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This paper describes how four rural schools on the mid-north coast of NSW pushed back against the current indoor classroom education model, instead prioritising the importance of ecologising learning beyond the school gate. While there has been considerable attention paid to Aboriginal and/or Torres Strait Islander practices associated with food systems and geographical domains in Australian school curricula, less attention has been paid to the natural Lore of the land and the underlying knowledge and practices shaping and maintaining sustainable land management. Here the authors recount the crucial role of the Gumbaynggirr people’s historical and contemporary cultural knowledge systems that acted as a cornerstone for school students to build their learning about Climate Change authentically with/within nature. Aboriginal knowledge systems derive from a deep relationship between plants and animals, entwined with spiritual practices. However, despite the potential significance of their contributions, Aboriginal and/or Torres Strait Islander people have not been adequately represented in the national discussions about Climate Change (HEAL Network & CRE-STRIDE (2021). Discussion Paper, Lowitja Institute, Melbourne, doi:10.48455/bthg-aj15.). This research found that when representatives from the local Aboriginal community lead teachers in Climate Change education, overwhelmingly student learning is enriched when it occurs in settings enabling a deep relationality with nature and Culture.
The COVID-19 pandemic showed the vital role of Emergency Medical Teams (EMTs) in international surge responses. The EMTs with their internationally skilled team members were able to meaningfully support countries facing the pandemic, especially those who were suffering from scarcity in the quality and quantity of workforce and financial resources within their health systems. This report summarizes the main operational challenges faced by UK-Med and The Polish Center for International Aid (PCPM) Emergency Medical Teams, based on experiences from their 32 COVID-19 deployments. In particular, the paper discusses the hindrances related to Ministries of Health expectations and the changing roles of EMTs during deployments.
Classic arguments about federalist governance emphasize an informational or learning role for decentralizing policy authority, but in practice, ideological outcomes frequently motivate this choice. We examine the role of ideology in the allocation of policy-making power by modeling a two-period interaction between an elected central executive and two local governments. Decentralization reduces the executive’s ability to set policy and control externalities but potentially insures against future policy reversals. In this environment, partial decentralization is a common outcome. Complete decentralization arises when executives are unlikely to be re-elected, party polarization is high, and institutional hurdles to policy-making are significant. These results help to clarify existing cross-national empirical findings on the determinants of centralization.
A total of 2848 denarii from the Nietulisko Małe Hoard, one of the largest hoards of Roman coins found in Poland, were digitised and documented using reflectance transformation imaging, highlighting the potential for this technology in numismatic research.
The National Institute for Health and Care Excellence (NICE) conducts health technology assessment to assess cost-effectiveness and budget impact. For treatments provided in vials, NICE often considers how treatments are dispensed and adjusts the economic modeling costs accordingly. Vial sharing and wastage are likely familiar concepts to stakeholders, but the same consideration is not consistently given to tablet packs.
Methods
Using anonymized examples, NICE assessed potential implications for cost-effectiveness and budget impact of different methods for modeling oral treatments. Firstly, the cost-effectiveness and budget impact were calculated based on a cost per milligram (mg) of treatment. The per mg cost was multiplied by the number of mg for each dose and did not account for the number of tablets or packs required. Using the same example, the cost per tablet was calculated by rounding each dose to the nearest whole tablet mg dose. Finally, the example was costed based on whole packs, which included the cost for any wasted tablets.
Results
The anonymized examples showed that costing per mg versus per tablet versus per pack can have a significant impact on cost-effectiveness and budget impact. One example showed that treatment costs per 28 days could increase by over GBP1,000 (USD1,271) when costing per whole pack compared to per mg. This led to a difference in the incremental cost-effectiveness ratio (ICER) of nearly GBP10,000 (USD12,716). Another example demonstrated a potential increase in budget impact of nearly GBP1 million (USD1.27 million) per year. This magnitude of impact on cost-effectiveness and budget has the potential to change health technology assessment decisions and affordability in the United Kingdom.
Conclusions
NICE is assessing an increasing number of oral treatments provided as tablet packs, not vials. This highlights the need to consider how pack sharing and wastage should be consistently considered in economic modeling. Developing standardized methods for modeling oral treatments would help ensure consistency of cost calculations and better reflect how treatments are dispensed in clinical practice.
