Association of fever and severe clinical course in bronchiolitis

Little attention has been given to the relation between fever and the severity of bronchiolitis. Therefore, the relation between fever and the clinical course of 90 infants (59 boys, 31 girls) hospitalised during one season with bronchiolitis was studied prospectively. Fever (defined as a single recording > 38.0°C or two successive recording > 37.8°C) was present in 28 infants. These infants were older (mean age, 5.3 v 4.0 months), had a longer mean hospital stay (4.2 v2.7 days), and a more severe clinical course (71.0%v 29.0%) than those infants without fever. Radiological abnormalities (collapse/consolidation) were found in 60.7% of the febrile group compared with 14.8% of the afebrile infants. These results suggest that monitoring of body temperature is important in bronchiolitis and that fever is likely to be associated with a more severe clinical course and radiological abnormalities.

The development of an advanced ship evacuation simulation software product and associated large scale testing facility for the collection of human shipboard behaviour data

When designing a new passenger ship or modifying an existing design, how do we ensure that the proposed design and crew emergency procedures are safe from an evacuation point of view? In the wake of major maritime disasters such as the Herald of Free Enterprise and the Estonia and in light of the growth in the numbers of high density, high-speed ferries and large capacity cruise ships, issues concerned with the evacuation of passengers and crew at sea are receiving renewed interest. In the maritime industry, ship evacuation models offer the promise to quickly and efficiently bring evacuation considerations into the design phase, while the ship is "on the drawing board". maritimeEXODUS-winner of the BCS, CITIS and RINA awards - is such a model. Features such as the ability to realistically simulate human response to fire, the capability to model human performance in heeled orientations, a virtual reality environment that produces realistic visualisations of the modelled scenarios and with an integrated abandonment model, make maritimeEXODUS a truly unique tool for assessing the evacuation capabilities of all types of vessels under a variety of conditions. This paper describes the maritimeEXODUS model, the SHEBA facility from which data concerning passenger/crew performance in conditions of heel is derived and an example application demonstrating the models use in performing an evacuation analysis for a large passenger ship partially based on the requirements of MSC circular 1033.

Deforestation and the spatio-temporal distribution of savannah and forest members of the Simulium damnosum complex in southern Ghana and south-western Togo

Spatio-temporal data on cytotaxonomic identifications of larvae of different members of the Simulium damnosum complex collected from rivers in southern Ghana and south-western Togo from 1975 until 1997 were analysed. When the data were combined, the percentages of savannah blackflies (S. damnosum sensu stricto and S. sirbanum) in the samples were shown to have been progressively increasing since 1975. The increases were statistically significant (P < 0·001), but the rates of increase were not linear. Further analyses were conducted according to the collection seasons and locations of the samples, to account for possible biases such as savannah flies occurring further south in the dry season or a preponderance of later samples from northern rivers having more savannah flies. These analyses showed that the increasing trend was statistically significant (P< 0·0001) only during the periods April to June and October to December. The presence of adult savannah flies carrying infective larvae (L3) indistinguishable from those of Onchocerca volvulus in the study zone was confirmed by examinations of captured flies. The percentages of savannah flies amongst the human-biting populations and the percentages with L3s in the head were higher during dry seasons than wet seasons and the savannah species were found furthest south (5 °25′N) in the dry season. Comparisons of satellite images taken in 1973 and 1990 over a study area in south-western Ghana encompassing stretches of the Tano and Bia rivers demonstrated that there have been substantial increases in urban and savannah areas, at the expense of forest. This was so not only for the whole images but also for subsamples of the images taken at 1, 2, 4, 8 and 16 km distant from sites alongside the River Tano. At every distance from the river, the percentages of pixels classified as urban or savannah have increased in 1990 compared with 1973, while those classified as degraded or dense forest have decreased. The possibility that the proportionate increases in savannah forms of the vectors of onchocerciasis, and hence in the likelihood of the transmission of savannah strains of the disease in formerly forested areas, were related to the decreases in forest cover is discussed.

The impact of the passenger response time distribution on ship evacuation performance

The International Maritime Organisation (IMO) has adopted the use of computer simulation to assist in the assessment of the assembly time for passenger ships. A key parameter required for this analysis and specified as part of the IMO guidelines is the passenger response time distribution. It is demonstrated in this paper that the IMO specified response time distribution assumes an unrealistic mathematical form. This unrealistic mathematical form can lead to serious congestion issues being overlooked in the evacuation analysis and lead to incorrect conclusions concerning the suitability of vessel design. In light of these results, it is vital that IMO undertake research to generate passenger response time data suitable for use in evacuation analysis of passenger ships. Until this type of data becomes readily available, it is strongly recommended that rather than continuing to use the artificial and unrepresentative form of the response time distribution, IMO should adopt plausible and more realistic response time data derived from land based applications. © 2005: Royal Institution of Naval Architects.

Recommendations on the nature of the passenger response time distribution to be used in the MSC 1033 assembly time analysis based on data derived from sea trials

The passenger response time distributions adopted by the International Maritime Organisation (IMO)in their assessment of the assembly time for passanger ships involves two key assumptions. The first is that the response time distribution assumes the form of a uniform random distribution and the second concerns the actual response times. These two assumptions are core to the validity of the IMO analysis but are not based on real data, being the recommendations of an IMO committee. In this paper, response time data collected from assembly trials conducted at sea on a real passanger vessel using actual passangers are presented and discussed. Unlike the IMO specified response time distributions, the data collected from these trials displays a log-normal distribution, similar to that found in land based environments. Based on this data, response time distributions for use in the IMO assesmbly for the day and night scenarios are suggested

Trembling the plane of immanence: media arts philosophy and the re-vision of art (or what’s acoustics got to do with the visual?)

