Water Efficiency: the contribution of construction products

This publication is about the role that construction product manufacturers have on managing water use and water efficiency. It discusses the ways in which manufacturers use water during the manufacturing phase and the innovations they are making to use water more efficiently as well as the types of products that manufacturers produce that assist other s in the built environment to manage water. It discusses the potential business risk to increasing scarcity of water, as well as the interaction between water, energy and carbon emissions. Finally it discusses the ways to measure and assess water use and its impact. Examples and case studies from the construction product manufacturing sector are provided

High-intensity interval training (HIT) for effective and time-efficient pre-surgical exercise interventions

The advancement of perioperative medicine is leading to greater diversity in development of pre-surgical interventions, implemented to reduce patient surgical risk and enhance post-surgical recovery. Of these interventions, the prescription of pre-operative exercise training is gathering momentum as a realistic means for enhancing patient surgical outcome. Indeed, the general benefits of exercise training have the potential to pre-operatively optimise several pre-surgical risks factors, including cardiorespiratory function, frailty and cognitive function. Any exercise programme incorporated into the pre-operative pathway of care needs to be effective and time efficient in that any fitness gains are achievable in the limited period between the decision for surgery and operation (e.g. 4 weeks).Fortunately, there is a large volume of research describing effective and time-efficient exercise training programmes within the discipline of sports science. Accordingly, the objective of our commentary is to synthesise contemporary exercise training research, both from non-clinical and clinical populations, with the overarching aim of informing the development of effective and time-efficient pre-surgical exercise training programmes.The development of such exercise training programmes requires the careful consideration of several key principles, namely frequency, intensity, time, type and progression of exercise. Therefore, in light of more recent evidence demonstrating the effectiveness and time efficiency of high-intensity interval training—which involves brief bouts of intense exercise interspersed with longer recovery periods—the principles of exercise training programme design will be discussed mainly in the context of such high-intensity interval training programmes. Other issues pertinent to the development, implementation and evaluation of pre-operative exercise training programmes, such as individual exercise prescription, training session monitoring and potential barriers and risks to high-intensity exercise are also discussed. The evidence presented suggests that individually prescribed and supervised high-intensity interval training programmes, encompassing a variety of exercise modes represent an effective and safe means of exercise therapy prior to surgery

Durability performance of structural concrete made with coarse recycled concrete aggregates

There is often a poor perception of the durability of concrete made with recycled concrete aggregates (RCA), as well as concerns regarding performance variability and contamination of the source material. Additional research regarding the addition of RCA in structural concrete is therefore required to more clearly determine the limits of its suitability. The influence of RCA on the mechanical properties of concrete has been well investigated; the effect on durability however, is less well understood. Chloride ions can be particularly detrimental to the durability of reinforced concrete and BS 8500 currently allows RCA in strength classes up to C40/50 for structures unlikely to be exposed to de-icing salts and marine environments during their design life. This research investigated the effect of coarse RCA in combination with supplementary cementitious materials on the resistance to chloride ingress of concrete in terms of surface resistivity, sorptivity and rapid chloride migration testing. Compressive cube testing was conducted to determine compliance with characteristic and target mean strengths. The results indicate that a higher replacement of natural aggregates with RCA causes a reduction in the resistance to water and chloride ingress, possibly due to the higher water absorption characteristics of the RCA. PFA and GGBS reduced the rate of water and chloride ingress compared to Portland cement concretes for all coarse RCA increments tested

An Intriguing X-ray Arc Surrounding the X-ray Source RX J053335-6854.9 toward the Large Magellanic Cloud

ROSAT observations of the Large Magellanic Cloud (LMC) have revealed a large diffuse X-ray arc around the point source RX J053335-6854.9. The relative locations of the diffuse and point sources suggest that they might originate from a common supernova explosion. We have analyzed the physical properties of the diffuse X-ray emission and determined that it is most likely a supernova remnant in a low-density medium in the LMC. We have also analyzed the X-ray and optical observations of RX J053335-6854.9 and concluded that it is a foreground dMe star in the solar neighborhood. Therefore, despite their positional coincidence, these two X-ray sources are physically unrelated.Comment: 13 pages, 5 figures, accepted for publication in the Astronomical Journal, 2004 Jan issu

The influence of the COVID-19 pandemic on mental wellbeing and psychological distress: impact upon a single country

