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.

Proposed methodology for the use of computer simulation to enhance aircraft evacuation certification

In this paper a methodology for the application of computer simulation to evacuation certification of aircraft is suggested. This involves the use of computer simulation, historic certification data, component testing, and full-scale certification trials. The methodology sets out a framework for how computer simulation should be undertaken in a certification environment and draws on experience from both the marine and building industries. In addition, a phased introduction of computer models to certification is suggested. This involves as a first step the use of computer simulation in conjunction with full-scale testing. The combination of full-scale trial, computer simulation (and if necessary component testing) provides better insight into aircraft evacuation performance capabilities by generating a performance probability distribution rather than a single datum. Once further confidence in the technique is established the requirement for the full-scale demonstration could be dropped. The second step in the adoption of computer simulation for certification involves the introduction of several scenarios based on, for example, exit availability, instructed by accident analysis. The final step would be the introduction of more realistic accident scenarios. This would require the continued development of aircraft evacuation modeling technology to include additional behavioral features common in real accident scenarios.

An analysis of the passenger to cabin crew ratio and exit reliability based on past survivable aviation accidents

A hotly debated issue in the area of aviation safety is the number of cabin crew members required to evacuate an aircraft in the event of an emergency. Most countries regulate the minimum number required for the safe operation of an aircraft, but these rulings are based on little if any scientific evidence. Another issue of concern is the failure rate of exits and slides. This paper examines these issues using the latest version of Aircraft Accident Statistics and Knowledge database AASK V4.0, which contains information from 105 survivable crashes and more than 2,000 survivors, including accounts from 155 cabin crew members.

Pseudo-spectral solutions for fluid flow and heat transfer in electro-metallurgical applications

The pseudo-spectral solution method offers a flexible and fast alternative to the more usual finite element and volume methods, particularly when the long-time transient behaviour of a system is of interest. The exact solution is obtained at grid collocation points leading to superior accuracy on modest grids. Furthermore, the grid can be freely adapted in time and space to particular flow conditions or geometric variations, especially useful where strongly coupled, time-dependent, multi-physics solutions are investigated. Examples include metallurgical applications involving the interaction of electromagnetic fields and conducting liquids with a free surface. The electromagnetic field determines the instantaneous liquid volume shape, which then affects the electromagnetic field. A general methodology of the pseudo-spectral approach is presented, with several instructive example applications: the aluminium electrolysis MHD problem, induction melting in a cold crucible and the dynamics of AC/DC magnetically levitated droplets. Finally, comparisons with available analytical solutions and to experimental measurements are discussed.

Urban labour, voice and legitimacy: economic development and the emergence of community unionism

Community unionism has emerged in the past decade as a growing strand of industrial relations research and is influencing trade union strategies for renewal. This article seeks to further develop the concept, while exploring the potential roles for unions in communities subject to projects of urban regeneration.

Ghost and self: Jung's paradigm shift and a response to Zinkin

Zinkin's lucid challenge to Jung makes perfect sense. Indeed, it is the implications of this `making sense' that this paper addresses. For Zinkin's characterization of the `self' takes it as a `concept' requiring coherence; a variety of abstract non-contextual knowledge that itself has a mythical heritage. Moreover, Zinkin's refinement of Jung seeks to make his work fit for the scientific paradigm of modernity. In turn, modernity's paradigm owes much to Newton's notion of knowledge via reductionism. Here knowledge or investigation is divided up into the smallest possible units with the aim of eventually putting it all together into `one' picture of scientific truth. Unfortunately, `reductionism' does not do justice to the resonant possibilities of Jung's writing. These look forward to a new scientific paradigm of the twenty-first century, of the interactive `field', emergence and complexity theory. The paper works paradoxically by discovering Zinkin's `intersubjective self' after all, in two undervalued narratives by Jung, his doctoral thesis and a short late ghost story. However, in the ambivalences and radical fictional experimentation of these fascinating texts can be discerned an-Other self, one both created and found. [From the Publisher]

Distress in children with learning disabilities at a respite unit: perspective on their experiences

Numerous studies have investigated the benefits of respite to families with a disabled child. Far fewer have examined the effects on the child and none have systematically compared information about this from different sources. Reports of behavioural reactions and views on distress were gathered from parents, teachers and respite staff. Children were also asked for their views. Over half the children (54%) were reported to show medium or strong negative reactions lasting for 1 or more days by a parent or teacher. Reported reactions varied widely between home and school and no concordance was found between parents, teachers and respite staff groups regarding distress. Some children's views differed from those of their parent or teacher. The findings highlight the extent of differences in perspectives and suggest the need for greater awareness of the possible distress to children attending respite. This is discussed in relation to factors such as the potential conflict of interests between parents and children, communication and behavioural difficulties, and the context in which the child is observed.

To the editor of BJLD

[Letter to the editor of BJLD]

An evaluation of the implementation of hand held health records with adults with learning disabilities: a cluster randomized controlled trial

Background: Personal health records were implemented with adults with learning disabilities (AWLD) to try to improve their health-care. Materials and Method: Forty GP practices were randomized to the Personal Health Profile (PHP) implementation or control group. Two hundred and one AWLD were interviewed at baseline and 163 followed up after 12 months intervention (PHP group). AWLD and carers of AWLD were employed as research interviewers. AWLD were full research participants. Results: Annual consultation rates in the intervention and control groups at baseline were low (2.3 and 2.6 visits respectively). A slightly greater increase occurred over the year in the intervention group 0.6 ()0.4 to 1.6) visits ⁄ year compared with controls. AWLD in PHP group reported more health problems at follow-up 0.9 (0.0 to 1.8). AWLD liked their PHP (92%) but only 63% AWLD and 55% carers reported PHP usage. Carers had high turnover (34%). Conclusions: No significant outcomes were achieved by the intervention.