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Mary Wollstonecraft (1759–1797) was one of the most influential and controversial women of her age. No writer, except perhaps her political foe, Edmund Burke, and her fellow reformer, Thomas Paine, inspired more intense reactions. In her brief literary career before her untimely death in 1797, Wollstonecraft achieved remarkable success in an unusually wide range of genres: from education tracts and political polemics, to novels and travel writing. Just as impressive as her expansive range was the profound evolution of her thinking in the decade that she flourished as an author. In this collection of essays, leading international scholars reveal the intricate biographical, critical, cultural, and historical context crucial for understanding Mary Wollstonecraft's oeuvre. Chapters including British radicalism and conservatism, French philosophes and English Dissenters, constitutional law and domestic law, sentimental literature, eighteenth-century periodicals and more, elucidate Wollstonecraft's social and political thought, historical writings, moral tales for children, and novels.
Silver nanowire (AgNW) diameters are typically characterized by manual measurement from high magnification electron microscope images. Measurement is monotonous and has potential ergonomic hazards. Because of this, statistics regarding wire diameter distribution can be poor, costly, and low-throughput. In addition, manual measurements are of unknown uncertainty and operator bias. In this paper we report an improved microscopy method for diameter and yield measurement of nanowires in terms of speed/automation and reduction of analyst variability. Each step in the process to generate these measurements was analyzed and optimized: microscope imaging conditions, sample preparation for imaging, image acquisition, image analysis, and data processing. With the resulting method, average diameter differences between samples of just a few nanometers can be confidently and statistically distinguished, allowing the identification of subtle incremental improvements in reactor processing conditions, and insight into nucleation and growth kinetics of AgNWs.
This essay investigates how the repressive wartime political and social environment in World War I encouraged three key American social justice movements to devise new tactics and strategies to advance their respective causes. For the African American civil rights, female suffrage, and civil liberties movements, the First World War unintentionally provided fresh opportunities for movement building, a process that included recruiting members, refining ideological messaging, devising innovative media strategies, negotiating with the government, and participating in nonviolent street demonstrations. World War I thus represented an important moment in the histories of all three movements. The constructive, rather than destructive, impact of the war on social justice movements proved significant in the short term (for the suffragist movement) and the long term (for the civil rights and civil liberties movements). Ultimately, considering these three movements collectively offers new insights into American war culture and the history of social movements.
To identify learning from a clinical microsystems (CMS) quality improvement initiative to develop a more integrated service across a falls care pathway spanning community and hospital services.
Falls present a major challenge to healthcare providers internationally as populations age. A review of the falls care pathway in Sheffield, United Kingdom, identified that pathway implementation was constrained by inconsistent co-ordination and integration at the hospital–community interface.
The initiative utilised the CMS quality improvement approach and comprised three phases. Phase 1 focussed on developing a climate for change through engaging stakeholders across the existing pathway and coaching frontline teams operating as microsystems in quality improvement. Phase 2 involved initiating change by working at the mesosystem level to identify priorities for improvement and undertake tests of change. Phase 3 engaged decision makers at the macrosystem level from across the wider pathway in achieving change identified in earlier phases of the initiative.
The initiative was successful in delivering change in relation to key aspects of the pathway, engaging frontline staff and decision makers from different services within the pathway, and in building quality improvement capability within the workforce. Viewing the pathway as a series of interrelated CMS enabled stakeholders to understand the complex nature of the pathway and to target key areas for change. Particular challenges encountered arose from organisational reconfiguration and cross-boundary working.
CMS quality improvement methodology may be a useful approach to promoting integration across a care pathway. Using a CMS approach contributed towards clinical and professional integration of some aspects of the service. Recognition of the pathway operating at meso- and macrosystem levels fostered wider stakeholder engagement with the potential of improving integration of care across a range of health and care providers involved in the pathway.
Adequate pain relief at the scene of injury and during transport to hospital is a major challenge in all acute traumas, especially for those with hip fractures, whose injuries are difficult to immobilize and long-term outcomes may be adversely affected by administration of opiate analgesics. Fascia Iliaca Compartment Block (FICB) is a procedure routinely undertaken by clinicians in emergency departments for hip fracture patients, but use by paramedics at the scene of emergency calls, is not yet evaluated (1).
We undertook a randomized controlled feasibility trial using novel audited scratchcard randomization to allocate eligible patients to FICB or usual care. Paramedics are recruited and trained to assess patients for hip fracture and carry out FICB. We will follow up patients to assess accuracy of paramedic diagnosis, acceptability to patients and paramedics, compliance of paramedics and also measures of pain, side effects, time in hospital and quality of life in order to plan a full trial if appropriate. The primary outcome measure is health related quality of life, measured using Short Form (SF)-12 at 1 and 6 months. Interviews and focus groups will be used to understand acceptability of FICB to patients and paramedics. This study was funded by Health and Care Research Wales (1003).
We have developed:
•paramedic pathway to assess patients for hip fracture and FICB
•paramedic training package, delivered by Consultant Anaesthetist
To date we have recruited nineteen paramedics; ten are fully trained and recruiting patients, the remainder are being trained. Fifty-four patients have been randomized and thirty-five have consented to follow-up. Thirteen 1-month and five 6-month follow-up questionnaires have been received.
This study will enable us to recommend whether to undertake a definitive multi-centre randomized controlled trial of FICB by paramedics for hip fracture to determine if the procedure is effective for patients and worthwhile for the National Health Service.
Prehospital point-of-care lactate (pLA) measurement may be a useful tool to assist paramedics with diagnosing a range of conditions, but only if it can be shown to be a reliable surrogate for serum lactate (sLA) measurement. The aim of this study was to determine whether pLA is a reliable predictor of sLA.
