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Settlement scaling theory, aqueducts, and the Roman Empire
Get PDFDespite the importance of understanding how ancient cities overcame the demographic, social, and economic constraints imposed by the lack of clean and fresh water, most scholars have been pessimistic about the value of exploring the relationship between the estimated populations of ancient cities and the delivery rates of aqueducts. Here, we draw on settlement scaling theory and use new evidence for the sizes of cities and a new compilation of the capacities of aqueducts, to reveal, for the first time, that there was a systematic relationship between them, with significant implications for our understanding of the functions of structures
The ‘problem of unity’ in Pindar: an old chestnut, new perspectives
No full textThe article considers unity and its counterpart, digression, as themes within Pindar’s own poetry, rather than a ‘problem’ for criticism to ‘solve’. The article considers Pindar’s treatment of action, time, and place (the so-called ‘Aristotelian unities’) alongside the modern critical concept of deixis (temporal, spatial, and person deixis). The property of indexical statements of being centred on a certain person, place, or time (‘me’, ‘here’, ‘now’; ‘him’, ‘there’, ‘then’) makes them naturally conducive to the creation of centripetal or centrifugal dynamics in a Pindaric ode, according to whether the implied deictic centre is constant or variable. It is argued that an important way of understanding Pindaric unity is as a complex equilibrium and counterpointing of competing and complementary principles of centripetalism and centrifugalism, not only acting within and across the areas of action, time, place, and person, but also observable in Pindar’s handling of grammatical, metrical, and thematic structures
Ethics of antibiotic course duration: shorter is better
No full textAntibiotic treatment course duration has for decades been dictated by two questionable ideas: first, that longer courses are more effective at curing bacterial infections; second, that longer courses are less likely to lead to drug resistance. Recently, the “shorter is better” movement has challenged the received wisdom, showing shorter-duration antibiotic courses provide similar cure rates, fewer antibiotic-related harms, and possibly less contribution to of antibiotic resistance for common infections. Yet, physicians typically still prescribe longer courses of antibiotics than clinical guidelines recommend. This is ethically unacceptable. In this paper, we argue that prescribing physicians are ethically obligated to prescribe shorter antibiotic courses, given that prescribing physicians bear duties both toward their patients and to protect public health. We rebut objections to our argument and furthermore argue for an ethical obligation of physician-researchers to conduct further trials comparing the shortest current evidence-based course of antibiotics with courses that are even shorter
Is a little learning dangerous?
No full textI argue that a little learning is often dangerous even for ideal reasoners who are operating in extremely simple scenarios and know all the relevant facts about how the evidence is generated. More precisely, I show that, on many plausible ways of assigning value to a credence in a hypothesis H, ideal Bayesians should sometimes expect other ideal Bayesians to end up with a worse credence if they gather additional evidence, even when they agree completely about the likelihoods of the evidence given both H and not-H. This provides a new reason for pessimism about the prospect of disagreeing individuals resolving their disagreement by consulting additional evidence
Trading zones between thick and thin: anthropological description as scaffold or mosaic
Get PDFReferring to the work of historian of science Peter Galison, I argue that anthropology requires thin description as an essential counterpart for thick description. Thin accounts provide the scaffolding within which thick descriptions sit. Galison uses the idea of a “trading zone” connecting different communities who, despite their differences (possibly including different ontologies), manage to coordinate joint activity. This idea works well for anthropological accounts of many societies, not least in relation to silent trade, in which exchange occurs without direct communication so that there is literally no sharing of meanings! Anthropology consists of mosaics of thick descriptions, held within thinly described structures. Galison uses what he calls “laminated descriptions” to comprehend interaction in trading zones. Ideas from complexity theory, emergence, and autopoiesis can be applied to avoid forms of positivistic reductionism. Finally, I give a sparse, summary account of change in Mambila traditional religion in terms of a trading zone of influences
The thrones of Latin America and British monarchism
No full textThis chapter reasserts extra-European monarchy as a major issue in nineteenth-century British international thought. It asks how the imperial thrones of Latin America influenced British political thinking between 1820 and 1870, and it argues that a principal intellectual effect was on conservative ideas and polemic. Casting Latin America as the site of a decisive trial between monarchy and republicanism, conservatives claimed that the success of the region’s monarchs—especially the emperor of Brazil—was proof that rule by kings secured political stability in the New World as well as in the Old World. This thesis sustained wider political and intellectual agendas. Ultimately, however, events cut the ground from under these conservative arguments, as it became clear that monarchy would have no place in the future of the New World. The case reveals that international monarchism played a consequential role in the reinvention of British conservatism. It also helps to explain why the association dissolved
