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"Clarke, Katherine"
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Shaping the geography of empire : man and nature in Herodotus' Histories
\"Focusing on the depiction of the natural world in Herodotus' Histories, this volume explores the fluid and complex network of spatial relationships that emerges from his narrative, examining its significance for the analysis of focalization in the work and for understanding the role of geography in the shaping of successive empires.\"-- Provided by publisher.
BOOK
Epidemiology of Mental Health Attendances at Emergency Departments: Systematic Review and Meta-Analysis
The characteristics of Emergency Department (ED) attendances due to mental or behavioural health disorders need to be described to enable appropriate development of services. We aimed to describe the epidemiology of mental health-related ED attendances within health care systems free at the point of access, including clinical reason for presentation, previous service use, and patient sociodemographic characteristics.
Systematic review and meta-analysis of observational studies describing ED attendances by patients with common mental health conditions.
18 studies from seven countries met eligibility criteria. Patients attending due to mental or behavioural health disorders accounted for 4% of ED attendances; a third were due to self-harm or suicidal ideation. 58.1% of attendees had a history of psychiatric illness and up to 58% were admitted. The majority of studies were single site and of low quality so results must be interpreted cautiously.
Prevalence studies of mental health-related ED attendances are required to enable the development of services to meet specific needs.
Journal Article
Billionaires' Row : tycoons, high rollers, and the epic race to build the world's most exclusive skyscrapers
\"A fly-on-the-wall account of the ferocious ambition, greed, and financial one-upmanship behind the most expensive real estate in the world: the new Manhattan megatowers known as Billionaires' Row -- from a staff reporter at The Wall Street Journal. To look south from Central Park these days is to gaze upon a physical manifestation of tens of billions of dollars in global wealth: a series of soaring spires dotting the skyline from Park Avenue to Broadway. Known as Billionaires' Row, these slender high-rise condos have transformed the skyline of New York City almost in stealth, thanks to the city's developer-friendly policies and a seemingly endless gush of cash from tech, finance, and moguls from Russia, China, and the Middle East. In just a few years, the cutthroat real estate impresarios behind these \"supertalls\" turned what was once a rundown strip of Midtown into the most expensive street on Earth. Most of us, however, will never be invited inside these gargantuan towers. The saga of Billionaires' Row epitomizes the \"new Gilded Age\" of twenty-first-century wealth. Behind the blue-tinted façade of One57, you might see financier Bill Ackman riding in an elevator to his $91.5 million apartment with computer legend Michael Dell, who paid $100.47 million for his. One block over, hedge fund billionaire Ken Griffin shattered records with his $238 million home at 220 Central Park South, the imposing limestone tower where the musician Sting also purchased a penthouse of his own. Most owners, however, remain shrouded in mystery. For some, these monuments to wealth are a place simply to park money; they have never bothered to visit. In Billionaires' Row, Wall Street Journal reporter Katherine Clarke reveals the riveting inside story of how a group of New York's most legendary developers went toe-to-toe with renegade upstarts in an ego-fueled race to build the tallest and most luxurious skyscrapers the world has ever known-and to burnish their legacies in the process. The result is a real-life drama complete with broken partnerships, broken marriages, lawsuits, and, for a few, triumph\"-- Provided by publisher.
Book
Plasma Parathyroid Hormone Concentration as a Predictor of Post-Operative Hypocalcemia in Dogs Diagnosed With Primary Hyperparathyroidism and Treated With Parathyroidectomy
Abstract
Background
Hypocalcemia is a relatively common complication after parathyroidectomy for treatment of primary hyperparathyroidism.
Objectives
To retrospectively evaluate clinical variables in dogs with primary hyperparathyroidism to determine whether or not an association exists between pre-surgical variables and the development of post-surgical hypocalcemia.
Animals
One hundred three dogs diagnosed with primary hyperparathyroidism and treated by parathyroidectomy in seven referral hospitals between 2010 and 2021.
Material and Methods
Data collected from medical records included signalment, physical examination findings, concurrent illnesses, ongoing medications, and clinicopathologic test results (including serum ALP activity, iCa, plasma phosphate and PTH concentrations). Dogs were assigned into groups based on lowest iCa post-surgery: Group1 ≥ 1.1 mmol/L, Group2 < 1.1 mmol/L. The Mann–Whitney U test assessed associations between several variables of interest and the occurrence of post-surgery hypocalcemia. ROC analyses were performed to identify variables that had the potential to predict the development of hypocalcemia after surgery.
Results
The median plasma PTH concentration pre-surgery in dogs which developed hypocalcemia after surgery was significantly higher (232 pg/mL {[IQR] 108–421}) than in dogs which did not develop hypocalcemia after surgery (81.5 pg/mL {IQR 58.5–145.0}; p < 0.001). Plasma PTH concentration had a fair to good ability to predict the development of post-surgery hypocalcemia, with AUC being 0.78 [95% confidence interval 0.67–0.89]. Using a cut-off of ≥ 75 pg/mL, pre-surgery plasma PTH concentration had a sensitivity of 96.6% and specificity of 42.3% for the development of post-surgery hypocalcemia. Dogs that developed hypocalcemia after surgery were older and had lower body weights.
Conclusion
Pre-surgery plasma PTH concentrations might be helpful in predicting those dogs at risk of developing hypocalcemia after parathyroidectomy.
Journal Article
Peer-supported Open Dialogue: a qualitative study of peer practitioners’ experiences and non-peer practitioners’ perspectives on peer involvement
Peer-supported Open Dialogue (POD) integrates peer practitioners within mental health teams, fostering a collaborative, person-centred and social network approach to care. Although peer practitioners are increasingly involved in Open Dialogue, the role of peer practitioners within such teams remains underexplored.
