A rare presentation of micro-angiopathic haemolytic anaemia in a critically ill patient: a case report

A 36-year-old woman presents to hospital peri-arrest with hypertension, sustained loss of consciousness following a tonic clonic seizure and a micropathic haemolytic anaemia on blood film. After initial resuscitation, more specialised treatment was instigated as the diagnosis became clearer but all was not as it first seemed. This case demonstrates the importance of re-examination, especially in the critically ill, in conjunction with unusual laboratory tests in order to eventually reach a rare diagnosis of a rare presentation

Preparing for the Rising Tide

On October 29, 2012, one of the largest Atlantic basin storms in recorded history hit the East Coast. Although Superstorm Sandy centered around New Jersey and New York when it made landfall, the massive storm system spanned 1,000 miles north to south, over three times the size of a typical hurricane. Luckily for Boston, Sandy’s storm surge hit the city near low tide, causing relatively minor coastal flooding. Had the storm hit 5½ hours earlier, 6.6 percent of the city could have been flooded, with floodwaters reaching City Hall. Events such as Superstorm Sandy highlight the growing relevance of climate change and draw attention to the importance of taking steps today to be prepared for the likely events of tomorrow. Preparing for the Rising Tide provides policy makers, planners and property owners with site-specific examples of how to assess vulnerability and increase resilience to coastal flooding over time. The United Nations Intergovernmental Panel on Climate Change (IPCC) defines vulnerability as the degree to which a system is susceptible to, and unable to cope with, adverse effects of climate change, including climate variability and extremes.” Vulnerability assessments focus action on highly sensitive populations, locations and infrastructure. Preparedness plans need to be robust enough to handle any future condition, and/or flexible enough change over time to meet needs as they arise. Ideally they include “no-regret” and co-benefit” solutions that extend beyond flood control goals. Cost-effective preparedness plans will result in both “here and now” and “prepare and monitor” actions based on threshold triggers such as sea level rise. Previous reports have described a range of large-scale adaptation strategies. This report takes those recommendations and applies them to specific properties in Boston. Some cities such as Seattle, WA and Charleston, SC are developing “floodable zones” that preserve the city’s access to its waterfront while minimizing damage when periodic flooding occurs. This concept of “living with water” is an option to consider in Boston as well

The managerial ombudsman

This article identifies a major development in the role and practice of the ombudsman. It argues that the New Public Management practices that have transformed public administration in the last 30 years have led to a more managerial approach to the ombudsman's work. The article's argument is developed through analysis of an empirical case study of the Scottish Public Services Ombudsman, which illustrates how the aims and techniques of managerialism have been deployed in the ombudsman context. The article evaluates the significance of these developments for the ombudsman institution and for the wider justice system. It examines the risks and opportunities inherent in this turn to managerialism and whether it represents a departure from the ombudsman's mission or a necessary adaptation to a changed world of public administration. In identifying the rise of the ‘managerial ombudsman’, the article provides a new framework for conceptualising developments in the modern ombudsman institution

Carbon Capture and Storage in Scotland and the European Union

Carbon capture and storage (CCS) is critical to decarbonising power sector and industrial emissions, and achieving climate mitigation targets. With world-leading decarbonisation targets, a large and mature hydrocarbon sector, existing pipeline infrastructure and extensive opportunities for geological CO2 storage under the North Sea, Scotland is uniquely placed to both deliver and benefit from CCS. The technology has the potential to enable major emissions reductions towards the Scottish Government's 2050 target - it can directly address over 50% of current total emissions from Scotland's energy sector and industry. Geological CO2 storage offshore Scotland represents a resource of European significance, which could securely contain many decades' worth of power and industrial emissions from across the European Union.Carbon capture and storage (CCS) is critical to decarbonising power sector and industrial emissions, and achieving climate mitigation targets. With world-leading decarbonisation targets, a large and mature hydrocarbon sector, existing pipeline infrastructure and extensive opportunities for geological CO2 storage under the North Sea, Scotland is uniquely placed to both deliver and benefit from CCS. The technology has the potential to enable major emissions reductions towards the Scottish Government's 2050 target - it can directly address over 50% of current total emissions from Scotland's energy sector and industry. Geological CO2 storage offshore Scotland represents a resource of European significance, which could securely contain many decades' worth of power and industrial emissions from across the European Union

Progress on Carbon Capture and Storage in the UK

Response to the Energy and Climate Change Select Committee call for evidenceResponse to the Energy and Climate Change Select Committee call for evidenc

Briefing: Carbon capture and storage in Scotland

With world-leading decarbonisation targets, a large and mature hydrocarbon sector, existing pipeline infrastructure and extensive opportunities for geological CO2 storage under the North Sea, Scotland is uniquely placed to deliver and benefit from carbon capture and storage (CCS). CCS has the potential to enable major Scottish emissions reductions towards the 2050 target - it can directly address over 50% of current total emissions from energy and industry.With world-leading decarbonisation targets, a large and mature hydrocarbon sector, existing pipeline infrastructure and extensive opportunities for geological CO2 storage under the North Sea, Scotland is uniquely placed to deliver and benefit from carbon capture and storage (CCS). CCS has the potential to enable major Scottish emissions reductions towards the 2050 target - it can directly address over 50% of current total emissions from energy and industry

Planning policy and the deployment of Carbon Capture and Storage in Scotland

Response to the Consultations on NPF3 and SPP, July 2013Response to the Consultations on NPF3 and SPP, July 201

The future of carbon capture and storage in Europe Response to COM (2013) 180

The future of carbon capture and storage in Europe Response to COM (2013) 180 finalThe future of carbon capture and storage in Europe Response to COM (2013) 180 fina

Carbon Capture and Storage in the EU's 2030 climate and energy framework

SCCS Policy Briefing and Recommendations for European Council Carbon Capture and Storage in the EU's 2030 climate and energy frameworkSCCS Policy Briefing and Recommendations for European Council Carbon Capture and Storage in the EU's 2030 climate and energy framewor