Operational expenditure costs for wave energy projects and impacts on financial returns

This paper examines 'availability' and the input metrics of operational expenditure (OPEX) for wave energy projects and reports on a case study which assesses the impact of these inputs on project profit returns. Case study simulations modelled a 75 MW wave energy project at two locations; the west coast of Ireland and the north coast of Portugal. Access and availability with respect to weather windows at both locations are discussed and their impact on energy output and wave farm operations is quantified. The input metrics used to calculate OPEX of wave energy projects are defined as well as the impact of OPEX on project net present value (NPV) and internal rate of return (IRR). Results indicate that access and resultant availability factors have a significant impact on case study results by reducing energy output and correspondingly financial returns. Furthermore, the technology maturity level designated for a project also impacts on availability factors and consequently energy output and NPV. Case study profits proved to be very sensitive to annual OPEX, especially if overhaul and replacement costs were accounted for. As a result of the impact of 'availability' on project profit returns. Feed-in tariffs will need to be tailored to the location in question as well as the device technology maturity level, with case study simulations indicating that high FIT will be required to support early stage WEC projects. (C) 2012 Elsevier Ltd. All rights reserved

Decision aids for people facing health treatment or screening decisions (Review)

Background Decision aids prepare people to participate in ’close call’ decisions that involve weighing benefits, harms, and scientific uncertainty. Objectives To conduct a systematic review of randomised controlled trials (RCTs) evaluating the efficacy of decision aids for people facing difficult treatment or screening decisions. Search strategy We searched MEDLINE (Ovid) (1966 to July 2006); Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library; 2006, Issue 2); CINAHL (Ovid) (1982 to July 2006); EMBASE (Ovid) (1980 to July 2006); and PsycINFO (Ovid) (1806 to July 2006). We contacted researchers active in the field up to December 2006. There were no language restrictions. Selection criteria We included published RCTs of interventions designed to aid patients’ decision making by providing information about treatment or screening options and their associated outcomes, compared to no intervention, usual care, and alternate interventions. We excluded studies in which participants were not making an active treatment or screening decision, or if the study’s intervention was not available to determine that it met the minimum criteria to qualify as a patient decision aid. Data collection and analysis Two review authors independently screened abstracts for inclusion, and extracted data from included studies using standardized forms. The primary outcomes focused on the effectiveness criteria of the International Patient Decision Aid Standards (IPDAS) Collaboration: attributes of the decision and attributes of the decision process. We considered other behavioural, health, and health system effects as secondary outcomes. We pooled results of RCTs using mean differences (MD) and relative risks (RR) using a random effects model. Main results This update added 25 new RCTs, bringing the total to 55. Thirty-eight (69%) used at least one measure that mapped onto an IPDAS effectiveness criterion: decision attributes: knowledge scores (27 trials); accurate risk perceptions (11 trials); and value congruence with chosen option (4 trials); and decision process attributes: feeling informed (15 trials) and feeling clear about values (13 trials). This review confirmed the following findings from the previous (2003) review. Decision aids performed better than usual care interventions in terms of: a) greater knowledge (MD 15.2 out of 100; 95% CI 11.7 to 18.7); b) lower decisional conflict related to feeling uninformed (MD -8.3 of 100; 95% CI -11.9 to -4.8); c) lower decisional conflict related to feeling unclear about personal values (MD -6.4; 95% CI -10.0 to -2.7); d) reduced the proportion of people who were passive in decision making (RR 0.6; 95% CI 0.5 to 0.8); and e) reduced proportion of people who remained undecided post-intervention (RR 0.5; 95% CI 0.3 to 0.8). When simpler decision aids were compared to more detailed decision aids, the relative improvement was significant in knowledge (MD 4.6 out of 100; 95% CI 3.0 to 6.2) and there was some evidence of greater agreement between values and choice. In this review, we were able to explore the use of probabilities in decision aids. Exposure to a decision aid with probabilities resulted in a higher proportion of people with accurate risk perceptions (RR 1.6; 95% CI 1.4 to 1.9). The effect was stronger when probabilities were measured quantitatively (RR 1.8; 95% CI 1.4 to 2.3) versus qualitatively (RR 1.3; 95% CI 1.1 to 1.5). As in the previous review, exposure to decision aids continued to demonstrate reduced rates of: elective invasive surgery in favour of conservative options, decision aid versus usual care (RR 0.8; 95% CI 0.6 to 0.9); and use of menopausal hormones, detailed versus simple aid (RR 0.7; 95% CI 0.6 to 1.0). There is now evidence that exposure to decision aids results in reduced PSA screening, decision aid versus usual care (RR 0.8; 95% CI 0.7 to 1.0) . For other decisions, the effect on decisions remains variable. As in the previous review, decision aids are no better than comparisons in affecting satisfaction with decision making, anxiety, and health outcomes. The effects of decision aids on other outcomes (patient-practitioner communication, consultation length, continuance, resource use) were inconclusive. There were no trials evaluating the IPDAS decision process criteria relating to helping patients to recognize a decision needs to be made, understand that values affect the decision, or discuss values with the practitioner. Authors’ conclusions Patient decision aids increase people’s involvement and are more likely to lead to informed values-based decisions; however, the size of the effect varies across studies. Decision aids have a variable effect on decisions. They reduce the use of discretionary surgery without apparent adverse effects on health outcomes or satisfaction. The degree of detail patient decision aids require for positive effects on decision quality should be explored. The effects on continuance with chosen option, patient-practitioner communication, consultation length, and cost-effectiveness need further evaluation. This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2009, Issue 3. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.</p

