Continuity of care for people with psychotic illness: its relationship to clinical and social functioning.

Background: The relationship between continuity of care and user characteristics or outcomes has rarely been explored. The ECHO study operationalized and tested a multi-axial definition of continuity of care, producing a seven-factor model used here. Aims: To assess the relationship between user characteristics and established components of continuity of care, and the impact of continuity on clinical and social functioning. Methods: The sample comprised 180 community mental health team users with psychotic disorders who were interviewed at three annual time-points, to assess their experiences of continuity of care and clinical and social functioning. Scores on seven continuity factors were tested for association with user-level variables. Results: Improvement in quality of life was associated with better Experience & Relationship continuity scores (better user-rated continuity and therapeutic relationship) and with lower Meeting Needs continuity factor scores. Higher Meeting Needs scores were associated with a decrease in symptoms. Conclusion: Continuity is a dynamic process, influenced significantly by care structures and organizational change.

An evaluation of the spatiotemporal structure of large-scale European drought within the HiGEM climate model

We compare the characteristics of synthetic European droughts generated by the HiGEM1 coupled climate model run with present day atmospheric composition with observed drought events extracted from the CRU TS3 data set. The results demonstrate consistency in both the rate of drought occurrence and the spatiotemporal structure of the events. Estimates of the probability density functions for event area, duration and severity are shown to be similar with confidence > 90%. Encouragingly, HiGEM is shown to replicate the extreme tails of the observed distributions and thus the most damaging European drought events. The soil moisture state is shown to play an important role in drought development. Once a large-scale drought has been initiated it is found to be 50% more likely to continue if the local soil moisture is below the 40th percentile. In response to increased concentrations of atmospheric CO2, the modelled droughts are found to increase in duration, area and severity. The drought response can be largely attributed to temperature driven changes in relative humidity. 1 HiGEM is based on the latest climate configuration of the Met Office Hadley Centre Unified Model (HadGEM1) with the horizontal resolution increased to 1.25 x 0.83 degrees in longitude and latitude in the atmosphere and 1/3 x 1/3 degrees in the ocean.

Changing building user attitude and organisational policy towards sustainable resource use in healthcare

Health care provision is significantly impacted by the ability of the health providers to engineer a viable healthcare space to support care stakeholders needs. In this paper we discuss and propose use of organisational semiotics as a set of methods to link stakeholders to systems, which allows us to capture clinician activity, information transfer, and building use; which in tern allows us to define the value of specific systems in the care environment to specific stakeholders and the dependence between systems in a care space. We suggest use of a semantically enhanced building information model (BIM) to support the linking of clinician activity to the physical resource objects and space; and facilitate the capture of quantifiable data, over time, concerning resource use by key stakeholders. Finally we argue for the inclusion of appropriate stakeholder feedback and persuasive mechanism, to incentivise building user behaviour to support organisational level sustainability policy.

Regional changes in wind energy potential over Europe using regional climate model ensemble projections

The impact of climate change on wind power generation potentials over Europe is investigated by considering ensemble projections from two regional climate models (RCMs) driven by a global climate model (GCM). Wind energy density and its interannual variability are estimated based on hourly near-surface wind speeds. Additionally, the possible impact of climatic changes on the energy output of a sample 2.5-MW turbine is discussed. GCM-driven RCM simulations capture the behavior and variability of current wind energy indices, even though some differences exist when compared with reanalysis-driven RCM simulations. Toward the end of the twenty-first century, projections show significant changes of energy density on annual average across Europe that are substantially stronger in seasonal terms. The emergence time of these changes varies from region to region and season to season, but some long-term trends are already statistically significant in the middle of the twenty-first century. Over northern and central Europe, the wind energy potential is projected to increase, particularly in winter and autumn. In contrast, energy potential over southern Europe may experience a decrease in all seasons except for the Aegean Sea. Changes for wind energy output follow the same patterns but are of smaller magnitude. The GCM/RCM model chains project a significant intensification of both interannual and intra-annual variability of energy density over parts of western and central Europe, thus imposing new challenges to a reliable pan-European energy supply in future decades.

