Key Sections Research Articles

Resilience Assessment of Road Networks in the Extremely Severe Disaster Areas of the Wenchuan Earthquake

On 12 May, 2008, a magnitude 7.9 earthquake struck Wenchuan County, Aba Tibetan and Qiang Autonomous Prefecture, Sichuan Province, causing substantial losses of human life and property. This paper takes ten counties and cities along the road network in the extremely severe disaster areas of the Wenchuan earthquake as research objects and extracts typical road network characteristics for 10 time points during the pre-earthquake, damage and repair processes. Then, it builds three resilience assessment indices, namely, the overall integrity, overall connectivity and effective connectivity with the complex network and resilience framework, to investigate the road network resilience. A resilience curve of the road system based on real data from the extremely severe disaster areas of the Wenchuan earthquake is obtained here for the first time, revealing the total variation characteristics and key sections of the road system in terms of resilience and proposing strategies for resilience optimization.

Geology aspects, sedimentation environments and oil-and-gas bearing capacity of Vendian and Cambrian deposits of Lena-Tunguska basin

At present time several dozen hydrocarbon fields are known in the Vendian-Cambrian complex of the Lena-Tunguska basin, which clearly does not exhaust its potential. The significant stratigraphic interval of the complex, its thickness (up to 3000 m), favorable properties laid down in sedimentogenesis, namely the presence of source, reservoir and seal deposits, allow us to hope for the discovery of new oil and gas deposits. Sedimentological studies of the Vendian-Cambrian complex, carried out using a network of key lithological sections and outcrops, made it possible to create a series of schematic maps of sedimentation environments on a scale of 1:5000000 for six time intervals (Nepa, Tira, Danilovo, Tommotian-Early Atdabanian, Botomian-Amgaian and Late Cambrian). The evolution of sedimentation of the Vendian-Cambrian complex is considered, as well as an assessment of its oil and gas properties, which are primarily associated with various sedimentation environments.

Transformational leadership, integration and supply chain risk management in Vietnam's manufacturing firms

PurposeDue to an increase in vulnerability, supply chain risk management (SCRM) has gained the attention of both researchers and practitioners. Although different approaches have been widely used to discuss the implementation of risk management, the impacts of leadership factors on SCRM have received little attention. To fill this gap in the literature, this study aims to examine whether transformational leadership and integration facilitate SCRM and enhance performance.Design/methodology/approachUsing 261 Vietnamese manufacturing companies as sample, this study applies partial least squares based structural equation modeling (SEM) to test the proposed hypotheses.FindingsThis study demonstrates three contributions for exist leadership and supply chain literature. First, the characteristics of transformational leadership effectively facilitate the internal and external integration in supply chain with higher responsiveness, visibility and integration. Second, transformational leadership has indirectly effect to supply chain risk management practice (SCRMP) throughout supply chain integration (SCI). Additionally, three dimensions of integration enable SCRM and partially mediate the relationship between transformational leadership and SCRM. Furthermore, SCRM not only plays a partially mediating role in the relationship between internal integration, customer integration and supply chain performance but also fully mediates the relationship between supplier integration and supply chain performance.Practical implicationsThis study addresses that the paper extends the content of the relationship between transformational leadership and SCI by three integration dimensions among of exist literature. Transformational leadership should be literarily included into part of leadership strategy on SCRMPs since it is shown to have an indirectly positive improvement effect on SCRM. In addition, the paper is targeted the supply chain downstream performance (SCDP) with integration and risk management with the concept of considering downstream performance is a key section to confront the external stakeholder and customers, Finally, the authors emphasized companies should be aware of the importance about how to include transformational leadership, SCI and SCRMP into its supply chain management.Originality/valueThis study contributes to the SCRM literature by empirically examining the effect of transformational leadership and SCI on SCRM and performance in Vietnam, which is few and far better than that of developed countries.

