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A reduced kinetic method (RKM) with a first-principles collision operator is introduced in a 1D2V planar geometry and implemented in a computationally inexpensive code to investigate non-local ion heat transport in multi-species plasmas. The RKM successfully reproduces local results for multi-species ion systems and the important features expected to arise due to non-local effects on the heat flux are captured. In addition to this, novel features associated with multi-species, as opposed to single species, cases are found. Effects of non-locality on the heat flux are investigated in mass and charge symmetric and asymmetric ion mixtures with temperature, pressure, and concentration gradients. In particular, the enthalpy flux associated with diffusion is found to be insensitive to sharp pressure and concentration gradients, increasing its significance in comparison to the conductive heat flux driven by temperature gradients in non-local scenarios. The RKM code can be used for investigating other kinetic and non-local effects in a broader plasma physics context. Due to its relatively low computational cost it can also serve as a practical non-local ion heat flux closure in hydrodynamic simulations or as a training tool for machine learning surrogates. [ABSTRACT FROM AUTHOR]

Familial hypercholesterolaemia (FH) is a genetic condition that is a preventable cause of premature cardiovascular morbidity and mortality. High-level evidence and clinical practice guidelines support preventative care for people with FH. However, it is estimated that less than 10% of people at risk of FH have been detected using any approach across Australian health settings. The aim of this study was to identify the implementation barriers to and facilitators of the detection of FH in Australia. Four, 2-hour virtual focus groups were facilitated by implementation scientists and a clinicians as part of the 2021 Australasian FH Summit. Template analysis was used to identify themes. There were 28 workshop attendees across four groups (n=6–8 each), yielding 13 barriers and 10 facilitators across three themes: (1) patient related, (2) provider related, and (3) system related. A "lack of care pathways" and "upskilling clinicians in identifying and diagnosing FH" were the most interconnected barriers and facilitators for the detection of FH. The relationships between barriers and facilitators across the patient, provider, and system themes indicates that a comprehensive implementation strategy is needed to address these different levels. Future research is underway to develop a model for implementing the Australian FH guidelines into practice. [ABSTRACT FROM AUTHOR]

Background Perioperative interventions could enhance early mobilisation and physical function after hip fracture surgery. Objective Determine the effectiveness of perioperative interventions on early mobilisation and physical function after hip fracture. Methods Ovid MEDLINE, CINAHL, Embase, Scopus and Web of Science were searched from January 2000 to March 2022. English language experimental and quasi-experimental studies were included if patients were hospitalised for a fractured proximal femur with a mean age 65 years or older and reported measures of early mobilisation and physical function during the acute hospital admission. Data were pooled using a random effect meta-analysis. Results Twenty-eight studies were included from 1,327 citations. Studies were conducted in 26 countries on 8,192 participants with a mean age of 80 years. Pathways and models of care may provide a small increase in early mobilisation (standardised mean difference [SMD]: 0.20, 95% confidence interval [CI]: 0.01–0.39, I 2 = 73%) and physical function (SMD: 0.07, 95% CI 0.00 to 0.15, I 2 = 0%) and transcutaneous electrical nerve stimulation analgesia may provide a moderate improvement in function (SMD: 0.65, 95% CI: 0.24–1.05, I 2 = 96%). The benefit of pre-operative mobilisation, multidisciplinary rehabilitation, recumbent cycling and clinical supervision on mobilisation and function remains uncertain. Evidence of no effect on mobilisation or function was identified for pre-emptive analgesia, intraoperative periarticular injections, continuous postoperative epidural infusion analgesia, occupational therapy training or nutritional supplements. Conclusions Perioperative interventions may improve early mobilisation and physical function after hip fracture surgery. Future studies are needed to model the causal mechanisms of perioperative interventions on mobilisation and function after hip fracture. [ABSTRACT FROM AUTHOR]

Philosophers disagree about whether outcome luck can affect an agent's "moral responsibility." Focusing on responsibility's "negative side," somemaintain, and others deny, that an action's results bear constitutively on how "blameworthy" the actor is, and on how much blame or punishment they "deserve." Crucially, both sides to the debate assume that an actor's blameworthiness and negative desert are equally affected--or unaffected--by an action's results. This article challenges that previously overlooked assumption, arguing that blameworthiness and desert are distinct moral notions that serve distinct normative functions: blameworthiness serves a liability function (removing a bar to otherwise impermissible treatments), whereas desert serves a favoring function (contributing new value to states of affairs, or providing new reasons for responsive treatments). Having distinguished (negative) desert from blameworthiness, the article proposes a novel resolution to the outcome-luck debate: that results do not affect an agent's liability to blame, but do affect the amount and severity of blame towhich the agent is justly liable, including by affecting the severity of blame that the agent deserves. [ABSTRACT FROM AUTHOR]

Realist evaluation is a method increasingly adopted to provide an understanding of how and why a program works, for whom, and under what circumstances. Initial program theories (IPT) are the crucial starting point of any realist evaluation, however descriptions about how they are developed in practice remain under-reported in the published literature. This article argues for the value of genuine research-group conversations using David Bohm's concept of dialogue in realist research. We label it the realist dialogic approach. We draw out the relational qualities as well as the contextual circumstances of dialogue through our development of IPT and interview guides for a research study on the implementation and scaling of a large-system value-based program to transform complex health services. We selected the relevant middle-range theories, conducted a literature review, and drew on informal discussions with key stakeholders, to develop IPT through research-group conversations. The benefits of this approach were: 1) development of rigorous, novel, deep and well-tailored IPT, 2) detailed understanding of the complex intervention under investigation and development of rapport and networks with participants, 3) empirically grounded Context-Mechanism-Outcome (CMO) configurations, predicated on suitable abstract and contextually-contingent middle-range theories, and 4) productive research team interactions which supported the entire research process. The challenges of this approach include: 1) establishing and retaining a sense of humility across the research team, 2) contextual circumstances can hinder dialogic relationship, and 3) time and resource heavy. This paper uses middle-range theory and ethnographic insights to advance the existing practice of realist evaluations and offer transferable lessons to other scholars considering similar approaches. Moreover, we content that the use of middle-range theory to extend the methodological literature is a novel contribution to realist work. [ABSTRACT FROM AUTHOR]

Implementation science in healthcare aims to understand how to get evidence into practice. Once this is achieved in one setting, it becomes increasingly difficult to replicate elsewhere. The problem is often attributed to differences in context that influence how and whether implementation strategies work. We argue that realist research paradigms provide a useful framework to express the effect of contextual factors within implementation strategy causal processes. Realist studies are theory-driven evaluations that focus on understanding how and why interventions work under different circumstances. They consider the interaction between contextual circumstances, theoretical mechanisms of change and the outcomes they produce, to arrive at explanations of conditional causality (i.e., what tends to work, for whom, under what circumstances). This Commentary provides example applications using preliminary findings from a large realist implementation study of system-wide value-based healthcare initiatives in New South Wales, Australia. If applied judiciously, realist implementation studies may represent a sound approach to help optimise delivery of the right care in the right setting and at the right time. [ABSTRACT FROM AUTHOR]

