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The UK Soft Drinks Industry Levy (SDIL) (announced in March 2016; implemented in April 2018) aims to incentivise reformulation of soft drinks to reduce added sugar levels. The SDIL has been applauded as a policy success, and it has survived calls from parliamentarians for it to be repealed. We aimed to explore parliamentary reaction to the SDIL following its announcement until two years post-implementation in order to understand how health policy can become established and resilient to opposition.
Design:
Searches of Hansard for parliamentary debate transcripts that discussed the SDIL retrieved 186 transcripts, with 160 included after screening. Five stages of Applied Thematic Analysis were conducted: familiarisation and creation of initial codebooks; independent second coding; codebook finalisation through team consensus; final coding of the dataset to the complete codebook; and theme finalisation through team consensus.
Setting:
The United Kingdom Parliament
Participants:
N/A
Results:
Between the announcement (16/03/2016) – royal assent (26/04/2017), two themes were identified 1: SDIL welcomed cross-party 2: SDIL a good start but not enough. Between royal assent – implementation (5/04/2018), one theme was identified 3: The SDIL worked – what next? The final theme identified from implementation until 16/03/2020 was 4: Moving on from the SDIL.
Conclusions:
After the announcement, the SDIL had cross-party support and was recognised to have encouraged reformulation prior to implementation. Lessons for governments indicate that the combination of cross-party support and a policy’s documented success in achieving its aim can help cement the resilience of it to opposition and threats of repeal.
Patients with unbalanced common atrioventricular canal can be difficult to manage. Surgical planning often depends on pre-operative echocardiographic measurements. We aimed to determine the added utility of cardiac MRI in predicting successful biventricular repair in common atrioventricular canal.
Methods:
We conducted a retrospective cohort study of children with common atrioventricular canal who underwent MRI prior to repair. Associations between MRI and echocardiographic measures and surgical outcome were tested using logistic regression, and models were compared using area under the receiver operator characteristic curve.
Results:
We included 28 patients (median age at MRI: 5.2 months). The optimal MRI model included the novel end-diastolic volume index (using the ratio of left ventricular end-diastolic volume to total end-diastolic volume) and the left ventricle–right ventricle angle in diastole (area under the curve 0.83, p = 0.041). End-diastolic volume index ≤ 0.18 and left ventricle–right ventricle angle in diastole ≤ 72° yield a sensitivity of 83% and specificity of 81% for successful biventricular repair. The optimal multimodality model included the end-diastolic volume index and the echocardiographic atrioventricular valve index with an area under the curve of 0.87 (p = 0.026).
Conclusions:
Cardiac MRI can successfully predict successful biventricular repair in patients with unbalanced common atrioventricular canal utilising the end-diastolic volume index alone or in combination with the MRI left ventricle–right ventricle angle in diastole or the echocardiographic atrioventricular valve index. A prospective cardiac MRI study is warranted to better define the multimodality characteristic predictive of successful biventricular surgery.
While in the United Kingdom, the government was initially slow to recognize the profound dangers of the COVID-19 pandemic, soon after Prime Minister Boris Johnson's initial plea to the public to ‘stay at home’, in March 2021, emergency legislation was rushed through parliament. On 25 March, the 350-page Coronavirus Act 2020 received royal assent, bringing the biggest restrictions on civil liberties in a generation into law the following day. Overnight, the Coronavirus Act, along with the broader raft of legal restrictions under The Health Protection (Coronavirus) Regulations 2020, made it unlawful to undertake a wide range of hitherto economically essential, prosocial and noncriminal activities. Even as the Act was rushed through parliament, civil liberties organizations were alerting parliamentarians to its dangers (Gidda, 2020).
