The long term implications for the future of Dental Anaesthetic Practice following the General Dental Council's Guidelines of November 1998

"The long term implicationsfor thefuture ofDental Anaesthetic Practice in Lincolnshirefollowing the General Dental Council's Guidelines ofNovember 1998."The subject of this thesis is based on the continuing requirements of patients for dental anaesthesia following the revised General Dental Council (GDC) Guidelines of November 1998.The factors to be considered in particular are issues which directly apply to referred patients for a dental general anaesthetic (DGA) namely - social class, gender, ethnicity, occupation, background education, attitude towards dental treatment and pre-operative medical history. In addition to considering the issues involved in assessing the suitability of patients for a general anaesthetic (GA) attention will be paid to the General Dental Practitioners (GDP) rationale for referring a patient for GA and whether the choice of such treatment was in any way influenced by the mindset of the patient. Issues relating to case selection will be taken into account along with the steps taken to avoid a repeat anaesthetic. The factors which motivate a GDP to offer GA, sedation or LA will be examined along with the possible reasons which guided the patient to make that decision. A look to the future will be undertaken with regard to GA and sedation services in the UK subsequent to the November 1998 guidelines with some emphasis placed on the adult use of such services.In order to assess the implications and effects of the GDC guidelines on GA services, a study of the attitudes and opinions of both referring and treating dentists was undertaken. This study also took into account the views and attitudes of patients both pre- and post-assessment.The methodology used was both qualitative and quantitative in nature involving the use of questionnaires; two questionnaires were sent to the referring and clinical dentist. The purpose of the questionnaire to the clinical dentists was to determine referral patterns post-guidelines and to monitor compliance with these, whilst the questionnaire to the treating dentists was designed to monitor attitudes regarding referrals for treatment. Likewise patients were given two questionnaires to determine whether patients referred for GA, sedation or LA were satisfied with the treatment plan and subsequent outcome.Since the Poswillo Report of 1990 there have been general recommendations to move from the position of GA towards sedation. Correspondingly part of the referring dentists questionnaire contained a section on this aspect of patient care.The results of the study are considered in detail and inferences drawn relating to the present and future provision of both GA and sedation in the UK

A CFD investigation of synthetic jets

On current helicopter designs, the rotor blades are commonly articulated at their root. This system is employed to ensure that the resultant force of the rotor disc acts through its hub, preventing a rolling moment from being produced in forward flight. The movement which the blades are allowed however, restricts control of the blade angle of attack and allows potential lifting capability to be lost. To address this problem, on-blade flow control using synthetic jets is suggested. Miniature synthetic jets show promise for the alleviation of a number of flow control problems. These may be especially suitable for helicopter application since proposed actuator designs are remotely activated and do not require a secondary jet fluid. These features mean that actuators may be located at large spanwise distances from the rotor hub. An investigation of the operation of synthetic jets and their ability to effect flow control is begun with a CFD study of a single synthetic jet actuator issuing into an otherwise still atmosphere. A jet flow is developed from a rapidly deforming cavity. Velocity profiles are compared with previously published data. Simulations are next extended to crossflow conditions. An alternative synthetic jet model is developed to improve computational efficiency. For this, the deforming cavity is removed and the flow to and from the actuator is simulated by means of an imposed sinusoidally varying velocity. Both approaches for the production of a synthetic jet flow are compared and the same essential features are found. Depending on conditions, different flow behaviours are observed. The actuator produces vortices on its blowing schedule which are either convected with the freestream, or become part of a recirculating system which becomes permanently established a short distance downstream of the actuator exit. When varying freestream and jet operating conditions, optimal mean reduction of surface pressures is found to coincide with the first occurrence of the latter flow behaviour. Using the simpler actuator model, a parameter study is performed to determine optimum jet operation across a range of conditions. The operation of a single synthetic jet on an aerofoil section is finally considered. The same flow behaviours are once again produced. On the aerofoil, the large velocity variation means that achieving the maximum pressure reduction requires operation at high values of reduced frequency. A single actuator makes only a small difference to the overall lift, but the improvement is encouraging and suggests that a number of actuators may make a more significant difference

A study of p120-catenin and its tyrosine phopshorylation in cancer cell adhesion and invasion

Abstract available p i

A study of p120-catenin and its tyrosine phosphorylation in cancer cell adhesion and invasion

Abstract available p i.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Recombinant human epoetin beta in the treatment of chemotherapy-related anemia

Anemia is a common complication of systemic anti-cancer treatment. In this context epoetin beta, like other erythropoiesis-stimulating agents (ESAs), has demonstrable efficacy in raising Hb concentration and reducing the requirement for red cell transfusion. Consequently ESA therapy has gained increasing prominence in the management of chemotherapy-related anemia. However, recent trial data have suggested a higher rate of thromboembolic events, enhanced tumor progression and reduced survival in some patients with cancer who receive ESA therapy. In response, regulatory authorities have mandated increasingly restrictive label changes. In light of these new developments we consider the current role of epoetin beta in the management of chemotherapy-related anemia

Scoping the nascent: An analysis of K-12 OER research 2012-2017

Awareness and use of Open Educational Resources (OER) has grown at all levels of education. Higher education researchers actively study OER but K-12 OER research indicates limited published results. To address this gap, this study examined articles meeting defined criteria and analyzed the results. Findings include cohesion of author-supplied keywords and ten primary categories of focus. From 38 articles studied, a variety of research methods were represented. Analysis showed Professional and Applied Sciences were overwhelmingly represented with the majority of articles within the discipline of Education and its fields with Humanities a distant second category of publication. The equal distribution between open and closed access journals may reflect changes to past scholarly publication practices. Citation analysis revealed divergences and reinforces the nascent quality of this topic. Future K-12 OER research that studies the complex change from resource scarcity to resource flexibility and digital abundance is needed

