Upstairs, Downstairs: Doctrine and Decorum in Two Sermons by John Donne

Published as David Colclough, Upstairs, Downstairs: Doctrine and Decorum in Two Sermons by John Donne, Huntington Library Quarterly, Vol. 73, No. 2 (June 2010), pp. 163-191. © 2010 by University of California Press/Henry E. Huntington Library and Art Gallery. Copying and permissions notice: Authorization to copy this content beyond fair use (as specified in Sections 107 and 108 of the U. S. Copyright Law) for internal or personal use, or the internal or personal use of specific clients, is granted by University of California Press/Henry E. Huntington Library and Art Gallery for libraries and other users, provided that they are registered with and pay the specified fee via Rightslink® on JSTOR (http://www.jstor.org/r/ucal) or directly with the Copyright Clearance Center, http://www.copyright.com

Evaluation of the theoretical and in-use performance of Exhaust Air Heat Pumps

Integrated units that combine Exhaust Air Heat Pumps (EAHPs) with Heat Recovery Ventilation (HRV) and, in some instances, Domestic Hot Water Storage (DHW), are becoming increasingly popular in the domestic market across Europe with over 24,000 EAHPs purchased in the EU in 2017 alone. Early research into using EAHPs demonstrated energy savings being conservatively between 20% and 50% when compared to conventional systems. Recent research has suggested that, in reality, EAHPs in-use energy performance can be worse than that estimated by various standardised theoretical assessment methods (COP/SPF in the range of 0.4 to 6.0). More worryingly, published data on this in-use operation is effectively non-existent for NZEB type dwellings and few studies have stress tested the robustness of the EN standards in accounting for the effects of in-use operation. The study presented in this paper investigated whether the standard methods used to predict in-use energy performance are sufficiently robust and adequately capture operational performance for EAHP systems. The energy performance of two identical EAHP systems in Ireland (one rural/ one urban) were monitored for close to 12 months. During the live in-use monitoring period, the EAHPs had ‘heat-pump/heat recovery only’ operating mode ratios of 16%/84% and 22%/77% for rural and urban systems respectively. The average HRE in-use efficiency was 92% and 64% for the rural and urban systems respectively. While the manufacturers stated Seasonal performance factors (SPF) ranging from 2.2 (for DHW) to 5.8 (for Space Heating), the average in-use SPF was found to vary between 1.7 and 3.8 depending on the boundary reported and the location. More research is urgently required in order to bring much needed clarity for designers and energy assessors regarding which boundaries can be universally applied to EAHP systems. Given the range of SPF which could apply to the HP’s examined, the paper highlights the importance of ensuring that realistic indicators of in use performance are provided, aiding appropriate decision-making by policymakers, industry and end-users

Mapping urban infrastructure interdependencies and fuzzy risks

This is the final version of the article. Available from Elsevier via the DOI in this record.In this study, we considered the relationships between different types of CI and services to simulate possible cascading effects during extreme hazard conditions brought on by climate change and how to analyse impacts with limited data resources. An area in central Bristol, UK, was used as the case study to investigate the interdependencies among select assets and services. A wide range of plausible scenarios caused by pipe bursts in the area were simulated using the CADDIES 2D modelling framework, to identify the hotspots with high risk. The impact on CI, including water supply, electricity, wastewater, solid waste, transportation, telecommunication, and emergency services were assessed by the HAZUR tool. The analysis demonstrated that with limited data resources the dynamics of the interdependencies between CI networks can be highlighted and a basis of risk quantification can be established. The same procedure can be repeated to evaluate the impact of other types of hazards, or the compound hazard scenarios to provide a holistic assessment. Therefore, urban planners and managers can further explore options of interventions for setting up strategies to strengthen city resilience.This study is supported by the RESCCUE (RESilience to cope with Climate Change in Urban arEas) project, funded by the European Union Horizon 2020 research and innovation programme (Grant Agreement No. 700174)

HNF1B mutations are associated with a Gitelman-like tubulopathy that develops during childhood

Mutations in the transcription factor hepatocyte nuclear factor 1B (HNF1B) are the most common inherited cause of renal malformations, yet also associated with renal tubular dysfunction, most prominently magnesium wasting with hypomagnesemia. The presence of hypomagnesemia has been proposed to help select appropriate patients for genetic testing. Yet, in a large cohort, hypomagnesemia was discriminatory only in adult, but not in pediatric patients. We therefore investigated whether hypomagnesemia and other biochemical changes develop with age.This article is freely available via Open Access. Click on the Additional Link to access full-text

Diagnosis of monogenic diabetes: 10-Year experience in a large multi-ethnic diabetes center.

