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Delivering compassionate NHS healthcare : a qualitative study exploring the ethical implications of resetting NHS maternity and paediatric services following the acute phase of the COVID-19 pandemic
No full textA distinction can be drawn between healthcare, where compassion is evident, and the functional delivery of health services. Measures to curb the spread of COVID-19, such as personal protective equipment, telehealth, and visiting restrictions created barriers to service delivery and put pressure on healthcare. Through 37 qualitative interviews with NHS senior managers (n = 11), health professionals (n = 26), and 5 focus group discussions with members of the public (n = 26), we explored experiences of the everyday ethical tensions created as services were being re-established following the acute phase of the COVID-19 pandemic in England. Our analysis enriches an understanding of compassionate care as outlined in NHS operational documents - covering the emotional, moral, and relational components of healthcare beyond the functionalities of treatment. From this analysis, we consider the normative standards underpinning NHS healthcare, concluding that, wherever possible, offering compassionate healthcare to patients and their families should be facilitated, and health professionals should themselves be compassionately supported in the workplace. Our findings foreground the need to consider the consequences of the short-term adoption of a functional treatment approach, including strategies that support health professionals and inform the public, to avoid the long-term damage caused by the fracturing of compassionate healthcare
Screening of hydrophilic polymers reveals broad activity in protecting phages during cryopreservation
Get PDFBacteriophages have many biotechnological and therapeutic applications, but as with other biologics, cryopreservation is essential for storage and distribution. Macromolecular cryoprotectants are emerging for a range of biologics, but the chemical space for polymer-mediated phage cryopreservation has not been explored. Here we screen the cryoprotective effect of a panel of polymers against five distinct phages, showing that nearly all the tested polymers provide a benefit. Exceptions were poly(methacrylic acid) and poly(acrylic acid), which can inhibit phage-infection with bacteria, making post-thaw recovery challenging to assess. A particular benefit of a polymeric cryopreservation formulation is that the polymers do not function as carbon sources for the phage hosts (bacteria) and hence do not interfere with post-thaw measurements. This work shows that phages are amenable to protection with hydrophilic polymers and opens up new opportunities for advanced formulations for future phage therapies and to take advantage of the additional functionality brought by the polymers
Absolute and relative stability of loss aversion across contexts
Get PDFIndividuals’ decisions under risk tend to be in line with the notion that “losses loom larger than gains.” This loss aversion in decision making is commonly understood as a stable individual preference that is manifested across different contexts. The presumed stability and generality, which underlies the prominence of loss aversion in the literature at large, has been recently questioned by studies reporting how loss aversion can disappear, and even reverse, as a function of the choice context. The present study investigated whether loss aversion reflects a trait-like attitude of avoiding losses or rather individuals’ adaptability to different contexts. We report three experiments investigating the within-subject context sensitivity of loss aversion in a two-alternative forced-choice task. Our results show that the choice context can shift people’s loss aversion, though somewhat inconsistently. Moreover, individual estimates of loss aversion are shown to have a considerable degree of stability. Altogether, these results indicate that even though the absolute value of loss aversion can be affected by external factors such as the choice context, estimates of people’s loss aversion still capture the relative dispositions toward gains and losses across individuals
Oscillation of an ultrasonically driven gas bubble in an asymmetric confined domain
No full textThis study numerically investigates the behaviour of an ultrasonically driven gas bubble between two parallel rigid circular walls with a cylindrical micro-indentation in one wall using the OpenFOAM software. The primary objective is to determine the conditions that facilitate the removal of particulate contamination from the indentation using the bubble jet. To accomplish this objective, various values of the indentation diameter D∗ were considered, ranging from 0 to 23. It was found that, when D∗<4.9, during the collapse phase, the bubble splits into two smaller sub-bubbles, within each of which a liquid jet emerges pointing towards the adjacent wall. Once the lower sub-bubble transforms into a toroidal shape, the high-speed liquid jet penetrates the indentation. This allows for the effective removal of particulate contamination present within the indentation specifically for cases where D∗<4. On the other hand, the lower sub-bubble completely vanishes when D∗≥4.9, rendering the removal of contamination impossible. It is important to note that for large values of D∗, there may exist situations in which numerical instability arises, resulting in the creation of artificial gas-filled regions within the liquid. We effectively resolve this issue through the proper treatment of the computational grid
Critical review : ‘Green’ ethylene production through emerging technologies, with a focus on plasma catalysis
