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Objectives/Goals: Aspiration causes or aggravates lung diseases. While bedside swallow evaluations are not sensitive/specific, gold standard tests for aspiration are invasive, uncomfortable, expose patients to radiation, and are resource intensive. We propose the development and validation of an AI model that analyzes voice to noninvasively predict aspiration. Methods/Study Population: Retrospectively recorded [i] phonations from 163 unique ENT patients were analyzed for acoustic features including jitter, shimmer, harmonic to noise ratio (HNR), etc. Patients were classified into three groups: aspirators (Penetration-Aspiration Scale, PAS 6–8), probable (PAS 3–5), and non-aspirators (PAS 1–2) based on video fluoroscopic swallow (VFSS) findings. Multivariate analysis evaluated patient demographics, history of head and neck surgery, radiation, neurological illness, obstructive sleep apnea, esophageal disease, body mass index, and vocal cord dysfunction. Supervised machine learning using five folds cross-validated neural additive network modelling (NAM) was performed on the phonations of aspirator versus non-aspirators. The model was then validated using an independent, external database. Results/Anticipated Results: Aspirators were found to have quantifiably worse quality of sound with higher jitter and shimmer but lower harmonics noise ratio. NAM modeling classified aspirators and non-aspirators as distinct groups (aspirator NAM risk score 0.528+0.2478 (mean + std) vs. non-aspirator (control) risk score of 0.252+0.241 (mean + std); p Discussion/Significance of Impact: We report the use of voice as a novel, noninvasive biomarker to detect aspiration risk using machine learning techniques. This tool has the potential to be used for the safe and early detection of aspiration in a variety of clinical settings including intensive care units, wards, outpatient clinics, and remote monitoring.
We argue that proxy failure contributes to poor measurement practices in psychological science and that a tradeoff exists between the legibility and fidelity of proxies whereby increasing legibility can result in decreased fidelity.
Evidence on the impact of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020.
Aims
To systematically review evidence on presentations to health services following self-harm during the COVID-19 pandemic.
Method
A comprehensive search of databases (WHO COVID-19 database; Medline; medRxiv; Scopus; PsyRxiv; SocArXiv; bioRxiv; COVID-19 Open Research Dataset, PubMed) was conducted. Studies published from 1 January 2020 to 7 September 2021 were included. Study quality was assessed with a critical appraisal tool.
Results
Fifty-one studies were included: 57% (29/51) were rated as ‘low’ quality, 31% (16/51) as ‘moderate’ and 12% (6/51) as ‘high-moderate’. Most evidence (84%, 43/51) was from high-income countries. A total of 47% (24/51) of studies reported reductions in presentation frequency, including all six rated as high-moderate quality, which reported reductions of 17–56%. Settings treating higher lethality self-harm were overrepresented among studies reporting increased demand. Two of the three higher-quality studies including study observation months from 2021 reported reductions in self-harm presentations. Evidence from 2021 suggests increased numbers of presentations among adolescents, particularly girls.
Conclusions
Sustained reductions in numbers of self-harm presentations were seen into the first half of 2021, although this evidence is based on a relatively small number of higher-quality studies. Evidence from low- and middle-income countries is lacking. Increased numbers of presentations among adolescents, particularly girls, into 2021 is concerning. Findings may reflect changes in thresholds for help-seeking, use of alternative sources of support and variable effects of the pandemic across groups.
The idea of the Anthropocene has been enormously generative and largely beneficial for academic discourse on human interactions with the environment. But, as is increasingly well understood, it also has significant problems. Perhaps the trickiest one is its implication of a species-wide agency. In his influential article ‘The Climate of History’ (2009), Dipesh Chakrabarty argues that traditional forms of cultural critique do not provide a sufficient framework for addressing climate change, which, after all, is a problem for humanity as a whole. He has since been taken to task, perhaps unfairly, by scholars who argue that the emphasis on ‘species being’, implied by the idea of the Anthropocene, effectively ignores the considerable economic, social and political inequalities that have created climate change and that are further fed by it. Like the casual invocation of ‘we’ in climate discourse, a key danger of the term ‘Anthropocene’ is that it distracts from understanding the history of anthropogenic environmental change as a history of carbon capitalism, for which a relatively small number of nations and multinationals have the bulk of responsibility. Crises such as global heating and biodiversity loss are inevitably intertwined with inequalities between individuals, classes and nations, and with imperialism, colonialism and their legacies. As noted in a 2015 Oxfam report on ‘Extreme Carbon Inequality’, the richest 10 per cent of the global population are responsible for 50 per cent of global emissions. Richer countries engage in a kind of neocolonialism by driving ecological destruction in the Global South, largely for their own benefit. The wealthier and more educated are disproportionately over-represented with respect to the discourse on climate change, despite being the most sheltered from its effects. This may explain the kind of binary thinking that produces apocalypticism, techno-utopianism and pure denialism: all the products of privilege that are less likely to attract people who are already having to make deep adaptations to climate change.
