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.
Cardiac intensivists frequently assess patient readiness to wean off mechanical ventilation with an extubation readiness trial despite it being no more effective than clinician judgement alone. We evaluated the utility of high-frequency physiologic data and machine learning for improving the prediction of extubation failure in children with cardiovascular disease.
This was a retrospective analysis of clinical registry data and streamed physiologic extubation readiness trial data from one paediatric cardiac ICU (12/2016-3/2018). We analysed patients’ final extubation readiness trial. Machine learning methods (classification and regression tree, Boosting, Random Forest) were performed using clinical/demographic data, physiologic data, and both datasets. Extubation failure was defined as reintubation within 48 hrs. Classifier performance was assessed on prediction accuracy and area under the receiver operating characteristic curve.
Of 178 episodes, 11.2% (N = 20) failed extubation. Using clinical/demographic data, our machine learning methods identified variables such as age, weight, height, and ventilation duration as being important in predicting extubation failure. Best classifier performance with this data was Boosting (prediction accuracy: 0.88; area under the receiver operating characteristic curve: 0.74). Using physiologic data, our machine learning methods found oxygen saturation extremes and descriptors of dynamic compliance, central venous pressure, and heart/respiratory rate to be of importance. The best classifier in this setting was Random Forest (prediction accuracy: 0.89; area under the receiver operating characteristic curve: 0.75). Combining both datasets produced classifiers highlighting the importance of physiologic variables in determining extubation failure, though predictive performance was not improved.
Physiologic variables not routinely scrutinised during extubation readiness trials were identified as potential extubation failure predictors. Larger analyses are necessary to investigate whether these markers can improve clinical decision-making.
Ecclesiastical courts were rightly seen by nineteenth-century thinkers as a closed shop, a court system separate from the general court system which had its own proctors, advocates and judges. These courts had jurisdiction over the laity in a number of matters such as marriage, burial and probate of wills, though this changed during the century. The chapter describes the attempts at reform, and the difficulties with discipline of the laity as well as clergy that were addressed in the course of legislative change. Appeal lay with the secular courts and here too lay problems, where the Judicial Committee of the Privy Council served as the final court of appeal
The Conclusion looks at what has happened from the twentieth century onwards, with social change affecting the relationship between Parliament and the Church of England. It traces the history of increasing lay involvement in a society that is growing ever more multicultural and multifaith. The Church of England has entered actively into ecumenical dialogue and inter-church cooperation. The wording of the liturgy has been modernised. The Conclusion looks at a series of attempts, still in train, to make more satisfactory provision for clergy discipline. It reviews the changes in property law as it affects the Church of England and modern Faculty jurisdiction. Parliament now exercises only a light touch in the making of the Church’s legislation.
This chapter sets the social and ecclesiastical scene. It introduces the place of ecclesiastical law in the law of England. It explores the changing place of the Church of England in the life of the nation from the early nineteenth century, the role of the universities in educating future clergy and the significant place of the bishops in political as well as pastoral and spiritual leadership. It describes the need for more churches as the Industrial Revolution took a growing proportion of the population from the country into the towns. It introduces the challenge of the Dissenters with their rival chapels and the complexities of applying ecclesiastical law when there were controversies.
Nineteenth-century England had a large population of Christians who did not belong to the Church of England, and a proportion of Jews, though as yet almost no Muslims. The civic position of Jews had partly improved by this time. There was growing interest in the problems presented by what would now be thought of as ‘ecumenical relations’, with the first Lambeth Conferences giving the matter consideration, though excluding the Roman Catholics. This chapter explores the relationships between the main categories of non-Anglican Protestant Christians, including the ways in which they might be regarded as being part of the Church, that is, having an authentic ecclesial identity. The refusal of the Friends (Quakers) to take oaths was accommodated and the rights of Roman Catholics were thought through, with particular reference to Ireland. Dissenting academies were providing an excellent higher education. Problems were arising about the payment of clerical income and the costs of maintaining churches because non-Anglicans resented having to make a contribution.