Background: Commercial delivery cyclists represent a uniquely vulnerable and poorly understood road user. The primary aim of this study was to pilot whether cycling injuries could be categorised as either commercial or non-commercial using documentation entered into routine hospital medical records, in order to determine the feasibility of conducting a large cohort study of commercial cycling injuries in the future. A secondary aim was to determine which key demographic, incident and injury characteristics were associated with commercial versus non-commercial cycling injuries in emergency. Methods: Pilot retrospective cohort study of adults presenting to an acute public hospital emergency department between May 2019 and April 2020 after sustaining a cycling-related injury. Multinomial logistic regression was used to examine the demographic, incident and injury characteristics associated with commercial compared to non-commercial cycling. Results: Of the 368 people presenting to the emergency department with a cycling-related injury, we were able to categorise 43 (11.7%) as commercial delivery cyclists, 153 (41.6%) as non-commercial cyclists and the working status of 172 (46.7%) was unable to be confirmed. Both commercial and unconfirmed cyclists were more likely to be younger than non-commercial cyclists. Compared to non-commercial cyclists, commercial cyclists were 11 times more likely to speak a language other than English (AOR 11.3; 95% CI 4.07–31.30; p<0.001), less likely to be injured from non-collision incidents than vehicle collisions (AOR 0.36; 95% CI 0.15–0.91; p=0.030) and were over 13 times more likely to present to the emergency department between 8.00pm and 12.00am compared to the early morning hours (12.00 to 8.00am) (AOR 13.43; 95% CI 2.20–82.10; p=0.005). Conclusions: The growth of commercial cycling, particularly through online food delivery services, has raised concern regarding commercial cyclist safety. Improvements in the recording of cycling injury commercial status is required to enable ongoing surveillance of commercial cyclist injuries and establish the extent and risk factors associated with commercial cycling. [ABSTRACT FROM AUTHOR]

Neuronal ceroid lipofuscinoses (NCL; Batten disease) are a group of inherited neurodegenerative diseases with a common set of symptoms including cognitive and motor decline and vision loss. Naturally occurring sheep models of CLN5 and CLN6 disease display the key clinical features of NCL, including a progressive loss of vision. We assessed retinal histology, astrogliosis, and lysosomal storage accumulation in CLN5 affected (CLN5−/−) and CLN6 affected (CLN6−/−) sheep eyes and age-matched controls at 3, 6, 12, and 18 months of age to determine the onset and progression of retinal pathology in NCL sheep. The retina of CLN5−/− sheep shows progressive atrophy of the outer retinal layers, widespread gliosis, and accumulation of lysosomal storage in retinal ganglion cells late in disease. In contrast, CLN6−/− retina shows significant atrophy of all retinal layers, progressive gliosis, and earlier accumulation of lysosomal storage. This study has highlighted the differential vulnerability of retinal layers and the time course of retinal atrophy in two distinct models of NCL disease. This data will be valuable in determining potential targets for ocular therapies and the optimal timing of these therapies for protection from retinal dysfunction and degeneration in NCL. [ABSTRACT FROM AUTHOR]

Objective. The primary aims of this study were to explore: (1) manifestations of socio-environmental models of allied health support provision in the disability sector; and (2) narrative experiences of individual allied health professionals in the disability sector. Methods. A narrative qualitative study using interviews from a purposive sample of two allied health professionals working in the disability sector explored manifestations of socio-environmental models of allied health support provision and their experiences from case examples. The key informants had more than 10 years of experience in the disability support services setting. Results. Seven key themes exploring manifestations of socio-environmental models of allied health professional practice in the disability sector emerged: (1) dignity of risk; (2) models of care; (3) considerations when working in the supported person's environment; (4) goal-oriented work; (5) informed choice and informed consent; (6) reactive and flexible plans; and (7) training and education role. Conclusions. Socio-environmental models of allied health support provision in the disability sector focus on empowering people with disability to achieve their goals. This may require displacement of cultural norms within the allied health professions. [ABSTRACT FROM AUTHOR]

Background: Implementing evidence into clinical practice is a key focus of healthcare improvements to reduce unwarranted variation. Dissemination of evidence-based recommendations and knowledge brokering have emerged as potential strategies to achieve evidence implementation by influencing resource allocation decisions. The aim of this study was to determine the effectiveness of these two research implementation strategies to facilitate evidence-informed healthcare management decisions for the provision of inpatient weekend allied health services.Methods and Findings: This multicentre, single-blinded (data collection and analysis), three-group parallel cluster randomised controlled trial with concealed allocation was conducted in Australian and New Zealand hospitals between February 2018 and January 2020. Clustering and randomisation took place at the organisation level where weekend allied health staffing decisions were made (e.g., network of hospitals or single hospital). Hospital wards were nested within these decision-making structures. Three conditions were compared over a 12-month period: (1) usual practice waitlist control; (2) dissemination of written evidence-based practice recommendations; and (3) access to a webinar-based knowledge broker in addition to the recommendations. The primary outcome was the alignment of weekend allied health provision with practice recommendations at the cluster and ward levels, addressing the adoption, penetration, and fidelity to the recommendations. The secondary outcome was mean hospital length of stay at the ward level. Outcomes were collected at baseline and 12 months later. A total of 45 clusters (n = 833 wards) were randomised to either control (n = 15), recommendation (n = 16), or knowledge broker (n = 14) conditions. Four (9%) did not provide follow-up data, and no adverse events were recorded. No significant effect was found with either implementation strategy for the primary outcome at the cluster level (recommendation versus control β 18.11 [95% CI -8,721.81 to 8,758.02] p = 0.997; knowledge broker versus control β 1.24 [95% CI -6,992.60 to 6,995.07] p = 1.000; recommendation versus knowledge broker β -9.12 [95% CI -3,878.39 to 3,860.16] p = 0.996) or ward level (recommendation versus control β 0.01 [95% CI 0.74 to 0.75] p = 0.983; knowledge broker versus control β -0.12 [95% CI -0.54 to 0.30] p = 0.581; recommendation versus knowledge broker β -0.19 [-1.04 to 0.65] p = 0.651). There was no significant effect between strategies for the secondary outcome at ward level (recommendation versus control β 2.19 [95% CI -1.36 to 5.74] p = 0.219; knowledge broker versus control β -0.55 [95% CI -1.16 to 0.06] p = 0.075; recommendation versus knowledge broker β -3.75 [95% CI -8.33 to 0.82] p = 0.102). None of the control or knowledge broker clusters transitioned to partial or full alignment with the recommendations. Three (20%) of the clusters who only received the written recommendations transitioned from nonalignment to partial alignment. Limitations include underpowering at the cluster level sample due to the grouping of multiple geographically distinct hospitals to avoid contamination.Conclusions: Owing to a lack of power at the cluster level, this trial was unable to identify a difference between the knowledge broker strategy and dissemination of recommendations compared with usual practice for the promotion of evidence-informed resource allocation to inpatient weekend allied health services. Future research is needed to determine the interactions between different implementation strategies and healthcare contexts when translating evidence into healthcare practice.Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12618000029291. [ABSTRACT FROM AUTHOR]

