Closed circuit rebreathing to achieve inert gas wash-in for multiple breath wash-out

Multiple breath wash-out (MBW) testing requires prior wash-in of inert tracer gas. Wash-in efficiency can be enhanced by a rebreathing tracer in a closed circuit. Previous attempts to deploy this did not account for the impact of CO2 accumulation on patients and were unsuccessful. We hypothesised that an effective rebreathe wash-in could be delivered and it would not alter wash-out parameters. Computer modelling was used to assess the impact of the rebreathe method on wash-in efficiency. Clinical testing of open and closed circuit wash-in–wash-out was performed in healthy controls and adult patients with cystic fibrosis (CF) using a circuit with an effective CO2 scrubber and a refined wash-in protocol. Wash-in efficiency was enhanced by rebreathing. There was no difference in mean lung clearance index between the two wash-in methods for controls (6.5 versus 6.4; p=0.2, n=12) or patients with CF (10.9 versus 10.8; p=0.2, n=19). Test time was reduced by rebreathe wash-in (156 versus 230 s for CF patients, p<0.001) and both methods were well tolerated. End wash-in CO2 was maintained below 2% in most cases. Rebreathe–wash-in is a promising development that, when correctly deployed, reduces wash-in time and facilitates portable MBW testing. For mild CF, wash-out outcomes are equivalent to an open circuit.

Exploring the Views of Police Officers on the Use of Video Taped Evidence in Child Abuse Cases in Northern Ireland

This paper sets out to explore the views and attitudes of police officers in the Greater Belfast area, concerning the process and use of video taped interviews with child witnesses, subsequently used as court evidence in child abuse cases. The information was collected by means of a postal questionnaire, completed by police officers who had all experienced joint interviews with social workers of child witnesses. With the increased use of video evidence as an alternative to the distressing experience of a child appearing in court to give evidence, the research findings and conclusions provide clear messages about future developments both nationally and internationally.

Parents' Views on Social Work Interventions in Child Welfare Cases

This article reports the findings of the third part of a three-part research project examining the potential for social workers to shift from a child protection to a child welfare orientation in their practice. Whilst social workers in the United Kingdom have been encouraged to make such changes they have been hampered by concerns to manage risk. Findings from the first two parts of the project had indicated that there was potential for a substantial proportion of child protection work to be redesignated as child welfare work, but that were this was achieved in practice there was evidence of continued influence of child protection processes as social workers sought to manage the risks inherent in child welfare cases. The study reported here sets out to ascertain the views of parents who were subject to child welfare interventions. The findings indicate that while parents feel apprehension with regard to contact with social workers, in the majority of cases successful relationships are formed. It is argued that social workers display considerable skill in monitoring potential risks whilst engaging with families and that the subtleties involved in such activity are not captured by official measures of governance which concentrate on more abstract indicators of performance.

Familial idiopathic methemoglobinemia revisited: original cases reveal 2 novel mutations in NADH cytochrome b5 reductase

In 1943, the first description of familial idiopathic methemoglobinemia in the United Kingdom was reported in 2 members of one family. Five years later, Quentin Gibson (then of Queen's University, Belfast, Ireland) correctly identified the pathway involved in the reduction of methemoglobin in the family, thereby describing the first hereditary trait involving a specific enzyme deficiency. Recessive congenital methemoglobinemia (RCM) is caused by a deficiency of reduced nicotinamide adenine dinucleotide (NADH)-cytochrome b5 reductase. One of the original propositi with the type 1 disorder has now been traced. He was found to be a compound heterozygote harboring 2 previously undescribed mutations in exon 9, a point mutation Gly873Ala predicting a Gly291Asp substitution, and a 3-bp in-frame deletion of codon 255 (GAG), predicting loss of glutamic acid. A brother and a surviving sister are heterozygous; each bears one of the mutations. Thirty-three different mutations have now been recorded for RCM. The original authors' optimism that RCM would provide material for future genetic studies has been amply justified.

Quantum manifestations of closed orbits in the photoexcitation scaled spectrum of the hydrogen atom in crossed fields

The scaled photoexcitation spectrum of the hydrogen atom in crossed electric and magnetic fields has been obtained by means of accurate quantum mechanical calculation using a new algorithm. Closed orbits in the corresponding classical system have also been obtained, using a new, efficient and practical searching procedure. Two new classes of closed orbit have been identified. Fourier transforming each photoexcitation quantum spectrum to yield a plot against scaled action has allowed direct comparison between peaks in such plots and the scaled action values of closed orbits, Excellent agreement has been found with all peaks assigned.

The closed orbits and the photo-excitation scaled spectrum of the hydrogen atom in crossed fields

In a recent Letter to the Editor (J Rao, D Delande and K T Taylor 2001 J. Phys. B: At. Mol. Opt. Phys. 34 L391-9) we made a brief first report of our quantal and classical calculations for the hydrogen atom in crossed electric and magnetic fields at constant scaled energy and constant scaled electric field strength. A principal point of that communication was our statement that each and every peak in the Fourier transform of the scaled quantum photo-excitation spectrum for scaled energy value epsilon = -0.586 538 871028 43 and scaled electric value (f) over tilde = 0.068 537 846 207 618 71 could be identified with a scaled action value of a found and mapped-out closed orbit up to a scaled action of 20. In this follow-up paper, besides presenting full details of our quantum and classical methods, we set out the scaled action values of all 317 closed orbits involved, together with the geometries of many.