Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 18

Search results for: Clare Littlewood

18 The Use of Online Multimedia Platforms to Deliver a Regional Medical Schools Finals Revision Course During the COVID-19 Pandemic

Authors: Matthew Edmunds, Andrew Hunter, Clare Littlewood, Wisha Gul, Gabriel Heppenstall-Harris, Thomas Humphries

Abstract:

Background: Revision courses for medical students undertaking their final examinations are commonplace throughout the UK. Traditionally these take the form of a series of lectures over multiple weeks or a single day of intensive lectures. The COVID-19 pandemic, however, has required medical educators to create new teaching formats to ensure they adhere to social distancing requirements. It has provided an unexpected opportunity to accelerate the development of students proficiency in the use of ‘technology-enabled communication platforms’, as mandated in the 2018 GMC Outcomes of Graduates. Recent advances in technology have made distance learning possible, whilst also providing novel and more engaging learning opportunities for students. Foundation Year 2 doctors at Aintree University Hospital developed an online series of videos to help prepare medical students in the North West and byond for their final medical school examinations. Method: Eight hour-long videos covering the key topics in medicine and surgery were posted on the Peer Learning Liverpool Youtube channel. These videos were created using new technology such as the screen and audio recording platform, Loom. Each video compromised at least 20 single best answer (SBA) questions, in keeping with the format in most medical school finals. Explanations of the answers were provided, and additional important material was covered. Students were able to ask questions by commenting on the videos, with the authors replying as soon as possible. Feedback was collated using an online Google form. Results: An average of 327 people viewed each video, with 113 students filling in the feedback form. 65.5% of respondents were within one month of their final medical school examinations. The average rating for how well prepared the students felt for their finals was 6.21/10 prior to the course and 8.01/10 after the course. A paired t-test demonstrated a mean increase of 1.80 (95% CI 1.66-1.93). Overall, 98.2% said the online format worked well or very well, and 99.1% would recommend the course to a peer. Conclusions: Based on the feedback received, the online revision course was successful both in terms of preparing students for their final examinations, and with regards to how well the online format worked. Free-text qualitative feedback highlighted advantages such as; students could learn at their own pace, revisit key concepts important to them, and practice exam style questions via the case-based format. Limitations identified included inconsistent audiovisual quality, and requests for a live online Q&A session following the conclusion of the course. This course will be relaunched later in the year with increased opportunities for students to access live feedback. The success of this online course has shown the roll that technology can play in medical education. As well as providing novel teaching modes, online learning allows students to access resources that otherwise would not be available locally, and ensure that they do not miss out on teaching that was previously provided face to face, in the current climate of social distancing.

Keywords: COVID-19 pandemic, Medical School, Online learning, Revision course

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17 The Effects of Hydraulic Retention Time on the Sludge Characteristics and Effluent Quality in an Aerobic Suspension Sequencing Batch Reactor

Authors: Ali W. N. Alattabi, Clare B. Harris, Rafid M. Alkhaddar, Montserrat Ortoneda, David A. Phipps, Ali Alzeyadi, Khalid S. Hashim

Abstract:

This study was performed to optimise the hydraulic retention time (HRT) and study its effects on the sludge characteristics and the effluent quality in an aerobic suspension sequencing batch reactor (ASSBR) treating synthetic wastewater. The results showed that increasing the HRT from 6 h to 12 h significantly improved the COD and Nitrate removal efficiency; it was increased from 78.7% - 75.7% to 94.7% – 97% for COD and Nitrate respectively. However, increasing the HRT from 12 h to 18 h reduced the COD and Nitrate removal efficiency from 94.7% - 97% to 91.1% – 94.4% respectively. Moreover, Increasing the HRT from 18 h to 24 h did not affect the COD and Nitrate removal efficiency. Sludge volume index (SVI) was used to monitor the sludge settling performance. The results showed a direct relationship between the HRT and SVI value. Increasing the HRT from 6 h to 12 h led to decrease the SVI value from 123 ml/g to 82.5 ml/g, and then it remained constant despite of increasing the HRT from 12 h to 18 h and to 24 h. The results obtained from this study showed that the HRT of 12 h was better for COD and Nitrate removal and a good settling performance occurred during that range.

Keywords: COD, hydraulic retention time, nitrate, sequencing batch reactor, sludge characteristics

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16 Tom Stoppard: The Amorality of the Artist

Authors: Majeed Mohammed Midhin, Clare Finburgh

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To maintain a healthy balanced loyalty between art and politics posits a debatable issue. The artist is always on the look out for the potential tension between those two realms. Therefore, one of the most painful dilemmas the artist finds is how to function in a society without sacrificing the aesthetic values of his/her work. In other words, the life-long awareness of failure which derives from the concept of the artist as caught between unflattering social realities and the need to invent genuine art forms becomes a fertilizing soil for the artists to dig deep into its origin. Thus, within the framework of this dilemma, the question of the responsibility of the artist and the relationship of the art to politics will be illuminating. The present paper tackles the idea of the amorality of the artist in selected plays by Tom Stoppard. However, Stoppard’s awareness of his situation as a refugee has led him to keep at a distance from politics. He tried hard to avoid any intervention into the realms of political debate, especially in his earliest work. On the one hand, it is not meant that he did not interest in politics as such, but rather he preferred to question it than to create a fixed ideological position. On the other hand, Stoppard’s refusal to intervene in politics is ascribed to his feeling of gratitude to Britain where he settled. As a result, Stoppard has frequently been criticized for a lack of political engagement and also for not leaning too much for the left when he does engage. His reaction to these public criticisms finds expression in his self-conscious statements which defensively stressed the artifice of his work. He, like Oscar Wilde thinks that the responsibility of the artist is devoted to the realm of his/her art. Consequently, his consciousness for the role of the artist is truly reflected in his two plays, Artist Descending a Staircase(1972) and Travesties(1974).

