Retrodeformation and muscular reconstruction of ornithomimosaurian dinosaur crania

Ornithomimosaur dinosaurs evolved lightweight, edentulous skulls that possessed keratinous rhamphothecae. Understanding the anatomy of these taxa allows for a greater understanding of “ostrich-mimic” dinosaurs and character change during theropod dinosaur evolution. However, taphonomic processes during fossilisation often distort fossil remains. Retrodeformation offers a means by which to recover a hypothesis of the original anatomy of the specimen, and 3D scanning technologies present a way to constrain and document the retrodeformation process. Using computed tomography (CT) scan data, specimen specific retrodeformations were performed on three-dimensionally preserved but taphonomically distorted skulls of the deinocheirid Garudimimus brevipes Barsbold, 1981 and the ornithomimids Struthiomimus altus Lambe, 1902 and Ornithomimus edmontonicus Sternberg, 1933. This allowed for a reconstruction of the adductor musculature, which was then mapped onto the crania, from which muscle mechanical advantage and bite forces were calculated pre- and post-retrodeformation. The extent of the rhamphotheca was varied in each taxon to represent morphologies found within modern Aves. Well constrained retrodeformation allows for increased confidence in anatomical and functional analysis of fossil specimens and offers an opportunity to more fully understand the soft tissue anatomy of extinct taxa

Public and Private Health Care Financing with Alternate Public Rationing

We develop a model to analyze health care nancing arrangements and under alternative public sector rationing rules. Health care is demanded by individuals varying in income and severity of illness. There is a limited supply of health care resources used to treat individuals, causing some individuals to go untreated. We examine outcomes under full public finance, full private finance, and mixed, parallel public and private finance under two rationing rules for the public sector: needs-based rationing and random rationing. Insurers (both public and private) must bid to obtain the necessary health care resources to treat their beneficiaries. While the public insurer's ability-to-pay is limited by its (fixed) budget, the private insurer's willingness-to-pay re ects the individuals' willingness-to-pay for care. When permitted, the private sector supplies supplementary health care to those willing and able to pay. The introduction of private insurance diverts treatment from relatively poor to relatively rich individuals. Moreover, if the public insurer allocates care according to need, the average severity of the untreated is higher in a mixed system than in a pure public system. While we can unambiguously sign most comparative static effects for a general set of distribution functions for income and severity, a complete analysis of the relationship between public sector rationing and the scope for a private health insurance market requires distributional assumptions. For a bivariate uniform distribution function we nd that the private health insurance market is smaller when the public sector rations according to need as compared to random allocation of health care.health care financing, rationing rules

Intra-Rater reliability of the Functional Movement Screen (FMS) amongst NHS Physiotherapists

Objectives: The primary aim of this study was to evaluate the intra-rater reliability of the FMS amongst a group of novice National Health Service (NHS) Physiotherapists. The secondary objective was to establish if Intra-rater reliability differed between non-specialist rotational Physiotherapists and Physiotherapists working within the musculoskeletal (MSk) setting. Design: Reliability Study. Method: Forty participants with no recent MSk injury were video recorded completing the 7 component FMS tests. Six NHS Physiotherapists with no previous experience using the FMS attended a 2 hour training programme delivered by a certified FMS practitioner. Raters then viewed and scored videos of the 40 participants completing the FMS. Results: The intra-rater reliability of FMS composite scores was Excellent (mean ICC of 0.91 (95% CI 0.81-0.96)). The non-specialist rotational Physiotherapist group demonstrated Good-Excellent intra-rater reliability (ICC 0.9; 95% CI 0.79-0.95). Specialist MSk Physiotherapists demonstrated Excellent intra-rater reliability (ICC 0.92; 95% CI 0.84-0.96). Intra-rater reliability of the 7 component tests of the FMS ranged from Poor-Excellent (KW 95% CI 0.11-0.98). Conclusion: Among novice NHS Physiotherapists, the FMS composite score demonstrated Excellent intra-rater reliability. MSk specialists were found to demonstrate a marginally superior level of intra-rater agreement compared to non-specialist rotational Physiotherapists; however this is likely to be negligible in a clinical context. Clinical specialism also appears to have little impact on the intra-rater reliability of FMS components with both groups of raters achieving a Poor-Excellent level of agreement. Keywords: Intra-rater, reliability, functional movement screen, FM

