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Harnessing the Mechanical Kerr Effect for Optical Control in Photonic Crystal Nanobeam Cavities
No full textThe mechanical Kerr effect in optomechanical photonic crystal nanobeam cavities is investigated, where high-power light induces deformation to modulate probe modes, enabling all-optical tunable photonic applications such as filters, sensors, and communication devices
Understanding Skill Transfer Between University and Workplace Through Reflective Practice: A Software Engineering Work-Based Learning Experience
Get PDFWork-based learning (WBL) programs in Software Engineering provide students with opportunities to apply academic knowledge in the workplace. However, how students navigate the transition between knowledge and skills acquired at university and their application in the workplace remains largely unexplored. We implemented a WBL Software Engineering program in which students spend most of their time in the workplace rather than at university. Reflective student essays were used to examine how our implementation supports the integration and transfer of learning between academic and professional contexts. University modules - such as those on software design patterns and programming - offered directly applicable skills, while foundational knowledge and problem-solving frameworks supported further development. Workplace experiences reinforced understanding, provided context, and enabled practical application. However, skills such as project management, leadership, and context switching were primarily developed in the workplace, revealing gaps between academic team projects and industry needs. Difficulties in transferring some advanced technical skills also point to a disconnect between academic instruction and industry application. Our findings suggest a cyclical relationship between university and workplace learning, with each enhancing the other. We propose key considerations for WBL program design, including curriculum alignment, structured skill development, and integrated delivery. Finally, we underscore the value of reflective essays in observing and supporting skill integration
Analysis of the kidney failure risk equation implementation in routine clinical practice and health inequalities in chronic kidney disease care: a retrospective cohort study
Get PDFBackground:
NICE guidelines recommend GPs use the kidney failure risk equation (KFRE) to identify people with chronic kidney disease (CKD) at higher risk of kidney failure. Albuminuria results are required to calculate KFRE.
Aim:
Analyse the implementation of KFRE into clinical practice and investigate if albuminuria testing varied amongst patients with CKD, particularly for underserved groups.
Design and setting:
Retrospective cohort study of 23,063 adults in Glasgow from 2013 to 2022.
Method:
We evaluated albuminuria testing rates and the predictive performance of KFRE in estimating 5-year kidney failure risk amongst people with CKD. Logistic regression models quantified associations between demographic/clinical variables and albuminuria testing. Amongst people who developed kidney failure, we retrospectively assessed the impact of KFRE on the timing of meeting criteria for referral to renal services.
Results:
Albuminuria testing was performed in 44.5% of 10,874 adults with CKD. Females (adjusted odds ratio (aOR) 0.86: 95% CI 0.79–0.93) and those with hypertension (aOR 0.69: 95% CI 0.63–0.77) were less likely to have albuminuria testing. Those aged 40–50 years (aOR 1.83: 95% CI 1.15–2.91), with diabetes (aOR 2.35: 95% CI 2.14–2.58) and living in the least socioeconomically deprived areas (aOR 1.11: 95% CI 1.00-1.23) were more likely to have albuminuria testing. Of 1,352 individuals with incident kidney failure, incorporating KFRE into referral guidelines helped identify high-risk patients early.
Conclusion:
KFRE could be calculated for less than half of people due to lack of albuminuria testing. Focus should be given to improving albuminuria testing and inequities identified to allow wider implementation of KFRE
Review of Gregory and Michaelian (eds.) Dreaming and Memory: Philosophical Issues
Get PDFDaniel Gregory and Kourken Michaelian’s edited volume Dreaming and Memory: Philosophical Issues is a very welcome development in what has been an area of intersection hitherto neglected in analytic philosophy. The book, the first of its kind, brings together philosophers of memory, dreaming, and of mind more generally, and is organised into three parts. The first explores the topic of remembering dreams, the second on the issue of whether dreaming ever
involves memory, and the final part contains various comparisons between dreaming and memory. I here provide an overview of the book then some brief concluding thoughts of my own
Shifting the skills conversation: building a lifelong learning culture to foster innovation in Scotland’s financial sector
Get PDFBuilding a sustainable, productive and inclusive financial services sector in Scotland means thinking beyond the needs of today. ‘Fostering innovation’ requires investing in people’s ability to think broader than what’s right in front of them, and such capability to be dynamic in behaviour, knowledge and practical expertise is built through the process of learning – over and over again, exploring many different skills and interests, and throughout life. It’s for this reason that in this white paper we propose shifting the skills conversation beyond plugging skills gaps and identifying which is the latest technical need in the workforce, and instead building a ‘lifelong learning’ culture to better foster innovation in Scotland’s financial sector, long-term
Economic evaluation of a complex intervention to improve the mental health of maltreated children in foster care (BeST? services trial)
Get PDFBackground:
Children in foster care who have experienced abuse and neglect are at risk of poor long-term health and societal outcomes. Evidence on the costs, benefits and cost-effectiveness of early interventions aimed at improving the mental health of abused and neglected children is limited.
