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This chapter examines how Pindar and Bacchylides make use of early epic (esp. Homer) in their victory odes, from an explicitly ’intertextualist’ perspective. It discusses (inter alia) the meaning of ’Homer’ in the fifth century BC to the earliest audiences of Pindar and Bacchylides and adverts to the complexity and multiplicity of the audiences of their victory odes. It argues furthermore for the critical importance and benefits of intertextual analysis of Pindar and Bacchylides, especially the ways in which interaction with texts such as those of archaic epic should prompt a wider openness to intertextual investigation of victory odes.
The gut microbiome is impacted by certain types of dietary fibre. However, the type, duration and dose needed to elicit gut microbial changes and whether these changes also influence microbial metabolites remain unclear. This study investigated the effects of supplementing healthy participants with two types of non-digestible carbohydrates (resistant starch (RS) and polydextrose (PD)) on the stool microbiota and microbial metabolite concentrations in plasma, stool and urine, as secondary outcomes in the Dietary Intervention Stem Cells and Colorectal Cancer (DISC) Study. The DISC study was a double-blind, randomised controlled trial that supplemented healthy participants with RS and/or PD or placebo for 50 d in a 2 × 2 factorial design. DNA was extracted from stool samples collected pre- and post-intervention, and V4 16S rRNA gene sequencing was used to profile the gut microbiota. Metabolite concentrations were measured in stool, plasma and urine by high-performance liquid chromatography. A total of fifty-eight participants with paired samples available were included. After 50 d, no effects of RS or PD were detected on composition of the gut microbiota diversity (alpha- and beta-diversity), on genus relative abundance or on metabolite concentrations. However, Drichlet’s multinomial mixture clustering-based approach suggests that some participants changed microbial enterotype post-intervention. The gut microbiota and fecal, plasma and urinary microbial metabolites were stable in response to a 50-d fibre intervention in middle-aged adults. Larger and longer studies, including those which explore the effects of specific fibre sub-types, may be required to determine the relationships between fibre intake, the gut microbiome and host health.
Emergency psychiatric care, unplanned hospital admissions, and inpatient health care are the costliest forms of mental health care. According to Statistics Canada (2018), almost 18% (5.3 million) of Canadians reported needing mental health support. However, just above half of this figure (56.2%) have reported their needs were fully met. To further expand capacity and access to mental health care in the province, Nova Scotia Health has launched a novel mental health initiative, the Rapid Access, and Stabilization Program (RASP).
Objectives
This study evaluates the effectiveness and impact of the RASP on high-cost health services utilization (e.g. ED visits, mobile crisis visits, and inpatient treatments) and related costs. It also assesses healthcare partners’ (e.g. healthcare providers, policymakers, community leaders) perceptions and patient experiences and satisfaction with the program and identifies sociodemographic characteristics, psychological conditions, recovery, well-being, and risk measures in the assisted population.
Methods
This is a hypothesis-driven program evaluation study that employs a mixed methods approach. A within-subject comparison will examine health services utilization data from patients attending RASP, one year before and one year after their psychiatry assessment at the program. A controlled between-subject comparison will use historical data from a control population will examine whether possible changes in high-cost health services utilization are associated with the intervention (RASP). The primary analysis involves extracting secondary data from provincial information systems, electronic medical records, and regular self-reported clinical assessments. Additionally, a qualitative sub-study will examine patient experience and satisfaction, and examine health care partners’ impressions.
Results
The results for the primary, secondary, and qualitative outcome measures to be available within 6 months of study completion. We expect that RASP evaluation findings will demonstrate a minimum 10% reduction in high-cost health services utilization and corresponding 10% cost savings, and also a reduction in the wait times for patient consultations with psychiatrists to less than 30 calendar days. In addition, we anticipate that patients, healthcare providers, and healthcare partners would express high levels of satisfaction with the new service.