Keywords: amorality, dilemma, aesthetic, responsibility of the artist, political theatre

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15 The Relationship between Operating Condition and Sludge Wasting of an Aerobic Suspension-Sequencing Batch Reactor (ASSBR) Treating Phenolic Wastewater

Authors: Ali Alattabi, Clare Harris, Rafid Alkhaddar, Ali Alzeyadi

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Petroleum refinery wastewater (PRW) can be considered as one of the most significant source of aquatic environmental pollution. It consists of oil and grease along with many other toxic organic pollutants. In recent years, a new technique was implemented using different types of membranes and sequencing batch reactors (SBRs) to treat PRW. SBR is a fill and draw type sludge system which operates in time instead of space. Many researchers have optimised SBRs’ operating conditions to obtain maximum removal of undesired wastewater pollutants. It has gained more importance mainly because of its essential flexibility in cycle time. It can handle shock loads, requires less area for operation and easy to operate. However, bulking sludge or discharging floating or settled sludge during the draw or decant phase with some SBR configurations are still one of the problems of SBR system. The main aim of this study is to develop and innovative design for the SBR optimising the process variables to result is a more robust and efficient process. Several experimental tests will be developed to determine the removal percentages of chemical oxygen demand (COD), Phenol and nitrogen compounds from synthetic PRW. Furthermore, the dissolved oxygen (DO), pH and oxidation-reduction potential (ORP) of the SBR system will be monitored online to ensure a good environment for the microorganisms to biodegrade the organic matter effectively.

Keywords: petroleum refinery wastewater, sequencing batch reactor, hydraulic retention time, Phenol, COD, mixed liquor suspended solids (MLSS)

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14 An Analysis on Community Based Heritage Tourism: A Resource for a Small Community in Rural County Clare, Ireland

Authors: Marie Taylor, Catriona Murphy

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The aim of this paper is to identify the factors of success in community based heritage tourism initiatives. Heritage and community are central to many tourism initiatives with heritage tourism having the potential to act as a catalyst for community development. This paper presents the findings of research that examined the relationship between heritage tourism and community development. The findings recognised that heritage tourism had economic, social and cultural benefits for a community as well as a role in strengthening concepts such as sense of identity, place, and authenticity. In addition, this paper proposes an assessment framework for sustainable community based heritage tourism to identify factors and contextual influences involved in their success or failure. In evaluating the sustainability of such initiatives, a number of issues are investigated including the continued role of stakeholders, the role of funding, the influence of collaboration and the changing role of rural development and its impact on community engagement. The research is descriptive, evaluative and explanatory research, exploring and analysing issues such as the development of community structures in community based heritage tourism. Thus, it will contribute to the development of potential tourism and community development policies and strategies at a local, national and international level. An interpretative and inductive approach is utilised, and a mixed method approach followed as it encapsulates the best of quantitative and qualitative research methods. The case studies focus on social enterprises in relation to tourism and community based tourism cooperatives as there are limited study and knowledge of these. Consequently, this research will contribute to the discourse on community based heritage tourism as an aspect of community development.

Keywords: collaboration, community-based heritage tourism, stakeholders, sustainable tourism

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13 Thriving Organisations: Recommendations to Create a Workplace Culture That Prioritises Both Well-being and Performance Equally

Authors: Clare Victoria Martin

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With reports of increased mental health problems and a lack of proactive, consistent well-being initiatives, well-being is a topical issue in the workplace, as well as a wider public health concern. Additionally, workplace well-being is closely linked to performance, both from a business perspective and in psychological research. Businesses are therefore becoming increasingly motivated to promote well-being, yet there are still barriers, including a lack of evidence-based workplace interventions, issues with measuring effectiveness and problems creating lasting cultural change. This review aimed to collate workplace well-being research to propose a comprehensive new model for delivering evidence-based workplace well-being training with a real potential for lasting impact. Method: A narrative review was conducted to meta-synthesise relevant research. Thematic analysis was then adopted as a systematic method of identifying key themes from the review to lead to practical recommendations. Interventions focusing on strengths, psychological capital, mindfulness and positivity (SPMP) dominated the research in this area, suggesting benefits of incorporating all four into training. However, to avoid a ‘quick fix’ mentality, the concept of training ‘well-being ambassadors’ as a preventative counterpart to mental health ‘first aiders’ was proposed alongside a new ‘REST and RISE’ model: well-being interventions should be ‘relatable’, ‘enjoyable’, ‘sociable’ and ‘trackable’ (REST) in order to increase ‘resilience’, ‘innovation’, ‘strengths’ and ‘engagement’ (RISE). If the REST principles are applied to interventions focusing on SPMP, research suggests individuals will RISE. Future research should empirically test this new well-being ambassador programme and REST/RISE model in an applied setting.

