High-precision radiocarbon measurements of contemporaneous tree-ring wood from the British Isles and New Zealand: AD 1850-950.

The University of Waikato, Hamilton, New Zealand and The Queen's University of Belfast, Northern Ireland radiocarbon dating laboratories have undertaken a series of high-precision measurements on decadal samples of dendrochronologically dated oak (Quercus petraea) from Great Britain and cedar (Libocedrus bidwillii) and silver pine (Lagarostrobos colensoi) from New Zealand. The results show an average hemispheric offset over the 900 yr of measurement of 40±13 yr. This value is not constant but varies with a periodicity of about 130 yr. The Northern Hemisphere measurements confirm the validity of the Pearson et al. (1986) calibration dataset.

Mediastinitis post revascularización miocárdica: impacto del cambio de profilaxis antibiótica en la fundación Cardioinfantil 2012 - 2013

INTRODUCCIÓN. La mediastinitis posterior a cirugía de revascularización miocárdica es una infección infrecuente, pero potencialmente fatal. En la Fundación Cardioinfantil se ha observado una tendencia al incremento de la misma en los últimos años, obligando a un cambio en las medidas de profilaxis antimicrobiana, pasando de cefalosporinas a vancomicina – gentamicina, sin embargo no se conoce aún el impacto de estas medidas. OBJETIVO: Determinar si el cambio de la profilaxis antibiótica en pacientes sometidos a revascularización miocárdica influye en una disminución de la incidencia de mediastinitis durante los años 2012 – 2013. METODOLOGÍA: Estudio de cohortes retrospectivo, evaluando la incidencia de mediastinitis post revascularización miocárdica, en pacientes expuestos a 2 diferentes tipos de profilaxis antimicrobiana (cefalosporinas vs vancomicina-gentamicina). Se describieron los patrones de susceptibilidad y resistencia de los patógenos encontrados en mediastinitis y la mortalidad de esta patología. RESULTADOS: Los patógenos más frecuentemente aislados en la mediastinitis fueron Staphylococcus aureus y Klebsiella pneumoniae, en la mayoría monomicrobiano. Se encontraron patógenos con perfiles de resistencia como betalactamasas de espectro extendido en Gram negativos y resistencia a la meticilina en cocos Gram positivos. El RR de mediastinitis del grupo expuesto a vancomicina-gentamicina respecto al grupo de cefalosporinas fue de 0,9 con IC 95% 0,28 – 3,28. CONCLUSIÓN: la epidemiologia microbiana de la mediastinitis no difiere de la reportada en otras series. La profilaxis antimicrobiana con vancomicina - gentamicina en pacientes sometidos a revascularización miocárdica, no redujo la incidencia de mediastinitis. Se propone regresar a la terapia de profilaxis con cefalosporinas.

New Zealand : further papers relative to the affairs of New Zealand (in continuation of papers presented 14th August, 1850) : presented to both houses of Parliament by command of Her Majesty, 7th August, 1851.

Mode of access: Internet.

English reports in law and equity : containing reports of cases in the House of Lords, Privy Council, Courts of Equity and Common Law; and in the Admiralty and Ecclesiastical Courts, including also cases in bankruptcy and crown cases reserved, [1850-1857]

Includes indexes.

Reports of cases argued and determined, 1798-1850;

Mode of access: Internet.

Commercial agreement between His Majesty's government in the United Kingdom and the government of Cuba. Havana, February 19, 1937. ...

"This copy of the United Kingdom-Cuba agreement is supplied free to subscribers of the Board of trade journal."

Board of Trade journal.

Edited by the Commercial Department of the Board of Trade from Apr. 1893 to Oct. 1916; by the Department of Commerical Intelligence from Oct. 1916-

Board of Trade journal.

Edited by the Commercial Department of the Board of Trade from Apr. 1893 to Oct. 1916; by the Department of Commercial Intelligence from Oct. 1916-

Rotuli parliamentorum; Index to the rolls of Parliament ... from ann. 6 Edw. I. to ann. 19 Hen. VII. (A.D. 1278.-A.D. 1503.)

Mode of access: Internet.

Documents relative to Central American affairs, and the enlistment question ...

Correspondence between Great Britain and the United States, in relation to Central American affairs, communicated to the first session of the Thirty-fourth Congress by the President of the United States with his annual message.--Correspondence in relation to Central American affairs, and the Clayton and Bulwer convention.--Correspondence in relation to enlistment of troops within the United States, by the agents of Great Britain.--The trial of Henry Hertz et al.

