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Allegory ‘speaks the other’, that which was previously unspoken, and sometimes that which is unspeakable. Allegory also makes present what was absent; allegories are often absent presences. Allegory offers a fullness of meaning, but often succeeds only in delivering linguistic emptiness. Allegory may be a stepping-stone from the unreal or less real to the more real, in the anagogical exegeses of Neoplatonism. Biblical typology connects two historical events, one Old- and one New-Testament, the latter being understood as the ‘fulfilment’ of the former. Just how empty that leaves the former is disputed: should we talk of supersession, or of transformation? The presence of allegory requires the collusion of the reader. Allegories may become absent when their presence is denied, as for example in a persistent critical denial of the ‘typologies’ of Aeneid 8. The plausible deniability of allegory can also serve political purposes. The absences and presences of personification allegory are explored in Ovid’s Metamorphoses and Prudentius’ Psychomachia. Ovid energises the long history of personifications conscious of their ‘selves’, while Prudentius brings words given bodies up against the Word made flesh. Finally I examine Claudian’s dissolution of the subjects of his panegyrical epics into a cloud of images and myths.
Target benefit (TB) plans that incorporate intergenerational risk sharing have been demonstrated to be welfare improving over the long term. However, there has been little discussion of the short-term benefits for members in a defined benefit (DB) plan that is transitioning to TB. In this paper, we adopt a two-step approach that is designed to ensure the long-term sustainability of the new plan, without unduly sacrificing the benefit security of current retirees. We propose a cohort-based transition plan for reducing intergenerational inequity. Our study is based on simulations using an economic scenario generator with some theoretical results under simplified settings.
To carry out a qualitative evidence synthesis to explore what influences the diet and physical activity of adolescents living in five countries that constitute the Transforming Adolescent Lives through Nutrition (TALENT) consortium (Cote D’Ivoire, Ethiopia, India, South Africa and The Gambia).
A search of electronic databases was conducted for qualitative articles published between 2000 and 2019.
Studies that explore influences on the diets and physical activity habits of adolescents aged 10–19 years.
Of the twelve included studies, none were identified from The Gambia or Cote D’Ivoire. The existing qualitative literature focussed on three major areas in relation to adolescents’ diet and physical activity: (1) the influence of body image and self-esteem; (2) social and environmental influences and (3) poverty. The limited existing literature focusses heavily on girls’ experiences particularly in relation to body image and dysfunctional eating practices.
In-depth research exploring adolescents’ perceptions of diet and physical activity is needed to better understand how both boys and girls, at different stages of adolescence, perceive health, diet and physical activity. More research with young people is required especially in countries where little exists to cover a wider range of issues that play a role in diet and physical activity.
To assess concordance with guidelines on monitoring vitamin D levels and prescribing prophylaxis or replacement. To assess the association between the implementation of local guidelines and prevalence of vitamin D deficiency.
Vitamin D deficiency is associated with various adverse health outcomes including osteoporosis, fractures and myalgia. Most recently, vitamin D deficiency has been hypothesised as a risk factor for severe COVID-19 infection. Risk factors for vitamin D deficiency include incarceration, ethnicity, diet and a diagnosis of psychiatric disorder. Vitamin D deficiency is known to be prevalent among individuals within forensic mental health institutions.
Local Trust guidelines advise that vitamin D levels should be checked within one-month of hospital admission, followed by checks at three-monthly intervals. Recommendations for prescribing depend on patients’ vitamin D levels; deficient (<25nmol/L), insufficient (25 < 50nmol/L) or adequate (50-150nmol/L). We assessed concordance with these guidelines at Broadmoor Hospital, UK.
Medical records, laboratory results and drug charts were assessed for a total of 75 patients across 15 wards. Data were collected using a standardised audit tool, including; date of admission, admission vitamin D level, most recent vitamin D level and the dose and frequency of vitamin D prescribed.
76.4% of patients had their vitamin D levels checked within one month of admission. 66.7% of patients had their vitamin D checked within the last 3 months. For patients with an admission vitamin D level recorded, 43.6% had deficient vitamin D levels, 43.6% had insufficient levels and 12.7% had adequate levels. For patients with a more recent serum vitamin D level, 14.5% had deficient levels, 38.7% had insufficient levels and 46.8% had adequate levels. For patients with a documented serum vitamin D level, 21.4% were prescribed the correct dose, 22.9% were under-dosed, 14.3% were over-dosed and 41.4% received no dose where guidelines suggested they should.
Comparison of admission and most recent vitamin D levels suggests a general improvement in prevalence of vitamin D deficiency associated with the implementation of local guidelines. However, we identify significant areas for improvement. A substantial proportion of patients lacked admission or regular monitoring of vitamin D levels and a substantial proportion of patients were under-dosed or received no dose where guidelines suggested they should have. We propose that better concordance with guidelines may improve clinical outcomes further. This may prove especially important during the COVID-19 pandemic, given a potential association between vitamin D deficiency and severity of respiratory infection.
