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This book explores the way in which, working within the investigative tradition associated with the Royal Society, the philosopher John Locke (1632-1704) used travellers' reports to develop a form of comparative social anthropology which was to inform his major philosophical works.

Point-of-care ultrasound (POCUS) is used increasingly during resuscitation. The aim of this study was to assess whether combining POCUS and electrocardiogram (ECG) rhythm findings better predicts outcomes during cardiopulmonary resuscitation in the emergency department (ED). We completed a health records review on ED cardiac arrest patients who underwent POCUS. Primary outcome measurements included return of spontaneous circulation (ROSC), survival to hospital admission, and survival to hospital discharge. POCUS was performed on 180 patients; 45 patients (25.0%; 19.2%-31.8%) demonstrated cardiac activity on initial ECG, and 21 (11.7%; 7.7%-17.2%) had cardiac activity on initial POCUS; 47 patients (26.1%; 20.2%-33.0%) achieved ROSC, 18 (10.0%; 6.3%-15.3%) survived to admission, and 3 (1.7%; 0.3%-5.0%) survived to hospital discharge. As a predictor of failure to achieve ROSC, ECG had a sensitivity of 82.7% (95% CI 75.2%-88.7%) and a specificity of 46.8% (32.1%-61.9%). Overall, POCUS had a higher sensitivity of 96.2% (91.4%-98.8%) but a similar specificity of 34.0% (20.9%-49.3%). In patients with ECG-asystole, POCUS had a sensitivity of 98.18% (93.59%-99.78%) and a specificity of 16.00% (4.54%-36.08%). In patients with pulseless electrical activity, POCUS had a sensitivity of 86.96% (66.41%-97.22%) and a specificity of 54.55% (32.21%-75.61%). Similar patterns were seen for survival to admission and discharge. Only 0.8% (0.0-4.7%) of patients with ECG-asystole and standstill on POCUS survived to hospital discharge. The absence of cardiac activity on POCUS, or on both ECG and POCUS together, better predicts negative outcomes in cardiac arrest than ECG alone. No test reliably predicted survival.

[...]resident duty hours in Canada decreased in 2013, based on research demonstrating increased medical errors after 24 hours of call.30–33 Additionally, 75% of EPs work in large urban non-academic, small urban, or rural centres.34 In these hospitals, without 24-hour in-house coverage, when a stable patient requires admission, it may be unreasonable to expect an on-call physician to come to the hospital for the sole purpose of writing orders. [...]to do so may limit the daytime care such a physician can safely provide to the community because of increased fatigue-related medical errors. The language used in 90% of the content was information-giving, leaving little time for exploration of issues or confirmation of understanding.37 Relying on this brief transmitter-oriented conversation to safely convey the intentions for ongoing patient care can be risky and may contribute to the significant adverse events attributed to handovers identified by the Joint Commission for Transforming Health Care.38 Policies that advise against EPs writing admission orders are outdated and from an era when EPs were interns and attendings were available to manage ED patients quickly. Diercks DB, Roe MT, Chen AY, Prolonged emergency department stays of non-ST-segment-elevation myocardial infarction patients are associated with worse adherence to the American College of Cardiology/American Heart Association guidelines for management and increased adverse events.

It was E.H. Carr who dismissed counterfactual history or the \"might-have-been\" school of history as a \"parlour game\" in What is History? Carr's rejection of counterfactual history was a response to Isaiah Berlin's criticism of those who believed in the \"vast impersonal forces\" of history rather than giving priority to the role of the individual and the accidental. For Berlin, Carr was following in the footsteps of Hegel and Marx in regarding history as process that was determined and governed by necessity rather than chance. While the influence of both Hegel and Marx can be seen in Carr's work, this article will argue that Carr's approach to history is distinct from that to be found in classical Marxism as exemplified by Marx, Engels, Plekhanov, Labriola and Trotsky who always accepted the role of chance in history. It compares Carr's historical method to that employed by Trotsky in his History of the Russian Revolution. Adapted from the source document.

It was E.H. Carr who dismissed counterfactual history or the \"might-have-been\" school of history as a \"parlour game\" in What is History? Carr's rejection of counterfactual history was a response to Isaiah Berlin's criticism of those who believed in the \"vast impersonal forces\" of history rather than giving priority to the role of the individual and the accidental. For Berlin, Carr was following in the footsteps of Hegel and Marx in regarding history as process that was determined and governed by necessity rather than chance. While the influence of both Hegel and Marx can be seen in Carr's work, this article will argue that Carr's approach to history is distinct from that to be found in classical Marxism as exemplified by Marx, Engels, Plekhanov, Labriola and Trotsky who always accepted the role of chance in history. It compares Carr's historical method to that employed by Trotsky in his History of the Russian Revolution.