Using HIT to deliver integrated care for the frail elderly in the UK: current barriers and future challenges

In this paper we briefly describe the results of a 3 year project examining the use of Health Information Technologies (e.g., electronic patient record systems) to deliver integrated care. In particular, we focus on one group of patient (the frail elderly) and efforts to design an e-health supported healthcare pathway (the frail elderly pathway – FEP). The aim of FEP is to bring together clinicians and staff from health and social care and allow them to share patient information. Our findings show that progress in delivering a fully-supported and working FEP has been slow, not least because of the difficulties experienced by healthcare staff in using current IT systems. In addition, there are many strategic and technical issues which remain unresolved (e.g., systems interoperability).

Economists are not dismal, the world is not a Petri dish and other reasons for optimism

One of the recurrent themes in the debate around how to ensure global food security concerns the capacity of the planet to support its growing population. Neo-Malthusian thinking suggests that we are in a situation in which further expansion of the population cannot be supported and that the population checks, with their dismal consequences envisaged by Malthus, will lead to a new era of stagnant incomes and population. More sophisticated models of the link between population and income are less gloomy however. They see population growth as an integral component of the economic growth which is necessary to ensure that the poorest achieve food security. An undue focus on the difficulties of meeting the demands of the increasing population risks damaging this growth. Instead, attention should be focused on ensuring that the conditions to ensure that economic growth accompanies population growth are in place.

Facilities management carbon footprints: an audit of critical elements of management and reporting

Concern for the environmental impact of organizations’ activities has led to the recognition and demand for organizations to manage and report on their carbon footprint. However, there is no limit as to the areas of carbon footprints required in such annual environmental reports. To deliver improvements in the quality of carbon footprint management and reporting, there is a need to identify the main elements of carbon footprint strategy that can be endorsed, supported and encouraged by facility managers. The study investigates carbon footprint elements managed and reported upon by facility manager in the UK. Drawing on a questionnaire survey of 256 facility managers in the UK, the key elements of carbon footprints identified in carbon footprint reports are examined. The findings indicate that the main elements are building energy consumption, waste disposal and water consumption. Business travel in terms of using public transport, air travel and company cars are also recognized as important targets and objectives for the carbon footprint strategy of several FM (facilities management) organizations.

Quantifying the relationship between temperature regulation in the ear and floret development stage in wheat (Triticum aestivum L.) under heat and drought stress

Thermal imaging is a valuable tool for the elucidation of gas exchange dynamics between a plant and its environment. The presence of stomata in wheat glumes and awns offers an opportunity to assess photosynthetic activity of ears up to and during flowering. The knowledge of spatial and temporal thermodynamics of the wheat ear may provide insight into interactions between floret developmental stage (FDS), temperature depression (TD) and ambient environment, with potential to be used as a high-throughput screening tool for breeders. A controlled environment study was conducted using six spring wheat (Triticum aestivum L.) genotypes of the elite recombinant inbred line Seri/Babax. Average ear temperature (AET) was recorded using a hand held infrared camera and gas exchange was measured by enclosing ears in a custom built cuvette. FDS was monitored and recorded daily throughout the study. Plants were grown in pots and exposed to a combination of two temperature and two water regimes. In the examined wheat lines, TD varied from 0.1°C to 0.6°C according to the level of stress imposed. The results indicated that TD does not occur at FDS F3, the peak of active flowering, but during the preceding stages prior to pollen release and stigma maturity (F1-F2). These findings suggest that ear temperature during the early stages of anthesis, prior to pollen release and full extension of the stigma, are likely to be the most relevant for identifying heat stress tolerant genotypes.

