A reading of the novels of James Courage : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in English at Massey University

Pages 132-142 – Best copy available.This thesis examines in detail the eight novels of James Courage (1903- 1963) expatriate New Zealand novelist. The Introduction provides some biographical details of the author's family, his early life in Canterbury province, and his subsequent years in England. The case is made for seeing each of Courage's novels as part of a developing canon of work in which the themes of family relationships and the ongoing struggle for the child to break free of emotional ties with the parents constantly recur and are imaginatively reworked. The relationship between the mother and son is seen to be of particular concern to the author. While some other literary influences are considered, especially that of D.H. Lawrence, the ideas of Sigmund Freud are seen as a major influence on Courage's thinking about primal relationships between parent and child, and about the establishment of sexual orientation. Some possible reasons for Courage's decision to live in England rather than New Zealand are suggested. The attempt is made to justify seeing the author as a "New Zealand" novelist in spite of his expatriate status. In this process of justification the ideas of H.S. Canby and LA, Gordon on the relationship between literature and national identity are also discussed. Courage is claimed to be a New Zealand rather than an English writer on the basis of his birth, his use of New Zealand settings in so many of his novels, the constant reworking of his early experiences in this country and his portrayal of the small but distinctive section of New Zealand society which he knew so well. In as much as Courage does seem to fictionalise his own experience his novels are seen as having a biographical basis, although the extent to which this is so cannot yet be determined until primary sources of biographical information become available. Following the introductory chapter separate chapters are devoted to full discussion of each novel, working in chronological order from the first, One House (1933), to the last, The Visit to Penmorten (1961 ). Salient features of each novel are discussed and illustrated with references to each text: the points considered fall into the two categories of mechanical considerations such as plotting, characterisation, setting, dialogue, symbolism, and so on, and themes. Links between the novels, particularly in the treatment and development of recurrent themes, are highlighted. It is demonstrated that Courage's novels show his ever­ increasing skill as a novelist and his growing self-confidence in treating of new or controversial themes, as well as the persistence of minor stylistic faults, especially the tendency to use melodramatic or self­ conscious dialogue in emotionally-charged scenes. The chapter devoted to discussion of A Way of Love focuses on Courage's unique status in New Zealand literature as the author of the first full- length novel to deal with the theme of homosexuality sensitively and realistically. The discussion involves consideration of the critical and bureaucratic reception of this novel in New Zealand at the time of its publication. Discussion of this novel and its successor includes looking at the ways in which James Courage was an innovative novelist. These include his concern in the fiction with the actual process of producing the fiction --a concern which is strikingly post-modern--and his use of detached, ironic black humour. The Conclusion points to areas of James Courage's life and writing in which further study remains to be done. The two Appendices contain useful material, much of it hitherto unpublished, regarding the publication of the novels and circumstances surrounding the "banning" of A Way of Love by the New Zealand authorities in the early nineteen-sixties

Deaths from Norovirus among the Elderly, England and Wales

Norovirus may be associated with ≈80 deaths/year

Progress and challenges in coupled hydrodynamic-ecological estuarine modeling

© The Author(s), 2015. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Estuaries and Coasts 39 (2016): 311-332, doi:10.1007/s12237-015-0011-y.Numerical modeling has emerged over the last several decades as a widely accepted tool for investigations in environmental sciences. In estuarine research, hydrodynamic and ecological models have moved along parallel tracks with regard to complexity, refinement, computational power, and incorporation of uncertainty. Coupled hydrodynamic-ecological models have been used to assess ecosystem processes and interactions, simulate future scenarios, and evaluate remedial actions in response to eutrophication, habitat loss, and freshwater diversion. The need to couple hydrodynamic and ecological models to address research and management questions is clear because dynamic feedbacks between biotic and physical processes are critical interactions within ecosystems. In this review, we present historical and modern perspectives on estuarine hydrodynamic and ecological modeling, consider model limitations, and address aspects of model linkage, skill assessment, and complexity. We discuss the balance between spatial and temporal resolution and present examples using different spatiotemporal scales. Finally, we recommend future lines of inquiry, approaches to balance complexity and uncertainty, and model transparency and utility. It is idealistic to think we can pursue a “theory of everything” for estuarine models, but recent advances suggest that models for both scientific investigations and management applications will continue to improve in terms of realism, precision, and accuracy.NKG, ALA, and RPS acknowledge support from the USGS Coastal and Marine Geology Program. DKR gratefully acknowledges support from NSF (OCE-1314642) and NIEHS (1P50-ES021923-01). MJB and JMPV gratefully acknowledge support from NOAA NOS NCCOS (NA05NOS4781201 and NA11NOS4780043). MJB and SJL gratefully acknowledge support from the Strategic Environmental Research and Development Program—Defense Coastal/Estuarine Research Program (RC-1413 and RC-2245)