Field Theory Entropy, the HH-theorem and the Renormalization Group

We consider entropy and relative entropy in Field theory and establish relevant monotonicity properties with respect to the couplings. The relative entropy in a field theory with a hierarchy of renormalization group fixed points ranks the fixed points, the lowest relative entropy being assigned to the highest multicritical point. We argue that as a consequence of a generalized $H$ theorem Wilsonian RG flows induce an increase in entropy and propose the relative entropy as the natural quantity which increases from one fixed point to another in more than two dimensions.Comment: 25 pages, plain TeX (macros included), 6 ps figures. Addition in title. Entropy of cutoff Gaussian model modified in section 4 to avoid a divergence. Therefore, last figure modified. Other minor changes to improve readability. Version to appear in Phys. Rev.

Cohort profile: the avon longitudinal study of parents and children: ALSPAC mothers cohort

The Avon Longitudinal Study of Children and Parents (ALSPAC) was established to understand how genetic and environmental characteristics influence health and development in parents and children. All pregnant women resident in a defined area in the South West of England, with an expected date of delivery between 1st April 1991 and 31st December 1992, were eligible and 13 761 women (contributing 13 867 pregnancies) were recruited. These women have been followed over the last 19–22 years and have completed up to 20 questionnaires, have had detailed data abstracted from their medical records and have information on any cancer diagnoses and deaths through record linkage. A follow-up assessment was completed 17–18 years postnatal at which anthropometry, blood pressure, fat, lean and bone mass and carotid intima media thickness were assessed, and a fasting blood sample taken. The second follow-up clinic, which additionally measures cognitive function, physical capability, physical activity (with accelerometer) and wrist bone architecture, is underway and two further assessments with similar measurements will take place over the next 5 years. There is a detailed biobank that includes DNA, with genome-wide data available on &gt;10 000, stored serum and plasma taken repeatedly since pregnancy and other samples; a wide range of data on completed biospecimen assays are available. Details of how to access these data are provided in this cohort profile

Cesagen response to Nuffield Council on bioethics consultation on novel neurotechnologies:intervening in the brain

