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AU in days of therapy per 1,000 patient days and microbiologic data from 2015 and 2016 were collected from 26 hospitals. The prevalences of Pseudomonas aeruginosa, extended-spectrum β-lactamase (ESBL)–producing bacteria, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE) were calculated and compared to the average prevalence of all hospitals in the network. This proportion was used to calculate the adjusted AU (a-AU) for various categories of antimicrobials. For example, a-AU of antipseudomonal β-lactams (APBL) was the AU of APBL divided by (prevalence of P. aeruginosa at that hospital divided by the average prevalence of P. aeruginosa). Hospitals were categorized by bed size and ranked by AU and a-AU, and the rankings were compared.
Most hospitals in 2015 and 2016, respectively, moved ≥2 positions in the ranking using a-AU of APBL (15 of 24, 63%; 22 of 26, 85%), carbapenems (14 of 23, 61%; 22 of 25; 88%), anti-MRSA agents (13 of 23, 57%; 18 of 26, 69%), and anti-VRE agents (18 of 24, 75%; 15 of 26, 58%). Use of a-AU resulted in a shift in quartile of hospital ranking for 50% of APBL agents, 57% of carbapenems, 35% of anti-MRSA agents, and 75% of anti-VRE agents in 2015 and 50% of APBL agents, 28% of carbapenems, 50% of anti-MRSA agents, and 58% of anti-VRE agents in 2016.
The a-AU considerably changes how hospitals compare among each other within a network. Adjusting AU by microbiological burden allows for a more balanced comparison among hospitals with variable baseline rates of resistant bacteria.
Substantial clinical heterogeneity of major depressive disorder (MDD) suggests it may group together individuals with diverse aetiologies. Identifying distinct subtypes should lead to more effective diagnosis and treatment, while providing more useful targets for further research. Genetic and clinical overlap between MDD and schizophrenia (SCZ) suggests an MDD subtype may share underlying mechanisms with SCZ.
The present study investigated whether a neurobiologically distinct subtype of MDD could be identified by SCZ polygenic risk score (PRS). We explored interactive effects between SCZ PRS and MDD case/control status on a range of cortical, subcortical and white matter metrics among 2370 male and 2574 female UK Biobank participants.
There was a significant SCZ PRS by MDD interaction for rostral anterior cingulate cortex (RACC) thickness (β = 0.191, q = 0.043). This was driven by a positive association between SCZ PRS and RACC thickness among MDD cases (β = 0.098, p = 0.026), compared to a negative association among controls (β = −0.087, p = 0.002). MDD cases with low SCZ PRS showed thinner RACC, although the opposite difference for high-SCZ-PRS cases was not significant. There were nominal interactions for other brain metrics, but none remained significant after correcting for multiple comparisons.
Our significant results indicate that MDD case-control differences in RACC thickness vary as a function of SCZ PRS. Although this was not the case for most other brain measures assessed, our specific findings still provide some further evidence that MDD in the presence of high genetic risk for SCZ is subtly neurobiologically distinct from MDD in general.
The paper discusses the Garboldisham macehead: an unusual decorated macehead carved from red deer antler. The macehead was found in the 1960s deposited in a tributary of the river Little Ouse, Norfolk and is decorated with three spirals, making it especially significant. This paper reports on the analysis of the decoration using digital imaging, discusses a new radiocarbon date recently obtained for the artefact, and discusses its significance alongside other dated antler maceheads.
