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Race may dominate everyday speech, media headlines and public policy, yet still questions of racialized blackness and whiteness in Shakespeare are resisted. In his compelling new book Ian Smith addresses the influence of systemic whiteness on the interpretation of Shakespeare's plays. This far-reaching study shows that significant parts of Shakespeare's texts have been elided, misconstrued or otherwise rendered invisible by readers who have ignored the presence of race in early modern England. Bringing the Black American intellectual tradition into fruitful dialogue with European thought, this urgent interdisciplinary work offers a deep, revealing and incisive analysis of individual plays, including Othello, The Merchant of Venice and Hamlet. Demonstrating how racial illiteracy inhibits critical practice, Ian Smith provides a necessary anti-racist alternative that will transform the way you read Shakespeare.
Offering an intimate history of how small things were used, handled, and worn, this collection shows how objects such as mugs and handkerchiefs were entangled with quotidian practices and rituals of bodily care. Small things, from tiny books to ceramic trinkets and toothpick cases, could delight and entertain, generating tactile pleasures for users while at the same time signalling the limits of the body's adeptness or the hand's dexterity. Simultaneously, the volume explores the striking mobility of small things: how fans, coins, rings, and pottery could, for instance, carry political, philosophical, and cultural concepts into circumscribed spaces. From the decorative and playful to the useful and performative, such small things as tea caddies, wampum beads, and drawings of ants negotiated larger political, cultural, and scientific shifts as they transported aesthetic and cultural practices across borders, via nationalist imagery, gift exchange, and the movement of global goods.
Written by an interdisciplinary team of scholars, this book offers novel perspectives on the history of medical writing and scientific thought-styles by examining patterns of change and reception in genres, discourse, and lexis in the period 1500-1820. Each chapter demonstrates in detail how changing textual forms were closely tied to major multi-faceted social developments: industrialisation, urbanisation, expanding trade, colonialization, and changes in communication, all of which posed new demands on medical care. It then shows how these developments were reflected in a range of medical discourses, such as bills of mortality, medical advertisements, medical recipes, and medical rhetoric, and provides an extensive body of case studies to highlight how varieties of medical discourse have been targeted at different audiences over time. It draws on a wide range of methodological frameworks and is accompanied by numerous relevant illustrations, making it essential reading for academic researchers and students across the human sciences.
Shakespeare Survey is a yearbook of Shakespeare studies and production. Since 1948, Survey has published the best international scholarship in English and many of its essays have become classics of Shakespeare criticism. Each volume is devoted to a theme, or play, or group of plays; each also contains a section of reviews of that year's textual and critical studies and of the year's major British performances. The theme for Volume 75 is 'Othello'. The complete set of Survey volumes is also available online at https://www.cambridge.org/core/what-we-publish/collections/shakespeare-survey This fully searchable resource enables users to browse by author, essay and volume, search by play, theme and topic and save and bookmark their results.
Parenting is a critical influence on the development of children across the globe. This handbook brings together scholars with expertise on parenting science and interventions for a comprehensive review of current research. It begins with foundational theories and research topics, followed by sections on parenting children at different ages, factors that affect parenting such as parental mental health or socioeconomic status, and parenting children with different characteristics such as depressed and anxious children or youth who identify as LGBTQ. It concludes with a section on policy implications, as well as prevention and intervention programs that target parenting as a mechanism of change. Global perspectives and the cultural diversity of families are highlighted throughout. Offering in-depth analysis of key topics such as risky adolescent behavior, immigration policy, father engagement, family involvement in education, and balancing childcare and work, this is a vital resource for understanding the most effective policies to support parents in raising healthy children.
Evolutionary psychiatry attempts to explain and examine the development and prevalence of psychiatric disorders through the lens of evolutionary and adaptationist theories. In this edited volume, leading international evolutionary scholars present a variety of Darwinian perspectives that will encourage readers to consider 'why' as well as 'how' mental disorders arise. Using insights from comparative animal evolution, ethology, anthropology, culture, philosophy and other humanities, evolutionary thinking helps us to re-evaluate psychiatric epidemiology, genetics, biochemistry and psychology. It seeks explanations for persistent heritable traits shaped by selection and other evolutionary processes, and reviews traits and disorders using phylogenetic history and insights from the neurosciences as well as the effects of the modern environment. By bridging the gap between social and biological approaches to psychiatry, and encouraging bringing the evolutionary perspective into mainstream psychiatry, this book will help to inspire new avenues of research into the causation and treatment of mental disorders.
