The Growth and Development of Sport in Co. Tipperary, 1840-1880

The growth and development of sport in Co. Tipperary, 1840 to 1880, was promoted and supported by the landed elite and military officer classes. In the instances of cricket, rugby union and association football, the military were the principle agency through which these sports were disseminated among the people of Tipperary. Sporting trends which were fashionable in Great Britain also became evident in Ireland, and by extension, Tipperary. The thesis demonstrates the emergence of these sports at a micro-level in Tipperary and the qualitative research is indicative of the trends by which they became apparent. The degree to which horse racing and hunting to hounds became an integral aspect of the social lives of the elite class is reflected countywide. The associational culture among this class became evident in summer time recreations most notably archery, lawn tennis and cricket. Cricket was the one sport which was quickly diffused throughout the sporting community of Tipperary as it became, in the 1870s, the most prolific team sport in the county and played by all classes. Sport took place without borders and to this end patronage was a key element of this support. There were some notable supporters who gave of their time and money to ensure that the best resources were in place to bring this about. In this respect the 3rd Marquis of Waterford was a leading figure. The thesis clearly shows that sporting diversions continued through the traumatic famine period. As everyday life continued, so too did recreational sport. Hurling remained a part of Tipperary life and the research identifies new sources to demonstrate this. The growth and evolution of sport in Co. Tipperary, 1840-1880, is put into context with comparable studies in Ireland and Great Britain as the Victorian penchant for sport manifested itself in this part of rural Ireland

Improving Medication Reconciliation Using Provider Education and an EHR Hard Stop

AIM: By using a sequence of two distinct interventions, we aim to improve the rate of medication reconciliation at Jefferson Internal Medicine Assoc.https://jdc.jefferson.edu/patientsafetyposters/1026/thumbnail.jp

Tackling the urban waste and food crises simultaneously and sustainably - examples from the Philippines and Burkina Faso

The current urban population of 3.3 billion is expected to reach 5 billion by 2030. This urbanisation of the global population is equally an urbanisation of poverty. Cities concentrate people, huge volumes of excreta and nutrients from vast areas of farmland into a limited area. For the urban poor in particular, these accumulations result in major health problems and a low standard of living. In recent decades sanitation practitioners and researchers have been working on modern sanitation systems that address two related urban problems the waste and the food production problem. The approaches developed are usually considered under the term ecological sanitation (ecosan) and are based on recognising the value of nutrients as part of a sustainable wastewater management system. Two large-scale projects from the Philippines and Burkina Faso, are presented to illustrate the benefit to the urban poor offered by affordable ecosan alternatives in terms of sanitation and fertiliser production

Sustainability criteria in sanitation planning

This article presents a list of sustainability criteria that might be of importance when assessing different sanitation solutions. The criteria presented are divided into the categories health, environment, economy, socio-culture, and technical function. We strongly recommend the use of sustainability criteria in any strategic sanitation planning and decision-making process whether on a macro or micro project level. Moreover, sanitation sustainability criteria can be used for follow-up and evaluation of sanitation systems. The list of criteria presented in this paper can be used to narrow down and focus discussions among decision-makers and also inspire to the development of context-specific sustainability criteria in the actual planning situation

The effects of temperature on nitrous oxide and oxygen mixture homogeneity and stability

<p>Abstract</p> <p>Background</p> <p>For many long standing practices, the rationale for them is often lost as time passes. This is the situation with respect to the storage and handling of equimolar 50% nitrous oxide and 50% oxygen volume/volume (v/v) mixtures.</p> <p>Methods</p> <p>A review was undertaken of existing literature to examine the developmental history of nitrous oxide and oxygen mixtures for anesthesia and analgesia and to ascertain if sufficient bibliographic data was available to support the position that the contents of a cylinder of a 50%/50% volume/volume (v/v) mixture of nitrous oxide and oxygen is in a homogenous single gas phase in a filled cylinder under normal conditions of handling and storage and if justification could be found for the standard instructions given for handling before use.</p> <p>Results</p> <p>After ranking and removing duplicates, a total of fifteen articles were identified by the various search strategies and formed the basis of this literature review. Several studies were identified that confirmed that 50%/50% v/v mixture of nitrous oxide and oxygen is in a homogenous single gas phase in a filled cylinder under normal conditions of handling and storage. The effect of temperature on the change of phase of the nitrous oxide in this mixture was further examined by several authors. These studies demonstrated that although it is possible to cause condensation and phase separation by cooling the cylinder, by allowing the cylinder to rewarm to room temperature for at least 48 hours, preferably in a horizontal orientation, and inverting it three times before use, the cylinder consistently delivered the proper proportions of the component gases as a homogenous mixture.</p> <p>Conclusions</p> <p>The contents of a cylinder of a 50%/50% volume/volume (v/v) mixture of nitrous oxide and oxygen is in a homogenous single gas phase in a filled cylinder under normal conditions of handling and storage. The standard instructions given for handling before are justified based on previously conducted studies.</p