Conclusions
This study will demonstrate the results of the Mental Health and Addictions Program (MHAP) efforts to provide stepped-care, particularly community-based support, to individuals with mental illnesses. Results will provide new insights into a novel community-based approach to mental health service delivery and contribute to knowledge on how to implement mental health programs across varying contexts.
Background: Intravenous Immunoglobulin (IVIg) use for Central Nervous System (CNS) conditions has increased over the last decade. In many CNS disorders, robust evidence for IVIg efficacy is still lacking. Building on the success of the British Columbia (BC) Neuromuscular IVIg utilization initiative, Guidelines for IVIg use in CNS conditions were developed. A provincial screening program was launched in 2023. Methods: For CNS IVIg, requests, diagnosis, dosing, consultation letters and treatment questionnaires were reviewed. Patient management was compared to provincial guidelines. A letter was sent to the ordering physician with the results of the review and treatment recommendations when management differed significantly from guidelines. Review of the first year’s cases was conducted. Results: Over the first 11 months of the program, 79 IVIg renewal requests were reviewed. The most common diagnoses were antibody mediated autoimmune encephalitis, severe drug resistant non-surgical epilepsy and Susac’s syndrome. Recommendations included dose reduction, discontinuation of IVIg, or initiation of alternative therapies for many of the requests. Conclusions: IVIg may be effective in the management of some CNS inflammatory conditions. A physician-led utilization program in BC with targeted education to ordering physicians promotes best practice. Review of year one data will inform a quality improvement cycle to optimize the guidelines.
We present a demonstration version of a commensal pipeline for Fast Radio Burst (FRB) searches using a real-time incoherent beam from the Murchison Widefield Array (MWA). The main science target of the pipeline are bright nearby FRBs from the local Universe (including Galactic FRBs like from SGR 1935+2154) which are the best candidates to probe FRB progenitors and understand physical mechanisms powering these extremely energetic events. Recent FRB detections by LOFAR (down to 110 MHz), the Green Bank Telescope (at 350 MHz), and Canadian Hydrogen Intensity Mapping Experiment (CHIME) detections extending down to 400 MHz, prove that there is a population of FRBs that can be detected below 350 MHz. The new MWA beamformer, known as the ‘MWAX multibeam beamformer’, can form multiple incoherent and coherent beams (with different parameters) commensally to any ongoing MWA observations. One of the beams is currently used for FRB searches (tested in 10 kHz frequency resolution and time resolutions between 0.1 and 100 ms). A second beam (in 1 Hz and 1 s frequency and time resolutions, respectively) is used for the Search for Extraterrestrial Intelligence (SETI) project. This paper focuses on the FRB search pipeline and its verification on selected known bright pulsars. The pipeline uses the FREDDA implementation of the Fast Dispersion Measure Transform algorithm (FDMT) for single pulse searches. Initially, it was tested during standard MWA observations, and more recently using dedicated observations of a sample of 11 bright pulsars. The pulsar PSR J0835-4510 (Vela) has been routinely used as the primary probe of the data quality because its folded profile was always detected in the frequency band 200 – 230 MHz with typical signal-to-noise ratio $>$10, which agrees with the expectations. Similarly, the low dispersion measure pulsar PSR B0950+08 was always detected in folded profile in the frequency band 140–170 MHz and so far has been the only object for which single pulses were detected. We present the estimated sensitivity of the search in the currently limited observing bandwidth of a single MWA coarse channel (1.28 MHz) and for the upgraded, future system with 12.8 MHz (10 channels) of bandwidth. Based on expected sensitivity and existing FRB rate measurements, we project an FRB detection rate between a few and a few tens per year with large uncertainty due to unknown FRB rates at low frequencies.
