Shopping for food: lessons from a London borough

Purpose – This paper aims to measure access to food in an inner London borough. Design/methodology/approach – There were six phases, which included designing food baskets, consultation with local residents and a shop survey. Recognising the cultural make-up of the borough food baskets and menus were developed for four key communities, namely: White British, Black Caribbean, Turkish, and Black African. Three areas were identified for the study and shopping hubs identified with a 500-metre radius from a central parade of shops. Findings – The findings paint an intricate web of interactions ranging from availability in shops to accessibility and affordability being key issues for some groups. It was found that in the areas studied there was availability of some key healthy items, namely fresh fruit and vegetables, but other items such as: fresh meat and poultry, fish, lower fat dairy foods, high fibre pasta and brown rice were not available. Access was found to be defined, by local people, as more extensive than just physical distance to/from shops – for many shopping was made more difficult by having to use taxis and inconvenient buses. Small shops were important in delivering healthy food options to communities in areas of deprivation and were judged to offer a better range and more appropriate food than the branches of the major supermarket chains. Research limitations/implications – The importance of monitoring the impact of shops and shop closures on healthy food availability is emphasised. From a policy perspective the findings suggest that approaches based on individual agency need to be balanced with upstream public health nutrition approaches in order to influence the options available. Originality/value – The paper is arguably the first to examine and dissect the issue of food availability and accessibility in the inner London borough in question, especially in the light of its proposed redevelopment for the London Olympics in 2012

Controlling basins of attraction in a neural network-based telemetry monitor

The size of the basins of attraction around fixed points in recurrent neural nets (NNs) can be modified by a training process. Controlling these attractive regions by presenting training data with various amount of noise added to the prototype signal vectors is discussed. Application of this technique to signal processing results in a classification system whose sensitivity can be controlled. This new technique is applied to the classification of temporal sequences in telemetry data

Nucleonics: Imagining the Nuclear Future in Chicago

This thesis reinterprets the postwar legacy of the University of Chicago’s Metallurgical Laboratory (“Met Lab”) by shifting the historiographic focus from the well-trodden “atom peace” narrative toward an alternative rooted in the concept of “nucleonics.” The “atom peace” account, shaped by archival holdings and scholarly emphasis on the atomic scientists’ movement, casts the Met Lab primarily as a political incubator for international nuclear arms control advocacy. Using Michel-Rolph Trouillot’s framework on the production of historical narratives, this study examines how the University Archives’ structure, accession practices, and curatorial priorities—alongside interventions by early historians such as Alice Kimball Smith—have reinforced this interpretation, privileging sources like the Franck Report while overshadowing other archival documentation. To offer a comparative perspective, this thesis re-centers analysis on the 1944 “Prospectus on Nucleonics” (also known as the Jeffries Report), a lesser-studied Met Lab document that articulated a broad technoscientific vision for the postwar nuclear field. Drafted by a mixed committee of academic physicists, industrial engineers, and administrators, the Jeffries Report coined “nucleonics” to encompass both fundamental nuclear science and applied technologies, from reactor engineering to nuclear medicine. It advanced a dualistic framework distinguishing pure, open academic research from applied, often secretive, industrial and military development, while anticipating tensions over intellectual property, monopolization, and government oversight. This vision forecast a tripartite postwar research structure—divided among universities, dedicated government laboratories, and private industry—that sought to balance collaboration with safeguards against overreach by any one sector. This thesis traces the influence and resonance of these ideas through the transformation of the Met Lab into Argonne National Laboratory (ANL), the first national laboratory and a direct institutional successor to the wartime program. Drawing on University of Chicago administrative records, it shows how early ANL leaders such as Walter Zinn navigated the same structural tensions envisioned in the Jeffries Report, particularly in negotiations over naval reactor contracts and in managing the interplay between classified defense projects and the university’s preference for fundamental research. Episodes from the late 1940s to early 1950s—including disputes over military priorities, contract conditions, and the Korean War mobilization—demonstrate both the durability and the limits of the nucleonics ideal in practice. By juxtaposing the dominant “atom peace” narrative with a “nucleonics” framework, this study not only recovers an underexamined strand of Met Lab history but also reveals how archival organization and research interest can shape historiographic outcomes. The renaming of Henry Moore’s sculpture from Atom Piece to Nuclear Energy emerges as an emblem of this broader shift—from commemorating unfulfilled peace advocacy to memorializing the expansive, contested scientific field the Met Lab helped define. In reframing the Met Lab’s significance through nucleonics, this thesis underscores the need for critical engagement with both the content of archival sources and the conditions of their preservation