As antiracist commentators and academics forewarned (Frazer-Carroll, 2020; Khan, 2020), racial disproportionality in policing has endured and often increased through the pandemic. As the first ‘lockdown’ came into effect, stop and search practices ‘surged’ despite the steep drop in crime rates (Grierson, 2020). Limited and prone to undercounting as they may be, Home Office data show that in the year ending March 2021, stop and search practices (under Section 1 of the Police and Criminal Evidence Act 1984) increased significantly to reach their highest level in seven years, impacting most on racially minoritized men (Home Office, 2022). Home Office data (2021) also show an increase in use of force for the year ending March 2021. This was racially disproportionate too, with Black people accounting for 16 per cent of those affected (though they make up just 3 per cent of the population according to the 2011 Census), and Asian people accounting for 8 per cent (7 per cent of the population according to the 2011 Census). In the summer of 2020, these patterns coalesced with mass global protests against racist police violence. The police murder of George Floyd in the United States catalyzed millions to march under the banner of Black Lives Matter (BLM) and spoke to the ongoing police brutality faced by racially minoritized people in Britain (Joseph-Salisbury et al, 2020).
Women and Music in Ireland is the inaugural volume of the new series of Irish Musical Studies, published by Boydell & Brewer. The original series, published initially by Irish Academic Press (from 1990 until 1995) and subsequently by Four Courts Press (from 1996 until 2019) comprised twelve volumes, making this new volume the thirteenth in all to appear. Each volume of the original series was designed to explore specific themes within the general domain of Irish musical scholarship, including the development of musicology as an Irish discipline, music and Irish cultural history, documents and sources of Irish musical history, the growth of theory and analysis in Ireland, as well as period-based collections devoted to Irish art music in the seventeenth, nineteenth and twentieth centuries. Two volumes of conference proceedings also appeared, one to mark the first international musicological conference in the history of the state in 1995 and the other to publish selected papers in Bach scholarship originally presented at the Ninth Biennial Conference on Baroque Music held at Trinity College Dublin in 2000. The series also featured an anthology of Irish church music, preceded by a companion volume of essays on the same subject.
The distinguishing feature of these volumes was that all of them, with the exception of the Bach volume, addressed topics that had hitherto received little or no previous scholarly attention, and certainly not to the extent of a collected volume of essays exclusively concerned with the topic in question. In this specific regard, Women and Music in Ireland is likewise a pioneering collection, and it thereby reflects the pervasive ambition of the series as a whole to open out and indeed to deepen our scholarly comprehension of Irish musical life. As the chapters in this new volume individually and collectively attest, the general discourse of women and music here attains not only to an Irish inflection of purpose and scholarly enquiry, but a decisive retrieval of the role of women in shaping the complexion of Irish musical life from the eighteenth century to the present day.
In this enterprise, many of the essays published here skilfully interrogate or deconstruct historical, social and cultural assumptions that have either eclipsed or distorted – often through the agency of gender politics – the originality and significance of women to the profession and practice of music in Ireland.
The inaugural data from the first systematic program of sea-ice observations in Kotzebue Sound, Alaska, in 2018 coincided with the first winter in living memory when the Sound was not choked with ice. The following winter of 2018–19 was even warmer and characterized by even less ice. Here we discuss the mass balance of landfast ice near Kotzebue (Qikiqtaġruk) during these two anomalously warm winters. We use in situ observations and a 1-D thermodynamic model to address three research questions developed in partnership with an Indigenous Advisory Council. In doing so, we improve our understanding of connections between landfast ice mass balance, marine mammals and subsistence hunting. Specifically, we show: (i) ice growth stopped unusually early due to strong vertical ocean heat flux, which also likely contributed to early start to bearded seal hunting; (ii) unusually thin ice contributed to widespread surface flooding. The associated snow ice formation partly offset the reduced ice growth, but the flooding likely had a negative impact on ringed seal habitat; (iii) sea ice near Kotzebue during the winters of 2017–18 and 2018–19 was likely the thinnest since at least 1945, driven by a combination of warm air temperatures and a persistent ocean heat flux.
