To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Queues are part of everyday routine and experienced by most shoppers, yet little attention has been given to providing historical accounts of queuing as a consumer task or as a shopper experience. This paper examines grocery shop queues and the changing experience of shoppers in historical perspective, specifically focusing upon the shift from counter-service to self-service grocery formats in Britain from 1945 to 1975. The paper draws upon a wide range of material using evidence from oral histories and witness groups, which is supported by contemporary sources from the Mass Observation Archive, newspapers, shopper surveys, and trade publications and reports. The conceptual framework developed in the paper explores the public and private dimensions of queues to consider the experiences and perceptions of shoppers during a period of rapid change in the retail grocery system. More generally, the paper contributes to our understanding of how management innovations are connected to untraded public values.
Background: Cervical spondylotic myelopathy (CSM) is the leading cause of spinal cord impairment. In a public healthcare system, wait times to see spine specialists and eventually access surgical treatment for CSM can be substantial. The goals of this study were to determine consultation wait times (CWT) and surgical wait times (SWT), and identify predictors of wait time length. Methods: Consecutive patients enrolled in the Canadian Spine Outcomes and Research Network (CSORN) prospective and observational CSM study from March 2015 to July 2017 were included. A data-splitting technique was used to develop and internally validate multivariable models of potential predictors. Results: A CSORN query returned 264 CSM patients for CWT. The median was 46 days. There were 31% mild, 35% moderate, and 33% severe CSM. There was a statistically significant difference in median CWT between moderate and severe groups; 207 patients underwent surgical treatment. Median SWT was 42 days. There was a statistically significant difference in SWT between mild/moderate and severe groups. Short symptom duration, less pain, lower BMI, and lower physical component score of SF-12 were predictive of shorter CWT. Only baseline pain and medication duration were predictive of SWT. Both CWT and SWT were shorter compared to a concurrent cohort of lumbar stenosis patients (p <0.001). Conclusions: Patients with shorter duration (either symptoms or medication) and less neck pain waited less to see a spine specialist in Canada and to undergo surgical treatment. This study highlights some of the obstacles to overcome in expedited care for this patient population.
The role played by the Arabian Peninsula in hominin dispersals out of Africa has long been debated. The DISPERSE Project has focused on south-western Arabia as a possible centre of hominin settlement and a primary stepping-stone for such dispersals. This work has led to the recent discovery, at Wadi Dabsa, of an exceptional assemblage of over 1000 lithic artefacts, including the first known giant handaxe from the Arabian Peninsula. The site and its associated artefacts provide important new evidence for hominin dispersals out of Africa, and give further insight into the giant handaxe phenomenon present within the Acheulean stone tool industry.
In monetary policy, decision makers seek to influence the expectations of agents in ways that can avoid making abrupt, dramatic, and unexpected decisions. Yet in October 1979, Chairman Paul Volcker led the Federal Reserve's Federal Open Market Committee (FOMC) unanimously to shift its course in managing U.S. monetary policy, which in turn eventually brought the era of high inflation to an end. Although some analysts argue that “the presence and influence of one individual”—namely, Volcker—is sufficient to explain the policy shift, this overlooks an important feature of monetary policymaking. FOMC chairmen—however, omnipotent they may appear—do not act alone. They require the agreement of other committee members, and in the 1979 revolution, the decision was unanimous. How, then, did Chairman Volcker manage to bring a previously divided committee to a consensus in October 1979, and moreover, how did he retain the support of the committee throughout the following year in the face of mounting political and economic pressure against the Fed? We use automated content analysis to examine the discourse of the FOMC (with this discourse recorded in the verbatim transcripts of meetings). In applying this methodology, we assess the force of the arguments used by Chairman Volcker and find that deliberation in the FOMC did indeed “matter” both in 1979 and 1980. Specifically, Volcker led his colleagues in coming to understand and apply the idea of credible commitment in U.S. monetary policymaking.
Substance dualism is on the move. Though the view remains unfashionable, a growing and diverse group of philosophers endorse it on impressive empirical, religious, and purely metaphysical grounds. In this note, I develop and evaluate one conceptual argument for substance dualism. According to that argument, we may derive a conclusion about our nature from the mere fact that we have the concept of a spirit. The argument is intriguing and fruitful; but I shall contend that it is, nonetheless, unsound.
