Routine delirium monitoring in a UK critical care unit

Introduction Delirium in the intensive care unit (ICU) is associated with increased morbidity and mortality. Using an assessment tool has been shown to improve the ability of clinicians in the ICU to detect delirium. The confusion assessment method for the ICU (CAM-ICU) is a validated delirium-screening tool for critically ill intubated patients. The aim of this project was to establish the feasibility of routine delirium screening using the CAM-ICU and to identify the incidence of delirium in a UK critical care unit.

Resource pressure and environmental change on the North African littoral: Epipalaeolithic to Roman gastropods from Cyrenaica, Libya.

This paper discusses the marine and terrestrial shell on Epipalaeolithic to Classical-period sites in the Cyrenaican coastlands, northeast Libya, with particular reference to the Haua Fteah, with parallel studies at a late-Roman farmstead and two small caves. Together they provide evidence for coastal and terrestrial environments and for the continued nutritional importance of gastropods to humans during the Holocene. Land snail evidence is consistent with regional vegetation in coastal Cyrenaica becoming increasingly open through the Holocene, as a result of some combination of climate change and human impact. Marine species suggest that the coastline near the Haua had been rocky throughout the Holocene. At Hagfet al-Gama, changing faunas provide evidence for sand encroachment onto a previously rocky shoreline in Hellenistic times. A biometric study of Osilinus turbinatus shows that in the archaeological sites these shells are systematically smaller than modern specimens, providing evidence for long-term dietary stress in the human populations around the Haua Fteah, with particularly severe stress in parts of the Epipalaeolithic. A biometric study of Patella spp. provided evidence for size selection, but also seems to show evidence for resource pressure. It is unlikely that variations in resource pressure seen in the mollusc biometrics are the result of climatic stress or natural ecological factors and explanations must be sought in society-environment dynamics.