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The Humber Outport: Lloyd’s Register in the Port of Hull since c.1760.
Get PDFFor over 260 years, Lloyd’s Register has worked to preserve life and property at sea. Throughout that time, the Society has maintained an active presence in its outports, one being Hull. By taking the uncharted connections between Lloyd’s Register and its Humber outport as a case study, this thesis investigates the work of the Society in the outports, and the extent to which it was involved with key industries and businesses in such ports. It also studies the importance of the outports to the institutional aims of the Society, as well as assessing the extent to which such goals were aided by its work in Hull.Lloyd’s Register has garnered little historiographical attention. Moreover, a London-centric focus dominates this limited historiography. By analysing the Society’s historical connections to Hull, and its involvement in some of the port’s key maritime industries and businesses, this research fills a significant gap in the historiography on Lloyd’s Register. The investigation draws upon underutilised primary source material from Lloyd’s Register Foundation Heritage and Education Centre in combination with parliamentary and institutional records. This material is deployed to address three overarching research questions: how did Lloyd’s Register operate in a provincial port like Hull? Did the involvement of Lloyd’s Register in outports extend beyond the Society’s work in surveying and classification? How important were provincial ports to the goals of Lloyd’s Register? The analysis sheds lights on the operational activity of the Society in Hull, and the scale of Lloyd’s Register’s presence in the port, as well as evaluating the influence such ports had on the Society. The thesis reveals that Hull has been a particularly important port in the history of the Society, and the connections that date back over 260 years could still be seen in and around Hull into the 2020s
Healthcare professionals’ perspectives of providing end-of-life care for infants, children and young people in acute settings: A multi-site qualitative study
Get PDFBackground: Paediatric end-of-life care is an important part of palliative care, and provides care and support for children in the last days, weeks, months or year of life. However, there is currently a picture of inconsistent and disjointed provision. Despite differences in delivery models across countries and cultures, healthcare professionals need to be able to support families through this difficult time. However, there is limited evidence to base high quality end-of-life care. Aim: To explore healthcare professionals’ experiences of delivering end-of-life care to infants, children and young people, their needs and the factors affecting access and implementation. Design: Qualitative study employing online focus groups, analysed using framework analysis. Setting/participants: Healthcare professionals who provided end-of-life care to infants, children and young people, across cancer centres and neonatal and paediatric intensive care units. Results: A total of 168 professionals from 13 tertiary hospitals participated in 23 focus groups. Three themes highlighted many barriers to delivering optimal care: (1) Professional perceptions of end-of-life care; (2) What we want to provide versus what we can and (3) Workforce and sustainability: Healthcare professional support. These illustrate professionals’ awareness and desire to deliver high-quality care, yet are constrained by a number of factors, suggesting the current system is not suitable. Conclusions: This study provides an in-depth exploration of paediatric end-of-life care, from those professionals working across the settings accounting for the majority of end-of-life care delivery. Many of these issues could be resolved by investment in: funding, time, education and support to enable delivery of increasingly complex end-of-life care
hybrid-chimes: a model for radiative cooling and the abundances of ions and molecules in simulations of galaxy formation
Get PDFRadiative processes play a pivotal role in shaping the thermal and chemical states of gas across diverse astrophysical environments, from the interstellar medium (ISM) to the intergalactic medium. We present a hybrid cooling model for cosmological simulations that incorporates a comprehensive treatment of radiative processes, including parametrizations of the interstellar radiation field, cosmic ray rates, and dust physics. The model uses the chimes chemical network and combines on-the-fly non-equilibrium calculations with quasi-equilibrium cooling rates. The quasi-equilibrium rates account for the time-dependent free electron fractions of elements tracked in non-equilibrium, balancing computational efficiency with physical accuracy. We evaluate the performance under various conditions, including the thermal evolution of primordial gas at the cosmic mean density, the properties of the warm and cold neutral media in Milky Way-like galaxies, and the atomic-to-molecular hydrogen transition. We demonstrate that thermal equilibrium predictions for the neutral phases of the ISM underestimate the median gas pressures in simulations of isolated galaxies by up to 0.5 dex. Finally we find that the atomic-to-molecular hydrogen transition is shifted to lower densities by up to 1 dex if oxygen is not included in the chemical network. Our work provides a robust framework for studying the multiphase ISM and its role in galaxy formation and evolution
