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This chapter discusses violence associated with the exercise of lordship and the culture of nobility in Europe from ca. 500-1500. For most of the twentieth century, historians argued that lordly violence rose and fell in inverse proportion to the power of ‘sovereign’ rulers, such as kings and emperors. It is now recognized that aristocrats in general and lords in particular played roles in medieval societies and polities that made their use of violence not just tolerable but also necessary. The practice of ‘feud’ has also come in for reassessment, increasingly understood not as anarchic or usurpatory, but re-envisaged as rule-based and self-limiting. Yet, if seigneurial violence now appears much more socially productive and politically intelligible to historians, it is important to realize that the exercise and experience of seigneurial violence varied a great deal according to social position and context. Aristocratic women were less likely than aristocratic men to be involved in such conflicts, and non-aristocrats, of both sexes, bore the brunt of the violence. This essay proceeds chronologically, examining changes in the ideas and practices that shaped how lords and nobles used violence in different regions.
A weakly nonlinear time-dependent theory for the evolution of superharmonics generated by the nonlinear self-interaction of a mode-1 internal tide in non-uniform stratification is developed and compared to numerical simulations. The forcing by the internal tide is found to excite near-pure mode-1 superharmonics whose natural frequency is moderately different from twice the internal tide frequency. Consequently, the superharmonics undergo a slow periodic growth and decay that is comparable to an acoustic ‘beat’. At low latitudes the beat frequency is smaller and the superharmonics can grow to larger amplitude, allowing for the possibility of a superharmonic cascade.
Intellectual disability has a complex effect on the well-being of affected individuals and their families. Previous research has identified multiple risk and protective factors for parental mental health, including socioeconomic circumstances and child behaviour.
This study explored whether genetic cause of childhood intellectual disability contributes to parental well-being.
Children from across the UK with intellectual disability due to diverse genetic causes were recruited to the IMAGINE-ID study. Primary carers completed the Development and Well-being Assessment, including a measure of parental distress (Everyday Feeling Questionnaire). Genetic diagnoses were broadly categorised into aneuploidy, chromosomal rearrangements, copy number variants (CNVs) and single nucleotide variants.
Compared with the UK general population, IMAGINE-ID parents (n = 888) reported significantly elevated emotional distress (Cohen's d = 0.546). Within-sample variation was related to recent life events and the perceived impact of children's difficulties. Impact was predicted by child age, physical disability, autistic characteristics and other behavioural difficulties. Genetic diagnosis also predicted impact, indirectly influencing parental well-being. Specifically, CNVs were associated with higher impact, not explained by CNV inheritance, neighbourhood deprivation or family structure.
The mental health of parents caring for a child with intellectual disability is influenced by child and family factors, converging on parental appraisal of impact. We found that genetic aetiologies, broadly categorised, also influence impact and thereby family risks. Recognition of these risk factors could improve access to support for parents, reduce their long-term mental health needs and improve well-being of individuals with intellectual disability.
Tax is traditionally viewed as the main funding mechanism for government spending. Consequently, social policy is often seen as something determined and constrained by tax revenue. Modern Monetary Theory (‘MMT’) presents a reversal of the tax-spend cycle, by identifying a spend-tax cycle. Using the UK as an example, we highlight that one of MMT’s most important, but under-explored, contributions is its potential to re-frame the role of tax from both a macroeconomic and social policy perspective. We use insights on the money removal, or cancellation function of taxes, derived from MMT, to demonstrate how this also creates possibilities for using tax to achieve social objectives such as mitigating income and wealth inequality, increasing access to housing, or funding a Green New Deal. For social policy researchers the challenge arising is to use these insights to re-engineer tax systems and redesign social tax expenditures (STEs) for creative social policy purposes.
We present a 53-year-old male with the rare constellation of stress cardiomyopathy, dextrocardia with situs inversus and anomalous coronary anatomy. This case highlights the difficulties faced when managing patients with uncommon disorders and demonstrates a rare overlap of acquired and CHD.
