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Roman long-handled ligulae, spoon-probes and spatula-probes are usually referred to as toilet equipment associated with the preparation and application of cosmetics and unguents. British and continental funerary assemblages show that they can also appear in medical kits, where they would have served a similar use for salves and other medicaments, and a few have been found with writing equipment, probably having been used in the preparation of inks. There is some possibility that they may have served a similar purpose for painters’ pigments. This paper brings together 197 of these instruments in the collection of Colchester Museums and assesses the evidence for their use and disposal in an urban environment, as well as any bias in their recovery. The alloys used in the manufacture of some examples have been analysed and compared to other Romano-British assemblages. A considerable number were found in the area of Colchester’s suburban Temple 10, which has been associated with both healing and votive deposition, but which lay in an area also used for the disposal of urban waste.
Colchester Museums has collected Roman-period medical instruments from the town since the late nineteenth century. Brought together here, along with items from the town housed in other institutions, their typological links or differences are explored, along with their wide range of uses. They are set in a variety of contexts, including a conquest-period British Doctor’s kit from Stanway, near Colchester, the alloys used in their manufacture, their distribution across the town and its suburbs, the diseases evident from late Romano-British human remains in the town’s cemeteries, and herbal remedies and other treatments. Interpretation of a previously enigmatic collyrium stamp attests to an eye infection not previously recorded in Roman Britain.
This article is concerned with the relationship between systemic and ideological changes affecting West European broadcasting and the nature of the regulatory responses. In theoretical terms the research interest Lies in the question of the extent to which changes in the nature of West European broadcasting regulation are determined by technological factors and forces in the international political economy. Particular attention is given to the factors impeding or constraining deregulation and to the argument that national institutional structures and traditions are mediating the impacts of technology, markets and ideology. Whilst the ultimate effects on future broadcasting regulation remain controversial, certain broad trends can be identified.
More people than ever are receiving support for mental health issues, and instances of suicide continue to grow. Although mental health funding has increased, UK government figures evidence that the National Health Service (NHS) does not have the resources required to respond to such growth in demand. The experiences of staff working in mental health services can offer insight into the efficacy of current provision and assist in service evaluation; however, research examining this issue outside of the COVID-19 pandemic, and in the context of community mental health, is lacking.
Aims
We aimed to explore the perspectives of staff working in a variety of mental health services in North-West England, to elucidate the current standard of care provided and highlight areas for improvement.
Method
One-to-one interviews were conducted with 26 staff members as part of a qualitative grounded theory analysis.
Results
Findings portrayed a community in crisis, consisting of the following themes: stabilisation not recovery, inefficient pathways and barriers to collaboration.
Conclusions
NHS services are struggling to meet the mental health needs of the population, resulting in lengthy waiting times for therapy, a lack of intervention-focused care and an over-reliance on the third sector. While crisis cafés are provided at low cost and result in satisfaction, policy-makers must ensure that these receive adequate funding and do not become overburdened. Staff reported that collaboration between clinical and non-clinical services would improve care pathways and reduce strain on the NHS, but judgemental attitudes and inflexible service development must be challenged to achieve this.
Globally, human rights violations experienced by persons with psychosocial, intellectual or cognitive disabilities continue to be a concern. The World Health Organization's (WHO) QualityRights initiative presents practical remedies to address these abuses. This paper presents an overview of the implementation of the initiative in Ghana.
Aims
The main objective of the QualityRights initiative in Ghana was to train and change attitudes among a wide range of stakeholders to promote recovery and respect for human rights for people with psychosocial, intellectual and cognitive disabilities.
Method
Reports of in-person and online training, minutes of meetings and correspondence among stakeholders of the QualityRights initiative in Ghana, including activities of international collaborators, were analysed to shed light on the implementation of the project in Ghana.
Results
In-person and online e-training on mental health were conducted. At the time of writing, 40 443 people had registered for the training, 25 416 had started the training and 20 865 people had completed the training and obtained a certificate. The team conducted 27 in-person training sessions with 910 people. The successful implementation of the project is underpinned by a committed partnership among stakeholders, strong leadership from the coordinating agency, the acceptance of the initiative and the outcome. A few challenges, both in implementation and acceptance, are discussed.
