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A multi-center validation of the electronic health record admission source and discharge location fields against the clinical notes for identifying inpatients with long-term care facility exposure
- Katherine E. Goodman, Monica Taneja, Laurence S. Magder, Eili Y. Klein, Mark Sutherland, Scott Sorongon, Pranita D. Tamma, Philip Resnik, Anthony D. Harris
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- Journal:
- Infection Control & Hospital Epidemiology , First View
- Published online by Cambridge University Press:
- 18 April 2024, pp. 1-6
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Identifying long-term care facility (LTCF)-exposed inpatients is important for infection control research and practice, but ascertaining LTCF exposure is challenging. Across a large validation study, electronic health record data fields identified 76% of LTCF-exposed patients compared to manual chart review.
Risk factors associated with overweight and obesity in people with severe mental illness in South Asia: cross-sectional study in Bangladesh, India, and Pakistan
- Koralagamage Kavindu Appuhamy, Danielle Podmore, Alex Mitchell, Helal Uddin Ahmed, Mark Ashworth, Jan R. Boehnke, Virtu Chongtham, Asiful Haidar Chowdhury, Olga P. Garcia, Richard I. G. Holt, Rumana Huque, Krishna Prasad Muliyala, Eline Klein Onstenk, Sukanya Rajan, David Shiers, Najma Siddiqi, S. Manjunatha, Gerardo A. Zavala
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- Journal:
- Journal of Nutritional Science / Volume 12 / 2023
- Published online by Cambridge University Press:
- 21 November 2023, e116
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Obesity is one of the major contributors to the excess mortality seen in people with severe mental illness (SMI) and in low- and middle-income countries people with SMI may be at an even greater risk. In this study, we aimed to determine the prevalence of obesity and overweight in people with SMI and investigate the association of obesity and overweight with sociodemographic variables, other physical comorbidities, and health-risk behaviours. This was a multi-country cross-sectional survey study where data were collected from 3989 adults with SMI from three specialist mental health institutions in Bangladesh, India, and Pakistan. The prevalence of overweight and obesity was estimated using Asian BMI thresholds. Multinomial regression models were then used to explore associations between overweight and obesity with various potential determinants. There was a high prevalence of overweight (17·3 %) and obesity (46·2 %). The relative risk of having obesity (compared to normal weight) was double in women (RRR = 2·04) compared with men. Participants who met the WHO recommendations for fruit and vegetable intake had 2·53 (95 % CI: 1·65–3·88) times greater risk of having obesity compared to those not meeting them. Also, the relative risk of having obesity in people with hypertension is 69 % higher than in people without hypertension (RRR = 1·69). In conclusion, obesity is highly prevalent in SMI and associated with chronic disease. The complex relationship between diet and risk of obesity was also highlighted. People with SMI and obesity could benefit from screening for non-communicable diseases, better nutritional education, and context-appropriate lifestyle interventions.
An unstable mode of the stratified atmosphere under the non-traditional Coriolis acceleration
- Ray Chew, Mark Schlutow, Rupert Klein
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- Journal:
- Journal of Fluid Mechanics / Volume 967 / 25 July 2023
- Published online by Cambridge University Press:
- 18 July 2023, A21
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The traditional approximation neglects the cosine components of the Coriolis acceleration, and this approximation has been widely used in the study of geophysical phenomena. However, the justification of the traditional approximation is questionable under a few circumstances. In particular, dynamics with substantial vertical velocities or geophysical phenomena in the tropics have non-negligible cosine Coriolis terms. Such cases warrant investigations with the non-traditional setting, i.e. the full Coriolis acceleration. In this manuscript, we study the effect of the non-traditional setting on an isothermal, hydrostatic and compressible atmosphere assuming a meridionally homogeneous flow. Employing linear stability analysis, we show that, given appropriate boundary conditions, i.e. a bottom boundary condition that allows for a vertical energy flux and non-reflecting boundary at the top, the atmosphere at rest becomes prone to a novel unstable mode. The validity of assuming a meridionally homogeneous flow is investigated via scale analysis. Numerical experiments were conducted, and Rayleigh damping was used as a numerical approximation for the non-reflecting top boundary. Our three main results are as follows: (i) experiments involving the full Coriolis terms exhibit an exponentially growing instability, yet experiments subjected to the traditional approximation remain stable; (ii) the experimental instability growth rate is close to the theoretical value; (iii) a perturbed version of the unstable mode arises even under sub-optimal bottom boundary conditions. Finally, we conclude our study by discussing the limitations, implications and remaining open questions. Specifically, the influence on numerical deep-atmosphere models and possible physical interpretations of the unstable mode are discussed.
