Learning, development, and support needs of community palliative care clinical nurse specialists

Background: The palliative care clinical nurse specialist (PC-CNS) is a core member of the specialist palliative care team. According to professional policy, the role has four specific components: clinical practice, education, research, and leadership and management. Little is known about how to support staff in this role. Aim: The aim of this study was to explore what learning, development, and support PC-CNSs in one hospice need to enable them to fulfil all components of their role. Design: Using a descriptive exploratory approach, semi-structured interviews were undertaken with a purposive sample of community PC-CNSs from a hospice in Northern Ireland. Interviews were audio-recorded, transcribed verbatim, and thematically analysed. Findings: Seventeen interviews were analysed and three themes identified: influence of organisational culture, influence of the individual, and learning and development solutions. Conclusions: Participants reported that the PC-CNS role was stressful. They identified that the organisational culture and indeed individuals themselves influenced the learning and development support available to help them fulfil the four components of the role. Working relationships and stability within teams affected how supported individuals felt and had implications for managers in meeting the needs of staff while balancing the needs of the service.

Vitamin D analogs differentially control antimicrobial peptide/"alarmin" expression in psoriasis

Antimicrobial peptides (AMPs) are strongly expressed in lesional skin in psoriasis and play an important role as proinflammatory "alarmins" in this chronic skin disease. Vitamin D analogs like calcipotriol have antipsoriatic effects and might mediate this effect by changing AMP expression. In this study, keratinocytes in lesional psoriatic plaques showed decreased expression of the AMPs beta-defensin (HBD) 2 and HBD3 after topical treatment with calcipotriol. At the same time, calcipotriol normalized the proinflammatory cytokine milieu and decreased interleukin (IL)-17A, IL-17F and IL-8 transcript abundance in lesional psoriatic skin. In contrast, cathelicidin antimicrobial peptide expression was increased by calcipotriol while psoriasin expression remained unchanged. In cultured human epidermal keratinocytes the effect of different vitamin D analogs on the expression of AMPs was further analyzed. All vitamin D analogs tested blocked IL-17A induced HBD2 expression by increasing IkappaB-alpha protein and inhibition of NF-kappaB signaling. At the same time vitamin D analogs induced cathelicidin through activation of the vitamin D receptor and MEK/ERK signaling. These studies suggest that vitamin D analogs differentially alter AMP expression in lesional psoriatic skin and cultured keratinocytes. Balancing AMP "alarmin" expression might be a novel goal in treatment of chronic inflammatory skin diseases.

HERQULES:System level cross-layer design exploration for efficient energy-quality trade-offs

In this paper, we present a unique cross-layer design framework that allows systematic exploration of the energy-delay-quality trade-offs at the algorithm, architecture and circuit level of design abstraction for each block of a system. In addition, taking into consideration the interactions between different sub-blocks of a system, it identifies the design solutions that can ensure the least energy at the "right amount of quality" for each sub-block/system under user quality/delay constraints. This is achieved by deriving sensitivity based design criteria, the balancing of which form the quantitative relations that can be used early in the system design process to evaluate the energy efficiency of various design options. The proposed framework when applied to the exploration of energy-quality design space of the main blocks of a digital camera and a wireless receiver, achieves 58% and 33% energy savings under 41% and 20% error increase, respectively. © 2010 ACM.

A dynamic sampling methodology for plasma etch processes using Gaussian process regression

Plasma etch is a key process in modern semiconductor manufacturing facilities as it offers process simplification and yet greater dimensional tolerances compared to wet chemical etch technology. The main challenge of operating plasma etchers is to maintain a consistent etch rate spatially and temporally for a given wafer and for successive wafers processed in the same etch tool. Etch rate measurements require expensive metrology steps and therefore in general only limited sampling is performed. Furthermore, the results of measurements are not accessible in real-time, limiting the options for run-to-run control. This paper investigates a Virtual Metrology (VM) enabled Dynamic Sampling (DS) methodology as an alternative paradigm for balancing the need to reduce costly metrology with the need to measure more frequently and in a timely fashion to enable wafer-to-wafer control. Using a Gaussian Process Regression (GPR) VM model for etch rate estimation of a plasma etch process, the proposed dynamic sampling methodology is demonstrated and evaluated for a number of different predictive dynamic sampling rules. © 2013 IEEE.