Edited by
Deepak Cyril D'Souza, Staff Psychiatrist, VA Connecticut Healthcare System; Professor of Psychiatry, Yale University School of Medicine,David Castle, University of Tasmania, Australia,Sir Robin Murray, Honorary Consultant Psychiatrist, Psychosis Service at the South London and Maudsley NHS Trust; Professor of Psychiatric Research at the Institute of Psychiatry
An excess or deficit of specific neurotransmitters or receptors has been the dominant theme for explaining the pathology of major mental illness for many decades. The best known example is that hyperdopaminergia is the cause of psychosis. Similar proposals have been made for glutamate and the endocannabinoids, based on the ability of drugs acting on these systems to elicit psychotic mental states. In addition, cannabis is also a risk factor for the development of schizophrenia. On this background, researchers have measured several endocannabinoid components in people with psychotic illness compared to controls. These components include synthesizing and degrading enzymes for anandamide and 2-arochodonylglycerol, the amount of endocannabinoid transmitter in the bloodstream or CSF and the availability of cannabinoid receptors. There is inconsistency in the field as a whole, but a number of intriguing findings have emerged, particularly reports of increased anandamide level in psychosis. In this chapter, the major studies are reviewed and collated.
The experience of working from home changed drastically with the arrival of COVID-19. Compared to pre-pandemic experiences, key differences included the vast number of people involved, its involuntary nature, the suddenness of its implementation, its lengthy duration, and the presence of others at home. The demands of this form of remote work during lockdown have partly been mitigated by the resources employees have accessed. This study aimed to investigate the factors impacting employee performance and wellbeing while compulsorily working from home during New Zealand's first nationwide lockdown. We analyzed qualitative data gathered from employees in two organizations. The resulting aggregate dimensions across both demands and resources include organizational factors, furniture and technology factors, and individual factors. Given the ongoing nature of COVID-19 we identify new research directions for investigating remote work, and practical implications focusing on suitable home furniture and technology, plans for future remote work, and supporting employees.
We consider the problem of moral disjunction in professional and business activities from a virtue-ethical perspective. Moral disjunction arises when the behavioral demands of a role conflict with personal morality; it is an important problem because most people in modern societies occupy several complex roles that can cause this clash to occur. We argue that moral disjunction, and the psychological mechanisms that people use to cope with it, are problematic because they make it hard to pursue virtue and to live with integrity. We present role coadunation as a process with epistemic and behavioral aspects that people can use to resolve moral disjunction with integrity. When role coadunation is successful, it enables people to live virtuous lives of appropriate narrative disunity and to honor their identity-conferring commitments. We show how role coadunation can be facilitated by interpretive communities and discuss the emergence and ideal features of those communities.
Background: Intravenous immunoglobulin (IVIG) may benefit many inflammatory central nervous system (CNS) disorders based on multiple immunomodulatory effects. IVIg is being used in inflammatory CNS conditions however robust evidence and guidelines are lacking in many disorders. Over the last 5 years, the percentage of IVIg used for CNS indications within neurology almost doubled in British Columbia (BC), Canada. Clear local guidelines may guide rational use. Methods: Consensus guidelines for IVIG use for CNS indications were developed by a panel of subspecialty neurologists and the Provincial Blood Coordinating Office, informed by focused literature review. Guidelines were structured similarly to existing BC peripheral nervous system guidelines and Australian Consensus Guidelines. Utilization and efficacy will be monitored provincewide on an ongoing basis. Results: Categories of conditions for Conditionally Approved (N=11) and Exceptional Circumstance Use (N=5) were created based on level of evidence for efficacy. Dosing and monitoring recommendations were made and outcomes measures defined. Rationale for Not Indicated conditions (N=2) was included. Guidelines were distributed to BC neurologists for feedback. This system will be re-evaluated after 1 year. Conclusions: IVIG use in CNS inflammatory conditions has an emerging role. Guidelines for use and monitoring of outcomes will help improve resource utilization and provide further evidence regarding effectiveness.