School-based group interpersonal therapy for adolescents with depression in rural Nepal: a mixed methods study exploring feasibility, acceptability, and cost
- Kelly Rose-Clarke, Prakash B. K., Jananee Magar, Indira Pradhan, Pragya Shrestha, Eliz Hassan, Gerard J. Abou Jaoude, Hassan Haghparast-Bidgoli, Delan Devakumar, Ludovico Carrino, Ginevra Floridi, Brandon A. Kohrt, Helen Verdeli, Kathleen Clougherty, Alexandra Klein Rafaeli, Mark Jordans, Nagendra P. Luitel
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- Journal:
- Global Mental Health / Volume 9 / 2022
- Published online by Cambridge University Press:
- 22 August 2022, pp. 416-428
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Background
Adolescents with depression need access to culturally relevant psychological treatment. In many low- and middle-income countries treatments are only accessible to a minority. We adapted group interpersonal therapy (IPT) for adolescents to be delivered through schools in Nepal. Here we report IPT's feasibility, acceptability, and cost.
MethodsWe recruited 32 boys and 30 girls (aged 13–19) who screened positive for depression. IPT comprised of two individual and 12 group sessions facilitated by nurses or lay workers. Using a pre-post design we assessed adolescents at baseline, post-treatment (0–2 weeks after IPT), and follow-up (8–10 weeks after IPT). We measured depressive symptoms with the Depression Self-Rating Scale (DSRS), and functional impairment with a local tool. To assess intervention fidelity supervisors rated facilitators' IPT skills across 27/90 sessions using a standardised checklist. We conducted qualitative interviews with 16 adolescents and six facilitators post-intervention, and an activity-based cost analysis from the provider perspective.
ResultsAdolescents attended 82.3% (standard deviation 18.9) of group sessions. All were followed up. Depression and functional impairment improved between baseline and follow-up: DSRS score decreased by 81% (95% confidence interval 70–95); functional impairment decreased by 288% (249–351). In total, 95.3% of facilitator IPT skills were rated superior/satisfactory. Adolescents found the intervention useful and acceptable, although some had concerns about privacy in schools. The estimate of intervention unit cost was US $96.9 with facilitators operating at capacity.
ConclusionsSchool-based group IPT is feasible and acceptable in Nepal. Findings support progression to a randomised controlled trial to assess effectiveness and cost-effectiveness.
The impact of maternal depressive symptoms and traumatic events on early childhood mental health in conflict-affected Timor-Leste
- Susan J. Rees, Mohammed Mohsin, Louis Klein, Zachary Steel, Wietse Tol, Mark Dadds, Valsamma Eapen, Zelia da Costa, Elisa Savio, Natalino Tam, Derrick Silove
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- Journal:
- BJPsych Open / Volume 8 / Issue 2 / March 2022
- Published online by Cambridge University Press:
- 24 February 2022, e51
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Background
Longitudinal studies are needed to examine the association between maternal depression, trauma and childhood mental health in conflict-affected settings.
AimsTo examine maternal depressive symptoms, trauma-related adversities and child mental health by using a longitudinal path model in conflict-affected Timor-Leste.
MethodWomen were recruited in pregnancy. At wave 1, 1672 of 1740 eligible women were interviewed (96% response rate). The final sample comprised 1118 women with complete data at all three time points. Women were followed up when the index child was aged 18 months (wave 2) and 36 months (wave 3). Measures included the Edinburgh Postnatal Depression Scale, lifetime traumatic events and the Child Behaviour Checklist. A longitudinal path analysis examined associations cross-sectionally and in a cross-lagged manner across time.
ResultsMaternal depressive symptom score was associated with child mental health (cross-sectional association at wave 2, β = 0.35, P < 0.001; cross-sectional association at wave 3, β = 0.33, P < 0.001). The maternal depressive symptom score at wave 1 was associated with child mental health at wave 2 (β = 0.12, P < 0.001), and the maternal depressive symptom score at wave 2 showed an indirect association with child mental health at wave 3 (indirect standardised coefficient 0.23, P < 0.001). There was a time-lagged relationship between child mental health at wave 2 and maternal depression at wave 3 (β = 0.08, P = 0.02).
