Tackling health inequalities through developing evidence-based policy and practice with childbearing women in prison: a consultation

A collaborative partnership between the Hallam Centre for Community Justice and the Mother and Infant Research Unit (MIRU) at the University of York was successful in securing funding to conduct this consultation project. This collaboration brought together the knowledge and expertise of researchers working in maternal and infant health and those with knowledge of the prison sector. This consultation scopes and maps the health needs and health care of childbearing women in prison, using the Yorkshire and Humberside region as a case study

Reporting of health-related quality of life in emergency laparotomy trials: a systematic review and narrative synthesis

Purpose Emergency laparotomy is associated with high morbidity for the surgical patient. Understanding patients’ health-related quality of life after their surgery is important to enhance the informed consent process, and to enable the evaluation and improvement of surgical care. This review aims to summarise the use of health-related quality of life tools in clinical trials involving patients undergoing emergency laparotomy. Methods A systematic review was undertaken of the scientific literature published in the MEDLINE® and PubMed databases between January 2011 and July 2021. A narrative synthesis approach was chosen to synthesise the diverse range of studies in a structured manner. All included papers were evaluated using the Cochrane Collaboration’s tool for assessing risk of bias. Results Eleven studies were selected for inclusion. Most of the studies had a low risk of bias. Two of the studies used health-related quality of life as the primary outcome measure. A variety of health-related quality of life measurement tools were used; the EQ-5D tool was the most popular questionnaire. Protocol adherence was dependent on the length of time which had elapsed after emergency surgery. Conclusion There are many perceived challenges to collecting health-related quality of life data in the emergency surgery setting. Many of these can be offset with progressive trial designs. There is a need for further research in the systematic development of patient-reported outcomes for use in emergency surgery

A 9-Month Hubble Space Telescope Near-UV Survey of M87. I. Light and Color Curves of 94 Novae, and a Re-determination of the Nova Rate

M87 has been monitored with a cadence of 5 days over a 9 month-long span through the near-ultraviolet (NUV:F275W) and optical (F606W) filters of the Wide Field Camera 3 (WFC3) of the $\textit{Hubble Space Telescope}$. This unprecedented dataset yields the NUV and optical light and color curves of 94 M87 novae, characterizing the outburst and decline properties of the largest extragalactic nova dataset in the literature (after M31 and M81). We test and confirm nova modelers' prediction that recurrent novae cannot erupt more frequently that once every 45 days; show that there are zero rapidly recurring novae in the central $\sim$ 1/3 of M87 with recurrence times $<$ 130 days; demonstrate that novae closely follow the K-band light of M87 to within a few arcsec of the galaxy nucleus; show that nova NUV light curves are as heterogeneous as their optical counterparts, and usually peak 5 to 30 days after visible light maximum; determine our observations' annual detection completeness to be 71 - 77\%; and measure the rate Rnova of nova eruptions in M87 as $352_{-37}^{+37}$/yr. The corresponding luminosity-specific classical nova rate for this galaxy is $7.91_{-1.20}^{+1.20}/yr/10^{10}L_\odot,_{K}$. These rates confirm that ground-based observations of extragalactic novae miss most faint, fast novae and those near the centers of galaxies. An annual M87 nova rate of 300 or more seems inescapable. A luminosity-specific nova rate of $\sim$ $7 - 10/yr/10^{10}L_\odot,_{K}$ in ${\it all}$ types of galaxies is indicated by the data available in 2023.Comment: Accepted/In Press in ApJS; 3 Tables, 108 Figures, 180 page

Structural Ceramic Composites for Nuclear Applications

A research program has been established to investigate fiber reinforced ceramic composites to be used as control rod components within a Very High Temperature Reactor. Two candidate systems have been identified, carbon fiber reinforced carbon (Cf/C) and silicon carbide fiber reinforced silicon carbide (SiCf/SiC) composites. Initial irradiation stability studies to determine the maximum dose for each composite type have been initiated within the High Flux Isotope Reactor at Oak Ridge National Laboratory. Test samples exposed to 10 dpa irradiation dose have been completed with future samples to dose levels of 20 and 30 dpa scheduled for completion in following years. Mechanical and environmental testing is being conducted concurrently at the Idaho National Laboratory and at Pacific Northwest National Laboratory. High temperature test equipment, testing methodologies, and test samples for high temperature (up to 1600º C) tensile strength and long duration creep studies have been established. Specific attention was paid to the architectural fiber preform design as well as the materials used in construction of the composites. Actual testing of both tubular and flat, "dog-bone" shaped tensile composite specimens will begin next year. Since there is no precedence for using ceramic composites within a nuclear reactor, ASTM standard test procedures will be established from these mechanical and environmental tests. Close collaborations between the U.S. national laboratories and international collaborators (i.e. France and Japan) are being forged to establish both national and international test standards to be used to qualify ceramic composites for nuclear reactor applications

