• The Fall of the House of Wynnstay: The 1885 Election in East Denbighshire

      Peters, Lisa; University of Chester (University of Wales Press, 2021-06)
      This article discusses the 1885 election in East Denbighshire when the Williams-Wynn family of Wynnstay lost the parliamentary seat that the family had represented for over 170 years. The election took place amidst the backdrop of legislative changes to corrupt practices, the electorate, and changing constituency boundaries. Conservative and Liberal party organisation in East Denbighshire is discussed.
    • Finding my voice: A qualitative exploration into the perceived impact of person‐centred counsellor training upon counsellors who were adopted as a baby

      Parkes, Charlotte Hannah; orcid: 0000-0002-8578-0768; email: 1327305@chester.ac.uk; email: c.hannah.parkes@gmail.com; Mintz, Rita (2021-05-10)
      Abstract: This small‐scale qualitative study explored how qualified person‐centred counsellors who were adopted as a baby perceived the impact of their person‐centred counselling training. The study focused on the adoptees’ experiences of adoption and how these influenced their experience of person‐centred counselling training. Data were analysed using interpretative phenomenological analysis to gain insight into how the participants made sense of their lived experience. The findings supported the difficulties associated with adoption, which not only are present in existing literature and research but also placed an emphasis on the particular vulnerabilities associated with being adopted as a baby. The findings further highlighted the positive impact of person‐centred counselling training on the participants’ personal development, which included the following: increased self‐awareness, self‐acceptance, identity development and ‘having a voice’. The findings confer implications for clinical practice in understanding the experience of adoptees who were adopted as a baby and for trainers in the planning and provision of person‐centred training. The research also identifies the healing aspects of person‐centred counselling training, which facilitated the participants’ positive self‐development. In addition, unique opportunities for counsellors who were also adopted as a baby are suggested and the need for the Adoption Support Fund to be extended to allow an adoptee of any age to access therapeutic support is also identified. The links made between adoption and person‐centred training are an original area of research and are worthy of further exploration.
    • Advances in Biofabrication for Tissue Engineering and Regenerative Medicine Applications

      Domingos, Marco; email: marco.domingos@manchester.ac.uk; Moxon, Sam; email: samuel.moxon@manchester.ac.uk (MDPI, 2021-05-09)
      Biofabrication strategies continue to gain considerable interest in the efforts to develop methods for better replicating in vitro models of human tissues [...]
    • Prediction of One Repetition Maximum Using Reference Minimum Velocity Threshold Values in Young and Middle-Aged Resistance-Trained Males

      Fernandes, John F. T.; email: jfmtfernandes@hotmail.co.uk; Dingley, Amelia F.; email: amelia.dingley@hartpury.ac.uk; Garcia-Ramos, Amador; orcid: 0000-0003-0608-8755; email: amagr@ugr.es; Perez-Castilla, Alejandro; orcid: 0000-0001-5535-2087; email: alexperez@ugr.es; Tufano, James J.; orcid: 0000-0001-8325-0344; email: tufano@ftvs.cuni.cz; Twist, Craig; orcid: 0000-0001-6168-0378; email: c.twist@chester.ac.uk (MDPI, 2021-05-07)
      Background: This study determined the accuracy of different velocity-based methods when predicting one-repetition maximum (1RM) in young and middle-aged resistance-trained males. Methods: Two days after maximal strength testing, 20 young (age 21.0 ± 1.6 years) and 20 middle-aged (age 42.6 ± 6.7 years) resistance-trained males completed three repetitions of bench press, back squat, and bent-over-row at loads corresponding to 20–80% 1RM. Using reference minimum velocity threshold (MVT) values, the 1RM was estimated from the load-velocity relationships through multiple (20, 30, 40, 50, 60, 70, and 80% 1RM), two-point (20 and 80% 1RM), high-load (60 and 80% 1RM) and low-load (20 and 40% 1RM) methods for each group. Results: Despite most prediction methods demonstrating acceptable correlations (r = 0.55 to 0.96), the absolute errors for young and middle-aged groups were generally moderate to high for bench press (absolute errors = 8.2 to 14.2% and 8.6 to 20.4%, respectively) and bent-over-row (absolute error = 14.9 to 19.9% and 8.6 to 18.2%, respectively). For squats, the absolute errors were lower in the young group (5.7 to 13.4%) than the middle-aged group (13.2 to 17.0%) but still unacceptable. Conclusion: These findings suggest that reference MVTs cannot accurately predict the 1RM in these populations. Therefore, practitioners need to directly assess 1RM.
    • The city‐island‐state, wounding cascade, and multi‐level vulnerability explored through the lens of Malta