Monogenic diabetes accounts for approximately 1-2% of all diabetes, and is difficult to distinguish from type 1 and type 2 diabetes. Molecular diagnosis is important, as the molecular subtype directs appropriate treatment. Patients are selected for testing according to clinical criteria, but up to 80% of monogenic diabetes in the UK has not been correctly diagnosed. We investigated outcomes of genetic testing in our center to compare methods of selecting patients, and consider avenues to increase diagnostic efficiency.This article is freely available online via Open Access. Click on the 'Additional Link' above to access the full-text via the publisher's site.Published (Open Access

The common p.R114W <i>HNF4A </i>mutation causes a distinct clinical subtype of monogenic diabetes

HNF4A mutations cause increased birth weight, transient neonatal hypoglycaemia and maturity onset diabetes of the young (MODY). The most frequently reported HNF4A mutation is p.R114W (previously p.R127W) but functional studies have shown inconsistent results, there is lack of co-segregation in some pedigrees and an unexpectedly high frequency in public variant databases. We confirm that p.R114W is a pathogenic mutation with an odds ratio of 30.4 (95% CI: 9.79 - 125, P=2x10(-21)) for diabetes in our MODY cohort compared to controls. p.R114W heterozygotes do not have the increased birth weight of patients with other HNF4A mutations (3476g vs. 4147g, P=0.0004) and fewer patients responded to sulfonylurea treatment (48% vs. 73%, P=0.038). p.R114W has reduced penetrance; only 54% of heterozygotes developed diabetes by age 30 compared to 71% for other HNF4A mutations. We re-define p.R114W as a pathogenic mutation causing a distinct clinical subtype of HNF4A MODY with reduced penetrance, reduced sensitivity to sulfonylurea treatment and no effect on birth weight. This has implications for diabetes treatment, management of pregnancy and predictive testing of at-risk relatives. The increasing availability of large-scale sequence data is likely to reveal similar examples of rare, low-penetrance MODY mutations.</p

Key features of palliative care service delivery to Indigenous peoples in Australia, New Zealand, Canada and the United States: A comprehensive review

Background: Indigenous peoples in developed countries have reduced life expectancies, particularly from chronic diseases. The lack of access to and take up of palliative care services of Indigenous peoples is an ongoing concern. Objectives: To examine and learn from published studies on provision of culturally safe palliative care service delivery to Indigenous people in Australia, New Zealand (NZ), Canada and the United States of America (USA); and to compare Indigenous peoples’ preferences, needs, opportunities and barriers to palliative care. Methods: A comprehensive search of multiple databases was undertaken. Articles were included if they were published in English from 2000 onwards and related to palliative care service delivery for Indigenous populations; papers could use quantitative or qualitative approaches. Common themes were identified using thematic synthesis. Studies were evaluated using Daly’s hierarchy of evidence-for-practice in qualitative research. Results: Of 522 articles screened, 39 were eligible for inclusion. Despite diversity in Indigenous peoples’ experiences across countries, some commonalities were noted in the preferences for palliative care of Indigenous people: to die close to or at home; involvement of family; and the integration of cultural practices. Barriers identified included inaccessibility, affordability, lack of awareness of services, perceptions of palliative care, and inappropriate services. Identified models attempted to address these gaps by adopting the following strategies: community engagement and ownership; flexibility in approach; continuing education and training; a whole-of-service approach; and local partnerships among multiple agencies. Better engagement with Indigenous clients, an increase in number of palliative care patients, improved outcomes, and understanding about palliative care by patients and their families were identified as positive achievements. Conclusions: The results provide a comprehensive overview of identified effective practices with regards to palliative care delivered to Indigenous populations to guide future program developments in this field. Further research is required to explore the palliative care needs and experiences of Indigenous people living in urban areas