Europe After Wyclif

This volume brings together scholarship that discusses late-medieval religious controversy on a pan-European scale, with particular attention to developments in England, Bohemia, and at the general councils of the fifteenth century. Controversies such as those that developed in England and Bohemia have received ample attention for decades, and recent scholarship has introduced valuable perspectives and findings to our knowledge of these aspects of European religion, literature, history, and thought. Yet until recently, scholars working on these controversies have tended to work in regional isolation, a practice that has given rise to the impression that the controversies were more or less insular, their significance measured in terms of their local or regional influence

Ophthalmoplegic Migraine and Infundibular Dilatation of a Cerebral Artery

Ophthalmoplegic migraine (OM) is a childhood disorder of uncertain etiology manifesting recurrent unilateral headache associated with a transitory oculomotor (usually IIIrd nerve) palsy. Recent publications emphasize the finding on MRI of contrast enhancement in the IIIrd nerve suggesting that OM may be a recurrent inflammatory neuropathy. We report the case of a 7-year-old boy with typical symptoms of this disorder. Angio MR and Angio CT revealed the presence of an infundibular dilatation of a perforating branch of the posterior cerebral artery adjacent to the symptomatic IIIrd nerve. We speculate that this and perhaps other cases of OM may have a different pathophysiology related to compression of the IIIrd nerve by an adjacent vascular structure that could activate the trigeminovascular system and produce migrainous pain

Perceptions About Hospice From a Community-Based Pilot Study: Lessons and Findings

Research investigating the knowledge and attitudes of diverse older adults about hospice care and end-of-life issues is needed to expand service utilization. This pilot study explored an urban area’s perceptions and awareness of hospice through local churches. The sample consisted of 148 adults age 43 and older. Although recruitment efforts resulted in a relatively homogenous sample, findings suggest a lack of knowledge about whether hospice is covered by Medicare, Medicaid, or private insurance. Perceptions of the expense of hospice, however, were not associated with knowledge of coverage. Respondents generally agreed that hospice is important and would recommend its services for their family members

CGILS Phase 2 LES Intercomparison of Response of Subtropical Marine Low Cloud Regimes to CO2\u3c/sub\u3e Quadrupling and a CMIP3 Composite Forcing Change

© 2016. The Authors. Phase 1 of the CGILS large-eddy simulation (LES) intercomparison is extended to understand if subtropical marine boundary-layer clouds respond to idealized climate perturbations consistently in six LES models. Here the responses to quadrupled carbon dioxide (“fast adjustment”) and to a composite climate perturbation representative of CMIP3 multimodel mean 2×CO2 near-equilibrium conditions are analyzed. As in Phase 1, the LES is run to equilibrium using specified steady summertime forcings representative of three locations in the Northeast Pacific Ocean in shallow well-mixed stratocumulus, decoupled stratocumulus, and shallow cumulus cloud regimes. The results are generally consistent with a single-LES study of Bretherton et al. () on which this intercomparison was based. Both quadrupled CO2 and the composite climate perturbation result in less cloud and a shallower boundary layer for all models in well-mixed stratocumulus and for all but a single LES in decoupled stratocumulus and shallow cumulus, corroborating similar findings from global climate models (GCMs). For both perturbations, the amount of cloud reduction varies across the models, but there is less intermodel scatter than in GCMs. The cloud radiative effect changes are much larger in the stratocumulus-capped regimes than in the shallow cumulus regime, for which precipitation buffering may damp the cloud response. In the decoupled stratocumulus and cumulus regimes, both the CO2 increase and CMIP3 perturbations reduce boundary-layer decoupling, due to the shallowing of inversion height

Optimising integrated stroke care in regional networks:A nationwide self-assessment study in 2012, 2015 and 2019

Background: To help enhance the quality of integrated stroke care delivery, regional stroke services networks in the Netherlands participated in a self-assessment study in 2012, 2015 and 2019. Methods: Coordinators of the regional stroke services networks filled out an online self-assessment questionnaire in 2012, 2015 and 2019. The questionnaire, which was based on the Development Model for Integrated Care, consisted of 97 questions in nine clusters (themes). Cluster scores were calculated as proportions of the activities implemented. Associations between clusters and features of stroke services were assessed by regression analysis. Results: The response rate varied from 93.1% (2012) to 85.5% (2019). Over the years, the regional stroke services networks increased in ‘size’: the median number of organisations involved and the volume of patients per network increased (7 and 499 in 2019, compared to 5 and 364 in 2012). At the same time, fewer coordinators were appointed for more than 1 day a week in 2019 (35.1%) compared to 2012 (45.9%). Between 2012 and 2019, there were statistically significantly more elements implemented in four out of nine clusters: ‘Transparent entrepreneurship’ (MD = 18.0% F(1) = 10.693, p = 0.001), ‘Roles and tasks’ (MD = 14.0% F(1) = 9.255, p = 0.003), ‘Patient-centeredness’ (MD = 12.9% F(1) = 9.255, p = 0.003), and ‘Commitment’ (MD = 11.2%, F(1) = 4.982, p = 0.028). A statistically significant positive correlation was found for all clusters between implementation of activities and age of the network. In addition, the number of involved organisations is associated with better execution of implemented activities for ‘Transparent entrepreneurship’, ‘Result-focused learning’ and ‘Quality of care’. Conversely, there are small but negative associations between the volume of patients and implementation rates for ‘Interprofessional teamwork’ and ‘Patient-centredness’. Conclusion: This long-term analyses of stroke service development in the Netherlands, showed that between 2012 and 2019, integrated care activities within the regional stroke networks increased. Experience in collaboration between organisations within a network benefits the uptake of integrated care activities