Flexible energetics of cheetah hunting strategies provide resistance against kleptoparasitism

Population viability is driven by individual survival, which in turn depends on individuals balancing energy budgets. As carnivores may function close to maximum sustained power outputs, decreased food availability or increased activity may render some populations energetically vulnerable. Prey theft may compromise energetic budgets of mesopredators, such as cheetahs and wild dogs, which are susceptible to competition from larger carnivores. We show that daily energy expenditure (DEE) of cheetahs was similar to size-based predictions and positively related to distance traveled. Theft at 25% only requires cheetahs to hunt for an extra 1.1 hour per day, increasing DEE by just 12%. Therefore, not all mesopredators are energetically constrained by direct competition. Other factors that increase DEE, such as those that increase travel, may be more
important for population viability.

Proportionality in Age Discrimination Cases - a Model Suitable for Socially Embedded Rights

This chapter discusses the use of proportionality in age discrimination cases before the Court of Justice of the European Union. It argues that the Court does not use this concept systematically - indeed it exposes some contradiction that make the case law seem arbitrary - and proposes a more fruitful use of the principle, which is in line with a modern conception of human rights. The chapter argues that the principle of proportionality stems from the time when human rights served the recently liberated burgeois elite in guarding their rights to property and liberty against the state. Today, states not only respect human rights (which is fully sufficient for this elite, who can rely on their inherited wealth to fend for themselves). They also protect and promote human rights, and these activities are a precondition for human rights to be practically relevant for the whole population. This also means that state activity, which is experienced as a limitation of rights to property and liberty by some, may constitute a measure to promote and protect human rights of others. In employment law - the only field where the EU ban on age discrimination is applied - this is a typical situation. If such a situation occurs, the principle of proportionality must be applied in a bifurcated way.It is not sufficient that the limitation of property rights is proportionate for the achievement of a public policy aim. If the aim of public policy is to enable the effective use of human rights, the limitation of the state action must be proportionate to the protection and promotion of those human rights. It is argued that the principle of proportionality is superior to less structures balancing acts (e.g. the Wednesbury principle), if it is applied both ways. Going over to the field of age discrimination, the chapter identifies a number of potentially colliding aims pursued in this field. Banning age discrimination may relate to genuine aims of anti-discrimination law if bias against older or very young workers is addressed. However, the EU ban of discrimination against all ages also serves to restructure employment law and policy to the age of flexibilisation, replacing the synchronisation principle that has been predominant for the welfare states of the 20th century. The former aim is related to human rights protection, while the latter aim is not (at least not always). This has consequences for applying the proportionality test. The chapter proposes different ways to argue the most difficult age discrimination cases, where anti-discrimination rationales and flexibilisation rationales clash

Compiler and Runtime Support for Hybrid Static/Dynamic Scheduling

One of the outstanding issues in parallel computing is the selection of task granularity. This work proposes a solution to the task granularity problem by lowering the overhead of the task scheduler and as such supporting very fine-grain tasks. Using a combination of static (compile-time) scheduling and dynamic (run-time) scheduling, we aim to make scheduling decisions as fast as with static scheduling while retaining the dynamic load- balancing properties of fully dynamic scheduling. We present an example application and discuss the requirements on the compiler and runtime system to realize hybrid static/dynamic scheduling.

