Decolonising Environmental Risk Assessments of Potentially Polluting Wrecks:a Case Study of the Wreck of the USS Mississinewa in Ulithi Lagoon, Federated States of Micronesia

Millions of tonnes of oil lie entombed within wrecks from two world wars which, when released, can cause environmental devastation. Wrecks are predominantly risk assessed by the Global North Nations responsible, resulting in an epistemology that separates human from nature. This research aimed to decolonise risk assessments to capture the spatially heterogeneous nature of human vulnerability to oil pollution. Triangulation analysis of interviews and official reports relating to the USS Mississinewa oil spill identified three Global South issues a Eurocentric risk assessment failed to capture: region-specific meteorological conditions causing the leak, remoteness making external resources slow to arrive, and the impact of the fishery closure on traditional subsistence lifestyles. A vulnerability assessment is proposed to prioritise wrecks in susceptible locations. Recommendations are made for a collaborative approach to wreck management by including local voices, resisting the Global North assumption of generality, and recognising the priorities of those living with wrecks

'If You Desire to Enjoy Life, Avoid Unpunctual People': Women, Timetabling and Domestic Advice, 1850–1910

In the second half of the nineteenth century domestic advice manuals applied the language of modern, public time management to the private sphere. This article uses domestic advice and cookery books, including Isabella Beeton's Book of Household Management, to argue that women in the home operated within multiple, overlapping temporalities that incorporated daily, annual, linear and cyclical scales. I examine how seasonal and annual timescales coexisted with the ticking clock of daily time as a framework within which women were instructed to organize their lives in order to conclude that the increasing concern of advice writers with matters of timekeeping and punctuality towards the end of the nineteenth century indicates not the triumph of 'clock time' but rather its failure to overturn other ways of thinking about and using time

Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry

Background: Clinical complexity is increasingly prevalent among patients with atrial fibrillation (AF). The ‘Atrial fibrillation Better Care’ (ABC) pathway approach has been proposed to streamline a more holistic and integrated approach to AF care; however, there are limited data on its usefulness among clinically complex patients. We aim to determine the impact of ABC pathway in a contemporary cohort of clinically complex AF patients. Methods: From the ESC-EHRA EORP-AF General Long-Term Registry, we analysed clinically complex AF patients, defined as the presence of frailty, multimorbidity and/or polypharmacy. A K-medoids cluster analysis was performed to identify different groups of clinical complexity. The impact of an ABC-adherent approach on major outcomes was analysed through Cox-regression analyses and delay of event (DoE) analyses. Results: Among 9966 AF patients included, 8289 (83.1%) were clinically complex. Adherence to the ABC pathway in the clinically complex group reduced the risk of all-cause death (adjusted HR [aHR]: 0.72, 95%CI 0.58–0.91), major adverse cardiovascular events (MACEs; aHR: 0.68, 95%CI 0.52–0.87) and composite outcome (aHR: 0.70, 95%CI: 0.58–0.85). Adherence to the ABC pathway was associated with a significant reduction in the risk of death (aHR: 0.74, 95%CI 0.56–0.98) and composite outcome (aHR: 0.76, 95%CI 0.60–0.96) also in the high-complexity cluster; similar trends were observed for MACEs. In DoE analyses, an ABC-adherent approach resulted in significant gains in event-free survival for all the outcomes investigated in clinically complex patients. Based on absolute risk reduction at 1 year of follow-up, the number needed to treat for ABC pathway adherence was 24 for all-cause death, 31 for MACEs and 20 for the composite outcome. Conclusions: An ABC-adherent approach reduces the risk of major outcomes in clinically complex AF patients. Ensuring adherence to the ABC pathway is essential to improve clinical outcomes among clinically complex AF patients

Impact of renal impairment on atrial fibrillation: ESC-EHRA EORP-AF Long-Term General Registry

Background: Atrial fibrillation (AF) and renal impairment share a bidirectional relationship with important pathophysiological interactions. We evaluated the impact of renal impairment in a contemporary cohort of patients with AF. Methods: We utilised the ESC-EHRA EORP-AF Long-Term General Registry. Outcomes were analysed according to renal function by CKD-EPI equation. The primary endpoint was a composite of thromboembolism, major bleeding, acute coronary syndrome and all-cause death. Secondary endpoints were each of these separately including ischaemic stroke, haemorrhagic event, intracranial haemorrhage, cardiovascular death and hospital admission. Results: A total of 9306 patients were included. The distribution of patients with no, mild, moderate and severe renal impairment at baseline were 16.9%, 49.3%, 30% and 3.8%, respectively. AF patients with impaired renal function were older, more likely to be females, had worse cardiac imaging parameters and multiple comorbidities. Among patients with an indication for anticoagulation, prescription of these agents was reduced in those with severe renal impairment, p <.001. Over 24 months, impaired renal function was associated with significantly greater incidence of the primary composite outcome and all secondary outcomes. Multivariable Cox regression analysis demonstrated an inverse relationship between eGFR and the primary outcome (HR 1.07 [95% CI, 1.01–1.14] per 10 ml/min/1.73 m2 decrease), that was most notable in patients with eGFR <30 ml/min/1.73 m2 (HR 2.21 [95% CI, 1.23–3.99] compared to eGFR ≥90 ml/min/1.73 m2). Conclusion: A significant proportion of patients with AF suffer from concomitant renal impairment which impacts their overall management. Furthermore, renal impairment is an independent predictor of major adverse events including thromboembolism, major bleeding, acute coronary syndrome and all-cause death in patients with AF

