This study analyzed the production and perception of Portuguese and English voiceless stops by twelve heritage learners of European Portuguese. Data were collected through two pseudoword reading tasks, a cross-linguistic rated dissimilarity task, and a cross-language perceptual assimilation task. The results show that Canadian English–European Portuguese bilinguals did not perceptually distinguish between aspirated and plain voiceless stops. However, the acoustic analysis revealed that they produced a significant language-specific difference between English aspirated and Portuguese unaspirated voiceless stops. Individual variation was observed in the categorization and production of heritage Portuguese plain stops and correlated with language use and perceived accent ratings.

Harnessing the power of the presidency, Lyndon Baines Johnson required America to wrestle with its past. Together, the powerful social movements of the 1960s and his Great Society catalyzed a cycle of reckoning and discomfort that changed America until the war in Vietnam, and anger and angst about government, identity, and power brought it to an end. We’ve tried to forget LBJ and, in some cases, what his presidency achieved and helped unearth. But we ignore him at our peril. The Johnson years have much to teach us, as America in the 1960s and today’s America have much in common. America today, as in the 1960s, is tumultuous. Armed with our memories and different conceptions of how we got here, we’re struggling to define our problems and the answers appear unknowable and out of reach. But instead of actively looking away from the past, we can choose to learn from it. Remembering Lyndon Johnson and his presidency – the good and the bad – offers us the opportunity to reposition government as an ally, not an enemy, and to acknowledge and confront the historically toxic relationship that binds power, politics, and American identity so we can move closer to our democratic aspirations.

Following our discussion of English vowels in Chapter 3 and rhoticity in Chapter 4, this chapter introduces you to English consonants, as well as variation in consonant inventories across varieties of English. We begin the chapter with a discussion of the characteristics of consonants, focusing on the classification of consonant sounds by place of articulation, manner of articulation, and voicing. This overview also examines consonant inventories cross-linguistically, to help you understand which consonants – and consonant features – are the most common across languages, and why.

The next two sections of the chapter provide an overview of English consonants by introducing the consonant phonemes common to many varieties of English, with variation in these inventories discussed as relevant. A brief overview of modern-day spelling of English consonants is also given. Consonant variation within varieties of English and phonological rules that govern this variation are then discussed. In the final section of the chapter, you will be guided through exercises designed to check your understanding of the content of the chapter and an analysis of your own English consonant inventory.

Oocyte pick-up is the process whereby oocytes are microscopically identified and pipetted from follicular fluid aspirates and placed into a culture environment prior to in vitro fertilization (IVF). This chapter sets out the laboratory operating procedure for oocyte pick-up and considers practical training methods and competency assessment. From the outset, it is important for embryologists or technicians to be aware that changes in the wider environment of a gamete or embryo can affect its immediate culture environment. The external environment includes not only the space in which the pick-up is performed – the flow hood, which much provide stable temperature and pH maintenance for the oocytes – but also the consumables and culture media used. Task-based training leading to competency should follow a robust pathway. Oocyte pick-up is a critical process and, as such, should be performed effectively and reproducibly by the embryologists within the team.

In this chapter, I argue that the philosophy of Friedrich Nietzsche is of central importance to the theory and practice of moral education in the 21st century. To make this case, I examine an oft-neglected text of Nietzsche’s early philosophical work: Schopenhauer as Educator. I argue that this text advances a theory of moral education with three key components: (i) a view about the particular cultural context of moral education in modernity, (ii) a conception of the proper aims of moral education, and (iii) an account of the appropriate pedagogical methods of moral education. I then discuss the kind of theory Nietzsche advances. I show that Nietzsche’s theory fits within a broadly exemplarist outlook, though it expands the standard theory and practice of exemplarist moral education in important ways. I argue that Nietzsche’s theory of moral education suggests two novel forms of exemplarist motivation – self-exemplarism and fallibilistic exemplarism – and further specifies the psychological conditions for moral aspiration and transformation to occur in educational spaces.

Since the late 1990s, anthropologists have increasingly turned their attention to ‘happiness’ and ‘well-being’, a field of study long dominated by moral philosophers, social psychologists, and welfare economists. This chapter reviews anthropological approaches to happiness and well-being, and their engagement with ideas from virtue ethics, value theory, and capabilities approaches to development. Across a range of ethnographic cases in which the concepts have been applied as well as from which analogous concepts have been drawn, we highlight the analytical tension between (a) a search for objective measures that can be used to guide efforts aimed at increasing well-being and reducing global inequities and (b) the exploration of cultural worlds in which different peoples conceive of and pursue ‘the good life’ in varied and sometimes incommensurate ways. This multidisciplinary analytical field has been productive for anthropological theory, but scepticism remains around the implications of its evaluative impulses and ambitions.