ConclusionsMaternal depressive symptoms are longitudinally associated with child mental health, and traumatic events play a role. Maternal depression symptoms are also affected by child mental health. Findings suggest the need for skilled assessment for depression, trauma-informed maternity care and parenting support in a post-conflict country such as Timor-Leste.
Sympathetic nervous system functioning during the face-to-face still-face paradigm in the first year of life
- Louis Klein, Frances L. Doyle, Jaimie C. Northam, Valsamma Eapen, Paul J. Frick, Eva R. Kimonis, David J. Hawes, Caroline Moul, Jenny L. Richmond, Divya Mehta, Antonio Mendoza Diaz, Mark R. Dadds
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- Journal:
- Development and Psychopathology / Volume 35 / Issue 2 / May 2023
- Published online by Cambridge University Press:
- 20 December 2021, pp. 471-480
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Contemporary theories of early development and emerging child psychopathology all posit a major, if not central role for physiological responsiveness. To understand infants’ potential risk for emergent psychopathology, consideration is needed to both autonomic reactivity and environmental contexts (e.g., parent–child interactions). The current study maps infants’ arousal during the face-to-face still-face paradigm using skin conductance (n = 255 ethnically-diverse mother–infant dyads; 52.5% girls, mean infant age = 7.4 months; SD = 0.9 months). A novel statistical approach was designed to model the potential build-up of nonlinear counter electromotive force over the course of the task. Results showed a significant increase in infants’ skin conductance between the Baseline Free-play and the Still-Face phase, and a significant decrease in skin conductance during the Reunion Play when compared to the Still-Face phase. Skin conductance during the Reunion Play phase remained significantly higher than during the Baseline Play phase; indicating that infants had not fully recovered from the mild social stressor. These results further our understanding of infant arousal during dyadic interactions, and the role of caregivers in the development of emotion regulation during infancy.
The role of procalcitonin results in antibiotic decision-making in coronavirus disease 2019 (COVID-19)
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- Valeria Fabre, Sara Karaba, Joe Amoah, Matthew Robinson, George Jones, Kathryn Dzintars, Morgan Katz, B. Mark Landrum, Sarojini Qasba, Pooja Gupta, Eili Klein, Sara E. Cosgrove
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 43 / Issue 5 / May 2022
- Published online by Cambridge University Press:
- 19 April 2021, pp. 570-575
- Print publication:
- May 2022
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Objective:
To evaluate the role of procalcitonin (PCT) results in antibiotic decisions for COVID-19 patients at hospital presentation.
Design, setting, and participants:Multicenter retrospective observational study of patients ≥18 years hospitalized due to COVID-19 at the Johns Hopkins Health system. Patients who were transferred from another facility with >24 hours stay and patients who died within 48 hours of hospitalization were excluded.
Methods:Elevated PCT values were determined based on each hospital’s definition. Antibiotic therapy and PCT results were evaluated for patients with no evidence of bacterial community-acquired pneumonia (bCAP) and patients with confirmed, probable, or possible bCAP. The added value of PCT testing to clinical criteria in detecting bCAP was evaluated using receiving operating curve characteristics (ROC).
Results:Of 962 patients, 611 (64%) received a PCT test. ROC curves for clinical criteria and clinical criteria plus PCT test were similar (at 0.5 ng/mL and 0.25 ng/mL). By bCAP group, median initial PCT values were 0.58 ng/mL (interquartile range [IQR], 0.24–1.14), 0.23 ng/mL (IQR, 0.1–0.63), and 0.15 ng/mL (IQR, 0.09–0.35) for proven/probable, possible, and no bCAP groups, respectively. Among patients without bCAP, an elevated PCT level was associated with 1.8 additional days of CAP therapy (95% CI, 1.01–2.75; P < .01) compared to patients with a negative PCT result after adjusting for potential confounders. Duration of CAP therapy was similar between patients without a PCT test ordered and a low PCT level for no bCAP and possible bCAP groups.
Conclusions:PCT results may be abnormal in COVID-19 patients without bCAP and may result in receipt of unnecessary antibiotics.
