Now showing items 1-20 of 5394

    • Review of Shortt, R. (2019) Outgrowing Dawkins: God for Grown-Ups. London: SPCK.

      Graham, Elaine; University of Chester
      This book is a direct response to Richard Dawkins’ book Outgrowing God: a beginner’s guide (Bantam Press, 2019) and continues Shortt’s long-standing engagement with New Atheism in such works as God Is No Thing (2015) and Does Religion Do More Harm than Good (2019). The substance of Shortt’s defence of religion is not that it does not have its destructive and dark sides, or even that atheism and religious doubt may not be legitimate intellectual positions. Rather, Shortt takes issue with charges that religious belief is illogical and intellectually specious, that religious commitment is deluded and infantile and religious institutions inherently barbaric and authoritarian.
    • Review of McClure, B. (2019). Emotions: Problems and Promise for Human Flourishing. Waco, TX: Baylor University Press.

      Graham, Elaine; University of Chester
      McClure undertakes an interdisciplinary, cross-cultural investigation into the role of human emotion in history, arguing that emotions are central to what makes us human. What unites all these perspectives is the way in which they set the measure of emotion against a set of value-judgements on the basis of emotions’ contribution to human virtue and well-being.
    • Ketogenic diets for drug-resistant epilepsy

      Martin-McGill, Kirsty J; Bresnahan, Rebecca; Levy, Robert G; Cooper, Paul N; University of Chester; University of Liverpool; The CroD ShiDa Health Centre, Rochdale; Salford Royal Hospitals NHS Trust
      Background Ketogenic diets (KDs) are high in fat and low in carbohydrates and have been suggested to reduce seizure frequency in people with epilepsy. Such diets may be beneficial for children with drug-resistant epilepsy. This is an update of a review first published in 2003, and last updated in 2018. Objectives To assess the effects of ketogenic diets for people with drug-resistant epilepsy. Search methods For this update, we searched the Cochrane Register of Studies (CRS Web) and MEDLINE (Ovid, 1946 to 26 April 2019) on 29 April 2019. The Cochrane Register of Studies includes the Cochrane Epilepsy Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), and randomised controlled trials (RCTs) from Embase, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We imposed no language restrictions. We checked the reference lists of retrieved studies for additional relevant studies. Selection criteria RCTs or quasi-RCTs of KDs for people of any age with drug-resistant epilepsy. Data collection and analysis Two review authors independently applied predefined criteria to extract data and evaluated study quality. We assessed the outcomes: seizure freedom, seizure reduction (50% or greater reduction in seizure frequency), adverse effects, cognition and behaviour, quality of life, and attrition rate. We incorporated a meta-analysis. We utilised an intention-to-treat (ITT) population for all primary analyses. We presented the results as risk ratios (RRs) with 95% confidence intervals (CIs). Main results We identified 13 studies with 932 participants; 711 children (4 months to 18 years) and 221 adults (16 years and over). We assessed all 13 studies to be at high risk of performance and detection bias, due to lack of blinding. Assessments varied from low to high risk of bias for all other domains. We rated the evidence for all outcomes as low to very low certainty. Ketogenic diets versus usual care for children Seizure freedom (RR 3.16, 95% CI 1.20 to 8.35; P = 0.02; 4 studies, 385 participants; very low-certainty evidence) and seizure reduction(RR 5.80, 95% CI 3.48 to 9.65; P < 0.001; 4 studies, 385 participants; low-certainty evidence) favoured KDs (including: classic KD, medium-chain triglyceride (MCT) KD combined, MCT KD only, simplified modified Atkins diet (MAD) compared to usual care for children. We are not confident that these estimated effects are accurate. The most commonly reported adverse effects were vomiting, constipation and diarrhoea for both the intervention and usual care group, but the true effect could be substantially different (low-certainty evidence). Ketogenic diet versus usual care for adults In adults, no participants experienced seizure freedom. Seizure reduction favoured KDs (MAD only) over usual care but, again, we are not confident that the effect estimated is accurate (RR 5.03, 95% CI 0.26 to 97.68; P = 0.29; 2 studies, 141 participants; very low-certainty evidence). Adults receiving MAD most commonly reported vomiting, constipation and diarrhoea (very low-certainty evidence). One study reported a reduction in body mass index (BMI) plus increased cholesterol in the MAD group. The other reported weight loss. The true effect could be substantially different to that reported. Ketogenic diet versus ketogenic diet for children Up to 55% of children achieved seizure freedom with a classical 4:1 KD aDer three months whilst up to 85% of children achieved seizure reduction (very low-certainty evidence). One trial reported a greater incidence of seizure reduction with gradual-onset KD, as opposed to fasting-onset KD. Up to 25% of children were seizure free with MAD and up to 60% achieved seizure reduction.Up to 25% of children became seizure free with MAD and up to 60% experienced seizure reduction. One study used a simplified MAD (sMAD)and reported that 15% of children gained seizure freedom rates and 56% achieved seizure reduction. We judged all the evidence described as very low certainty, thus we are very unsure whether the results are accurate.The most commonly reported adverse effects were vomiting, constipation and diarrhoea (5 studies, very low-certainty evidence). Two studies reported weight loss. One stated that weight loss and gastrointestinal disturbances were more frequent, with 4:1 versus 3:1 KD,whilst one reported no difference in weight loss with 20 mg/d versus 10 mg/d carbohydrates. In one study, there was a higher incidence of hypercalcuria amongst children receiving classic KD compared to MAD. All effects described are unlikely to be accurate. Ketogenic diet versus ketogenic diet for adults One study randomised 80 adults (aged 18 years and over) to either MAD plus KetoCal during the first month with MAD alone for the second month, or MAD alone for the first month followed by MAD plus KetoCal for the second month. No adults achieved seizure freedom. More adults achieved seizure reduction at one month with MAD alone (42.5%) compared to MAD plus KetoCal (32.5%), however, by three months only 10% of adults in both groups maintained seizure reduction. The evidence for both outcomes was of very low certainty; we are very uncertain whether the effects are accurate.Constipation was more frequently reported in the MAD plus KetoCal group (17.5%) compared to the MAD only group (5%) (1 study, very low-certainty evidence). Diarrhoea and increase/change in seizure pattern/semiology were also commonly reported (17.5% to 20% of participants). The true effects of the diets could be substantially different to that reported. Authors' conclusions The evidence suggests that KDs could demonstrate effectiveness in children with drug-resistant epilepsy, however, the evidence for the use of KDs in adults remains uncertain. We identified a limited number of studies which all had small sample sizes. Due to the associatedr isk of bias and imprecision caused by small study populations, the evidence for the use of KDs was of low to very low certainty.More palatable but related diets, such as the MAD, may have a similar effect on seizure control as the classical KD, but could be associated with fewer adverse effects. This assumption requires more investigation. For people who have drug-resistant epilepsy or who are unsuitable for surgical intervention, KDs remain a valid option. Further research is required, particularly for adults with drug-resistant epilepsy.
    • Gestational diabetes and progression to type two diabetes mellitus: missed opportunities of follow up and prevention?