Using non-personal computers for eLearning: Sri Lankan experience

Communal Internet access facilities or telecentres are considered a good way to provide connectivity to people who do not possess home connectivity. Attempts are underway to utilize telecentres as eLearning centres providing access to learning materials to students who would otherwise not be able to take up eLearning. This paper reports on the findings of qualitative interviews conducted with 18 undergraduate students from two Sri Lankan universities on their eLearning experiences using communal Internet access centres. The findings suggest that despite the efforts by telecentres to provide a good service to eLearners, there are various problems faced by students including: costs, logistics, scarcity of resources, connectivity speeds, excessive procedures, and lack of support. The experiences of these Sri Lankan students suggest that there is much that needs to be understood about user perspectives in using telecentres, which could help formulate better policies and strategies to support eLearners who depend on communal access facilities.

Higher Education: Understanding the impact of distance learning mode on user information assimilation and satisfaction

There is increasing pressure to capture of video within Higher Education. Although much research has looked at how communication technologies enhance information transfer during playback of video, consideration of technical issues seems incongruous if we do not consider how presentation mode affects information assimilated by, and satisfaction of, learners with a range of individual differences, and from a range of different backgrounds. This paper considers whether a relationship exists between the media and presentation mode used in recorded content, and the level of information assimilation and satisfaction perceived by learners with a range of individual differences. Results aim to inform learning practitioners whether generic delivery is justified, or whether tailoring content delivery enhances the experience of specific learner groups.

A time-invariant visco-elastic windkessel model relating blood flow and blood volume

The difference between the rate of change of cerebral blood volume (CBV) and cerebral blood flow (CBF) following stimulation is thought to be due to circumferential stress relaxation in veins (Mandeville, J.B., Marota, J.J.A., Ayata, C., Zaharchuk, G., Moskowitz, M.A., Rosen, B.R., Weisskoff, R.M., 1999. Evidence of a cerebrovascular postarteriole windkessel with delayed compliance. J. Cereb. Blood Flow Metab. 19, 679–689). In this paper we explore the visco-elastic properties of blood vessels, and present a dynamic model relating changes in CBF to changes in CBV. We refer to this model as the visco-elastic windkessel (VW) model. A novel feature of this model is that the parameter characterising the pressure–volume relationship of blood vessels is treated as a state variable dependent on the rate of change of CBV, producing hysteresis in the pressure–volume space during vessel dilation and contraction. The VW model is nonlinear time-invariant, and is able to predict the observed differences between the time series of CBV and that of CBF measurements following changes in neural activity. Like the windkessel model derived by Mandeville, J.B., Marota, J.J.A., Ayata, C., Zaharchuk, G., Moskowitz, M.A., Rosen, B.R., Weisskoff, R.M., 1999. Evidence of a cerebrovascular postarteriole windkessel with delayed compliance. J. Cereb. Blood Flow Metab. 19, 679–689, the VW model is primarily a model of haemodynamic changes in the venous compartment. The VW model is demonstrated to have the following characteristics typical of visco-elastic materials: (1) hysteresis, (2) creep, and (3) stress relaxation, hence it provides a unified model of the visco-elastic properties of the vasculature. The model will not only contribute to the interpretation of the Blood Oxygen Level Dependent (BOLD) signals from functional Magnetic Resonance Imaging (fMRI) experiments, but also find applications in the study and modelling of the brain vasculature and the haemodynamics of circulatory and cardiovascular systems.

The Joint UK Land Environment Simulator (JULES), model description – part 1: energy and water fluxes

This manuscript describes the energy and water components of a new community land surface model called the Joint UK Land Environment Simulator (JULES). This is developed from the Met Office Surface Exchange Scheme (MOSES). It can be used as a stand alone land surface model driven by observed forcing data, or coupled to an atmospheric global circulation model. The JULES model has been coupled to the Met Office Unified Model (UM) and as such provides a unique opportunity for the research community to contribute their research to improve both world-leading operational weather forecasting and climate change prediction systems. In addition JULES, and its forerunner MOSES, have been the basis for a number of very high-profile papers concerning the land-surface and climate over the last decade. JULES has a modular structure aligned to physical processes, providing the basis for a flexible modelling platform.

