A pilot study of email in an e-mentoring relationship

E-mentoring is an alternative to conventional face-to-face mentoring, incorporating the use of email, bulletin boards, discussion groups, instant messaging and videoconferencing. In a pilot trial, a New Zealand midwife mentored two new graduate midwives using a secure email system. The main themes of the email messages exchanged were debriefing and reflection, clinical queries, provision of information and discussion of professional issues. The pilot study showed that e-mentoring is a feasible option for midwives and warrants further investigation. Both mentor and mentees found the experience to be a helpful one. One of the advantages for both mentor and mentees was the flexibility of communication, since responses to email messages could be made at times that suited the authors. Nevertheless, issues of Internet access and the technical expertise of midwives will need to be considered in order for large scale e-mentoring to be implemented.

A pilot study of online assessment of childhood speech disorders

We investigated the feasibility of assessing childhood speech disorders via an Internet-based telehealth system (eREHAB). The equipment provided videoconferencing through a 128 kbit/s Internet link, and enabled the transfer of pre-recorded video and audio data from the participant to the online clinician. Six children (mean age = 5.3 years) with a speech disorder were studied. Assessments of single-word articulation, intelligibility in conversation, and oro-motor structure and function were conducted for each participant, with simultaneous scoring by a face to face and an online clinician. There were high levels of agreement between the two scoring environments for single-word articulation (92%), speech intelligibility (100%) and oro-motor tasks (91%). High levels of inter- and intra-rater agreement were achieved for the online ratings for most measures. The results suggest that an Internet-based assessment protocol has potential for assessing paediatric speech disorders.

Predictors of an antibiotic prescription by GPs for respiratory tract infections: a pilot

Background. Antibiotics are over-prescribed for respiratory tract infections in Australia. Objectives. The aim of this study was to describe the clinical predictors of GPs' prescribing of antibiotics. Methods. We used Clinical Judgment Analysis to study the responses of GPs to hypothetical paper-based vignettes of a 20-year-old with a respiratory tract infection. The nature of four symptoms and signs (colour of nasal mucous discharge; soreness of the throat; presence of fever; and whether any cough was productive of sputum) was varied and their effect on prescribing measured using logistic regression. Results. Twenty GPs participated. The nature of each symptom and sign significantly predicted prescribing of an antibiotic. Cough productive of yellow sputum; presence of sore throat; fever; and coloured nasal mucus increased the probability of an antibiotic being prescribed. Conclusions. GPs are influenced by clinical signs and symptoms to use antibiotics for respiratory infections for which there is poor evidence of efficacy from the literature.

Evaluation of a pilot telemedicine network for accident and emergency work

A pilot accident and emergency. teleconsulting service was established in Scotland. It was based at the accident and emergency department of the main hospital in Aberdeen. There were three peripheral sites in rural Grampian (Peterhead, Turriff and Huntly) and one in the Shetland Isles. The videoconferencing equipment used was connected by ISDN at 384 kbit/s. During the 15 months of the study, 1998 videoconference calls were made, of which 402 (20%) calls were made to the accident and emergency department for clinical consultations. The majority of the clinical calls (95%) were made between 09:00 and 17:00, and more than 90% were completed within 20 min. During the majority of calls (87%) one or more X-ray images were transmitted. The majority of patients (89%) received treatment without transportation to the main centre in Aberdeen. The present study demonstrated that accident and emergency teleconsultations can be technically reliable, effective in reducing the number of patient transfers and acceptable to the referring clinicians. As a result, approximately pound1.5 million has been made available by the government to develop a national system for Scotland.

Dispensing activity in a community pharmacy-based repeat dispensing pilot project

Objective: To measure changes in dispensing activity in a UK repeat dispensing pilot study and to estimate any associated cost savings. Method: Patients were provided with two successive three-monthly repeat prescriptions containing all of the items on their "repeat medicines list" and valid at a study pharmacy. Pharmacists consulted with patients at the time of supply and completed a patient-monitoring form. Prescriptions with pricing data were returned by the UK Prescription Pricing Authority. These data were used to calculate dispensing activity, the cost of dispensed items and an estimate of cost savings on non-dispensed items. A retrospective identification of items prescribed during the six months prior to the project was used to provide a comparison with those dispensed during the project and thus a more realistic estimate of changes. Setting: 350 patients from two medical practices in a large English City, with inner city and suburban locations, and served by seven pharmacies. Key findings: There were methodological challenges in establishing a robust framework for calculating changes. Based on all of the items that patients could have obtained from their repeat list, 23.8% were not dispensed during the intervention period. A correction was then made to allow for a comparison with usage in the six months prior to the study. Based on the corrected data, there was an estimated 11.3% savings in drug costs compared with the pre-intervention period. There was a marked difference in changes between the two practices, the pharmacies and individual patients. The capitation-based remuneration method was acceptable to all but one of the community pharmacists. Conclusion: The repeat dispensing system reduced dispensing volume in comparison with the control period. A repeat dispensing system with a focus on patients' needs and their use of medicines might be cost neutral.

