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Samuel Beckett's Poetry is the first book-length study of Beckett's complete poetry, designed for students and scholars of twentieth century poetry and literature, as well as for specialists of Beckett's work. This volume explores how poetry provided Beckett a medium of expression during key moments in his life, from his earliest attempts at securing a reputation as a published writer, to the work of restoring his own speech while suffering aphasia shortly before his death. Often these were moments of desperation and discouragement, when more substantial works were not possible: moments of illness, of personal loss or of public disaster. This volume includes an introduction that contextualizes Beckett as a poet and a chronology of the composition and publication of all his known poems. Essays offer a range of critical perspectives, from translation theory, war poetics and Irish Studies to Beckett's debts to Modernism, Romanticism and the Jazz Age.
Quizzes are a ubiquitous part of the dementia social care landscape. This article explores why. Using an ethnographic approach which draws on close analysis of communication, we examine dementia quizzes as a ‘social practice’, and what such a lens can tell us about their popularity in social care settings. Vignettes of real interactions drawn from ten different quizzes recorded in four different group settings attended by 28 people living with dementia and 15 staff members are presented to highlight particular issues. We show that the conditions of post-diagnosis dementia social care are uniquely well suited to an activity such as quizzes which are malleable, requiring little preparation or materials, and impose a communication framework which can help to organise the interactional space. Quizzes also draw on previously forged interactional competences, such as turn-taking and question–answer sequences, a skill that has been shown to persist even as dementia progresses. Finally, we argue that the meaning of quizzes with people with dementia feeds into wider societal values and associations attached to memory, dementia and personhood. The extent to which quizzes are akin to a ‘test’ or a fun and enjoyable social activity rests in how they are enacted. We suggest that practice can be adapted, developed and made more inclusive through input from people living with dementia themselves.
In his spirited defence of a thick constructivist approach to the study of international relations, Friedrich Kratochwil repeatedly invites us to adopt the perspective of the first-person plural. Without a conception of ‘we’, there is no language or discourse, no possibility for authority or justice, no collective sense of right and wrong. But how does the constructed ‘we’ relate to the psychological and biological agent, ‘I’, who is engaged in practice?
For Kratochwil, ‘we-intentionality’ cannot be reduced to the antecedent beliefs or feelings of individuals. For as long as members of a group accept the legitimacy of decisions made on their behalf, groups can have ‘beliefs’ that previously were not held by any of the members individually. Collective intentionality presupposes a conception of the ‘we’ to which the individual attaches some value or meaning (Kratochwil, 2018: 26).
At first glance the argument is compelling enough, yet it begs the question of the origins of the group in the first place. If, as Kratochwil (Kratochwil, 2018: 28) is quick to assert, the Hobbesian contract cannot emerge in a state of nature characterized by generalized distrust, are we to start our analysis of social organization from the assumption of generalized trust and the absence of any individuals motivated to abuse it for egoistic purposes?
A related objective is to draw our attention to the ways in which language not only describes but also constitutes the social world. Most social facts are reproduced via concepts that find their articulation in language and derive their meaning from malleable practice. The implications for social science epistemology are significant. ‘[E] specially in the social world, the question of what “is” (“this note is legal tender”) runs from the mind to the world (mind dependence), instead of the other way around as conceptualized by positivist “theories” ‘ (Kratochwil, 2018: 7). Yet it is worth reminding ourselves that the mind is a property of individuals, even as Kratochwil takes pains to point out, we can recognize collective intentionality without postulating something like a collective mind.
The methodological reflections in this chapter are based on a qualitative study of youth volunteering in deprived urban areas in Glasgow, Scotland conducted during my doctorate (2013– 18). The research explored young people's understandings of volunteering, their routes to participation, the meanings they attributed to it and barriers to participation. Young volunteers and non-volunteers, aged 12– 18, were recruited to focus groups and interviews from youth organisations and educational institutions. Interviews were also conducted with youth workers. The focus of this chapter, however, is on the methodological issues encountered during fieldwork with young people. The chapter explores the role of gatekeepers, the negotiation of access and consent, recruitment challenges and the combined use of focus groups and interviews. It reflects on my attempt to use participatory methods during the pilot study and examines what ‘failed’ interviews can teach us about the research process. The chapter takes a reflexive approach and considers how, due to demographic differences and varying meanings attributed to volunteering, ‘outsider’ researchers can encounter challenges when studying voluntary action.