      Walker, Emma; Flannery, Orla; Mackillop, Lucy; University of Chester; Manchester Metropolitan University; Nuffield Department of Reproductive Health, Oxford University Hospitals NHS Foundation Trust;
      Abstract Background: The incidence of type 2 diabetes (T2DM) is increasing. Having a pregnancy complicated by gestational diabetes mellitus (GDM) is a potent risk factor for the later development of T2DM. Aims: To explore the characteristics of women diagnosed with GDM in a single centre and their follow up for progression to T2DM. Methods: A retrospective cohort study using anonymised data of one hundred and fifty four (154) women with GDM receiving maternity care at the Oxford University Hospitals NHS Foundation Trust (OUHFT) in 2010 and their follow up until 2018. Results: The prevalence of GDM in women delivering in Oxfordshire in 2010 was 3.4%. 70% of pregnant women were overweight or obese (with 51% being obese) at booking. Gestational weight gain (GWG) was excessive in 29% of women, when compared to Institute of Medicine (IOM) guidelines. Almost a quarter of women (23.4%) had no follow up after delivery. Over a median follow up of 3.5 years (range 0-8 years) nearly one in six (16.9%) of the total cohort (22% of those tested) went on to develop T2DM. 74% of women with GDM were multiparous, and 65% of nulliparous women were tested compared to 81% of multiparous women. There was a significant difference between multiparous women (53.8%) compared to nulliparous women (46.2%) developing T2DM (p=0.01). There was no significant difference in BMI (p=0.866) or GWG (p=0.83) in women who progressed to T2DM versus those who did not. Conclusion: The risk of T2DM after GDM is substantial however, follow up rates of this population is poor. Subsequent screening of women with GDM and their management crosses secondary and primary care with scope for improvement in counselling of women of the importance of annual reviews, in data collection and follow up in both obstetrics and general practice. The implementation of a recall system, an education programme for general practitioners and/or a registry of women diagnosed with GDM could be useful to identify those at high risk of developing T2DM as well as providing a platform for the potential development of interventions to prevent progression to T2DM after GDM.
    • Influence of contextual factors, technical performance and movement demands on the subjective task load associated with professional rugby league match-play