Background: Health and medical research funding agencies are increasingly interested in measuring the impact of funded research. We present a research impact case study for the first four years of an Australian National Health and Medical Research Council funded Centre of Research Excellence in Cardiovascular Outcomes Improvement (2016-2020). The primary aim of this paper was to explore the application of a research impact matrix to assess the impact of cardiovascular outcomes improvement research.Methods: We applied a research impact matrix developed from a systematic review of existing methodological frameworks used to measure research impact. This impact matrix was used as a bespoke tool to identify and understand various research impacts over different time frames. Data sources included a review of existing internal documentation from the research centre and publicly available information sources, informal iterative discussions with 10 centre investigators, and confirmation of information from centre grant and scholarship recipients.Results: By July 2019, the impact on the short-term research domain category included over 41 direct publications, which were cited over 87 times (median journal impact factor of 2.84). There were over 61 conference presentations, seven PhD candidacies, five new academic collaborations, and six new database linkages conducted. The impact on the mid-term research domain category involved contributions towards the development of a national cardiac registry, cardiovascular guidelines, application for a Medicare Benefits Schedule reimbursement item number, introduction of patient-reported outcome measures into several databases, and the establishment of nine new industry collaborations. Evidence of long-term impacts were described as the development and use of contemporary management for aortic stenosis, a cardiovascular risk prediction model and prevention targets in several data registries, and the establishment of cost-effectiveness for stenting compared to surgery.Conclusions: We considered the research impact matrix a feasible tool to identify evidence of academic and policy impact in the short- to midterm; however, we experienced challenges in capturing long-term impacts. Cost containment and broader economic impacts represented another difficult area of impact to measure. [ABSTRACT FROM AUTHOR]

The overall 30 year Nb3Sn conductor program for ITER provides an unusual opportunity to look at the issues created by the application of novel Nb3Sn technology on a large scale. ITER design criteria have evolved to make use of the features of the industrialized material, exploiting advantages as well as managing the disadvantages. There are lessons from the successes and failures to be learned for the future application of very high current Nb3Sn strands in fusion and high energy physics. The behaviour of Nb3Sn strands in the large compound ITER conductors is still producing surprises after 25 years of development, industrial production and testing, with the Nb3Sn strain sensitivity and brittleness producing many more subtle design impacts than originally foreseen. The results now obtained at the end of the ITER production suggest that, as a novelty for Nb3Sn, there are options for conditioning the strands in the ITER conductors that can be applied during commissioning and which could reduce the impact of brittleness by as much as one third. [ABSTRACT FROM AUTHOR]

Each year over 200 million malaria infections occur, with over 400 000 associated deaths. Vaccines formed with attenuated whole parasites can induce protective memory CD8 T cell responses against liver-stage malaria; however, widespread administration of such vaccines is logistically challenging. Recent scientific findings are delineating how protective memory CD8 T cell populations are primed and maintained and how such cells mediate immunity to liver-stage malaria. Memory CD8 T cell anatomic localization and expression of transcription factors, homing receptors, and signaling molecules appear to play integral roles in protective immunity to liver-stage malaria. Further investigation of how such factors contribute to optimal protective memory CD8 T cell generation and maintenance in humans will inform efforts for improved vaccines. Novel discoveries about the role of memory CD8 T cells in mediating immunity to liver-stage malaria are informing methods of resolving historical issues of malaria vaccine efficacy and implementation. Liver resident memory (Trm) cells are essential to mediate sterilizing immunity against liver-stage malaria after whole-parasite immunization in mouse models. Circulating memory CD8 T cell contributions to protection remain undefined. Mechanisms of liver Trm cell generation, maintenance, and protective function are active areas of investigation. The unique hepatic microenvironment appears to dictate phenotypic characteristics and motility dynamics of local liver Trm cells at homeostasis. [ABSTRACT FROM AUTHOR]

On the 5 January 1983, 10-year-old Louise Bell was abducted while she slept in her bedroom, south of Adelaide. Louise was never seen again. This high profile case had a significant impact on the lives of Louise's friends and family, as well as the general public of South Australia. The case remained unsolved for over 30 years. In November 2016, Dieter Pfennig was convicted for the abduction and murder of Louise Bell. Forensic Short Tandem Repeat (STR) typing performed as part of a cold case examination was a crucial element to solving this case. The case is of broader interest since it reflects the developments in forensic genetic STR typing over the last decade, particularly in the methodologies for evaluation of the evidence. This case marks the end of the 'Low Copy Number' (LCN) debate. [ABSTRACT FROM AUTHOR]

Abstract Protea punctata and P. venusta are closely related, but morphologically distinct, species that naturally hybridize in the wild. Here we examined patterns of hybridization and cryptic introgression in seedlings grown from seeds collected at Blesberg Mountain in the Swartberg Mountain range. We used restriction site associated genotyping by sequencing (RAD-Seq) to identify 7185 single nucleotide polymorphisms (SNPs) to characterize genetic identity. We found evidence for extensive introgression in seedlings within maternal families, more than can be explained by mating between pure parental species. We conclude that there is cryptic introgression between these two species and that morphological identification in the field underestimates the extent of hybridization in this system. Highlights • Protea punctata and P. venusta naturally hybridize in the wild. • Intensive genetic work reveals extensive introgression within maternal lines. • Maternal morphology often conceals cryptic introgression and variation in offspring. [ABSTRACT FROM AUTHOR]

