Modern-day clinical course of type 1 diabetes mellitus after 30 years' duration:the diabetes control and complications trial/epidemiology of diabetes interventions and complications and Pittsburgh epidemiology of diabetes complications experience (1983-2005)

Clinical treatment goals of type 1 diabetes mellitus (T1DM) have changed since the Diabetes Control and Complications Trial (DCCT) demonstrated reduced long-term complications with intensive diabetes therapy. There have been few longitudinal studies to describe the clinical course of T1DM in the age of intensive therapy. Our objective was to describe the current-day clinical course of T1DM.

Day-Ahead Optimal Charging/Discharging Scheduling for Electric Vehicles in Micro-Grids

A micro-grid is an autonomous system which can be operated and connected to an external system or isolated with the help of energy storage systems (ESSs). While the daily output of distributed generators (DGs) strongly depends on the temporal distribution of natural resources such as wind and solar, unregulated electric vehicle (EV) charging demand will deteriorate the imbalance between the daily load and generation curves. In this paper, a statistical model is presented to describe daily EV charging/discharging behaviour. An optimisation problem is proposed to obtain economic operation for the micro-grid based on this model. In day-ahead scheduling, with estimated information of power generation and load demand, optimal charging/discharging of EVs during 24 hours is obtained. A series of numerical optimization solutions in different scenarios is achieved by serial quadratic programming. The results show that optimal charging/discharging of EVs, a daily load curve can better track the generation curve and the network loss and required ESS capacity are both decreased. The paper also demonstrates cost benefits for EVs and operators.

Day case stapled haemorrhoidopexy for prolapsing haemorrhoids

Objective Conventional surgical management of prolapsing haemorrhoids is by excisional haemorrhoidectomy. Postoperative pain has restricted the application of such procedures in the day case setting. These operations remain associated with a period of restricted activity. The use of circular stapling devices as an alternative to the excisional approach in the management of haemorrhoids has been described. This study reports our experience of stapled haemorrhoidopexy as a day case procedure.

Methods Patients with third or fourth degree haemorrhoids were eligible for the procedure. Patients were considered suitable candidates for day case surgery based on conventional parameters. Symptoms were assessed using a previously validated symptom severity rating score. Stapled haemorrhoiclopexy was carried out using a circular stapling device. Pain scores were obtained prior to discharge. Patients were admitted if pain was uncontrolled despite oral analgesia. Symptoms were re-scored at six-week follow-up.

Results Over a 70-month period 168 consecutive stapled haemorrhoidopexies were performed or directly supervised by one consultant colorectal surgeon. One hundred and ten (65%) patients were considered appropriate candidates for day case surgery by conventional criteria. Ninety-six (87.3%) patients successfully underwent stapled haemorrhoidopexyon a day case basis. Fourteen (12.7%) patients required admission on the day of surgery (5 for early Postoperative bleeding, 4 for pain necessitating continuing opiate analgesia, two for urinary retention and three for surgery performed late in the day). Six (5%) patients were re-admitted postoperatively; four for pain relief and two because of urinary retention. Of the day case patients, 91 (82.7%) and 56 (50.9%) had been seen for 6 week and 6 month review, respectively, at the time of analysis. Symptom scores were 6 (pre-operatively) vs 0 (postoperatively) (P <0.01). 76/91 (83.5%) patients reviewed at 6/52 were asymptomatic.

Conclusion Stapled haemorrhoidopexy is a safe and effective procedure that can be carried out on selected patients on a day case basis. Complications are of a similar nature to excisional haemorrhoidectomy.

Out of the Shadows: A one day investigation of the politics of architecture explored through the lens of post-conflict, Belfast

This booklet covers the itinerary and some of the findings of a day-long visit to Belfast on the 7th November 2014 by Peter Oborn; Vice President International of the Royal Institute of British Architects. His visit was in response to a motion submitted to the RIBA council (19.05.2014) calling for the suspension of the Israeli Association of United Architects from the International Union of Architects. Despite members of council speaking against the motion it was carried; 23 members voting for, 16 against, and 10 abstentions. Subsequently the RIBA came under considerable pressure to consider its position in such critical contexts. This visit to Belfast was part of a wider fact-finding mission and evidence taking. At its heart was the question: 'Is it appropriate for the institute (RIBA) to engage with communities facing civil conflict and/or natural disaster and, if so, how it can do so most effectively.' The visit was facilitated by Ruth Morrow, Professor of Architecture, School of Planning, Architecture & Civil Engineering, Queen's University Belfast, and Martin Hare, Royal Society of Ulster Architects (RSUA) president.

'Something That Unites Us All': Understandings of St. Patrick's Day Parades as Representing the Irish National Group

The present study investigates how attendees at national celebratory crowd events-specifically St. Patrick's Day parades-understand the role of such events in representing and uniting the national community. We conducted semi-structured interviews with people who attended St. Patrick's Day parades in either Dublin or Belfast. In year 1, full-length interviews were conducted before and after the events (N=17), and in years 1 and 2, shorter interviews were conducted during the events (year 1 N=170; year 2 N=142). Interview data were analysed using thematic analysis, allowing the identification of three broad themes. Participants reported that (i) the events extend the boundary of the national group, using participation to define who counts as Irish; (ii) the events strategically represent the nature of the national group, maximising positive images and managing stereotypical representations; and (iii) symbolism serves to unify the group but can also disrupt already fragile unity and so must be managed. Overall, this points to a strategic identity dimension to these crowd events. We discuss the implications of these findings for future research in terms of the role of large-scale celebratory events in the strategic representation of everyday social identities.

The Day After Tomorrow: Transition Management, Spatial Planning & the Low Carbon Economy

Many of the societal challenges that current spatial planning practice claims to be addressing (climate change, peak oil, obesity, aging society etc) encompass issues and timescales that lie beyond the traditional scope planning policy (Campbell 2006). The example of achieving a low carbon economy typifies this in that it demands a process of society-wide transition, involving steering a wide range of factors (markets, infrastructure, governance, individual behaviour etc). Such a process offers a challenge to traditional approaches to planning as they cannot be guided by a fixed blueprint, given the timescales involved (up to 50 years) and an enhanced level of uncertainty, social resistance, lack of control over implementation and a danger of ‘policy lock in’ (Kemp et al 2007). One approach to responding to these challenges is the concept of transition management which has emerged from studies of science, technology and innovation (Geels 2002, Markard et al 2012). Although not without criticism, this perspective attempts to uncertainty and complexity encompassing long term visions that integrates multi-level, multi-actor and multi-domain perspectives (Rotmans et al 2001).
 
Given its origins, research on transition management has tended to neglect spatial contexts (Coenen et al 2012) and, related to this, it’s relationship with spatial planning is poorly understood. Using the example of the low carbon transition, this paper will review the relationships between the concepts, methodologies and goals of transition management and spatial planning to explore whether a closer integration of the two fields offers benefits to achieving the long term challenges facing society.