Attitudes of consultant ophthalmologists in the UK to initial management of glaucoma patients presenting with severe visual field loss: a national survey

BACKGROUND: Recent National Institute of Clinical Excellence guidance suggests primary surgery should be offered to patients presenting with glaucoma with severe visual field loss. We undertook a survey of UK consultant ophthalmologists to determine if this represents current practice and explore attitudes towards managing patients with advanced glaucoma at presentation.

DESIGN: Questionnaire evaluation study.

PARTICIPANTS: All consultant ophthalmologists currently practicing in the UK.

METHODS: A single-page questionnaire was posted to all consultants (n = 910) currently practicing in the UK along with a pre-paid return envelope. A second questionnaire was sent to non-responders (n = 459).

MAIN OUTCOME MEASURES: Questionnaire responses.

RESULTS: 626 responses were received representing 68.8% of the population surveyed. 152 (24%) volunteered a specialist interest in glaucoma. Consensus opinion for both glaucoma specialists (64.9%) and non-glaucoma specialists (62.4%) was to start with primary medical therapy, most commonly citing surgical risk as the primary reason (23% and 22%, respectively) for this approach. Most felt the highest intraocular pressure measurement during follow up (measured in clinic) was the most important variable for prevention of further visual loss (60% of glaucoma specialists and 55% of non-glaucoma specialists). Eighty-three per cent of all responders suggested they would change their practice if evidence supporting primary surgery as a safe and more effective approach existed.

CONCLUSIONS: Recent National Institute of Clinical Excellence guidance does not reflect the current management approach of UK ophthalmologists. The primary concern was related to potential complications of surgery although most practitioners would be willing to change their practice if evidence existed supporting primary surgery in patients presenting with advanced glaucoma.

An investigation of Mode I and Mode II fracture toughness enhancement using aligned carbon nanotubes forests at the crack interface

A novel approach for introducing aligned multi-walled carbon nanotubes (MWCNTs) in a carbon-fibre composite pre-impregnated (prepreg) laminate, to improve the through-thickness fracture toughness, is presented. Carbon nanotube (CNT) 'forests' were grown on a silicon substrate with a thermal oxide layer, using a chemical vapour deposition (CVD) process. The forests were then transferred to a pre-cured laminate interface, using a combination of pressure and heat, while maintaining through-thickness CNT alignment. Standard Mode I and four-point bend end-notched flexure Mode II tests were undertaken on a set of specimens and compared with pristine specimens. Mode I fracture toughness for T700/M21 laminates was improved by an average of 31% while for T700/SE84LV specimens, an improvement of 61% was observed. Only T700/M21 specimens were tested in Mode II which yielded an average fracture toughness improvement of 161%. Scanning Electron Microscopy (SEM) showed good wetting of the CNT forest as well as evidence of penetration of the forest into the adjacent plies. © 2013 Elsevier Ltd.

D3.1 Benefits Analysis of the Initial Operational Cruiser-Feeder Concept

The REsearch on a CRuiser Enabled Air Transport Environment (RECREATE) project is considers the introduction and airworthiness of cruiser-feeder operations for civil aircraft. Cruiser-feeder operations are investigated as a promising pioneering idea for the air transport of the future. The soundness of the concept of cruiser-feeder operations for civil aircraft can be understood, taking air-to-air refueling operations as an example. For this example, a comprehensive estimate of the benefits can be made, which shows a fuel burn reduction potential and a CO2 emission reduction of 31% for a typical 6000 nautical miles flight with a payload of 250 passengers. This reduction potential is known to be large by any standard. The top level objective of the RECREATE project is to demonstrate on a preliminary design level that cruiser-feeder operations (as a concept to reduce fuel burn and CO2 emission levels) can be shown to comply with the airworthiness requirements for civil aircraft. The underlying Scientific and Technological (S&T) objectives are to determine and study airworthy operational concepts for cruiser-feeder operations, and to derive and quantify benefits in terms of CO2 emission reduction but also other benefits.

Work Package (WP) 3 has the objective to substantiate the assumed benefits of the cruiser/feeder operations through refined analysis and simulation. In this report, initial benefits evaluation of the initial RECREATE cruiser/feeder concepts is presented. The benefits analysis is conducted in delta mode, i.e. comparison is made with a baseline system. Since comparing different aircraft and air transport systems is never a trivial task, appropriate measures and metrics are defined and selected first. Non-dimensional parameters are defined and values for the baseline system derived.

The impact of cruiser/feeder operations such as air-to-air refueling are studied with respect to fuel-burn (or carbon-dioxide), noise and congestion. For this purpose, traffic simulations have been conducted.
Cruiser/feeder operations will have an impact on dispatch reliability as well. An initial assessment of the effect on dispatch reliability has been made and is reported.

Finally, a considerable effort has been made to create the infrastructure for economic delta analysis of the cruiser/feeder concept of operation. First results of the cost analysis have been obtained.

Student teachers' experiences of initial teacher preparation in England:Core themes and variation

Drawing on data generated via large-scale survey and in-depth interview methods, this article reports findings which show that being a student teacher in early-twenty-first-century England is a demanding personal experience which requires considerable engagement and commitment in the face of built-in challenges and risks, and which engenders, for many, highly charged affective responses. Student teachers are centrally concerned during this time with their (changing) identities, their relationships with others and the relevance of course provision. Findings also indicate that, in some respects, student teachers’ accounts of their experiences are systematically differentiated according to a number of factors, notably the initial teacher preparation route being followed, their age, and their prior conceptions and expectations of teaching and of learning to teach. These findings are situated in the broader literature on teacher development and some implications for teacher educators are discussed. © 2008 Taylor & Francis

Student Teachers’ Perceptions of the Effectiveness of their Initial Preparation

What influences how well-prepared student teachers feel towards working in schools upon completion of their initial teacher preparation (ITP)? In order to investigate this question, we used a path analysis using data from a longitudinal study investigating the experiences of trainee and early career phase teachers in England. The data were generated via self-complete questionnaires and follow-up telephone interviews with 1,322 trainees. Those on undergraduate or school-based programmes felt better prepared to work as teachers than one-year postgraduate trainees, perhaps because the former give higher ratings of the quality of assessment of, and feedback received on, teaching practice, and because of the clarity of theory-practice links in programmes. Across different kinds of ITP programme, good relationships with school-based mentors significantly boosted trainees' confidence that their ITP had effectively prepared them for teaching. Trainees' motives for entering the profession and their initial concerns about and expectations of ITP also affected their perceptions of its effectiveness, by shaping the way they experienced aspects of their courses. Implications of these findings for policy and practice in teacher preparation are discussed. © 2011 Blackwell Publishing Ltd.