Investigating the Performance of Solar Steam Generation Using a Carbonized Cotton-Based Evaporator

Solar-driven steam generation as a potential green technology has attracted extensive attention to solve the freshwater scarcity crisis. Photothermal materials as the key section of solar steam generation have been widely reported. However, there is still a challenge in developing easily prepared, environmental-friendly, and low-cost materials. Herein, the simple, scalable, and porous carbonized cotton was prepared as an evaporator to enhance solar-based evaporation, which has excellent light absorption ability in the range of the full spectrum (300–2,500 nm). Benefiting from 95% solar absorption and the pores between the cellulose tubes, the carbonized cotton heated by plate carbonization reaches a steam generation rate of 0.8 kg m−2 h−1, which is about 5 times that of untreated cotton. Compared with tube furnace carbonization, flat plate heating carbonization of cotton requires lower equipment requirements and does not need nitrogen protection and cleaning tar, and the photothermal conversion efficiencies of both are similar. In addition, carbonized cotton as an evaporator was heated up rapidly under 1 sun irradiation and reached a stable temperature in 20 s, greatly improving the photothermal conversion rate. Therefore, plate heating carbonized cotton provides a good idea for preparing solar photothermal conversion materials and a novel strategy for simplifying the production of biomass thermal evaporators.

Testing a proposed new chronology for the Jasmund Glacitectonic Complex (SW Baltic Sea): No indication of incipient deformation during MIS 3

Weichselian advances of the Scandinavian Ice Sheet have generated several glacitectonically deformed structures in the southwestern Baltic Sea area. One example is the 100 km 2 large Jasmund Glacitectonic Complex (JGC), which was formed proglacially and consists of two subparallel-orientated sets of composite ridges that represent a northern and southern structural complex. The two-part morphological structure of the JGC suggests a formation by two ice advances, one approaching from NE and one from SE direction. So far, this divided structure has been assumed to have been formed by short-time ice-front oscillations during an MIS 2 ice advance. However, based on their recently published ice dynamic model for MIS 3 and the available age data from Jasmund, lüthgens et al. (2020) propose a chronological reinterpretation of the JGC development, according to which two distinct ice advances during early and late MIS 3 formed the JGC. In order to test this novel stratigraphical model for the JGC formation, five OSL samples were taken from fluvial and lacustrine deposits at a key section near Glowe (NW Jasmund). The investigated succession is divided into pre-kinematic sediments, deposited before the glacitectonic deformation, and post-kinematic sediments, deposited after the deformation. Our results show that the youngest dated pre-tectonic sediment has a burial age between ∼40 and 34 ka, which rules out a glacitectonic deformation during an early MIS 3 ice advance (∼60–50 ka). In addition, by reviewing the existing age data set, a development of the JGC during an early and late MIS 3 advance of the SIS must be rejected. Instead, our data confirm the genesis of the JGC during MIS 2.

Clinical Evaluation of Siponimod for the Treatment of Secondary Progressive Multiple Sclerosis: Pathophysiology, Efficacy, Safety, Patient Acceptability and Adherence.

IntroductionA number of disease-modifying therapies have been approved for use in relapsing-remitting multiple sclerosis (MS) in the past two decades. However, only few treatment options are available for patients with secondary progressive multiple sclerosis (SPMS). Siponimod has recently been approved for use in patients with active forms of SPMS (who experience clinical relapses or new lesions on MRI superimposed on secondary progression independent of relapse activity).ObjectiveThe aim of this article is to provide a comprehensive review on the mechanism of action, efficacy, safety, cost effectiveness and patient adherence with siponimod.MethodsWe performed a PubMed search using the search terms: “siponimod”, “secondary progressive multiple sclerosis”, “sphingosine 1-phosphate modulators”. Titles and abstract were screened and selected for relevance to the key section of this article.FindingsSiponimod is an oral sphingosine-1-phosphate receptor (S1PR) modulator with selectivity to S1PR-1 and 5. Modulation of this receptor on lymphocytes causes its internalization and degradation, preventing their egress from lymphoid tissues to the blood. In the pivotal Phase 3 randomized controlled trial EXPAND, siponimod was superior to placebo in reducing the risk of disability progression confirmed at 3 and 6 months, as well as the development of new MRI lesions and the rate of brain volume loss. Secondary analysis also showed a benefit on measures of cognitive functioning. The risk of lymphopenia and first-dose bradycardia appears to be lower with siponimod compared to non-selective S1P1R modulators. Different CYP2C9 genotypes affect the metabolism of siponimod; hence, genetic testing is required to adapt the titration and final dose accordingly.ConclusionLong-term extension and real-world studies will allow further evaluation of efficacy and safety in this population. Future research should focus on better defining SPMS, and identifying biomarkers of progression and outcome measures of treatment response in this category of patients.

