Irish Methodism and servant leadership – a vision of ministry for the twenty-first century

The fundamental concern of this thesis is to articulate a vision for ministry in Irish Methodism for the twenty-first century based on the theory and practice of Servant Leadership. It will show how Servant Leadership offers the most effective framework for the development of ordained ministry in the Irish Methodist Church. Chapter One presents the research methodologies utilised in the thesis. These include historical analysis of sources, a review of literary resources and empirical methodologies. The latter includes thematic analysis of qualitative data and the presentation of findings gathered from semi-structured interviews. Chapter Two identifies the unique context of the origins and development of Irish Methodism in contrast to English Methodism. This detailed historical analysis shows the radical differences in context between Ireland and England and simultaneously illustrates the symbiotic relationship between these two branches of Methodism. Chapter Three addresses the themes of ministry and leadership. It draws deeply on primary sources in the Irish Methodist historical archive, Edgehill House Belfast. The chapter outlines the evolving nature of ordained ministry and considers the challenges facing the contemporary Irish Methodist Church. Chapter Four surveys the definitions of servant leadership to unearth their unique and creative insights for an original vision of ministry. The chapter argues that the servant leadership commitment to the development of people is fundamental to the practice of ministry. Chapter Five presents the empirical data drawn from eighteen semi-structured interviews with ordained ministers. These interviews explore the participants’ ministry experience, perceptions of leadership, and understanding of servant leadership. Chapter Six discusses the findings of the research. It asserts that servant leadership provides an innovative framework for understanding the role of the contemporary Methodist minister. It claims confidently that this framework enables ministers to lead congregations and facilitate growth in the twenty-first century Irish Methodist Church

Influence of salinity and cadmium on the volume of Pacific herring eggs

Changes in total volume and volume of the yolk and perivitelline space of Pacific herring eggs were examined throughout incubation at 5°C in relation to salinity of the incubation medium (5, 20, 35‰ S), and after exposure to cadmium (0.05–10 ppm Cd) at 20‰ S. After fertilization and filling of the perivitelline space there was a decline in total egg volume in all salinities until 60–80 hr after fertilization. There followed a period of relative stability of total volume (100–240 hr), then a slow decline until hatching (240–618 hr). There was an inverse relation, between egg volume and salinity at all stages of egg development. Eggs transferred from 20‰ to 5 or 35‰ S, 87.4 hr after fertilization (90% blastodermal overgrowth of the yolk), showed only minor changes in total egg volume within the period of relative stability (100–240 hr). Prior to 80 hr, changes in egg volume appeared primarily to be simpleadjustments to prevailing osmotic and ionic conditions, modified, however, by presumed irreversible changes induced in the egg in relation to salinity experience at, and shortly after, fertilization. Subsequently, between 80–100 hr, egg volume appears to becomeregulated, commencing in the interval between late blastodermal overgrowth and blastopore closure. Yolk volume declined after fertilization, reached a minimum 40–60 hr after fertilization, increased to 100 hr, then decreased in the period of relative stability of total volume — presumably in relation to rapid growth of the embryo. In the latter period, yolk volume appeared resistant to change when eggs are transferred from 20 ‰ to 5 or 35 ‰ S, 87.4 hr, after fertilization. Volume of the perivitelline space reached a maximum after fertilization, then decreased until about 100 hr; between 100 and 240 hr it increased rapidly and was influenced only in a minor way by salinity changes in the incubation medium 87.4 hr after fertilization. Eggs exposed to cadmium in the interval between 1/2 and 30 hr after fertilization showed major reductions in total egg volume; total volume in the period of relative stability (100–240 hr) was much reduced and normal volume was not recovered after removal of such eggs to uncontaminated water at 30 hr

