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Additive manufacturing (AM) is projected to require 60,000 jobs in the UK by 2025, but there are a series of barriers to the industrial application. One of the most problematic is non-comprehensive knowledge in design for AM (DfAM). This study aims to test the effect of two undergraduate DfAM teaching approaches. A visual and audial approach (design lecture) and a kinaesthetic, problem-based learning (PBL) approach (manufacturing laboratory) were compared against technical and participant perspective criteria to assess the learning, engagement, and self-efficacy of the students. The participants were set a DfAM challenge; to redesign a bracket. The technical merits of the designs were evaluated after teaching through a design lecture alone or after a design lecture and manufacturing-laboratory. The participant's perspective was evaluated at the end of the study. The groups who undertook both the design lecture and manufacturing laboratory showed a mean technical mark of 100% for criteria (C) 13 ("Parts have been consolidated into one part"), 91.7% for C14 ("The bracket is hollowed where possible") and 100% for C16 ("Manufacture was successful"). These technical marks demonstrate a statistically significant increase over those of the groups who undertook the design lecture alone. The participant evaluation reinforced this result; the manufacturing laboratory was chosen more frequently in answer to questions on applicability (Q13 = 83%), preparedness (Q15 = 83%), and gaining confidence in DfAM (Q31 = 74%). This study demonstrates the importance of PBL in DfAM, both to increase technical aptitude of the student (creativity and manufacturing) and their perspective on their own learning and self-efficacy.

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Background: Ketorolac may attenuate the maternal stress response to tracheal intubation, while avoiding opioid-induced neonatal depression. We aimed to evaluate the haemodynamic and hormonal effects of prophylactic ketorolac on surgical stress and analgesia after caesarean delivery., Methods: After ethical approval, 90 patients scheduled for elective caesarean delivery were randomly allocated receive either ketorolac 15 mg i.v. bolus 20 min before induction, followed by an infusion of 7.5 mg/h (n=45), or saline placebo (n=45). Anaesthesia was maintained with 50% nitrous oxide in oxygen with 0.5% isoflurane. Haemodynamic variables, plasma cortisol concentrations, uterine relaxation, need for supplementary doses of oxytocin, peri-operative blood loss, haematocrit, Apgar scores at 1 and 5 min, postoperative pain scores at rest and movement, and tramadol consumption were recorded., Results: After induction, patients receiving ketorolac had a smaller increase in heart rate, systolic and mean arterial blood pressure (P<0.001) and lower plasma cortisol concentrations, (32.2+/-7.61 vs. 45+/-15.1 microg/dL, P<0.05), lower pain scores at rest and movement for the first two postoperative hours (P<0.001) and a longer time to first request for analgesia. Fewer patients in the ketorolac group received tramadol in the four hours after surgery (7 (15.6%) vs. 14 (31.1%), P=0.004). There were no differences between groups in peri-operative blood loss, vomiting or Apgar scores. There was no echocardiographic evidence of premature closure of the ductus arteriosus in the newborns., Conclusion: Prophylactic ketorolac is safe and effective in attenuating the maternal stress response to intubation and improves the quality of analgesia after caesarean delivery.