Keywords: performance, positive psychology, thriving, workplace well-being

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12 Adopting Structured Mini Writing Retreats as a Tool for Undergraduate Researchers

Authors: Clare Cunningham

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Whilst there is a strong global research base on the benefits of structured writing retreats and similar provisions, such as Shut Up and Write events, for academic staff and postgraduate researchers, very little has been published about the worth of such events for undergraduate students. This is despite the fact that, internationally, undergraduate student researchers experience similar pressures, distractions and feelings towards writing as those who are at more senior levels within the academy. This paper reports on a mixed-methods study with cohorts of third-year undergraduate students over the course of four academic years. This involved a range of research instruments adopted over the four years of the study. They include the administration of four questionnaires across three academic years, a collection of ethnographic recordings in the second year, and the collation of reflective journal entries and evaluations from all four years. The final two years of data collection took place during the period of Covid-19 restrictions when writing retreats moved to the virtual space which adds an additional dimension of interest to the analysis. The analysis involved the collation of quantitative questionnaire data to observe patterns in expressions of attitudes towards writing. Qualitative data were analysed thematically and used to corroborate and support the quantitative data when appropriate. The resulting data confirmed that one of the biggest challenges for undergraduate students mirrors those reported in the findings of studies focused on more experienced researchers. This is not surprising, especially given the number of undergraduate students who now work alongside their studies, as well as the increasing number who have caring responsibilities, but it has, as yet, been under-reported. The data showed that the groups of writing retreat participants all had very positive experiences, with accountability, a sense of community and procrastination avoidance some of the key aspects. The analysis revealed the sometimes transformative power of these events for a number of these students in terms of changing the way they viewed writing and themselves as writers. The data presented in this talk will support the proposal that retreats should much more widely be offered to undergraduate students across the world.

Keywords: academic writing, students, undergraduates, writing retreat

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11 An Online Questionnaire Investigating UK Mothers' Experiences of Bottle Refusal by Their Breastfed Baby

Authors: Clare Maxwell, Lorna Porcellato, Valerie Fleming, Kate Fleming

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A review of global online forums and social media reveals large numbers of mothers experiencing bottle refusal by their breastfed baby. It is difficult to determine precise numbers due to a lack of data, however, established virtual communities illustrate thousands of posts in relation to the issue. Mothers report various negative consequences of bottle refusal including delaying their return to work, time and financial outlay spent on methods to overcome it and experiencing stress, anxiety, and resentment of breastfeeding. A search of the literature revealed no studies being identified, and due to a lack of epidemiological data, a study investigating mother’s experiences of bottle refusal by their breastfed baby was undertaken. The aim of the study was to investigate UK mothers’ experiences of bottle refusal by their breastfed baby. Data were collected using an online questionnaire collecting quantitative and qualitative data. 841 UK mothers who had experienced or were experiencing bottle refusal by their breastfed baby completed the questionnaire. Data were analyzed using descriptive statistics and non-parametric testing. The results showed 61% (516/840) of mothers reported their breastfed baby was still refusing/had never accepted a bottle, with 39% (324/840) reporting their baby had eventually accepted. The most frequently reported reason to introduce a bottle was so partner/family could feed the baby 59% (499/839). 75% (634/841) of mothers intended their baby to feed on a bottle ‘occasionally’. Babies who accepted a bottle were more likely to be older at 1st attempt to introduce one than those babies who refused (Mdn = 12 weeks v 8 weeks, n = 286) (p = <0.001). Length of time taken to acceptance was 9 weeks (Mdn = 9, IQR = 18, R = 103.9, n = 306) with the older the baby was at 1st attempt to introduce a bottle being associated with a shorter length of time to acceptance (p = < 0.002). 60% (500/841) of mothers stated that none of the methods they used had worked. 26% (222/841) of mothers reported bottle refusal had had a negative impact upon their overall breastfeeding experience. 47% (303/604) reported they would have tried to introduce a bottle earlier to prevent refusal. This study provides a unique insight into the scenario of bottle refusal by breastfed babies. It highlights that bottle refusal by breastfed babies is a significant issue, which requires recognition from those communicating breastfeeding information to mothers.

Keywords: bottle feeding, bottle refusal, breastfeeding, infant feeding

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10 An Adaptive Decomposition for the Variability Analysis of Observation Time Series in Geophysics

Authors: Olivier Delage, Thierry Portafaix, Hassan Bencherif, Guillaume Guimbretiere

