Identifying type 2 diabetes risk classification systems and recommendations for review of podiatric care in an Australian Aboriginal health clinic

Background - There are several risk classification systems developed to facilitate diabetic foot assessments and prioritise diabetes patients for foot prevention services according to risk factors. Utilisation of both The University of Texas Diabetic Foot Risk Classification System (UTDFRCS) and The National Evidence-Based Guideline on Prevention, Identification and Management of Foot Complications in Diabetes (Part of the Guidelines on Management of Type 2 Diabetes), allows guidance for the podiatrist in terms of review timeframes for future assessments and treatment. The aim of this clinical audit was to classify Aboriginal type 2 diabetes subjects’ risk status according to UTDFRCS and identify if evidence based standards are being met for podiatry services at the Albury-Wodonga Aboriginal Health Service in New South Wales, Australia. Methods - A retrospective clinical audit over a twenty six month period was undertaken at the Albury-Wodonga Aboriginal Health Service, New South Wales. This is a primary health care facility that started podiatry services in August 2011. The primary variables of interest were the UTDFRCS for each subject and whether those participants met or did not meet the National Evidence-Based Guideline for review appointment timeframes. Other variables of interest include age, gender, duration of diabetes, occasions of visits and cancelled and failure to attend appointments to the podiatry service over the data collection period. Results - There was excellent overall adherence (94 %) of this sample population (n = 729) to the National Evidence-Based Guideline for podiatric review timeframes according to their risk status. Males were reported to be less likely to comply with the review timeframes compared to women. There was no association between risk status and age (OR = 1.04, p = 0.11), duration of diabetes (OR = 1.03, p = 0.71) or gender (OR = 0.77, p = 0.67). Conclusions - Regular foot examinations aid in stratifying patients according to risk status, guiding podiatry interventions to reduce the likelihood of ulceration and amputation. This primary health care setting has achieved podiatric evidence based standards for Aboriginal people with type 2 diabetes, demonstrated by acceptable timeframes for review appointments

Pre-school experience and Key Stage 2 performance in English and Mathematics

This report considers children\u27s educational attainment in English and mathematics at the end of primary school (age 11). Children\u27s educational attainment in English and mathematics was derived from their national Key Stage 2 assessments. The analyses have considered the child\u27s level of Key Stage 2 attainment in terms of the effects of child, family, home environment and preschool experience variables as well as the child\u27s ability at the start of primary school

Children, play and computers in pre-school education

The paper reports a study designed to inform the development of an information and communication technology strategy for the pre-school years of education. The main methods of collecting evidence were observations at seven pre-school settings and interviews with at least two practitioners and a number of children at each site. Practitioners generally referred to children “playing with the computer”. We describe some of the problems to be found in the emphasis on free play in nurseries and play groups when this means children are using computers as complete novices. There were few examples of peer support; adults rarely intervened or offered guidance and the most common form of intervention was reactive supervision. Interaction with a computer was therefore a limited experience for most children, but we provide examples of guided interaction that suggest a way forward for professional development

A European Pharmaceutical Aerosol Group (EPAG)-led cross-industry assessment of inlet flow rate profiles of compendial DPI test systems: Part 1 – experimental data

We report outcomes from an EPAG-led cross-industry study, characterizing flow rate/elapsed-time profiles of equipment used for testing dry powder inhalers (DPIs). A thermal mass flow sensor was used by nine organizations in a round-robin approach to record inlet flow rate-time profiles of individual participant compendial test systems (TS) including either sample collection tubes (SCT) or a cascade impactor (either the Andersen 8-stage non-viable impactor, ACI, or the Next Generation Impactor, NGI) equipped with USP/PhEur induction port and pre-separator. An inlet orifice generated a 4-kPa pressure drop at each of the target flow rates (30, 60 and 90 L/min), simulating a pressure drop typical for high-, medium- and low-resistance DPIs respectively. Rise times to 90% of these target flow rates (t90) were longest with largest internal dead volume and followed the order NGI>ACI >SCT>TS. When the surrogate DPI (4-kPa orifice) was absent, t90 values generally lengthened with increasing target flow rate. In contrast, the opposite behaviour was observed when the surrogate DPI was present. A flow acceleration parameter was also calculated, expressed as the slope between the 20% and 80% flow rates of each final steady flow value (slopet20/t80). Greater flow acceleration occurred at higher final flow rates, irrespective of apparatus, but the presence of the surrogate DPI was associated with slower flow acceleration. These flow rate-rise time profiles will be useful for those involved in evaluating equipment for characterizing both existing and new DPIs

