26729 research outputs found
Sort by
Prevalence of electronic screening for sepsis in National Health Service acute hospitals in England
Get PDFSepsis is a worldwide public health problem. Rapid identification is associated with improved patient outcomes—if followed by timely appropriate treatment.
Objectives
Describe digital sepsis alerts (DSAs) in use in English National Health Service (NHS) acute hospitals.
Methods
A Freedom of Information request surveyed acute NHS Trusts on their adoption of electronic patient records (EPRs) and DSAs.
Results
Of the 99 Trusts that responded, 84 had an EPR. Over 20 different EPR system providers were identified as operational in England. The most common providers were Cerner (21%). System C, Dedalus and Allscripts Sunrise were also relatively common (13%, 10% and 7%, respectively). 70% of NHS Trusts with an EPR responded that they had a DSA; most of these use the National Early Warning Score (NEWS2). There was evidence that the EPR provider was related to the DSA algorithm. We found no evidence that Trusts were using EPRs to introduce data driven algorithms or DSAs able to include, for example, pre-existing conditions that may be known to increase risk.
Not all Trusts were willing or able to provide details of their EPR or the underlying algorithm.
Discussion
The majority of NHS Trusts use an EPR of some kind; many use a NEWS2-based DSA in keeping with national guidelines.
Conclusion
Many English NHS Trusts use DSAs; even those using similar triggers vary and many recreate paper systems. Despite the proliferation of machine learning algorithms being developed to support early detection of sepsis, there is little evidence that these are being used to improve personalised sepsis detection
How consulting a medium after bereavement influences the grieving process – an interpretative phenomenological analysis
No full textThe purpose of this study was to explore the influence of ‘assisted’ after-death communications (ADCs) (that is, through a medium), on the grieving process of the bereaved. It also sought to explore the existential dimensions experienced by the bereaved. Six bereaved participants in the UK who had experienced assisted ADCs took part in semi- structured interviews. The data was analysed using Interpretative Phenomenological Analysis (Smith et al., 2009). The emerging themes were: 1) Pain and Loss (living with grief after the bereavement); 2) Being with Others; 3) The Unknown; 4) Religious/Spiritual Beliefs and 5) Reflections on Life and Death after Assisted ADCs. Key findings showed that the participants were able to form a continuing bond with the deceased through spontaneous and assisted ADCs, which was comforting. More specifically, assisted ADCs (medium readings) facilitated ‘bilateral communication’ for resolving unfinished business, reassurance, and giving advice. A novel finding was a discarnate who communicated (through the medium) about his life in the ‘other world.’
The existential analysis showed that a continuing bond was a complex transition experienced in all four dimensions of existence (physical, personal, social and spiritual). The findings also showed that becoming bereaved was an ontological experience for the participants, who became very aware of aspects of their existence, including beliefs, meaning and purpose, and their mortality. The implications of the findings relate to the necessity for counselling professionals and mental health practitioners to understand and acknowledge the reality and potentially positive role that ADCs play in managing grief and supporting those experiencing them without judgment
Performance analysis of Multiple-RIS-Based NOMA systems
Get PDFIn this paper, we present a study on a model of multirelay radio network system that utilizes reconfigurable intelligent surfaces (RISs). We investigate the use of nonorthogonal multiple access (NOMA) combined with cooperative RIS systems, using partial RIS selection (PRISs). Specifically, the RISs act as relays to forward data from the base station to the two users. The focus of this paper is to analyze the outage probabilities and throughput for the two users. Based on the results, we examine how PRISs affect the performance of the proposed NOMA scheme. The derived asymptotic expressions show that the proposed model can improve user fairness. Finally, we compare the analysis results with the simulation results and find good agreement
Beans with bugs: Covert carnivory and infested seed selection by the red-nosed cuxiú monkey