Laserska desorpcijsko–ionizacijska masena spektroskopija potpomognuta sa C60

An application of C60-assisted laser desorption/ionization mass spectrometry of two organic samples including insulin (5734 Da), bovine albumin (66 000 Da) and a heteropoly inorganic system: phosphotungstic acid H3PO4(WO3)12×H2O, is presented. A nitrogen laser (337 nm) on a linear tandem time-of-flight mass spectrometer is used for the observation of the laser-power dependence of mass spectra.Opisuje se primjena laserske desorpcijsko–ionizacijske masene spektroskopije sa dva organska pripravka, insulin (5734 Da) sa crijevnim albuminom (66 000 Da), te heteropolni anorganski sistem od fosforovolframske kiseline, H3PO4(WO3)12×H2O. Primijenjen je dušikov laser pri linearnom tandem masenom spektrometru s mjerenjem vremena proleta i proučavana je ovisnost masenih spektara o snazi laserskog snopa. Pokazano je da se tehnika slojeva sa C60 kao substratom za desorpciju organskih ili neorganskih molekula, može primijeniti kao alternativna dobro poznatoj MALDI metodi

Very preterm infants engage in an intervention to train their control of attention: results from the feasibility study of the Attention Control Training (ACT) randomised trial

Background Very premature birth (gestational age between 28 and 31 + 6 weeks) is associated with increased risk of cognitive delay and attention deficit disorder, which have been linked to anomalies in the development of executive functions (EFs) and their precursors. In particular, very preterm (VP) infants display anomalies in controlling attention and gathering task-relevant information. Early interventions that support attention control may be pivotal in providing a secure base for VP children’s later attainments. The Attention Control Training (ACT) is a cognitive training intervention that targets infants’ abilities to select visual information according to varying task demands but had not been tested in VP infants. We conducted a feasibility study to test the processes we intend to use in a trial delivering the ACT to VP infants. Methods and design We tested recruitment and retention of VP infants and their families in a randomised trial, as well as acceptability and completion of baseline and outcome measures. To evaluate these aims, we used descriptive quantitative statistics and qualitative methods to analyse feedback from infants’ caregivers. We also investigated the quality of eye-tracking data collected and indicators of infants’ engagement in the training, using descriptive statistics. Results Twelve VP infants were recruited, and 10 (83%) completed the study. Participants’ parents had high education attainment. The rate of completion of baseline and outcome measures was optimal. VP infants demonstrated engagement in the training, completing on average 84 min of training over three visits, and displaying improved performance during this training. Eye-tracking data quality was moderate, but this did not interfere with infants’ engagement in the training. Discussion The results suggest the ACT can be delivered to VP infants. However, challenges remain in recruitment of numerous and diverse samples. We discuss strategies to overcome these challenges informed by results of this study. Trial registration Registered Registration ID: NCT03896490. Retrospectively registered at Clinical Trials Protocol Registration and Results System (clinicaltrials.gov)

Salt and Water Retention Is Associated with Microinflammation and Endothelial Injury in Chronic Kidney Disease

BACKGROUND: Progressive chronic kidney disease (CKD) inevitably leads to salt and water retention and disturbances in the macro-and microcirculation. OBJECTIVES: We hypothesize that salt and water dysregulation in advanced CKD may be linked to inflammation and microvascular injury pathways. METHODS: We studied 23 CKD stage 5 patients and 11 healthy controls (HC). Tissue sodium concentration was assessed using 23Sodium magnetic resonance (MR) imaging. Hydration status was evaluated using bioimpedance spectroscopy. A panel of inflammatory and endothelial biomarkers was also measured. RESULTS: CKD patients had fluid overload (FO) when compared to HC (overhydration index: CKD = 0.5 ± 1.9 L vs. HC = -0.5 ± 1.0 L; p = 0.03). MR-derived tissue sodium concentrations were predominantly higher in the subcutaneous (SC) compartment (median [interquartile range] CKD = 22.4 mmol/L [19.4-31.3] vs. HC = 18.4 mmol/L [16.6-21.3]; p = 0.03), but not the muscle (CKD = 24.9 ± 5.5 mmol/L vs. HC = 22.8 ± 2.5 mmol/L; p = 0.26). Tissue sodium in both compartments correlated to FO (muscle: r = 0.63, p < 0.01; SC: rs = 0.63, p < 0.01). CKD subjects had elevated levels of vascular cell adhesion molecule (p < 0.05), tumor necrosis factor-alpha (p < 0.01), and interleukin (IL)-6 (p = 0.01) and lower levels of vascular endothelial growth factor-C (p = 0.04). FO in CKD was linked to higher IL-8 (r = 0.51, p < 0.05) and inversely associated to E-selectin (r = -0.52, p = 0.01). Higher SC sodium was linked to higher intracellular adhesion molecule (ICAM; rs = 0.54, p = 0.02). CONCLUSION: Salt and water accumulation in CKD appears to be linked with inflammation and endothelial activation pathways. Specifically IL-8, E-Selectin (in FO), and ICAM (in salt accumulation) may be implicated in the pathophysiology of FO and merit further investigation

