Looking in the wrong place for healthcare improvements: a system dynamics study of an accident and emergency department

Accident and Emergency (A&E) units provide a route for patients requiring urgent admission to acute hospitals. Public concern over long waiting times for admissions motivated this study, whose aim is to explore the factors which contribute to such delays. The paper discusses the formulation and calibration of a system dynamics model of the interaction of demand pattern, A&E resource deployment, other hospital processes and bed numbers; and the outputs of policy analysis runs of the model which vary a number of the key parameters. Two significant findings have policy implications. One is that while some delays to patients are unavoidable, reductions can be achieved by selective augmentation of resources within, and relating to, the A&E unit. The second is that reductions in bed numbers do not increase waiting times for emergency admissions, their effect instead being to increase sharply the number of cancellations of admissions for elective surgery. This suggests that basing A&E policy solely on any single criterion will merely succeed in transferring the effects of a resource deficit to a different patient group.

The notions of 'restriction' and 'discrimination' in the context of the free movement of persons provisions: from a relationship of interdependence to one of (almost complete) independence

This article aims to analyse how the meaning of the notions of ‘restrictions’ and ‘discrimination’ in EU free movement law has developed through the years, and to explore how the relationship between them has evolved. It is explained that the two concepts under examination had originally been closely intertwined, in the sense that one defined the other, the element holding them together being the aim of the relevant provisions to liberalise the inter-State movement of persons in the EU, as part of the process of establishing an internal market. Yet, more recently, the way that the Court has chosen to delimit their scope, illustrates that each of these notions can now have a life of its own, meaning that ‘discrimination’ can include discriminatory measures which do not lead to restrictions that are contrary to the free movement provisions, and ‘restriction’ can cover national measures that are not discriminatory.

Investigations into plant biochemical wound-response pathways involved in the production of aphid-induced plant volatiles

Feeding damage to plants by insect herbivores induces the production of plant volatiles, which are attractive to the herbivores natural enemies. Little is understood about the plant biochemical pathways involved in aphid-induced plant volatile production. The aphid parasitoid Diaeretiella rapae can detect and respond to aphid-induced volatiles produced by Arabidopsis thaliana. When given experience of those volatiles, it can learn those cues and can therefore be used as a novel biosensor to detect them. The pathways involved in aphid-induced volatile production were investigated by comparing the responses of D. rapae to volatiles from a number of different transgenic mutants of A. thaliana, mutated in their octadecanoid, ethylene or salicylic acid wound-response pathways and also from wild-type plants. Plants were either undamaged or infested by the peach-potato aphid, Myzus persicae. It is demonstrated that the octadecanoid pathway and specifically the COI1 gene are required for aphid-induced volatile production. The presence of salicylic acid is also involved in volatile production. Using this model system, in combination with A. thaliana plants with single point gene mutations, has potential for the precise dissection of biochemical pathways involved in the production of aphid-induced volatiles

Christian Gottlob Heyne and the changing fortunes of the commentary in the age of Altertumswissenschaft

This chapter discusses the pedagogic and scholarly priorities that informed Heyne’s commentaries on Tibullus (1755), Virgil (1767-75) and Homer (1802), as well as their initial critical reception. Like those of his teachers, Gesner and Ernesti, Heyne’s works eschew detailed textual scholarship in favour of aesthetic and historicizing appreciation of literary works as wholes. Their formal innovations – most notably the relegation of advanced philological discussions to endnotes and the inclusion of excursuses on significant historical and cultural questions – are an attempt to tailor a traditional format to the demands of an Enlightened age and the cultural-historical interests of the new Altertumswissenschaft. The chapter discusses their contrasting critical receptions in order to raise questions about the viability of Heyne’s endeavours to make a traditional medium fit new concerns.

Gap junctions and connexin hemichannels in the regulation of haemostasis and thrombosis

Platelets are involved in the maintenance of haemostasis but their inappropriate activation leads to thrombosis, a principal trigger for heart attack and ischemic stroke. Although platelets circulate in isolation, upon activation they accumulate or aggregate together to form a thrombus, where they function in a coordinated manner to prevent loss of blood and control wound repair. Recent reports indicate that the stability and functions of a thrombus are maintained through sustained, contact dependent signalling between platelets. Given the role of gap junctions in the coordination of tissue responses, it was hypothesized that gap junctions may be present within a thrombus and mediate intercellular communication between platelets. Therefore studies were performed to explore the presence and functions of connexins in platelets. In this brief review, the roles of hemichannels and gap junctions in the control of thrombosis and haemostasis and the future directions for this research will be discussed.