Suppose that we disagree about a matter of constitutional law. Say that one of us contends, and the other denies, that transgender persons have constitutional rights to be treated in accord with their gender identity. It appears that we disagree about "what the law is." And, most probably, we disagree about what the law is on this matter because we disagree about what generally makes it the case that our constitutional law is this rather than that. Constitutional theory should provide guidance. Theorists should try to explain what gives our constitutional rules the contents that they have, or what makes true constitutional propositions true; they should aim to provide what I will call a "constitutive theory" of constitutional law. It is obvious that we do not all share a constitutive theory. It is less obvious, and strikingly underappreciated, that we have precious few candidates to choose from. Few of our many prescriptive theories regarding how judges should exercise the power of judicial review have straightforward constitutive implications. This Article presents an original constitutive theory of American constitutional law (and of law generally), founded on the familiar distinction between two types of constitutional norms: "principles" and "rules." It argues: first, that rules are determined by the interaction of principles, in a manner that can be loosely modeled as force addition; and second, that the principles are "grounded" in mental states, speech-acts, and behaviors of persons who make up the constitutional community, much as rules of fashion or of billiards are grounded in behaviors of persons who make up their normative communities. In short: social facts determine constitutional principles, and constitutional principles determine constitutional rules. I call the account "principled positivism." It is positivist, pluralist, and dynamic. Principled positivism maintains that we can come to know our constitutional rules by discerning the contents, contours, and weights of our constitutional principles. Accordingly, the Article offers a preliminary and partial inventory of our constitutional principles--principles concerning the legal significance of what the enacted text says and what its authors intended; principles about the force of judicial precedents and of extra-judicial practices; principles of popular sovereignty, the distribution of governing power, and the demands of liberty and equality. It then puts the principles to work, illustrating how they operate in diverse constitutional controversies, from same-sex marriage to the scope of Congress's commerce power. [ABSTRACT FROM AUTHOR]

The article discusses what law and sport have something to teach each other. It explains the reliance of sports and legal systems on the same type of tool to achieve a diversity of ends within a diversity of constraints. Some of the lessons that lawyers and law students can learn from sport, including those related to the use of rules to their advantage and those related to the imposition of penalties on cheaters.

Background: It is widely acknowledged that health policy and management decisions rarely reflect research evidence. Therefore, it is important to determine how to improve evidence-informed decision-making. The primary aim of this systematic review was to evaluate the effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare. The secondary aim of the review was to describe factors perceived to be associated with effective strategies and the inter-relationship between these factors.Methods: An electronic search was developed to identify studies published between January 01, 2000, and February 02, 2016. This was supplemented by checking the reference list of included articles, systematic reviews, and hand-searching publication lists from prominent authors. Two reviewers independently screened studies for inclusion, assessed methodological quality, and extracted data.Results: After duplicate removal, the search strategy identified 3830 titles. Following title and abstract screening, 96 full-text articles were reviewed, of which 19 studies (21 articles) met all inclusion criteria. Three studies were included in the narrative synthesis, finding policy briefs including expert opinion might affect intended actions, and intentions persisting to actions for public health policy in developing nations. Workshops, ongoing technical assistance, and distribution of instructional digital materials may improve knowledge and skills around evidence-informed decision-making in US public health departments. Tailored, targeted messages were more effective in increasing public health policies and programs in Canadian public health departments compared to messages and a knowledge broker. Sixteen studies (18 articles) were included in the thematic synthesis, leading to a conceptualisation of inter-relating factors perceived to be associated with effective research implementation strategies. A unidirectional, hierarchal flow was described from (1) establishing an imperative for practice change, (2) building trust between implementation stakeholders and (3) developing a shared vision, to (4) actioning change mechanisms. This was underpinned by the (5) employment of effective communication strategies and (6) provision of resources to support change.Conclusions: Evidence is developing to support the use of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare. The design of future implementation strategies should be based on the inter-relating factors perceived to be associated with effective strategies.Trial Registration: This systematic review was registered with Prospero (record number: 42016032947). [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives The aim of this study was to determine if the addition of daily ward interview data improves the capture of hospital quality and safety indicators compared with incident reporting systems alone. An additional aim was to determine the potential characteristics influencing under-reporting of hospital quality and safety indicators in incident reporting systems. Methods A prospective, observational study was performed at two tertiary metropolitan public hospitals. Research assistants from allied health backgrounds met daily with the nurse in charge of the ward and discussed the occurrence of any falls, pressure injuries and rapid response medical team calls. Data were collected from four general medical wards, four surgical wards, an orthopaedic, neurosciences, plastics, respiratory, renal, sub-acute and acute medical assessment unit. Results An estimated total of 303 falls, 221 pressure injuries and 884 rapid response medical team calls occurred between 15 wards across two hospitals, over a period of 6 months. Hospital incident reporting systems underestimated falls by 30.0%, pressure injuries by 59.3% and rapid response medical team calls by 17.0%. The use of ward interview data collection in addition to hospital incident reporting systems improved data capture of falls by 23.8% ( n = 72), pressure injuries by 21.7% ( n = 48) and rapid response medical team calls by 12.7% ( n = 112). Falls events were significantly less likely to be reported if they occurred on a Monday ( P = 0.04) and pressure injuries significantly more likely to be reported if they occurred on a Wednesday ( P = 0.01). Conclusions Hospital quality and safety indicators (falls, pressure injuries and rapid response medical team calls) were under-reported in incident reporting systems, with variability in under-reporting between wards and the day of event occurrence. The use of ward interview data collection in addition to hospital incident reporting systems improved reporting of hospital quality and safety indicators. [ABSTRACT FROM AUTHOR]

Studies the ablation of gallstones using a pulsed KrF excimer laser in both air and water. Applications of photoablation; Advantage of photoablation; Primary components of gallstones; Conclusion.

Monoamine uptake inhibitors are common treatments for depression; however, the therapeutic efficacy of these drugs varies widely. Two factors that are commonly linked to clinical outcome are age and serotonin transporter ( SERT) genotype. Mouse models provide powerful tools to study consequences of age and genotype on antidepressant-like efficacy; however, to date, systematic studies of this nature are lacking. Here, we used the tail suspension test ( TST), a preclinical assay for antidepressant efficacy, to gain insight into age and SERT genotype dependency of immobility time in the TST under control conditions (saline injection) and in response to the tricyclic antidepressant, desipramine ( DMI). Immobility after saline injection in juvenile, adolescent, adult, mature adult and middle-aged mice (postnatal days 21, 28, 90, 210 and 300, respectively) significantly increased with age; however, the rate of increase was slower for SERT null (−/−) mice than for wild-type (+/+) or heterozygote (+/−) mice. Desipramine reduced immobility across ages and SERT genotypes. Middle-aged, but not adult, SERT−/− mice were significantly more sensitive to DMI than age-matched SERT+/+ or SERT+/− mice. Desipramine was less potent in middle-aged SERT+/+ and SERT+/− mice than in adult SERT+/+ or SERT+/− mice. Regardless of age, DMI's maximal effects were greater in SERT−/− mice than in SERT+/+ or SERT+/− mice. These results show that immobility time in the TST varies as a function of age and SERT genotype, underscoring the utility of the TST as a potential model to examine age- and SERT genotype-dependent influences on antidepressant response. [ABSTRACT FROM AUTHOR]

