This article takes one facet of the controversy engulfing the Church of England in the mid-nineteenth century over ritualism-the interpretation of the rubrics in the Book of Common Prayer governing clerical dress-and explores it through the writings of three representatives of very different standpoints. It considers, first, the careful academic scholarship of James Craigie Robertson (1813-82), Professor of Ecclesiastical History at King's College, London, and Canon of Canterbury Cathedral, arguing against ritualist innovations. It then turns to Thomas Walter Perry (1815-91), a strong advocate for eucharistic vestments. Finally, it explores the polemical Protestantism of Richard Paul Blakeney (1820-84). Each author is considered the contexts of the Tractarian and ritualist movements and of the wider liturgical and aesthetic developments of the period. The article concludes that no church party emerged victorious from the "battle of the rubric," and that the conflict significantly undermined the ideal of conformity to the Book of Common Prayer as a sign and source of unity in the Church of England.
Critical management scholars now frequently designate workplace wellbeing as a managerial technology of control. Among several points of criticism, organisational wellbeing solutions are viewed as ineffective, instrumental, discriminatory, individualistic, and coercive. Yet, increasingly, workers' wellbeing is an explicit public policy concern enacted prior to and alongside organisational settings. Identifying workplace wellbeing as such can expand extant critique to recognise it as a hegemonic project, and, specifically, a discourse of depoliticised labour reform. This argument is abductively developed through analysis of a resource hub backed by the UK government, using the What's the Problem Represented to Be approach as a guide, and combining both qualitative and computational methods. I show wellbeing is problematised in four ways: individual, economic, cultural, and voluntary. Each of these problematisations deploys depoliticising strategies which reproduce dominant employment relations. The workplace wellbeing policy discourse is a sincere, corporate-led attempt to improve workers' experiences of employment, but through strategies that are limited by an avoidance of contestation and regulation, as well as a mystification of both the harms of work, critiques of social justice, and more proactive solutions which would engage with working conditions. Therefore, workplace wellbeing discourse is both a product and continuation of the liberalisation and depoliticisation of employment relations.
ABSTRACT Background The rapid assessment of the conditions is crucial for the prognosis of atrial fibrillation (AF) patients admitted to the emergency department (ED). We aim to derive and validate a more accurate and simplified scoring model to optimize the triage of AF patients in the ED. Materials and Methods We conducted a retrospective study using data from the Medical Information Mart for Intensive Care (MIMIC‐IV) database and developed scoring models employing the Random Forest algorithm. The area under the receiver operating characteristic (ROC) curve (AUC) was used to measure the performance of the prediction for intensive care unit (ICU) stay, and the death likelihood within 3, 7, and 30 days following the ED admission. Results The study included 30 366 AF patients, randomly divided into training, validation, and testing cohorts at a 7:1:2 ratio. The training set consisted of 21 257 patients, the validation set included 3036 patients, and the remaining 6073 patients were classified as the validation set. Among the cohorts, 9594 patients (32%) required ICU transfers, with mortality rates of 1% at 3 days, 3% at 7 days, and 6% at 30 days. In the testing set, the scoring models demonstrated strong discriminative ability with AUCs of 0.724 for ICU stay, 0.782 for 3‐day mortality, 0.755 for 7‐day mortality, and 0.767 for 30‐day mortality. Conclusion We derived and validated novel simplified scoring models with good discriminative performance to predict the likelihood of ICU stay, 3‐day, 7‐day, and 30‐day death in AF patients after ED admission.
To delineate the criteria that characterize healthcare as a complex adaptive system (CAS), including nonlinearity, self-organization, and emergence. Thereafter, we reframe health disparity as an emergent phenomenon, and show how this alternative perspective can be used to identify novel strategies and opportunities to close the health equity gap. It is a moral imperative to ensure that every individual is afforded a minimal level of medical care, regardless of background or means. Unfortunately, healthcare systems around the world are failing to deliver on this commitment. One of the greatest frustrations is the growing inequity in health outcomes between the ‘haves’ and ‘have nots.’ Traditional models of understanding and addressing health disparity have fallen short and the health inequity gap continues to increase. We need to think differently. Healthcare is a CAS—the interactions between patients, care providers, and suppliers lead to outcomes that are more than the sum of the contributions of the individual agents. In this context, health disparity is an emergent phenomenon, the result of complex interactions among multiple interdependent variables that are unevenly distributed across people of different backgrounds. Using infant mortality rate as our outcome of interest, we define a novel 3-stage framework to understanding health disparity. Healthcare is a CAS and health disparity is an emergent phenomenon—it is independent of the motivation of individuals, and is neither intended nor desired. This alternative framework can be used to identify novel strategies and opportunities to close the health equity gap.
