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The Icelandic crust is characterized by low δ18O values that originate from pervasive high-temperature hydrothermal alteration by 18O-depleted meteoric waters. Igneous rocks in Iceland with δ18O values significantly higher than unaltered oceanic crust (~5.7‰) are therefore rare. Here we report on rhyolitic intra-caldera samples from a cluster of Neogene central volcanoes in Borgarfjörður Eystri, Northeast Iceland, that show whole-rock δ18O values between +2.9 and +17.6‰ (n = 6), placing them among the highest δ18O values thus far recorded for Iceland. Extra-caldera rhyolite samples from the region, in turn, show δ18O whole-rock values between +3.7 and +7.8‰ (n = 6), consistent with the range of previously reported Icelandic rhyolites. Feldspar in the intra-caldera samples (n = 4) show δ18O values between +4.9 and +18.7‰, whereas pyroxene (n = 4) shows overall low δ18O values of +4.0 to +4.2‰, consistent with regional rhyolite values. In combination with the evidence from mineralogy and rock H2O contents, the high whole-rock δ18O values of the intra-caldera rhyolites appear to be the result of pervasive isotopic exchange during subsolidus hydrothermal alteration with 18O-enriched water. This alteration conceivably occurred in a near-surface hot spring environment at the distal end of an intra-caldera hydrothermal system, and was probably fed by waters that had already undergone significant isotope exchange with the country rock. Alternatively, 18O-enriched alteration fluids may have been produced during evaporation and boiling of standing water in former caldera lakes, which then interacted with the intra-caldera rock suites. Irrespective of the exact exchange processes involved, a previously unrecognized and highly localized δ18O-enriched rock composition exists on Iceland and thus probably within the Icelandic crust too.
Tomography produces complex volumetric datasets containing the entire internal structure and density of an object in three dimensions (3D). Interpreting volumetric data requires 3D visualization but needs specialized software distinguishable from more familiar tools used in animation for 3D surface data. This tutorial reviews 3D visualization techniques for volumetric data using the open-source tomviz software package. A suite of tools including two-dimensional (2D) slices, surface contours, and full volume rendering provide quantitative and qualitative analysis of volumetric information. The principles outlined here are applicable to a wide range of 3D tomography techniques and can be applied to volumetric datasets beyond materials characterization.
With manufacturers seeking investment opportunities in Africa, it is timely to explore the interaction of advanced manufacturing technology (AMT) and human resource management approaches there. Because research elsewhere suggests that the effects of the interaction differ across national boundaries, we investigated empowerment approaches and AMT utilisation in Nigeria and New Zealand. Using operational-level survey data from 153 manufacturing managers/CEOs in both countries, we explored the role of national culture on managerial attitudes towards employee empowerment during AMT adoption. Drawing on Hofstede’s cultural dimensions, our results suggest that the observed differences in AMT–empowerment interface are attributable to different national values. The results specifically indicated that during AMT adoption, New Zealand’s liberal culture encourages managers to empower employees more than does Nigeria’s authoritarian one. The results would particularly assist practitioners to recognise the traditional/conservative nature of African values when practicing HR in a country like Nigeria.
We measured the hydrogen and oxygen isotope composition (δ2H and δ18O) of precipitation and stream water from the Soft Plume River at multiple spatiotemporal scales on sub-Antarctic Marion Island, Indian sector of the Southern Ocean. Monthly precipitation δ2H and δ18O values ranged from -43.7‰ to -14.7‰ and from -7.0‰ to -3.3‰ (n=13), respectively. Stream water values ranged from -48.0‰ to -25.4‰ for δ2H and from -7.6‰ to -4.0‰ for δ18O (n=92). The monthly precipitation data yielded a local meteoric water line with the equation δ2H=8.4δ18O+11.4. There was no clear seasonality in isotope composition present in precipitation and stream water. Along the stream, no significant difference was observed between sites. However, δ2H and δ18O values were lower and more variable at the highest site. This is probably the result of the ‘amount effect’, where more precipitation fell at a higher elevation compared with a downstream site in the catchment. The findings illustrate spatiotemporal patterns in precipitation and stream water isotopes and provide insight into mechanisms affecting their composition on sub-Antarctic Marion Island.
An evidence-based emergency department (ED) atrial fibrillation and flutter (AFF) pathway was developed to improve care. The primary objective was to measure rates of new anticoagulation (AC) on ED discharge for AFF patients who were not AC correctly upon presentation.
This is a pre-post evaluation from April to December 2013 measuring the impact of our pathway on rates of new AC and other performance measures in patients with uncomplicated AFF solely managed by emergency physicians. A standardized chart review identified demographics, comorbidities, and ED treatments. The primary outcome was the rate of new AC. Secondary outcomes were ED length of stay (LOS), referrals to AFF clinic, ED revisit rates, and 30-day rates of return visits for congestive heart failure (CHF), stroke, major bleeding, and death.
ED AFF patients totalling 301 (129 pre-pathway [PRE]; 172 post-pathway [POST]) were included; baseline demographics were similar between groups. The rates of AC at ED presentation were 18.6% (PRE) and 19.7% (POST). The rates of new AC on ED discharge were 48.6 % PRE (95% confidence interval [CI] 42.1%-55.1%) and 70.2% POST (62.1%-78.3%) (20.6% [p<0.01; 15.1-26.3]). Median ED LOS decreased from 262 to 218 minutes (44 minutes [p<0.03; 36.2-51.8]). Thirty-day rates of ED revisits for CHF decreased from 13.2% to 2.3% (10.9%; p<0.01; 8.1%-13.7%), and rates of other measures were similar.