Get PDFMembers of the Neotropical primate genus Chiropotes eat large volumes of immature seeds. However, such items are often low in available proteins, and digestion of seeds is further inhibited by tannins. This suggests that overall plant-derived protein intake is relatively low. We examined the presence of insect larvae in partially eaten fruits, compared with intact fruit on trees, and examined fecal pellets for the presence of larvae. We found that red-nosed cuxiú (Chiropotes albinasus) individuals may supplement their limited seed-derived protein intake by ingesting seed-inhabiting insects. Comparison of fruits partially eaten for their seeds with those sampled directly from trees showed that fruits with insect-containing seeds were positively selected in 20 of the 41 C. albinasus diet items tested, suggesting that fruits with infested seeds are actively selected by foraging animals. We found no differences in accessibility to seeds, that is, no differences in husk penetrability between fruits with infested and uninfested seeds excluding the likelihood that insect-infestation results in easier access to the seeds in such fruits. Additionally, none of the C. albinasus fecal samples showed any evidence of living pupae or larvae, indicating that infesting larvae are digested. Our findings raise the possibility that these seed-predating primates might provide net benefits to the plant species they feed on, since they feed from many species of plants and their actions may reduce the populations of seed-infesting insects
A secure network coding based image communications in two-hop wireless relay networks
Get PDFThis paper investigates the image communications in two-hop wireless relay networks (TH-WRNs) where a source node sends images to a destination node with the assistance of a relay node via two hops, i.e. source-to-relay and relay-to-destination links. Due to the broadcast nature of wireless media, there exists an eavesdropper who tries to overhear and recover the images. Aiming to enhance the security and also to save transmission bandwidth of the image communications, we propose a secure relaying transmission (SRT) protocol by exploiting both random linear network coding (RLNC) and image super-resolution (ISR) techniques. In the proposed protocol, the original high-resolution (HR) images are downscaled at the source node and the RLNC is employed at both the source and relay nodes to conceal the original images from the eavesdropper. The RLNC decoding and ISR are adopted at the destination node to decode and recover the HR images, while the eavesdropper cannot decode the images due to the unawareness of the coefficient matrices and the reference images in the RLNC. It is shown that the proposed SRT protocol achieves a significantly higher performance at the destination than at the eavesdropper. Furthermore, with high-quality relaying hops, the SRT protocol outperforms the secure direct transmission (SDT) protocol with only a direct link between the source and the destination nodes. Finally, simulation results are provided to verify the findings
Early photographic work exhibited in 'The English at Home: 20th Century Domestic Photographs from the Hyman Collection', The Centre for British Photography, London
No full textBillingham exhibited early photographic work in the show 'The English at Home: 20th Century Domestic Photographs from the Hyman Collection'. The exhibition was one of a number of two inaugural shows opening the Centre for the first time. The other was called Headstrong: Women and Empowerment.
The English at Home explored the central place of the home in British photography over the last century.
The exhibition borrowed its title from one of the most important twentieth century photography publications, Bill Brandt’s first book, The English at Home (1935) and proposed that to understand contemporary depictions of the home there is much to learn from an exploration of a lineage that began with Bill Brandt and traveled through the crucial years of Picture Post magazine and on to the more conceptual strategies of photographers since the 1970s. The exhibition was broadly thematic and included major historical series as well as some of the most important work of more recent years.
One idea of the show was to take the viewer on a journey from the street, up the front steps, and into the private spaces of the living room, kitchen and bedroom.
The exhibition bagins by exploring the ways in which the neighbourhood streets were an extension of the home, a place to chat with neighbours and for children to play. It then went inside the home. Running through this was a strand that built from Brandt's work to address the ways in which these images reflect and critique the English class system.