After more than half a century since their unexpected discovery and identification as neutron stars, the observation and understanding of pulsars touches upon many areas of astronomy and astrophysics. The literature on pulsars is vast and the observational techniques used now cover the whole of the electromagnetic spectrum from radio to gamma-rays. Now in its fifth edition, this volume has been reorganised and features new material throughout. It provides an introduction in historical and physical terms to the many aspects of neutron stars, including condensed matter, physics of the magnetosphere, supernovae and the development of the pulsar population, propagation in the interstellar medium, binary stars, gravitation and general relativity. The current development of a new generation of powerful radio telescopes, designed with pulsar research in mind, makes this survey and guide essential reading for a growing body of students and astronomers.
Wesley Hohfeld is known the world over as the legal theorist who famously developed a taxonomy of legal concepts. His contributions to legal thinking have stood the test of time, remaining relevant nearly a century after they were first published. Yet, little systematic attention has been devoted to exploring the full significance of his work. Beginning with a lucid, annotated version of Hohfeld's most important article, this volume is the first to offer a comprehensive look at the scope, significance, reach, intricacies, and shortcomings of Hohfeld's work. Featuring insights from leading legal thinkers, the book also contains many of Hohfeld's previously unseen personal papers, shedding new light on the complex motivations behind Hohfeld's projects. Together, these selected papers and original essays reveal a portrait of a multifaceted and ambitious intellectual who did not live long enough to see the impact of his ideas on the study of law.
In addition to time and place, which are inseparable from sociolinguistic variation, language may vary according to age, social class, sex or (social) gender, ethnicity, medium, style, and register. Contact between speakers often leads to change, and different patterns result according to whether this contact involves first-language (L1) or second language (L2) acquisition. Thus, ‘family tree’ aspects of language change are largely accounted for by transmission (involving L1 acquisition), whilst ‘wave model’ changes can be explained in terms of diffusion (involving L2 acquisition). Languages with a high degree of L2 contact will tend to simplify, whilst stable bilingualism or isolation will often lead to complexification. Contact may be interlinguistic or intralinguistic, sometimes resulting in complex linguistic repertoires, with up to four different levels existing simultaneously (national standard, regional standard, interdialectal koiné, local dialect). Contact may also result in code-switching, the emergence of contact vernaculars, and ‘language death’. The receptiveness of a variety to contact influence depends on the extent to which its social networks are open or closed and on the social attitudes of its speakers. Standard languages emerge through a variety of conscious and unconscious processes, and attempts may be made to give non-standard speech varieties a distinct linguistic identity through codification and the creation of literature.
To report on the prevalence of different types of breast-milk substitutes (BMS) marketing and the compliance of such marketing with the “Control of Marketing of Infant and Young Child Food Act 2017” (The Act) and the “International Code of Marketing of Breastmilk Substitutes (WHO Code)” in Thailand.
Design:
Cross-sectional quantitative study, guided by the WHO/UNICEF NetCode Periodic Assessment Protocol.
Setting:
Health facilities and retail outlets in Bangkok, Thai media.
Participants and data sources:
Mothers of 0-2-year-old children, health professionals, promotions at retail outlets and health facilities, product labels, marketing on television and the internet.
Results:
Marketing to mothers was highly prevalent, mostly from electronic or digital media, while BMS companies provided items to health professionals to distribute to mothers. Promotional materials in health facilities displayed company brands or logos. At retail outlets, most promotions were price-related. Around two-fifths of labels contained nutrition or health claims. Television marketing was growing-up-milk advertisements, while internet promotions were varied from price-related materials to product reviews.
Most instances of non-compliant BMS marketing with the Act were advertisements to mothers, and most were infant formula. Most non-compliant BMS marketing with the WHO Code was mainly concerned growing-up milks, which are not covered by the Act and appeared in the media.
