364 research outputs found

    Iranian hospitality : from caravanserai to bazaar to reporting symbolic experience

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    This paper reports case studies seeking to address one of the great problems of social science: namely, the extent to which is it possible or desirable accurately to report conscious experience (Hulburt & Scwitzgebel 2007). An interpretive ethnographic approach is used to address this problem. Caravanserais and bazaars in Iran have always offered multi-sensual experiences and represented aspects of symbolic interaction, as well as facilitating physical exchange, between travellers and locals. This is true in their origins, in their nineteenth and twentieth century usage, and in their contemporary roles which increasingly include heritage tourism accommodation or heritage retailing. Using two case studies the paper explores the role that hospitality has played and shows that it has been fundamental to their evolution and remains so, particularly for the commercial caravanserais and tea houses which now exist as refurbished heritage accommodation and restaurants

    Emergency medical dispatch recognition, clinical intervention and outcome of patients in traumatic cardiac arrest from major trauma : an observational study

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    © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.OBJECTIVES: The aim of this study is to describe the demographics of reported traumatic cardiac arrest (TCA) victims, prehospital resuscitation and survival to hospital rate. SETTING: Helicopter Emergency Medical Service (HEMS) in south-east England, covering a resident population of 4.5 million and a transient population of up to 8 million people. PARTICIPANTS: Patients reported on the initial 999 call to be in suspected traumatic cardiac arrest between 1 July 2016 and 31 December 2016 within the trust's geographical region were identified. The inclusion criteria were all cases of reported TCA on receipt of the initial emergency call. Patients were subsequently excluded if a medical cause of cardiac arrest was suspected. OUTCOME MEASURES: Patient records were analysed for actual presence of cardiac arrest, prehospital resuscitation procedures undertaken and for survival to hospital rates. RESULTS: 112 patients were reported to be in TCA on receipt of the 999/112 call. 51 (46%) were found not to be in TCA on arrival of emergency medical services. Of the 'not in TCA cohort', 34 (67%) received at least one advanced prehospital medical intervention (defined as emergency anaesthesia, thoracostomy, blood product transfusion or resuscitative thoracotomy). Of the 61 patients in actual TCA, 10 (16%) achieved return-of-spontaneous circulation. In 45 (88%) patients, the HEMS team escorted the patient to hospital. CONCLUSION: A significant proportion of patients reported to be in TCA on receipt of the emergency call are not in actual cardiac arrest but are critically unwell requiring advanced prehospital medical intervention. Early activation of an enhanced care team to a reported TCA call allows appropriate advanced resuscitation. Further research is warranted to determine which interventions contribute to improved TCA survival.Peer reviewedFinal Published versio

    Iranian hospitality : embodiment, experience and representation

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    This paper seeks to triangulate methods to locate the essence of Iranian hospitality within heritage settings. It uses caravanserais, hostels for travellers and their trains of animals, and bazaars, covered markets, as its foci. These buildings have always offered multi-sensual experiences and represented aspects of symbolic interaction, as well as facilitating physical exchange, between travellers and locals. Hospitality has been fundamental to their evolution and remains so, particularly for the commercial caravanserais and tea houses which now exist as refurbished heritage accommodation and restaurants. There has always been a strong tradition of hospitality in the Islamic world, and Islamic practice emulates Ibrahim in the Koran. The first method used is to interpret physical structures, and in particular to show how the physical form of caravanserais traditionally embodied dimensions of expectation and behaviour that have characterised hospitality since it was first codified. The second method recognises the importance of personal sensing and reflection as a method, articulating personal experiences between individuals to come to a group experience. Bazaars are the focus of this second method. These were communities within communities, and had commonly caravanserais, tea houses, houses, workshops, baths, mosques and madrasas sited within them. Their architecture is commonly geometrical and enclosed. Personal sensing is used as a means of representing the felt experiences of authenticity and sincerity which these buildings and their communities and users facilitate, and the role of hospitality within this. The third method used is a content analysis of the representations of utilitarian, experiential and symbolic selling points collated from Iranian tourism and hospitality knowledgeables. The third method operationalises the Prentice-O'Gorman Destination Appraisal Matrix methodology, as a means of understanding the experiential and symbolic products offered by contemporary Iranian hospitality. Particular attention is paid to authenticity and sincerity within the hospitality and wider tourism offering of Iran

    Hormonal Correlates and Predictors of Nutritional Recovery in Malnourished African Children.

