Minerva Elements Records
Now showing items 1-12 of 76397
From fact to fiction: a reflexive analysis of how screenwriter and subject intersect in the transformative process of authoring a modern biopic
The choice to work within the fictional frame of the biopic genre gives the screenwriter powerful representational tools to vivify character. But the tension between historical fidelity, and narrative fiction, raises important ethical questions. What responsibility does the marketing phrase, "based on a true story" place on the shoulders of the socially responsible screenwriter who is essentially writing a fiction? This practice-based enquiry responds to these questions by challenging the pervasive expectation that writers of historical and biographical fiction defend their truth claims on the methodological terms of the historian, and offers an alternative to a media studies proposal to cross-fertilise screenwriting practice with media ethics. By reframing the conversation away from empirical notions of historical fidelity, and consequentialist models of ethical evaluation, a significant methodological issue emerges, one that stems from a profound misconception of filmmaking practice that views the making of moving images as the non-reflexive application of mechanical skills. To counter this misconception, a working definition of filmmaking methodology is articulated, where mise-en-scene is shown to operate as a core reflexive strategy. This definition is intended to open up a conversation, and contribute to a better understanding of how filmmaking practice, of which screenwriting is a part, can generate and disseminate new knowledge in a range of forms and genres, including the biopic. Defining filmmaking as a creative practice also provides guidance to scholars, irrespective of discipline, who wish to engage with filmmaking as a rigorous methodological approach to conducting their own enquiries.
Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)
(ELIFE SCIENCES PUBLICATIONS LTD, 2021-03-09)
From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study
(ELSEVIER SCI LTD, 2018-05-01)
BACKGROUND: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. METHODS: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. FINDINGS: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p<0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05-2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p<0·001). INTERPRETATION: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication. FUNDING: DFID-MRC-Wellcome Trust Joint Global Health Trial Development Grant, National Institute of Health Research Global Health Research Unit Grant.
Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries The International Surgical Outcomes Study group
(ELSEVIER SCI LTD, 2016-11-01)
BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN51817007
Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019
(ELSEVIER SCIENCE INC, 2021-09-04)
BACKGROUND: Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. METHODS: We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (U5MR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. FINDINGS: Global U5MR decreased from 71·2 deaths per 1000 livebirths (95% uncertainty interval [UI] 68·3-74·0) in 2000 to 37·1 (33·2-41·7) in 2019 while global NMR correspondingly declined more slowly from 28·0 deaths per 1000 live births (26·8-29·5) in 2000 to 17·9 (16·3-19·8) in 2019. In 2019, 136 (67%) of 204 countries had a U5MR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030, 154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9·65 million (95% UI 9·05-10·30) in 2000 and 5·05 million (4·27-6·02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3·76 million [95% UI 3·53-4·02]) in 2000 to 48% (2·42 million; 2·06-2·86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0·80 (95% UI 0·71-0·86) deaths per 1000 livebirths and U5MR to 1·44 (95% UI 1·27-1·58) deaths per 1000 livebirths, and in 2019, there were as many as 1·87 million (95% UI 1·35-2·58; 37% [95% UI 32-43]) of 5·05 million more deaths of children younger than 5 years than the survival potential frontier. INTERPRETATION: Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve U5MR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. FUNDING: Bill & Melinda Gates Foundation.
Measurement of charged particle multiplicities and densities in pp collisions root s=7 TeV in the forward region
Charged particle multiplicities are studied in proton-proton collisions in the forward region at a centre-of-mass energy of [Formula: see text]TeV with data collected by the LHCb detector. The forward spectrometer allows access to a kinematic range of [Formula: see text] in pseudorapidity, momenta greater than [Formula: see text] and transverse momenta greater than [Formula: see text]. The measurements are performed using events with at least one charged particle in the kinematic acceptance. The results are presented as functions of pseudorapidity and transverse momentum and are compared to predictions from several Monte Carlo event generators.
Measurement of psi (2S) polarisation in pp collisions at root s=7 TeV
The polarisation of prompt [Formula: see text] mesons is measured by performing an angular analysis of [Formula: see text] decays using proton-proton collision data, corresponding to an integrated luminosity of 1.0[Formula: see text], collected by the LHCb detector at a centre-of-mass energy of 7 TeV. The polarisation is measured in bins of transverse momentum [Formula: see text] and rapidity [Formula: see text] in the kinematic region [Formula: see text] and [Formula: see text], and is compared to theoretical models. No significant polarisation is observed.