The first demonstration of laser action in ruby was made in 1960 by T. H. Maiman of Hughes Research Laboratories, USA. Many laboratories worldwide began the search for lasers using different materials, operating at different wavelengths. In the UK, academia, industry and the central laboratories took up the challenge from the earliest days to develop these systems for a broad range of applications. This historical review looks at the contribution the UK has made to the advancement of the technology, the development of systems and components and their exploitation over the last 60 years.
Many institutions are attempting to implement patient-reported outcome (PRO) measures. Because PROs often change clinical workflows significantly for patients and providers, implementation choices can have major impact. While various implementation guides exist, a stepwise list of decision points covering the full implementation process and drawing explicitly on a sociotechnical conceptual framework does not exist.
Methods:
To facilitate real-world implementation of PROs in electronic health records (EHRs) for use in clinical practice, members of the EHR Access to Seamless Integration of Patient-Reported Outcomes Measurement Information System (PROMIS) Consortium developed structured PRO implementation planning tools. Each institution pilot tested the tools. Joint meetings led to the identification of critical sociotechnical success factors.
Results:
Three tools were developed and tested: (1) a PRO Planning Guide summarizes the empirical knowledge and guidance about PRO implementation in routine clinical care; (2) a Decision Log allows decision tracking; and (3) an Implementation Plan Template simplifies creation of a sharable implementation plan. Seven lessons learned during implementation underscore the iterative nature of planning and the importance of the clinician champion, as well as the need to understand aims, manage implementation barriers, minimize disruption, provide ample discussion time, and continuously engage key stakeholders.
Conclusions:
Highly structured planning tools, informed by a sociotechnical perspective, enabled the construction of clear, clinic-specific plans. By developing and testing three reusable tools (freely available for immediate use), our project addressed the need for consolidated guidance and created new materials for PRO implementation planning. We identified seven important lessons that, while common to technology implementation, are especially critical in PRO implementation.
As a musical agent of domestic social discourse, the piano has few rivals in the nineteenth century. George Bernard Shaw’s remark in 1894 that ‘the pianoforte is the most important of all musical instruments; its invention was to music what the invention of printing was to poetry’ echoes a more general remembrance which is constantly affirmed in bourgeois culture throughout the 1800s and for long afterwards. Nevertheless, the mediating influence of the piano as a conduit of social meaning in cinema and literature has received considerably less attention than it warrants. Moreover, the representation of salon culture in nineteenth-century fiction, as well as in twentieth-century cinema, deepens the contextual and communicative significance of the piano intimated by Shaw’s observation.
In this chapter, I would like to show how the piano scenes in Mike Leigh’s film Topsy-Turvy (1999) inflect our understanding of salon culture as a mode of representation in which the medium of film affords new meaning to the musical transactions it portrays. The film is a brilliant dramatisation of the lives of W. S. Gilbert and Arthur Sullivan in the period leading up to and during the first production of their masterpiece, The Mikado (1885). But Topsy-Turvy is also a richly textured and intricate portrayal of Victorian society in which the piano variously and compellingly features as a nexus of social, sexual and emotional exchange. Several scenes in the film represent the piano at the heart of a salon culture in which music functions as an essential (rather than merely decorative or aesthetic) mode of social communication. These scenes represent the piano in a host of different settings (a private drawing-room, a brothel, a formal musical soirée and a bedroom); collectively, they explore the connection between music and social discourse in the late nineteenth century.
My reading of these scenes is informed by two preliminary considerations which, taken together, indicate a more general context in which this reading might be situated. Even if we allow for recent research on the piano in nineteenth-century musical culture (some of which stems from Cyril Ehrlich’s classic study which originally appeared in 1976), literary and cinematic representations of the piano remain to be investigated more thoroughly than has been the case to date.
Wagner was the literary musician par excellence … he produced his own dramatic poems, thus giving dramatic integrity to opera, and making symphony articulate. A Beethoven symphony (except for the articulate part of the ninth) expresses noble feeling, but not thought: it has moods, but no ideas. Wagner added thought and produced the music-drama.