Comparative Modeling of Cod-Capelin Dynamics in the Newfoundland-Labrador Shelves and Barents Sea Ecosystems

The Atlantic cod (Gadus morhua) stocks in the Newfoundland-Labrador Shelves (NL) and Barents Sea (BS) ecosystems have shown divergent trajectories over the last 40 years. Both stocks experienced either an important decline (BS) or a collapse (NL) in the mid-1980s and early 1990s, respectively. After these population reductions, the BS stock quickly rebounded and it is currently at record high levels, while the NL stock, despite showing some improvement since the mid-2000s, remains at low levels. Fishing and environmental conditions are known to be important drivers of cod dynamics in both ecosystems, especially the availability of high energy prey like capelin (Mallotus villosus), however, the question of how different or similar these two stocks truly are remains. Could, for example, the NL cod stock rebuild if presented to conditions like the ones experienced by BS cod? To explore such questions, we developed a simple biomass dynamic model for cod using a bioenergetic-allometric approach. This model includes fisheries catches and capelin availability as external drivers and was implemented for both ecosystems. Despite the contrasting trends, the model produced very good fits, and showed some remarkably similar estimated parameters in both systems. We explored these similarities by (a) performing the thought experiment of transferring cod stocks between ecosystems by switching estimated key parameters between models and comparing the output, and (b) implementing an integrated model architecture which allowed fitting common parameters for both stocks to evaluate the similarity of key vital rates. Our results indicate that cod trajectories in NL and BS can be reliably described using simple bioenergetic-allometric arguments, fishery catches, and capelin availability. Model parameters that encapsulate intrinsic vital rates were not significantly different between stocks. This indicates that NL and BS cod stocks are biologically similar, and that the differences in their trajectories are driven by the ecosystem context in which these stocks are embedded, and suggests that the NL stock would be expected to rebuild if enough capelin were available. This also indicates that capelin status and trend should be an important consideration for effective management of these cod stocks.publishedVersio

Understanding the use of diagnostic imaging and its role in decision-making in musculoskeletal pain conditions affecting the lower back, knee, and shoulder

Musculoskeletal (MSK) pain conditions are one of the most common reasons for primary care consultation. The epidemiological evidence suggests that the most common body sites for MSK pain are the lower back, knee, and shoulder respectively, with most presentations being non-traumatic in nature. In turn, this PhD focuses on non-traumatic MSK pain conditions affecting the lower back, knee, and shoulder. The use of diagnostic imaging has been acknowledged as a challenge within the NHS, with year-on-year increases in the number of diagnostics being requested contributing to extra demand on radiology services. In many situations, there is considerable clinical uncertainty in relation to the diagnosis and when this uncertainty exists, it has also been reported that scan results are perceived by patients as authoritative. This PhD thesis used multi-methods design to achieve the aims of better understanding the reasons for requesting imaging, and how the results are used. Two scoping reviews are presented which outline the recommendations for imaging use from clinical practice guidelines, and how these are largely consistent with recommendations within public-facing websites. These recommendations outline how the routine use of diagnostic imaging is discouraged, reserved for cases where specific or serious pathology is suspected or where the person is not responding to initial management and the result is expected to change clinical management. Two qualitative studies are then presented that explore why and how imaging is used from the perspective of the patient and the clinician. These findings consider the role of patient expectations, making sense of symptoms, managing uncertainty, and involvement in decision-making. The findings of this PhD conclude with recommendations for practice, policy and research with a focus on the potential of personalised care and communication skills as methods to optimise diagnostic imaging use. A foundation has been established upon which further research could be undertaken

A Population-Based Study of Eating Disorders in Young Persons in Malta: Prevalence in Males Nearly Equals that in Females

Objective: The objective of this study was to examine the prevalence of eating disorders and attitudes to food and eating for youths between 10 and 16 years of age, in order to aid in the diagnosis and treatment of eating disorders in young people through empirical research in a previously unexamined area. Methods: The tool selected for this population-based study was the ChEAT, i.e. the Children’s Eating Attitudes Test. A representative cohort of 400, randomly sampled, young people aged 10-16, were asked all 26 questions of the ChEAT via telephone, while their parents/guardians were asked socio-demographic questions, Results: 5.5% (2.25% M, 3.25% F) of the cohort scored at or above the cut-off of 20, indicating the presence of an eating disorder. No significant associations were found between disordered eating and socio-demographic data. Conclusions: Findings indicate that males are catching up to females in eating disorder diagnoses. A male slightly higher mean ChEAT ≥20 could denote that disordered eating could be more acute for young men who are between 10 to 16 years old than it is for young women aged 10 to 16. The lack of significant association between the disordered eating and socio-demographic data could be a factor of the ages under examination in this study, and possibly these associations could arise at later ages

