The Engineering Council’s influence on Building Services Engineering education and qualifications: towards an internationalist education and training model

A large number of Building Services Engineering (BSE) graduates from UK universities either already live and work abroad, or aspire to do so, and the destinations for such migrants are most often English-speaking countries or countries where English is commonly used in business. Academic programmes in BSE are usually professionally accredited by the Chartered Institution of Building Services Engineers (CIBSE) under licence from the Engineering Council (EC). In the common destination countries for UK BSE graduates the Washington, Sydney and Dublin Accord (WSDA) agreements prevail, meaning that there is a mutual recognition of engineering qualifications and professional accreditation of academic courses, and this facilitates international mobility. Since it is widely accepted that buildings account for as much as 50% of greenhouse gas emissions worldwide, it could be said that there is a worldwide sustainability agenda with respect to buildings. The common factor across national boundaries is that Building Services Engineers, as central members of building design teams, must provide much of the specialist practical knowledge to enable more energy efficient buildings to be designed and constructed, and it is therefore likely that UK educated engineers will be working in far more varied overseas locations in the near future. The main aim of the work is to synthesise an education and training model to encourage and enable international mobility of UK BSE graduates, and to carry out some evaluation of this model. This work sets out initially to question whether a UK education in BSE necessarily provides UK graduates with the best possible skillset for work abroad. The influence of the EC upon the content of BSE study programmes has been examined, and the research assesses the benefits of the EC’s influence in countries with different economic and political priorities to the UK, other western economies and to the WSDA countries. Following identification and analysis of the main issues, the model was constructed and evaluations were made using semi-structured interviews. The methodology used in this research is necessarily underpinned by a pragmatist paradigm, which has led to the use of a mixed methods blended approach. In addition to thorough review and analysis of literature, the practical methods employed include a questionnaire survey and semi-structured interviews in three phases: an exploratory phase, an in-depth analysis, and a concluding phase. The early conclusions indicated that the EC influence upon BSE study programmes is generally regarded as necessary and beneficial, since it provides an engineering skillset that is internationally respected and recognised. There is, however, less confidence in applying this in an international arena outside of the WSDA umbrella since different parts of the world face different economic challenges, divergent societal imperatives, and diverse attitudes to sustainability and green issues. An education and training model was constructed to address these issues and, after initial testing, was found generally to be a workable proposition to enhance the international prospects of UK BSEs, and further, could be adopted in the UK under the auspices of the Degree Apprenticeship initiatives. Such a model is, however, unlikely to be adopted in many overseas locations due to differing cultural views on the value of work-based learning and apprenticeship

Caffeine intake during pregnancy and adverse birth outcomes: a systematic review and dose–response meta-analysis

Caffeine is commonly consumed during pregnancy, crosses the placenta, with fetal serum concentrations similar to the mother’s, but studies of birth outcome show conflicting findings. We systematically searched Medline and Embase for relevant publications. We conducted meta-analysis of dose–response curves for associations between caffeine intake and spontaneous abortion, stillbirth, preterm delivery, low birth weight and small for gestational age (SGA) infants. Meta-analyses included 60 unique publications from 53 cohort and case–control studies. An increment of 100 g caffeine was associated with a 14 % (95 % CI 10–19 %) increase in risk of spontaneous abortion, 19 % (5–35 %) stillbirth, 2 % (-2 to 6 %) preterm delivery, 7 % (1–12 %) low birth weight, and 10 % (95 % CI 6–14 %) SGA. There was substantial heterogeneity in all models, partly explained by adjustment for smoking and previous obstetric history, but not by prospective assessment of caffeine intake. There was evidence of small-study effects such as publication bias. Greater caffeine intake is associated with an increase in spontaneous abortion, stillbirth, low birth weight, and SGA, but not preterm delivery. There is no identifiable threshold below which the associations are not apparent, but the size of the associations are generally modest within the range of usual intake and are potentially explained by bias in study design or publication. There is therefore insufficient evidence to support further reductions in the maximum recommended intake of caffeine, but maintenance of current recommendations is a wise precaution

Participatory policy making by dairy producers to reduce anti-microbial use on farms