Geophytes are hardy, resilient plants that are tolerant of cold temperatures and drought and are well documented as a reliable food source for hunter-gatherers worldwide. Human settlement patterns and foraging behaviors have long been associated with the use of nutrient-dense geophytes rich in carbohydrates, fiber, vitamins, and minerals. Indigenous communities in the northern Great Basin developed cultural practices centered around gathering, preparing, and consuming important geophytic plants. These practices became deeply embedded in their cultural identity, forming rituals, stories, and traditions that persist today. Although there is strong ethnographic precedent for the significance of geophytes, finding evidence of their use in the archaeological record remains a challenge. This study analyzed archaeological starch residue extracted from bedrock metates in the uplands of Warner Valley, Oregon. Systematic studies of starch granules collected from extant plant communities growing near archaeological sites were applied to the identification of archaeological granules. Starch granules from geophytes, specifically Lomatium spp. (biscuitroot), were identified on metate surfaces at all sites, thus providing direct evidence for the collection and processing of geophyte vegetables. Evidence of geophyte plant processing on bedrock metates contributes to archaeological theories about subsistence strategies, food-processing technologies, social organization, and cultural practices in past human societies.
When no criterion variable is available, the combination of tests or other variables by the use of multiple correlation is not possible. Three methods of combining variables are described mathematically, and discussed with reference to the linear combination of tests. Iterative computational schemes are outlined and illustrated.
In many situations it is desirable or necessary to administer a set of tests to several different groups, and to ask if the results obtained in the different groups may be regarded as being essentially the same in some sense. In the case of two variables (one dependent and one independent) one may, for instance, ask if the errors of estimate and the regression lines may be regarded as being the same for the populations from which the different groups are drawn. For this case, the present article considers tests for three hypotheses regarding the populations from which the different groups are drawn: (a) HA, the hypothesis that all standard errors of estimate are equal; (b) HB, the hypothesis that all regression lines are parallel, (assuming HA); and (c) HC, the hypothesis that the regression lines are identical, (assuming HB). Test criteria for these three hypotheses and their sampling theory for large samples are presented. The results are extended to the case of several independent variables. An illustrative problem is presented for two groups, two independent and one dependent variable.
Before 2000, the UK operated one of the most liberal political finance regimes of any established democracy. Parties were highly dependent on private financing, state funding was minimal, limited transparency requirements existed with respect to party income or expenditure, and no limits applied to national election spending. Far-reaching reforms introduced by Labour in 2000 changed this regulatory environment radically, establishing donation disclosure requirements and capping election spending. However, Labour's reforms did not include significant increases in state funding, leaving the UK as a continued outlier in Western Europe in assuming political parties should predominantly be funded through private means. In this paper, we show how the Conservatives ultimately prospered under Labour's reforms, enabling them to greatly outspend Labour at four general elections from 2010 to 2019. Using the public registers created by Labour's reforms, we document how the party's financial re-stabilisation while in opposition was assisted to a surprising degree by state funding and how the party's donor base has shifted towards wealthy individuals and privately owned companies since its return to government in 2010. We conclude with a number of observations about how the apparently exceptional UK case can help generate important insights for the comparative study of political finance.
In this chapter, we test the efficacy of community policing in thirteen districts throughout rural Uganda. As in many authoritarian regimes, police in Uganda serve the dual role of providing security to citizens on the one hand and quelling dissent and opposition on behalf of the regime on the other. Community policing may help citizens delink the political arm of the police from less politicized local officers. The community policing initiative we study was locally designed and funded by the Ugandan police. Our evaluation combines administrative crime data from the Uganda Police Force with surveys of thousands of Ugandan citizens, local leaders, and police officers. While the initiative we study succeeded in increasing the frequency of interactions between citizens and the police in these far-flung villages and improved citizens’ understanding of the criminal justice system, we find no evidence that it reduced crime, enhanced perceptions of safety, improved attitudes towards the police, or strengthened norms of cooperation with the police. These results are consistent with other chapters in this volume and point to the potential limitations of community policing in low-income countries.
Recent progress has been made towards developing automated companions for the elderly. Building on work in the early days of artificial intelligence that showed that computers could deliver non-directive counselling, the possibility arises that computers could be used to provide people with an opportunity for spiritual conversation. Research using Wizard-of-Oz methodology shows that at least some people find it helpful to have spiritual conversations with what they believe to be an avatar, and work using GPT-3 shows that computers can be an acceptable interlocutor in spiritual conversation. The possibility now arises of developing a spiritual companion that would be personalised for a particular individual and become familiar with their spiritual life. This would not, in every way, replace a human spiritual guide, but could provide a resource that at least some people would find valuable and would assist in their spiritual development.
