Study Design: Mixed-method consensus process. Objectives: Degenerative cervical myelopathy (DCM) is a common and disabling condition that arises when mechanical stress damages the spinal cord as a result of degenerative changes in the surrounding spinal structures. RECODE-DCM ( RE search Objectives and C ommon D ata E lements for D egenerative C ervical M yelopathy) aims to improve efficient use of health care resources within the field of DCM by using a multi-stakeholder partnership to define the DCM research priorities, to develop a minimum dataset for DCM clinical studies, and confirm a definition of DCM. Methods: This requires a multi-stakeholder partnership and multiple parallel consensus development processes. It will be conducted via 4 phases, adhering to the guidance set out by the COMET (Core Outcomes in Effectiveness Trials) and JLA (James Lind Alliance) initiatives. Phase 1 will consist of preliminary work to inform online Delphi processes (Phase 2) and a consensus meeting (Phase 3). Following the findings of the consensus meeting, a synthesis of relevant measurement instruments will be compiled and assessed as per the COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments) criteria, to allow recommendations to be made on how to measure agreed data points. Phase 4 will monitor and promote the use of eventual recommendations. Conclusions: RECODE-DCM sets out to establish for the first time an index term, minimum dataset, and research priorities together. Our aim is to reduce waste of health care resources in the future by using patient priorities to inform the scope of future DCM research activities. The consistent use of a standard dataset in DCM clinical studies, audit, and clinical surveillance will facilitate pooled analysis of future data and, ultimately, a deeper understanding of DCM.
For prey animals to negotiate successfully the fundamental trade-off between predation and starvation, a realistic assessment of predation risk is vital. Prey responses to conspicuous indicators of risk (such as looming predators or fleeing conspecifics) are well documented, but there should also be strong selection for the detection of more subtle cues. A predator's head orientation and eye-gaze direction are good candidates for subtle but useful indicators of risk, since many predators orient their head and eyes towards their prey as they attack. We describe the first explicit demonstration of a bird responding to a live predator's eye-gaze direction. We present wild-caught European starlings (Sturnus vulgaris) with human 'predators' whose frontal appearance and gaze direction are manipulated independently, and show that starlings are sensitive to the predator's orientation, the presence of eyes and the direction of eye-gaze. Starlings respond in a functionally significant manner: when the predator's gaze was averted, starlings resumed feeding earlier, at a higher rate and consumed more food overall. By correctly assessing lower risk and returning to feeding activity earlier (as in this study), the animal gains a competitive advantage over conspecifics that do not respond to the subtle predator cue in this way.
Marriage rates in twenty-first-century Britain are historically low, divorce and separation are historically high, and marriage is no longer generally seen as necessary for legitimate sexual relationships, long-term partnership or even parenting. Yet at the same time weddings have become more prominent, both as social aspiration and as popular culture. But why have a wedding, especially an ornate, expensive and time-consuming wedding, when there appears to be little social need to do so? Similarly, weddings have never been more free from cultural norms and official control – so why do these supposedly unique and deeply personal events usually replay the same assumed traditions? We draw from a small qualitative sample of 15 interviews with white, heterosexual celebrants to address these questions. While existing accounts posit weddings as a social display of success, emphasizing distinction, and manipulation by a powerful wedding industry, we argue that weddings involve celebrants necessarily adapting from, and re-serving, tradition as a process of bricolage. This shapes the four major discourses interviewees used to give meanings to their weddings: the project of the couple, relationality, re-traditionalization and romanticized consumption. At the same time many couples did not want to be distinctively unique, but rather distinctively normal. This is what we call ‘individualized conformity’.
Drawing on a 2011 national survey and 50 semi-structured interviews, we explore the differing ways in which those in living apart together (LAT) relationships discuss and experience notions of commitment. We found that sexual exclusivity in LAT relationships is expected by the large majority, regardless of their reasons for living apart. The majority of the interviewees also expressed a high degree of commitment to their partner in terms of love, care and intimacy, alongside an appreciation of the increased freedom and autonomy that living apart has to offer. Respondents were divided into four groups according to their perceived commitment: 1. Autonomous commitment, 2. Contingent commitment, 3. Ambivalent commitment, and 4. Limited commitment. Despite differing degrees of commitment, however, the overall finding was that the importance of relating and making relational decisions was central, even in the lives of those living in such unconventional relationship styles.
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