Fighting Through the Heat: How Male Aggression Influences Demography Under Recurrent Heatwaves
Get PDFSexual selection is a potent evolutionary force that can enhance adaptation and reduce mutational load, while simultaneously reducing survival, or causing sexual conflict that reduces fitness of one or both sexes. Many populations face extreme, short-term stress events like heatwaves. The combined effects of sexual and environmental selection on population demography during and after such events remain poorly understood, even though such combined effects could be crucial for the persistence of small, endangered populations under climate change. In this study, we investigated how male aggression affects survival in a population during environmental stress. This was done by manipulating the expression of an aggressive male fighter morph in small populations of the male-dimorphic mite Sancassania berlesei, using pheromonal cues from high-density populations. We then exposed some of these populations to recurrent periods of extreme heat and monitored survival over eight generations. We found that heat exposure reduced survival, more severely in females than in males, and survival was lower in populations with higher fighter prevalence, but there was no interaction between temperature and fighter prevalence. Furthermore, survival declined across generations, and the decline was steeper in populations with lower prevalence of fighters, leading to the loss of their initial survival advantage by the last generation. Three populations exposed to heat went extinct from the reduced fighter expression regime. Our findings imply that despite its cost to individual survival, male aggression does not exacerbate population sensitivity to heatwaves over generations. Furthermore, we demonstrate that the mortality costs of male aggression are gradually compensated over successive generations, which could be a result of a more effective purging of inbreeding depression. Thus, while the additive effect of aggression and heatwaves on survival may increase demographic risks for bottlenecked populations in the short term, sexual selection may increase the resilience of populations to prolonged bottlenecks
Symptom prevalence in gastrointestinal cancer: a secondary analysis of IPOS data
Get PDFPurpose: Patients with gastro-intestinal (GI) cancer have a high symptom burden; however, comparative data to other cancers is lacking. The aim is to determine symptom prevalence for people with GI cancer receiving specialist palliative care in the community. Method: Secondary analysis of anonymised routinely collected symptom registry data from those receiving community-based specialist palliative care, between 2020 and 2023. Results: One thousand seven hundred thirty-three patients with GI cancer received 2,332 episodes of specialist palliative care. Common symptoms were: - pain (77% prevalence in GI cancer vs 73% other cancers); with 49% reporting being moderately/severely/overwhelmingly affected in GI vs 46% in other cancers.- nausea (34% in GI cancer vs 25% other cancers); with 16% moderately/severely/overwhelmingly affected in GI vs 11% in other cancers.- vomiting (17% in GI cancer vs 11% other cancers); with 8% moderately/severely/overwhelmingly affected in GI vs 5% in other cancers.- poor appetite (77% in GI cancer vs 68% other cancers); with 56% moderately/severely/overwhelmingly affected in GI vs 46% in other cancers. poor mobility (79% in GI cancer vs 84% other cancer); with 53% moderately/severely/overwhelmingly affected in GI vs 62% in other cancers. Conclusion: This novel study provides comparative evidence about the nature of the high symptom burden for those with GI cancer and shows that poor appetite, nausea, vomiting, and worse mobility are more prevalent compared to other cancers, while pain and weakness are of similar prevalence. The underlying reasons may relate to illness trajectory, referral timing, or other causes and need further exploration
How do patient information documents present dialysis and conservative kidney management? A document analysis
Get PDFBackground Most older people with advanced kidney disease face a decision between conservative kidney management (CKM) or dialysis and must weigh their potential benefits, risks and impacts on quality and length of life. Patient information documents are designed to supplement patients' understanding of their kidney disease and explain treatment options to support decision-making. We aimed to explore how patient information documents frame the treatment options of CKM and dialysis and consider implications for patients' treatment choice. Methods We conducted a qualitative document analysis of patient information documents collected from four UK renal outpatient departments with variation in rates of CKM for people ≥75 years of age. Data were analysed using critical discourse analysis. Results Three global themes were identified: 1) Treatment options are not presented equally: Dialysis was constructed as the assumed patient choice. CKM was often omitted as an option; when included, it was always mentioned last and was typically constructed negatively. 2) Deciding is challenging: Treatment decision-making, particularly choosing CKM, was portrayed as a challenge requiring emotional support, with clinicians the ultimate decision-maker. 3) Dialysis is living, CKM is dying: Patient information documents presented patients as living with one treatment option choice (dialysis) and dying with another (CKM). Advance care planning, palliative care and information about dying were presented only in the context of CKM, implying these were irrelevant topics for people choosing dialysis. Conclusions Patient information documents presented unbalanced explanations of dialysis and CKM. Dialysis was framed as 'treatment' and possible complications were minimized. CKM was framed as 'non-treatment' and linked to advance care planning, palliative care and death. Inaccurate framing of both CKM and dialysis may mean patients exclude treatment options that may be more concordant with their goals, values and preferences
