60 research outputs found

    T.L. Treadwell and E.E. Treadwell to A.C. Blair, 20 February 1855

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    https://egrove.olemiss.edu/aldrichcorr_c/1090/thumbnail.jp

    Receipt, 17 October 1850

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    https://egrove.olemiss.edu/aldrichcorr_b/1245/thumbnail.jp

    A technical solution to a professional problem: The risk management functions of prognosticators in the context of prognostication post-cardiac arrest

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    The risk management functions of prognosticators in the context of prognostication post-cardiac arrest. Cardiac arrest (CA) is a major cause of mortality and morbidity globally. Two-thirds of deaths among patients admitted to intensive care units following out-of-hospital CA are due to neurological injury, with most as a consequence of withdrawing life-sustaining treatment, following prognostication of unfavorable neurological outcome. Given the ramifications of prognosis for patient outcome, post-cardiac arrest (P-CA) guidelines stress the importance of minimizing the risk of falsely pessimistic predictions. Although prognosticator use is advocated to this end, % accurate prognosticators remain elusive, therefore prognostication P-CA remains pervaded by uncertainty and risk. Bioethical discourse notwithstanding, when located within a wider socio-cultural context, prognostication can be seen to present risk and uncertainty challenges of a professional nature. Such challenges do not, however, subvert the medical profession's moral and ethical prognostication obligation. We interpret prognosticator use as an attempt to manage professional risk presented by prognostication P-CA and demonstrate how through performing "risk work," prognosticators serve professional functions, mediating tension between the professional duty to prognosticate, and risk presented. We draw on sociological analyses of risk and uncertainty, and the professions to explicate these (hitherto less enunciated) professional risk management functions of prognosticators. Accordingly, the use of prognosticators is conceived of as a professional response-a technical/scientific solution to the problem of professional risk, inherent within the P-CA prognostication process

    The feasibility of nurse-delivered, low-intensity cognitive behavioural therapy for irritable bowel syndrome.

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    Introduction: This study assessed the feasibility of nurse-delivered cognitive behavioural therapy (CBT) for the treatment of irritable bowel syndrome (IBS). Methods and analysis: A mixed-method design was used, and 20 participants were randomly allocated to high-intensity CBT (n=5), guided self-help (n=5), self-help only (n=5) or treatment as usual (n=5). Ten intervention participants completed semi-structured interviews. Quantitative data were analysed using descriptive statistics; qualitative data were analysed using group thematic analysis. Results: Barriers to the interventions were lack of therapist contact, negative preconceptions about treatment and factors relating to supporting materials. Treatment facilitators included therapist-facilitated relaxation, narratives located within self-help materials and social support mechanisms. Conclusion: Further development of the low-intensity interventions in collaboration with service users is required to improve intervention acceptability and relevance.N/

    PHysical activity Implementation Study In Community-dwelling AduLts (PHISICAL): study protocol

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    Background: Falls in older people are a leading causes of unintentional injury. Due to an ageing population, injuries are likely to increase unless more is done to reduce older people’s falls risk. In clinical trials, the Falls Management Exercise (FaME) programme has reduced the rate of falls and falls-related injuries in community-dwelling older adults. However, the commissioning of FaME is inconsistent across England, potentially due to a lack of evidence that FaME can be delivered effectively in a ‘real world’ setting. The PHISICAL study is designed to study the implementation of FaME in a range of different settings in England. Methods: The PHISICAL study will use mixed-methods triangulation multi-level design to explore the implementation of FaME. Framework analysis of semi-structured interviews with up to 90 stakeholders (exercise programme users, service providers, referrers and commissioners) and observational data from locally-led communities of practice will identify the factors that influence FaME’s implementation. Quantitative, anonymised, routine service data from up to 650 exercise programme users, including measures of falls and physical activity, will allow assessment of whether the benefits of FaME reported in clinical trials translate to the ‘real world’ setting. Conclusion: The findings from this study will be used to develop a toolkit of resources and guidance to inform the commissioning and delivery of future FaME programmes. This study has the potential to inform public health prevention strategies, and in doing so may reduce the number of falls in the older population, whilst delivering cost savings to health and social care services

    CSP Hybrid Space Computing for STP-H5/ISEM on ISS

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    The Space Test Program (STP) at the Department of Defense (DoD) supports the development, evaluation, and advancement of new technologies needed for the future of spaceflight. STP-Houston provides opportunities for DoD and civilian space agencies to perform on-orbit research and technology demonstrations from the International Space Station (ISS). The STP-H5/ISEM (STP-Houston 5, ISS SpaceCube Experiment Mini) payload is scheduled for launch on the upcoming SpaceX 10 mission and will feature new technologies, including a hybrid space computer developed by the NSF CHREC Center, working closely with the NASA SpaceCube Team, known as the CHREC Space Processor (CSP). In this paper, we present the novel concepts behind CSP and the CSPv1 flight technologies on the ISEM mission. The ISEM-CSP system was subjected to environmental testing, including a thermal vacuum test, a vibration test, and two radiation tests, and results were encouraging and are presented. Primary objectives for ISEM-CSP are highlighted, which include processing, compression, and downlink of terrestrial-scene images for display on Earth, and monitoring of upset rates in various subsystems to provide environmental information for future missions. Secondary objectives are also presented, including experiments with features for fault-tolerant computing, reliable middleware services, FPGA partial reconfiguration, device virtualization, and dynamic synthesis

    Ethical choices behind quantifications of fair contributions under the Paris Agreement

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    The Parties to the UNFCCC and Paris Agreement agreed to act on the basis of equity to protect the climate system. Equitable effort sharing is an irreducibly normative matter, yet some influential studies have sought to create quantitative indicators of equitable effort that claim to be value-neutral (despite evident biases). Many of these studies fail to clarify the ethical principles underlying their indicators, some mislabel approaches that favour wealthy nations as ‘equity approaches’ and some combine contradictory indicators into composites we call derivative benchmarks. This Perspective reviews influential climate effort-sharing assessments and presents guidelines for developing and adjudicating policy-relevant (but not ethically neutral) equity research
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