Ice internal friction: Standard theoretical perspectives on friction codified, adapted for the unusual rheology of ice, and unified

Sea ice contains flaws including frictional contacts. We aim to describe quantitatively the mechanics of those contacts, providing local physics for geophysical models. With a focus on the internal friction of ice, we review standard micro-mechanical models of friction. The solid's deformation under normal load may be ductile or elastic. The shear failure of the contact may be by ductile flow, brittle fracture, or melting and hydrodynamic lubrication. Combinations of these give a total of six rheological models. When the material under study is ice, several of the rheological parameters in the standard models are not constant, but depend on the temperature of the bulk, on the normal stress under which samples are pressed together, or on the sliding velocity and acceleration. This has the effect of making the shear stress required for sliding dependent on sliding velocity, acceleration, and temperature. In some cases, it also perturbs the exponent in the normal-stress dependence of that shear stress away from the value that applies to most materials. We unify the models by a principle of maximum displacement for normal deformation, and of minimum stress for shear failure, reducing the controversy over the mechanism of internal friction in ice to the choice of values of four parameters in a single model. The four parameters represent, for a typical asperity contact, the sliding distance required to expel melt-water, the sliding distance required to break contact, the normal strain in the asperity, and the thickness of any ductile shear zone.

The Impact of office productivity cloud computing on energy consumption and greenhouse gas emissions

Cloud computing is usually regarded as being energy efficient and thus emitting less greenhouse gases (GHG) than traditional forms of computing. When the energy consumption of Microsoft’s cloud computing Office 365 (O365) and traditional Office 2010 (O2010) software suites were tested and modeled, some cloud services were found to consume more energy than the traditional form. The developed model in this research took into consideration the energy consumption at the three main stages of data transmission; data center, network, and end user device. Comparable products from each suite were selected and activities were defined for each product to represent a different computing type. Microsoft provided highly confidential data for the data center stage, while the networking and user device stages were measured directly. A new measurement and software apportionment approach was defined and utilized allowing the power consumption of cloud services to be directly measured for the user device stage. Results indicated that cloud computing is more energy efficient for Excel and Outlook which consumed less energy and emitted less GHG than the standalone counterpart. The power consumption of the cloud based Outlook (8%) and Excel (17%) was lower than their traditional counterparts. However, the power consumption of the cloud version of Word was 17% higher than its traditional equivalent. A third mixed access method was also measured for Word which emitted 5% more GHG than the traditional version. It is evident that cloud computing may not provide a unified way forward to reduce energy consumption and GHG. Direct conversion from the standalone package into the cloud provision platform can now consider energy and GHG emissions at the software development and cloud service design stage using the methods described in this research.

Collaboration model for SSMEnetUK: a service science perspective

This paper aims to design a collaboration model for a Knowledge Community - SSMEnetUK. The research identifies SSMEnetUK as a socio-technical system and uses the core concepts of Service Science to explore the subject domain. The paper is positioned within the concept of Knowledge Management (KM) and utilising Web 2.0 tools for collaboration. A qualitative case study method was adopted and multiple data sources were used. In achieving that, the degree of co-relation between knowledge management activities and Web 2.0 tools for collaboration in the scenario are pitted against the concept of value propositions offered by both customer/user and service provider. The proposed model provides a better understanding of how Knowledge Management and Web 2.0 tools can enable effective collaboration within SSMEnetUK. This research is relevant to the wider service design and innovation community because it provides a basis for building a service-centric collaboration platform for the benefit of both customer/user and service provider.

