A consideration of the concepts of justice formulated by some twentieth century theologians and their application to some problems of English law in the 1970’s

Thesis submitted for the degree of B.C.L. entitled:- "A consideration of the concepts of Justice formulated by some twentieth century theologians and their application to some problems of English law in the 1970's."This study in jurisprudence aims to discover what value and relevance some recent theological thought on the nature and application of Justice has on some of the practical problems of English law in the 1970's. To this end four theologians and two broad areas of legal concern have been examined and analysed. The theologians studied are Earth, Maritain, Tillich and Moltmann. They have been chosen to span the whole of the century to date and to represent different theological traditions and approaches. Their life and general theological approach, their concept of Justice and their application of such a concept to issues germane to this study are examined. Of the two legal areas examined the first is the 'equality' legislation which covers recent attempts to legislate for racial and sexual equality. The other is the recent legislation, or attempts at legislation, dealing with the 'right of life'. This covers such legal areas as abortion, euthanasia, the definition of life and the use of advanced medical technology. The legislative philosophy, the effectiveness of the legislation and its subsequent application by the Courts are all examined. The final Chapters attempt to assess whether the theologians examined have sufficient unanimity to provide a coherent concept of Justice and a specifically Christian contribution to the matters under discussion. The conclusion being in the affirmative it is then examined to what extent Christian precepts enumerated by them have been influential or could be used as a critical tool for the possible amendment or extension of the legislation

BTS guideline for oxygen use in adults in healthcare and emergency settings

The full Guideline for oxygen use in adults in healthcare and emergency settings, published in Thorax1 provides an update to the 2008 BTS Emergency oxygen guideline.2 The following is a summary of the recommendations and good practice points. The sections noted to within this summary refer to the full guideline sections

Establishing a gold standard for manual cough counting: video versus digital audio recordings

BACKGROUND: Manual cough counting is time-consuming and laborious; however it is the standard to which automated cough monitoring devices must be compared. We have compared manual cough counting from video recordings with manual cough counting from digital audio recordings. METHODS: We studied 8 patients with chronic cough, overnight in laboratory conditions (diagnoses were 5 asthma, 1 rhinitis, 1 gastro-oesophageal reflux disease and 1 idiopathic cough). Coughs were recorded simultaneously using a video camera with infrared lighting and digital sound recording. The numbers of coughs in each 8 hour recording were counted manually, by a trained observer, in real time from the video recordings and using audio-editing software from the digital sound recordings. RESULTS: The median cough frequency was 17.8 (IQR 5.9–28.7) cough sounds per hour in the video recordings and 17.7 (6.0–29.4) coughs per hour in the digital sound recordings. There was excellent agreement between the video and digital audio cough rates; mean difference of -0.3 coughs per hour (SD ± 0.6), 95% limits of agreement -1.5 to +0.9 coughs per hour. Video recordings had poorer sound quality even in controlled conditions and can only be analysed in real time (8 hours per recording). Digital sound recordings required 2–4 hours of analysis per recording. CONCLUSION: Manual counting of cough sounds from digital audio recordings has excellent agreement with simultaneous video recordings in laboratory conditions. We suggest that ambulatory digital audio recording is therefore ideal for validating future cough monitoring devices, as this as this can be performed in the patients own environment

Objective cough frequency in Idiopathic Pulmonary Fibrosis

Background: Cough is a common presenting symptom in patients with Idiopathic Pulmonary Fibrosis (IPF). This study measured cough rates in IPF patients and investigated the association between cough and measures of health related quality of life and subjective cough assessments. In addition, IPF cough rates were related to measures of physiological disease severity and compared to cough rates in health and other respiratory conditions.Methods: Nineteen IPF patients, mean age 70.8 years ± 8.6, five female (26.3%) were studied. Subjects performed full pulmonary function testing, 24 hour ambulatory cough recordings, completed a cough related quality of life questionnaire (Leicester Cough Questionnaire) and subjectively scored cough severity with a visual analogue scale. Ambulatory cough recordings were manually counted and reported as number of coughs per hour.Results: The 24hr cough rates were high (median 9.4, range 1.5-39.4), with day time rates much higher than night time (median 14.6, range 1.9-56.6 compared to 1.9, range 0-19.2, p = 0.003). Strong correlations were found between objective cough frequency and both the VAS (day r = 0.80, p &lt; 0.001, night r = 0.71, p = 0.001) and LCQ (r = -0.80, p &lt; 0.001), but not with measures of pulmonary function. Cough rates in IPF were higher than healthy subjects (p &lt; 0.001) and asthma patients (p &lt; 0.001) but similar to patients with chronic cough (p = 0.33).Conclusions: This study confirms objectively that cough is a major, very distressing and disabling symptom in IPF patients. The strong correlations between objective cough counts and cough related quality of life measures suggest that in IPF patient's, perception of cough frequency is very accurate.</p

