicated that yes/no vocabulary tests assess primarily knowledge of form recognition, supporting its use as a lexical proficiency measure to estimate bilinguals’ receptive language proficiency.
Tree-afflicting pests, such as insects and pathogens, could change forests in ways promoting invasions by non-native plants. After tree death associated with the fungal pathogen oak wilt (Bretziella fagacearum) and its attempted containment (severing root connectivity and sanitation removal of infected trees), we examined change in cover of the non-native liana Oriental bittersweet (Celastrus orbiculatus Thunb.; hereafter Celastrus) at 28 sites in temperate black oak (Quercus velutina Lam.) forests, Ohio, USA. During our 5-yr study spanning 2020 to 2024, Celastrus cover increased significantly (P < 0.05) through time at oak wilt sites but not in untreated reference forest sites without evidence of oak wilt. Celastrus cover increased by an order of magnitude, up to an average of 32 times among oak wilt treatments up to 10 yr old. By 2024, Celastrus cover ranged from 6% to 22% on average in 5- to 10-yr-old oak wilt treatments, compared with 1% cover in reference forest. Results indicate that non-native plant invasion accelerated following disturbance associated with a fungal pathogen and its attempted containment and, more generally, suggest that tree-afflicting pests can promote invasive plants in forests. Co-management of tree-afflicting pests and non-native plants may become increasingly important to ensure forests recovering from tree mortality are dominated by native plants.
Dinah Craik’s 1851 novella The Half-Caste tells the story of how a half-Indian heiress, Zillah Le Poer, faces manipulative attempts by the greedy British side of her family to control her fortune which she thwarts by marrying her older Scottish guardian. This reading of Craik’s novel examines the production of race at a period when dominant British imperialism was believed to depend largely on hierarchies of race allegedly constructed by heredity. Walters argues that Craik describes how new racial identities can be produced by the ‘affective capacity of brown, Eurasian, female bodies to feel connection with – and dependence on white women’, with resulting implications for racial hierarchies and Empire itself. The chapter examines the idea of race in part as a function of feeling and reveals a ‘slippage between affective and racially scientific methods of assessing difference’.
Two-dimensional (2D) leaky-wave antennas (LWAs) are commonly designed to radiate pencil beams at broadside and/or scanned conical beams. Recently, the possibility to radiate narrow null patterns at broadside has also been preliminarily explored. In this work, we first review the design rules to obtain a pencil beam from an infinite 2D LWA and then show how they change for having a beam with a narrow null at broadside. The effects of antenna truncation are also accounted for in both cases, and numerical results show how the optimum conditions are in turn affected. Finally, full-wave validations of practical structures excited with either horizontal or vertical dipoles validate the analysis.
Positive, negative and disorganised psychotic symptom dimensions are associated with clinical and developmental variables, but differing definitions complicate interpretation. Additionally, some variables have had little investigation.
Aims
To investigate associations of psychotic symptom dimensions with clinical and developmental variables, and familial aggregation of symptom dimensions, in multiple samples employing the same definitions.
Method
We investigated associations between lifetime symptom dimensions and clinical and developmental variables in two twin and two general psychosis samples. Dimension symptom scores and most other variables were from the Operational Criteria Checklist. We used logistic regression in generalised linear mixed models for combined sample analysis (n = 875 probands). We also investigated correlations of dimensions within monozygotic (MZ) twin pairs concordant for psychosis (n = 96 pairs).
Results
Higher symptom scores on all three dimensions were associated with poor premorbid social adjustment, never marrying/cohabiting and earlier age at onset, and with a chronic course, most strongly for the negative dimension. The positive dimension was also associated with Black and minority ethnicity and lifetime cannabis use; the negative dimension with male gender; and the disorganised dimension with gradual onset, lower premorbid IQ and substantial within twin-pair correlation. In secondary analysis, disorganised symptoms in MZ twin probands were associated with lower premorbid IQ in their co-twins.
