John Deakin Heaton and the ‘elusive civic pride of the Victorian middle class’

‘Civic pride’ is often studied in the abstract through architectural or institutional histories, or as a rather vague group attribute associated with pride in place or ideologies of urban ‘improvement’. This article offers a new perspective, using the unique journals of Leeds doctor John Deakin Heaton, together with the records of a range of cultural, medical and educational institutions, to analyse the matrix of social, familial, religious and professional identities which shaped the public activities of an influential but relatively obscure individual. It also explores the mechanisms through which Heaton influenced decision making, and the limits of his ability to promote public above personal or professional interest

Heroes in the age of celebrity: Lafayette, Kossuth and John Bright in nineteenth-century America

This article explores the relationship between the ‘hero’ and the celebrity culture in the nineteenth-century United States. Even by the 1820s, the activities of print media and entrepreneurial manufacturers meant that individuals widely recognised and worshipped as ‘heroes’ almost inevitably became part of the nascent celebrity culture of the age, while some actively courted this connection to pursue their own political or financial agendas. However, using the receptions of three foreign heroes, the Marquis de Lafayette, Lajos Kossuth and John Bright, the article contends that we can still make valid distinctions between the two states through the analysis of cultural practice and discourse. In turn, by conceptualising ‘hero’ and ‘celebrity’ as two axes on the graph of fame, it is possible to use such analysis to assess more accurately a given individual’s public reputation

The physiological expression of inducible nitric oxide synthase (iNOS) in the human colon

Inducible nitric oxide synthase (iNOS) is expressed in the colonic epithelium in both inflammatory bowel disease and colorectal cancer. Nitric oxide (NO), the product of this enzyme, has been implicated in the pathogenesis of both conditions. However, there are conflicting data on whether iNOS is expressed in the normal, uninflamed human colon. To evaluate the expression of iNOS in histologically normal, non-inflamed human colonic mucosa. Reverse transcription polymerase chain reaction (RT-PCR), immunoblotting, and immunohistochemistry were used to investigate the expression of iNOS in 17 histologically normal specimens obtained at colectomy performed for colorectal neoplasia. In addition, 16 endoscopic mucosal biopsies, taken from normal individuals, were also evaluated. Eleven surgical specimens and 16 endoscopic biopsies from patients with refractory ulcerative colitis were used as inflammatory controls. All types of specimens expressed iNOS mRNA. Immunoblotting revealed a protein of approximately 130 kDa consistent with iNOS in mucosal extracts of 77% of normal individuals, and 85% of diseased controls. Immunolabelling localised this protein to the surface epithelium in most of the normal specimens and also to the crypt epithelium and inflammatory cells in the diseased controls. These findings provide evidence that iNOS is often expressed in the surface epithelium of non-inflamed human colon, suggesting that it is induced by local luminal factors, such as bacterial lipopolysaccharide (endotoxin). The resultant NO produced at this site might act as an oxidative barrier, reducing bacterial translocation and providing a means of defence against pathogenic microorganisms

An exploration of social and economic outcome and associated health-related quality of life after critical illness in general intensive care unit survivors: a 12-month follow-up study.

INTRODUCTION: The socio-economic impact of critical illnesses on patients and their families in Europe has yet to be determined. The aim of this exploratory study was to estimate changes in family circumstances, social and economic stability, care requirements and access to health services for patients during their first 12 months after ICU discharge. METHODS: Multi-center questionnaire-based study of survivors of critical illness at 6 and 12 months after ICU discharge. RESULTS: Data for 293 consenting patients who spent greater than 48 hours in one of 22 UK ICUs were obtained at 6 and 12 months post-ICU discharge. There was little evidence of a change in accommodation or relationship status between pre-admission and 12 months following discharge from an ICU. A negative impact on family income was reported by 33% of all patients at 6 months and 28% at 12 months. There was nearly a 50% reduction in the number of patients who reported employment as their sole source of income at 12 months (19% to 11%) compared with pre-admission. One quarter of patients reported themselves in need of care assistance at 6 months and 22% at 12 months. The majority of care was provided by family members (80% and 78%, respectively), for half of whom there was a negative impact on employment. Amongst all patients receiving care, 26% reported requiring greater than 50 hours a week. Following discharge, 79% of patients reported attending their primary care physician and 44% had seen a community nurse. Mobility problems nearly doubled between pre-admission and 6 months (32% to 64%). Furthermore, 73% reported moderate or severe pain at 12 months and 44% remained significantly anxious or depressed. CONCLUSIONS: Survivors of critical illness in the UK face a negative impact on employment and commonly have a care requirement after discharge from hospital. This has a corresponding negative impact on family income. The majority of the care required is provided by family members. This effect was apparent by 6 months and had not materially improved by 12 months. This exploratory study has identified the potential for a significant socio-economic burden following critical illness