      Main, Geoff; orcid: 0000-0001-8453-1527; email: g.main@exeter.ac.uk; Schembri, John; Speake, Janet; Gauci, Ritienne; Chester, David (2021-05-06)
      In this paper, we introduce the concept of “city‐island‐state” into a discussion of small highly urbanised islands. We place the “city” at the forefront of our analysis by bringing together the geographies of the “city” and “state,” together with a wider discussion of factors that may cause both the wounding of the city and an increase in the precariousness of the “island.” We apply this concept to the advanced city‐island‐state of Malta (Central Mediterranean), which is a densely populated, urbanised small island archipelago with about 500,000 inhabitants and operates as a single city with an urban core, suburbs, and a rural hinterland that is rapidly decreasing in size. This city‐island‐state is frequently considered as being “safe” from external geophysical, climatic, and anthropogenic wounding, but, in reality, Malta, as a city, an island, and an independent nation‐state, is faced with multiple internal and external pressures that increase its precariousness and vulnerability to such externalities. Some of these are socio‐economic, but others are environmental. We argue that the potential for wounding is particularly marked in Malta, that it is exacerbated by the contemporary globalised neoliberal world of flows and interconnectivities, and that this represents a multi‐level wounding cascade: wounding the city wounds the island and, by extension, the state.
    • Heuristic assessment of psychological interventions in schools (HAPI Schools)

      Platt, Ian A.; orcid: 0000-0003-2497-6713; email: iap1hss@bolton.ac.uk; Kannangara, Chathurika; orcid: 0000-0001-6955-8158; Carson, Jerome; orcid: 0000-0002-7596-116X; Tytherleigh, Michelle; orcid: 0000-0003-2498-8175 (2021-05-02)
      Abstract: Children spend more time in school than in any other formal setting and, with mental illness in children on the rise, there is more pressure on schools to intervene in student mental health than ever before. In the current study, two phases of semistructured interviews were conducted with school leaders and special educational needs coordinators (Phase 1, N = 23; Phase 2, N = 11), to investigate first‐hand experiences in dealing with student mental illness. Thematic analysis, drawing on Grounded Theory, was used to identify themes. The results identified deprivation as one of the main causes of mental ill‐health in students, with insufficient budgets, inappropriate mental health services, and overly long waiting times as barriers to intervention. Difficulties in identifying appropriate mental health interventions to use in school were also reported. The authors propose a simple four‐point heuristic, for assessing the quality of school‐based mental health interventions to be used by school staff, so that educators can more readily identify appropriate mental health support for their students.
    • Heuristic assessment of psychological interventions in schools (HAPI Schools)

      Platt, Ian A.; orcid: 0000-0003-2497-6713; Kannangara, Chathurika; orcid: 0000-0001-6955-8158; Carson, Jerome; orcid: 0000-0002-7596-116X; Tytherleigh, Michelle; orcid: 0000-0003-2498-8175 (Wiley, 2021-05-02)
    • Validation of CIP2A as a Biomarker of Subsequent Disease Progression and Treatment Failure in Chronic Myeloid Leukaemia