Female sea turtles are promiscuous, with clutches of eggs often sired by multiple males and rates of multiple paternity varying greatly within and across species. We investigated levels of multiple paternity in loggerhead sea turtles (Caretta caretta) from three rookeries in Western Australia by analysing polymorphic species-specific genetic markers. We predicted that the level of multiple paternity would be related to female population size and hence the large rookery at Dirk Hartog Island would have higher rates of multiple paternity than two smaller mainland rookeries at Gnaraloo Bay and Bungelup Beach. Contrary to our prediction, we found highly variable rates of multiple paternity among the rookeries that we sampled, which was unrelated to female population size (25% at Bungelup Beach, 86% at Gnaraloo Bay, and 36% at Dirk Hartog Island). Approximately 45 different males sired 25 clutches and the average number of sires per clutch ranged from 1.2 to 2.1, depending on the rookery sampled. The variance in rates of multiple paternity among rookeries suggests that operational sex ratios are variable in Western Australia. Periodic monitoring would show whether the observed patterns of multiple paternity for these three rookeries are stable over time, and our data provide a baseline for detecting shifts in operational sex ratios. [ABSTRACT FROM AUTHOR]

Aim: To determine whether home-use icterometry improves parental recognition of neonatal jaundice, early care seeking and treatment to minimize risks of bilirubin encephalopathy. Methods: Cluster-randomised controlled trial of community-level icterometry used at home by mothers in Chi Linh, Vietnam. Rural health-care workers identified and enrolled term newborns. Post-partum mothers received jaundice education and icterometry instructions and were cluster-randomised by commune. Cases received icterometers (icterometer group (IG)) and controls did not (control group (CG)). Subjects received mobile telephone calls from post-natal days 2-7 to determine maternal recognition by visual inspection and icterometer detection of jaundice (>3.0 on five-point scale). Mothers without telephones, premature newborns (<35 weeks) or newborns hospitalised >5 days were excluded. Results: Three hundred fifty-two subjects were enrolled (183 IG and 169 CG), of whom 11 (3.4%) were lostto telephone follow-up. Jaundice was recognised and/or detected in 94 (27%) of all newborns. Icterometry helped 11 mothers (6%) detect neonatal jaundice that was not visually recognised by IG mothers. Detection by IG mothers was not statistically greater than CG mothers (P = 0.09). Follow-up care seeking was 8% in both groups (P = 0.2), and 11% of jaundiced newborns received treatment (9% IG vs. 16% CG, P = 0.3). Newborns who received care had bilirubin measurements that averaged 257 μmol/L IG vs. 322 μmol/L CG (P = 0.3). There were no deaths. Conclusions: In this pilot study, home-use icterometry may help improve parental detection of jaundice in rural Vietnam. However, larger studies are necessary to determine the changes in recognition, care seeking and treatment. [ABSTRACT FROM AUTHOR]

Background: Weanimix is an important food for children in Ghana. Mothers are trained to prepare homemade weanimix from beans, groundnuts and maize for their infants. Groundnuts and maize are prone to aflatoxin contamination while fumonisin contaminates maize. Aflatoxin, is produced by the Asperguillus fungi while fumonisin, is produced by Fusarium fungi. These mycotoxins occur in tropical areas worldwide due to favorable climate for their growth. Objective: The objective of the study was to determine the levels of aflatoxin and fumonisin in homemade weanimix in the Ejura-Sekyedumase district in the Ashanti Region of Ghana. Methods: Thirty six homemade weanimix samples (50g each) were collected from households. Aflatoxin and fumonisin were measured using a fluorometric procedure described by the Association of Official Analytical Chemist (AOAC official method 993.31, V1 series 4). Results: Aflatoxin and fumonisin were detected in all 36 samples, range 7.9-500ppb. Fumonisin levels range: 0.74-11.0ppm). Thirty (83.3%) of the thirty six samples were over the action limit of 20ppb for aflatoxin with an overall mean of 145.2 ppb whiles 58.3% of the samples had fumonisins above the action limit of 4 ppm with an overall mean of 4.7 ppm . Conclusion: There were significant aflatoxin and fumonisin contamination of homemade weanimix. Children fed on this nutritional food were being exposed to unacceptable levels of aflatoxin and fumonisin. Therefore there is a critical need to educate mothers on the dangers of mycotoxin exposure and to develop strategies to eliminate exposure of children fed homemade weanimix to aflatoxin and fumonisin. [ABSTRACT FROM AUTHOR]

The strong strain sensitivity of the critical properties of Nb3Sn is well established. However, the roles played by both the reversible strain sensitivity and the susceptibility to brittle fracture of Nb3Sn filaments is still leading to unexpected results and resulting design modifications of conductors. Practical conductors require acceptance of less than perfect superconducting behaviour because such conductors actually operate continuously in a slightly resistive mode. Performance testing of the ITER conductors has provided a unique database of both strand and corresponding conductor performance. The test database includes strand characterization under uniaxial and bending strain, superconducting measurements on full-size conductor samples and microscopic investigations into filament fracture. A simple mechanical and electrical model of the strands and a multistage cable (capable of operation at 12 T and 45 kA) that focuses on predicting the imperfect superconducting behaviour is used to provide insight into the processes governing the observed conductor behaviour.The conclusions show that a short twist pitch at the first cabling stage provides the best operating conditions for the strands, and further that some strand mechanical properties, essentially a high stiffness to bending and a low stiffness to pinching, increase the ability of the strands to tolerate less well optimized cables. [ABSTRACT FROM AUTHOR]

The U-238 series of radionuclides is of relevance in a variety of environmental contexts ranging from the remediation of former uranium mining and milling facilities to the deep geological disposal of solid radioactive wastes. Herein, we review what is known concerning the behaviour of radionuclides from the U-238 decay chain in soils and plants. This review is intended to provide a single comprehensive source of information to anyone involved in undertaking environmental impact assessment studies relating to this decay chain. Conclusions are drawn relating to values and ranges of distribution coefficients appropriate to uranium, thorium, radium, lead and polonium in different soil types and under various environmental conditions. Similarly, conclusions are drawn relating to plant:soil concentration ratios for these elements for different plant and soil types, and consideration is given to the distribution of these elements within plants following both root uptake and foliar application. [ABSTRACT FROM AUTHOR]

The article discusses pluralistic nonoriginalism and a reported combinability problem in regards to U.S. constitutional law and the originalism theory of constitutional interpretation as of June 2013. Other topics include constitutional theorists, the U.S. Supreme Court case Marbury v. Madison, and legal philosopher H.L.A. Hart's book "The Concept of Law." Fellow philosopher and legal theorist Ronald Dworkin is also mentioned.

