• The city‐island‐state, wounding cascade and multi‐level vulnerability explored through the lens of Malta

      Main, Geoff; orcid: 0000-0001-8453-1527; Schembri, John; Speake, Janet; Gauci, Ritienne; Chester, David (Wiley, 2021-03-20)
    • 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.
    • The city‐island‐state, wounding cascade, and multi‐level vulnerability explored through the lens of Malta

      Main, Geoff; orcid: 0000-0001-8453-1527; Schembri, John; Speake, Janet; Gauci, Ritienne; Chester, David (Wiley, 2021-05-06)
    • The city‐island‐state, wounding cascade, and multi‐level vulnerability explored through the lens of Malta

      Main, Geoff; orcid: 0000-0001-8453-1527; Schembri, John; Speake, Janet; Gauci, Ritienne; Chester, David (Wiley, 2021-05-06)
    • The Comparative Effects of Mesenchymal Stem Cell Transplantation Therapy for Spinal Cord Injury in Humans and Animal Models: A Systematic Review and Meta-Analysis

      Johnson, Louis D. V.; email: louisdvj@gmail.com; Pickard, Mark R.; email: m.pickard@chester.ac.uk; Johnson, William E. B.; email: eustace.johnson@chester.ac.uk (MDPI, 2021-03-16)
      Animal models have been used in preclinical research to examine potential new treatments for spinal cord injury (SCI), including mesenchymal stem cell (MSC) transplantation. MSC transplants have been studied in early human trials. Whether the animal models represent the human studies is unclear. This systematic review and meta-analysis has examined the effects of MSC transplants in human and animal studies. Following searches of PubMed, Clinical Trials and the Cochrane Library, published papers were screened, and data were extracted and analysed. MSC transplantation was associated with significantly improved motor and sensory function in humans, and significantly increased locomotor function in animals. However, there are discrepancies between the studies of human participants and animal models, including timing of MSC transplant post-injury and source of MSCs. Additionally, difficulty in the comparison of functional outcome measures across species limits the predictive nature of the animal research. These findings have been summarised, and recommendations for further research are discussed to better enable the translation of animal models to MSC-based human clinical therapy.
    • The Comparative Effects of Mesenchymal Stem Cell Transplantation Therapy for Spinal Cord Injury in Humans and Animal Models: A Systematic Review and Meta-Analysis.

      Johnson, Louis D V; Pickard, Mark R; Johnson, William E B (2021-03-16)
      Animal models have been used in preclinical research to examine potential new treatments for spinal cord injury (SCI), including mesenchymal stem cell (MSC) transplantation. MSC transplants have been studied in early human trials. Whether the animal models represent the human studies is unclear. This systematic review and meta-analysis has examined the effects of MSC transplants in human and animal studies. Following searches of PubMed, Clinical Trials and the Cochrane Library, published papers were screened, and data were extracted and analysed. MSC transplantation was associated with significantly improved motor and sensory function in humans, and significantly increased locomotor function in animals. However, there are discrepancies between the studies of human participants and animal models, including timing of MSC transplant post-injury and source of MSCs. Additionally, difficulty in the comparison of functional outcome measures across species limits the predictive nature of the animal research. These findings have been summarised, and recommendations for further research are discussed to better enable the translation of animal models to MSC-based human clinical therapy.
    • The complementarities of digitalisation and productivity: redefining boundaries for financial sector

      Gul, Razia; Ellahi, Nazima; Leong, Kelvin; Malik, Qaiser Ali (Informa UK Limited, 2021-12-21)
    • The complex tapestry of relationships which surround adoptive families: a case study

      Hamilton, Paula; Forgacs-Pritchard, Kevin (Informa UK Limited, 2020-03-17)
    • The COVID-19 pandemic: local to global implications as perceived by urban ecologists

      Douglas, Ian; orcid: 0000-0002-2451-8133; email: ian.douglas@manchester.ac.uk; Champion, Mark; Clancy, Joy; Haley, David; Lopes de Souza, Marcelo; Morrison, Kerry; Scott, Alan; Scott, Richard; Stark, Miriam; Tippett, Joanne; et al. (Springer Singapore, 2020-09-11)
      Abstract: The global COVID-19 pandemic is affecting everyone, but in many different ways, stimulating contrasting reactions and responses: opportunities for some, difficulties for many. A simple survey of how individual workers in urban ecology have been coping with COVID-19 constraints found divergent responses to COVID-19 on people’s activities, both within countries and between continents. Many academics felt frustrated at being unable to do fieldwork, but several saw opportunities to change ways of working and review their engagement with the natural world. Some engaging with social groups found new ways of sharing ideas and developing aspirations without face-to-face contact. Practitioners creating and managing urban greenspaces had to devise ways to work and travel while maintaining social distancing. Many feared severe funding impacts from changed local government priorities. Around the world, the COVID-19 pandemic has amplified issues, such as environmental injustice, disaster preparation and food security, that have been endemic in most countries across the global south in modern times. However, developing and sustaining the strong community spirit shown in many places will speed economic recovery and make cities more resilient against future geophysical and people-made disasters. Significantly, top-down responses and one-size-fits-all solutions, however good the modelling on which they are based, are unlikely to succeed without the insights that local knowledge and community understanding can bring. We all will have to look at disaster preparation in a more comprehensive, caring and consistent way in future.
    • The current and potential role of community pharmacy in asset-based approaches to health and wellbeing: a qualitative study

