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Intro -- Dedication -- Epigraph -- Foreword -- Prologue -- 1. Jump Street -- 2. The Phoenix Way -- 3. The Gods Demand a Wire -- 4. Making the Omelet -- 5. Renegade -- 6. Defeated -- 7. Revelations and Regrets -- 8. Do Something -- 9. Categorical Denial -- 10. Leap into the Boundless -- 11. Whistle-Blowing Is a Full-Time Job -- 12. The Smallest Minority -- 13. A Shade of the Truth -- Aftermath -- Acknowledgments -- About John Dodson -- Copyright.

The book covers state-of-the-art considerations on how climate change has and will deliver impacts on major globalised biophysical and societal themes that will affect the way the world functions. Human activity has resulted in changes to atmospheric chemistry and land cover, and caused serious decline in biodiversity. Modifying biogeochemical cycles leads to complex feedbacks. The future climate will have impact on food security and agriculture, water supply and quality, storm and cyclone frequency, shoreline stability, biodiversity and the future of biological resources. Earth scientists might be asked to forecast any potential abrupt or environmental surprises. A sound knowledge of the Earth System will improve the chances of achieving this, by developing climate models that will reduce the degree of uncertainty in regional climate prediction. This volume sets out a framework of research issues that show how the Earth sciences contribute to a better understanding of climate change and suggests where future research will best contribute to the wellbeing of society. The key topics discussed are: - climate change patterns over the last four glacial cycles, - the variability in climate over the last 1000 years, - impact that past climate change has had on societies, - the role of human activities in climate forcing, - the role of models in predicting future climate and how we can assess their merit, - the future and likely future climate trajectories.

Imprint from colophon. ; Half-title. ; Mode of access: Internet. ; Talbot collection of British pamphlets.

Background-Little is known regarding use of cardiac therapies and clinical outcomes among older myocardial infarction (MI) patients with cognitive impairment. Methods and Results-Patients >= 65 years old with MI in the NCDR (National Cardiovascular Data Registry) Chest Pain-MI Registry between January 2015 and December 2016 were categorized by presence and degree of chart-documented cognitive impairment. We evaluated whether cognitive impairment was associated with all-cause in-hospital mortality after adjusting for known prognosticators. Among 43 812 ST-segment-elevation myocardial infarction (STEMI) patients, 3.9% had mild and 2.0% had moderate/severe cognitive impairment; among 90 904 non-ST-segment-elevation myocardial infarction (NSTEMI patients, 5.7% had mild and 2.6% had moderate/severe cognitive impairment. A statistically significant but numerically small difference in the use of primary percutaneous coronary intervention was observed between patients with STEMI with and without cognitive impairment (none, 92.1% versus mild, 92.8% versus moderate/severe, 90.4%; P=0.03); use of fibrinolysis was lower among patients with cognitive impairment (none, 40.9% versus mild, 27.4% versus moderate/severe, 24.2%; P<0.001). Compared with NSTEMI patients without cognitive impairment, rates of angiography, percutaneous coronary intervention, and coronary artery bypass grafting were significantly lower among patients with NSTEMI with mild (41%, 45%, and 70% lower, respectively) and moderate/severe cognitive impairment (71%, 74%, and 93% lower, respectively). After adjustment, compared with no cognitive impairment, presence of moderate/severe (STEW: odds ratio, 2.2, 95% CI, 1.8-2.7; NSTEMI: odds ratio, 1.7, 95% CI, 1.4-2.0) and mild cognitive impairment (STEMI: OR, 1.3, 95% CI, 1.1-1.5; NSTEMI: odds ratio, 1.3, 95% CI, 1.2-1.5) was associated with higher in-hospital mortality. Conclusions-Patients with NSTEMI with cognitive impairment are substantially less likely to receive invasive cardiac care, while patients with STEMI with cognitive impairment receive similar primary percutaneous coronary intervention but less fibrinolysis. Presence and degree of cognitive impairment was independently associated with increased in-hospital mortality. Approaching clinical decision making for older patients with MI with cognitive impairment requires further study. ; American College of Cardiology Foundation's National Cardiovascular Data Registry (NCDR); National Institute on AgingUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA) [K23 AG052463]; National Heart, Lung, and Blood InstituteUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Heart Lung & Blood Institute (NHLBI) [R01HL126911, R01HL137734, R01HL137794, R01HL136660, U54HL143541]; National Center for Complementary and Integrative Health; Heart and Stroke National New Investigator/Ontario Clinician Scientist Award; Government of Ontario Early Researcher AwardMinistry of Research and Innovation, Ontario; Peter Munk Cardiac Centre, University Health Network; Heart and Stroke Richard Lewar Centre of Excellence in Cardiovascular Research, University of TorontoUniversity of Toronto; Women's College Research InstituteUniversity of Toronto; Department of Medicine, Women's College Hospital; Department of Medicine ; Open access journal ; This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.