The ITER magnet procurement is now well underway. The magnet systems consist of 4 superconducting coil sets (toroidal field (TF), poloidal field (PF), central solenoid (CS) and correction coils (CC)) which use both NbTi and Nb3Sn-based conductors. The magnets sit at the core of the ITER machine and are tightly integrated with each other and the main vacuum vessel. The total weight of the system is about 10000 t, of which about 500 t are Nb3Sn strands and 250 t, NbTi. The reaction of the magnetic forces is a delicate balance that requires tight control of tolerances and the use of high-strength, fatigue-resistance steel forgings. Integration and support of the coils and their supplies, while maintaining the necessary tolerances and clearance gaps, have been completed in steps, the last being the inclusion of the feeder systems. Twenty-one procurement agreements have now been signed with 6 of the ITER Domestic Agencies for all of the magnets together with the supporting feeder subsystems. All of them except one (for the CS coils) are so-called Build to Print agreements where the IO provides the detailed design including full three-dimensional CAD models. The production of the first components is underway (about 175 t of Nb3Sn strand was finished by July 2011) and manufacturing prototypes of TF coil components are being completed. The paper will present a design overview and the manufacturing status. [ABSTRACT FROM PUBLISHER]

Growth kinetics, growth mechanisms, and the effect ofsolvent compositionfor the antisolvent crystallization of paracetamol in methanol–watermixtures have been determined by means of isothermal seeded batchexperiments at constant solvent composition. A numerical model incorporatingthe population balance equation based on antisolvent free solubilitywas fitted to the desupersaturation data, and growth rate parametersare evaluated. An attenuated total reflectance–Fourier transforminfrared (ATR-FTIR) probe was employed to measure online solute concentrationand focused beam reflectance measurement (FBRM) was utilized to ensurenegligible nucleation occurred. The model is validated by the finalparticle size distributions (PSDs) and online solute concentrationmeasurements. Crystal growth rate was found to decrease with increasingwater mass fractions up to a mass fraction of 0.68 where an increaseis observed. A method has been introduced linking the effect of solventcomposition with the growth mechanism and the growth rates. Utilizingthe growth mechanism it has been postulated that a combination ofthe solubility gradient, viscosity, selective adsorption, and surfaceroughening are responsible for the reduction in growth rates withsolvent composition. Furthermore, the effects of seed mass, size andinitial supersaturation on the crystal growth rates were investigatedto demonstrate the efficacy of the model at predicting these variousphenomena. [ABSTRACT FROM AUTHOR]

This Essay explores a question of superficial triviality: when sports use instant replay technology to review on-field calls, what standard of review should they employ? The conventional view is that on-field calls should be entrenched against reversal such that, if the reviewing official has any doubt about the correctness of the initial call, he must let it stand even if he thinks it very probably wrong. Indeed, in the wake of officiating debacles at last summer's FIFA World Cup, commentators proposed not only that soccer employ instant replay, but also that it follow the NFL in directing officials to overturn on-field calls only when "indisputable visual evidence" (IVE) reveals that call to be mistaken. This Essay argues that common wisdom in favor of IVE overlooks important considerations against entrenchment and likely rests upon mistaken premises, and it offers several concrete proposals for reform. A lengthy investigation into the optimal standard of review for instant replay in sports might seem frivolous. But it serves a deeper ambition. We are in the early years of sports' colonization by econometricians, as legal theorists remain watching from the sidelines. That is unfortunate. Formal organized sports are, in effect, legal systems, and legal theorists might find much both to teach and to learn by paying closer attention to competitive athletics. In short, legal theorists would benefit from a sustained engagement with what I have termed, in previous work, "the jurisprudence of sport." As a case study in this nascent field, this Essay reveals that the problem of appellate review in sports is surprisingly rich and complex-implicating profound questions concerning the relationships among desert, entitlement, and justice; the difference between mistake and error; and the contours of loss aversion and omission bias, among other things. But it shows even more than that. The jurisprudence of sport maintains that sporting practices and norms can teach lessons for ordinary legal systems as surely as the other way around. illustrating that claim, this Essay draws from football replay practices an argument to reform the criminal trial system to accommodate two verdicts of acquittal, not just one. [ABSTRACT FROM AUTHOR]

The article focuses on the jurisprudence and philosophy of sports law. Topics include the rules of "no harm, no foul," and "no harm, no penalty," in sports games such as football and hockey, the legal theory of temporal variance in sports law, athletic virtues and behavior of players, and rules about faults in the game.

The partial defense of provocation provides that a person who kills in the heat of passion brought on by legally adequate provocation is guilty of manslaughter rather than murder. The defense traces back to the twelfth century and exists today, in some form, in almost every U.S. state and other common law jurisdictions. But long history and wide application have not produced agreement on the rationale for the doctrine. To the contrary, the search for a coherent and satisfying rationale remains among the main occupations of criminal law theorists. The dominant scholarly view holds that provocation is best explained and defended as a partial excuse on the grounds that the killer's inflamed emotional state so compromised his ability to conform his conduct to the demands of reason and law as to render him substantially less blameworthy for his conduct. In contrast, a small minority of scholars have maintained, without significant argumentative support, that provocation is best understood as a partial justification on the ground that the provoked killing is less wrongful than is an unprovoked killing, ceteris paribus. Recently, other commentators have argued that provocation mitigation is neither partial excuse nor partial justification. Against all of these familiar positions, we argue that partial excuse and partial justification are necessary and sufficient conditions for provocation manslaughter. In our view, an intentional killing deserves to be punished and labeled as manslaughter rather than murder only when, because of provocation, this particular killing is significantly less wrongful than the standard intentional killing and when, because of the actor's partial lack of control, he is less blameworthy for committing an act that remains all-things-considered wrongful. In elaborating and defending our account, we rebut the oft-repeated but rarely challenged propositions that justification and excuse, even in partial forms, are mutually exclusive, and that the very notion of partial justification is incoherent. We also draw forth implications for how the sentencing ranges for murder and manslaughter should be related. [ABSTRACT FROM AUTHOR]

An essay on the construction of constitutional texts and how they relate to the constitutional decision and implementation is presented. It addresses the originalist views on linguistic meaning with regards to the constitutional texts, the constraints imposed by the law and the view of pragmatists on the fundamental mistake of the taxonomic project. It concludes that portions of the U.S. Constitution could be distinguished as legal or linguistic interpretation if they could not always be identical in legal meaning or semantic content.

