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 email@example.com
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.
A Concise History of Albania charts the history of Albania and its people, within their Balkan and European contexts. It shows the country's journey from its ancient past, still shrouded in mystery and controversy, through its difficult transition from a particularly brutal form of communism to an evolving form of democracy and a market economy. Bernd Fischer and Oliver Schmitt challenge some of the traditional narratives concerning the origins of the Albanians, and the relations between Albanians and their Balkan neighbours. This authoritative and up-to-date single-volume history analyses the political, social, economic, and cultural developments which led to the creation of the Albanian state and the modern nation, as well as Albania's more recent experience with authoritarianism, war, and communism. It greatly contributes to our understanding of the challenges facing contemporary Albanians, as well as the issues confronting the region as a whole as it attempts to grapple with one of the last remaining significant ethnic issues in the Balkans.
An invaluable reference for graduate students and academic researchers, this book introduces the basic terminology, methods and theory of the physics of flow in porous media. Geometric concepts, such as percolation and fractals, are explained and simple simulations are created, providing readers with both the knowledge and the analytical tools to deal with real experiments. It covers the basic hydrodynamics of porous media and how complexity emerges from it, as well as establishing key connections between hydrodynamics and statistical physics. Covering current concepts and their uses, this book is of interest to applied physicists and computational/theoretical Earth scientists and engineers seeking a rigorous theoretical treatment of this topic. Physics of Flow in Porous Media fills a gap in the literature by providing a physics-based approach to a field that is mostly dominated by engineering approaches.
This chapter examines the role of imagination in enabling economic actors to make sense of the world and decide how to act and the part played by metaphorical thinking and analytical imagination within the discipline of economics. It starts from the assumption that modern capitalism is a quintessentially creative and imaginative system, characterized by constant novelty and radical uncertainty. The authors argue that economic behavior is therefore necessarily guided by working fictions and, in particular, by fictional expectations that combine individual imaginaries and social narratives with calculation. Building on insights from literary theory, the chapter examines the structuring and performative role of narratives and models and concludes that market power rests with those able to make their narratives and imaginaries count. Championing a new form of narrative economics, the authors propose that economists should employ discourse analysis to read the contingent interpretations that economic actors use to navigate uncertain futures.
The adoption of dicamba-resistant cotton (Gossypium hirsutum L.) cultivars allows using dicamba to reduce weed populations across growing seasons. However, the overuse of this tool risks selecting new herbicide resistant biotypes. The objectives of this research were to determine the population trajectories of several weed species and track the frequency of glyphosate-resistant Palmer amaranth (Amaranthus palmeri S. Watson) (GR) over 8 years in dicamba-resistant cotton. An experiment was established in North Carolina in 2011, and during the first four years, different herbicide programs were applied. These programs included postemergence applications of glyphosate, alone or with dicamba, with or without residual herbicides. During the last 4 years, all programs received glyphosate plus dicamba. Biennial rotations of postemergence applications of glyphosate only and glyphosate plus dicamba postemergence with and without preemergence herbicides were also included. Sequential applications of glyphosate plus dicamba were applied to the entire test area for the final 4 years of the study. No herbicide program was entirely successful in controlling the weed community. Weed population trajectories were different according to species and herbicide program, creating all possible outcomes; some increased, other decreased, and others remained stable. Density of resistant A. palmeri increased during the first 4 years with glyphosate only programs (up to 11739 plants per m2) and decreased a 96% during the final 4 years when glyphosate plus dicamba was implemented. This species had a strong influence on population levels of other weed species in the community. Goosegras [Eleusine indica (L.) Gaertn.] was not affected by A. palmeri population levels and even increased its density in some herbicide programs, indicating that not only herbicide resistance but also reproductive rates and competitive dynamics are critical for determining weed population trajectories under intensive herbicide-based control programs. Frequency of GR reached a maximum of 62% after 4 years and maintained those levels until the end of the experiment.
Recently, the existence of so-called granular bubbles and droplets has been demonstrated experimentally. Granular bubbles and droplets are clusters of particles that respectively rise and sink if submerged in an aerated and vibrated bed of another granular material of different size and/or density. However, currently, there is no model that explains the coherent motion of these clusters and predicts the transition between a rising and sinking motion. Here, we propose an analytical model predicting accurately the neutral buoyancy limit of a granular bubble/droplet. This model allows the compilation of a regime map identifying five distinct regimes of granular bubble/droplet motion.
Political scientists have increasingly deployed conjoint survey experiments to understand multidimensional choices in various settings. In this paper, we show that the average marginal component effect (AMCE) constitutes an aggregation of individual-level preferences that is meaningful both theoretically and empirically. First, extending previous results to allow for arbitrary randomization distributions, we show how the AMCE represents a summary of voters’ multidimensional preferences that combines directionality and intensity according to a probabilistic generalization of the Borda rule. We demonstrate why incorporating both the directionality and intensity of multi-attribute preferences is essential for analyzing real-world elections, in which ceteris paribus comparisons almost never occur. Second, and in further empirical support of this point, we show how this aggregation translates directly into a primary quantity of interest to election scholars: the effect of a change in an attribute on a candidate’s or party’s expected vote share. These properties hold irrespective of the heterogeneity, strength, or interactivity of voters’ preferences and regardless of how votes are aggregated into seats. Finally, we propose, formalize, and evaluate the feasibility of using conjoint data to estimate alternative quantities of interest to electoral studies, including the effect of an attribute on the probability of winning.
