11237 research outputs found
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Understanding and improving non-UK service and transition in the British Armed Forces
No full textThis research reports findings from a two-year study into Commonwealth and non-UK service personnel, veterans, and families' experience in the British Armed Forces. Findings centre on career progression, visas and immigration, and culture and belonging. A series of recommendations are included regarding improving service life and transition to civilian life for non-UK personnel, veterans and families.</p
The Charles Lamb Bulletin, Winter 2023
No full textCharles Lamb Bulletin Winter 2023 edition with essays by Philip W. Martin, Bryony Streets, Clay Daniel and Essaka Joshua. Reviews by Eva Lippold, Richard Cronin, Emma Mason, Sharon Ruston, R.M. Healy, Koenraad Claes, Paul Stephens. pp. 112
Setting Up a Just and Fair ICU Triage Process during a Pandemic: A Systematic Review
No full textIntroduction: Triage is a dynamic and complex decision-making process to determine fair access to medical care in mass casualty situations. Triage takes place through healthcare settings including Intensive Care Units (ICUs). Triage governing principles have been subject to ethical debates for a long time specifically with the recent global pandemic of COVID-19. This study aims to revisit the ethical principles guiding patient prioritisation during recent COVID-19 disaster triage in the Indian subcontinent and attempts to look for principles with consideration of social justice. Methods: Key electronic databases such as WHO, EMBASE, and DOAJ were used to access published literature relating to ICU triage in the Indian subcontinent. Literature on and from 2015–2022 were included in this study. The SPICE framework was used to identify the literature. The Inclusion criteria were as follows: Literature with ethical connotations focusing on India and neighbouring countries, and in an ICU setting during pandemics. The Exclusion criteria were as follows: Literature focusing on other countries, without ethical foundations, hospital admissions, and non-COVID-19 ICU admissions. The PRISMA standard was applied to screen the appropriate literature. The BOOLEAN operator “OR” was used to enhance the literature search. Finally, six papers were found suitable for this study and thus were included in the literature review. Additionally, for the second time, the frequency of certain ethical phrases was reassessed in the plans and guidelines to check the changed awareness of ethical pandemic planning, if any. A thematic analysis was applied to analyse the data and generate findings and new knowledge. Results: The findings highlight gaps in knowledge around ICU triaging in the region which indicates the scope of better ethical pandemic preparation at the regional level. The findings show that there is a debate between researchers on prioritisation from available resources and ethical perspectives and principles associated with fair access to healthcare even during pandemic times. The literature also highlights enhancing the regional capacity and building equitable approaches to reduce existing health inequities and the need of the social justice framework for ICU triaging during a pandemic. Conclusions: ICU triaging in five South Asian neighbour nations was studied for the presence of a guided ethical framework. Additionally, for the second time, certain ethical phrases were reassessed in the plans and guidelines; however, usage of those terms was found to be significantly low. The discussion shows that the plans and guidelines have the scope to improve ethical ICU triaging in these countries and in the specific region. After analysing different ethical guidelines, this study emphasises that there is a need for a just and fair framework, specifically a social justice framework in ICU triage in the subcontinent to address the underlying health inequities.</p
Deep learning assisted InAs/InP quantum-dash laser structured light modes detection under foggy channel
No full textThis paper demonstrates L-band quantum-dash laser (QDL) based orbital angular momentum (OAM) structured light in a free space optics communication (FSO) system. A 4-ary OAM-shift-keying pattern coding communication system, based on Laguerre Gaussian (LG) and superposition LG (MuxLG) mode families, has been investigated under a foggy FSO channel. In addition, joint mode identification and channel condition estimation have been developed at the receiver side using advanced deep learning (DL) methods. We utilize and compare the performance of the convolutional neural networks (CNN) and UNET algorithms. An experimental setup has been conducted using an in-house controlled foggy chamber which allows an FSO transmission of 3-m length. Furthermore, we propose a data balancing approach to the experimental dataset by data augmentation. Visibility prediction results have shown a measured root mean square error of 17(18) m and 10(10) m for 4-ary LG(MuXLG) using CNN and UNET models, respectively. Moreover, the DL models provide an average mode classification accuracy of 94% under various channel visibility conditions.</p