Overview of the design of the ITER heating neutral beam injectors

The heating neutral beam injectors (HNBs) of ITER are designed to deliver 16.7MWof 1 MeVD0 or 0.87 MeVH0 to the ITER plasma for up to 3600 s. They will be the most powerful neutral beam\uf0a0(NB) injectors ever, delivering higher energy NBs to the plasma in a tokamak for longer than any previous systems have done. The design of the HNBs is based on the acceleration and neutralisation of negative ions as the efficiency of conversion of accelerated positive ions is so low at the required energy that a realistic design is not possible, whereas the neutralisation ofH 12 andD 12 remains acceptable ( 4856%). The design of a long pulse negative ion based injector is inherently more complicated than that of short pulse positive ion based injectors because: \u2022 negative ions are harder to create so that they can be extracted and accelerated from the ion source; \u2022 electrons can be co-extracted from the ion source along with the negative ions, and their acceleration must be minimised to maintain an acceptable overall accelerator efficiency; \u2022 negative ions are easily lost by collisions with the background gas in the accelerator; \u2022 electrons created in the extractor and accelerator can impinge on the extraction and acceleration grids, leading to high power loads on the grids; \u2022 positive ions are created in the accelerator by ionisation of the background gas by the accelerated negative ions and the positive ions are back-accelerated into the ion source creating a massive power load to the ion source; \u2022 electrons that are co-accelerated with the negative ions can exit the accelerator and deposit power on various downstream beamline components. The design of the ITER HNBs is further complicated because ITER is a nuclear installation which will generate very large fluxes of neutrons and gamma rays. Consequently all the injector components have to survive in that harsh environment. Additionally the beamline components and theNBcell, where the beams are housed, will be activated and all maintenance will have to be performed remotely. This paper describes the design of theHNBinjectors, but not the associated power supplies, cooling system, cryogenic system etc, or the high voltage bushingwhich separates the vacuum of the beamline fromthehighpressureSF6 of the high voltage (1MV) transmission line, through which the power, gas and coolingwater are supplied to the beam source. Also themagnetic field reduction system is not described

Understanding teaching assistant self-efficacy in role and in training: its susceptibility to influence

There has been a noted growth in the number of teaching assistants (TAs) in mainstream schools (DfE, 2013a). Research is inconclusive about their efficacy at changing outcomes for children (Alborz et al 2009; Blatchford et al, 2009) and has proposed more training for TAs (Russell et al, 2005). Generic training models have suggested that enhancing self-efficacy in turn improves performance. This exploratory study investigated factors that may influence TAs’ sense of self-efficacy and its susceptibility to influence in training. Following two modes of mode of school-based training by Educational Psychologists (EPs) data were collected from 14 mainstream secondary school TAs using focus groups. A thematic analysis noted themes regarding self-efficacy, aligned with Bandura’s (1977) sources of information, outcome expectations and whole school support and norms. Review of the data is likely to be able to guide potential trainers to coach consult strategies which are self-efficacy supportive and which address contextual factors including the perceived status of TAs in schools

Assessment for learning : a model for the development of a child’s self competence in the early years of education

