A first record of Chara vulgaris var. papillata Wallroth. Ex A. Braun (Charales) in the Maltese Islands (Central Mediterranean)

The Maltese list of characeans includes Chara vulgaris of which the most commonly occurring variant is C. vulgaris var. longibracteata. A less common variant, C. vulgaris var. papillata, has been recorded for the first time locally in mats of Chara vulgaris examined from il-Qattara pool and Qawra (Dwejra, Gozo).peer-reviewe

The current knowledge of the spider fauna of the Maltese Islands, with the addition of some new records (Arachnida : Araneae)

The current knowledge of the spider fauna of the Maltese Islands is reviewed. Four species are recorded for the first time, and information is given about the banded argiope, Argiope trifasciata, which is thought to be a recently introduced species. An updated checklist of the spider fauna of the Maltese Islands is also provided.peer-reviewe

Efficacy of Telephone Information and Advice on Welfare: the Need for Realist Evaluation

In the context of increased marketisation in welfare provision, formal information and advice (I&A) is widely assumed to enable users, as consumers, to make informed choices about services, support and care. There is emerging evidence that telephone I&A services represent important ways of providing such services. This article proposes a framework that identifies key areas of focus delineating the efficacy of I&A, which is then used in a comprehensive literature review to critique existing research on outcomes and/or impact of telephone I&A. Existing, predominately quantitative, research has critical weaknesses. There is a lack of adequate contextual focus, understanding agency, and how I&A is used in different contexts to influence causal processes. The article contends that the efficacy of I&A is not adequately reported and provides much needed theoretical clarity in key areas, including the desirability of further realist evaluation approaches

Practice Nurses' views of their role in the management of Chronic Fatigue Syndrome/Myalagic Encephalitis: a qualitative study

<p>Abstract</p> <p>Background</p> <p>NICE guidelines suggest that patients with Chronic Fatigue Syndrome/Myalgic Encephalitis (CFS/ME) should be managed in Primary Care. Practice Nurses are increasingly being involved in the management of long-term conditions, so are likely to also have a growing role in managing CFS/ME. However their attitudes to, and experiences of patients with CFS/ME and its management must be explored to understand what barriers may exist in developing their role for this group of patients. The aim of this study was to explore Practice Nurses' understanding and beliefs about CFS/ME and its management.</p> <p>Methods</p> <p>Semi-structured interviews with 29 Practice Nurses. Interviews were transcribed verbatim and an iterative approach used to develop themes from the dataset.</p> <p>Results</p> <p>Practice nurses had limited understanding about CFS/ME which had been largely gained through contact with patients, friends, personal experiences and the media rather than formal training. They had difficulty seeing CFS/ME as a long term condition. They did identify a potential role they could have in management of CFS/ME but devalued their own skills in psychological intervention, and suggested counselling would be an appropriate therapeutic option. They recognised a need for further training and on going supervision from both medical and psychological colleagues. Some viewed the condition as contentious and held pejorative views about CFS/ME. Such scepticism and negative attitudes will be a significant barrier to the management of patients with CFS/ME in primary care.</p> <p>Conclusion</p> <p>The current role of Practice Nurses in the ongoing management of patients with CFS/ME is limited. Practice Nurses have little understanding of the evidence-base for treatment of CFS/ME, particularly psychological therapies, describing management options in terms of advice giving, self-help or counselling. Practice Nurses largely welcomed the potential development of their role in this area, but identified barriers and training needs which must be addressed to enable them to feel confident managing of patients with this condition. Training must begin by addressing negative attitudes to patients with CFS/ME.</p

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

Background: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. Methods: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. Findings: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96–1·28). Interpretation: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. Funding: National Institute for Health Research Health Services and Delivery Research Programme

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme

The Global Political Economy of Israel (Radio Interview with Jonathan Nitzan)

Jonathan Nitzan on the political economy of Israel, the Middle East and global accumulation

The Profits of War (Radio interview with Jonathan Nitzan)

Why capitalists aren’t eager to stop the Middle East wars. (Duration: 25 minutes) NOTE: There is an error in the interview. Nitzan notes that, in 2000-2005, the four leading oil companies earned one trillion dollars in net profit. The correct number is one third of a trillion ($338 billion)

Fast and Accurate Output Error Estimation for Memristor-Based Deep Neural Networks

International audienceMemristors allow computing in memory, which may be leveraged by deep neural network (DNN) accelerators to reduce energy footprint. However, such gains in energy efficiency come at the cost of noise on the computation results due to the analog nature of memristors. In this work, we introduce a theoretical framework to estimate the mean squared error (MSE) of a memristor-based DNN. We propose an efficient software implementation of this framework which is shown to be orders of magnitude faster than using Monte-Carlo simulations. Additionally, we study two different techniques for mapping convolutional layers to memristors and compare their relative impact on the mean squared error and its computation time. The accuracy of the proposed analysis is first evaluated on a simple regression problem, and then on a more complex classification task with a network capable of achieving high accuracy on the CIFAR-10 dataset, which shows that our method is efficient over practical up-to-date DNNs. The proposed framework is then used to perform a meta-heuristic optimization of the memristor maximal conductance value so as to minimize the energy usag