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Most observation data sequences in geophysics can be interpreted as resulting from the interaction of several physical processes at several time and space scales. As a consequence, measurements time series in geophysics have often characteristics of non-linearity and non-stationarity and thereby exhibit strong fluctuations at all time-scales and require a time-frequency representation to analyze their variability. Empirical Mode Decomposition (EMD) is a relatively new technic as part of a more general signal processing method called the Hilbert-Huang transform. This analysis method turns out to be particularly suitable for non-linear and non-stationary signals and consists in decomposing a signal in an auto adaptive way into a sum of oscillating components named IMFs (Intrinsic Mode Functions), and thereby acts as a bank of bandpass filters. The advantages of the EMD technic are to be entirely data driven and to provide the principal variability modes of the dynamics represented by the original time series. However, the main limiting factor is the frequency resolution that may give rise to the mode mixing phenomenon where the spectral contents of some IMFs overlap each other. To overcome this problem, J. Gilles proposed an alternative entitled “Empirical Wavelet Transform” (EWT) which consists in building from the segmentation of the original signal Fourier spectrum, a bank of filters. The method used is based on the idea utilized in the construction of both Littlewood-Paley and Meyer’s wavelets. The heart of the method lies in the segmentation of the Fourier spectrum based on the local maxima detection in order to obtain a set of non-overlapping segments. Because linked to the Fourier spectrum, the frequency resolution provided by EWT is higher than that provided by EMD and therefore allows to overcome the mode-mixing problem. On the other hand, if the EWT technique is able to detect the frequencies involved in the original time series fluctuations, EWT does not allow to associate the detected frequencies to a specific mode of variability as in the EMD technic. Because EMD is closer to the observation of physical phenomena than EWT, we propose here a new technic called EAWD (Empirical Adaptive Wavelet Decomposition) based on the coupling of the EMD and EWT technics by using the IMFs density spectral content to optimize the segmentation of the Fourier spectrum required by EWT. In this study, EMD and EWT technics are described, then EAWD technic is presented. Comparison of results obtained respectively by EMD, EWT and EAWD technics on time series of ozone total columns recorded at Reunion island over [1978-2019] period is discussed. This study was carried out as part of the SOLSTYCE project dedicated to the characterization and modeling of the underlying dynamics of time series issued from complex systems in atmospheric sciences

Keywords: adaptive filtering, empirical mode decomposition, empirical wavelet transform, filter banks, mode-mixing, non-linear and non-stationary time series, wavelet

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9 Accurate Energy Assessment Technique for Mine-Water District Heat Network

Authors: B. Philip, J. Littlewood, R. Radford, N. Evans, T. Whyman, D. P. Jones

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UK buildings and energy infrastructures are heavily dependent on natural gas, a large proportion of which is used for domestic space heating. However, approximately half of the gas consumed in the UK is imported. Improving energy security and reducing carbon emissions are major government drivers for reducing gas dependency. In order to do so there needs to be a wholesale shift in the energy provision to householders without impacting on thermal comfort levels, convenience or cost of supply to the end user. Heat pumps are seen as a potential alternative in modern well insulated homes, however, can the same be said of older homes? A large proportion of housing stock in Britain was built prior to 1919. The age of the buildings bears testimony to the quality of construction; however, their thermal performance falls far below the minimum currently set by UK building standards. In recent years significant sums of money have been invested to improve energy efficiency and combat fuel poverty in some of the most deprived areas of Wales. Increasing energy efficiency of older properties remains a significant challenge, which cannot be achieved through insulation and air-tightness interventions alone, particularly when alterations to historically important architectural features of the building are not permitted. This paper investigates the energy demand of pre-1919 dwellings in a former Welsh mining village, the feasibility of meeting that demand using water from the disused mine workings to supply a district heat network and potential barriers to success of the scheme. The use of renewable solar energy generation and storage technologies, both thermal and electrical, to reduce the load and offset increased electricity demand, are considered. A wholistic surveying approach to provide a more accurate assessment of total household heat demand is proposed. Several surveying techniques, including condition surveys, air permeability, heat loss calculations, and thermography were employed to provide a clear picture of energy demand. Additional insulation can bring unforeseen consequences which are detrimental to the fabric of the building, potentially leading to accelerated dilapidation of the asset being ‘protected’. Increasing ventilation should be considered in parallel, to compensate for the associated reduction in uncontrolled infiltration. The effectiveness of thermal performance improvements are demonstrated and the detrimental effects of incorrect material choice and poor installation are highlighted. The findings show estimated heat demand to be in close correlation to household energy bills. Major areas of heat loss were identified such that improvements to building thermal performance could be targeted. The findings demonstrate that the use of heat pumps in older buildings is viable, provided sufficient improvement to thermal performance is possible. Addition of passive solar thermal and photovoltaic generation can help reduce the load and running cost for the householder. The results were used to predict future heat demand following energy efficiency improvements, thereby informing the size of heat pumps required.

Keywords: heat demand, heat pump, renewable energy, retrofit

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8 Continuous Glucose Monitoring Systems and the Improvement in Hypoglycemic Awareness Post-Islet Transplantation: A Single-Centre Cohort Study

