Against the backdrop of health research regulation, this work engages in an exploration of, and offers suggestions towards, how the decision maker can negotiate the complex path of the difficult decision. It is argued that whilst rules and principles are heavily relied upon in order to determine what to do, this reliance takes place without adequate reflection of the different ways in which we seek to rely upon these decision-making aids. What is most often the topic of analysis is the content which rules and principles carry rather than consideration of the different functions which each can fulfil or their (un)suitability in helping the decision maker. Before we consider which principles or rules should inform our decisions, we need to understand why we are using rules and principles. It follows that in order to understand why we might use rules and principles, we must understand how rules and principles can actually help us to reach decisions. Through the development and refinement of a conceptual tree, this thesis sheds light on the how and the why, in order to help decision makers determine the which. Through the metaphor of a continuum, additional insights are offered on the interrelationships that might co-exist between rules and principles. This thesis begins by offering an analysis of pre-existing understandings of rules and principles from legal theory and bioethics literatures. Additionally, I consider the implications of principle-centric and rule-centric approaches to decision-making. Through the overarching metaphor of a tree, a conceptualisation of best practice instantiations, which represent a helpful middle-ground between rules and principles is also offered. This can provide significant practical support to the decision maker in navigating the path of the difficult decision.

Certain debris accumulations in Bottelnek are ascribed a rock glacier origin on the basis of morphological and sedimentological evidence. Radiocarbon dating indicates that rock glaciers were active at or subsequent to 21 000 BP and that cold, stadial conditions, existed on the region after 27 000 BP and before 13 000 BP, during the Bottelnek Stadial. At least sporadic permafrost existed in Bottelnek when the rock glaciers were active.

Ten canines were utilized in a repeated design to examine the effects of stress associated with work on activity expenditure, core body temperature, and salivary cortisol. However, only eight canines had valid data results due to the ninth canine having a metabolic syndrome that was not diagnosed. The tenth canine was removed from the study prior to initiation of the search scenario due to aggression. The objective was to observe the impact of stressors associated with work on activity expenditure, core body temperature, and salivary cortisol in human remains detection canines. Nine canines were randomly assigned to 1 of 3 simulated search sites which each had two repetitions 1A) RU (rubble area with two concealed partial cadavers); 1B) RU (open crop field with one concealed partial cadaver); 2A) WA (wooded area with two concealed partial cadavers elevated off the ground); 2B) WA (wooded area with two concealed partial cadavers); 3A) MC (mass casualty area with eight exposed full body cadavers); 3B) MC (mass casualty area with five buried full body cadavers). Canines searched for an average of 90 minutes at each site which was then followed by a 10 minute rotation period where canines randomly rotated to one of the other two sites. Upon completion of the third site, canines repeated the first site location. There was a 69 minute rest period between the second and third rotation. Canines were rotated through search sites such that one canine was actively working (AW), the next canine was waiting to work (WW) and was exposed to visual and auditory stimulation in preparation for work and the third canine in the rotation was not working (NW) and crated in the handler’s vehicle with no visual or auditory stimulation associated with work 100 feet from WW area. Total activity expenditure was not influenced by site (P = 0.89) which may indicate detection canines were efficient in expending energy during this study. This correlated with the walk activity expenditure by site as it did not differ based on site (P = 0.16). The canines expended a similar amount of walk energy at each site and this may demonstrate that canines spent more time searching and in scent of the cadaver(s). Conversely, run activity expenditure was influenced by site (P = 0.03), specifically RU site was greater than MC site. When further comparison of the RU repetitions was analyzed, the second repetition was greater than the first in run activity expenditure (P < 0.0001). Canines at the RU site during the second repetition had an easier ability to run compared to the first repetition because of the nature of the site. Total activity expenditure was influenced by rotation (P = 0.04) but was not influenced by rotation within site (P = 0.17). The first rotation was greater than the fourth rotation which may indicate a psychological stressor such as anticipation of the work and possible acclimation of the site. The fourth rotation was at the same location site as the first rotation and canines did not have the novelty of the site as a psychological stressor during the fourth rotation. Canines that did not have exposure to full body cadavers prior to this study did not have greater total activity expenditure (P = 0.46) at the MC site compared to canines that did have exposure to full body cadavers prior to the study. There was an effect of phase on core body temperature (P = 0.0003). However, 95.3% of canines had their core body temperature peaked in the NW phase directly after the AW phase. Which demonstrates that core body temperature continued to increase post exercise. There was also a plateau in the core body temperature for 18 minutes post exercise which could indicate peripheral vasodilation. Attenuation of core body temperature occurred 37 minutes after cessation of the AW phase. There was an effect of site (P < 0.0001), rotation (P < 0.0001), and rotation within site (P < 0.0001) on core body temperature. This may indicate that there was a boundary layer stimulus that acted as a psychological stressor. In addition, the second and third rotation were greater than the first and fourth rotation which is most likely due to the increase in humidity during the second rotation. Core body temperature was impacted by total activity expenditure (P < 0.0001) which is to be expected with increased exercise, core body temperature increases. Salivary cortisol was influenced by site (P = 0.003), specifically the WA site was greater than the MC and the RU site. The WA site may have had a stronger psychological stressor with the tree lines compared to the MC and the RU sites. Rotation within site did impact salivary cortisol (P < 0.0001). However, rotation alone did not influence salivary cortisol (P = 0.42). Core body temperature did not impact salivary cortisol (P = 0.18). Total activity expenditure did not affect salivary cortisol (P = 0.73). Salivary cortisol and age of canine did display a pattern (P = 0.003). Salivary cortisol and exposure to prior full body cadaver did not displayed a pattern (P = 0.78). Based on these results, some physical stressors such as site, rotation, and exercise impacted activity expenditure, core body temperature, and salivary cortisol. This thesis provides limited data dissemination on three physiological parameters that may be impacted on independent variables that are associated with search scenario work. More research is needed to confirm if these specific stressors observed impact activity expenditure, core body temperature, and salivary cortisol in human remains detection canines.