South American Triassic geochronology: Constraints and uncertainties for the tempo of Gondwanan non-marine vertebrate evolution

Gondwanan sedimentary deposits preserve a rich archive of Triassic non-marine vertebrate evolution. This fossil record is integral to understanding early Mesozoic global change events, including the end-Permian and end-Triassic mass extinctions, Carnian Pluvial Episode, and macroevolutionary events such as the origin of dinosaurs. Until very recently, almost all of these fossil assemblages were dated by exclusively biostratigraphic means, which made robust correlation to the GSSP-defined timescale difficult. Furthermore, recent advances in radioisotopic dating and magnetostratigraphy have demonstrated that many of these biostratigraphic schemes were imprecise and that key index taxa have different first and last appearances across geographic space. Thankfully, over the past ten years, new radioisotopic and magnetostratigraphic age constraints from fossiliferous sequences in South America have allowed the revision of the absolute ages and relative correlation of key Gondwanan vertebrate assemblages.Here, we review these geochronologic age constraints from South America, describe and revise their accuracy and uncertainties, present new U–Pb zircon age data for a key section in Venezuela, infer preliminary age models for these successions, and discuss what they mean for the correlation of fossiliferous Triassic units in Gondwana. This synthesis suggests that although radioisotopic age data are often numerous, the geological uncertainties associated with U–Pb zircon dates using micro-beam techniques (LA-ICPMS and SIMS) mean that the age of most sedimentary units cannot be constrained better than a precision of ± 3–5 Ma. Although CA-TIMS U–Pb zircon ages and 40Ar/39Ar ages can be more precise and accurate, they only result in well-constrained age models when multiple ages are available throughout the section (e.g., Ischigualasto-Villa Unión Basin of northwest Argentina), and even then, issues with lateral correlation within basins remain. Nonetheless, these data demonstrate that South America has high potential for developing a precise and accurate Triassic non-marine numerical timescale for Gondwanan vertebrate evolution.

Aptamers against Pathogenic Bacteria: Selection Strategies and Apta-assay/Aptasensor Application for Food Safety.

Pathogenic bacteria are primarily kinds of detrimental agents that cause mankind illness via contaminated food with traits of multiple types, universality, and low content. In view of the detection demands for rapidity, aptamer recognition factors emerged as a substitution for antibodies, which are short single strands of nucleic acid selected via in vitro. They display certain superiorities over antibodies, such as preferable stability, liable modification, and cost-efficiency. Taking advantage of the situation, numerous aptamers against pathogenic bacteria have been successfully selected and applied, yet there are still restrictions on commercial availability. In this review, the strategies/approaches to key sections in pathogen aptamers SELEX and post-SELEX are summarized and sorted out. Recently, optical, electrochemical, and piezoelectric aptamer-based assays or sensors dedicated to pathogen detection have been critically reviewed. Ultimately, the existing challenges and future trends in this field are proposed to further promote development prospects.