The research and I
Before discussing the methods, I want to provide an account of my positionality and route to the research. Qualitative methods are associated with a constructivist epistemology that views research as a process of meaning-making. Discussions between researchers and participants are shaped by the histories and biographies each brings to the encounter. Accordingly, my reflections on the methods I employed are contingent upon the interactions I had in the field and, without a brief biographical sketch, something may be lost in the following account.
I was born into a middle-class family in the south-east of England. My parents, who met while studying at university, relocated from the northwest a few years before I was born. I attended an independent day school that offered a variety of extra-curricular activities to ‘build character’ and enhance university applications – the assumption being that pupils would attend university. Aside from a brief stint in a charity shop one summer, I had little engagement with volunteering until I was an undergraduate, studying sociology at the University of Liverpool. While studying, I volunteered with a variety of groups, including adults with learning difficulties, deaf and blind children, asylum seekers and other students.
Prior to the COVID-19 pandemic, our research group initiated a pediatric practice-based randomized trial for the treatment of childhood obesity in rural communities. Approximately 6 weeks into the originally planned 10-week enrollment period, the trial was forced to pause all study activity due to the COVID-19 pandemic. This pause necessitated a substantial revision in recruitment, enrollment, and other study methods in order to complete the trial using virtual procedures. This descriptive paper outlines methods used to recruit, enroll, and manage clinical trial participants with technology to obtain informed consent, obtain height and weight measurements by video, and maintain participant engagement throughout the duration of the trial.
The study team reviewed the IRB records, protocol team meeting minutes and records, and surveyed the site teams to document the impact of the COVID-19 shift to virtual procedures on the study. The IRB approved study changes allowed for flexibility between clinical sites given variations in site resources, which was key to success of the implementation.
All study sites faced a variety of logistical challenges unique to their location yet successfully recruited the required number of patients for the trial. Ultimately, virtual procedures enhanced our ability to establish relationships with participants who were previously beyond our reach, but presented several challenges and required additional resources.
Lessons learned from this study can assist other study groups in navigating challenges, especially when recruiting and implementing studies with rural and underserved populations or during challenging events like the pandemic.
Background: In November 2020, bamlanivimab received emergency use authorization (EUA) to treat patients with early, mild-to-moderate COVID-19 who are at high risk of progression. Montefiore Medical Center serves an economically underserved community of >1.4 million residents in the Bronx, New York. Montefiore’s antimicrobial stewardship team (AST) developed a multidisciplinary treatment pathway for patients meeting EUA criteria: (1) outpatients and hospital associates and (2) acute-care patients (EDs or inpatient). Methods: The Montefiore AST established a centralized process for screening high-risk COVID-19 patients 7 days a week. Referrals were sent by e-mail from occupational health, primary care practices, specialty practices, emergency departments, and urgent care centers. Patients were screened in real time and were treated in the ED or a newly established infusion center within 24 hours. After infusion, all patients received phone calls from nurses and had an infectious diseases televisit. Demographics, clinical symptoms, subsequent ED visit or hospital admission, and timing from infusion to ED or hospitalization were obtained from the electronic health record. Results: In total, 281 high-risk patients (median age, 62 years; 57% female) received bamlanivimab at the infusion center or in the acute-care setting between December 2, 2020, and January 27, 2021 (Table 1). The number of treated patients increased weekly (Figure 1). Also, 62% were Hispanic or black, and 96% met EUA criteria. Furthermore, 51 (18%) were referred from occupational health, 205 (73%) were referred from the community, and 25 (9%) were inpatients (https://www.fda.gov/media/143605/download). All patients were successfully infused without adverse reactions. In addition, 23 patients (8.2%) were hospitalized and 6 (2.1%) visited EDs within 30 days of treatment. The average number of days between symptom onset and infusion was 4.9. The median age of admitted versus nonadmitted patients was 68 years versus 61.5 years (P = .07). Conclusions: An AST-coordinated bamlanivimab treatment program successfully treated multiple high-risk COVID-19 patients and potentially reduced hospitalizations. However, the effort, personnel, and resources required are significant. Dedicated hospital investment is necessary for maximal success.