Increases in the longevity of desiccation-phase developing rice seeds: response to high temperature drying depends on harvest moisture content

• Background and Aims Earlier studies have suggested that the drying conditions routinely used by genebanks may not be optimal for subsequent seed longevity. The aim of this study was to compare the effect of hot-air drying with low temperature drying on subsequent seed longevity for 20 diverse rice accessions and to consider how factors related to seed production history might influence the results. • Methods Seeds were produced according to normal regeneration procedures at IRRI. They were harvested at different times (harvest date and days after anthesis (DAA), once for each accession) and dried either in a drying room (DR; 15% RH, 15°C), or in a flat-bed heated-air batch dryer (BD; 45°C, 8 h d-1) for up to 6 daily cycles followed by drying in the DR. Relative longevity was assessed by storage at 10.9% moisture content (m.c.) and 45°C. • Key Results Initial drying in the BD resulted in significantly greater longevity compared with the DR for 14 accessions (seed lots): the period of time for viability to fall to 50% for seeds dried in the BD as a percentage of that for seeds dried throughout in the DR varied between 1.3 and 372.2% for these 14 accessions. The seed lots that responded the most were harvested earlier in the season and at higher moisture content. Drying in the BD did not reduce subsequent longevity compared with DR drying for any of the remaining accessions. • Conclusions Seeds harvested at a m.c. where, according to the moisture desorption isotherm, they could still be metabolically active (>16.2%), may be in the first stage of the post-mass maturity, desiccation phase of seed development and able to increase longevity in response to hot-air drying. The genebank standards regarding seed drying for rice and, perhaps, for other tropical species should be reconsidered.

Assessing the carcinogenic potential of low-dose exposures to chemical mixtures in the environment: the challenge ahead

Lifestyle factors are responsible for a considerable portion of cancer incidence worldwide, but credible estimates from the World Health Organization and the International Agency for Research on Cancer (IARC) suggest that the fraction of cancers attributable to toxic environmental exposures is between 7% and 19%. To explore the hypothesis that low-dose exposures to mixtures of chemicals in the environment may be combining to contribute to environmental carcinogenesis, we reviewed 11 hallmark phenotypes of cancer, multiple priority target sites for disruption in each area and prototypical chemical disruptors for all targets, this included dose-response characterizations, evidence of low-dose effects and cross-hallmark effects for all targets and chemicals. In total, 85 examples of chemicals were reviewed for actions on key pathways/mechanisms related to carcinogenesis. Only 15% (13/85) were found to have evidence of a dose-response threshold, whereas 59% (50/85) exerted low-dose effects. No dose-response information was found for the remaining 26% (22/85). Our analysis suggests that the cumulative effects of individual (non-carcinogenic) chemicals acting on different pathways, and a variety of related systems, organs, tissues and cells could plausibly conspire to produce carcinogenic synergies. Additional basic research on carcinogenesis and research focused on low-dose effects of chemical mixtures needs to be rigorously pursued before the merits of this hypothesis can be further advanced. However, the structure of the World Health Organization International Programme on Chemical Safety 'Mode of Action' framework should be revisited as it has inherent weaknesses that are not fully aligned with our current understanding of cancer biology.

Confessionalism and conversion in the Reformation

Recent research on the Reformation has been concerned with the process by which lay people acquired a religious identity, whether it began merely as an act of political obedience or by a sudden ‘conversion’ to new doctrines. Confessional politics made it imperative for rulers to try to control the religious allegiances of their people, but the doctrine of conversion (as a spiritual change) made this theoretically impossible. Instead, a ‘culture of persuasion’ developed by which clerical and secular rulers sought to persuade their people to accept teachings authorized by the state. The possibility of religious dissent, of converting away from the state-sanctioned denomination, made conversion an issue whose importance was far greater than the actual number of converts. The study of confessionalism and conversion emphasises two theses fundamental to Reformation studies: that the era produced radical changes in the ways that people thought about their personal and communal identities, and that it made individuals’ religious choices the urgent concern of their governors.

Girls talk: authorship and authenticity in the reception of Lena Dunham's Girls

By examining the discourse around Lena Dunham's HBO comedy Girls (2012– present), this article argues that the programme served as a space to think through female authorship, televisual representations and cultural tensions surrounding young womanhood. Central to this discourse was the narrative asserting Girls' and Dunham's 'authenticity', originality and universality, which sought to legitimate her gendered authorship and interest in the comedy of female intimacy within HBO' s masculine prestige channel identity. Charting three cycles of discourse surrounding the programme's debut, this article explores the paratextual framing by promotional concerns, television critics and women' s websites. It highlights how journalists and critics furthered HBO's paratextual framing of Dunham, which was later countered by the networked spaces of niche online media, which used the programme as a space to productively work through industrial and cultural tensions; particularly those surrounding female comic authorship, autobiography and intersectionality.

Corpus approaches to language in the media

The main aim of this chapter is to offer an overview of research that has adopted the methodology of Corpus Linguistics to study aspects of language use in the media. The overview begins by introducing the key principles and analytical tools adopted in corpus research. To demonstrate the contribution of corpus approaches to media linguistics, a selection of recent corpus studies is subsequently discussed. The final section summarises the strengths and limitations of corpus approaches and discusses avenues for further research.