Justice in Contention: The Dynamics of Legal Mobilisation in Caimanes'' Environmental Struggle
No full textThis paper examines legal mobilisation in socio-environmental movements through the Caimanes case, a Chilean community opposing the Los Pelambres mining project. It integrates structural and agency perspectives, highlighting the community's adaptation to political and legal opportunities and focusing on distributive environmental justice. The study identifies two protest cycles: the first seeking compensation, leading to community divisions, and the second addressing mining externalities, fostering unity and solidarity. It discusses judicial mobilisation's limitations, including challenges in aligning community and legal advisors' aims and constraints within the Chilean judicial system. The analysis, based on fieldwork and secondary sources, contributes to understanding legal strategies in environmental justice movements, emphasizing strategic decision-making's importance.</p
Incident allergic diseases in post-COVID-19 condition: multinational cohort studies from South Korea, Japan and the UK
No full textAs mounting evidence suggests a higher incidence of adverse consequences, such as disruption of the immune system, among patients with a history of COVID-19, we aimed to investigate post-COVID-19 conditions on a comprehensive set of allergic diseases including asthma, allergic rhinitis, atopic dermatitis, and food allergy. We used nationwide claims-based cohorts in South Korea (K-CoV-N; n = 836,164; main cohort) and Japan (JMDC; n = 2,541,021; replication cohort A) and the UK Biobank cohort (UKB; n = 325,843; replication cohort B) after 1:5 propensity score matching. Among the 836,164 individuals in the main cohort (mean age, 50.25 years [SD, 13.86]; 372,914 [44.6%] women), 147,824 were infected with SARS-CoV-2 during the follow-up period (2020−2021). The risk of developing allergic diseases, beyond the first 30 days of diagnosis of COVID-19, significantly increased (HR, 1.20; 95% CI, 1.13−1.27), notably in asthma (HR, 2.25; 95% CI, 1.80−2.83) and allergic rhinitis (HR, 1.23; 95% CI, 1.15−1.32). This risk gradually decreased over time, but it persisted throughout the follow-up period (≥6 months). In addition, the risk increased with increasing severity of COVID-19. Notably, COVID-19 vaccination of at least two doses had a protective effect against subsequent allergic diseases (HR, 0.81; 95% CI, 0.68−0.96). Similar findings were reported in the replication cohorts A and B. Although the potential for misclassification of pre-existing allergic conditions as incident diseases remains a limitation, ethnic diversity for evidence of incident allergic diseases in post-COVID-19 condition has been validated by utilizing multinational and independent population-based cohorts.</p
Psychometric evaluation of a revised version of the body appreciation scale-2 for autistic adults (BAS-2A)
No full textEmerging evidence points to unique conceptualisations of positive body image in autistic individuals. However, there are no existing measures of positive body image that have been developed or validated for use with autistic adults. To rectify this, we developed a revised version of the BAS-2 – the BAS-2A – and examined its factorial validity and psychometric properties in a sample of autistic adults from the United Kingdom. Based on the results of exploratory factor analysis and scale purification, we extracted a 12-item, unidimensional model of BAS-2A scores in a first split-subsample (n = 273). Confirmatory factor analysis supported the unidimensional model of BAS-2A scores in a second split-subsample (n = 277). BAS-2A scores presented adequate composite reliability, measurement invariance across gender identity, and patterns of construct validity. For both women and men, BAS-2A scores correlated positively with self-esteem, well-being, quality of life, and adaptive coping, and inversely with dietary restraint, weight/shape overvaluation, body dissatisfaction, and depression. Finally, BAS-2A scores demonstrated incremental validity, predicting self-esteem over-and-above body dissatisfaction. However, temporal stability of the BAS-2A over three weeks was not supported. These results support the BAS-2A as a psychometrically robust measure of body appreciation for use in autistic adults from the United Kingdom.
