History and Theology in the Writings of the Chronicler

It would seem as if the Greek title of the two books of Chronicles, Ta Paraleipomena (“The things omitted ) has left a certain legacy of doubt about the value of the work of the Chronicler. In liturgical use as well as in reconstructions of the history, particularly those of a more conservative kind, the tendency has often been for passages from 1 and 2 Chronicles to be inserted or utilized at what appear to be appropriate places when Samuel and Kings are being read or the history of that period is being surveyed, by way of supplementing the material covered in those books

High country river processes : a technical discussion of results from research on the Kowai River system, Springfield, Canterbury

A sub-catchment (Torlesse Stream) of the Kowai River, Canterbury, has been the site of an interdisciplinary study of the relationships between erosion and stream sedimentation (Hayward 1975). It was logical to extend the stream sediment investigation of that study (Hayward 1978) into the Kowai system proper in order to establish changes in the nature and distribution of the stream sediments with distance downstream. The sediment sampling study, comprising Part I of Paper A in this volume, analyses the changes in size, distribution, form and rock type of the river gravels from ahead water mountain stream to the wide braided river beds of the middle reaches of the Kowai River. Part 2 of Paper A discusses the possible implications for the management that these sediment studies have for this and other similar river systems. It is believed that if thought necessary it is possible to design a river training programme to guide the river towards a more manageable pattern. Paper B of this volume compares the results of the present river gravel survey with those from a sedimentological analysis of fluvio-glacial outwash gravels deposited several thousand years ago within the lower reaches of the Kowai system. This comparative study is used to indicate differences in the hydrologic environment prevailing at their respective times of deposition, and aids in our understanding of the processes at work in hill and high country rivers today. Both Papers A and B relate to the Kowai River system, but the authors wish to emphasise that the findings from these studies are believed to have application to other similar gravel bed river systems

‘Lower than a Snake’s Belly’ : Discursive Constructions of Dignity and Heroism in Low-Status Garbage Work

In this paper, we consider how dignity is discursively constructed in the context of work dominated by physicality and dirt. Based on semi-structured interviews with garbage workers, our analysis considers how the deprivations they experience are cast through discourses intended to construct their individual and collective worth. We consider the manner in which dignity maybe denied to such workers through popular repudiations of individuality and status. We demonstrate how this positioning arises from contact with physical dirt, and associations with socially dirty work based on ascriptions of servility, abuse and ambivalence. We go on to consider how garbage workers respond to this positioning through discourses of ‘everyday heroism’. Heroism is evoked through three interrelated narratives that speaks to a particular type of masculinity. The first takes the form of a classic process of reframing and recalibration through which workers not only renegotiate their public position and status, but also point to the inherent value to be had in working with dirt as part of that which we identify as a process of ‘affirmation’. The second narrative arises from the imposition of favourable social and occupational comparisons that effectively elevate garbage collectors’ social position. The third discourse—and previously unobserved in respect of garbage work—centres on paternalistic practices of care. Combined, these discourses disrupt the generally held view that dirty work is antithetical to heroism and wounds dignity

Isolated patellofemoral osteoarthritis: A systematic review of treatment options using the GRADE approach

Background and purpose The optimal treatment for isolated patellofemoral osteoarthritis is unclear at present. We systematically reviewed the highest level of available evidence on the nonoperative and operative treatment of isolated patellofemoral osteoarthritis to develop an evidenced-based discussion of treatment options

The Human Capital Hoax: Work, Debt and Insecurity in the Era of Uberization

Human capital theory - developed by neoclassical economists like Gary Becker and Theodore Schultz – is widely considered a useful way to explain how employees might enhance their value in organizations, leading to improved skill, autonomy and socio-economic wellbeing. This essay argues the opposite. Human capital theory implies that employees should bear the costs (and benefits) of their investment. Highly individualized training and work practices are an inevitable corollary. Self-employment, portfolio careers, the ‘gig economy’ and ondemand business models (including Uber and Deliveroo) faithfully reflect the assumptions that inform human capital theory. I term this the radical responsibilization of the workforce and link it to growing economic insecurity, low productivity, diminished autonomy and worrying levels of personal debt. The essay concludes by proposing some possible solutions

The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with >80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes

Understanding staff perspectives of quality in practice in healthcare

BACKGROUND: Extensive work has been focussed on developing and analysing different performance and quality measures in health services. However less has been published on how practitioners understand and assess performance and the quality of care in routine practice. This paper explores how health service staff understand and assess their own performance and quality of their day to day work. Asking staff how they knew they were doing a good job, it explored the values, motivations and behaviours of staff in relation to healthcare performance. The paper illustrates how staff perceptions of quality and performance are often based on different logics to the dominant notions of performance and quality embedded in current policy. METHODS: Using grounded theory and qualitative, in-depth interviews this research studied how primary care staff understood and assessed their own performance and quality in everyday practice. 21 people were interviewed, comprising of health visitors, occupational therapists, managers, human resources staff and administrators. Analytic themes were developed using open and axial coding. RESULTS: Diverse aspects of quality and performance in healthcare are rooted in differing organisational logics. Staff values and personal and professional standards are an essential element in understanding how quality is co-produced in everyday service interactions. Tensions can exist between patient centred, relational care and the pressures of efficiency and rationalisation. CONCLUSIONS: Understanding the perspectives of staff in relation to how quality in practice develops helps us to reflect on different mechanisms to manage quality. Quality in everyday practice relies upon staff values, motivations and behaviours and how staff interact with patients, putting both explicit and tacit knowledge into specific action. However organisational systems that manage quality often operate on the basis of rational measurement. These do not always incorporate the intangible, relational and tacit dimensions of care. Management models need to account for these relational and experiential aspects of care quality to support the prioritisation of patients’ needs. Services management, knowledge management and ethics of care literature can provide stronger theoretical building blocks to understand how to manage quality in practice. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-015-0788-1) contains supplementary material, which is available to authorized users

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Exile and restoration: A Study of Hebrew thought of the sixth century B.C.

Philadelphiaxv, 286 p.: bibl., index; 21 cm

I & II Chronicles, Ezra, Nehemiah

London320 p.; 19 cm