Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13

Search results for: Feargal Brennan

13 Non-Stationary Stochastic Optimization of an Oscillating Water Column

Authors: María L. Jalón, Feargal Brennan


A non-stationary stochastic optimization methodology is applied to an OWC (oscillating water column) to find the design that maximizes the wave energy extraction. Different temporal cycles are considered to represent the long-term variability of the wave climate at the site in the optimization problem. The results of the non-stationary stochastic optimization problem are compared against those obtained by a stationary stochastic optimization problem. The comparative analysis reveals that the proposed non-stationary optimization provides designs with a better fit to reality. However, the stationarity assumption can be adequate when looking at averaged system response.

Keywords: non-stationary stochastic optimization, oscillating water, temporal variability, wave energy

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12 Changes in When and Where People Are Spending Time in Response to COVID-19

Authors: Nicholas Reinicke, Brennan Borlaug, Matthew Moniot


The COVID-19 pandemic has resulted in a significant change in driving behavior as people respond to the new environment. However, existing methods for analyzing driver behavior, such as travel surveys and travel demand models, are not suited for incorporating abrupt environmental disruptions. To address this, we analyze a set of high-resolution trip data and introduce two new metrics for quantifying driving behavioral shifts as a function of time, allowing us to compare the time periods before and after the pandemic began. We apply these metrics to the Denver, Colorado metropolitan statistical area (MSA) to demonstrate the utility of the metrics. Then, we present a case study for comparing two distinct MSAs, Louisville, Kentucky, and Des Moines, Iowa, which exhibit significant differences in the makeup of their labor markets. The results indicate that although the regions of study exhibit certain unique driving behavioral shifts, emerging trends can be seen when comparing between seemingly distinct regions. For instance, drivers in all three MSAs are generally shown to have spent more time at residential locations and less time in workplaces in the time period after the pandemic started. In addition, workplaces that may be incompatible with remote working, such as hospitals and certain retail locations, generally retained much of their pre-pandemic travel activity.

Keywords: COVID-19, driver behavior, GPS data, signal analysis, telework

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11 A Questionnaire Survey Reviewing Radiographers' Knowledge of Computed Tomography Exposure Parameters

Authors: Mohammad Rawashdeh, Mark McEntee, Maha Zaitoun, Mostafa Abdelrahman, Patrick Brennan, Haytham Alewaidat, Sarah Lewis, Charbel Saade


Despite the tremendous advancements that have been generated by Computed Tomography (CT) in the field of diagnosis, concerns have been raised about the potential cancer induction risk from CT because of the exponentially increased use of it in medicine. This study aims at investigating the application and knowledge of practicing radiographers in Jordan about CT radiation. In order to collect the primary data of this study, a questionnaire was designed and distributed by social media using a snow-balling sampling method. The respondents (n=54) have answered 36 questions including the questions about their demographic information, knowledge about Diagnostic Reference Levels (DRLs), CT exposure and adaptation of pediatric patients exposure. The educational level of the respondents was either at a diploma degree (35.2%) or bachelor (64.8%). The results of this study have indicated a good level of general knowledge between radiographers about the relationship between image quality, exposure parameters, and patient dose. The level of knowledge related to DRL was poor where less than 7.4 percent of the sample members were able to give specific values for a number of common anatomical fields, including abdomen, brain, and chest. Overall, Jordanian radiographers need to gain more knowledge about the expected levels of the dose when applying good practice. Additional education on DRL or DRL inclusion in educational programs is highlighted.

