Mid-term survival after abdominal aortic aneurysm surgery predicted by cardiopulmonary exercise testing (Br J Surg 2007; 94: 966-969)

No abstract available

Evaluation of the Altogether Better Asset Mapping in Sharrow and Firth Park, Sheffield

‘I am My Community’ is an asset mapping exercise led by Altogether Better that has explored a model by which trained Community Health Champions (CHCs) are used to undertake an inventory of the physical and social assets linked to the health and well-being of their communities and neighbourhoods. The project, which started in 2011 and was completed in April 2012, was undertaken in two communities in Sheffield, Sharrow and Firth Park, by two delivery organisations, ShipShape and SOAR. A steering group including Altogether Better, the Department of Health, Sheffield Well-Being Consortium, Sheffield City Council, ShipShape staff and CHCs, SOAR staff and CHCs, and South Yorkshire Police has overseen the delivery and development of the project and work. This report presents findings from an evaluation of the ‘I am My Community’ asset mapping, conducted by the Centre for Health Promotion Research, Institute for Health and Wellbeing at Leeds Metropolitan University. It presents evidence about the engagement of CHCs in asset mapping and offers recommendations regarding their involvement in future projects

The Leeds Winter Warmth Campaign: Stakeholder Evaluation

The winter of 2012/13 was longer and colder than usual; whilst temperatures were average in December, it was colder than usual from January through to May. March was the coldest it has been for 50 years (Met Office, 2013). This evaluation focuses on the organisations funded by the Winter Warmth campaign to deliver services to Leeds residents. The overriding aim of the evaluation was to inform the operation of possible future schemes, with good practices and any issues identified. The views of organisations on the need for the funds and how the campaign was organised were ascertained. How they delivered the services, reached clients and worked with other stakeholders is explored and their suggestions for improvements described. This report should be read alongside the overall campaign report, by Leeds City Council, and the beneficiary report

An evaluation of the Department of Health’s Health and Social Care Volunteering Fund

The Health and Social Care Volunteering Fund (HSCVF) is an innovative programme that was established in 2009 by the Department of Health (DH) to build organisational and community capacity for volunteering through a national and local grant scheme. The HSCVF has offered both funds and tailored support to health and social care projects delivered by Voluntary, Community and Social Enterprise (VCSE) organisations. The HSCVF is managed by a partnership led by Ecorys and with expertise from leading national voluntary sector organisations: Attend, Community Service Volunteers (CSV) and Primetimers. To date the HSCVF has funded a total of 157 local and national projects, of which 114 are currently live. This report presents findings from an evaluation of the HSCVF with a specific focus on the 2010/2011 national and local projects, conducted by a team from the Institute for Health & Wellbeing at Leeds Metropolitan University. It presents evidence on the extent to which, how and in what ways the HSCVF programme has built organisational and community capacity across the national and local HSCVF projects, as well as on the health and social outcomes that resulted

Labour efficiency on-farm

End of project reportImprovements in milking efficiency have a greater influence than any other aspect of the dairy farmers work on overall farm labour inputs (Whipp, 1992). In order to facilitate the examination of milking process labour inputs, the milking process may be divided into the following three components: herding pre and post milking (transfer of cows to and from the milking parlour); milking (milking tasks / work routines within the parlour); and washing (washing of milking machine and yard). Meanwhile, within milking specifically, the number of cows milked per operator per hour is the best measure of both the performance of the operator and the milking installation (Clough, 1978). This is affected by the following three factors: the milking times of the cows, the number and arrangement of the milking units, and the operator’s work routine (Whipp, 1992). The addition of extra milking units will only increase milking performance if the operator has idle time during milking (Hansen, 1999)

Randomized crossover comparison between the i-gel and the LMA-Unique in anaesthetized, paralysed adults

