Evidence underlying the clinical management of diabetic macular oedema

Diabetic retinopathy (DR) is the leading cause of visual loss in the developed world in those of working age, and its prevalence is predicted to double by 2025. The management of diabetic retinopathy has traditionally relied on screening, on laser treatment delivered by ophthalmologists, and on optimising blood glucose and blood pressure. Recent evidence suggests that the role of systemic factors is more complex than originally thought, and that drugs such as ACE inhibitors, fibrates and glitazones may all influence the course of diabetic macular oedema. Antagonism of vascular endothelial growth factor offers a new therapeutic avenue that may transform the management of diabetic macular oedema. Several other therapeutic options are under investigation and development, including aminoguanidine, sorbinol, ruboxistaurin and autologous stem cell transfusion. © Royal College of Physicians, 2013.

Women (Re)Negotiating Care across Family Generations: Intersections of Gender and Socioeconomic Status

Changing Generations, a study of intergenerational relations in Ireland undertaken between 2011 and 2013 by the Social Policy and Ageing Research Centre (SPARC), Trinity College, Dublin, and the Irish Centre for Social Gerontology (ICSG), NUI Galway, used the Constructivist Grounded Theory method to interrogate support and care provision between generations. This article draws on interviews with 52 women ages 18 to 102, allowing for simultaneous analysis of older and younger women’s perspectives. The intersectionality of gender and class emerged as central to the analysis. Socioeconomic positions shape contrasting forms of interdependency among family generations, ranging from “enmeshed” lives among lower socioeconomic groups to “freed” lives among higher socioeconomic groups. Women are initiating changes in how care and support flow across generations. Older women in higher socioeconomic groups are attuned to how emotional capital women expend across family generations can constrain (young) women’s lives. In an expression of solidarity, older women are renegotiating the place of care labor in their own lives and in the lives of younger women. A new reciprocity emerges that amounts to women “undoing gender.” This process is, however, deeply classed as it is women in higher socioeconomic groups whose resources best place them to renegotiate care.

A microbiological survey of a constructed wetland system supplied by dairy 'dirty water' effluent

A constructed wetland at Greenmount College, Co. Antrim, N. Ireland was built in 2004 to study the treatment of ‘dirty water’ effluent from the Greenmount dairy unit. The effluent has a mean BOD5 of c.1000 mg/L and contains milking parlour wash-water and runoff from silage clamps and yard areas lightly contaminated with cattle manure. The nominal water retention time of this wetland is 100 days. The primary purposes of the wetland are to eliminate organic pollution and eutrophication risk from nitrogen and phosphorus compounds. However the wetland should also effectively remove any zoonotic pathogens present in manure and milk. Accordingly, a 12-month microbiological survey of water in the five ponds of the wetland commenced in August 2007. The aims of the survey are to determine changes, as effluent passes through the wetland system, in a broad range of indicator organisms (faecal coliforms, Escherichia coli, Enterococcus faecalis and Clostridium perfringens) and the occurrence of several pathogens - Salmonella, Campylobacter, Cryptosporidium and Mycobacterium avium subsp. paratuberculosis (Map). The highest indicator organism counts - E. coli and faecal coliforms, 103-104 CFU/ml - are observed in pond 1, and a significant reduction (1-3 log10) in all indicator organisms occurs as water passes through the wetland from pond 1 to pond 5. Hence the wetland is efficient at reducing levels of indicator organisms in the dairy effluent. Salmonella and Campylobacter spp. are being detected intermittently in all the ponds, whilst Cryptosporidium and Map have yet to be detected, and so the ability of the wetland to reduce/eliminate specific pathogens is less clear at present.

Exploring diversity through ethos in initial teacher education

This paper considers whether there is value in introducing student teachers to schools of different ethos as part of their initial teacher education. A 2-year study of undergraduate post-primary student teachers at a university college in Northern Ireland reveals that encounters with schools of different ethos can help student teachers to understand differences between schools and their visions of education, as well as correcting misunderstandings and challenging stereotypes. It is argued that as a result of experiencing diverse examples of ethos, student teachers may also be helped to understand the complexity of schools as organisations and to position themselves and their professional practice within wider debates about the aims of education and schools as communities of practice. © 2008 Elsevier Ltd. All rights reserved.

Land, Popular Politics and Agrarian Violence in Late Nineteenth Century Ireland

"Land, Popular Politics and Agrarian Violence in Ireland" provides an original and insightful study of the highly formative Land War and Home Rule from a local and regional perspective. Lucey examines the emergence and development of the largest mass political mobilisation brought about in nineteenth-century Ireland in the form of the Land League, and subsequently the National League, in the south-western county of Kerry. Such an unprecedented level of local political activity was matched by an upsurge in agrarian violence and the outbreak of serious outrage, which was largely orchestrated by secret societies known as Moonlighters. In turn, this book provides an important exploration of the dynamics behind the mass political mobilisation and agrarian violence that dominated Kerry society during the 1880s. The role of Fenians, radical agrarian agitators and moderate constitutional nationalists are all examined within the county.This study has importance beyond the local and provides a range of insights into motivations behind political action and violence at an everyday level during one of the most seminal and transformative eras in the development of modern Irish history. This title is suitable for students and academics of nineteenth-century Irish history and general readers.

Advanced Ceramic Substrate with Ordered and Designed Micro-Structure for Applications in Automotive Catalysts

This study describes an innovative monolith structure designed for applications in automotive catalysis using an advanced manufacturing approach developed at Imperial College London. The production process combines extrusion with phase inversion of a ceramic-polymer-solvent mixture in order to design highly ordered substrate micro-structures that offer improvements in performance, including reduced PGM loading, reduced catalyst ageing and reduced backpressure.

