Les privilèges des métiers, l’intégration verticale et l’organisation de la production des textiles de soie à Paris aux xiiie et xive siècles

L’industrie de la soie dans le Paris médiéval a deux hiérarchies : celle des privilèges corporatifs, qui accorde aux merciers la plus grande autonomie dans l’administration du métier et aux fileuses le moins d’autonomie, et la hiérarchie de l’organisation de la production, qui donne aux merciers le contrôle vertical de la filière sur les fileuses et les femmes qui tissent des couvre-chefs, mais pas sur les teinturiers, les hommes fabricant des tissus en soie et faisant de petits articles de mercerie. Néanmoins, en dépit de l’indépendance de beaucoup de métiers de la soie, le prévôt de Paris accorda en 1324 aux merciers la police sur l’ensemble de la filière.The silk industry of medieval Paris had two hierarchies : that of guild privileges, which gave the mercers the greatest amount of self-governing autonomy and the throwsters the least amount of self-governing autonomy ; and that of the organisation of production, which gave the mercers vertical control over the throwsters and the women who wove headcoverings but not over the dyers, male weavers of silk cloth, and makers of small mercery goods. Nevertheless, despite the independence of many of the silk crafts, in 1324 the royal provost granted the mercers policing authority over all of those groups

Determining Wastewater User Service Charge Rates

Good financial management is a critical part of all wastewater operations. It allows you to establish the user service charge rates necessary to keep your utility financially healthy and running smoothly. This publication was designed to help small to medium-sized wastewater utility operations decide how much they should be charging their residential, commercial, and industrial customers for wastewater services. It includes a Lotus 1-2-3 computer model program and manual procedures to help you calculate specific values for your system\u27s user service charges. [The computer program referenced throughout this document is not available.

Clustering populations by health and social care with multiple long-term conditions: a cohort study - the English Longitudinal Study of Ageing (ELSA)

Background The integration of health and social care services is a potential solution for improving care, despite monetary constraints and increasing demand. How two or more multiple long-term conditions (MLTC) cluster, interact and associate with socioeconomic factors, and affect access to unscheduled primary healthcare services is understudied. Aim To cluster an MLTC population by health and social care, examine clusters, and quantify associations with health outcomes. Method A retrospective cohort study was conducted using the ELSA database (2002 to 2019) on 19802 participants aged ≥50 years. Ten major health conditions, and social care need, including difficulty in activities of daily living (ADL) and mobility, for example, were used to cluster MLTC by latent class modelling. Multivariate logistic regression models were used to establish further association. Results The mean age of the participants at baseline (wave 2) was about 66 years and 55% of participants were female, with more than 60% developing MLTC in their lifetime (waves 2 to 9). Of the five distinct latent clusters, cluster 5 was the most significant cluster composed of lung diseases, stroke, dementia, and high ADL and mobility difficulty scores. The majority of the participants were aged 70–79 years, female, and married. The odds of having a longer nursing home stay were 8.97 (95% confidence interval = 4.36 to 18.45), and death was 10% higher in this cluster compared to the highest probability cluster 4 in the maximally adjusted regression model. Conclusion This study identified MLTC clusters by social care need with the highest primary care demand. Targeting clinical practice to prevent MLTC progression for these groups may lessen future pressures on primary care demand

Koinonia

Best Practices FeaturesStudents of Concern Committee: Coordinating Care, Connie Horton and Mark Davis Want to Change Student Culture on Your Campus? Do the CORE!, Eric Lowdermilk Spotlight FeaturesYou Only Get 1 Up, Justin Heth and Caleb Farmer The Season, Sharon Virkler Book ReviewsThe Future of Christian Learning: An Evangelical and Catholic Dialogue (by Mark Noll and James Turner), reviewed by Philip D. Byers Restoring Rebecca: A Story of Traumatic Stress, Caregiving and the Unmasking of a Superhero (by Christopher Marchand), reviewed by David M. Johnstone A Review of Culture Making: Recovering our Creative Calling (by Andy Crouch), reviewed by Jeff Rioux Revisiting How Minority Students Experience College: Implications for Planning and Policy (by LKemuel Watson, Melvin Terrell, Doris Wright, Fred Bonner II, Michael Cuyjet, James Gold, Donna Rudy and Dawn Person), reviewed by Joshua Canada Excerpts from Breathe: Finding Freedom to Thrive in Relationships after Childhood Sexual Abuse, Nicole Braddock Bromley ReflectionsMy Journey into Student Affairs, Kim Stave FeaturesThe President\u27s Corner Editor\u27s Deskhttps://pillars.taylor.edu/acsd_koinonia/1079/thumbnail.jp