Platinum-based chemotherapy in metastatic breast cancer : the Leicester (UK) experience

Aims: After failure of anthracycline- and taxane-based chemotherapy in metastatic breast cancer, treatment options until recently were limited. Until the introduction of capecitabine and vinorelbine, no standard regimen was available. We conducted a retrospective study to determine the efficacy and toxicity of platinum-based chemotherapy in metastatic breast cancer. Materials and methods: Forty-two women with metastatic breast cancer previously treated with anthracyclines (93%) and/or taxanes (36%) received mitomycin-vinblastine-cisplatin (MVP) (n = 23), or cisplatin-etoposide (PE) (n = 19), as first-, second- and third-line treatment at a tertiary referral centre between 1997 and 2002. Chemotherapy was given every 3 weeks as follows: mitomycin-C (8 mg/m 2) (cycles 1, 2, 4, 6), vinblastine (6 mg/m 2), and cisplatin (50 mg/m 2) all on day 1; and cisplatin (75 mg/m 2) and etoposide (100 mg/m 2) on day 1 and (100 mg/m 2) orally twice a day on days 2-3. Results: The response rate for 40 evaluable patients (MVP: n = 23; PE: n = 17) was 18% (95% confidence interval [CI]: 9-32%). The response rate to MVP was 13% (95% CI: 5-32%, one complete and two partial responses) and to PE 24% (10-47%, four partial responses). Disease stabilised in 43% (26-63%) and 47% (26-69%) of women treated with MVP and PE, respectively. After a median follow-up of 18 months, 37 women (MVP: n = 19; PE: n = 18) died from their disease. Median (range) progression-free survival and overall survival were 6 months (0.4-18.7) and 9.9 months (1.3-40.8), respectively. Median progression-free survival for the MVP and PE groups was 5.5 and 6.2 months (Log-rank, P = 0.82), and median overall survival was 10.2 and 9.4 months (Log-rank, P = 0.46), respectively. The main toxicity was myelosuppression. Grades 3-4 neutropenia was more common in women treated with PE than in women treated with MVP (74% vs 30%; P = 0.012), but the incidence of neutropenic sepsis, relative to the number of chemotherapy cycles, was low (7% overall). The toxicity-related hospitalisation rate was 1.2 admissions per six cycles of chemotherapy. No treatment-related deaths occurred. MVP and PE chemotherapy have modest activity and are safe in women with metastatic breast cancer. © 2005 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Cultural Policy

The development of cultural policy during the twentieth century is underscored by three key developments. First, the formation of the Arts Council of Great Britain in 1946, first headed by the Cambridge economist Lord Keynes, saw the scaffolding developed for ongoing government support for the arts. In doing so, it established the principle of an “arm’s length” relationship between the government of the day and individual artists, through the development of independent arts boards engaged in the peer review of creative works. Second, the formation of the Fifth Republic in France in 1958 saw the creation of a Ministry of Culture, headed by the writer André Malraux. Malraux and his successors have seen three major tasks for a national cultural policy: government support for the creation of new artistic and cultural works; the promotion and maintenance of cultural heritage; and enabling equitable access to creative works and creative opportunities through all segments of society. Finally, at a global level, agencies such as UNESCO have sought to promote national cultural policies as an element of national sovereignty, particularly in the developing world, and this has involved addressing sources of structural inequality in the distribution of global cultural and communications resources...

Metsäpirulainen : Liikemies Erik Johan Längman (1799-1863) talousjärjestelmän murroksessa

The Forest devil. Businessman Erik Johan Längman (1799 1863) in the transition of economic system In Finnish historiography, Erik Johan Längman (1799-1863) bears a bad reputation of his own level: a mean, profit-seeking businessman who did not care too much about methods in his operations. Although little known, Längman has been praised as one of the pioneers of modern industry in the Grand Duchy of Finland, which belonged to the Russian Empire. From the mid 1830s Längman owned iron mill and several sawmills around the country. The growing demand of the markets in the 1830s, especially in Great Britain, marked a strong stimulus to Finnish lumber industry. At the same time claims for stricter rule over the sawmill industry were raised by high officials. The momentum of the conflict, the Forest Act of 1851, brought an end to illegal overproduction. In this biography, particular emphasis is laid on the entrepreneurial behaviour of Längman, but also on the effect the entrepreneurs had on the Crown s policies. On the other hand, how did the limitations imposed by the Crown guide the actions of the sawmill owners? The solutions adopted by the sawmill owners and the manoeuvring of the government are in a constant dialogue in this study. The Finnish sawmill industry experienced a major change in its techniques and methods of acquiring timber during the 1830s. Längman particularly, with his acquisition organisation, was able to find and reach faraway forests with unexpected results. The official regulating system with its strict producing quotas couldn t follow the changes. When the battle against the sawmill industry really started on, in 1840, it didn t happen for the benefit of iron industry, as argued previously, but to save Crown forests from depletion. After the mid 1840s Längman and the leader of the Finnish nationalistic movement, J. V. Snellman questioned the rationality of the entire regulation system and in doing so they also posed a threat against the aristocratic power. The influential but now also badly provoked chairman of the economic division of senate, Lars Gabriel von Haartman, accused the sawmill-owners harder than ever and took the advantage of the reactionary spirit of imperial Russia to launch the state forest administration. Längman circumvented the conditions of privileges, felled Crown forests illegally and accusations were brought against him for destroying his competitors. The repeated conflicts spoke primarily about a superior business idea and organisational ability. Although Längman spent his last years mostly abroad he still had interests in Finnish timber business when the liberation of sawmill-industry was established, in 1861. Surprisingly, the antagonism around the Crown forests continued, probably even more heated.

