An Investigation into the utilisation of ethanolamine by uropathogenic E. coli

Urinary tract infections (UTIs) are one of the most common bacterial infections worldwide with E. coli as the causal organism responsible for 75% of all cases. Uropathogenic E. coli (UPEC) naturally reside in the gastrointestinal tract (GI tract) and infect the urinary tract via migratory ascension of the urethra. Ethanolamine, an amino alcohol found naturally in phospholipids as phosphatidylethanolamine, can be metabolised by bacteria to be used as an alternate source of nitrogen and carbon. Within the GI tract ethanolamine provides pathogenic bacteria with a competitive advantage over the commensal bacteria. The ability of bacteria to utilise ethanolamine is dependent on the presence of the ethanolamine utilisation (eut) operon encoding enzymes and bacterial microcompartment packaging. Recent studies suggest the regulator of the eut operon, eutR, can modulate the expression of virulence factors in Enterohaemorrhagic E. coli (EHEC). Transcriptome analysis of UPEC in active UTIs has found that the eut operon is expressed within the urinary tract and confers a competitive advantage in the murine urinary tract, but the exact mechanism conferring this advantage is not known. The aim of this thesis was to investigate the utilisation of ethanolamine by UPEC. This thesis provides evidence that ethanolamine is present in the urine at concentrations of approximately 0.57mM and correlated with the expression of the eut operon in UPEC infected urine. Additionally, the ability to metabolise ethanolamine by the eut operon is conserved across UPEC in this cohort (Cork University Hospital, Cork). Ethanolamine provides UPEC with a growth advantage as a sole nitrogen source in modified M9 minimal medium and an artificial urine medium (AUM). Metabolite analysis shows that the growth advantage observed in both media correlates with ethanolamine metabolism. Expression of eut operon genes and electron microscopy evidence of bacterial microcompartment formation was found in UPEC strain U1 metabolising ethanolamine in AUM. Mutational analysis confirmed a requirement for a functional eut operon to metabolise ethanolamine and suggests that ethanolamine is utilised by UPEC as an additional carbon source. Ethanolamine provide U1 with a competitive growth advantage at 10mM concentrations in vitro. RT-PCR provides evidence that suggests ii ethanolamine regulated the expression of type 1 fimbriae in U1. In conclusion, this thesis supports the hypothesis that ethanolamine provides UPEC with a growth advantage in urine with a potential role in the pathogenicity of UTIs

Mobilising volunteers to deliver a school-based arts-in-nature practice to support children’s mental health and wellbeing: a modified e-Delphi Study with primary school staff

Arts-in-nature practice has been shown to have positive impacts on children’s mental health and wellbeing; however, introducing new innovations in schools can be challenging and requires involvement of staff in the process. The ‘Branching Out’ project explored how arts-in-nature practice can be scaled up to achieve greater reach in primary schools by mobilising community volunteers. We implemented an exploratory, multi-level mixed methods approach, including a modified e-Delphi study which was used to achieve consensus around a new delivery model of arts-in-nature practice in primary schools. Whilst a pilot study tested the implementation of the proposed model in one region, the e-Delphi study explored how the proposed Branching Out model, including the use of volunteers and various options for delivery, would be perceived more widely by primary school staff across different contexts. The survey incorporated implementation measures designed to determine the acceptability, appropriateness, and feasibility of the proposed model. Completion of two rounds of the e-Delphi study captured the views of 42 primary school staff members in total. The findings confirmed the acceptability of the arts-in-nature practice and the use of volunteers, suggested appropriate staff champions and groups of children who would benefit, and determined the preferred options for delivery in terms of feasibility. Overall, consensus was reached regarding the proposed model of arts-in-nature practice in primary schools with high levels of agreement regarding its acceptability, appropriateness, and feasibility. The e-Delphi study provided valuable perspectives of primary school staff that led to the refinement of the Branching Out model for mobilising volunteers to deliver arts-in-nature practice to promote children’s mental health. Delphi studies have the potential to enable expert input into policy and practice and provide an opportunity for teachers to have a voice in the delivery and development of school-based interventions

Sustainable Outdoor Education: Organisations Connecting Children and Young People with Nature through the Arts

There is an increasing concern regarding the mental health and wellbeing of children and young people; as a result, schools are increasingly expected to provide support, but they have few resources to do so. As such, there is a need for establishing mechanisms for supporting the health and wellbeing of children and young people that are relatively easy and cost-effective and that can be embedded within the school day to ensure sustainability. The overarching aim of our Branching Out project was to understand how successful elements from one such programme that supports children’s mental health through the art-in-nature-based practice can be expanded from school-based approaches that reach small numbers of children to include whole communities. This paper reports on one strand that examined the practice of organisations offering arts and/or nature-based activities outdoors in schools, either as part of the curriculum or as an extra-curricular activity. Survey questions served as an a priori thematic framework around the characteristics of arts-in-nature activities delivered; the perceived impacts of activities; working with volunteers, teachers, and schools; and barriers to expansion and sustainability. Despite extensive searching, identifying, and recruiting relevant arts organisations was difficult; however, respondents strongly supported the notion that the arts-in-nature practice has a positive impact on children and young people’s connection to nature, supports their mental health and wellbeing, and engages them with their local environment. Yet, challenges were identified in engaging teachers and schools and funding such projects, suggesting a need for a multi-professional approach to creating more sustainable and impactful practice for children, young people, and communities

‘Time to spread my wings’ An investigative study exploring the effects of inpatient mental health rehabilitation What is the effect of inpatient mental health rehabilitation on an individual’s functional performance and do changes impact quality of life?