The influence of surface melt on the flow of Greenland's largest outlet glaciers remains poorly known and in situ observations are few. We use field observations to link surface meltwater forcing to glacier-wide diurnal velocity variations on East Greenland's Helheim Glacier over two summer melt seasons. We observe diurnal variations in glacier speed that peak ~6.5 h after daily maximum insolation and extend from the terminus region to the equilibrium line. Both the amplitude of the diurnal speed variation and its sensitivity to daily melt are largest at the glacier terminus and decrease up-glacier, suggesting that the magnitude of the response is controlled not only by melt input volume and temporal variability, but also by background effective pressure, which approaches zero at the terminus. Our results provide evidence that basal lubrication by meltwater drives diurnal velocity variations at Greenland's marine-terminating glaciers in a similar manner to alpine glaciers and Greenland's land-terminating outlet glaciers.
Healthcare personnel with severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection were interviewed to describe activities and practices in and outside the workplace. Among 2,625 healthcare personnel, workplace-related factors that may increase infection risk were more common among nursing-home personnel than hospital personnel, whereas selected factors outside the workplace were more common among hospital personnel.
The coronavirus disease 2019 (COVID-19) pandemic has resulted in shortages of personal protective equipment (PPE), underscoring the urgent need for simple, efficient, and inexpensive methods to decontaminate masks and respirators exposed to severe acute respiratory coronavirus virus 2 (SARS-CoV-2). We hypothesized that methylene blue (MB) photochemical treatment, which has various clinical applications, could decontaminate PPE contaminated with coronavirus.
The 2 arms of the study included (1) PPE inoculation with coronaviruses followed by MB with light (MBL) decontamination treatment and (2) PPE treatment with MBL for 5 cycles of decontamination to determine maintenance of PPE performance.
MBL treatment was used to inactivate coronaviruses on 3 N95 filtering facepiece respirator (FFR) and 2 medical mask models. We inoculated FFR and medical mask materials with 3 coronaviruses, including SARS-CoV-2, and we treated them with 10 µM MB and exposed them to 50,000 lux of white light or 12,500 lux of red light for 30 minutes. In parallel, integrity was assessed after 5 cycles of decontamination using multiple US and international test methods, and the process was compared with the FDA-authorized vaporized hydrogen peroxide plus ozone (VHP+O3) decontamination method.
Overall, MBL robustly and consistently inactivated all 3 coronaviruses with 99.8% to >99.9% virus inactivation across all FFRs and medical masks tested. FFR and medical mask integrity was maintained after 5 cycles of MBL treatment, whereas 1 FFR model failed after 5 cycles of VHP+O3.
MBL treatment decontaminated respirators and masks by inactivating 3 tested coronaviruses without compromising integrity through 5 cycles of decontamination. MBL decontamination is effective, is low cost, and does not require specialized equipment, making it applicable in low- to high-resource settings.
ABSTRACT IMPACT: Current practice guidelines offer a variety of treatment options for sternal reconstruction but complications and infections remain a serious surgical problem. This work seeks to provide a comprehensive picture of the com-morbidities and reconstructive methods that lead to success and improve patient outcomes. OBJECTIVES/GOALS: Patients that undergo cardiac surgery via the median sternotomy approach are at risk of wound complications that require repair. We seek to evaluate how outcomes of sternal reconstruction are influenced by patient comorbidities, flap usage and internal mammary artery grafts and methods of sternal closure. METHODS/STUDY POPULATION: We identified patients between 2005 and 2020 who underwent sternotomy followed by debridement and flap coverage at our institution. Comorbidities, method of reconstruction, demographic data, surgical history, and other factors pertaining to mortality and morbidity were collected. The data will then be analyzed to identify population characteristics using logistic regression variables to determine univariate and adjusted multivariable measures of association with mortality. We present the pre-liminary data analyzed using chi-square and one-way anova in R. RESULTS/ANTICIPATED RESULTS: In this study we present a preliminary characterization of one institution’s sternal reconstruction patient outcomes with a variety of reconstruction methods including pectoralis advancement flaps, omental flaps and latissumus dorsi flaps. Notable preoperative comorbidities include 50% of patients > age 60, 18% with diabetes mellitus, 18 % with diagnosed hypertension, 18% with COPD, and 9% with a smoking history DISCUSSION/SIGNIFICANCE OF FINDINGS: In an evolving cardiothoracic landscape, clinical characteristics of patients being treated for sternal reconstructive surgery present a moving target. Understanding current risk factors, preoperative management and timing for aggressive surgical treatment offers an opportunity to update treatment protocol and maximize successful outcomes.
