Covering the Dead in Later Prehistoric Britain: Elusive Objects and Powerful Technologies of Funerary Performance

This paper examines the containment and covering of people and objects in burials throughout later prehistory in Britain. Recent analyses of grave assemblages with exceptionally well-preserved organic remains have revealed some of the particular roles played by covers in funerary contexts. Beyond these spectacular examples, however, the objects involved in covering and containing have largely been overlooked. Many of the ‘motley crew’ of pots and stones used to wrap, cover, and contain bodies (and objects) were discarded or destroyed by antiquarian investigators in their quest for more immediately dazzling items. Organic containers and covers – bags, coffins, shrouds, blankets – are rarely preserved. Our study brings together the diverse and often elusive objects that played a part in covering and containing prehistoric burials, including items that directly enclosed bodies and objects, and those that potentially pinned together (now mostly absent) organic wraps. Overall, we contend, wrapping, covering, and containing were significantly more prevalent in prehistoric funerary practices than has previously been recognised.AHR

A New Large †Pachycormiform (Teleosteomorpha: †Pachycormiformes) from the Lower Jurassic of Germany, with Affinities to the Suspension-Feeding Clade, and Comments on the Gastrointestinal Anatomy of Pachycormid Fishes

Pachycormiformes is a diverse clade of stem-teleost actinopterygian fishes with a stratigraphic range from the Lower Jurassic (Toarcian) to Upper Cretaceous (Maastrichtian). The Toarcian Posidonienschiefer Formation in SW Germany records the earliest occurrence of †Pachycormiformes in the fossil record, offering unique and crucial insight into the clade’s origins and early adaptive radiation in the Early Jurassic. However, Early Jurassic taxa remain poorly studied with the taxonomic diversity and stratigraphic/geographic distributions insufficiently defined, thus masking the early part of this evolutionary radiation. Here, we report a new genus and species of pachycormid fish from the Posidonienschiefer Formation identified by phylogenetic analysis as falling in an intermediate position between Saurostomus and Ohmdenia at the base of the suspension-feeding clade. The new taxon shows a unique suite of cranial and postcranial characters. Several synapomorphies of the suspension-feeding clade, notably, the morphology of the hyomandibula, elongation of the skull, and reduced squamation are shared with the new taxon. The intestinal tract is exceptionally preserved, providing one of the most complete examples of pachycormid gastric anatomy. A comparison of the gastrointestinal anatomy of the new genus with other pachycormiforms indicates extensive taxonomic variation within the clade, in the configuration of both the midgut and spiral valve, potentially related to trophic divergence. The results highlight an underestimated high diversity and the rapid acquisition of trophic specializations in Pachycormiformes much earlier in the clade’s evolution than previously considered

Findings from an online survey of family carer experience of the management of challenging behaviour in people with intellectual disabilities, with a focus on the use of psychotropic medication

Background: There is relatively little published data that report the experiences and views of family carers of people with intellectual disabilities who display challenging behaviour who are prescribed psychotropic medication. / Materials and methods: An online structured questionnaire was created by the Challenging Behaviour Foundation, a UK charity, and family carers of people with intellectual disability. Questions concerned the management of challenging behaviour and asked family carers about their experiences and views on the use of psychotropic medication. Responses were gathered between August and October 2016. Results are summarised using descriptive and inferential statistics and descriptive analysis of free‐text comments. / Findings: Ninety‐nine family carers completed the survey. Family carers reported gaps in the holistic and proactive management of challenging behaviour. Whilst some felt involved in decisions around psychotropic medication prescribing, others described feeling marginalised and lacking information and influence. The decision to prescribe psychotropic medication evoked complex emotions in family carers and medication use was associated with mixed outcomes in those prescribed. Family carers identified areas of good practice and those areas where they believe improvements are needed. / Conclusions: Psychotropic medication should be only one option in a multimodal approach to challenging behaviour, but this may not always be reflected in current practice. Greater effort needs to be made to ensure that services are equipped to provide optimum care and to embed shared decision‐making into routine practice

CD4 cell responses to combination antiretroviral therapy in patients starting therapy at high CD4 cell counts

