Earliest Holocene south Greenland ice sheet retreat within its late Holocene extent

Early Holocene summer warmth drove dramatic Greenland ice sheet (GIS) retreat. Subsequent insolation-driven cooling caused GIS margin readvance to late Holocene maxima, from which ice margins are now retreating. We use 10Be surface exposure ages from four locations between 69.4°N and 61.2°N to date when in the early Holocene south to west GIS margins retreated to within these late Holocene maximum extents. We find that this occurred at 11.1 ± 0.2 ka to 10.6 ± 0.5 ka in south Greenland, significantly earlier than previous estimates, and 6.8 ± 0.1 ka to 7.9 ± 0.1 ka in southwest to west Greenland, consistent with existing 10Be ages. At least in south Greenland, these 10Be ages likely provide a minimum constraint for when on a multicentury timescale summer temperatures after the last deglaciation warmed above late Holocene temperatures in the early Holocene. Current south Greenland ice margin retreat suggests that south Greenland may have now warmed to or above earliest Holocene summer temperatures

Assessing the consistency assumptions underlying network meta-regression using aggregate data

When numerous treatments exist for a disease (treatments 1, 2, 3 etc.), network meta-regression (NMR) examines whether each relative treatment effect (e.g. mean difference for 2 vs. 1, 3 vs. 1, 3 vs. 2 etc.) differs according to a covariate (e.g. disease severity). Two consistency assumptions underlie NMR: consistency of the treatment effects at the covariate value zero and consistency of the regression coefficients for the treatment by covariate interaction. The NMR results may be unreliable when the assumptions do not hold. Furthermore, interactions may exist but are not found because inconsistency of the coefficients is masking them; for example, when the treatment effect increases as the covariate increases using direct evidence but the effect decreases with the increasing covariate using indirect evidence.We outline existing NMR models that incorporate different types of treatment by covariate interaction. We then introduce models that can be used to assess the consistency assumptions underlying NMR for aggregate data. We extend existing node-splitting models, the unrelated mean effects inconsistency model and the design by treatment inconsistency model to incorporate covariate interactions. We propose models for assessing both consistency assumptions simultaneously and models for assessing each of the assumptions in turn to gain a more thorough understanding of consistency.We apply the methods in a Bayesian framework to trial-level data comparing anti-malarial treatments using the covariate average age, and to four fabricated datasets to demonstrate key scenarios.We discuss the pros and cons of the methods and important considerations when applying models to aggregated data

Story in health and social care

This paper offers a brief consideration of how narrative, in the form of people‟s own stories, potentially figures in health and social care provision as part of the impulse towards patient-centred care. The rise of the epistemological legitimacy of patients‟ stories is sketched here. The paper draws upon relevant literature and original writing to consider the ways in which stories can mislead as well as illuminate the process of making individual treatment care plans

Vitamin D status in chronic fatigue syndrome/myalgic encephalomyelitis: a cohort study from the North-West of England

Objective Severe vitamin D deficiency is a recognised cause of skeletal muscle fatigue and myopathy. The aim of this study was to examine whether chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is associated with altered circulating vitamin D metabolites. Design Cohort study. Setting UK university hospital, recruiting from April 2014 to April 2015. Participants Ninety-two patients with CFS/ME and 94 age-matched healthy controls (HCs). Main outcome measures The presence of a significant association between CFS/ME, fatigue and vitamin D measures. Results No evidence of a deficiency in serum total 25(OH) vitamin D (25(OH)D2 and 25(OH)D3 metabolites) was evident in individuals with CFS/ME. Liquid chromatography tandem mass spectrometry (LC–MS/MS) analysis revealed that total 25(OH)D was significantly higher (p=0.001) in serum of patients with CFS/ME compared with HCs (60.2 and 47.3 nmol/L, respectively). Analysis of food/ supplement diaries with WinDiets revealed that the higher total 25(OH) vitamin D concentrations observed in the CFS/ ME group were associated with increased vitamin D intake through use of supplements compared with the control group. Analysis of Chalder Fatigue Questionnaire data revealed no association between perceived fatigue and vitamin D levels. Conclusions Low serum concentrations of total 25(OH) D do not appear to b

