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Joshua Lowe, San Antonio Military Medical Center,Rachel Bridwell, Uniformed Services University of Health Sciences,John Patrick, San Antonio Military Medical Center,Alec Pawlukiewicz, Carl R. Darnall Army Medical Center,Gillian Schmitz, Uniformed Services University of Health Sciences,Michael Yoo, University of Texas Health San Antonio
This clinical vignette follows a nine-year-old girl presenting with progressive respiratory distress triggered by a viral illness. Although she has no formal asthma diagnosis, her history, physical exam, and pediatric asthma score support a working diagnosis of moderate asthma exacerbation, later escalating to severe. Learners must assess severity, initiate guideline-based treatment, and decide when to escalate therapy. This case reinforces the importance of early recognition, structured evaluation, and noninvasive management including continuous albuterol, corticosteroids, magnesium, and epinephrine. It also emphasizes the critical decision to avoid intubation unless absolutely necessary, highlighting the risks of dynamic hyperinflation and barotrauma in asthmatic patients. Pediatric-specific tools like the PAS guide management decisions and help communicate illness severity clearly to consultants and caregivers. By navigating the stepwise approach to worsening asthma, learners gain confidence in making timely interventions that prevent deterioration and reduce morbidity in pediatric patients.
The essays in this collection are remarkable for the wealth of the evidence and the power of the arguments presented, about Roman republican women, by twenty-first century women–and men–from around the globe. The capacious reach of the research shared, notwithstanding the ostensibly narrow scope of the topic, demands a similarly capacious perspective in framing a response to these, puissant, riches. Hence I would urge all of us who benefit from this research to be as elastic, and as generous, as possible in thinking, for the future, about how we might most capaciously and productively define all three terms that have framed this volume–women, wealth, and power–in the context of their time, place and socio-cultural ambiance. I consequently pose the question: in our subsequent investigations on this topic, what and whom might we include in each of these three analytical categories, women, wealth, and power, that have yet to be accorded as much scrutiny as they might?
In this chapter, I highlight specific challenges the continuo players face when performing Strozzi’s music. I argue that only by understanding Strozzi’s music as well as its poetry and harmonic language that the harpsichordist can truly partner with the singer to deliver a dynamic performance. First, most of Strozzi’s music is sparsely notated, so the continuo player must figure out the harmonies and notate figured bass according to their own analysis. Second, Strozzi—like composers of her time—does not provide performance instruction on how long the realized chords should be held or how they should be arpeggiated. To that end, I examine the cases of long-held notes and provide concrete suggestions on how one might approach the realization and timing based on text and rhetoric. In addition, I discuss how figured bass can be utilized to flesh out the melodies in written-out ritornello when no treble part is provided.
Agriculture has been an unloved policy area in the history of Germany’s Social Democratic Party (SPD). Already lying at the intersection of interest-based constituency politics, party ideology, electioneering, fiscal and trade policy, economics, welfare, and government coalition-making, farm policy became even more complicated when the geopolitical question of European agricultural integration arose in the 1950s. Throughout, the SPD remained concerned that farmers could rise against democracy if their demands went unmet. The SPD’s policy preference was for economic rationalisation and low agricultural tariffs, mitigated by an active (but not excessive) welfare policy for farmers. Instead, government support for farmers and agricultural protectionism actually increased under SPD-led governments in the 1920s and again in 1969–1974. Political objectives to attract farm support and lessen rural antagonism towards social democracy ran against the party’s policy preferences. In the exercise of practical social democracy, choices have to be made. This chapter argues that, in the end, agricultural policy proved to be a second-order policy. Party leadership bartered the SPD’s preferred agricultural policy away to gain the political breathing space they needed to carry on in government and implement first-order priorities that lay closer to their hearts.
Divided into two sections (“Iona: Dark Waters and the Tabernacle of the Sun” and “Clonmacnoise: Time, Season, and Shadow”), this chapter explores the two monastic sites for which there is the best-surviving archeological evidence as to the monuments’ original position and surroundings. It argues that Insular artists integrated the animating effects of dynamic skies (stars, moon, sun, clouds) and changing vistas to extend the meaning of the crosses’ complex iconographic programs. It includes comparisons with manuscript illustrations.
Part I of the book provides the framework and contexts for appreciating the significance of local history-writing. Chapter 1 deals with the different professional and elite groups who were the principal producers of history in the early Islamic world. Many works were produced by those loosely known as religious scholars (ʿulamāʾ, sing. ʿālim), but other professional groups such as government chancery officials and administrators (kuttāb, sing. kātib) are considered as well, as are those who can be very loosely labelled litterateurs (udabāʾ, sing. adīb). The chapter investigates how these groups thought about themselves as communities and how they derived social authority as elites. It is frequently assumed that these groups used history-writing as one way of underpinning their authority, but it is less frequently examined explicitly how such authority operated. Since this book absolutely agrees with the now well-established principal that history-writing supported the position and authority of relevant groups, it is important to establish in what precise ways this worked and what the opportunities to exercise authority were to those groups whose members produced local histories.
