Macmillan, Verwoerd, and the 1960 `wind of change' speech

Just over fifty years ago, Prime Minister Macmillan made an extensive tour of Africa, culminating in his 'wind of change' speech in Cape Town. This article traces Macmillan's progress through Africa with particular emphasis on his intervention in South African politics. It offers a novel reading of the 1960 'wind of change' speech, arguing that the message was far more conciliatory with respect to white South African interests than is usually assumed. Pragmatism rather than principle was always the prime consideration. Far from being cowed by Macmillan's oratory or his message, Verwoerd stood up to Macmillan and, at least in the eyes of his supporters, gave as good as he got. The shock of the 'wind of change' speech was more evident in Britain and in British settler regions of Africa than in South Africa. Macmillan's advisers had an inflated view of the import of the speech and in many ways misread Verwoerd's brand of Afrikaner nationalism. One of the consequences of the speech was to embolden Verwoerd politically, and to prepare him for the declaration of republican status in 1961 and departure from the commonwealth

A systematic review and critical appraisal of quality indicators to assess optimal palliative care for older people with dementia

© The Author(s) 2019Background: A challenge for commissioners and providers of end-of-life care in dementia is to translate recommendations for good or effective care into quality indicators that inform service development and evaluation. Aim: To identify and critically evaluate quality indicators for end-of-life care in dementia. Results: We found 8657 references, after de-duplication. In all, 19 publications describing 10 new and 3 updated sets of indicators were included in this review. Ultimately, 246 individual indicators were identified as being relevant to dementia end-of-life care and mapped against EAPC guidelines. Conclusions: We systematically derived and assessed a set of quality indicators using a robust framework that provides clear definitions of aspects of palliative care, which are dementia specific, and strengthens the theoretical underpinning of new complex interventions in end-of-life care in dementia.Peer reviewedFinal Published versio

Modular Hardware Design with Timeline Types

Modular design is a key challenge for enabling large-scale reuse of hardware modules. Unlike software, however, hardware designs correspond to physical circuits and inherit constraints from them. Timing constraints -- which cycle a signal arrives, when an input is read -- and structural constraints -- how often a multiplier accepts new inputs -- are fundamental to hardware interfaces. Existing hardware design languages do not provide a way to encode these constraints; a user must read documentation, build scripts, or in the worst case, a module's implementation to understand how to use it. We present Filament, a language for modular hardware design that supports the specification and enforcement of timing and structural constraints for statically scheduled pipelines. Filament uses timeline types, which describe the intervals of clock-cycle time when a given signal is available or required. Filament enables safe composition of hardware modules, ensures that the resulting designs are correctly pipelined, and predictably lowers them to efficient hardware.Comment: Extended version of PLDI '23 pape

Developing an applied model for making decisions towards the end of life about care for someone with dementia

BACKGROUND: Many people with dementia reach the end-of-life without an advance care plan. Many are not ready to have conversations about end-of-life, and decision-making is left to their families and professionals when they no longer have capacity. Carers may benefit from further support with decision-making. To develop this support, it is important to understand the decision-making process. AIM: Explore with family carers and people living with dementia the decision-making process and factors that influence decision-making in dementia end of life care, to produce a model of decision-making in the context of dementia end-of-life care. METHODS: Semi-structured interviews with 21 family carers and 11 people with dementia in England (2018–2019) from memory clinics, general practice and carer organisations. Interviews were analysed using thematic analysis and findings were mapped onto the Interprofessional Shared Decision Making model, refined to produce a modified model of decision-making in dementia. RESULTS: Participants described five key decisions towards the end-of-life as examples of decision making. We used these experiences to produce a modified model of decision-making in dementia end-of-life-care. The model considers the contextual factors that influence the decision-making process, including: personal preferences; advance care planning and Lasting Power of Attorney; capacity and health and wellbeing of the person with dementia; support from others and clarity of roles. The decision-making process consists of seven inter-linked stages: 1) identifying the decision maker or team; 2) sharing and exchanging information; 3) clarifying values and preferences; 4) managing and considering emotions; 5) considering the feasibility of options; 6) balancing preferred choice and the actual choice; and 7) implementation and reflecting on outcomes. CONCLUSIONS: The modified model breaks down the decision-making process and attempts to simplify the process while capturing the subtle nuances of decision making. It provides a framework for conversations and supporting decisions by carers

SWASHES: a compilation of Shallow Water Analytic Solutions for Hydraulic and Environmental Studies

