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To assess the utility of an automated, statistically-based outbreak detection system to identify clusters of hospital-acquired microorganisms.
Multicenter retrospective cohort study.
The study included 43 hospitals using a common infection prevention surveillance system.
A space–time permutation scan statistic was applied to hospital microbiology, admission, discharge, and transfer data to identify clustering of microorganisms within hospital locations and services. Infection preventionists were asked to rate the importance of each cluster. A convenience sample of 10 hospitals also provided information about clusters previously identified through their usual surveillance methods.
We identified 230 clusters in 43 hospitals involving Gram-positive and -negative bacteria and fungi. Half of the clusters progressed after initial detection, suggesting that early detection could trigger interventions to curtail further spread. Infection preventionists reported that they would have wanted to be alerted about 81% of these clusters. Factors associated with clusters judged to be moderately or highly concerning included high statistical significance, large size, and clusters involving Clostridioides difficile or multidrug-resistant organisms. Based on comparison data provided by the convenience sample of hospitals, only 9 (18%) of 51 clusters detected by usual surveillance met statistical significance, and of the 70 clusters not previously detected, 58 (83%) involved organisms not routinely targeted by the hospitals’ surveillance programs. All infection prevention programs felt that an automated outbreak detection tool would improve their ability to detect outbreaks and streamline their work.
Automated, statistically-based outbreak detection can increase the consistency, scope, and comprehensiveness of detecting hospital-associated transmission.
The extent to which indices of maternal physiological arousal (skin conductance augmentation) and regulation (vagal withdrawal) while parenting predict infant attachment disorganization and behavior problems directly or indirectly via maternal sensitivity was examined in a sample of 259 mothers and their infants. Two covariates, maternal self-reported emotional risk and Adult Attachment Interview attachment coherence were assessed prenatally. Mothers' physiological arousal and regulation were measured during parenting tasks when infants were 6 months old. Maternal sensitivity was observed during distress-eliciting tasks when infants were 6 and 14 months old, and an average sensitivity score was calculated. Attachment disorganization was observed during the Strange Situation when infants were 14 months old, and mothers reported on infants' behavior problems when infants were 27 months old. Over and above covariates, mothers' arousal and regulation while parenting interacted to predict infant attachment disorganization and behavior problems such that maternal arousal was associated with higher attachment disorganization and behavior problems when maternal regulation was low but not when maternal regulation was high. This effect was direct and not explained by maternal sensitivity. The results suggest that maternal physiological dysregulation while parenting places infants at risk for psychopathology.
This Summary for Policymakers presents key findings from the Special Report on Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation (SREX). The SREX approaches the topic by assessing the scientific literature on issues that range from the relationship between climate change and extreme weather and climate events (‘climate extremes’) to the implications of these events for society and sustainable development. The assessment concerns the interaction of climatic, environmental, and human factors that can lead to impacts and disasters, options for managing the risks posed by impacts and disasters, and the important role that non-climatic factors play in determining impacts. Box SPM.1 defines concepts central to the SREX.
The character and severity of impacts from climate extremes depend not only on the extremes themselves but also on exposure and vulnerability. In this report, adverse impacts are considered disasters when they produce widespread damage and cause severe alterations in the normal functioning of communities or societies. Climate extremes, exposure, and vulnerability are influenced by a wide range of factors, including anthropogenic climate change, natural climate variability, and socioeconomic development (Figure SPM.1). Disaster risk management and adaptation to climate change focus on reducing exposure and vulnerability and increasing resilience to the potential adverse impacts of climate extremes, even though risks cannot fully be eliminated (Figure SPM.2). Although mitigation of climate change is not the focus of this report, adaptation and mitigation can complement each other and together can significantly reduce the risks of climate change. [SYR AR4, 5.3]
An examination of the evidence provided by medieval Irish chronicles for political organisation in the Gaelic world before about 1200 has shown that there was an absolute minimum of 600 population groups led by kings in the 750 years of record from the mid-fifth to the late twelfth century. The distribution of these across time and space is interestingly complicated, and detailed discussion of it will have to await publication of the evidence. Suffice it to say, for the moment, that, contrary to what has been stated by some historians over the last generation, the local kingship of local population groups is as visible in Ireland in the twelfth century as it is in the seventh. For what is now Scotland, of course, one could not make any such statement: from the later ninth century at the very latest (and arguably from the mid-eighth) Gaelic North Britain underwent a series of transformations, not the least aspect of which is the dramatic reduction in coverage of its affairs in the extant Irish chronicles – which date, as they stand, from the late eleventh to the mid-seventeenth century.