PARLIAMENTARY RESEARCH SERVICES: FOREIGN EXPERIENCE AND RECCOMENDATIONS FOR UKRAINE

The article emphasizes attention to the main mechanisms for ensuring internal political security aimed at reducing and avoiding threats to fully develop а state in accordance with its purposes, which is the part of the national interests of the country. The power of the people is realized through the exercise of the final choice between the programs proposed to them or individual political forces, which it authorizes to implement the activities provided for by the relevant programs and decisions. The importance and role of the "internal political" sphere is analyzed, which is closely linked to ensuring the sovereignty of the people to exercise their own power using a variety of political mechanisms through which the people declare their existence. Democratic political systems include mechanisms to ensure that participants in the political process have access to the communications necessary to communicate to the people the information they need to make adequate choices, mechanisms to formalize the choice of people, ensuring that their results are binding on all other subjects, and mechanisms to ensure the implementation of decisions approved by the people's will. It has been found that the implementation of mechanisms of democracy contributes to the consolidation of a democratic society, ensuring domestic political security and the ability of the political system to respond promptly to the threat of national security. The emphasis on the need to preserve the system of mechanisms of democracy from destruction due to abuse of power. Their action should be aimed at preserving competition between political forces that compete for delegated to the people of power. It is determined that in modern democratic systems, the non-homogeneity of society finds its expression in the distribution and deconcentration of power, which ensures the participation of the opposition in the processes of its implementation. An important role in this process is given to democratic elections as an instrument against attempts to usurp power, as well as a referendum to be held in the event of changes to the country's constitution or key sections, changes in territory and more.

From Theology And Philosophy To Psychology In The West

This study aims to explore the Western epistemological shift over the last five hundred years: a move from Christianity to secularism. To do this, we will address key philosophical, theological and psychological developments and their respective proponents in history. We will also note the consequences of these ideas on broader human society. We will approach this topic from a Biblical epistemological foundation, allowing our faith in God to guide our interpretation of these developments. This article is divided into five key sections, each addressing the concerns of different ages in history. We discover that relativism is what binds all of these ages and developments together.

Evidence-based Features of Writing Instruction in Widely Used Kindergarten English Language Arts Curricula

ABSTRACT This study described the features of writing instruction in widely used kindergarten English Language Arts programs and examined their alignment with evidence-based, best-practice guidelines. Three popular curricula were selected for analyses: Reading Wonders, Journeys, and Reading Street. Our coding of teacher manuals focused on instructional provisions for composing, spelling, and handwriting in key instructional sections within each curriculum: (1) genre writing, (2) grammar, and (3) reading instruction. Lessons for coding were sampled from the beginning, middle, and end of each program, comprising 12 weeks of instruction. Results indicated that, although variable across curricula, there were several features of writing instruction that aligned with evidence-based guidelines. All curricula included daily writing lessons and activities, along with provisions for teaching the writing process and basic writing skills (i.e., sentence construction, spelling, handwriting). However, instruction in basic writing skills were often isolated and support for these skills was rarely embedded within the context of children’s own written compositions. In addition, children had relatively less opportunities to independently write their own compositions in genre writing compared to teacher modeling writing or using shared writing. Results of this study could inform efforts to revise or develop curricula to better facilitate the writing development of kindergartners.

201P Readability of thoracic surgery consent forms in Queensland, Australia

Written consent forms are a key component of obtaining informed consent from patients prior to lung cancer surgery. Reading literacy among Australians is generally poor, and it is recommended that written content is at a year 7 level to make it usable for most people. The aim of this project was to assess the readability of consent forms for thoracic surgery in Queensland, Australia. Queensland Health consent forms for “Thoracoscopy Surgical (VATS) &/or other procedures” and “Thoracotomy for Lung Resection” were obtained. The readability of the sections relating to risks of surgery (Section C), patient consent (Section G), and the patient information sheet were assessed via an online readability software program, using five separate validated methods: (i) Flesch-Kincaid grade level, (ii) the SMOG (Simple Measure of Gobbledygook), (iii) Coleman-Liau index, (iv) Automated readability index, (v) Linsear Wriste formula. Statistical analysis was performed using Microsoft Excel. The mean ± standard deviation reading grade level from all algorithms for risks of surgery, patient consent, and patient information was 7.81 ± 1.75, 10.77 ± 0.75, and 7.59 ± 1.14 respectively. The “Thoracotomy” form had the highest average grade level (8.81 ± 1.85) followed by “Thoracoscopy Surgical (VATS) &/or other procedures” (8.63 ± 2.06). Significant inter-algorithm differences were noted, with the Coleman-Liau nearly two grades higher than others, however the patient consent subsection was consistently above the recommended reading grade of year 7 among all algorithms. The readability of key sections of the Queensland Health thoracic surgery consent forms is above the recommended reading grade of year 7, and a large percentage of the population would be unable to fully comprehend the information. Consideration should be made to lower the reading grade level of patient consent forms.