This is the author accepted manuscript. The final version is available from Blackwell Publishing via the DOI in this record.Pressures for more responsible use of anti‐microbial (AM) medicines in food animals are likely to increase from policymakers and the food industry, including retailers. To address this challenge, participatory approaches to welfare interventions and disease prevention may also be necessary alongside more conventional regulatory measures. This article describes the process of enabling groups of dairy producers to use a participatory policy making approach to develop an AM stewardship policy. The policy includes measures agreed to by all producers for more responsible use of AMs, whilst maintaining or improving dairy herd health and welfare. This process provided a unique opportunity for collaboration and dialogue between producers, veterinarians, industry and researchers. Its participatory nature encouraged comprehensive learning for all involved. This integration of science with producers’ knowledge and experience led to credible and practical recommendations designed to deliver real and lasting change in AM use. The multidisciplinary nature of this research marks a significant contribution to embedding social science skills and approaches into the veterinary sphere. As an initial step in creating better understanding of how participatory approaches with farmers can be applied in a UK context and more widely, this work serves as a pilot for promoting more responsible use of veterinary medicines in other livestock species

Infrared Spectroscopy of Ammonia on Iron: Adsorption, Synthesis and the Influence of Oxygen

We report on reflection absorption infrared spectroscopy (RAIRS) investigations into the influence of oxygen on the surface chemistry of NH3 on Fe{111}. Pre-adsorption of oxygen is found to strengthen the interaction between ammonia and the surface, albeit at the lowest oxygen coverage examined the effect is only notable when the ammonia coverage becomes high. At higher oxygen coverage, the same effect is observed even with very low ammonia coverage. In cases where the oxygen overlayer is ordered, the effects are seen quite clearly, but for disordered overlayers the surface heterogeneity makes assignment of absorption features more difficult; nevertheless, comparison with the ordered examples allows us to identify the same underlying behaviour. When potassium is coadsorbed with oxygen, the effect on ammonia adsorption is threefold, including potassium-dominated and oxygen-dominated features, alongside features that suggest either cancelling or absent influences from the atomic adsorbates. Synthesis of ammonia from nitrogen adatoms in 0.6 mbar H2 shows clear evidence of very similar surface interactions

Methodological bias in cluster randomised trials

Background: Cluster randomised trials can be susceptible to a range of methodological problems. These problems are not commonly recognised by many researchers. In this paper we discuss the issues that can lead to bias in cluster trials. Methods: We used a sample of cluster randomised trials from a recent review and from a systematic review of hip protectors. We compared the mean age of participants between intervention groups in a sample of 'good' cluster trials with a sample of potentially biased trials. We also compared the effect sizes, in a funnel plot, between hip protector trials that used individual randomisation compared with those that used cluster randomisation. Results: There is a tendency for cluster trials, with evidence methodological biases, to also show an age imbalance between treatment groups. In a funnel plot we show that all cluster trials show a large positive effect of hip protectors whilst individually randomised trials show a range of positive and negative effects, suggesting that cluster trials may be producing a biased estimate of effect. Conclusion: Methodological biases in the design and execution of cluster randomised trials is frequent. Some of these biases associated with the use of cluster designs can be avoided through careful attention to the design of cluster trials. Firstly, if possible, individual allocation should be used. Secondly, if cluster allocation is required, then ideally participants should be identified before random allocation of the clusters. Third, if prior identification is not possible, then an independent recruiter should be used to recruit participants

The influence of 'significant others' on persistent back pain and work participation: a qualitative exploration of illness perceptions

Background Individual illness perceptions have been highlighted as important influences on clinical outcomes for back pain. However, the illness perceptions of 'significant others' (spouse/partner/close family member) are rarely explored, particularly in relation to persistent back pain and work participation. The aim of this study was to initiate qualitative research in this area in order to further understand these wider influences on outcome. Methods Semi-structured interviews based on the chronic pain version of the Illness Perceptions Questionnaire-Revised were conducted with a convenience sample of UK disability benefit claimants, along with their significant others (n=5 dyads). Data were analysed using template analysis. Results Significant others shared, and perhaps further reinforced, claimants' unhelpful illness beliefs including fear of pain/re-injury associated with certain types of work and activity, and pessimism about the likelihood of return to work. In some cases, significant others appeared more resigned to the permanence and negative inevitable consequences of the claimant's back pain condition on work participation, and were more sceptical about the availability of suitable work and sympathy from employers. In their pursuit of authenticity, claimants were keen to stress their desire to work whilst emphasising how the severity and physical limitations of their condition prevented them from doing so. In this vein, and seemingly based on their perceptions of what makes a 'good' significant other, significant others acted as a 'witness to pain', supporting claimants' self-limiting behaviour and statements of incapacity, often responding with empathy and assistance. The beliefs and responses of significant others may also have been influenced by their own experience of chronic illness, thus participants lives were often intertwined and defined by illness. Conclusions The findings from this exploratory study reveal how others and wider social circumstances might contribute both to the propensity of persistent back pain and to its consequences. This is an area that has received little attention to date, and wider support of these findings may usefully inform the design of future intervention programmes aimed at restoring work participation

