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This article explores the ancient city of Terracina, its strategic location, and its significant Roman sanctuary dedicated to Iuppiter Anxur. This youthful Jupiter, known for his beardless depiction, oversaw a sanctuary on Monte Sant’Angelo, which remains an important archaeological site. The location of the temple of Iuppiter Anxur, however, despite extensive study over 150 years, has not been precisely identified. The site includes three terraces with structures such as the Great Temple and Terrace A, which features notable architectural and functional elements. Ongoing research since 2021 has aimed to uncover more about the site’s development and its cultural importance. The article examines various hypotheses about the temple’s location and the role of Iuppiter Anxur within the sacred landscape of Terracina. For the first time, a comprehensive architectural reconstruction of the sanctuary has been proposed, offering new insights into its design and cultural significance. This reconstruction suggests a sophisticated architectural complex with important religious and cultural roles in ancient Terracina.
During mass-casualty incidents (MCIs), prehospital triage is performed to identify which patients most urgently need medical care. Formal MCI triage tools exist, but their performance is variable. The Shock Index (SI; heart rate [HR] divided by systolic blood pressure [SBP]) has previously been shown to be an efficient screening tool for identifying critically ill patients in a variety of in-hospital contexts. The primary objective of this study was to assess the ability of the SI to identify trauma patients requiring urgent life-saving interventions in the prehospital setting.
Methods:
Clinical data captured in the Alberta Trauma Registry (ATR) were used to determine the SI and the “true” triage category of each patient using previously published reference standard definitions. The ATR is a provincial trauma registry that captures clinical records of eligible patients in Alberta, Canada. The primary outcome was the sensitivity of SI to identify patients classified as “Priority 1 (Immediate),” meaning they received urgent life-saving interventions as defined by published consensus-based criteria. Specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated as secondary outcomes. These outcomes were compared to the performance of existing formal MCI triage tools referencing performance characteristics reported in a previously published study.
Results:
Of the 9,448 records that were extracted from the ATR, a total of 8,650 were included in the analysis. The SI threshold maximizing Youden’s index was 0.72. At this threshold, SI had a sensitivity of 0.53 for identifying “Priority 1” patients. At a threshold of 1.00, SI had a sensitivity of 0.19.
Conclusions:
The SI has a relatively low sensitivity and did not out-perform existing MCI triage tools at identifying trauma patients who met the definition of “Priority 1” patients.
In this paper, I explore the notion of public interest embedded in the Procurement Act 2023. I use this new piece of post-Brexit legislation as a contemporary example of the difficulty in designing a ‘public interest centred’ system of public procurement regulation. I show how a mix of partly overlapping explicit, referential, and implicit public interest goals results in a situation where there are multiple sources of objectives contracting authorities need to consider in their decision-making, but there is no prioritisation of sources or objectives. I also show that, despite this kaleidoscopic proliferation of sources and objectives, and due to the unavailability of effective means of judicial challenge or administrative oversight, contracting authorities retain almost unlimited discretion to shape the public interest and ‘what it looks like’ in relation to the award of each public contract. This challenges the centralised approach to procurement policy taken by recent and current UK Governments and, in particular, raises significant questions on the likely effectiveness of ‘mission-driven’ procurement. I close with a call to reconsider how public procurement can foster the public interest, in light of its limitations as a regulatory tool.
The USCCB statement resourcing lay ecclesial ministry relies on two biblical images; a mixed metaphor pairing an historical reality of the Pauline ecclesial co-worker and a Matthean parabolic narrative of day laborers. Examining this combined metaphor discloses how their tensions mirror the statement’s theological and pastoral divergences on the scope and authority of lay ministry leadership. The metaphor’s meaning and the statement’s text reinforce one another’s ambiguities enough that they can both highlight the vital ecclesial importance of lay ministry, or allow it to be interpreted in a clericalized way which undermines lay ministers’ value. This analysis is contextualized by pandemic-era stresses on lay ministers, even as there are new recognitions of their importance and value by Pope Francis and the synodal process. The status of these important ministers as true co-workers in the Pauline sense remains largely unrealized, highlighting the need for renewed theological and pastoral efforts to encourage their proper agency in the life of the Church.