Keywords: computed tomography, CT scan, DRLs, exposure parameters, image quality, radiation dose

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10 'Utopian Performatives' for Peace: A Radical Approach to Evaluating the Value of Documentary Theatre in Northern Ireland

Authors: Harry Mccallum


In the last decade, there has been an upsurge in documentary theatre projects that seek to address issues arising from ‘the Troubles’ by theatre and community organisations such as The Playhouse, Kabosh, and The Verbal Arts Centre. This movement has been supported by a variety of funding agencies who have identified the importance of the instrumental use of theatre for generating societal development. However, with this upsurge in interest comes complications surrounding the subjectivity of evaluations and an understanding of their empirical impact on society. This largely theoretical led-discussion promotes the engagement of Jill Dolan’s ‘utopian performatives’ (2005) within the remit of documentary theatre for peacebuilding practices in Northern Ireland.‘Utopian Performatives’ are described as being profound moments in a theatre production that transforms audience members into a state of ‘hopeful feeling’.As a concept, they are situated within the discourse surrounding audience reception and the ‘affective turn’ (Brennan, 2004; Clough and Halley, 2007; Ahmed, 2014), which indicates its persistence on a short-term ephemeral outlook. It is therefore important to understand how this short-term ‘affect’ can expand into a longer-term ‘effect.’ Through this interdisciplinary study between ‘peace’ and ‘theatre’ studies, I am proposinga theoretical framework that examines how these individual ‘utopian performatives’ at the personal level can lead to a change at the societal level. The framework understands that ‘utopian performatives’ have the capacity to generate discussion and empower audience members to actively strive for a ‘positive peace’; something which is evidently absent in a contemporary Northern Ireland.

Keywords: theatre, peacebuilding, conflict transformation, northern Ireland

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9 Quantifying Wave Attenuation over an Eroding Marsh through Numerical Modeling

Authors: Donald G. Danmeier, Gian Marco Pizzo, Matthew Brennan


Although wetlands have been proposed as a green alternative to manage coastal flood hazards because of their capacity to adapt to sea level rise and provision of multiple ecological and social co-benefits, they are often overlooked due to challenges in quantifying the uncertainty and naturally, variability of these systems. This objective of this study was to quantify wave attenuation provided by a natural marsh surrounding a large oil refinery along the US Gulf Coast that has experienced steady erosion along the shoreward edge. The vegetation module of the SWAN was activated and coupled with a hydrodynamic model (DELFT3D) to capture two-way interactions between the changing water level and wavefield over the course of a storm event. Since the marsh response to relative sea level rise is difficult to predict, a range of future marsh morphologies is explored. Numerical results were examined to determine the amount of wave attenuation as a function of marsh extent and the relative contributions from white-capping, depth-limited wave breaking, bottom friction, and flexing of vegetation. In addition to the coupled DELFT3D-SWAN modeling of a storm event, an uncoupled SWAN-VEG model was applied to a simplified bathymetry to explore a larger experimental design space. The wave modeling revealed that the rate of wave attenuation reduces for higher surge but was still significant over a wide range of water levels and outboard wave heights. The results also provide insights to the minimum marsh extent required to fully realize the potential wave attenuation so the changing coastal hazards can be managed.

Keywords: green infrastructure, wave attenuation, wave modeling, wetland

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8 Impact Force Difference on Natural Grass Versus Synthetic Turf Football Fields

Authors: Nathaniel C. Villanueva, Ian K. H. Chun, Alyssa S. Fujiwara, Emily R. Leibovitch, Brennan E. Yamamoto, Loren G. Yamamoto


Introduction: In previous studies of high school sports, over 15% of concussions were attributed to contact with the playing surface. While artificial turf fields are increasing in popularity due to lower maintenance costs, artificial turf has been associated with more ankle and knee injuries, with inconclusive data on concussions. In this study, natural grass and artificial football fields were compared in terms of deceleration on fall impact. Methods: Accelerometers were placed on the forehead, apex of the head, and right ear of a Century Body Opponent Bag (BOB) manikin. A Riddell HITS football helmet was secured onto the head of the manikin over the accelerometers. This manikin was dropped onto natural grass (n = 10) and artificial turf (n = 9) high school football fields. The manikin was dropped from a stationary position at a height of 60 cm onto its front, back, and left side. Each of these drops was conducted 10 times at the 40-yard line, 20-yard line, and endzone. The net deceleration on impact was calculated as a net vector from each of the three accelerometers’ x, y, and z vectors from the three different locations on the manikin’s head (9 vector measurements per drop). Results: Mean values for the multiple drops were calculated for each accelerometer and drop type for each field. All accelerometers in forward and backward falls and one accelerometer in side falls showed significantly greater impact force on synthetic turf compared to the natural grass surfaces. Conclusion: Impact force was higher on synthetic fields for all drop types for at least one of the accelerometer locations. These findings suggest that concussion risk might be higher for athletes playing on artificial turf fields.

