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Darwin's frogs Rhinoderma darwinii and Rhinoderma rufum are the only known species of amphibians in which males brood their offspring in their vocal sacs. We propose these frogs as flagship species for the conservation of the Austral temperate forests of Chile and Argentina. This recommendation forms part of the vision of the Binational Conservation Strategy for Darwin's Frogs, which was launched in 2018. The strategy is a conservation initiative led by the IUCN SSC Amphibian Specialist Group, which in 2017 convened 30 governmental, non-profit and private organizations from Chile, Argentina and elsewhere. Darwin's frogs are iconic examples of the global amphibian conservation crisis: R. rufum is categorized as Critically Endangered (Possibly Extinct) on the IUCN Red List, and R. darwinii as Endangered. Here we articulate the conservation planning process that led to the development of the conservation strategy for these species and present its main findings and recommendations. Using an evidence-based approach, the Binational Conservation Strategy for Darwin's Frogs contains a comprehensive status review of Rhinoderma spp., including critical threat analyses, and proposes 39 prioritized conservation actions. Its goal is that by 2028, key information gaps on Rhinoderma spp. will be filled, the main threats to these species will be reduced, and financial, legal and societal support will have been achieved. The strategy is a multi-disciplinary, transnational endeavour aimed at ensuring the long-term viability of these unique frogs and their particular habitat.
In the 1821 Preface to his Elements of the philosophy of right, Hegel famously claimed that ‘philosophy…is its own time comprehended in thoughts’. It is tempting to view history in equivalent terms. After all, historical research usually engages the past under the influence of contemporary concerns. Topics acquire pertinence on account of prevailing values and interests. And yet there is a clear difference between being roused to investigate a subject as a result of its ongoing resonance and interpreting its meaning in terms of current attitudes. This distinction, however, is often blurred, and with it appropriate relations between historical analysis and moral judgement. It may well be that, at the level of political philosophy, each of these activities can be reconciled; but first their respective provinces should be carefully delimited.
Delirium affects 11% to 47% of post-operative cardiac surgery patients and is associated with higher mortality and morbidity rates. However, the pathophysiology of this syndrome is largely unknown.
To investigate whether increased concentration of pre- and postoperative plasma cortisol predicts the development of delirium after coronary artery bypass graft surgery (CABG). Secondly, to assess whether the association between cortisol and delirium is stress-related or mediated by other pathologies, such as major depressive disorder (MDD) or cognitive impairment.
The patients were examined one day preoperatively with Mini International Neuropsychiatric Interview and Montreal Cognitive Assessment to screen for depression and cognitive impairment, respectively. Blood samples for cortisol levels were collected both pre- and post-operatively. The Confusion Assessment Method was used within the first five days postoperatively to screen for a diagnosis of delirium.
Postoperative delirium developed in 36% (41of 113) of participants. Multivariate logistic regression analysis revealed two groups independently associated with an increased risk of developing post-operative delirium:
1) Those with pre-operatively raised cortisol levels and
2) Those with a pre-operative diagnosis of MDD associated with raised levels of cortisol post-operatively. According to ROC
analysis the most optimal cutoff values of the preoperative and postoperative cortisol concentration which predict the development of delirium were 353.55 nmol/L, and 994.10 nmol/L, respectively.
Raised peri-operative plasma cortisol concentrations are associated with delirium after CABG surgery. This may be an important pathophysiological consideration in the increased risk of post-operative delirium seen in patients with a preoperative diagnosis of MDD.
Sexually-violent practices and ideologies have varied dramatically over time and geographical region. There have also been important shifts in the weighting given to its two components: “sexual” and “violence”. Sexual violence is deeply rooted in specific political, economic, social, and cultural contexts. In exploring these issues on a global-scale the first question to ask is: who is entitled to label something as “sexually violent”? Despite the incredible personal suffering inflicted on victims of sexual assault, under-reporting is pervasive: victims routinely struggle to find words for their pain. Cognitive distortions about gender, sexuality, and violence have left legacies of abuse that are difficult to counter. Perpetrators of violence are often presented as victims and, in the context of mass rapes during wartime, international law has been sluggish in responding. The chapter concludes by evaluation the attempts by victims of sexual violence, feminists, politicians, lawmakers, police, and community activists to resist and eradicate sexual violence not only in their own societies but also globally. Rape thrives in situations of structural inequality. Although women act in sexually aggressive ways (and there is some evidence that the proportion of female aggressors is increasing), in the final analysis, political attempts to reduce and finally eliminate sexual aggression must start with the main perpetrators. Eradicating rape requires a radically different conception of agency and masculinity.
