Dystopian wor(l)ds: language within and beyond experience

This thesis examines language in a range of modern and contemporary dystopian literary fiction, and argues for a reinterpretation of Whorfian linguistics as a means of advancing understanding of the dystopian genre's acknowledged propensity to influence the habitual world-view of its readership. Using close stylistic analysis, and with an emphasis on textual patterning, it identifies and examines two distinct and characteristic `languages' of dystopia, and considers the ways in which these discourses contribute to linguistic relativity as a dynamic process in the reading of these fictions. Chapter one defines more precisely the literary genre of dystopia, particularly in relation to notions of space and time, and emphasises the genre's necessary participation in the socio-historical circumstances of its conception and production (the site of a discourse here termed reflective language). The (re)placement of these environments in a futuristic setting is also examined and is shown to be marked by a second discourse, termed speculative language. Chapter two outlines the theoretical foundations of the study and supports its positioning at the interface between the study of language and the study of literature by drawing on theories from both disciplines to orient its subsequent analyses. In this chapter, the concept of linguistic relativity, or Whorfianism, is re-figured as a process intrinsic to the reading of dystopian narratives, and is combined with the more literary critical theory of cognitive estrangement. In order to maintain focus on the reader-text relationship, and to locate the analyses from a readerly perspective, some common, or `folklinguistic', beliefs about translatability and the `inadequacy' of language are also invoked. Chapters three, four, and five are devoted to case studies: chapter three discusses the non-Newspeak speculative language in George Orwell's Nineteen Eighty-Four, and chapter four begins with an analysis of reflective language in the same novel before looking at three other twentieth-century dystopian texts (Katherine Burdekin's Swastika Night, L. P. Hartley's Facial Justice, and Margaret Atwood's The Handmaid's Tale). Chapter five brings together speculative and reflective language in its consideration of Atwood's Oryx and Crake, which also serves to bring this study into the twenty-first century. A summary and conclusions follow in chapter six

Social Media Networks and Community Development in Work-based Undergraduate Students

Abstract The purpose of the study was to explore how students on two related work-based degree courses with limited opportunities for face to face interaction used social media platforms to support their experiences and learning. The students involved work as teaching assistants in a range of mainstream and special schools in the East Midlands and attend classes one day a week. It was noted by tutors that students made frequent references to using various social media platforms for sharing student-to-student information relating to the taught sessions or assignments in preference to the university’s virtual learning environment. To investigate this phenomenon, a case study approach, using focus groups and a paired interview, was adopted. The entire student population on the courses was invited to participate, so the sample was self-selecting and a total of 11% of the students volunteered, participating in either a focus group discussion or paired interview. The study found that students made extensive use of social media platforms, mainly Facebook and Whatsapp, for academic and affective support. Students found this to be an effective way to keep in touch with one another away from university, to share resources and experiences and felt that it helped with their identity as a higher education student

Pregnancy and neonatal outcomes of COVID-19: The PAN-COVID study

Objective To assess perinatal outcomes for pregnancies affected by suspected or confirmed SARS-CoV-2 infection. Methods Prospective, web-based registry. Pregnant women were invited to participate if they had suspected or confirmed SARS-CoV-2 infection between 1st January 2020 and 31st March 2021 to assess the impact of infection on maternal and perinatal outcomes including miscarriage, stillbirth, fetal growth restriction, pre-term birth and transmission to the infant. Results Between April 2020 and March 2021, the study recruited 8239 participants who had suspected or confirmed SARs-CoV-2 infection episodes in pregnancy between January 2020 and March 2021. Maternal death affected 14/8197 (0.2%) participants, 176/8187 (2.2%) of participants required ventilatory support. Pre-eclampsia affected 389/8189 (4.8%) participants, eclampsia was reported in 40/ 8024 (0.5%) of all participants. Stillbirth affected 35/8187 (0.4 %) participants. In participants delivering within 2 weeks of delivery 21/2686 (0.8 %) were affected by stillbirth compared with 8/4596 (0.2 %) delivering ≥ 2 weeks after infection (95 % CI 0.3–1.0). SGA affected 744/7696 (9.3 %) of livebirths, FGR affected 360/8175 (4.4 %) of all pregnancies. Pre-term birth occurred in 922/8066 (11.5%), the majority of these were indicated pre-term births, 220/7987 (2.8%) participants experienced spontaneous pre-term births. Early neonatal deaths affected 11/8050 livebirths. Of all neonates, 80/7993 (1.0%) tested positive for SARS-CoV-2. Conclusions Infection was associated with indicated pre-term birth, most commonly for fetal compromise. The overall proportions of women affected by SGA and FGR were not higher than expected, however there was the proportion affected by stillbirth in participants delivering within 2 weeks of infection was significantly higher than those delivering ≥ 2 weeks after infection. We suggest that clinicians’ threshold for delivery should be low if there are concerns with fetal movements or fetal heart rate monitoring in the time around infection