Arguments for substance dualism—the theory that we are at least partly nonmaterial beings—abound. Many such arguments begin with our capacity to engage in conscious thought and end with dualism. Such are familiar. But there is another route to dualism. It begins with our moral value and ends with dualism. In this article, we develop and assess the prospects for this new style of argument. We show that, though one version of the argument does not succeed, there may yet be a deep problem for standard physical accounts of our nature.
To aid in preparation of military medic trainers for a possible new curriculum in teaching junctional tourniquet use, the investigators studied the time to control hemorrhage and blood volume lost in order to provide evidence for ease of use.
Models of junctional tourniquet could perform differentially by blood loss, time to hemostasis, and user preference.
In a laboratory experiment, 30 users controlled simulated hemorrhage from a manikin (Combat Ready Clamp [CRoC] Trainer) with three iterations each of three junctional tourniquets. There were 270 tests which included hemorrhage control (yes/no), time to hemostasis, and blood volume lost. Users also subjectively ranked tourniquet performance. Models included CRoC, Junctional Emergency Treatment Tool (JETT), and SAM Junctional Tourniquet (SJT). Time to hemostasis and total blood loss were log-transformed and analyzed using a mixed model analysis of variance (ANOVA) with the users represented as random effects and the tourniquet model used as the treatment effect. Preference scores were analyzed with ANOVA, and Tukey’s honest significant difference test was used for all post-hoc pairwise comparisons.
All tourniquet uses were 100% effective for hemorrhage control. For blood loss, CRoC and SJT performed best with least blood loss and were significantly better than JETT; in pairwise comparison, CRoC-JETT (P < .0001) and SJT-JETT (P = .0085) were statistically significant in their mean difference, while CRoC-SJT (P = .35) was not. For time to hemostasis in pairwise comparison, the CRoC had a significantly shorter time compared to JETT and SJT (P < .0001, both comparisons); SJT-JETT was also significant (P = .0087). In responding to the directive, “Rank the performance of the models from best to worst,” users did not prefer junctional tourniquet models differently (P > .5, all models).
The CRoC and SJT performed best in having least blood loss, CRoC performed best in having least time to hemostasis, and users did not differ in preference of model. Models of junctional tourniquet performed differentially by blood loss and time to hemostasis.
KraghJFJr, LunatiMP, KharodCU, CunninghamCW, BaileyJA, StockingerZT, CapAP, ChenJ, AdenJK3d, CancioLC. Assessment of Groin Application of Junctional Tourniquets in a Manikin Model. Prehosp Disaster Med. 2016;31(4):358–363.
Some philosophers say that you do not think in the primary or nonderivative sense. Rather, they say some item distinct from you (perhaps one of your parts or something of which you are a part) does your thinking for you; you inherit your mental life from that item. In this paper, I argue that this is a mistake. We do not inherit our thoughts in this way.
Plastic surgery may be the last remaining true general surgical specialty. All areas of the body remain within the remit of the plastic surgeon, from hand and limb surgery, body surface surgery, breast and head and neck oncology and reconstruction, to body cavity surgery, harvesting jejunum or intra-abdominal omentum as part of a reconstructive procedure, or using body wall tissue to obliterate intrathoracic cavities. This makes the life of the plastic surgery anaesthetist varied and testing.
Plastic surgery anaesthesia similarly encompasses the full range of anaesthetic challenges, including the extremes of age, significant patient co-morbidities and the obstructed, difficult and shared airway. In addition the anaesthetist may be required to manipulate the cardiovascular parameters to minimise bleeding or ensure adequate blood flow to a flap reconstruction. Both general and regional anaesthesia skills are essential, along with a finesse to ensure smooth emergence from anaesthesia and minimal post-operative pain, nausea and vomiting.
In addition to procedure-specific anaesthetic concerns, plastic surgical procedures present some general challenges.
