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ONE of the most fruitful developments in recent writing about the history of medieval Scotland has been the openness displayed towards comparison and context, and in this our honorand has played no small part. Questions have been raised about state formation, nationhood and about ethnicity. The period between about 1000 and 1300 has been seen as the time when a united kingdom was created, capable of withstanding the pressure applied by Edward I (1272–1307) and his mighty war machine. In this the importation of a new foreign elite played a crucial role. The chronology, the character and the extent of change have all been debated. The periodisation of medieval Scottish history has been discussed: Matthew Hammond traced the enduring characterisation in Scottish historiography of a change from ‘Celtic’ Scotland to the ‘Norman’ twelfth century. Associating that transition with a particular reign has attracted different views. For Andrew Lang, writing more than a century ago, Celtic dominance came to an end with the death of Alexander I (1107–24), to be succeeded by Anglo-Norman and English dominance.
The reign of David I (1124–53) for a long time seemed to be the start of a brave new world, admittedly with important elements of continuity. The subtitle of a biography is ‘the king who made Scotland’. However, Alice Taylor has argued that the later twelfth century was the key period of take off for the medieval Scottish polity. This, she argued, rested on a fruitful symbiosis between crown and aristocracy, rather than inevitable opposition, and that whilst institutions and customs were imported from England, they were not slavishly copied but adapted. Rees Davies's suggestion that Scotland experienced a process of Anglicisation, therefore needs modification. Thus both periodisation and the nature of change have here been called into question.
The high reputation of King David was established as early as the twelfth century by William of Malmesbury and Aelred of Rievaulx. The former, who addressed one of his prefatory letters to his great work The Deeds of the Kings of the English to the king, was particularly complimentary about what he saw as David's civilized manners and scathing about those of Alexander's wife, Sibyl, a point to be discussed here below.
To evaluate coronavirus disease 2019 (COVID-19) vaccine hesitancy among healthcare personnel (HCP) with significant clinical exposure to COVID-19 at 2 large, academic hospitals in Philadelphia, Pennsylvania.
Design, setting, and participants:
HCP were surveyed in November–December 2020 about their intention to receive the COVID-19 vaccine.
The survey measured the intent among HCP to receive a COVID-19 vaccine, timing of vaccination, and reasons for or against vaccination. Among patient-facing HCP, multivariate regression evaluated the associations between healthcare positions (medical doctor, nurse practitioner or physician assistant, and registered nurse) and vaccine hesitancy (intending to decline, delay, or were unsure about vaccination), adjusting for demographic characteristics, reasons why or why not to receive the vaccine, and prior receipt of routine vaccines.
Among 5,929 HCP (2,253 medical doctors [MDs] and doctors of osteopathy [DOs], 582 nurse practitioners [NPs], 158 physician assistants [PAs], and 2,936 nurses), a higher proportion of nurses (47.3%) were COVID-vaccine hesitant compared with 30.0% of PAs and NPs and 13.1% of MDs and DOs. The most common reasons for vaccine hesitancy included concerns about side effects, the newness of the vaccines, and lack of vaccine knowledge. Regardless of position, Black HCP were more hesitant than White HCP (odds ratio [OR], ∼5) and females were more hesitant than males (OR, ∼2).
Although most clinical HCP intended to receive a COVID-19 vaccine, intention varied by healthcare position. Consistent with other studies, hesitancy was also significantly associated with race or ethnicity across all positions. These results highlight the importance of understanding and effectively addressing reasons for hesitancy, especially among frontline HCP who are at increased risk of COVID exposure and play a critical role in recommending vaccines to patients.
Anecdotal evidence suggests the use of bolus tube feeding is increasing in the long-term home enteral tube feed (HETF) patients. A cross-sectional survey to assess the prevalence of bolus tube feeding and to characterise these patients was undertaken. Dietitians from ten centres across the UK collected data on all adult HETF patients on the dietetic caseload receiving bolus tube feeding (n 604, 60 % male, age 58 years). Demographic data, reasons for tube and bolus feeding, tube and equipment types, feeding method and patients’ complete tube feeding regimens were recorded. Over a third of patients receiving HETF used bolus feeding (37 %). Patients were long-term tube fed (4·1 years tube feeding, 3·5 years bolus tube feeding), living at home (71 %) and sedentary (70 %). The majority were head and neck cancer patients (22 %) who were significantly more active (79 %) and lived at home (97 %), while those with cerebral palsy (12 %) were typically younger (age 31 years) but sedentary (94 %). Most patients used bolus feeding as their sole feeding method (46 %), because it was quick and easy to use, as a top-up to oral diet or to mimic mealtimes. Importantly, oral nutritional supplements (ONS) were used for bolus feeding in 85 % of patients, with 51 % of these being compact-style ONS (2·4 kcal (10·0 kJ)/ml, 125 ml). This survey shows that bolus tube feeding is common among UK HETF patients, is used by a wide variety of patient groups and can be adapted to meet the needs of a variety of patients, clinical conditions, nutritional requirements and lifestyles.
Between the imperial coronation of Edgar in 973 and the death of Henry II in 1189, English society was transformed. This lively and wide-ranging study explores social and political change in England across this period, and examines the reasons for such developments, as well as the many continuities. By putting the events of 1066 firmly in the middle of her account, Judith Green casts new light on the significance of the Norman Conquest. She analyses the changing ways that kings, lords and churchmen exercised power, especially through the building of massive stone cathedrals and numerous castles, and highlights the importance of London as the capital city. The book also explores themes such as changes in warfare, the decline of slavery and the integration of the North and South West, as well as concepts such as state, nationalism and patriarchy.