Besides Billingham, other photographers included Shirley Baker, John Bulmer, Bill Brandt, Ken Grant, Bert Hardy, Nick Hedges, Kurt Hutton, Colin Jones, Karen Knorr, Sirkka-Liisa Konttinen, Marketa Luskacova, Roger Mayne, Daniel Meadows, David Moore, Martin Parr, Charlie Phillips, Jo Spence and Edith Tudor-Hart
Neonatal jaundice
No full textThis chapter has been designed to equip the readers with an understanding of the physiology of bilirubin metabolism, physiological jaundice and pathological jaundice, including the assessment of the newborn, identification of jaundice, and immediate and ongoing management
Identifying fibroblast growth factor receptor 3 as a mediator of periosteal osteochondral differentiation through the construction of microRNA-based interaction networks
Get PDFHuman periosteum-derived progenitor cells (hPDCs) have the ability to differentiate towards both the chondrogenic and osteogenic lineages. This coordinated and complex osteochondrogenic differentiation process permits endochondral ossification and is essential in bone development and repair. We have previously shown that humanised cultures of hPDCs enhance their osteochondrogenic potentials in vitro and in vivo; however, the underlying mechanisms are largely unknown. This study aimed to identify novel regulators of hPDC osteochondrogenic differentiation through the construction of miRNA-mRNA regulatory networks derived from hPDCs cultured in human serum or foetal bovine serum as an alternative in silico strategy to serum characterisation. Sixteen differentially expressed miRNAs (DEMis) were identified in the humanised culture. In silico analysis of the DEMis with TargetScan allowed for the identification of 1503 potential miRNA target genes. Upon comparison with a paired RNAseq dataset, a 4.5% overlap was observed (122 genes). A protein–protein interaction network created with STRING interestingly identified FGFR3 as a key network node, which was further predicted using multiple pathway analyses. Functional analysis revealed that hPDCs with the activating mutation FGFR3N540K displayed increased expressions of chondrogenic gene markers when cultured under chondrogenic conditions in vitro and displayed enhanced endochondral bone formation in vivo. A further histological analysis uncovered known downstream mediators involved in FGFR3 signalling and endochondral ossification to be upregulated in hPDC FGFR3N540K-seeded implants. This combinational approach of miRNA-mRNA-protein network analysis with in vitro and in vivo characterisation has permitted the identification of FGFR3 as a novel mediator of hPDC biology. Furthermore, this miRNA-based workflow may also allow for the identification of drug targets, which may be of relevance in instances of delayed fracture repair
The importance of appearing trustworthy in the workplace: performance analysts’ perspectives
Get PDFThe discipline of performance analysis is founded upon the collection and analysis of objective and reliable data to support the coaching process. While research has begun to identify the potential importance of trust in applied sporting environments, there remains a paucity of inquiry that seeks to explicitly investigate trustworthiness in the work of performance analysts. To redress this situation Jisc online survey data was collected from performance analysts (n = 88, age: 37 ± 11 years, experience: 8 ± 6 years) practising across sporting contexts and geographic areas. Findings showed that: (1) appearing trustworthy to a range of working others was an important goal for performance analysts, (2) trustworthiness was considered essential for building positive working relationships, respect and perceptions of role-related competence (3) being perceived as trustworthy can generate desirable as well as help to avoid undesirable working conditions, including career progression and employment security, (4) analysts often seek to influence others perceptions of their trustworthiness by demonstrating important characteristics such as technical and tactical knowledge, being friendly and approachable, being punctual and hardworking, and evidenced-based, (5) an important facet of this was, often in conjunction with the coaching staff, concealing known information, particularly to athletes regarding poor performance to avoid psychological damage or where the data did not fit the coach’s approach, and (6) most performance analysts suggested the professional preparation and development of performance analysts needs to place greater emphasis on facilitating social sensibilities that practitioners can use to enhance perceptions about their workplace trustworthiness. The findings of this study generate new knowledge regarding the social features of performance analysis work, thus contributing to a growing critical social analysis of sport work in performance environments, as well as raising important practical implications for those responsible for educating the performance analysis workforce
The role of life satisfaction: hidden link between brand attachment and brand supportive behavior
No full textOur research documented that brand attachment has a significant positive effect on brand supportive behavior not only directly, but also indirectly through enhanced life satisfaction. Building on previous work on brand attachment and theories of positive psychology, particularly BBT, the hidden link through life satisfaction was found to play a significant role in influencing brand supportive behaviors across various product categories. Through two studies, we find that the hidden link has two routes, one positive and the other negative, which affect life satisfaction and ultimately brand supportive behavior in opposite directions. We further find that there is a category difference in terms of the effects of the two routes between positional and non-positional categories. Most importantly, we find that the effects of brand attachment through the two routes can be managed by two moderators, hope and fantasy