      Mullen, Thomas; Twist, Craig; Daniels, Matthew; Dobbin, Nick; Highton, Jamie; University of Chester
      Purpose: The aim of the study was to identify the association between several contextual match factors, technical performance and external movement demands on the subjective task load of elite rugby league players. Methods: Individual subjective task load, quantified using the National Aeronautics and Space Administration Task Load Index (NASA-TLX), was collected from 29 professional rugby league players from one club competing in the European Super League throughout the 2017 season. The sample consisted of 26 matches, culminating in 441 individual data points. Linear mixed-modelling was adopted to analyze the data for relationships and revealed that various combinations of contextual factors, technical performance and movement demands were associated with subjective task load. Results: Greater number of tackles (effect size correlation ± 90% CI; η2= 0.18 ±0.11), errors (η2= 0.15 ±0.08) decelerations (η2= 0.12 ±0.08), increased sprint distance (η2= 0.13 ±0.08), losing matches (η2= 0.36 ±0.08) and increased perception of effort (η2= 0.27 ±0.08) led to most likely – very likely increases in subjective total task load. The independent variables included in the final model for subjective mental demand (match outcome, time played and number of accelerations) were unclear, excluding a likely small correlation with the number of technical errors (η2= 0.10 ±0.08). Conclusions: These data provide a greater understanding of the subjective task load and their association with several contextual factors, technical performance and external movement demands during rugby league competition. Practitioners could use this detailed quantification of internal loads to inform the prescription of recovery sessions and current training practices.
    • Soft Power and International Political Marketing

      Sun, Henry; harris, Phil; University of Chester
      Joseph Nye defines soft power as the ability of “getting others to want the outcomes that you want” through persuasion and attraction of one’s ideas or the ability to set the political agenda to shape the preferences of others. Nye further argues that in the international arena, besides the military and economic power, there is a third dimension which is characterized as indirect power, cooptive power, and intangible power in contrary to direct power, coercive power, and tangible power. Nye states, “The ability to establish references tends to be associated with intangible power resources such as culture, ideology and institutions. This dimension can be thought of as soft power, in contrast to the hard command power usually associated with tangible resources like military and economic strength.” Henry Sun defines international political marketing as following: International Political Marketing seeks to establish, maintain and enhance long-term relations among nation-states, political actors and organizations, so that the objectives of stakeholders involved are met. This is done by mutual exchange and fulfillment of promises through cross-border and cross-culture marketing strategy and management
    • Family-owned businesses in the global marketplace: A taxonomy for generational evolution and directions for future research

      Ozdemir, Ozlem; harris, Phil; University of Chester; Regents University, London
      The words “global company” often conjure up images of large, publicly-traded organizations, while the words “family-owned business” may evoke images of small, tightly held companies. However, some of the world’s largest global companies are actually family-owned businesses. Global marketing research has paid little attention to investigating decision making and behavior in family-owned businesses. It has paid even less attention to the important role that women play in leading family-owned businesses. This chapter illuminates these gaps. The current study builds on extant theory about family business cultural impacts on succession using a multidimensional model of succession that adapts stewardship theory while including the previously under-researched perspectives of family-owned businesses. Keywords: Family-Owned Business, Succession, Women
    • A Novel Approach for Autism Spectrum Condition patients with Eating Disorders: Analysis of Treatment Cost-savings

      Tchanturia, Kate; Dandil, Yasemin; Li, Zhuo; Smith, Katherine; Leslie, Monica; Byford, Sarah; King's College London; South London and Maudsley NHS Foundation Trust; Illia University
      Objective: In the current economic context, it is critical to ensure that eating disorder (ED) treatments are both effective and cost-effective. We describe the impact of a novel clinical pathway developed to better meet the needs of autistic patients with EDs on the length and cost of hospital admissions. Method: The pathway was based on the Institute for Healthcare’s Model of Improvement methodology, using an iterative Plan, Do, Study, Act format to introduce change and to co-produce the work with people with lived experience and with healthcare professionals. We explored the change in length and cost of admissions before and after the pathway was introduced. Results: Preliminary results suggest that the treatment innovations associated with this pathway have led to reduced lengths of admission for patients with the comorbidity, which were not seen for patients without the comorbidity. Estimated cost-savings were approximately £22,837 per patient and approximately £275,000 per year for the service as a whole. Conclusion: Going forward, our aim is to continue to evaluate the effectiveness and cost-effectiveness of investment in the pathway to determine whether the pathway improves the quality of care for patients with a comorbid ED and autism and is good value for money.
    • Enhancing the formulation of Shared Mental Models in football players

