Health in the medieval world: Regionality and the bioarchaeology of Ireland and Britain

This study assesses regional health patterns in early medieval Ireland and Britain by analysing and interpreting palaeopathological indicators of stress. This was achieved by incorporating the results of demographic and palaeopathological study into the specific historical contexts. Although relatively small islands, both are home to unique and diverse cultural, physical, and political landscapes, which could potentially affect the general health of the population in different ways. To accurately answer the research question, a bioarchaeological survey of six regions within both islands was carried out, specifically analysing and comparing the demographic profile and general health trends within each region with one another. Results from the analysis have demonstrated statistically significant differences within and between the islands. Inferring that even the more subtle differences observed within the cultural, physical, and political landscapes, such as in the case of Ireland and Britain, can and do affect general health trends. The health of early medieval Ireland and Britain appears to be significantly affected by the physical landscape, specifically a north/south divide. The most northerly regions, Scotland South and Ireland North, manifested higher levels of stress indicators when compared to the more southerly positioned regions. Although it can only be hypothesised what factors within these regions are causing, enhancing or buffering stress, the study has established the potential and necessity for regional work to be continued when interpreting the historical past of these two islands.

Introduction: queering regionality

To 'address' the region of the sexual is not to effortlessly attend to its boundary, but instead to address an epistle that may or may not reach its destination. At what address might the edge of sexuality be situated? And what response might be received from that address? The outstanding quartet of papers in this special issue of Transformations are written to address that limit, in four different constitutive contexts.

An empirical examination of relative profitability in the nursing facility industry between ownership form and regionality in the state of Texas

The purpose of this research is to examine the relative profitability of the firm within the nursing facility industry in Texas. An examination is made of the variables expected to affect profitability and of importance to the design and implementation of regulatory policy. To facilitate this inquiry, specific questions addressed are: (1) Do differences in ownership form affect profitability (defined as operating income before fixed costs)? (2) What impact does regional location have on profitability? (3) Do patient case-mix and access to care by Medicaid patients differ between proprietary and non-profit firms and facilities located in urban versus rural regions, and what association exists between these variables and profitability? (4) Are economies of scale present in the nursing home industry? (5) Do nursing facilities operate in a competitive output market characterized by the inability of a single firm to exhibit influence over market price?^ Prior studies have principally employed a cost function to assess efficiency differences between classifications of nursing facilities. The inherent weakness in this approach is that it only considers technical efficiency. Not both technical and price efficiency which are the two components of overall economic efficiency. One firm is more technically efficient compared to another if it is able to produce a given quantity of output at the least possible costs. Price efficiency means that scarce resources are being directed towards their most valued use. Assuming similar prices in both input and output markets, differences in overall economic efficiency between firm classes are assessed through profitability, hence a profit function.^ Using the framework of the profit function, data from 1990 Medicaid Costs Reports for Texas, and the analytic technique of Ordinary Least Squares Regression, the findings of the study indicated (1) similar profitability between nursing facilities organized as for-profit versus non-profit and located in urban versus rural regions, (2) an inverse association between both payor-mix and patient case-mix with profitability, (3) strong evidence for the presence of scale economies, and (4) existence of a competitive market structure. The paper concludes with implications regarding reimbursement methodology and construction moratorium policies in Texas. ^

Climate variability over the last 35,000 years recorded in marine and terrestrial archives in the Australian region : an OZ-INTIMATE compilation

