The Nature and Meaning of Insulin Pump Use in Emerging Adults with Type 1 Diabetes

Emerging adults (ages 18-25) with type 1 diabetes are a vulnerable population as they transition from the family home and their pediatric healthcare providers and deal with multiple competing demands. There is very little literature addressing those in this developmental group who use insulin pump technology for diabetes self-management. Listening to the voices of emerging adults who use insulin pump technology will increase our understanding of their experience and will give health care providers the opportunity to develop evidence based practice based on their lived experiences. The qualitative research, using the hermeneutic phenomenological approach described by Max van Manen, provides a deeper understanding of the day-to-day journey of the emerging adult. Four themes represent the essences that were ultimately viewed as strategies used by emerging adults as they crossed from adolescence to adulthood with type 1 diabetes and an insulin pump. This journey is presented metaphorically as learning to walk a tightrope

On frontal and ventilated models of the main thermocline

A new similarity approach is applied to the thermocline equations in order to examine contrasting frontal and ventilated models of the main thermocline. The method of solution involves reducing the number of independent variables of the controlling partial differential equation, leading to a particular form for the solutions which satisfy appropriate boundary conditions. A frontal model of the thermocline is obtained following the study of Salmon and Hollerbach (1991). When the vertical diffusivity becomes vanishingly small, an interior front in the subtropical gyre appears at the depth where the vertical velocity changes sign. The front separates downwelling warm water in the subtropical gyre from the underlying upwelling of cold, deep water. These solutions appear to be robust to changes in the vertical diffusivity profile, as long as there is a small, nonzero value in the interior. However, when there is uniform diffusivity, there is no implied surface heat flux and surface isotherms are coincident with streamlines. As the diffusivity increases toward the surface, the surface heat input increases in magnitude and the temperature field becomes more plausible. A ventilated model of the thermocline is formed using the similarity approach with a diffusive surface boundary-layer overlying an adiabatic interior. In this case, the temperature and velocity fields are solved for in the limit of uniform potential vorticity. There is now a more plausible cross-isothermal flow in the surface layer with a polewards decrease in temperature, and the implied surface heat input increases equatorwards. Fluid is subducted from the surface boundary layer into the adiabatic interior and forms a continuous thermocline. In conclusion, the contrasting frontal and ventilated solutions arise from modeling different aspects of the circulation, rather than depending on the type of model employed. The ventilated solutions form a thermocline by advecting the surface temperature field into the interior of a subtropical gyre, whereas the frontal solutions create a thermocline from the interaction of the wind-driven gyre and the underlying thermohaline circulation. These thermocline solutions might occur separately or together in the real ocean, although both solutions might be modified by higher-order processes or more complicated forcing

Characterising the optical properties of galaxy clusters with GMPhoRCC

We introduce the Gaussian Mixture full Photometric Red sequence Cluster Characteriser (GMPhoRCC), an algorithm for determining the redshift and richness of a galaxy cluster candidate. By using data from a multi-band sky survey with photometric redshifts, a red sequence colour magnitude relation (CMR) is isolated and modelled and used to characterise the optical properties of the candidate. GMPhoRCC provides significant advantages over existing methods including, treatment of multi-modal distributions, variable width full CMR red sequence, richness extrapolation and quality control in order to algorithmically identify catastrophic failures. We present redshift comparisons for clusters from the GMBCG, NORAS, REFLEX and XCS catalogues, where the GMPhoRCC estimates are in excellent agreement with spectra, showing accurate, unbiased results with low scatter ($\sigma_{\delta z / (1+z)} \sim 0.014$). We conclude with the evaluation of GMPhoRCC performance using empirical Sloan Digital Sky Survey (SDSS) like mock galaxy clusters. GMPhoRCC is shown to produce highly pure characterisations with very low probabilities ($<1\%$) of spurious, clean characterisations. In addition GMPhoRCC is shown to demonstrate high rates of completeness with respect to recovering redshift, richness and correctly identifying the BCG.Comment: 22 Pages, 18 figure

Characterization of high finesse mirrors: loss, phase shifts and mode structure in an optical cavity

An extensive characterization of high finesse optical cavities used in cavity QED experiments is described. Different techniques in the measurement of the loss and phase shifts associated with the mirror coatings are discussed and their agreement shown. Issues of cavity field mode structure supported by the dielectric coatings are related to our effort to achieve the strongest possible coupling between an atom and the cavity.Comment: 8 pages, 4 figure

The results of a survey highlighting issues with feedback on medical training in the United Kingdom and how a Smartphone App could provide a solution

BACKGROUND: Feedback drives learning in medical education. Healthcare Supervision Logbook (HSL) is a Smartphone App developed at Sheffield Teaching Hospitals for providing feedback on medical training, from both a trainee's and a supervisor's perspective. In order to establish a mandate for the role of HSL in clinical practice, a large survey was carried out. METHODS: Two surveys (one for doctors undertaking specialty training and a second for consultants supervising their training) were designed. The survey for doctors-in-training was distributed to all specialty trainees in the South and West localities of the Health Education Yorkshire and the Humber UK region. The survey for supervisors was distributed to all consultants involved in educational and clinical supervision of specialty trainees at Sheffield Teaching Hospitals. RESULTS: The results confirm that specialty trainees provide feedback on their training infrequently-66 % do so only annually. 96 % of the specialty trainees owned a Smartphone and 45 % said that they would be willing to use a Smartphone App to provide daily feedback on the clinical and educational supervision they receive. Consultant supervisors do not receive regular feedback on the educational and clinical supervision they provide to trainees-56 % said they never received such feedback and 33 % said it was only on an annual basis. 86 % of consultants surveyed owned a Smartphone and 41 % said they would be willing to use a Smartphone App to provide feedback on the performance of trainees they were supervising. CONCLUSIONS: Feedback on medical training is recorded by specialty trainees infrequently and consultants providing educational and clinical supervision often do not receive any feedback on their performance in this area. HSL is a simple, quick and efficient way to collect and collate feedback on medical training to improve this situation. Good support and education needs to be provided when implementing this new technology

Abnormalities of the retinal cone system in retinitis pigmentosa

AbstractPatients with retinitis pigmentosa (RP) show delayed inner retinal responses as measured by the cone ERG response to a 30 Hz stimulus. To determine the extent to which this delay results from abnormalities of cone phototransduction, cone ERGs to single flashes were obtained from 21 patients with RP and a model of cone phototransduction was fitted to the leading edge of the a-waves of these ERGs. Nearly all patients showed an abnormally low sensitivity of cone phototransduction consistent with a reduction in the amplification of transduction. This abnormality can account for part of the delayed 30 Hz response. Analysis of post-receptoral potentials indicated that RP also slows the responses of the inner retina. A combination of these two factors, a sensitivity change at the receptor and a delay in the response of the inner retina, produces the delayed response of the cone flicker ERG in patients with RP