      Robbins, Mandy; Newton, Joseph L. (University of Chester, 2020-06-24)
      A significant amount of research has examined the development of Decision-Making (DM) in sport. However, only a limited amount of research has explored decisions in the context of which they are made. Using the Naturalistic Decision-Making (NDM) paradigm this thesis employs Cognitive Task Analysis (CTA) approaches and Performance Analysis (PA) within a professional football environment, through the lens of a performance analyst. Applying the DM Framework, outlined by Richards, Collins and Mascarenhas (2016), this thesis applied a mixed method approach using three CTA approaches; Critical Decision Method (CDM), Thinking Aloud Problem Solving (TAPS) and Concept Mapping (CM) to examine the development of Shared Mental Models (SMMs). Additionally, PA data was collected to measure on-field application of SMMs in the format of match performance. Method: The development of DM ability was examined using professional footballers (n=16) and professional coaches (n=2), over an eight-week period. PA provided video footage of critical attacking play situations for use in team meetings. Meetings were designed to empower players in the DM process and involved the integration of CTA approaches in the form of a DM booklet. The booklet consisted of questions and diagrams relating to six clips identified by the coaches. Players and coaches would reflect on the clips individually and collectively as a team in an off-field setting. Each clip was split into three Phases, and six clips were shown to all team members in weekly meetings. To ascertain the retention of SMMs developed over the eight weeks, qualitative narratives recorded by the players (DM booklets) were analysed. No CTA processes were applied on week seven, as this was classified as a retention week. The CTA booklet recorded individual team members understanding of the situation and facilitated group discussions after clips. PA analysed data in the form of match statistics to assess transference of SMMs to the field of play. Results: CTA analysed data qualitatively indicated that individual Situational Awareness (SA) improved. Players identified more key themes in weeks six and eight compared to week one, indicating a development in SMMs and increased compatibility of SMM outlined by the two expert coach’s SA. Additionally, the complexity of the players SMMs and team SMMs developed. The PA data illustrated that the team generated more shots on target and more shots on target per Phase 3 entry in weeks six and eight than week zero (pre-investigation). The improved on-field performance of key performance indicators, combined with the increased identification of key themes and growing compatibility of players SMM in line with the expert coaches, demonstrate a more developed SMM which resulted in enhanced DM by the team. In summary, the application of PA and CTA methods within an off-field environment provides a mechanism to develop SMMs in a professional football team which transfer to enhancing on-field team DM in competitive play. However, this work utilising off-field learning environments to enhance DM, is still in its early stages and more research is needed.
    • An examination of the lived experience of students passing through the eleven-plus grammar school selection process: An interpretation through a Bourdieuian lens.

