Ashurst Hospital

Despite the intense debate on the advantages and disadvantages of adopting integrated supervision that has taken place in recent years, little is known about the experiences of countries that have adopted it and the obstacles and challenges they have faced to implement it. In an attempt to shed light on this area, the authors present the results of a survey conducted in a group of 15 countries that have adopted integrated supervision. After a brief review of the literature on integrated supervision, the authors examine four topics: 1) The reasons cited by this group of countries for establishing an integrated supervisory agency. 2) The scope of regulatory and supervisory powers of these agencies. 3) The progress of these agencies in harmonizing their regulatory and supervisory practices across the intermediaries they supervise. 4) The practical problems faced by policymakers in adopting integrated supervision. The survey revealed that the group of integrated supervisory agencies is not as homogeneous as it seems. Important differences arise with regard to the scope of regulatory and supervisory powers the agencies have been given. In fact, contrary to popular belief, less than 50 percent of the agencies can be categorized as mega-supervisors. Another finding is that in most countries progress toward the harmonization of prudential regulation and supervision across financial intermediaries remains limited. Interestingly, the survey revealed that practically all countries believe they have achieved a higher degree of harmonization in the regulation and supervision of banks and securities companies than between banks and insurance firms. The survey also identified some practical problems faced by this group of countries in establishing their unified supervisory agencies. The authors discuss these problems, along with the practical lessons and recommendations provided by the 15 agencies to other countries considering integrated supervision, in the final section of the paper.

BACKGROUND: The effectiveness of parent training (PT) when delivered as part of specialist tier-two services for preschool AD/HD children has been recently demonstrated. AIMS: To assess the effectiveness of the same PT programme when delivered as part of routine primary care by non-specialist nurses. METHOD: A sample of 89 3-year-old children with preschool AD/HD took part in a controlled trial of an eight-week (one hour a week), health visitor delivered, PT package. Children, allocated randomly to PT (n = 59) and waiting list control (WLC; n = 30) groups, were compared. RESULTS: PT did not reduce AD/HD symptoms. Maternal well-being decreased in both PT and WLC groups. CONCLUSIONS: While PT is an effective intervention for preschool AD/HD when delivered in specialized settings, these benefits do not appear to generalize when programme are delivered as part of routine primary care by non-specialist nurses.

Abstract The boundary element method (BEM) was used to study galvanic corrosion using linear and logarithmic boundary conditions. The linear boundary condition was implemented by using the linear approach and the piecewise linear approach. The logarithmic boundary condition was implemented by the piecewise linear approach. The calculated potential and current density distribution were compared with the prior analytical results. For the linear boundary condition, the BEASY program using the linear approach and the piecewise linear approach gave accurate predictions of the potential and the galvanic current density distributions for varied electrolyte conditions, various film thicknesses, various electrolyte conductivities and various area ratio of anode/cathode. The 50‐point piecewise linear method could be used with both linear and logarithmic polarization curves.

This book analyses the complex relationship between corporate governance and economic development by focusing on the reform of corporate governance, the role of the legal system, and the interconnections with the financial system.

Thermal analysis of two-dimensional and three-dimensional two-layer device structures have been carried out using the boundary element method (BEM). The resulting thermal profiles for two different device structures agree very well with those obtained using analytical solutions. This agreement indicates not only the accuracy of the BEM but also the correct derivation of the analytical solutions.< <ETX xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">&gt;</ETX>

Abstract Boundary element formulations employing time‐independent fundamental solutions are becoming popular for treating transient problems described by parabolic or hyperbolic partial differential equations. This paper describes the extension of one such formulation, named the dual reciprocity boundary element method, to non‐linear transient heat conduction problems with temperature‐dependent material parameters and boundary conditions of the radiative type. The original non‐linear diffusion equation is solved in a transform space, where it appears in a pseudo‐linear form, since it contains a modified time variable which is itself a function of position. The problem is solved by using an iterative algorithm of the Newton‐Raphson type.

The computer simulation of galvanic corrosion systems has been shown to provide accurate information that can be used to improve design and avoid costly failure. The systems capability to model any general geometry coupled with the ability to accept a wide variety of forms of polarization data enables its effective use in a wide variety of marine and industrial applications. A number of cathodic protection applications are presented as a special case of galvanic corrosion.

