We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save 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 saving content to .
To save content items to your Kindle, first ensure coreplatform@cambridge.org
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 saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved 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.
The remarkable archaeological record of Neolithic Orkney has ensured that these islands play a prominent role in narratives of European late prehistory, yet knowledge of the subsequent Bronze Age is comparatively poor. The Bronze Age settlement and cemetery at the Links of Noltland, on the island of Westray, offers new evidence, including aDNA, that points to a substantial population replacement between the Late Neolithic and Bronze Age. Focusing on funerary practice, the authors argue for interconnecting identities centred on household and community, patrilocality and inheritance. The findings prompt a reconsideration of the Orcadian Bronze Age, with wider implications for population movement and the uptake of cultural innovations more widely across prehistoric north-western Europe.
As part of a quality improvement project beginning in October 2011, our centre introduced changes to reduce radiation exposure during paediatric cardiac catheterisations. This led to significant initial decreases in radiation to patients. Starting in April 2016, we sought to determine whether these initial reductions were sustained.
Methods:
After a 30-day trial period, we implemented (1) weight-based reductions in preset frame rates for fluoroscopy and angiography, (2) increased use of collimators and safety shields, (3) utilisation of stored fluoroscopy and virtual magnification, and (4) hiring of a devoted radiation technician. We collected patient weight (kg), total fluoroscopy time (min), and procedure radiation dosage (cGy-cm2) for cardiac catheterisations between October, 2011 and September, 2019.
Results:
A total of 1889 procedures were evaluated (196 pre-intervention, 303 in the post-intervention time period, and 1400 in the long-term group). Fluoroscopy times (18.3 ± 13.6 pre; 19.8 ± 14.1 post; 17.11 ± 15.06 long-term, p = 0.782) were not significantly different between the three groups. Patient mean radiation dose per kilogram decreased significantly after the initial quality improvement intervention (39.7% reduction, p = 0.039) and was sustained over the long term (p = 0.043). Provider radiation exposure was also significantly decreased from the onset of this project through the long-term period (overall decrease of 73%, p < 0.01) despite several changes in the interventional cardiologists who made up the team over this time period.
Conclusion:
Introduction of technical and clinical practice changes can result in a significant reduction in radiation exposure for patients and providers in a paediatric cardiac catheterisation laboratory. These reductions can be maintained over the long term.
Land divisions are ubiquitous features of the British countryside. Field boundaries, enclosures, pit alignments, and other forms of land division have been used to shape and delineate the landscape over thousands of years. While these divisions are critical for understanding economies and subsistence, the organization of tenure and property, social structure and identity, and their histories of use have remained unclear. Here, the authors present the first robust, Bayesian statistical chronology for land division over three millennia within a study region in England. Their innovative approach to investigating long-term change demonstrates the unexpected scale of later ‘prehistoric’ land demarcation, which may correspond to the beginnings of increasing social hierarchy.
The Bronze Age in Britain is now a term often used to include both the first use of copper c. 2400 bc and also tin-bronze from c. 2100 bc, all of which required the extensive use of copper. Prehistoric mining for this metal has been identified in surface and underground workings in Parys Mine, Mynydd Parys, Anglesey, although almost all of the surface workings are now obscured by the extensive deep spoil from more recent mining in the industrial period. These copper-bearing ores are in bedded lodes, together with some intruded vein deposits. The Bronze Age workings have been exposed underground where they have been intersected by the early 19th century industrial workings on and above the 16 fathom and 20 fathom levels in the Parys Mine. Spoil exposures contain stone hammers (‘mauls’), wood fragments, and charcoal; samples of the latter have been radiocarbon dated with chronological modelling suggesting activity took place in the first half of the 2nd millennium cal bc. Although relatively limited in extent, these important prehistoric mining sites are among the earliest found in the UK. They have survived due to their protection from surface erosion and limited accessibility.
The Glastonbury Lake Village in Somerset, UK, is made up of 90 mounds comprising 40 roundhouses. Excavations between 1892 and 1907 revealed Iron Age structural and material remains unparalleled in Western Europe. The settlement's exact chronology, however, has remained uncertain. Here, the authors present a programme of radiocarbon and dendrochronological dating and chronological modelling on samples from recent excavations. The results indicate that the site was founded in the early second century cal BC, with the last structures being built just over a century later. This new, robust chronology can be used to date a wide range of associated material culture, and complements chronologies established for other Iron Age sites.
This chapter examines the place in English history memory of what is generally considered the original ‘event’ of the Reformation: Martin Luther’s posting of the Ninety-five Theses to the door of the Castle Church in Wittenberg on 31 October 1517. Despite its uncertain historical veracity, the episode was prioritised by the ideological demands of the first Reformation centenary celebrated in Germany in 1617, and thereafter (particularly in the nineteenth century) it became a magnet of Protestant artistic expression and cultural identity. In England, however, interest in Luther’s ‘Thesenanschlag’ remained remarkably muted through the seventeenth and eighteenth centuries. Even in 1817, when a commemorative impulse fired by imaginative remembering of the episode swept through Lutheran Germany, Scandinavia and the United States, English interest remained muted. Across the nineteenth century as a whole, non-conformists were much more likely than Anglicans to celebrate the valour and significance of Luther’s ‘deed’. The reticence points to a long-standing reluctance among Anglicans to acknowledge Luther, even at a remove, as a founder of the Church of England. Yet a long-standing failure to advance consensually any alternative date or event as the foundational moment of the English Reformation is striking, underlining the unresolved tension over continuity versus rupture which lies at the heart of Anglican historical identity.