Results of 2021 for the Consolidated Budgets of the Subjects of the Russian Federation: Overcoming the Crisis or Changing the Model of Intergovernmental Relations?

Theyear2021was quite favorable for the consolidated budgets of the subjects of the RussianFederation. The revival of economic activity in the regions and positive trends in the worldcommodity markets have led to an increase in tax and non-tax revenues of regional budgets.Themost significant increase in revenues to the consolidated budgets of the RF subjects wasprovided due to the recovery of wholesale and retail trade. The growth of its own revenuesallowedthe federal budget to reduce the total amount of financial assistance to the subjectsof the Russian Federation. At the same time, there was a pronounced increase in targetedtypesof support while reducing non-targeted ones. The volume of equalization subsidies inreal terms has decreased. The shift in emphasis in financial support to targeted transfers hasled to a pronounced trend towards an increase in the share of federal funds in the structureof expenditures on key sections of the consolidated budgets of the RF subjects within theframework of joint competence. The growth of expenditures of sub-federal budgets in 2021significantly lagged behind the increase in revenue receipts, but was higher than the rate ofinflation. Financing of housing and communal services, the national economy and educationgrew most dynamically. The result of the execution of consolidated budgets in 2021 was asurplus. At the same time, a number of RF subjects budgets were executed with a deficit.Some regions were forced to resort to deficit financing to maintain spending at the level oflast year’s values. Although the total amount of state and municipal debt slightly decreased,there was an increase in debt in some regions.

Global transportation of plastics and microplastics: A critical review of pathways and influences

The rapid development of modern society has largely increased the usage of plastic. Concerns arise when vast amount of plastic waste has been generated and disposed. The accumulated evidences suggest that plastic waste in all the natural matrixes has become a global contaminant, principles such as geological and biogeochemical cycles for plastic pollution have been proposed. Before a full estimation of plastic mass flow, however, the pathways, directions and influences involved in plastic transportation are warranted to be addressed. We made this critical review based on the quantitative and narrative approaches in plastic and microplastic sources, sinks and transportation at global and historical scales. We also addressed the roles of anthropogenic influences in the global transportation of microplastic. The hydrological, meteorological, oceanic and even biological progresses naturally influence the plastic cycle and flow directions within the Earth's Four Spheres. Anthropogenic activities participated in all sections of plastic transportation, from sources to sinks. The contribution from anthropogenic activities remains unknown but several point sources including primary emissions and landfills have been confirmed. The primary outcomes point out that plastic pollution is highly complex issues in terms of natural and human-driven dynamics. We suggested that more efforts were needed in seeking the key sections in plastic transportation between environmental compartments at a global scale.

Unravelling the histories of Proterozoic shales through in situ Rb-Sr dating & trace element laser ablation analysis