Objective: To examine CD4 cell responses to combination antiretroviral therapy (cART) in patients enrolled in the Australian HIV Observational Database who commenced cART at CD4 cell counts >350 cells per microliter. Methods: CD4 cell counts were modelled using random effects, repeated measurement models in 432 HIV-infected adults from Australian HIV Observational Database who commenced their first cART regimen and had a baseline CD4 count >350 cells per microliter. Using published AIDS and/or death incidence rates combined with the data summarized by time and predicted CD4 cell count, we calculated the expected reduction in risk of an event for different starting baseline CD4 strata. Results: Mean CD4 counts increased above 500 cells per microliter in all baseline CD4 strata by 12 months (means of 596, 717, and 881 cells/μL in baseline CD4 strata 351-500, 501-650, and >650 cells/μL, respectively) and after 72 months since initiating cART, mean CD4 cell counts (by increasing baseline CD4 strata) were 689, 746, 742 cells per microliter. The expected reduction in risk of mortality for baseline CD4 counts >650 cells per microliter relative to 351-500 cells per microliter was approximately 8%, an absolute risk reduction 0.33 per 1000 treated patient-years. Conclusions: Patients starting cART at high CD4 cell counts (>650 cells/μL) tend to maintain this immunological level over 6 years of follow-up. Patients starting from 351 to 500 CD4 cells per microliter achieve levels of >650 cells per microliter after approximately 3 years of cART. Initiating cART with a baseline CD4 count 501-650 or >650 cells per microliter relative to 351-500 cells per microliter indicated a minimal reduction in risk of AIDS incidence and/or death. Copyright © 2011 Lippincott Williams & Wilkins

The effect of moving to East Village, the former London 2012 Olympic and Paralympic Games Athletes' Village, on mode of travel (ENABLE London study, a natural experiment)

Background Interventions to encourage active modes of travel (walking, cycling) may improve physical activity levels, but longitudinal evidence is limited and major change in the built environment / travel infrastructure may be needed. East Village (the former London 2012 Olympic Games Athletes Village) has been repurposed on active design principles with improved walkability, open space and public transport and restrictions on residential car parking. We examined the effect of moving to East Village on adult travel patterns. Methods One thousand two hundred seventy-eight adults (16+ years) seeking to move into social, intermediate, and market-rent East Village accommodation were recruited in 2013–2015, and followed up after 2 years. Individual objective measures of physical activity using accelerometry (ActiGraph GT3X+) and geographic location using GPS travel recorders (QStarz) were time-matched and a validated algorithm assigned four travel modes (walking, cycling, motorised vehicle, train). We examined change in time spent in different travel modes, using multilevel linear regresssion models adjusting for sex, age group, ethnicity, housing group (fixed effects) and household (random effect), comparing those who had moved to East Village at follow-up with those who did not. Results Of 877 adults (69%) followed-up, 578 (66%) provided valid accelerometry and GPS data for at least 1 day (≥540 min) at both time points; half had moved to East Village. Despite no overall effects on physical activity levels, sizeable improvements in walkability and access to public transport in East Village resulted in decreased daily vehicle travel (8.3 mins, 95%CI 2.5,14.0), particularly in the intermediate housing group (9.6 mins, 95%CI 2.2,16.9), and increased underground travel (3.9 mins, 95%CI 1.2,6.5), more so in the market-rent group (11.5 mins, 95%CI 4.4,18.6). However, there were no effects on time spent walking or cycling

Exploring the Ambulatory Transitional Care Experience from Residential Aged Care Facilities (RACF) to Ambulatory Care Services

Objective(s): To explore the transitional care journey through Ambulatory care Services (ACS) for older residents from Residential Aged Care Facilities (RACF). To develop a clearer understanding of older residents needs and any gaps in current services provided; and to inform the development of a model of care to improve the resident’s transitional care journey Study Design: A qualitative project design using extensive stakeholder engagement Method: The Ambulatory Care (AC) experience was explored through semi-structured interviews with residents and their carers to determine gaps in transitional care continuity. Focus groups with RACF and ACS staff were also utilized. Journey mapping was used to support anecdotal evidence. Results: Three residents and 2 carers were interviewed and a total of 40 RACF and ACS staff attended 5 focus groups. Principal Findings: Qualitative data analysis identified four main themes across the transition journey: Inconsistent and adhoc communication; Just waiting around; Is it doing more harm than good?; and Unmet expectations.Conclusion: The results of this study have highlighted shortcomings in the provision of quality care in this transitional care group of older clients. A collaborative approach across organizational boundaries is necessary to ensure the development of an integrated person centered model to ensure the best transition to ambulatory care for RACF residents exists

The Physics and Mathematics of the Second Law of Thermodynamics

The essential postulates of classical thermodynamics are formulated, from which the second law is deduced as the principle of increase of entropy in irreversible adiabatic processes that take one equilibrium state to another. The entropy constructed here is defined only for equilibrium states and no attempt is made to define it otherwise. Statistical mechanics does not enter these considerations. One of the main concepts that makes everything work is the comparison principle (which, in essence, states that given any two states of the same chemical composition at least one is adiabatically accessible from the other) and we show that it can be derived from some assumptions about the pressure and thermal equilibrium. Temperature is derived from entropy, but at the start not even the concept of `hotness' is assumed. Our formulation offers a certain clarity and rigor that goes beyond most textbook discussions of the second law.Comment: 93 pages, TeX, 8 eps figures. Updated, published version. A summary appears in Notices of the Amer. Math. Soc. 45 (1998) 571-581, math-ph/980500