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With the rapid expansion of the Infection Prevention Control/Healthcare Epidemiology (IPC/HE) fields over recent decades, the pivotal roles of IPC/HE in hospital regulation, quality improvement, patient safety, and healthcare finances have become increasingly apparent. Consequently, the demand for effective IPC/HE leaders has surged.1,2 Training in IPC/HE is essential for all infectious diseases (ID) fellows (both adult and pediatric), including those planning a career in hospital epidemiology as well as those planning to focus on general ID, transplant, HIV, etc. ID fellows, however, have historically felt ill-prepared in IPC/HE. Joiner et al’s survey highlighted this gap, revealing that only half of respondents felt adequately trained in infection control, despite half of them participating in infection control in their practice.3 IPC/HE fellow education is not currently standardized, and most IPC/HE training is led by individual mentors and healthcare facilities.
To examine the extent and nature of food and non-alcoholic drink advertising displayed on public transport and infrastructure on school routes.
Design:
Audit of outdoor advertisements on government-controlled public transport and associated infrastructure (e.g. tram shelters, bus stops) on busy school routes in Victoria, Australia. Using a strict protocol, trained field workers collected data on the type and content of outdoor advertising during February 2023 (start of school year). Food/drink advertising was classified (unhealthy or healthy) according to the Council of Australian Governments Health Council National interim guide to reduce children’s exposure to unhealthy food and drink promotion (2018).
Setting:
Government-controlled buses, trams and public transport infrastructure on routes from eleven of the busiest train stations in metropolitan Melbourne and regional Victoria, Australia to fifty public primary and secondary schools. Stations were chosen based on annual patronage, area-based socio-economic area (SEA) and regionality).
Results:
156 out of 888 advertisements were for food and non-alcoholic drinks. Of these, almost six in ten (58 %) were deemed unhealthy irrespective of SEA or regionality. Marketing appeals most featured were taste (31 %), convenience (28 %) and emotion (9 %). A significantly higher proportion of unhealthy advertisements were displayed within 500 m of schools v. outside this radius (91 % v. 57 %, P < 0·01).
Conclusion:
Given the detrimental impacts of exposure to unhealthy food/drink advertising on children’s diets, the pervasive, powerful presence of such advertising across government public transport assets, particularly around schools, contradicts public health recommendations to protect children from exposure to and influence by this harmful marketing and warrants government action.
Emerging from a shift in the relationship between archaeology and museums, the ‘Making the Museum’ project investigates the makers of the archaeological and ethnographic collections of the Pitt Rivers Museum in Oxford, positioning archaeological theory and method as essential tools for uncovering the ‘hidden histories’ of these makers.
Vaccines have revolutionised the field of medicine, eradicating and controlling many diseases. Recent pandemic vaccine successes have highlighted the accelerated pace of vaccine development and deployment. Leveraging this momentum, attention has shifted to cancer vaccines and personalised cancer vaccines, aimed at targeting individual tumour-specific abnormalities. The UK, now regarded for its vaccine capabilities, is an ideal nation for pioneering cancer vaccine trials. This article convened experts to share insights and approaches to navigate the challenges of cancer vaccine development with personalised or precision cancer vaccines, as well as fixed vaccines. Emphasising partnership and proactive strategies, this article outlines the ambition to harness national and local system capabilities in the UK; to work in collaboration with potential pharmaceutic partners; and to seize the opportunity to deliver the pace for rapid advances in cancer vaccine technology.
In 2018, the AOC Archaeology Group unearthed a unique Roman figurine in Sandy, Bedfordshire, likely an offering in a domestic shrine or lararium. The figurine features a distinctive Gallic cloak, similar to those found on copper-alloy figurines in Trier and Cambridgeshire and on numerous relief sculptures. It may be related to the hooded garment known as the birrus mentioned in Diocletian's Edict on Maximum Prices of a.d. 301, including the expensive Birrus Britannicus.
Depression is common in people with dementia, and negatively affects quality of life.
Aims
This paper aims to evaluate the cost-effectiveness of an intervention for depression in mild and moderate dementia caused by Alzheimer's disease over 12 months (PATHFINDER trial), from both the health and social care and societal perspectives.
Method
A total of 336 participants were randomised to receive the adapted PATH intervention in addition to treatment as usual (TAU) (n = 168) or TAU alone (n = 168). Health and social care resource use were collected with the Client Service Receipt Inventory and health-related quality-of-life data with the EQ-5D-5L instrument at baseline and 3-, 6- and 12-month follow-up points. Principal analysis comprised quality-adjusted life-years (QALYs) calculated from the participant responses to the EQ-5D-5L instrument.
Results
The mean cost of the adapted PATH intervention was estimated at £1141 per PATHFINDER participant. From a health and social care perspective, the mean difference in costs between the adapted PATH and control arm at 12 months was −£74 (95% CI −£1942 to £1793), and from the societal perspective was −£671 (95% CI −£9144 to £7801). The mean difference in QALYs was 0.027 (95% CI −0.004 to 0.059). At £20 000 per QALY gained threshold, there were 74 and 68% probabilities of adapted PATH being cost-effective from the health and social care and societal perspective, respectively.