Triage at mass gatherings in Australia is commonly performed by staff members with first aid training. There have been no evaluations of the performance of first aid staff with respect to diagnostic accuracy or identification of presentations requiring ambulance transport to hospital.
It was hypothesized that triage decisions by first aid staff would be considered correct in at least 61% of presentations.
A retrospective audit of 1,048 presentations to a single supplier of event health care services in Australia was conducted. The presentations were assessed based on the first measured set of physiological parameters, and the primary triage decision was classified as “expected” if the primary and secondary triage classifications were the same or “not expected” if they differed. The performance of the two triage systems was compared using area under the receiver operating characteristic curve (AUROC) analysis.
The expected decision was made by first aid staff in 674 (71%) of presentations. Under-triage occurred in 131 (14%) presentations and over-triage in 142 (15%) presentations. The primary triage strategy had an AUROC of 0.7644, while the secondary triage strategy had an AUROC of 0.6280, which was significantly different (P = .0199).
The results support the continued use of first aid trained staff members in triage roles at Australian mass gatherings. Triage tools should be simple, and the addition of physiological variables to improve the sensitivity of triage tools is not recommended because such an approach does not improve the discriminatory capacity of the tools.
Serotonin and sympathomimetic toxicity (SST) after ingestion of amphetamine-based drugs can lead to severe morbidity and death. There have been evaluations of the safety and efficacy of on-site treatment protocols for SST at music festivals.
The study aimed to examine the safety and efficacy of treating patients with SST on-site at a music festival using a protocol adapted from hospital-based treatment of SST.
The study is an audit of presentations with SST over a one-year period. The primary outcome was need for ambulance transport to hospital. The threshold for safety was prospectively defined as less than 10% of patients requiring ambulance transport to hospital.
The protocol suggested patients be treated with a combination of benzodiazepines; cold intravenous (IV) fluid; specific therapies (cyproheptadine, chlorpromazine, and clonidine); rapid sequence intubation; and cooling with ice, misted water, and convection techniques.
One patient of 13 (7.7%) patients with mild or moderate SST required ambulance transport to hospital. Two of seven further patients with severe SST required transport to hospital.
On-site treatment may be a safe, efficacious, and efficient alternative to urgent transport to hospital for patients with mild and moderate SST. The keys to success of the protocol tested included inclusive and clear education of staff at all levels of the organization, robust referral pathways to senior clinical staff, and the rapid delivery of therapies aimed at rapidly lowering body temperature. Further collaborative research is required to define the optimal approach to patients with SST at music festivals.
Immersion of patients in a body bag filled with ice and water is recommended as prehospital management of severe hyperthermia. Experienced paramedics have raised a number of concerns about the use of this technique; particularly, whether cardiac monitoring equipment would remain functional once immersed. This test showed that monitoring equipment does remain functional and provides advice about safety considerations. The test should reassure practitioners that such an approach is feasible.
HUMAN RIGHTS TECTONICS THROUGH AN ISSUE-BASED APPROACH
Joanna Bourke Martignoni, Senior Researcher at the Geneva Academy of International Humanitarian Law and Human Rights, Switzerland; Lecturer in Human Rights at the University of Fribourg, Switzerland
This chapter analyses selected examples of the United Nations (UN) treaty-monitoring bodies’ application of an intersectional lens to sexual and reproductive rights issues. While the concept of intersectionality has occupied centre stage in much of the gender and postcolonial studies literature produced since the 1980s, the use of intersectional perspectives by the international human rights mechanisms has a much more recent history.
Intersectionality is both a method of observation and an action-oriented form of practice. It aims to uncover and redress forms of privilege and oppression that remain hidden from view in the single attribute analyses of inequality traditionally used by international and national human rights monitoring mechanisms. The present chapter looks at the way in which the treaty-monitoring bodies are increasingly deploying the concept of intersectionality – both explicitly and implicitly – to address issues of sexual and reproductive rights.
