The 'Unified airway': The RCPCH care pathway for asthma/or rhinitis

Abstract Aims The Royal College of Paediatrics and Child Health (RCPCH) Science and Research Department was commissioned by the Department of Health to develop national care pathways for children with allergies: the asthma/rhinitis care pathway is the third such pathway. Asthma and rhinitis have been considered together. These conditions co-exist commonly, have remarkably similar immuno-pathology and an integrated management approach benefits symptom control. Method The asthma/rhinitis pathway was developed by a multidisciplinary working group and was based on a comprehensive review of evidence. The pathway was reviewed by a broad group of stakeholders including the public and was approved by the Allergy Care Pathways Project Board and the RCPCH Clinical Standards Committee. Results The pathway entry points are defined by symptom type and severity at presentation. Acute severe rhinitis and life-threatening asthma are presented as distinct entry routes to the pathway, recognising that initial care of these conditions requires presentation-specific treatments. However, the pathway emphasises that ideal long term care should take account of both conditions in order to achieve maximal improvements in disease control and quality of life. Conclusions The pathway recommends that acute presentations of asthma and/or rhinitis should be treated separately. Where both conditions exist, ongoing management should address the upper and lower airways. The authors recommend that this pathway is implemented locally by a multidisciplinary team (MDT) with a focus on creating networks. The MDT within these networks should work with patients to develop and agree on care plans that are age and culturally appropriate.

Optical Cooling Using the Dipole Force

The term `laser cooling' is applied to the use of optical means to cool the motional energies of either atoms and molecules, or micromirrors. In the literature, these two strands are kept largely separate; both, however suffer from severe limitations. Laser cooling of atoms and molecules largely relies on the internal level structure of the species being cooled. As a result, only a small number of elements and a tiny number of molecules can be cooled this way. In the case of micromirrors, the problem lies in the engineering of micromirrors that need to satisfy a large number of constraints---these include a high mechanical Q-factor, high reflectivity and very good optical quality, weak coupling to the substrate, etc.---in order to enable efficient cooling. During the course of this thesis, I will draw these two sides of laser cooling closer together by means of a single, generically applicable scattering theory that can be used to explain the interaction between light and matter at a very general level. I use this `transfer matrix' formalism to explore the use of the retarded dipole--dipole interaction as a means of both enhancing the efficiency of micromirror cooling systems and rendering the laser cooling of atoms and molecules less species selective. In particular, I identify the `external cavity cooling' mechanism, whereby the use of an optical memory in the form of a resonant element (such as a cavity), outside which the object to be cooled sits, can potentially lead to the construction of fully integrated optomechanical systems and even two-dimensional arrays of translationally cold atoms, molecules or even micromirrors.

Mathematical Modelling of a Reciprocating Piston Expander

Modern internal combustion (IC) engines reject around two thirds of the energy provided by the fuel as low-grade waste heat. Capturing a portion of this waste heat energy and transforming it into a more useful form of energy could result in a significant reduction in fuel consumption. By using the low-grade heat, an organic Rankine cycle (ORC) can produce mechanical work from a pressurised organic fluid with the use of an expander.
Ideal gas assumptions are shown to produce significant errors in expander performance predictions when using an organic fluid. This paper details the mathematical modelling technique used to accurately model the thermodynamic processes for both ideal and non-ideal fluids within the reciprocating expander. A comparison between the two methods illustrates the extent of the errors when modelling a reciprocating piston expander. Use of the ideal gas assumptions are shown to produce an error of 55% in the prediction of power produced by the expander when operating on refrigerant R134a.

Identification of damping in a bridge using a moving instrumented vehicle

In recent years, there has been a significant increase in the number of bridges which are being instrumented and monitored on an ongoing basis. This is in part due to the introduction of bridge management systems designed to provide a high level of protection to the public and early warning if the bridge becomes unsafe. This paper investigates a novel alternative; a low-cost method consisting of the use of a vehicle fitted with accelerometers on its axles to monitor the dynamic behaviour of bridges. A simplified half-car vehicle-bridge interaction model is used in theoretical simulations to test the effectiveness of the approach in identifying the damping ratio of the bridge. The method is tested for a range of bridge spans and vehicle velocities using theoretical simulations and the influences of road roughness, initial vibratory condition of the vehicle, signal noise, modelling errors and frequency matching on the accuracy of the results are investigated.