There is strong research evidence to support the pharmacological treatment of post-traumatic stress disorder (PTSD) as a second line to trauma-focused psychological interventions. Fluoxetine, paroxetine, sertraline and venlafaxine are the best-evidenced drugs, with lower-level evidence for other medications. It is important that prescribing for PTSD is evidence-based.
Infants undergoing stage 1 palliation for hypoplastic left heart syndrome may have post-operative feeding difficulties. Although the cause of feeding difficulties in these patients is multi-factorial, residual arch obstruction may affect gut perfusion, contributing to feeding intolerance. We hypothesised that undergoing arch reintervention following stage 1 palliation would be associated with post-operative feeding difficulties.
This was a retrospective cohort study. We analysed data from the National Pediatric Cardiology Quality Improvement Collaborative, which maintains a multicentre registry for infants with hypoplastic left heart syndrome discharged home following stage 1 palliation. Patients who underwent arch reintervention (percutaneous or surgical) prior to discharge following stage 1 palliation were compared with those who underwent non-aortic arch interventions after stage 1 palliation and those who underwent no intervention. Median post-operative days to full enteral feeds and weight for age z-scores were compared. Predictors of post-operative days to full feeds were identified.
Among patients who underwent arch reintervention, post-operative days to full enteral feeds were greater than for those who underwent non-aortic arch interventions (25 versus 16, p = 0.003) or no intervention (median days 25 versus 12, p < 0.001). Arch intervention, multiple interventions, gestational age, and the presence of a gastrointestinal anomaly were predictors of days to full feeds.
Repeat arch intervention is associated with a longer time to achieve full enteral feeding in patients with hypoplastic left heart syndrome after stage 1 palliation. Further investigation of this association is needed to understand the role of arch obstruction in feeding problems in these patients.
Involving stakeholders has been acknowledged as a way to improve quality and relevance in health research. The mechanisms that support effective research engagement with stakeholders have not been studied in the area of concussion. Concussion is a large public health concern worldwide with billions of dollars spent on health care services and research with improvements in care and service delivery not moving forward as quickly as desired. Enabling effective stakeholder engagement could improve concussion research and care.
The aim of the study was to identify potential benefits, challenges, and motivators to engaging in research by gathering the perspectives of adults with lived experience of concussion.
A thematic analysis of qualitative responses collected from a convenience sample attending a provincial brain injury conference (n = 60) was undertaken using open coding followed by axial coding.
Four themes regarding benefits to engagement emerged: first-hand account, meaningful recovery, research relevance, and better understanding of gaps. Three forces inhibited engagement: environmental barriers, injury-related constraints, and personal deterrents. Four enablers supported engagement: focus on positive impact, build connections, create a supportive environment, and provide financial assistance.
Understanding stakeholder’s perspectives on research engagement is an important issue that may serve to improve research quality. There may be unique nuances at play with injury-specific stakeholders that require researchers to consider a balance between reducing inhibitors while supporting enablers. These findings are preliminary and limited. Nevertheless, they provide needed insight and guidance for ongoing investigation regarding improvement of stakeholder engagement in concussion research.
Junk-food marketing contributes significantly to childhood obesity, which in turn imposes major health and economic burdens. Despite this, political priority for addressing junk-food marketing has been weak in many countries. Competing interests, worldviews and beliefs of stakeholders involved with the issue contribute to this political inertia. An integral group of actors for driving policy change are parliamentarians, who champion policy and enact legislation. However, how parliamentarians interpret and portray (i.e. frame) the causes and solutions of public health nutrition problems is poorly understood. The present study aimed to understand how Australian parliamentarians from different political parties frame the problem of junk-food marketing.
Framing analysis of transcripts from the Australian Government’s Parliamentary Hansard, involving development of a theoretical framework, data collection, coding transcripts and thematic synthesis of results.
Parliamentarian framing generally reflected political party ideology. Liberal parliamentarians called for minimal government regulation and greater personal responsibility, reflecting the party’s core values of liberalism and neoliberalism. Greens parliamentarians framed the issue as systemic, highlighting the need for government intervention and reflecting the core party value of social justice. Labor parliamentarians used both frames at varying times.