The COVID-19 pandemic is likely to have affected the psychological well-being and mental health of many people. Data on prevalence rates of mental health problems are needed for mental health service planning. Psychological well-being and prevalence of clinically significant mental distress were measured in a large sample from Wales 11–16 weeks into lockdown and compared to population-based data collected in 2019 before the COVID-19 pandemic. Data were collected using an online survey disseminated across Wales and open to adults (age 16+) from 9th June to 13th July 2020. Psychological well-being was indexed via the Warwick-Edinburgh Mental Well-being Scale, and psychological distress was indexed via the K10. Data from 12,989 people who took part in this study were compared to that from April 2018 - March 2019, gathered by the National Survey for Wales (N = 11,922). Well-being showed a large decrease from 2019 levels. Clinically significant psychological distress was found in around 50% of the population (men = 47.4%, women = 58.6%), with around 20% showing “severe” effects (men = 17.0%, women = 20.9%): a 3–4-fold increase in prevalence. Most affected were young people, women, and those in deprived areas. By June-July 2020 the COVID-19 pandemic had dramatic effects on the mental health of people living in Wales (and by implication those in the UK and beyond). The effects are larger than previous reports. This probably reflects that the current data were taken deeper into the lockdown period than previous evaluations. Mental health services need to prepare for this wave of mental health problems with an emphasis on younger adults, women, and in areas of greater deprivation

Psychological distress and resilience in first responders and health care workers during the COVID?19 pandemic

During the COVID-19 pandemic, first responders and health care workers faced elevated virus-related risks through prolonged contacts with the public. Research suggests that these workers already experienced lower levels of psychological well-being linked to occupational risks. Thus, the pandemic’s impact might have particularly affected mental health in these groups. This paper analysed data from a large-scale Welsh population study (N = 12,989) from June to July 2020. Levels of psychological distress were compared across various occupations, including police, fire and rescue, and NHS health care workers. Resilience was also indexed, and its role considered as a protective factor for psychological distress. Surprisingly, health care workers reported lower distress levels than the general population. Further, fire and rescue and police groups had lower distress than most groups and significantly higher resilience. Within police officers, higher resilience levels were protective for distress. Fire and rescue workers were half as likely as others to report distress, even accounting for demographic factors and resilience. The findings offer an optimistic view of psychological resilience in these critical occupations. They illustrate potential benefits to one’s mental health of playing a crucial societal role during crises and reiterate the importance of enhancing resilience within groups who encounter high-risk situations daily. Practitioner points Our findings provide evidence that health care workers and first responders showed lower levels of psychological distress than the general population during the first period of lockdown due to the COVID-19 pandemic in the United Kingdom. This may indicate that playing a critical role in society during an episode of crisis, and acting to help others, may be protective of one’s own mental health. The research also provides an optimistic view of the psychological resilience of critical first responders and health care workers during a period early on in the COVID-19 pandemic (June–July 2020). This highlights the benefits of fostering resilience in those working within high-risk first responder and health care occupations

Haematological cancers: improving outcomes. A summary of updated NICE service guidance in relation to Specialist Integrated Haematological Malignancy Diagnostic Services (SIHMDS).

Haematological malignancies are a diverse group of cancers that affect the blood, bone marrow and lymphatic systems. Laboratory diagnosis of haematological malignancies is dependent on combining several technologies, including morphology, immunophenotyping, cytogenetics and molecular genetics correlated clinical details and classification according to the current WHO guidelines. The concept of the Specialised Integrated Haematological Malignancy Diagnostic Services (SIHMDS) has evolved since the UK National Institute for Health and Care Excellence (NICE) Improving Outcomes Guidance (IOG) in 2003 and subsequently various models of delivery have been established. As part of the 2016 update to the NICE IOG, these models were systematically evaluated and recommendations produced to form the basis for quality standards for future development of SIHMDS. We provide a summary of the systematic review and recommendations. Although the recommendations pertain to the UK National Health Service (NHS), they have relevance to the modern delivery of diagnostic services internationally

Variability in COVID-19 in-hospital mortality rates between national health service trusts and regions in England: A national observational study for the Getting It Right First Time Programme

Background A key first step in optimising COVID-19 patient outcomes during future case-surges is to learn from the experience within individual hospitals during the early stages of the pandemic. The aim of this study was to investigate the extent of variation in COVID-19 outcomes between National Health Service (NHS) hospital trusts and regions in England using data from March–July 2020. Methods This was a retrospective observational study using the Hospital Episode Statistics administrative dataset. Patients aged ≥ 18 years who had a diagnosis of COVID-19 during a hospital stay in England that was completed between March 1st and July 31st, 2020 were included. In-hospital mortality was the primary outcome of interest. In secondary analysis, critical care admission, length of stay and mortality within 30 days of discharge were also investigated. Multilevel logistic regression was used to adjust for covariates. Findings There were 86,356 patients with a confirmed diagnosis of COVID-19 included in the study, of whom 22,944 (26.6%) died in hospital with COVID-19 as the primary cause of death. After adjusting for covariates, the extent of the variation in-hospital mortality rates between hospital trusts and regions was relatively modest. Trusts with the largest baseline number of beds and a greater proportion of patients admitted to critical care had the lowest in-hospital mortality rates. Interpretation There is little evidence of clustering of deaths within hospital trusts. There may be opportunities to learn from the experience of individual trusts to help prepare hospitals for future case-surges