While deep brain stimulation (DBS) for movement disorders is now considered an evidence-based pillar in the management of medication refractory Parkinson’s disease (PD), essential tremor (ET), and dystonia, some healthcare providers remain hesitant to embrace the management of DBS patients because DBS programming is perceived as complicated, time-consuming, and highly technical. Adding to this “intimidation factor” is that in recent years two new manufacturers, Abbott and Boston Scientific, joined pioneer Medtronic in the (US) DBS market in 2016 and 2019, respectively. At first glance, having three different DBS platforms does not seem to simplify matters.
This report describes a cluster of patients infected by Serratia marcescens in a metropolitan neonatal intensive care unit (NICU) and a package of infection control interventions that enabled rapid, effective termination of the outbreak.
Cross-sectional analytical study using whole-genome sequencing (WGS) for phylogenetic cluster analysis and identification of virulence and resistance genes.
NICU in a metropolitan tertiary-care hospital in Sydney, Australia.
All neonates admitted to the level 2 and level 3 neonatal unit.
Active inpatient and environmental screening for Serratia marcescens isolates with WGS analysis for identification of resistance genes as well as cluster relatedness between isolates. Planning and implementation of a targeted, multifaceted infection control intervention.
The cluster of 10 neonates colonized or infected with Serratia marcescens was identified in a metropolitan NICU. Two initial cases involved devastating intracranial infections with brain abscesses, highlighting the virulence of this organism. A targeted and comprehensive infection control intervention guided by WGS findings enabled termination of this outbreak within 15 days of onset. WGS examination demonstrated phylogenetic linkage across the cluster, and genomic unrelatedness of later strains identified in the neonatal unit and elsewhere.
A comprehensive, multipronged, infection control package incorporating close stakeholder engagement, frequent microbiological patient screening, environmental screening, enhanced cleaning, optimization of hand hygiene and healthcare worker education was paramount to the prompt control of Serratia marcescens transmission in this neonatal outbreak. WGS was instrumental in establishing relatedness between isolates and identification of possible transmission pathways in an outbreak setting.
It has been suggested that psychosocial factors are related to survival time of inpatients with cancer. However, there are not many studies examining the relationship between spiritual well-being (SWB) and survival time among countries. This study investigated the relationship between SWB and survival time among three East Asian countries.
This international multicenter cohort study is a secondary analysis involving newly admitted inpatients with advanced cancer in palliative care units in Japan, South Korea, and Taiwan. SWB was measured using the Integrated Palliative Outcome Scale (IPOS) at admission. We performed multivariate analysis using the Cox proportional hazards model to identify independent prognostic factors.
A total of 2,638 patients treated at 37 palliative care units from January 2017 to September 2018 were analyzed. The median survival time was 18.0 days (95% confidence interval [CI] 16.5–19.5) in Japan, 23.0 days (95% CI 19.9–26.1) in Korea, and 15.0 days (95% CI 13.0–17.0) in Taiwan. SWB was a significant factor correlated with survival in Taiwan (hazard ratio [HR] 1.27; 95% CI 1.01–1.59; p = 0.04), while it was insignificant in Japan (HR 1.10; 95% CI 1.00–1.22; p = 0.06), and Korea (HR 1.02; 95% CI 0.77–1.35; p = 0.89).
Significance of results
SWB on admission was associated with survival in patients with advanced cancer in Taiwan but not Japan or Korea. The findings suggest the possibility of a positive relationship between spiritual care and survival time in patients with far advanced cancer.
Paediatric chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) effects 0.5–3.28% of children. NICE guidance recommends Activity Management, Graded Exercise Therapy or Cognitive Behavioural Therapy for fatigue (CBT-f). Approximately 15% of patients do not achieve full recovery within one year with current treatments. Acceptance and Commitment Therapy (ACT) is an effective treatment in many chronic illnesses. There are no studies investigating ACT for paediatric CFS/ME. This feasability study aimed to assess if ACT is a feasible and acceptable alternative treatment when current treatment has not led to recovery.
This feasability cohort study aimed to enrol a minimum of 12 participants aged 11–18 yearswith CFS/ME attending the Royal United Hospitals Bath NHS Foundation Trust Specialist Paediatric CFS/ME Service, who were still symptomatic after 12 months or 12 sessions of standard treatment and were offered six to 12 sessions of ACT. Retention and recruitment data were analysed. Participants were asked to complete questionnaires before, during and after treatment. A selection of participants and their parents were interviewed about their experience of the study. Interviews were analysed using thematic analysis.
19 participants (95% of those approached) were recruited. Only 4 participants of this hard-to-reach group did not complete treatment.
