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This volume explores journeys across time and space in Greek and Latin literature, taking as its starting point the paradigm of travel offered by the epic genre. The epic journey is central to the dynamics of classical literature, offering a powerful lens through which characters, authors, and readers experience their real and imaginary worlds. The journey informs questions of identity formation, narrative development, historical emplotment, and constructions of heroism - topics that move through and beyond the story itself. The act of moving to and from 'home' - both a fixed point of spatial orientation and a transportable set of cultural values - thus represents a physical journey and an intellectual process. In exploring its many manifestations, the chapters in this collection reconceive the centrality of the epic journey across a wide variety of genres and historical contexts, from Homer to the moon.
Cathedrals are usually thought to have had little role in the English Reformation and the reasons for their very survival in the new Church of England have been questioned. Instead of being an irrelevant and closed-off institution, Durham Cathedral was intellectually close to its Reformation-era bishop, the conservative Cuthbert Tunstall, and was involved in diocesan matters throughout his episcopate. Tunstall's evangelical successors also appreciated its potential for reform and the need to use its staff and resources. Cathedrals thus could be a tool to be used in the reformation of the diocese on both sides of the emerging confessional divide.
Background: Buprenorphine/naloxone (bup/nal) is a partial opioid agonist/antagonist and recommended first line treatment for opioid use disorder (OUD). Emergency departments (EDs) are a key point of contact with the healthcare system for patients living with OUD. Aim Statement: We implemented a multi-disciplinary quality improvement project to screen patients for OUD, initiate bup/nal for eligible individuals, and provide rapid next business day walk-in referrals to addiction clinics in the community. Measures & Design: From May to September 2018, our team worked with three ED sites and three addiction clinics to pilot the program. Implementation involved alignment with regulatory requirements, physician education, coordination with pharmacy to ensure in-ED medication access, and nurse education. The project is supported by a full-time project manager, data analyst, operations leaders, physician champions, provincial pharmacy, and the Emergency Strategic Clinical Network leadership team. For our pilot, our evaluation objective was to determine the degree to which our initiation and referral pathway was being utilized. We used administrative data to track the number of patients given bup/nal in ED, their demographics and whether they continued to fill bup/nal prescriptions 30 days after their ED visit. Addiction clinics reported both the number of patients referred to them and the number of patients attending their referral. Evaluation/Results: Administrative data shows 568 opioid-related visits to ED pilot sites during the pilot phase. Bup/nal was given to 60 unique patients in the ED during 66 unique visits. There were 32 (53%) male patients and 28 (47%) female patients. Median patient age was 34 (range: 21 to 79). ED visits where bup/nal was given had a median length of stay of 6 hours 57 minutes (IQR: 6 hours 20 minutes) and Canadian Triage Acuity Scores as follows: Level 1 – 1 (2%), Level 2 – 21 (32%), Level 3 – 32 (48%), Level 4 – 11 (17%), Level 5 – 1 (2%). 51 (77%) of these visits led to discharge. 24 (47%) discharged patients given bup/nal in ED continued to fill bup/nal prescriptions 30 days after their index ED visit. EDs also referred 37 patients with OUD to the 3 community clinics, and 16 of those individuals (43%) attended their first follow-up appointment. Discussion/Impact: Our pilot project demonstrates that with dedicated resources and broad institutional support, ED patients with OUD can be appropriately initiated on bup/nal and referred to community care.
How judges and arbitrators in international courts and tribunals do or ought to judge are perennial topics. For the 2018 ASIL Annual Meeting, we assembled a panel of judges, practitioners, and scholars for an informal conversation on the modern, practical aspects of judging in international courts and in arbitral tribunals.