Paradigm shift in public administration: Implications for teaching in professional training programs

10.1111/j.1540-6210.2009.02085.xPublic Administration Review69SUPPL.

Gifting cultures and artisanal guilds in sixteenth-and early seventeenth-century London

This article reconsiders the gift within London's sixteenth- and early seventeenth-century livery companies. Previous research into guild gift-giving cultures has focused exclusively upon substantial bequests of money and property by mercantile elites to the ‘great twelve’ livery companies. Through charitable gifts, citizens established godly reputations and legacies, perpetuated through the guild institution. It is argued here that a rich culture of material gift-giving, hitherto overlooked by historians, also thrived within London's craft guilds. Drawing on company gift books, inventories, and material survivals from guild collections, this article examines typologies of donors and gifts, the anticipated ‘returns’ on the gift by the recipient company, and the ideal spatial and temporal contexts for gift-giving. This material approach reveals that master artisans negotiated civic status, authority, and memory through the presentation of a wide range of gifted artefacts for display and ritual use in London's livery halls. Moreover, this culture of gift-giving was so deep-rooted and significant that it survived the Reformation upheavals largely intact. Finally, the embellishment of rituals of gifting, and the synchronization of gifting and feasting rites from the second half of the sixteenth century, are further evidence for the resurgence of English civic culture in this era

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Pneumatology of the Qur'ān : a study in phenomenology

The western student of the Qur'ān who attempts to interpret this scripture which is held to be sacred and inviolable by millions of pious Muslims throughout the world must constantly re-examine his methods of study and his principles of interpretation, knowing that he will be challenged from two fronts--from the standpoint of critical accuracy and from the standpoint of religious dogma. One objective of the present study is to begin developing a method of Qur'ānic interpretation which is intended to meet this two-fold challenge. This task has been pursued by following the approach called "phenomenology" as it has developed in the general field of History of Religions during the past two generations. Since this approach has not been applied systematically to Qur'ānic studies, an introductory chapter has been devoted to a survey of the main principles of phenomenology, an application of these principles to the study of the Qur'ān, and an outline of a proposed phenomenological method for the exegesis and interpretation of the Qur'ān

Effect of anesthesia on renal R

Blood oxygen level-dependent (BOLD) MRI is increasingly used to assess renal tissue oxygenation during disease based on the transverse relaxation rate (R(2)*). In preclinical small animal models, the requisite use of anesthesia during imaging may lead to functional changes which influence R(2)* and confound results. The purpose of this study is to evaluate the effects of four common anesthetic compounds on renal R(2)* in healthy mice. Five female ICR mice were imaged with BOLD MRI approximately 25 minutes after induction with isoflurane (Iso; 1% or 1.5%, delivered in 100% O(2)), ketamine/xylazine (KX), sodium pentobarbital (PB) or 2,2,2-tribromoethanol (TBE). A significant effect of anesthetic agent on R(2)* was observed in all tissue layers of the kidney, including the cortex, outer stripe of the outer medulla (OSOM), inner stripe of the outer medulla (ISOM), and inner medulla (IM). Pairwise significant differences in R(2)* between specific agents were found in the cortex, OSOM, and ISOM, with the largest difference observed in the ISOM between 1.5% Iso (26.6 ± 1.7 s(-1)) and KX (66.0 ± 7.1 s(-1)). The difference between 1% Iso and KX in the ISOM was not abolished when KX was administered with supplemental 100% O(2) or when 1% Iso was delivered in 21% O(2), indicating that the fraction of inspired oxygen did not account for observed differences. Our results indicate that the choice of anesthesia has a large influence on the observed R(2)* in mouse kidney, and anesthetic effects must be considered in the design and interpretation of renal BOLD MRI studies