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A primary mode for the creation and dissemination of poetry in Renaissance Italy was the oral practice of singing and improvising verse to the accompaniment of a stringed instrument. Singing to the Lyre is the first comprehensive study of this ubiquitous practice, which was cultivated by performers ranging from popes, princes, and many artists, to professionals of both mercantile and humanist background. Common to all was a strong degree of mixed orality based on a synergy between writing and the oral operations of memory, improvisation, and performance. As a cultural practice deeply rooted in language and supported by ancient precedent, cantare ad lyram (singing to the lyre) is also a reflection of Renaissance cultural priorities, including the status of vernacular poetry, the study and practice of rhetoric, the oral foundations of humanist education, and the performative culture of the courts reflected in theatrical presentations and Castiglione's Il cortegiano.
We aimed to estimate the cost-effectiveness of brief weight-loss counselling by dietitian-trained practice nurses, in a high-income-country case study.
A literature search of the impact of dietary counselling on BMI was performed to source the ‘best’ effect size for use in modelling. This was combined with multiple other input parameters (e.g. epidemiological and cost parameters for obesity-related diseases, likely uptake of counselling) in an established multistate life-table model with fourteen parallel BMI-related disease life tables using a 3 % discount rate.
New Zealand (NZ).
We calculated quality-adjusted life-years (QALY) gained and health-system costs over the remainder of the lifespan of the NZ population alive in 2011 (n 4·4 million).
Counselling was estimated to result in an increase of 250 QALY (95 % uncertainty interval −70, 560 QALY) over the population’s lifetime. The incremental cost-effectiveness ratio was 2011 $NZ 138 200 per QALY gained (2018 $US 102 700). Per capita QALY gains were higher for Māori (Indigenous population) than for non-Māori, but were still not cost-effective. If willingness-to-pay was set to the level of gross domestic product per capita per QALY gained (i.e. 2011 $NZ 45 000 or 2018 $US 33 400), the probability that the intervention would be cost-effective was 2 %.
The study provides modelling-level evidence that brief dietary counselling for weight loss in primary care generates relatively small health gains at the population level and is unlikely to be cost-effective.
This article examines the politics of race, religion and nation in relation to blackface minstrelsy during the first decades of the twentieth century. Having been superseded by more modern amusements, minstrelsy was outdated as a performance genre, yet the minstrel show served as a forum for Neil O'Brien and the Knights of Columbus fraternal society to participate in the invention of a white American Catholic identity. For fraternal society members, estranged from national belonging by religious difference, these performances situated the group as proponents of an old-fashioned American tradition, structured around anti-blackness. At a time of anti-Catholic sentiment, Catholic fraternal society members gathered for minstrel performances, distancing themselves from black people and marking themselves as white Americans.
Tertullian's treatise De pallio is the briefest and most difficult of the North African's works. Its purpose, ostensibly, is to advocate for a change in clothing from the toga to the pallium. This sartorial shift functions, in turn, as a metaphor for conversion to the philosophical life, which, at the end of the treatise, is revealed to be the Christian life. Towards the centre of the work, Tertullian turns to nature to support his argument, citing the example of five different animals. This essay analyses his description of the chameleon, arguing that it is a riddle: drawing on the natural historians, Tertullian paints a realistic picture of the small lizard, but at the same time, skews the description of these features to depict the philosopher. The purpose of this central sketch is to alert listeners to the nature of the speech as a guessing game, and to point to the complex identity of the speaker.
To examine the strengths and opportunities for improvement of current home care education practices to inform the development of the Home Care for Heart Health intervention, and to develop a web-based intervention for parents and clinicians with complimentary print materials that could provide the right education at the right time to foster a safer transition from hospital to home.
An inter-professional focus group of parents, clinicians, and designers was formed to co-create a home care education intervention for parents of children with congenital heart disease (CHD) and their care team. We used the Integrated New Product Development process model created by Jonathon Cagan and Craig Vogel at Carnegie Mellon University to develop the intervention. This process model is a way of thinking that combines horizontal and inter-disciplinary teams, stakeholder-centric focus, and a system of qualitative discovery and development evolving towards quantitative methods of refinement.
Our team developed the Home Care for Heart Health intervention. The evidenced-based intervention includes a quick reference guide for parents of children with CHD, an accompanying app, family-friendly pathways, and clinician education.
Using an inter-professional approach, our team of clinicians, parents, and design experts were able to co-create a clinician–parent home care education intervention with broad application and lifelong relevance to the Congenital Heart Disease Community.
Our intervention has the potential to be used as a model for other home care education interventions for parents of children with chronic illnesses.
Despite its established efficacy, access to internet-delivered CBT (iCBT) remains limited in a number of countries. Translating existing programs and using a minimally monitored model of delivery may facilitate its dissemination across countries.
This randomized control trial aims to evaluate the efficacy of an iCBT transdiagnostic program translated from English to French and offered in Canada using a minimally monitored delivery model for the treatment of anxiety and depression.
