Linking Environmental Sustainability and Healthcare: The Effects of an Energy Saving Intervention in Two Hospitals

Set in a real organisational setting, this study examines the challenges of implementing environmentally sustainable behaviour in healthcare. It evaluates the success of a real energy saving behaviour change intervention, based on social marketing principles, which targeted the employees of two National Health Service (NHS) hospitals. It also explores the intervention benefits for three key stakeholders: the organisation/hospitals, hospital employees and patients. A rich secondary dataset containing actual workplace behaviour measures (collected via observations) and self-reported data from employee interviews and patient questionnaires is used for this purpose. The intervention encouraged three employee energy saving actions (called TLC actions): (1) Turn off machines, (2) Lights out when not needed, and (3) Close doors when possible; which led to energy savings and carbon reduction for the two hospitals. Hospital employees reported a greater level of work efficiency as a result of engaging in TLC actions, which increased the 'quiet time' periods in both hospitals. Indirectly, employees' TLC actions also improved patients' quality of sleep (which in turn is positively associated with greater patient hospital experience satisfaction). These findings shed light on the benefits of social marketing interventions targeting energy saving behaviour change for multiple stakeholders in healthcare organisations. They also illustrate connections between environmental sustainability and social and political pillars of corporate social responsibility. Additionally, organisational culture was highlighted as a key challenge in changing practices. To encourage long-term sustainable behaviour, this study recommends a pre-intervention assessment of infrastructure and equipment, the communication of expected benefits to motivate higher involvement of employees, the need for internal green champions and the dissemination of post-intervention feedback on various energy saving and patient indicators

Women, anger, and aggression an interpretative phenomenological analysis

This study reports a qualitative phenomenological investigation of anger and anger-related aggression in the context of the lives of individual women. Semistructured interviews with five women are analyzed using interpretative phenomenological analysis. This inductive approach aims to capture the richness and complexity of the lived experience of emotional life. In particular, it draws attention to the context-dependent and relational dimension of angry feelings and aggressive behavior. Three analytic themes are presented here: the subjective experience of anger, which includes the perceptual confusion and bodily change felt by the women when angry, crying, and the presence of multiple emotions; the forms and contexts of aggression, paying particular attention to the range of aggressive strategies used; and anger as moral judgment, in particular perceptions of injustice and unfairness. The authors conclude by examining the analytic observations in light of phenomenological thinking

Hyperhomocysteinemia is detrimental to pregnancy in mice and is associated with preterm birth

AbstractElevated levels of homocysteine produce detrimental effects in humans but its role in preterm birth is not known. Here we used a mouse model of hyperhomocysteinemia to examine the relevance of homocysteine to preterm birth. The mouse carries a heterozygous deletion of cystathionine β-synthase (Cbs+/−). Gestational period was monitored in wild type and Cbs+/− female mice. Mouse uterine and placental tissues, human primary trophoblast cells, and human myometrial and placental cell lines were used to determine the influence of homocysteine on expression of specific genes in vitro. The activity of BKCa channel in the myometrial cell line was monitored using the patch-clamp technique. We found that hyperhomocysteinemia had detrimental effects on pregnancy and induced preterm birth in mice. Homocysteine increased the expression of oxytocin receptor and Cox-2 as well as PGE2 production in uterus and placenta, and initiated premature uterine contraction. A Cox-2 inhibitor reversed these effects. Gpr109a, a receptor for niacin, induced Cox-2 in uterus. Homocysteine upregulated GPR109A and suppressed BKCa channel activity in human myometrial cells. Deletion of Gpr109a in Cbs+/− mice reversed premature birth. We conclude that hyperhomocysteinemia causes preterm birth in mice through upregulation of the Gpr109a/Cox-2/PGE2 axis and that pharmacological blockade of Gpr109a may have potential in prevention of preterm birth

Observations of TeV gamma-rays from Mrk 421 during Dec. 2005 to Apr. 2006 with the TACTIC telescope