<b>Background</b>: The i-gel differs from other supraglottic airway devices, in that it has a softer, non-inflatable cuff. This study was designed to compare the performance of the i-gel and the LMA-Unique (LMA-U) when used during anaesthesia in paralysed patients. <b>Methods</b>: Both devices were studied in 39 anaesthetized, paralysed patients in a randomized crossover trial. The primary outcome was airway leak pressure. Secondary outcomes included time to insertion, the number of insertion and reposition attempts, leak volumes, and leak fractions. <b>Results</b>: There was no significant difference between the airway leak pressures of the two devices [median (IQR) leak pressures 25 (22–30) vs 22 (20–28) cm H2O for the i-gel and LMA-U, respectively; P=0.083, 95% CI of the mean difference –0.32 to 4.88 cm H2O]. The median (IQR) insertion time for the i-gel was significantly less than for the LMA-U [12.2 (9.7–14.3) vs 15.2 (13.2–17.3) s; P=0.007]. All the LMA-U devices and 38 of 39 i-gel airways were inserted at the first attempt. The number of manipulations required after insertion to achieve a clear airway was the same in both the groups (four in each). There were no statistically significant differences in leak volumes or leak fractions during controlled ventilation. <b>Conclusions</b>: We found no difference in leak pressures and success rate of first-time insertion between the i-gel and the LMA-U. Time to successful insertion was significantly shorter for the i-gel. We conclude that the i-gel provides a reasonable alternative to the LMA-U for controlled ventilation during anaesthesia

B-type natriuretic peptide predicts deterioration in functional capacity following lung resection

OBJECTIVES Following lung resection, there is a decrease in the functional capacity and quality of life, which is not fully explained by changes in pulmonary function. Previous work demonstrates that B-type natriuretic peptide (BNP) is associated with short- and long-term complications following lung resection, leading to the suggestion that cardiac dysfunction may contribute to functional deterioration. Our aim was to investigate any relationship between BNP and subjective and objective indices of functional deterioration following lung resection surgery. METHODS Twenty-seven patients undergoing lung resection had serum BNP measured preoperatively, on postoperative day (POD)1 and POD2, and at 2 months postoperatively. The functional deterioration was assessed using 6-min walk tests and the Medical Research Council dyspnoea scale. ‘Deterioration in functional capacity’ was defined as either an increase in the Medical Research Council dyspnoea score or a significant decrease in the 6-min walk test distance. RESULTS BNP increased over time (P < 0.01) and was significantly elevated on POD1 and POD2 (P < 0.02 for both). Seventeen patients demonstrated functional deterioration 2 months postoperatively. At all perioperative time points, BNP was significantly higher in patients showing deterioration (P < 0.05 for all). Preoperative BNP was predictive of functional deterioration at 2 months with an area under the receiver-operating characteristic curve of 0.82 (P = 0.01, 95% confidence interval 0.65–0.99). CONCLUSIONS This study has demonstrated, using subjective and objective measures, that preoperative BNP is a predictor of functional deterioration following lung resection. BNP may have a role in preoperative risk stratification in this population, allowing therapy in future to be targeted towards high-risk patients with the aim of preventing postoperative cardiac dysfunction. Clinical trial registration number: NCT01892800

Applications of a Hybrid Manufacturing Process for Fabrication and Repair of Metallic Structures

Since its appearance, rapid prototyping technology has been of interest to various industries that are looking for a process to produce/build a part directly from a CAD model in a short time. Among them, the direct metal deposition process is the only process which directly manufactures a fully dense metal part without intermediate steps. However, challenges of the direct metal deposition process include building overhang structures, producing precision surfaces, and making parts with complex structures. Coupled between the additive and the subtractive processes into a single workstation, the integrated process, or hybrid process, can produce a metal part with machining accuracy and surface finish. Therefore, the hybrid process is potentially a very competitive process to fabricate and repair metallic structures. This paper summarizes the current development of the hybrid process to process high temperature metallic materials, including tool steel and Ti64. Research in simulation and modeling, process development, and actual part building and repair are discussed