A recently developed therapy for treatment of acute respiratory failure requires that the patient's metabolic carbon dioxide production be eliminated by a membrane oxygenator operated in an extracorporeal blood circuit. In conjunction with peripheral cannulation, the oxygenator should be optimised for CO₂ removal at low blood flow rates of 1.5 ℓ/min or less for adults. An extensive literature survey revealed that very few publications dealt with oxygenator CO₂ performance at low flow rates. Two commercial devices, the Terumo CAPIOX II (1.6 m² and 3.3 m² membrane areas) hollow fibre oxygenator and the Travenol TMO (2.25 m² membrane area) parallel-plate oxygenator were evaluated in relation to the new therapy. A theoretical model describing carbon dioxide transfer in membrane oxygenators was used to correlate the experimental data. The Terumo CAPIOX II 3.3 m² unit was the only device capable of satisfying the carbon dioxide removal requirements necessary for the new therapy at the low blood flow rates stipulated. Effects of blood and gas flow maldistribution were also studied in the TMO and CAPIOX II units respectively. Non-uniform blood flow was not a major factor contributing to the decline in CO₂ transfer performance compared with theory. This was confirmed in experiments with a modified TMO unit. Comparison with theory indicated that the membrane resistance was the controlling factor for CO₂ transfer in the CAPIOX II device. A method was developed to assess the CO₂ transmission rate (Gco₂) through oxygenator membranes under gas-membrane-liquid contact conditions. This forms the basis for the selection of suitable membrane materials for oxygenators. Although the GCO₂ values for homogeneous silicone rubber membranes were consistent with the results of previous workers, significantly higher values were obtained for microporous polypropylene membranes. For microporous membranes under liquid contact conditions a 5-fold reduction in GCO₂ is obtained in this study compared to gas-membrane-gas tests, indicating that micropore wetting imposes a significant resistance to CO₂ transfer.

Introduction Overall the evidence is consistent and robust that UK South Asian communities are at elevated risk of lifestyle related disease. A potential worsening of obesity related risk in South Asian children carries implications for persisting disparities in chronic disease across generations making it advantageous to target this specific group for obesity prevention. Psychosocial factors are particularly important in obesity and key to understanding the determinants of dietary and physical activity behaviour, and factors that might influence behaviour modification in South Asians. The study aims to identify beliefs and perceptions that contribute to health risk and health protective behaviours in young UK South Asian families and to develop a theory which can be used to define specific objectives that lead to effective behaviour change to improve health outcomes for this population. Design Grounded theory methodology was applied to investigate how factors influence South Asian mother’s decisions to engage in health behaviours for themselves and their children taking into account specific beliefs and practices influencing health behaviours. Semi-structured interviews were carried out with seven female participants who were mothers to young children aged 5-12 years of age. Results The grounded theory is underpinned by three categories that emerged out of analysis of the data; cultural identity, health beliefs and barriers. These categories and their properties, tell the story of the influences and pressures on South Asian mothers as they attempt to negotiate a healthy family lifestyle. The data emerged to form a grounded theory of the balancing act South Asian mothers engage in to negotiate a healthy family lifestyle. Conclusions This study contributes to an improved understanding of the unique factors influencing young South Asian family’s health behaviours and recognition of the need to help them to find a healthier lifestyle balance. In addition, it has revealed how these factors relate to the initiation and maintenance of a healthy lifestyle and will be of use to health professionals and service providers when designing interventions to address and prevent health inequalities among this group. Emphasising the need to involve both the family and their community in interventions, in order for them to be effective. Limitations of these findings and their implications for future research and practice are considered.

This study was undertaken in part as a response to proposed changes in the curriculum and teaching of Physical Education in Irish post-primary schools. I have been involved in Physical Education Teacher Education (PETE) for almost thirty years, almost entirely in Ireland, and I have a strong commitment to the promotion of child-centred Physical Education which I believe may be threatened by the proposed changes. My concerns are evident within this study which focuses on three Physical Education teachers in contemporary Ireland over a period of approximately three years during which three Draft New Syllabuses for Physical Education were written by the National Council for Curriculum and Assessment. These teachers share concerns and values regarding the teaching of Physical Education which broadly concur with my espoused ideology. Each is aware of their preferred pedagogical practices and is articulate in their defence of them. Within this study, the professional practices of these teachers are examined in the context of societal changes and the proposed curriculum changes in Physical Education evidenced in the new syllabuses. Inspiration is drawn from Basil Bernstein's work which Sadovnik (1995, p. 7) claims 'promised to connect the societal, institutional, interactional and intrapsychic levels of sociological analysis'. This study accepts Bernstein's analysis which provides a systematic structural theory allowing micro and macro aspects of the education system to be inter-related.

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This research evaluates the role of flexible methods of delivering social work education in widening access to professional qualification. It examines: • The personal profiles of applicants on flexible/part-time social work programmes and compares these with those of full-time students • Whether opportunities for flexible study increase the diversity of applicants to pre-registration Masters level programmes • The kinds of flexibility that increase the diversity of applicants to pre-registration social work programmes The research method is informed by reflexivity, incorporating all aspects of knowledge and experience providing depth to interpretation of data. Data on 162 social work students registered on a postgraduate pre-registration programme was collected over four years and examined using a sequential exploratory research design. Data was collected from three main sources: HEI cohort statistics, questionnaires and individual interviews with eight selected students. Findings suggest: Black and Minority Ethnic (BME) students enter social work education through social care for career progression in the absence of alternative employment; knowledgeable and experienced practitioners study for qualifications that allow them to continue in their role; opportunity, rather than planning, facilitates access to study; and values promoted within social work education conflict with those experienced in the workplace. Limited diversity was identified within students on the flexible route associated with age, personal situation, disability and distance from the HEI. These students represented two distinct groups, polarised in terms of experience, knowledge and aspirations. Trends and patterns were identified across and within the whole student group: BME students were multiply-disadvantaged, travelling further, earning less, and facing limited opportunity; and numbers of younger, White students were increasing. Findings indicate a need to broaden notions of flexibility in programme structure and delivery. Recommendations include using a modular approach; delivery methods that facilitate local study; and establishing a “whole-career” approach to social work education.

The incidence of Heath Care Associated Infection is a major patient safety concern in the United Kingdom and reducing the morbidity and mortality associated with this has become a National Health Service priority. It is generally accepted that this objective will require a multi-factorial approach where infection prevention and control is seen as everybody’s business. However, some strategies receive greater exposure than others and hand hygiene is widely touted as a common sense solution to a complex problem. This discourse based study combined the techniques of Corpus Linguistics with Critical Discourse Analysis to explore the Textual, Discursive and Sociocultural features of hand hygiene discourse. This took place across three language domains, the Academy, the Newspaper Media and Organisational Policy Makers. These three cultural elites take a consistent account of the problem and the solution. Broadly hand hygiene is portrayed as effective, compliance is basic, performance is poor and Health Care Workers should be held to account through zero tolerance policies and if necessary disciplinary action. However, not only does this background the messy, contextual factors of implementing a hand hygiene policy it imposes a one size fits all approach and measurement programme on compliance that hides the true nature of performance and this ultimately impacts on patient care. This study calls for junior clinicians for whom policy has the greatest impact to become more engaged in the policy making process. In a spirit of openness trusts should adopt linguistic devices that recognise the dynamic nature of practice and a more educational, sophisticated approach to audit.

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