The Australian region spans some 60° of latitude and 50° of longitude and displays considerable regional climate variability both today and during the Late Quaternary. A synthesis of marine and terrestrial climate records, combining findings from the Southern Ocean, temperate, tropical and arid zones, identifies a complex response of climate proxies to a background of changing boundary conditions over the last 35,000 years. Climate drivers include the seasonal timing of insolation, greenhouse gas content of the atmosphere, sea level rise and ocean and atmospheric circulation changes. Our compilation finds few climatic events that could be used to construct a climate event stratigraphy for the entire region, limiting the usefulness of this approach. Instead we have taken a spatial approach, looking to discern the patterns of change across the continent. The data identify the clearest and most synchronous climatic response at the time of the Last Glacial Maximum (LGM) (21 ± 3 ka), with unambiguous cooling recorded in the ocean, and evidence of glaciation in the highlands of tropical New Guinea, southeast Australia and Tasmania. Many terrestrial records suggest drier conditions, but with the timing of inferred snowmelt, and changes to the rainfall/runoff relationships, driving higher river discharge at the LGM. In contrast, the deglaciation is a time of considerable south-east to north-west variation across the region. Warming was underway in all regions by 17 ka. Post-glacial sea level rise and its associated regional impacts have played an important role in determining the magnitude and timing of climate response in the north-west of the continent in contrast to the southern latitudes. No evidence for cooling during the Younger Dryas chronozone is evident in the region, but the Antarctic cold reversal clearly occurs south of Australia. The Holocene period is a time of considerable climate variability associated with an intense monsoon in the tropics early in the Holocene, giving way to a weakened monsoon and an increasingly El Niño-dominated ENSO to the present. The influence of ENSO is evident throughout the southeast of Australia, but not the southwest. This climate history provides a template from which to assess the regionality of climate events across Australia and make comparisons beyond our region. The data identify the clearest and most synchronous climatic response at the time of the Last Glacial Maximum (LGM) (21 ± 3 ka), with unambiguous cooling recorded in the ocean, and evidence of glaciation in the highlands of tropical New Guinea, southeast Australia and Tasmania. Many terrestrial records suggest drier conditions, but with the timing of inferred snowmelt, and changes to the rainfall/runoff relationships, driving higher river discharge at the LGM. In contrast, the deglaciation is a time of considerable south-east to north-west variation across the region. Warming was underway in all regions by 17 ka. Post-glacial sea level rise and its associated regional impacts have played an important role in determining the magnitude and timing of climate response in the north-west of the continent in contrast to the southern latitudes. No evidence for cooling during the Younger Dryas chronozone is evident in the region, but the Antarctic cold reversal clearly occurs south of Australia. The Holocene period is a time of considerable climate variability associated with an intense monsoon in the tropics early in the Holocene, giving way to a weakened monsoon and an increasingly El Niño-dominated ENSO to the present. The influence of ENSO is evident throughout the southeast of Australia, but not the southwest. This climate history provides a template from which to assess the regionality of climate events across Australia and make comparisons beyond our region.

The topography of multiple drug use among adolescent Australians : findings from the National Drug Strategy Household Survey

Introduction and aims: Despite evidence that many Australian adolescents have considerable experience with various drug types, little is known about the extent to which adolescents use multiple substances. The aim of this study was to examine the degree of clustering of drug types within individuals, and the extent to which demographic and psychosocial predictors are related to cluster membership. Design and method: A sample of 1402 adolescents aged 12-17. years were extracted from the Australian 2007 National Drug Strategy Household Survey. Extracted data included lifetime use of 10 substances, gender, psychological distress, physical health, perceived peer substance use, socioeconomic disadvantage, and regionality. Latent class analysis was used to determine clusters, and multinomial logistic regression employed to examine predictors of cluster membership. Result: There were 3 latent classes. The great majority (79.6%) of adolescents used alcohol only, 18.3% were limited range multidrug users (encompassing alcohol, tobacco, and marijuana), and 2% were extended range multidrug users. Perceived peer drug use and psychological distress predicted limited and extended multiple drug use. Psychological distress was a more significant predictor of extended multidrug use compared to limited multidrug use. Discussion and conclusion: In the Australian school-based prevention setting, a very strong focus on alcohol use and the linkages between alcohol, tobacco and marijuana are warranted. Psychological distress may be an important target for screening and early intervention for adolescents who use multiple drugs.

Regional versus urban differences in teenage alcohol use: Does parental disapproval account for these differences?

- Objective To investigate if parental disapproval of alcohol use accounts for differences in adolescent alcohol use across regional and urban communities. - Design Secondary data analysis of grade-level stratified data from a random sample of schools. - Setting High schools in Victoria, Australia. - Participants A random sample of 10273 adolescents from Grade 7 (mean age=12.51 years), 9 (14.46 years) and 11 (16.42 years). - Main outcome measures The key independent variables were parental disapproval of adolescent alcohol use and regionality (regional/ urban), and the dependent variable was past 30 days alcohol use. - Results After adjusting for potential confounders, adolescents in regional areas were more likely to use alcohol in the past 30 days (OR=1.83, 1.44 and 1.37 for Grades 7, 9 and 11, respectively, P<0.05), and their parents have a lower level of disapproval of their alcohol use (b=-0.12, -0.15 and -0.19 for Grades 7, 9 and 11, respectively, P<0.001). Bootstrapping analyses suggested that 8.37%, 23.30% and 39.22% of the effect of regionality on adolescent alcohol use was mediated by parental disapproval of alcohol use for Grades 7, 9 and 11 participants respectively (P<0.05). - Conclusions Adolescents in urban areas had a lower risk of alcohol use compared with their regional counterparts, and differences in parental disapproval of alcohol use contributed to this difference.