As a music critic, Bernard Shaw (1856–1950) was nothing if not honest in his appraisals. He was also scathing, cantankerous and wilfully given to a hectoring and didactic strain of pronouncement which made him the bete noir of Victorian musical culture and – in some respects – its most implacable adversary. Between 1876 and 1898 (when he published The Perfect Wagnerite) he produced numerous columns for the London press (especially The Star, where he wrote from February 1885 under the pseudonym Corno di Bassetto, and The World, where he wrote from May 1890 as ‘GBS’), columns which now amount to an invaluable (if idiosyncratic) record of English musical life at the close of the nineteenth century. Thereafter, as his career as a dramatist took hold and made him famous, Shaw wrote much less frequently on musical matters, but he continued to publish essays and correspondence on music (including two notable exchanges with Ernest Newman) throughout his long lifetime. His last such publication appeared nine days after his death in November 1950.
The three stout volumes of Shaw's collected music criticism published in 1981 as Shaw's Music (and edited by his indefatigable bibliographer and scholarly advocate, Dan H. Laurence) give due notice of the formative role and abiding presence of music in Shaw's development as a writer. They also attest a striking and pervasive relationship between Shaw's perhaps unrivalled experience of British public musical life and his own convictions about musical meaning. Shaw's journalism extends from reviews of Clara Schumann's performances in London and Wagner's visits there in the 1870s to appraisals of Richard Strauss and Arnold Schoenberg shortly before and after the First World War. As late as 1923 (in his preface to the fourth edition of The Perfect Wagnerite) he was still chiding the British public because of its failure to recognize the sea-change that had occurred in English music over the course of his career.
Carbapenem-resistant Enterobacteriaceae (CRE) are a significant clinical and public health concern. Understanding the distribution of CRE colonization and developing a coordinated approach are key components of control efforts. The prevalence of CRE in the District of Columbia is unknown. We sought to determine the CRE colonization prevalence within healthcare facilities (HCFs) in the District of Columbia using a collaborative, regional approach.
DESIGN
Point-prevalence study.
SETTING
This study included 16 HCFs in the District of Columbia: all 8 acute-care hospitals (ACHs), 5 of 19 skilled nursing facilities, 2 (both) long-term acute-care facilities, and 1 (the sole) inpatient rehabilitation facility.
PATIENTS
Inpatients on all units excluding psychiatry and obstetrics-gynecology.
METHODS
CRE identification was performed on perianal swab samples using real-time polymerase chain reaction, culture, and antimicrobial susceptibility testing (AST). Prevalence was calculated by facility and unit type as the number of patients with a positive result divided by the total number tested. Prevalence ratios were compared using the Poisson distribution.
RESULTS
Of 1,022 completed tests, 53 samples tested positive for CRE, yielding a prevalence of 5.2% (95% CI, 3.9%–6.8%). Of 726 tests from ACHs, 36 (5.0%; 95% CI, 3.5%–6.9%) were positive. Of 244 tests from long-term-care facilities, 17 (7.0%; 95% CI, 4.1%–11.2%) were positive. The relative prevalence ratios by facility type were 0.9 (95% CI, 0.5–1.5) and 1.5 (95% CI, 0.9–2.6), respectively. No CRE were identified from the inpatient rehabilitation facility.
CONCLUSION
A baseline CRE prevalence was established, revealing endemicity across healthcare settings in the District of Columbia. Our study establishes a framework for interfacility collaboration to reduce CRE transmission and infection.
The black cutworm, Agrotis ipsilon (Hufnagel), is of major economic importance in many areas of the world. In recent years, adequate methods for assessing the toxicity of insecticides to the black cutworm have been developed (Begg and Harris, 1958; Begg et al., in preparation; Harris and Mazurek, 1961). However, with the exception of the works by Crumb (1929) and Satterthwait (1933), less research has been devoted to the life history of this insect.