Prospective, multicentre study of screening, investigation and management of hyponatraemia after subarachnoid haemorrhage in the UK and Ireland

Background: Hyponatraemia often occurs after subarachnoid haemorrhage (SAH). However, its clinical significance and optimal management are uncertain. We audited the screening, investigation and management of hyponatraemia after SAH. Methods: We prospectively identified consecutive patients with spontaneous SAH admitted to neurosurgical units in the United Kingdom or Ireland. We reviewed medical records daily from admission to discharge, 21 days or death and extracted all measurements of serum sodium to identify hyponatraemia (<135 mmol/L). Main outcomes were death/dependency at discharge or 21 days and admission duration >10 days. Associations of hyponatraemia with outcome were assessed using logistic regression with adjustment for predictors of outcome after SAH and admission duration. We assessed hyponatraemia-free survival using multivariable Cox regression. Results: 175/407 (43%) patients admitted to 24 neurosurgical units developed hyponatraemia. 5976 serum sodium measurements were made. Serum osmolality, urine osmolality and urine sodium were measured in 30/166 (18%) hyponatraemic patients with complete data. The most frequently target daily fluid intake was >3 L and this did not differ during hyponatraemic or non-hyponatraemic episodes. 26% (n/N=42/164) patients with hyponatraemia received sodium supplementation. 133 (35%) patients were dead or dependent within the study period and 240 (68%) patients had hospital admission for over 10 days. In the multivariable analyses, hyponatraemia was associated with less dependency (adjusted OR (aOR)=0.35 (95% CI 0.17 to 0.69)) but longer admissions (aOR=3.2 (1.8 to 5.7)). World Federation of Neurosurgical Societies grade I–III, modified Fisher 2–4 and posterior circulation aneurysms were associated with greater hazards of hyponatraemia. Conclusions: In this comprehensive multicentre prospective-adjusted analysis of patients with SAH, hyponatraemia was investigated inconsistently and, for most patients, was not associated with changes in management or clinical outcome. This work establishes a basis for the development of evidence-based SAH-specific guidance for targeted screening, investigation and management of high-risk patients to minimise the impact of hyponatraemia on admission duration and to improve consistency of patient care

Missense mutations in the insulin promoter factor-1 gene predispose to type 2 diabetes

The transcription factor insulin promoter factor-1 (IPF-1) plays a central role in both the development of the pancreas and the regulation of insulin gene expression in the mature pancreatic beta cell. A dominant-negative frameshift mutation in the IPF-l gene was identified in a single family and shown to cause pancreatic agenesis when homozygous and maturity-onset diabetes of the young (MODY) when heterozygous. We studied the role of IPF-1 in Caucasian diabetic and nondiabetic subjects from the United Kingdom. Three novel IPF-1 missense mutations (C18R, D76N, and R197H) were identified in patients with type 2 diabetes. Functional analyses of these mutations demonstrated decreased binding activity to the human insulin gene promoter and reduced activation of the insulin gene in response to hyperglycemia in the human beta-cell line Nes2y. These mutations are present in 1% of the population and predisposed the subject to type 2 diabetes with a relative risk of 3.0. They were not highly penetrant MODY mutations, as there were nondiabetic mutation carriers 25-53 years of age. We conclude that mutations in the IPF-1 gene may predispose to type 2 diabetes and are a rare cause of MODY and pancreatic agenesis, with the phenotype depending upon the severity of the mutation