Conceptual framework on barriers and facilitators to implementing perinatal mental health care and treatment for women: the MATRIx evidence synthesis

Background Perinatal mental health difficulties can occur during pregnancy or after birth and mental illness is a leading cause of maternal death. It is therefore important to identify the barriers and facilitators to implementing and accessing perinatal mental health care. Objectives Our research objective was to develop a conceptual framework of barriers and facilitators to perinatal mental health care (defined as identification, assessment, care and treatment) to inform perinatal mental health services. Methods Two systematic reviews were conducted to synthesise the evidence on: Review 1 barriers and facilitators to implementing perinatal mental health care; and Review 2 barriers to women accessing perinatal mental health care. Results were used to develop a conceptual framework which was then refined through consultations with stakeholders. Data sources Pre-planned searches were conducted on MEDLINE, EMBASE, PsychInfo and CINAHL. Review 2 also included Scopus and the Cochrane Database of Systematic Reviews. Review methods In Review 1, studies were included if they examined barriers or facilitators to implementing perinatal mental health care. In Review 2, systematic reviews were included if they examined barriers and facilitators to women seeking help, accessing help and engaging in perinatal mental health care; and they used systematic search strategies. Only qualitative papers were identified from the searches. Results were analysed using thematic synthesis and themes were mapped on to a theoretically informed multi-level model then grouped to reflect different stages of the care pathway. Results Review 1 included 46 studies. Most were carried out in higher income countries and evaluated as good quality with low risk of bias. Review 2 included 32 systematic reviews. Most were carried out in higher income countries and evaluated as having low confidence in the results. Barriers and facilitators to perinatal mental health care were identified at seven levels: Individual (e.g. beliefs about mental illness); Health professional (e.g. confidence addressing perinatal mental illness); Interpersonal (e.g. relationship between women and health professionals); Organisational (e.g. continuity of carer); Commissioner (e.g. referral pathways); Political (e.g. women’s economic status); and Societal (e.g. stigma). These factors impacted on perinatal mental health care at different stages of the care pathway. Results from reviews were synthesised to develop two MATRIx conceptual frameworks of the (1) barriers and (2) facilitators to perinatal mental health care. These provide pictorial representations of 66 barriers and 39 facilitators that intersect across the care pathway and at different levels. Limitations In Review 1 only 10% of abstracts were double screened and 10% of included papers methodologically appraised by two reviewers. The majority of reviews included in Review 2 were evaluated as having low (n = 14) or critically low (n = 5) confidence in their results. Both reviews only included papers published in academic journals and written in English. Conclusions The MATRIx frameworks highlight the complex interplay of individual and system level factors across different stages of the care pathway that influence women accessing perinatal mental health care and effective implementation of perinatal mental health services. Recommendations for health policy and practice These include using the conceptual frameworks to inform comprehensive, strategic and evidence-based approaches to perinatal mental health care; ensuring care is easy to access and flexible; providing culturally sensitive care; adequate funding of services; and quality training for health professionals with protected time to do it. Future work Further research is needed to examine access to perinatal mental health care for specific groups, such as fathers, immigrants or those in lower income countries.