Some uniform stability and convergence results for integral equations on the real line and projection methods for their solution

The paper considers second kind equations of the form (abbreviated x=y + K2x) in which and the factor z is bounded but otherwise arbitrary so that equations of Wiener-Hopf type are included as a special case. Conditions on a set are obtained such that a generalized Fredholm alternative is valid: if W satisfies these conditions and I − Kz, is injective for each z ε W then I − Kz is invertible for each z ε W and the operators (I − Kz)−1 are uniformly bounded. As a special case some classical results relating to Wiener-Hopf operators are reproduced. A finite section version of the above equation (with the range of integration reduced to [−a, a]) is considered, as are projection and iterated projection methods for its solution. The operators (where denotes the finite section version of Kz) are shown uniformly bounded (in z and a) for all a sufficiently large. Uniform stability and convergence results, for the projection and iterated projection methods, are obtained. The argument generalizes an idea in collectively compact operator theory. Some new results in this theory are obtained and applied to the analysis of projection methods for the above equation when z is compactly supported and k(s − t) replaced by the general kernel k(s,t). A boundary integral equation of the above type, which models outdoor sound propagation over inhomogeneous level terrain, illustrates the application of the theoretical results developed.

Calculating the application criticality and business risk from technology obsolescence

The problem of technology obsolescence in information intensive businesses (software and hardware no longer being supported and replaced by improved and different solutions) and a cost constrained market can severely increase costs and operational, and ultimately reputation risk. Although many businesses recognise technological obsolescence, the pervasive nature of technology often means they have little information to identify the risk and location of pending obsolescence and little money to apply to the solution. This paper presents a low cost structured method to identify obsolete software and the risk of their obsolescence where the structure of a business and its supporting IT resources can be captured, modelled, analysed and the risk to the business of technology obsolescence identified to enable remedial action using qualified obsolescence information. The technique is based on a structured modelling approach using enterprise architecture models and a heatmap algorithm to highlight high risk obsolescent elements. The method has been tested and applied in practice in three consulting studies carried out by Capgemini involving four UK police forces. However the generic technique could be applied to any industry based on plans to improve it using ontology framework methods. This paper contains details of enterprise architecture meta-models and related modelling.

The counter-propagating Rossby-wave perspective on baroclinic instability. II: Application to the Charney model

The constant-density Charney model describes the simplest unstable basic state with a planetary-vorticity gradient, which is uniform and positive, and baroclinicity that is manifest as a negative contribution to the potential-vorticity (PV) gradient at the ground and positive vertical wind shear. Together, these ingredients satisfy the necessary conditions for baroclinic instability. In Part I it was shown how baroclinic growth on a general zonal basic state can be viewed as the interaction of pairs of ‘counter-propagating Rossby waves’ (CRWs) that can be constructed from a growing normal mode and its decaying complex conjugate. In this paper the normal-mode solutions for the Charney model are studied from the CRW perspective. Clear parallels can be drawn between the most unstable modes of the Charney model and the Eady model, in which the CRWs can be derived independently of the normal modes. However, the dispersion curves for the two models are very different; the Eady model has a short-wave cut-off, while the Charney model is unstable at short wavelengths. Beyond its maximum growth rate the Charney model has a neutral point at finite wavelength (r=1). Thereafter follows a succession of unstable branches, each with weaker growth than the last, separated by neutral points at integer r—the so-called ‘Green branches’. A separate branch of westward-propagating neutral modes also originates from each neutral point. By approximating the lower CRW as a Rossby edge wave and the upper CRW structure as a single PV peak with a spread proportional to the Rossby scale height, the main features of the ‘Charney branch’ (0and interior PV structure of the neutral modes appearing at r=1. The behaviour of the other branches and neutral points is essentially the same when viewed from the CRW perspective, but with cancelling interior PV structures reducing the self and mutual interaction of the CRWs. The underlying dynamics determining the nature of all the solutions is the difference in the scale-dependence of PV inversion for boundary and interior PV anomalies, the Rossby-wave propagation mechanism and the CRW interaction. The behaviour of the Charney modes and the first neutral branch, which rely on tropospheric PV gradients, are arguably more applicable to the atmosphere than modes of the Eady model where the positive PV gradient exists only at the tropopause

DTM generation from LIDAR data using skewness balancing

LIght Detection And Ranging (LIDAR) data for terrain and land surveying has contributed to many environmental, engineering and civil applications. However, the analysis of Digital Surface Models (DSMs) from complex LIDAR data is still challenging. Commonly, the first task to investigate LIDAR data point clouds is to separate ground and object points as a preparatory step for further object classification. In this paper, the authors present a novel unsupervised segmentation algorithm-skewness balancing to separate object and ground points efficiently from high resolution LIDAR point clouds by exploiting statistical moments. The results presented in this paper have shown its robustness and its potential for commercial applications.