Keywords: concussion, football, biomechanics, sports

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7 Hydrodynamics of Periphyton Biofilters in Recirculating Aquaculture

Authors: Adam N. Bell, Sarina J. Ergas, Michael Nystrom, Nathan P. Brennan, Kevan L. Main


Integrated Multi-Trophic Aquaculture systems (IMTA) have the potential to improve the sustainability of seafood production, generate organic fertilizer and feed, remove waste discharges and reduce energy use. IMTA can include periphyton biofilters where algae and microbes grow on surfaces, along with caught detritus and amphipods. Periphyton biofilters provide many advantages: nitrification, denitrification, primary production and ecological diversity. The goal of this study was to determine how biofilter hydraulic residence time (τ) effects periphyton biomass production, dissolved oxygen (DO) and nutrient removal. A pilot scale recirculating aquaculture system (RAS) was designed, constructed and operated at different hydraulic residence times (τ= 1, 2, 4, 6, 8 hours per tank). For each τ, a conservative tracer study was conducted to investigate system hydrodynamics. Data on periphyton weights, pH, nitrogen species, phosphorus, temperature and DO were collected. The tracer study for τ =1 hour revealed that the normalized time < τ, indicating short-circuiting. Periphyton biomass production rate was relatively unaffected by τ (R_e<1 for all τ). Average ammonia nitrogen removal was > 75% for all trials. Nitrate and nitrite did not accumulate in the RAS for τ≥4 hours due to enhanced denitrification in anoxic zones. For τ≥4 hours DO concentration was at a maximum of 4 mg L-1 after 14:00, and decreased to 0 mg L-1 during nighttime. At τ=1 hour, the RAS stayed > 2 mg L-1 and DO was more evenly distributed. For the validation trial, the culture tank was stocked with Centropomus undecimalis (common snook) and the system was operated at τ= 1 hr. Preliminary results showed that a RAS with an integrated periphyton biofilter could support fish health with low nutrient concentrations DO > 6 mg L-1.

Keywords: sustainable aquaculture, resource recovery, nitrogen, microalgae, hydrodynamics, integrated multi-trophic aquaculture

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6 Using Teachers' Perceptions of Science Outreach Activities to Design an 'Optimum' Model of Science Outreach

Authors: Victoria Brennan, Andrea Mallaburn, Linda Seton


Science outreach programmes connect school pupils with external agencies to provide activities and experiences that enhance their exposure to science. It can be argued that these programmes not only aim to support teachers with curriculum engagement and promote scientific literacy but also provide pivotal opportunities to spark scientific interest in students. In turn, a further objective of these programmes is to increase awareness of career opportunities within this field. Although outreach work is also often described as a fun and satisfying venture, a plethora of researchers express caution to how successful the processes are to increases engagement post-16 in science. When researching the impact of outreach programmes, it is often student feedback regarding the activities or enrolment numbers to particular science courses post-16, which are generated and analysed. Although this is informative, the longevity of the programme’s impact could be better informed by the teacher’s perceptions; the evidence of which is far more limited in the literature. In addition, there are strong suggestions that teachers can have an indirect impact on a student’s own self-concept. These themes shape the focus and importance of this ongoing research project as it presents the rationale that teachers are under-used resources when it comes to considering the design of science outreach programmes. Therefore, the end result of the research will consist of a presentation of an ‘optimum’ model of outreach. The result of which should be of interest to the wider stakeholders such as universities or private or government organisations who design science outreach programmes in the hope to recruit future scientists. During phase one, questionnaires (n=52) and interviews (n=8) have generated both quantitative and qualitative data. These have been analysed using the Wilcoxon non-parametric test to compare teachers’ perceptions of science outreach interventions and thematic analysis for open-ended questions. Both of these research activities provide an opportunity for a cross-section of teacher opinions of science outreach to be obtained across all educational levels. Therefore, an early draft of the ‘optimum’ model of science outreach delivery was generated using both the wealth of literature and primary data. This final (ongoing) phase aims to refine this model using teacher focus groups to provide constructive feedback about the proposed model. The analysis uses principles of modified Grounded Theory to ensure that focus group data is used to further strengthen the model. Therefore, this research uses a pragmatist approach as it aims to focus on the strengths of the different paradigms encountered to ensure the data collected will provide the most suitable information to create an improved model of sustainable outreach. The results discussed will focus on this ‘optimum’ model and teachers’ perceptions of benefits and drawbacks when it comes to engaging with science outreach work. Although the model is still a ‘work in progress’, it provides both insight into how teachers feel outreach delivery can be a sustainable intervention tool within the classroom and what providers of such programmes should consider when designing science outreach activities.