Mitchell ND, Baker GB. An update on the role of glutamate in the pathophysiology of depression. Objective: To review the literature on the involvement of glutamate (Glu), including its interactions with other neurochemical systems, in the pathophysiology of depression. Method: A MEDLINE search using the terms glutamate, depression and major depressive disorder, was performed. Results: Alterations in proteins involved in glutamatergic signalling are implicated in variations in behaviour in animal models of depression. Drugs acting at Glu receptors appear to have antidepressant-like effects in these models, and traditional antidepressant pharmacotherapies act on the glutamatergic system. Recent evidence from genetic studies and in vivo spectroscopy also correlate glutamatergic dysfunction with depression. Trials of N-methyl-d-aspartate receptor antagonists in humans have provided mixed results. Conclusion: A growing body of evidence indicates that the glutamatergic system is involved in the pathophysiology of depression, and may represent a target for intervention. [ABSTRACT FROM AUTHOR]

AIM: To examine the characteristics of computerized decision support systems (CDSS) currently available to nurses working in the National Health Service (NHS) in England. METHOD: A questionnaire survey sent to a stratified random sample of 50% of all NHS care providers (Trusts) in England, asking respondents to provide information on CDSS currently used by nurses. RESULTS: Responses were received from 108 of the 277 Trusts included in the sample. Electronic patient record systems were the most common type of CDSS reported by Trusts (n = 61) but they were least likely to have features that have been associated with improved clinical outcomes. CONCLUSIONS: The availability of CDSS with features that have been associated with improved patient outcomes for nurses in the NHS in England is limited. There is some evidence that the nature of the Trust affects whether or not nurses have access to CDSS to assist their decision making. IMPLICATIONS FOR NURSING MANAGEMENT: The implementation of CDSS is increasing throughout the NHS. Many CDSS are introduced without adequate evidence to support its introduction and there is little evaluation of the benefits once they are implemented. Policy makers and nursing management should consider whether the introduction of CDSS aids nurse decision making and benefits patient outcomes. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to identify an early marker of functional impairment after an implantable cardioverter-defibrillator (ICD) shock as a predictor of heart failure progression. Background: The ICD population has substantial risk of death due to progressive pump failure. Methods: Near-field (NF) bipolar right ventricular (RV) electrograms (EGMs) during induced ventricular fibrillation (VF) and 10 s after rescue ICD shock were analyzed in 310 patients (mean age 59 ± 14.5 years, 219 men [71%]) with structural heart disease, New York Heart Association functional class I to III, and implanted with a single- or dual-chamber Medtronic (Minneapolis, Minnesota) ICD for primary (245 patients, 79%) or secondary prevention of sudden cardiac arrest. A local injury current (LIC) on NF RV EGM was defined as a deviation of EGM potential ≥1 mV or ≥15% of the preceding R-wave peak-to-peak amplitude. Results: During mean follow-up of 29.3 ± 15.0 months, the combined end point of death or hospitalization due to congestive heart failure (CHF) exacerbation was documented in 40 patients (12.9%, or 5.3% per person-year of follow-up). LIC was observed in 106 patients. In multivariate risk analysis, after adjustment for baseline prognostic factors (ejection fraction, history of atrial fibrillation, diabetes mellitus) and appropriate ICD shocks during follow-up, patients with observed LIC after induced VF rescue ICD shock at ICD implantation were more likely to die or to be hospitalized (hazard ratio: 2.69; 95% confidence interval: 1.41 to 5.14; p = 0.003). Conclusions: Transient LIC on bipolar NF RV EGM after induced VF rescue ICD shock is associated with increased risk of CHF progression, future hospitalizations due to CHF exacerbation, and subsequent heart failure death. [Copyright &y& Elsevier]

Abstract: The central solenoid (CS) of the ITER tokamak contributes to the inductive flux to drive the plasma, to the shaping of the field lines in the divertor region and to vertical stability control. It is made of 6 independent coils, using a Nb3Sn cable-in-conduit superconducting conductor, held together by a vertical precompression structure. This design enables ITER to access a wide operating window of plasma parameters, up to 17MA and covering inductive and non-inductive operation. Each coil is based on a stack of multiple pancake winding units to minimise joints. A glass–polyimide electrical insulation, impregnated with epoxy resin, is giving a high voltage operating capability, tested up to 29kV. The CS performance is fatigue driven mainly by the stress levels in the conductor jacket and in the precompression structure needed to keep the modules in contact during the repulsive forces which can arise in operation. A rigid connection to the TF coils provided at one end and a centering support at the other end allow to resist net vertical forces as well as unbalanced radial forces while avoiding torsion transmission from the TF Coils to the CS assembly. [Copyright &y& Elsevier]

Electronic access to research information for health professionals is a key component in developing evidence-based healthcare. As nurses take on extended roles and work more autonomously, it is assumed that they will take increasing advantage of these technologies. However, little is known about the decisions that nurses make and the information needs that arise within the context of those decisions. This article presents an analysis of 410 nurse-patient consultations and interviews with 76 primary care nurses, and explores nurses' information needs and their use of electronic information tools. The findings suggest that, if we wish to encourage nurses to use research information in clinical practice, we need to move from ;pull' to ;push' technology. [ABSTRACT FROM AUTHOR]

The diffuse plasma that fills galaxy groups and clusters (the intracluster medium) is a by-product of galaxy formation. The present thermal state of this gas results from a competition between gas cooling and heating. The heating comes from two distinct sources: gravitational heating associated with the collapse of the dark matter halo and additional thermal input from the formation of galaxies and their black holes. A long-term goal of this research is to decode the observed temperature, density and entropy profiles of clusters and to understand the relative roles of these processes. However, a long-standing problem has been that cosmological simulations based on smoothed particle hydrodynamics (SPH) and Eulerian mesh-based codes predict different results even when cooling and galaxy/black hole heating are switched off. Clusters formed in SPH simulations show near power-law entropy profiles, while those formed in Eulerian simulations develop a core and do not allow gas to reach such low entropies. Since the cooling rate is closely connected to the minimum entropy of the gas distribution, the differences are of potentially key importance. In this paper, we investigate the origin of this discrepancy. By comparing simulations run using theGADGET-2 SPH code and theFLASH adaptive Eulerian mesh code, we show that the discrepancy arises during the idealized merger of two clusters and that the differences are not the result of the lower effective resolution of Eulerian cosmological simulations. The difference is not sensitive to the minimum mesh size (in Eulerian codes) or the number of particles used (in SPH codes). We investigate whether the difference is the result of the different gravity solvers, the Galilean non-invariance of the mesh code or an effect of unsuitable artificial viscosity in the SPH code. Instead, we find that the difference is inherent to the treatment of vortices in the two codes. Particles in the SPH simulations retain a close connection to their initial entropy, while this connection is much weaker in the mesh simulations. The origin of this difference lies in the treatment of eddies and fluid instabilities. These are suppressed in the SPH simulations, while the cluster mergers generate strong vortices in the Eulerian simulations that very efficiently mix the fluid and erase the low-entropy gas. We discuss the potentially profound implications of these results. [ABSTRACT FROM AUTHOR]