The TACTIC $\gamma$-ray telescope has observed Mrk 421 on 66 clear nights from Dec. 07, 2005 to Apr. 30, 2006, totalling $\sim$ 202 hours of on-source observations. Here, we report the detection of flaring activity from the source at $\geq$ 1 TeV energy and the time-averaged differential $\gamma$-ray spectrum in the energy range 1-11 TeV for the data taken between Dec. 27, 2005 to Feb. 07, 2006 when the source was in a relatively higher state as compared to the rest of the observation period. Analysis of this data spell, comprising about $\sim$97h reveals the presence of a $\sim 12.0 \sigma$ $\gamma$-ray signal with daily flux of $>$ 1 Crab unit on several days. A pure power law spectrum with exponent $-3.11\pm0.11$ as well as a power law spectrum with an exponential cutoff $(\Gamma = -2.51\pm0.26$ and $E_0=(4.7\pm2.1) TeV)$ are found to provide reasonable fits to the inferred differential spectrum within statistical uncertainties. We believe that the TeV light curve presented here, for nearly 5 months of extensive coverage, as well as the spectral information at $\gamma$-ray energies of $>$ 5 TeV provide a useful input for other groups working in the field of $\gamma$-ray astronomy.Comment: 13pages,4figures; Accepted for publication in Astroparticle Physic

Lattice instabilities of PbZrO3/PbTiO3 [1:1] superlattices from first principles

Ab initio phonon calculations for the nonpolar reference structures of the (001), (110), and (111) PbZrO_3/PbTiO_3 [1:1] superlattices are presented. The unstable polar modes in the tetragonal (001) and (110) structures are confined in either the Ti- or the Zr-centered layers and display two-mode behavior, while in the cubic (111) case one-mode behavior is observed. Instabilities with pure oxygen character are observed in all three structures. The implications for the ferroelectric behavior and related properties are discussed.Comment: 12 pages, 2 figures, 7 tables, submitted to PR

Age, pathology and CA-125 are prognostic factors for survival in patients with brain metastases from gynaecological tumours

Background and purpose: Brain metastases originating from gynaecological tumours are a rare phenomenon, but have an increasing incidence due to better targeted therapies. This study aimed to identify factors that predict survival in these patients, which can be used in creating a robust prognostic tool for shared decision making.Materials and methods: We identified a consecutive cohort of 73 patients treated for gynaecological brain metastases in two tertiary institutions. Baseline demographics, pathology and serum CA-125 were included in a multivariable Cox proportional hazards model.Results: Median overall survival in our cohort was 14.4 months, with a one-year survival of 56.4% and a two-year survival of 39.1%. Thirty-eight patients (52.1%) had ovarian carcinoma as the primary malignancy. The following factors were significantly associated with survival: age (HR 1.05 per year), CA-125 (HR 1.02 par 50 U/ml), and uterine and vulvar primary tumours (when compared to ovarian carcinoma, with HRs 3.07 and 8.70). A post-hoc analysis with primary tumour site reclassified into ovary versus non-ovary showed a HR of 0.50 for ovarian primary tumour type.Conclusion: We have found that age, pathology and CA-125 are prognostic factors for survival in patients with brain metastases from gynaecological tumours. Our findings may provide a foundation for future development of prediction models, for the benefit of both patients and physicians. (c) 2020 The Authors. Published by Elsevier B.V. on behalf of European Society for Radiotherapy and Oncology.Scientific Assessment and Innovation in Neurosurgical Treatment Strategie

Realistic Equations of State for the Primeval Universe

Early universe equations of state including realistic interactions between constituents are built up. Under certain reasonable assumptions, these equations are able to generate an inflationary regime prior to the nucleosynthesis period. The resulting accelerated expansion is intense enough to solve the flatness and horizon problems. In the cases of curvature parameter \kappa equal to 0 or +1, the model is able to avoid the initial singularity and offers a natural explanation for why the universe is in expansion.Comment: 32 pages, 5 figures. Citations added in this version. Accepted EPJ

Overview of the Characteristic Features of the Magnetic Phase Transition with Regards to the Magnetocaloric Effect: the Hidden Relationship Between Hysteresis and Latent Heat