Treatment resistance causes significant burden in psychosis. Clozapine is the only evidence-based pharmacologic intervention available for people with treatment-resistant schizophrenia; current guidelines recommend commencement after two unsuccessful trials of standard antipsychotics.
Aims
This paper aims to explore the prevalence of treatment resistance and pathways to commencement of clozapine in UK early intervention in psychosis (EIP) services.
Method
Data were taken from the National Evaluation of the Development and Impact of Early Intervention Services study (N = 1027) and included demographics, medication history and psychosis symptoms measured by the Positive and Negative Syndrome Scale (PANSS) at baseline, 6 months and 12 months. Prescribing patterns and pathways to clozapine were examined. We adopted a strict criterion for treatment resistance, defined as persistent elevated positive symptoms (a PANSS positive score ≥16, equating to at least two items of at least moderate severity), across three time points.
Results
A total of 143 (18.1%) participants met the definition of treatment resistance of having continuous positive symptoms over 12 months, despite treatment in EIP services. Sixty-one (7.7%) participants were treatment resistant and eligible for clozapine, having had two trials of standard antipsychotics; however, only 25 (2.4%) were prescribed clozapine over the 12-month study period. Treatment-resistant participants were more likely to be prescribed additional antipsychotic medication and polypharmacy, instead of clozapine.
Conclusions
Prevalent treatment resistance was observed in UK EIP services, but prescription of polypharmacy was much more common than clozapine. Significant delays in the commencement of clozapine may reflect a missed opportunity to promote recovery in this critical period.
Radiocarbon dating and Bayesian chronological modelling have provided precise new dating for the henge monument of Mount Pleasant in Dorset, excavated in 1970–1. A total of 59 radiocarbon dates are now available for the site and modelling of these has provided a revised sequence for the henge enclosure and its various constituent parts: the timber palisaded enclosure, the Conquer Barrow, and the ditch surrounding Site IV, a concentric timber and stone monument. This suggests that the henge was probably built in the 26th century cal bc, shortly followed by the timber palisade and Site IV ditch. These major construction events took place in the late Neolithic over a relatively short timespan, probably lasting 35–125 years. The principal results are discussed for each element of the site, including comparison with similar monument types elsewhere in Britain and Ireland, and wider implications for late Neolithic connections and later activity at the site associated with Beaker pottery are explored.
We undertook a strengths, weaknesses, opportunities, and threats (SWOT) analysis of Northern Hemisphere tree-ring datasets included in IntCal20 in order to evaluate their strategic fit with the demands of archaeological users. Case studies on wiggle-matching single tree rings from timbers in historic buildings and Bayesian modeling of series of results on archaeological samples from Neolithic long barrows in central-southern England exemplify the archaeological implications that arise when using IntCal20. The SWOT analysis provides an opportunity to think strategically about future radiocarbon (14C) calibration so as to maximize the utility of 14C dating in archaeology and safeguard its reputation in the discipline.
Hydrogen lithography has been used to template phosphine-based surface chemistry to fabricate atomic-scale devices, a process we abbreviate as atomic precision advanced manufacturing (APAM). Here, we use mid-infrared variable angle spectroscopic ellipsometry (IR-VASE) to characterize single-nanometer thickness phosphorus dopant layers (δ-layers) in silicon made using APAM compatible processes. A large Drude response is directly attributable to the δ-layer and can be used for nondestructive monitoring of the condition of the APAM layer when integrating additional processing steps. The carrier density and mobility extracted from our room temperature IR-VASE measurements are consistent with cryogenic magneto-transport measurements, showing that APAM δ-layers function at room temperature. Finally, the permittivity extracted from these measurements shows that the doping in the APAM δ-layers is so large that their low-frequency in-plane response is reminiscent of a silicide. However, there is no indication of a plasma resonance, likely due to reduced dimensionality and/or low scattering lifetime.
Since 1993 Historic England (and its predecessor English Heritage) has commissioned 9074 radiocarbon (14C) measurements on archaeological samples. Over 80% of these have been interpreted within formal Bayesian statistical models. The multiple strands of reinforcing evidence incorporated in these models provide precise chronologies that make stringent demands on the accuracy of the 14C results included in the analysis. Inter-laboratory replication is consequently a routine part of model construction and validation. We report an analysis of replicate measurements on 1089 archaeological samples. It is clear that laboratory reproducibility accounts for only part of the observed variation. The type of material dated is also critical to the reproducibility of measurements, with some sample types proving particularly problematic.
In late summer, sometime between cal a.d. 340–405, a hoard of tightly packed, stacked copper-alloy vessels was deposited in the Vale of Pewsey, Wiltshire. The corrosion of the vessels allowed for the preservation of delicate plant macrofossils and pollen. Analysis of this material has provided insights into the date, season and context of this act of structured deposition. A second hoard of similar vessels was deposited in the fourth or fifth century only a few miles away at Wilcot. The hoards and their deposition relate to Romano-British lifeways, at a time when the region was on the cusp of a dramatic period of change. The distribution of late Roman coins and belt fittings offers further insights into the social and economic character of Wiltshire at their times of deposition.
England's first Tudor monarchs were formally devoted to the cult of St Thomas of Canterbury. In popular memory, however, Thomas was a champion of law and custom, an opponent of untrammelled royal power, and – especially among the clergy – a martyr for ecclesiastical ‘liberties’. This suggests that the pre-Reformation Church was considerably less ‘monarchical’ than is sometimes supposed. In the 1530s Thomas became a powerful symbol of resistance to Henry VIII's royal supremacy. However, the fact that he could be portrayed as a patron of the clergy's sectional interests helps to explain how opposition was weakened and divided.