Conclusions:
BMS marketing does not fully comply with the Act or the WHO Code. The Thai government should conduct regular monitoring and enforcement activities, educate health professionals, and strengthen the Act’s provisions on the media and growing-up milk to fully align with the WHO Code.
The dissociative subtype of post-traumatic stress disorder (PTSD-DS) was introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and is characterised by symptoms of either depersonalisation or derealisation, in addition to a diagnosis of post-traumatic stress disorder (PTSD). This systematic review and meta-analysis sought to estimate the point prevalence of current PTSD-DS, and the extent to which method of assessment, demographic and trauma variables moderate this estimate, across different methods of prevalence estimation. Studies included were identified by searching MEDLINE (EBSCO), PsycInfo, CINAHL, Academic Search Complete and PTSDpubs, yielding 49 studies that met the inclusion criteria (N = 8214 participants). A random-effects meta-analysis estimated the prevalence of PTSD-DS as 38.1% (95% CI 31.5–45.0%) across all samples, 45.5% (95% CI 37.7–53.4%) across all diagnosis-based and clinical cut-off samples, 22.8% (95% CI 14.8–32.0%) across all latent class analysis (LCA) and latent profile analysis (LPA) samples and 48.1% (95% CI 35.0–61.3%) across samples which strictly used the DSM-5 PTSD criteria; all as a proportion of those already with a diagnosis of PTSD. All results were characterised by high levels of heterogeneity, limiting generalisability. Moderator analyses mostly failed to identify sources of heterogeneity. PTSD-DS was more prevalent in children compared to adults, and in diagnosis-based and clinical cut-off samples compared to LCA and LPA samples. Risk of bias was not significantly related to prevalence estimates. The implications of these results are discussed further.
The past few years have seen a rapid global scramble of governments developing strategic plans for Artificial Intelligence (AI). We focus in this chapter on four of the largest global economies and what their AI plans mean for higher education. Since 2016, China, the EU, the US, and the UK have all published strategic plans for AI (Fa, 2017; Hall and Pesenti, 2017; USA Government, 2019; European Commission, 2020). These plans’ speed appears to indicate a matter of urgency and a sense of high governmental priority. This chapter discusses how these plans differ, what we might look out for and the likely developments ahead for higher education. Higher education is of central importance to meet the coming AI economy’s demands, and embracing AI is broadly considered a transformative existential requirement for many universities’ survival (Aoun, 2017). How governments and their higher learning institutions are planning this transformation is of the utmost importance to us all.
The acquisition and procurement of major weapons systems is fraught with difficulties. They tend to be delivered late, over budget and unable to meet requirements. This Element provides an economic analysis of why this happens. Market structure, demand by the military and supply by the arms firms, shapes the conduct of the agents and generates the poor performance observed. The military are trying to counter an evolving threat, subject to a budget constraint, high R&D costs and new technologies. The interaction between a government made up of warring tribes and arms firms with considerable market and political power is further complicated by a set of what economists call 'principal-agent' problems, which are examined. While the poor performance has prompted many countries to propose reforms, the difficulty of the task and the institutional incentives faced by the actors mean that the reforms rarely solve the problem.
This is a cross-sectional service evaluation study of the vaccination programme within the high secure setting of Broadmoor hospital with a view of improving the quality of it's delivery. We aimed to establish patients views about COVID-19 vaccinations particularly if there are any themes as to why the patients choose/did not choose to receive the vaccine. This information will be used to help us understand how to overcome vaccine hesitancy and anti-vaccine beliefs.
Methods
Patients across Eight wards were asked to participate in the study. 56 patients agreed to be administered the following semi-structured questionnaire by the doctors.
1. Have you had a COVID-19 vaccine?
2. Do you think there any advantages to taking a COVID-19 vaccine? Yes/No. If you think there are any advantages, please write these
3. Do you have any fears or worries about the COVID-19 vaccine? Yes/No. If you do have any fears or worries, please write these.
The results of this were reviewed and put into the categories that are cited below.
Results
14 patients had no vaccination, 2 had one, 38 had two or more.
