Parallel Lives: Sophocles' heroes in the twentieth century

A study of twentieth century adaptations of Sophocles' Antigone, Oedipus Rex, and Philoctetes. Two modern plays are addressed in each chapter: Heaney & Gide, Anouilh & Brecht, Cocteau & Cixous. The topics discussed include the use of Greek tragedy as political metaphor and the impact of that on plot and character, the use of metatheatre, and the role of the chorus

International Veterinary Epilepsy Task Force Consensus Proposal: Diagnostic approach to epilepsy in dogs

This article outlines the consensus proposal on diagnosis of epilepsy in dogs by the International Veterinary Epilepsy Task Force. The aim of this consensus proposal is to improve consistency in the diagnosis of epilepsy in the clinical and research settings. The diagnostic approach to the patient presenting with a history of suspected epileptic seizures incorporates two fundamental steps: to establish if the events the animal is demonstrating truly represent epileptic seizures and if so, to identify their underlying cause. Differentiation of epileptic seizures from other non-epileptic episodic paroxysmal events can be challenging. Criteria that can be used to make this differentiation are presented in detail and discussed. Criteria for the diagnosis of idiopathic epilepsy (IE) are described in a three-tier system. Tier I confidence level for the diagnosis of IE is based on a history of two or more unprovoked epileptic seizures occurring at least 24 h apart, age at epileptic seizure onset of between six months and six years, unremarkable inter-ictal physical and neurological examination, and no significant abnormalities on minimum data base blood tests and urinalysis. Tier II confidence level for the diagnosis of IE is based on the factors listed in tier I and unremarkable fasting and post-prandial bile acids, magnetic resonance imaging (MRI) of the brain (based on an epilepsy-specific brain MRI protocol) and cerebrospinal fluid (CSF) analysis. Tier III confidence level for the diagnosis of IE is based on the factors listed in tier I and II and identification of electroencephalographic abnormalities characteristic for seizure disorders. The authors recommend performing MRI of the brain and routine CSF analysis, after exclusion of reactive seizures, in dogs with age at epileptic seizure onset 6 years, inter-ictal neurological abnormalities consistent with intracranial neurolocalisation, status epilepticus or cluster seizure at epileptic seizure onset, or a previous presumptive diagnosis of IE and drug-resistance with a single antiepileptic drug titrated to the highest tolerable dose

Choice Experiments and Design Decision-Making

There is a growing interest in evidence-based design in landscape architecture. This is an exploratory study of the choice experiment method: an economic approach used by many other disciplines but not yet landscape architecture, to collect empirical evidence on the public's preferences for different landscape design characteristics. A choice experiment was conducted for an open space development in downtown Baltimore. The outcomes of the experiment provided a basis for the design of a downtown surface parking lot into a public open space. Design decisions were made with better clarity and confidence that the design solution could maximize utility and value to the public

The evaluation of undergraduate nurses’ attitudes, perspectives and perceptions toward older people

This literature review was undertaken to evaluate undergraduate nurses' attitudes and perspectives toward older people and perceptions of working with older people. The objectives were to (1) identify if undergraduate nurses hold positive or negative attitudes and perspectives toward older people and perceptions of working with older people, and (2) determine if positive attitudes, perspectives and perceptions can be established, maintained and improved with curriculum activities.Literature review.For the period 2008-2013, the literature search included an electronic database search (Medline, CINAHL, Healthsource/Academic Edition, PsycINFO and PubMed) and a hand search of reference lists of the papers included.The analysis of 32 studies revealed that undergraduate nurses' attitudes, perspectives and perceptions are positive and it is recommended that this be the starting point for the development of curriculum activities and future research to maintain and improve this result. Finally, the limitations of recent studies are identified and a research agenda for future studies is proposed

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Sepsis-related deaths in the at-risk population on the wards: attributable fraction of mortality in a large point-prevalence study