Sixty-three French speakers recruited in Canada were randomized to iCBT or a waiting-list. A French translation of an established program, the Wellbeing Course, was offered over 8 weeks using a minimally monitored delivery model. Primary outcome measures were the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9), which were obtained pre-treatment, post-treatment and at 3-month follow-up.
Mixed-effects models revealed that participants in the treatment group had significantly lower PHQ-9 and GAD-7 scores post-treatment than controls with small between-groups effect sizes (d = 0.34 and 0.37, respectively). Within-group effect sizes on primary outcome measures were larger in the treatment than control group. Clinical recovery rates on the PHQ-9 and GAD-7 were significantly higher among the treatment group (40 and 56%, respectively) than the controls (13 and 16%, respectively).
The provision of a translated iCBT program using a minimally monitored delivery model may improve patients’ access to treatment of anxiety and depression across countries. This may be an optimal first step in improving access to iCBT before sufficient resources can be secured to implement a wider range of iCBT services.
As more debates in American politics become constitutional questions, effective citizens must engage in constitutional interpretation. While most Americans venerate the Constitution as a part of a national, civil religion, levels of constitutional knowledge are also very low. In this paper, we analyze how ordinary Americans approach the task of constitutional interpretation. An analysis of two cross-sectional surveys indicates constitutional hermeneutics are a product of political factors, religious affiliation, and biblical interpretive preferences. We also present the results of a survey experiment where the manipulation of a clergy's interpretation of a biblical passage affects how respondents interpret both scripture and the Constitution, providing a potential causal mechanism for learning how to engage in hermeneutics.
The adoption of chemical fallow rotations in Pacific Northwest dryland winter wheat production has caused a weed species composition shift in which scouringrush has established in production fields. Thus, there has been interest in identifying herbicides that effectively control scouringrush in winter wheat–chemical fallow cropping systems. Field experiments were established in growers’ fields near Reardan, WA, in 2014, and The Dalles, OR, in 2015. Ten herbicide treatments were applied to mowed and nonmowed plots during chemical fallow rotations. Scouringrush stem densities were quantified the following spring and after wheat harvest at both locations. Chlorsulfuron plus MCPA-ester resulted in nearly 100% control of scouringrush through wheat harvest. Before herbicide application, mowing had no effect on herbicide efficacy. We conclude chlorsulfuron plus MCPA-ester is a commercially acceptable treatment for smooth and intermediate scouringrush control in winter wheat–chemical fallow cropping systems; however, the lack of a positive yield response when scouringrushes were controlled should factor into management decisions.
Residual herbicides are routinely applied to control troublesome weeds in pumpkin production. Fluridone and acetochlor, Groups 12 and 15 herbicides, respectively, provide broad-spectrum PRE weed control. Field research was conducted in Virginia and New Jersey to evaluate pumpkin tolerance and weed control to PRE herbicides. Treatments consisted of fomesafen at two rates, ethalfluralin, clomazone, halosulfuron, fluridone, S-metolachlor, acetochlor emulsifiable concentrate (EC), acetochlor microencapsulated (ME), and no herbicide. At one site, fluridone, acetochlor EC, acetochlor ME, and halosulfuron injured pumpkin 81%, 39%, 34%, and 35%, respectively, at 14 d after planting (DAP); crop injury at the second site was 40%, 8%, 19%, and 33%, respectively. Differences in injury between the two sites may have been due to the amount and timing of rainfall after herbicides were applied. Fluridone provided 91% control of ivyleaf morningglory and 100% control of common ragweed at 28 DAP. Acetochlor EC controlled redroot pigweed 100%. Pumpkin treated with S-metolachlor produced the most yield (10,764 fruits ha–1) despite broadcasting over the planted row; labeling requires a directed application to row-middles. A separate study specifically evaluated fluridone applied PRE at 42, 84, 126, 168, 252, 336, and 672 g ai ha–1. Fluridone resulted in pumpkin injury ≥95% when applied at rates of ≥168 g ai ha–1; significant yield loss was noted when the herbicide was applied at rates >42 g ai ha–1. We concluded that fluridone and acetochlor formulations are unacceptable candidates for pumpkin production.
In this paper we use formal tools from category theory to develop a foundation for creating and managing models in systems where knowledge is distributed across multiple representations and formats. We define a class of models which incorporate three different representations---computations, logical semantics, and data--as well as model mappings (functors) to establish relationships between them. We prove that our models support model merge operations called colimits and use these to define a methodology for model integration.
Introduction: Children diagnosed with medulloblastoma (MB) who are refractory to upfront therapy or experience recurrence have very poor prognoses. Although phase I and phase II trials exist, these treatments bear significant treatment-related morbidity and mortality. Methods: A retrospective review of children diagnosed with a recurrence of MB from 2002 to 2015 at McMaster University was undertaken. Results: Recurrent disease in 10 patients involved leptomeningeal dissemination, with 3 experiencing local recurrence. In three recurrent patients the disease significantly progressed, and the children were palliated. The remaining 10 children underwent some form of salvage therapy, including surgical re-resection, radiation, and chemotherapy, either in isolation or in varying combinations. Of the 13 children experiencing treatment-refractory or recurrent disease, 4 are currently alive with a median follow-up of 38.5 months (75.5 months). Of the eight patients with molecular subgrouping data, none of the Wnt MB experienced recurrence. Conclusion: Recurrent MB carried a poor prognosis with a 5-year overall survival (OS) of 18.2% despite the administration of salvage therapy. The upfront therapy received, available treatment, and tolerability of the proposed salvage therapy resulted in significant heterogeneity in the treatment of our recurrent cohort.
