Critical care in childbearing for midwives

Many women who have higher–risk pregnancies, complications or medical conditions require specialist obstetric or multidisciplinary care. Increasingly women, whose condition deteriorates and becomes critical during childbirth, are being cared for by midwives in obstetric high dependency units within the labour ward, rather than being cared for by nurses in ITU. Critical Care in Childbearing for Midwives explores all aspects of management, support and care of childbearing women who become critically ill due to pre–existing conditions or who develop critical illness as a result of complications of childbearing. It examines predisposing factors which result in the need for critical care, addresses specialist monitoring technology and skills, and explores autonomous practice and team approaches to providing care for critically ill women in childbearing.

A conceptual framework for designing pharmaceutical reverse logistics networks in China

Over latest decade, Reverse Logistics (RL) has gained more and more attention from both industry and academia. In the past, most research on RL has been focused on automobile, electronic waste, computer, paper, package and package material. There is very little research and practice on drug recycling. Nevertheless, it is vital important to properly dispose expired drug because of hazardous contain which may harm to people and environment. In China, public awareness of the harmfulness of expired drugs is still very low and very few efforts have been made to recycle drugs. Therefore, this research aims to build up a conceptual framework to indentify factors of influencing drug recycling in China, from scratch borrowing from existing literature and industry practices in other recycling areas. This framework helps in designing reverse logistic (RL) network and also can provide a useful reference tool for policymakers at the local and national level. Furthermore, a primary research is planed to validate the framework and RL network.

Impacts of climate change on marine ecosystem production in societies dependent on fisheries

Growing human populations and changing dietary preferences are increasing global demands for fish, adding pressure to concerns over fisheries sustainability. Here we develop and link models of physical, biological and human responses to climate change in 67 marine national exclusive economic zones, which yield approximately 60% of global fish catches, to project climate change yield impacts in countries with different dependencies on marine fisheries. Predicted changes in fish production indicate increased productivity at high latitudes and decreased productivity at low/mid latitudes, with considerable regional variations. With few exceptions, increases and decreases in fish production potential by 2050 are estimated to be <10% (mean C3.4%) from present yields. Among the nations showing a high dependency on fisheries, climate change is predicted to increase productive potential in West Africa and decrease it in South and Southeast Asia. Despite projected human population increases and assuming that per capita fish consumption rates will be maintained1, ongoing technological development in the aquaculture industry suggests that projected global fish demands in 2050 could be met, thus challenging existing predictions of inevitable shortfalls in fish supply by the mid-twenty-first century. This conclusion, however, is contingent on successful implementation of strategies for sustainable harvesting and effective distribution of wild fish products from nations and regions with a surplus to those with a deficit. Changes in management effectiveness2 and trade practices5 will remain the main influence on realized gains or losses in global fish production.

Within-Otolith Variability in Chemical Fingerprints: Implications for Sampling Designs and Possible Environmental Interpretation

Largely used as a natural biological tag in studies of dispersal/connectivity of fish, otolith elemental fingerprinting is usually analyzed by laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS). LA-ICP-MS produces an elemental fingerprint at a discrete time-point in the life of a fish and can generate data on within-otolith variability of that fingerprint. The presence of within-otolith variability has been previously acknowledged but not incorporated into experimental designs on the presumed, but untested, grounds of both its negligibility compared to among-otolith variability and of spatial autocorrelation among multiple ablations within an otolith. Here, using a hierarchical sampling design of spatial variation at multiple scales in otolith chemical fingerprints for two Mediterranean coastal fishes, we explore: 1) whether multiple ablations within an otolith can be used as independent replicates for significance tests among otoliths, and 2) the implications of incorporating within-otolith variability when assessing spatial variability in otolith chemistry at a hierarchy of spatial scales (different fish, from different sites, at different locations on the Apulian Adriatic coast). We find that multiple ablations along the same daily rings do not necessarily exhibit spatial dependency within the otolith and can be used to estimate residual variability in a hierarchical sampling design. Inclusion of within-otolith measurements reveals that individuals at the same site can show significant variability in elemental uptake. Within-otolith variability examined across the spatial hierarchy identifies differences between the two fish species investigated, and this finding leads to discussion of the potential for within-otolith variability to be used as a marker for fish exposure to stressful conditions. We also demonstrate that a 'cost'-optimal allocation of sampling effort should typically include some level of within-otolith replication in the experimental design. Our findings provide novel evidence to aid the design of future sampling programs and improve our general understanding of the mechanisms regulating elemental fingerprints.

