247 research outputs found

    The UK market for energy service contracts in 2014–2015

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    This paper provides an overview of the UK market for energy service contracts in 2014 and highlights the growing role of intermediaries. Using information from secondary literature and interviews, it identifies the businesses offering energy service contracts, the sectors and organisations that are purchasing those contracts, the types of contract that are available, the areas of market growth and the reasons for that growth. The paper finds that the UK market is relatively large, highly diverse, concentrated in particular sectors and types of site and overwhelmingly focused upon established technologies with high rates of return. A major driver is the emergence of procurement frameworks for energy service contracts in the public sector. These act as intermediaries between clients and contractors, thereby lowering transaction costs and facilitating learning. The market is struggling to become established in commercial offices, largely as a result of split incentives, and is unlikely to develop further in this sector without different business models, tenancy arrangements and policy initiatives. Overall, the paper concludes that energy service contracts can play an important role in the transition to a low-carbon economy, especially when supported by intermediaries, but their potential is still limited by high transaction costs

    "The missing ingredient":The patient perspective of health related quality of life in bronchiectasis: a qualitative study

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    Abstract Background Bronchiectasis is a heterogeneous disease which affects quality of life. Measuring symptoms and quality of life has proved challenging and research is limited by extrapolation of questionnaires and treatments from other diseases. The objective of this study was to identify the major contributors to quality of life in bronchiectasis and to evaluate existing health related quality of life questionnaires in bronchiectasis. Methods Eight adults with bronchiectasis participated in one to one semi-structured interviews. These were recorded and transcribed verbatim. Thematic analysis was used to identify core themes relevant to disease burden and impact. Participant views on current health related quality of life questionnaires were also surveyed. Results Bronchiectasis symptoms are highly individual. Core themes identified were symptom burden, symptom variation, personal measurement, quality of life and control of symptoms. Themes contributing to quality of life were: social embarrassment, sleep disturbance, anxiety and modification of daily and future activities. Evaluation of 4 existing questionnaires established their individual strengths and weaknesses. A synthesis of the participants’ perspective identified desirable characteristics to guide future tool development. Conclusions: This qualitative study has identified core themes associated with symptoms and quality of life in bronchiectasis. Current treatments and quality of life tools do not fully address or capture the burden of disease in bronchiectasis from the patients’ perspective

    Reactor physics project final report

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    "September 30, 1970."Statement of responsibility on title-page reads: Editors, M. J. Driscoll, I. Kaplan, D. D. Lanning, N. C. Rasmussen. Contributors: V. K. Agarwala, F. M. Clikeman, M. J. Driscoll, Y. Hukai, L. L. Izzo, I. Kaplan, M. S. Kazimi, D.D. Lanning, T.C. Leung, E.L. McFarland, N.C. Rasmussen, S.S. Seth, G.E. Sullivan, and A.T. SuppleIncludes bibliographical referencesFinal report; January 1, 1968 to September 30, 1970This is the final report in an experimental and theoretical program to develop and apply single- and few-element methods for the determination of reactor lattice parameters. The period covered by the report is January 1, 1968 through September 30, 1970. In addition to summarizing results for the entire contract period, this report also serves as the final annual report; thus, work completed in the period of October 1, 1969 through September 30, 1970 is dealt with in more detail than the earlier work. Methods were developed to measure the heterogeneous parameters 17, [Gamma] [eta] and [Alpha] for single fuel elements immersed in moderator in an exponential tank using foil activation measurements external to the fuel. These methods were applied to clustered fuel rods in D 20 moderator and single fuel rods in H 20 moderator, and the results were extended to and compared with data on complete multi-element lattices reported by other laboratories. Advanced gamma spectrometric methods using Ge(Li) detectors were applied to the analysis of both prompt and fission product decay gammas for the nondestructive analysis of the fuel used in this work. The latter includes both simulated burned fuel containing plutonium and actual burned fuel irradiated to 20,000 MWD/T in the Dresden BWR.U.S. Atomic Energy Commission contract AT (30-1)-394

    Capillary filling with pseudo-potential binary Lattice-Boltzmann model

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    We present a systematic study of capillary filling for a binary fluid by using a mesoscopic lattice Boltzmann model for immiscible fluids describing a diffusive interface moving at a given contact angle with respect to the walls. The phenomenological way to impose a given contact angle is analysed. Particular attention is given to the case of complete wetting, that is contact angle equal to zero. Numerical results yield quantitative agreement with the theoretical Washburn law, provided that the correct ratio of the dynamic viscosities between the two fluids is used. Finally, the presence of precursor films is experienced and it is shown that these films advance in time with a square-root law but with a different prefactor with respect to the bulk interface.Comment: 13 pages, 8 figures, accepted for publication on The European journal of physics

    Design and characteristics of the prophylactic intra-operative ventricular arrhythmia ablation in high-risk LVAD candidates (PIVATAL) trial

