Potential advantages in heat and power production when biogas is collected from several digesters using dedicated pipelines - A case study in the "Province of West-Flanders" (Belgium)

In the case study “West-Flanders” costs of electricity and heat production are estimated if a dedicated biogas grid using pipelines would be implemented to centralize energy production in a region. Heat may not be used effectively at digester sites, e.g. because of a change in treatment of digestate. A large scale centralized combined heat and power (CHP) engine can produce additional electrical power at a hub, i.e. central collection point, and has lower specific costs compared to decentralized CHPs at digester sites. A biogas transport model is used to calculate transport costs in a grid. These costs, partly balanced by a scale advantage in CHP costs, are attributed to the additional electrical energy (80%) and heat (20%) produced. If the hub is at a digester site, costs of additional electricity can be as low as 4.0 €ct kWhe−1 and are in many cases below 12 €ct kWhe−1, i.e. in the same order of magnitude or lower than costs of electricity from biogas produced using separate CHPs at the different digester sites; costs of heat at the hub show to be lower than 1 €ct kWhth−1 assuming an effective heat use of 50%. In case a hub is situated at a location with high potential heat demand, i.e. a heat sink, transport of biogas from one digester only to a central located hub can provide 3.4 MWth of heat at 1.95 €ct kWhth−1. For such a centrally located hub additional electrical energy costs show to be slightly higher, but with three or more digesters these costs are lower than 20 €ct kWhe−1 and heat costs are around 0.5 €ct kWhth−1. With a centralized hub more renewable energy is produced, i.e. a more efficient use of biomass feedstock. It is concluded that costs for additional electricity and heat can be at a competing level and scale advantages in a CHP can be a driver to collect biogas at a hub using a biogas grid

Do national policies for complaint handling in English hospitals support quality improvement? Lessons from a case study

Background. A range of public inquiries in the English National Health Service have indicated repeating failings in complaint handling, and patients are often left dissatisfied. The complex, bureaucratic nature of complaints systems is often cited as an obstacle to meaningful investigation and learning, but a detailed examination of how such bureaucratic rules, regulations, and infrastructure shape complaint handling, and where change is most needed, remains relatively unexplored. Methods. Through staff interviews and documentary analysis, we examined how complaints are handled, investigated, and monitored within an acute NHS trust rated as well-performing in complaint handling. We sought to examine how national policies structure local practices of complaint handling, how are they understood by those responsible for enacting them within local practice, and if there are any discrepancies between policies-as-intended and their reality in local practice. Results. Findings illustrate four areas of practice where national policies and regulations result in adverse consequences in local practices, and partly function to undermine an improvement-focused approach to complaints. These include muddled routes for raising formal complaints, investigative procedures structured to scrutinize the ‘validity’ of complaints, irreliable data collection systems, and adverse incentives and workarounds resulting from bureaucratic performance targets. Conclusion. This study demonstrates how national policies and regulations for complaint handling can impede, rather than promote, quality improvement in local settings. Accordingly, we propose a number of necessary reforms, including patient involvement in complaints investigations, the establishment of independent investigation bodies, and more meaningful data analysis strategies to uncover and address systemic causes behind recurring complaints

Learning from complaints in healthcare: a realist review of academic literature, policy evidence and front-line insights

Introduction: A global rise in patient complaints has been accompanied by growing research to effectively analyse complaints for safer, more patient-centric care. Most patients and families complain to improve the quality of healthcare, yet progress has been complicated by a system primarily designed for case-by-case complaint handling. Aim: To understand how to effectively integrate patient-centric complaint handling with quality monitoring and improvement. Method: Literature screening and patient codesign shaped the review's aim in the first stage of this three-stage review. Ten sources were searched including academic databases and policy archives. In the second stage, 13 front-line experts were interviewed to develop initial practice-based programme theory. In the third stage, evidence identified in the first stage was appraised based on rigour and relevance, and selected to refine programme theory focusing on what works, why and under what circumstances. Results: A total of 74 academic and 10 policy sources were included. The review identified 12 mechanisms to achieve: patient-centric complaint handling and system-wide quality improvement. The complaint handling pathway includes (1) access of information; (2) collaboration with support and advocacy services; (3) staff attitude and signposting; (4) bespoke responding; and (5) public accountability. The improvement pathway includes (6) a reliable coding taxonomy; (7) standardised training and guidelines; (8) a centralised informatics system; (9) appropriate data sampling; (10) mixed-methods spotlight analysis; (11) board priorities and leadership; and (12) just culture. Discussion: If healthcare settings are better supported to report, analyse and use complaints data in a standardised manner, complaints could impact on care quality in important ways. This review has established a range of evidence-based, short-term recommendations to achieve this

Evidence for a shared etiological mechanism of psychotic symptoms and obsessive-compulsive symptoms in patients with psychotic disorders and their siblings

The prevalence of obsessive-compulsive disorder in subjects with psychotic disorder is much higher than in the general population. The higher than chance co-occurrence has also been demonstrated at the level of subclinical expression of both phenotypes. Both extended phenotypes have been shown to cluster in families. However, little is known about the origins of their elevated co-occurrence. In the present study, evidence for a shared etiological mechanism was investigated in 3 samples with decreasing levels of familial psychosis liability: 987 patients, 973 of their unaffected siblings and 566 healthy controls. The association between the obsessive-compulsive phenotype and the psychosis phenotype c.q. psychosis liability was investigated. First, the association was assessed between (subclinical) obsessive-compulsive symptoms and psychosis liability. Second, in a cross-sib cross-trait analysis, it was examined whether (subclinical) obsessive-compulsive symptoms in the patient were associated with (subclinical) psychotic symptoms in the related unaffected sibling. Evidence was found for both associations, which is compatible with a partially shared etiological pathway underlying obsessive-compulsive and psychotic disorder. This is the first study that used a cross-sib cross-trait design in patients and unaffected siblings, thus circumventing confounding by disease-related factors present in clinical samples