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Agreement between self‐reported and objectively assessed physical activity among out‐of‐hospital cardiac arrest survivors
No full textBackground: Low level of physical activity is a risk factor for new cardiac events in out‐of‐hospital cardiac arrest (OHCA) survivors. Physical activity can be assessed by self‐reporting or objectively by accelerometery.Aim: To investigate the agreement between self‐reported and objectively assessed physical activity among OHCA survivorsHypothesisSelf‐reported levels of physical activity will show moderate agreement with objectively assessed levels of physical activity.MethodCross‐sectional study including OHCA survivors in Sweden, Denmark, and the United Kingdom. Two questions about moderate and vigorous intensity physical activity during the last week were used as self‐reports. Moderate and vigorous intensity physical activity were objectively assessed with accelerometers (ActiGraph GT3X‐BT) worn upon the right hip for 7 consecutive days.Results: Forty‐nine of 106 OHCA survivors answered the two questions for self‐reporting and had 7 valid days of accelerometer assessment. More physically active days were registered by self‐report compared with accelerometery for both moderate intensity (median 5 [3:7] vs. 3 [0:5] days; p < 0.001) and vigorous intensity (1 [0:3] vs. 0 [0:0] days; p < 0.001). Correlations between self‐reported and accelerometer assessed physical activity were sufficient (moderate intensity: rs = 0.336, p = 0.018; vigorous intensity: rs = 0.375, p = 0.008), and agreements were fair and none to slight (moderate intensity: k = 0.269, p = 0.001; vigorous intensity: k = 0.148, p = 0.015). The categorization of self‐reported versus objectively assessed physical activity showed that 26% versus 65% had a low level of physical activity.Conclusion: OHCA survivors reported more physically active days compared with the results of the accelerometer assessment and correlated sufficiently and agreed fairly and none to slightly.</p
Ecotoxicological effects of leachate from e-cigarettes and e-liquid on the performance of perennial ryegrass (Lolium perenne)
No full textOnce littered, disposable e-cigarettes present a complex type of waste in the environment. They typically contain a lithium battery, electronics to produce vapour and remnant e-liquid, all of which could leach into the environment. The effects of littered e-cigarettes are not well understood, and they have not been tested in terrestrial ecosystems. To address this, an experiment was set up to assess how leachate from e-cigarettes with or without a battery, but also e-liquid on its own can alter fundamental physical characteristics of Lolium perenne (perennial ryegrass) when irrigated with contaminated water. After 31 days, shoot length of L. perenne was not measurably affected, but the biomass was significantly reduced by 30% when e-liquid, and 24% when leachate from intact e-cigarettes was present compared to control plants. Plants grown with leachate or e-liquid displayed a significant level of early senescence of leaf apices, and the chlorophyll content was increased. Furthermore, root biomass was significantly less (29–46%) compared to the control. Leachate from used disposable e-cigarettes can affect the performance of plants when entering the soil ecosystem, therefore stricter regulations are needed to prevent this new type of electronic litter from becoming more widespread. </p
Comparison of bolus versus continuous thermodilution derived indices of microvascular dysfunction in revascularized coronary syndromes
No full textBackground: The assessment of coronary microvascular dysfunction (CMD) using invasive methods is a field of growing interest, however the preferred method remains debated. Bolus and continuous thermodilution are commonly used methods, but weak agreement has been observed in patients with angina with non-obstructive coronary arteries (ANOCA). This study examined their agreement in revascularized acute coronary syndromes (ACS) and chronic coronary syndromes (CCS) patients. Objective: To compare bolus thermodilution and continuous thermodilution indices of CMD in revascularized ACS and CCS patients and assess their diagnostic agreement at pre-defined cut-off points.
Methods: Patients from two centers underwent paired bolus and continuous thermodilution assessments after revascularization. CMD indices were compared between the two methods and their agreements at binary cut-off points were assessed.
Results: Ninety-six patients and 116 vessels were included. The mean age was 64 ± 11 years, and 20 (21 %) were female. Overall, weak correlations were observed between the Index of Microcirculatory Resistance (IMR) and continuous thermodilution microvascular resistance (Rµ) (rho = 0.30p = 0.001). The median coronary flow reserve (CFR) from continuous thermodilution (CFRcont) and bolus thermodilution (CFRbolus) were 2.19 (1.76–2.67) and 2.55 (1.50–3.58), respectively (p
Conclusions: There is a significant difference and weak agreement between bolus and continuous thermodilutionderived indices, which must be considered when diagnosing CMD in ACS and CCS patients. </p
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