The Murchison Widefield Array (MWA) is a low-frequency aperture array capable of high-time and frequency resolution astronomy applications such as pulsar studies. The large field-of-view of the MWA (hundreds of square degrees) can also be exploited to attain fast survey speeds for all-sky pulsar search applications, but to maximise sensitivity requires forming thousands of tied-array beams from each voltage-capture observation. The necessity of using calibration solutions that are separated from the target observation both temporally and spatially makes pulsar observations vulnerable to uncorrected, frequency-dependent positional offsets due to the ionosphere. These offsets may be large enough to move the source away from the centre of the tied-array beam, incurring sensitivity drops of
${\sim}30{-}50\%$
in Phase II extended array configuration. We analyse these offsets in pulsar observations and develop a method for mitigating them, improving both the source position accuracy and the sensitivity. This analysis prompted the development of a multi-pixel beamforming functionality that can generate dozens of tied-array beams simultaneously, which runs a factor of ten times faster compared to the original single-pixel version. This enhancement makes it feasible to observe multiple pulsars within the vast field of view of the MWA and supports the ongoing large-scale pulsar survey efforts with the MWA. We explore the extent to which ionospheric offset correction will be necessary for the MWA Phase III and the low-frequency square kilometre array (SKA-low).
Laboratory tests were carried out in order to examine the population growth of Prostephanus truncatus (Horn) (Coleoptera: Bostrychidae) and Sitophilus oryzae (L.) (Coleoptera: Curculionidae) on maize. These two species were placed either simultaneously or one species was allowed to colonize the kernels 7 days earlier than the other, at two temperatures, 26 and 30 °C for 65 days. Apart from progeny production, grain quality parameters, such as insect-damaged kernels (IDK) and undamaged kernels (NDK), the weight of frass and kernel weight were measured. Our data confirms that temperature plays a key role in the competition of these two species; P. truncatus seems to perform better at the higher temperature (30 °C), regardless of the presence of an additional species. Moreover, the results of the present study demonstrates that P. truncatus outcompetes S. oryzae. Sitophilus oryzae produced fewer progeny than P. truncatus in all combinations. Given the outcome of a competition, we hypothesize that most of the kernel damage was due to feeding by P. truncatus. Based on these data, we surmise that P. truncatus has a competitive advantage as an invasive species in new areas with stored maize, even in the presence of S. oryzae.
Background: Intravenous immunoglobulin (IVIG) may benefit many inflammatory central nervous system (CNS) disorders based on multiple immunomodulatory effects. IVIG is being used in inflammatory CNS conditions however robust evidence and guidelines are lacking in many disorders. Over the last 5 years, the percentage of IVIG used for CNS indications within neurology almost doubled in British Columbia (BC), Canada. Clear local guidelines may guide rational use. Methods: Consensus guidelines for IVIG use for CNS indications were developed by a panel of subspecialty neurologists and the Provincial Blood Coordinating Office, informed by focused literature review. Guidelines were structured similarly to existing BC peripheral nervous system guidelines and Australian Consensus Guidelines. Utilization and efficacy will be monitored provincewide on an ongoing basis. Results: Categories of conditions for Possible Indication (N=11) and Exceptional Circumstance Use (N=4) were created based on level of evidence for efficacy. Dosing and monitoring recommendations were made and outcomes measures defined. Rationale for Not Indicated conditions (N=3) was included. Guidelines will be distributed to BC neurologists for feedback and re-evaluated after 1 year. Conclusions: IVIG use in CNS inflammatory conditions has an emerging role. Guidelines for use and monitoring of outcomes will help improve resource utilization and provide further evidence regarding effectiveness.
We present a second-personal account of corporate moral agency. This approach is in contrast to the first-personal approach adopted in much of the existing literature, which concentrates on the corporation’s ability to identify moral reasons for itself. Our account treats relationships and communications as the fundamental building blocks of moral agency. The second-personal account rests on a framework developed by Darwall. Its central requirement is that corporations be capable of recognizing the authority relations that they have with other moral agents. We discuss the relevance of corporate affect, corporate communications, and corporate culture to the second-personal account. The second-personal account yields a new way to specify first-personal criteria for moral agency, and it generates fresh insights into the reasons those criteria matter. In addition, a second-personal analysis implies that moral agency is partly a matter of policy, and it provides a fresh perspective on corporate punishment.
