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The Victorian City of London’s financial center expanded and renewed its building infrastructure virtually unimpeded by considerations of urban preservation, conservation, or public opinion. The next phase of massive rebuilding, during the long post-1945 boom, appeared likely to follow the same pattern. However, by the mid-1960s, the freedom of City office owner-occupiers and developers to do as they wished with their buildings had become substantially constrained by rising conservationist sentiment. This paper explores this process through the history of the design, building, and eventual aborted demolition of Gibson Hall, the Bishopsgate headquarters of National Provincial Bank for over a century. This paper charts the life of Gibson Hall, in particular its conception, design, and, ultimately, its attempted redevelopment. We also consider the long-term consequences of the rebalancing between economic and conservation objectives for the nature of British urban redevelopment and the adoption of a “throwaway” business headquarters style—to remove any risk of popular support for preservation.
This chapter discusses a range of issues related to good clinical practice in psychopharmacology. It has been written to address the wide readership of care professionals who are involved in prescribing, monitoring and/or advising patients about psychiatric medication, which includes psychiatrists, pharmacists, psychiatric nurses, primary care physicians and hospital doctors.
Understanding how plants alter their growth in response to interplant competition is an overlooked but complex problem. Previous studies have characterized the effect of light and water stress on soybean or common ragweed growth in monoculture, but no study has characterized soybean and common ragweed growth in mixture. A field study was conducted in 2015 and 2016 at the University of Nebraska-Lincoln to characterize the growth response of soybean and common ragweed with different irrigation levels and intraspecific and interspecific interference. The experiment was arranged in a split-plot design with irrigation level (0, 50%, 100% replacement of simulated evapotranspiration) as the main plot and common ragweed density (0, 2, 6, 12 plants m−1 row) as the subplot. Crop- and weed-free controls and three mixture treatments were included as subplots. Periodic destructive samples of leaf area and biomass of different organ groups were collected, and leaf area index (LAI), aboveground biomass partitioning, specific leaf area (SLA), and leaf area ratio (LAR) were calculated. Additionally, soybean and common ragweed yield were harvested, and 100-seed weight and seed production were determined. Soybean did not alter biomass partitioning, SLA, or LAR in mixture with common ragweed. Soybean LAI, biomass, and seed size were affected by increasing common ragweed density. Conversely, common ragweed partitioned less new biomass to leaves and increased SLA in response to increased interference. Common ragweed LAI, biomass, and seed number were reduced by the presence of soybean and increasing common ragweed density; however, seed weight was not affected. Results show that adjustment in biomass partitioning, SLA, and LAR is not the method that soybean uses to remain plastic under competition for light. Common ragweed demonstrated plasticity in both biomass partitioning and SLA, indicating an ability to maintain productivity under intra- and inter-specific competition for light or soil resources.
Dementia is a neurodegenerative disorder with global impact, with the largest proportion of cases occurring in low- and middle-income countries. It is estimated that there are 46.8 million cases globally with approximately 10 million new cases each year or a new case occurring every 3 sec (Prince et al., 2015). For comparison there are 36.7 million HIV cases with an estimated 2 million new cases each year (WHO, 2017). The rise in dementia prevalence is largely due to population ageing, with the oldest being at highest risk. To date there are no diseases modifying medications for Alzheimer's disease or the other causes of dementia. Academics and research groups are increasingly focused on prevention or delay of dementia (Brayne and Miller, 2017) and a number of organizations now prioritize dementia, indicating a strong and coherent international effort to address this problem. Examples include the World Health Organisation (WHO), which has established a Global Dementia Observatory; the World Dementia Council; the Organisation for Economic Co-operation and Development (OECD); the U.S. National Alzheimer's Project Act (NAPA); and the Global Council on Brain Health.
