Auswahl der wissenschaftlichen Literatur zum Thema „Vale Royal (England)“

Abstract Introduction Within the clinical setting of emergency anaesthesia the lack of ready to administer preparations poses a high risk to patients. The CIVAS@IP5 Medicines hub were approached by Cardiff and Vale University Health Board in response to a quality improvement project to prepare ready to administer anaesthesia. To manufacture these medicines required the use of semi-automated technology and development of manufacturing techniques to meet the quantity and range of products required including Ketamine, Rocuronium and Fentanyl. These are some of the first products developed for manufacture using a Grifill 4.0 Semi-automated Medicines Pump within the UK. Aim To develop new ready-to-administer products or use in emergency intubation scenarios within critical clinical settings, manufactured using innovative and newly developed processes. The products would be presented with the Royal College of Anaesthetists label colour scheme and have extended shelf lives assigned to allow suitability of use. Methods The project required three separate stages of methodology. First within Cardiff and Vale UHB, a clinical agreement on standardised concentrations of Ketamine, Fentanyl and Rocuronium was required. Secondly, development within CIVAS@IP5 of a Semi-automated compounding process that had been fully process mapped, assessed via HAACP analysis. This process was then validated for microbiological integrity and efficiency using Gage R&R principles to prove repeatability and reproducibility of a quality product. The final stage involved collaborative development of the final presentation and facilitation of its use locally. Ethical approval was not required for this service development initiative and evaluation. Results The new methodology for semi-automated preparation of ready-to-administer injectable medicines gave the following capacity timings for the three agreed concentrations recommended by the Royal College of Anaesthetists. Fentanyl 250mcg in 5mL – 54 seconds per syringe (Batch size 200 syringes). Rocuronium 250mg in 10mL – 2 minutes per syringe (Batch size 50 syringes). Ketamine 100mg in 10mL – 1 minute 32 seconds per syringe (Batch size 40 syringes). These timings are compared to current documented preparations of 5 minutes 42 seconds for syringes made manually in pharmacy technical services settings. This meant Cardiff and Value UHB could be provided with their emergency intubation medication in a ready-to-use format within a pharmacy manufacturing capacity expenditure of 4 hours and 12 minutes per month when compared to the same manual preparation taking 26 hours. A literature search allowed extended shelf lives of up to 100 days to be applied to the products, and the labels designed in collaboration with anaesthetic colleagues in Cardiff and Vale UHB. The clinical impact is that for emergency intubation scenarios clinicians have ready-to-administer medications at the point of care. Discussion/Conclusion Use of semi-automation within Pharmacy Technical Services can greatly increase the production output of medicines allowing products where there is a current unmet demand to be prepared. The impact is an increased service capacity for the provision of well designed, clinically significant products to clinical areas improving efficiency, patient safety and clinical delivery of treatment in emergency situations. References 1. Kothari, D. Colour coded syringe Labels: a modification to enhance patient safety. British Journal of Anaesthesia. 2013;110(6):1056-1058 2. P., C., Transforming NHS pharmacy aseptic services in England: a national report for the Department of Health and Social Care by Lord Carter of Coles. 2020. 3. Grifols. Gri-fill 4 Semi-automatic Compounding Device. 2019. Available from: https://www.grifolsinclusiv.com/documents/90075605/0/inclusiv+Gri-fill+4+Brochure/ae8ce6e8-d2e0-49e0-b76f-8121539db44a

The repatriation of the human remains of Indigenous peoples collected within a colonial context has been the subject of debate within UK museums over the last 30 years, with many museums now having returned human remains to their countries of origin. Although the repatriation of human remains is often characterised as the 'journey home', there has been a lack of consideration of the physical presence and mobility of the remains and the meanings created as they move through different spaces. This study uses the repatriations from The Royal College of Surgeons of England (RCS) to Australia, New Zealand and Hawaii as case studies to consider three key areas: (i) the impact of repatriation on museum landscapes; (ii) the journey of the repatriated remains and how this mobility intersects with wider discussions about restitution, sovereignty, identity, relatedness, memory and memorialisation; and (iii) the repatriation archives, how they are thought about by the institutions that hold them and their future potential and meaning within a post-colonial context. Taking a more-than-representational approach and engaging with the materiality, mobility and agency of the repatriated remains and the documentation that relates to them, this study bridges the gap between research considering the approach of museums to repatriation, and ethnographic studies on the meanings of the return of ancestral remains to individual communities. Combining work on museum geographies, deathscapes and absence opens up new ways of theorising and discussing repatriation through understanding the process in terms of the tension between absence and presence, and human remains as being in or out of place. Through engaging with the materiality and agency of the remains and viewing repatriation through a spatial lens, this thesis deals with aspects of the process that have received little attention in previous studies, foregrounding the challenging nature of repatriation for communities, the issues around unprovenanced remains, and discussions about the control, management and meaning of information and data, identifying that a significant legacy of repatriation for RCS is the documentation the museum continues to hold. What the journey of the ancestral remains repatriated by RCS illustrates is the emotive materiality of the remains, and agency that they and the distributed repatriation archive have as actors within social networks. It is therefore proposed that the concept of repatriation as having problematised human remains collections within UK museums is replaced with a nuanced and contextually sensitive understanding that recognises the role of the human remains in social interactions that impact on the emotional geographies of museum practice, and that rather than framing repatriation as post-colonial act that is either political or therapeutic, the return of ancestral remains be understood as part of a process of decolonisation in which there is space for discussion, disagreement and debate amongst all stakeholders.