Conclusions
The exposure of the WHO QualityRights initiative to a substantial number of key stakeholders involved in mental healthcare in Ghana is critical to reducing human rights abuses for people with psychosocial, intellectual and cognitive disabilities.
Transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is possible among symptom-free individuals. Patients are avoiding medically necessary healthcare visits for fear of becoming infected in the healthcare setting. We screened 489 symptom-free healthcare workers for SARS-CoV-2 and found no positive results, strongly suggesting that the prevalence of SARS-CoV-2 was <1%.
Despite being identified as a pervasive emotion in the modern workplace (Pfeffer & Sutton, 2000), fear oddly has not received a corresponding amount of attention among management researchers. In fact, Kish-Gephart, Detert, Treviño, and Edmondson (2009, p. 163) observe that we still have much to learn about the nature of fear in workplace settings, including “what it is, how and why it is experienced, and to what effects.” Bennis (1966) notes further that fear has always been a part of the work environment (see also Connelly & Turner, 2018), but it remains an especially important issue in today’s workplaces because of the effects of rapid and ongoing organizational change, which are often linked to uncertain outcomes (Bordia, Hobman, Jones, Gallois, & Callan, 2004; Tiedens & Linton, 2001). Our aim in this chapter is to provide an overview of fear (arising from uncertainty) as a discrete emotion, to identify stimuli that may trigger fear at work, and to identify the potential positive and negative outcomes that can be linked to employees’ fear. We also outline potential pathways for future research on fear of uncertainty in the workplace.
Although school-based programmes for the identification of children and young people (CYP) with mental health difficulties (MHD) have the potential to improve short- and long-term outcomes across a range of mental disorders, the evidence-base on the effectiveness of these programmes is underdeveloped. In this systematic review, we sought to identify and synthesise evidence on the effectiveness and cost-effectiveness of school-based methods to identify students experiencing MHD, as measured by accurate identification, referral rates, and service uptake.
Method
Electronic bibliographic databases: MEDLINE, Embase, PsycINFO, ERIC, British Education Index and ASSIA were searched. Comparative studies were included if they assessed the effectiveness or cost-effectiveness of strategies to identify students in formal education aged 3–18 years with MHD, presenting symptoms of mental ill health, or exposed to psychosocial risks that increase the likelihood of developing a MHD.
Results
We identified 27 studies describing 44 unique identification programmes. Only one study was a randomised controlled trial. Most studies evaluated the utility of universal screening programmes; where comparison of identification rates was made, the comparator test varied across studies. The heterogeneity of studies, the absence of randomised studies and poor outcome reporting make for a weak evidence-base that only generate tentative conclusions about the effectiveness of school-based identification programmes.
Conclusions
Well-designed pragmatic trials that include the evaluation of cost-effectiveness and detailed process evaluations are necessary to establish the accuracy of different identification models, as well as their effectiveness in connecting students to appropriate support in real-world settings.
The chemical stabilities of mendipite, Pb3O2Cl2, diaboleïte, Pb2CuCl2(OH)4, chloroxiphite, Pb3CuCl2O2(OH)2, and cumengéite, Pb19Cu24Cl42 (OH)44, have been determined in aqueous solution at 298.2 K. Values of standard Gibbs free energy of formation, ΔGf°, for the four minerals are −740, −1160, −1129, and −15163±20 kJ mol−1 respectively. These values have been used to construct the stability diagram shown in fig. I which illustrates their relationships to each other and to the minerals cotunnite, PbCl2, paralaurionite, PbOHCl, and litharge, PbO. This diagram shows that mendipite occupies a large stability field and should readily form from cold, aqueous, mineralizing solutions containing variable amounts of lead and chloride ions, and over a broad pH range. The formation of paralaurionite and of cotunnite requires a considerable increase in chloride ion concentration, although paralaurionite can crystallize under much less extreme conditions than cotunnite. The encroachment of the copper minerals on to the stability fields of those mineral phases containing lead(II) only is significant even at very low relative activities of cupric ion. Chloroxiphite has a large stability field, and at given concentrations of cupric ion, diaboleïte is stable at relatively high aCl−. Cumengéite will only form at high concentrations of chloride ion.