Keywords: educational partnerships, science education, science outreach, teachers

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5 Midterm Clinical and Functional Outcomes After Treatment with Ponseti Method for Idiopathic Clubfeet: A Prospective Cohort Study

Authors: Neeraj Vij, Amber Brennan, Jenni Winters, Hadi Salehi, Hamy Temkit, Emily Andrisevic, Mohan V. Belthur


Idiopathic clubfoot is a common lower extremity deformity with an incidence of 1:500. The Ponseti Method is well known as the gold standard of treatment. However, there is limited functional data demonstrating correction of the clubfoot after treatment with the Ponseti method. The purpose of this study was to study the clinical and functional outcomes after the Ponseti method with the Clubfoot Disease-Specific Instrument (CDS) and pedobarography. This IRB-approved prospective study included patients aged 3-18 who were treated for idiopathic clubfoot with the Ponseti method between January 2008 and December 2018. Age-matched controls were identified through siblings of clubfoot patients and other community members. Treatment details were collected through a chart review of the included patients. Laboratory assessment included a physical exam, gait analysis, and pedobarography. The Pediatric Outcomes Data Collection Instrument and the Clubfoot Disease-Specific Instrument were also obtained on clubfoot patients (CF). The Wilcoxson rank-sum test was used to study differences between the CF patients and the typically developing (TD) patients. Statistical significance was set at p < 0.05. There were a total of 37 enrolled patients in our study. 21 were priorly treated for CF and 16 were TD. 94% of the CF patients had bilateral involvement. The age at the start of treatment was 29 days, the average total number of casts was seven to eight, and the average total number of casts after Achilles tenotomy was one. The reoccurrence rate was 25%, tenotomy was required in 94% of patients, and ≥1 tenotomy was required in 25% of patients. There were no significant differences between step length, step width, stride length, force-time integral, maximum peak pressure, foot progression angles, stance phase time, single-limb support time, double limb support time, and gait cycle time between children treated with the Ponseti method and typically developing children. The average post-treatment Pirani and Dimeglio scores were 5.50±0.58 and 15.29±1.58, respectively. The average post-treatment PODCI subscores were: Upper Extremity: 90.28, Transfers: 94.6, Sports: 86.81, Pain: 86.20, Happiness: 89.52, Global: 88.6. The average post-treatment Clubfoot Disease-Specific Instrument scores subscores were: Satisfaction: 73.93, Function: 80.32, Overall: 78.41. The Ponseti Method has a very high success rate and remains to be the gold standard in the treatment of idiopathic clubfoot. Timely management leads to good outcomes and a low need for repeated Achilles tenotomy. Children treated with the Ponseti method demonstrate good functional outcomes as measured through pedobarography. Pedobarography may have clinical utility in studying congenital foot deformities. Objective measures for hours of brace wear could represent an improvement in clubfoot care.