Resilience in Extremely Preterm/Extremely Low Birth Weight Kindergarten Children
- H. Gerry Taylor, Nori Minich, Mark Schluchter, Kimberly Andrews Espy, Nancy Klein
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- Journal:
- Journal of the International Neuropsychological Society / Volume 25 / Issue 4 / April 2019
- Published online by Cambridge University Press:
- 03 May 2019, pp. 362-374
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Objectives: Research on developmental outcomes of preterm birth has traditionally focused on adverse effects. This study investigated the prevalence and correlates of resilience in 146 extremely preterm/extremely low birth weight (EPT/ELBW) children (gestational age <28 weeks and/or birth weight <1000 g) attending kindergarten and 111 term-born normal birth weight (NBW) controls. Methods: Adaptive competence (i.e., “resilience” in the EPT/ELBW group) was defined by scores within grade expectations on achievement tests and the absence of clinically elevated parent ratings of child behavior problems. The “adaptive” children who met these criteria were compared to the “maladaptive” children who did not on child and family characteristics. Additional analyses were conducted to assess the conjoint effects of group (ELBW vs. NBW) and family factors on adaptive competence. Results: A substantial minority of the EPT/ELBW group (45%) were competent compared to a majority of NBW controls (73%), odds ratio (95% confidence interval)=0.26 (0.15, 0.45), p<.001. Adaptive competence was associated with higher cognitive skills, more favorable ratings of behavior and learning not used to define adaptive competence, and more advantaged family environments in both groups, as well as with a lower rate of earlier neurodevelopmental impairment in the EPT/ELBW group. Higher socioeconomic status and more favorable proximal home environments were associated with competence independent of group, and group differences in competence persisted across the next two school years. Conclusions: The findings document resilience in kindergarten children with extreme prematurity and highlight the role of environmental factors as potential influences on outcome. (JINS, 2019, 25, 362–374)
Finite-amplitude gravity waves in the atmosphere: travelling wave solutions
- Mark Schlutow, R. Klein, U. Achatz
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- Journal:
- Journal of Fluid Mechanics / Volume 826 / 10 September 2017
- Published online by Cambridge University Press:
- 15 August 2017, pp. 1034-1065
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Wentzel–Kramers–Brillouin theory was employed by Grimshaw (Geophys. Fluid Dyn., vol. 6, 1974, pp. 131–148) and Achatz et al. (J. Fluid Mech., vol. 210, 2010, pp. 120–147) to derive modulation equations for non-hydrostatic internal gravity wave packets in the atmosphere. This theory allows for wave packet envelopes with vertical extent comparable to the pressure scale height and for large wave amplitudes with wave-induced mean-flow speeds comparable to the local fluctuation velocities. Two classes of exact travelling wave solutions to these nonlinear modulation equations are derived here. The first class involves horizontally propagating wave packets superimposed over rather general background states. In a co-moving frame of reference, examples from this class have a structure akin to stationary mountain lee waves. Numerical simulations corroborate the existence of nearby travelling wave solutions under the pseudo-incompressible model and reveal better than expected convergence with respect to the asymptotic expansion parameter. Travelling wave solutions of the second class also feature a vertical component of their group velocity but exist under isothermal background stratification only. These waves include an interesting nonlinear wave–mean-flow interaction process: a horizontally periodic wave packet propagates vertically while draining energy from the mean wind aloft. In the process it decelerates the lower-level wind. It is shown that the modulation equations apply equally to hydrostatic waves in the limit of large horizontal wavelengths. Aside from these results of direct physical interest, the new nonlinear travelling wave solutions provide a firm basis for subsequent studies of nonlinear internal wave instability and for the design of subtle test cases for numerical flow solvers.