OBJECTIVES/SPECIFIC AIMS: To create a searchable public registry of all Quality Improvement (QI) projects. To incentivize the medical professionals at UF Health to initiate quality improvement projects by reducing startup burden and providing a path to publishing results. To reduce the review effort performed by the internal review board on projects that are quality improvement Versus research. To foster publication of completed quality improvement projects. To assist the UF Health Sebastian Ferrero Office of Clinical Quality & Patient Safety in managing quality improvement across the hospital system. METHODS/STUDY POPULATION: This project used a variant of the spiral software development model and principles from the ADDIE instructional design process for the creation of a registry that is web based. To understand the current registration process and management of quality projects in the UF Health system a needs assessment was performed with the UF Health Sebastian Ferrero Office of Clinical Quality & Patient Safety to gather project requirements. Biweekly meetings were held between the Quality Improvement office and the Clinical and Translational Science – Informatics and Technology teams during the entire project. Our primary goal was to collect just enough information to answer the basic questions of who is doing which QI project, what department are they from, what are the most basic details about the type of project and who is involved. We also wanted to create incentive in the user group to try to find an existing project to join or to commit the details of their proposed new project to a data registry for others to find to reduce the amount of duplicate QI projects. We created a series of design templates for further customization and feature discovery. We then proceed with the development of the registry using a Python web development framework called Django, which is a technology that powers Pinterest and the Washington Post Web sites. The application is broken down into 2 main components (i) data input, where information is collected from clinical staff, Nurses, Pharmacists, Residents, and Doctors on what quality improvement projects they intend to complete and (ii) project registry, where completed or “registered” projects can be viewed and searched publicly. The registry consists of a quality investigator profile that lists contact information, expertise, and areas of interest. A dashboard allows for the creation and review of quality improvement projects. A search function enables certain quality project details to be publicly accessible to encourage collaboration. We developed the Registry Matching Algorithm which is based on the Jaccard similarity coefficient that uses quality project features to find similar quality projects. The algorithm allows for quality investigators to find existing or previous quality improvement projects to encourage collaboration and to reduce repeat projects. We also developed the QIPR Approver Algorithm that guides the investigator through a series of questions that allows an appropriate quality project to get approved to start without the need for human intervention. RESULTS/ANTICIPATED RESULTS: A product of this project is an open source software package that is freely available on GitHub for distribution to other health systems under the Apache 2.0 open source license. Adoption of the Quality Improvement Project Registry and promotion of it to the intended audience are important factors for the success of this registry. Thanks goes to the UW-Madison and their QI/Program Evaluation Self-Certification Tool (https://uwmadison.co1.qualtrics.com/SE/?SID=SV_3lVeNuKe8FhKc73) used as example and inspiration for this project. DISCUSSION/SIGNIFICANCE OF IMPACT: This registry was created to help understand the impact of improved management of quality projects in a hospital system. The ultimate result will be to reduce time to approve quality improvement projects, increase collaboration across the UF Health Hospital system, reduce redundancy of quality improvement projects and translate more projects into publications.
Spring tillage is a component of an integrated weed management strategy for control of early emerging glyphosate-resistant weeds such as common ragweed; however, the effect of tillage on common ragweed emergence pattern is unknown. The objectives of this study were to evaluate whether spring tillage during emergence would influence the emergence pattern or stimulate additional emergence of common ragweed and to characterize common ragweed emergence in southeast Nebraska. A field experiment was conducted for three years (2014 to 2016) in Gage County, Nebraska in a field naturally infested with glyphosate-resistant common ragweed. Treatments consisted of a no-tillage control and three spring tillage timings. The Soil Temperature and Moisture Model (STM2) software was used to estimate soil temperature and moisture at a 2-cm depth. The Weibull function was fit to total common ragweed emergence (%) with day of year (DOY), thermal time, and hydrothermal time as independent variables. Tillage treatments and year had no effect on total common ragweed emergence (P=0.88 and 0.35, respectively) and time to 10, 25, 50, 75, and 90% emergence (P=0.31). However, emergence pattern was affected by year (P=<0.001) with 50% total emergence reached on May 5 in 2014, April 20 in 2015, and April 2 in 2016 and 90% total emergence reached on May 12, 2014, May 8, 2015, and April 30, 2016. According to the corrected information-theoretic model comparison criterion (AICc), the Weibull function with thermal time and base temperature of 3 C best explained the emergence pattern over three years. This study concludes that spring tillage does not stimulate additional emergence; therefore, after the majority of the common ragweed has emerged and before the crop has been planted, tillage could be used as an effective component of an integrated glyphosate-resistant common ragweed management program in Nebraska.
