My concern here is not with explaining why the "New Covenant" failed to capture the political imagination of the electorate; rather, my interest lies in how the covenant as a political symbol was analyzed by both the media and scholarship. My suggestion is that this treatment is itself symbolic of a far deeper dilemma that faces not only President Clinton but also future presidents. The problem is this: at the same time that the public turns increasingly to the President to provide a "vision" of a common purpose and direction to government and society, the articulation of that vision rests on a rhetoric that in both media and scholarly accounts has been devalued. By this I mean that rhetoric is no longer viewed as conveying a sense of values, experiences, and purpose. This devaluing has occurred because rhetoric has come to be analyzed as a technical instrument of political persuasion. And though there are certainly technical aspects of rhetoric, our contemporary focus on rhetorical technique excludes from our analysis, and may even undercut, the critical role of rhetoric in providing a meaningful vocabulary that is essential to a continuing democratic discourse.
My concern here is not with explaining why the "New Covenant" failed to capture the political imagination of the electorate; rather, my interest lies in how the covenant as a political symbol was analyzed by both the media and scholarship. My suggestion is that this treatment is itself symbolic of a far deeper dilemma that faces not only President Clinton but also future presidents. The problem is this: at the same time that the public turns increasingly to the President to provide a "vision" of a common purpose and direction to government and society, the articulation of that vision rests on a rhetoric that in both media and scholarly accounts has been devalued. By this I mean that rhetoric is no longer viewed as conveying a sense of values, experiences, and purpose. This devaluing has occurred because rhetoric has come to be analyzed as a technical instrument of political persuasion. And though there are certainly technical aspects of rhetoric, our contemporary focus on rhetorical technique excludes from our analysis, and may even undercut, the critical role of rhetoric in providing a meaningful vocabulary that is essential to a continuing democratic discourse.
A wheat field with remnants of crumbled, brownish stone, broken glass, and square-headed nails is the remains of Fort Zarah, abandoned over ninety years ago. For many years a mystery enshrouded the Fort's existence. The efforts of county historians to uncover documentary historical materials about Fort Zarah were only partially successful. It was the challenge of uncovering forgotten history that created the desire to write this thesis. The early results of research were disappointing, as historical materials were extremely scarce and limited in content. The search for materials was expanded into the National Archives in Washington, the Kansas State Historical Society at Topeka, and the Denver Public Library, as well as all diaries, journals, and newspapers available. In addition to these documents the writer visited the site of Fort Zarah and talked with local historians. Troops had been stationed at the important Walnut Creek Crossing since 1853. Here the Walnut Creek was forded in order to follow the Santa Fe Trail. The growth of commercial intercourse and the discovery of gold in Colorado had brought an increase in the traffic on the Santa Fe Trail, and disturbed the hunting grounds of nomadic Indians, following their chief means of livelihood, the buffalo. In 1864, a general Indian War ensued and added protection on the Santa Fe Trail was needed to protect the fringe area of military posts already established in the region. As a result Fort Zarah, a one-company outpost was established in 1864 near the Walnut Creek Crossing. The life and duty of the soldiers stationed at Fort Zarah was extremely hard and demanding, as Indian attacks were sporadic and the troops were quite busy escorting wagon trains to and from forts Harker, Larned, and the Cow Creek Ranch. In 1866, council was held at Fort Zarah with the Kiowa, Commanche, Cheyenne, Arapahoe, and Apache nations for the purpose of signing the amendments to the Treaty of the Little Wichita. Many prominent leaders of the Indian and Federal Government were present, but only two tribes signed the amendments. In 1867, an enlarged Fort was built at a cost of $110,000, one mile form the original site. One year later the garrison at Fort Zarah successfully repelled an Indian attack of over 150 Kiowas. By 1869, Indian hostilities dropped to a minimum as warring tribes were driven south and westward. With the end of the Indian wars of 1864-1869, Fort Zarah was no longer useful or practical. In October, 1869, the fort was ordered dismantled, and the tin roof and other valuable parts of the structure were removed to Fort Harker.
The COVID-19 pandemic has fundamentally changed the way that public health professionals work and communicate. Over a very short time span, remote working arrangements have become the norm, and meetings have shifted online. Physical distancing measures have accelerated a trend toward digital communication and social exchange. At the same time, the work of epidemiologists has been held under a magnifying glass by journalists, governments and the general public, in a way not previously seen. With social media becoming an integral part of our society over the last decade, Twitter is now a key communication tool and platform for social networking among epidemiologists (#EpiTwitter). In this article, we reflect on the use of Twitter by field epidemiologists and public health microbiologists for rapid professional exchange, public communication of science and professional development during the pandemic and the associated risks. For those field epidemiologists new to social media, we discuss how Twitter can be used in a variety of ways, both at their home institutions and during field deployment. These include information dissemination, science communication and public health advocacy, professional development, networking and experience exchange. ; Peer Reviewed
Work performed at the Los Alamos Scientific Laboratory under Government Contract W-7405-eng-36. ; "Approved for Release: February 8, 1950." ; "AECU-708, (LADC-746)" ; Includes bibliographical references. ; Mode of access: Internet.
International audience ; Pesticides are applied to agricultural fields to optimise crop yield and their global use is substantial. Their consideration in life cycle assessment (LCA) is affected by important inconsistencies between the emission inventory and impact assessment phases of LCA. A clear definition of the delineation between the product system model (life cycle inventory-LCI, technosphere) and the natural environment (life cycle impact assessment-LCIA, ecosphere) is missing and could be established via consensus building.A workshop held in 2013 in Glasgow, UK, had the goal of establishing consensus and creating clear guidelines in the following topics: (1) boundary between emission inventory and impact characterisation model, (2) spatial dimensions and the time periods assumed for the application of substances to open agricultural fields or in greenhouses and (3) emissions to the natural environment and their potential impacts. More than 30 specialists in agrifood LCI, LCIA, risk assessment and ecotoxicology, representing industry, government and academia from 15 countries and four continents, met to discuss and reach consensus. The resulting guidelines target LCA practitioners, data (base) and characterisation method developers, and decision makers.The focus was on defining a clear interface between LCI and LCIA, capable of supporting any goal and scope requirements while avoiding double counting or exclusion of important emission flows/impacts. Consensus was reached accordingly on distinct sets of recommendations for LCI and LCIA, respectively, recommending, for example, that buffer zones should be considered as part of the crop production system and the change in yield be considered. While the spatial dimensions of the field were not fixed, the temporal boundary between dynamic LCI fate modelling and steady-state LCIA fate modelling needs to be defined.For pesticide application, the inventory should report pesticide identification, crop, mass applied per active ingredient, application method or ...
Background: Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods: This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings: Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16-30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77-0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50-0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80-0·88; p<0·001), and full lockdowns (0·57, 0·54-0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation: Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services.
Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.