      Clark, Richard E.; email: clarkre@liverpool.ac.uk; Basabrain, Ammar A.; email: a.a.basabrain@liverpool.ac.uk; Austin, Gemma M.; email: gemmajon2003@yahoo.co.uk; Holcroft, Alison K.; email: alisonkholcroft@hotmail.co.uk; Loaiza, Sandra; email: sandra.loaiza@nhs.net; Apperley, Jane F.; email: j.apperley@imperial.ac.uk; Law, Christopher; email: K.C.Law@liverpool.ac.uk; Scott, Laura; email: l.scott1@liverpool.ac.uk; Parry, Alexandra D.; email: alexparry@virginmedia.com; Bonnett, Laura; orcid: 0000-0002-6981-9212; email: L.J.Bonnett@liverpool.ac.uk; et al. (MDPI, 2021-04-29)
      Background: It would be clinically useful to prospectively identify the risk of disease progression in chronic myeloid leukaemia (CML). Overexpression of cancerous inhibitor of protein phosphatase 2A (PP2A) (CIP2A) protein is an adverse prognostic indicator in many cancers. Methods: We examined CIP2A protein levels in diagnostic samples from the SPIRIT2 trial in 172 unselected patients, of whom 90 received imatinib and 82 dasatinib as first-line treatment. Results: High CIP2A levels correlated with inferior progression-free survival (p = 0.04) and with worse freedom from progression (p = 0.03), and these effects were confined to dasatinib recipients. High CIP2A levels were associated with a six-fold higher five-year treatment failure rate than low CIP2A levels (41% vs. 7.5%; p = 0.0002), in both imatinib (45% vs. 11%; p = 0.02) and dasatinib recipients (36% vs. 4%; p = 0.007). Imatinib recipients with low CIP2A levels had a greater risk of treatment failure (p = 0.0008). CIP2A levels were independent of Sokal, Hasford, EUTOS (EUropean Treatment and Outcome Study), or EUTOS long-term survival scores (ELTS) or the presence of major route cytogenetic abnormalities. No association was seen between CIP2A levels and time to molecular response or the levels of the CIP2A-related proteins PP2A, SET, SET binding protein 1 (SETBP1), or AKT. Conclusions: These data confirm that high diagnostic CIP2A levels correlate with subsequent disease progression and treatment failure. CIP2A is a simple diagnostic biomarker that may be useful in planning treatment strategies.
    • Impact of integrating mental health services within existing tuberculosis treatment facilities

      Pasha, Aneeta; orcid: 0000-0002-2699-4301; Siddiqui, Hasha; Ali, Shiza; Brooks, Meredith B; Maqbool, Naveen R; Khan, Aamir J (SAGE Publications, 2021-04-27)
      Introduction: Depression and anxiety among tuberculosis (TB) patients can adversely affect TB treatment adherence and completion. Aim: We studied whether integrating mental health services into existing TB treatment programs would reduce symptoms of depression and anxiety and improve treatment completion among patients with drug-susceptible TB. Methods: Integrated practice units (IPUs) for TB and mental health were established within six existing TB treatment facilities in Karachi, Pakistan. Patients were screened for depression and anxiety and, if symptomatic, offered a mental health intervention consisting of at least four counseling sessions. We measured changes in reported levels of depression and anxiety symptoms from baseline following completion of counseling sessions, and rates of TB treatment completion. Results: Between February 2017 and June 2018, 3500 TB patients were screened for depression and anxiety. 1057 (30.2%) symptomatic patients received a baseline adherence session. 1012 enrolled for a mental health intervention received at least 1 counseling session. 522 (51.5%) reported no symptoms after four to six sessions. Symptomatic patients who completed at least four counseling sessions had higher rates of TB treatment completion than those who did not (92.9% vs 75.1%; p < 0.0001). Conclusion: Mental health interventions integrated within TB programs can help reduce symptoms of depression and anxiety and improve TB treatment completion.
    • Impact of integrating mental health services within existing tuberculosis treatment facilities

      Pasha, Aneeta; orcid: 0000-0002-2699-4301; email: aneeta.pasha@ird.global; Siddiqui, Hasha; Ali, Shiza; Brooks, Meredith B; Maqbool, Naveen R; Khan, Aamir J (SAGE Publications, 2021-04-27)
      Introduction:: Depression and anxiety among tuberculosis (TB) patients can adversely affect TB treatment adherence and completion. Aim:: We studied whether integrating mental health services into existing TB treatment programs would reduce symptoms of depression and anxiety and improve treatment completion among patients with drug-susceptible TB. Methods:: Integrated practice units (IPUs) for TB and mental health were established within six existing TB treatment facilities in Karachi, Pakistan. Patients were screened for depression and anxiety and, if symptomatic, offered a mental health intervention consisting of at least four counseling sessions. We measured changes in reported levels of depression and anxiety symptoms from baseline following completion of counseling sessions, and rates of TB treatment completion. Results:: Between February 2017 and June 2018, 3500 TB patients were screened for depression and anxiety. 1057 (30.2%) symptomatic patients received a baseline adherence session. 1012 enrolled for a mental health intervention received at least 1 counseling session. 522 (51.5%) reported no symptoms after four to six sessions. Symptomatic patients who completed at least four counseling sessions had higher rates of TB treatment completion than those who did not (92.9% vs 75.1%; p < 0.0001). Conclusion:: Mental health interventions integrated within TB programs can help reduce symptoms of depression and anxiety and improve TB treatment completion.
    • TCF3 Dominant Negative Variant Causes an Early Block in B-Lymphopoiesis and Agammaglobulinemia.