Background: It is well documented that malnutrition has been and still is a widespread problem in NHS hospitals, yet it is not considered a priority. Sub-optimal nutrition in pregnancy can adversely affect the health of both mother and foetus. Poor dietary intaks following pelvic radiotherapy can impact on health and recovery of cancer sufferers. In Uk hospitals, numerous policies and campaigns have attempted to increase awareness and improve clinical management of malnutrition in recent decades, with limited success. The researcher is also a dietitian at the study hospital and so has an obligation to increase awareness and management of malnutrition. Aims: To identify the prevalence of some nutrition related problems in NHS hospital; to explore which areas of the community contribute malnourished women to the hospital; to investigate the role of malnutrition and its promotion within 'holistic care' and to review recent guidelines and policies aimed at tackling malnutrition in NHS hospitals.

This essay argues that repression and defense mechanisms contribute to the unreliability of Stevens’ narrationthrough three aspects: Stevens’ uncertainty of certain memories, his failure to report certain scenescorrectly and his defensive, self-contradictory discourse. There is no single best way to define what is consideredreliable and what is unreliable in narratology because the complexity of fictional characters will renderdifferent kinds of unreliability. This essay detects three kinds of unreliability of Stevens corresponding to thethree aspects mentIoned above: the first kind results from the untrustworthiness of our memory, the secondkind is the contradiction between the voice of the narrator and the other characters and the third kind lieswithin the narrative discourse. The unreliability of Stevens’ narration attributes to repression and defensemechanisms. The five kinds of defense mechanisms analyzed in the essay are selective memory, denial,projection, reaction formation and rationalization. In order to defend his self-image as a great butler, Stevenslies to or hides from himself and tries to avoid acknowledging certain undesirable thoughts or emotions. Eventhough Stevens becomes more reliable as he gains more self-realization during the road trip, his defensesare still on.