Conclusions
These results confirm associations that dimensions share in common and strengthen the evidence for distinct associations of co-occurring positive symptoms with ethnic minority status, negative symptoms with male gender and disorganised symptoms with substantial familial influences, which may overlap with influences on premorbid IQ.
V5579 Sgr was a fast nova discovered in 2008 April 18.784 UT. We present the optical spectroscopic observations of the nova observed from the Castanet Tolosan, SMARTS, and CTIO observatories spanning over 2008 April 23 to 2015 May 11. The spectra are dominated by hydrogen Balmer, Fe II, and O I lines with P-Cygni profiles in the early phase, typical of an Fe II class nova. The spectra show He I and He II lines along with forbidden lines from N, Ar, S, and O in the nebular phase. The nova showed a pronounced dust formation episode that began about 20 days after the outburst. The dust temperature and mass were estimated using the WISE data from spectral energy distribution (SED) fits. The PAH-like features are also seen in the nova ejecta in the mid-infrared Gemini spectra taken 522 d after the discovery. Analysis of the light curve indicates values of $t_2$ and $t_3$ about 9 and 13 days, respectively, placing the nova in the category of fast nova. The best-fit cloudy model of the early decline phase JHK spectra obtained on 2008 May 3 and the nebular optical spectrum obtained on 2011 June 2 shows a hot white dwarf source with $T_{BB}$$\sim$ 2.6 $\times$ 10$^5$ K having a luminosity of 9.8 $\times$ 10$^{36}$ ergs s$^{-1}$. Our abundance analysis shows that the ejecta is significantly enhanced relative to solar, O/H = 32.2, C/H = 15.5, and N/H = 40.0 in the early decline phase and O/H = 5.8, He/H = 1.5, and N/H = 22.0 in the nebular phase.
Despite major advancements in surgery and anesthesia, the risk of mortality following cardiac and non-cardiac surgery remains high and is frequently associated with perioperative organ dysfunction. Neurological derangements range from brief postoperative delirium to postoperative cognitive dysfunction to perioperative stroke with associated impact on quality of life and mortality. Major adverse cardiac events and arrhythmias play a significant role in adverse clinical outcomes following all surgical procedures. GI dysfunction represents one of the more common complications following surgery, while hepatic dysfunction remains infrequent but largely uninvestigated. Perioperative endocrine dysfunction consists of both hyperglycemia and hypoglycemia, both of which can have significant effects on perioperative course and recovery. Postoperative pulmonary complications remain one of the more common perioperative complications depending on patient-related and surgical factors. Perioperative acute kidney injury is common in the perioperative setting. This chapter briefly explores the impact of cardiac and non-cardiac surgery on individual organ systems and some of the effects of these perturbations on perioperative morbidity and mortality.
OBJECTIVES/GOALS: Analyze how the Endowment HIREC ‘s Mentoring and Career Coach Model A productive mentoring relationship is essential to advance researchers into being independent and bring extramural funds. METHODS/STUDY POPULATION: Provide Hispanic researchers mentoring and career coaching to strengthen their pathway as researcher. The HiREC’s Career Coach and Mentoring Component (CCMC) is an innovated approach to support long-lasting research mentoring relationships in our institution. This approach was developed to advance research to eliminate health disparities, promote multidisciplinary translational research in a Minority Institution and sustain research infrastructure and services, career, and workforce development initiatives. Promising Faculty are target and early and mid-career investigators interested in pursuing a research career. To implement the CCMC with the Visiting Endowed Chair a HiREC Advisory Leadership Group in Mentoring will be established, with researchers from Puerto Rico, and US mainland. RESULTS/ANTICIPATED RESULTS: Three Hispanic mid-career women from the School of Medicine and one from the School of Health Professions from the University of Puerto Rico received a HiREC Advanced Research Award of $50,000. The awardees achieved their goals; completed their research plan, research infrastructure needs, peer-reviewed publications, and submission of a competitive grant. They also provided successful perspectives on mentoring relationships in a Minority institution. Each one showed the mentor’s and mentee’s experiences as fundamental for their research advancements, productivity, leadership, and successful results. HiIREC’s mentoring component with the Visiting Endowed Chairs improves a healthy work environment and expands the research agenda for each awardee sustaining the institutional research culture. DISCUSSION/SIGNIFICANCE: A productive mentoring relationship is essential to advance researchers into being independent and bring extramural funds. Four mentees received formal, long-term guidance and endowment funds for their research infrastructure requirements with successful outcomes. HiREC contributes to building up an institutional mentoring program.
