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n in bottom-trawl surveys, was also similar in 2018 to 2017 and 2019, supporting the evidence that food was not scarce in the summer of 2018 in the vicinity of St. Lawrence Island. Of two moribund thick-billed murres collected at the end of the mortality event, one tested positive for a novel re-assortment H10 strain of avian influenza with Eurasian components, likely contracted during the non-breeding season. It is not currently known how widely spread infection of murres with the novel virus was, thus insufficient evidence exists to attribute the die-off to an outbreak of avian influenza. We conclude that food shortage alone is not an adequate explanation for the mortality of thick-billed murres in 2018, and highlight the importance of rapid response to mortality events in order to document alternative or confounding causes of mortality.This article explores the relationship between lesbian activists and the "psy professions" (especially psychology and psychiatry) in England from the 1960s to the 1980s. We draw on UK-based LGBTQIA+ archive sources and specifically magazines produced by, and for, lesbians. We use this material to identify three key strategies used within the lesbian movement to contest psycho-pathologisation during this 30-year period from respectable collaborationist forms of activism during the 1960s; to more liberationist oppositional politics during the early 1970s; to radical feminist separatist activism in the 1980s. Whilst these strategies broadly map onto activist strategies deployed within the wider lesbian and gay movement during this time, this article explores how these politics manifested in particular ways, specifically in relation to the psy disciplines in the UK. We describe these strategies, illustrating them with examples of activism from the archives. We then use this history to problematise a linear, overly reductionist or binary history of liberation from psycho-pathologisation. Finally, we explore some complexities in the relationship between sexuality, activism and the psy professions.There is a growing literature on the impact of Covid-19 on commercial and labour conditions at suppliers in apparel global value chains (GVCs). Yet much less is known about the implications for suppliers operating in regional value chains (RVCs) in the global South. In this article, we focus on Eswatini, which has grown to become the largest African manufacturer and exporter of apparel to the region. We draw on a combination of firm-level export data and interviews with stakeholders before and after the Covid-19 lockdown to shed light on the influence of private and public governance on suppliers' economic and social upgrading and downgrading. We point to the coexistence of two separate private governance structures the first characterised by direct contracts between South African retailers and large manufacturers (direct suppliers); the second operating through indirect purchasing via intermediaries from relatively smaller producers (indirect suppliers). While direct suppliers enjoyed higher levels of economic and social upgrading than indirect suppliers before Covid-19, the pandemic reinforced this division, with severe price cuts for indirect suppliers. Furthermore, while retailers provided some direct suppliers with support throughout the crisis, this was not the case for indirect suppliers, who remain comparatively more vulnerable. In terms of public governance, the negative consequences of the lockdown on firms' income and workers' livelihoods have been compounded by the state's ineffective response. Our paper contributes to the research on RVCs in the global South, enhancing our understanding of how different governance structures and external shocks affect firms' and workers' upgrading and downgrading prospects.International efforts have taken place to alleviate poverty by adopting several obligations within the international society; one of these obligations is the provision of safe access to water and sanitation. The MDGs helped people around the world to gain improved water sources and better sanitation. Although the sectoral aid increased from 20% between 1990 and 1992 (only 4.9% distributed for water supply and sanitation (W&S)) to 35% between 2002 and 2004 (only 3.9% allocated for W&S), facts showed that the allocated aid was biased to social aims rather than infrastructural targets. In this study, I am focusing on the donors' commitment for W&S, whether their ODA for these two sub-sectors is aligned with the intentions of the SDGs. I find that donors allocated W&S aid by focusing on governments in general with higher governance indicators, and that poorer countries received a higher allocation of aid.We consider the problem of estimating the policy and transition probability model of a Markov Decision Process from data (state, action, next state tuples). The transition probability and policy are assumed to be parametric functions of a sparse set of features associated with the tuples. We propose two regularized maximum likelihood estimation algorithms for learning the transition probability model and policy, respectively. An upper bound is established on the regret, which is the difference between the average reward of the estimated policy under the estimated transition probabilities and that of the original unknown policy under the true (unknown) transition probabilities. We provide a sample complexity result showing that we can achieve a low regret with a relatively small amount of training samples. We illustrate the theoretical results with a healthcare example and a robot navigation experiment.
In Germany, aconstant demographic change is taking place, which leads to an increasing aging of the society. The present study aimed to analyze natural deaths occurring at an age of ≥ 65years, since health vulnerability in this age group is gaining importance.
Autopsy reports of the Institute of Forensic Medicine, University Hospital of the Goethe University Frankfurt/Main, Germany, were retrospectively evaluated regarding natural death cases of ≥ 65-year-olds in atime comparison (periodI 2000-2002; periodII 2013-2015).