The study aims to assess whether supplementation with the probiotic Lactobacillus rhamnosus HN001 (HN001) can reduce the prevalence of gestational diabetes mellitus (GDM). A double-blind, randomised, placebo-controlled parallel trial was conducted in New Zealand (NZ) (Wellington and Auckland). Pregnant women with a personal or partner history of atopic disease were randomised at 14–16 weeks’ gestation to receive HN001 (6×109 colony-forming units) (n 212) or placebo (n 211) daily. GDM at 24–30 weeks was assessed using the definition of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) (fasting plasma glucose ≥5·1 mmol/l, or 1 h post 75 g glucose level at ≥10 mmol/l or at 2 h ≥8·5 mmol/l) and NZ definition (fasting plasma glucose ≥5·5 mmol/l or 2 h post 75 g glucose at ≥9 mmol/l). All analyses were intention-to-treat. A total of 184 (87 %) women took HN001 and 189 (90 %) women took placebo. There was a trend towards lower relative rates (RR) of GDM (IADPSG definition) in the HN001 group, 0·59 (95 % CI 0·32, 1·08) (P=0·08). HN001 was associated with lower rates of GDM in women aged ≥35 years (RR 0·31; 95 % CI 0·12, 0·81, P=0·009) and women with a history of GDM (RR 0·00; 95 % CI 0·00, 0·66, P=0·004). These rates did not differ significantly from those of women without these characteristics. Using the NZ definition, GDM prevalence was significantly lower in the HN001 group, 2·1 % (95 % CI 0·6, 5·2), v. 6·5 % (95 % CI 3·5, 10·9) in the placebo group (P=0·03). HN001 supplementation from 14 to 16 weeks’ gestation may reduce GDM prevalence, particularly among older women and those with previous GDM.
We describe new conversion laws, from CO molecular line data to inferred mass column, based on observations of the three main CO isotopologues in several surveys of the Galactic Plane. The new conversion laws replace the use of the single “X-factor” in widespread use, with a more physically-based relationship between the CO line’s optical depth, excitation, and column density. It has the effect of increasing the inferred mass column, over the single X-factor, by typically a factor of 2–3. This means that the molecular mass of the Milky Way may have been substantially underestimated in previous studies, and suggests that scaling laws like the Kennicutt-Schmidt relations may also need to be recalibrated. Because of its statistical basis on a large fraction of our Galaxy’s ISM, this new law is also recommended for use in studies of other Milky-Way-analogue spiral galaxies.
I review the major science outcomes to date of the Galactic Census of High- and Medium-mass Protostars (CHaMP), and also report the latest observational results on this unbiased, uniform sample of massive, cluster-forming molecular clumps, based on new mm-wave and IR data. These clouds represent the vast, subthermally-excited population of clumps predicted by Narayanan et al. (2008) to dominate the molecular mass of disk galaxies. Besides confirming their existence, we have presented evidence that these massive clumps probably spend a large fraction (90–95%) of their long lives (possibly up to 100 Myr) in a mostly quiescent, low star formation rate (SFR) state. This is likely ended when a density or internal pressure threshold is crossed, after which vigorous, massive cluster formation consumes the densest gas with a high SFR, dispersing the embedding envelope. New results presented in two other posters at this Symposium include (1) the first analysis of HCN emission from the dense gas (Schap et al.2015), and (2) the first deep photometry of clusters in this sample based on NIR AAT & CTIO data, and on MIR Warm Spitzer IRAC data (Dallilar et al.2015).
