THE DYNAMICS OF A TIDAL INTRUSION FRONT IN A NATURAL ESTUARY: EFFECTS ON MULTIBEAM SONAR ACCURACY

This research has utilised high-resolution measurements of density and velocity to investigate the formation of a transient tidal intrusion front in a narrow, macrotidal estuary, and model the impact of such a frontal system on the accuracy of multibeam sonar surveys. The front was found to form during spring tides, when the barotropic inflow was sufficient to arrest the buoyant outflow from the estuary. This has been shown to be driven by changes in channel width and depth, creating a hydraulic control point. These changes in topography are demonstrated to interact with the flow m a similar manner to theoretical two-layer flow over the lee side of a sill. Enhanced shear at the density interface, provided by increasing barotropic and baroclinic flows during the flooding tide, eventually led to the decay of the frontal system. There was no surface manifestation of this front during neap tides. Further measurements have confirmed that the relatively weak barotropic flow at this time was not sufficient to overcome the stratification in a two layer regime. Frontal dynamics have been shown to conform to theoretical predictions, and an evaluation of the key frontal discrimmators has confirmed the validity of their use in such an environment. The development of a multibeam sonar refraction model has facilitated an assessment of the accuracy of hydrographic surveys conducted in the presence of a tidal intrusion fronts. Major reductions in swath width have been shown to be required when traversing a tidal intrusion front, with a flat sonar transducer array providing the most effective survey results. Undersampling the sound velocity field in the vicinity of a tidal intrusion front leads to major depth errors usmg all multibeam sonar transducer configurations; hence, accepted methods of sound velocity sampling in estuarine environments should be updated with immediate effect. Recommendations have been made that sampling in such an environment is undertaken at least hourly, at intervals of less than 50 m in order to maximise hydrographic survey efficiency.Britannia Royal Naval Colleg

International recruitment of radiographers and the development of a workplace integration support package: Project evaluation

Introduction In October 2020, a regional workforce action group was established jointly by Health Education England (HEE) and NHS England and Improvement (NHSEI) in the South West to work collaboratively to address the workforce challenges within diagnostic imaging. Fifty-eight internationally recruited radiographers were offered employment in departments across the region, the majority of them taking up their posts in the UK in early 2021. The aim of the study presented here was to evaluate the efficacy of a training resource developed by Plymouth Marjon University, with input from HEE and NHSEI, to support workplace and cultural integration for the new recruits. Methods The training package to help newly recruited radiographers from outside the UK integrate into their host departments was developed using flexible learning opportunities centred on reusable digital learning assets. Self-paced e-learning sessions were augmented by group ‘connected’ sessions online. Two surveys were undertaken, exploring the impact of this workforce integration programme for International radiographers joining the NHS. Results Survey results indicate that the integration programme's three-phase strategy has seen an impact on 6 out of 12 self-efficacy measures, raised awareness of challenges, and increased personal awareness of implications for practice. By the end of the programme, delegates were in the top two quintiles for their average well-being score. Conclusion Principal recommendations include ensuring digital accessibility for new recruits as part of the on-boarding process, considering the timing of delivery of any online connected support sessions, the provision of long-term pastoral support; and mandating the training requirement for managers and team leaders. Implications for practice Success of international recruitment campaigns can be enhanced through the implementation of an online integration packag

International Recruitment of Radiographers and the Development of a Workplace Integration Support Package Project Evaluation Report

In October 2020, a regional workforce action group was established jointly by Health Education England (HEE) and NHS England and Improvement (NHSEI) in the South West to work collaboratively to address the workforce challenges within diagnostic imaging. The group was established to support the restoration and recovery of services and identify interventions required to develop and enhance the future diagnostic imaging workforce in the region and then support the implementation of these interventions. As part of the blueprint strategy that arose from the regional adopt and adapt workstream, an international recruitment campaign was identified as an intervention that could address an immediate shortfall of radiographers, fill vacancies and support diagnostic recovery. Following a successful in-country recruitment campaign in Dubai, 58 radiographers were offered employment in departments across the region. Recognising the many challenges that staff may encounter when relocating to work in the UK it was identified that new recruits would need additional support. Plymouth Marjon University was contracted to provide a package of training to help newly recruited radiographers from outside the UK integrate successfully into their host departments. Applying novel pedagogy (the eLEARN approach) to develop flexible learning opportunities centred around reusable digital learning assets, self-paced e-learning sessions were augmented by group ‘connected’ sessions online, facilitated by a tutor. The programme’s three-phase strategy that focused on a targeted ‘before, during and after’ has seen an impact on a number of self-efficacy measures, a raised awareness of challenges, and personal awareness of implications for practice. It has acted to support a smooth transition through onboarding and beyond to both new recruits and their departments. The principal recommendations following development and implementation of this Workplace Integration Package include ensuring digital accessibility for new recruits as part of the on-boarding process, considering the timing of delivery of any online connected support sessions, the provision of long-term pastoral support; and mandating the training requirement for managers and team leaders to improve engagement

UK-Wide Multicenter Evaluation of Second-line Therapies in Primary Biliary Cholangitis