Irritant Contact Dermatitis from Jet Fuel

westjem/vol10/iss3/art22/]. images in emergency medicin

Atrial Fibrillation Occurring After Smoking Marijuana: A Case Report and Review of the Literature

Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia, occurring primarily in individuals with known risk factors such as advanced age, heart failure, and coronary artery disease. Cannabis use produces several cardiovascular changes resulting in proarrhythmic effects on the heart. Case Report: A 38-year-old woman with no significant past medical history presented to the emergency department (ED) complaining of palpitations with associated shortness of breath occurring after smoking marijuana. She was found to be in AF. Evaluation in the ED and during hospitalization found no cardiac or metabolic conditions that predisposed to AF. The AF resolved within three hours of onsetwithout intervention. Conclusion: Cannabis use should be considered as a possible etiology of new-onset AF, especially in relatively young patients with no other predisposing risk factors

Effect of second timed appointments for non-attenders of breast cancer screening in England : a randomised controlled trial

BACKGROUND: In England, participation in breast cancer screening has been decreasing in the past 10 years, approaching the national minimum standard of 70%. Interventions aimed at improving participation need to be investigated and put into practice to stop this downward trend. We assessed the effect on participation of sending invitations for breast screening with a timed appointment to women who did not attend their first offered appointment within the NHS Breast Screening Programme (NHSBSP). METHODS: In this open, randomised controlled trial, women in six centres in the NHSBSP in England who were invited for routine breast cancer screening were randomly assigned (1:1) to receive an invitation to a second appointment with fixed date and time (intervention) or an invitation letter with a telephone number to call to book their new screening appointment (control) in the event of non-attendance at the first offered appointment. Randomisation was by SX number, a sequential unique identifier of each woman within the NHSBSP, and at the beginning of the study a coin toss decided whether women with odd or even SX numbers would be allocated to the intervention group. Women aged 50-70 years who did not attend their first offered appointment were eligible for the analysis. The primary endpoint was participation (ie, attendance at breast cancer screening) within 90 days of the date of the first offered appointment; we used Poisson regression to compare the proportion of women who participated in screening in the study groups. All analyses were by intention to treat. This trial is registered with Barts Health, number 009304QM. FINDINGS: We obtained 33 146 records of women invited for breast cancer screening at the six centres between June 2, 2014, and Sept 30, 2015, who did not attend their first offered appointment. 26 054 women were eligible for this analysis (12 807 in the intervention group and 13 247 in the control group). Participation within 90 days of the first offered appointment was significantly higher in the intervention group (2861 [22%] of 12 807) than in the control group (1632 [12%] of 13 247); relative risk of participation 1·81 (95% CI 1·70-1·93; p<0·0001). INTERPRETATION: These findings show that a policy of second appointments with fixed date and time for non-attenders of breast screening is effective in improving participation. This strategy can be easily implemented by the screening sites and, if combined with simple interventions, could further increase participation and ensure an upward shift in the participation trend nationally. Whether the policy should vary by time since last attended screen will have to be considered. FUNDING: National Health Service Cancer Screening Programmes and Department of Health Policy Research Programme

The organisation and delivery of health improvement in general practice and primary care: a scoping study