Coastal Zone Ecosystem Services: From science to values and decision making; a case study

This research is concerned with the following environmental research questions: socio-ecological system complexity, especially when valuing ecosystem services; ecosystems stock and services flow sustainability and valuation; the incorporation of scale issues when valuing ecosystem services; and the integration of knowledge from diverse disciplines for governance and decision making. In this case study, we focused on ecosystem services that can be jointly supplied but independently valued in economic terms: healthy climate (via carbon sequestration and storage), food (via fisheries production in nursery grounds), and nature recreation (nature watching and enjoyment). We also explored the issue of ecosystem stock and services flow, and we provide recommendations on how to value stock and flows of ecosystem services via accounting and economic values respectively. We considered broadly comparable estuarine systems located on the English North Sea coast: the Blackwater estuary and the Humber estuary. In the past, these two estuaries have undergone major land-claim. Managed realignment is a policy through which previously claimed intertidal habitats are recreated allowing the enhancement of the ecosystem services provided by saltmarshes. In this context, we investigated ecosystem service values, through biophysical estimates and welfare value estimates. Using an optimistic (extended conservation of coastal ecosystems) and a pessimistic (loss of coastal ecosystems because of, for example, European policy reversal) scenario, we find that context dependency, and hence value transfer possibilities, vary among ecosystem services and benefits. As a result, careful consideration in the use and application of value transfer, both in biophysical estimates and welfare value estimates, is advocated to supply reliable information for policy making.

What are the local impacts of energy systems on marine ecosystem services: a systematic map protocol

Background: Increasing concentrations of atmospheric greenhouse gases (GHG) and its impact on the climate has resulted in many international governments committing to reduce their GHG emissions. The UK, for example, has committed to reducing its carbon emissions by 80% by 2050. Suggested ways of reaching such a target are to increase dependency on offshore wind, offshore gas and nuclear. It is not clear, however, how the construction, operation and decommissioning of these energy systems will impact marine ecosystem services, i.e. the services obtained by people from the natural environment such as food provisioning, climate regulation and cultural inspiration. Research on ecosystem service impacts associated with offshore energy technologies is still in its infancy. The objective of this review is to bolster the evidence base by firstly, recording and describing the impacts of energy technologies at the marine ecosystems and human level in a consistent and transparent way; secondly, to translate these ecosystem and human impacts into ecosystem service impacts by using a framework to ensure consistency and comparability. The output of this process will be an objective synthesis of ecosystem service impacts comprehensive enough to cover different types of energy under the same analysis and to assist in informing how the provision of ecosystem services will change under different energy provisioning scenarios. Methods: Relevant studies will be sourced using publication databases and selected using a set of selection criteria including the identification of: (i) relevant subject populations such as marine and coastal species, marine habitat types and the general public; (ii) relevant exposure types including offshore wind farms, offshore oil and gas platforms and offshore structures connected with nuclear; (iii) relevant outcomes including changes in species structure and diversity; changes in benthic, demersal and pelagic habitats; and changes in cultural services. The impacts will be synthesised and described using a systematic map. To translate these findings into ecosystem service impacts, the Common International Classification of Ecosystem Services (CICES) and Millennium Ecosystem Assessment (MEA) frameworks are used and a detailed description of the steps taken provided to ensure transparency and replicability.

Intercultural competence in the area of drug dependencies

This article takes a multidimensional or biopsychosocial conception of drug dependency as its starting point. Within this analytical framework, we advocate making the intercultural dimension more visible, since it is essential for the design and implementation of integral intervention processes. We propose intercultural competence as a working model that can increase the capacities of institutions and professionals —a particularly important consideration in the case of social work— in order to effectively address the aforementioned cultural dimension. After an extensive review of the scientific literature, we have defined five processes that can contribute to strengthening an institution’s intercultural competence and four processes that can do the same for a professional’s intercultural competence. Though selected for application in the area of drug dependencies, all these processes can also prove useful in improving attention to any other kind of culturally diverse group or person.

Measurement of oxygen storage capacity in automotive catalysts

There is considerable disagreement in the literature on available oxygen storage capacity, and on the reaction rates associated with the storage process, for three-way automotive catalysts. This paper seeks to address the issue of oxygen storage capacity in a clear and precise manner. The work described involved a detailed investigation of oxygen storage capacity in typical samples of automotive catalysts. The capacity has also been precisely defined and estimates have been made of the specific capacity based on catalyst dimensions. A purpose-built miniature catalyst test rig has been assembled to allow measurement of the capacity and the experimental procedure has been developed to ensure accurate measurement. The measurements from the first series of experiments have been compared with the theoretical calculations and good agreement is seen. A second series of experiments allowed the effect of temperature on oxygen storage capacity to be investigated. This work shows very clearly the large variation of the capacity with temperature.

The Development of a Two-Dimensional Transient Catalyst Model for Direct Injection Two-Stroke Applications.