We present the Three-mm Ultimate Mopra Milky Way Survey, a new mm-wave molecular-line mapping survey of the southern Galactic Plane, and its first data releases and science results. ThrUMMS maps a 60° × 2° sector of our Galaxy's fourth quadrant, using a combination of fast mapping techniques with the Mopra radio telescope, simultaneously in the J = 1→0 lines of 12CO, 13CO, C18O, and CN near 112 GHz, at 1′.2 and 0.3 km s−1 resolution, with 1.2 K/ch sensitivity for 12CO and 0.7 K/ch for the other transitions. The calibrated data cubes from these observations are made freely available to the community on the ThrUMMS website, http://www.astro.ufl.edu/thrumms, after processing through our pipeline. Here, we summarise the first science results, on global variations in the iso-CO line ratios and on a detailed multiwavelength study of the GMCs near l=333°.
In this project, we focus on the analysis of infrared observations of the clumps defined with the Galactic Census of High- and Medium-mass Protostars (ChaMP) (Barnes et al.2011). We derive line of sight infrared extinction values, star counts and protostar candidates around the molecular gas emission obtained with the Mopra telescope. Then, we examine the correlation between radio and infrared properties of the clumps. For this stage of the project, we use the Vela-Carina and 2MASS catalogs to obtain a preliminary understanding of the final results. For the later stages, we will extract infrared photometry from our deep AAT near-IR and Spitzer 3.6 and 4.5 μm images. With the final deep photometry results, we will compile the properties of individual clusters.
The CHaMP project has identified a uniform sample of 303 massive (20–8000 M⊙), dense (200–30,000 cm−3) molecular clumps in a large sector of the southern Milky Way that includes much of the Carina Arm. These are the kinds of clumps that are likely to be the precursors to IRDCs, large stellar clusters, and massive stars. We report new results of the physical conditions in these clouds based on the J=1 → 0 emission at 3mm from the HCN molecule. Analysis of the HCN emission from these clumps reveals that the physical conditions in the gas (i.e., the excitation temperature, optical depth, and column density) do not follow the molecular line emissivity in a straightforward way. This means that large fractions of the molecular material involved in massive cluster formation, while not completely“dark”, are under-luminous and easily missed in certain studies.
Knowledge on the ecology of humpback whales in the eastern North Atlantic is lacking by comparison with most other ocean basins. Humpback whales were historically over-exploited in the region and are still found in low relative abundances. This, coupled with their large range makes them difficult to study. With the aim of informing more effective conservation measures in Ireland, the Irish Whale and Dolphin Group began recording sightings and images suitable for photo-identification of humpback whales from Irish waters in 1999. Validated records submitted by members of the public and data from dedicated surveys were analysed to form a longitudinal study of individually recognizable humpback whales. The distribution, relative abundance and seasonality of humpback whale sighting records are presented, revealing discrete important areas for humpback whales in Irish coastal waters. An annual easterly movement of humpback whales along the southern coast of Ireland is documented, mirroring that of their preferred prey: herring and sprat. Photo-identification images were compared with others collected throughout the North Atlantic (N = 8016), resulting in matches of two individuals between Ireland and Iceland, Norway and the Netherlands but no matches to known breeding grounds (Cape Verde and West Indies). This study demonstrates that combining public records with dedicated survey data is an effective approach to studying low-density, threatened migratory species over temporal and spatial scales that are relevant to conservation and management.
It is uncertain whether antipsychotic long-acting injection (LAI) medication in schizophrenia is associated with better clinical outcomes than oral preparations.
To examine the impact of prior treatment delivery route on treatment outcomes and whether any differences are moderated by adherence.
Analysis of data from two pragmatic 1-year clinical trials in which patients with schizophrenia were randomised to either an oral first-generation antipsychotic (FGA), or a non-clozapine second-generation antipsychotic (SGA, CUtLASS 1 study), or a non-clozapine SGA or clozapine (CUtLASS 2 study).