Early medieval Ireland is famed for its monasticism, and the century running from 540 to 640 is that of the major monastic founders, while also being marked by individual ascetic enthusiasm. For the most part, however, contemporary documentation comprises laconic notices in the annals, with just a scattering of more informative texts such as the Penitential of Finnian and The Alphabet of Piety. Against this background Columbanus stands out as the one figure for whom we have sufficient sources to enable us to discern his monastic vision and to see something of how he put it into practice. From his pen we have six letters, a series of thirteen sermons preached to his monks, a Regula Monachorum and Regula Coenobialis, a penitential and two poems, while within a generation of his death Jonas produced his Life of Columbanus and his Disciples, which, for all its spin-doctoring, was the work of a well-informed author.
There is, however, a problem about taking Columbanus as representative of the formative period of Irish monasticism. Although born in Leinster and trained in Comgall's monastery of Bangor, Columbanus had left Ireland around 591 to go as a peregrinus to the Continent. Thereafter he was based in Frankia, where his most important foundation was Luxeuil, until 610, when he was expelled. However, he escaped being sent back to Ireland and instead found his way to the Bregenz area and then over the Alps to northern Italy, where he founded a final monastery at Bobbio, and died in 615.
She's young. She's beautiful. She's Irish. So she's dead meat: at least in opera, where box office and body count go hand in hand.
This review of Healy Willan's opera Deirdre, a distant descendant of the early Irish tale Longes Mac nUislenn, is in a long interpretative tradition, even if indirectly. Of course, the twentieth-century opera is at many removes from the medieval narrative, separated by time and language, by substance and genre. Nevertheless, it reflects an assumption that this saga of broken bonds between men, of fraternal exile, of sex and death, pivots around its central female character, Deirdre. She is simultaneously catalyst and victim, helpless to save her lover Noísiu, and Noísiu's brothers, from deathly betrayal. This is no surprise: the Gaelic Irish themselves recalibrated the story. It was reinvented in the fourteenth or fifteenth century as Oidheadh Chloinne Uisnigh – still a tale of shattered male loyalties but now acted against a more emotive narrative of doomed love. This appealingly affective aesthetic underlies nearly all subsequent versions of what was increasingly seen as Deirdre's story, including those in English. Significantly, even Keating's retelling of the tale in Foras Feasa ar Éirinn, one largely based on Longes Mac nUislenn rather than Oidheadh Chloinne Uisnigh, did not displace the latter. Instead, subsequent redactions of the narrative attempted to harmonise the accounts, ultimately leaving the main substance of Oidheadh Chloinne Uisnigh intact. In the process Deirdre's identification as a suitably tragic Irish woman became predominant.
A cartulary of the Benedictine cathedral priory of Bath, which on the evidence of its script has been dated to around the mid-twelfth century, contains an indulgence granted by Marcus Cluanensis episcopus to the ‘truly penitent’ who with alms and prayers would visit the church at Bath on the feast of the Exaltation of the Cross (14 September). The text, which is printed in Appendix 1,2 is preceded in the cartulary by similar indulgences from Theobald, archbishop of Canterbury (1138–61), and Robert, bishop of Bath (1136–66), and followed by one from Nicholas, bishop of Llandaff (1148–83). As is usual in texts of indulgences, none contains a witness-list and this makes dating difficult, with the added consequence in the case of Marcus that his very identity remains obscure. The four indulgences evidently form a series, as in each the period of remission is twenty days and is linked to the celebration of the same feast. However, there are also differences in the wording of the four texts which may indicate that they were not necessarily issued on the same occasion. The indulgence of Robert, bishop of Bath, recorded that he had consecrated a cross in the cathedral church on the feast of the Exaltation of the Cross, and it was the acquisition of this new cross which appears to have occasioned the indulgences. It is conceivable that Robert may have been assisted at the consecration ceremony by one or more of the other bishops who also granted indulgences.
In 1988 Máire Herbert's magisterial Iona, Kells and Derry laid out a clear map of the progression of the authority within the Columban familia along the lines indicated in the title, with the comarbus or ‘successorship’ of the founder saint Columba passing to each of the named major monasteries within the federation from the sixth to the twelfth century. Importantly, she gave careful consideration to the nature of the ‘hand-over’ periods between the institutions, making it clear, for instance, that despite the construction of the monastery of Kells during the period 807–14, the idea of Iona's abandonment for Kells in the early ninth century owing to Viking raids was simply a modern myth. The comarbus of Colum Cille, by her reckoning, arrived in Kells de facto only with the accession of the comarba Pátraic, Mael Brigte mac Tornáin (891–927). There is no clear evidence that Mael Brigte was based at Kells itself, but his long rule (nearly forty years in Armagh, thirty-six as successor of Colum Cille), apparently spent in Ireland, and the certain fact that by the early eleventh century successors of Columba were based there, made it probable to Herbert that subsequent tenthcentury successors were in Kells de jure. Its loss of authority came only in the twelfth century, with the rise of Derry under the patronage of the Mac Lochlainn dynasty, 1150 being, in John Bannerman's words, Derry's ‘annus mirabilis’.