Fabrication of Mullite Body Using Superplastic Transient Phase

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65799/1/j.1151-2916.1992.tb05542.x.pd

Transmission of Staphylococcus aureus between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencing

Background: Health-care workers have been implicated in nosocomial outbreaks of Staphylococcus aureus, but the dearth of evidence from non-outbreak situations means that routine health-care worker screening and S aureus eradication are controversial. We aimed to determine how often S aureus is transmitted from health-care workers or the environment to patients in an intensive care unit (ICU) and a high-dependency unit (HDU) where standard infection control measures were in place. Methods: In this longitudinal cohort study, we systematically sampled health-care workers, the environment, and patients over 14 months at the ICU and HDU of the Royal Sussex County Hospital, Brighton, England. Nasal swabs were taken from health-care workers every 4 weeks, bed spaces were sampled monthly, and screening swabs were obtained from patients at admission to the ICU or HDU, weekly thereafter, and at discharge. Isolates were cultured and their whole genome sequenced, and we used the threshold of 40 single-nucleotide variants (SNVs) or fewer to define subtypes and infer recent transmission. Findings: Between Oct 31, 2011, and Dec 23, 2012, we sampled 198 health-care workers, 40 environmental locations, and 1854 patients; 1819 isolates were sequenced. Median nasal carriage rate of S aureus in health-care workers at 4-weekly timepoints was 36·9% (IQR 35·7–37·3), and 115 (58%) health-care workers had S aureus detected at least once during the study. S aureus was identified in 8–50% of environmental samples. 605 genetically distinct subtypes were identified (median SNV difference 273, IQR 162–399) at a rate of 38 (IQR 34–42) per 4-weekly cycle. Only 25 instances of transmission to patients (seven from health-care workers, two from the environment, and 16 from other patients) were detected. Interpretation: In the presence of standard infection control measures, health-care workers were infrequently sources of transmission to patients. S aureus epidemiology in the ICU and HDU is characterised by continuous ingress of distinct subtypes rather than transmission of genetically related strains. Funding: UK Medical Research Council, Wellcome Trust, Biotechnology and Biological Sciences Research Council, UK National Institute for Health Research, and Public Health England

On the notion of home and the goals of palliative care

The notion of home is well known from our everyday experience, and plays a crucial role in all kinds of narratives about human life, but is hardly ever systematically dealt with in the philosophy of medicine and health care. This paper is based upon the intuitively positive connotation of the term “home.” By metaphorically describing the goal of palliative care as “the patient’s coming home,” it wants to contribute to a medical humanities approach of medicine. It is argued that this metaphor can enrich our understanding of the goals of palliative care and its proper objectives. Four interpretations of “home” and “coming home” are explored: (1) one’s own house or homelike environment, (2) one’s own body, (3) the psychosocial environment, and (4) the spiritual dimension, in particular, the origin of human existence. Thinking in terms of coming home implies a normative point of view. It represents central human values and refers not only to the medical-technical and care aspects of health care, but also to the moral context

The pursuit of happiness: the social and scientific origins of Hans Selye’s natural philosophy of life

© The Author(s) 2012. Open access article.In 1956, Hans Selye tentatively suggested that the scientific study of stress could ‘help us to formulate a precise program of conduct’ and ‘teach us the wisdom to live a rich and meaningful life’. Nearly two decades later, Selye expanded this limited vision of social order into a full-blown philosophy of life. In Stress without Distress, first published in 1974, he proposed an ethical code of conduct designed to mitigate personal and social problems. Basing his arguments on contemporary understandings of the biological processes involved in stress reactions, Selye referred to this code as ‘altruistic egotism’. This article explores the origins and evolution of Selye’s ‘natural philosophy of life’, analysing the links between his theories and adjacent intellectual developments in biology, psychosomatic and psychosocial medicine, cybernetics and socio-biology, and situating his work in the broader cultural framework of modern western societies.Wellcome Trus