In what follows, we do not answer every question [by the Nuffield Council on Bioethics). We first proceed with our comments, referring to the numbered questions as appropriate. Thereafter, we give a case study from recent studies within Cesagen to illustrate more general insights for public policy. Case study 1 illustrates some of the complications that arise in public consultation about human enhancement, in particular, with reference to idealistic perceptions which are strongly influenced by long-term popular imaginations about the future of humans and their societies. As we said in a response to a previous consultation, our position is that attention needs to be paid to how the technologies and the associated issues are framed – ethically, politically, scientifically, and by whom. This includes how a given technology is itself described (typically well before it actually exists, if it comes to do so); the claims made for its purported benefits; how stakeholders are conceptualised; how social-cultural aspects will evolve. Such framing is not exclusively a scientific and technological matter but involves cultural and social imaginations as well as artistic ones

The influence of online images on self-harm: A qualitative study of young people aged 16-24

To date, research on the role of the Internet in self-harm has focused on young people's interaction via the medium of text, with limited consideration of the effect of images. This qualitative study explores how young people understand and use online images of self-harm. Semi-structured interviews were conducted with a community sample of 21 individuals aged 16–24 living in Wales, UK, with a previous history of self-harm. Interviewees reported the role of the Internet in normalising young people's self-harm. Images rather than textual interactions are the primary reason cited for using the Internet for self-harm purposes. Images invoke a physical reaction and inspire behavioural enactment, with Tumblr, which permits the sharing of images by anonymous individuals, being the preferred platform. Viewing online images serves a vital role in many young people's self-harm, as part of ritualistic practice. Online prevention and intervention need to attend to the importance of images

What is Trauma-Informed Care?

Trauma-informed care is a popular term used today, yet its application and how it is applied varies. This article will address: what is trauma? what is trauma-informed care (TIC) ? and examples of how to apply the guiding principles of TIC into practice

Parental Substance Abuse As an Early Traumatic Event. Preliminary Findings on Neuropsychological and Personality Functioning in Young Drug Addicts Exposed to Drugs Early.

open5noParental substance use is a major risk factor for child development, heightening the risk of drug problems in adolescence and young adulthood, and exposing offspring to several types of traumatic events. First, prenatal drug exposure can be considered a form of trauma itself, with subtle but long-lasting sequelae at the neuro-behavioral level. Second, parents’ addiction often entails a childrearing environment characterized by poor parenting skills, disadvantaged contexts and adverse childhood experiences (ACEs), leading to dysfunctional outcomes. Young adults born from/raised by parents with drug problems and diagnosed with a Substance Used Disorder (SUD) themselves might display a particularly severe condition in terms of cognitive deficits and impaired personality function. This preliminary study aims to investigate the role of early exposure to drugs as a traumatic event, capable of affecting the psychological status of young drug addicts. In particular, it intends to examine the neuropsychological functioning and personality profile of young adults with severe SUDs who were exposed to drugs early in their family context. The research involved three groups, each consisting of 15 young adults (aged 18–24): a group of inpatients diagnosed with SUDs and exposed to drugs early, a comparison group of non-exposed inpatients and a group of non-exposed youth without SUDs. A neuropsychological battery (Esame Neuropsicologico Breve-2), an assessment procedure for personality disorders (Shedler-Westen Assessment Procedure-200) and the Symptom CheckList-90-Revised were administered. According to present preliminary results, young drug addicts exposed to drugs during their developmental age were characterized by elevated rates of neuropsychological impairments, especially at the expense of attentive and executive functions (EF); personality disorders were also common but did not differentiate them from non-exposed youth with SUDs. Alternative multi-focused prevention and intervention programs are needed for children of drug-misusing parents, addressing EF and adopting a trauma-focused approach.openParolin, Micol; Simonelli, Alessandra; Mapelli, Daniela; Sacco, M.; Cristofalo, P.Parolin, Micol; Simonelli, Alessandra; Mapelli, Daniela; Sacco, M.; Cristofalo, P