Across both trials, 43% (n = 155) of participants were prescribed an FGA-LAI before randomisation. At 1-year follow-up they showed less improvement in quality of life, symptoms and global functioning than those randomised from oral medication. This difference was confined to patients rated as less than consistently adherent pre-randomisation. The relatively poor improvement in the patients prescribed an LAI pre-randomisation was ameliorated if they had been randomised to clozapine rather than another SGA. There was no advantage to being randomly assigned from an LAI at baseline to a non-clozapine oral SGA rather than an oral FGA.
A switch at randomisation from an LAI to an oral antipsychotic was associated with poorer clinical and functional outcomes at 1-year follow-up compared with switching from one oral antipsychotic to another. This effect appears to be moderated by adherence, and may not extend to switching to clozapine. This has implications for clinical trial design: the drug from which a participant is randomised may have a greater effect than the drug to which they are randomised.
History flows in streams that overlap and sometimes shift direction. From the early 1980s, just such a shift was discernible in the history of the developed democracies. For thirty years after World War II, their states took on greater roles in the allocation of resources as governments anxious to avoid the social conflicts of the inter-war years adopted activist economic policies and generous social benefits to construct a Keynesian welfare state (Offe 1983; Eichengreen 2007). However, economic recession and slower rates of growth during the 1970s gave rise to widespread disillusionment with existing modes of policymaking. In reaction, policymakers began to argue that employment was the responsibility of markets rather than governments and growth could be restored only by expanding the ambit and competitiveness of markets (Hall 1993; McNamara 1998: Blyth 2002).
The pioneering steps were taken by governments elected under Margaret Thatcher in 1979 and Ronald Reagan in 1980. In the context of widespread fears about national decline, they promised to restore the prosperity of the nation by enhancing the role of markets vis-à-vis the state in the economy (Krieger 1986). Paradoxically, the initial requirement was a more assertive state (Gamble 1988). The two administrations initiated legislation to reduce the power of trade unions and fought high-profile battles with British miners and American air controllers. In the name of deregulation, they privatized national enterprises, contracted out public services, tightened social benefits, and made many markets more competitive (King 1987; Vogel 1998; Prasad 2006).
Second-generation antipsychotics have been thought to cause fewer
extrapyramidal side-effects (EPS) than first-generation antipsychotics,
but recent pragmatic trials have indicated equivalence.
To determine whether second-generation antipsychotics had better outcomes
in terms of EPS than first-generation drugs.
We conducted an intention-to-treat, secondary analysis of data from an
earlier randomised controlled trial (n = 227). A
clinically significant difference was defined as double or half the
symptoms in groups prescribed first- v.
second-generation antipsychotics, represented by odds ratios greater than
2.0 (indicating advantage for first-generation drugs) or less than 0.5
(indicating advantage for the newer drugs). We also examined EPS in terms
of symptoms emergent at 12 weeks and 52 weeks, and symptoms that had
resolved at these time points.
At baseline those randomised to the first-generation antipsychotic group
(n = 118) had similar EPS to the second-generation
group (n = 109). Indications of resolved Parkinsonism
(OR = 0.5) and akathisia (OR = 0.4) and increased tardive dyskinesia (OR
= 2.2) in the second-generation drug group at 12 weeks were not
statistically significant and the effects were not present by 52 weeks.
Patients in the second-generation group were dramatically (30-fold) less
likely to be prescribed adjunctive anticholinergic medication, despite
equivalence in terms of EPS.
The expected improvement in EPS profiles for participants randomised to
second-generation drugs was not found; the prognosis over 1 year of those
in the first-generation arm was no worse in these terms. The place of
careful prescription of first-generation drugs in contemporary practice
remains to be defined, potentially improving clinical effectiveness and
avoiding life-shortening metabolic disturbances in some patients
currently treated with the narrow range of second-generation
antipsychotics used in routine practice. This has educational
implications because a generation of psychiatrists now has little or no
experience with first-generation antipsychotic prescription.