To better delineate multiplexed gastrointestinal polymerase chain reaction (PCR) panel (MGPP) diagnostic and therapeutic stewardship for patients undergoing treatment for acute leukemia including indications and benefits of testing, optimal timing, and interpretation of results.
Study design:
We retrieved all MGPP ordered on 662 consecutive patients admitted with newly diagnosed acute leukemia between June 2015 and May 2024.
Setting:
Regional referral center for acute leukemia.
Results:
Fifty-one (17%) of 305 MGPP obtained on the 198 patients who underwent testing identified at least one and 4 (1%) more than one diarrheagenic pathogen. The probability of a positive result was greater if obtained as an outpatient [20/52(38%)], but was not related to type of leukemia, sex, or age. Among the positive results, the pathogens identified included Clostridioides difficile (78% of tests), norovirus (16%), diarrheagenic Escherichia coli (6%), adenovirus 40/41 (4%), and Giardia lamblia (4%). The results of 30 of the 305 tests resulted in a change in treatment (28 C. difficile, 2 G. lamblia). For the MGPP C. difficile results with an accompanying toxin determination, this included treatment following 16/19 tests with a positive toxin result and 11/19 with a negative. Actionable results other than C. difficile were rarely seen in the inpatient population.
Conclusions:
MGPP testing is most useful when administered as an outpatient and of little benefit for inpatients with hospital-onset diarrhea. Since MGPP is sensitive and does not distinguish between colonization and causes of diarrhea, caution is needed in interpretation of results, especially for toxin-negative C. difficile.
We aimed to systematically review primary studies exploring workplace bullying of psychiatric trainees, including rates, forms of bullying, perpetrators and help-seeking. We searched Ovid MEDLINE, PubMed, CINAHL, PsycINFO and Embase using PRISMA guidelines. The inclusion criterion was primary research papers surveying or interviewing psychiatry trainees with respect to perceived workplace bullying by staff members. Exclusion criteria were secondary research papers and papers whose only focus was bullying by patients or carers.
Results
Substantial levels of bullying were reported in all five included studies. Perpetrators were often reported to be consultants, managers or peers. Most trainees did not obtain help for bullying and harassment. All of the studies had methodological limitations.
Clinical implications
Concerning levels of workplace bullying have been reported by psychiatric trainees in the UK and abroad. Further methodologically robust studies are required to evaluate the current levels and nature of this bullying, and strategies to prevent and manage it.
The European Green Deal aims to reduce global emissions by minimizing the use of resources. Early validation of products helps to reduce rework, costs and therefore resources. However, validation of complex mechatronic products is challenging due to interdependencies. Companies are applying systems engineering to meet this challenge. Current validation approaches are insufficient in the early design phases. This paper presents an approach to validation using the system architecture in the B2B sector. A machine tool and a custom built machine are presented as evaluation examples.
Digital Twins are perceived differently between and within industry and academia regarding applications and potentials. For this reason, a round table was formed based on the Digital Twin Workshop of the Design Conference 2022. One of the results of this round table is this contribution, which deals with a survey within the industry. The survey captured the understanding of the different roles in the creation and use of Digital Twins, the requirements and hurdles as well as the perception of methodological support. In addition, factors that influence the perception were identified.
The morphological characteristics of starch granules preserved on ancient ground stone tools can reveal which plant species were processed and consumed and even infer tool function. Bedrock metates are commonly associated with the processing of localized seasonal resources, providing potential evidence for past human lifeways, including foods collected and processed, social gatherings, settlement patterns, land investment, and territorial behavior. In contrast to ground stone artifacts preserved in a buried context that have been studied extensively, limited starch research has been conducted on the potential for environmental contamination of open-air bedrock mortars and metates exposed to natural erosional elements. This project examines the residue samples of bedrock metates from three archaeological sites in southern Oregon in the United States to compare the starch yields of extraneous material cleaned from the grinding surface to those extracted from interstitial matrices deeper within the bedrock. Significantly greater number of starch granules were recovered from deep within the cracks and crevices than from the surface. Our study suggests that environmental contamination can be managed if separate surface and control samples are collected and analyzed in conjunction with the interstitial samples. Examining the potential for environmental contamination on exposed grinding surfaces is crucial for confidence in starch granule results and improving our understanding of human dietary behavior.