Get PDFOver the years, numerous studies have explored the green synthesis of ethylene. Within this context, the focus of this perspective shifts toward plasma technology, which has demonstrated the capability to convert methane into ethylene. Plasma catalysis creates distinctive physical and chemical environments, particularly at normal temperature and pressure, distinguishing it from alternative methods. Nevertheless, the utilization of atmospheric pressure plasma is intricate, posing scientific challenges in the realms of physics and chemistry. In this viewpoint, various key performance aspects are evaluated, encompassing methane conversion efficiency, ethylene selectivity, and specific energy input. These scientific pros and cons are then assessed for their readiness for industrial-scale implementation. Initially, the potential for small-scale ethylene production is examined, leveraging existing robust process technologies to unlock fresh market and supply chain opportunities. Subsequently, the sustainability of plasma technology for green ethylene production is compared to conventional ethylene production and alternative green ethylene production methods, including biomass-based approaches. Contrary to perhaps optimistic expectations, current literature evidence does not uniformly favor the latter, indicating the potential for plasma-based green ethylene processes. Additionally, this paper underscores the importance of considering Environmental, Social, and Governance factors that influence business decisions. Finally, this review underscores plasma technology as a potentially promising approach for green ethylene synthesis from methane, offering unique advantages under normal conditions while simultaneously presenting scientific challenges. It assesses its viability for small-scale production and benchmarks its sustainability against conventional and alternative methods, emphasizing the importance of a sustainable future for the green petrochemical industry
Knowing that one is in pain and 'feeling that' one is in pain
No full textIt is sometimes suggested that a person knows that she is in pain (when she does) by ‘feeling that’ she is in pain. If this is true, it would undermine a whole philosophical tradition, one which views self-knowledge, canonically including self-knowledge of pain, as distinctive in lacking an explanatory basis. But what does it mean to say that a person ‘can feel that’ she is in pain? I argue that depending on what ‘feeling that one is in pain’ is supposed to mean, the claim that self-knowledge of pain is based on feeling that one is in pain is either absurd, beside the point, or empty. On the contrary, I suggest that we should take the baselessness of self-knowledge seriously. Doing so would rightly be thought theoretically problematic if it entailed that self-knowledge were utterly opaque to the understanding. But I argue that it does not entail this. I close by explaining how a Constitutivist account of self-knowledge can grant that it lacks an explanatory basis, and yet accept that it is perfectly explicable
Development and quality appraisal of a new English breast screening linked dataset as part of the Age, test Threshold and frequency of Mammography screening (ATHENA-M) study
Get PDFObjectives
To build a data set capturing the whole breast cancer screening journey from individual breast cancer screening records to outcomes and assess data quality.
Methods
Routine screening records (invitation, attendance, test results) from all 79 English NHS breast screening centres between January 1, 1988 and March 31, 2018 were linked to cancer registry (cancer characteristics and treatment) and national mortality data. Data quality was assessed using comparability, validity, timeliness, and completeness.
Results
Screening records were extracted from 76/79 English breast screening centres, 3/79 were not possible due to software issues. Data linkage was successful from 1997 after introduction of a universal identifier for women (NHS number). Prior to 1997 outcome data are incomplete due to linkage issues, reducing validity. Between January 1, 1997 and March 31, 2018, a total of 11 262 730 women were offered screening of whom 9 371 973 attended at least one appointment, with 139 million person-years of follow-up (a median of 12.4 person years for each woman included) with 73 810 breast cancer deaths and 1 111 139 any-cause deaths. Comparability to reference data sets and internal validity were demonstrated. Data completeness was high for core screening variables (>99%) and main cancer outcomes (>95%).
Conclusions
The ATHENA-M project has created a large high-quality and representative data set of individual women’s screening trajectories and outcomes in England from 1997 to 2018, data before 1997 are lower quality
Impact of riding posture and regenerative braking on electric motorcycle energy consumption
Get PDFIn this paper, the impact of riding posture and regenerative braking on electric motorcycle energy economy is described. The motorcycle longitudinal dynamic model is first built to describe the motorcycle acceleration, tyre load transfer and energy consumption. Through energy consumption analysis based on the world motorcycle test cycle-class 3-2 (WMTC 3-2), the low riding posture can save up to 22.65% of energy consumption than the high riding posture, and regenerative
braking can help to save up to 7.65% of energy consumption, which demonstrates the benefit of riding posture control and regenerative braking on energy saving. It is also demonstrated that riding posture has an impact on the rear tyre load and the available rear tyre longitudinal force. At low tyre road friction conditions, higher riding posture can provide more rear tyre longitudinal force for accelerating and regenerative braking, which improves the motorcycle dynamic performance and energy economy