OBJECTIVES/GOALS: The objective of this study is to assess the feasibility and preliminary impact of a physiotherapy protocol for developing an individualized home-based physical activity program to increase physical activity (PA) levels in sedentary older adults with Type II Diabetes Mellitus (T2DM) living in Puerto Rico (PR). METHODS/STUDY POPULATION: This will be a pilot study with two phases. In phase 1, we will design a novel patient-centered home-based PA program protocol for adults ≥65 years with T2DM based on the Information-Motivation-Behavioral Skills model. Its content validity will be assessed through focus groups with 10 experts and 10 older adults and analyzed using a directed content analysis. Phase 2 we will be program implementation using a one-group, repeated measures design with 12 adults ≥65 years with T2DM. PA levels will be assessed by recording active minutes with a Fitbit. Risk of falls, balance, strength, and physical function will be assessed through standardized tests validated for this population. Statistical analysis will include descriptive statistics, comparisons via chi-square/Fisher’s exact test, and non-parametric tests. RESULTS/ANTICIPATED RESULTS: We expect to recruit a minimum of 12 participants and to administer the program for 12 weeks at a frequency of two visits per week. We anticipate that implementing and supervising the home-based PA protocol will be feasible as determined by recruitment and retention rates, patients’ satisfaction, and compliance with the program. We also expect that this protocol will increase physical activity levels, improve general strength, balance, physical function, and reduce the risk of falls in sedentary older adults with T2DM. DISCUSSION/SIGNIFICANCE: As the third cause of death in PR, T2DM represents a public health challenge. An effective home-based PA program may decrease morbidity and mortality rates in older adults by increasing PA and functional health. This study will provide data for planning a randomized controlled trial to assess its effectiveness in the outcomes of interest.
Formation of authigenic trioctahedral Mg-rich smectite is common in evaporative lake sediments, but was not described previously in modern marine evaporative environments. This study documents formation of authigenic K-rich, Mg-smectite during very early diagenesis in the dominantly siliciclastic Salina Ometepec (Baja California), a large supratidal evaporative sabkha complex near the mouth of the Colorado River. Here, sediment pore waters are exceptionally Mg2+-rich relative to other marine evaporative environments due to suppressed sulfate reduction which limits production of carbonate alkalinity and, hence, carbonate (particularly dolomite) precipitation. Sediment cores were obtained along a five km transect seaward across the hypersaline mud flat to evaluate how these atypical geochemical conditions would affect the clay mineral compositions.
Scanning transmission electron microscopy (STEM) observations show that the smectite from the marine Inlet, near the sediment source, consists of grains of irregular shape that give selected area diffraction (SAED) patterns reflecting dominant turbostratic stacking. Analytical electron microscopy (AEM) analyses indicate that K+ is the dominant interlayer cation; the mean composition is approximately K0.7(Al3.3Fe(III)0.3Mg0.5)(Al0.5Si7.5)O20(OH)4. Such smectite is implied to be detrital in part because it is similar to smectite known to be deposited by the Colorado River.
