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DJ/producers in world electronica are technicians of ecstasy actively transporting dancefloor participants into states of altered consciousness. In the kitbag of these digital alchemists is a form of media-shamanism I call nanomedia – i.e. audio samples from film, TV, games, etc. – repurposed in a remixtical practice by which producers and performers of electronic music evoke and promote nonordinary states. A repurposed media ecology provides the sonic decor to the ecstatic experience, decaling the soundscape, and augmenting the vibe, on dancefloors planetwide.
Evolutionary science can serve as the high-level organising principle for understanding psychiatry. Evolutionary concepts generate new models and ideas for future psychiatric study, research, policy and therapy. The authors accordingly make the case for the inclusion of evolutionary biology in the postgraduate education of psychiatric trainees.
Background: There is little empirical research into lay definitions of frailty. Objectives: (1) To explore the definitions of frailty among older men, and (2) to explore if these definitions match commonly used clinical definitions of frailty. Methods: Analysis of open-ended questions to survey data from a prospective cohort study of older airmen. The definitions of frailty were elicited, and grouped according to themes. Results: 147 men responded (mean age: 93). There was considerable heterogeneity in older men’s’ definitions of frailty, and no theme of frailty was predominant. The most common theme was impairment in activities of daily living. Older men’s’ definition of frailty was not consistent with any commonly used medical theory of frailty. Conclusions: Most older men think frailty is important, but their definitions are not consistent. Frailty may be a heterogeneous experience, which different people experience differently.
Rapid identification of esophageal intubations is critical to avoid patient morbidity and mortality. Continuous waveform capnography remains the gold standard for endotracheal tube (ETT) confirmation, but it has limitations. Point-of-care ultrasound (POCUS) may be a useful alternative for confirming ETT placement. The objective of this study was to determine the accuracy of paramedic-performed POCUS identification of esophageal intubations with and without ETT manipulation.
A prospective, observational study using a cadaver model was conducted. Local paramedics were recruited as subjects and each completed a survey of their demographics, employment history, intubation experience, and prior POCUS training. Subjects participated in a didactic session in which they learned POCUS identification of ETT location. During each study session, investigators randomly placed an ETT in either the trachea or esophagus of four cadavers, confirmed with direct laryngoscopy. Subjects then attempted to determine position using POCUS both without and with manipulation of the ETT. Manipulation of the tube was performed by twisting the tube. Descriptive statistics and logistic regression were used to assess the results and the effects of previous paramedic experience.
During 12 study sessions, from March 2014 through December 2015, 57 subjects participated, evaluating a total of 228 intubations: 113 tracheal and 115 esophageal. Subjects were 84.0% male, mean age of 39 years (range: 22 - 62 years), with median experience of seven years (range: 0.6 - 39 years). Paramedics correctly identified ETT location in 158 (69.3%) cases without and 194 (85.1%) with ETT manipulation. The sensitivity and specificity of identifying esophageal location without ETT manipulation increased from 52.2% (95% confidence interval [CI], 43.0-61.0) and 86.7% (95% CI, 81.0-93.0) to 87.0% (95% CI, 81.0-93.0) and 83.2% (95% CI, 0.76-0.90) after manipulation (P<.0001), without affecting specificity (P=.45). Subjects correctly identified 41 previously incorrectly identified esophageal intubations. Paramedic experience, previous intubations, and POCUS experience did not correlate with ability to identify tube location.
Paramedics can accurately identify esophageal intubations with POCUS, and manipulation improves identification. Further studies of paramedic use of dynamic POCUS to identify inadvertent esophageal intubations are needed.
LemaPC, O’BrienM, WilsonJ, St. JamesE, LindstromH, DeAngelisJ, CaldwellJ, MayP, ClemencyB.Avoid the Goose! Paramedic Identification of Esophageal Intubation by Ultrasound. Prehosp Disaster Med.2018;33(4):406–410
Natural graphite can be exfoliated into thin films by trapping it at the interface between water and heptane [S. J Woltornist, A. J. Oyer, J-M. Y. Carrillo, A.V. Dobrynin, and D.H. Adamson, ACS Nano 7, 7062 (2013)]. In this work, we add functional elements into these graphitic thin films by introducing additives into the water phase prior to exfoliation. We report the successful incorporation of ZnO nanoparticles thereby enabling the composite films to act as effective ultraviolet photodetectors. In a similar manner, integration of silver nanowires is achieved, which results in an enhancement of the electrical conductivity of graphite.