Authors: Clare Flood, Shareen Forbes

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Background: Type 1 diabetes mellitus (T1DM) is an autoimmune disorder affecting >400,000 people in the UK alone, with the global prevalence expected to double in the next decade. Islet transplant offers a minimally-invasive procedure with very low morbidity and almost no mortality, and is now as effective as whole pancreas transplant. The procedure was introduced to the UK in 2011 for patients with the most severe type 1 diabetes mellitus (T1DM) – those with unstable blood glucose, frequently occurring episodes of severe hypoglycemia and impaired awareness of hypoglycemia (IAH). Objectives: To evaluate the effectiveness of islet transplantation in improving glycemic control, reducing the burden of hypoglycemia and improving awareness of hypoglycemia through a single-centre cohort study at the Royal Infirmary of Edinburgh. Glycemic control and degree of hypoglycemic awareness will be determined and monitored pre- and post-transplantation to determine effectiveness of the procedure. Methods: A retrospective analysis of data collected over three years from the 16 patients who have undergone islet transplantation in Scotland. Glycated haemoglobin (HbA1c) was measured and continuous glucose monitoring systems (CGMS) were utilised to assess glycemic control, while Gold and Clarke score questionnaires tested IAH. Results: All patients had improved glycemic control following transplant, with optimal control seen visually at 3 months post-transplant. Glycemic control significantly improved, as illustrated by percentage time in hypoglycemia in the months following transplant (p=0.0211) and HbA1c (p=0.0426). Improved Clarke (p=0.0034) and Gold (p=0.0001) scores indicate improved glycemic awareness following transplant. Conclusion: While the small sample of islet transplant recipients at the Royal Infirmary of Edinburgh prevents definitive conclusions being drawn, it is indicated that through our retrospective, single-centre cohort study of 16 patients, islet transplant is capable of improving glycemic control, reducing the burden of hypoglycemia and IAH post-transplant. Data can be combined with similar trials at other centres to increase statistical power but from research in Edinburgh, it can be suggested that the minimally invasive procedure of islet transplantation offers selected patients with extremely unstable T1DM the incredible opportunity to regain control of their condition and improve their quality of life.

Keywords: diabetes, islet, transplant, CGMS

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7 Investigating the Feasibility of Berry Production in Central Oregon under Protected and Unprotected Culture

Authors: Clare S. Sullivan

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The high desert of central Oregon, USA is a challenging growing environment: short growing season (70-100 days); average annual precipitation of 280 mm; drastic swings in diurnal temperatures; possibility of frost any time of year; and sandy soils low in organic matter. Despite strong demand, there is almost no fruit grown in central Oregon due to potential yield loss caused by early and late frosts. Elsewhere in the USA, protected culture (i.e., high tunnels) has been used to extend fruit production seasons and improve yields. In central Oregon, high tunnels are used to grow multiple high-value vegetable crops, and farmers are unlikely to plant a perennial crop in a high tunnel unless proven profitable. In May 2019, two berry trials were established on a farm in Alfalfa, OR, to evaluate raspberry and strawberry yield, season length, and fruit quality in protected (high tunnels) vs. unprotected culture (open field). The main objective was to determine whether high tunnel berry production is a viable enterprise for the region. Each trial was arranged using a split-plot design. The main factor was the production system (high tunnel vs. open field), and the replicated, subplot factor was berry variety. Four day-neutral strawberry varieties and four primocane-bearing raspberry varieties were planted for the study and were managed using organic practices. Berries were harvested once a week early in the season, and twice a week as production increased. Harvested berries were separated into ‘marketable’ and ‘unmarketable’ in order to calculate percent cull. First-year results revealed berry yield and quality differences between varieties and production systems. Strawberry marketable yield and berry fruit size increased significantly in the high tunnel compared to the field; percent yield increase ranged from 7-46% by variety. Evie 2 was the highest yielding strawberry, although berry quality was lower than other berries. Raspberry marketable yield and berry fruit size tended to increase in the high tunnel compared to the field, although variety had a more significant effect. Joan J was the highest yielding raspberry and out-yielded the other varieties by 250% outdoor and 350% indoor. Overall, strawberry and raspberry yields tended to improve in high tunnels as compared to the field, but data from a second year will help determine whether high tunnel investment is worthwhile. It is expected that the production system will have more of an effect on berry yield and season length for second-year plants in 2020.

Keywords: berries, high tunnel, local food, organic

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6 Structural and Functional Correlates of Reaction Time Variability in a Large Sample of Healthy Adolescents and Adolescents with ADHD Symptoms

Authors: Laura O’Halloran, Zhipeng Cao, Clare M. Kelly, Hugh Garavan, Robert Whelan

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Reaction time (RT) variability on cognitive tasks provides the index of the efficiency of executive control processes (e.g. attention and inhibitory control) and is considered to be a hallmark of clinical disorders, such as attention-deficit disorder (ADHD). Increased RT variability is associated with structural and functional brain differences in children and adults with various clinical disorders, as well as poorer task performance accuracy. Furthermore, the strength of functional connectivity across various brain networks, such as the negative relationship between the task-negative default mode network and task-positive attentional networks, has been found to reflect differences in RT variability. Although RT variability may provide an index of attentional efficiency, as well as being a useful indicator of neurological impairment, the brain substrates associated with RT variability remain relatively poorly defined, particularly in a healthy sample. Method: Firstly, we used the intra-individual coefficient of variation (ICV) as an index of RT variability from “Go” responses on the Stop Signal Task. We then examined the functional and structural neural correlates of ICV in a large sample of 14-year old healthy adolescents (n=1719). Of these, a subset had elevated symptoms of ADHD (n=80) and was compared to a matched non-symptomatic control group (n=80). The relationship between brain activity during successful and unsuccessful inhibitions and gray matter volume were compared with the ICV. A mediation analysis was conducted to examine if specific brain regions mediated the relationship between ADHD symptoms and ICV. Lastly, we looked at functional connectivity across various brain networks and quantified both positive and negative correlations during “Go” responses on the Stop Signal Task. Results: The brain data revealed that higher ICV was associated with increased structural and functional brain activation in the precentral gyrus in the whole sample and in adolescents with ADHD symptoms. Lower ICV was associated with lower activation in the anterior cingulate cortex (ACC) and medial frontal gyrus in the whole sample and in the control group. Furthermore, our results indicated that activation in the precentral gyrus (Broadman Area 4) mediated the relationship between ADHD symptoms and behavioural ICV. Conclusion: This is the first study first to investigate the functional and structural correlates of ICV collectively in a large adolescent sample. Our findings demonstrate a concurrent increase in brain structure and function within task-active prefrontal networks as a function of increased RT variability. Furthermore, structural and functional brain activation patterns in the ACC, and medial frontal gyrus plays a role-optimizing top-down control in order to maintain task performance. Our results also evidenced clear differences in brain morphometry between adolescents with symptoms of ADHD but without clinical diagnosis and typically developing controls. Our findings shed light on specific functional and structural brain regions that are implicated in ICV and yield insights into effective cognitive control in healthy individuals and in clinical groups.