This study aimed to investigate the relationships between diet quality, the relative abundance of butyrate-producing bacteria of the gut microbiome and muscle mass, strength and function. In this cross-sectional study, n = 490 men (64.4 ± 13.5 years) from the Geelong Osteoporosis Study provided food frequency questionnaire data, from which the Australian Recommended Food Score (ARFS) and Dietary Inflammatory Index (DII) score were calculated. Muscle mass (skeletal muscle index from DXA-derived lean mass), muscle strength (handgrip strength) and muscle function (Timed Up-and-Go test) were measured. Participants provided stool samples for 16S rRNA gene sequencing. There was no evidence of associations between alpha or beta diversity and muscle health measures. A healthier ARFS score was positively associated with the relative abundance of butyrate-producing bacteria (β 0.09, 95%CI 0.03, 0.15) and a higher (pro-inflammatory) DII score was associated with lower relative abundance of butyrate-producing bacteria (β −0.60, 95%CI −1.06, −0.15). The relative abundance of butyrate-producing bacteria was positively associated with healthier muscle mass, strength and function; however, these relationships were attenuated in multivariable models. These findings support the role of diet quality in achieving a healthier gut microbiome, however, further evidence is required for a gut-muscle axis in humans.
Subglacial sediments have the potential to reveal information about the controls on glacier flow, changes in ice-sheet history and characterise life in those environments. Retrieving sediments from beneath the ice, through hot water drilled access holes at remote field locations, present many challenges. Motivated by the need to minimise weight, corer diameter and simplify assembly and operation, British Antarctic Survey, in collaboration with UWITEC, developed a simple mechanical percussion corer. At depths over 1000 m however, manual operation of the percussion hammer is compromised by the lack of clear operator feedback at the surface. To address this, we present a new auto-release-recovery percussion hammer mechanism that makes coring operations depth independent and improves hammer efficiency. Using a single rope tether for both the corer and hammer operation, this modified percussion corer is relatively simple to operate, easy to maintain, and has successfully operated at a depth of >2130 m.
To examine children’s sugar-sweetened beverage (SSB) and water intakes in relation to implemented intervention activities across the social ecological model (SEM) during a multilevel community trial.
Children’s Healthy Living was a multilevel, multicomponent community trial that reduced young child obesity (2013–2015). Baseline and 24-month cross-sectional data were analysed from nine intervention arm communities. Implemented intervention activities targeting reduced SSB and increased water consumption were coded by SEM level (child, caregiver, organisation, community and policy). Child SSB and water intakes were assessed by caregiver-completed 2-day dietary records. Multilevel linear regression models examined associations of changes in beverage intakes with activity frequencies at each SEM level.
US-Affiliated Pacific region.
Children aged 2–8 years (baseline: n 1343; 24 months: n 1158).
On average (± sd), communities implemented 74 ± 39 SSB and 72 ± 40 water activities. More than 90 % of activities targeted both beverages together. Community-level activities (e.g. social marketing campaign) were most common (61 % of total activities), and child-level activities (e.g. sugar counting game) were least common (4 %). SSB activities across SEM levels were not associated with SSB intake changes. Additional community-level water activities were associated with increased water intake (0·62 ml/d/activity; 95 % CI: 0·09, 1·15) and water-for-SSB substitution (operationalised as SSB minus water: –0·88 ml/d/activity; 95 % CI: –1·72, –0·03). Activities implemented at the organization level (e.g. strengthening preschool wellness guidelines) and policy level (e.g. SSB tax advocacy) also suggested greater water-for-SSB substitution (P < 0·10).
Community-level intervention activities were associated with increased water intake, alone and relative to SSB intake, among young children in the Pacific region.