Innovative implementation of iLearn e-Portfolio for Personal Development Planning

iLearn is a Web 2.0 tool developed in Blackboard to help students with Personal Development Planning (PDP). This paper describes a case study on how the innovative use of mobile digital technology in iLearn e-Portfolio for developing reflective portfolios for PDP benefits the students. The e-Portfolio tool benefits students as it enables them to create and share portfolios, record achievements and reflections that support future job applications and promotion. Students find it beneficial because they can make use of iLearn e-Portfolio to keep academic records and achievements, activities and interests, work experience, reflective practice, employer information and some other useful resources, and also to tailor their CV and covering letters including evidence to support their CV, transferable skills and selling points. Useful information for preparing for an interview, reflecting after an event and any thoughts and evaluation can be kept in iLearn e-Portfolio. Keeping assessment and feedback records in iLearn e-Portfolio enables students to know their progress, to identify any gaps they need to fill to develop their study practices and areas for development. The key points from the feedback on the assignments and assessments are beneficial for future improvement. The reflections on the assignments and how students make use of the advice are particularly useful to improve their overall performance. In terms of pedagogical benefits, the “Individual Learner Profile” records and reviews evidence in verbal communication, basic and higher academic skills, time management, numeracy skill and IT skills, students become increasingly aware of their own strengths and any weaker areas that may require development. The e-Portfolio also provides opportunity for students to reflect on the experience and skills they have gained whilst participating in activities outside their studies. As the iLearn e-Portfolio is a reflective practice tool, it is consistent with the principle of Schon's reflective practitioner to reframe problems and to explore the consequences of actions. From the students’ feedback, for those who engage regularly in iLearn, they are better able to set agendas for their Personal Tutorial meetings and provide their Personal Tutor with a unique record of their achievements, skills and attributes which help them writing effective references for them. They make the most of their student experience in general. They also enhance their transferable skills and employability overall. The iLearn e-Portfolio prepares for the workplace and life beyond University including continuing professional development. Students are aware of their transferable skills, evidence of the skills and skill level, including award or accreditation, and their personal reflection on their transferable skills. It is beneficial for students to be aware of their transferable skills, to produce evidence of the skills and skills level such as award and accreditation, and to record their personal reflection on their transferable skills. Finally, the innovative use of mobile digital technology in iLearn e-Portfolio for developing reflective portfolios for PDP will improve their employability.