Invited lecture at the Royal Academy of Art.

Synthesis of a 1,4-benzodiazepine containing palladacycle with in vitro anticancer and cathepsin B activity

The reaction of the five-membered C,N-palladacycle [(L)PdCl](2), where LH = 1-methyl-5-phenyl-1H-1,4-benzodiazepin-2(3H)-one, with 1,2-ethanebis(diphenylphosphine), dppe, leads to the formation of the bridged palladacycle. [Pd(2)L(2)(mu-dppe)Cl(2)] 3, which was characterised in solution by (1)H and (31)P NMR spectroscopy and in the solid state by X-ray crystallography. Complex 3 was tested in vitro against a number of cell lines. For example, it inhibited K562 leukaemia cells with an IC(50) value of 4.3 microM (1 h exposure) and displayed cathepsin B inhibitory action with an IC(50) value of 3 microM.

Excellent correlation between cathepsin B inhibition and cytotoxicity for a series of palladacycles

The reaction of the five- or six-membered C,N or C,S-palladacycles [(L)PdCl](2) with PTA (1,3,5-triaza-7-phosphaadamantane) led to the monomeric complexes [(L)Pd(PTA)Cl] 6a, 6b and 7 where LH= N,N-dimethyl-1-phenylmethanamine, benzyl(methyl)sulfane or 1-methyl-5-phenyl-1H-benzo[e][1,4]diazepin-2(3H)-one respectively. Dimeric complexes have also been synthesised: [Pd(2)L(2)(mu-dppe)Cl(2)], where LH = 1-methyl-5-phenyl-1H-benzo[e][1,4]diazepin-2(3H)-one (1a), (R)- or (S)-3-isopropyl-1-methyl-5-phenyl-1H-benzo[e][1,4]diazepin-2(3H)-one (1b, 1c), [Pd(2)L(2)(mu-dppf)Cl(2)], where L= 1-methyl-5-phenyl-1H-benzo[e][1,4]diazepin-2(3H)-one (4a) or (R)-3-isopropyl-1-methyl-5-phenyl-1H-benzo[e][1,4]diazepin-2(3H)-one (4b), respectively, and dppe = 1,2-bis(diphenylphosphino)ethane, dppf = 1,1'-bis(diphenylphosphino)ferrocene. The complexes were characterised in solution, by (1)H and (31)P NMR spectroscopy, and single crystals of complexes 6b and 7 were studied in the solid state by X-ray crystallography. The palladacycles were evaluated for in vitro activity as cytotoxic agents on A2780/S cells and also as cathepsin B inhibitors, an enzyme implicated in a number of cancer related events.

Ethnic variations in the experiences of mental health service users in England: results of a national patient survey programme

Background: Minority ethnic groups in the UK are reported to have a poor experience of mental health services, but comparative information is scarce. Aims: To examine ethnic differences in patients’ experience of community mental health services. Method: Trusts providing mental health services in England conducted surveys in 2004 and 2005 of users of community mental health services. Multiple regression was used to examine ethnic differences in responses. Results: About 27 000 patients responded to each of the surveys, of whom 10% were of minority ethnic origin. In the 2004 survey, age, living alone, the 2004 survey, age, living alone, detention and hospital admissions were stronger predictors of patient experience than ethnicity. Self-reported mental health status had the strongest explanatory effect. In the 2005 survey, the main negative differences relative to the White British were for Asians. Conclusions: Ethnicity had a smaller effect on patient experience than other variables. Relative to the White British, the Black group did not report negative experiences whereas the Asian group were most likely to respond negatively. However, there is a need for improvements in services for minority ethnic groups, including access to talking therapies and better recording of ethnicity.

Tied to the job: affective and relational components of nurse retention

Paper investigates whether affective and relational components of nurses' experience of work have a significant impact on their intentions to leave either the job or the nursing profession in models that control for other factors (sociodemographic, work conditions, perceptions of quality of care) that are known to affect career decisions. [Abridged Abstract]

Routine maintenance and sustainability of existing social housing

Presently the UK social housing stock accounts for approximately 18% of the total UK housing with maintenance costs in the region of £1.25 billion per annum. In terms of its impact on the environment, housing is generally responsible for approximately 27% of the UK’s CO2 emissions. The extent to which routine maintenance (planned preventative and responsive) can be used as a vehicle to improve the overall sustainability (social, environmental and economic) of existing social housing is one focus of a 5 year EPSRC funded research programme. This paper reports on the findings of a series of in-depth interviews with social housing providers examining current social housing maintenance practices and attitudes towards sustainability. This paper will report the initial findings of interviews and outline a new performance based multi-criteria maintenance model from which an AHP hierarchy will be presented, integrating the principles of sustainability into maintenance strategies

Meeting the health needs of people with learning disabilities: guidance for nursing staff

This guide has been produced to support registered nurses and nursing students in primary and secondary care, who are trained in branches other than learning disabilities, to deliver high quality health care to people with learning disabilities.