Liquid-liquid extraction in a pilot scale rotating disc contactor

A study of the hydrodynamics and mass transfer characteristics of a liquid-liquid extraction process in a 450 mm diameter, 4.30 m high Rotating Disc Contactor (R.D.C.) has been undertaken. The literature relating to this type of extractor and the relevant phenomena, such as droplet break-up and coalescence, drop mass transfer and axial mixing has been revjewed. Experiments were performed using the system C1airsol-350-acetone-water and the effects of drop size, drop size-distribution and dispersed phase hold-up on the performance of the R.D.C. established. The results obtained for the two-phase system C1airso1-water have been compared with published correlations: since most of these correlations are based on data obtained from laboratory scale R.D.C.'s, a wide divergence was found. The hydrodynamics data from this study have therefore been correlated to predict the drop size and the dispersed phase hold-up and agreement has been obtained with the experimental data to within +8% for the drop size and +9% for the dispersed phase hold-up. The correlations obtained were modified to include terms involving column dimensions and the data have been correlated with the results obtained from this study together with published data; agreement was generally within +17% for drop size and within +14% for the dispersed phase hold-up. The experimental drop size distributions obtained were in excellent agreement with the upper limit log-normal distributions which should therefore be used in preference to other distribution functions. In the calculation of the overall experimental mass transfer coefficient the mean driving force was determined from the concentration profile along the column using Simpson's Rule and a novel method was developed to calculate the overall theoretical mass transfer coefficient Kca1, involving the drop size distribution diagram to determine the volume percentage of stagnant, circulating and oscillating drops in the sample population. Individual mass transfer coefficients were determined for the corresponding droplet state using different single drop mass transfer models. Kca1 was then calculated as the fractional sum of these individual coefficients and their proportions in the drop sample population. Very good agreement was found between the experimental and theoretical overall mass transfer coefficients. Drop sizes under mass transfer conditions were strongly dependant upon the direction of mass transfer. Drop Sizes in the absence of mass transfer were generally larger than those with solute transfer from the continuous to the dispersed phase, but smaller than those with solute transfer in the opposite direction at corresponding phase flowrates and rotor speed. Under similar operating conditions hold-up was also affected by mass transfer; it was higher when solute transfered from the continuous to the dispersed phase and lower when direction was reversed compared with non-mass transfer operation.

The human immune system: Part 2

For the immune system to function effectively, the body must be able to distinguish foreign antigens from self antigens. However, the mechanisms which maintain this distinction may break down and result in an auto-immune disease in which self-reacting antibodies and T-cells are produced. This article discusses first, the evidence for the existence of human auto-immune disease and second, the auto-immune diseases which have characteristic ocular symptoms.

Development and application of magnetoencephalographic methods in the investigation of the human visual system

This thesis is an exploration of the organisation and functioning of the human visual system using the non-invasive functional imaging modality magnetoencephalography (MEG). Chapters one and two provide an introduction to the ‘human visual system and magnetoencephalographic methodologies. These chapters subsequently describe the methods by which MEG can be used to measure neuronal activity from the visual cortex. Chapter three describes the development and implementation of novel analytical tools; including beamforming based analyses, spectrographic movies and an optimisation of group imaging methods. Chapter four focuses on the use of established and contemporary analytical tools in the investigation of visual function. This is initiated with an investigation of visually evoked and induced responses; covering visual evoked potentials (VEPs) and event related synchronisation/desynchronisation (ERS/ERD). Chapter five describes the employment of novel methods in the investigation of cortical contrast response and demonstrates distinct contrast response functions in striate and extra-striate regions of visual cortex. Chapter six use synthetic aperture magnetometry (SAM) to investigate the phenomena of visual cortical gamma oscillations in response to various visual stimuli; concluding that pattern is central to its generation and that it increases in amplitude linearly as a function of stimulus contrast, consistent with results from invasive electrode studies in the macaque monkey. Chapter seven describes the use of driven visual stimuli and tuned SAM methods in a pilot study of retinotopic mapping using MEG; finding that activity in the primary visual cortex can be distinguished in four quadrants and two eccentricities of the visual field. Chapter eight is a novel implementation of the SAM beamforming method in the investigation of a subject with migraine visual aura; the method reveals desynchronisation of the alpha and gamma frequency bands in occipital and temporal regions contralateral to observed visual abnormalities. The final chapter is a summary of main conclusions and suggested further work.