Keywords: functional outcomes, pediatric deformity, patient-reported outcomes, talipes equinovarus

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4 Exploring Closed-Loop Business Systems Which Eliminates Solid Waste in the Textile and Fashion Industry: A Systematic Literature Review Covering the Developments Occurred in the Last Decade

Authors: Bukra Kalayci, Geraldine Brennan


Introduction: Over the last decade, a proliferation of literature related to textile and fashion business in the context of sustainable production and consumption has emerged. However, the economic and environmental benefits of solid waste recovery have not been comprehensively searched. Therefore at the end-of-life or end-of-use textile waste management remains a gap. Solid textile waste reuse and recycling principles of the circular economy need to be developed to close the disposal stage of the textile supply chain. The environmental problems associated with the over-production and –consumption of textile products arise. Together with growing population and fast fashion culture the share of solid textile waste in municipal waste is increasing. Focusing on post-consumer textile waste literature, this research explores the opportunities, obstacles and enablers or success factors associated with closed-loop textile business systems. Methodology: A systematic literature review was conducted in order to identify best practices and gaps from the existing body of knowledge related to closed-loop post-consumer textile waste initiatives over the last decade. Selected keywords namely: ‘cradle-to-cradle ‘, ‘circular* economy* ‘, ‘closed-loop* ‘, ‘end-of-life* ‘, ‘reverse* logistic* ‘, ‘take-back* ‘, ‘remanufacture* ‘, ‘upcycle* ‘ with the combination of (and) ‘fashion* ‘, ‘garment* ‘, ‘textile* ‘, ‘apparel* ‘, clothing* ‘ were used and the time frame of the review was set between 2005 to 2017. In order to obtain a broad coverage, Web of Knowledge and Science Direct databases were used, and peer-reviewed journal articles were chosen. The keyword search identified 299 number of papers which was further refined into 54 relevant papers that form the basis of the in-depth thematic analysis. Preliminary findings: A key finding was that the existing literature is predominantly conceptual rather than applied or empirical work. Moreover, the enablers or success factors, obstacles and opportunities to implement closed-loop systems in the textile industry were not clearly articulated and the following considerations were also largely overlooked in the literature. While the circular economy suggests multiple cycles of discarded products, components or materials, most research has to date tended to focus on a single cycle. Thus the calculations of environmental and economic benefits of closed-loop systems are limited to one cycle which does not adequately explore the feasibility or potential benefits of multiple cycles. Additionally, the time period textile products spend between point of sale, and end-of-use/end-of-life return is a crucial factor. Despite past efforts to study closed-loop textile systems a clear gap in the literature is the lack of a clear evaluation framework which enables manufacturers to clarify the reusability potential of textile products through consideration of indicators related too: quality, design, lifetime, length of time between manufacture and product return, volume of collected disposed products, material properties, and brand segment considerations (e.g. fast fashion versus luxury brands).

Keywords: circular fashion, closed loop business, product service systems, solid textile waste elimination

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3 Effectiveness of a Physical Activity Loyalty Scheme to Maintain Behaviour Change: A Cluster Randomised Controlled Trial

Authors: Aisling Gough, Ruth F. Hunter, Jianjun Tang, Sarah F. Brennan, Oliver Smith, Mark A. Tully, Chris Patterson, Alberto Longo, George Hutchinson, Lindsay Prior, David French, Jean Adams, Emma McIntosh, Frank Kee