The difficulties inherent in identifying a suitable comparator against whom the presence of discrimination or disadvantage can be assessed are highlighted. In some instances, the treaty bodies have failed to adequately address intersectional factors, such as belonging to an ethnic minority group or being a human rights defender, that have a direct bearing on the realisation of sexual and reproductive rights. In other situations, exemplified in the approach taken by the majority of the Human Rights Committee (HRC) in the Amanda Jane Mellet v Ireland case (2016),it is argued that the misuse of an intersectional comparator may potentially obscure, rather than illuminate, broader gendered power relations.
The chapter concludes with some reflections about the prospects and limitations of intersectional approaches to sexual and reproductive rights and the capacity of the UN human rights monitoring mechanisms to engage in the nuanced, radical and frequently contradictory analyses of inequalities and power relations that such approaches require.
THEORISING AND APPLYING INTERSECTIONAL METHODS
Intersectionality is a form of resistant knowledge developed to unsettle conventional mindsets, challenge oppressive power, think through the full architecture of structural inequalities and asymmetrical life opportunities, and seek a more just world.
Scholars and activists working within the frameworks of critical race feminism and postcolonial studies have long engaged with issues of intersectional oppression. These groups emphasise that gender, ethnicity, disability, age, socio-economic status and other identity characteristics are reflections of political, social and economic power constellations, which promote or limit an individual's enjoyment of rights and capabilities.
Our ALMA observations of HCO+ and HCN show such redshifted absorption toward an isolated core, BHR 71. Both lines show a similar redshifted absorption profile. We also found emissions of complex organic molecules (COMs) around 345 GHz from a compact region centered on the continuum source, which is barely resolved with a beam of 0″27, corresponding to ∼50 AU.
Low-mass stars form from the gravitational collapse of dense molecular cloud cores. While a general consensus picture of this collapse process has emerged, many details on how mass is transferred from cores to stars remain poorly understood. MASSES (Mass Assembly of Stellar Systems and their Evolution with the SMA), an SMA large project, has just finished surveying all 74 Class 0 and Class I protostars in the nearby Perseus molecular cloud to reveal the interplay between fragmentation, angular momentum, and outflows in regulating accretion and setting the final masses of stars. Scientific highlights are presented in this proceedings, covering the topics of episodic accretion, hierarchical thermal Jeans fragmentation, angular momentum transfer, envelope grain sizes, and disk evolution.
Borderline personality disorder (BPD) is characterised by recurring crises, hospitalisations, self-harm, suicide attempts, addictions, episodes of depression, anxiety and aggression and lost productivity. The objective of this study is to determine the use of direct health care resources by persons with BPD in Ireland and the corresponding costs.
This prevalence-based micro-costing study was undertaken on a sample of 196 individuals with BPD attending publicly funded mental health services in Ireland. All health care costs were assessed using a resource utilisation questionnaire completed by mental health practitioners. A probabilistic sensitivity analysis, using a Monte Carlo simulation, was performed to examine uncertainty.
Total direct healthcare cost per individual was €10 844 annually (ranging from 5228 to 20 609). Based on a prevalence of 1% and an adult population (18–65 years) of 2.87 million, we derived that there were 28 725 individuals with BPD in Ireland. Total yearly cost of illness was calculated to be up to €311.5 million.
There is a dearth of data on health care resource use and costs of community mental health services in Ireland. The absence of this data is a considerable constraint to research and decision-making in the area of community mental health services. This paper contributes to the limited literature on resource use and costs in community mental health services in Ireland. The absence of productivity loss data (e.g. absenteeism and presenteeism), non-health care costs (e.g. addiction treatment), and indirect costs (e.g. informal care) from study participants is a limitation of this study.
Toward Democracy traces a remarkable journey across two continents. Its aim, as the subtitle indicates, is to chart “the struggle for self-rule” in European and American thought. Its scope and erudition are at once imposing and inspiring. Not only has the author mastered several historical literatures, he also demonstrates considerable knowledge of a range of primary materials spanning ancient, European and American history.
Examining the political thought of the Irish Revolution poses two distinct problems. First, we need to establish how we should date the Revolution for the purposes of intellectual history. There is no doubting that the 1916 Easter Rising was an event in British and Irish politics, but it was also an event in the world of ideas. Any serious consideration of this episode and its aftermath therefore needs to trace its origins to patterns of thought as well as shifts in affairs, and the two processes do not necessarily coincide. The second requirement for understanding the role of political thought in the Revolution is to reconstruct carefully the actual doctrines articulated and deployed. Irish historians have been reluctant to engage in this process of interpretation. Yet a more searching account of political ideas in the period has the potential to change our approach to the Revolution as a whole.
