Neonatal BCG: a time for change

© 2022 The Authors. Published by BMJ. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: http://dx.doi.org/10.1136/archdischild-2021-323239The BCG vaccination programme in the UK is risk based and has usually been given to eligible babies soon after birth. On advice from the Joint Committee on Vaccination and Immunisation, NHS England and Improvement recently revised the timing of this vaccination to 28 days after birth or soon thereafter. In this article, we highlight the change in timing of vaccination, the rationale and barriers to BCG uptake that this change may pose.Published versio

Neonatal BCG : a time for change

The BCG vaccination programme in the UK is risk based and has usually been given to eligible babies soon after birth. On advice from the Joint Committee on Vaccination and Immunisation, NHS England and Improvement recently revised the timing of this vaccination to 28 days after birth or soon thereafter. In this article, we highlight the change in timing of vaccination, the rationale and barriers to BCG uptake that this change may pose

The role of children in their HIV-positive parents’ management of antiretroviral therapy in Uganda

Adjustment to life on antiretroviral therapy (ART) and living with HIV as a long-term chronic condition, pose significant medical, social and economic challenges. We investigated children’s role in supporting HIV-positive parents to self-manage life on ART. Between 2010 and 2012, we conducted a qualitative study using semi-structured interviews with 38 HIV-positive parents who had been on ART for over a year. They were randomly selected from people accessing ART from three delivery sites in Wakiso district, Uganda. Data were analysed thematically. Participants reported children between the ages of 1 and 47 years providing support. Children were a source of happiness, self-worth, encouragement, and comfort. Both younger and older children supported parents’ adherence to treatment through reminding them to take the drugs and honour clinic appointments. Older children provided money to buy medication, food and shelter. Parents reported that the encouragement they received after they disclosed to their children enhanced their survival. After HIV disclosure to their children many of their fears about the future were allayed. Thinking about their children’s future brought hope. However, looking after younger children while on ART could be burdensome since some parents could not work to their full capacity due to reduced physical health. Children are an important resource in their parents’ adjustment to living with HIV while taking ART. There is a need for children to be supported by appropriate policy and other social and health development structures

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Addressing the climate challenge

In 2021, colleagues from across the University of Birmingham community were invited to write articles about topics relevant to the COP26 climate change summit. In this series of articles, experts from across many different disciplines provide new insight and evidence on how we might all understand and tackle climate change

Using an Adaptive Scenarios Approach to Establish Strategies for Tomorrow’s Workplace

This paper aims to demonstrate that it is important to have a methodological process that is reflexive and flexible to achieve fluid interactions that add rigour and energy to the overall process of a built environment project. Therefore, it outlines three phases of the Prospective Through Scenarios futures process used in a study called the “Workplace of the Future”. It also discusses how and why the methodology evolved during the course of the project with participant feedback as the main source of information for the analysis. Furthermore, novel qualitative futures techniques have been applied to a discipline that is usually reactive and quantitative

State Feedback Control of Electrorheological Fluids

Electrorheological (ER) fluids have electrically controllable stiffness, viscosity, and heat transfer properties. Since the 1940s researchers have attempted to model the properties of ER fluids and have proposed applications which attempt to utilize their special characteristics in the operation of hydraulic valves, soft clutches, and active suspension systems. Early attempts to make these applications commercially successful were hampered by the relatively slow, nonlinear response of ER fluids under on-off control of high electric fields. Successful applications will require fast, precise control of the response of ER fluids, independent of application at low field strengths. This study presents a new approach to the control of ER fluids that overcomes the problems of imprecise, slow, nonlinear response and high electric fields. An optical sensor was used to indicate the ER fluid state in a layered composite window. Feedback control of ER fluid state was developed and compared to conventionally actuated ER fluids. Feedback control employs the state sensor and high initial electric field strength to speed ER state response, then lowers the field strength to the minimum level required to achieve the desired ER fluid state. Predicted responses were compared to experimentally measured responses and showed excellent agreement. Laboratory measurements showed that a proportional state feedback control system yielded an electrorheological fluid which responded 35 times faster and 21 times more accurately than possible with a conventional openloop fluid control system. Although the use of ER fluids in feedback control systems have been proposed in the past, this work is the first application of feedback control to the fluid itself. INTRODUCTION As early as the 19th century (Duff 1896; Quinke 1897), scientists began studying electrorheological (ER) response, although it was not until research by Winslow (1947) that electroviscous phenomena gained prominent attention. He introduced the concept of controlling the viscosity of an electro-viscous fluid by use of an electric field (Winslow 1947, 1949). Flow resistance of these fluids increased with field strength when exposed to AC electric fields on the order of 4kV/mm. He observed a “fibrous” structure composed of particle chains generally aligned with the applied electric field. Winslow hypothesized that these field induced particle chains increased the viscosity of the fluid. An ER fluid consists of fine polarizable particles suspended in a fluid of lower dielectric constant. Typically such fluids are assembled with a continuous hydrophobic liquid phase (e.g. silicone oil) containing hydrophilic particles (e.g. Zeolite). The density of the particles is matched as closely as possible with that of the oil to ensure good dispersion upon mixing of the ER fluid (Stangroom 1978, 1983). An applied electric field aligns the dipoles of water molecules trapped in particles, thus polarizing the particles. Particle polarization changes their organization in the fluid and causes changes in fluid rheological properties (Fig. 1). When particle chains are subjected to fluid shearing forces, the particles still attract even though they may be pulled away from each other (Duclos et al 1988). Higher electric field strength increases polarization and causes particle chains to pull together tighter and to lengthen the chains through the addition of more particles (Klingenberg et al, 1989). These longer, stronger particle chains result in higher fluid viscosity and stiffness. At LES