Search for long-lived particles decaying to jet pairs
A search is presented for long-lived particles with a mass between 25 and 50 [Formula: see text] and a lifetime between 1 and 200[Formula: see text] in a sample of proton-proton collisions at a centre-of-mass energy of [Formula: see text] TeV, corresponding to an integrated luminosity of 0.62 [Formula: see text], collected by the LHCb detector. The particles are assumed to be pair-produced by the decay of a standard model-like Higgs boson. The experimental signature of the long-lived particle is a displaced vertex with two associated jets. No excess above the background is observed and limits are set on the production cross-section as a function of the long-lived particle mass and lifetime.
Search for long-lived heavy charged particles using a ring imaging Cherenkov technique at LHCb
A search is performed for heavy long-lived charged particles using 3.0 [Formula: see text] of proton-proton collisions collected at [Formula: see text][Formula: see text] 7 and 8 TeV with the LHCb detector. The search is mainly based on the response of the ring imaging Cherenkov detectors to distinguish the heavy, slow-moving particles from muons. No evidence is found for the production of such long-lived states. The results are expressed as limits on the Drell-Yan production of pairs of long-lived particles, with both particles in the LHCb pseudorapidity acceptance, [Formula: see text]. The mass-dependent cross-section upper limits are in the range 2-4 fb (at 95 % CL) for masses between 14 and 309 [Formula: see text].
Measurement of the (eta c)(1S) production cross-section in proton-proton collisions via the decay (eta c)(1S) -> p(p)over-bar
The production of the [Formula: see text] state in proton-proton collisions is probed via its decay to the [Formula: see text] final state with the LHCb detector, in the rapidity range [Formula: see text] and in the meson transverse-momentum range [Formula: see text]. The cross-section for prompt production of [Formula: see text] mesons relative to the prompt [Formula: see text] cross-section is measured, for the first time, to be [Formula: see text] at a centre-of-mass energy [Formula: see text] using data corresponding to an integrated luminosity of 0.7 fb[Formula: see text], and [Formula: see text] at [Formula: see text] using 2.0 fb[Formula: see text]. The uncertainties quoted are, in order, statistical, systematic, and that on the ratio of branching fractions of the [Formula: see text] and [Formula: see text] decays to the [Formula: see text] final state. In addition, the inclusive branching fraction of [Formula: see text]-hadron decays into [Formula: see text] mesons is measured, for the first time, to be [Formula: see text], where the third uncertainty includes also the uncertainty on the [Formula: see text] inclusive branching fraction from [Formula: see text]-hadron decays. The difference between the [Formula: see text] and [Formula: see text] meson masses is determined to be [Formula: see text].
A precise measurement of the B-0 meson oscillation frequency
The oscillation frequency, [Formula: see text], of [Formula: see text] mesons is measured using semileptonic decays with a [Formula: see text] or [Formula: see text] meson in the final state. The data sample corresponds to 3.0[Formula: see text] of pp collisions, collected by the LHCb experiment at centre-of-mass energies [Formula: see text] = 7 and 8[Formula: see text]. A combination of the two decay modes gives [Formula: see text], where the first uncertainty is statistical and the second is systematic. This is the most precise single measurement of this parameter. It is consistent with the current world average and has similar precision.
Frailty associations with socioeconomic status, healthcare utilisation and quality of life among older women residing in regional Australia
Objectives: The health and well-being of older women may be influenced by frailty and low socioeconomic status (SES). This study examined the association between frailty and SES, healthcare utilisation and quality of life (QOL) among older women in regional Australia. Methods: Cross-sectional analysis of the Geelong Osteoporosis Study was conducted on 360 women (ages ≥60yr) in the 15-year follow up. Frailty was identified using modified Fried's phenotype. Individual SES measures and healthcare utilisation were documented by questionnaire. Area-based SES was determined by cross-referencing residential addresses with the Australian Bureau of Statistics Index of Relative Socio-economic Advantage and Disadvantage (IRSAD). QOL was measured using the Australian World Health Organisation Quality of Life Instrument (WHOQoL-Bref). Multinomial logistic regression was conducted with frailty groupings as outcome. Results: Sixty-two (17.2%) participants were frail, 199 (55.3%) pre-frail and 99 (27.5%) robust. Frail participants were older with higher body mass index. Frailty was associated with lower education but not marital status, occupation or IRSAD. Strong associations with frailty were demonstrated for all WHOQoL-Bref domains. Frailty was associated with more primary care doctor visits (p<0.001). Conclusions: This population-based study highlights the significant impact of frailty on older women, indicating reduced QOL and increased primary care doctor visits.