Review of Marine Spatial Planning Best Practice of Relevance to Ireland

Making room for new marine uses and safeguarding more traditional uses, without degrading the marine environment, will require the adoption of new integrated management strategies. Current management frameworks do not facilitate the integrated management of all marine activities occurring in one area. To address this issue, the government developed Harnessing Our Ocean Wealth – An Integrated Marine Plan (IMP) for Ireland. Harnessing Our Ocean
Wealth presents a ‘roadmap’ for adopting an integrated approach to marine governance and for achieving the Government’s ambitious targets for the maritime sector, including: exceeding €6.4 billion turnover annually by 2020, and doubling its contribution to GDP to 2.4% by 2030. As part of this roadmap, Harnessing Our Ocean Wealth endorses the development of an appropriate Marine Spatial Planning (MSP) Framework. One way to develop an MSP Framework is to learn from early adapters. Critical assessments of key
elements of MSP as implemented in early initiatives can serve to inform the development of an appropriate framework. The aim of this project is to contribute to the development of this framework by reporting on
MSP best practice relevant to Ireland. Case study selection and evaluation criteria are outlined in the next section. This is followed by a presentation of case study findings. The final section of the report focuses on outlining how the lessons could be transferred to the Irish context.

Reducing Child Protection Error in Social Work: Towards an Holistic-Rational Perspective

Social work in the United Kingdom remains embroiled in concerns about child protection error. The serious injury or death of vulnerable children continues to evince much consternation in the public and private spheres. Governmental responses to these concerns invariably draw on technocratic solutions involving more procedures, case management systems, information technology and bureaucratic regulation. Such solutions flow from an implicit use of instrumental rationality based on a ‘means-end’ logic. While bringing an important perspective to the problem of child protection error, instrumental rationality has been overused limiting discretion and other modes of rational inquiry. This paper argues that the social work profession should apply an enlarged form of rationality comprising not only the instrumental-rational mode but also the critical-rational, affective-rational and communicative-rational forms. It is suggested that this combined, conceptual arsenal of rational inquiry leads to a gestalt which has been termed the holistic-rational perspective. It is also argued that embracing a more rounded perspective such as this might offer greater opportunities for reducing child protection error.

Going above and beyond: how sustainability culture and entrepreneurial orientation drive social sustainability supply chain practice adoption

Purpose
– This paper aims to examine what drives the adoption of different social sustainability supply chain practices. Research has shown that certain factors drive the adoption of environmental sustainability practices but few focus on social supply chain practices, delineate which practices are adopted or what drives their adoption.

Design/methodology/approach
– The authors examine the facilitative role of sustainability culture to explain the adoption of social sustainability supply chain practices: basic practices, consisting of monitoring and management systems and advanced practices, which are new product and process development and strategic redefinition. The authors then explore the role played by a firm’s entrepreneurial orientation in shaping and reinforcing the adoption of social sustainability supply chain practices. A survey of 156 supply chain managers in multiple industries in Ireland was conducted to test the relationship between the variables.

Findings
– The findings show that sustainability culture is positively related to all the practices, and entrepreneurial orientation impacts and moderates social sustainability culture in advanced social sustainability supply chain adoption.

Research limitations/implications
– As with any survey, this is a single point in time with a single respondent. Implications for managers include finding the right culture in the organisation to implement social sustainability supply chain management practices that go beyond monitoring to behavioural changes in the supply chain with implications beyond the dyad of buyer and supplier to lower tier suppliers and the community surrounding the supply chain.

Practical implications
– The implications for managers include developing and fostering cultural attributes in the organisation to implement social sustainability supply chain management practices that go beyond monitoring suppliers to behavioural changes in the supply chain with implications beyond the dyad of buyer and supplier to lower tier suppliers and the community surrounding the supply chain.