Respiratory sounds in healthy people: a systematic review

There is a lack of systematised information on respiratory sounds of healthy people. This impairs health professionals from differentiating respiratory sounds of healthy people from people with respiratory diseases, which may affect patients' diagnosis and treatment. Therefore, this systematic review aimed to characterise respiratory sounds of healthy people.publishe

Evidence for models of diagnostic service provision in the community: literature mapping exercise and focused rapid reviews

Background Current NHS policy favours the expansion of diagnostic testing services in community and primary care settings. Objectives Our objectives were to identify current models of community diagnostic services in the UK and internationally and to assess the evidence for quality, safety and clinical effectiveness of such services. We were also interested in whether or not there is any evidence to support a broader range of diagnostic tests being provided in the community. Review methods We performed an initial broad literature mapping exercise to assess the quantity and nature of the published research evidence. The results were used to inform selection of three areas for investigation in more detail. We chose to perform focused reviews on logistics of diagnostic modalities in primary care (because the relevant issues differ widely between different types of test); diagnostic ultrasound (a key diagnostic technology affected by developments in equipment); and a diagnostic pathway (assessment of breathlessness) typically delivered wholly or partly in primary care/community settings. Databases and other sources searched, and search dates, were decided individually for each review. Quantitative and qualitative systematic reviews and primary studies of any design were eligible for inclusion. Results We identified seven main models of service that are delivered in primary care/community settings and in most cases with the possible involvement of community/primary care staff. Not all of these models are relevant to all types of diagnostic test. Overall, the evidence base for community- and primary care-based diagnostic services was limited, with very few controlled studies comparing different models of service. We found evidence from different settings that these services can reduce referrals to secondary care and allow more patients to be managed in primary care, but the quality of the research was generally poor. Evidence on the quality (including diagnostic accuracy and appropriateness of test ordering) and safety of such services was mixed. Conclusions In the absence of clear evidence of superior clinical effectiveness and cost-effectiveness, the expansion of community-based services appears to be driven by other factors. These include policies to encourage moving services out of hospitals; the promise of reduced waiting times for diagnosis; the availability of a wider range of suitable tests and/or cheaper, more user-friendly equipment; and the ability of commercial providers to bid for NHS contracts. However, service development also faces a number of barriers, including issues related to staffing, training, governance and quality control. Limitations We have not attempted to cover all types of diagnostic technology in equal depth. Time and staff resources constrained our ability to carry out review processes in duplicate. Research in this field is limited by the difficulty of obtaining, from publicly available sources, up-to-date information about what models of service are commissioned, where and from which providers. Future work There is a need for research to compare the outcomes of different service models using robust study designs. Comparisons of ‘true’ community-based services with secondary care-based open-access services and rapid access clinics would be particularly valuable. There are specific needs for economic evaluations and for studies that incorporate effects on the wider health system. There appears to be no easy way of identifying what services are being commissioned from whom and keeping up with local evaluations of new services, suggesting a need to improve the availability of information in this area. Funding The National Institute for Health Research Health Services and Delivery Research programme

Point of view in narrative discourse: a comparison of British Sign Language

Expressing the point of view of a character and marking changes in point of view (POV) are key aspects of narrative discourse. The concept of POV has been discussed in the literature in various contexts, including deixis, logophoricity and subjectivity. A variety of linguistic and non-linguistic devices are used to indicate a particular POV, including nominal and pronominal reference, and facial expressions and intonation. Spoken languages can mark changes in POV using strategies such as direct and indirect discourse, the former coupled with optional paralinguistic cues such as intonation, whereas signed languages can mark changes in POV in a unique way using referential shift. Referential shift is a common device in sign language narrative discourse, where the signer 'becomes' a referent by taking on one or more attributes of that referent, such as facial expression and/or body position (Loew, 1984). Within a referential shift construction, verbs and pronouns which are marked for first person refer to the referent being portrayed rather than the signer. This study examines how point of view is marked in three fables, each told by native users of British Sign Language (BSL) and native speakers of English, and explores how the strategies used by signers and speakers can be explained by theories of conceptual spaces, such as that suggested by Liddell (2003a) for signed languages and Ehlich (1979, 1985) for spoken languages

Point of view in narrative discourse : a comparison of British sign language and spoken English

EThOS - Electronic Theses Online ServiceGBUnited Kingdo