Authigenic components in marine sediments are important archives for past environment reconstructions. However, defining reliable age constraints and assessing the effects of post depositional overprints in Precambrian sequences are challenging. We demonstrate a new laserbased analytical approach that has the potential to rapidly and accurately evaluate the depositional and alteration histories of Proterozoic shales. Our study employs a novel application of in situ Rb-Sr dating coupled with simultaneous trace-element analysis using reaction-cell laser ablation– inductively coupled plasma–tandem mass spectrometry (LA-ICPMS/MS). We present results from shales sourced from two wells in the Proterozoic McArthur Basin, northern Australia. These rocks have been widely used by previous studies as a key section for ancient biogeochemical and paleoredox reconstructions. Shales from well UR5 yielded initial ⁸⁷Sr/⁸⁶Sr ratios, Rb-Sr ages, and rare earth element plus yttrium (REEY) patterns similar to those of a dolerite sampled from the same core. We propose that the UR5 samples chronicle hydrothermal alteration instigated by the dolerite intrusion. In contrast, a correlative shale from well UR6 yielded an age consistent with the expected depositional age (1577 ± 56 Ma) with REEY and initial ⁸⁷Sr/⁸⁶Sr ratios similar to ca. 1.5 Ga seawater. We suggest that this sample records the minimum depositional age and early marine diagenetic history for this unit. This new technique can date Proterozoic shales quickly, cheaply, and with minimum sample preparation. Importantly, ages are triaged to differentiate between those recording primary marine versus secondary processes. This novel approach provides a potentially powerful tool for dating and fingerprinting the vast array of ancient marine shales for further studies of Earth systems through deep time.

GPS data in taxi-sharing system: Analysis of potential demand and assessment of fuel consumption based on routing probability model

With the emergence of big geospatial data and the breakthrough of massive data processing, taxi-sharing offers the public a novel transportation mode with high comfort but low cost. However, designing a taxi-sharing system to effectively allocate taxi resources and provides high public acceptance services is an urgent problem to be solved. Furthermore, to what extent the taxi-sharing can be an eco-friendly service without bringing extra pressure to urban emission, fuel consumption, and transportation system is still an unanswered question. This paper proposes a methodology framework to design a taxi-sharing system with driver routing probability based matching and dispatching algorithms. The methodology is capable of matching multiple taxi trips into a sharing trip, with consideration of temporal and spatial feasibilities. The matching of sharing trips includes the determination of which trips to match and the sequence of the destinations. To examine the potential of operation efficiency improved and fuel consumption reduced in taxi-sharing, three scenarios are proposed with different constraints, representing different operation strategies. The sharing trips are then dispatched to the taxis. The potential of operating performance improvement and the potential of fuel consumption reduction are analyzed in the three scenarios. It is found that the delivery part of taxi-sharing may produce more travel distance because of the detour. The key factor for taxi-sharing service to reduce Vehicle Kilometres Travelled is the idle trips and the taxi resources saved. Considering both delivery trips and idle trips together, although taxi-sharing can reduce total fuel consumption in the city, it may increase traffic pressure in certain range area, especially in the key road sections or intersections in the urban road network and the area with high traffic demand.

“Leading to God’s Deepening Life”: Considerations of Saint Ignatius of Loyola as Spiritual Guide for Ongoing Transformation in Christ

This article seeks to explore the spiritual guidance of Saint Ignatius of Loyola as a worthy spiritual guide for our time as we consider some ways that we might seek to more clearly understand and authentically live out the call of Christ in our life journey. In this context of considering the work of Ignatius’ Spiritual Exercises as a viable tool for such interior conversion, it is necessary for the work of this article to take a closer look at some highlights of Ignatius’ own life journey in order to appropriately consider the significance of key sections of his Spiritual Exercises and the dynamics for Christian formation and transformation inherent in these selected texts. I seek to argue that any assessment of our spiritual maturity in Christ finds clear context in our everyday life experiences as Saint Ignatius so aptly demonstrates

Flame out! End-Triassic mass extinction polycyclic aromatic hydrocarbons reflect more than just fire