This was a retrospective study of adult patients over a 12-month period who had pLA measured by paramedics in an urban Australian setting and were transported by ambulance to a tertiary hospital where sLA was measured. Patients were excluded if they suffered a cardiopulmonary arrest at any time, had missing data, or if sLA was not measured within 24 hours of arrival. Levels of agreement were determined using methods proposed by Bland and Altman.
A total of 290 patients were transported with a pLA recorded. After exclusions, there were 155 patients (55.0% male; age 71 [SD=18] years) remaining who had sLA recorded within 24 hours. Elevated pLA (>2.0mMol/L) was associated with sLA measurement (76.1% vs 23.9%; OR 3.18; 95% CI, 1.88-5.37; P<.0001). Median time between measurements was 89 minutes (IQR=75). Overall, median pLA was higher than sLA (3.0 [IQR=2.0] mMol/L vs 1.7 [IQR=1.3]; P<.001). Bland-Altman analysis on all participants showed a mean difference of 1.48 mMol/L (95% CI, -3.34 to 6.31). Normal pLA was found to be a true negative in 82.9% of cases, and elevated pLA was a true positive in 48.3% of cases. When the time between measurements was less than 60 minutes (n=25), normal pLA predicted normal sLA with 100% accuracy, with a false-positive rate of 18.2%. As time between measurements increased, accuracy diminished and the false-positive rate increased.
Overall, the level of agreement between pLA and sLA was poor. Accuracy of pLA diminished markedly as the time between the two measurements increased. It may be possible to use pLA as a screening tool; when considered this way, pLA performed much better, though larger prospective trials would be needed to confirm this.
SwanKL, KeeneT, AvardBJ. A 12-Month Clinical Audit Comparing Point-of-Care Lactate Measurements Tested by Paramedics with In-Hospital Serum Lactate Measurements. Prehosp Disaster Med. 2018;33(1):36–42.
Recent research has revealed the complex origins of political identification and the possible effects of this identification on social and political behavior. This article reports the results of a structural equation analysis of national survey data that attempts to replicate the finding that an individual’s negativity bias predicts conservative ideology. The analysis employs the Motivational Activation Measure (MAM) as an index of an individual’s positivity offset and negativity bias. In addition, information-seeking behavior is assessed in relation to traditional and interactive media sources of political information. Results show that although MAM does not consistently predict political identification, it can be used to predict extremeness of political views. Specifically, high negativity bias was associated with extreme conservatism, whereas low negativity bias was associated with extreme liberalism. In addition, political identification was found to moderate the relationship between motivational traits and information-seeking behavior.
The history of the Reformation begins, and often ends, with Martin Luther. The history of Luther's biography is a chronicle of the perspectives from which Luther has been approached. Throughout the twentieth century, with few exceptions, his greatness was accepted as being beyond question, with each interpreter offering a new explanation for the Reformer's heroic place in European religious history. Scott Hendrix has been contributing to Luther studies since Luther and the Papacy (1981); his Short Introduction (2010) and an earlier biography (2009) are marked by lucidity and accuracy. His careful work on the little-known Urbanus Rhegius (1489–1541) and other Reformers has brought these significant participants in the expansion of religious reform out of the shadows of historical oblivion. For care with material and clarity of exposition, Hendrix is well positioned to write the American Luther biography of this anniversary year.
Cover crop–based, organic rotational no-till (CCORNT) corn and soybean systems have been developed in the mid-Atlantic region to build soil health, increase management flexibility, and reduce labor. In this system, a roller-crimped cover crop mulch provides within-season weed suppression in no-till corn and soybean. A cropping system experiment was conducted in Pennsylvania, Maryland, and Delaware to test the cumulative effects of a multitactic weed management approach in a 3-yr hairy vetch/triticale–corn–cereal rye–soybean–winter wheat CCORNT rotation. Treatments included delayed planting dates (early, intermediate, late) and supplemental weed control using high-residue (HR) cultivation in no-till corn and soybean phases. In the no-till corn phase, HR cultivation decreased weed biomass relative to the uncultivated control by 58%, 23%, and 62% in Delaware, Maryland, and Pennsylvania, respectively. In the no-till soybean phase, HR cultivation decreased weed biomass relative to the uncultivated treatment planted in narrow rows (19 to 38 cm) by 20%, 41%, and 78% in Delaware, Maryland, and Pennsylvania, respectively. Common ragweed was more dominant in soybean (39% of total biomass) compared with corn (10% of total biomass), whereas giant foxtail and smooth pigweed were more dominant in corn, comprising 46% and 22% of total biomass, respectively. Common ragweed became less abundant as corn and soybean planting dates were delayed, whereas giant foxtail and smooth pigweed increased as a percentage of total biomass as planting dates were delayed. At the Pennsylvania location, inconsistent termination of cover crops with the roller-crimper resulted in volunteer cover crops in other phases of the rotation. Our results indicate that HR cultivation is necessary to achieve adequate weed control in CCORNT systems. Integration of winter grain or perennial forages into CCORNT systems will also be an important management tactic for truncating weed seedbank population increases.
The H3O+ ion is a key species in the oxygen chemistry leading to H2O, OH and O2. Chemical models predict O2 and H2O to be the dominant oxygen-bearing molecules in interstellar clouds. However, neither of them can easily be observed in the bulk of the interstellar medium because of blockage from the Earth's atmosphere. Determination of the abundance and distribution of the precursor H3O+ ion might thus provide an important indirect measure of their abundances.