This chapter discusses a series of high-profile cases in which significant disputes arose involving the application of ecclesiastical law. It begins with Parliament’s debates on its role and authority in this area as it attempted more than once to frame legislation for clergy discipline and the discussions in Convocation. It considers the Gompertz case, raising questions about the role of the bishop; the contrasting churchmanships of Evangelicals and Tractarians; and the controversy about biblical interpretation prompted by the publication of Essays and Reviews. The case of James Shore tested the law on the effect of a clergyman’s finding his opinions had changed to such an extent that he was no longer a member of the Church of England, while still effectively retaining his Anglican priesthood. The chapter also covers the cases of William Bennett and the ‘real presence’, and George Denison’s lengthy dispute with the Bishop of Exeter on the effect of baptism. It ends with the case of Alexander Mackonochie and controversy over the regulation of public worship.
This chapter turns to the experiences of the laity when they found themselves in ecclesiastical courts in disputes over marriage, wills and burial, disorderly behaviour, or unacceptable use of language: speech crimes: brawling, defamation and blasphemy. It looks at examples of the costs and consequences to the laity of finding themselves in ecclesiastical courts, and the role of the debtors’ prisons.
This chapter explores the history and extent of the jurisdiction of Parliament over the ecclesiastical law of the Church of England and the role of bishops sitting as members of the House of Lords, some of them prominent and controversial. Among the ecclesiastical lawyers were several who served as Members of Parliament. The nineteenth century saw the revival of Convocation, the Church’s own Parliament, and the chapter follows it in its efforts to re-establish itself. The Church owned a great deal of property, and lay property holders had opportunities to exploit their rights to the gift of clerical livings. There were accusations of simony. In both contexts there were property disputes. All this sharpened the long-standing question of the relationship between temporalities which were the proper business of secular law and the spiritualities which were not.
Throughout the nineteenth century the relationship between the State and the Established Church of England engaged Parliament, the Church, the courts and – to an increasing degree – the people. During this period, the spectre of Disestablishment periodically loomed over these debates, in the cause – as Trollope put it – of 'the renewal of inquiry as to the connection which exists between the Crown and the Mitre'. As our own twenty-first century gathers pace, Disestablishment has still not materialised: though a very different kind of dynamic between Church and State has anyway come into being in England. Professor Evans here tells the stories of the controversies which have made such change possible – including the revival of Convocation, the Church's own parliament – as well as the many memorable characters involved. The author's lively narrative includes much valuable material about key areas of ecclesiastical law that is of relevance to the future Church of England.
The Hawaiian archipelago was formerly home to one of the most species-rich land snail faunas (> 752 species), with levels of endemism > 99%. Many native Hawaiian land snail species are now extinct, and the remaining fauna is vulnerable. Unfortunately, lack of information on critical habitat requirements for Hawaiian land snails limits the development of effective conservation strategies. The purpose of this study was to examine the plant host preferences of native arboreal land snails in Puʻu Kukui Watershed, West Maui, Hawaiʻi, and compare these patterns to those from similar studies on the islands of Oʻahu and Hawaiʻi. Concordant with studies on other islands, we found that four species from three diverse families of snails in Puʻu Kukui Watershed had preferences for a few species of understorey plants. These were not the most abundant canopy or mid canopy species, indicating that forests without key understorey plants may not support the few remaining lineages of native snails. Preference for Broussaisia arguta among various island endemic snails across all studies indicates that this species is important for restoration to improve snail habitat. As studies examining host plant preferences are often incongruent with studies examining snail feeding, we suggest that we are in the infancy of defining what constitutes critical habitat for most Hawaiian arboreal snails. However, our results indicate that preserving diverse native plant assemblages, particularly understorey plant species, which facilitate key interactions, is critical to the goal of conserving the remaining threatened snail fauna.