The climate emergency is of course unprecedented, but it is also the product of a long history of global inequality and therefore should be understood genealogically.
The Afterword addresses the historical dominance of white voices in British nature writing, and the marginality of race, class and gender politics in the genre. This tendency matches continuing inequalities in the social and ethnic composition of British environmentalist movements. Contemporary nature writing also reflects regional inequalities, with many of its leading figures clustering around East Anglia. Nonetheless, Elizabeth-Jane Burnett’s recent book The Grassling exemplifies British nature writing that stands out not only through the unconventional background of its author, but also through its experimental techniques. At the same time, platforms such as The Willowherb Review suggest that the genre and the critical culture around it are gradually changing to allow room for more diverse voices. However, nature writers of colour venturing into rural environments still find themselves contending with the stark racial divide between Britain’s cities and countryside. Similarly, a growing range of LGBTQ* nature writers are becoming increasingly visible in the genre and challenging heteronormative codings of the rural. In the aftermath of Brexit and a global pandemic, Britain’s nature writers confront a nation highly divided and isolated, and a literary heritage permeated by elitist elements which need to be reckoned with.
British nature writing is a conflict-ridden mode that speaks to contradictions in the modern condition, and a crisis-ridden mode that addresses the modern crises of the environment, of representation and of the alienated self. It returns repeatedly to problems of mimesis and the non-transparency of language, and to the slippages between ecological facts and the cultural imagination. ‘Nature writing’ is a problematic category, and classifications of earlier literature as such must be qualified, recognising the historical overlapping of environmental literature with natural history and other genres. Although British nature writing grew in dialogue with its American equivalent, it has always been less concerned than the latter with the wilderness, addressing more cultivated environments in which wildlife intermingles with human social and economic activity. The genre has long sought spiritual renewal and significance in wildlife and engaged in conservation movements, although its environmentalist ethics have not been consistent. British nature writing has also been deeply shaped by the pastoral and georgic traditions, causing it to waver between the foci of leisurely contemplation and laborious activity.
Chapter 4 examines contemporary nature writing, initially focusing on the ‘new nature writing’ of the past few decades. It argues that this writing, ostensibly an attempt to engage with the ‘post-natural’ conditions of the Anthropocene, is haunted by a feeling of inadequacy in relation to its predecessors and marked by the frustrations of ‘late style’. Indeed, many British writers of the period are best seen as ‘late Moderns’, expressing deep-seated anxieties about themselves, their writing, and their position in a rapidly diminishing natural world. This thesis is examined in relation to writers whose work simultaneously attempts to recall the wild and reflects on the impossibility of that exercise; other writers are then brought in to examine those contemporary post-industrial landscapes that might create the conditions of possibility for a ‘new wild’. The second half of the chapter pursues this line of argument, but in relation to another popular subgenre, animal writing, which is seen as containing regenerative potential but also as communicating unsettling insights into the always unstable relationship between animal others and human selves. The chapter then concludes with some reflections on a different kind of violence, the violence of the elements, which in today’s era of accelerated climate change is both significantly influenced by human beings and beyond the bounds of human control.
Chapter 1 reveals the complexity and self-consciousness of Romantic nature writing, bringing together authors who share an interest in nonhuman nature as a dynamic process. It also addresses the porousness of Romantic nature writing as a mode of engagement across different kinds of texts. A key claim is that, while Gilbert White’s localism and close field observations were influential on later nature writing, so was the strand of confessional autobiography pioneered by Jean-Jacques Rousseau. Romantic nature writing is often represented as a self-aggrandising masculine mode. But women writers such as Dorothy Wordsworth and Charlotte Smith were significant, particularly in their portrayals of nonhuman nature as entangled with everyday human life. The chapter also addresses labouring-class writers, bringing John Clare’s natural history prose into dialogue with the work of the artist Thomas Bewick and the novelist and poet James Hogg. All three resisted and lamented the forces of modernisation, but did so through developing innovative modes of representation. Even at its most backward-looking, Romantic nature writing engaged with the contradictions and conflicts of modernity. And, while influenced by natural theology, it also dared to speculate about deep time and the transience of human species.