Prenatal exposure to nicotine, tobacco’s major addictive constituent, has been shown to reduce birth weight and increases apoptosis, oxidative stress, and mitochondrial dysfunction in the postnatal pancreas. Given that upregulated levels of the pro-oxidative adapter protein p66shc is observed in growth-restricted offspring and is linked to beta-cell apoptosis, the goal of this study was to investigate whether alterations in p66shc expression underlie the pancreatic deficits in nicotine-exposed offspring. Maternal administration of nicotine in rats increased p66shc expression in the neonatal pancreas. Similarly, nicotine treatment augmented p66shc expression in INS-1E pancreatic beta cells. Increased p66shc expression was also associated with decreased histone H3 lysine 9 methylation. Finally, nicotine increased the expression of Kdm4c, a key histone lysine demethylase, and decreased Suv39h1, a critical histone lysine methyltransferase. Collectively, these results suggest that upregulation of p66shc through posttranslational histone modifications may underlie the reported adverse outcomes of nicotine exposure on pancreatic function.
Hamit Bozarslan, Ecole des Hautes Etudes en Sciences Sociales, Paris,Cengiz Gunes, The Open University, Milton Keynes,Veli Yadirgi, School of Oriental and African Studies, University of London
The history of women’s activism in the Kurdistan Region of Iraq (KRI) is closely intertwined with the history of political resistance. In the 1950s, women mobilized against political oppression. Later, they joined the struggle as members of the underground movement, as couriers, as protectors and nurturers of male fighters, and sometimes as the peshmerga (those who face death) fighters. However, only few women played leadership roles in the resistance. After 1992, when a form of autonomy was attained, civil society organizations, including independent women’s organizations, proliferated. This growth in the 1990s and 2000s, combined with the end of the four-year Kurdish civil war in 1998, led to the formation of collaborative networks and umbrella organizations. Now we can speak of a women’s movement that, despite its internal shortcomings and outside obstacles, has been able to bring about change in the region (Hardi, 2013). This chapter builds on two earlier studies about the women’s movement in the Kurdistan Region of Iraq (Hardi, 2011, 2013). It draws on the voices of a group of experts to highlight the achievements and limitations and focuses on what to do next to surpass the perceived stagnation.
External evaluations by an international committee of the scientific risk assessment and decision-making processes of the Netherlands Competent Authority for the authorisation of plant protection products and biocides (Ctgb) were conducted in 2013 and 2018. Based on the experience drawn from them, a general guidance for such visitations is suggested. An international visitation committee examined the structure and management of the Authority, its human resources and staff policy, the scientific processes and output, the documentation and communication of its decisions and the mechanisms for keeping up to date with international scientific developments. Attention was paid to the degree of openness and transparency throughout the organisation and in particular when dealing with confidential information. From the experience gained it can be concluded that visitations not aiming at finding mistakes and omissions but instead focusing on recommendations and constructive suggestions will result in cooperation, mutual trust and acceptance of the recommendations made. A follow-up visitation after a few years can be effective in maintaining a traceable, high-level scientific output. In view of the strong drive towards the European Union-wide harmonisation of the regulatory practices of hazardous chemicals, a voluntary evaluation of regulatory authorities’ scientific performance is recommended as a means for organisational learning.
Evidence supports the use of group therapy for symptom reduction and improving functioning in people with psychosis. However, research guidelines highlight the importance of establishing the feasibility of interventions. Adherence is an important indicator of feasibility and an essential step in supporting the development of the evidence base for group interventions. This review aims to estimate adherence, and possible barriers and facilitators, to psychotherapeutic groups in people with psychosis.
Embase, Ovid MEDLINE and PsycINFO databases were searched for cross-referencing terms related to group therapy and psychosis. Studies were assessed against inclusion criteria and methodological quality was evaluated. Data wasextracted from each paper including the average session attendance, demographic, clinical, study and therapy-related characteristics and the impact of these on adherence levels evaluated.
Fifty-nine original research papers were included, reporting on 52 independent studies which consisted of 66 therapy groups comprised of 2109 participants. Average adherence was 76.4% (s.d. = 17.4). Adherence was improved by receiving incentives and was higher in participants of older age. Study sample size was inversely associated with adherence levels. Study quality was variable with approximately 61.5% found to be at risk of bias. The results support the feasibility of group therapy and suggest that adherence in people with psychosis is not dissimilar to those for people experiencing common mental health difficulties. These findings, alongside efficacy evidence, support the use of group interventions in people with psychosis but also highlight the need for further high-quality research on the efficacy for these approaches.