Examining the social impact of social housing

The impact of social housing in our Society needs to be constantly reviewed and analysed. Considering the massive amount of resources we put into the system, the State deserves a return on its investment in terms of quality of life and social wellbeing of the people using those services. It is useless investing so much money in that area and people remain at the bottom of the heap struggling to make ends meet, ostracised by the community and never managing to move from German sociologist Ferdinand Tönnies’ renowned concept, Gesellschaft to Gemeinschaft. This study which was mainly a desk top research commissioned by the Housing Authority attempted to bring to the fore the main challenges we have in this sector. This study was another loop whereby the Faculty in collaboration with another of our stakeholders engages in this field of study by zooming into a particular phenomenon and present a number of proposals the commissioning agency can act upon.peer-reviewe

Guidelines for the use of diagnostic imaging in musculoskeletal pain conditions affecting the lower back, knee and shoulder: A scoping review

Background Musculoskeletal (MSK) pain is one of the most common reasons for primary care consultation, particularly pain in the lower back (LBP), knee and shoulder. The use of diagnostic imaging for MSK pain is increasing, but it is unclear whether this increase is justified on the basis of clinical practice guideline (CPG) recommendations. Aim To identify and map the content of CPGs that informs the use of diagnostic imaging in those with nontraumatic LBP, knee and shoulder pain in primary and intermediate care in the UK. Design and Setting A scoping review of CPGs. Methods This scoping review was conducted and is reported in accordance with PRISMA guidance. A broad search strategy included electronic searches of MEDLINE, CINAHL, PsychINFO and SPORTDiscus from 2009 to 17 April 2019. This was conducted alongside a search of guideline repositories and was combined with a snowball search of Google, relevant professional bodies and use of social media. Results 31 relevant CPGs were included. Routine use of diagnostic imaging for those with nontraumatic LBP, knee or shoulder pain is generally discouraged in primary care or intermediate care. Diagnostic imaging should be reserved for when specific or serious pathology is suspected or where the person is not responding to initial nonsurgical management and the imaging result is expected to change clinical management decisions. Conclusion Diagnostic imaging should not be routinely requested in primary or intermediate care for nontraumatic LBP, knee or shoulder pain. CPGs do not justify the increasing imaging rates in the UK for MSK pain

Recommendations on patient-facing websites regarding diagnostic imaging for low back, knee, and shoulder pain: A scoping review

Objective To describe and synthesise the content of public-facing websites regarding the use of diagnostic imaging for adults with lower back pain, knee, and shoulder pain. Methods Scoping review conducted in accordance with PRISMA guidance. A Google search was performed to identify public-facing websites that were either United Kingdom-based, or National Health Service affiliated. The DISCERN tool was used to appraise website quality before information regarding the use of imaging was synthesised using thematic analysis. Results Eighty-six websites were included, with 48 making reference to the use of imaging. The information within the majority (n = 43) of public-facing websites aligns with best available evidence. Where there is inconsistency, this may be explained by lower website quality. Three themes were apparent regarding the use of imaging – imaging to inform diagnosis and management; imaging in context; patient experience and expectations. Conclusion The recommendations and rationale for use of imaging contained within public-facing websites does not appear to justify the increase in imaging rates for musculoskeletal pain in the UK. Innovation Publicly available information following a novel search strategy, is largely aligned with best evidence, further understanding is required to determine reasons for requesting imaging from a patient and clinician perspective

Armed Forces of Malta - Faculty for Social Wellbeing partnership for social inclusion : evaluation report

During these last years, the Faculty for Social Wellbeing has been working with the AFM to try and find ways to share knowledge on very complex and interesting matters around migration, radicalisation and integration. This project in collaboration with the AFM has focused on a number of areas, firstly by providing conversation between the Faculty and AFM specialised services, secondly by offering a short course to soldiers and also officials within the army and finally by using these experiences to list out what we think are the challenges being faced by the AFM in these areas. The openness of the AFM, their willingness to engage in this conversation has proved to be crucial, productive and engaging. We look forward to keeping this collaboration going. [excerpt]peer-reviewe