When Is a Sprint a Sprint? A Review of the Analysis of Team-Sport Athlete Activity Profile

The external load of a team-sport athlete can be measured by tracking technologies, including global positioning systems (GPS), local positioning systems (LPS) and vision-based systems. These technologies allow for the calculation of displacement, velocity and acceleration during a match or training session. The accurate quantification of these variables is critical so that meaningful changes in team-sport athlete external load can be detected. High-velocity running, including sprinting, may be important for specific team-sport match activities, including evading an opponent or creating a shot on goal. Maximal accelerations are energetically demanding and frequently occur from a low velocity during team-sport matches. Despite extensive research, conjecture exists regarding the thresholds by which to classify the high velocity and acceleration activity of a team-sport athlete. There is currently no consensus on the definition of a sprint or acceleration effort, even within a single sport. The aim of this narrative review was to examine the varying velocity and acceleration thresholds reported in athlete activity profiling. The purposes of this review were therefore to (1) identify the various thresholds used to classify high-velocity or –intensity running plus accelerations; (2) examine the impact of individualized thresholds on reported team-sport activity profile; (3) evaluate the use of thresholds for court-based team-sports and; (4) discuss potential areas for future research. The presentation of velocity thresholds as a single value, with equivocal qualitative descriptors, is confusing when data lies between two thresholds. In Australian football, sprint efforts have been defined as activity > 4.00 m·s-1 or > 4.17 m·s-1. Acceleration thresholds differ across the literature, with > 1.11 m·s-2, 2.78 m·s-2, 3.00 m·s-2 and 4.00 m·s-2 utilized across a number of sports. It is difficult to compare literature on field-based sports due to inconsistencies in velocity and acceleration thresholds, even within a single sport. Velocity and acceleration thresholds have been determined from physical capacity tests. Limited research exists on the classification of velocity and acceleration data by female team-sport athletes. Alternatively, data mining techniques may be used to report team-sport athlete external load, without the requirement of arbitrary or physiologically defined thresholds

Spatiotemporal dynamics of insulitis in human Type 1 diabetes

This is the final version of the article. Available from the publisher via the DOI in this record.Type 1 diabetes (T1D) is an auto-immune disease characterised by the selective destruction of the insulin secreting beta cells in the pancreas during an inflammatory phase known as insulitis. Patients with T1D are typically dependent on the administration of externally provided insulin in order to manage blood glucose levels. Whilst technological developments have significantly improved both the life expectancy and quality of life of these patients, an understanding of the mechanisms of the disease remains elusive. Animal models, such as the NOD mouse model, have been widely used to probe the process of insulitis, but there exist very few data from humans studied at disease onset. In this manuscript, we employ data from human pancreases collected close to the onset of type 1 diabetes and propose a spatio-temporal computational model for the progression of insulitis in human T1D, with particular focus on the mechanisms underlying the development of insulitis in pancreatic islets. This framework allows us to investigate how the time-course of insulitis progression is affected by altering key parameters, such as the number of the CD20+ B cells present in the inflammatory infiltrate, which has recently been proposed to influence the aggressiveness of the disease. Through the analysis of repeated simulations of our stochastic model which track the number of beta cells within an islet, we find that increased numbers of B cells in the peri-islet space lead to faster destruction of the beta cells. We also find that the balance between the degradation and repair of the basement membrane surrounding the islet is a critical component in governing the overall destruction rate of the beta cells and their remaining number. Our model provides a framework for continued and improved spatio-temporal modelling of human T1D.This work was generously supported by the Wellcome Trust Institutional Strategic Support Award (WT105618MA). KT gratefully acknowledges the financial support of the EPSRC via grant EP/N014391/1. We are also pleased to acknowledge financial support from the European Unions Seventh Framework Programme PEVNET [FP7/2007-2013] under grant agreement number 261441 to NM. The participants of the PEVNET consortium are described at http://www.uta.fi/med/pevnet/ publications.html. Additional support was from a JDRF Career Development Award (5-CDA-2014-221-A-N) to SR and project grant 15/0005156 from Diabetes UK (to NM and SR)