Middle-Late Wolfcampian phylloid algal/Tubiphytes biohermal complexes have been found exposed in western outliers of the Hueco Mountains of far west Texas. Paleogeographically, the bioherms are located along the fault-controlled shelf margin between the Late Paleozoic Diablo Platform and Orogrande Basin. Although Virgilian and Early Wolfcampian phylloid algal mounds are well-known from the Hueco and Sacramento Mountains, outcropping Middle-Late Wolfcampian bioherms have not been described previously from the Orogrande Basin area.
The biohermal complexes are exposed in three large outliers that lie about 3 miles west of the main Hueco Mountains and extend for about 12 miles in a north-south direction. The shelf margin complexes are in the Hueco Canyon Formation and correlate to well-bedded shelf facies in the main Hueco Mountains based on fusulinid biostratigraphy.
The phylloid algal/Tubiphytes shelf margin bioherms contain an upward shallowing facies succession, which consists of, in ascending order: (1) phylloid algal wackestone-bafflestone, (2) phylloid algal bafflestone-packstone, (3) phylloid algal-fusulinid bafflestone-packstone, and (4) Tubiphytes boundstones and Tubiphytes-fusulinid-phylloid algal packstones and grainstones. Unlike some previously described Wolfcampian phylloid algal buildups, the phylloid algal mound facies in these buildups contain only rare calcisponges, heliosponges, and marine radial fibrous cements. On the crest of the southern outlier there occurs a rather different type of bioherm, which contains nodular boundstones that are composed of encrusting red algae and bryozoans, and in which calcisponges are common. That bioherm is thought to be slightly younger in age than the phylloid algal/Tubiphytes bioherms, and it might also have been formed in a deeper-water setting.
Bordering the phylloid algal/Tubiphytes bioherms on the seaward side are overlapping tongues and channels of lithoclastic-skeletal debris and skeletal grainstones and packstones. Some of these forereef units extend seaward into slope facies, which consist of dark-gray cherty limestones that generally lack skeletal fossils, but contain a rich ichnofossil assemblage in the shallower upper slope beds. Backreef facies consist mainly of skeletal-peloidal packstones and wackstones.
The Hueco Mountains outlier exposures are significant because: (1) they establish the presence of a Middle-Late Wolfcampian shelf margin with distinct topographic relief in the southern Orogrande Basin, and (2) they provide an easily accessible field laboratory to study Middle-Late Wolfcampian shelf-to-basin facies relationships and shelf margin bioherms. Middle-Late Wolfcampian shelf margin bioherms are of particular interest because they represent an important transitional stage in the evolutionary history of Late Paleozoic reef communities, and because they form important petroleum reservoirs just to the east in the Delaware and Midland Basins.
Distinguishing sea-ice-rafted debris (SIRD) from iceberg-rafted debris is crucial to an interpretation of ice-rafting history; however, there are few paleo-sea-ice proxies. This study characterizes quartz grain microfeatures of modern SIRD from the Arctic Ocean, and compares these results with microfeatures from representative glacial deposits to potentially differentiate SIRD from ice-rafted sediments which have been recently subjected to glacial processes. This allows us to evaluate the use of grain microfeatures as a paleo-sea-ice proxy. SIRD grains were largely subrounded, with medium relief, pervasive silica dissolution and a high abundance of breakage blocks and microlayering. The glacial grains were more angular, with lower relief and higher abundances of fractures and striations/gouges. Discriminate analysis shows a distinct difference between SIRD and glacial grains, with ˂7% of the SIRD grains containing typical glacial microtextures, suggesting this method is a useful means of inferring paleo-sea-ice presence in the marine record. We propose that differences in microfeatures of SIRD and glacial ice-rafted debris reflect differences in sediment transport and weathering histories. Sediment transported to a coastal setting and later rafted by sea ice would be subject to increased chemical weathering, whereas glaciers that calve icebergs would bypass the coastal marine environment, thus preserving their glacial signature.