The evidence-based pathway led to an improvement in the rate of patients with new AC upon discharge, a reduction in ED LOS, and decreased revisit rates for CHF.
Here, we report reproducible and accurate measurement of crystallographic parameters using scanning transmission electron microscopy. This is made possible by removing drift and residual scan distortion. We demonstrate real-space lattice parameter measurements with <0.1% error for complex-layered chalcogenides Bi2Te3, Bi2Se3, and a Bi2Te2.7Se0.3 nanostructured alloy. Pairing the technique with atomic resolution spectroscopy, we connect local structure with chemistry and bonding. Combining these results with density functional theory, we show that the incorporation of Se into Bi2Te3 causes charge redistribution that anomalously increases the van der Waals gap between building blocks of the layered structure. The results show that atomic resolution imaging with electrons can accurately and robustly quantify crystallography at the nanoscale.
As health threats appear with increasing regularity in our food systems and other food crises loom worldwide, we look to rural areas to provide local and nutritious foods. Educationally, we seek approaches to food studies that engage students and their communities and, ultimately, lead to positive action. Yet food studies receive only generic coverage and tangential attention within existing curricula. This article, reporting a pilot study located at Canada's geographic and cultural edge, focuses on local knowledge about past and present food practices. Objectives are to test pedagogies that bring all students greater opportunities for engagement and learning about their physical environment and food history, and that can be applied to rural and, with modifications, urban settings. Three critical, place-base pedagogical approaches — experiential, discovery and arts-based — to classroom teaching and learning are discussed, as well as implications for educational leadership, teacher training and curriculum development.
In 1967, all London medical schools were separate institutions based on their teaching hospitals, many of which had moved from their original central sites. Successive attempts at merger met resistance, but by 2000 there were just five undergraduate schools, all incorporated in large multi-faculty colleges with the exception of St George's.
IMPERIAL COLLEGE LONDON
In the north-west, Imperial College absorbed St Mary's Hospital in 1989 and in 1997 also took in Charing Cross and Westminster Hospitals (already merged in 1983).
Charing Cross Hospital
Early development of general practice teaching
Charing Cross Hospital medical school started in the mid-nineteenth century at the hospital building near The Strand, London. It was small, taking twenty to thirty new students annually. General practice teaching started in the 1950s when students were invited to stay with a general practitioner (usually an alumnus) for three weeks in their final year. Most practices were outside London (often rural), enabling students to experience the daily life of a general practitioner, including out of hours work and living with his family.
Charing Cross Hospital moved to Fulham in 1974, and the annual school intake increased to 120. The final-year general practice attachment expanded accordingly and the Dean, Professor Glenister, initiated plans for an undergraduate general practice teaching unit. The education committee of the north and west London faculty of the RCGP took great interest in the developments, especially as the GMC was threatening to remove accreditation from schools that did not have departments of general practice.
Late Quaternary terrestrial climate records from the semi-arid zone of the Western Cape of South Africa are rare. However, palaeoenvironmental information may be inferred from ancient termite mounds of the region. Calcrete lenses in these mounds have δ13C and δ18O values that show systematic changes with radiocarbon dates, which range from 33,629–36,709 to 21,676–23,256 cal yr BP. These dates confirm that these heuweltjies had been present in the landscape since the last glacial period. The decrease in δ13C and δ18O from 33,629–36,709 to 21,676–23,256 cal yr BP indicates that climate information is recorded by the calcretes. It is suggested that a progressive decline in air temperature and an increase in moisture availability, and a decline in abundance of C4 or CAM plants, occurred in the region during the time heuweltjie calcite precipitated.
The Jwalapuram Locality 9 rockshelter in southern India dates back to 35 000 years ago and it is emerging as one of the key sites for documenting human activity and behaviour in South Asia. The excavated assemblage includes a proliferation of lithic artefacts, beads, worked bone and fragments of a human cranium. The industry is microlithic in character, establishing Jwalapuram 9 as one of the oldest and most important sites of its kind in South Asia.
Helen Lester, General Practitioner and Professor of Primary Care, School of Community Based Medicine University of Manchester,
Harry Allen, Consultant in Old-Age Psychiatry, Manchester Mental Health and Social Care Trust,
Simon Cocksedge, General Practitioner and Lecturer in General Practice, University of Manchester,
Joy Ratcliffe, Consultant in Old-Age Psychiatry, Manchester Mental Health and Social Care Trust,
Steve Iliffe, General Practitioner and Professor of Primary Care, Royal Free and University College, Medical School, London,
Cornelius Katona Dean, Consultant and Senior Lecturer in Psychiatry, Kent Institute of Medicine and Health Sciences, University of Kent,
Dr Chris Fox, Consultant and Senior Lecturer in Psychiatry Kent, Institute of Medicine and Health Sciences, University of Kent
In the next three case commentaries we asked our contributors to comment on more complicated cases where input from both primary and secondary health care and social care would be necessary.
Depression with psychotic features
Mrs Paulette B is an African-Caribbean lady who came over to the UK 50 years ago with her husband. She raised six children who have all done very well and all except one live in different parts of the UK. When her husband died, Mrs PB threw herself into her work with the local church, helping run a group for young women and teaching in the Sunday School. For the last three months she has been off her food, unable to concentrate, less interested in things and reluctant to go to church, fearing that she will bring some calamity onto the congregation.
In the last two weeks, she has been aware of a man's voice warning her to stay at home and to avoid answering the telephone as her thoughts will be recorded. Initially she thought this might be her husband's voice but has now become convinced that it is the voice of the vicar and so when he called on her last week, she spoke to him through the door. She told him she knew that she had committed ‘the unforgivable sin’.