An evaluation of an adapted United States model of pharmaceutical care to improve psychoactive prescribing for nursing home residents in Northern Ireland (Fleetwood NI Study).

OBJECTIVES: To test the effect of an adapted U.S. model of pharmaceutical care on prescribing of inappropriate psychoactive (anxiolytic, hypnotic, and antipsychotic) medications and falls in nursing homes for older people in Northern Ireland (NI).

DESIGN: Cluster randomized controlled trial.

SETTING: Nursing homes randomized to intervention (receipt of the adapted model of care; n=11) or control (usual care continued; n=11).

PARTICIPANTS: Residents aged 65 and older who provided informed consent (N=334; 173 intervention, 161 control).

INTERVENTION: Specially trained pharmacists visited intervention homes monthly for 12 months and reviewed residents' clinical and prescribing information, applied an algorithm that guided them in assessing the appropriateness of psychoactive medication, and worked with prescribers (general practitioners) to improve the prescribing of these drugs. The control homes received usual care.

MEASUREMENTS: The primary end point was the proportion of residents prescribed one or more inappropriate psychoactive medicine according to standardized protocols; falls were evaluated using routinely collected falls data mandated by the regulatory body for nursing homes in NI.

RESULTS: The proportion of residents taking inappropriate psychoactive medications at 12 months in the intervention homes (25/128, 19.5%) was much lower than in the control homes (62/124, 50.0%) (odds ratio=0.26, 95% confidence interval=0.14–0.49) after adjustment for clustering within homes. No differences were observed at 12 months in the falls rate between the intervention and control groups.

CONCLUSION: Marked reductions in inappropriate psychoactive medication prescribing in residents resulted from pharmacist review of targeted medications, but there was no effect on falls.

COLREGs-based collision avoidance strategies for unmanned surface vehicles

The aim of this paper is to report the preliminary development of an automatic collision avoidance technique for unmanned marine craft based on standardised rules, COLREGs, defined by the International Maritime Organisation. It is noted that all marine surface vessels are required to adhere to COLREGs at all times in order to minimise or eliminate the risk of collisions. The approach presented is essentially a reactive path planning algorithm which provides feedback to the autopilot of an unmanned vessel or the human captain of a manned ship for steering the craft safely. The proposed strategy consists of waypoint guidance by line-of-sight coupled with a manual biasing scheme. This is applied to the dynamic model of an unmanned surface vehicle. A simple PID autopilot is incorporated to ensure that the vessel adheres to the generated seaway. It is shown through simulations that the resulting scheme is able to generate viable trajectories in the presence of both stationary and dynamic obstacles. Rules 8 and 14 of the COLREGs, which apply to the amount of manoeuvre and to a head-on scenario respectively are simulated. A comparison is also made with an offline or deliberative grid-based path planning algorithm which has been modified to generate COLREGs-compliant routes.

Electric Vehicles and Energy Storage: a case study on Ireland

Renewable energy is generally accepted as an important component of future electricity grids. In late 2008, the Government of the Republic of Ireland set a target of 10% of all vehicles in its transport fleet be powered by electricity by 2020. This paper examines the potential contributions Electric Vehicles (EVs) can make to facilitate increased electricity generation from variable renewable sources such as wind generation in the Republic of Ireland. It also presents an overview of the technical and economic issues associated with this target.

State-of the art in electric vehicles charging infrastructure

The international introduction of electric vehicles (EVs) will see a change in private passenger car usage, operation and management. There are many stakeholders, but currently it appears that the automotive industry is focused on EV manufacture, governments and policy makers have highlighted the potential environmental and job creation opportunities while the electricity sector is preparing for an additional electrical load on the grid system. If the deployment of EVs is to be successful the introduction of international EV standards, universal charging hardware infrastructure, associated universal peripherals and user-friendly software on public and private property is necessary. The focus of this paper is to establish the state-of-the-art in EV charging infrastructure, which includes a review of existing and proposed international standards, best practice and guidelines under consideration or recommendation.

Electric vehicles and displaced gaseous emission

Electric vehicles (EV) do not emit tailpipe exhaust fumes in the same manner as internal combustion engine vehicles. Optimal benefits can only be achieved, if EVS are deployed effectively, so that the tailpipe emissions are not substituted by additional emissions in the electricity sector. This paper examines the potential contributions that Plug in Hybrid Electric Vehicles can make in reducing carbon dioxide. The paper presents the results of the generation expansion model for Northern Ireland and the Republic of Ireland built using the dynamic programming based long term generation expansion planning tool called the Wien Automatic System Planning IV tool. The model optimizes power dispatch using hourly electricity demand curves for each year up to 2020, while incorporating generator characteristics and certain operational requirements such as energy not served and loss of load probability while satisfying constraints on environmental emissions, fuel availability and generator operational and maintenance costs. In order to simulate the effect of PHEV, two distinct charging scenarios are applied based on a peak tariff and an off peak tariff. The importance and influence of the charging regime on the amount of energy used and gaseous emissions displaced is determined and discussed.

Quantifying the Energy & carbon emissions implications of a 10% electric vehicles target

EU Directive 2009/28/EC on Renewable Energy requires each Member State to ensure 10% of transport energy (excluding aviation and marine transport) comes from renewable sources by 2020 (10% RES-T target). In addition to the anticipated growth in biofuels, this target is expected to be met by the increased electrification of transport coupled with a growing contribution from renewable energy to electricity generation. Energy use in transport accounted for nearly half of Ireland’s total final energy demand and about a third of energy-related carbon dioxide emissions in 2007. Energy use in transport has grown by 6.3% per annum on average in the period 1990 – 2007. This high share and fast growth relative to other countries highlights the challenges Ireland faces in meeting ambitious renewable energy targets. The Irish Government has set a specific target for Electric Vehicles (EV) as part of its strategy to deliver the 10% RES-T target. By 2020, 10% of all vehicles in its transport fleet are to be powered by electricity. This paper quantifies the impacts on energy and carbon dioxide emissions of this 10% EV target by 2020. In order to do this an ‘EV Car Stock’ model was developed to analyse the historical and future make-up of the passenger car portion of the fleet to 2025. Three scenarios for possible take-up in EVs were examined and the associated energy and emissions impacts are quantified. These impacts are then compared to Ireland’s 10% RES-T target and greenhouse gas (GHG) emissions reduction targets for 2020. Two key findings of the study are that the 10% EV target contributes 1.7% to the 10% RES-T target by 2020 and 1.4% to the 20% reduction in Non-ETS emissions by 2020 relative to 2005.

Electric Vehicles - a well to wheel analysis

The European Union has set a target for 10% renewable energy in transport by 2020, which will be met using both biofuels and electric vehicles. In the case of biofuels, for the purposes of meeting the target, the biofuel must achieve greenhouse gas savings of 35% relative to the fossil fuel replaced. For biofuels, greenhouse gas savings can be calculated using life cycle analysis, or the European Union default values. In contrast, all electricity used in transport is considered to be the same, regardless of the source or the type of electric vehicle. However, the choice of the electric vehicle and electricity source will have a major impact on the greenhouse gas savings. This paper examines different electric-vehicle scenarios in terms of greenhouse gas savings, using a well-to-wheel life cycle analysis.