Smectite from the hypersaline mud flat occurs as aggregates of small subhedral pseudohexagonal plate or lath-shaped crystals ≤250 nm in diameter, with thicknesses varying between three and ten layers. The SAED patterns reflect substantial turbostratic stacking, but with a greater frequency of interlayer coherency as compared with detrital smectite. Crystals from greater sediment depths are larger and more nearly euhedral. This smectite is dominantly trioctahedral, with mean composition approximately K0.7(Al0.7Fe(III)0.5Mg4.45)(Al1.2Si6.8)O20(OH)4 (saponitic). This smectite is inferred to be dominantly authigenic in origin.
The X-ray diffraction (XRD) and STEM/AEM data collectively imply that detrital aluminous dioctahedral smectite reacts to form authigenic Mg-rich trioctahedral smectite, driven in part by the high Mg2+/ Ca2+ ratio of pore waters. Such early-formed Mg-rich smectite may be the precursor for the trioctahedral mixed-layer smectite, corrensite, and chlorite assemblages found in ancient marine evaporative sequences. These results also add to the accumulating evidence that interlayer K+ in marine smectite is fixed during the earliest stages of marine diagenesis near the sediment water interface.
The adsorption mechanisms of divalent cations in zeolite nanopore channels can vary as a function of their pore dimensions. The nanopore inner-sphere enhancement (NISE) theory predicts that ions may dehydrate inside small nanopore channels in order to adsorb more closely to the mineral surface if the nanopore channel is sufficiently small. The results of an electron paramagnetic resonance (EPR) spectroscopy study of Mn and Cu adsorption on the zeolite minerals zeolite Y (large nanopores), ZSM-5 (intermediate nanopores), and mordenite (small nanopores) are presented. The Cu and Mn cations both adsorbed via an outer-sphere mechanism on zeolite Y based on the similarity between the adsorbed spectra and the aqueous spectra. Conversely, Mn and Cu adsorbed via an inner-sphere mechanism on mordenite based on spectrum asymmetry and peak broadening of the adsorbed spectra. However, Mn adsorbed via an outer-sphere mechanism on ZSM-5, whereas Cu adsorbed on ZSM-5 shows a high degree of surface interaction that indicates that it is adsorbed closer to the mineral surface. Evidence of dehydration and immobility was more readily evident in the spectrum of mordenite than in that of ZSM-5, indicating that Cu was not as close to the surface on ZSM-5 as it was when adsorbed on mordenite. Divalent Mn cations are strongly hydrated and are held strongly only in zeolites with small nanopore channels. Divalent Cu cations are also strongly hydrated, but can dehydrate more easily, presumably due to the Jahn-Teller effect, and are held strongly in zeolites with medium-sized nanopore channels or smaller.
The Stricker Learning Span (SLS) is a computer-adaptive word list memory test specifically designed for remote assessment and self-administration on a web-based multi-device platform (Mayo Test Drive). Given recent evidence suggesting the prominence of learning impairment in preclinical Alzheimer’s disease (AD), the SLS places greater emphasis on learning than delayed memory compared to traditional word list memory tests (see Stricker et al., Neuropsychology in press for review and test details). The primary study aim was to establish criterion validity of the SLS by comparing the ability of the remotely-administered SLS and inperson administered Rey Auditory Verbal Learning Test (AVLT) to differentiate biomarkerdefined groups in cognitively unimpaired (CU) individuals on the Alzheimer’s continuum.
Participants and Methods:
Mayo Clinic Study of Aging CU participants (N=319; mean age=71, SD=11; mean education=16, SD=2; 47% female) completed a brief remote cognitive assessment (∼0.5 months from in-person visit). Brain amyloid and brain tau PET scans were available within 3 years. Overlapping groups were formed for 1) those on the Alzheimer’s disease (AD) continuum (A+, n=110) or not (A-, n=209), and for 2) those with biological AD (A+T+, n=43) vs no evidence of AD pathology (A-T-, n=181). Primary neuropsychological outcome variables were sum of trials for both the SLS and AVLT. Secondary outcome variables examined comparability of learning (1-5 total) and delay performances. Linear model ANOVAs were used to investigate biomarker subgroup differences and Hedge’s G effect sizes were derived, with and without adjusting for demographic variables (age, education, sex).