Objective Sepsis mortality is reported to be high worldwide, however recently the attributable fraction of mortality due to sepsis (AFsepsis) has been questioned. If improvements in treatment options are to be evaluated, it is important to know what proportion of deaths are potentially preventable or modifiable after a sepsis episode. The aim of the study was to establish the fraction of deaths directly related to the sepsis episode on the general wards and emergency departments. Results 839 patients were recruited over the two 24-h periods in 2016 and 2017. 521 patients fulfilled SEPSIS-3 criteria. 166 patients (32.4%) with sepsis and 56 patients (17.6%) without sepsis died within 90 days. Out of the 166 sepsis deaths 12 (7.2%) could have been directly related to sepsis, 28 (16.9%) possibly related and 96 (57.8%) were not related to sepsis. Overall AFsepsis was 24.1%. Upon analysis of the 40 deaths likely to be attributable to sepsis, we found that 31 patients (77.5%) had the Clinical Frailty Score ≥ 6, 28 (70%) had existing DNA-CPR order and 17 had limitations of care orders (42.5%)

Activity theory, complexity and sports coaching: An epistemology for a discipline

The aim of this article is two-fold. Firstly, it is to advance the case for Activity Theory (AT) as a credible and alternative lens to view and research sports coaching. Secondly, it is to position this assertion within the wider debate about the epistemology of coaching. Following a framing introduction, a more comprehensive review of the development and current conceptualisation of AT is given. Here, AT’s evolution through three distinct phases and related theorists, namely Vygotsky, Leont’ev and Engeström, is initially traced. This gives way to a more detailed explanation of AT’s principal conceptual components, including ‘object’, ‘subject’, ‘tools’ (mediating artefacts), ‘rules’, a ‘community’ and a ‘division of labour’. An example is then presented from empirical work illustrating how AT can be used as a means to research sports coaching. The penultimate section locates such thinking within coaching’s current ‘epistemological debate; arguing that the coaching ‘self’ is not an autonomous individual, but a relative part of social and cultural arrangements. Finally, a conclusion summarises the main points made, particularly in terms in presenting the grounding constructivist epistemology of AT as a potential way forward for sports coaching

Red-flag sepsis and SOFA identifies different patient population at risk of sepsis-related deaths on the general ward

Controversy exists regarding the best diagnostic and screening tool for sepsis outside the intensive care unit (ICU). Sequential organ failure assessment (SOFA) score has been shown to be superior to systemic inflammatory response syndrome (SIRS) criteria, however, the performance of “Red Flag sepsis criteria” has not been tested formally. The aim of the study was to investigate the ability of Red Flag sepsis criteria to identify the patients at high risk of sepsis-related death in comparison to SOFA based sepsis criteria. We also investigated the comparison of Red Flag sepsis to quick SOFA (qSOFA), SIRS, and national early warning score (NEWS) scores and factors influencing patient mortality. Patients were recruited into a 24-hour point-prevalence study on the general wards and emergency departments across all Welsh acute hospitals. Inclusion criteria were: clinical suspicion of infection and NEWS 3 or above in-line with established escalation criteria in Wales. Data on Red Flag sepsis and SOFA criteria was collected together with qSOFA and SIRS scores and 90-day mortality. 459 patients were recruited over a 24-hour period. 246 were positive for Red Flag sepsis, mortality 33.7% (83/246); 241 for SOFA based sepsis criteria, mortality 39.4% (95/241); 54 for qSOFA, mortality 57.4% (31/54), and 268 for SIRS, mortality 33.6% (90/268). 55 patients were not picked up by any criteria. We found that older age was associated with death with OR (95% CI) of 1.03 (1.02–1.04); higher frailty score 1.24 (1.11–1.40); DNA-CPR order 1.74 (1.14–2.65); ceiling of care 1.55 (1.02–2.33); and SOFA score of 2 and above 1.69 (1.16–2.47). The different clinical tools captured different subsets of the at-risk population, with similar sensitivity. SOFA score 2 or above was independently associated with increased risk of death at 90 days. The sequalae of infection-related organ dysfunction cannot be reliably captured based on routine clinical and physiological parameters alone

Australian youth work education: Curriculum renewal and a model for sustainability for niche professions

The four main purposes of this project were to: • Renew the curriculum for Australian youth work professional education, applying the approach to curriculum outlined by Barnett and Coate (2005) • Investigate the potential for cross-institutional sharing of courseware and educational materials that will facilitate future benchmarking, inter-sectoral and inter-professional pathways, and international qualification recognition • Promote long-term change through the establishment of a cross-sectoral youth work educators network • Suggest starting points for a sustainability model for other niche professions