In 1206 Chinggis Khan replaced the warring factions of Mongolia with a single polity, the Great Mongol Realm (Yeke Mongqol Ulus). The ulus was ruled by a khan, who allocated pastures, households and revenues to his relatives as shares (qubi). Chinggis granted the first allocation to his brothers and senior sons in 1207 but many more redistributions took place in the coming decades. Many of these appanages grew so large that their holders challenged the khan's dominance and even broke free of his control to form their own polities (uluses). This article will explore the fluidity of the Mongol appanage system by taking the qubi of Chinggis Khan's grandson Ariq Böke (d. 1266) as a case study. The Ariq Bökids established their own secondary ulus in Inner Asia, before fragmenting and lending their support to neighbouring khans in the fourteenth century.

The fragmentation of the Ilkhanate (1258–1335) midway through the fourteenth century coincided with the publication of several verse histories that were based upon the Blessed History (Tārīkh-i Mubārak) of Rashīd al-Dīn Hamadānī (d. 1318). Seen by many as lacking originality, these texts have often been treated as a new form of literary expression rather than a source of information about key episodes in Ilkhanid history. While it may be true that the verse histories are largely reliant on other sources for information about events that occurred before their time, the choice of what to copy and how it was presented reveals a great deal about changing attitudes to power, religion, and class as the Hülegüid Dynasty weakened and new power brokers appeared. This article will analyse how four verse histories—the Shāhnāmah-yi Chingīzī of Shams al-Dīn Kāshānī (1312–1316), the Ẓafarnāmah of Ḥamdallāh Mustawfī Qazvīnī (1335), the Shāhanshāhnāmah of Aḥmad Tabrīzī (1337), and the Ghāzānnāmah of Nūrī Azhdarī (1361)—reproduced the biography of the prominent Ilkhanid commander, Amīr Nawrūz (d. 1297), to gauge how changing circumstances influenced their view of the past. It will be shown that, although these stories may not offer much in the way of new information about Nawrūz, they do show how writers attempted to reshape their narratives to reinforce values of piety, justice, and loyalty during the Chinggisid crisis of the fourteenth century.

During the initial surge of the COVID-19 pandemic in the spring and summer of 2020, paediatric heart centres were forced to rapidly alter the way patient care was provided to minimise interruption to patient care as well as exposure to the virus. In this survey-based descriptive study, we characterise changes that occurred within paediatric cardiology practices across the United States and described provider experience and attitudes towards these changes during the pandemic. Common changes that were implemented included decreased numbers of procedures, limiting visitors and shifting towards telemedicine encounters. The information obtained from this survey may be useful in guiding and standardising responses to future public health crises.

By the beginning of the fourteenth century the court histories of the Īl-Khānate had begun to lament that ‘qarachu’ (non-royal) commanders dominated the realm. The same histories report that these qarachu were drawn from the families of the khans’ royal guardsmen (kešik). The fact that these kešik families had come to eclipse, and in some cases threaten, the power of their Chinggisid patrons suggests a much broader transformation of the Īl-Khān polity from the patrimonial government of the khan's household, which characterised the early Mongol Empire, to a quasi-feudal state, dominated by a powerful military aristocracy. The present study will elucidate how this new aristocracy supported their authority through the hereditary transmission of armies, property and, offices, which entrenched their position at the summit of Īl-Khān polity.

In 688/1289 Nawrūz Aqa, a leading Mongol magnate, began a rebellion in Khurasan to resist the Ilkhan Arghun's attempts to centralize power and loosen the Mongol aristocracy's grip on provincial government. The rebellion of Nawrūz was significantly different from any Mongol uprising that had occurred in the Ilkhanate to that date: it was distinguished by the successful fusion of Chinggisid and Islamic traditions of political and spiritual authority to support Nawrūz's challenge against the Hülegüid monarchy. This new hybrid political philosophy allowed Nawrūz to mobilize both the sedentary and nomadic populations of Khurasan to overhaul the power structure of the Ilkhanate. The present study of the early career and rebellion of Amīr Nawrūz will reveal how his movement forced the Turco-Mongolian leadership to reconfigure its political, social and religious relationships, among themselves and with the sedentary Muslim population they ruled.

Fall detectors are a form of remote monitoring assistive technology that have the potential to enhance the wellbeing of adults at risk from falling. In this paper, the ethical issues raised by the use of fall detectors are examined. The fall detection devices currently available are outlined, and a summary of how these devices require social-care services, or family carers, to respond in particular ways, is provided. The ethical issues associated with the use of fall detectors are classified under four headings: autonomy, privacy, benefit, and the use of resources. These issues, we argue, arise out of the nature of the technology itself, and the way that this technology is integrated into the day-to-day support package of the person for whom it is provided. It is argued that manufacturers have a duty to provide information about the ‘ethical side-effects’ associated with the use of a particular device, and that the process of making a decision to provide a person with a fall detector should include a checklist of questions that is designed to enable decision makers to work through the ethical issues raised.

Collaboration is used by the US National Security Council as a means to integrate inter-federal government agencies during planning and execution of common goals towards unified, national security. The concept of collaboration has benefits in the healthcare system by building trust, sharing resources, and reducing costs. The current terrorist threats have made collaborative medical training between military and civilian agencies crucial.

This review summarizes the long and rich history of collaboration between civilians and the military in various countries and provides support for the continuation and improvement of collaborative efforts. Through collaboration, advances in the treatment of injuries have been realized, deaths have been reduced, and significant strides in the betterment of the Emergency Medical System have been achieved. This review promotes collaborative medical training between military and civilian medical professionals and provides recommendations for the future based on medical collaboration.

Background. The role of physical illness and life problems in contributing to suicide in older people is potentially important with regard to suicide prevention.

Method. The aim of the study was to determine the life problems other than psychiatric illness contributing to suicide in older people. Semi-structured psychological autopsy interviews, covering life problems and physical illness prior to death, were conducted with informants for 100 people aged 60 years old and over who died through suicide in five English counties. Interviews were completed with informants for 54 age- and sex-matched control subjects who died through natural causes.

Results. The three most frequent life problems associated with suicide were physical illness, interpersonal problems, and bereavement. Physical health problems were present in 82% and felt to be contributory to death in 62%. Pain, breathlessness and functional limitation were the most frequent symptoms. Interpersonal problems were present in 55% of the sample and contributory in 31%. The corresponding figures for bereavement-related problems were 47% and 25%. In the case-control analysis, the problems found to be risk factors for suicide were problems related to a bereavement over 1 year before death (OR 3·5, 95% CI 1·2–10·6), and problems with accommodation (OR 5·0, 95% CI 1·1–22·8), finances (p=0·01), and retirement (p=0·02).

Conclusion. Physical illness, interpersonal problems and bereavement are commonly associated with suicide in older people, but financial, accommodation, retirement and long- term bereavement-related problems may be more specific risk factors.