Background: As a large proportion of the UK workforce is employed in sedentary occupations, worksite interventions have the potential to contribute significantly to the health of the population. The UK Government is currently encouraging the use of financial incentives to promote healthier lifestyles but there is a dearth of evidence regarding the effectiveness and sustainability of incentive schemes to promote physical activity in the workplace. Methods: A large cluster RCT is currently underway, incorporating nested behavioural economic field experiments and process evaluation, to evaluate the effectiveness of a Physical Activity Loyalty Scheme. Office-based employees were recruited from large public sector organisations in Lisburn and Belfast (Northern Ireland) and randomised to an Intervention or Control group. Participants in the Intervention Group were encouraged to take part in 150 minutes of physical activity per week through provision of financial incentives (retailer vouchers) to those who met physical activity targets throughout the course of the 6 month intervention. Minutes of physical activity were monitored when participants passed by sensors (holding a keyfob) placed along main walking routes, parks and public transport stops nearby their workplace. Participants in the Control Group will complete the same outcome assessments (waiting-list control). The primary outcome is steps per day measured via pedometers (7 days). Secondary outcomes include health and wellbeing (Short Form-8, EuroQol-5D-5L, Warwick Edinburgh Mental Well Being Scale), and work absenteeism and presenteeism. Data will be collected at baseline, 6, 12 and 18 months. Information on PAL card & website usage, voucher downloads and redemption of vouchers will also be collected as part of a comprehensive process evaluation. Results: In total, 853 participants have been recruited from 9 workplaces in Lisburn, 12 buildings within the Stormont Estate, Queen’s University Belfast and Belfast City Hospital. Participants have been randomised to intervention and control groups. Baseline and 6-month data for the Physical Activity Loyalty Scheme has been collected. Findings regarding the effectiveness of the intervention from the 6-month follow-up data will be presented. Discussion: This study will address the gap in knowledge regarding the effectiveness and cost-effectiveness of a workplace-based financial incentive scheme to promote a healthier lifestyle. As the UK workforce is increasingly sedentary, workplace-based physical activity interventions have significant potential in terms of encouraging employees to partake in physical activity during the working day which could lead to substantial improvements in physical activity levels overall. Implications: If a workplace based physical activity intervention such as this proves to be both effective and cost-effective, there is great potential to contribute significantly to the health and wellbeing of the workforce in the future. Workplace-based physical activity interventions have the potential to improve the physical and mental health of employees which may in turn lead to economic benefits for the employer, such as reduction in rates of absenteeism and increased productivity.

Keywords: behaviour change, cluster randomised controlled trial, loyalty scheme, physical activity

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2 Sustainable Antimicrobial Biopolymeric Food & Biomedical Film Engineering Using Bioactive AMP-Ag+ Formulations

Authors: Eduardo Lanzagorta Garcia, Chaitra Venkatesh, Romina Pezzoli, Laura Gabriela Rodriguez Barroso, Declan Devine, Margaret E. Brennan Fournet


New antimicrobial interventions are urgently required to combat rising global health and medical infection challenges. Here, an innovative antimicrobial technology, providing price competitive alternatives to antibiotics and readily integratable with currently technological systems is presented. Two cutting edge antimicrobial materials, antimicrobial peptides (AMPs) and uncompromised sustained Ag+ action from triangular silver nanoplates (TSNPs) reservoirs, are merged for versatile effective antimicrobial action where current approaches fail. Antimicrobial peptides (AMPs) exist widely in nature and have recently been demonstrated for broad spectrum of activity against bacteria, viruses, and fungi. TSNP’s are highly discrete, homogenous and readily functionisable Ag+ nanoreseviors that have a proven amenability for operation within in a wide range of bio-based settings. In a design for advanced antimicrobial sustainable plastics, antimicrobial TSNPs are formulated for processing within biodegradable biopolymers. Histone H5 AMP was selected for its reported strong antimicrobial action and functionalized with the TSNP (AMP-TSNP) in a similar fashion to previously reported TSNP biofunctionalisation methods. A synergy between the propensity of biopolymers for degradation and Ag+ release combined with AMP activity provides a novel mechanism for the sustained antimicrobial action of biopolymeric thin films. Nanoplates are transferred from aqueous phase to an organic solvent in order to facilitate integration within hydrophobic polymers. Extrusion is used in combination with calendering rolls to create thin polymerc film where the nanoplates are embedded onto the surface. The resultant antibacterial functional films are suitable to be adapted for food packing and biomedical applications. TSNP synthesis were synthesized by adapting a previously reported seed mediated approach. TSNP synthesis was scaled up for litre scale batch production and subsequently concentrated to 43 ppm using thermally controlled H2O removal. Nanoplates were transferred from aqueous phase to an organic solvent in order to facilitate integration within hydrophobic polymers. This was acomplised by functionalizing the TSNP with thiol terminated polyethylene glycol and using centrifugal force to transfer them to chloroform. Polycaprolactone (PCL) and Polylactic acid (PLA) were individually processed through extrusion, TSNP and AMP-TSNP solutions were sprayed onto the polymer immediately after exiting the dye. Calendering rolls were used to disperse and incorporate TSNP and TSNP-AMP onto the surface of the extruded films. Observation of the characteristic blue colour confirms the integrity of the TSNP within the films. Antimicrobial tests were performed by incubating Gram + and Gram – strains with treated and non-treated films, to evaluate if bacterial growth was reduced due to the presence of the TSNP. The resulting films successfully incorporated TSNP and AMP-TSNP. Reduced bacterial growth was observed for both Gram + and Gram – strains for both TSNP and AMP-TSNP compared with untreated films indicating antimicrobial action. The largest growth reduction was observed for AMP-TSNP treated films demonstrating the additional antimicrobial activity due to the presence of the AMPs. The potential of this technology to impede bacterial activity in food industry and medical surfaces will forge new confidence in the battle against antibiotic resistant bacteria, serving to greatly inhibit infections and facilitate patient recovery.