Results:
Both SLS and AVLT performances were worse in the biomarker positive relative to biomarker negative groups (unadjusted p’s<.05). Because biomarker positive groups were significantly older than biomarker negative groups, group differences were attenuated after adjusting for demographic variables, but SLS remained significant for A+ vs A- and for A+T+ vs A-T- comparisons (adjusted p’s<.05) and AVLT approached significance (p’s .05-.10). The effect sizes for the SLS were slightly better (qualitatively, no statistical comparison) for separating biomarker-defined CU groups in comparison to AVLT. For A+ vs A- and A+T+ vs A-T- comparisons, unadjusted effect sizes for SLS were -0.53 and -0.81 and for AVLT were -0.47 and -0.61, respectively; adjusted effect sizes for SLS were -0.25 and -0.42 and for AVLT were -0.19 and -0.26, respectively. In secondary analyses, learning and delay variables were similar in terms of ability to separate biomarker groups. For example, unadjusted effect sizes for SLS learning (-.80) was similar to SLS delay (.76), and AVLT learning (-.58) was similar to AVLT 30-minute delay (-.55) for the A+T+ vs AT- comparison.
Conclusions:
Remotely administered SLS performed similarly to the in-person-administered AVLT in its ability to separate biomarker-defined groups in CU individuals, providing evidence of criterion validity. The SLS showed significantly worse performance in A+ and A+T+ groups (relative to A- and A-T-groups) in this CU sample after demographic adjustment, suggesting potential sensitivity to detecting transitional cognitive decline in preclinical AD. Measures emphasizing learning should be given equal consideration as measures of delayed memory in AD-focused studies, particularly in the preclinical phase.
Mayo Test Drive (MTD): Test Development through Rapid Iteration, Validation and Expansion, is a web-based multi-device (smartphone, tablet, personal computer) platform optimized for remote self-administered cognitive assessment that includes a computer-adaptive word list memory test (Stricker Learning Span; SLS; Stricker et al., 2022; Stricker et al., in press) and a measure of processing speed (Symbols Test: Wilks et al., 2021). Study aims were to determine criterion validity of MTD by comparing the ability of the MTD raw composite and in-person administered cognitive measures to differentiate biomarkerdefined groups in cognitively unimpaired (CU) individuals on the Alzheimer’s continuum.
Participants and Methods:
Mayo Clinic Study of Aging CU participants (N=319; mean age=71, SD=11, range=37-94; mean education=16, SD=2, range=6-20; 47% female) completed a brief remote cognitive assessment (∼0.5 months from in-person visit). Brain amyloid and brain tau PET scans were available within 3 years. Overlapping groups were formed for 1) those on the Alzheimer’s disease (AD) continuum (A+, n=110) or not (A-, n=209), and for 2) those with biological AD (A+T+, n=43) or with no evidence of AD pathology (A-T-, n=181). Primary outcome variables were MTD raw composite (SLS sum of trials + an accuracy-weighted Symbols response time measure), Global-z (average of 9 in-person neuropsychological measures) and an in-person screening measure (Kokmen Short Test of Mental Status, STMS; which is like the MMSE). Linear model ANOVAs were used to investigate biomarker subgroup differences and Hedge’s G effect sizes were derived, with and without adjusting for demographic variables (age, education, sex).
