Forced migrants involved in setting the agenda and designing research to reduce impacts of complex emergencies: combining Swarm with patient and public involvement

Background: Many events with wide-ranging negative health impacts are notable for complexity: lack of predictability, non-linear feedback mechanisms and unexpected consequences. A multi-disciplinary research team was tasked with reducing the public health impacts from complex events, but without a pre-specified topic area or research design. This report describes using patient and public involvement within an adaptable but structured development process to set research objectives and aspects of implementation. Methods: An agile adaptive development approach, sometimes described as swarm, was used to identify possible research areas. Swarm is meant to quickly identify strengths and weaknesses of any candidate project, to accelerate early failure before resources are invested. When aspects of the European migration crisis were identified as a potential priority topic area, two representatives of forced migrant communities were recruited to explore possible research ideas. These representatives helped set the specific research objectives and advised on aspects of implementation, still within the swarm framework for project development. Results: Over ten months, many research ideas were considered by the collaborative working group in a series of six group meetings, supplemented by email contact in between. Up to four possible research ideas were scrutinised at any one meeting, with a focus on identifying practical or desirable aspects of each proposed project. Interest settled on a study to solicit original data about successful strategies that forced migrants use to adapt to life in the UK, with an emphasis on successfully promoting resilience and minimizing emotional distress. “Success in resettlement” was identified to be a more novel theme than “barriers to adaption” research. A success approach encourages participation when individuals may find discussion of mental illness stigmatising. The patient representatives helped with design of patient-facing and interview training materials, interviewer training (mock interviews), and aspects of the recruitment. Conclusion: Using patient and public involvement (PPI) within an early failure development approach that itself arises from theory on complex adaptive systems, we successfully implemented a dynamic development process to determine research topic and study design. The PPI representatives were closely involved in setting research objectives and aspects of implementation

Byzantine horse skeletons of Theodosius harbour: 1.Paleopathology

Archaeological excavations were started in 2004 during the Yenikapi station project which is the most important change centre of Metro railway system and Marmaray hub passage in the European side. Many antique shipwrecks have been revealed and the area was confirmed as the Theodosius harbour. On the 58.000 m(2) excavation area many archaeological items and scattered horse skeletons were recovered. By examining those horse skeletons, their relation with the Theodosius harbour were studied and questions about the management conditions and rearing purposes of Byzantine horses were tried to be answered. It was thought that the Byzantine horses had been used for riding and loading at Yenikapi. in an attempt to give the presumptive reasons of pathologies on those skeletons

Byzantine Horse Skeletons of Theodosius Harbour: 2. Withers height estimation

This study is a continuation of our previous work that focused on maintenance, intended use and pathologies of horses from the Byzantine period. In the current research Byzantine horse skeletons were investigated in order to estimate their withers heights and structural features. The skeletons were found during Marmaray Project works at Yenikapi, Istanbul, where Theodosius Harbour was located in the past. Materials have been collected during archaeological excavations started in 2004 and covering an area of 58.000 m(2). The data obtained were compared and classified. In general, the specimens were "medium" sized (38.72%, withers height 136-144 cm), and "large-medium" (36.31%, withers height 144-152 cm). According to the classification based on Brauner's metacarpal slenderness index, the horses were described as "slightly slender legged" (40%)

MORPHOMETRIC ANALYSIS OF THE FORAMEN MAGNUM OF BYZANTINE DOGS EXCAVATED IN ISTANBUL YENIKAPI AT THE SITE OF THEODOSIUS HARBOUR

This study presents the results of morphometric analysis of a total of 473 skulls ascribed to adult animals were sufficiently complete to allow the measurement of their foramen magnum; and for 472 of them the foramen magnum index could be calculated. The dorsal notch was only seen in the group of mesocephalic dogs where about 17% of all skulls exhibited this feature. The average length of the dorsal notch was found to be 2.59 mm. Not a single skull in the dolichocephalic dog group showed any sign of a dorsal notch. The results of this study show that the dorsal notch in the foramen magnum widely seen dogs of the Middle Ages, and point to a morphological variation