Type 2 diabetes: a case study

Increased prevalence of diabetes in the community has been accompanied by an increase in diabetes in hospitalised patients. About a quarter of these patients experience a hypoglycaemic episode during their admission, which is associated with increased risk of mortality and length of stay. This article examines the aetiology, pathophysiology, diagnosis and treatment of type 2 diabetes using a case study approach. The psychosocial implications for the patient are also discussed. The case study is based on a patient with diabetes who was admitted to hospital following a hypoglycaemic episode and cared for during a practice placement. The importance of early diagnosis of diabetes and the adverse effects of delayed diagnosis are discussed.

Space and Place: Lessons from National School Buildings in the North of Ireland

Forms of integrated schooling are currently promoted in post-conflict Northern Ireland, but an earlier attempt to establish secular education in Ireland during the nineteenth and early twentieth centuries – the Irish National Schools system – is often forgotten. A preliminary archaeological study of former National Schools indicated differences in size, placement and external appearance between rural and urban buildings, possibly linked to the expression of divergent cultural and religious traditions in conflict with the reforming principles of the national system. This paper uses archaeological and anthropological perspectives to examine the social and cultural significance of such schools, including the first recorded excavation of an Irish National School, in relation to their past and current significance for education, identity, landscape, place and kinship.

Preparing medical students for normal birth: an interactive workshop by pre-registration midwifery students.

There is an increasing recognition of the need to improve inter professional relationships within clinical practice (DoH, 2001). Evidence supports the assertion that health care professionals who are able to communicate and work effectively together and who have a mutual respect and understanding for one another’s roles will provide a higher standard of care (McPherson et al, 2001; Begley, 2008). Providing inter professional education within a University setting offers an opportunity for a non-threatening learning environment where students can develop confidence and build collaborative working relationships with one another (Saxell et al, 2009).
An inter-professional education initiative was developed in Queen’s University Belfast within the Schools of Nursing and Midwifery and Medicine and piloted in 2014. The aim of the collaboration was to introduce concepts of normal labour and birth to fourth year medical students prior to their obstetric and gynaecological placement in hospital. The teaching staff felt this would be an excellent opportunity for final year pre-registration midwifery students to demonstrate their knowledge and understanding on normality in labour and birth by preparing interactive workshops with the medical students. The midwifery students were provided with an outline agenda in relation to content for the workshop, but then were allowed creative licence with regard to delivery of the workshop. The workshops consisted of approximately 4 midwifery students to 12 medical students. Resources such as birthing balls, birth mannequins, dolls and pelvises were available to the students to increase interactivity. Significant emphasis was placed upon the importance of relationship building with women in labour and the concept of being ‘with woman’ was core to all elements of teaching. Midwifery students undertook acting roles such as the labouring woman, partner or a midwife role and acted out mini scenarios such as contacting for advice about early labour; positions for labour or positions for birth. Medical students were prompted to vocalise about their feelings towards labour and birth and encouraged to think about their role within the birth setting.
Preliminary evaluations of the workshops have been extremely positive from both the midwifery students and the medical students. The midwifery students have commented on the enjoyable aspects of team working for preparing for the workshop and also the confidence gained from teaching the medical students. The medical students have evaluated the teaching by the midwifery students positively and felt that it lowered their anxiety going into the labour setting. A number of midwifery and medical students have subsequently worked with one another within the practice setting which has been recognised as beneficial. Both Schools have recognised the benefits of this form of inter professional education and have subsequently made a commitment to embed it within each curriculum.

Characterization of x-ray lens for use in probing high energy density states of matter

By using polycapillary lenses to focus laser-produced x-ray sources to high intensities, an improvement in signal-to-noise ratio can be achieved. Here the He-alpha line emission produced by driving a titanium backlighter target is focused by a polycapillary lens and the output characterized. The x-ray spot is measured to have a peak intensity of 4.5 x 10(7) photons, with a total photon count of 8.8 x 10(8) in 0.13 +/- 0.01 mm(2). This setup is equivalent to placing the backlighter target 3 mm from the sample with a 600 mu m diameter pinhole. The polycapillary lens enables the placement of the backlighter target at a much larger distance from the sample to be studied and therefore has the ability to greatly improve the signal-to-noise ratio on detectors. We demonstrate this with two simple diffraction experiments using pyrolytic graphite and polycrystalline aluminium.