An analysis of returned medicines in primary care

Objective: The number of pharmaceutical items issued on prescription is continually rising and contributing to spiralling healthcare costs. Although there is some data highlighting the quantity, in terms of weight of medicines returned specifically to community pharmacies, little is known about the specific details of such returns or other destinations for wasted medications. This pilot study has been designed to investigate the types and amounts of medicines returned to both general practices (GPs) and associated local community pharmacies determining the reasons why these medicines have been returned. Method: The study was conducted in eight community pharmacies and five GP surgeries within East Birmingham over a 4-week period. Main outcome Measure: Reason for return and details of returned medication. Results: A total of 114 returns were made during the study: 24 (21.1) to GP surgeries and 90 (78.9) to community pharmacies. The total returns comprised 340 items, of which 42 (12.4) were returned to GPs and 298 (87.6) to pharmacies, with the mean number of items per return being 1.8 and 3.3, respectively. Half of the returns in the study were attributed to the doctor changing or stopping the medicine; 23.7 of returns were recorded as excess supplies or clearout often associated with patients' death and 3.5 of returns were related to adverse drug reactions. Cardiovascular drugs were most commonly returned, amounting to 28.5 of the total drugs returned during the study. Conclusions: The results from this pilot study indicate that unused medicines impose a significant financial burden on the National Health Service as well as a social burden on the United Kingdom population. Further studies are examining the precise nature of returned medicines and possible solutions to these issues. © Springer 2005

Sediment dispersal in the northwestern Adriatic Sea

Author Posting. © American Geophysical Union, 2008. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 113 (2008): C11S03, doi:10.1029/2006JC003868.Sediment dispersal in the Adriatic Sea was evaluated using coupled three-dimensional circulation and sediment transport models, representing conditions from autumn 2002 through spring 2003. The calculations accounted for fluvial sources, resuspension by waves and currents, and suspended transport. Sediment fluxes peaked during southwestward Bora wind conditions that produced energetic waves and strengthened the Western Adriatic Coastal Current. Transport along the western Adriatic continental shelf was nearly always to the south, except during brief periods when northward Sirocco winds reduced the coastal current. Much of the modeled fluvial sediment deposition was near river mouths, such as the Po subaqueous delta. Nearly all Po sediment remained in the northern Adriatic. Material from rivers that drain the Apennine Mountains traveled farther before deposition than Po sediment, because it was modeled with a lower settling velocity. Fluvial sediment delivered to areas with high average bed shear stress was more highly dispersed than material delivered to more quiescent areas. Modeled depositional patterns were similar to observed patterns that have developed over longer timescales. Specifically, modeled Po sediment accumulation was thickest near the river mouth with a very thin deposit extending to the northeast, consistent with patterns of modern sediment texture in the northern Adriatic. Sediment resuspended from the bed and delivered by Apennine Rivers was preferentially deposited on the northern side of the Gargano Peninsula, in the location of thick Holocene accumulation. Deposition here was highest during Bora winds when convergences in current velocities and off-shelf flux enhanced delivery of material to the midshelf.The authors are grateful for funding and support from the Office of Naval Research’s Coastal Geosciences and Marine Modeling programs, the U.S. Geological Survey, and NATO’s SACLANT-CEN

Evaluating the potential for the environmentally sustainable control of foot and mouth disease in Sub-Saharan Africa

Strategies to control transboundary diseases have in the past generated unintended negative consequences for both the environment and local human populations. Integrating perspectives from across disciplines, including livestock, veterinary and conservation sectors, is necessary for identifying disease control strategies that optimise environmental goods and services at the wildlife-livestock interface. Prompted by the recent development of a global strategy for the control and elimination of foot-and-mouth disease (FMD), this paper seeks insight into the consequences of, and rational options for potential FMD control measures in relation to environmental, conservation and human poverty considerations in Africa. We suggest a more environmentally nuanced process of FMD control that safe-guards the integrity of wild populations and the ecosystem dynamics on which human livelihoods depend while simultaneously improving socio-economic conditions of rural people. In particular, we outline five major issues that need to be considered: 1) improved understanding of the different FMD viral strains and how they circulate between domestic and wildlife populations; 2) an appreciation for the economic value of wildlife for many African countries whose presence might preclude the country from ever achieving an FMD-free status; 3) exploring ways in which livestock production can be improved without compromising wildlife such as implementing commodity-based trading schemes; 4) introducing a participatory approach involving local farmers and the national veterinary services in the control of FMD; and 5) finally the possibility that transfrontier conservation might offer new hope of integrating decision-making at the wildlife-livestock interface

Characterizing wave- and current- induced bottom shear stress : U.S. middle Atlantic continental shelf