Originality/value
– This is the first time, to the authors’ knowledge, that cultural and entrepreneurial variables have been tested for social sustainability supply chain practices, giving them new insights into how and why social sustainability supply chain practices are adopted.

Monitoring Bridge Dynamic Behaviour using an Instrumented Two Axle Vehicle

Highway structures such as bridges are subject to continuous degradation primarily due to ageing, loading and environmental factors. A rational transport policy must monitor and provide adequate maintenance to this infrastructure to guarantee the required levels of transport service and safety. Increasingly in recent years, bridges are being instrumented and monitored on an ongoing basis due to the implementation of Bridge Management Systems. This is very effective and provides a high level of protection to the public and early warning if the bridge becomes unsafe. However, the process can be expensive and time consuming, requiring the installation of sensors and data acquisition electronics on the bridge. This paper investigates the use of an instrumented 2-axle vehicle fitted with accelerometers to monitor the dynamic behaviour of a bridge network in a simple and cost-effective manner. A simplified half car-beam interaction model is used to simulate the passage of a vehicle over a bridge. This investigation involves the frequency domain analysis of the axle accelerations as the vehicle crosses the bridge. The spectrum of the acceleration record contains noise, vehicle, bridge and road frequency components. Therefore, the bridge dynamic behaviour is monitored in simulations for both smooth and rough road surfaces. The vehicle mass and axle spacing are varied in simulations along with bridge structural damping in order to analyse the sensitivity of the vehicle accelerations to a change in bridge properties. These vehicle accelerations can be obtained for different periods of time and serve as a useful tool to monitor the variation of bridge frequency and damping with time.

A Parametric Study of a Drive by Bridge Inspection System Based on the Morlet Wavelet

Many of the bridges currently in use worldwide are approaching the end of their design lives. However, rehabilitating and extending the lives of these structures raises important safety issues. There is also a need for increased monitoring which has considerable cost implications for bridge management systems. Existing structural health monitoring (SHM) techniques include vibration-based approaches which typically involve direct instrumentation of the bridge and are important as they can indicate the deterioration of the bridge condition. However, they can be labour intensive and expensive. In the past decade, alternative indirect vibration-based approaches which utilise the response of a vehicle passing over a bridge have been developed. This paper investigates such an approach; a low-cost approach for the monitoring of bridge structures which consists of the use of a vehicle fitted with accelerometers on its axles. The approach aims to detect damage in the bridge while obviating the need for direct instrumentation of the bridge. Here, the effectiveness of the approach in detecting damage in a bridge is investigated using a simplified vehicle-bridge interaction (VBI) model in theoretical simulations and a scaled VBI model in a laboratory experiment. In order to identify the existence and location of damage, the vehicle accelerations are recorded and processed using a continuous Morlet wavelet transform and a damage index is established. A parametric study is carried out to investigate the effect of parameters such as the bridge span length, vehicle speed, vehicle mass, damage level and road surface roughness on the accuracy of results.

Smartphone and GPS technology for freeroaming dog population surveillance -a methodological study (Studio metodologico sull’applicazione di smartphone e tecnologia GPS alla sorveglianza delle popolazioni di cani vaganti)

Free-roaming dogs (FRD) represent a potential threat to the quality of life in cities from an ecological, social and public health point of view. One of the most urgent concerns is the role of uncontrolled dogs as reservoirs of infectious diseases transmittable to humans and, above all, rabies. An estimate of the FRD population size and characteristics in a given area is the first step for any relevant intervention programme. Direct count methods are still prominent because of their non-invasive approach, information technologies can support such methods facilitating data collection and allowing for a more efficient data handling. This paper presents a new framework for data collection using a topological algorithm implemented as ArcScript in ESRI® ArcGIS software, which allows for a random selection of the sampling areas. It also supplies a mobile phone application for Android® operating system devices which integrates Global Positioning System (GPS) and Google Maps™. The potential of such a framework was tested in 2 Italian regions. Coupling technological and innovative solutions associated with common counting methods facilitate data collection and transcription. It also paves the way to future applications, which could support dog population management systems.