Innovative use of e-portfolio for personal development

iLearn is a quasi-Web 2.0 tool developed in Blackboard to help users with Personal Development Planning (PDP). This paper describes a case study on how the innovative use of mobile digital technology in iLearn e-Portfolio for developing reflective portfolios for PDP benefits the users, who are training to be professionals in construction management and surveying, The e-Portfolio tool benefits users as it enables them to create and share portfolios, record achievements and reflections that support future job applications and promotion. Users find it beneficial because they can make use of iLearn e-Portfolio to keep academic records and achievements, activities and interests, work experience, reflective practice, employer information and some other useful resources, and also to tailor their CV and covering letters including evidence to support their CV, transferable skills and selling points. Useful information for preparing for an interview, reflecting after an event and any thoughts and evaluation can be kept in iLearn e-Portfolio. Keeping assessment and feedback records in iLearn e-Portfolio enables learners to know their progress, to identify any gaps they need to fill to develop their study practices and areas for development. The key points from the feedback on the assignments and assessments are beneficial for future improvement. The reflections on the tasks and how they make use of the advice are particularly useful to improve their overall performance. In terms of pedagogical benefits, the “Individual Learner Profile” records and reviews evidence in verbal communication, basic and higher academic skills, time management, numeracy skill and IT skills, learners become increasingly aware of their own strengths and any weaker areas that may require development. The e-Portfolio also provides opportunity for them to reflect on the experience and skills they have gained whilst participating in activities outside their studies. As the iLearn e-Portfolio is a reflective practice tool, it is consistent with the principle of Schon's reflective practitioner to reframe problems and to explore the consequences of actions. From the users’ feedback, for those who engage regularly in iLearn, they are better able to set agendas for their supervision meetings and provide their supervisor with a unique record of their achievements, skills and attributes which help them writing effective references for them. They make the most of their learning experience in general. They also enhance their transferable skills and employability overall. The iLearn e-Portfolio prepares them for the workplace including continuing professional development. Users are aware of their transferable skills, evidence of the skills and skill level, including award or accreditation, and their personal reflection on their transferable skills. It is beneficial for them to be aware of their transferable skills, to produce evidence of the skills and skills level such as award and accreditation, and to record their personal reflection on their transferable skills. Finally, the innovative use of mobile digital technology in iLearn e-Portfolio for developing reflective portfolios for PDP will improve their employability.

Research note: amendments to the model for predicting age at sexual maturity for growing pullets of layer strains following changes in photoperiod

A model was published by Lewis et al. (2002) to predict the mean age at first egg (AFE) for pullets of laying strains reared under non-limiting environmental conditions and exposed to a single change in photoperiod during the rearing stage. Subsequently, Lewis et al. (2003) reported the effects of two opposing changes in photoperiod, which showed that the first change appears to alter the pullet's physiological age so that it responds to the second change as though it had been given at an earlier age (if photoperiod was decreased), or later age (if photoperiod was increased) than the true chronological age. During the construction of a computer model based on these two publications, it became apparent that some of the components of the models needed adjustment. The amendments relate to (1) the standard deviation (S.D.) used for calculating the proportion of a young flock that has attained photosensitivity, (2) the equation for calculating the slope of the line relating AFE to age at transfer from one photoperiod to another, (3) the equation used for estimating the distribution of AFE as a function of the mean value, (4) the point of no return when pullets which have started spontaneous maturation in response to the current photoperiod can no longer respond to a late change in photoperiod and (5) the equations used for calculating the distribution of AFE when the trait is bimodal.

Stock assessment for fishery management - A framework guide to the stock assessment tools of the Fisheries Management Science Programme (FMSP)

This document provides guidelines for fish stock assessment and fishery management using the software tools and other outputs developed by the United Kingdom's Department for International Development's Fisheries Management Science Programme (FMSP) from 1992 to 2004. It explains some key elements of the precautionary approach to fisheries management and outlines a range of alternative stock assessment approaches that can provide the information needed for such precautionary management. Four FMSP software tools, LFDA (Length Frequency Data Analysis), CEDA (Catch Effort Data Analysis), YIELD and ParFish (Participatory Fisheries Stock Assessment), are described with which intermediary parameters, performance indicators and reference points may be estimated. The document also contains examples of the assessment and management of multispecies fisheries, the use of Bayesian methodologies, the use of empirical modelling approaches for estimating yields and in analysing fishery systems, and the assessment and management of inland fisheries. It also provides a comparison of length- and age-based stock assessment methods. A CD-ROM with the FMSP software packages CEDA, LFDA, YIELD and ParFish is included.