An approximate model for cancellous bone screw fixation

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2013 Taylor & Francis.This paper presents a finite element (FE) model to identify parameters that affect the performance of an improved cancellous bone screw fixation technique, and hence potentially improve fracture treatment. In cancellous bone of low apparent density, it can be difficult to achieve adequate screw fixation and hence provide stable fracture fixation that enables bone healing. Data from predictive FE models indicate that cements can have a significant potential to improve screw holding power in cancellous bone. These FE models are used to demonstrate the key parameters that determine pull-out strength in a variety of screw, bone and cement set-ups, and to compare the effectiveness of different configurations. The paper concludes that significant advantages, up to an order of magnitude, in screw pull-out strength in cancellous bone might be gained by the appropriate use of a currently approved calcium phosphate cement

Addressing resistance to antibiotics in systematic reviews of antibiotic interventions

Antibiotics are among the most important interventions in healthcare. Resistance of bacteria to antibiotics threatens the effectiveness of treatment. Systematic reviews of antibiotic treatments often do not address resistance to antibiotics even when data are available in the original studies. This omission creates a skewed view, which emphasizes short-term efficacy and ignores the long-term consequences to the patient and other people. We offer a framework for addressing antibiotic resistance in systematic reviews. We suggest that the data on background resistance in the original trials should be reported and taken into account when interpreting results. Data on emergence of resistance (whether in the body reservoirs or in the bacteria causing infection) are important outcomes. Emergence of resistance should be taken into account when interpreting the evidence on antibiotic treatment in randomized controlled trials or systematic reviews

Madness and Mindfulness: How the "Personal" is "Political"

The chapter examines the institutionalization of unreason and the potential role of meditation in disclosing its roots. It is argued that meditative awareness can enable critical reflection on, and transformation of, practices that diminish our rational awareness. Mindfulness may contribute to this awareness, but its lack of an ethical frame renders it vulnerable to narcissistic appropriation and corporate commercialization. Accordingly, mindfulness is limited in disclosure, and counteracting, of the needless perpetuation of suffering associated with ego-building and defensive emotions, as manifest in contemporary expressions of sectarianism and fanaticism. The examination of antidotes to unreason and freedom is accomplished through a series of critical reflections upon the insights generated by Wright Mills’ The Sociological Imagination, Carol Hanisch’s “The Personal is Political,” and Freire’s Pedagogy of the Oppressed. These texts provide complementary commentaries on the development of progressive, emancipatory consciousness and praxis to which, I conjecture, meditation, as distinct from the mindfulness movement, contributes

Madness and Mindfulness

The chapter examines the institutionalization of unreason and the potential role of meditation in disclosing its roots. It is argued that meditative awareness can enable critical reflection on, and transformation of, practices that diminish our rational awareness. Mindfulness may contribute to this awareness, but its lack of an ethical frame renders it vulnerable to narcissistic appropriation and corporate commercialization. Accordingly, mindfulness is limited in disclosure, and counteracting, of the needless perpetuation of suffering associated with ego-building and defensive emotions, as manifest in contemporary expressions of sectarianism and fanaticism. The examination of antidotes to unreason and freedom is accomplished through a series of critical reflections upon the insights generated by Wright Mills’ The Sociological Imagination, Carol Hanisch’s “The Personal is Political,” and Freire’s Pedagogy of the Oppressed. These texts provide complementary commentaries on the development of progressive, emancipatory consciousness and praxis to which, I conjecture, meditation, as distinct from the mindfulness movement, contributes

Experimental evidence that livestock grazing intensity affects cyclic vole population regulation processes

Peer reviewedPublisher PD