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    Background: Malnourished children show variable growth responses to nutritional rehabilitation. We aimed to investigate whether these differences could be explained by variations in growth and energy-regulating hormones. Methods: Quasi-experimental study: Children aged 6-24 months in rural Gambia were recruited to controls if weight-for-height z-score (WHZ) > -2 (n = 22), moderate acute malnutrition if WHZ  -3 (n = 18) or severe acute malnutrition if WHZ < -3 (n = 20). Plasma hormone and salivary CRP levels were determined by ELISA. Results: In univariable analyses, increases in weight-for-age z-score (WAZ) in malnourished children were positively correlated with insulin (F-ratio 7.8, p = 0.006), C-peptide (F-ratio 12.2, p < 0.001) and cortisol (F-ratio 5.0, p = 0.03). In multivariable analysis, only baseline C-peptide (F-ratio 7.6, p = 0.009) predicted the changes in WAZ over 28 days of interventions. Conclusion: In rural Gambian, malnourished children, although it cannot be used in isolation, baseline C-peptide was a predictor of future response to rehabilitation

    HIV Drugs Inhibit Transfer of Plasmids Carrying Extended-Spectrum β-Lactamase and Carbapenemase Genes

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    More and more bacterial infections are becoming resistant to antibiotics. This has made treatment of many infections very difficult. One of the reasons this is such a large problem is that bacteria are able to share their genetic material with other bacteria, and these shared genes often include resistance to a variety of antibiotics, including some of our drugs of last resort. We are addressing this problem by using a fluorescence-based system to search for drugs that will stop bacteria from sharing resistance genes. We uncovered a new role for two drugs used to treat HIV and show that they are able to prevent the sharing of two different types of resistance genes in two unique bacterial strains. This work lays the foundation for future work to reduce the prevalence of resistant infections.Antimicrobial-resistant (AMR) infections pose a serious risk to human and animal health. A major factor contributing to this global crisis is the sharing of resistance genes between different bacteria via plasmids. The WHO lists Enterobacteriaceae, such as Escherichia coli and Klebsiella pneumoniae, producing extended-spectrum β-lactamases (ESBL) and carbapenemases as “critical” priorities for new drug development. These resistance genes are most often shared via plasmid transfer. However, finding methods to prevent resistance gene sharing has been hampered by the lack of screening systems for medium-/high-throughput approaches. Here, we have used an ESBL-producing plasmid, pCT, and a carbapenemase-producing plasmid, pKpQIL, in two different Gram-negative bacteria, E. coli and K. pneumoniae. Using these critical resistance-pathogen combinations, we developed an assay using fluorescent proteins, flow cytometry, and confocal microscopy to assess plasmid transmission inhibition within bacterial populations in a medium-throughput manner. Three compounds with some reports of antiplasmid properties were tested; chlorpromazine reduced transmission of both plasmids and linoleic acid reduced transmission of pCT. We screened the Prestwick library of over 1,200 FDA-approved drugs/compounds. From this, we found two nucleoside analogue drugs used to treat HIV, abacavir and azidothymidine (AZT), which reduced plasmid transmission (AZT, e.g., at 0.25 μg/ml reduced pCT transmission in E. coli by 83.3% and pKpQIL transmission in K. pneumoniae by 80.8% compared to untreated controls). Plasmid transmission was reduced by concentrations of the drugs which are below peak serum concentrations and are achievable in the gastrointestinal tract. These drugs could be used to decolonize humans, animals, or the environment from AMR plasmids

    The relationship between wasting and stunting: a retrospective cohort analysis of longitudinal data in Gambian children from 1976 to 2016