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    BACKGROUND: The use of a Left Ventricular Assist Device (LVAD) in patients with advanced heart failure refractory to optimal medical management has progressed steadily over the past two decades. Data have demonstrated reduced LVAD efficacy, worse clinical outcome, and higher mortality for patients who experience significant ventricular tachyarrhythmia (VTA). We hypothesize that a novel prophylactic intra-operative VTA ablation protocol at the time of LVAD implantation may reduce the recurrent VTA and adverse events postimplant. METHODS: We designed a prospective, multicenter, open-label, randomized-controlled clinical trial enrolling 100 patients who are LVAD candidates with a history of VTA in the previous 5 years. Enrolled patients will be randomized in a 1:1 fashion to intra-operative VTA ablation (n = 50) versus conventional medical management (n = 50) with LVAD implant. Arrhythmia outcomes data will be captured by an implantable cardioverter defibrillator (ICD) to monitor VTA events, with a uniform ICD programming protocol. Patients will be followed prospectively over a mean of 18 months (with a minimum of 9 months) after LVAD implantation to evaluate recurrent VTA, adverse events, and procedural outcomes. Secondary endpoints include right heart function/hemodynamics, healthcare utilization, and quality of life. CONCLUSION: The primary aim of this first-ever randomized trial is to assess the efficacy of intra-operative ablation during LVAD surgery in reducing VTA recurrence and improving clinical outcomes for patients with a history of VTA

    Intoxicants and the invention of 'consumption'

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    In 1600 the word ‘consumption’ was a term of medical pathology describing the ‘wasting, petrification of things’. By 1700 it was also a term of economic discourse: ‘In commodities, the value rises as its quantity is less and vent greater, which depends upon it being preferred in its consumption’. The article traces the emergence of this key category of economic analysis to debates over the economy in the 1620s and subsequent disputes over the excise tax, showing how ‘consumption’ was an early term in the developing lexicon of political economy. In so doing the article demonstrates the important role of ‘intoxicants’ – i.e. addictive and intoxicating commodities like alcohols and tobaccos – in shaping these early meanings and uses of ‘consumption’. It outlines the discursive importance of intoxicants, both as the foci for discussions of ‘superfluous’ and ‘necessary’ consumption and the target of legislation on consumption. And it argues that while these discussions had an ideological dimension, or dimensions, they were also responses to material increases in the volume and diversity of intoxicants in early seventeenth-century England. By way of conclusion the article suggests the significance of the Low Countries as a point of reference for English writers, as well as a more capacious and semantically sensitive approach to changes in early-modern consumption practices

    Epithelial dysregulation in obese severe asthmatics with gastro-oesophageal reflux

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    The role of war in deep transitions: exploring mechanisms, imprints and rules in sociotechnical systems

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    This paper explores in what ways the two world wars influenced the development of sociotechnical systems underpinning the culmination of the first deep transition. The role of war is an underexplored aspect in both the Techno-Economic Paradigms (TEP) approach and the Multi-level perspective (MLP) which form the two key conceptual building blocks of the Deep Transitions (DT) framework. Thus, we develop a conceptual approach tailored to this particular topic which integrates accounts of total war and mechanisms of war from historical studies and imprinting from organisational studies with the DT framework’s attention towards rules and meta-rules. We explore in what ways the three sociotechnical systems of energy, food, and transport were affected by the emergence of new demand pressures and logistical challenges during conditions of total war; how war impacted the directionality of sociotechnical systems; the extent to which new national and international policy capacities emerged during wartime in the energy, food, and transport systems; and the extent to which these systems were influenced by cooperation and shared sacrifice under wartime conditions. We then explore what lasting changes were influenced by the two wars in the energy, food, and transport systems across the transatlantic zone. This paper seeks to open up a hitherto neglected area in analysis on sociotechnical transitions and we discuss the importance of further research that is attentive towards entanglements of warfare and the military particularly in the field of sustainability transitions

    The mystery of the cerebellum: clues from experimental and clinical observations

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    Abstract The cerebellum has a striking homogeneous cytoarchitecture and participates in both motor and non-motor domains. Indeed, a wealth of evidence from neuroanatomical, electrophysiological, neuroimaging and clinical studies has substantially modified our traditional view on the cerebellum as a sole calibrator of sensorimotor functions. Despite the major advances of the last four decades of cerebellar research, outstanding questions remain regarding the mechanisms and functions of the cerebellar circuitry. We discuss major clues from both experimental and clinical studies, with a focus on rodent models in fear behaviour, on the role of the cerebellum in motor control, on cerebellar contributions to timing and our appraisal of the pathogenesis of cerebellar tremor. The cerebellum occupies a central position to optimize behaviour, motor control, timing procedures and to prevent body oscillations. More than ever, the cerebellum is now considered as a major actor on the scene of disorders affecting the CNS, extending from motor disorders to cognitive and affective disorders. However, the respective roles of the mossy fibres, the climbing fibres, cerebellar cortex and cerebellar nuclei remains unknown or partially known at best in most cases. Research is now moving towards a better definition of the roles of cerebellar modules and microzones. This will impact on the management of cerebellar disorders
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