Global warming induced-wildfires of the 21st century reveal the catastrophic effects that widespread biomass burning has on flora and fauna. During mass extinction events, similar wildfire episodes are considered to play an important role in driving perturbations in terrestrial ecosystems. To better evaluate the record of biomass burning and potential carbon cycle feedbacks at the end-Triassic mass extinction (∼202 Ma; ETE), we investigated the relative abundances of a range of polycyclic aromatic hydrocarbons (PAHs) and the δ13C values of regular isoprenoids and n-alkanes at key sections in the SW UK. These data reveal little evidence for intensive wildfire activity during the extinction event, in contrast to what has been reported elsewhere in European, Chinese, and Greenland ETE sections. Herein, PAHs instead reflect greater contributions from an episode of soil erosion that we attribute to Large Igneous Province (LIP)-driven acid rain, and possible distal sources of smoke, suggestive of fire elsewhere in the UK/European basins. This terrestrial ecosystem perturbation is coincident with those in the marine realm, indicating ecosystem perturbations occurred across multiple habitats throughout the latest Rhaetian in the SW UK. Additionally, this geochemical approach reveals that the precursor carbon isotope excursion (CIE) routinely used in chemostratigraphic correlations is unrelated to LIP activity, but instead results from the increased input of terrestrially derived 13C-depleted plant material. Furthermore, we find the initial CIE (commonly used to mark the extinction level, but which is now known to precede the ETE) is also unrelated to biomass burning. Collectively, these data reveal that processes other than combustion of terrestrial material are important for the terrestrial phase of the ETE in the SW UK. Similar investigations are required on other ETE sections, both those in close proximity to the LIP driving the extinction and those further afield, to more clearly determine the negative effect(s) of LIPs and their geographic extent in the terrestrial realm.

Evidence for stages of landscape evolution in Central Mexico during the late Quaternary from paleosol-pedosediment sequences

AbstractPaleosols interbedded with pyroclastic deposits have been proven to be an important paleoenvironmental proxy for the late Quaternary in Central Mexico. We studied a key upland section and several profiles on the slopes and lowlands of the Tlaxcala Block, assuming that the topographic variability of the soil-sedimentary mantle contains the complete record of the landscape history. The upland section included three paleosols separated by tepetates (compact volcanic pedosediments) and reflected a general trend of environmental evolution during the last 40 ka. Particle-size distribution, bulk chemical composition, magnetic characteristics, computed tomography, and micromorphological observations demonstrated a strong seasonality of paleoclimate at the end of MIS3, followed by cool wet conditions during the last glacial maximum, subsequent warming at the beginning of the Holocene, and drying during the last 3 ka. It was shown that tepetates had well-developed pedogenetic features that contribute to the paleosol record. The studied slope and lowland profiles reflected the main phases of geomorphic activity in the terminal Pleistocene and the early Holocene. These phases are linked to paleoclimate fluctuations in Central Mexico at the end of the last glaciation.

781 IMPROVING THE QUALITY OF DO NOT ATTEMPT CARDIO-PULMONARY RESUSCITATION (DNACPR) FORM COMPLETION

Abstract Introduction The completion of a Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) form represents an important part of patient care. However, this can be a sensitive process that has gained national media interest. The aim of this Quality Improvement (QI) Project was to improve the quality of DNACPR form completion in a Care of the Elderly Department. Methods The QI project ran from May 2019 to January 2021 and was overseen by a multi-disciplinary team (including patient representation). DNACPR forms on the Care of the Elderly wards were audited monthly against 7 standards which correspond to key sections on the DNACPR form. During the data collection process, interventions were implemented using Plan-Do-Study-Act cycles. Interventions included: appointing ‘DNACPR Champions’ to complete monthly audits and provide personalised clinician feedback, the introduction of a new mandatory e-learning module, the creation of an alert system on nerve centre (the Trust’s electronic handover system) and the development of new DNACPR patient information including webpage development, videos and leaflets. Results The project has led to sustained improvements in majority of the 7 standards. The biggest improvements were seen in the inclusion of a review date, correct completion of the mental capacity assessment and the use of patient information leaflets. The documentation of discussions with patient and relatives remained below the audit standards and was largely unchanged during the QI project. Conclusion A multi-disciplinary and multi-faceted QI approach has shown to improve the quality of DNACPR form completion. Further work is needed to continue this process and a focus on staff training and ward-level processes will be the priority.