Writing in Britain and Ireland, c. 400 to c. 800

No abstract available

Clinical Trials in Head Injury

Traumatic brain injury (TBI) remains a major public health problem globally. In the United States the incidence of closed head injuries admitted to hospitals is conservatively estimated to be 200 per 100,000 population, and the incidence of penetrating head injury is estimated to be 12 per 100,000, the highest of any developed country in the world. This yields an approximate number of 500,000 new cases each year, a sizeable proportion of which demonstrate signficant long-term disabilities. Unfortunately, there is a paucity of proven therapies for this disease. For a variety of reasons, clinical trials for this condition have been difficult to design and perform. Despite promising pre-clinical data, most of the trials that have been performed in recent years have failed to demonstrate any significant improvement in outcomes. The reasons for these failures have not always been apparent and any insights gained were not always shared. It was therefore feared that we were running the risk of repeating our mistakes. Recognizing the importance of TBI, the National Institute of Neurological Disorders and Stroke (NINDS) sponsored a workshop that brought together experts from clinical, research, and pharmaceutical backgrounds. This workshop proved to be very informative and yielded many insights into previous and future TBI trials. This paper is an attempt to summarize the key points made at the workshop. It is hoped that these lessons will enhance the planning and design of future efforts in this important field of research.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63185/1/089771502753754037.pd

Emerging Geopolitical Trends and Security in the Association of Southeast Asian Nations, the People's Republic of China, and India (ACI) Region

The rapid economic growth in the region consisting of the Association of Southeast Asian Nations (ASEAN), the People's Republic of China (PRC), and India has begun to change the strategic landscape of the world. The accretion of military power that inevitably followed the region's economic growth is altering the balance of power within the region and between Asia and the West. This background paper outlines the geopolitical trends in a region that has become the center stage of international politics in the 21st century. It begins with a review of the idea of Asia in the 20th century and identifies the inherited political legacy of Asia in the middle of the 20th century. The paper then provides an assessment of the region's unfolding geopolitical transformation in recent years and asks if the regional structures in Asia can cope with it. The paper also explores the problems of integrating the two rising Asian powers, the PRC and India, into the structures of global governance. It concludes with a brief discussion on the strategic policy imperatives facing the ACI region

Immunoglobulin, glucocorticoid, or combination therapy for multisystem inflammatory syndrome in children: a propensity-weighted cohort study.

BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C), a hyperinflammatory condition associated with SARS-CoV-2 infection, has emerged as a serious illness in children worldwide. Immunoglobulin or glucocorticoids, or both, are currently recommended treatments. METHODS: The Best Available Treatment Study evaluated immunomodulatory treatments for MIS-C in an international observational cohort. Analysis of the first 614 patients was previously reported. In this propensity-weighted cohort study, clinical and outcome data from children with suspected or proven MIS-C were collected onto a web-based Research Electronic Data Capture database. After excluding neonates and incomplete or duplicate records, inverse probability weighting was used to compare primary treatments with intravenous immunoglobulin, intravenous immunoglobulin plus glucocorticoids, or glucocorticoids alone, using intravenous immunoglobulin as the reference treatment. Primary outcomes were a composite of inotropic or ventilator support from the second day after treatment initiation, or death, and time to improvement on an ordinal clinical severity scale. Secondary outcomes included treatment escalation, clinical deterioration, fever, and coronary artery aneurysm occurrence and resolution. This study is registered with the ISRCTN registry, ISRCTN69546370. FINDINGS: We enrolled 2101 children (aged 0 months to 19 years) with clinically diagnosed MIS-C from 39 countries between June 14, 2020, and April 25, 2022, and, following exclusions, 2009 patients were included for analysis (median age 8·0 years [IQR 4·2-11·4], 1191 [59·3%] male and 818 [40·7%] female, and 825 [41·1%] White). 680 (33·8%) patients received primary treatment with intravenous immunoglobulin, 698 (34·7%) with intravenous immunoglobulin plus glucocorticoids, 487 (24·2%) with glucocorticoids alone; 59 (2·9%) patients received other combinations, including biologicals, and 85 (4·2%) patients received no immunomodulators. There were no significant differences between treatments for primary outcomes for the 1586 patients with complete baseline and outcome data that were considered for primary analysis. Adjusted odds ratios for ventilation, inotropic support, or death were 1·09 (95% CI 0·75-1·58; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids and 0·93 (0·58-1·47; corrected p value=1·00) for glucocorticoids alone, versus intravenous immunoglobulin alone. Adjusted average hazard ratios for time to improvement were 1·04 (95% CI 0·91-1·20; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids, and 0·84 (0·70-1·00; corrected p value=0·22) for glucocorticoids alone, versus intravenous immunoglobulin alone. Treatment escalation was less frequent for intravenous immunoglobulin plus glucocorticoids (OR 0·15 [95% CI 0·11-0·20]; p<0·0001) and glucocorticoids alone (0·68 [0·50-0·93]; p=0·014) versus intravenous immunoglobulin alone. Persistent fever (from day 2 onward) was less common with intravenous immunoglobulin plus glucocorticoids compared with either intravenous immunoglobulin alone (OR 0·50 [95% CI 0·38-0·67]; p<0·0001) or glucocorticoids alone (0·63 [0·45-0·88]; p=0·0058). Coronary artery aneurysm occurrence and resolution did not differ significantly between treatment groups. INTERPRETATION: Recovery rates, including occurrence and resolution of coronary artery aneurysms, were similar for primary treatment with intravenous immunoglobulin when compared to glucocorticoids or intravenous immunoglobulin plus glucocorticoids. Initial treatment with glucocorticoids appears to be a safe alternative to immunoglobulin or combined therapy, and might be advantageous in view of the cost and limited availability of intravenous immunoglobulin in many countries. FUNDING: Imperial College London, the European Union's Horizon 2020, Wellcome Trust, the Medical Research Foundation, UK National Institute for Health and Care Research, and National Institutes of Health