This study compares the performance of the novel substrate for CO oxidation against commercially available 400 cpsi and 900 cpsi catalysts using gas concentrations and a flow rate equivalent to those experienced by a full catalyst brick when attached to a vehicle. Due to the novel micro-structure, no washcoat was required for the initial testing and 13 g/ft3 of Pd was deposited directly throughout the substrate structure in the absence of a washcoat.

Initial results for CO oxidation indicate that the advanced micro-structure leads to enhanced conversion efficiency. Despite an 79% reduction in metal loading and the absence of a washcoat, the novel substrate sample performs well, with a light-off temperature (LOT) only 15 °C higher than the commercial 400 cpsi sample.

To test the effects of catalyst ageing on light-off temperature, each sample was aged statically at a temperature of 1000 °C, based on the Bench Ageing Time (BAT) equation. The novel substrate performed impressively when compared to the commercial samples, with a variation in light-off temperature of only 3% after 80 equivalent hours of ageing, compared to 12% and 25% for the 400 cpsi and 900 cpsi monoliths, respectively.

Morphological study of the uncommon rectus sterni muscle in German cadavers

Objective: The present investigation has been designed to study the incidence of the rectus stern muscle in German human cadavers dissected in the Kingdom of Saudi Arabia, trying to find a postulation for the development of such muscle when present. Design: Gross dissection of 130 cadavers, of both sexes, was performed throughout a period of 10 years. Setting: Department of Anatomy College of Medicine, King Faisal University, Dammam, Saudi Arabia. Intervention: Investigation of the origin and insertion of the rectus sterni and measurements of its length and width. Results: Two adult cadavers, one of each sex, had shown well-developed bilateral rectus stern muscles. All muscles identified were parasternal in position, being superficial to the medial portion of the pectoralis major muscle. Minor morphological differences were observed among the four muscle masses concerning their length, breadth, origin and insertion. Conclusion: The current study has determined the incidence of the rectus sterni muscle, in German cadavers to be 1.54% per bodies examined compared to 4% in cadavers from Saudis. Such a frequency is compared to that reported in different geographic populations. The rectus sterni muscle is innervated by the anterior cutaneous branches of the intercostal nerves. The description of the rectus sterni muscle and its incidence determined in the present study, might be of a great help for clinicians radiographing or tackling the pectoral region.

Calcification and ossification of the convexity of the falx cerebri and related subdural space in human cadavers

OBJECTIVE: The present work was planned to report the incidence of calcification and ossification of an isolated cranial dural fold. The form, degree of severity and range of extension of such changes will be described. Involvement of the neighboring brain tissue and blood vessels, whether meningeal or cerebral, will also be determined. The results of this study might highlight the occasional incidence of intracranial calcification and ossification in images of the head and their interpretation, by radiologists and neurologists, to be of dural or vascular origin.

METHODS: Two human formalin-fixed cadavers, one middle-aged female another older male, were investigated at the Anatomy Laboratory, College of Medicine, King Faisal University, Dammam, Kingdom of Saudi Arabia during the period from 2000 to 2003. In each cadaver, the skullcap was removed and the convexity of the cranial dura mater, as well as the individual dural folds, were carefully examined for any calcification or ossification. The meningeal and cerebral blood vessels together with the underlying brain were grossly inspected for such structural changes. Calcified or ossified tissues, when identified, were subjected to histological examination to confirm their construction.

RESULTS: The female cadaver showed a calcified parietal emissary vein piercing the skullcap and projecting into the scalp. The latter looked paler and deficient in hair on its right side. The base of the stump was surrounded by a granular patch of calcification. The upper convex border of the falx cerebri was hardened and it presented granules, plaques and a cauliflower mass, which all proved to be osseous in structure. The meningeal and right cerebral vessels were mottled with calcium granules. The underlying temporal and parietal lobes of the right cerebral hemisphere were degenerated. The male cadaver also revealed a calcified upper border of the falx cerebri and superior sagittal sinus. Osseous granules and plaques, similar to those of the first specimen, were also identified but without gross changes in the underlying brain.

CONCLUSION: Calcification or ossification of an isolated site of the cranial dura mater and the intracranial blood vessels might occur. These changes should be kept in mind while interpreting images of the skull and brain. Clinical assessment and laboratory investigations are required to determine whether these changes are idiopathic, traumatic, or as a manifestation of a generalized disease such as hyperparathyroidism, vitamin D-intoxication, or chronic renal failure.

From Francis Hutcheson to James McCosh: Irish Presbyterians and Defining the Scottish Philosophy in the Nineteenth Century

This article examines the disputes amongst Irish Presbyterians about the teaching of moral philosophy by Professor John Ferrie in the college department of the Royal Belfast Academical Institution in the early nineteenth century and the substantive philosophical and theological issues that were raised. These issues have largely been ignored by Irish historians, but a discussion of them is of general relevance to historians of ideas as they illuminate a series of broader questions about the definition and development of Scottish philosophy. These are represented in the move from two philosophers who had strong connections with Irish Presbyterianism—Francis Hutcheson, the early eighteenth-century moral sense philosopher and theological moderate from County Down, and James McCosh, nineteenth-century exponent of modified Common Sense philosophy at Queen's College Belfast and a committed evangelical. In particular, this article addresses three important themes—the definition and character of ‘the Scottish philosophy’, the relationship between evangelicalism and Common Sense philosophy, and the process of development and adaptation that occurred in eighteenth-century Scottish thought during the first half of the nineteenth century.