<p> Archaeological and historical literature neglects music and sound. The quantity and distribution of musical remains found during archaeological excavations at Coalwood, a Cleveland-Cliffs Iron Company (CCI) logging camp active from 1901&ndash;1912 in the Upper Peninsula of Michigan, addresses the importance of music to the people that lived there. Musical reed plates from harmonicas, concertinas, and accordions were recovered and examined. These musical remains have traditionally been ignored as a diagnostic artifact, but here, I use them as primary evidence to access the daily lives of people in the northern woods. To do this, I will present how CCI developed Coalwood as a lumber camp and some of the people that lived there. Then, I will explore the soundscape through artifacts and bring attention to formal and informal music ensembles and the music they play. I will demystify the reed plate and present a typology of reed plates.</p><p>

The aim of this thesis was to critically evaluate the evidence for disarticulated human remains in shell middens, using sites in northwest Europe dating to the Late Mesolithic/Early Neolithic as case studies. Traditionally, disarticulated remains placed in shell middens have been overlooked and assumed to be the result of burial disturbance with little in-depth analysis to the plausibility of this as an interpretation. The research considers whether it is possible to determine that the remains occurred through disturbance to inhumations, and to assess to what extent it is possible to reconstruct the processes of deposition of disarticulated remains. A new methodology has been developed with specific emphasis on identifying what taphonomic processes may have led to commingled human remains to be found at shell midden sites. Six hypothetical bone profile diagrams are presented, based on differing taphonomic processes known to affect burial remains. These hypothetical diagrams then provide comparative models to assess the evidence presented in the case studies. Three case studies located on the coast of western Scotland; Cnoc Coig, An Corran and Carding Mill Bay, demonstrate that it is likely that the placement of human remains into ancient shell middens emerged as part of secondary burial practices employed around the time of the Mesolithic/ Neolithic transition, while a Danish case study, Havnø, highlights a potential change in practices occurring from the Mesolithic into the Neolithic. Critically, the close assessment of the disarticulated remains provides strong evidence that disarticulated remains in shell middens are likely to be the result of more complex burial processes than previously thought.

The repatriation of the human remains of Indigenous peoples collected within a colonial context has been the subject of debate within UK museums over the last 30 years, with many museums now having returned human remains to their countries of origin. Although the repatriation of human remains is often characterised as the 'journey home', there has been a lack of consideration of the physical presence and mobility of the remains and the meanings created as they move through different spaces. This study uses the repatriations from The Royal College of Surgeons of England (RCS) to Australia, New Zealand and Hawaii as case studies to consider three key areas: (i) the impact of repatriation on museum landscapes; (ii) the journey of the repatriated remains and how this mobility intersects with wider discussions about restitution, sovereignty, identity, relatedness, memory and memorialisation; and (iii) the repatriation archives, how they are thought about by the institutions that hold them and their future potential and meaning within a post-colonial context. Taking a more-than-representational approach and engaging with the materiality, mobility and agency of the repatriated remains and the documentation that relates to them, this study bridges the gap between research considering the approach of museums to repatriation, and ethnographic studies on the meanings of the return of ancestral remains to individual communities. Combining work on museum geographies, deathscapes and absence opens up new ways of theorising and discussing repatriation through understanding the process in terms of the tension between absence and presence, and human remains as being in or out of place. Through engaging with the materiality and agency of the remains and viewing repatriation through a spatial lens, this thesis deals with aspects of the process that have received little attention in previous studies, foregrounding the challenging nature of repatriation for communities, the issues around unprovenanced remains, and discussions about the control, management and meaning of information and data, identifying that a significant legacy of repatriation for RCS is the documentation the museum continues to hold. What the journey of the ancestral remains repatriated by RCS illustrates is the emotive materiality of the remains, and agency that they and the distributed repatriation archive have as actors within social networks. It is therefore proposed that the concept of repatriation as having problematised human remains collections within UK museums is replaced with a nuanced and contextually sensitive understanding that recognises the role of the human remains in social interactions that impact on the emotional geographies of museum practice, and that rather than framing repatriation as post-colonial act that is either political or therapeutic, the return of ancestral remains be understood as part of a process of decolonisation in which there is space for discussion, disagreement and debate amongst all stakeholders.

