Around 1500 England's society and economy had reached a turning point. After a long period of slow change and even stagnation, an age of innovation and initiative was in motion, with enclosure, ...voyages of discovery, and new technologies. It was an age of fierce controversy, in which the government was fearful of beggars and wary of rebellions. The 'commonwealth' writers such as Thomas More were sharply critical of the greed of profit hungry landlords who dispossessed the poor. This book is about a wool merchant and large scale farmer who epitomises in many ways the spirit of the period. John Heritage kept an account book, from which we can reconstruct a whole society in the vicinity of Moreton in Marsh, Gloucestershire. He took part in the removal of a village which stood in the way of agricultural 'improvement', ran a large scale sheep farm, and as a 'woolman' spent much time travelling around the countryside meeting with gentry, farmers, and peasants in order to buy their wool. He sold the wool he produced himself, and the fleeces he gathered, to London merchants who exported wool through Calais to the textile towns of Flanders. The wool growers named in the book can be studied in their native villages, and their lives can be reconstructed in the round, interacting in their communities, adapting their farming to new circumstances, and arranging the building of their local churches. A Country Merchant has some of the characteristics of a biography, is part family history and part local history, with some landscape history. Dyer explores themes in economic and social history without neglecting the religious and cultural background. His central concern is to demonstrate the importance of the peasants' contribution to a changing economy.
Purpose of review To highlight the recent evidence for antibiotic pharmacokinetics and pharmacodynamics (PK/PD) in enhancing patient outcomes in sepsis and septic shock. We also summarise the ...limitations of available data and describe future directions for research to support translation of antibiotic dose optimisation to the clinical setting. Recent findings Sepsis and septic shock are associated with poor outcomes and require antibiotic dose optimisation, mostly due to significantly altered pharmacokinetics. Many studies, including some randomised controlled trials have been conducted to measure the clinical outcome effects of antibiotic dose optimisation interventions including use of therapeutic drug monitoring. Current data support antibiotic dose optimisation for the critically ill. Further investigation is required to evolve more timely and robust precision antibiotic dose optimisation approaches, and to clearly quantify whether any clinical and health-economic benefits support expanded use of this treatment intervention. Summary Antibiotic dose optimisation appears to improve outcomes in critically ill patients with sepsis and septic shock, however further research is required to quantify the level of benefit and develop a stronger knowledge of the role of new technologies to facilitate optimised dosing.
The rapid heating rates (ΔT/δt) achieved in a microwave (MW) reactor has been shown to accelerate reaction rates due to the direct power absorbed (P abs) into the reactants leading to faster ...kinetics. The P abs is proportional to the dielectric cross section of the materials as defined by the real (ε′) and imaginary (ε″) components. In a nanocrystal, the dielectric cross-section will be frequency dependent as well as size dependent. In this work, the frequency dependent growth of nickel nanocrystals at frequencies of 2.45, 15.50, and 18.00 GHz at constant ΔT/δt was studied to evaluate the frequency dependence on MW growth of Ni. A scaling law behavior for growth rates is observed that is shown to depend on the MW electric field strength. A relationship is derived between the “configurational energy” of the precursor molecules and the final nanoparticle size. The study provides a clear description of a microwave effect that is dependent on the frequency and power of the microwave and offers further insight into the physical chemistry of microwave applications to nanomaterial synthesis.
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The desire for designing efficient synthetic methods that lead to industrially important nanomaterials has led a desire to more fully understand the mechanism of growth and how modern synthetic ...techniques can be employed. Microwave (MW) synthesis is one such technique that has attracted attention as a green, sustainable method. The reports of enhancement of formation rates and improved quality for MW driven reactions are intriguing, but the lack of understanding of the reaction mechanism and how coupling to the MW field leads to these observations is concerning. In this manuscript, the growth of a metal nanoparticles (NPs) in a microwave cavity is spectroscopically analyzed and compared with the classical autocatalytic method of NP growth to elucidate the underpinnings for the observed enhanced growth behavior for metal NPs prepared in a MW field. The study illustrates that microwave synthesis of nickel and gold NPs below saturation conditions follows the Finke–Watzky mechanism of nucleation and growth. The enhancement of the reaction arises from the size-dependent increase in MW absorption cross section for the metal NPs. For Ni, the presence of oxides is considered via theoretical computations and compared to dielectric measurements of isolated nickel NPs. The study definitively shows that MW growth can be modeled by an autocatalytic mechanism that directly leads to the observed enhanced rates and improved quality widely reported in the nanomaterial community when MW irradiation is employed.
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Objective: to determine the effect of risk factor modification and balance exercise on falls rates in residential care homes. Design: cluster randomised controlled trial. Participants: 196 residents ...(aged 60 years or over) in 20 residential care homes were enrolled (38% response rate). Homes were randomly allocated to intervention and control arms. A total of 102 residents were consigned to the intervention arm and 94 to the control arm. Intervention: a multifactorial falls prevention programme including 3 months gait and balance training, medication review, podiatry and optometry. Main outcome measures: number of falls/recurrent falls per person, number of medications per person, and change in Tinetti gait and balance measure. Results: in the intervention group there was a mean of 2.2 falls per resident per year compared with 4.0 in the control group; this failed to reach statistical significance (P = 0.2) once the intra-cluster correlation (ICC, 0.10) had been accounted for. Several risk factors were reduced in the intervention arm. Conclusions: falls risk factor reduction is possible in residents of care homes. A modest reduction in falls rates was demonstrated but this failed to reach statistical significance.
Introduction:
Secondary hyperparathyroidism (SHPT) is a complication of chronic kidney disease (CKD). Beyond skeletal complications, uncontrolled SHPT is associated with cardiovascular mortality. ...Vitamin D receptor activators (VDRAs) are a mainstay of therapy for SHPT; however, use is limited by hypercalcemia, though less so with calcitriol analogs such as paricalcitol and there is emerging experience with oral formulations for non-SHPT indications. The role of VDRAs in the treatment of SHPT becomes a complex question as alternative strategies have developed.
Areas covered:
This review summarizes trials that established the safety and efficacy of paricalcitol for SHPT. Comparative experience with paricalcitol as against other VDRAs will be reviewed as will the experience with paricalcitol in non-dialysis CKD and comparative experience with non-VDRA-based therapy.
Expert opinion:
VDRA therapy is considered first-line therapy for treatment of SHPT. Paricalcitol has demonstrated superiority to calcitriol with respect to parathyroid hormone suppression and calcium-phosphorus balance. Oral formulations of paricalcitol appear to be similarly effective for SHPT. While there is evidence to suggest adjunctive antiproteinuria benefit with the use of VDRAs, efficacy of these agents to slow the progression of CKD or to reduce cardiovascular risk has not yet been demonstrated.
Peasants had an important role as poultry keepers in late medieval England. Literary sources and administrative documents show that many rural households provided themselves with at least a cock and ...between 5 and 7 hens. These birds contributed to the subsistence of the household mainly with eggs which supplemented the mainly cereal diet. Occasionally a fowl was eaten for a special meal. A minority of producers maintained a dozen or more fowls, or they kept a flock of geese, capable of yielding a useful income from the market. A few peasants profited from dovecots. Peasant surpluses of birds and eggs were sometimes sold through poulterers who coordinated the trade, supplying the needs of townspeople and the households of the wealthy. Poultry occupied a special place in peasant culture.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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