Methods:
This study reports the within-trial economic evaluation alongside BEST?, a randomized controlled trial comparing the New Orleans Intervention Model (NIM) with services as usual (SAU), targeting children aged 0–60 months entering UK foster care.
In line with guidance for conducting economic evaluations of complex and social care interventions, a cost-utility analysis (CUA) estimated incremental cost of NIM per quality-adjusted life year (QALY); a cost-effectiveness analysis estimated incremental cost per unit improvement in child mental health; and a cost-consequence analysis combined costs with broad-ranging outcomes.
Results:
NIM is significantly more costly than SAU (NIM: £10 002; SAU: £4336), with wide cost variations according to context. There are no significant differences between NIM and SAU in QALYs or child mental health.
Conclusions:
Within the current UK care systems, NIM is not a cost-effective alternative to SAU. However, these results need to be interpreted with caution and within the prevailing service provision context
Clinical outcomes in frail elderly patients undergoing small-bowel capsule endoscopy
Get PDFObjective: Small-bowel capsule endoscopy (SBCE) is being used with increasing frequency. It is important, however, to ensure that the frail elderly in particular are undergoing investigations which have a positive impact on their ongoing management. We aimed to determine the SBCE rate in the elderly, the clinical outcomes, and if clinical frailty may be used to tailor SBCE.
Design/methods: Patients aged ≥65 who had a SBCE performed at the Royal Infirmary of Edinburgh from 1 January 2016 to 1 December 2021 were identified. Demographic, clinical and SBCE results were collected and statistical analysis was performed.
Results: In total, 189 patients aged ≥65 years underwent SBCE. Median age at SBCE was 72 years (IQR 68–76); 63.0% (n=119) were women. The most common indication for SBCE was iron-deficiency anaemia (n=174, 92.1%).
A total of 15.9% (n=30) patients were clinically frail (Clinical Frailty Scale ≥5). Frail patients had reduced survival at 1 (p=0.003), 3 (p<0.001) and 5 (p<0.0001) years post-SBCE. The most common pathology in this group was angioectasia (33.3%, n=10). Double balloon enteroscopy was performed in 1 frail patient, compared with 11 non-frail patients (p=0.488).
Conclusions: Our results indicate that small bowel bleeding in the frail elderly is most likely to be associated with angioectasia. Given the high mortality at follow-up and risks of subsequent investigations in this group, conservative treatment with oral or parenteral iron may be more appropriate. Investigating these patients with SBCE is unlikely to alter management and clinical outcome
Growing around grief: the lived experience of parentally-bereaved young people in the UK
Get PDFMore than 100 children per day in the UK experience the death of their parent before the age of 18. Parentally-bereaved young people (PBYP) face considerable hardships including detrimental health and wellbeing outcomes across their lifespan. This study’s aim was to explore the lived experience of PBYP in the UK to understand their experiences and needs. Nine semi-structured interviews were conducted with young people aged 18–25 in Scotland. Thematic analysis was carried out using the Dual Process Model (DPM) as an exploratory lens. Four themes were identified: grief experiences, cumulative stressors, valued support, and coping mechanisms and management strategies. The themes reflected the DPM’s components: loss-orientation, restoration-orientation and oscillation, but the DPM was not fully able to account for the wider social and interpersonal contextual factors discussed. The article proposes further research to explore extensions to the DPM to account for these factors. Practice recommendations include improved bereavement protocols, education for peers and educational staff, and bereavement support interventions
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