Paikallisuus ja alueellisuus osuustoimintayritysten liiketoiminnassa

Työn tarkoituksena on ymmärtää ja kuvata paikallisuuden ja alueellisuuden merkitystä osuustoimintayritysten liiketoiminnassa. Tavoitteena on ymmärtää, mitä ovat alueellisuus ja paikallisuus kohdeyritysten näkökulmasta katsottuna, kuinka ne ilmenevät yritysten toiminnassa ja mikäon niiden merkitys liiketoiminnassa. Tutkimus on luonteeltaan laadullinen tapaustutkimus. Tutkimuksen empiirisenä aineistona toimivat kohdeyritysten toimitusjohtajien sekä yhden OP-ryhmän ja osuustoiminnan asiantuntijan yksilöhaastattelut. Haastattelut tehtiin vuoden 2005 kesällä kohdeyritysten toimitiloissa. Tutkimustulokset osoittavat, että paikallisuudella ja alueellisuudella on merkittävä lisäarvo osuuskuntien liiketoiminnassa. Paikallisuus ja alueellisuus tarjoavat mahdollisuuden osuustoiminnan ominaispiirteiden hyödyntämiseen ja konkretisoimiseen asiakkaiden arvostamalla, ihmisläheisellä liiketoimintatavalla ja edesauttavatnäin ollen liiketoiminnassa menestymistä.

The new higher education reality: what is an appropriate model to address the widening participation agenda?

Along with the massification of higher education comes a need for new models to support the success of greater numbers of diverse students. A greater proportion of these students are ‘non-traditional’ in terms of preparedness, socioeconomic status  and geography. This paper introduces an Associate Degree model designed to support this new higher education reality of broader student cohorts, thin regional markets and cross-sectoral collaboration. Background literature on challenges facing the higher education sector and its prospective students is presented, with a particular focus on regionality. An argument is made for the role of curriculum and pedagogy as enablers of non-traditional student success. This is supported by the results of a mixed-methods exploratory study. This Associate Degree model was attractive to students and institutes. Students experienced similar levels of challenge, workload and progress to their traditional peers. While technology was essential for the success of the model, it played a supporting role to the relationships and multiple modes of learning it facilitated. This article provides insights for institutions seeking to address the broadening participation agenda.

Asynchrony and regional differences in the reproductive cycle of the greenback stingaree Urolophus viridis from south-eastern Australia

Determining the periodicity of the reproductive cycle in chondrichthyan species when the population is recruiting asynchronously, as found for Urolopus viridis, can be problematic. The reproductive cycle generally requires distinguishable trends in reproductive indices across the population. The present study utilised other similar and sympatric urolophid species with synchronous reproductive cycles. Through data collected in the present study and comparisons of maximum total length (TL), periodicity of egg and embryo in utero, ovarian cycles, largest ovarian follicle diameter, and matrotrophic contribution (percentage increase from egg to embryo after maternal histotroph supplement) from similar studies, an annual reproductive cycle can be hypothesised. Sampling across two separate regions of Lakes Entrance (LE) and Western Bass Strait (WBS), U. viridis also showed regionality in several of the reproductive indices. Maximum TL and mass for females, mean size-at-birth, and female size-at-maturity and size-at-maternity in LE were markedly smaller than in WBS. In both regions litter size (1–2) increased with TL, with an exception of one female in WBS producing a litter of 3 which could be attributed to the larger TL. The implication of U. viridis producing such few young annually is they have the lowest biological productivity of any urolophid species in south-eastern Australia.

Regional versus urban differences in teenage alcohol use: Does parental disapproval account for these differences?

Objective: To investigate if parental disapproval of alcohol use accounts for differences in adolescent alcohol use across regional and urban communities. Design: Secondary data analysis of grade-level stratified data from a random sample of schools. Setting: High schools in Victoria, Australia. Participants: A random sample of 10273 adolescents from Grade 7 (mean age=12.51 years), 9 (14.46 years) and 11 (16.42 years). Main outcome measures: The key independent variables were parental disapproval of adolescent alcohol use and regionality (regional/ urban), and the dependent variable was past 30 days alcohol use. Results: After adjusting for potential confounders, adolescents in regional areas were more likely to use alcohol in the past 30 days (OR=1.83, 1.44 and 1.37 for Grades 7, 9 and 11, respectively, P<0.05), and their parents have a lower level of disapproval of their alcohol use (b=-0.12, -0.15 and -0.19 for Grades 7, 9 and 11, respectively, P<0.001). Bootstrapping analyses suggested that 8.37%, 23.30% and 39.22% of the effect of regionality on adolescent alcohol use was mediated by parental disapproval of alcohol use for Grades 7, 9 and 11 participants respectively (P<0.05). Conclusions: Adolescents in urban areas had a lower risk of alcohol use compared with their regional counterparts, and differences in parental disapproval of alcohol use contributed to this difference.