      Al Sheikh, Ebtehal; Arkwright, Peter D; email: peter.arkwright@manchester.ac.uk; Herwadkar, Archana; Hussell, Tracy; Briggs, Tracy A (2021-04-27)
    • Women in British Buddhism: Commitment, Connection, Community

      LLewellyn, Dawn (Informa UK Limited, 2021-04-26)
    • Shift work is associated with positive COVID-19 status in hospitalised patients.

      Maidstone, Robert; Anderson, Simon G; Ray, David W; Rutter, Martin K; Durrington, Hannah J; orcid: 0000-0002-9990-9446; Blaikley, John F; orcid: 0000-0001-7651-5682 (2021-04-26)
      Shift work is associated with lung disease and infections. We therefore investigated the impact of shift work on significant COVID-19 illness. 501 000 UK Biobank participants were linked to secondary care SARS-CoV-2 PCR results from Public Health England. Healthcare worker occupational testing and those without an occupational history were excluded from analysis. Multivariate logistic regression (age, sex, ethnicity and deprivation index) revealed that irregular shift work (OR 2.42, 95% CI 1.92 to 3.05), permanent shift work (OR 2.5, 95% CI 1.95 to 3.19), day shift work (OR 2.01, 95% CI 1.55 to 2.6), irregular night shift work (OR 3.04, 95% CI 2.37 to 3.9) and permanent night shift work (OR 2.49, 95% CI 1.67 to 3.7) were all associated with positive COVID-19 tests compared with participants that did not perform shift work. This relationship persisted after adding sleep duration, chronotype, premorbid disease, body mass index, alcohol and smoking to the model. The effects of workplace were controlled for in three ways: (1) by adding in work factors (proximity to a colleague combined with estimated disease exposure) to the multivariate model or (2) comparing participants within each job sector (non-essential, essential and healthcare) and (3) comparing shift work and non-shift working colleagues. In all cases, shift work was significantly associated with COVID-19. In 2017, 120 307 UK Biobank participants had their occupational history reprofiled. Using this updated occupational data shift work remained associated with COVID-19 (OR 4.48 (95% CI 1.8 to 11.18). Shift work is associated with a higher likelihood of in-hospital COVID-19 positivity. This risk could potentially be mitigated via additional workplace precautions or vaccination. [Abstract copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.]
    • Vitamin B12 status in health and disease: a critical review. Diagnosis of deficiency and insufficiency – clinical and laboratory pitfalls

      Sobczyńska-Malefora, Agata; orcid: 0000-0001-7349-9517; Delvin, Edgard; McCaddon, Andrew; Ahmadi, Kourosh R.; Harrington, Dominic J.; orcid: 0000-0003-4786-9240 (Informa UK Limited, 2021-04-21)
    • Sarcopenia estimation using psoas major enhances P-POSSUM mortality prediction in older patients undergoing emergency laparotomy: cross-sectional study.