The Sasanian Empire had many large, multicultural and typically heavily defended cities. Literary sources are filled with direct or indirect references to the deportation or internal transfer of populations from one region to another, and boosting the urban population was clearly an important part of imperial economic planning, but there has been relatively little study of Sasanian urbanism. This chapter provides a timely overview by re-examining the archaeological evidence for the physical appearance and distribution of some of these urban centres, discusses their forms, and uses Google imagery to locate two previously archaeologically unrecorded cities which feature in the Arab conquest and Heraclius’ campaign shortly before. It goes on to use the excavated evidence from three city sites in Iraq, Iran and Turkmenistan to illustrate the physical appearance of residential and/or commercial quarters, and concludes with some observations on the importance of the Sasanian urban economy.
The term ‘Sasanian’ conjures a popular image of armoured knights, fire worshippers, courtly arts and conspicuous consumption, but a 400-year empire which stretched from Syria to Pakistan, recovered from the capture and death of one emperor on an eastern battlefield, and was one of Rome's biggest rivals and threats was not just built on exceptional kingship, feudalism and faith. Its success lay instead in effective bureaucracy and good management. Integrated planning for economic, military and civilian needs was fundamental, and without it the massive capital projects and military capabilities of the Sasanian state could not have been sustained. The huge number of mints known from marks on silver drachms implies a monetarised economy despite the fact that many of the mints are still physically unlocated. Moreover, many seals give the names of cities with which their owners were associated. The rapid movement of the Arab-led armies during the Islamic conquest was regularly punctuated by lengthy sieges and protracted negotiations with local commanders, which can be explained by the sheer number of cities and the scale of their defences.
Both physical frailty and cognitive impairment predict death, but the joint effect of these two factors is uncertain. The objectives are to determine if the Mini-mental state examination (MMSE) and the Frailty Index (FI) predict death over a five-year interval after accounting for the effect of the other; and if there is an interaction in this effect.
An analysis of an existing prospective cohort study of 1,751 community living older adults followed over a five-year time frame. Age, gender, and education were self-reported. The predictor variables were the FI – a measure of frailty based on the “Accumulation of Deficits” model of frailty; and the MMSE. Cox proportional hazards models were constructed for the outcome of time to death.
The unadjusted Hazard Ratio (HR) (95% CI) for mortality was 2.17 (1.69, 2.80) for those who were only cognitively impaired, 2.02 (1.53, 2.68) for those who were only frail, and 3.57 (2.75, 4.62) for those who were both frail and cognitively impaired with the reference group of those who were neither frail nor cognitively impaired. Adjusted for age, gender, and education, the HR (95% CI) was 1.49 (1.13. 1.95) for those who were only cognitively impaired, 1.81 (1.35, 2.41) for those who were only frail, and 2.28 (1.69, 3.09) for those who were both frail and cognitively impaired.
Both frailty and cognitive impairment are predictors of mortality and the effect is cumulative. There was no interaction in this effect.
Evolutionary science remains an overlooked area in psychiatry and medicine. The newly established Royal College of Psychiatrists' Evolutionary Psychiatry Special Interest Group aims to reverse this trend by raising the profile of evolutionary thinking among College members and others further afield. Here we provide a brief outline of the importance of the evolutionary approach to both the theory and practice of psychiatry and for future research.