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    Background: The etiologic relationship between wasting and stunting is poorly understood, largely because of a lack of high-quality longitudinal data from children at risk of undernutrition. Objectives: The aim of this study was to describe the interrelationships between wasting and stunting in children aged <2 y. Methods: This study involved a retrospective cohort analysis, based on growth-monitoring records spanning 4 decades from clinics in rural Gambia. Anthropometric data collected at scheduled infant welfare clinics were converted to z scores, comprising 64,342 observations on 5160 subjects (median: 12 observations per individual). Children were defined as "wasted" if they had a weight-for-length z score <-2 against the WHO reference and "stunted" if they had a length-for-age z score <-2. Results: Levels of wasting and stunting were high in this population, peaking at approximately (girls-boys) 12-18% at 10-12 months (wasted) and 37-39% at 24 mo of age (stunted). Infants born at the start of the annual wet season (July-October) showed early growth faltering in weight-for-length z score, putting them at increased risk of subsequent stunting. Using time-lagged observations, being wasted was predictive of stunting (OR: 3.2; 95% CI: 2.7, 3.9), even after accounting for current stunting. Boys were more likely to be wasted, stunted, and concurrently wasted and stunted than girls, as well as being more susceptible to seasonally driven growth deficits. Conclusions: We provide evidence that stunting is in part a biological response to previous episodes of being wasted. This finding suggests that stunting may represent a deleterious form of adaptation to more overt undernutrition (wasting). This is important from a policy perspective as it suggests we are failing to recognize the importance of wasting simply because it tends to be more acute and treatable. These data suggest that stunted children are not just short children but are children who earlier were more seriously malnourished and who are survivors of a composite process

    The relationship between wasting and stunting: a retrospective cohort analysis of longitudinal data in Gambian children from 1976 to 2016.

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    BACKGROUND: The etiologic relationship between wasting and stunting is poorly understood, largely because of a lack of high-quality longitudinal data from children at risk of undernutrition. OBJECTIVES: The aim of this study was to describe the interrelationships between wasting and stunting in children aged <2 y. METHODS: This study involved a retrospective cohort analysis, based on growth-monitoring records spanning 4 decades from clinics in rural Gambia. Anthropometric data collected at scheduled infant welfare clinics were converted to z scores, comprising 64,342 observations on 5160 subjects (median: 12 observations per individual). Children were defined as "wasted" if they had a weight-for-length z score <-2 against the WHO reference and "stunted" if they had a length-for-age z score <-2. RESULTS: Levels of wasting and stunting were high in this population, peaking at approximately (girls-boys) 12-18% at 10-12 months (wasted) and 37-39% at 24 mo of age (stunted). Infants born at the start of the annual wet season (July-October) showed early growth faltering in weight-for-length z score, putting them at increased risk of subsequent stunting. Using time-lagged observations, being wasted was predictive of stunting (OR: 3.2; 95% CI: 2.7, 3.9), even after accounting for current stunting. Boys were more likely to be wasted, stunted, and concurrently wasted and stunted than girls, as well as being more susceptible to seasonally driven growth deficits. CONCLUSIONS: We provide evidence that stunting is in part a biological response to previous episodes of being wasted. This finding suggests that stunting may represent a deleterious form of adaptation to more overt undernutrition (wasting). This is important from a policy perspective as it suggests we are failing to recognize the importance of wasting simply because it tends to be more acute and treatable. These data suggest that stunted children are not just short children but are children who earlier were more seriously malnourished and who are survivors of a composite process

    Determination of the Michel Parameters rho, xi, and delta in tau-Lepton Decays with tau --> rho nu Tags

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    Using the ARGUS detector at the e+ee^+ e^- storage ring DORIS II, we have measured the Michel parameters ρ\rho, ξ\xi, and ξδ\xi\delta for τ±l±ννˉ\tau^{\pm}\to l^{\pm} \nu\bar\nu decays in τ\tau-pair events produced at center of mass energies in the region of the Υ\Upsilon resonances. Using τρν\tau^\mp \to \rho^\mp \nu as spin analyzing tags, we find ρe=0.68±0.04±0.08\rho_{e}=0.68\pm 0.04 \pm 0.08, ξe=1.12±0.20±0.09\xi_{e}= 1.12 \pm 0.20 \pm 0.09, ξδe=0.57±0.14±0.07\xi\delta_{e}= 0.57 \pm 0.14 \pm 0.07, ρμ=0.69±0.06±0.08\rho_{\mu}= 0.69 \pm 0.06 \pm 0.08, ξμ=1.25±0.27±0.14\xi_{\mu}= 1.25 \pm 0.27 \pm 0.14 and ξδμ=0.72±0.18±0.10\xi\delta_{\mu}= 0.72 \pm 0.18 \pm 0.10. In addition, we report the combined ARGUS results on ρ\rho, ξ\xi, and ξδ\xi\delta using this work und previous measurements.Comment: 10 pages, well formatted postscript can be found at http://pktw06.phy.tu-dresden.de/iktp/pub/desy97-194.p
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