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).

A novel satellite mission concept for upper air water vapour, aerosol and cloud observations using integrated path differential absorption LiDAR limb sounding

We propose a new satellite mission to deliver high quality measurements of upper air water vapour. The concept centres around a LiDAR in limb sounding by occultation geometry, designed to operate as a very long path system for differential absorption measurements. We present a preliminary performance analysis with a system sized to send 75 mJ pulses at 25 Hz at four wavelengths close to 935 nm, to up to 5 microsatellites in a counter-rotating orbit, carrying retroreflectors characterized by a reflected beam divergence of roughly twice the emitted laser beam divergence of 15 µrad. This provides water vapour profiles with a vertical sampling of 110 m; preliminary calculations suggest that the system could detect concentrations of less than 5 ppm. A secondary payload of a fairly conventional medium resolution multispectral radiometer allows wide-swath cloud and aerosol imaging. The total weight and power of the system are estimated at 3 tons and 2,700 W respectively. This novel concept presents significant challenges, including the performance of the lasers in space, the tracking between the main spacecraft and the retroreflectors, the refractive effects of turbulence, and the design of the telescopes to achieve a high signal-to-noise ratio for the high precision measurements. The mission concept was conceived at the Alpbach Summer School 2010.

Plane wave approximation of homogeneous Helmholtz solutions

In this paper, we study the approximation of solutions of the homogeneous Helmholtz equation Δu + ω 2 u = 0 by linear combinations of plane waves with different directions. We combine approximation estimates for homogeneous Helmholtz solutions by generalized harmonic polynomials, obtained from Vekua’s theory, with estimates for the approximation of generalized harmonic polynomials by plane waves. The latter is the focus of this paper. We establish best approximation error estimates in Sobolev norms, which are explicit in terms of the degree of the generalized polynomial to be approximated, the domain size, and the number of plane waves used in the approximations.

Plane wave approximation in linear elasticity

We consider the approximation of solutions of the time-harmonic linear elastic wave equation by linear combinations of plane waves. We prove algebraic orders of convergence both with respect to the dimension of the approximating space and to the diameter of the domain. The error is measured in Sobolev norms and the constants in the estimates explicitly depend on the problem wavenumber. The obtained estimates can be used in the h- and p-convergence analysis of wave-based finite element schemes.

Spectrally invariant approximation within atmospheric radiative transfer

Certain algebraic combinations of single scattering albedo and solar radiation reflected from, or transmitted through, vegetation canopies do not vary with wavelength. These ‘‘spectrally invariant relationships’’ are the consequence of wavelength independence of the extinction coefficient and scattering phase function in veg- etation. In general, this wavelength independence does not hold in the atmosphere, but in cloud-dominated atmospheres the total extinction and total scattering phase function vary only weakly with wavelength. This paper identifies the atmospheric conditions under which the spectrally invariant approximation can accu- rately describe the extinction and scattering properties of cloudy atmospheres. The validity of the as- sumptions and the accuracy of the approximation are tested with 1D radiative transfer calculations using publicly available radiative transfer models: Discrete Ordinate Radiative Transfer (DISORT) and Santa Barbara DISORT Atmospheric Radiative Transfer (SBDART). It is shown for cloudy atmospheres with cloud optical depth above 3, and for spectral intervals that exclude strong water vapor absorption, that the spectrally invariant relationships found in vegetation canopy radiative transfer are valid to better than 5%. The physics behind this phenomenon, its mathematical basis, and possible applications to remote sensing and climate are discussed.

Radar scattering from ice aggregates using the horizontally aligned oblate spheroid approximation

The assumed relationship between ice particle mass and size is profoundly important in radar retrievals of ice clouds, but, for millimeter-wave radars, shape and preferred orientation are important as well. In this paper the authors first examine the consequences of the fact that the widely used ‘‘Brown and Francis’’ mass–size relationship has often been applied to maximumparticle dimension observed by aircraftDmax rather than to the mean of the particle dimensions in two orthogonal directions Dmean, which was originally used by Brown and Francis. Analysis of particle images reveals that Dmax ’ 1.25Dmean, and therefore, for clouds for which this mass–size relationship holds, the consequences are overestimates of ice water content by around 53% and of Rayleigh-scattering radar reflectivity factor by 3.7 dB. Simultaneous radar and aircraft measurements demonstrate that much better agreement in reflectivity factor is provided by using this mass–size relationship with Dmean. The authors then examine the importance of particle shape and fall orientation for millimeter-wave radars. Simultaneous radar measurements and aircraft calculations of differential reflectivity and dual-wavelength ratio are presented to demonstrate that ice particles may usually be treated as horizontally aligned oblate spheroids with an axial ratio of 0.6, consistent with them being aggregates. An accurate formula is presented for the backscatter cross section apparent to a vertically pointing millimeter-wave radar on the basis of a modified version of Rayleigh–Gans theory. It is then shown that the consequence of treating ice particles as Mie-scattering spheres is to substantially underestimate millimeter-wave reflectivity factor when millimeter-sized particles are present, which can lead to retrieved ice water content being overestimated by a factor of 4.h

Cloud-resolving model simulations with one- and two-way couplings via the weak temperature gradient approximation