      Moran, Paul; Atherton, Frances; Sheldrake, John, L (University of ChesterUniversity of Chester, 2019-08)
      There are currently 153 grammar schools in England (Bolton, 2017). The option to attend a grammar school for secondary education is based on successfully passing the eleven-plus assessment. Government discourse when justifying the grammar school system has repeatedly highlighted the emancipatory nature of the selection process, citing increased opportunities for social mobility for those students from lower income households (Foster, Long, and Roberts 2016). Research has shown that there are potential dangers of high stakes testing on young people in terms of their mental health and wellbeing (Hutchins, 2015). Based on a review of the literature on selective education in England, there is a lack of research that focusses on the emotional impact of the eleven-plus on the young people who are in a selective system. This study aims to obtain accurate information about the very emotional personal experiences of children moving through the selection process for secondary school. The 'draw, write and tell' technique is used in order to gather the data. ‘Draw, write and tell’ involves the child drawing or constructing a piece of art using another medium such as clay and creating a piece of artwork which illustrates their thoughts or feelings about a particular research topic. The child is also encouraged to write words around the work and openly discuss their work with their peers which assists in the accurate interpretation of the work. The data obtained is from a sample of five students from a primary school based on the Wirral peninsula in the North West of England, this is a fully selective education authority. Using the tools of Pierre Bourdieu as a sociological lens through which to explore the selection process, the aim of this research is to highlight the significant socio-economic disparity between students who attend grammar schools and those who do not. Through the careful analysis of the children’s own narratives, many of Bourdieu’s key themes including habitus, capital, fields, doxa and symbolic violence are applied to the existence of the elevenplus and the reasons why students from deprived backgrounds are more likely to be unsuccessful in their endeavours to gain access to grammar schools. A clear emergent theme that comes from the analysis of the narratives within the context of the local data is that students who have access to capital in all its forms, are far more likely to pass the elevenplus. The study draws conclusions that support Bourdieu’s assertion that education serves to maintain the status quo in society and that despite the potential damaging effects of the selection process on the self-esteem of the students, individuals continue to behave as their habitus would predict and many strive to be a part of a field that they deem superior. On this basis it is recommended that if government want to address the issue of social mobility then the focus should be on promoting educational quality in all comprehensive schools in order to make them a more attractive destination. Efforts in improving outcomes from the comprehensive education system may reduce the desire for students to go through the selection process, which creates high levels of stress and anxiety for many, as well as public feelings of failure for the majority. The findings of the thesis suggest that whilst the selective education system does in fact largely maintain the status quo in society, the pressure experienced by students as they go through the selection process is largely dependent upon their socio-economic status and their familial habitus.
    • Review: Nicole Discenza, Inhabited Spaces: Anglo-Saxon Constructions of Place

      Pickles, Thomas; University of Chester (Oxford University Press, 2019-03-25)
      A book review.
    • Interaction between Metabolic Genetic Risk Score and Dietary Fatty Acid Intake on Central Obesity in a Ghanaian Population

      Alsulami, Sooad; Nyakotey, David; Dudek, Kamila; Bawah, Abdul-Malik; Lovegrove, Julie; Annan, Reggie; Ellahi, Basma; Karani, Santhanakrishnan Vimaleswaran; University of Reading, University of Chester and Kumasi University (MDPI, 2020-07-27)
      Obesity is a multifactorial condition arising from the interaction between genetic and lifestyle factors. We aimed to assess the impact of lifestyle and genetic factors on obesity-related traits in 302 healthy Ghanaian adults. Dietary intake and physical activity were assessed using a 3 day repeated 24 h dietary recall and global physical activity questionnaire, respectively. Twelve single nucleotide polymorphisms (SNPs) were used to construct 4-SNP, 8-SNP and 12-SNP genetic risk scores (GRSs). The 4-SNP GRS showed significant interactions with dietary fat intakes on waist circumference (WC) (Total fat, Pinteraction = 0.01; saturated fatty acids (SFA), Pinteraction = 0.02; polyunsaturated fatty acids (PUFA), Pinteraction = 0.01 and monounsaturated fatty acids (MUFA), Pinteraction = 0.01). Among individuals with higher intakes of total fat (>47 g/d), SFA (>14 g/d), PUFA (>16 g/d) and MUFA (>16 g/d), individuals with ≥3 risk alleles had a significantly higher WC compared to those with <3 risk alleles. This is the first study of its kind in this population, suggesting that a higher consumption of dietary fatty acid may have the potential to increase the genetic susceptibility of becoming centrally obese. These results support the general dietary recommendations to decrease the intakes of total fat and SFA, to reduce the risk of obesity, particularly in individuals with a higher genetic predisposition to central obesity.
    • Exploring the impact, value and limitations of reflective practice groups for clergy in a Church in Wales diocese

      Gubi, Peter Madsen; University of Chester
      This research explores the impact, value and limitations of reflective practice groups for Clergy in a Church in Wales diocese. The aims were to explore what participants of reflective practice groups experience as the impact, value and limitations of their groups, and to better understand any implications for delivery of reflective practice groups for Clergy. Two focus groups comprising of the participants from two reflective practice groups from a diocese in the Church in Wales were interviewed, and the data analysed using Interpretative Phenomenological Analysis. Two superordinate themes emerged along with ten subordinate themes. The key findings are that the participants of both groups clearly found them to be a valuable experience and self-defined the impact on their ministries as: creating more reflective clergy; developing greater wisdom; building and gaining affirmed strategies that they could take back into relationships within their parishes; enabling a different perspective to be gained on management expectations; development of self-preservation strategies for coping with those expectations; improvement in practice and relationships within their work; improving their priestly skills; managing boundaries more appropriately; approaching meetings more positively; managing situations in more helpful ways; and discerning what God may be saying in certain situations.
    • Social Care Workers’ Experiences of Assessing Parents with Learning Disabilities: An Interpretative Phenomenological Analysis Study Based in the Northwest of England.