Many plastic surgical procedures are performed in conjunction with other surgical teams. Breast, maxillofacial, ear nose and throat or other surgical teams may resect a tumour, for which the plastic surgeon is required to provide a reconstructive solution, while the orthopaedic surgeon may require plastic surgical involvement while reconstructing a severely damaged limb. This requires meticulous pre-operative planning, which must include the anaesthetist. It is essential that the anaesthetist is aware of what procedures are to be performed, what position the patient is required to be in, whether any position changes are required intra-operatively and what sides and sites can or cannot be used for vascular access and invasive monitoring. Particularly with regards to resection of head and neck tumours, a plan of airway management both intra- and post-operatively is required including whether a tracheostomy is planned. Such planning needs to be made well in advance and should be re-confirmed at the surgical (WHO) team brief in theatre.
In February 2013, the LEECH (LBTI Exozodi Exoplanet Common Hunt) survey began its 100-night campaign from the Large Binocular Telescope atop Mount Graham in Arizona. LEECH neatly complements other high-contrast planet imaging efforts by observing stars in L' band (3.8 microns) as opposed to the shorter wavelength near-infrared bands (1–2.3 microns). This part of the spectrum offers deeper mass sensitivity for intermediate age (several hundred Myr-old) systems, since their Jovian-mass planets radiate predominantly in the mid-infrared. In this proceedings, we present the science goals for LEECH and a preliminary contrast curve from some early data.
Increasing spatial resolution and contrast capabilities will make possible new direct detections of exoplanets, exozodis, and circumstellar disks. The Large Binocular Telescope Interferometer (LBTI) has been engineered to sit at the combined focus of the Large Binocular Telescope's two 8.4m apertures. Both apertures are equipped with 672-actuator deformable secondary mirrors, the first of the next generation of “extreme” adaptive optics (AO) systems. We present an overview of the LBTI AO instrument suite and detail current on-sky performance.
A survey of the Milky Way disk and the Magellanic System at the wavelengths of the 21-cm atomic hydrogen (H i) line and three 18-cm lines of the OH molecule will be carried out with the Australian Square Kilometre Array Pathfinder telescope. The survey will study the distribution of H i emission and absorption with unprecedented angular and velocity resolution, as well as molecular line thermal emission, absorption, and maser lines. The area to be covered includes the Galactic plane (|b| < 10°) at all declinations south of δ = +40°, spanning longitudes 167° through 360°to 79° at b = 0°, plus the entire area of the Magellanic Stream and Clouds, a total of 13 020 deg2. The brightness temperature sensitivity will be very good, typically σT≃ 1 K at resolution 30 arcsec and 1 km s−1. The survey has a wide spectrum of scientific goals, from studies of galaxy evolution to star formation, with particular contributions to understanding stellar wind kinematics, the thermal phases of the interstellar medium, the interaction between gas in the disk and halo, and the dynamical and thermal states of gas at various positions along the Magellanic Stream.
The purpose of this study was to explore the differences in initial status and growth trajectories of college students who did and did not participate in a voluntourism experience. A key objective of the study was to explore the backgrounds of the participants, comparing them to similar nonvoluntourists, to better understand what compelled them to spend their spring break engaged in community service in a distant location. The participants were 617 students at a university in the Midwestern United States, half of whom participated in a voluntour. Voluntourists reported higher levels of yearly civic engagement, civic attitude, openness, compassion, cognitive drive and reflectivity. The developmental disparities evident before the tour continued to grow over the course of five weeks. Implications for marketing, program design and education are discussed within the context of the burgeoning voluntourism industry.
Walnuts contain a number of potentially neuroprotective compounds like vitamin E, folate, melatonin, several antioxidative polyphenols and significant amounts of n-3 α-linolenic fatty acid. The present study sought to determine the effect of walnuts on verbal and non-verbal reasoning, memory and mood. A total of sixty-four college students were randomly assigned to two treatment sequences in a crossover fashion: walnuts–placebo or placebo–walnuts. Baseline data were collected for non-verbal reasoning, verbal reasoning, memory and mood states. Data were collected again after 8 weeks of intervention. After 6 weeks of washout, the intervention groups followed the diets in reverse order. Data were collected once more at the end of the 8-week intervention period. No significant increases were detected for mood, non-verbal reasoning or memory on the walnut-supplemented diet. However, inferential verbal reasoning increased significantly by 11·2 %, indicating a medium effect size (P = 0·009; d = 0·567). In young, healthy, normal adults, walnuts do not appear to improve memory, mood or non-verbal reasoning abilities. However, walnuts may have the ability to increase inferential reasoning.