In recent years policy documents, curricula and other educational initiatives have promoted a pedagogy founded on the concept of independent learning. This is broadly defined as ‘having the belief in yourself to think through learning activities, problems or challenges, make decisions about your learning and act upon those decisions (Blandford and Knowles, 2009:336). The central role of Assessment for Learning (AfL) in this process is often overlooked in practice. By considering the findings from a small scale research study this article addresses the central role of the teacher /practitioner in developing effective AfL in the early years classroom (3-5 years)

The peer relations of pupils with special educational needs in mainstream primary schools:The importance of meaningful contact and interaction with peers

Background and aims: Children with special educational needs (SEN) are generally less accepted by peers in school and have fewer friendships than those without SEN. However, little research has examined peer relations across multiple dimensions, relative to severity of need and in relation to classroom experiences and individual behavioural characteristics. This unique study aimed to extend understanding of the peer relations of pupils with differing levels of SEN support relative to children of differing attainment levels without a formally recognised SEN and in relation to levels of social contact in class and teacher ratings of behaviour. Sample: Three hundred and seventy-five 9-11-year-old children recruited from 13 classes in 4 mainstream primary schools in the south of England. Fifty-nine pupils had been identified as having a SEN, of which 17 had a statement of SEN. Method: Pupil sociometric questionnaires provided a range of peer relations measures and the extent of meaningful contact with peers. Pupil behaviour was rated by teachers using the Pupil Behaviour Rating scales. Analyses examined differences in peer relations measures, pupil behaviour and meaningful contact across different levels of educational need. Results: Compared to pupils without SEN, pupils with a statement of SEN had lower levels of peer acceptance, fewer reciprocated friendships, and were less integrated into peer groups. Whilst internalising behaviours, such as social anxiousness and anxiety, and externalising behaviours, such as aggression and hyperactivity, were related to peer relations measures, frequency of meaningful contact with peers was more predictive of peer relations measures than either SEN status or behaviour. Conclusion: Findings point to the crucial role of meaningful social contact in the classroom for children’s relationships with peers. The study advances understanding by highlighting that greater opportunity for meaningful social contact may improve social involvement of, as well as enhance academic outcomes for, pupils with SEN educated in mainstream schools

The role of pre-school quality in promoting resilience in the cognitive development of young children

The study reported here investigates the role of pre-school education as a protective factor in the development of children who are at risk due to environmental and individual factors. This investigation builds upon earlier research by examining different kinds of 'quality' in early education and tests the hypothesis that pre-schools of high quality can moderate the impacts of risks upon cognitive development. Cognitive development was measured in 2857 English pre-schoolers at 36 and 58 months of age, together with 22 individual risks to children's development, and assessments were made of the quality of their pre-school provision. Multilevel Structural Equation Modelling revealed that: the global quality of pre-school can moderate the effects of familial risk (such as poverty); the relationships between staff and children can moderate the effects of child level risk (such as low birth weight); and the specific quality of curricular provision can moderate the effects of both. Policy makers need to take quality into account in their efforts to promote resilience in young 'at risk' children through early childhood services

Language support for immigrant children: a study of state schools in the UK and US

In recent decades, immigrants, refugees and asylum seekers have sought a new way of life in large numbers, often leaving their countries of origin behind in search of places that offer a better way of life. The purpose of this study was to investigate how elementary and middle school students in state schools in Reading, England (primarily speakers of Asian languages), and Richmond, Virginia (primarily speakers of Spanish), were supported academically, when most children’s first language was not English. The authors were interested in exploring whether or not there were cultural or structural differences in the way each country helped or hindered these students as they progressed through the school systems. Three UK schools in a district of approximately 100,000 and three US schools in a district of approximately 250,000 were the focus of this exploration from 2000 to 2003. Findings indicated that there were cultural and legislative differences and similarities. Teachers and administrators in both countries attempted to provide services with limited and sometimes diminishing resources. Community support varied based on resources, attitudes toward various ethnic groups, and the coping strategies adopted by these groups in their new environments. Marked differences appeared with regard to the manner in which assessments took place and how the results were made available to the public