Cyfraith Hywel, the law of Hywel, was the system of law followed in Wales throughout the Middle Ages; attributed to Hywel ap Cadell (Hywel Dda), d. 949 or 950, it survives in some forty manuscripts dating from the mid-thirteenth century to the fifteenth century. It was a native legal system, distinct from both English law and Canon Law; had the system survived to this day, it would be a third class of law in the United Kingdom, a Volksrecht-system to join the Scottish civil law tradition and the English common law.
The manuscripts of Welsh law divide into three Welsh groups or redactions, named after eminent lawyers noted in the prologues of each redaction: Iorwerth, Blegywryd and Cyfnerth. The Latin manuscripts form a separate group. There are eight manuscripts in the Iorwerth redaction, and they take up the first letters of the alphabet in the sigla assigned to them by Aneurin Owen. They are: Aberystwyth, National Library of Wales, Peniarth 29 (The Black Book of Chirk, Owen's A); London, British Library, Cotton Titus D.ii (B); BL Cotton Caligula A.iii (C); NLW Peniarth 32 (D); BL Additional MS. 14931 (E); NLW Peniarth 35 (G); NLW Peniarth 40 (K); and NLW Peniarth 39 (named Lew by William Maurice, it was not known to Owen). Llyfr Colan, NLW Peniarth MS 30, is a revised version of the Iorwerth redaction. The Iorwerth redaction is from north Wales and includes some of the earliest manuscripts of Welsh law; the text itself can be linked to the kingdom of Gwynedd during the time of Llywelyn ap Iorwerth and Llywelyn ap Gruffudd.
In a short tract on the Milesian Invasion there is a curious passage in which the Sons of Míl arrive in Ireland only to find the island inhabited by a group of Hebrew maidens. The maidens will not give up their land without receiving a payment (tindscra) for their ‘friendship’ (cairdes): ‘Is de at fir crendai mnai i n-Eri co brath ar im chrenad lanamnai isin doman oilcheanai.’ Rudolf Thurneysen has discussed this passage in relation to the notion of marriage by bride-purchase and states that this passage represents the older procedure whereby a man simply buys a wife without expecting a dowry in return. In this essay the extant sources for this practice are re-examined and it is argued that the concept of the husband purchasing his wife may be more a linguistic and terminological artefact than a reflection of reality.
A second instance of this usage occurs in the mythological text Tochmarc Étaíne ‘the wooing of Étaín’. In his analysis of this text Thomas Charles-Edwards discusses, among other matters, the possible significance of the use of the verbs renaid ‘sells’ and crenaid ‘buys’ in relation to the marriage of Étaín and Midir.
Specifically, he discusses the type of marriage Óengus arranges for his fosterfather, Midir, and Midir's later acquisition of Étaín from her husband, Eochaid Airem. In the former marriage arrangement Óengus effectively purchases Étaín from her father, Ailill, who, according to Charles-Edwards's interpretation, might thereby forfeit all of his rights to compensation should any injury be done to his daughter.
… sequentis temporis successu ex improviso dedit mihi Exanceastre, cum omni parochia, quae ad se pertinebat, in Saxonia et in Cornubia …
This passage in Asser's Life of King Alfred has given rise to discussion owing to the uncertainty of the meaning of the word parochia, and particularly with regard to its potential implications for the ecclesiastical assimilation of Cornwall into Wessex, since Cornwall's integration into Wessex advanced considerably during King Alfred's reign. The translation by Keynes and Lapidge, using the noncommittal word ‘jurisdiction’, wisely avoids precision about its implications. My purpose here is to examine some aspects of this clause in closer detail than has been possible in the more general surveys in which it has usually been discussed.
One preliminary aspect to be clarified is the exact meaning of Saxonia and Cornubia. It has generally been assumed without comment that, in this context, these words mean the later Devon and Cornwall respectively. The interpretation is surely right, but it bears closer examination. At this period such words would normally be understood with an ethnic or linguistic meaning, rather than a political one. In fact the River Tamar was probably, in the late ninth century, the boundary forming not only the administrative division between Devon and Cornwall but also, for much of its course, the linguistic division between speakers of West Saxon and Cornish.