Abstract The governing differential equation for the potential field in a typical electrolyte encountered in cathodic protection (e.g. seawater) is Laplace's equation. Green's second identity allows this equation to be written in Boundary Integral form which may be reduced to a system of linear algebraic equations using the techniques of Finite Elements. The resulting method is known as the Boundary Element Method. Since all the unknowns are on the boundary the system of equations is much smaller than that obtained using domain techniques such as the Finite Element or Finite Difference methods. Data preparation is similarly greatly reduced. Although the governing differential equation is linear, the boundary conditions are typically non-linear and time dependent due to the nature of the polarization curves which relate the potential and current density on anode and cathode. Fortunately, although the Boundary Element Method cannot easily model non-linearities within the domain, non-linear boundary conditions are easily incorporated. An example of the method applied to analyse the current density dis tributions on a real structure, a design for an oil production platform now under construction for the Worth Sea, gives some idea of the power and practicality of the method.

Previous research often emphasised the similarity of shareholder protection in common law (or English legal origin) countries. Conversely, this article found a remarkable diversity of shareholder protection in common law countries. Using our new shareholder protection index with 60 variables, we presented some graphical representations to highlight and discuss diversity across the UK, the US and India. Our study finds that the UK, the US and India do not only differ in the modes by which law on shareholder protection has changed over time but also in the mechanisms by which they protect shareholders or the areas of emphasis. For instance, we find that of the three countries, the Indian law on shareholder protection has changed the least due to judge-made law and contains the maximum number of provisions relating to public control or mandatory law as a mechanism for protecting shareholders. The UK law in relation to voting powers has improved over the concerned period with increased empowerment of the general meeting. With respect to the laws dealing with listed company variables, we find that in the UK the law improved steadily since the 1990s and in the US it particularly leaped in 2002. The laws in India in this regard really started developing only after the late 1980s and early 1990s with major improvements around 2001. Thus our study shows that even amongst three undoubtedly English legal origin countries the laws vary so much that their classification into one single group according to their legal origins seems almost naive. This also casts a doubt on the claim that a particular legal origin matters for the quality of law which in turn affects corporate growth and economic development.This paper is part of a wider research project. The related papers can be downloaded at http://ssrn.com/abstract=897479 and http://ssrn.com/abstract=940567.

The condition of coatings on the metallic surface of the hull of a vessel changes over its lifetime due to the action of the sea, deterioration of the paint itself, damage caused by impacts, etc. Although increased current demand from an impressed current cathodic protection (ICCP) system can indicate the presence of damage, the location and extent is unknown. The position, size and the seriousness of the damage are important issues from mainly two points of view. Corrosion: If the hull of the structure is corroded, the ship works inefficiently and can become dangerous from the crack initiation viewpoint. Noisiness of the vessel: As the damage proliferates along the hull structure, the current flux from the anode to the cathode also increases. This increases the noise of the vessel and makes it more detectable to an enemy from the defence point of view. The goal of this work is to find a reliable method to discover the state of the coating of a vessel by using the commonly available data of its system of cathodic protection, ICCP. Copyright © 2004 John Wiley & Sons, Ltd.

Computer simulation has been widely used to predict the corrosion related electric and electromagnetic signatures of naval vessels. The modelling strategy has varied from simple dipole type models to detailed boundary element models of the vessel and its environment. For the dipole models users have had to choose the location and strength of the dipoles based upon experience, using range data or data from similar vessels. Whereas the boundary element model enables the user to define the actual geometry of the vessel, the electrochemical properties of the materials and the properties of the environment as data to the model and obtain predictions of the electric and magnetic signatures.

Abstract Deepwater Oil &amp; Gas developments consist of many more components designed to extract, transport and store the oil when compared with developments in shallower waters. Designing the cathodic protection [CP] systems to protect the individual components is problematic without an appreciation as to how CP systems fitted to the various components will interact with one another once the entire asset is commissioned. For a recent deep-water project, a computer modeling study was commissioned to provide information on the performance of the CP systems protecting each of the subsea structures and in particular the interaction currents flowing between them. The principal aim was to ensure that the impressed current CP (ICCP) system on the hull of the FPSO would be operated in such a manner as to reduce interaction with the sub sea sacrificial anode CP (SACP) systems to the minimum possible throughout the operating life of the field and to develop an understanding of the probable behavior of CP systems on the key components (FPSO, Oil offloading lines &amp; Buoy, Riser Structures, etc.) particularly in respect of sacrificial anode lives. As CP monitoring data becomes available from the field, the intention is to further refine and develop the model as a working tool that will be used to provide input to Risk Based Inspection and maintenance planning. Information is now available from surveys carried out on the structure and the paper compares the model predictions with the measured data. The paper describes the strategy and rationale behind the modeling studies and some of the major lessons learned from the comparisons.