In almost all sessions participants reported that they felt ‘totally’ listened to in post session questionnaires (31/33 sessions).
Preliminary interviews (n = 12) indicate acceptability of ACT, with all young people and their parents stating that they thought ACT should be offered to this population. Participants particularly commented that the absence of thought challenging (used in CBT-f) was a positive element of ACT. Participant's openness to try new approaches and altruistic desire to be in a study was noted.
Recruitment data indicate that it is feasible to recruit and retain 11–18-year-olds with CFS/ME to a study offering ACT. Interviews with participants and parents were broadly positive suggesting ACT is an acceptable treatment in this population.
Results indicated that it is both feasible and acceptable to offer ACT to 11–18-year-olds with CFS/ME using this protocol, supporting the prospect of an RCT in this area.
We present outcomes of a newly developed Community Rehabilitation team (MhIST) using the context of Jen's personal story. Jen is a 31-year-old student and freelance journalist. This story encompasses her journey from inpatient rehabilitation services to the community, completed with support from MhIST.
“For nearly four years, I was sectioned under the Mental Health Act as an inpatient in hospital. As I had been denied my fundamental liberties for so long, the prospect of leaving hospital for good and enjoying total freedom was both exhilarating and terrifying. How would I fare in the community, living on my own? Would I be lonely? Would I relapse? Would I survive?”
Upon leaving hospital, I immediately received intensive support from MhIST. They were the bridge between the gulf that was hospital and the community. Since leaving hospital, I have been relishing my freedom. I enjoy meeting up with my friends after so long apart. I have volunteered at The Storyhouse, a local arts venue. The Spider Project – a non-clinical community mental health service in Chester - has also provided me with fulfilling activities from yoga to creative writing. The MHIST team have not only kept me well but, most importantly, helped me thrive. Leaving hospital has been an adventure. It has been a joy to regain my independence and freedom. To live rather than to exist. Life is amazing. Long may it continue.”
MhIST provides an intensive rehabilitation and recovery service, delivering bespoke packages of care to individuals. This is achieved using key working and a shared team approach, outcome focused goal-based interventions, weekly reflective/formulation meetings, and a focus on social rehabilitation. Patients referred to MhIST will have a high level of complexity plus severe, treatment refractory symptoms, with impaired social, interpersonal and occupational function and high support needs. They may have co-occurring mental health conditions including substance misuse or neurodevelopmental disorders.
MhIST is a new service and has been active for around 6 months. The first 10 patients referred have been from acute wards (3), community mental health teams (1), and inpatient rehabilitation wards (6). 60% of patients are currently housed in independent accommodation.
Jen's story narrates the experience she encountered during transition from inpatient rehabilitation services to the community. This was completed with support from MhIST, a new community rehabilitation service which provides an intensive rehabilitation and recovery service.
The purpose of this study aims to explore the relationships between business portfolio reconfiguration and firm performance in developing countries as well as the moderating roles played by organizational slack, capabilities and ownership structure. By using the perspectives of dynamic capabilities, resources-based view and social network, this study proposes that there is a U-shaped relationship between business portfolio reconfiguration and firm performance. Furthermore, while R&D capability, marketing capability and foreign ownership are expected to positively moderate this U-shaped relationship, organizational slack, state and domestic ownership may potentially make this U-shaped relationship less pronounced. We draw our observations from Shanghai and Shenzhen Stock Exchanges in China from 2008 to 2017, and obtain 26,151 firm-year observations, which are consisted of 3,508 publicly traded companies. The results generally support our hypotheses, and some theoretical and practical implications are extracted from this study.
Worldwide, there are limited data on the prevalence of postpartum anaemia and iron status. The aims of the present study were to assess the prevalence of anaemia and iron deficiency (ID) by three iron indicators 14 weeks postpartum, their relations to haemoglobin (Hb) and associations with ethnicity and clinical factors in a multi-ethnic population. We conducted a population-based cohort study of 573 women followed from early pregnancy. The prevalence of postpartum anaemia (Hb <12·0 g/dl) was 25 %. ID prevalence varied from 39 % by serum ferritin (SF <15 μg/l), to 19 % by soluble transferrin receptor (sTfR >4·4 mg/l) and 22 % by total body iron (TBI < 0 mg/kg). The mean Hb concentration was 12·8 g/dl in women with no ID, 12·6 g/dl in those with ID by SF only and 11·6 g/dl in those with ID by SF, sTfR and TBI. ID by sTfR and TBI defined by the current threshold values probably identified a more severe iron-deficient population compared with ID assessed by SF. Compared with Western Europeans, the prevalence of anaemia was at least the double in ethnic minorities (26–40 % v. 14 %; P < 0·01–0·05), and the prevalence of ID by sTfR and TBI, but not of ID by SF < 15 μg/l, was significantly higher in some minority groups. After adjustment for covariates, only South Asians had lower Hb and higher sTfR concentration. Insufficient iron intake, gestational anaemia or ID, and postpartum haemorrhage were associated with lower postpartum Hb concentration and poorer iron status.