This article was published in the journal, Metallurgical and Materials Transactions E [Springer / © The Minerals, Metals & Materials Society and ASM International]. The final publication is available at Springer via http://dx.doi.org/10.1007/s40553-014-0015-8The magnetocaloric effect has seen a resurgence in interest over the last 20 years as a means towards an alternative energy efficient cooling method. This has resulted in a concerted effort to develop the so-called “giant” magnetocaloric materials with large entropy changes that often come at the expense of hysteretic behavior. But do the gains offset the disadvantages? In this paper, we review the relationship between the latent heat of several giant magnetocaloric systems and the associated magnetic field hysteresis. We quantify this relationship by the parameter Δμ 0 H/ΔS L, which describes the linear relationship between field hysteresis, Δμ 0 H, and entropy change due to latent heat, ΔS L. The general trends observed in these systems suggest that itinerant magnets appear to consistently show large ΔS L accompanied by small Δμ 0 H (Δμ 0 H/ΔS L = 0.02 ± 0.01 T/(J K−1 kg−1)), compared to local moment systems, which show significantly larger Δμ 0 H as ΔS L increases (Δμ 0 H/ΔS L = 0.14 ± 0.06 T/(J K−1 kg−1))

Test, Evaluation, and Demonstration of Practical Devices/Systems to Reduce Aerodynamic Drag of Tractor/Semitrailer Combination Unit Trucks

Class 8 heavy-duty trucks account for over three-quarters of the total diesel fuel used by commercial trucks (trucks with GVWRs more than 10,000 pounds) in the United States each year. At the highway speeds at which these trucks travel (i.e., 60 mph or greater), aerodynamic drag is a major part of total horsepower needed to move the truck down the highway, Reductions in aerodynamic drag can yield measurable benefits in fuel economy through the use of relatively inexpensive and simple devices. The goal of this project was to examine a number of aerodynamic drag reduction devices and systems and determine their effectiveness in reducing aerodynamic drag of Class 8 tractor/semitrailer combination-units, thus contributing to DOE's goal of reducing transportation petroleum use. The project team included major heavy truck manufacturers in the United States, along with the management and industry expertise of the Truck Manufacturers Association as the lead investigative organization. The Truck Manufacturers Association (TMA) is the national trade association representing the major North American manufacturers of Class 6-8 trucks (GVWRs over 19,500 lbs). Four major truck manufacturers participated in this project with TMA: Freightliner LLC; International Truck and Engine Corporation; Mack Trucks Inc.; and Volvo Trucks North America, Inc. Together, these manufacturers represent over three-quarters of total Class 8 truck sales in the United States. These four manufacturers pursued complementary research efforts as part of this project. The project work was separated into two phases conducted over a two-year period. In Phase I, candidate aerodynamic devices and systems were screened to focus research and development attention on devices that offered the most potential. This was accomplished using full-size vehicle tests, scale model tests, and computational fluid dynamics analyses. In Phase II, the most promising devices were installed on full-size trucks and their effect on fuel economy was determined, either through on-road testing or full-size wind tunnel testing. All of the manufacturers worked with devices and systems that offer practical solutions to reduce aerodynamic drag, accounting for functionality, durability, cost effectiveness, reliability, and maintainability. The project team members and their roles and responsibilities are shown in Figure 2-1. Figure 2-2 shows the Phase I and II project schedules for all four projects and associated management activities

Search for the lepton-flavor-violating decays Bs0→e±μ∓ and B0→e±μ∓

A search for the lepton-flavor-violating decays Bs0→e±μ∓ and B0→e±μ∓ is performed with a data sample, corresponding to an integrated luminosity of 1.0  fb-1 of pp collisions at √s=7  TeV, collected by the LHCb experiment. The observed number of Bs0→e±μ∓ and B0→e±μ∓ candidates is consistent with background expectations. Upper limits on the branching fractions of both decays are determined to be B(Bs0→e±μ∓)101  TeV/c2 and MLQ(B0→e±μ∓)>126  TeV/c2 at 95% C.L., and are a factor of 2 higher than the previous bounds