BACKGROUND: Over a 10-year period (1984-1996) a child guidance clinic developed a service in the community for parents with young children with mental health problems. This included support for primary care staff and training courses. The clinical input to the young children developed from a clinic within the child guidance clinic (1984-87), to a specialist clinic for under fives (1990-91) to a service run by a nurse in the community (1994-95), with nurses referring to colleagues only the more complicated cases. METHOD: The work in 1990-91 was compared with the work in 1994-95. The family and clinic scored the outcome of the work, by recording the severity of the problem, separately, on unanchored 5-point Likert scales before and after treatment. For the evaluation in 1994-95 a satisfaction questionnaire was also developed. The cost of running the two different clinics was calculated. RESULTS: The results indicated that there was a slight fall in the effect size for the clinical work in 1994-95, but this method of working was two-thirds of the cost of the previous clinic. The parents were satisfied with both services. The post-contact parental satisfaction questionnaire had face validity, construct validity and internal consistency. CONCLUSIONS: Nurses working on their own in the community can be a cost effective method for working with families with young children. Some families will need to be referred on to specialist teams and more work needs to be done to establish which families and when referral is appropriate. The questionnaire was shown to be a valid and reliable way of assessing family satisfaction.

Purpose To highlight ESG litigation risks and present an overview of the present landscape of ESG disputes in Europe – with a particular focus on England – and globally. Design/methodology/approach This article provides an overview of ESG factors, how they impact on companies, and potential claims that can arise from ESG issues. It also provides recommendations on how companies can prepare for, respond to, and ultimately resolve ESG disputes. Findings The number of ESG cases that are being brought (and won) by claimants in various courts around the world is rapidly increasing. There is a need for companies to prepare for, respond to, and resolve ESG disputes that they may become party to. Practical implications Companies need to take notice of the growing trend of ESG disputes and claims being brought, and in particular prepare for, respond to, and resolve them. Originality/value Expert analysis and guidance from experienced dispute resolution and environmental lawyers.

Background: Several adjunctive medications are available to reduce OFF time between levodopa/carbidopa (LD/CD) doses for people with Parkinson’s disease (PD). Objective: To explore how individuals with PD balance benefits and burdens when considering adjunctive medications. Methods: US adults (30– 83 years) with self-reported PD, currently treated with LD/CD, who experienced OFF episodes were recruited through the Fox Insight study to complete a discrete-choice experiment survey. Respondents selected among experimentally designed profiles for hypothetical adjunctive PD treatments that varied in efficacy (additional ON time), potential adverse effects (troublesome dyskinesia, risk of diarrhea, risk of change in bodily fluid color), and dosing frequency or the option “No additional medicine”. Data were analyzed with random-parameters logit models. Results: Respondents (N=480) would require ≥ 60 additional minutes of daily ON time to accept either a 40% risk of change in bodily fluid color or 10 additional minutes with troublesome dyskinesia daily. Respondents would require 40 additional minutes of daily ON time to accept a 10% risk of diarrhea and 22 additional minutes of daily ON time to switch from 1 additional pill each day to 1 pill with each LD/CD dose. On average, respondents preferred adjunctive PD medication over no additional medication. Results predicted that 59.1% of respondents would select a hypothetical treatment profile similar to opicapone, followed by no additional medication (27.5%) and a hypothetical treatment profile similar to entacapone (13.4%). Limitations: The data collected were based on responses to hypothetical choice profiles in the survey questions. The attributes and levels selected for this study were intended to reflect the characteristics of opicapone and entacapone; attributes associated with other adjunctive therapies were not evaluated. Conclusion: Patients with PD expressed interest in adjunctive treatment to increase ON time and would accept reduced ON time to avoid adverse effects. Plain Language Summary: People with Parkinson’s disease may experience OFF time, when their symptoms return between doses of levodopa/carbidopa. Some medicines can reduce OFF time when taken in addition to levodopa/carbidopa. These additional medicines have their own benefits and side effects. In this study, researchers used a survey to understand what side effects people with Parkinson’s disease would accept to have more ON time. Respondents were presented with a series of choices between 2 hypothetical medicines that increased daily ON time or no additional medicine. The medicines were described by 5 features (benefits and side effects). Respondents’ answers to the survey questions allowed researchers to estimate which unwanted side effects people with Parkinson’s disease would accept in exchange for additional ON time. The most important features of a medicine to reduce OFF time, in order, were (1) Lower risk of a change in urine, sweat, or saliva color; (2) Fewer additional minutes with troublesome dyskinesia each day; and (3) Increase in daily ON time. Introducing a 40% risk of change in urine, sweat, or saliva color (from no risk) would require more than 60 minutes of additional daily ON time to offset. An additional 10 minutes of troublesome dyskinesia each day would require more than 60 minutes of additional daily ON time. Introducing a 10% risk of diarrhea (from no risk) would require 40 minutes of additional ON time. Individuals’ preferences for the key features of medications that reduce OFF time for people with Parkinson’s disease should be considered when making treatment decisions. Keywords: discrete choice, Parkinson’s, stated preferences