Evidence of locally enhanced target heating due to instabilities of counter-streaming fast electron beams

The high-current fast electron beams generated in high-intensity laser-solid interactions require the onset of a balancing return current in order to propagate in the target material. Such a system of counter-streaming electron currents is unstable to a variety of instabilities such as the current-filamentation instability and the two-stream instability. An experimental study aimed at investigating the role of instabilities in a system of symmetrical counter-propagating fast electron beams is presented here for the first time. The fast electron beams are generated by double-sided laser-irradiation of a layered target foil at laser intensities above 10(19) W/cm(2). High-resolution X-ray spectroscopy of the emission from the central Ti layer shows that locally enhanced energy deposition is indeed achieved in the case of counter-propagating fast electron beams

Unsteady tip leakage characteristics and heat transfer on turbine blade tip and casing

An unsteady numerical investigation was performed to examine time dependent behaviors of the tip leakage flow structures and heat transfer on the rotor blade tip and casing in a single stage gas turbine engine. A transonic, high-pressure
turbine stage was modeled and simulated using a stage pressure ratio of 3.2. The rotor’s tip clearance was 1.2 mm in height (3% of the rotor span) and its speed was set at 9500 rpm. Periodic flow is observed for each vane passing period. Tip leakage flow as well as heat transfer data showed highly time dependent behaviors. A stator trailing edge shock appears as the turbine stage is operating at transonic conditions. The shock alters the flow condition in the rotor section, namely, the tip leakage flow structures and heat transfer rate distributions. The instantaneous Nusselt number distributions are compared to the time averaged and steady-state results. The same patterns in tip leakage flow
structures and heat transfer rate distributions were observed in both unsteady and steady simulations. However, the unsteady simulation captured the locally time-dependent high heat transfer phenomena caused by the unsteady interaction with the upstream vane trailing-edge shock and the passing wake.

Computational scheduling methods for integrating plug-in electric vehicles with power systems: a review

Traditional internal combustion engine vehicles are a major contributor to global greenhouse gas emissions and other air pollutants, such as particulate matter and nitrogen oxides. If the tail pipe point emissions could be managed centrally without reducing the commercial and personal user functionalities, then one of the most attractive solutions for achieving a significant reduction of emissions in the transport sector would be the mass deployment of electric vehicles. Though electric vehicle sales are still hindered by battery performance, cost and a few other technological bottlenecks, focused commercialisation and support from government policies are encouraging large scale electric vehicle adoptions. The mass proliferation of plug-in electric vehicles is likely to bring a significant additional electric load onto the grid creating a highly complex operational problem for power system operators. Electric vehicle batteries also have the ability to act as energy storage points on the distribution system. This double charge and storage impact of many uncontrollable small kW loads, as consumers will want maximum flexibility, on a distribution system which was originally not designed for such operations has the potential to be detrimental to grid balancing. Intelligent scheduling methods if established correctly could smoothly integrate electric vehicles onto the grid. Intelligent scheduling methods will help to avoid cycling of large combustion plants, using expensive fossil fuel peaking plant, match renewable generation to electric vehicle charging and not overload the distribution system causing a reduction in power quality. In this paper, a state-of-the-art review of scheduling methods to integrate plug-in electric vehicles are reviewed, examined and categorised based on their computational techniques. Thus, in addition to various existing approaches covering analytical scheduling, conventional optimisation methods (e.g. linear, non-linear mixed integer programming and dynamic programming), and game theory, meta-heuristic algorithms including genetic algorithm and particle swarm optimisation, are all comprehensively surveyed, offering a systematic reference for grid scheduling considering intelligent electric vehicle integration.

Domestic fridge-freezer load aggregation to support ancillary services

Grid operators and electricity retailers in Ireland manage peak demand, power system balancing and grid congestion by offering relevant incentives to consumers to reduce or shift their load. The need for active consumers in the home using smart appliances has never been greater, due to increased variable renewable generation and grid constraints. In this paper an aggregated model of a single compressor fridge-freezer population is developed. A price control strategy is examined to quantify and value demand response savings during a representative winter and summer week for Ireland in 2020. The results show an average reduction in fridge-freezer operating cost of 8.2% during winter and significantly lower during summer in Ireland. A peak reduction of at least 68% of the average winter refrigeration load is achieved consistently during the week analysed using a staggering control mode. An analysis of the current ancillary service payments confirms that these are insufficient to ensure widespread uptake by the small consumer, and new mechanisms need to be developed to make becoming an active consumer attractive. Demand response is proposed as a new ancillary service called ramping capability, as the need for this service will increase with more renewable energy penetration on the power system.