      Simpson, Gregory; orcid: 0000-0002-9779-1747; email: gregorysimpson@doctors.org.uk; Wilson, Jeremy; Vimalachandran, Dale; McNicol, Frances; Magee, Conor (2021-04-21)
      Emergency laparotomy is a considerable component of a colorectal surgeon's workload and conveys substantial morbidity and mortality, particularly in older patients. Frailty is associated with poorer surgical outcomes. Frailty and sarcopenia assessment using Computed Tomography (CT) calculation of psoas major area predicts outcomes in elective and emergency surgery. Current risk predictors do not incorporate frailty metrics. We investigated whether sarcopenia measurement enhanced mortality prediction in over-65 s who underwent emergency laparotomy and emergency colorectal resection. An analysis of data collected prospectively during the National Emergency Laparotomy Audit (NELA) was conducted. Psoas major (PM) cross-sectional area was measured at the L3 level and a ratio of PM to L3 vertebral body area (PML3) was calculated. Outcome measures included inpatient, 30-day and 90-day mortality. Statistical analysis was conducted using Mann-Whitney, Chi-squared and receiver operating characteristics (ROC). Logistic regression was conducted using P-POSSUM variables with and without the addition of PML3. Nine-hundred and forty-four over-65 s underwent emergency laparotomy from three United Kingdom hospitals were included. Median age was 76 years (IQR 70-82 years). Inpatient mortality was 21.9%, 30-day mortality was 16.3% and 90-day mortality was 20.7%. PML3 less than 0.39 for males and 0.31 for females indicated significantly worse outcomes (inpatient mortality 68% vs 5.6%, 30-day mortality 50.6% vs 4.0%,90-day mortality 64% vs 5.2%, p < 0.0001). PML3 was independently associated with mortality in multivariate analysis (p < 0.0001). Addition of PML3 to P-POSSUM variables improved area under the curve (AUC) on ROC analysis for inpatient mortality (P-POSSUM:0.78 vs P-POSSUM + PML3:0.917), 30-day mortality(P-POSSUM:0.802 vs P-POSSUM + PML3: 0.91) and 90-day mortality (P-POSSUM:0.79 vs P-POSSUM + PML3: 0.91). PML3 is an accurate predictor of mortality in over-65 s undergoing emergency laparotomy. Addition of PML3 to POSSUM appears to improve mortality risk prediction.
    • Vitamin B

      Sobczyńska-Malefora, Agata; orcid: 0000-0001-7349-9517; Delvin, Edgard; McCaddon, Andrew; Ahmadi, Kourosh R; Harrington, Dominic J; orcid: 0000-0003-4786-9240 (2021-04-21)
      Vitamin B (cobalamin) is an essential cofactor for two metabolic pathways. It is obtained principally from food of animal origin. Cobalamin becomes bioavailable through a series of steps pertaining to its release from dietary protein, intrinsic factor-mediated absorption, haptocorrin or transcobalamin-mediated transport, cellular uptake, and two enzymatic conversions ( methionine synthase and methylmalonyl-CoA-mutase) into cofactor forms: methylcobalamin and adenosylcobalamin. Vitamin B deficiency can masquerade as a multitude of illnesses, presenting different perspectives from the point of view of the hematologist, neurologist, gastroenterologist, general physician, or dietician. Increased physician vigilance and heightened patient awareness often account for its early presentation, and testing sometimes occurs during a phase of vitamin B insufficiency before the main onset of the disease. The chosen test often depends on its availability rather than on the diagnostic performance and sensitivity to irrelevant factors interfering with vitamin B markers. Although serum B is still the most commonly used and widely available test, diagnostics by holotranscobalamin, serum methylmalonic acid, and plasma homocysteine measurements have grown in the last several years in routine practice. The lack of a robust absorption test, coupled with compromised sensitivity and specificity of other tests (intrinsic factor and gastric parietal cell antibodies), hinders determination of the cause for depleted B status. This can lead to incorrect supplementation regimes and uncertainty regarding later treatment. This review discusses currently available knowledge on vitamin B , informs the reader about the pitfalls of tests for assessing its deficiency, reviews B status in various populations at different disease stages, and provides recommendations for interpretation, treatment, and associated risks. Future directions for diagnostics of B status and health interventions are also discussed.
    • Toward ‘Vaccine Internationalism’: The Need for an Equitable and Coordinated Global Vaccination Approach to Effectively Combat COVID-19

      Wong, Brian L. H.; email: b.wong@ucl.ac.uk; Green, Manfred S.; reid, John; Martin-Moreno, Jose M.; Davidovitch, Nadav; Chambaud, Laurent; Leighton, Lore; Sheek-Hussein, Mohamud; Dhonkal, Ranjeet; Otok, Robert; et al. (Frontiers Media S.A., 2021-04-14)
    • Tears evoke the intention to offer social support: A systematic investigation of the interpersonal effects of emotional crying across 41 countries