Conclusions
The addition of the adapted PATH intervention to TAU for people with dementia and depression generated cost savings alongside a higher quality of life compared with TAU alone; however, the improvements in costs and QALYs were not statistically significant.
This paper reviews the existing literature to identify specific challenges that may arise in the context of providing palliative and end-of-life (EOL) care for Hindu patients in the physical, psychological, and spiritual domains. We offer practical strategies where appropriate to mitigate some of these challenges. We review how the Hindu faith impacts EOL decision-making, including the role of the family in decision-making, completion of advance directives, pain management, and decisions around artificial nutrition and hydration (ANH) and cardiopulmonary resuscitation (CPR).
Methods
The PubMed, MEDLINE Complete, Cochrane, and Embase databases were searched for articles using the search strings combinations of keywords such as Palliative care, Hindu, Hinduism, End of Life Care, India, Spirituality, and South Asian. Once inclusion criteria were applied, 40 manuscripts were eligible for review.
Results
Our results are organized into the following 4 sections – how Hindu religious or spiritual beliefs intersect with the physical, psychological, and spiritual domains: and decision-making at the EOL.
Significance of results
Hindu beliefs, in particular the role of karma, were shown to impact decision-making regarding pain management, ANH and CPR, and advance directive completion. The complexity of Hindu thought leaves a significant role for interpretation and flexibility for individual factors in decision-making at the EOL.
The 7th edition of the Canadian Stroke Best Practice Recommendations (CSBPR) is a comprehensive summary of current evidence-based recommendations, appropriate for use by healthcare providers and system planners, and intended to drive healthcare excellence, improved outcomes and more integrated health systems. This edition includes a new module on the management of cerebral venous thrombosis (CVT). Cerebral venous thrombosis is defined as thrombosis of the veins of the brain, including the dural venous sinuses and/or cortical or deep veins. Cerebral venous thrombosis is a rare but potentially life-threatening type of stroke, representing 0.5–1.0% of all stroke admissions. The reported rates of CVT are approximately 10–20 per million and appear to be increasing over time. The risk of CVT is higher in women and often associated with oral contraceptive use and with pregnancy and the puerperium. This guideline addresses care for adult individuals who present to the healthcare system with current or recent symptoms of CVT. The recommendations cover the continuum of care from diagnosis and initial clinical assessment of symptomatic CVT, to acute treatment of symptomatic CVT, post-acute management, person-centered care, special considerations in the long-term management of CVT, including pregnancy and considerations related to CVT in special circumstances such as trauma and vaccination. This module also includes supporting materials such as implementation resources to facilitate the adoption of evidence into practice and performance measures to enable monitoring of uptake and effectiveness of recommendations.
This volume argues that we must examine the boundaries in fiction and non-fiction crime writing with an awareness of and turn toward the unseen structures and spatial uncertainties that so often lead to and reflect collective fears and anxieties. Drawing upon the insights and expertise of an international array of scholars, the chapters within explore the interplay of the literary, historical, social, and cultural in various modes of crime writing from the 1890s to as recent as 2017. They examine unseen structures and uncertain spaces, and simultaneously provide new insights into the works of iconic authors, such as Christie, and iconic fictional figures, like Holmes, as well as underexplored subjects, including Ukrainian detective fiction of the Soviet period and crime writing by a Bengali police detective at the turn of the twentieth century. The breadth of coverage - of both time and place - is an indicator of a text in which seasoned readers, advanced students, and academics will find new perspectives on crime writing employing theories of cultural memory and deep mapping.
Over a century ago, in his examination of “The Sensational in Modern English Prose Fiction” (1919), Walter Clarke Phillips declared, “Whatever sources of appeal may come or go, there is one which from the very structure of modern democratic society seldom bids for applause unheeded—that is, the appeal to fear” (2). It is to this appeal that we owe the abundance of crime writing at our disposal—a trove of mystery that undoubtedly fascinates in its ability to entertain while safely reflecting the ugliest truths about ourselves and the societies in which we live. In this vein, crime fiction persists as one of the most popular genres of literature across the globe, a fact that is further evinced by the inundation of onscreen adaptations of crime narratives, dramas, capers, and comic books which now, more than ever, reflect our common anxieties about the perceived failures of modern social institutions. That is because, as Catherine Nickerson asserts in “Murder as Social Criticism,” crime fiction “is deeply enmeshed with most of the thornier problems of the Victorian, modern, and postmodern eras, including gender roles and privileges, racial prejudice and the formation of racial consciousness, the significance and morality of wealth and capital, and the conflicting demands of privacy and social control” (1997, 744). Thus, crime fiction would appear to be the perfect vehicle for examining the origins and endurance of those societal fears which are firmly grounded in such conceptions and the perceived boundaries that perpetuate them, but this volume argues that we must examine those boundaries in fiction and nonfiction crime writing with an awareness of and turn toward the unseen structures that produce the spatial uncertainties that so often lead to such collective anxieties.
This collection makes a unique contribution to current scholarship on crime writing by gathering in one place texts that take multifaceted approaches to how these boundaries are drawn and how they respond to changes—sudden and forced or unseen and gradual—in relation to social and/or political power.