Technical efficiency of blood component preparation in blood centres of 10 European countries

Various reasons, such as ethical issues in maintaining blood resources, growing costs, and strict requirements for safe blood, have increased the pressure for efficient use of resources in blood banking. The competence of blood establishments can be characterized by their ability to predict the volume of blood collection to be able to provide cellular blood components in a timely manner as dictated by hospital demand. The stochastically varying clinical need for platelets (PLTs) sets a specific challenge for balancing supply with requests. Labour has been proven a primary cost-driver and should be managed efficiently. International comparisons of blood banking could recognize inefficiencies and allow reallocation of resources. Seventeen blood centres from 10 countries in continental Europe, Great Britain, and Scandinavia participated in this study. The centres were national institutes (5), parts of the local Red Cross organisation (5), or integrated into university hospitals (7). This study focused on the departments of blood component preparation of the centres. The data were obtained retrospectively by computerized questionnaires completed via Internet for the years 2000-2002. The data were used in four original articles (numbered I through IV) that form the basis of this thesis. Non-parametric data envelopment analysis (DEA, II-IV) was applied to evaluate and compare the relative efficiency of blood component preparation. Several models were created using different input and output combinations. The focus of comparisons was on the technical efficiency (II-III) and the labour efficiency (I, IV). An empirical cost model was tested to evaluate the cost efficiency (IV). Purchasing power parities (PPP, IV) were used to adjust the costs of the working hours and to make the costs comparable among countries. The total annual number of whole blood (WB) collections varied from 8,880 to 290,352 in the centres (I). Significant variation was also observed in the annual volume of produced red blood cells (RBCs) and PLTs. The annual number of PLTs produced by any method varied from 2,788 to 104,622 units. In 2002, 73% of all PLTs were produced by the buffy coat (BC) method, 23% by aphaeresis and 4% by the platelet-rich plasma (PRP) method. The annual discard rate of PLTs varied from 3.9% to 31%. The mean discard rate (13%) remained in the same range throughout the study period and demonstrated similar levels and variation in 2003-2004 according to a specific follow-up question (14%, range 3.8%-24%). The annual PLT discard rates were, to some extent, associated with production volumes. The mean RBC discard rate was 4.5% (range 0.2%-7.7%). Technical efficiency showed marked variation (median 60%, range 41%-100%) among the centres (II). Compared to the efficient departments, the inefficient departments used excess labour resources (and probably) production equipment to produce RBCs and PLTs. Technical efficiency tended to be higher when the (theoretical) proportion of lost WB collections (total RBC+PLT loss) from all collections was low (III). The labour efficiency varied remarkably, from 25% to 100% (median 47%) when working hours were the only input (IV). Using the estimated total costs as the input (cost efficiency) revealed an even greater variation (13%-100%) and overall lower efficiency level compared to labour only as the input. In cost efficiency only, the savings potential (observed inefficiency) was more than 50% in 10 departments, whereas labour and cost savings potentials were both more than 50% in six departments. The association between department size and efficiency (scale efficiency) could not be verified statistically in the small sample. In conclusion, international evaluation of the technical efficiency in component preparation departments revealed remarkable variation. A suboptimal combination of manpower and production output levels was the major cause of inefficiency, and the efficiency did not directly relate to production volume. Evaluation of the reasons for discarding components may offer a novel approach to study efficiency. DEA was proven applicable in analyses including various factors as inputs and outputs. This study suggests that analytical models can be developed to serve as indicators of technical efficiency and promote improvements in the management of limited resources. The work also demonstrates the importance of integrating efficiency analysis into international comparisons of blood banking.