Developing employability within a university engineering curriculum

This article provides case studies for incorporating employability in a higher education setting. A professional studies module for a small class (30 students) of third-year aerospace engineers gave insight into industrial challenges while promoting career development. It was delivered mainly by industrial speakers and involved practical tasks and workshops. A more sustainable employability curriculum now supports students in all four years of the School’s three degree programmes, offering a structured development of skills and sector understanding. A notable increase in students obtaining sandwich year placements has been observed.

Reviewing the Literature on the Breakdown of Foster Care Placements for Young People: Complexity and the Social Work Task

Young people in long-term foster care are at risk of experiencing poor social, emotional, behavioural and educational outcomes. Moreover, these placements have a significantly greater chance of breaking down compared to those involving children. This article critically evaluates the factors associated with this particular outcome. It was carried out through a literature review conducted by a social work practitioner in one Health and Social Care Trust in Northern Ireland. The findings evidenced that, apart from overriding safety concerns, placement breakdown was not a one-off event but rather a complex process involving the interplay between a range of dynamic risk and protective factors over time, operating in the wider context of the young person’s history and life experiences. The significance of these findings for social work practitioners is finally considered by identifying key theories to inform understanding and intervention.

Mineralisation of 2,4-dichlorophenol and glucose placed into the same or different hydrological domains as a bacterial inoculant

The spatial location of microorganisms in the soil three-dimensional structure with respect to their substrates plays an important role in the persistence and turnover of natural and xenobiotic organic compounds. To study the effect of spatial location on the mineralisation of ¹⁴C-2,4-dichlorophenol (2,4-DCP, 0.15 or 0.31 μmol g^-1) and ¹⁴C-glucose (2.77 μmol g^-1), columns packed with autoclaved soil aggregates (2-5 mm) were used. Using a chloride tracer of water movement, the existence of 'immobile' water, which was by-passed by preferentially flowing 'mobile' water, was demonstrated. By manipulation of the soil moisture content, the substrates were putatively placed to these conceptual hydrological domains (immobile and mobile water). Leaching studies revealed that approximately 1.7 (glucose) and 3.4 (2.4-DCP) times the amount of substrate placed in mobile water was recovered in the first 4 fractions of leachate when compared to substrate placed in immobile water. The marked difference in the breakthrough curves was taken as evidence of successful substrate placement. The 2,4-DCP degrading bacterium, Burkholderia sp. RASCc2, was inoculated in mobile water (1.8-5.2 × 10⁷ cells g^-1 soil) and parameters (asymptote, time at maximum rate, calculated maximum rate) describing the mineralisation kinetics of 2,4-DCP and glucose previously added to immobile or mobile water domains were compared, For glucose, there was no significant effect (P > 0.1) of substrate placement on any of the mineralisation parameters. However, substrate placement had a significant effect (P < 0.05) on parameters describing 2,4-DCP mineralisation. In particular, 2,4-DCP added in mobile water was mineralised with a greater maximum rate and with a reduced time at maximum rate when compared to 2,4-DCP added to immobile water. The difference in response between the two test substrates may reflect the importance of sorption in controlling the spatial bioavailability of compounds in soil. © 2002 Elsevier Science Ltd. All rights reserved.

Innovative interprofessional teaching session on labour and childbirth for undergraduate medical and midwifery students