Parliamentarians’ framing was generally consistent with their party ideology, though subject to changes over time. This project provides insights into the role of framing and ideology in shaping public health policy responses and may inform communication strategies for nutrition advocates. Advocates might consider using frames that resonate with the ideologies of different political parties and adapting these over time.
The boll weevil spread across the South from 1892 to 1922 with devastating effect on cotton cultivation. The resulting shift away from this child labor–intensive crop lowered the opportunity cost of school attendance. We investigate the insect’s long-run effect on educational attainment using a sample of adults from the 1940 census linked back to their childhood census records. Both white and black children who were young (ages 4 to 9) when the weevil arrived saw increased educational attainment by 0.24 to 0.36 years. Our results demonstrate the potential for conflict between child labor in agriculture and educational attainment.
Christian preaching and the genre of the sermon developed both inside and outside the cloister, evolving as they circulated between secular and religious audiences. Whereas few monks (beyond the ones who became bishops) were ordained in the early centuries of Western monasticism, the difference between monks and secular clergy moved gradually to sharper definition in the eighth century, as more and more monks were being ordained. Debates intensified in the late eleventh and early twelfth centuries over the duty and authorization for preaching by monks, particularly outside the monastery. While Jerome (347–420) had asserted that the duty of monks is “not to teach, but to weep,” Rupert of Deutz (c. 1075–1129), addressing his extensive biblical commentaries to prelates and monk-priests, argued forcefully that preaching stood first among their responsibilities. For Rupert, the impetus toward renewal and reform in the twelfth century rested upon correct and authorized preaching. Bernard of Clairvaux (1090–1153), alarmed over unauthorized preaching of monks and lay persons, stated that “it is not expedient for a monk to preach in public, nor is it seemly for a novice, nor proper for anyone unless he is expressly sent.” The temptation to preach publicly is thus a fox, evil disguised as good. Nonetheless, Gratian’s (d. 1144/5) Decretum recognized that “monks chosen by the people, consecrated by the bishop with the consent of the abbot, have the right to the legitimate exercise of their power.” Within traditional communities that followed the RB, and Cistercian and Carthusian monasteries, abbots and designated representatives preached to their monastic congregations. Female superiors, such as Hildegard of Bingen (1098–1179), addressed their religious communities, presumably with permission of the abbot or superior. The statutes of the double monastery at Admont explain that a sister could preach to her community when the abbot or his representative could not be present. Abbots, some monks, and Hildegard herself preached outside their monasteries as well.
Research into global uses of English, and particularly ELF (English as a Lingua Franca), has highlighted the diversity and fluidity of communicative practices in intercultural and transcultural communication through English. Successful intercultural/transcultural communication involves the ability to make use of and negotiate multilingual/plurilingual linguistic resources, a variety of communicative practices and strategies, and movement between global, national, local, and emergent frames of reference. This is a very different conception of competence to that typically utilised in English language teaching (ELT) with its pre-determined ‘code’ consisting of a restricted range of grammatical, lexical, and phonological forms and minimal concern with the sociocultural dimension of communication. The need for a reconceptualisation of language in applied linguistics and more recently ELT has begun to receive serious scholarly attention. However, this needs to be accompanied by a focus on the wider intercultural and transcultural communicative practices in which language is embedded and enmeshed. This entails recognition of the central place of intercultural competence and the awareness that is necessary to manage such complexity, variation, and fluidity in communication. As such, this chapter addresses Hall and Wicaksono’s (this volume) call to interrogate and be “explicit about what we, as applied linguists, think English is – our ontologies of English – and how these ontologies underpin our educational ideologies and professional practices”, with a particular focus on the intercultural and transcultural dimensions to both English use and education policy and practice.
Computational modeling is an important aspect of the research on nuclear waste materials. In particular, atomistic simulations, when used complementary to experimental efforts, contribute to the scientific basis of safety case for nuclear waste repositories. Here we discuss the state-of-the-art and perspectives of atomistic modeling for nuclear waste management on a few cases of successful synergy of atomistic simulations and experiments. In particular, we discuss here: (1) the potential of atomistic simulations to investigate the uranium oxidation state in mixed-valence uranium oxides and (2) the ability of cementitious barrier materials to retain radionuclides such as 226Ra and 90Sr, and of studtite/metastudtite secondary peroxide phases to incorporate actinides such as Np and Am. The new contribution we make here is the computation of the incorporation of Sr by C-S-H (calcium silicate hydrate) phases.