Originally developed by applying models from cognitive psychology to the study of foreign policy decision making, the field of behavioral IR is undergoing important transformations. Building on a broader range of models, methods, and data from the fields of neuroscience, biology, and genetics, behavioral IR has moved beyond the staid debate between rational choice and psychology and instead investigates the plethora of mechanisms selected by evolution for solving adaptive problems. This opens new opportunities for collaboration between scholars informed by rational choice and behavioral insights. Examining the interactions between the individual's genetic inheritance, social environment, and downstream behavior of individuals and groups, the emerging field of behavioral epigenetics offers novel insights into the methodological problem of aggregation that has confounded efforts to apply behavioral findings to IR. In the first instance empirical, behavioral IR raises numerous normative and philosophical questions best answered in dialogue with political and legal theorists.
This study investigated metabolic, endocrine, appetite and mood responses to a maximal eating occasion in fourteen men (mean: age 28 (sd 5) years, body mass 77·2 (sd 6·6) kg and BMI 24·2 (sd 2·2) kg/m2) who completed two trials in a randomised crossover design. On each occasion, participants ate a homogenous mixed-macronutrient meal (pizza). On one occasion, they ate until ‘comfortably full’ (ad libitum) and on the other, until they ‘could not eat another bite’ (maximal). Mean energy intake was double in the maximal (13 024 (95 % CI 10 964, 15 084) kJ; 3113 (95 % CI 2620, 3605) kcal) compared with the ad libitum trial (6627 (95 % CI 5708, 7547) kJ; 1584 (95 % CI 1364, 1804) kcal). Serum insulin incremental AUC (iAUC) increased approximately 1·5-fold in the maximal compared with ad libitum trial (mean: ad libitum 43·8 (95 % CI 28·3, 59·3) nmol/l × 240 min and maximal 67·7 (95 % CI 47·0, 88·5) nmol/l × 240 min, P < 0·01), but glucose iAUC did not differ between trials (ad libitum 94·3 (95 % CI 30·3, 158·2) mmol/l × 240 min and maximal 126·5 (95 % CI 76·9, 176·0) mmol/l × 240 min, P = 0·19). TAG iAUC was approximately 1·5-fold greater in the maximal v. ad libitum trial (ad libitum 98·6 (95 % CI 69·9, 127·2) mmol/l × 240 min and maximal 146·4 (95 % CI 88·6, 204·1) mmol/l × 240 min, P < 0·01). Total glucagon-like peptide-1, glucose-dependent insulinotropic peptide and peptide tyrosine–tyrosine iAUC were greater in the maximal compared with ad libitum trial (P < 0·05). Total ghrelin concentrations decreased to a similar extent, but AUC was slightly lower in the maximal v. ad libitum trial (P = 0·02). There were marked differences on appetite and mood between trials, most notably maximal eating caused a prolonged increase in lethargy. Healthy men have the capacity to eat twice the energy content required to achieve comfortable fullness at a single meal. Postprandial glycaemia is well regulated following initial overeating, with elevated postprandial insulinaemia probably contributing.
This chapter examines the regulatory framework governing the use of human embryos and gametes in treatment and research in the United Kingdom. This framework, overseen by the Human Fertilisation and Embryology Authority (HFEA), permits the use of germline genome modification in human embryos for specific research purposes, but it does not currently allow such modified embryos to be used in treatment. The chapter goes on to consider how germline genome modification may become a licensable treatment in the future, building on the recent experience of regulating research into mitochondrial donation and its clinical application in the United Kingdom. The legal and ethical challenges raised against the use of mitochondrial donation (and likely to be raised against the clinical use of germline genome modification) are also considered, including concerns arising out of EU legislation.
It has often been suggested by scholars that John Gower, like other contemporary poets, found it hard to reconcile his conception of an ideal social order with the realities and complexities of a new commercial world. In this view, Gower was a conservative voice fighting anachronistically against the tide of recent socio-economic change, his attitude towards merchants being seen as at best equivocal whilst his stance towards retailers was one of strident antipathy. Janet Coleman, for instance, suggests that writers such as Gower were ‘fearful of the traditional world being turned upside down by the rising third estate’. Ethan Knapp presents Gower's views on towns and trade as constituting a response to ‘the emergent economic forces (and their social agents) in his own day’ and argues that even though Gower accepted the need for trade, he also had a ‘deep ambivalence’ about the effects of growing commercialisation which was corroding traditional social structures. Yet, in reality, the ‘emergence’ of a mercantile elite and of a monetised and commercialised economy had been in train for nearly two hundred years by the time Gower was writing. Indeed, the kinds of criticisms of commerce made by Gower were already evident in the work of social commentators of the thirteenth and early fourteenth centuries as much as they were in the post-Black Death era.