      Lovell, Andrew; Constance, Lyndsey J. (University of Chester, 2020-06-26)
      Aims: Qualitative research has identified a number of issues when working with parents with learning disabilities. Pre-conceived ideas, professional discrimination and a high percentage of children living away from the family home have featured heavily in the literature. However, less is known about the assessment process, and how practitioners adapt their skills to assess this parental group. The current study therefore aimed to gain an in-depth understanding of the assessment process, utilising a qualitative approach. The study focused upon the experiences of social care assessors from children’s and adult services, and sought to explore the following: the approach social care workers adopt when assessing parents with learning disabilities; if appropriate knowledge is embedded into practice to assess competently; experiences of the application of the PAMS 4.0; multi-disciplinary approach to assessment, and how this exhibits in practice. Method: Semi-structured interviews were carried out with fourteen frontline social care practitioners from children’s and adult services who had direct experience of assessing parents with learning disabilities. The transcripts of the interviews were analysed using Interpretative Phenomenological Analysis (IPA). Results: The analysis produced four master themes. These were; inadequate knowledge to understand complexities; hierarchy; reasonable adjustments; assessing parental ability. An analysis of these master themes and the related super-ordinate themes is presented. Discussion: The results are considered in light of the experiences of the participants, and how this impacts on the assessment of parents with learning disabilities. The study finds that whilst there is evidence the participants hold pre-conceived ideas, a lack of relevant skills and knowledge as well as an unstructured implementation of the Parenting Assessment Manual 4.0, are both contributing factors. Furthermore, problematic multi-agency working and managerial influences impact on the overall outcomes for parents with learning disabilities and their families.
    • Spinal motor neurite outgrowth over glial scar inhibitors is enhanced by coculture with bone marrow stromal cells

      Wright, Karina; Johnson, William Eustace Basil; Uchida, Kenzo; Bara, Jennifer J.; Roberts, Sally; Masari, Wagih E.; Aston University; Keele University
      BACKGROUND CONTEXT: Transplantation of bone marrow cells into spinal cord lesions promotes functional recovery in animal models, and recent clinical trials suggest possible recovery also in humans. The mechanisms responsible for these improvements are still unclear. PURPOSE: To characterize spinal cord motor neurite interactions with human bone marrow stromal cells (MSCs) in an in vitro model of spinal cord injury (SCI). STUDY DESIGN/SETTING: Previously, we have reported that human MSCs promote the growth of extending sensory neurites from dorsal root ganglia (DRG), in the presence of some of the molecules present in the glial scar, which are attributed with inhibiting axonal regeneration after SCI. We have adapted and optimized this system replacing the DRG with a spinal cord culture to produce a central nervous system (CNS) model, which is more relevant to the SCI situation. METHODS: We have developed and characterized a novel spinal cord culture system. Human MSCs were cocultured with spinal motor neurites in substrate choice assays containing glial scar–associated inhibitors of nerve growth. In separate experiments, MSC-conditioned media were analyzed and added to spinal motor neurites in substrate choice assays. RESULTS: As has been reported previously with DRG, substrate-bound neurocan and Nogo-A repelled spinal neuronal adhesion and neurite outgrowth, but these inhibitory effects were abrogated in MSC/spinal cord cocultures. However, unlike DRG, spinal neuronal bodies and neurites showed no inhibition to substrates of myelin-associated glycoprotein. In addition, the MSC secretome contained numerous neurotrophic factors that stimulated spinal neurite outgrowth, but these were not sufficient stimuli to promote spinal neurite extension over inhibitory concentrations of neurocan or Nogo-A. CONCLUSIONS: These findings provide novel insight into how MSC transplantation may promote regeneration and functional recovery in animal models of SCI and in the clinic, especially in the chronic situation in which glial scars (and associated neural inhibitors) are well established. In addition, we have confirmed that this CNS model predominantly comprises motor neurons via immunocytochemical characterization. We hope that this model may be used in future research to test various other potential interventions for spinal injury or disease states
    • Stigma: the representation of anorexia nervosa in UK newspaper Twitter feeds.