The reported incidence of Clostridoides difficile infection (CDI) has increased in recent years, partly due to broadening adoption of nucleic acid amplification tests (NAATs) replacing enzyme immunoassay (EIA) methods. Our aim was to quantify the impact of this switch on reported CDI rates using a large, multihospital, empirical dataset.
We analyzed 9 years of retrospective CDI data (2009–2017) from 47 hospitals in the southeastern United States; 37 hospitals switched to NAAT during this period, including 24 with sufficient pre- and post-switch data for statistical analyses. Poisson regression was used to quantify the NAAT-over-EIA incidence rate ratio (IRR) at hospital and network levels while controlling for longitudinal trends, the proportion of intensive care unit patient days, changes in surveillance methodology, and previously detected infection cluster periods. We additionally used change-point detection methods to identify shifts in the mean and/or slope of hospital-level CDI rates, and we compared results to recorded switch dates.
For hospitals that transitioned to NAAT, average unadjusted CDI rates increased substantially after the test switch from 10.9 to 23.9 per 10,000 patient days. Individual hospital IRRs ranged from 0.75 to 5.47, with a network-wide IRR of 1.75 (95% confidence interval, 1.62–1.89). Reported CDI rates significantly changed 1.6 months on average after switching to NAAT testing (standard deviation, 1.9 months).
Hospitals that switched from EIA to NAAT testing experienced an average postswitch increase of 75% in reported CDI rates after adjusting for other factors, and this increase was often gradual or delayed.
Modern humans evolved in Africa approximately 200,000 years ago (Campbell and Tishkoff 2010). As groups migrated out of Africa they underwent bottlenecks leading to sharp reductions in population size and genetic diversity (Amos and Hoffman 2010; Harpending and Rogers 2000; Ramachandran et al. 2005). To this day, African populations retain the most genetic diversity globally (Auton et al. 2015). In order to survive both within and out of Africa, early human populations had to adapt to their novel environments, including new food resources, colder climates, higher altitudes, and, especially, infectious diseases (Balaresque et al. 2007; Fumagalli et al. 2011). These adaptive requirements, facilitated by natural selection, led to an increased frequency of alleles that were beneficial in that environment. Due to the fact that these adaptive requirements were driven by local environmental pressures, some of these evolutionarily advantageous alleles display geographic and ancestral specificity, as observed in the genomes of present-day humans (Fumagalli et al. 2011).
Microwave plasma chemical vapor deposition (MPCVD) was used to diffuse boron into tantalum using plasma initiated from a feedgas mixture containing hydrogen and diborane. The role of substrate temperature and substrate bias in influencing surface chemical structure and hardness was investigated. X-ray diffraction shows that increased temperature results in increased TaB2 formation (relative to TaB) along with increased strain in the tantalum body-centered cubic lattice. Once the strained tantalum becomes locally supersaturated with boron, TaB and TaB2 precipitate. Additional boron remains in a solid solution within the tantalum. The combination of precipitation and solid solution hardening along with boron-induced lattice strain may help explain the 40 GPa average hardness measured by nanoindentation. Application of negative substrate bias did not further increase the hardness, possibly due to etching from increased ion bombardment. These results show that MPCVD is a viable method for synthesis of superhard borides based on plasma-assisted diffusion.
The dystopian scenario of an ‘artificial intelligence takeover’ imagines artificial intelligence (AI) becoming the dominant form of intelligence on Earth, rendering humans redundant. As a society we have become increasingly familiar with AI and robots replacing humans in many tasks, certain jobs and even some areas of medicine, but surely this is not the fate of psychiatry?
Here a computational neuroscientist (Janaina Mourão-Miranda) and psychiatrist (Justin Taylor Baker) suggest that psychiatry as a profession is relatively safe, whereas psychiatrists Christian Brown and Giles William Story predict that robots will be taking over the asylum.