The early Mesolithic site of Star Carr (approximately 11 ka BP) is widely acknowledged as one of the most important wetland sites in Northern Europe. It has provided some of the most informative archaeological evidence for hunter-gatherer lifestyles in Britain at that time. However, recent observations suggest that the site is no longer providing the conditions necessary for such remarkable archaeological preservation. In 2007 and 2008, excavations at the site uncovered artefacts displaying alarming levels of diagenesis, suggesting that current conditions may be leading to the destruction of any organic material yet to be uncovered. Geochemical and hydrological investigations suggest that this is closely linked to changes occurring due to drying out of the site. However, scientific data regarding the rates and mechanisms of decay in such acidic environments are severely lacking. The aim of this thesis is to apply an experimental approach to investigate the observed deterioration, in order to answer some key questions: Is Star Carr undergoing accelerated deterioration, and if so, how are the changing site conditions contributing to this? Ultimately, by learning more about the key factors facilitating degradation in the specific burial environments at Star Carr, strategies to slow or stop the deterioration can be recommended, both for Star Carr and other wetland archaeological sites. A suite of appropriate analytical methods have been tested and applied to assess deterioration in both bone and wood. It has been shown that as different techniques provide complementary and sometimes contradictory information, a multi-analytical approach is needed. Using these techniques it has been shown that bone mineral rapidly dissolves in acidic solutions, buffering the acidity. As a result, collagen is left exposed and also breaks down leading to the loss of bio-archaeological information. The effects of pH on wood degradation are more subtle, but burial experiments show that drying out of the burial environment can have a severely detrimental effect on the survival of structural polymers in wood. Analysis of material excavated from Star Carr has shown that preservation differs across the site. For bone this is closely related to the geochemical conditions. It seems likely that bone in the current state of preservation would quickly deteriorate further at the low sediment pH recorded. Due to the localised differences in geochemistry and organic preservation across the site, any mitigation strategies aimed at slowing organic decay need to carefully consider all material that may yet be buried, and their varying states of diagenesis. Rapid changes in both materials (bone and wood) following excavation have also been observed. It is recommended that post-excavation strategies be designed to slow or stop these changes.

Polymer pipes have been used in water distribution networks in the UK since the 1950’s. Prior to this, the water system implemented in the Victorian era had served the country for over 100 years. In more recent times, the Victorian pipe system has undergone extensive renovation. Much of this has required the replacement of the old network using polymer pipes, which are expected to have a working life of 50-100 years. The value of using polymer water pipes has been studied for many decades. Specifically, research has used set conditions to determine overall pipe in-service lifetime. However, these set conditions often do not mirror reality; in-service pipes experience and must cope with, different loads, varying soil types and changeable chemical composition of water additives. As a result, water companies currently have no methodology to accurately determine the remaining in-service life of their polymer pipes. Currently, a water pipe is only replaced when it has failed, or is deemed to have reached the end of its in-service life. The ability to do small scale tests to obtain accurate service life information would greatly benefit the planning of works and the locating of sites where pipes are no longer fit for service. This in turn would improve cost effectiveness of pipe replacement works and importantly, maintain good customer-relations. This thesis aimed to review how different techniques could be utilised to predict the overall lifetime of polymer pipes under various, more realistic conditions, and to critically assess each for suitability and accuracy. To thoroughly investigate each of these techniques, tests were carried out on polyethylene pipes. Two different polyethylene grades currently used by Thames Water were tested: PE100 used mostly as the central main pipeline and PE80 used to connect the mains to the customer. Accelerated ageing was employed to artificially age pipe material for varying periods of time and under different stresses and temperatures. In order to quantify the incurred effects upon the polymer pipe, specific markers pertaining to polymer carbonyl content, crystallinity, density and susceptibility to thermal oxidation were subsequently investigated. Extrapolation methods were then used to identify suitable markers for determining remaining in-service lifetime of polymer pipe. The results presented in this thesis are of numerous chemical evaluations carried out on various aged polyethylene samples. The identification and subsequent use of appropriate chemical evaluation techniques allowed the generation of a method that ranked pipes in terms of replacement priority. Furthermore, these results indicate that polyethylene degrades via a different mechanism in Arkopal as compared with water; it appears that Arkopal promotes polymer chain disentanglement, not oxidation-related embrittlement.