      Bowen, Matt; Lovell, Andrew; Waller, Rhian; University of Chester
      Background There is evidence that the representation of mental health in newspapers has an influence on readers’ attitudes, however, relatively little is known about how the industry presents accounts of anorexia nervosa. Further, the industry increasingly uses Twitter as a medium for reaching readers and this remains an under-examined area of research. Aims To explore the representation of anorexia nervosa in the UK national press’ Twitter feeds. Method Frame analysis was used to examine the manner in which anorexia nervosa was represented in the Twitter feeds of all national UK newspapers between 2009-2019 (n=332). This qualitative approach used Braun and Clarke’s stages of thematic analysis, while drawing on Van Gorp’s use of a frame matrix to support the definition of the news frames. Results The analysis identified four news frames: social model, illness model, stress-recovery model and clickbait model. Conclusions The newspapers drew on a range of perspectives in their representation of anorexia nervosa, which typically were not stigmatising in their accounts. However, there was a pattern of using sensationalistic images in some of the tweets, which may encourage readers to view people with anorexia nervosa as Other, and as a consequence contribute to stigmatisation.
    • Early Transplantation of Mesenchymal Stem Cells After Spinal Cord Injury Relieves Pain Hypersensitivity Through Suppression of Pain-Related Signaling Cascades and Reduced Inflammatory Cell Recruitment

      Johnson, William Eustace Basil; Watanabe, Shuji; Uchida, Kenzo; Nakajima, Hideaki; Matsuo, Hideaki; Sugita, Daisuke; Yoshida, Ai; Honjoh, Kazuya; Baba, Hisatoshi; Aston University, University of Fukui
      Bone marrow-derived mesenchymal stem cells (BMSC) modulate inflammatory/immune responses and promote motor functional recovery after spinal cord injury (SCI). However, the effects of BMSC transplantation on central neuropathic pain and neuronal hyperexcitability after SCI remain elusive. This is of importance because BMSC-based therapies have been proposed for clinical treatment. We investigated the effects of BMSC transplantation on pain hypersensitivity in green fluorescent protein (GFP)-positive bone marrow-chimeric mice subjected to a contusion SCI, and the mechanisms of such effects. BMSC transplantation at day 3 post-SCI improved motor function and relieved SCI-induced hypersensitivities to mechanical and thermal stimulation. The pain improvements were mediated by suppression of protein kinase C-γ and phosphocyclic AMP response element binding protein expression in dorsal horn neurons. BMSC transplants significantly reduced levels of p-p38 mitogen-activated protein kinase and extracellular signal-regulated kinase (p-ERK1/2) in both hematogenous macrophages and resident microglia and significantly reduced the infiltration of CD11b and GFP double-positive hematogenous macrophages without decreasing the CD11b-positive and GFP-negative activated spinal-microglia population. BMSC transplants prevented hematogenous macrophages recruitment by restoration of the blood-spinal cord barrier (BSCB), which was associated with decreased levels of (a) inflammatory cytokines (tumor necrosis factor-α, interleukin-6); (b) mediators of early secondary vascular pathogenesis (matrix metallopeptidase 9); (c) macrophage recruiting factors (CCL2, CCL5, and CXCL10), but increased levels of a microglial stimulating factor (granulocyte-macrophage colony-stimulating factor). These findings support the use of BMSC transplants for SCI treatment. Furthermore, they suggest that BMSC reduce neuropathic pain through a variety of related mechanisms that include neuronal sparing and restoration of the disturbed BSCB, mediated through modulation of the activity of spinal-resident microglia and the activity and recruitment of hematogenous macrophages.
    • The developing landscape of diagnostic and prognostic biomarkers for spinal cord injury in cerebrospinal fluid and blood