Social scientists generally enjoy substantial latitude in selecting measures and models for hypothesis testing. Coupled with publication and related biases, this latitude raises the concern that researchers may intentionally or unintentionally select models that yield positive findings, leading to an unreliable body of published research. To combat this “fishing” problem in medical studies, leading journals now require preregistration of designs that emphasize the prior identification of dependent and independent variables. However, we demonstrate here that even with this level of advanced specification, the scope for fishing is considerable when there is latitude over selection of covariates, subgroups, and other elements of an analysis plan. These concerns could be addressed through the use of a form of comprehensive registration. We experiment with such an approach in the context of an ongoing field experiment for which we drafted a complete “mock report” of findings using fake data on treatment assignment. We describe the advantages and disadvantages of this form of registration and propose that a comprehensive but nonbinding approach be adopted as a first step to combat fishing by social scientists. Likely effects of comprehensive but nonbinding registration are discussed, the principal advantage being communication rather than commitment, in particular that it generates a clear distinction between exploratory analyses and genuine tests.
Large trace fossils attributed to the ichnogenus Psilonichnus (Fürsich) have been identified in subtidal sediments of the Red Crag Formation (late Pliocene) of Walton-on-the-Naze, Essex, U.K. The traces are vertical or inclined, tapering cylindrical structures, occasionally branched, up to 2.3 m long. The structures are mud-rich relative to the surrounding sediment and their fills often show a spiralling grain fabric. The ichnogenus Psilonichnus has formerly been attributed to the burrowing activities of intertidal and supratidal crab species. The known fossil crab assemblage of the Red Crag contains no deep burrowing species. The traces are thus attributed to other crustaceans, possibly thalassinidean shrimps. The occurrence indicates that Psilonichnus may have a greater palaeoenvironmental range than previously realized.
Background: Patients with Rett syndrome (RTT) may demonstrate parkinsonianfeatures. Here, we report a preliminary cross-sectional and prospectiveevaluation of the evolution, regional distribution, and eventual incidenceof rigid tone in a cohort of MECP2 mutation-positivepatients. Methods: In 51 participants, muscle tone rigidity in extremity regions andneck plus hypomimia were quantified using an RTT rigidity distribution(RTTRD) score with a range of 0 to 15. RTTRD scores were correlated withage, ability to walk and speak, mutation type, and, in a small subgroup(n=9), cerebrospinal fluid (CSF) homovanillic acid (HVA) and5-hydroxyindole-acetic acid levels. Results: Participant ages ranged from 2 years and 5 months, to 54 years.Rigidity was found in 43/51 (84.3%); it appeared as early as age 3,increased in extent with age, and was present in all participants aged ≥13.Ankle region rigidity appeared first, followed by proximal legs, arms, neck,and face. Ambulatory participants (n=21) had lower RTTRD scores thannonambulatory (n=30; p=0.003). We found a trend to lower scores inparticipants with retained speech (n=13) versus those with none (n=38;p=0.074), and no difference in scores for those with truncating (n=25)versus missense mutations (n=22; p=0.387). RTTRD scores correlatednegatively with CSF HVA levels (R=−0.83; p=0.005), but not with5-hydroxyindole-acetic acid levels (R=−0.45; p=0.22). Conclusions: Although assessment of muscle tone is somewhat subjective and theRTTRD has not been validated, this study nevertheless suggests thatparkinsonian rigidity in RTT is common and frequently increases in extentwith age; its severity correlates directly with impaired ambulation andinversely with CSF HVA levels.
On rare occasions anticonvulsant medication may cause severe or fatal toxic reactions. This position paper, approved by the Canadian Association for Child Neurology, examines the value of routine blood and urine screening to prevent catastrophic reactions in asymptomatic patients. The basic assumptions of such a screening program are faulty or unproven. Although not definitive, available studies of screening do not appear to support its value. It is recommended that routine blood and urine screening be discontinued in asymptomatic patients. Until such time as further research is able to identify patients at special risk, it is suggested that patients be carefully informed of the early symptoms of severe toxic reactions and report these immediately to a physician.