Effect of Planting Depth and Isoxaflutole Rate on Corn Injury in Nebraska
- Gail A. Wicks, Stevan Z. Knezevic, Mark Bernards, Robert G. Wilson, Robert N. Klein, Alex R. Martin
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- Journal:
- Weed Technology / Volume 21 / Issue 3 / September 2007
- Published online by Cambridge University Press:
- 20 January 2017, pp. 642-646
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Field experiments were conducted at five sites in Nebraska in 2000 and 2001 to determine the effect of planting depth and isoxaflutole rate on the response of an isoxaflutole-sensitive corn hybrid, ‘Pioneer 33-G’ across variable environments. Corn was planted at depths of 2.5 and 5.0 cm, and isoxaflutole was applied PRE at the recommended (1×) and twice the recommended (2×) rate. The effects of planting depth and herbicide rate on injury varied considerably across site–years. When injury was evident, it was generally greater at the high rate of isoxaflutole (2×) and at the shallow planting depth (2.5 cm). In most site–years, corn recovered from early season injury, and yields were not reduced, except at Scottsbluff, NE, and North Platte, NE, where soils were lower in organic matter and higher in pH. Isoxaflutole rates should be carefully selected for soils with low organic matter and high pH.
An Environmental Scan of Academic Emergency Medicine at the 17 Canadian Medical Schools: Why Does this Matter to Emergency Physicians?
- Ian G. Stiell, Jennifer D. Artz, Eddy S. Lang, Jonathan Sherbino, Laurie J. Morrison, James Christenson, Jeffrey J. Perry, Claude Topping, Robert Woods, Robert S. Green, Rodrick Lim, Kirk Magee, John Foote, Garth Meckler, Mark Mensour, Simon Field, Brian Chung, Martin Kuuskne, James Ducharme, Vera Klein, Jill McEwen
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- Journal:
- Canadian Journal of Emergency Medicine / Volume 19 / Issue 1 / January 2017
- Published online by Cambridge University Press:
- 21 July 2016, pp. 39-46
- Print publication:
- January 2017
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Objective
We sought to conduct a major objective of the CAEP Academic Section, an environmental scan of the academic emergency medicine programs across the 17 Canadian medical schools.
MethodsWe developed an 84-question questionnaire, which was distributed to academic heads. The responses were validated by phone by the lead author to ensure that the questions were answered completely and consistently. Details of pediatric emergency medicine units were excluded from the scan.
ResultsAt eight of 17 universities, emergency medicine has full departmental status and at two it has no official academic status. Canadian academic emergency medicine is practiced at 46 major teaching hospitals and 13 specialized pediatric hospitals. Another 69 Canadian hospital EDs regularly take clinical clerks and emergency medicine residents. There are 31 full professors of emergency medicine in Canada. Teaching programs are strong with clerkships offered at 16/17 universities, CCFP(EM) programs at 17/17, and RCPSC residency programs at 14/17. Fourteen sites have at least one physician with a Master’s degree in education. There are 55 clinical researchers with salary support at 13 universities. Sixteen sites have published peer-reviewed papers in the past five years, ranging from four to 235 per site. Annual budgets range from $200,000 to $5,900,000.
ConclusionThis comprehensive review of academic activities in emergency medicine across Canada identifies areas of strengths as well as opportunities for improvement. CAEP and the Academic Section hope we can ultimately improve ED patient care by sharing best academic practices and becoming better teachers, educators, and researchers.
12 - WTO accessions from a member's perspective: safeguarding the rules-based system
- from Original members
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- By Mark Linscott, Trade Representative for WTO and multilateral affairs, Cecilia Klein, European Union
- Edited by Uri Dadush, Carnegie Endowment for International Peace, Washington DC, Chiedu Osakwe
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- WTO Accessions and Trade Multilateralism
- Published online:
- 05 November 2015
- Print publication:
- 10 September 2015, pp 397-400
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Summary
ABSTRACT
Forms of collective action and balanced commitment through negotiations were the foundation of the General Agreement on Tariffs and Trade (GATT) and the structure for its daily work. These remain at the centrepiece of work in the WTO, in a system structured on the balance of rights and obligations. GATT contracting parties established the principles of balance and reciprocity, trade liberalisation and a system of mediation and dispute settlement for mutual resolution of GATT provisions. From this base, expansion of membership, pursuant to accession negotiations, has required a commitment to accepting GATT/WTO rules resulting from previous negotiations. WTO accession supports applicants' efforts for economic reform and integration into world markets. This is one of the most important benefits of membership. Although challenging, accession negotiations and the implementation of WTO provisions support important economic goals such as sustainable growth, the promotion of high-tech industries, attraction of foreign direct investment, raised living standards and global assertion of national trade interest.