‘Power’, Benjamin Disraeli lamented, ‘it has come to me too late.’ He was fortunate that, at the age of 70, it came to him at all. Ironically, it was William Gladstone who made it possible as he disintegrated the Liberal coalition that had dominated politics since 1846. But Disraeli had played some part in his downfall, for with his 1872 speeches at the Crystal Palace and Manchester he had belatedly constructed a serviceable Conservative ideology for the politics of the wider electorate he had brought into being in 1867. The revived One Nation vision had two components: first, an association of the Conservatives with the idea of social reform, in contrast with the Liberal obsession with institutional tinkering, and second, a celebration of the British Empire, as opposed to Gladstone's embarrassed reserve upon colonial issues. These two themes ought to have provided matter enough for a Conservative government. Unfortunately, they were always more rhetorical than practical conceptions, and Disraeli entered office with no programme for either. This fact has fuelled two of the most controversial debates concerning his politics. Was Disraeli a social reformer, and was he ever really an imperialist? The answer to both questions is an equivocal one. Yes, Disraeli was content to see his government associated with social reform and imperial gestures, but this still this leaves the issue of how far Disraeli personally encouraged these developments as elements in a definite strategy of governance. In either case the matter is debatable, and it is hard to avoid the conclusion that the coherence of Tory policy in both these areas has owed more to the subsequent writings of friends and critics than to the thinking of Disraeli himself. In any case, the narrative of Disraeli's government was shaped more by external events. In 1876 the Eastern Question was reignited by the heavy-handed methods deployed by the Turks to suppress Balkan nationalism. While Disraeli sought to apply the Eastern policy he had learned from Lord Palmerston, the massacre of civilians in Bulgaria provoked a popular outcry that summoned Gladstone from retirement, thereby initiating an exercise in popular campaigning that was to set a new style in politics and, after four years of invective against Disraeli and all his works, carried Gladstone back to power in 1880 and returned Disraeli to the opposition benches (though this time, as Lord Beaconsfield, in the House of Lords).
This book traces the often sharply differing perspectives historians have formed with regard to the key incidents in the careers of the two foremost politicians of the Victorian age – Gladstone and Disraeli. Following the parallel careers of both men, it focuses upon such contentious questions as why Disraeli opposed Corn Law repeal in 1846, if and when Gladstone became a Liberal, why Disraeli oversaw the 1867 Reform Act, how successful a Chancellor of the Exchequer was Gladstone, whether Disraeli was ever an Imperialist, and why Gladstone took up the cause of Irish Home Rule. In each case it juxtaposes the various interpretations of events historians have advocated, guiding the reader through the often complicated and nuanced debates. Motivating this approach is the conviction that history is a continually evolving subject in which finality is not to be looked for. Every generation poses new questions, or reformulates answers to old ones, and nowhere has this been more apparent than in our understanding of the Victorian age, which has retained the capacity to both challenge and provoke us, and whose legacy continues to actively shape our present and future. It is this very fluidity and contestability of key historical doctrines that gives the subject its perennial attraction and ensures that every student must confront the issues for themselves, and weigh up the sometimes bewildering array of theories and explanations, so as to come to their own conclusion. This book provides a uniquely rich and comprehensive guide through the historiographical terrain of Victorian Britain and will be an invaluable asset to any student grappling with the rivalry between Gladstone and Disraeli and the issues that formed both them and the Victorian age of which we are the heirs.
The death of Lord Palmerston in 1865 revitalized British politics. For ten years his charismatic personality had dominated Westminster, and with his demise a host of personalities and issues asserted their claims to attention. First among these was Lord John Russell. Despite having played a prominent part in passing the 1832 Reform Act, and serving as prime minister in the late 1840s, Russell had found his career blocked by Palmerston's popularity, and his hopes of revisiting the subject of reform had been frustrated. Now again the leader of a Liberal government, he moved quickly to bring forward a Reform Bill, the passage of which through the Commons was delegated to William Gladstone. This 1866 Reform Bill was a moderate one, lowering the voting qualification in boroughs from the occupancy of a house commanding a rent of £10 per annum to one liable to an annual rent of £7. It was intended, thereby, to enfranchise the skilled working class, who were not only associated with an estimable sobriety but also had the additional virtue of being expected to vote Liberal. Unfortunately, Russell and Gladstone had not anticipated the emergence of a group of about 40 Liberal MPs vehemently opposed to extending the vote to the uneducated working class. Led by Robert Lowe, these Adullamites were able to defeat the measure by allying with the Conservatives. The government resigned and a Tory administration was formed, with Lord Derby as prime minister and Benjamin Disraeli as leader of the House of Commons. What should this government do about Reform? Disraeli preferred to do nothing. But the emergence of a popular protest movement, triggered by the failure of the Liberal Bill, persuaded Derby that it would benefit the Conservatives to bring forward their own Bill, rather than allow the Liberals to take up reform at the earliest opportunity. The result was a proposal to extend the vote in the Boroughs to all men who personally paid rates (household suffrage). To counterbalance the radicalism of this measure, additional votes were to be given to members of the propertied class (the Fancy Franchises).