Abstract To accurately assess galvanic performance of dissimilar metal components under atmospheric corrosion we need to predict corrosion rates for galvanic couples covered by thin layer electrolytes that commonly occur in the natural environment. In this study we used finite element models of interdigitated electrode (IDE) sensors to help characterize the changing electrolyte properties on a sensor surface during a salt aerosol spray dosing experiment. Different volumes of a sodium chloride solution were sprayed on electrode grids capable of measuring either solution conductance or galvanic current. Computer models of these electrode grids were developed to predict the relative changes in electrolyte properties occurring as applied salt loading was increased; experimental measurements were used to guide model assumptions. The goal of this approach is to characterize electrolyte properties representative of thin film environments in a laboratory controlled environment. Results from this work provide new insight into the spatial extent of electrolyte films developing under different salt loads during simple relative humidity cycle testing. This work supports advancement in understanding the nature of electrolyte films that may occur in the natural environment and provides further guidance on appropriate domain and boundary conditions to consider in finite-element based atmospheric corrosion models.

Abstract Deepwater Oil &amp; Gas developments consist of many more components designed to extract, transport and store the oil when compared with developments in shallower waters. Designing the cathodic protection [CP] systems to protect the individual components is problematic without an appreciation as to how CP systems fitted to the various components will interact with one another once the entire asset is commissioned. For a recent deep-water project, a computer modeling study was commissioned to provide information on the performance of the CP systems protecting each of the subsea structures and in particular the interaction currents flowing between them. The principal aim was to ensure that the impressed current CP (ICCP) system on the hull of the FPSO would be operated in such a manner as to reduce interaction with the sub sea sacrificial anode CP systems to the minimum possible throughout the operating life of the field and to develop an understanding of the probable behavior of CP systems on the key components (FPSO, Oil offloading lines &amp; Buoy, Riser Structures, etc.) particularly in respect of sacrificial anode lives. In addition, a further aim was to provide a working tool for Operations that could be used to aid ICCP control beyond the design and construct phases, and to provide input to Risk Based Inspection and maintenance planning. The paper will describe the strategy and rationale behind the modeling studies and some of the lessons learned and the plans for validation and ongoing maintenance of the model as ROV and field data becomes available.

Abstract The efficiency of cathodic protection is driven by various environmental parameters, the main ones being: the geometry of the protected structure, the electrolyte resistivity, and of course the steel polarization curve. The aim of this study is to assess the influence of those parameters on the current distribution and on the potential attenuation. In particular, an investigation will be made into the apparently contradictory influences of the resistivity. For this investigation, two configurations of CP system applied to storage tanks bottom are studied by 3D modeling. The first is a tank bottom for which a membrane is installed a few tens of cm underneath, with an anodic grid system located in the confined space. The second is the usual design where no membrane is installed below the tank and where anodes are located around the periphery of the tank.

An interdisciplinary outpatient rehabilitation clinic was set up to assess patients with severe and complex disabilities. The rehabilitation team consisted of a physician, a nurse, a community liaison occupational therapist, a community physiotherapist and a speech and language therapist. Each patient was assessed in the clinic for half a day. The patients' carers were encouraged to attend. A total of 25 consecutive new patients were studied. The findings of the study suggest that the range of therapeutic interventions carried out during the outpatient clinic visit were comparable to the standard model of care. To evaluate the effectiveness of this service in preventing hospital admissions the case histories of the study patients were presented to three consultants in rehabilitation medicine who were asked to give their management decision on each case, but were not told the objectives of the study. Analysis of the consultants' decisions showed that there was agreement between all consultants that five patients needed admission to hospital for evaluation or treatment and two out of the three physicians said that they would have admitted a further eight patients. In fact, none of our patients was admitted, which suggests that the model of outpatient multi disciplinary assessment service proposed here may reduce the need for admissions to hospital.

Expert evidence is a controversial question in arbitration, where discussions on how expert evidence should be regulated to achieve that arbitrators receive expert opinions as independent as possible is the usual practice. But it is being forgotten that, strictly speaking, the parties are the ones that designate their own experts and also the ones that could lose the most if the Arbitral Tribunal rejects an expert's arguments due to his or her lack of impartiality. For that reason, this article analyses the grounds why expert evidence is mistrusted, the solutions continuously offered to this respect and their efficiency. In conclusion, it is stated that the most relevant solution to give validity to expert evidence is the existence of mechanisms that enable both the parties and the Arbitral Tribunal to call into question the experts' opinions.On the other hand, the interest aroused by what has been mentioned above involves that other relevant topics receive less attention. Therefore, this article also studies questions related to expert evidence such as confidentiality, the assessment of evidence and the experts' liability, among others.