There is an increasing recognition of the need to improve interprofessional relationships within clinical practice (Midwifery 2020, 2010). Evidence supports the assertion that healthcare professionals who are able to communicate and work effectively together and who have a mutual respect and understanding for one another’s roles will provide a higher standard of care (McPherson et al, 2001; Miers et al, 2005; Begley, 2008). The joint Royal College of Obstetrics & Gynaecologists(RCOG) / Royal College of Midwives (RCM) report (2008 Page 8) on clinical learning environment and recruitment recommended that “Inter-professional learning strategies should be introduced and supported at an early stage in the medical and midwifery undergraduate students' experience and continued throughout training.” Providing interprofessional education within a University setting offers an opportunity for a non-threatening learning environment where students can develop confidence and build collaborative working relationships with one another (Saxell et al, 2009).Further research supports the influence of effective team working on increased client satisfaction. Additionally it identifies that the integration of interprofessional learning into a curriculum improves students’ abilities to interact professionally and provides a better understanding of role identification within the workplace than students who have only been exposed to uniprofessional education (Meterko et al, 2004; Pollard and Miers, 2008; Siassakos, et al, 2009; Wilhelmsson et al, 2011; Murray-Davis et al, 2012). An interprofessional education indicative has been developed by teaching staff from the School of Nursing and Midwifery and School of Medicine at Queen’s University Belfast. The aim of the collaboration was to enhance interprofessional learning by providing an opportunity for medical students and midwifery students to interact and communicate prior to medical students undertaking their obstetrics and gynaecology placements. This has improved medical students placement experience by facilitating them to learn about the process of birth and familiarisation of the delivery suite environment and it also has the potential to enhance interprofessional relationships. Midwifery students benefit through the provision of an opportunity to teach and facilitate learning in relation to normal labour and birth and has provided them with an opportunity to build stronger and more positive relationships with another profession. This opportunity also provides a positive, confidence building forum where midwifery students utilise teaching and learning strategies which would be transferable to their professional role as registered midwives. The midwifery students were provided with an outline agenda in relation to content for the workshop, but then were allowed creative licence with regard to delivery of the workshop. The interactive workshops are undertaken within the University’s clinical education centre, utilising low fidelity simulation. The sessions are delivered 6 times per year and precede the medical students’ obstetric/gynaecology placement. All 4th year medical and final year midwifery students have an opportunity to participate. Preliminary evaluations of the workshops have been positive from both midwifery and medical students. The teaching sessions provided both midwifery and medical students with an introduction to inter professional learning and gave them an opportunity to learn about and respect each other’s roles. The midwifery students have commented on the enjoyable aspects of team working for preparing for the workshop and also the confidence gained from teaching medical students. The medical students have evaluated the teaching by midwifery students positively and felt that it lowered their anxiety levels going into the labour setting. A number of midwifery and medical students have subsequently worked with one another within the practice setting which has been recognised as beneficial. Both Schools have recognised the benefits of interprofessional education and have subsequently made a commitment to embed it within each curriculum.

Central-Tapped Node Linked Modular Fault-Tolerance Topology for SRM Applications

Electric vehicles (EVs) and hybrid electric vehicles (HEVs) can reduce greenhouse gas emissions while switched reluctance motor (SRM) is one of the promising motor for such applications. This paper presents a novel SRM fault-diagnosis and fault-tolerance operation solution. Based on the traditional asymmetric half-bridge topology for the SRM driving, the central tapped winding of the SRM in modular half-bridge configuration are introduced to provide fault-diagnosis and fault-tolerance functions, which are set idle in normal conditions. The fault diagnosis can be achieved by detecting the characteristic of the excitation and demagnetization currents. An SRM fault-tolerance operation strategy is also realized by the proposed topology, which compensates for the missing phase torque under the open-circuit fault, and reduces the unbalanced phase current under the short-circuit fault due to the uncontrolled faulty phase. Furthermore, the current sensor placement strategy is also discussed to give two placement methods for low cost or modular structure. Simulation results in MATLAB/Simulink and experiments on a 750-W SRM validate the effectiveness of the proposed strategy, which may have significant implications and improve the reliability of EVs/HEVs.

Common Themes in Multi-block Structured Quad/Hex Mesh Generation

The automatic generation of structured multi-block quadrilateral (quad) and hexahedral (hex) meshes has been researched for many years without definitive success. The core problem in quad / hex mesh generation is the placement of mesh singularities to give the desired mesh orientation and distribution [1]. It is argued herein that existing approaches (medial axis, paving / plastering, cross / frame fields) are actually alternative views of the same concept. Using the information provided by the different approaches provides additional insight into the problem.

Effect of position of near addition in an asymmetric refractive multifocal intraocular lens on quality of vision

Purpose
To evaluate the impact of the position of an asymmetric multifocal near segment on visual quality.

Setting
Cathedral Eye Clinic, Belfast, United Kingdom.

Design
Retrospective comparative case series.

Methods
Data from consecutive patients who had bilateral implantation of the Lentis Mplus LS-312 multifocal intraocular lens were divided into 2 groups. One group received inferonasal near-segment placement and the other, superotemporal near-segment placement. A +3.00 diopter (D) reading addition (add) was used in all eyes. The main outcome measures included uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), contrast sensitivity, and quality of vision. Follow-up was 3 months.

