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An introductory chapter briefly outlines relevant historiography of courtier studies in general and analyses of elite female servants more narrowly. This introduction establishes important classifications of household servants and demonstrates how roles and terminology shifted over time as the royal court and household grew in both size and complexity over the course of the later Middle Ages. In addition to illuminating categories of female service, the introduction details the sources and methodology employed to produce this analysis of medieval English ladies-in-waiting, highlighting the goals, successes, and limits of this kind of prosopographical methodology. The introduction argues that an analysis of ladies-in-waiting offers insight into female social networks, gender dynamics at court, and issues of power, authority, and wealth, along with how women accessed these features, in late medieval society.
In June of 2024, Becton Dickinson experienced a blood culture bottle shortage for their BACTEC system, forcing health systems to reduce usage or risk exhausting their supply. Virginia Commonwealth University Health System (VCUHS) in Richmond, VA decided that it was necessary to implement austerity measures to preserve the blood culture bottle supply.
Setting:
VCUHS includes a main campus in Richmond, VA as well as two affiliate hospitals in South Hill, VA (Community Memorial Hospital (CMH)) and Tappahannock Hospital in Tappahannock, VA. It also includes a free-standing Emergency Department in New Kent, VA.
Patients:
Blood cultures from both pediatric and adult patients were included in this study.
Interventions:
VCUHS intervened to decrease blood culture utilization across the entire health system. Interventions included communication of blood culture guidance as well as an electronic health record order designed to guide providers and discourage wasteful ordering.
Results:
Post-implementation analyses showed that interventions reduced overall usage by 35.6% (P < .0001) and by greater than 40% in the Emergency Departments. The impact of these changes in utilization on positivity were analyzed, and it was found that the overall positivity rate increased post-intervention from 8.8% to 12.1% (P = .0115) and in the ED specifically from 10.2% to 19.5% (P < .0001).
Conclusions:
These findings strongly suggest that some basic stewardship interventions can significantly change blood culture practice in a manner that minimizes the impact on patient care.
Napoleon is widely admired as a military strategist who embraced the violence of modern war and understood the potential of mass armies. Yet he wrote little about the practice of strategy beyond a few rather bland maxims, claiming to rely on offence and opportunism on the battlefield. But these offensive tactics had a strategic purpose. He sought to crush his opponents in decisive battles, not just to destroy enemy armies but to impose his will in the peace talks that followed. As First Consul and later as Emperor he channelled the resources of the state to the cause of military success and imperial expansion. His goal was political as much as it was military, mobilising all the resources of the Empire in its pursuit. Napoleon conscripted mass armies in the lands he conquered, imposed French-style administrative systems, and imposed taxes and customs duties. He was focused on Europe, where the other powers developed their own strategies to counter him, repeatedly forging alliances to defend their sovereignty and to thwart his imperial ambitions. Each country had its own war aims. Russia looked to expand into the Balkans, Prussia to conquer Poland, and Britain to consolidate its colonial presence overseas.
Research is needed to improve the performance of primary health care. In Africa, few family physicians conduct research, and therefore an online research training and mentorship programme was developed to build research capacity amongst novice and early career researchers.
Aim:
To evaluate the implementation of the AfriWon Research Collaborative (ARC) training and e-mentorship programme in sub-Saharan Africa.
Methods:
A 10-module online curriculum was supported by peer and faculty e-mentorship, to mentor participants in writing a research protocol. A convergent mixed methods study combined quantitative and qualitative data to evaluate nine implementation outcomes.
Findings:
Fifty-three participants (20 mentees, 19 peer mentors, and 14 faculty mentors), mostly male (70%), participated in the ARC online programme. The programme was seen as an acceptable and appropriate initiative. Mentees were mostly postgraduate students from African countries. Faculty mentors were mostly experienced researchers from outside of Africa. There were issues with team selection, orientation, communication, and role clarification. Only 35% of the mentees completed the programme. Alignment of mentoring in teams and engagement with the online learning materials was an issue. Costs were relatively modest and dependent on donor funds.
Conclusion:
Despite many challenges, the majority of participants supported the sustainability of the programme. The evaluation highlights the strengths and weaknesses of the ARC programme and e-mentoring. The ARC working group needed to ensure better organization and leadership of the teams. Going forward the programme should focus more on developing peer mentors and local supervisory capacity as well as the mentees.
Chapter 1 examines the general political, social, economic, and cultural aspects of early post-Nazi Romania, looking at the political struggle and the main economic and social developments. This chapter also discusses the official and unofficial (popular) antisemitism that did not disappear from local society and how it impacted Jewish lives during the first post-Holocaust years.
This chapter, the result of extensive fieldwork primarily focusing on Shanghai and Wuhan, where the most significant lockdowns occurred, uncovers the unexamined role of Chinese homeowners and their associations in monitoring and resisting the party-state’s encroachments on individual rights during the COVID pandemic, a phenomenon I term “cooperating to resist.” This chapter demonstrates that the cooperation of Chinese homeowners, which was indispensable to the party-state’s ability to maintain its pandemic control measures, brought them the power to mobilize, resist, and contribute to an abrupt ending of China’s lockdown policy which the party-state’s top leadership had attached its legitimacy to.
Pulmonary atresia with intact ventricular septum is a rare congenital cardiac lesion with significant anatomical heterogeneity. Surgical planning of borderline cases remains challenging and is primarily based on echocardiography. The aim was to identify echocardiographic parameters that correlate with surgical outcome and to develop a discriminatory calculator.