During both periods, atotal of 1206 autopsies concerning this age group were performed. Among these, 404cases (33.5%) of unnatural death and 39cases (3.2%) of acombination of natural and unnatural death were recorded; in 94cases (7.8%), the manner of death could not be elucidated. The majority (
= 669; 55.5%) included cases of natural death. In the largest group of these (
= 350; 52.3%), cardiac causes of death were predominant, followed by 132 (19.7%) respiratory and 47 (7.0%) abdom may be attributed to increasingly better medical care and to a significantly higher rate of stent implantation. Especially in times of pandemics, the role of forensic gerontology will become more important.
The year 2020 will always stand in the shadow of the pandemic triggered by the coronavirus 2019 (COVID-19). The first three quarter years of 2020 were characterized by an unprecedented reduction of elective inpatient services and a prioritization of intensive care capacity for the treatment of COVID-19 patients. This also resulted in clear consequences for the services provided in cardiac surgery. Selleck 8-OH-DPAT In addition, during the course of the year the personnel in hospitals were confronted with a plethora of amendments in the legal framework conditions. Nevertheless, the modified German diagnosis-related groups (G-DRG) system 2021 was calculated by the Institute for the Remuneration System in Hospitals (InEK). This article describes and assesses the most important amendments of the modified G‑DRG system 2021 for cardiac, thoracic and vascular surgery.
Analysis of the relevant diagnoses, procedures and G‑DRG structures in the system versions for 2020 and 2021 based on the information published by the InEK and the ed in 2022 and will presumably be much expanded, will once again clearly increase the enforcement of outpatient performance of services that were previously performed as inpatient treatment.
For cardiovascular surgery there are manifold amendments with sometimes substantial repercussions for the case proceeds. Additionally, for many German hospitals the effects of the corona pandemic are not yet finally foreseeable. A further increasingly more urgent influencing factor particularly affecting vascular medicine is the increasing pressure to promote outpatient treatment. In this respect, the catalogue for outpatient operations in hospitals (AOP), which is expected in 2022 and will presumably be much expanded, will once again clearly increase the enforcement of outpatient performance of services that were previously performed as inpatient treatment.An outbreak of the COVID-19 pandemic is a major public health disease as well as a challenging task to people with comorbidity worldwide. According to a report, comorbidity enhances the risk factors with complications of COVID-19. Here, we propose and explore a mathematical framework to study the transmission dynamics of COVID-19 with comorbidity. Within this framework, the model is calibrated by using new daily confirmed COVID-19 cases in India. The qualitative properties of the model and the stability of feasible equilibrium are studied. The model experiences the scenario of backward bifurcation by parameter regime accounting for progress in susceptibility to acquire infection by comorbidity individuals. The endemic equilibrium is asymptotically stable if recruitment of comorbidity becomes higher without acquiring the infection. Moreover, a larger backward bifurcation regime indicates the possibility of more infection in susceptible individuals. A dynamics in the mean fluctuation of the force of infection is investigated with different parameter regimes. A significant correlation is established between the force of infection and corresponding Shannon entropy under the same parameters, which provides evidence that infection reaches a significant proportion of the susceptible.Inspired by the experimental and numerical findings, we study the dynamic instabilities of two coupled nonlinear delay differential equations that are used to describe the coherent oscillations between the top and bottom boundary layers in turbulent Rayleigh-Bénard convection. By introducing two sensitivity parameters for the instabilities of the top and bottom boundary layers, we find three different types of solutions, namely in-phase single-period oscillations, multi-period oscillations and chaos. The chaos solution contains rare but large amplitude fluctuations. The statistical properties of these fluctuations are consistent with those observed in the experiment for the massive eruption of thermal plumes, which causes random reversals of the large-scale circulation in turbulent Rayleigh-Bénard convection. Our study thus provides new insights into the origin of rare massive eruptions and sudden changes of large-scale flow pattern that are often observed in convection systems of geophysical and astrophysical scales.Decision and policy makers in disaster management are compelled to look at alternative measures during the COVID-19 pandemic. They require integrated measures to both reduce the spread of COVID-19 and response to disasters. The measures to mitigate damage of disaster amid COVID-19 can become expensive and inefficient compared to single disaster responses, resulting in delays. Hence, a balance is crucial to successfully manage co-occurring disasters, and new holistic approaches are necessary to produce efficient responses during the COVID-19 outbreak.
The online version of this article (10.1007/s11069-021-04658-0) contains supplementary material, which is available to authorized users.
The online version of this article (10.1007/s11069-021-04658-0) contains supplementary material, which is available to authorized users.