This study aimed to explore (a) the experiences of peer practitioners working within Open Dialogue teams in the Open Dialogue: Development and Evaluation of a Social Intervention for Severe Mental Illness trial, and (b) the perspectives of non-peer Open Dialogue practitioners regarding peer involvement. Our further objectives were to understand the nature, degree and perceived impact of peer practitioner involvement in Open Dialogue.
A qualitative study was conducted using semi-structured interviews and joint interviews with peer practitioners (
= 9). Additionally, excerpts from 11 interviews and 4 focus groups (
= 18), in which non-peer practitioners discussed peer practitioners' contributions in Open Dialogue, were analysed. Thematic analysis was employed to identify key themes.
Three themes were developed. The first focuses on the perceived influence of peer practitioners on Open Dialogue network meetings; the second explores the opportunities and challenges of working as a peer practitioner in Open Dialogue, while the third details the perceived impact of peer practitioners on team and organisational culture.
Open Dialogue's emphasis on a flattened hierarchy facilitates the integration of peer practitioners, enabling them to contribute meaningfully to network meetings and team culture. Despite the overall positive experiences, peers still faced common challenges faced by those in other services, such as low pay and occasional instances of a compromised, flattened hierarchy.
Journal Article
Developing consensus outcome measures in juvenile systemic sclerosis: a global survey of pediatric rheumatologists and literature review
Background
Juvenile systemic sclerosis (JSSc) is a rare multisystemic disease with high morbidity and mortality rates. Treatment options remain limited, and there is a significant unmet need for effective therapies. This study aims to address this gap by investigating current JSSc management practices and identifying key outcome measures that can be used to inform the development of standardized assessment tools for future clinical trials.
Methods
A web-based survey was distributed to pediatric rheumatologists to assess cardiopulmonary assessment standard of care practices and immunosuppressive treatment use in JSSc. Respondents were categorized by region (North America, Europe, Latin America, and Asia/Africa), and country income level. A scoping literature review was conducted using the PRISMA-SCR framework to identify outcome measures for six domains in SSc.
Results
One hundred forty-one pediatric rheumatologists from 26 countries completed the survey. Significant variations in JSSc cardiopulmonary assessment practices across regions and income levels were noted. Respondents in North America and Europe reported using pulmonary function tests (PFTs) with diffusing capacity of the lungs for carbon monoxide (DLCO) more frequently than those in Latin America, or Asia/Africa (
p
< 0.001). The 6-min walk test (6MWT) was used less frequently by respondents in North America than other regions (
p
= 0.004). Use of oral corticosteroid and cyclophosphamide for treatment of JSSc varies significantly based on country income level, with higher usage in low- and middle-income nations. The scoping review identified 848 relevant articles for data extraction (ranging from 36 to 156 per domain) from a pool of 31,825 records, which were screened in multiple stages by 39 investigators.
Conclusion
We found significant variability in JSSc assessment and treatment preferences, influenced by geography and income. This highlights the urgent need for international collaboration and standardized approaches in JSSc care.
Journal Article
Testicular ischemia in deficiency of adenosine deaminase 2 (DADA2)
Background
Deficiency of adenosine deaminase 2 (DADA2) is a rare autosomal recessive autoinflammatory condition. Recognised features include vasculitis predominantly affecting medium sized vessels, livedoid skin rash, central and peripheral nervous system involvement, variable degrees of immunodeficiency, and marrow failure, amongst other clinical presentations. We present the case of a six year old male with DADA2 who presented with acute testicular ischaemia secondary to vasculitis, the first such description in DADA2.
Case presentation
A six year old male presented acute right-sided testicular pain. His history included transient infantile neutropenia, resolved hepatosplenomegaly, and longstanding livedo racemosa, leading to screening and confirmation of DADA2 caused by homozygous c.139G > C (p.G47R) mutation of
ADA2.
As his only clinical feature was that of mild livedo racemosa with normal laboratory parameters at diagnosis, he was being actively monitored prior to starting any treatment. At a routine clinic follow-up a 24 h history of testicular pain was noted on systems review. He was afebrile, and his only physical signs were that of moderate livedo racemosa, and tenderness of the right testicle. Laboratory parameters revealed C-reactive protein (CRP) 8 mg/L (reference range [RR] < 20 mg/L); erythrocyte sedimentation rate (ESR) 28 mm/hr. (RR < 10); and serum amyloid A (SAA)5 mg/L (RR < 10). Ultrasound-scan of the scrotum revealed significantly reduced perfusion of the right testes, without torsion. Surgical scrotal exploration confirmed testicular ischaemia without torsion. Histology demonstrated ischaemic seminiferous tubules with intervening haemorrhage and acute inflammatory cells, consistent with vasculitis of the testis as the cause. He was treated with high dose intravenous methyl-prednisolone followed by a weaning course of oral prednisolone, and subcutaneous adalimumab (anti-tumour necrosis factor alpha, anti-TNFα). Repeat ultrasound-scan 3 weeks later revealed good testicular perfusion, with a small area of focal infarction. At last follow-up (11 months post-event) he remained asymptomatic, on treatment with adalimumab.
Conclusion
The phenotype of DADA2 continues to expand, and we add testicular infarction to the features of DADA2. CRP and SAA cannot be relied on as reliable biomarkers to predict tissue ischaemia and hence who to target for anti-TNFα therapy in DADA2, since these remained steadfastly normal before, during, and after testicular infarction in this case.
Journal Article