Objectives: Individuals with schizophrenia have difficulties on measures of executive functioning such as initiation and suppression of responses and strategy development and implementation. The current study thoroughly examines performance on the Hayling Sentence Completion Test (HSCT) in individuals with schizophrenia, introducing novel analyses based on initiation errors and strategy use, and association with lifetime clinical symptoms. Methods: The HSCT was administered to individuals with schizophrenia (N=77) and age- and sex-matched healthy controls (N=45), along with background cognitive tests. The standard HSCT clinical measures (initiation response time, suppression response time, suppression errors), composite initiation and suppression error scores, and strategy-based responses were calculated. Lifetime clinical symptoms [formal thought disorder (FTD), positive, negative] were calculated using the Lifetime Dimensions of Psychosis Scale. Results: After controlling for baseline cognitive differences, individuals with schizophrenia were significantly impaired on the suppression response time and suppression error scales. For the novel analyses, individuals with schizophrenia produced a greater number of initiation errors and subtly wrong errors, and produced fewer responses indicative of developing an appropriate strategy. Strategy use was negatively correlated with FTD symptoms in individuals with schizophrenia. Conclusions: The current study provides further evidence for deficits in the initiation and suppression of verbal responses in individuals with schizophrenia. Moreover, an inability to attain a strategy at least partly contributes to increased semantically connected errors when attempting to suppress responses. The association between strategy use and FTD points to the involvement of executive deficits in disorganized speech in schizophrenia. (JINS, 2016, 22, 735–743)
The appearance of the distinctive ‘Beaker package’ marks an important horizon in British prehistory, but was it associated with immigrants to Britain or with indigenous converts? Analysis of the skeletal remains of 264 individuals from the British Chalcolithic–Early Bronze Age is revealing new information about the diet, migration and mobility of those buried with Beaker pottery and related material. Results indicate a considerable degree of mobility between childhood and death, but mostly within Britain rather than from Europe. Both migration and emulation appear to have had an important role in the adoption and spread of the Beaker package.
There is something curious and intriguing about the place of the period 1780–1830 in Rancière's work. He has written a great deal about it, if often in a rather piecemeal fashion, and its most prominent intellectual figures repeatedly loom large in his historical panoramas, though sometimes fleetingly: Kant and Hegel, Goethe and Schiller, Schelling and the Schlegels, Hugo and Chateaubriand, Wordsworth, Byron and Keats. He repeatedly refers back to the period as apparently in some sense decisive for modern politics and, above all, modern aesthetics. Phrases like ‘depuis deux siècles’ and ‘depuis le XVIIIe siècle’ recur in his work. Yet, since Rancière aims to break with what he calls ‘the standard intelligibility of history’, he turns out to be distrustful, sometimes deeply distrustful, of concepts frequently associated with the period: the birth of modernity, the beginning of the democratic revolution, the inception of the modern will to liberation, the inauguration of the modern progressivisms, the emergence of the modern narratives of progress. Rancière urges the need to resist a conception of any politics as being ‘tied to a determined historical project’, like that supposedly engendered by the emancipatory drive of the French Revolution (PA, 51). He is adamant in his refusal to confer the status of a transcendental on any specific concept, like justice or equality, that would appear to underwrite such a project. He is likewise sceptical of explanatory historical systems that too crudely map historical and cultural phenomena on to allegedly coherent historical contexts thought of as totalities, and opposes all ideas of ‘grand historical master-signifiers’ which might appear to govern epochs, like modernity, as mere carryovers from onto-theology (TP, 207–8). He has been explicitly dismissive of Alain Badiou's grand theory of the event and what he takes to be its insistence on the ‘rupture exemplaire’ (TP, 207), the absolute break with the historically given.
When a Master doth a thing a second time, lightly it is for the better.
George Gage to Sir Dudley Carleton, 1 November 1617
This chapter will probe early modern notions of creativity by considering the artistic activities, in and for England, of the most sought-after painter in seventeenth-century Europe – Peter Paul Rubens. The artist's busy workshop helped to satisfy the demand for his works, and as a result Rubens's English patrons, ranging from various dignitaries to Charles I himself, were the recipients of paintings with varying degrees of the master's own participation. An inquiry into Rubens's practice of delegating to studio assistants, and into the value placed by him and his British viewers on autography, will elucidate attitudes towards the manual aspects of creation. A related area of investigation will focus on the phenomenon of self-repetition in the artist's works for his English clients, some of which works were replicas of earlier compositions or reused motifs from previous inventions. Finally, a broader exploration of responses to self-replication, extending at times beyond the shores of England or the confines of painting, will bring to the fore the tensions inherent in early modern attitudes to art.