34 patients said there were advantages, 13 said no advantages and 9 did not know. The themes of the advantages were established: Protects you from bad infection and symptoms (48), stops you from passing it on to others (3), blank (13), others (13) which included “Important to follow government guidelines, proven through history to work, it was offered, I'm more concerned with hepatitis, The doctor would have my best interests.”
30 patients stated that they did have fears and 26 did not. Common themes established were; side effects (17), Not tested correctly/given too quickly (5), Blood clots (2), positive comments (2), blank (22), others (10), which included, “Interaction with medications, more fear about face masks, injecting humanity with something could kill them, infertile generation, Control the public, don't like injections and alter the DNA genome.” The common side effects of concern were “painful arm, fever and headache.”
Conclusion
68% of patients had 2 or more vaccinations across the 8 wards studied. The commonest advantages cited by 86% of patients was to protect themselves from serious illness. The commonest fears or worries were of side-effects that result from the vaccine, although 46% patients had no worries and 39% gave no explanation for fears or worries. The fears and worries appeared mainly related to vaccine hesitancy rather than fixed generalised anti- vaccine views.
Advertisements for audio equipment in midcentury magazines, such as High Fidelity and HiFi Review, shaped the constructions that determined how masculinity was modeled, embodied, and fashioned in the United States at midcentury. A hi-fi setup was a material expression of self and masculinity that could be ever tweaked, refashioned, and adjusted. Tonearms, however, were (and still are) delicate, troublesome, and, when improperly calibrated, capable of destroying record grooves. Manufacturers, advertisers, and magazine contributors who strategically gendered other technologies as masculine—such as amplifiers and speakers—struggled to imbue tonearms with the same virility, toughness, and power. If the hi-fi system served as an embodied simulacrum of the masculine self, then the tonearm was a necessary and omni-present symbolic point of gendered questioning in masculine identity formation. In this article, I argue that the tonearm is a site of fluidity and ambiguity within a modular masculine system, and I demonstrate that the discourses around tonearms in 1950s hi-fi magazines provide an alternative window into discussions of gender and sexuality in United States print culture. Through image analysis and close reading of advertisements and equipment reviews, I decentralize hegemonic masculinity and make room for readings that draw upon feminist and queer theory. More broadly, I submit that mid-twentieth-century hi-fi discourses do not produce a single brand of anxiously conforming maleness, but rather an array of modular masculinities.
Physician associates (PAs) are becoming more commonplace in psychiatric services in the UK to help address long term workforce difficulties. The 2019 NHS Long Term Plan detailed a commitment to transforming mental health care in England recognising that services were not meeting current or future increase in demand. Health Education England's (HEE) report, Stepping Forward to 2020/21: The Mental Health Workforce Plan for England, described a longer-term strategy to expand the mental health workforce, including recruiting 5,000 people into ‘new roles’ including physician associates. The NHS Mental Health Implementation Plan 2019/20–2023/24 stated an aim of recruiting 140 PAs to the workforce over five years in addition to the requirements specified in the HEE report. Competence frameworks make the link between evidence and practice and can be a valuable basis for training, an agenda for supervision and a guide for self-monitoring and personal development for people working in the role.
Methods
The competence framework was developed by the National Collaborating Centre for Mental Health (NCCMH). The work was overseen by an expert reference group, comprising experts in training PAs in mental health, PAs, researchers and experts by experience, all selected for their expertise in research, training and service delivery. The completed framework was then sent to relevant stakeholders including the Faculty of Physician Associates and patient groups for comment and adapted accordingly.
Results
The completed framework has been arranged into seven domains: Knowledge of Mental Health, Professional/Legal Issues, Engagement and Communication, Diagnostic Assessment and Treatment Planning, Interventions, Team Working and Metacompetences. This reflects the expected roles and responsibilities of PAs working in mental health.
Conclusion
The Competence Framework for PAs will help those involved in mental health care services who wish to deepen their understanding of the PA role, and will be useful to team members working with PAs, to their managers and to commissioners. It will support the work of PA supervisors and peer coordinators, and those delivering education and training to them. It also brings a level of standardisation of the role. More work will be needed to adapt the Competence Framework for PAs for specialist contexts, such as in dementia care or children and young people's services.