Aims and objectives. To explore how nurses use computerised clinical decision support systems in clinical practice and the factors that influence use. Background. There is limited evidence for the benefits of computerised clinical decision support systems in nursing, with the majority of existing research focusing on nurses' use of decision support for telephone triage. Research has suggested that several factors including nurses' experience, features of the technology system and organisational factors may influence how decision support is used in practice. Design. A multiple case site study. Methods. Four case sites were purposively selected to provide variation in staff experience, technology used and decisions supported by the technology. Data were collected in each case site using non-participant observation of nurse/patient consultations (n = 115) and interviews with nurses (n = 55). Data were analysed using thematic content analysis. Results. Computerised decision support systems were used in a variety of ways by nurses, including recording information, monitoring patients' progress and confirming decisions that had already been made. Nurses' experience with the decision and the technology affected how they used a decision support system and whether or not they over-rode recommendations made by the system. The ability of nurses to adapt the technology also affected its use. Conclusions. How nurses use computerised decision support appears to be the result of an interaction between a nurses' experience and their ability to adapt the technology to 'fit' with local clinical practice. Relevance to clinical practice. One of the stated aims of introducing computerised decision support systems to assist nursing practice is to reduce variation and/or the number of errors associated with clinical practice. The study found unanticipated uses in such systems such as the routine over-riding of recommendations which could lead to an increase rather than a decrease in variation or errors. [ABSTRACT FROM AUTHOR]

Critical analysis of originalism should start by confronting a modest puzzle: Most commentators suppose that originalism is deeply controversial, while others complain that it means too many things to mean anything at all. Is one of these views false? If not, how can we square the term's ambiguity with the sense that it captures a subject of genuine debate?, Perhaps self-professed originalists champion a version of originalism that their critics don't reject, while the critics challenge a version that proponents don't maintain. Contemporary originalists disagree about many things: which feature of the Constitution's original character demands fidelity (framers' intent, ratifiers' understanding, or public meaning); why such fidelity is required; and whether this interpretive obligation binds judges alone or citizens, legislators, and executive officials too. But on one dimension of potential variability-the dimension of strength-originalists are mostly united: They believe that those who follow some aspect of a provision's original character must give that original aspect priority over all other considerations (with a possible exception for continued adherence to non-originalist judicial precedents). That is, when the original meaning (or intent, etc.) is adequately discernible, the interpreter must follow it. This is the thesis that self-professed originalists maintain and that their critics (the non-originalists) deny. Non-originalists have challenged this thesis on varied wholesale grounds, which include: that the target of the originalist search is undiscoverable or nonexistent; that originalism is self-refuting because the framers intended that the Constitution not be interpreted in an originalist vein; and that originalism yields bad outcomes. This Article proceeds differently. Instead of mounting a global objection—one purporting to hold true regardless of the particular arguments on which proponents of originalism rely-1 endeavor to catalogue and critically assess the varied arguments proffered in originalism's defense. Those arguments are of two broad types-hard and soft. Originalism is "hard" when grounded on reasons that purport to render it (in some sense) inescapably true; it is "soft" when predicated on contingent and contestable weighings of its costs and benefits relative to other interpretive approaches. That is, hard arguments seek to show that originalism reflects some sort of conceptual truth or follows logically from premises the interlocutor already can be expected to accept; soft arguments aim to persuade others to revise their judgments of value or their empirical or predictive assessments. The most common hard arguments contend that originalism is entailed either by intentionalism or by binding constitutionalism. Soft arguments claim that originalist interpretation best serves diverse values like democracy and the rule of law. I seek to show that the hard arguments for originalism are false and that the soft arguments are implausible. The upshot is not that constitutional interpretation should disregard framers' intentions, ratifiers' understandings, or original public meanings. Of course we should care about these things. But originalism is a demanding thesis. We can take the original character of the Constitution seriously without treating it as dispositive. That original intents and meanings matter is not enough to render originalism true. [ABSTRACT FROM AUTHOR]

Nurses are increasingly working more autonomously in extended roles, yet we know little about the nature of the decisions they make. Decisions vary in terms of complexity, ambiguity and presentation, and the nature of the decision task impacts on the process of decision making, such as the likelihood of using a decision tool. Thus, knowledge about the nature of nursing decisions is essential for development of effective decision tools. This article presents an analysis of 410 nurse-patient consultations and interviews with 76 primary care nurses, and explores the nature of the decisions that primary care nurses make and the impact of that on their use of and attitudes towards decision tools. Copyright c 2009 SAGE Publications Ltd. [ABSTRACT FROM AUTHOR]

Abstract: The first 2 years of the ITER IO has seen substantial progress towards the construction of the magnets, in three main areas. Firstly, the design has been developed under the conflicting constraints to minimise construction costs and to maximise plasma physics performance. Building construction momentum while updating the design to take account of new physics assessments of the coil requirements has been challenging. Secondly, with a stabilising design, it has been possible for the Domestic Agencies to launch the first industrial procurement contracts. And thirdly, critical R&D to confirm the performance of the Nb3Sn cable in conduit design is proceeding successfully. The design consolidation has been accompanied by design reviews involving the international community. The reviews conducted by magnet experts have enabled a consensus to be built on choosing between some of the design options in the original ITER basic design in 2001. The major design decisions were to maintain the circular Nb3Sn conductor embedded in radial plates for the toroidal field (TF) coils and to maintain NbTi-based conductors for the PF coils. Cold testing, at low current, is also being introduced for quality control purposes for all coils. [Copyright &y& Elsevier]

A means of deriving a disturbance index reflecting forest use history is demonstrated here to establish a disturbance gradient and enable comparison of different forest areas within and across individual forests. Detailed reference is made to Kakamega Forest in western Kenya for which a long-term time series has been established, although the study is spread to four further forests in Kenya and Uganda. A wide variety of sources are drawn upon for spatially resolved data that are integrated in a geographic information system. Three indices are derived: for commercial disturbance, local disturbance, and forest cover change. Results show a wide range of disturbance values (from low to heavy) for the research sites within Kakamega Forest, while results for Budongo and Mabira Forest sites show low and moderate levels, respectively. Correlations of low disturbance levels with nature or national reserves appear to be marked, while a correlation of disturbance with differing management authority is also suggested with Kenya Wildlife Service achieving the lowest disturbance levels. Results from the index are reviewed against other means of estimating disturbance with the conclusion that disturbance evaluations should be both spatially resolved and long-term in nature. [ABSTRACT FROM AUTHOR]

An R&D program is being carried out in view of the qualification of the Toroidal Field (TF) coil conductor. It consists of an extensive characterization of several Nb3Sn strand candidates, the cabling of those strands into prototype TF conductors with various combinations of twist pitch and void fraction and the measurement of the performance of conductor short samples in representative condition of transport current, magnetic field and temperature. Industries and laboratories are involved worldwide in this R&D program which is expected to provide the basis to finalize the TF conductor design. The Nb3Sn strands proposed by each of the six Participant Teams involved in the procurement of the TF conductor will then be qualified in the final cable configuration by the successful test of a short sample in the Sultan facility. The status and the first results of the R&D program are presented together with the qualification plan. [ABSTRACT FROM AUTHOR]