The role of consumption in material reduction opportunities: the impact of product lifetime in supplying the UK steel demand

Most of the products purchased in the UK are manufactured in other countries. As a result, worldwide greenhouse gases (GHG) emissions released to manufacture all products purchased in the UK are significantly higher than the UK territorial emissions. More than one half of global industrial emissions result from the use of steel, cement, paper, plastics, and aluminium. In this paper, the UK consumption of products that embody these five materials is estimated. For steel, which is the most widely used among these five materials, consumption and accumulation patterns are examined across four product categories. The impact of steel product lifetime extension is examined for the UK as one option for material demand reduction at the consumption stage of the supply chain. Different levels of steel product lifetimes are simulated for the UK in 2050 and their impacts are examined in terms of UK steel production, implicit steel imports, and global carbon dioxide emissions. Steel product lifetime extension promotes a reduction in the need for steel imports, by reducing the demand for new steel, which leads to lower carbon dioxide emissions required to supply the UK steel demand. The results demonstrate the criticality of a focus on the consumption stage, since any interventions made towards demand reduction of end-use goods leads to material reduction across the supply chain

The Journal of the Friends' Historical Society vol. 5 No. 1

1. Notices. 2. Notes and Queries. 3. The Westmorland and Swaledale Seekers in 1651. 4. Extracts from the Minute Book of the Sufferings of Friends in Mansfield. 5. Reminiscences of the Friends' Meeting, Manchester. 6. Women Ministers stopped by Highwaymen. 7. Presentations of Quakers in Episcopal Visitations, 1662-1679. 8. Elisha Bates. 9. Keye-Worsley Marriage Certificate, 1666. 10. Thomas Areskine, Brewer, of Edinburgh. 11. Meeting Records. 12. A Glimpse of Ancient Friends in Dorset I. 13. Distribution of Literature in Cornwall, 1734. 14. William White, M.D. F.R.S. of York. 15. Friends in Barbadoes. 16. Some Quaker Teachers in 1736. 17. Friends in Current Literature. 18. Editors' Note. 19. Anecdote of Obed Cook, Schoolmaster. 20. Early Quaker Booksellers of York

How and why are communities of practice established in the healthcare sector? A systematic review of the literature

Background: Communities of Practice (CoPs) are promoted in the healthcare sector as a means of generating and sharing knowledge and improving organisational performance. However CoPs vary considerably in the way they are structured and operate in the sector. If CoPs are to be cultivated to benefit healthcare organisations, there is a need to examine and understand their application to date. To this end, a systematic review of the literature on CoPs was conducted, to examine how and why CoPs have been established and whether they have been shown to improve healthcare practice. Methods. Peer-reviewed empirical research papers on CoPs in the healthcare sector were identified by searching electronic health-databases. Information on the purpose of establishing CoPs, their composition, methods by which members communicate and share information or knowledge, and research methods used to examine effectiveness was extracted and reviewed. Also examined was evidence of whether or not CoPs led to a change in healthcare practice. Results: Thirty-one primary research papers and two systematic reviews were identified and reviewed in detail. There was a trend from descriptive to evaluative research. The focus of CoPs in earlier publications was on learning and exchanging information and knowledge, whereas in more recently published research, CoPs were used more as a tool to improve clinical practice and to facilitate the implementation of evidence-based practice. Means by which members communicated with each other varied, but in none of the primary research studies was the method of communication examined in terms of the CoP achieving its objectives. Researchers are increasing their efforts to assess the effectiveness of CoPs in healthcare, however the interventions have been complex and multifaceted, making it difficult to directly attribute the change to the CoP. Conclusions: In keeping with Wenger and colleagues' description, CoPs in the healthcare sector vary in form and purpose. While researchers are increasing their efforts to examine the impact of CoPs in healthcare, cultivating CoPs to improve healthcare performance requires a greater understanding of how to establish and support CoPs to maximise their potential to improve healthcare

Speed has an effect on multiple-object tracking independently of the number of close encounters between targets and distractors

