Ear care: an update for nurses (part 1)

A healthy ear is vital not just for hearing, but for balance and for full engagement with the community. In the first of two articles, Kat Millward reviews the anatomy of the ear, outlines methods of dealing with cerumen, and discusses methods of assessment and diagnosis Our ears are essential for both hearing and balance. Up to 4% of the population will have difficulties with their ears relating to impacted cerumen and many of them will present in primary care with ear discomfort or hearing difficulties. In the first of two articles, we review the anatomy and physiology of the ear and cerumen production, followed by a discussion of the key aspects of making an assessment using the SOAP (Subjective, Objective, Assessment, Plan) mnemonic

In-service Initial Teacher Education in the Learning and Skills Sector in England: Integrating Course and Workplace Learning

The aim of the paper is to advance understanding of in-service learning and skills sector trainee teachers’ learning and propose ways of improving their learning. A conceptual framework is developed by extending Billett’s (International Journal of Educational Research 47:232–240, 2008) conceptualisation of workplace learning, as a relationally interdependent process between the opportunities workplaces afford for activities and interactions and how individuals engage with these, to a third base of participation, the affordances of the initial teacher education course. Hager and Hodkinson’s (British Educational Research Journal 35:619–638, 2009) metaphor of ‘learning as becoming’ is used to conceptualise the ways trainees reconstruct learning in a continuous transactional process of boundary crossing between course and workplace. The findings of six longitudinal case studies of trainees’ development, and evidence from other studies, illustrate the complex interrelationships between LSS workplace affordances, course affordances and trainee characteristics and the ways in which trainees reconstruct learning in each setting. The experience of teaching and interacting with learners, interactions with colleagues, and access to workplace resources and training are important workplace affordances for learning. However, some trainees have limited access to these affordances. Teaching observations, course activities and experiences as a learner are significant course affordances. Trainees’ beliefs, prior experiences and dispositions vary and significantly influence their engagement with course and workplace affordances. It is proposed that better integration of course and workplace learning through guided participation in an intentional workplace curriculum and attention to the ways trainees choose to engage with this, together with the use of practical theorising has the potential to improve trainee learning

Endovascular repair or open repair for ruptured abdominal aortic aneurysm: a Cochrane systematic review

OBJECTIVES: Emergency endovascular aneurysm repair (eEVAR) may improve outcomes for patients with ruptured abdominal aortic aneurysm (RAAA). The study aim was to compare the outcomes for eEVAR with conventional open surgical repair for the treatment of RAAA. SETTING: A systematic review of relevant publications was performed. Randomised controlled trials (RCTs) comparing eEVAR with open surgical repair for RAAA were included. PARTICIPANTS: 3 RCTs were included, with a total of 761 patients with RAAA. INTERVENTIONS: Meta-analysis was performed with fixed-effects models with ORs and 95% CIs for dichotomous data and mean differences with 95% CIs for continuous data. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome was short-term mortality. Secondary outcome measures included aneurysm-specific and general complication rates, quality of life and economic analysis. RESULTS: Overall risk of bias was low. There was no difference between the 2 interventions on 30-day (or in-hospital) mortality, OR 0.91 (95% CI 0.67 to 1.22; p=0.52). 30-day complications included myocardial infarction, stroke, composite cardiac complications, renal complications, severe bowel ischaemia, spinal cord ischaemia, reoperation, amputation and respiratory failure. Reporting was incomplete, and no robust conclusion was drawn. For complication outcomes that did include at least 2 studies in the meta-analysis, there was no clear evidence to support a difference between eEVAR and open repair. Longer term outcomes and cost per patient were evaluated in only a single study, thus precluding definite conclusions. CONCLUSIONS: Outcomes between eEVAR and open repair, specifically 30-day mortality, are similar. However, further high-quality trials are required, as the paucity of data currently limits the conclusions

Sodium and Potassium Ion Selective Conjugated Polymers for Optical Ion Detection in Solution and Solid State