Sensitivity and specificity of the ECAS in Parkinson’s disease and Progressive Supranuclear Palsy

Disentangling Parkinson’s disease (PD) and progressive supranuclear palsy (PSP) may be a diagnostic challenge. Cognitive signs may be useful, but existing screens are often insufficiently sensitive or unsuitable for assessing people with motor disorders. We investigated whether the newly developed ECAS, designed to be used with people with even severe motor disability, was sensitive to the cognitive impairment seen in PD and PSP and able to distinguish between these two disorders. Thirty patients with PD, 11 patients with PSP, and 40 healthy controls were assessed using the ECAS, as well as an extensive neuropsychological assessment. The ECAS detected cognitive impairment in 30% of the PD patients, all of whom fulfilled the diagnostic criteria for mild cognitive impairment. The ECAS was also able to detect cognitive impairment in PSP patients, with 81.8% of patients performing in the impaired range. The ECAS total score distinguished between the patients with PSP and healthy controls with high sensitivity (91.0) and specificity (86.8). Importantly, the ECAS was also able to distinguish between the two syndromes, with the measures of verbal fluency offering high sensitivity (82.0) and specificity (80.0). In sum, the ECAS is a quick, simple, and inexpensive test that can be used to support the differential diagnosis of PSP

Baseline characteristics of people experiencing homelessness with a recent drug overdose in the PHOENIx pilot randomised controlled trial

Background: Drug-related deaths in Scotland are the highest in Europe. Half of all deaths in people experiencing homelessness are drug related, yet we know little about the unmet health needs of people experiencing homelessness with recent non-fatal overdose, limiting a tailored practice and policy response to a public health crisis. Methods: People experiencing homelessness with at least one non-fatal street drug overdose in the previous 6 months were recruited from 20 venues in Glasgow, Scotland, and randomised into PHOENIx plus usual care, or usual care. PHOENIx is a collaborative assertive outreach intervention by independent prescriber NHS Pharmacists and third sector homelessness workers, offering repeated integrated, holistic physical, mental and addictions health and social care support including prescribing. We describe comprehensive baseline characteristics of randomised participants. Results: One hundred and twenty-eight participants had a mean age of 42 years (SD 8.4); 71% male, homelessness for a median of 24 years (IQR 12–30). One hundred and eighteen (92%) lived in large, congregate city centre temporary accommodation. A quarter (25%) were not registered with a General Practitioner. Participants had overdosed a mean of 3.2 (SD 3.2) times in the preceding 6 months, using a median of 3 (IQR 2–4) non-prescription drugs concurrently: 112 (87.5%) street valium (benzodiazepine-type new psychoactive substances); 77 (60%) heroin; and 76 (59%) cocaine. Half (50%) were injecting, 50% into their groins. 90% were receiving care from Alcohol and Drug Recovery Services (ADRS), and in addition to using street drugs, 90% received opioid substitution therapy (OST), 10% diazepam for street valium use and one participant received heroin-assisted treatment. Participants had a mean of 2.2 (SD 1.3) mental health problems and 5.4 (SD 2.5) physical health problems; 50% received treatment for physical or mental health problems. Ninety-one per cent had at least one mental health problem; 66% had no specialist mental health support. Participants were frail (70%) or pre-frail (28%), with maximal levels of psychological distress, 44% received one or no daily meal, and 58% had previously attempted suicide. Conclusions: People at high risk of drug-related death continue to overdose repeatedly despite receiving OST. High levels of frailty, multimorbidity, unsuitable accommodation and unmet mental and physical health care needs require a reorientation of services informed by evidence of effectiveness and cost-effectiveness. Trial registration UK Clinical Trials Registry identifier: ISRCTN 10585019