The two-hour orbit of a binary millisecond X-ray pulsar

Typical radio pulsars are magnetized neutron stars that are born rapidly rotating and slow down as they age on time scales of 10 to 100 million years. However, millisecond radio pulsars spin very rapidly even though many are billions of years old. The most compelling explanation is that they have been "spun up" by the transfer of angular momentum during accretion of material from a companion star in so-called low-mass X-ray binary systems, LMXBs. (LMXBs consist of a neutron star or black hole accreting from a companion less than one solar mass.) The recent detection of coherent X-ray pulsations with a millisecond period from a suspected LMXB system appears to confirm this link. Here we report observations showing that the orbital period of this binary system is two hours, which establishes it as an LMXB. We also find an apparent modulation of the X-ray flux at the orbital period (at the two per cent level), with a broad minimum when the pulsar is behind this low-mass companion star. This system seems closely related to the "black widow" millisecond radio pulsars, which are evaporating their companions through irradiation. It may appear as an eclipsing radio pulsar during periods of X-ray quiescence.Comment: 4 pages with 1 figure. Style files included. Fig. 2 deleted and text revised. To appear in Nature. Press embargo until 18:00 GMT on 1998 July 2

Is the pharmacy profession innovative enough?: meeting the needs of Australian residents with chronic conditions and their carers using the nominal group technique

Background Community pharmacies are ideally located as a source of support for people with chronic conditions. Yet, we have limited insight into what innovative pharmacy services would support this consumer group to manage their condition/s. The aim of this study was to identify what innovations people with chronic conditions and their carers want from their ideal community pharmacy, and compare with what pharmacists and pharmacy support staff think consumers want. Methods We elicited ideas using the nominal group technique. Participants included people with chronic conditions, unpaid carers, pharmacists and pharmacy support staff, in four regions of Australia. Themes were identified via thematic analysis using the constant comparison method. Results Fifteen consumer/carer, four pharmacist and two pharmacy support staff groups were conducted. Two overarching themes were identified: extended scope of practice for the pharmacist and new or improved pharmacy services. The most innovative role for Australian pharmacists was medication continuance, within a limited time-frame. Consumers and carers wanted improved access to pharmacists, but this did not necessarily align with a faster or automated dispensing service. Other ideas included streamlined access to prescriptions via medication reminders, electronic prescriptions and a chronic illness card. Conclusions This study provides further support for extending the pharmacist’s role in medication continuance, particularly as it represents the consumer’s voice. How this is done, or the methods used, needs to optimise patient safety. A range of innovative strategies were proposed and Australian community pharmacies should advocate for and implement innovative approaches to improve access and ensure continuity of care

Coexistence of the topological state and a two-dimensional electron gas on the surface of Bi2Se3

Topological insulators are a recently discovered class of materials with fascinating properties: While the inside of the solid is insulating, fundamental symmetry considerations require the surfaces to be metallic. The metallic surface states show an unconventional spin texture, electron dynamics and stability. Recently, surfaces with only a single Dirac cone dispersion have received particular attention. These are predicted to play host to a number of novel physical phenomena such as Majorana fermions, magnetic monopoles and unconventional superconductivity. Such effects will mostly occur when the topological surface state lies in close proximity to a magnetic or electric field, a (superconducting) metal, or if the material is in a confined geometry. Here we show that a band bending near to the surface of the topological insulator Bi$_2$Se$_3$ gives rise to the formation of a two-dimensional electron gas (2DEG). The 2DEG, renowned from semiconductor surfaces and interfaces where it forms the basis of the integer and fractional quantum Hall effects, two-dimensional superconductivity, and a plethora of practical applications, coexists with the topological surface state in Bi$_2$Se$_3$. This leads to the unique situation where a topological and a non-topological, easily tunable and potentially superconducting, metallic state are confined to the same region of space.Comment: 12 pages, 3 figure