      Astbury, Jayne; orcid: 0000-0001-5885-4306; email: jayne.astbury@manchester.ac.uk; Schafheutle, Ellen; Brown, Jane; Cutts, Christopher (Springer International Publishing, 2021-02-26)
      Abstract: Background Asset-based approaches seek to positively mobilise the strengths, capabilities, and resources of individuals and communities. To date, limited consideration has been given to the potential value of this approach in relation to community pharmacy practice, yet this is important and timely given community pharmacy’s expanding role and contribution to public health initiatives. Objectives This qualitative study aimed to explore the current and potential role of community pharmacy in asset-based approaches. Methods Fifteen semi-structured telephone interviews were undertaken with community pharmacists and project leads, and public health policy and strategic leads in the UK. Transcripts were analysed using simultaneous inductive open and deductive coding using an applied Theory of Change as an illustrative lens. Results The shift towards patient-facing roles in community pharmacy was felt to offer expanded relational opportunities to engage and collaborate with individuals, communities, and other stakeholders. However, only a small number of respondents described examples of systemic asset-based working within the pharmacy sector. The adoption of asset-based approaches was challenged or enabled by several factors including the availability of protected time/resources, workplace and organisational culture/values, strategic leadership, commissioning, and funding arrangements. Conclusions The study provides valuable insights into the potential for community pharmacy, a previously unconsidered sector, to further adopt and contribute to asset-based approaches and play a more central role in the improvement of public health and reduction of health inequalities.
    • The development of clinical thinking in trainee physicians: the educator perspective

      Locke, Rachel; orcid: 0000-0003-3300-4908; email: Rachel.locke@winchester.ac.uk; Mason, Alice; Coles, Colin; Lusznat, Rosie-Marie; Masding, Mike G. (BioMed Central, 2020-07-16)
      Abstract: Background: An important element of effective clinical practice is the way physicians think when they encounter a clinical situation, with a significant number of trainee physicians challenged by translating their learning into professional practice in the clinical setting. This research explores the perceptions of educators about how trainee physicians develop their clinical thinking in clinical settings. It considers what educators and their colleagues did to help, as well as the nature of the context in which they worked. Method: A qualitative approach was used in this study with in depth interviews carried out with educators as key informants. Rich data derived from 15 interview transcripts were analysed thematically in a rigorous and iterative process. Results: Three broad and overlapping themes were identified: working in an educationally minded culture; proximity of the educator to the trainee physician; and trajectory of the trainee physician. The departments in which these educators worked emphasised the importance for the education of trainee physicians. All members of the team were responsible for education of the team, and all members, particularly senior nurses, were able to give feedback upon the trainee physicians’ progress. Educators described working side by side with their trainee physician and frequently being in close proximity to them which means that the educator was both easily accessible and spent more time with their trainee physicians. They described a trajectory of the trainee physicians through the placement with close monitoring and informal assessment throughout. Conclusion: Recommendations are made as to how trainee physicians can be supported to develop their clinical thinking. Educators and managers can analyse their own and their department’s practice and select the recommendations relevant to their local circumstances in order to make change. This study adds the educator perspective to a body of literature about the importance of context and supportive learning environments. As such the discussion is applicable to the education of other health professionals.
    • The development, feasibility and acceptability of a coach-led intervention to ease novice community pharmacists' transition to practice.

