Forward and inverse transport of particulate matter and gaseous pollutants affecting the region bordering the English Channel

The ATTMA "Aerosol Transport in the Trans-Manche Atmosphere" project investigates the transportation and dispersion of air pollutants across the English Channel, in collaboration with local authorities and other Universities in Southern England and Northern France. The research is concerned with both forward and inverse (receptor based) tracking. Two alternative dispersion simulation methods are used: (a) Lagrangian Particle Dispersion (LPD) models, (b) Eulerian Finite Volume type models. This paper is concerned with part (a), the simulations based on LPD models. Two widely applied LPD models are used and compared. Since in many observed episodes the source of pollution is traced outside the region of interest, long range, trans-continental transport is also investigated.

The impact of the nursing workforce on patient outcomes in intensive care

Introduction: Evidence from studies conducted mainly in the US and mainland Europe suggests that characteristics of the workforce, such as nurse patient ratios and workload (measured in a number of different ways) may be linked to variations in patient outcomes across health care settings (Carmel and Rowan 2001). Few studies have tested this relationship in the UK thus questions remain about whether we are justified in extrapolating evidence from studies conducted in very different health care systems. Objectives: To investigate whether characteristics of the nursing workforce affect patient mortality UK Intensive Care Units. Data: Patient data came from the case mix programme, Intensive Care National Audit and Research Centre (ICNARC), while information about the units came from a survey of all ICUs in England (Audit Comission 1998). The merged data set contained information on 43,859 patients in 69 units across England. ICNARC also supplied a risk adjustment variable to control for patient characteristics that are often the most important determinants of survival. Methods: Multivariate multilevel logistic regression. Findings: Higher numbers of direct care nurses and lower scores on measures of workload(proportion of occupied beds at the time the patient was admitted and mean daily transfers into the unit) were associated with lower mortality rates. Furthermore, the effect of the number of direct care nurses was greatest on the life chances of the patients who were most at risk of dying. Implications: This study has wide implications for workforce policy and planning because it shows that the size of the nursing workforce is associated with mortality (West et al 2006). Few studies have demonstrated this relationship in the UK. This study has a number of strengths and weaknesses and further research is required to determine whether this relationship between the nursing workforce and patient outcomes is causal.