Keywords: ADHD, fMRI, reaction-time variability, default mode, functional connectivity

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5 A Randomised Controlled Trial and Process Evaluation of the Lifestart Parenting Programme

Authors: Sharon Millen, Sarah Miller, Laura Dunne, Clare McGeady, Laura Neeson

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This paper presents the findings from a randomised controlled trial (RCT) and process evaluation of the Lifestart parenting programme. Lifestart is a structured child-centred programme of information and practical activity for parents of children aged from birth to five years of age. It is delivered to parents in their own homes by trained, paid family visitors and it is offered to parents regardless of their social, economic or other circumstances. The RCT evaluated the effectiveness of the programme and the process evaluation documented programme delivery and included a qualitative exploration of parent and child outcomes. 424 parents and children participated in the RCT: 216 in the intervention group and 208 in the control group across the island of Ireland. Parent outcomes included: parental knowledge of child development, parental efficacy, stress, social support, parenting skills and embeddedness in the community. Child outcomes included cognitive, language and motor development and social-emotional and behavioural development. Both groups were tested at baseline (when children were less than 1 year old), mid-point (aged 3) and at post-test (aged 5). Data were collected during a home visit, which took two hours. The process evaluation consisted of interviews with parents (n=16 at baseline and end-point), and focus groups with Lifestart Coordinators (n=9) and Family Visitors (n=24). Quantitative findings from the RCT indicated that, compared to the control group, parents who received the Lifestart programme reported reduced parenting-related stress, increased knowledge of their child’s development, and improved confidence in their parenting role. These changes were statistically significant and consistent with the hypothesised pathway of change depicted in the logic model. There was no evidence of any change in parents’ embeddedness in the community. Although four of the five child outcomes showed small positive change for children who took part in the programme, these were not statistically significant and there is no evidence that the programme improves child cognitive and non-cognitive skills by immediate post-test. The qualitative process evaluation highlighted important challenges related to conducting trials of this magnitude and design in the general population. Parents reported that a key incentive to take part in study was receiving feedback from the developmental assessment, which formed part of the data collection. This highlights the potential importance of appropriate incentives in relation to recruitment and retention of participants. The interviews with intervention parents indicated that one of the first changes they experienced as a result of the Lifestart programme was increased knowledge and confidence in their parenting ability. The outcomes and pathways perceived by parents and described in the interviews are also consistent with the findings of the RCT and the theory of change underpinning the programme. This hypothesises that improvement in parental outcomes, arising as a consequence of the programme, mediate the change in child outcomes. Parents receiving the Lifestart programme reported great satisfaction with and commitment to the programme, with the role of the Family Visitor being identified as one of the key components of the programme.

Keywords: parent-child relationship, parental self-efficacy, parental stress, school readiness

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4 The Effects of the GAA15 (Gaelic Athletic Association 15) on Lower Extremity Injury Incidence and Neuromuscular Functional Outcomes in Collegiate Gaelic Games: A 2 Year Prospective Study

Authors: Brenagh E. Schlingermann, Clare Lodge, Paula Rankin

Abstract:

Background: Gaelic football, hurling and camogie are highly popular field games in Ireland. Research into the epidemiology of injury in Gaelic games revealed that approximately three quarters of the injuries in the games occur in the lower extremity. These injuries can have player, team and institutional impacts due to multiple factors including financial burden and time loss from competition. Research has shown it is possible to record injury data consistently with the GAA through a closed online recording system known as the GAA injury surveillance database. It has been established that determining the incidence of injury is the first step of injury prevention. The goals of this study were to create a dynamic GAA15 injury prevention programme which addressed five key components/goals; avoid positions associated with a high risk of injury, enhance flexibility, enhance strength, optimize plyometrics and address sports specific agilities. These key components are internationally recognized through the Prevent Injury, Enhance performance (PEP) programme which has proven reductions in ACL injuries by 74%. In national Gaelic games the programme is known as the GAA15 which has been devised from the principles of the PEP. No such injury prevention strategies have been published on this cohort in Gaelic games to date. This study will investigate the effects of the GAA15 on injury incidence and neuromuscular function in Gaelic games. Methods: A total of 154 players (mean age 20.32 ± 2.84) were recruited from the GAA teams within the Institute of Technology Carlow (ITC). Preseason and post season testing involved two objective screening tests; Y balance test and Three Hop Test. Practical workshops, with ongoing liaison, were provided to the coaches on the implementation of the GAA15. The programme was performed before every training session and game and the existing GAA injury surveillance database was accessed to monitor player’s injuries by the college sports rehabilitation athletic therapist. Retrospective analysis of the ITC clinic records were performed in conjunction with the database analysis as a means of tracking injuries that may have been missed. The effects of the programme were analysed by comparing the intervention groups Y balance and three hop test scores to an age/gender matched control group. Results: Year 1 results revealed significant increases in neuromuscular function as a result of the GAA15. Y Balance test scores for the intervention group increased in both the posterolateral (p=.005 and p=.001) and posteromedial reach directions (p= .001 and p=.001). A decrease in performance was determined for the three hop test (p=.039). Overall twenty-five injuries were reported during the season resulting in an injury rate of 3.00 injuries/1000hrs of participation; 1.25 injuries/1000hrs training and 4.25 injuries/1000hrs match play. Non-contact injuries accounted for 40% of the injuries sustained. Year 2 results are pending and expected April 2016. Conclusion: It is envisaged that implementation of the GAA15 will continue to reduce the risk of injury and improve neuromuscular function in collegiate Gaelic games athletes.