A cloud-resolving model is modified to implement the weak temperature gradient approximation in order to simulate the interactions between tropical convection and the large-scale tropical circulation. The instantaneous domain-mean potential temperature is relaxed toward a reference profile obtained from a radiative–convective equilibrium simulation of the cloud-resolving model. For homogeneous surface conditions, the model state at equilibrium is a large-scale circulation with its descending branch in the simulated column. This is similar to the equilibrium state found in some other studies, but not all. For this model, the development of such a circulation is insensitive to the relaxation profile and the initial conditions. Two columns of the cloud-resolving model are fully coupled by relaxing the instantaneous domain-mean potential temperature in both columns toward each other. This configuration is energetically closed in contrast to the reference-column configuration. No mean large-scale circulation develops over homogeneous surface conditions, regardless of the relative area of the two columns. The sensitivity to nonuniform surface conditions is similar to that obtained in the reference-column configuration if the two simulated columns have very different areas, but it is markedly weaker for columns of comparable area. The weaker sensitivity can be understood as being a consequence of a formulation for which the energy budget is closed. The reference-column configuration has been used to study the convection in a local region under the influence of a large-scale circulation. The extension to a two-column configuration is proposed as a methodology for studying the influence on local convection of changes in remote convection.

Understanding lake and catchment history as a tool for integrated lake management

Sustainable lake management for nutrient-enriched lakes must be underpinned by an understanding of both the functioning of the lake, and the origins of changes in nutrient loading from the catchment. To date, limnologists have tended to focus on studying the impact of nutrient enrichment on the lake biota, and the dynamics of nutrient cycling between the water column, biota and sediments within the lake. Relatively less attention has been paid to understanding the specific origins of nutrient loading from the catchment and nutrient transport pathways linking the lake to its catchment. As such, when devising catchment management strategies to reduce nutrient loading on enriched lakes, assumptions have been made regarding the relative significance of non-point versus point sources in the catchment. These are not always supported by research conducted on catchment nutrient dynamics in other fields of freshwater science. Studies on nutrient enrichment in lakes need to take account of the history of catchment use and management specific to each lake in order to devise targeted and sustainable management strategies to reduce nutrient loading to enriched lakes. Here a modelling approach which allows quantification of the relative contribution of nutrients from each specific point and non-point catchment source over the course of catchment history is presented. The approach has been applied to three contrasting catchments in the U.K. for the period 1931 to present. These are the catchment of Slapton Ley in south Devon, the River Esk in Cumbria and the Deben Estuary in Suffolk. Each catchment showed marked variations in the nature and intensity of land use and management. The model output quantifies the relative importance of point source versus non-point livestock and land use sources in each of the catchments, and demonstrates the necessity for an understanding of site-specific catchment history in devising suitable management strategies for the reduction of nutrient loading on enriched lakes.

Suspended and bed load sediment transport dynamics in two lowland UK streams—storm integrated monitoring

A great deal of work recently has focused on suspended and bedload sediment transport, driven primarily by interest in contaminant transfer. However, uncertainties regarding the role of storm events, macrophyte beds and interactions between the two phases of sediment still exist. This paper compares two study sites within the same catchment whose geology varies significantly. The differences in hydrology, suspended sediment (SS) transport and bed load transport that this causes are examined. In addition, a method to predict the mobilization of different size fractions of sediment during given flows is investigated using critical entrainment thresholds.

Correction of atmospheric delay effects in radar interferometry using a nested mesoscale atmospheric model

The temporal variability of the atmosphere through which radio waves pass in the technique of differential radar interferometry can seriously limit the accuracy with which the method can measure surface motion. A forward, nested mesoscale model of the atmosphere can be used to simulate the variable water content along the radar path and the resultant phase delays. Using this approach we demonstrate how to correct an interferogram of Mount Etna in Sicily associated with an eruption in 2004-5. The regional mesoscale model (Unified Model) used to simulate the atmosphere at higher resolutions consists of four nested domains increasing in resolution (12, 4, 1, 0.3 km), sitting within the analysis version of a global numerical model that is used to initiate the simulation. Using the high resolution 3D model output we compute the surface pressure, temperature and the water vapour, liquid and solid water contents, enabling the dominant hydrostatic and wet delays to be calculated at specific times corresponding to the acquisition of the radar data. We can also simulate the second-order delay effects due to liquid water and ice.

Community-based climate change adaptation strategies for integrated prawn-fish-rice farming in Bangladesh to promote social-ecological resilience

Farming freshwater prawns with fish in rice fields is widespread in coastal regions of southwest Bangladesh because of favourable resources and ecological conditions. This article provides an overview of an ecosystem-based approach to integrated prawn-fish-rice farming in southwest Bangladesh. The practice of prawn and fish farming in rice fields is a form of integrated aquaculture-agriculture, which provides a wide range of social, economic and environmental benefits. Integrated prawn-fish-rice farming plays an important role in the economy of Bangladesh, earning foreign exchange and increasing food production. However, this unique farming system in coastal Bangladesh is particularly vulnerable to climatechange. We suggest that community-based adaptation strategies must be developed to cope with the challenges. We propose that integrated prawn-fish-rice farming could be relocated from the coastal region to less vulnerable upland areas, but caution that this will require appropriate adaptation strategies and an enabling institutional environment.