Results:
Remotely administered MTD raw composite showed comparable to slightly larger effect sizes compared to Global-z. Unadjusted effect sizes for MTD raw composite for differentiating A+ vs. A- and A+T+ vs. A-T- groups, respectively, were -0.57 and -0.84 and effect sizes for Global-z were -0.54 and -0.73 (all p’s<.05). Because biomarker positive groups were significantly older than biomarker negative groups, group differences were attenuated after adjusting for demographic variables, but MTD raw composite remained significant for A+T+ vs A-T- (adjusted effect size -0.35, p=.007); Global-z did not reach significance for A+T+ vs A-T- (adjusted effect size -0.19, p=.08). Neither composite reached significance for adjusted analyses for the A+ vs A- comparison (MTD raw composite adjusted effect size= -.22, p=.06; Global-z adjusted effect size= -.08, p=.47). Results were the same for an alternative MTD composite using traditional z-score averaging methods, but the raw score method is preferred for comparability to other screening measures. The STMS screening measure did not differentiate biomarker groups in any analyses (unadjusted and adjusted p’s>.05; d’s -0.23 to 0.05).
Conclusions:
Remotely administered MTD raw composite shows at least similar ability to separate biomarker-defined groups in CU individuals as a Global-z for person-administered measures within a neuropsychological battery, providing evidence of criterion validity. Both the MTD raw composite and Global-z showed greater ability to separate biomarker positive from negative CU groups compared to a typical screening measure (STMS) that was unable to differentiate these groups. MTD may be useful as a screening measure to aid early detection of Alzheimer’s pathological changes.
Feeding by Critically Endangered forest elephants Loxodonta cyclotis in rural plantations is a conservation issue in Gabon, but studies characterizing drivers of spatiotemporal patterns of human–elephant interactions remain sparse, hindering mitigation. In this study, we use GPS tracking data from two elephants to characterize temporal patterns of village visitation, and surveys of 101 local farmers across seven villages to determine local patterns of crop planting and harvesting and of human–elephant interactions. Local farmers' perceptions of elephant visitations and empirical data on such visits were positively correlated with local crop availability. However, considering the two elephants separately revealed that the correlations were driven by just one individual, with the second elephant showing weak links between crop availability and visitation, highlighting the challenges in reliably predicting human–wildlife interactions. The most popular local perceptions of the drivers of elephant visitation were the presence of crops (53% of responses) and logging (39%). The most popular proposed interventions were letting the government find a solution (32%), killing problem elephants (30%) and providing compensation for lost crops (22%). We discuss the potential feasibility and efficacy of the proposed solutions in the context of human–elephant interactions. Future research efforts should focus on collaring elephants in zones with high potential for negative human–elephant interaction and expanding perception surveys to villages with contrasting ecological contexts (e.g. with and without logging in their surrounding forests), as these could influence local perceptions of conflicts and conservation initiatives.
Normative neuropsychological data are essential for interpretation of test performance in the context of demographic factors. The Mayo Normative Studies (MNS) aim to provide updated normative data for neuropsychological measures administered in the Mayo Clinic Study of Aging (MCSA), a population-based study of aging that randomly samples residents of Olmsted County, Minnesota, from age- and sex-stratified groups. We examined demographic effects on neuropsychological measures and validated the regression-based norms in comparison to existing normative data developed in a similar sample.
Method:
The MNS includes cognitively unimpaired adults ≥30 years of age (n = 4,428) participating in the MCSA. Multivariable linear regressions were used to determine demographic effects on test performance. Regression-based normative formulas were developed by first converting raw scores to normalized scaled scores and then regressing on age, age2, sex, and education. Total and sex-stratified base rates of low scores (T < 40) were examined in an older adult validation sample and compared with Mayo’s Older Americans Normative Studies (MOANS) norms.
Results:
Independent linear regressions revealed variable patterns of linear and/or quadratic effects of age (r2 = 6–27% variance explained), sex (0–13%), and education (2–10%) across measures. MNS norms improved base rates of low performance in the older adult validation sample overall and in sex-specific patterns relative to MOANS.
Conclusions:
Our results demonstrate the need for updated norms that consider complex demographic associations on test performance and that specifically exclude participants with mild cognitive impairment from the normative sample.