Background &amp; aims: thirty-to-forty percent of patients with primary biliary cholangitis inadequately respond to ursodeoxycholic acid. Our aim was to assemble national, real-world data on the effectiveness of obeticholic acid (OCA) as a second-line treatment, alongside non-licensed therapy with fibric acid derivatives (bezafibrate or fenofibrate).Methods: this was a nationwide observational cohort study conducted from August 2017 until June 2021.Results: we accrued data from 457 patients; 349 treated with OCA and 108 with fibric acid derivatives. At baseline/pre-treatment, individuals in the OCA group manifest higher risk features compared with those taking fibric acid derivatives, evidenced by more elevated alkaline phosphatase values, and a larger proportion of individuals with cirrhosis, abnormal bilirubin, prior non-response to ursodeoxycholic acid, and elastography readings &gt;9.6kPa (P &lt; .05 for all). Overall, 259 patients (OCA) and 80 patients (fibric acid derivatives) completed 12 months of second-line therapy, yielding a dropout rate of 25.7% and 25.9%, respectively. At 12 months, the magnitude of alkaline phosphatase reduction was 29.5% and 56.7% in OCA and fibric acid groups (P &lt; .001). Conversely, 55.9% and 36.4% of patients normalized serum alanine transaminase and bilirubin in the OCA group (P &lt; .001). The proportion with normal alanine transaminase or bilirubin values in the fibric acid group was no different at 12 months compared with baseline. Twelve-month biochemical response rates were 70.6% with OCA and 80% under fibric acid treatment (P = .121). Response rates between treatment groups were no different on propensity-score matching or on sub-analysis of high-risk groups defined at baseline.Conclusion: across the population of patients with primary biliary cholangitis in the United Kingdom, rates of biochemical response and drug discontinuation appear similar under fibric acid and OCA treatment.</p

Guidelines on the management of abnormal liver blood tests

These updated guidelines on the management of abnormal liver blood tests have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the liver section of the BSG. The original guidelines, which this document supersedes, were written in 2000 and have undergone extensive revision by members of the Guidelines Development Group (GDG). The GDG comprises representatives from patient/carer groups (British Liver Trust, Liver4life, PBC Foundation and PSC Support), elected members of the BSG liver section (including representatives from Scotland and Wales), British Association for the Study of the Liver (BASL), Specialist Advisory Committee in Clinical Biochemistry/Royal College of Pathology and Association for Clinical Biochemistry, British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN), Public Health England (implementation and screening), Royal College of General Practice, British Society of Gastrointestinal and Abdominal Radiologists (BSGAR) and Society of Acute Medicine. The quality of evidence and grading of recommendations was appraised using the AGREE II tool. These guidelines deal specifically with the management of abnormal liver blood tests in children and adults in both primary and secondary care under the following subheadings: (1) What constitutes an abnormal liver blood test? (2) What constitutes a standard liver blood test panel? (3) When should liver blood tests be checked? (4) Does the extent and duration of abnormal liver blood tests determine subsequent investigation? (5) Response to abnormal liver blood tests. They are not designed to deal with the management of the underlying liver disease.</p

‘A Girl's Love’: Lord Alfred Douglas as Homoerotic Muse in the Poetry of Olive Custance

This is an Accepted Manuscript of an article published by Taylor & Francis in Women: a Cultural Review on 15/09/2011, available online: http://dx.doi.org/10.1080/09574042.2011.585045.This article explores the relationship between the poet Olive Custance and her husband Lord Alfred Douglas, arguing that Custance constructed Douglas as a male muse figure in her poetry, particularly the sequence ‘Songs of a Fairy Princess’ (Rainbows 1902). The introduction sets out Custance's problematic historical positioning as a ‘decadent’ poet who published nothing following the Great War, but whose work came too late to fit into strictly ‘fin de siècle’ categories. I suggest, however, that Custance's oscillating constructions of gender and sexuality make her more relevant to the concerns of modernity than has previously been acknowledged and her work anticipates what is now termed ‘queer’. The first main section of the article traces the cultural background of the fin de siècle male muse, arguing that Custance's key influences—male homoerotic writers such as Wilde and Pater—meant it was logical that she should imagine the muse as male, despite the problems associated with gender-reversals of the muse-poet relationship which have been identified by several feminist critics. I then move on to focus specifically on how Shakespearean discourses of gender performance and cross-dressing played a key role in Custance and Douglas's courtship, as they exchanged the fluid roles of ‘Prince’, ‘Princess’ and ‘Page’. The penultimate section of the article focuses on discourses of fairy tale and fantasia in Custance's ‘Songs of a Fairy Princess’ sequence, in which these fantasy roles contribute to a construction of Douglas as a feminised object, and the relationship between the ‘Prince’ and ‘Princess’ is described in terms of narcissistic sameness. My paper concludes by tracing the demise of Custance and Douglas's relationship; as Douglas attempted to be more ‘manly’, he sought to escape the role of object, resulting in Custance losing her male muse. But her sexually-dissident constructions of the male muse remain important experiments worthy of critical attention

Think twice before you accept that job

xi, 167 p.; 23 cm

Qthreads: An api for programming with millions of lightweight threads

Large scale hardware-supported multithreading, an attractive means of increasing computational power, benefits significantly from low per-thread costs. Hardware support for lightweight threads is a developing area of research. Each architecture with such support provides a unique interface, hindering development for them and comparisons between them. A portable abstraction that provides basic lightweight thread control and synchronization primitives is needed. Such an abstraction would assist in exploring both the architectural needs of large scale threading and the semantic power of existing languages. Managing thread resources is a problem that must be addressed if massive parallelism is to be popularized. The qthread abstraction enables development of large-scale multithreading applications on commodity architectures. This paper introduces the qthread API and its Unix implementation, discusses resource management, and presents performance results from the HPCCG benchmark. 1