Numerous codes are being developed to solve Shallow Water equations. Because there are used in hydraulic and environmental studies, their capability to simulate properly flow dynamics is critical to guarantee infrastructure and human safety. While validating these codes is an important issue, code validations are currently restricted because analytic solutions to the Shallow Water equations are rare and have been published on an individual basis over a period of more than five decades. This article aims at making analytic solutions to the Shallow Water equations easily available to code developers and users. It compiles a significant number of analytic solutions to the Shallow Water equations that are currently scattered through the literature of various scientific disciplines. The analytic solutions are described in a unified formalism to make a consistent set of test cases. These analytic solutions encompass a wide variety of flow conditions (supercritical, subcritical, shock, etc.), in 1 or 2 space dimensions, with or without rain and soil friction, for transitory flow or steady state. The corresponding source codes are made available to the community (http://www.univ-orleans.fr/mapmo/soft/SWASHES), so that users of Shallow Water-based models can easily find an adaptable benchmark library to validate their numerical methods.Comment: 40 pages There are some errors in the published version. This is a corrected versio

Psychiatric morbidity and social capital in rural communities of the Greek North Aegean islands

Which facets of social capital affect mental health in rural settings? This study explores the association between different aspects of social capital and psychiatric morbidity in rural communities of the Greek North Aegean islands. A large number of individual and community characteristics which may influence psychiatric morbidity are concurrently examined in multilevel models to account for the clustering of individuals within rural settings. The current findings indicate that psychiatric morbidity is to a large extent clustered within rural communities. Individuals’ perceived divisions in the community, i.e., political party preference, landholdings etc., low social support networks and lack of perceived solidarity are associated with psychiatric morbidity according to theoretical expectation. At the community level this risk is lower in villages with over 250 residents, where there are youth clubs or a common threat, for instance, property crime

Lipoprotein particles in patients with pediatric Cushing disease and possible cardiovascular risks.

BackgroundCardiovascular (CV) complications are the most significant cause of mortality in adults with Cushing disease (CD); little is known about CV risk factors in children with CD. Measurement of lipoprotein particles by nuclear magnetic resonance (NMR) spectroscopy is a novel technology to assess CV risk. The objective of the current study is to analyze the NMR lipid profile in pediatric CD patients before and 1 year after remission.MethodsNMR lipid profile was obtained via the Vantera NMR analyzer, using frozen serum samples from 33 CD patients (mean age 13.8 ± 4.0 years) evaluated between 1997 and 2017 at the National Institutes of Health (NIH) Clinical Center (CC).ResultsGlycA (glycosylated acute-phase proteins), triglyceride-rich particles (TRLP medium and very small sizes), low-density lipoprotein (LDL) particles (LDLP total and large size), high-density lipoprotein (HDL) particles (HDLP total, medium and small sizes), total cholesterol, LDL-cholesterol, HDL-cholesterol, GlycA inflammatory biomarker, and apolipoprotein B and apolipoprotein A1 (ApoA1) concentrations showed statistically significant changes after remission of CD (p < 0.05).ConclusionIn our study population, most of the lipid variables improved post-CD remission, with the exception of HDL and ApoA1, indicating that NMR lipoprotein profile may be a helpful tool in assessing the CV risk in pediatric patients with CD

Oral function and its association with nutrition and quality of life in nursing home residents with and without dementia: A cross-sectional study.

BACKGROUND: Oral health problems increase with age, and are common in nursing home residents, especially in those with dementia. These problems can lead to tooth loss, diminished oral function and malnutrition. OBJECTIVES: To compare oral function, nutritional status and quality of life (QoL) between residents with and without dementia, and to examine associations between these variables. METHODS: Cross-sectional study conducted in four UK nursing homes. Residents aged 65 + with and without dementia were included. Information was collected on demographics, dental status, quality of swallowing and chewing, xerostomia and orofacial pain. During oral examination, information was collected on number of teeth and occlusal units (OU), and functional categories (eg, OU combined with dentures). Multiple linear regression was used for statistical analysis. RESULTS: Of 84 residents with and 27 without dementia participated. Residents with dementia had significantly fewer teeth (Dementia median (IQR) = 14 (6-21), vs No dementia 22 (12.75-24.25); P = .021), fewer OU (Dementia median (IQR) = 0 (0-3), vs No dementia 4 (0-7); P = .001) and poorer functional categories (Z = -3.283; P = .001), and nutritional status was significantly poorer than those without (Dementia Mean (SD) = 8.3 (2.7), vs No dementia 10.4 (2.0); P = .002). In the regression model, quality of chewing (Coef (95% CI) = -1.27 (-2.22, -0.31); P = .010) was significantly correlated with nutritional status. CONCLUSION: Oral function and nutritional status of residents with dementia was poorer than those without. Almost half of all residents had insufficient oral function, which was negatively associated with QoL and nutritional status

Oral desensitization to milk: how to choose the starting dose!

Mori F, Pucci N, Rossi ME, de Martino M, Azzari C, Novembre E. Oral desensitization to milk: how to choose the starting dose! Pediatr Allergy Immunol 2010: 21: e450–e453. © 2009 John Wiley & Sons A/