      Hulme CH; Brown SJ; Fuller HR; Riddell J; Osman A; Chowdhury J; Kumar N; Johnson WE; Wright KT; Keele University, RJAH Orthopaedic Hospital, University of Glasgow, University of Chester (Nature Publishing Group, 2016-12-20)
      STUDY DESIGN: Review study. OBJECTIVES: The identification of prognostic biomarkers of spinal cord injury (SCI) will help to assign SCI patients to the correct treatment and rehabilitation regimes. Further, the detection of biomarkers that predict permanent neurological outcome would aid in appropriate recruitment of patients into clinical trials. The objective of this review is to evaluate the current state-of-play in this developing field. SETTING: Studies from multiple countries were included. METHODS: We have completed a comprehensive review of studies that have investigated prognostic biomarkers in either the blood or cerebrospinal fluid (CSF) of animals and humans following SCI. RESULTS: Targeted and unbiased approaches have identified several prognostic biomarkers in CSF and blood. These proteins associate with cellular damage following SCI and include components from neurons, oligodendrocytes and reactive astrocytes, that is, neurofilament proteins, glial fibrillary acidic protein, Tau and S100 calcium-binding protein β. Unbiased approaches have also identified microRNAs that are specific to SCI, as well as other cell damage-associated proteins. CONCLUSIONS: The discovery and validation of stable, specific, sensitive and reproducible biomarkers of SCI is a rapidly expanding field of research. So far, few studies have utilised unbiased approaches aimed at the discovery of biomarkers within the CSF or blood in this field; however, some targeted approaches have been successfully used. Several studies using various animal models and some with small human patient cohorts have begun to pinpoint biomarkers in the CSF and blood with putative prognostic value. An increased sample size will be required to validate these biomarkers in the heterogeneous clinical setting.
    • The influence of pH and fluid dynamics on the antibacterial efficacy of 45S5 Bioglass Short title: Antibacterial efficacy of 45S5 Bioglass

      Begum, Saima; Johnson, William Eustace Basil; Worthington, Tony; Martin, Richard; Aston University (IOP Publishing, 2016-02-02)
      In recent years, there has been considerable interest in the potential antibacterial properties that bioactive glasses may possess. However, there have been several conflicting reports on the antibacterial efficacy of 45S5 Bioglass®. Various mechanisms regarding its mode of action have been proposed, such as changes in the environmental pH, increased osmotic pressure, and 'needle-like' sharp glass debris which could potentially damage prokaryotic cell walls and thus inactivate bacteria. In this current study, a systematic investigation was undertaken on the antibacterial efficacy of 45S5 Bioglass® on Escherichia coli NCTC 10538 and Staphylococcus aureus ATCO 6538 under a range of clinically relevant scenarios including varying Bioglass® concentration, direct and indirect contact between Bioglass® and microorganisms, static and shaking incubation conditions, elevated and neutralised pH environments. The results demonstrated that, under elevated pH conditions, Bioglass® particles have no antibacterial effect on S. aureus while a concentration dependent antibacterial effect against E. coli was observed. However, the antibacterial activity ceased when the pH of the media was neutralised. The results of this current study, therefore, suggest that the mechanism of antibacterial activity of Bioglass® is associated with changes in the environmental pH; an environment that is less likely to occur in vivo due to buffering of the system.
    • Bone Marrow-Derived Mesenchymal Stem Cells Become Antiangiogenic When Chondrogenically or Osteogenically Differentiated: Implications for Bone and Cartilage Tissue Engineering

      Bara, Jennifer; Johnson, William Eustace Basil; Roberts, Sally; McCarthy, Helen E.; Humphrey, Emma; AO Institute, Davos, Switzerland; Aston University; Keele University
      Osteochondral tissue repair requires formation of vascularized bone and avascular cartilage. Mesenchymal stem cells stimulate angiogenesis both in vitro and in vivo but it is not known if these proangiogenic properties change as a result of chondrogenic or osteogenic differentiation. We investigated the angiogenic/antiangiogenic properties of equine bone marrow-derived mesenchymal stem cells (eBMSCs) before and after differentiation in vitro. Conditioned media from chondrogenic and osteogenic cell pellets and undifferentiated cells was applied to endothelial tube formation assays using Matrigel. Additionally, the cell secretome was analysed using LC-MS/MS mass spectrometry and screened for angiogenesis and neurogenesis-related factors using protein arrays. Endothelial tube-like formation was supported by conditioned media from undifferentiated eBMSCs. Conversely, chondrogenic and osteogenic conditioned media was antiangiogenic as shown by significantly decreased length of endothelial tube-like structures and degree of branching compared to controls. Undifferentiated cells produced higher levels of angiogenesis-related proteins compared to chondrogenic and osteogenic pellets. In summary, eBMSCs produce an array of angiogenesis-related proteins and support angiogenesis in vitro via a paracrine mechanism. However, when these cells are differentiated chondrogenically or osteogenically, they produce a soluble factor(s) that inhibits angiogenesis. With respect to osteochondral tissue engineering, this may be beneficial for avascular articular cartilage formation but unfavourable for bone formation where a vascularized tissue is desired.