A good deal of general information on the law relating to theft is to be found in the surviving Old Irish legal material from the seventh to the ninth centuries AD. The main law text on this topic is Bretha im Gatta ‘judgements about thefts’, though it is incomplete, owing to the loss of a page in the manuscript. Material on theft is also present in a number of other Old Irish law texts, such as Críth Gablach, Bechbretha and Bretha Cairdi.
The earlier material in Irish contains little specific information on the legal mechanisms for the recovery of stolen property. However, this aspect of the law of theft is touched on in more detail in a Treatise by Giolla na Naomh Mac Aodhagáin, chief judge of Connacht (ardollamh Connacht), whose death in 1309 is recorded in the annals. One passage which deals with the tracking of stolen cattle has been edited and translated by W. N. Osborough in an article entitled ‘The Irish Custom of Tracts’, published in the Irish Jurist. The general principle is that if the cattle can be tracked – presumably by the owner accompanied by witnesses – to a particular place, the inhabitants of that place must pay for the theft (íoc na gaide), unless they can show that the track continues in another direction, i.e. ‘to put the track of the theft from them’ (lorg na gaide do chur díobh).
The early-eighth-century collection of canons known as Collectio Canonum Hibernensis includes a book entitled On presbyters and priests. Chapter twenty-five deals with correct punishment to be meted out to priests who are absent from their locality:
Sinodus Hibernensis decrevit, ut sacerdos una tantum die ab ecclesia defuerit; si duobus, peniteat VII diebus cum pane et aqua; si autem mortuus ad ecclesiam adlatus fuerit et ille absens, penitere debet quia poenae reus illius est. B. Item: Si in uno die dominico ab ecclesia defuerit, agat penitentiam XX dierum cum pane et aqua, si autem duobus aut tribus, submovendus honore gradus sui.
This is a relatively rare example of concern about a priest's relationship with his congregation in this particular source. The other twenty-six chapters in the book concern the nature of the priest's role, their Old Testament precursors, the nature of sacrifice, the rituals of ordination and (by far the greatest area of concern, with ten separate chapters) the rules governing clerical income.
The evidence for the duties and functions of priests and their role in Irish society is not limited to On presbyters and priests, but can also be found scattered through other books within the Collectio. In Book twenty-one, for example, On judgement, a priest is identified as a suitable person to be a judge, along with fourteen other characters including a bishop, a king, a legal scholar, a kinsman (on issues concerning his own kin), a craftsman (on matters pertaining to his own craft), the old, the poor and the wise.
The capacity to hold court can be a key to the distribution and exercise of political power; to the existence of public or of private power; and to the interplay both between local community and landlords and between local community and rulers' agents. Of course, the phrase ‘holding court’ in modern English offers a multiplicity of meanings, just as the notion of holding court in the early Middle Ages covers a multiplicity of occasions: there were kings' courts, bishops' courts, secular lords' courts, monastic lords' courts – where business was done, celebrations held, visitors received, dues paid, gifts exchanged, plans made. My concern in this paper is with the court as judicial court – the place where disputes were heard, in accordance with fixed procedures and in the knowledge of such law as pertained, and where disputes were sometimes settled, sometimes judged, and unsuccessful litigants were sometimes sentenced.
My particular concern is with the presidency of the court. Did someone always preside, and was the presidency always held by a single individual? Can we always identify a president? Could someone preside in absentia – in other words, be notionally but not physically present? Was presiding separable from judging? Determining who presided in court is much more difficult to fathom than one might initially think. There are issues concerning both the normal actions, powers and obligations of court holders and also the meaning of words: it might be supposed, for example, that use of the Latin word ante ‘before’ would clearly identify a president, but that certainly was not always the case.
Compert Mongáin ocus Serc Duibe Lacha do Mongán (The Birth of Mongán and Mongán's Love for Dub Lacha – or Dub Lacha's Love for Mongán) belongs to the broad category of narrative Alan Bruford termed ‘Romantic Tales’, encompassing in his view ‘all the late medieval and later romances found in Irish manuscripts from the fifteenth to the nineteenth centuries and the related folktales’. The earliest copy is contained in the Book of Fermoy, written for David Mór son of Maurice Roche in the middle of the fifteenth century, and it was in Bruford's view among the best of the Romantic tales produced at a time when ‘Irish poets and scribes enjoyed the patronage of a powerful Irish-speaking aristocracy of mixed Norman and Irish descent’. Notwithstanding this, unlike other contemporary compositions which enjoyed widespread popularity in the seventeenth century and later, as far as post-classical transmission is concerned, our tale survives in a solitary copy written in Munster about the year 1811 by Seághan Mac Mathghamhna and entitled Tóruigheacht Duibhe Lacha Láimhe Ghile ‘The Pursuit of Dub Lacha of the White Hand’.