Using cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS), it was shown for four different types of carbon that electrode treatments at negative potentials enhance the kinetics of VIV-VV and inhibit the kinetics of VII-VIII while electrode treatments at positive potentials inhibit the kinetics of VIV-VV and enhance the kinetics of VII-VIII. These observations may explain conflicting reports in the literature. The potentials required for activation and deactivation of electrodes were examined in detail. The results suggest that interchanging the positive and negative electrodes in a vanadium flow battery (VFB) would reduce the overpotential at the negative electrode and so improve the performance. This is supported by flow-cell experiments. Thus, periodic catholyte-anolyte interchange, or equivalent alternatives such as battery overdischarge, show promise of improving the voltage efficiency of VFBs.
Persecutory delusions may be unfounded threat beliefs maintained by
safety-seeking behaviours that prevent disconfirmatory evidence being
successfully processed. Use of virtual reality could facilitate new
To test the hypothesis that enabling patients to test the threat
predictions of persecutory delusions in virtual reality social
environments with the dropping of safety-seeking behaviours (virtual
reality cognitive therapy) would lead to greater delusion reduction than
exposure alone (virtual reality exposure).
Conviction in delusions and distress in a real-world situation were
assessed in 30 patients with persecutory delusions. Patients were then
randomised to virtual reality cognitive therapy or virtual reality
exposure, both with 30 min in graded virtual reality social environments.
Delusion conviction and real-world distress were then reassessed.
In comparison with exposure, virtual reality cognitive therapy led to
large reductions in delusional conviction (reduction 22.0%,
P = 0.024, Cohen's d = 1.3) and
real-world distress (reduction 19.6%, P = 0.020, Cohen's
d = 0.8).
Cognitive therapy using virtual reality could prove highly effective in
The Parkes radio telescope has been used to search a list of small, dense southern dark clouds and Bok globules for ammonia emission at 23.7 GHz. The ammonia observations, together with IRAS data and the cloud’s visual appearance, have been used to determine a short list of dark clouds for observation with the infrared imaging system (IRIS) on the Anglo-Australian Telescope, in an attempt to determine the dust density distribution within the clouds. Near-infrared images of a number of the short listed clouds have been obtained with IRIS at J, H and K’. Preliminary results are reported for this ammonia survey, together with IRIS images of the strong ammonia source DC 297.7–2.8. Coincident with the dense ammonia core of this object is an IRAS ‘core’ source, IRAS 11590–6452 and an extremely interesting near-infrared source, which lies on the edge of the error ellipse of the IRAS source.
Ultracompact H II regions are small, dense regions of ionised gas surrounding high-mass stars which are still embedded in their natal molecular clouds. A survey of such regions has been commenced in an attempt to improve our understanding of the processes of high-mass star formation. The initial stages of the survey have involved selection of likely candidates from the IRAS Point Source Catalogue, correlation with radio continuum emission at 4·85 GHz and subsequent observations of methanol maser emission at 6·668 GHz. Preliminary results of the methanol maser survey are given.
Background: Many patients do not respond adequately to current pharmacological or psychological treatments for psychosis. Persistent persecutory delusions are common in clinical services, and cause considerable patient distress and impairment. Our aim has been to build a new translational personalized treatment, with the potential for wide use, that leads to high rates of recovery in persistent persecutory delusions. We have been developing, and evaluating individually, brief modular interventions, each targeting a key causal factor identified from our cognitive model. These modules are now combined in “The Feeling Safe Programme”. Aims: To test the feasibility of a new translational modular treatment for persistent persecutory delusions and provide initial efficacy data. Method: 12 patients with persistent persecutory delusions in the context of non-affective psychosis were offered the 6-month Feeling Safe Programme. After assessment, patients chose from a personalized menu of treatment options. Four weekly baseline assessments were carried out, followed by monthly assessments. Recovery in the delusion was defined as conviction falling below 50% (greater doubt than certainty). Results: 11 patients completed the intervention. One patient withdrew before the first monthly assessment due to physical health problems. An average of 20 sessions (SD = 4.4) were received. Posttreatment, 7 out of 11 (64%) patients had recovery in their persistent delusions. Satisfaction ratings were high. Conclusions: The Feeling Safe Programme is feasible to use and was associated with large clinical benefits. To our knowledge this is the first treatment report focused on delusion recovery. The treatment will be tested in a randomized controlled trial.