Giordani's Opus 1 quintets, published in London in 1771, are believed to have been the first pieces of their kind. They catered to a lively interest in new instrumental combinations displayed by royal and aristocratic amateurs in England at this time. In addition to their historical value, they extend the repertory of quintets for keyboard and strings backward by approximately fifty years. These fine examples of the galant style are equally suited to harpsichord or pianoforte.

Abstract In 1531 Sir Thomas Elyot took it upon himself to explain why Christian kings set such store by stately ceremonial at their coronations. Hereditary monarchs were invested with the symbols of their office in public, so ran The Book Named The Governor, in order to impress in their subjects ‘perpetual reverence, which is fountain of obedience’.1 Elyoes opinion of the value of royal propaganda, and others like it, have caught the imagination of modern scholars, and of differing traditions. Both political and art historians have addressed the relationship between the theory and the imagery of sixteenth-century English kingship. We read how the Tudor crown inherited the defence of royal imagnificence’ presented in The Governance of England by Sir John Fortescue (d. c.1477) and developed it into something new, a doctrine of absolute non-resistance.2

Abstract The development of long-distance, especially seaborne, trade is one of the most demonstrable sources of British urban growth between 1050 and 1300. It was chiefly beneficial to eastern England and Scotland, whose economies it integrated into the expanding North Sea trading area; northern France (including Flanders) and the Rhineland were the principal trading partners. A statistical assessment of the magnitude of change is only possible in part; the evidence of customs accounts becomes available for English ports from 1275, for Welsh ports from the beginning of the fourteenth century, and for Scottish ports from 1327. Comparison between English customs returns of the years 1304–5 with customs dues recorded in a royal exchequer account of 1204 suggests that over that hundred years the value of English overseas trade may have tripled in real terms.

This chapter complicates the received image of Milton as firebrand republican, showing a consistent sympathy in his thought with “red” unitary sovereignty. That sympathy displays itself differently at different points in his career, from an early acceptance of royal prerogative in the Ludlow Maske, to mid-career arguments for the sovereignty of Parliament, to a late godly republicanism anticipating the rule of a spiritual elect. Illumining these developments of Milton’s thought are, respectively, the precarity of the Council in the Marches of Wales, of which Milton’s patron the Earl of Bridgewater was president; a Tacitist approach to liberty and prudentia; and the manuscript writings of Sir Henry Vane, the younger, which include a lengthy commentary on the Book of Job. In closing, the role of the “people” in popular sovereignty is considered, as the category appears in Milton and in Schmitt.

The trend towards increasing secular interest in jewellery was probably maintained throughout the thirteenth century, though precise dating of individual pieces remains difficult. With only small amounts of gold to be found in the south of France and Hungary, western Europeans continued to depend upon both gold and gems coming by overland routes from or through the Arab world, with Italian merchants acting as intermediaries. In 1257 Henry III was able to attempt to imitate continental kings by issuing gold coins, not to facilitate trade but to attract gold into the mint to back up his loans and pledges, and to use as alms. The care that went into the coins’ design shows that they were thought of as having prestige value, and the decision to represent the king carrying the orb and sceptre was most probably made in homage to one of the issues of his revered predecessor Edward the Confessor; the royal seal was also changed, to a design that adapted Edward’s image of an enthroned king ruling as a judge like Solomon rather than as a military leader with a sword. Henry’s gold coins were only produced in small numbers and for a very short time, but they show that the importance of the symbolism of a currency was still understood, though no more effort was made with the designs of everyday silver coins than in previous reigns. The amount of coinage in circulation is shown both by single finds and hoards, not only in England but in Wales and Scotland as well. Excavation of the church at Capel Maelog, Powys, produced coins of Henry III, Edward I (1272–1307), and Richard II (1377–99), suggesting that the use of English money had spread into Welsh culture. The Welsh kings did not mint their own coins, however, unlike the kings of Scotland, whose coins were allowed to circulate in England just as English ones did north of the border. Presumably exclusion of a rival’s image was no longer a matter of pride. No hoard in Britain hidden during the middle part of the thirteenth century has objects in it to help to establish a chronology for jewellery.