Der 2. Korintherbrief sucht in seinem ersten Hauptteil (1.15–7.16) die Anstöße aufzuarbeiten, die die Gemeinde im Vorfeld des Briefs an der Ausübung des apostolischen Dienstes durch Paulus genommen hat. Wie die Eröffnung dieses Hauptteils in 1.15–2.2 zu verstehen ist, ist aber in der Forschung umstritten.
Der Aufsatz untersucht die literarische Verortung, den formalen Aufbau und die sprachliche Ausgestaltung des Gedankengangs, um dessen Sinngehalt und Funktion zu klären. Es wird aufgezeigt, wie der Abschnitt einerseits die Modifikation der paulinischen Besuchsabsichten, andererseits das Unterlassen eines angekündigten weiteren Aufenthalts verteidigt. Vor dem Horizont einer grundsätzlichen Reflexion der Basis, Eigenart und Aufgabe des paulinischen Apostolats korrigiert er die negative Wahrnehmung des Paulus auf Seiten der Adressaten und zeigt in drei Schritten auf, dass dieser gerade mit seinen die Gemeinde enttäuschenden Entscheidungen den ihm und seiner Mitarbeiterschaft gegebenen apostolischen Auftrag sachgerecht wahrgenommen hat.
The lengthy chanson de geste that mythologizes the life of the French knight Bertrand du Guesclin (c. 1320–1380) sends a strong message about military masculinities and the kind of man who is worthy of praise. It comes as no surprise, then, that du Guesclin responds quite firmly against a charge of cowardice levelled against him when he advises Henry of Trastamara against engaging in the Battle of Najera:
Mais pour tant que parle en avez ensement,
Et ainssi reprouve m’avez villainement,
Foy que je doy a Dieu le divin sacrament,
Demain leur liveroy bataille et content
Et seroy le premier a mon commencement!
La poura on veoir de moy le bon talent,
Ne se je suis traitres ne coars ensement.
(But since you have talked about it, / and so villainously reproach me, / by the faith in the divine sacrament which I owe God, / tomorrow I will give them battle and satisfaction / and I will be the first from my command! / Then you will see my good intentions, / that I am neither a traitor nor a coward either.)
Consistently loyal to whichever cause he was fighting for, the historical Bertrand du Guesclin very much earned his reputation and the rewards that came to him. The poem that commemorated and mythologized his life has a strong message about military masculinities that shows why he was so respected. His unwavering loyalty meant that he could act as he saw fit, even when his actions were questionable. This loyalty is part of the poem's argument: those who are consistently loyal are the worthiest of praise. This article explores more of the poem's arguments about military masculinities.
The historical Bertrand du Guesclin (c. 1320–1380), a minor Breton noble, was one of the most famous of the French soldiers of his generation, valuable enough to be mythologized both in his lifetime and in subsequent centuries. He proved himself so useful that he served the last ten years of his life as Constable of France, a military position hitherto reserved for someone of the higher nobility. When the Hundred Years’ War between England and France escalated after 1369, he managed to retake much of the territory lost to the English after the Battle of Poitiers (1356) and the subsequent Treaty of Bretigny (1360).
Clinical outcomes of repetitive transcranial magnetic stimulation (rTMS) for treatment of treatment-resistant depression (TRD) vary widely and there is no mood rating scale that is standard for assessing rTMS outcome. It remains unclear whether TMS is as efficacious in older adults with late-life depression (LLD) compared to younger adults with major depressive disorder (MDD). This study examined the effect of age on outcomes of rTMS treatment of adults with TRD. Self-report and observer mood ratings were measured weekly in 687 subjects ages 16–100 years undergoing rTMS treatment using the Inventory of Depressive Symptomatology 30-item Self-Report (IDS-SR), Patient Health Questionnaire 9-item (PHQ), Profile of Mood States 30-item, and Hamilton Depression Rating Scale 17-item (HDRS). All rating scales detected significant improvement with treatment; response and remission rates varied by scale but not by age (response/remission ≥ 60: 38%–57%/25%–33%; <60: 32%–49%/18%–25%). Proportional hazards models showed early improvement predicted later improvement across ages, though early improvements in PHQ and HDRS were more predictive of remission in those < 60 years (relative to those ≥ 60) and greater baseline IDS burden was more predictive of non-remission in those ≥ 60 years (relative to those < 60). These results indicate there is no significant effect of age on treatment outcomes in rTMS for TRD, though rating instruments may differ in assessment of symptom burden between younger and older adults during treatment.