Impact of clinical phenotypes on management and outcomes in European atrial fibrillation patients: a report from the ESC-EHRA EURObservational Research Programme in AF (EORP-AF) General Long-Term Registry

Background: Epidemiological studies in atrial fibrillation (AF) illustrate that clinical complexity increase the risk of major adverse outcomes. We aimed to describe European AF patients\u2019 clinical phenotypes and analyse the differential clinical course. Methods: We performed a hierarchical cluster analysis based on Ward\u2019s Method and Squared Euclidean Distance using 22 clinical binary variables, identifying the optimal number of clusters. We investigated differences in clinical management, use of healthcare resources and outcomes in a cohort of European AF patients from a Europe-wide observational registry. Results: A total of 9363 were available for this analysis. We identified three clusters: Cluster 1 (n = 3634; 38.8%) characterized by older patients and prevalent non-cardiac comorbidities; Cluster 2 (n = 2774; 29.6%) characterized by younger patients with low prevalence of comorbidities; Cluster 3 (n = 2955;31.6%) characterized by patients\u2019 prevalent cardiovascular risk factors/comorbidities. Over a mean follow-up of 22.5 months, Cluster 3 had the highest rate of cardiovascular events, all-cause death, and the composite outcome (combining the previous two) compared to Cluster 1 and Cluster 2 (all P <.001). An adjusted Cox regression showed that compared to Cluster 2, Cluster 3 (hazard ratio (HR) 2.87, 95% confidence interval (CI) 2.27\u20133.62; HR 3.42, 95%CI 2.72\u20134.31; HR 2.79, 95%CI 2.32\u20133.35), and Cluster 1 (HR 1.88, 95%CI 1.48\u20132.38; HR 2.50, 95%CI 1.98\u20133.15; HR 2.09, 95%CI 1.74\u20132.51) reported a higher risk for the three outcomes respectively. Conclusions: In European AF patients, three main clusters were identified, differentiated by differential presence of comorbidities. Both non-cardiac and cardiac comorbidities clusters were found to be associated with an increased risk of major adverse outcomes

Bacterioplankton dynamics in surface waters of the north-eastern (sub-)tropical Atlantic Ocean affected by Aeolian dust

The microbial community dominates biogeochemical cycling of the ocean, affecting global climate.The impact of physical disturbance of near surface microbial populations was studied in the northeasterntropical and subtropical Atlantic Ocean. This region lies beneath easterly trade winds,resulting in strong perturbations in terms of wind driven mixing and Aeolian dust deposition.Firstly, the region’s surface water bacterioplankton community was compared with adjacentregions in terms of metabolic activity, by measuring the uptake rates of radioactively labelledamino acids (3H-leucine and 35S-methionine) as a proxy for bacterial production. Remarkably, therewas little variation in uptake rates between the two Atlantic (sub-)tropical gyres. Rates reflectedregional photosynthetic biomass, except in the study region. The bacterioplankton community ofthis region was less metabolically active than that of the oligotrophic north Atlantic gyre, despiteocean colour data identifying the region as productive. The region’s uniqueness is probably relatedto the episodic Saharan dust inputs experienced.To test whether dust deposition controls microbial community structure, surface communitieswere compared, using flow cytometry and fluorescence in situ hybridisation, between two winterperiods when either wind-driven mixing or dust deposition occurred. Wind-driven mixing wasassociated with domination by the ubiquitous SAR11 clade of Alphaproteobacteria, whereas keyprimary producers, Prochlorococcus cyanobacteria, numerically dominated during calmerconditions. Phytoplankton-associated Bacteroidetes and Synechococcus cyanobacteria were mostabundant during turbulent conditions. Gammaproteobacteria, encompassing opportunistic species,were the only group to benefit from dust inputs; thus dust deposition seems to have a minorinfluence on the region’s bacterioplankton community compared to wind mixing, suggestingcommunity change following dust storm events may be linked to nutrients delivered by windmixing, as much as from dust.To test further whether changes in the SAR11 and Prochlorococcus populations varied betweenyears due to wind- or dust-related perturbation, a method based on 35S-methionine uptake wasdeveloped for measuring the metabolic response of these groups to Aeolian dust, whilst excludingwind impacts. Subsurface seawater samples were treated with freshly collected dust, addeddirectly or indirectly as a “leachate” after its rapid dissolution in deionised water. Prochlorococcusand SAR11 cells were sorted by flow cytometry to determine their group-specific responses. BothProchlorococcus and SAR11 were metabolically impaired by the addition of dust, which may explainthe low metabolic activity observed in the region (mentioned above). Although SAR11 showedminor positive responses to dust leachate additions, leachate proved detrimental to Prochlorococcus.Thus dust dissolution in situ appears to be more deleterious to Prochlorococcus than SAR11 andhence could initiate a compositional shift in the indigenous bacterioplankton, suggesting theobserved switch from SAR11- to Prochlorococcus-domination following dust deposition (mentionedabove) was indeed a result of an alternative stimulus, most likely wind stress.In conclusion, whereas dust deposition may prove beneficial to bacterioplankton species withhigh nutrient demands, such as some Gammaproteobacteria, it does not appear to affect the ambientdominant bacterioplankton groups of the northeast (sub-)tropical Atlantic to the same degree aswind-driven perturbations. Furthermore, large dust deposition events may prove detrimental toambient populations, resulting in low community metabolic activity

A history of English dress from the Saxon period to the present day,

Mode of access: Internet

Women in English life from mediæval to modern times.

Mode of access: Internet

Women in English life: From mediaeval to modern times. Vol. II

Photocopy.Mode of access: Internet