Aspects of design for a spare parts provisioning system

This thesis describes an investigation by the author into the spares operation of compare BroomWade Ltd. Whilst the complete system, including the warehousing and distribution functions, was investigated, the thesis concentrates on the provisioning aspect of the spares supply problem. Analysis of the historical data showed the presence of significant fluctuations in all the measures of system performance. Two Industrial Dynamics simulation models were developed to study this phenomena. The models showed that any fluctuation in end customer demand would be amplified as it passed through the distributor and warehouse stock control systems. The evidence from the historical data available supported this view of the system's operation. The models were utilised to determine which parts of the total system could be expected to exert a critical influence on its performance. The lead time parameters of the supply sector were found to be critical and further study showed that the manner in which the lead time changed with work in progress levels was also an important factor. The problem therefore resolved into the design of a spares manufacturing system. Which exhibited the appropriate dynamic performance characteristics. The gross level of entity presentation, inherent in the Industrial Dynamics methodology, was found to limit the value of these models in the development of detail design proposals. Accordingly, an interacting job shop simulation package was developed to allow detailed evaluation of organisational factors on the performance characteristics of a manufacturing system. The package was used to develop a design for a pilot spares production unit. The need for a manufacturing system to perform successfully under conditions of fluctuating demand is not limited to the spares field. Thus, although the spares exercise provides an example of the approach, the concepts and techniques developed can be considered to have broad application throughout batch manufacturing industry.

Human performance modelling as an aid in the process of manufacturing system design

Manufacturing system design is an ongoing activity within industry. Modelling tools based on Discrete Event Simulation are often used by practitioners during this design cycle. However, such tools do not adequately model the behaviour of 'direct' workers in manufacturing environments. There is an important need to expand the capability of modelling to include the relationships between human centred factors (demography, attitudes, beliefs, etc), their working environment (physical and organizational), and their subsequent performance in terms of productive routines. Therefore, this paper describes research that has formed a pilot modelling methodology that is an important first step in providing such a capability.

Modelling and experimental verification of a solar-powered liquid desiccant cooling system for greenhouse food production in hot climates

Experiments and theoretical modelling have been carried out to predict the performance of a solar-powered liquid desiccant cooling system for greenhouses. We have tested two components of the system in the laboratory using MgCl2 desiccant: (i) a regenerator which was tested under a solar simulator and (ii) a desiccator which was installed in a test duct. Theoretical models have been developed for both regenerator and desiccator and gave good agreement with the experiments. The verified computer model is used to predict the performance of the whole system during the hot summer months in Mumbai, Chittagong, Muscat, Messina and Havana. Taking examples of temperate, sub-tropical, tropical and heat-tolerant tropical crops (lettuce, soya bean, tomato and cucumber respectively) we estimate the extensions in growing seasons enabled by the system. Compared to conventional evaporative cooling, the desiccant system lowers average daily maximum temperatures in the hot season by 5.5-7.5 °C, sufficient to maintain viable growing conditions for lettuce throughout the year. In the case of tomato, cucumber and soya bean the system enables optimal cultivation through most summer months. It is concluded that the concept is technically viable and deserves testing by means of a pilot installation at an appropriate location.

Auto-solitons guided by in-line nonlinear optical loop mirrors in dispersion-managed communication systems

Summary form only given. Both dispersion management and the use of a nonlinear optical loop mirror (NOLM) as a saturable absorber can improve the performance of a soliton-based communication system. Dispersion management gives the benefits of low average dispersion while allowing pulses with higher powers to propagate, which helps to suppress Gordon-Haus timing jitter without sacrificing the signal-to-noise ratio. The NOLM suppresses the buildup of amplifier spontaneous emission noise and background dispersive radiation which, if allowed to interact with the soliton, can lead to its breakup. We examine optical pulse propagation in dispersion-managed (DM) transmission system with periodically inserted in-line NOLMs. To describe basic features of the signal transmission in such lines, we develop a simple theory based on a variational approach involving Gaussian trial functions. It, has already been proved that the variational method is an extremely effective tool for description of DM solitons. In the work we manage to include in the variational description the point action of the NOLM on pulse parameters, assuming that the Gaussian pulse shape is inherently preserved by propagation through the NOLM. The obtained results are verified by direct numerical simulations

Auto-solitons guided by in-line nonlinear optical loop mirrors in dispersion-managed communication systems

Summary form only given. Both dispersion management and the use of a nonlinear optical loop mirror (NOLM) as a saturable absorber can improve the performance of a soliton-based communication system. Dispersion management gives the benefits of low average dispersion while allowing pulses with higher powers to propagate, which helps to suppress Gordon-Haus timing jitter without sacrificing the signal-to-noise ratio. The NOLM suppresses the buildup of amplifier spontaneous emission noise and background dispersive radiation which, if allowed to interact with the soliton, can lead to its breakup. We examine optical pulse propagation in dispersion-managed (DM) transmission system with periodically inserted in-line NOLMs. To describe basic features of the signal transmission in such lines, we develop a simple theory based on a variational approach involving Gaussian trial functions. It, has already been proved that the variational method is an extremely effective tool for description of DM solitons. In the work we manage to include in the variational description the point action of the NOLM on pulse parameters, assuming that the Gaussian pulse shape is inherently preserved by propagation through the NOLM. The obtained results are verified by direct numerical simulations