Chapter 3 addresses the Modern period. As good a way as any of designating the period is via Eric Hobsbawm’s moniker the Short Twentieth Century (1914–91), which he sees as an age of extremes marked, especially in its first half, by a sequence of potentially world-ending catastrophes bookended by the two world wars. Much nature writing of the time evidences this apocalyptic trend, though it also takes heart in the regenerative properties of nature, which is viewed, via the lenses of such fast-developing disciplines as ecology and ethology, with an increasingly scientific eye. The first part of the chapter draws accordingly on writing which, informed by evolving ecological understandings, also debates the protectionist measures needed to combat species extinction in an ecologically threatened world. These ecological threats are then brought to bear on early- to mid-twentieth-century rural writing, which is often all too hastily viewed as reacting against the modern forces of industrialisation and urbanisation, but is better seen as belonging to a complex machinery of rural representation adapted to the cultural needs of post-war England as well as to the new technological demands of a rapidly modernising world.
Victorian nature writing vacillated between escapist pastoral idealism and hands-on georgic realism. Its narrators were at once labourers and idlers, scientists and aesthetes. The genre’s hybridity allowed it to mediate between mechanistic paradigms of nature and religious beliefs and experiences. Natural environments were constructed as realms of both Darwinian struggle and spiritual revelation. Imagining nature appreciation as a form of self-culture sometimes encouraged a nascent ecological and humanitarian sensibility. However, Victorian nature writing remained generally anthropocentric, centring the human mind. Yet, some authors, particularly later in the period, also framed wild environments and organisms as radically alien and unknowable. These different tendencies were often expressed through rhetoric of strangeness and estrangement, which dovetailed with ambivalences about identity, place and belonging. While authors classified objects, creatures and plants as alternately native or foreign, these categories frequently became blurred or uncertain. Authors also equivocated on where to locate ‘nature’, tracing it through rural, coastal and urban areas, in the great outdoors and human homes. Authors discussed include John Ruskin, Charles Kingsley, Philip Henry Gosse, Margaret Gatty, Hugh Miller, Eliza Brightwen, Richard Jefferies and W. H. Hudson.
Why do we speak so much of nature today when there is so little of it left? Prompted by this question, this study offers the first full-length exploration of modern British nature writing, from the late eighteenth century to the present. Focusing on non-fictional prose writing, the book supplies new readings of classic texts by Romantic, Victorian and Contemporary authors, situating these within the context of an enduringly popular genre. Nature writing is still widely considered fundamentally celebratory or escapist, yet it is also very much in tune with the conflicts of a natural world under threat. The book's five authors connect these conflicts to the triple historical crisis of the environment; of representation; and of modern dissociated sensibility. This book offers an informed critical approach to modern British nature writing for specialist readers, as well as a valuable guide for general readers concerned by an increasingly diminished natural world.
We examine the Scotch Whisky Association’s (SWA) role in protecting “Scotch whisky” between c. 1945 and c. 1990. Using new archival evidence, we demonstrate that the SWA intensively lobbied the UK government to achieve coordination between domestic and European regulations governing Scotch whisky and whisky. The SWA’s nonmarket activities were consonant with some trade associations but in other respects they were atypical. The SWA extended its activities to supranational bodies and engaged in extensive domestic and foreign litigation. The key message from this article is that the SWA built the world-renowned appellation “Scotch whisky” even though this marque was not registered as an appellation until the late twentieth century.
Over the past two centuries, apocalypse and extinction have become powerful secular tropes, and have been given new urgency in the context of escalating global heating and biodiversity loss. This chapter examines how the environmental humanities can analyse, complicate, democratise, and challenge these tropes. It addresses present-day speculations about the future of the biosphere, both within the field, and in wider culture through the activities of groups such as Extinction Rebellion. It explores the entanglements of these speculations with questions of justice, and offers an analysis of relationships humanity, inequality, and catastrophe in Mary Shelley’s novels Frankenstein (1818) and The Last Man (1826). The chapter ends with some suggestions about the role of the environmental humanities in an ecological emergency. In particular, it addresses how the field might contribute to the communal task of finding urgent solutions for social-environmental problems, while at the same time maintaining focus on issues of justice and rigorous critique of totalising narratives, including the language of solutions and of apocalypse itself.
Romantic nature writing emerges at roughly the same time as the industrial innovations that will eventually lead to global carbon capitalism and therefore is for some scholars coeval with the birth of the Anthropocene. This chapter takes a genealogical approach to the Anthropocene by suggesting that there are significant continuities between Romantic literature and contemporary discourses on environmental catastrophe. Focusing on two case studies – William Cowper’s The Task and Mary Shelley’s Frankenstein, both of which responded to climate change caused by volcanic eruptions – this chapter shows how Romantic writers address what it means to be alive at a catastrophic turning point in planetary history. They are concerned with the power of the human imagination to shape its environments, yet also with our vulnerability to elemental forces that we may affect but that we cannot control.