Importance of resolution and model configuration when downscaling extreme precipitation

Dynamical downscaling is frequently used to investigate the dynamical variables of extra-tropical cyclones, for example, precipitation, using very high-resolution models nested within coarser resolution models to understand the processes that lead to intense precipitation. It is also used in climate change studies, using long timeseries to investigate trends in precipitation, or to look at the small-scale dynamical processes for specific case studies. This study investigates some of the problems associated with dynamical downscaling and looks at the optimum configuration to obtain the distribution and intensity of a precipitation field to match observations. This study uses the Met Office Unified Model run in limited area mode with grid spacings of 12, 4 and 1.5 km, driven by boundary conditions provided by the ECMWF Operational Analysis to produce high-resolution simulations for the Summer of 2007 UK flooding events. The numerical weather prediction model is initiated at varying times before the peak precipitation is observed to test the importance of the initialisation and boundary conditions, and how long the simulation can be run for. The results are compared to raingauge data as verification and show that the model intensities are most similar to observations when the model is initialised 12 hours before the peak precipitation is observed. It was also shown that using non-gridded datasets makes verification more difficult, with the density of observations also affecting the intensities observed. It is concluded that the simulations are able to produce realistic precipitation intensities when driven by the coarser resolution data.

Urban integrated meteorological observations: practice and experience in Shanghai, China

Observations of atmospheric conditions and processes in citiesare fundamental to understanding the interactions between the urban surface and weather/climate, improving the performance of urban weather, air quality and climate models, and providing key information for city end-users (e.g. decision-makers, stakeholders, public). In this paper, Shanghai's urban integrated meteorological observation network (SUIMON) and some examples of intended applications are introduced. Its characteristics include being: multi- purpose (e.g. forecast, research, service), multi-function (high impact weather, city climate, special end-users), multi-scale (e.g. macro/meso-, urban-, neighborhood, street canyon), multi-variable (e.g. thermal, dynamic, chemical, bio-meteorological, ecological), and multi- platform (e.g. radar, wind profiler, ground-based, satellite based, in-situ observation/ sampling). Underlying SUIMON is a data management system to facilitate exchange of data and information. The overall aim of the network is to improve coordination strategies and instruments; to identify data gaps based on science and user driven requirements; and to intelligently combine observations from a variety of platforms by using a data assimilation system that is tuned to produce the best estimate of the current state of the urban atmosphere.

Evaluation of boundary-layer type in a weather forecast model utilising long-term Doppler lidar observations

Many studies evaluating model boundary-layer schemes focus either on near-surface parameters or on short-term observational campaigns. This reflects the observational datasets that are widely available for use in model evaluation. In this paper we show how surface and long-term Doppler lidar observations, combined in a way to match model representation of the boundary layer as closely as possible, can be used to evaluate the skill of boundary-layer forecasts. We use a 2-year observational dataset from a rural site in the UK to evaluate a climatology of boundary layer type forecast by the UK Met Office Unified Model. In addition, we demonstrate the use of a binary skill score (Symmetric Extremal Dependence Index) to investigate the dependence of forecast skill on season, horizontal resolution and forecast leadtime. A clear diurnal and seasonal cycle can be seen in the climatology of both the model and observations, with the main discrepancies being the model overpredicting cumulus capped and decoupled stratocumulus capped boundary-layers and underpredicting well mixed boundary-layers. Using the SEDI skill score the model is most skillful at predicting the surface stability. The skill of the model in predicting cumulus capped and stratocumulus capped stable boundary layer forecasts is low but greater than a 24 hr persistence forecast. In contrast, the prediction of decoupled boundary-layers and boundary-layers with multiple cloud layers is lower than persistence. This process based evaluation approach has the potential to be applied to other boundary-layer parameterisation schemes with similar decision structures.

Annotating climate data with commentary: the CHARMe project

The CHARMe project enables the annotation of climate data with key pieces of supporting information that we term “commentary”. Commentary reflects the experience that has built up in the user community, and can help new or less-expert users (such as consultants, SMEs, experts in other fields) to understand and interpret complex data. In the context of global climate services, the CHARMe system will record, retain and disseminate this commentary on climate datasets, and provide a means for feeding back this experience to the data providers. Based on novel linked data techniques and standards, the project has developed a core system, data model and suite of open-source tools to enable this information to be shared, discovered and exploited by the community.