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonThis mixed methodology, 3-phase study at one NHS rehabilitation unit explores the experiences of 19 participants recruited over a 2 year period. Participants engaged in individual semi-structured interviews, and were invited to complete both the Lancashire Quality of Life Profile and the Assessment of Motor and Process Skills at admission, discharge and follow-up. Not all participants reached the point of discharge in the study period, and a few became too unwell to continue. At the point of follow-up, of the 10 remaining participants one dropped out due to work or educational commitments, three were re-admitted to hospital, and one did not come for appointments as agreed. To illustrate change over time, five participants have been brought to the fore through the use of case studies. The case studies synthesise the quantitative changes in the individual’s quality of life and functional performance with a personal narrative of their experience of their stay in the rehabilitation unit. The findings of the study are rich. Firstly, they highlight the range of losses experienced prior to rehabilitation and the importance of understanding this narrative as part of the recovery journey. Secondly, rehabilitation creates a sense of hope, but not all interactions with staff in the unit were viewed as hopeful. Hope was at its lowest when participants were not included in key decisions. Thirdly, while for some participants occupational performance and quality of life increased over time, for others it decreased. This study indicates tentative links between occupational performance and quality of life. Recommendations include enhancing client involvement in key decisions regarding rehabilitation choices, routine assessment of occupational performance levels, formally expanding rehabilitation into the community and considering grief work alongside more traditional rehabilitation interventions. Areas for further research include exploration of the links between quality of life and occupational performance levels

The kinematic factors associated with elite level pistol shooting performance

This thesis considered the kinematic factors associated with elite pistol shooting performance. The first three studies examined performance in the newly introduced modern pentathlon combined event. Study 1 demonstrated that shooting performances differed significantly between the combined event and the original precision shooting format. Pistol shooters achieved significantly higher scores, and significantly smaller pistol and centre of pressure movements, than modern pentathletes in the precision event (p<.05). No significant differences were evident between the groups for combined event shooting (p>.05), highlighting that the most successful precision shooters were not guaranteed success in the combined event. Studies 2 and 3 examined how shooting performance changed within and between each shooting series. Aiming time did not change significantly within any series (p>.05), and so participants experienced a similar degree of pistol and centre of pressure movement for each shot, and achieved similar scores. No significant differences were evident in shooting performances between each shooting series (p>.05), despite the additional 1 km run phases. Thus, each running phase appeared to have little impact on shooting performance. Individual analysis used in each study highlighted the extent of individual variation in shooting performances, and demonstrated that group analysis is not sufficient to reflect the performances of individual participants. The final two studies examined elite precision shooting performances. Study 4 provided a descriptive analysis of torso, shoulder, wrist and pistol movement during the final second before the shot. Participants produced variable movement patterns for the upper limb, reflecting the principle of abundancy, in order to control the motion of the pistol. The exact patterns varied between participants, further supporting the importance of using individual analysis to examine pistol shooting performance. Study 5 examined the effects of stance position on shooting performance. Changing stance position produced significant differences in the scores achieved by each participant (p<.05). The most effective mediolateral and anterior-posterior stance widths, and the mechanisms behind the changes in performance, varied between participants. Thus, it was recommended that pistol shooters should examine stance position in greater detail when attempting to enhance performance

Artscaping with Community Artscapers: Research findings from the Branching Out project

The overarching Branching Out research project aimed to establish how ‘Artscaping’, the arts-in-nature practice developed by Cambridge Curiosity and Imagination (CCI), can be scaled up to reach more children by mobilising community assets to deliver it in schools. This involved development through various research methods and co-creation of a Branching Out model in which volunteers, teaching assistants and teachers were trained and supported by artists as ‘Community Artscapers’ who then facilitated Artscaping for small groups of children in their schools. Family therapy charity Cambridge Acorn Project and Fullscope were also partners. The model was piloted in six primary schools in Cambridgeshire and Peterborough in 2022: the Branching Out project pilot. For the purposes of this report, we refer to the pilot in schools as the project. This report presents qualitative findings from the Branching Out project based on interviews with Community Artscapers and school senior leadership about their experience. It covers the background and research approach for Branching Out, the learning from establishing and delivering the Branching Out model, and the key impacts for the children, Community Artscapers, and schools

Life History of the Marine Isopod Cyathura polita in the Saint John River Estuary, New Brunswick: a Species at the Northern Extent of its Range

The marine isopod, Cyathura polita, inhabits estuaries on the east coast of North America from the Gulf of Mexico to the Bay of Fundy, Canada. We studied C. polita in the Saint John estuary to test for potential differences in life history that might occur because of the northern location of the population. In the Saint John, based on our interpretation from a six-month sampling program (May-October), the population exhibits a three-year life cycle, one year longer than more southern populations, and stretching over four summers. Our study supported the occurrence of protogynic hermaphroditism. After two summers as juveniles, individuals matured as females during their third summer, then displayed sex reversal by becoming males that fall, and finally reproducing as males in their fourth summer of life before death. Mean length of C. polita from the Saint John was greater than individuals from more southern populations (females, 13.8 &plusmn; 2.14 mm; males, 16.3 &plusmn; 2.41 mm). Annual brood release occurred in late July-early August. Mean fecundity of females was 53.2 &plusmn; 18.9 embryos per brood, which was greater than found in southern populations. Cyathura polita is rare in Canada and is known only from the Saint John and along the northern shore of the Bay of Fundy to the border of the United States