“It's what's behind the mask”: Psychological diversity in compassionate patient care

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record Introduction: The Francis Report recommended an increased focus on compassion in healthcare, and recognition and non-judgmental acceptance of diversity is fundamental in compassionate patient care. The aim of this study was to achieve a wider understanding of diversity that includes individual patient needs, expectations, perceptions and feelings during diagnostic imaging. Methods: Using thirty-four semi-structured interviews with individual patients, this qualitative study explored their experiences of undergoing diagnostic radiography examinations and asked what compassionate care meant to them and how it is perceived and manifested in the brief, task-focussed and highly technical diagnostic projection imaging encounter. Data were analysed using Thematic Analysis. Results: Four key themes were identified from the analysis; these were: feelings and vulnerability; hidden emotions; professionalism and valued qualities and communication. Conclusion: Diversity is defined not only in terms of socio-cultural differences but also psychological ones, i.e. individual emotional and attitudinal characteristics, some of which may be consciously or unconsciously concealed. In order that patients are treated equitably and all of their care needs met, recommendations include a broader focus in education and training to include adapting communication skills and techniques in perception and expression of non-verbal cues. Further research into the pressures specific to the time-pressured, task-focussed, highly technical and rapid turnover environment of projection imaging radiography and how this impacts upon compassionate patient care would make a useful contribution to the field

Acute acetaminophen ingestion improves performance and muscle activation during maximal intermittent knee extensor exercise

This is the author accepted manuscript. The final version is available from the publisher via the DOI in this record.AIM: Acetaminophen is a commonly used medicine for pain relief and emerging evidence suggests that it may improve endurance exercise performance. This study investigated some of the physiological mechanisms by which acute acetaminophen ingestion might blunt muscle fatigue development. METHODS: Thirteen active males completed 60 × 3 s maximum voluntary contractions (MVC) of the knee extensors with each contraction separated by a 2 s passive recovery period. This protocol was completed 60 min after ingesting 1 g of maltodextrin (placebo) or 1 g of acetaminophen on two separate visits. Peripheral nerve stimulation was administered every 6th contraction for assessment of neuromuscular fatigue development, with the critical torque (CT), which reflects the maximal sustainable rate of oxidative metabolism, taken as the mean torque over the last 12 contractions. Surface electromyography was recorded continuously as a measure of muscle activation. RESULTS: Mean torque (61 ± 11 vs. 58 ± 14% pre-exercise MVC) and CT (44 ± 13 vs. 40 ± 15% pre-exercise MVC) were greater in the acetaminophen trial compared to placebo (both P  0.05). However, the decline in electromyography amplitude was attenuated in the acetaminophen trial, with electromyography amplitude being greater compared to placebo from 210 s onwards (P < 0.05). CONCLUSION: These findings indicate that acute acetaminophen ingestion might be ergogenic by increasing CT and preserving muscle activation during high-intensity exercise.This research was not sponsored by any funding body external to University of Exete

Using zoo welfare assessments to identify common issues in developing country zoos

Zoo animal welfare is a high priority for many institutions worldwide, with modern zoos now ensuring that animals are housed and cared for to the highest standards. However, in countries where this knowledge is not as available or understood, standards may be lower. The aim of this research was to investigate if there were common zoo welfare concerns across developing country zoos. Wild Welfare is a charity working globally to improve welfare for zoo animals and has an independent welfare audit that is carried out before any intervention occurs. The Wild Welfare Audit, consisting of 110 questions, covering nine topics, was completed at 11 zoos in seven developing countries (Brazil, Egypt, Libya, Indonesia, Thailand, Malaysia and Vietnam) following a Likert scale score (1-3). A principal component analysis was also performed to evaluate the audit questions. The results suggest that common areas of concern were animal behaviour, positive animal mental states and human health and safety. These themes were likely due to the lack knowledge and understanding that may be linked to historical and cultural differences. This research has helped to revise the welfare audit as well as inform future intervention strategies for improving developing country zoo animal welfare