What do high penetrations of wind power mean for gas generation?

Dependency on thermal generation and continued wind power growth in Europe due to renewable energy and greenhouse gas emissions targets has resulted in an interesting set of challenges for power systems. The variability of wind power impacts dispatch and balancing by grid operators, power plant operations by generating companies and market wholesale costs. This paper quantifies the effects of high wind power penetration on power systems with a dependency on gas generation using a realistic unit commitment and economic dispatch model. The test system is analyzed under two scenarios, with and without wind, over one year. The key finding of this preliminary study is that despite increased ramping requirements in the wind scenario, the unit cost of electricity due to sub-optimal operation of gas generators does not show substantial deviation from the no wind scenario.

A techno-economic feasibility study of high altitude wind power in Northern Ireland

Globally the amount of installed terrestrial wind power both onshore and offshore has grown rapidly over the last twenty years. Most large onshore and offshore wind turbines are designed to harvest winds within the atmospheric boundary layer, which can be vary variable due to terrain and weather effects. The height of the neutral atmospheric boundary layer is estimated at above 1300m. A relatively new concept is to harvest more consistent wind conditions above the atmospheric boundary layer using high altitude wind harvesting devices such as tethered kites, air foils and dirigible rotors. This paper presents a techno-economic feasibility study of high altitude wind power in Northern Ireland. First this research involved a state of the art review of the resource and the technologies proposed for high altitude wind power. Next the techno-economic analysis involving four steps is presented. In step one, the potential of high altitude wind power in Northern Ireland using online datasets (e.g. Earth System Research Laboratory) is estimated. In step two a map for easier visualisation of geographical limitations (e.g. airports, areas of scenic beauty, flight paths, military training areas, settlements etc.) that could impact on high altitude wind power is developed. In step three the actual feasible resource available is recalculated using the visualisation map to determine the ‘optimal’ high altitude wind power locations in Northern Ireland. In the last step four the list of equipment, resources and budget needed to build a demonstrator is provided in the form of a concise techno-economic appraisal using the findings of the previous three steps.

A Numerical Study of Inlet Geometry for a Low Inertia Mixed Flow Turbocharger Turbine

Mixed flow turbines can offer improvements over typical radial turbines used in automotive turbochargers, with regards to transient performance and low velocity ratio efficiency. Turbine rotor mass dominates the rotating inertia of the turbocharger, and any reductions of mass in the outer radii of the wheel, including the rotor back-disk, can significantly reduce this inertia and improve the acceleration of the assembly. Off-design, low velocity ratio conditions are typified by highly tangential flow at the rotor inlet and a non-zero inlet blade angle is preferred for such operating conditions. This is achievable in a Mixed Flow Turbine without increasing bending stresses within the rotor blade, which is beneficial in high speed and high inlet temperature turbine design. A range of mixed flow turbine rotors was designed with varying cone angle and inlet blade angle and each was assessed at a number of operating points. These rotors were based on an existing radial flow turbine, and both the hub and shroud contours and exducer geometry were maintained. The inertia of each rotor was also considered. The results indicated that there was a trade-off between efficiency and inertia for the rotors and certain designs may be beneficial for the transient performance of downsized, turbocharged engines.

Developed turbulence and nonlinear amplification of magnetic fields in laboratory and astrophysical plasmas

The visible matter in the universe is turbulent and magnetized. Turbulence in galaxy clusters is produced by mergers and by jets of the central galaxies and believed responsible for the amplification of magnetic fields. We report on experiments looking at the collision of two laser-produced plasma clouds, mimicking, in the laboratory, a cluster merger event. By measuring the spectrum of the density fluctuations, we infer developed, Kolmogorov-like turbulence. From spectral line broadening, we estimate a level of turbulence consistent with turbulent heating balancing radiative cooling, as it likely does in galaxy clusters. We show that the magnetic field is amplified by turbulent motions, reaching a nonlinear regime that is a precursor to turbulent dynamo. Thus, our experiment provides a promising platform for understanding the structure of turbulence and the amplification of magnetic fields in the universe.