In view of the limited number of acute inpatient beds relative to demand in England, a thorough assessment prior to referral is paramount in ascertaining clinical need. A comprehensive risk assessment is crucial in light of patient safety and assessing risk to others. Moreover, the appropriateness of an acute bed should be considered, and whether psychiatric intensive care or forensic services may be more appropriate for the patient. In line with this, the Birmingham and Solihull Mental Health Foundation Trust (BSMHFT) admissions policy details standards of the assessment prior to referral to acute inpatient services. Pre-referral assessment should be carried out by a multidisciplinary team including a senior doctor. It should include rationale and plan of care for admission, risk assessment and section status on admission alongside type of bed being requested. Referrals are accepted from multiple teams including Home Treatment, the Place of Safety and Liaison Psychiatry. Aim: To audit adherence to the pre-referral policy for acute inpatient admissions to a male and female ward in BSMHFT, including comprehensive assessment, plan of care and consideration of appropriate bed type.
Methods
A retrospective audit of pre-referral documentation for all admissions from April to September 2019 to a male and separate female acute inpatient unit at the Zinnia Centre, Birmingham was carried out. This included 83 male admissions and 82 female admissions. Documentation was reviewed on the clinical system Rio. Parameters reviewed included assessing clinician, assessment summary, capacity assessment, consideration of bed type, plan of care and section details.
Results
Overall, almost half of admissions (49%) were assessed by a full Mental Health Act team, 34% by a senior psychiatric doctor and the remainder by psychiatric nurses in the referring department. An up-to-date assessment summary was completed in the majority of cases (67%) prior to referral. Risk assessments were completed in 82% of cases. 35% of cases included a detailed plan of care which met audit standards. Capacity assessment alongside outcome was documented in 13% of cases. The type of bed was only considered in 13% of cases.
Conclusion
Whilst assessment and risk documentation was completed in the majority of cases, few cases had a clear plan of care and appropriateness of bed type was rarely considered in assessment. Greater adherence to the pre-referral process could facilitate treatment decisions during admission and seek to ensure a safer inpatient environment.
There has been increasing recognition that healthy cultures within NHS organisations are key to delivering high-quality, safe care (King's Fund). A focus towards developing systems which recognise and learn from excellence has been shown to improve services’ safety and contribute to staff's morale (Kelly et al. 2016). In 2019 Secure Services at Devon Partnership NHS Trust (DPT) developed an Excellence reporting system. Once successfully piloted, the intention was to extend to other departments before expanding to the entire Trust. Our aims initially were SMART: for 13 reports per week in Secure services and 8 in Perinatal (a smaller team). As we expanded the aim became qualitative: for a system to be embedded so staff could as readily and instinctively report Excellence as they could an error.
Methods
We developed our Theory of Change using Deming's theory of profound knowledge, ran a series of PDSAs, and introduced an Excellence system. We engaged early adopters, sent hand-written cards and shared data widely.
Learning included understanding setting up the system, and the importance of a team rather than an individual holding the system. We took this forward to bring the system to Perinatal. We continued to run PDSAs, then ran monthly trust-wide meetings providing space to learn from other directorates.
Results
Staff were initially excited, reports submitted, feedback good, then a plateau and slump.
Something was stopping the system perpetuating. When staff received timely thanks, and others heard about it, staff would go on to promote excellence. However, this was not possible without sufficient admin resources.
In early 2021 we changed tact and approached the top: we presented data to Directors who recognised the value and agreed to support. We then set about publicising the system, and demonstrating at trust-wide meetings.
By July 2021 we saw 10 reports per week in the Specialist Directorate.
By early 2022 reports were being inputted from staff across all directorates and our monthly meetings began to focus on sharing the learning.
Conclusion
We recognised the system's potential impact on safety and staff morale but struggled to sustain the system and support dwindled when staff were stretched.
After approaching leaders, then allocated resources, it allowed for more success. However, it is not yet fully embedded in our Trust's culture.
A lot of our work happened during COVID-19 and despite challenges there has been a new-found flexibility to innovate, greater ease to negotiate, and instigate change.