Keywords: GAA15, Gaelic games, injury prevention, neuromuscular training

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3 Endometrial Ablation and Resection Versus Hysterectomy for Heavy Menstrual Bleeding: A Systematic Review and Meta-Analysis of Effectiveness and Complications

Authors: Iliana Georganta, Clare Deehan, Marysia Thomson, Miriam McDonald, Kerrie McNulty, Anna Strachan, Elizabeth Anderson, Alyaa Mostafa

Abstract:

Context: A meta-analysis of randomized controlled trials (RCTs) comparing hysterectomy versus endometrial ablation and resection in the management of heavy menstrual bleeding. Objective: To evaluate the clinical efficacy, satisfaction rates and adverse events of hysterectomy compared to more minimally invasive techniques in the treatment of HMB. Evidence Acquisition: A literature search was performed for all RCTs and quasi-RCTs comparing hysterectomy with either endometrial ablation endometrial resection of both. The search had no language restrictions and was last updated in June 2020 using MEDLINE, EMBASE, Cochrane Central Register of Clinical Trials, PubMed, Google Scholar, PsycINFO, Clinicaltrials.gov and Clinical trials. EU. In addition, a manual search of the abstract databases of the European Haemophilia Conference on women's health was performed and further studies were identified from references of acquired papers. The primary outcomes were patient-reported and objective reduction in heavy menstrual bleeding up to 2 years and after 2 years. Secondary outcomes included satisfaction rates, pain, adverse events short and long term, quality of life and sexual function, further surgery, duration of surgery and hospital stay and time to return to work and normal activities. Data were analysed using RevMan software. Evidence synthesis: 12 studies and a total of 2028 women were included (hysterectomy: n = 977 women vs endometrial ablation or resection: n = 1051 women). Hysterectomy was compared with endometrial ablation only in five studies (Lin, Dickersin, Sesti, Jain, Cooper) and endometrial resection only in five studies (Gannon, Schulpher, O’Connor, Crosignani, Zupi) and a mixture of the Ablation and Resection in two studies (Elmantwe, Pinion). Of the 1² studies, 10 reported women’s perception of bleeding symptoms as improved. Meta-analysis showed that women in the hysterectomy group were more likely to show improvement in bleeding symptoms when compared with endometrial ablation or resection up to 2-year follow-up (RR 0.75, 95% CI 0.71 to 0.79, I² = 95%). Objective outcomes of improvement in bleeding also favored hysterectomy. Patient satisfaction was higher after hysterectomy within the 2 years follow-up (RR: 0.90, 95%CI: 0.86 to 0.94, I²:58%), however, there was no significant difference between the two groups at more than 2 years follow up. Sepsis (RR: 0.03, 95% CI 0.002 to 0.56; 1 study), wound infection (RR: 0.05, 95% CI: 0.01 to 0.28, I²: 0%, 3 studies) and Urinary tract infection (UTI) (RR: 0.20, 95% CI: 0.10 to 0.42, I²: 0%, 4 studies) all favoured hysteroscopic techniques. Fluid overload (RR: 7.80, 95% CI: 2.16 to 28.16, I² :0%, 4 studies) and perforation (RR: 5.42, 95% CI: 1.25 to 23.45, I²: 0%, 4 studies) however favoured hysterectomy in the short term. Conclusions: This meta-analysis has demonstrated that endometrial ablation and endometrial resection are both viable options when compared with hysterectomy for the treatment of heavy menstrual bleeding. Hysteroscopic procedures had better outcomes in the short term with fewer adverse events including wound infection, UTI and sepsis. The hysterectomy performed better when measuring more long-term impacts such as recurrence of symptoms, overall satisfaction at two years and the need for further treatment or surgery.