Diet is a modifiable risk factor for chronic disease and a potential modulator of telomere length (TL). The study aim was to investigate associations between diet quality and TL in Australian adults after a 12-week dietary intervention with an almond-enriched diet (AED). Participants (overweight/obese, 50–80 years) were randomised to an AED (n 62) or isoenergetic nut-free diet (NFD, n 62) for 12 weeks. Diet quality was assessed using a Dietary Guideline Index (DGI), applied to weighed food records, that consists of ten components reflecting adequacy, variety and quality of core food components and discretionary choices within the diet. TL was measured by quantitative PCR in samples of lymphocytes, neutrophils, and whole blood. There were no significant associations between DGI scores and TL at baseline. Diet quality improved with AED and decreased with NFD after 12 weeks (change from baseline AED + 9·8 %, NFD − 14·3 %; P < 0·001). TL increased in neutrophils (+9·6 bp, P = 0·009) and decreased in whole blood, to a trivial extent (–12·1 bp, P = 0·001), and was unchanged in lymphocytes. Changes did not differ between intervention groups. There were no significant relationships between changes in diet quality scores and changes in lymphocyte, neutrophil or whole blood TL. The inclusion of almonds in the diet improved diet quality scores but had no impact on TL mid-age to older Australian adults. Future studies should investigate the impact of more substantial dietary changes over longer periods of time.
The first demonstration of laser action in ruby was made in 1960 by T. H. Maiman of Hughes Research Laboratories, USA. Many laboratories worldwide began the search for lasers using different materials, operating at different wavelengths. In the UK, academia, industry and the central laboratories took up the challenge from the earliest days to develop these systems for a broad range of applications. This historical review looks at the contribution the UK has made to the advancement of the technology, the development of systems and components and their exploitation over the last 60 years.
This study aimed to evaluate hearing outcomes and device safety in a large, single-surgeon experience with the totally implantable active middle-ear implants.
Methods
This was a retrospective case series review of 116 patients with moderate-to-severe sensorineural hearing loss undergoing implantation of active middle-ear implants.
Results
Mean baseline unaided pure tone average improved from 57.6 dB before surgery to 34.1 dB post-operatively, signifying a mean gain in pure tone average of 23.5 dB (p = 0.0002). Phonetically balanced maximum word recognition score improved slightly from 70.5 per cent to 75.8 per cent (p = 0.416), and word recognition score at a hearing level of 50 dB values increased substantially from 14.4 per cent to 70.4 per cent (p < 0.0001). Both revision and explant rates were low and dropped with increasing surgeon experience over time.
Conclusion
This study showed excellent post-operative hearing results with active middle-ear implants with regard to pure tone average and word recognition score at a hearing level of 50 db. Complication rates in this case series were significantly lower with increasing experience of the surgeon. Active middle-ear implants should be considered in appropriate patients with moderate-to-severe sensorineural hearing loss who have struggled with conventional amplification and are good surgical candidates.
Medical care is predicated on ‘do no harm’, yet the urgency to find drugs and vaccines to treat or prevent COVID-19 has led to an extraordinary effort to develop and test new therapies. Whilst this is an essential cornerstone of a united global response to the COVID-19 pandemic, the absolute requirements for meticulous efficacy and safety data remain. This is especially pertinent to the needs of pregnant women; a group traditionally poorly represented in drug trials, yet a group at heightened risk of unintended adverse materno-fetal consequences due to the unique physiology of pregnancy and the life course implications of fetal or neonatal drug exposure. However, due to the complexities of drug trial participation when pregnant (be they vaccines or therapeutics for acute disease), many clinical drug trials will exclude them. Clinicians must determine the best course of drug treatment with a dearth of evidence from either clinical or preclinical studies, where at least in the short term they may be more focused on the outcome of the mother than of her offspring.