More recent scholarship on Gower, merchants and the city has sought to reassess the late-fourteenth-century context for his writings and suggests that the poet was more aware of the contemporary concerns of his audience than has often been recognised. Thus, Jonathan Hsy argues that while the detailed description of London's trade offered in the Mirour de l’Ommeostensibly adopts the framework of traditional anti-mercantile tropes such as the figure of ‘Triche’, the poet's flexible linguistic style produced a more nuanced perspective on the urban milieu than he is often given credit for. Roger Ladd has similarly examined the sophisticated ways that Gower critiqued mercantile practices and notes that while the Mirour de l’Ommelists the frauds which trade could involve, it also presents trade as a social good, a view which would have appealed to its likely mercantile audience as would Gower's criticisms of alien merchants.
Light and intermittent smokers (LITS) represent almost 50% of all current smokers. Research is needed to understand smoking motives among adult light smokers.
To explore smoking cues and motivators among a racially diverse sample of adult LITS (≤10 CPD). In addition, we explored differences between native (always smoked ≤10), and converted (former heavier) LITS.
We used purposive sampling to recruit participants who were native and converted LITS and to include equal numbers of African Americans, Whites and Latinos. We coded and analyzed transcripts using a stage approach to identify themes.
Four main themes emerged that may be unique to light smokers and suggests potential strategies for intervention: (1) smoking in response to cues and control, (2) identifying as a smoker, (3) concern about health consequences, and (4) other priorities influencing smoking. There were some differences among smoking cues and motivators by race and ethnicity, and differences between native and converted LITS.
Overall, LITS reported drivers of smoking that were unrelated to symptoms of nicotine withdrawal. Even when experiencing salient cues, our LITS cohort expressed the ability to assert control over smoking by abstaining when situational contexts made smoking inconvenient.
Community advisory boards (CABs) are a valuable strategy for engaging and partnering with communities in research. Eighty-nine percent of Clinical and Translational Science Awardees (CTSA) responding to a 2011 survey reported having a CAB. CTSAs’ experiences with CABs are valuable for informing future practice. This study was conducted to describe common CAB implementation practices among CTSAs; document perceived benefits, challenges, and contributions; and examine their progress toward desirable outcomes. A cross-CTSA collaborative team collected survey data from respondents representing academic and/or community members affiliated with CTSAs with CABs. Data representing 44 CTSAs with CABs were analyzed using descriptive statistics. A majority of respondents reported practices reflecting respect for CAB members’ expertise and input such as compensation (75%), advisory purview beyond their CTSA’s Community Engagement program (88%), and influence over CAB operations. Three-quarters provide members with orientation and training on roles and responsibilities and 89% reported evaluating their CAB. Almost all respondents indicated their CTSA incorporates the feedback of their CABs to some degree; over half do so a lot or completely. This study profiles practices that inform CTSAs implementing a CAB and provide an evaluative benchmark for those with existing CABs.
On the threshold of our modernity, on 29 March 1901, Lionel Mapleson made two artful cylinder phonautogramsof the air. It was no ordinary air. His wax tracings captured for posterity the legendary vocal tones of the fifty-year-old Jean de Reszke and the chorus of the old Metropolitan Opera House in Richard Wagner’s Lohengrin. The atmosphere was thick with anticipation for this final gala performance of the first twentieth-century season, an event that had been offered as an extra night to subscribers, and the last time that Reszke would appear in New York in a complete opera. The newspapers reported a crush as never before in the lobby and outside on the street for ‘the strongest cast which can be brought together’, including Jean’s younger brother Édouard, David Bispham, Adolph Mühlmann, soprano Milka Ternina and Bohemian–German contralto Ernestine Schumann-Heink.