Replicas and Studio Hands
Although Rubens's stay in England as a diplomatic envoy dates to 1629–30, his relationship with English patrons had begun some thirteen years earlier when Sir Dudley Carleton, the English Ambassador to The Hague, had sought to trade a diamond chain for a hunt scene by the artist.
This book has its origins in an interdisciplinary conference of the same name, held at the University of Manchester in September 2008 as part of a four-year research project entitled ‘Musical Creativity in Restoration England’, which was funded by the Arts and Humanities Research Council in the UK. The conference brought together a group of seventeenth-century specialists including those working in cultural studies, print culture, the history of ideas, and of course historians of art, architecture, theatre, literature and music, to explore how we can seek to understand what it meant to be creative in the early modern period in England. Te symposium revealed the wide variety of approaches to studying creativity being taken by scholars and research students across the humanities, and led to exciting and fruitful cross-fertilization of ideas between its participants, resulting in discussions that in some cases have led to long-lasting research collaborations.
Tis book presents a selection of twelve essays that were developed from the twenty papers given at the conference. In selecting this group, the editors have sought to include a representative sample of the research that was presented, while also aiming to ensure that the collection is accessible to a genuinely interdisciplinary readership. While music examples are used in some of the chapters, these are kept to a minimum, and are supported by audio samples available at www.alc.manchester. ac.uk/subjects/music/research/projects/musicalcreativity.
This essay grows from a concern with the old art-historical problem of how the perception of art, or in this case more specifically architecture, changes over time. It sets out to explore how verbal representations preserve clues about such changes in the way we see the world, while proposing that the dialogue between subject and object is perhaps more palpable in texts than it is in pictures. The protagonist is seventeenth-century diarist John Evelyn, who travelled in Italy between 1644 and 1646. The account of this journey forms part of his seminal Diary, which he compiled mainly retrospectively from the 1660s onwards. One of the main seventeenth-century English sources for historians of all fields and by some even regarded as having changed travel writing, Evelyn is nevertheless well known for having copied generous parts of his text from earlier guidebooks.2 In the following I will try to dismantle sentence by sentence one short passage in which he describes the city of Genoa. Comparing his text to other seventeenth-century guidebooks allows us to see not only what Evelyn copied, but also what he altered, what he added, and, more importantly, what these alterations and additions tell us about contemporary modes of perception and representation. The ensuing analysis raises questions about concepts of creativity and originality in the period while probing the ordering of vision and knowledge in the seventeenth century.
Creation: a making or forming of something, as it were, out of nothing Edward Phillips, The New World of Words
Edward Phillips's attempt to define creation in 1671 highlights a number of issues that are central to developments in thinking about creativity, knowledge and artistic innovation during the seventeenth century. His idea of creating ‘something’ from ‘nothing’ implies, at one level, absolute novelty: a lack of precedence, a complete rupture with and effacement of a past state or experience; something appears where once there was emptiness or blankness. Simultaneously, however, the emphasis on ‘making’ and especially ‘forming’ suggests that there are materials to be moulded: existing matter to be reshaped into something new; Phillips suggests that creation has to be made from something, even as this ‘some-thing’ is described as ‘no-thing’. This ambivalence – the ‘as it were’ in the definition – hints at the multiple concepts and interpretations of creativity that existed in the seventeenth century.
In the early modern period – particularly in the realm of epistemology – creation was understood both in terms of reshaping, translating and reconfiguring that which exists and as the production of fresh entities ‘out of nothing’. Seventeenth-century theories of creativity seem to emanate from precisely this tension between novelty and precedent, between the purity of the new and the foundation of the old.