      Zickfeld, Janis H.; van de Ven, Niels; Pich, Olivia; Schubert, Thomas W.; Berkessel, Jana B.; Pizarro, José J.; Bhushan, Braj; Mateo, Nino Jose; Barbosa, Sergio; Sharman, Leah; et al. (Elsevier, 2021-04-13)
      Tearful crying is a ubiquitous and likely uniquely human phenomenon. Scholars have argued that emotional tears serve an attachment function: Tears are thought to act as a social glue by evoking social support intentions. Initial experimental studies supported this proposition across several methodologies, but these were conducted almost exclusively on participants from North America and Europe, resulting in limited generalizability. This project examined the tears-social support intentions effect and possible mediating and moderating variables in a fully pre-registered study across 7007 participants (24,886 ratings) and 41 countries spanning all populated continents. Participants were presented with four pictures out of 100 possible targets with or without digitally-added tears. We confirmed the main prediction that seeing a tearful individual elicits the intention to support, d = 0.49 [0.43, 0.55]. Our data suggest that this effect could be mediated by perceiving the crying target as warmer and more helpless, feeling more connected, as well as feeling more empathic concern for the crier, but not by an increase in personal distress of the observer. The effect was moderated by the situational valence, identifying the target as part of one's group, and trait empathic concern. A neutral situation, high trait empathic concern, and low identification increased the effect. We observed high heterogeneity across countries that was, via split-half validation, best explained by country-level GDP per capita and subjective well-being with stronger effects for higher-scoring countries. These findings suggest that tears can function as social glue, providing one possible explanation why emotional crying persists into adulthood.
    • Physiological Characteristics of Female Soccer Players and Health and Performance Considerations: A Narrative Review.

      Randell, Rebecca K; orcid: 0000-0003-1141-9766; email: rebecca.randell@pepsico.com; Clifford, Thomas; Drust, Barry; Moss, Samantha L; Unnithan, Viswanath B; De Ste Croix, Mark B A; Datson, Naomi; Martin, Daniel; Mayho, Hannah; Carter, James M; et al. (2021-04-12)
      Female soccer has seen a substantial rise in participation, as well as increased financial support from governing bodies over the last decade. Thus, there is an onus on researchers and medical departments to develop a better understanding of the physical characteristics and demands, and the health and performance needs of female soccer players. In this review, we discuss the current research, as well as the knowledge gaps, of six major topics: physical demands, talent identification, body composition, injury risk and prevention, health and nutrition. Data on female talent identification are scarce, and future studies need to elucidate the influence of relative age and maturation selection across age groups. Regarding the physical demands, more research is needed on the pattern of high-intensity sprinting during matches and the contribution of soccer-specific movements. Injuries are not uncommon in female soccer players, but targeting intrinsically modifiable factors with injury prevention programmes can reduce injury rates. The anthropometric and physical characteristics of female players are heterogeneous and setting specific targets should be discouraged in youth and sub-elite players. Menstrual cycle phase may influence performance and injury risk; however, there are few studies in soccer players. Nutrition plays a critical role in health and performance and ensuring adequate energy intake remains a priority. Despite recent progress, there is considerably less research in female than male soccer players. Many gaps in our understanding of how best to develop and manage the health and performance of female soccer players remain.
    • Volatile Liquid Detection by Terahertz Technologies

      Baxter, Harry W; Worrall, Adam A; Pang, Jie; Chen, Riqing; email: riqing.chen@fafu.edu.cn; Yang, Bin; email: b.yang@chester.ac.uk (Frontiers Media S.A., 2021-04-08)
      The prospect of being able to move through security without the inconvenience of separating liquids from bags is an exciting one for passengers, and there are important operational benefits for airports as well. Here, two terahertz (THz) systems, 100 GHz sub-THz line scanner and attenuation total reflection-based THz time domain spectroscopy (TDS), have been used to demonstrate the capability of identifying different liquid samples. Liquid samples’ THz complex permittivities are measured and their differences have contributed to the variation of 100 GHz 2D images of volatile liquids with different volumes inside of cannister bottles. The acquired attenuation images at 100 GHz can easily be used to distinguish highly absorbed liquids (Water, Ethanol, Fuel Treatment Chemicals) and low loss liquids (Petrol, Diesel, Kerosene and Universal Bottle Cleaner). The results give a promising feasibility for mm-wave imager and THz spectroscopy to efficiently identify different volatile liquids.