Neurocognitive functioning in school-aged cystinosis patients

Contains fulltext : 89600.pdf (publisher's version ) (Closed access)INTRODUCTION: Cystinosis is an autosomal recessive disorder leading to intralysosomal cystine accumulation in various tissues. It causes renal Fanconi syndrome and end stage renal failure around the age of 10 years if not treated with cysteamine. Children with cystinosis seem to have a normal intelligence but frequently show learning difficulties. These problems may be due to specific neurocognitive deficits rather than impaired renal function. Whether cysteamine treatment can improve cognitive functioning of cystinosis patients is thus far unknown. We aim to analyze neurocognitive functioning of school-aged cystinosis patients treated with cysteamine in order to identify specific deficits that can lead to learning difficulties. PATIENTS AND METHODS: Fourteen Dutch and Belgian school-aged cystinosis patients were included. Glomerular filtration rate was estimated using the Schwartz formula. Children were tested for general intelligence, visual-motor integration, inhibition, interference, sustained attention, accuracy, planning, visual memory, processing speed, motor planning, fluency and speed, and behavioural and emotional functioning using standardized methods. RESULTS: Glomerular filtration rate ranged from 22 to 120 ml min(-1) 1.73 m(-2). Median full-scale intelligence was below the average of a normal population (87, range 60-132), with a discrepancy between verbal (median 95, range 60-125) and performance (median 87, range 65-130) intelligence. Over 50% of the patients scored poorly on visual-motor integration, sustained attention, visual memory, planning, or motor speed. The other tested areas showed no differences between patients' and normal values. CONCLUSION: Neurocognitive diagnostics are indicated in cystinosis patients. Early recognition of specific deficits and supervision from special education services might reduce learning difficulties and improve school careers.1 december 201

The COMPASS Experiment at CERN

The COMPASS experiment makes use of the CERN SPS high-intensitymuon and hadron beams for the investigation of the nucleon spin structure and the spectroscopy of hadrons. One or more outgoing particles are detected in coincidence with the incoming muon or hadron. A large polarized target inside a superconducting solenoid is used for the measurements with the muon beam. Outgoing particles are detected by a two-stage, large angle and large momentum range spectrometer. The setup is built using several types of tracking detectors, according to the expected incident rate, required space resolution and the solid angle to be covered. Particle identification is achieved using a RICH counter and both hadron and electromagnetic calorimeters. The setup has been successfully operated from 2002 onwards using a muon beam. Data with a hadron beam were also collected in 2004. This article describes the main features and performances of the spectrometer in 2004; a short summary of the 2006 upgrade is also given.Comment: 84 papes, 74 figure

Emotional design and human-robot interaction

Recent years have shown an increase in the importance of emotions applied to the Design field - Emotional Design. In this sense, the emotional design aims to elicit (e.g., pleasure) or prevent (e.g., displeasure) determined emotions, during human product interaction. That is, the emotional design regulates the emotional interaction between the individual and the product (e.g., robot). Robot design has been a growing area whereby robots are interacting directly with humans in which emotions are essential in the interaction. Therefore, this paper aims, through a non-systematic literature review, to explore the application of emotional design, particularly on Human-Robot Interaction. Robot design features (e.g., appearance, expressing emotions and spatial distance) that affect emotional design are introduced. The chapter ends with a discussion and a conclusion.info:eu-repo/semantics/acceptedVersio

X-shooter, the new wide band intermediate resolution spectrograph at the ESO Very Large Telescope

X-shooter is the first 2nd generation instrument of the ESO Very Large Telescope(VLT). It is a very efficient, single-target, intermediate-resolution spectrograph that was installed at the Cassegrain focus of UT2 in 2009. The instrument covers, in a single exposure, the spectral range from 300 to 2500 nm. It is designed to maximize the sensitivity in this spectral range through dichroic splitting in three arms with optimized optics, coatings, dispersive elements and detectors. It operates at intermediate spectral resolution (R~4,000 - 17,000, depending on wavelength and slit width) with fixed echelle spectral format (prism cross-dispersers) in the three arms. It includes a 1.8"x4" Integral Field Unit as an alternative to the 11" long slits. A dedicated data reduction package delivers fully calibrated two-dimensional and extracted spectra over the full wavelength range. We describe the main characteristics of the instrument and present its performance as measured during commissioning, science verification and the first months of science operations.Comment: accepted for publication in A&

The IAXO Helioscope

The IAXO (International Axion Experiment) is a fourth generation helioscope with a sensitivity, in terms of detectable signal counts, at least 104 better than CAST phase-I, resulting in sensitivity on ga¿ one order of magnitude better. To achieve this performance IAXO will count on a 8-coil toroidal magnet with 60 cm diameter bores and equipped with X-ray focusing optics into 0.20 cm2 spots coupled to ultra-low background Micromegas X-ray detectors. The magnet will be on a platform that will allow solar tracking for 12 hours per day. The next short term objectives are to prepare a Technical Design Report and to construct the first prototypes of the hardware main ingredients: demonstration coil, X-ray optics and low background detector while refining the physics case and studying the feasibility studies for Dark Matter axions