For over sixty-five years, nations have worked together to create a legal-diplomatic framework for international trade that can expand their market horizons beyond bilateral and regional agreements. The 1947 General Agreement on Tariffs and Trade (GATT) was the result of such an effort, intended to create an agreed structure of rules within which badly needed post-Second World War trade liberalisation could be safely undertaken. There was hope in the 1940s that the GATT would be soon replaced with a more elaborate trade organisation, one that could stand with the World Bank and the International Monetary Fund (IMF), to support economic development and growth. However, the GATT framework of thirty-eight articles was all there was for almost fifty years. Within this simple framework of mutual commitment, the contracting parties to the GATT met periodically to elaborate principles for conducting international trade with the objective of implementing, for themselves and for future contracting parties, the benefits and obligations outlined in its text. They established the principles of balance and reciprocity in the application of trade measures. They sponsored additional multilateral efforts at trade liberalisation, i.e. ‘rounds’ of tariff liberalisation. They created fora for discussion between trade negotiating sessions which became accepted multilateral institutions. They established a system of mediation and dispute settlement to ensure that questions about GATT provisions could be mutually settled.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. 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11 - Epilogue: British economic growth, 1270–1870
- Stephen Broadberry, London School of Economics and Political Science, Bruce M. S. Campbell, Queen's University Belfast, Alexander Klein, University of Kent, Canterbury, Mark Overton, University of Exeter, Bas van Leeuwen, University of Warwick
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Summary
Introduction
Between 1270 and 1870 Britain slowly progressed from the periphery of the European economy to centre-stage of an integrated world economy. In the process it escaped from Malthusian constraints and by the eighteenth century had successfully reconciled rising population with rising living standards. This final chapter reflects upon this protracted but profound economic transformation from the perspective of the national income estimates assembled in Part I and analysed in Part II of this book. Because Britain’s economic rise did not unfold in isolation, account is taken of the broader comparative context provided by the national income reconstructions now available for several other Eurasian countries: Spain from 1282, Italy from 1310 and Holland from 1348, plus Japan from 725, China from 980 and India from 1600. All are output-based estimates but have been derived via a range of alternative approaches according to the nature of the available historical evidence. Several make ingenious use of real wage rates and urbanisation ratios (Malanima, 2011; Álvarez-Nogal and Prados de la Escosura, 2013), two economic indicators often used as surrogates for estimates of GDP per head. Only the GDP estimates for Holland, like these for Britain, have been made the hard way, by summing the weighted value-added outputs of the agricultural, industrial and service sectors and then dividing the results by estimates of total population obtained by reconciling time-series and cross-sectional demographic data. Methodologically, the British and Dutch national income estimates are therefore the most directly comparable. Each is free from overdependence upon any single or narrow range of data series and, instead, they encapsulate variations in the wide range of economic indicators, appropriately weighted in line with their importance in overall economic activity, from which they have been reconstructed.
2 - Agricultural land use
- Stephen Broadberry, London School of Economics and Political Science, Bruce M. S. Campbell, Queen's University Belfast, Alexander Klein, University of Kent, Canterbury, Mark Overton, University of Exeter, Bas van Leeuwen, University of Warwick
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Introduction
Agriculture was for long the single largest component of the English and British economies, both in terms of its share of employment and the value of its output. The latter was a function of the amount of land under cultivation, the uses to which it was put, the productivities of crops and animals and their respective prices. The main purpose of this chapter is to describe the methods used to derive the areas under arable and grass and, in particular, the total sown acreage. The crops produced and animals stocked are the subjects of the following chapter. Along the way, it will be demonstrated that claims that the peak arable area in the medieval period may have exceeded 20 million acres (Clark, 2007a: 124) are unrealistic, since, on the best available evidence, the combined total under field crops and fallow could not have been more than 12.75 million acres. In the absence of significant food imports, this limited both the population that could be supported and the supply of kilocalories per head needed for survival. It also shaped the production choices made by agricultural producers.
Comprehensive national agricultural statistics were collected annually from 1866 and provide the starting point for calculating the acreages of arable and grass (Anon, 1968; Coppock, 1984). Together with the tithe files, which provide a precise but incomplete guide to the share of land in each county devoted to arable production during the 1830s (Kain, 1986; Overton, 1986), they are used to provide a nineteenth-century benchmark. The chapter proceeds as follows. After a discussion of the potential agricultural area of England in Section 2.2, Section 2.3 reviews the arable acreage by county from the tithe files of the 1830s and from the agricultural statistics of 1871. Section 2.4 then examines changes in land use between 1290 and 1871, while Section 2.5 presents county-level estimates of the arable acreage in 1290. Section 2.6 provides a further cross-check by examining changes in land use between 1086 and 1290. Finally, Section 2.7 provides estimates of land use for a number of benchmark years between 1270 and 1871.