Background This project examines the organisation and delivery of health improvement activities by and within general practice and the primary health-care team. The project was designed to examine who delivers these interventions, where they are located, what approaches are developed in practices, how individual practices and the primary health-care team organise such public health activities, and how these contribute to health improvement. Our focus was on health promotion and ill-health prevention activities. Aims The aim of this scoping exercise was to identify the current extent of knowledge about the health improvement activities in general practice and the wider primary health-care team. The key objectives were to provide an overview of the range and type of health improvement activities, identify gaps in knowledge and areas for further empirical research. Our specific research objectives were to map the range and type of health improvement activity undertaken by general practice staff and the primary health-care team based within general practice; to scope the literature on health improvement in general practice or undertaken by health-care staff based in general practice and identify gaps in the evidence base; to synthesise the literature and identify effective approaches to the delivery and organisation of health improvement interventions in a general practice setting; and to identify the priority areas for research as defined by those working in general practice. Methods We undertook a comprehensive search of the literature. We followed a staged selection process involving reviews of titles and abstracts. This resulted in the identification of 1140 papers for data extraction, with 658 of these papers selected for inclusion in the review, of which 347 were included in the evidence synthesis. We also undertook 45 individual and two group interviews with primary health-care staff. Findings Many of the research studies reviewed had some details about the type, process or location, or who provided the intervention. Generally, however, little attention is paid in the literature to examining the impact of the organisational context on the way services are delivered or how this affects the effectiveness of health improvement interventions in general practice. We found that the focus of attention is mainly on individual prevention approaches, with practices engaging in both primary and secondary prevention. The range of activities suggests that general practitioners do not take a population approach but focus on individual patients. However, it is clear that many general practitioners see health promotion as an integral part of practice, whether as individual approaches to primary or secondary health improvement or as a practice-based approach to improving the health of their patients. Our key conclusion is that there is currently insufficient good evidence to support many of the health improvement interventions undertaken in general practice and primary care more widely. Future Research Future research on health improvement in general practice and by the primary health-care team needs to move beyond clinical research to include delivery systems and be conducted in a primary care setting. More research needs to examine areas where there are chronic disease burdens – cancer, dementia and other disabilities of old age. Reviews should be commissioned that examine the whole prevention pathway for health problems that are managed within primary care drawing together research from general practice, pharmacy, community engagement, etc

Evaluation of a service intervention to improve awareness and uptake of bowel cancer screening in ethnically-diverse areas

The Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis receives funding for a research programme from the UK Department of Health Policy Research Programme (grant no. 106/0001). It is a collaboration between researchers from seven institutions (the Queen Mary University of London, the UCL, the King’s College London, the London School of Hygiene and Tropical Medicine, the Hull York Medical School, the Durham University and the Peninsula Medical School)

Uptake in cancer screening programmes:a priority in cancer control

Achieving adequate levels of uptake in cancer screening requires a variety of approaches that need to be shaped by the characteristics of both the screening programme and the target population. Strategies to improve uptake typically produce only incremental increases. Accordingly, approaches that combine behavioural, organisational and other strategies are most likely to succeed. In conjunction with a focus on uptake, providers of screening services need to promote informed decision making among invitees. Addressing inequalities in uptake must remain a priority for screening programmes. Evidence informing strategies targeting low-uptake groups is scarce, and more research is needed in this area. Cancer screening has the potential to make a major contribution to early diagnosis initiatives in the United Kingdom, and will best be achieved through uptake strategies that emphasise wide coverage, informed choice and equitable distribution of cancer screening services

From Home Energy Audit to Retrofit and Beyond

Many in Michigan, like countless others across the United States, live in energy inefficient, detached single-family homes. There is an enormous opportunity to decrease state residential energy consumption and its subsequent greenhouse gas emissions, improve occupant comfort, and bolster home values by auditing and retrofitting these homes with more efficient energy systems. In accordance with Michigan state law PA 295, DTE Energy maintains an energy optimization (EO) program aimed at conserving electricity and gas. Under this program, the utility company offers residential customers several options and incentives to invest in energy saving measures. However, participation by homeowners has been limited. Through collaboration between the University of Michigan and DTE Energy, this project sought to evaluate the effectiveness of the utility’s audit-to-retrofit programs and overall residential EO program. Software tools—including MySQL (a relational database management system), R (a statistical analysis package), ArcGIS (a geographic information system), and SurveyGizmo (an online survey development platform) — facilitated quantitative and qualitative program evaluation. These findings informed actionable recommendations to increase program participation, improve customer satisfaction, and target future EO participants. This comprehensive assessment examined both temporal and spatial scales and should help create better mechanisms for data storage, manipulation, and visualization. Largescale data analysis in the context of residential energy efficiency is becoming increasingly necessary and important for utilities. An integrated approach such as the one laid out in this report could improve the way utilities like DTE Energy implement home energy efficiency programs, assess these programs, and help increase participation for future programs.Master of ScienceNatural Resources and EnvironmentUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/97777/4/From_Home_Energy_Audit_to_Retrofit_and_Beyond.May_2013.V22.pd