This paper describes the development of a two-dimensional transient catalyst model. Although designed primarily for two-stroke direct injection engines, the model is also applicable to four-stroke lean burn and diesel applications. The first section describes the geometries, properties and chemical processes simulated by the model and discusses the limitations and assumptions applied. A review of the modeling techniques adopted by other researchers is also included. The mathematical relationships which are used to represent the system are then described, together with the finite volume method used in the computer program. The need for a two-dimensional approach is explained and the methods used to model effects such as flow and temperature distribution are presented. The problems associated with developing surface reaction rates are discussed in detail and compared with published research. Validation and calibration of the model is achieved by comparing predictions with measurements from a flow reactor. While an extensive validation process, involving detailed measurements of gas composition and thermal gradients, has been completed, the analysis is too detailed for publication here and is the subject of a separate technical paper.

The Validation of a Two-Dimensional Transient Catalyst Model for Direct Injection Two-Stroke Applications

This paper describes the detailed validation of a computer model designed to simulate the transient light-off in a two-stroke oxidation catalyst. A plug flow reactor is employed to provide measurements of temperature and gas concentration at various radial and axial locations inside the catalyst. These measurements are recorded at discrete intervals during a transient light-off in which the inlet temperature is increased from ambient to 300oC at rates of up to 6oC/sec. The catalyst formulation used in the flow reactor, and its associated test procedures, are then simulated by the computer and a comparison made between experimental readings and model predictions. The design of the computer model to which this validation exercise relates is described in detail in a separate technical paper. The first section of the paper investigates the warm-up characteristics of the substrate and examines the validity of the heat transfer predictions between the wall and the gas in the absence of chemical reactions. The predictions from a typical single-component CO transient light-off test are discussed in the second section and are compared with experimental data. In particular the effect of the temperature ramp on the light-off curve and reaction zone development is examined. An analysis of the C3H6 conversion is given in the third section while the final section examines the accuracy of the light-off curves which are produced when both CO and C3H6 are present in the feed gas. The analysis shows that the heat and mass transfer calculations provided reliable predictions of the warm-up behaviour and post light-off gas concentration profiles. The self-inhibition and cross-inhibition terms in the global rate expressions were also found to be reasonably reliable although the surface reaction rates required calibration with experimental data.

Modelling of Unsteady Gas-Dynamic Flow in a Pipe and at its Exit Using CFD

Traditionally the simulation of the thermodynamic aspects of the internal combustion engine has been undertaken using one-dimensional gas-dynamic models to represent the intake and exhaust systems. CFD analysis of engines has been restricted to modelling of in-cylinder flow structures. With the increasing accessibility of CFD software it is now worth considering its use for complete gas-dynamic engine simulation. This paper appraises the accuracy of various CFD models in comparison to a 1D gas-dynamic simulation. All of the models are compared to experimental data acquired on an apparatus that generates a single gas-dynamic pressure wave. The progress of the wave along a constant area pipe and its subsequent reflection from the open pipe end are recorded with a number of high speed pressure transducers. It was found that there was little to choose between the accuracy of the 1D model and the best CFD model. The CFD model did not require experimentally derived loss coefficients to accurately represent the open pipe end; however, it took several hundred times longer to complete its analysis. The best congruency between the CFD models and the experimental data was achieved using the RNG k-e turbulence model. The open end of the pipe was most effectively represented by surrounding it with a relatively small volume of cells connected to the rest of the environment using a pressure boundary.

A Home from Hospital service for older people.

Current policy and practice emphasises much more than ever before a need for purchasers and providers to reduce appropriately the length of hospital stay. Consequently, a number of early discharge “schemes” have been developed. This paper presents the findings from an evaluation of a “home from hospital” (HFH) scheme. The HFH service provides a maximum of six weeks intensive domiciliary care for older people on their discharge from hospital. The aim of the service is to facilitate early discharge from hospital and to assist patients to regain independence. The study reported here elicited the views and perceptions of clients and professionals involved in the HFH scheme about the quality, efficiency and effectiveness of the service. Seventy-five clients were discharged from hospital to the HFH scheme during a two month period and those who consented to participate in the study were interviewed after discharge from the HFH service (n = 40). Participants had attended hospital for various conditions but the largest group were fracture patients. Hospital staff and community based professionals completed a questionnaire about the service. Overall, clients and professionals perceived the HFH scheme as a beneficial service, though some minor problems existed at an individual level. Clients’ dependency levels generally decreased during their time on the scheme. Research using a controlled design is necessary in order to draw firm conclusions about the cost-effectiveness of a HFH service. Overall, home-from-hospital appears to be an effective model of an early discharge scheme worthy of further attention.