      Magola, Esnath; email: esnath.magola@manchester.ac.uk; Willis, Sarah C; email: sarah.willis@manchester.ac.uk; Schafheutle, Ellen I; email: ellen.schafheutle@manchester.ac.uk (2021-04-16)
      Despite reported benefits of transition support programmes for other healthcare professionals, no evidence-based support interventions exist to ease newly-registered novice community pharmacists' (NCPs) transition into practice. To develop an intervention to provide psychosocial support, support the development of professional behaviours and skills of novice pharmacists in community pharmacy and conduct an evaluation. The Medical Research Council (MRC) guidance for developing complex interventions was applied to develop a 17-week, pharmacist coach-led intervention, using a social media group, a face-to-face introductory workshop, two webinars, weekly case studies, portfolios (reflective logs and development plans) and a handbook. Twelve newly-registered NCPs participated. A coach log and semi-structured interviews collected data on feasibility, acceptability and perceived impact. Findings suggest the intervention was feasible and highly acceptable to NCPs, who perceived the coach and social media group to be the most valuable components. The coach was described as non-judgemental, approachable and collaborative. Provision of guided one-to-one reflection was viewed as useful for debriefing, feedback and meaningful reflection, and supported development of reflection-in-action. The face-to-face workshop was considered important for establishing rapport and trust. The social media group was most valued for providing an accessible, confidential and responsive support network, in which NCPs felt psychologically safe to learn. This component was reported to present opportunities for developmental discourse and shared reflection with peers, thus reducing the sense of professional isolation. NCPs reported that the intervention led to increases in meaningful learning, confidence, critical reasoning, self-awareness and self-reflection. The webinars and handbook were identified as the least valuable components. A transition-support intervention using an experienced pharmacist coach, delivered within a safe, supportive, albeit online facilitated learning environment, appeared feasible and valuable in supporting guided reflection and developmental discourse. This facilitates transformative learning, and supports NCPs to gain proficiency and become independent reflective practitioners. [Abstract copyright: Copyright © 2021 Elsevier Inc. All rights reserved.]
    • The diagnostic utility of clinical exome sequencing in 60 patients with hearing loss disorders: A single‐institution experience

      Molina‐Ramírez, Leslie P.; orcid: 0000-0001-7573-6846; Burkitt‐Wright, Emma MM.; Saeed, Haroon; orcid: 0000-0002-2624-0518; McDermott, John H.; orcid: 0000-0002-5220-8837; Kyle, Claire; Wright, Ronnie; Campbell, Christopher; Bhaskar, Sanjeev S.; Taylor, Algy; Dutton, Laura; et al. (2021-07-05)
    • The Drosophila Larval Locomotor Circuit Provides a Model to Understand Neural Circuit Development and Function

      Hunter, Iain; email: Iain.hunter-2@manchester.ac.uk; Coulson, Bramwell; Zarin, Aref Arzan; Baines, Richard A. (Frontiers Media S.A., 2021-07-01)
      It is difficult to answer important questions in neuroscience, such as: “how do neural circuits generate behaviour?,” because research is limited by the complexity and inaccessibility of the mammalian nervous system. Invertebrate model organisms offer simpler networks that are easier to manipulate. As a result, much of what we know about the development of neural circuits is derived from work in crustaceans, nematode worms and arguably most of all, the fruit fly, Drosophila melanogaster. This review aims to demonstrate the utility of the Drosophila larval locomotor network as a model circuit, to those who do not usually use the fly in their work. This utility is explored first by discussion of the relatively complete connectome associated with one identified interneuron of the locomotor circuit, A27h, and relating it to similar circuits in mammals. Next, it is developed by examining its application to study two important areas of neuroscience research: critical periods of development and interindividual variability in neural circuits. In summary, this article highlights the potential to use the larval locomotor network as a “generic” model circuit, to provide insight into mammalian circuit development and function.
    • The dynamic relationship between hearing loss, quality of life, socioeconomic position and depression and the impact of hearing aids: answers from the English Longitudinal Study of Ageing (ELSA).

      Tsimpida, Dialechti; orcid: 0000-0002-3709-5651; email: dialechti.tsimpida@manchester.ac.uk; Kontopantelis, Evangelos; Ashcroft, Darren M; Panagioti, Maria (2021-08-12)
      The adverse impact of hearing loss (HL) extends beyond auditory impairment and may affect the individuals' psychosocial wellbeing. We aimed to examine whether there exists a causal psychosocial pathway between HL and depression in later life, via socioeconomic factors and quality of life, and whether hearing aids usage alleviates depressive symptoms over time. We examined the longitudinal relationship between HL and depressive symptoms (CES-D) applying dynamic cross-lagged mediation path models. We used the full dataset of participants aged 50-89 years (74,908 person-years), from all eight Waves of the English Longitudinal Study of Ageing (ELSA). Their quality of life (CASP-19) and their wealth were examined as the mediator and moderator of this relationship, respectively. Subgroup analyses investigated differences among those with hearing aids within different models of subjectively and objectively identified HL. All models were adjusted for age, sex, retirement status and social engagement. Socioeconomic position (SEP) influenced the strength of the relationship between HL and depression, which was stronger in the lowest versus the highest wealth quintiles. The use of hearing aids was beneficial for alleviating depressive symptoms. Those in the lowest wealth quintiles experienced a lower risk for depression after the use of hearing aids compared to those in the highest wealth quintiles. HL poses a substantial risk for depressive symptoms in older adults, especially those who experience socioeconomic inequalities. The early detection of HL and provision of hearing aids may not only promote better-hearing health but could also enhance the psychosocial wellbeing of older adults, particularly those in a lower SEP. [Abstract copyright: © 2021. The Author(s).]
    • The Effect of Authigenic Clays on Fault Zone Permeability