Keywords: antimicrobial, biodegradable, peptide, polymer, nanoparticle

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1 The Impact of the Macro-Level: Organizational Communication in Undergraduate Medical Education

Authors: Julie M. Novak, Simone K. Brennan, Lacey Brim


Undergraduate medical education (UME) curriculum notably addresses micro-level communications (e.g., patient-provider, intercultural, inter-professional), yet frequently under-examines the role and impact of organizational communication, a more macro-level. Organizational communication, however, functions as foundation and through systemic structures of an organization and thereby serves as hidden curriculum and influences learning experiences and outcomes. Yet, little available research exists fully examining how students experience organizational communication while in medical school. Extant literature and best practices provide insufficient guidance for UME programs, in particular. The purpose of this study was to map and examine current organizational communication systems and processes in a UME program. Employing a phenomenology-grounded and participatory approach, this study sought to understand the organizational communication system from medical students' perspective. The research team consisted of a core team and 13 medical student co-investigators. This research employed multiple methods, including focus groups, individual interviews, and two surveys (one reflective of focus group questions, the other requesting students to submit ‘examples’ of communications). To provide context for student responses, nonstudent participants (faculty, administrators, and staff) were sampled, as they too express concerns about communication. Over 400 students across all cohorts and 17 nonstudents participated. Data were iteratively analyzed and checked for triangulation. Findings reveal the complex nature of organizational communication and student-oriented communications. They reveal program-impactful strengths, weaknesses, gaps, and tensions and speak to the role of organizational communication practices influencing both climate and culture. With regard to communications, students receive multiple, simultaneous communications from multiple sources/channels, both formal (e.g., official email) and informal (e.g., social media). Students identified organizational strengths including the desire to improve student voice, and message frequency. They also identified weaknesses related to over-reliance on emails, numerous platforms with inconsistent utilization, incorrect information, insufficient transparency, assessment/input fatigue, tacit expectations, scheduling/deadlines, responsiveness, and mental health confidentiality concerns. Moreover, they noted gaps related to lack of coordination/organization, ambiguous point-persons, student ‘voice-only’, open communication loops, lack of core centralization and consistency, and mental health bridges. Findings also revealed organizational identity and cultural characteristics as impactful on the medical school experience. Cultural characteristics included program size, diversity, urban setting, student organizations, community-engagement, crisis framing, learning for exams, inefficient bureaucracy, and professionalism. Moreover, they identified system structures that do not always leverage cultural strengths or reduce cultural problematics. Based on the results, opportunities for productive change are identified. These include leadership visibly supporting and enacting overall organizational narratives, making greater efforts in consistently ‘closing the loop’, regularly sharing how student input effects change, employing strategies of crisis communication more often, strengthening communication infrastructure, ensuring structures facilitate effective operations and change efforts, and highlighting change efforts in informational communication. Organizational communication and communications are not soft-skills, or of secondary concern within organizations, rather they are foundational in nature and serve to educate/inform all stakeholders. As primary stakeholders, students and their success directly affect the accomplishment of organizational goals. This study demonstrates how inquiries about how students navigate their educational experience extends research-based knowledge and provides actionable knowledge for the improvement of organizational operations in UME.

Keywords: medical education programs, organizational communication, participatory research, qualitative mixed methods

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