Results
Patients ranged in age from 43 to 76 years. The inferonasal group comprised 80 eyes (40 patients) and the superotemporal group, 76 eyes (38 patients). The mean 3-month spherical equivalent was −0.11 D ± 0.49 (SD) in the inferonasal group and −0.18 ± 0.46 D in the superotemporal group. The mean postoperative UDVA was 0.14 ± 0.10 logMAR and 0.18 ± 0.15 logMAR, respectively. The mean monocular UNVA was 0.21 ± 0.14 logRAD and 0.24 ± 0.13 logRAD, respectively. No significant differences were observed in the higher-order aberrations, total Strehl ratio (point-spread function), or modulation transfer function between the groups. Dysphotopic symptoms measured with a validated quality-of-vision questionnaire were not significantly different between groups.

Conclusion
Positioning of the near add did not significantly affect objective or subjective visual function parameters.

An examination of student and provider perceptions of voluntary sector social work placements in Northern Ireland

Practice based learning in Northern Ireland is a core element of social work education and comprising 50% of the degree programme for undergraduate and postgraduate students. This article presents evidence about the perceptions of practice learning from voluntary sector/non-government organisation (NGO) placement providers and final year social work students on social work degree programmes in Northern Ireland in 2011. It draws on data from 121 respondents from189 final year students and focus group interviews with voluntary sector providers offering 16% (85) of the total placements available to students. The agencies who participated in the research study provide a total of 55 PLOs to social work students, and are therefore fairly representative in terms of voluntary sector (NGO) provision. The article locates these data in the context of practice learning pedagogy and the changes introduced by the Regional Strategy for Practice Learning Provision in Northern Ireland 2010–2015. Several themes emerged including; induction, support and guidance, practice educator/student relationship, professional identity and confidence in risk assessment and decision-making. Social work educators, placement providers and employers must be cognisant of newly qualified social workers’ needs in terms of consolidating knowledge within the formative stages of their professional development.

Investigation of tanpura string vibrations using a two-dimensional time-domain model incorporating coupling and bridge friction

Tanpura string vibrations have been investigated previously using numerical models based on energy conserving schemes derived from a Hamiltonian description in one-dimensional form. Such time-domain models have the property that, for the lossless case, the numerical Hamiltonian (representing total energy of the system) can be proven to be constant from one time step
to the next, irrespective of any of the system parameters; in practice the Hamiltonian can be shown to be conserved within machine precision. Models of this kind can reproduce a jvari effect, which results from the bridge-string interaction. However the one-dimensional formulation has recently been shown to fail to replicate the jvaris strong dependence on the thread placement. As a first step towards simulations which accurately emulate this sensitivity to the thread placement, a twodimensional model is proposed, incorporating coupling of controllable level between the two string polarisations at the string termination opposite from the barrier. In addition, a friction force acting when the string slides across the bridge in horizontal direction is introduced, thus effecting a further damping mechanism. In this preliminary study, the string is terminated at the position of the thread. As in the one-dimensional model, an implicit scheme has to be used to solve the system, employing Newton's method to calculate the updated positions and momentums of each string segment. The two-dimensional model is proven to be energy conserving when the loss parameters are set to zero, irrespective of the coupling constant. Both frequency-dependent and independent losses are then added to the string, so that the model can be compared to analogous instruments. The influence of coupling and the bridge friction are investigated.

Confronto tra diverse localizzazioni di un impianto eolico contemperando produttività ed impatto visivo

This paper proposes a series of variations in designing the location of a wind farm on Monti della Tolfa. These project solutions aim at mitigating the visual impact caused by the wind aerogenerators. Besides the usual location of the wind aerogenerators on the skyline, these alternatives within the project design relate to the placement of wind turbines in the middle and at the bottom of the hillside. Other possible mitigation forms relate to the dimensions and the colour of the wind towers. This study proposes both a non-monetary and monetary analysis of the visual impact related to each project proposal. The final aim of the paper is to analyze economic and financial costs-benefits for each alternative to find out the economic optimal solution.

Optimal deployment of geographically distributed workflow engines on the cloud

When orchestrating Web service workflows, the geographical placement of the orchestration engine (s) can greatly affect workflow performance. Data may have to be transferred across long geographical distances, which in turn increases execution time and degrades the overall performance of a workflow. In this paper, we present a framework that, given a DAG-based workflow specification, computes the optimal Amazon EC2 cloud regions to deploy the orchestration engines and execute a workflow. The framework incorporates a constraint model that solves the workflow deployment problem, which is generated using an automated constraint modelling system. The feasibility of the framework is evaluated by executing different sample workflows representative of scientific workloads. The experimental results indicate that the framework reduces the workflow execution time and provides a speed up of 1.3x-2.5x over centralised approaches.