Keywords: menorrhagia, hysterectomy, ablation, resection

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2 Construction and Cross-Linking of Polyelectrolyte Multilayers Based on Polysaccharides as Antifouling Coatings

Authors: Wenfa Yu, Thuva Gnanasampanthan, John Finlay, Jessica Clarke, Charlotte Anderson, Tony Clare, Axel Rosenhahn

Abstract:

Marine biofouling is a worldwide problem at vast economic and ecological costs. Historically it was combated with toxic coatings such as tributyltin. As those coatings being banned nowadays, finding environmental friendly antifouling solution has become an urgent topic. In this study antifouling coatings consisted of natural occurring polysaccharides hyaluronic acid (HA), alginic acid (AA), chitosan (Ch) and polyelectrolyte polyethylenimine (PEI) are constructed into polyelectrolyte multilayers (PEMs) in a Layer-by-Layer (LbL) method. LbL PEM construction is a straightforward way to assemble biomacromolecular coatings on surfaces. Advantages about PEM include ease of handling, highly diverse PEM composition, precise control over the thickness and so on. PEMs have been widely employed in medical application and there are numerous studies regarding their protein adsorption, elasticity and cell adhesive properties. With the adjustment of coating composition, termination layer charge, coating morphology and cross-linking method, it is possible to prepare low marine biofouling coatings with PEMs. In this study, using spin coating technology, PEM construction was achieved at smooth multilayers with roughness as low as 2nm rms and highly reproducible thickness around 50nm. To obtain stability in sea water, the multilayers were covalently cross-linked either thermally or chemically. The cross-linking method affected surface energy, which was reflected in water contact angle, thermal cross-linking led to hydrophobic surfaces and chemical cross-linking generated hydrophilic surfaces. The coatings were then evaluated regarding its protein resistance and biological species resistance. While the hydrophobic thermally cross-linked PEM had low resistance towards proteins, the resistance of chemically cross-linked PEM strongly depended on the PEM termination layer and the charge of the protein, opposite charge caused high adsorption and same charge low adsorption, indicating electrostatic interaction plays a crucial role in the protein adsorption processes. Ulva linza was chosen as the biological species for antifouling performance evaluation. Despite of the poor resistance towards protein adsorption, thermally cross-linked PEM showed good resistance against Ulva spores settlement, the chemically cross-linked multilayers showed poor resistance regardless of the termination layer. Marine species adhesion is a complex process, although it involves proteins as bioadhesives, protein resistance its own is not a fully indicator for its antifouling performance. The species will pre select the surface, responding to cues like surface energy, chemistry, or charge and so on. Thus making it difficult for one single factors to determine its antifouling performance. Preparing PEM coating is a comprehensive work involving choosing polyelectrolyte combination, determining termination layer and the method for cross-linking. These decisions will affect PEM properties such as surface energy, charge, which is crucial, since biofouling is a process responding to surface properties in a highly sensitive and dynamic way.

Keywords: hyaluronic acid, polyelectrolyte multilayers, protein resistance, Ulva linza zoospores

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1 Microplastics in Fish from Grenada, West Indies: Problems and Opportunities

Authors: Michelle E. Taylor, Clare E. Morrall

Abstract:

Microplastics are small particles produced for industrial purposes or formed by breakdown of anthropogenic debris. Caribbean nations import large quantities of plastic products. The Caribbean region is vulnerable to natural disasters and Climate Change is predicted to bring multiple additional challenges to island nations. Microplastics have been found in an array of marine environments and in a diversity of marine species. Occurrence of microplastic in the intestinal tracts of marine fish is a concern to human and ecosystem health as pollutants and pathogens can associate with plastics. Studies have shown that the incidence of microplastics in marine fish varies with species and location. Prevalence of microplastics (≤ 5 mm) in fish species from Grenadian waters (representing pelagic, semi-pelagic and demersal lifestyles) harvested for human consumption have been investigated via gut analysis. Harvested tissue was digested in 10% KOH and particles retained on a 0.177 mm sieve were examined. Microplastics identified have been classified according to type, colour and size. Over 97% of fish examined thus far (n=34) contained microplastics. Current and future work includes examining the invasive Lionfish (Pterois spp.) for microplastics, investigating marine invertebrate species as well as examining environmental sources of microplastics (i.e. rivers, coastal waters and sand). Owing to concerns of pollutant accumulation on microplastics and potential migration into organismal tissues, we plan to analyse fish tissue for mercury and other persistent pollutants. Despite having ~110,000 inhabitants, the island nation of Grenada imported approximately 33 million plastic bottles in 2013, of which it is estimated less than 5% were recycled. Over 30% of the imported bottles were ‘unmanaged’, and as such are potential litter/marine debris. A revised Litter Abatement Act passed into law in Grenada in 2015, but little enforcement of the law is evident to date. A local Non-governmental organization (NGO) ‘The Grenada Green Group’ (G3) is focused on reducing litter in Grenada through lobbying government to implement the revised act and running sessions in schools, community groups and on local media and social media to raise awareness of the problems associated with plastics. A local private company has indicated willingness to support an Anti-Litter Campaign in 2018 and local awareness of the need for a reduction of single use plastic use and litter seems to be high. The Government of Grenada have called for a Sustainable Waste Management Strategy and a ban on both Styrofoam and plastic grocery bags are among recommendations recently submitted. A Styrofoam ban will be in place at the St. George’s University campus from January 1st, 2018 and many local businesses have already voluntarily moved away from Styrofoam. Our findings underscore the importance of continuing investigations into microplastics in marine life; this will contribute to understanding the associated health risks. Furthermore, our findings support action to mitigate the volume of plastics entering the world’s oceans. We hope that Grenada’s future will involve a lot less plastic. This research was supported by the Caribbean Node of the Global Partnership on Marine Litter.

Keywords: Caribbean, microplastics, pollution, small island developing nation

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