This paper is not subject to U.S. copyright. The definitive version was published in Continental Shelf Research 52 (2013): 73-86, doi:10.1016/j.csr.2012.10.012.Waves and currents create bottom shear stress, a force at the seabed that influences sediment texture distribution, micro-topography, habitat, and anthropogenic use. This paper presents a methodology for assessing the magnitude, variability, and driving mechanisms of bottom stress and resultant sediment mobility on regional scales using numerical model output. The analysis was applied to the Middle Atlantic Bight (MAB), off the U.S. East Coast, and identified a tidally-dominated shallow region with relatively high stress southeast of Massachusetts over Nantucket Shoals, where sediment mobility thresholds are exceeded over 50% of the time; a coastal band extending offshore to about 30 m water depth dominated by waves, where mobility occurs more than 20% of the time; and a quiescent low stress region southeast of Long Island, approximately coincident with an area of fine-grained sediments called the “Mud Patch”. The regional high in stress and mobility over Nantucket Shoals supports the hypothesis that fine grain sediment winnowed away in this region maintains the Mud Patch to the southwest. The analysis identified waves as the driving mechanism for stress throughout most of the MAB, excluding Nantucket Shoals and sheltered coastal bays where tides dominate; however, the relative dominance of low-frequency events varied regionally, and increased southward toward Cape Hatteras. The correlation between wave stress and local wind stress was lowest in the central MAB, indicating a relatively high contribution of swell to bottom stress in this area, rather than locally generated waves. Accurate prediction of the wave energy spectrum was critical to produce good estimates of bottom shear stress, which was sensitive to energy in the long period waves.P.S. Dalyander was supported by the U.S. Geological Survey Mendenhall Research Fellowship Program

Genetic Discrimination Between LADA and Childhood-Onset Type 1 Diabetes Within the MHC

OBJECTIVE The MHC region harbors the strongest loci for latent autoimmune diabetes in adults (LADA); however, the strength of association is likely attenuated compared with that for childhood-onset type 1 diabetes. In this study, we recapitulate independent effects in the MHC class I region in a population with type 1 diabetes and then determine whether such conditioning in LADA yields potential genetic discriminators between the two subtypes within this region. RESEARCH DESIGN AND METHODS Chromosome 6 was imputed using SNP2HLA, with conditional analysis performed in type 1 diabetes case subjects (n = 1,985) and control subjects (n = 2,219). The same approach was applied to a LADA cohort (n = 1,428) using population-based control subjects (n = 2,850) and in a separate replication cohort (656 type 1 diabetes case, 823 LADA case, and 3,218 control subjects). RESULTS The strongest associations in the MHC class II region (rs3957146, beta [SE] = 1.44 [0.05]), as well as the independent effect of MHC class I genes, on type 1 diabetes risk, particularly HLA-B*39 (beta [SE] = 1.36 [0.17]), were confirmed. The conditional analysis in LADA versus control subjects showed significant association in the MHC class II region (rs3957146, beta [SE] = 1.14 [0.06]); however, we did not observe significant independent effects of MHC class I alleles in LADA. CONCLUSIONS In LADA, the independent effects of MHC class I observed in type 1 diabetes were not observed after conditioning on the leading MHC class II associations, suggesting that the MHC class I association may be a genetic discriminator between LADA and childhood-onset type 1 diabetes.Peer reviewe

Preventive evidence into practice (PEP) study: implementation of guidelines to prevent primary vascular disease in general practice protocol for a cluster randomised controlled trial

There are significant gaps in the implementation and uptake of evidence-based guideline recommendations for cardiovascular disease (CVD) and diabetes in Australian general practice. This study protocol describes the methodology for a cluster randomised trial to evaluate the effectiveness of a model that aims to improve the implementation of these guidelines in Australian general practice developed by a collaboration between researchers, non-government organisations, and the profession.This study is funded by an Australian National Health and Medical Research Council (NHMRC) Partnership grant (ID 568978) together with the Australian National Heart Foundation, Royal Australian College of General Practitioners, and the BUPA Foundation. MH is supported by a NHMRC Senior Principle Research Fellowship

Hundreds of variants clustered in genomic loci and biological pathways affect human height

Most common human traits and diseases have a polygenic pattern of inheritance: DNA sequence variants at many genetic loci influence the phenotype. Genome-wide association (GWA) studies have identified more than 600 variants associated with human traits, but these typically explain small fractions of phenotypic variation, raising questions about the use of further studies. Here, using 183,727 individuals, we show that hundreds of genetic variants, in at least 180 loci, influence adult height, a highly heritable and classic polygenic trait. The large number of loci reveals patterns with important implications for genetic studies of common human diseases and traits. First, the 180 loci are not random, but instead are enriched for genes that are connected in biological pathways (P = 0.016) and that underlie skeletal growth defects (P < 0.001). Second, the likely causal gene is often located near the most strongly associated variant: in 13 of 21 loci containing a known skeletal growth gene, that gene was closest to the associated variant. Third, at least 19 loci have multiple independently associated variants, suggesting that allelic heterogeneity is a frequent feature of polygenic traits, that comprehensive explorations of already-discovered loci should discover additional variants and that an appreciable fraction of associated loci may have been identified. Fourth, associated variants are enriched for likely functional effects on genes, being over-represented among variants that alter amino-acid structure of proteins and expression levels of nearby genes. Our data explain approximately 10% of the phenotypic variation in height, and we estimate that unidentified common variants of similar effect sizes would increase this figure to approximately 16% of phenotypic variation (approximately 20% of heritable variation). Although additional approaches are needed to dissect the genetic architecture of polygenic human traits fully, our findings indicate that GWA studies can identify large numbers of loci that implicate biologically relevant genes and pathways.