Frontmatter
- Stephen Broadberry, London School of Economics and Political Science, Bruce M. S. Campbell, Queen's University Belfast, Alexander Klein, University of Kent, Canterbury, Mark Overton, University of Exeter, Bas van Leeuwen, University of Warwick
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1 - Population
- Stephen Broadberry, London School of Economics and Political Science, Bruce M. S. Campbell, Queen's University Belfast, Alexander Klein, University of Kent, Canterbury, Mark Overton, University of Exeter, Bas van Leeuwen, University of Warwick
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Summary
Introduction
Economic growth can be either extensive or intensive. Extensive growth arises where more output is produced in line with a growing population but living standards remain constant, while intensive growth arises where more output is produced by each person. In the former case, there is no economic development, as the economy simply reproduces itself on a larger scale: in the latter, living standards rise as the economy goes through a process of economic development. To understand the long-run growth of the British economy reaching back to the thirteenth century therefore requires knowledge of the trajectories followed by both population and GDP. Of particular interest is whether periods of intensive growth, distinguished by rising GDP per head, were accompanied by expanding or contracting population. For it is one thing for living standards to rise during a period of population decline, such as that induced by the recurrent plagues of the second half of the fourteenth century, when survivors found themselves able to add the land and capital of those who had perished to their own stocks, but quite another for living standards and population to rise together, particularly given the emphasis of Malthus [1798] on diminishing returns. Indeed, Kuznets (1966: 34–85) identified simultaneous growth of population and income per head (i.e. the concurrence of intensive and extensive growth) as one of the key features that distinguished modern from pre-industrial economic growth.
7 - Consumption
- Stephen Broadberry, London School of Economics and Political Science, Bruce M. S. Campbell, Queen's University Belfast, Alexander Klein, University of Kent, Canterbury, Mark Overton, University of Exeter, Bas van Leeuwen, University of Warwick
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Introduction
Chapter 6 has argued that workers responded to changes in real wage rates by adapting how hard they worked so as to maintain their earnings. Household incomes therefore tracked GDP per head rather than real wage rates and progressively improved over time, doubling between the early fourteenth and late seventeenth centuries and doubling again over the course of the industrial revolution. Higher incomes translated into changing patterns of consumption and the forms these consumption choices took are the subjects of this chapter. Section 7.2 reconstructs the kilocalorie value and composition of diets based on the agricultural-output estimates presented in Chapter 3, augmented by information on imported foodstuffs. Given that populations require an average daily food intake per head of 2,000 kilocalories (Livi-Bacci, 1991: 27) to provide sufficient nourishment for both economic and biological reproduction, these calculations also provide a useful cross-check on the consistency of the agricultural-output and population estimates. Section 7.3 then considers non-food consumption drawing upon early modern evidence of material culture as revealed by probate inventories. Again, these trends need to be consistent with those of industrial output reconstructed in Chapter 4.
Price, habit, fashion and status all shaped the budgetary decisions taken by households. Demand for food was inelastic up to the point where basic subsistence needs had been met, but as incomes rose there were clear trade-offs to be obtained between increasing consumption of cheap sources of kilocalories such as pottage, potatoes and salted herrings on the one hand, or indulging in more expensive refined bread, quality ale and beer, dairy produce and meat, plus the imported luxuries of wine, sugar, tea, cocoa and tobacco, on the other. In effect, higher incomes allowed more households to trade up to a respectability basket of foodstuffs providing a more varied and processed diet but not necessarily more kilocalories. The changing relative prices of arable, livestock and luxury products influenced these consumption decisions, while the relative cheapness or dearness of food determined how much disposable income could be devoted to the increasingly varied and tempting array of non-food consumer goods (Figure 5.02).
Index
- Stephen Broadberry, London School of Economics and Political Science, Bruce M. S. Campbell, Queen's University Belfast, Alexander Klein, University of Kent, Canterbury, Mark Overton, University of Exeter, Bas van Leeuwen, University of Warwick
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