Spatial dynamics of homicide in medieval English cities: the Medieval Murder Map project
Get PDFThis study examines the spatial patterns of homicide in three 14th-century English cities—London, York, and Oxford—through the Medieval Murder Map project, which visualizes 355 homicide cases derived from coroners’ inquests. Integrating historical criminology with contemporary spatial crime theories, we outline a new historical criminology of space, focused on how urban environments shaped patterns of lethal violence in the past. Findings reveal similarities in all three cities. Homicides were highly concentrated in key nodes of urban life such as markets, squares, and thoroughfares. Temporal patterns indicate that most homicides occurred in the evening and on weekends, aligning with routine activity theory. Oxford had far higher homicide rates than London and York, and a higher proportion of organized group-violence, suggestive of high levels of social disorganization and impunity. Spatial analyses reveal distinct areas related to town-gown conflicts and violence fuelled by student factionalism. In London, findings suggest distinct clusters of homicide which reflect differences in economic and social functions. In all three cities, some homicides were committed in spaces of high visibility and symbolic significance. The findings highlight how public space shaped urban violence historically. The study also raises broader questions about the long-term decline of homicide, suggesting that changes in urban governance and spatial organization may have played a crucial role in reducing lethal violence
Developing a decision support tool for the continuation or deprescribing of antithrombotic therapy in patients receiving end-of-life care: Protocol for a European Delphi study
Get PDFIntroduction: To develop a European shared decision support tool (SDST), a Delphi process will be used to reach consensus about aspects relating to the continuation or deprescribing of antithrombotic therapy (ATT) in cancer patients at the end of life. As part of the SERENITY project, this study corresponds to work package (WP) 4. Methods: Findings from SERENITY WPs 1–3 (realist review, flash mob research, epidemiological and qualitative studies) informed the Delphi study. The WP4 steering committee had two objectives. (1) to build a representative expert panel comprising physicians, pharmacists, nurses and psychologists from eight European countries; and (2) to advise on the content of the Delphi form, divided into four sections: context, content, SDST design and trial outcomes. The form was reviewed by the SERENITY patient and public involvement group to ensure that it met patients’ needs. The Delphi study will take place in three rounds held at 6-week intervals, involving experts from eight countries. Consensus will be reached on items with at least 70 % agreement. The steering committee will review and validate the results across the different rounds. Results: Through this Delphi study, the following aspects will be defined: characterisation of candidate patients for discussion about ATT deprescribing; healthcare team roles in ATT decision-making; specific information and communication requirements for patients when making deprescribing decisions; SDST content priorities; and optimal outcomes for the planned clinical trial. Conclusion: This study will feed directly into the development and evaluation of the SDST, aimed at reducing complications and improving quality-of-life in end-of-life cancer patients receiving ATT
Machine learning-based predictive modelling of renewable energy adoption in developing countries
Get PDFThis study explores global renewable energy trends in alignment with the 2030 Sustainable Development Goals. Employing and fine-tuning the ExtraTreesRegressor, models were developed to predict adoption levels of electricity from solar, wind, hydro, and biomass sources. Strategic random search parameters were used to optimize the ExtraTreesRegressor. Evaluation based on Mean Square Error (MSE) and R-squared (R2) scores revealed that the ExtraTreesRegressor, outperformed other state-of-the-art regression models. Notably, the solar model exhibited commendable performance in test set evaluation (MSE: 0.4450, R2: 0.9849) and cross-validation (MSE: 4.3279, R2: 0.9079). Similarly, the wind model showed robust outcomes in both test set evaluation (MSE: 1.2233, R2: 0.9969) and cross-validation (MSE: 5.3136, R2: 0.9846). However, the hydro model faced nuanced challenges with test set evaluation (MSE: 33.3474, R2: 0.9960) and cross-validation (MSE: 20.4235, R2: 0.9961). The biomass model achieved notable results in test set evaluation (MSE: 0.3196, R2: 0.9960) and cross-validation (MSE: 0.5943, R2: 0.9901). Based on the findings from this study, GDP, non-renewable electricity consumption, and population size have been identified as key drivers of renewable energy adoption. Insights from this research will contribute to a deeper understanding of the intricate dynamics influencing renewable energy landscapes in developing countries