Multiple-object tracking (MOT) studies have shown that tracking ability declines as object speed increases. However, this might be attributed solely to the increased number of times that target and distractor objects usually pass close to each other (“close encounters”) when speed is increased, resulting in more target–distractor confusions. The present study investigates whether speed itself affects MOT ability by using displays in which the number of close encounters is held constant across speeds. Observers viewed several pairs of disks, and each pair rotated about the pair’s midpoint and, also, about the center of the display at varying speeds. Results showed that even with the number of close encounters held constant across speeds, increased speed impairs tracking performance, and the effect of speed is greater when the number of targets to be tracked is large. Moreover, neither the effect of number of distractors nor the effect of target–distractor distance was dependent on speed, when speed was isolated from the typical concomitant increase in close encounters. These results imply that increased speed does not impair tracking solely by increasing close encounters. Rather, they support the view that speed affects MOT capacity by requiring more attentional resources to track at higher speeds

How well do the theory of reasoned action and theory of planned behaviour predict intentions and attendance at screening programmes? A meta-analysis

Meta-analysis was used to quantify how well the Theories of Reasoned Action and Planned Behaviour have predicted intentions to attend screening programmes and actual attendance behaviour. Systematic literature searches identified 33 studies that were included in the review. Across the studies as a whole, attitudes had a large-sized relationship with intention, while subjective norms and perceived behavioural control (PBC) possessed medium-sized relationships with intention. Intention had a medium-sized relationship with attendance, whereas the PBC-attendance relationship was small sized. Due to heterogeneity in results between studies, moderator analyses were conducted. The moderator variables were (a) type of screening test, (b) location of recruitment, (c) screening cost and (d) invitation to screen. All moderators affected theory of planned behaviour relationships. Suggestions for future research emerging from these results include targeting attitudes to promote intention to screen, a greater use of implementation intentions in screening information and examining the credibility of different screening providers

It is time to talk about people: a human-centered healthcare system

Examining vulnerabilities within our current healthcare system we propose borrowing two tools from the fields of engineering and design: a) Reason's system approach [1] and b) User-centered design [2,3]. Both approaches are human-centered in that they consider common patterns of human behavior when analyzing systems to identify problems and generate solutions. This paper examines these two human-centered approaches in the context of healthcare. We argue that maintaining a human-centered orientation in clinical care, research, training, and governance is critical to the evolution of an effective and sustainable healthcare system

A trial assessing N-3 as treatment for injury-induced cachexia (ATLANTIC trial): does a moderate dose fish oil intervention improve outcomes in older adults recovering from hip fracture?

<p>Abstract</p> <p>Background</p> <p>Proximal femoral fractures are associated with increased morbidity and mortality. Pre-existing malnutrition and weight loss amongst this patient group is of primary concern, with conventional nutrition support being largely ineffective. The inflammatory response post proximal femoral fracture surgery and the subsequent risk of cachexia may explain the inability of conventional high energy high protein management to produce an anabolic response amongst these patients. Omega-3 fatty acids derived from fish oils have been extensively studied for their anti-inflammatory benefits. Due to their anti-inflammatory properties, the benefit of fish oil combined with individualized nutrition support amongst proximal femoral fracture patients post surgery is an attractive potential therapeutic strategy. The aim of the ATLANTIC trial is to assess the potential benefits of an anti-inflammatory dose of fish oil within the context of a 12 week individualised nutrition program, commencing seven days post proximal femoral fracture surgery.</p> <p>Methods/Design</p> <p>This randomized controlled, double blinded trial, will recruit 150 community dwelling elderly patients aged ≥65 years, within seven days of surgery for proximal femoral fracture. Participants will be randomly allocated to receive either a 12 week individualized nutrition support program complemented with 20 ml/day anti-inflammatory dose fish oil (~3.6 g eicosapentaenoic acid, ~2.4 g docosahexanoic acid; intervention), or, a 12 week individualized nutrition support program complemented with 20 ml/day low dose fish oil (~0.36 g eicosapentaenoic acid, ~0.24 g docosahexanoic acid; control).</p> <p>Discussion</p> <p>The ATLANTIC trial is the first of its kind to provide fish oil combined with individualized nutrition therapy as an intervention to address the inflammatory response experienced post proximal femoral fracture surgery amongst elderly patients. The final outcomes of this trial will assist clinicians in the development of effective and alternative treatment methods post proximal femoral fracture surgery which may ultimately result in a reduction in systemic inflammation, loss of weight and lean muscle and improvements in nutritional status, mobility, independence and quality of life among elderly patients.</p> <p>Trial Registration</p> <p>ACTRN12609000241235</p