O programa de saúde da família e os princípios básicos do Sistema Único de Saúde na realidade de Santana do Matos RN

This work shows the professional staff of the Family Health Program (PSF) in Santana do Matos City perceive the Unified Health System (SUS). Their discourse and recognition of the advances of SUS, as well as their participation on the implementation of the system, are analyzed. The Brazilian Ministry of Health instituted it in 1994 in order to rebuild the health politics on a new basis, substituting the traditional model. The city-centered implementation of SUS was instituted on May 27, 1992 by the act nº 631/92 and today it experiences a Full Management of Basic Attention. In July 2001 the PSF program was started in the city with 5 teams: 2 in the urban zone and 3 in the rural one. The methodology was developed with the combination of qualitative and quantitative research with the employment of a questionnaire with both open and closed inquiries to 31 members of the program. The study appointed that, no matter how positive and enlarged be the staff s concept of health and SUS, they dont s have on understanding of the total chain of the system on its integrality, hierarchy and regionality what hinders the system performance close to the users. The PSF incorporates and reaffirms the basic principles of the SUS; however, on its everyday employment it has not yet abandoned totally the curative model, which is reinforced by the hospital-centered and physiscian-centerend culture

Paleoproductivity reconstruction for the eastern equatorial Pacific

Productivity at six core locations in the eastern equatorial Pacific (EEP) was reconstructed with a benthic foraminiferal transfer function. The core records show strong regionality, especially where affected by Peru margin upwelling of deeper Equatorial Undercurrent Water (EUC) (originally coming from the subantarctic). This "Peru margin" record differs from that seen along the equator where divergence leads to shallow upwelling, and it is generally inverse to that seen in cores outside the areas of equatorial upwelling. Principal components analysis shows that the main productivity pattern correlates well to the global oxygen isotope record and has lowest values during isotope stages 2 and 4. In addition to this, equatorial cores show a higher frequency pattern of variation which becomes much more pronounced during MIS 3 and 2. The reconstructions based on benthic foraminifera were tested against those from nonaccumulation rate based inorganic chemical proxies of export production. These were found to correlate well in the region influenced by Peru upwelling, and also to share common features for sites along the equator. All the nonaccumulation rate based paleotracers are consistent with one another and differ from accumulation rate derived proxies. The differences between the two classes of paleotracers may result from uncertainties in calculating actual biogenic fluxes since 230Th-normalized results conform more to those we obtained. Analysis of planktonic carbon isotope values for the EEP, and their comparison to the record of the Pacific subantarctic, indicates that the subantarctic contribution to the EUC was reduced during MIS 3 and 2.

Quantitative analysis of immunolabeling for serotonin and for glutamate transporters after administration of imipramine and citalopram

Serotonin (5-hydroxytryptamine, 5-HT) is an amine neurotransmitter derived from tryptophan and is important in brain systems regulating mood, emotional behavior, and sleep. Selective serotonin reuptake inhibitor (SSRI) drugs are used to treat disorders such as depression, stress, eating disorders, autism, and schizophrenia. It is thought that these drugs act to prolong the action of 5-HT by blocking reuptake. This may lead to decreased 5-HT content in the nerve fibers themselves; however, this has not previously been directly demonstrated. We have studied the effects of administration of two drugs, imipramine and citalopram, on levels of 5-HT in nerve fibers in the murine brain. Quantitative analysis of the areal density of 5-HT fibers throughout the brain was performed using ImageJ software. While a high density of fibers was observed in mid- and hind-brain regions and areas such as thalamus and hypothalamus, densities were far lower in areas such as cortex, where SSRIs might be thought to exert their actions. As anticipated, imipramine and citalopram produced a decline in 5-HT levels in nerve fibers, but the result was not uniform. Areas such as inferior colliculus showed significant reduction whereas little, if any, change was observed in the adjacent superior colliculus. The reason for, and significance of, this regionality is unclear. It has been proposed that serotonin effects in the brain might be linked to changes in glutamatergic transmission. Extracellular glutamate levels are regulated primarily by glial glutamate transporters. Qualitative evaluation of glutamate transporter immunolabeling in cortex of control and drug-treated mice revealed no discernable difference in intensity of glutamate transporter immunoreactivity. These data suggest that changes in intracellular and extracellular levels of serotonin do not cause concomitant changes in astroglial glutamate transporter expression, and thus cannot represent a mechanism for the delayed efficacy of antidepressants when administered clinically. © 2005 Elsevier B.V. All rights reserved.