Learning Together 1: an educational model for training GPs, paediatricians: initial findings.

Learning Together is primarily an educational intervention, where paediatric registrars [SpRs] and General Practice (GP) registrars [GPSTs] see children together in a primary care setting. Over a six month period in 2013/2014, 44 learning pairs were set up mainly in North East and Central London. Proof of concept for the model at scale was achieved. Reported learning demonstrated: clinical learning themes of new knowledge, skill and communication skills; and collaborative themes of ongoing collaboration, satisfaction with team working and change in attitudes. These themes were identified in both sets of trainees. The self-reported learning is backed up by the results of a retrospective notes review of four common conditions based on NICE guidelines; constipation, asthma, feverish illness and eczema (CAFE). Guidance adherence improved from 57% before the intervention in solo GP training consultations to 72% during the joint clinic intervention (p < 0.01). After the intervention when the GP registrars returned to normal consultations, guidance adherence was 77% compared to before the intervention (p < 0.01). In addition 99% of the parents, who handed in feedback forms or took part in interviews, reported a good experience of care, and 87% reported increased confidence to manage their children's health following the consultation. A second, linked article examines the cost utility of Learning Together in its South London extension

Complexing additives to reduce the immiscible phase formed in the hybrid ZnBr2 flow battery

The zinc-bromine redox flow battery (RFB) is one of a very few commercially viable RFB energy storage system capable of integration with intermittent renewable energy sources to deliver improved energy management. However, due to the volatility of the electrogenerated bromine and potential for its crossover from positive to negative electrolytes, this system requires the use of quaternary ammonium complexes (N-methyl-N-ethylpyrrolidinium, (MEP)) to capture this bromine. This produces an immiscible phase with the Br2 which requires a complex network of pipes, pumps and automated controls to ensure access to the electroactive material during discharge. In this work, the use of novel quaternary ammonium complexes to capture the electrogenerated bromine but to keep it in the aqueous phase is examined. Three compounds, 1-(carboxymethyl) pyridine-1-ium, 1-(2-carboxymethyl)-1-methylmorpholin-1-ium and 1-(2-carboxymethyl)-1-methylpyrrolidin-1-ium, were found to successfully reduce the volume of the immiscible phase formed on complexing with the polybromide (Brx-) whilst displaying similar enthalpy of vaporisation values as that of MEP. Electrochemical analysis also revealed that these compounds did not impact on the electrode kinetics of the Br-/Brx- reaction indicating that the resulting surface film formed with these compounds behaved as a chemically modified electrode, in contrast to the surface film formed with MEP

On the theory of coronal heating mechanisms

Theoretical models describing solar coronal heating mechanisms are reviewed in some detail. The requirements of chromospheric and coronal heating are discussed in the context of the fundamental constraints encountered in modelling the outer solar atmosphere. Heating by acoustic processes in the 'nonmagnetic' parts of the atmosphere is examined with particular emphasis on the shock wave theory. Also discussed are theories of heating by electrodynamic processes in the magnetic regions of the corona, either magnetohydrodynamic waves or current heating in the regions with large electric current densities (flare type heating). Problems associated with each of the models are addressed

The Multi-Sensory Design of a Synesthete\u27s Everyday Experience

Perception, which can be defined as becoming aware of occurrences in the world through the senses, is different for every person (Merriam-Webster). My thesis deals with perception in the form of a condition called synesthesia and the communication of this condition using graphic design. Synesthesia is a condition that involves the involuntary crossing of the senses, resulting in multi-sensory experiences every time a synesthete absorbs the world and visible language. Utilizing the field of graphic design, I created several projects to communicate my three goals of conducting research on synesthesia, sharing what I experience every day, and educating others about synesthesia. I used the inspiration of many important sources about synesthesia to create a graphic design-centered action plan that resulted in a book titled A Story of Synesthetic Discovery, several research posters, and a visual song that utilizes my visual perception of the world as a synesthete