We introduce a new modelling framework to explain socio-economic differences in mortality in terms of an affluence index that combines information on individual wealth and income. The model is illustrated using data on older Danish males over the period 1985–2012 reported in the Statistics Denmark national register database. The model fits the historical mortality data well, captures their key features, generates smoothed death rates that allow us to work with a larger number of sub-groups than has previously been considered feasible, and has plausible projection properties.
To examine the association between parenting styles and overall child dietary quality within households that are low-income and food-insecure.
Child dietary intake was measured via a 24 h dietary recall. Dietary quality was assessed using the Healthy Eating Index-2005 (HEI-2005). Parenting styles were measured and scored using the Parenting Styles and Dimensions Questionnaire. Linear regressions were used to test main and interaction associations between HEI-2005 scores and parenting styles.
Non-probability sample of low-income and food-insecure households in South Carolina, USA.
Parent–child dyads (n 171). Parents were ≥18 years old and children were 9–15 years old.
We found a significant interaction between authoritative and authoritarian parenting style scores. For those with a mean authoritarian score, each unit increase in authoritative score was associated with a higher HEI-2005 score (b = 3·36, P < 0.05). For those with an authoritarian score that was 1 sd above the mean authoritarian score, each unit increase in authoritative score was associated with a higher HEI-2005 score (b = 8.42, P < 0.01). For those with an authoritarian score that was −1 sd below the mean authoritarian score, each unit increase in authoritative score was associated with a lower HEI-2005 score; however, this was not significant (b = −1·69, P > 0·05). Permissive parenting style scores were negatively associated with child dietary quality (b = −2·79, P < 0·05).
Parenting styles should be considered an important variable that is associated with overall dietary quality in children living within low-income and food-insecure households.
Coccidial infections reduce fat-soluble vitamin status and bone mineralisation in broiler chickens. We hypothesised that broilers infected with Eimeria maxima would benefit from increased dietary supplementation with vitamin D (vitD) or with 25-hydroxycholecalciferol (25(OH)D3 or 25D3). Broilers were assigned to diets with low (L) or commercial (M) vitD levels (25 v. 100 μg/kg) supplemented as cholecalciferol (D3) or 25D3. At day 11 of age, birds were inoculated with water or 7000 E. maxima oocysts. Pen performance was calculated over the early (days 1–6), acute (days 7–10) and recovery periods (days 11–14) post-infection (pi). At the end of each period, six birds per treatment were dissected to assess long bone mineralisation, plasma levels of 25D3, Ca and P, and intestinal histomorphometry. Parasite replication and transcription of cytokines IL-10 and interferon-γ (IFN-γ) were assessed at day 6 pi using quantitative PCR. Performance, bone mineralisation and plasma 25D3 levels were significantly reduced during infection (P < 0·05). M diets or diets with 25D3 raised plasma 25D3, improved performance and mineralisation (P < 0·05). Offering L diets compromised feed efficiency pi, reduced femur breaking strength and plasma P levels at day 10 pi in infected birds (P < 0·05). Contrastingly, offering M diets or diets with 25D3 resulted in higher parasite loads (P < 0·001) and reduced jejunal villi length at day 10 pi (P < 0·01), with no effect on IL-10 or IFN-γ transcription. Diets with M levels or 25D3 improved performance and mineralisation, irrespective of infection, while M levels further improved feed efficiency and mineralisation in the presence of coccidiosis.
Blake Morrison’s chapter explores his reinterpretation of the Brontës’ lives within the context of the theatre of Chekhov. Writing candidly of his preparation of We Are Three Sisters (2011) for production, Morrison considers the ways in which intertextual resonances can disperse the traditional gloom of biographical interpretations of the Brontës and highlight instead qualities of resourceful authorship and human resilience. Morrison outlines how his imagining of the lives of the Brontës within the framework of a Chekhovian play was informed by themes and ideas that both preoccupied the Brontës’ writing lives and feature in Chekhov’s Three Sisters (1900). Using the Chekhov as a template, rather than something to be slavishly adhered to, Morrison found a way to negotiate the boundaries between biography and fiction(s): weaving lines from novels and letters of the Brontës into the fabric of the play, and listening to words of the letters in particular. Morrison considers how he avoided either too rigidly imposing the Chekhovian framework, or equating the thoughts of fictional characters and their creators. He was concerned to challenge stereotypes of the Brontës as repressed, miserable and unworldly and to show the Haworth of the Brontës’ day as a place open to intellectual discussion.