Surgery represents a physiologic challenge to even healthy patients - and many patients enter surgery with risk-intensifying co-morbidities. As a result, medical emergencies can occur during any surgery. Recognition and early management of these crises is crucial. Thus, this chapter seeks to provide an overview of serious medical emergencies that may arise in the preoperative period, ranging from anaphylaxis to diabetic ketoacidosis. To provide context for investigations and treatment, a brief outline of the relevant pathophysiology and/or epidemiology accompanies each problem. Building upon that foundation, this chapter describes the rudiments of recognising the emergencies and managing them appropriately. It is not the goal of the chapter to address the included issues comprehensively but to impart basic, essential knowledge of medical emergencies that will help the reader to participate in the provision of safe care in the operative setting.

As Medicare has focused more on hospital readmissions and care transitions over time, programs and movements aimed at providing geriatric-focused care have developed nationally. These programs aim to minimize and prevent hazards of hospitalization, decrease readmissions, provide safer transitions to the post-acute setting, and decrease length of stay while acknowledging and addressing specific care considerations of hospitalized older adults, such as dementia, sensory impairment, and mobility impairment. Inpatient geriatric assessments help providers tailor care plans to the specific needs of individual hospitalized older adults and determine their post-acute care needs, and also help with appropriate counseling of family and caregivers. Prevention measures are vital during hospitalization of older adults, who are at higher risk of delirium, pressure injury, falls, aspiration, malnutrition, sleep disturbances, and venous thromboembolism. Detailed transition plans and specialized discharge summaries are important to highlight the needs of older adults as they transition to post-acute care settings, and should allow for providers to resume the care plan seamlessly, including continuation of advanced care planning conversations.

Key Learning Points

1. 1. Drowning is a leading global killer of children and young adults.

2. 2. Outcomes from drowning are uncertain, principally determined by the time of cerebral anoxia, and not the extent of pulmonary aspiration and soiling.

3. 3. Trauma should be considered as a potential cause or consequence of drowning; hence, protective C-spine measures should be considered.

4. 4. Rescue breaths should be administered to both adult and paediatric drowned patients with or without spontaneous circulation.

5. 5. Hypothermia is commonplace in drowned patients and should be managed with active rewarming to 34°C.

Chapter 10 of The Cambridge Companion to Sappho describes the distinctive features of Sappho’s poetic dialect, highlighting especially significant points and noting particular difficulties.

Endovascular thrombectomy (EVT) with highly effective reperfusion devices is beneficial for: 1) relatively broadly selected acute ischaemic stroke patients with anterior circulation large vessel occlusions (LVOs) who have failed or are ineligible for intravenous fibrinolysis, up to 7 h after onset; and 2) imaging-selected patients with a favorable penumbral profile (small core and substantial salvageable tissue) 6–24h after onset. Among early-presenting patients, benefit is strongly time-dependent; for every 4 m delay in door-to-reperfusion time, 1 of every 100 patients has a worse disability outcome. Based on the trial evidence, EVT is strongly endorsed by guidelines worldwide. Within the first 7h, benefit is evident in patients under and over age 80, and in patients with up to moderate early ischaemic changes on imaging (ASPECTS 6-10). Systems of care should be optimized to deliver likely LVO patients to endovascular-capable stroke centers, and for procedure start (arterial puncture) within 75m, and optimally within 45m, after ED arrival. Large-scale trials are testing: best prehospital recognition and routing protocols: novel device designs to increase reperfusion rates in large and also medium vessel occlusions; bridging neuroprotection and collateral enhancement; potential benefit in patients with large cores; and best concomitant therapies, including sedation mode and post-procedure blood pressure management.

Pulmonary aspiration of gastric contents during general anaesthesia can be fatal. A 1956 report identified pulmonary aspiration as the commonest cause of death during general anaesthesia and NAP4 reported similarly in 2011. Major efforts have been made to reduce its incidence. Cricoid pressure (force) was introduced in the 1960s but remains controversial. Recent studies and new techniques have shed further light on the debate. The role of second generation supraglottic airway devices and videolaryngoscopy is also discussed.