What are Business Models: Towards a Theory of Performative Representations

Despite a rich extant literature, it is unclear what business models are. We assess three dominant conceptions of business models in the academic literature: as transactional structures, value extracting devices, and mechanisms for structuring the organization. To overcome the shortcomings of these approaches, we draw on theories of performativity, social typecasting, and managerial cognition. We propose an alternative conception of business models as performative representations that work in three ways: as narratives that convince, typifications that legitimate, and recipes that guide social action. Rather than actual features of firms, business models are representations that allow managers to articulate and instantiate the value of new technologies

Synthesis of hetero-bifunctional, end-capped oligo-EDOT derivatives

Conjugated oligomers of 3,4-ethylenedioxythiophene (EDOT) are attractive materials for tissue engineering applications, and as model systems for studying the properties of the widely used polymer PEDOT. We report here the facile synthesis of a series of keto-acid end-capped oligo-EDOT derivatives (n = 2-7) through a combination of a glyoxylation end capping strategy and iterative direct arylation chain extension. Importantly, these structures not only represent the longest oligo-EDOTs reported, but are also bench stable in contrast to previous reports on such oligomers. The constructs reported here can undergo subsequent derivatization for integration into higher order architectures, such as those required for tissue engineering applications. The synthesis of hetero-bifunctional constructs, as well as those containing mixed monomer units is also reported, allowing further complexity to be installed in a controlled manner. Finally, we describe the optical and electrochemical properties of these oligomers and demonstrate the importance of the keto-acid in determining their characteristics

Eocene–early Oligocene climate and vegetation change in southern China: Evidence from the Maoming Basin

Although the Eocene-Oligocene climate transition marks a critical point in the development of the ‘icehouse’ global climate of the present little is known about this important change in the terrestrial realm at low latitudes. Our palynological study of the Shangcun Formation shows it to be early Oligocene in age: palyno-assemblages in the lower part of the formation indicate a cool interval dominated by conifer pollen in the earliest Oligocene followed by a warmer regime in the second half of the early Oligocene. To quantify middle Eocene to late early Oligocene climate conditions at low (~ 20°N) palaeolatitudes in southern Asia several thousand leaf fossil specimens from the Maoming Basin, southern China, were subjected to a multivariate (CLAMP) analysis of leaf form. For terrestrial palaeoclimate comparisons to be valid the palaeoaltitude at which the proxy data are obtained must be known. We find that leaves preserved in the Youganwo (middle Eocene), Huangniuling (late Eocene) and Shangcun (early Oligocene) formations were likely to have been deposited well above sea level at different palaeoelevations. In the Youganwo Formation fine-grained sediments were deposited at an altitude of ~ 1.5 km, after which the basin dropped to ~ 0.5 km by the time the upper Huangniuling sediments were deposited. The basin floor then rose again by 0.5 km reaching an altitude of approximately 1 km in which the Shangcun Formation fine-grained sediments were accumulated. Within the context of these elevation changes the prevailing climates experienced by the Youganwo, Lower Huangniuling, Upper Huangniuling and Shangcun fossil floras were humid subtropical with hot summers and warm winters, but witnessed a progressive increase in rainfall seasonality. By the early Oligocene rainfall seasonality was similar to that of the modern monsoonal climate of Guangdong Province, southern China. All floras show leaf physiognomic spectra most similar to those growing under the influence of the modern Indonesia-Australia Monsoon, but with no evidence of any adaptation to today's South or East Asia Monsoon regimes. The Upper Huangniuling Flora, rich in dipterocarp plant megafossils, grew in the warmest conditions with the highest cold month mean temperature and at the lowest altitude

Where there’s ‘willingness’ there’s a way: barriers and facilitators to maternal, newborn and child health data sharing by the private health sector in Uttar Pradesh, India

In India and Uttar Pradesh (UP), the private health sector plays an important role in health care services, including institutional deliveries, but there is limited information on the availability of maternal, newborn and child health (MNCH) data that private facilities maintain and share with the public health information system. Sharing data could help the public sector plan their resources more efficiently. Aim of the study: To explore current practices of MNCH data availability and sharing/reporting by private health facilities and the barriers and facilitators to data sharing