Performance of formulae based estimates of glomerular filtration rate for carboplatin dosing in stage 1 seminoma

<b>Background:</b> Single cycle carboplatin, dosed by glomerular filtration rate (GFR), is standard adjuvant therapy for stage 1 seminoma. Accurate measurement of GFR is essential for correct dosing. Isotopic methods remain the gold standard for the determination of GFR. Formulae to estimate GFR have improved the assessment of renal function in non-oncological settings. We assessed the utility of these formulae for carboplatin dosing.<p></p> <b>Methods:</b> We studied consecutive subjects receiving adjuvant carboplatin for stage 1 seminoma at our institution between 2007 and 2012. Subjects underwent 51Cr-ethylene diamine tetra-acetic acid (EDTA) measurement of GFR with carboplatin dose calculated using the Calvert formula. Theoretical carboplatin doses were calculated from estimated GFR using Chronic Kidney Disease-Epidemiology (CKD-EPI), Management of Diet in Renal Disease (MDRD) and Cockcroft–Gault (CG) formulae with additional correction for actual body surface area (BSA). Carboplatin doses calculated by formulae were compared with dose calculated by isotopic GFR; a difference <10% was considered acceptable.<p></p> <b>Results:</b> 115 patients were identified. Mean isotopic GFR was 96.9 ml/min/1.73 m2. CG and CKD-EPI tended to overestimate GFR whereas MDRD tended to underestimate GFR. The CKD-EPI formula had greatest accuracy. The CKD-EPI formula, corrected for actual BSA, performed best; 45.9% of patients received within 10% of correct carboplatin dose. Patients predicted as underdosed (13.5%) by CKD-EPI were more likely to be obese (p = 0.013); there were no predictors of the 40.5% receiving an excess dose.<p></p> <b>Conclusions:</b> Our data support further evaluation of the CKD-EPI formula in this patient population but clinically significant variances in carboplatin dosing occur using non-isotopic methods of GFR estimation. Isotopic determination of GFR should remain the recommended standard for carboplatin dosing when accuracy is essential.<p></p&gt

Real-time measurement of pelvis and trunk kinematics during treadmill locomotion using a low-cost depth-sensing camera: A concurrent validity study

There is currently no suitable kinematic system for a large-scale prospective trial assessing risk factors of musculoskeletal disorders. A practical kinematic system is described which involves the use of a single low-cost depth-sensing camera for the real-time measurement of 3-dimensional linear and angular pelvic and trunk range-of-movement (ROM). The method is based on the creation and processing of dynamic point clouds taken from the posterior surface of the pelvis and trunk. Nine healthy participants performed 3 trials of treadmill locomotion when walking at self-selected speed (3.6-5.6 km/h), running at 70% (10.9-14.0 km/h) and 90% of maximal speed (14.0-18.0 km/h). Stride-by-stride linear and angular ROM data were captured concurrently using the single depth-sensing camera running at 30Hz (KinectTM for Windows, Microsoft, USA) and a six-camera motion capture system at 100Hz (Vicon MX13, Vicon Motion Systems, United Kingdom). Within subject correlation coefficients between the practical and criterion method ranged from very large to nearly perfect (r = 0.87–1.00) for the linear ROM. Correlation coefficients for the angular ROM ranged from moderate to very large (r = 0.41–0.80). The limits of agreement between the two systems for linear movements was ≤ 9.9 mm at all velocities of gait and ≤ 4.6 degrees at all velocities of gait. The single camera system using depth-sensing technology is capable of capturing linear pelvic and trunk ROM during treadmill locomotion with reasonable precision when compared to the criterion method. Further improvements to the measurement of angles and validation across a wider population are recommended

〈Article〉Softening Power : Cuteness as Organizational Communication Strategy in Japan and the West

This paper describes the use of cute communications (visual or verbal, and in various media) as an organizational communication strategy prevalent in Japan and emerging in western countries. Insights are offered for the use of such communications and for the understanding/critique thereof. It is first established that cuteness in Japan–kawaii–is chiefly studied as a sociocultural or psychological phenomenon, with too little analysis of its near-omnipresent institutionalization and conveyance as mass media. The following discussion clarifies one reason for this gap in research–the widespread conflation of \u27organizational communication\u27 with advertising/branding, notwithstanding the variety of other messaging–public relations, employee communications, public service announcements, political campaigns–conveyed through cuteness by Japanese institutions. It is then argued that what few theorizations exist of organizational kawaii communications overemphasize their negative aspects or potentials, attributing to them both too much iniquity and too much influence. Outside of Japan studies, there is even less up-to-date scholarship on organizational cuteness, critical or otherwise. And there are no such studies at all, whether focused on Japan or elsewhere, that integrate intercultural insights. In a preliminary contribution toward such knowledge, we discuss the understudied, longstanding, and increasing use of this strategy by western companies. Points of comparison and contrast with Japanese kawaii are highlighted, in both its organizational and pop-cultural aspects, drawing also on sociological studies of the west\u27s current cuteness craze. Guiding insights are offered and future research directions specified, both for those seeking to advise western organizations in communicating cutely, and for those concerned that such softening power will be abused