EPSRC. Grant Number: EP/G037515/1; EC FP7 Project SC2. Grant Number: 610115; EC FP7 Project ArtESun. Grant Number: 604397; EC FP7 POLYMED. Grant Number: 61253

Investigation of the thermoelectric response in conducting polymers doped by solid-state diffusion

The thermoelectric effect is a physical phenomenon which intricately relates the thermal energy of charge carriers to their charge transport. Understanding the mechanism of this interaction in different systems lies at the heart of inventing novel materials which can revolutionize thermoelectric power gener- ation technology. Despite a recent surge of interest in organic thermoelectric materials, the community has had difficulties in formulating the charge trans- port mechanism in the presence of a significant degree of disorder. Here, we analyze the thermoelectric properties of various conducting polymers doped by a solid-state diffusion of dopant molecules based on a transport model with a power-law energy-dependence of transport function. A fine control of the degree of doping via post-doping annealing provides an accurate empirical evidence of a strong energy dependence of the carrier mobility in the conducting polymers. A superior thermoelectric power factor of conducting polymers doped by solid-state diffusion to that of other doping methods can be attributed to a resulting higher intrinsic mobility and higher free carrier concentration.The research leading to these results has received funding from the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007-2013) / ERC grant agreement n 610115. Keehoon Kang thanks the for financial support from Samsung Scholarship Foundation and the National Creative Research Laboratory program (Grant No. 2012026372) through the National Research Foundation of Korea, funded by the Korean Ministry of Science and ICT. K.B. acknowledges funding by the German Research Foundation (BR 4869/1-1)

Cricket, migration and diasporic communities

Ever since different communities began processes of global migration, sport has been an integral feature in how we conceptualise and experience the notion of being part of a diaspora. Sport provides diasporic communities with a powerful means for creating transnational ties, but also shapes ideas of their ethnic and racial identities. In spite of this, theories of diaspora have been applied sparingly to sporting discourses. Due mainly to its central role in spreading dominant white racial narratives within the British Empire, and the various ways different ethnic groups have ‘played’ with the meanings and associations of the sport in the (post-)colonial period, cricket is an interesting focus for academic research. Despite W.G. Grace’s claim that cricket advances civilisation by promoting a common bond, binding together peoples of vastly different backgrounds, to this day cricket operates strict symbolic boundaries; defining those who do, and equally, do not belong. C.L.R. James’ now famous metaphor of looking ‘beyond the boundary’ captures the belief that, to fully understand the significance of cricket, and the sport’s roles in changing and shaping society, one must consider the wider social and political contexts within which the game is played. The collection of papers in this special issue does just that. Cricket acts as the point of departure in each, but the way in which ideas of power, representation and inequality are ‘played out’ is unique in each

Investigation of transition frequencies of two acoustically coupled bubbles using a direct numerical simulation technique

The theoretical results regarding the ``transition frequencies'' of two acoustically interacting bubbles have been verified numerically. The theory provided by Ida [Phys. Lett. A 297 (2002) 210] predicted the existence of three transition frequencies per bubble, each of which has the phase difference of $\pi /2$ between a bubble's pulsation and the external sound field, while previous theories predicted only two natural frequencies which cause such phase shifts. Namely, two of the three transition frequencies correspond to the natural frequencies, while the remaining does not. In a subsequent paper [M. Ida, Phys. Rev. E 67 (2003) 056617], it was shown theoretically that transition frequencies other than the natural frequencies may cause the sign reversal of the secondary Bjerknes force acting between pulsating bubbles. In the present study, we employ a direct numerical simulation technique that uses the compressible Navier-Stokes equations with a surface-tension term as the governing equations to investigate the transition frequencies of two coupled bubbles by observing their pulsation amplitudes and directions of translational motion, both of which change as the driving frequency changes. The numerical results reproduce the recent theoretical predictions, validating the existence of the transition frequencies not corresponding to the natural frequency.Comment: 18 pages, 8 figures, in pres

Mediastinal cryptococcosis masquerading as therapy-refractory lymphoma

published_or_final_versionSpringer Open Choice, 21 Feb 201