The assessment of enriched apoplastic extracts using proteomic approaches

In plant tissues the extracellular environment or apoplast, incorporating the cell wall, is a highly dynamic compartment with a role in many important plant processes including defence, development, signalling and assimilate partitioning. Soluble apoplast proteins from Arabidopsis thaliana, Triticum aestivum and Oryza sativa were separated by two-dimensional electrophoresis. The molecular weights and isoelectric points for the dominant proteins were established prior to excision, sequencing and identification by matrix-assisted laser-desorption ionisation time of flight mass spectrometry (MALDI - TOF MS). From the selected spots, 23 proteins from O. sativa and 25 proteins from A. thaliana were sequenced, of which nine identifications were made in O. sativa (39%) and 14 in A. thaliana (56%). This analysis revealed that: (i) patterns of proteins revealed by two-dimensional electrophoresis were different for each species indicating that speciation could occur at the level of the apoplast, (ii) of the proteins characterised many belonged to diverse families reflecting the multiple functions of the apoplast and (iii), a large number of the apoplast proteins could not be identified indicating that the majority of extracellular proteins are yet to be assigned. The principal proteins identified in the aqueous matrix of the apoplast were involved in defence, i.e. germin-like proteins or glucanases, and cell expansion, i.e. β-D-glucan glucohydrolases. This study has demonstrated that proteomic analysis can be used to resolve the apoplastic protein complement and to identify adaptive changes induced by environmental effectors.

Comparative effects of fatty acids on endothelial inflammatory gene expression

Background: Endothelial dysfunction may be related to adverse effects of some dietary fatty acids (FAs). Although in vitro studies have failed to show consistent findings, this may reflect the diverse experimental protocols employed and the limited range of FAs and end points studied. Aims: To investigate the effect of dietary FA type (saturated, monounsaturated, n-6 and n-3 polyunsaturated fatty acids), concentration, incubation time and cell stimulation state, on a broad spectrum of endothelial inflammatory gene expression. Methods: Using human umbilical vein endothelial cells, with and without stimulation (+/- 10 ng/ml TNF alpha), the effects of arachidonic (AA), docosahexaenoic (DHA), eicosapentaenoic (EPA), linoleic (LA), oleic (OA) and palmitic acids (PA) (10, 25 and 100 mu M), on the expression of genes encoding a number of inflammatory proteins and transcription factors were assessed by quantitative real time RT-PCR. Results: Individual FAs differentially affect endothelial inflammatory gene expression in a gene-specific manner. EPA, LA and OA significantly up-regulated MCP-1 gene expression compared to AA (p = 0.001, 0.013, 0.008, respectively) and DHA (p < 0.0005, = 0.004, 0.002, respectively). Furthermore, cell stimulation state and FA incubation time significantly influenced reported FA effects on gene expression. Conclusions: The comparative effects of saturated, monounsaturated, n-6 and n-3 polyunsaturated FAs on endothelial gene expression depend on the specific FA investigated, its length of incubation, cell stimulation state and the gene investigated. These findings may explain existing disparity in the literature. This work was funded by the EC, Framework Programme 6 via the LIPGENE project (FOOD-CT-2003-505944).

Evidence of immunomodulatory effects of a novel probiotic, Bifidobacterium longum bv. infantis CCUG 52486

Bifidobacterium longum bv. infantis CCUG 52486 was originally isolated from healthy elderly subjects and demonstrated to have particular ecological fitness and anti-pathogenic effects. Bifidobacteria are commonly associated with immunomodulatory properties, especially in older people, but this strain has not been investigated for effects on immune function. This study aimed to explore the immunomodulatory effects of this novel probiotic, compared with three commercial strains, B. longum SP 07/3, L. rhamnosus GG (L.GG) and L. casei Shirota (LcS). Human peripheral blood mononuclear cells (PBMCs) were isolated from fasting blood of young or older volunteers and exposed to probiotic strains or Con A. NK activity and activation, and cytokine release were enhanced by all probiotics with strain-specificities. The effect of B. infantis on NK activity was influenced by ageing. Except for L.GG, probiotics increased IFN-γ production to a much greater degree in young subjects, and increased IL-6 production to a much greater degree in older subjects. Based on IL-10/IL-12 ratios, B. infantis resulted in the most anti-inflammatory profile of all of the probiotics. These results suggest that B. infantis CCUG 52486 has strong immunomodulatory potential compared with well-known commercial strains, and that the immune response to probiotics may be influenced by ageing.