      Farrell, N. J. C.; orcid: 0000-0002-8491-9094; email: natalie.farrell@manchester.ac.uk; Debenham, N.; Wilson, L.; Wilson, M. J.; Healy, D.; orcid: 0000-0003-2685-1498; King, R. C.; Holford, S. P.; orcid: 0000-0002-4524-8822; Taylor, C. W. (2021-10-15)
      Abstract: Clays are understood to form the majority of fluid‐flow barriers in faulted reservoirs and numerous fault gouge and fault seal studies have quantified the volumes of smeared and abraded clays create fluid‐flow barriers along fault surfaces. However, clay‐related permeability adjacent to the fault surface, including in the fault damage zone, has largely been neglected. Previous studies have shown the morphology and distribution of unfaulted authigenic clays, and not just clay volume, exert a significant control on the magnitude of permeability. However, fault‐related studies have neither characterized deformed authigenic clays nor addressed their influence on fluid‐flow. In this study laboratory permeabilities of faulted, authigenic clay bearing sandstones sampled from the Otway basin (Australia) and the Orcadian basin (UK) present trends which; (a) do not correspond to expected patterns of fluid‐flow in faulted clay‐bearing sandstones and, (b) cannot be explained using published models of permeability related to changing clay volume. Microscopic analysis shows that faulting has disaggregated authigenic clays and, similarly to framework grain deformation, comminuted and sheared clay grains. However, instead of impeding fluid‐flow, analysis of pore networks (using mercury injection porosimetry) showed that faulting of authigenic clays has increased pore connectivity, contributing to increased magnitude of permeability and development of permeability anisotropy. Contrary to published results of faulting and fluid‐flow in impure sandstones, our results show that fault related processes involving the formation of clays in the fault zone can increase permeability and reduce the capillary threshold pressures of fault rocks relative to the unfaulted host rock.
    • The effect of different storage media on the monomer elution and hardness of CAD/CAM composite blocks.

      Alamoush, Rasha A; Sung, Rehana; Satterthwaite, Julian D; Silikas, Nick; email: nick.silikas@manchester.ac.uk (2021-05-04)
      This study aimed to assess the effect of different storage media on the hardness and monomer elution of CAD/CAM composite blocks. Five resin-composite blocks (RCB), one polymer-infiltrated ceramic network (PICN) block (Enamic (EN)), one ceramic-filled poly ether ether ketone (PEEK) block (Dentokeep (DK)), and one feldspathic ceramic block. Microhardness was measured using a Vickers indenter tester (FM-700, Future Tech Corp., Japan). In addition 4 conventional resin-composites were investigated for monomer elution using high performance liquid chromatography (HPLC) after storage in different media for 3 months. The data were analysed by three-way ANOVA, two-way ANOVA, one-way ANOVA, Tukey's post hoc test and the independent t-test (α=0.05 for all tests). The specimens stored in the water had a hardness reduction ranging from 0.9% to 24.4%. In artificial saliva, the specimens had a hardness reduction ranging from 2.8% to 23.2%. The hardness reduction percentage in 75% Ethanol/Water (E/W) ranged between 3.8% and 35.3%. All materials, except GR (resin-composite block) and DK (Polyetheretherketone (PEEK)), showed a variable extent of monomer elution into 75% E/W with significantly higher amounts eluted from conventional composites. GRA and GND (conventional resin-composites) eluted TEGDMA in artificial saliva and GRA eluted TEGDMA in water. The hardness of CAD/CAM composite blocks was affected by different storage media, and they were not as stable as ceramic, with PICN exhibited superior hardness stability to all of the resin-composite blocks in all the storage media and was comparable to ceramic block. The hardness reduction percentage of the CAD/CAM composite blocks was influenced by the filler loading and resin-matrix composition.Minimal or no monomer elution from CAD/CAM blocks was detected. [Abstract copyright: Copyright © 2021. Published by Elsevier Inc.]