Bridging conformal prediction and scenario optimization
Get PDFConformal prediction and scenario optimization constitute two important classes of statistical learning frameworks to certify decisions made using data. They have found numerous applications in control theory, machine learning and robotics. Despite intense research in both areas, and apparently similar results, a clear connection between these two frameworks has not been established. By focusing on the so-called vanilla conformal prediction, we show rigorously how to choose appropriate score functions and set predictor map to recover well-known bounds on the probability of constraint violation associated with scenario programs. We also show how to treat ranking of nonconformity scores as a one-dimensional scenario program with discarded constraints, and use such connection to recover vanilla conformal prediction guarantees on the validity of the set predictor. We also capitalize on the main developments of the scenario approach, and show how we could analyze calibration conditional conformal prediction under this lens. Our results establish a theoretical bridge between conformal prediction and scenario optimization
The utilisation and cost of social care after hip fracture: a prospective observational cohort study
No full textBackground: The cost of medical care associated with hip fracture has been reported but the cost of social care is less well understood. Social care costs include formal residential and home care and home adaptations, but also informal care from family and friends. This study investigated the utilisation and cost of care beyond acute hospital stays following hip fracture.
Methods: A multi-centre, prospective observational study of patients ≥60 years with a hip fracture in the United Kingdom (UK), with four-months follow-up. Marginal costs were calculated, with scenario analysis projecting the cost to the UK hip fracture population. A two-part model was used to calculate the incremental mean cost attributable to complications following surgery.
Results: Among 16,679 patients with a hip fracture, the mean cost of social care was £15,525 (95% CI: 14,991–16,059) per person. Mean cost per person for the change in residential requirements was £1,656 (95% CI: 1,568–1,743); formal and informal home care £12,849 (95% CI: 12,448–13,250); and home adaptations £1,021 (95% CI: 976–1,067)]. The projected national cost of social care in the first four months following all hip fractures in the UK was £1.25 billion. Incremental mean cost of social care for patients who developed a surgery-specific or general complication were £1,264 (95% CI: 58–2,469) and £1,418 (95% CI: 792–2,043) per person, respectively.
Conclusion: Social care represents a substantial and often under-recognised component of the economic burden following hip fracture. Formal and informal care were major cost drivers after discharge from hospital and may rival or exceed the cost of acute hospital care
Reported problems and responses during the conduct of stepped-wedge cluster randomised trials in healthcare settings: a qualitative systematic review
No full textBackground: The Stepped-Wedge Cluster Randomised Trial (SW-CRT) is a pragmatic complex design which can be difficult to implement. We aimed to summarise the reported problems and responses to problems, in studies recently published after the publication of the reporting guidelines for SW-CRTs.
Methods: We searched the literature for SW-CRTs published between 9 November 2018 and 23 February 2021 to identify reported SW-CRT-related problems (defined as relating to the components of the design, i.e., involving clusters and the staggered intervention implementation) and responses to problems. We carried out a thematic analysis to derive descriptive themes and overarching analytical themes.
Results: Among 84 included SW-CRTs, 62 (74%) reported 107 problems related to the SW-CRT design, and 38 responses to 36 problems were reported by 24 trials. The ‘problems’ formed six descriptive problem themes: ‘participant recruitment’, ‘cluster issues’ (e.g. cluster merger or drop-out), ‘internal factors’ (e.g. logistic or administrative issues), ‘external factors’ (e.g. weather or religious events), ‘outcome measurement’ (e.g. practicalities around measurement of repeated outcomes) and ‘intervention implementation’ (e.g. delays or contamination).
The ‘responses’ formed six descriptive themes: ‘adding new clusters’, ‘modifying the randomisation’, ‘reducing contamination’, ‘changing outcomes’, ‘intention-to-treat’ and ‘modifying the analysis’.
Conclusions: SW-CRTs commonly run into problems. Two overarching and conflicting analytical problem themes emerged: the ‘struggle to adhere to the protocol’, given the defining features of the SW-CRT design, when faced against ‘real-life pressures’ created by internal and external factors. Further research is needed to explore whether responses to these problems have resource or integrity ramifications