Methods:
Retrospective review of all pulmonary atresia with intact ventricular septum cases at a statewide tertiary paediatric cardiac centre was performed between 2004 and 2020. Demographic, clinical, and echocardiographic data were collected. Logistic regression was used to develop a discriminatory tool for prediction of biventricular repair.
Results:
Forty patients were included. Overall mortality was 27.5% (n = 11) and confined to patients managed as univentricular (11 vs 0, p = 0.027). Patients who underwent univentricular palliation were more likely to have an associated coronary artery abnormality (17 vs 3, p = 0.001). Fifteen surviving patients (51.7%) achieved biventricular circulation while 14 (48.3%) required one-and-a-half or univentricular palliation. Nineteen patients (47.5%) underwent percutaneous pulmonary valve perforation. No patients without tricuspid regurgitation achieved biventricular repair. The combination of tricuspid valve/mitral valve annulus dimension ratio and right ventricle/left ventricle length ratio identified biventricular management with a sensitivity of 93% and specificity of 96%. An online calculator has been made available.
Conclusion:
Pulmonary atresia with intact ventricular septum is a challenging condition with significant early and interstage morbidity and mortality risk. Patient outcomes were comparable to internationally reported data. Right ventricle/left ventricle length and tricuspid valve/mitral valve annulus dimension ratios identified a biventricular pathway with a high level of sensitivity and specificity. Absent tricuspid regurgitation was associated with a univentricular outcome.
In this chapter Soviet strategy in practice is viewed through the lens of Soviet interventions within the Soviet bloc: East Germany in 1953, Hungary in 1956 and Czechoslovakia in 1968. The Kremlin’s struggle for justifying interventions within the socialist bloc provides an interesting analysis of the decision making, objectives, priorities and means of Soviet intervention, while also allowing an examination of the extent to which the Soviet leadership learnt from previous mistakes. The interventions illustrate an interesting kind of progression from unilateral decision making in 1953 to consultation of Soviet allies within the Warsaw Pact, and beyond in 1956 to a so-called ‘coalition of the willing’ of five Warsaw Pact countries, which collectively intervened in Czechoslovakia in August 1968. Concerns for the security and integrity of the Soviet bloc as well as fears for a domino-effect of unrest spilling over into neighbouring Warsaw Pact countries informed Soviet decision making. This chapter accordingly also argues that the Kremlin was increasingly reluctant to intervene, as shown in the Solidarnosc trade union crisis in Poland in 1980–1981. The chapter concludes with a brief comparison with the motives and methods of Russian president Vladimir Putin to invade Ukraine in 24 February 2022.
Chapter 5 discusses the postwar international struggle for and against restitution carried out by the Romanian government and the local and international Jewish organizations that aimed to convince the Allies who prepared the peace treaty with Romania. On the one hand, it shows the local Jewish leaders’ and organizations’ efforts to obtain restitution, reparations, and restoration of rights by enlisting support from international Jewish organizations and Allied (Western) politicians. On the other hand, it highlights how most of the Romanian politicians and diplomats tried to limit restitution in favor of the Jews. In this chapter, the author also discusses other reparative justice measures adopted by the post-Antonescu governments, including the payment of limited reparations (pensions to some categories of survivors of camps, ghettos, and pogroms) and the return of citizenship.
This chapter argues that it is ethical to buy sweatshop products. It explains why arguments to the contrary made in the business ethics literature fail, why sweatshops are not wrongfully exploitative, and why it is better to benefit workers a little bit rather than not at all. It also considers how background injustices impact the ethics of sweatshop employment, and finally reviews issues of worker autonomy and goals other than the welfare of sweatshop workers.
Super-resolution of turbulence is a term used to describe the prediction of high-resolution snapshots of a flow from coarse-grained observations. This is typically accomplished with a deep neural network and training usually requires a dataset of high-resolution images. An approach is presented here in which robust super-resolution can be performed without access to high-resolution reference data, as might be expected in an experiment. The training procedure is similar to data assimilation, wherein the model learns to predict an initial condition that leads to accurate coarse-grained predictions at later times, while only being shown coarse-grained observations. Implementation of the approach requires the use of a fully differentiable flow solver in the training loop to allow for time-marching of predictions. A range of models are trained on data generated from forced, two-dimensional turbulence. The networks have reconstruction errors which are similar to those obtained with ‘standard’ super-resolution approaches using high-resolution data. Furthermore, the methods are comparable to the performance of standard data assimilation for state estimation on individual trajectories, outperforming these variational approaches at initial time and remaining robust when unrolled in time where performance of the standard data-assimilation algorithm improves.
Several chapters in this volume draw attention to the multiple human rights violations that international migrants face on their journey. This chapter argues that simply calling for a strengthening of migrants’ rights is not enough. If we want to combat the de facto lawlessness of modern migration regimes and the resulting rightlessness of international migrants, we need to enhance not only migrants’ legal rights, but also their political agency and hence develop new political institutions which are accountable to both citizens and migrants. Yet, rather than advocating a global reform, this chapter proposes a model of demoi-cratic migration governance. Migrants’ mobility and membership rights should no longer remain within the absolute discretion of single states or nations but should become the object of reciprocal decision-making between them. Compared with both national and global reforms, demoi-cratic decision-making has a double advantage. It protects the continued existence of bounded political communities which form its central building blocks while at the same time strengthening the voice of international migrants by transforming the citizens of all participating states into potential migrants who, via their national representatives, can codetermine the rights that they will be granted in other member states.