This chapter will chart the early turbulent years after the Treaty of Managua, which gave Nicaragua sovereignty over an autonomous Mosquito Reserve. As Nicaragua attempted to consolidate and control the transit route, it pushed for greater incorporation of Greytown and the Reserve within the Republic. This chapter will follow the tense standoff between Nicaragua and the Mosquito Kingdom, which would ultimately be brought to international arbitration through British initiative. In this context, the opening of the Suez Canal sparked off renewed American interest leading to the Lull survey of 1872–1873, which underscored the paradoxical reality that as the struggle over the canal route and Mosquito Reserve threatened to become an international issue, the local conditions of Greytown were slowly making the entry point of the proposed canal route unnavigable. Ironically, Nicaragua’s efforts to leverage U.S. interests in the canal led to conflict with Guatemala’s aggressive unionism, undermining ideals of regional unity.
Pablo Neruda lived in the crossroads of the cultural Cold War and its influence in Latin America. At once an ardent defender of the Soviet Union and the policies dictated from the Politburo, but also falling prey to the tensions that those directions generated in Latin America, the Chilean poet made the attempt (and ultimately failed to bring it to completion) to reconcile his views on democracy with the more radical members of Salvador Allende’s government. After the coup, amid the raids against all members of the political left, Neruda became a thorn in the side of the junta, and a potential menace that needed to be neutralized. The ensuing controversy regarding the judicial process to find the real cause of his death, not complete in its totality as of yet, contextualizes the rest of this essay.
This concluding chapter discusses the main contributions of the volume, notably the implications of adopting a practical approach to social democracy. It also considers the key analytical lessons from the chapters for understanding the evolution of reformist politics, policy-making as well as the role rhetoric, language, and ideology. It also reflects on the wider implications of this agenda by examining its relevance to other parts of the world, such as Latin America (Brazil) and East Central Europe (Poland), and other policy areas, notably immigration. The analysis implies that the core logic of practical social democracy could be applicable across a wide range of countries and policy areas, but it also highlights that the specific nature of the feasible trade-offs between governance, electoral, and organisational imperatives vary across such settings and over time, thereby contributing to the diversity of reformist parties and policies.
Sophocles belongs to that small group of authors whose works – or some fraction of them – have always been classics.1 Even Euripides, who was ultimately more influential – more widely performed after his death, more often quoted and studied – than Sophocles, was not as popular for a start, whereas Sophocles, like Homer as represented by the Iliad and Odyssey, or Virgil, or Horace, did not have to wait to achieve canonical status. A high proportion of his plays were outstandingly successful when first put on in the drama competitions of his lifetime; some of the most admired of these became part of the theatrical repertoire after his death and stayed there as long as plays were performed; at least a handful were intensively studied by the students and scholars of later antiquity, survived as classics in the Christian educational system of the Byzantine period and safely reached print in Venice in 1502.
Part II of the book turns to the field of history-writing more specifically and includes three chapters that approach the categorisation of history as universal or local in three different ways. Chapter 4 introduces early Islamic universal history-writing and the key concerns and interests of authors and compilers of such works down to the end of the fifth/eleventh century. It begins with a discussion of what a universal history was in the early Islamic world and moves on to look at the contexts and purposes of universal history-writing. The chapter ends with some consideration of whether universal histories are really any less parochial than local histories in their concerns.
The fetus depends on the mother not only for oxygen and essential nutrients for optimal intrauterine survival, but also for the removal of carbon dioxide and metabolic by-products. Therefore, disorders in the maternal renal, hepatic and respiratory systems may result in accumulation of waste products within the fetal compartment, leading to fetal compromise. Chronic maternal hypoxia can result in impaired uteroplacental oxygenation leading to intrauterine growth restriction and reduced fetal movements. On a CTG, this would appear as decreased baseline variability, slightly increased baseline rate and repetitive shallow decelerations. Conditions such as diabetic ketoacidosis can cause maternal acidosis and the transfer of ketoacids across the placenta, resulting in repetitive, ‘unprovoked’ late decelerations and/or reduced baseline FHR variability and absence of cycling. Maternal anti-Ro (SSA) and anti-La (SSB) antibodies can bind to fetal conducting system of the heart and cause atrioventricular heart block, resulting in a baseline bradycardia on the CTG trace.
The Introduction presents the topic of feminine imagery for the Church and the book’s method for examining this imagery in both expository and literary sources and across the traditional medieval and early modern periodization divide. It presents Lady Church both as a theological person with a transcendent ontological status not identical to the ecclesiastical institution and as a literary figure developed through drama, poetry, and literary techniques used in other genres.
The fifth chapter continues the excavation and evaluation of evidence in the making of a government pension contract by describing the circumstances under which reforms have proven effective against constitutional contention. It probes the power of reservation clauses, the credence of contemporary commentary like employee handbooks, the impact of persuasive authority, and the influence of the Supreme Court of the United States. It identifies which forms of proof have been the most effective and why, along with what matters have been missed. In assessing the evidence for and against the creation of a contract, this chapter prioritizes sources, comments on their respective import, and otherwise argues for courts to undertake an expansive inquiry to determine whether government pension benefits receive contract protection.
The Science of the Supernatural might, at first, feel like an oxymoron. I don’t think most people would immediately see the myriad connections between the paranormal and psychology. I didn’t at first, either. I’ve always loved ghost stories, horror movies, and scary novels. I have a distinct memory of lying in my bed as a kid, trying unsuccessfully to go to sleep. I had just read Stephen King’s short story “The Boogeyman.” I remember staring at my closet door, sure that it was slowly creaking open. Certain that the boogeyman was on the other side, waiting to kill me.