Shape up and Ship out: Do Bt-Resistant Corn Earworm Moths, Helicoverpa zea, Have Wing Shapes Better Suited to Long Distance Flight? arworm M oths, Helicoverpa zea , H ave W ing S hapes B etter S uited to L ong D istance F light?

Evolution of resistance within insects to pest control has frequently resulted in changes to the organism’s morphotype, including changes in wing shape. By measuring these changes, it is possible to distinguish resistant from non-resistant populations. Geometric morphometrics (GM) quantifies morphological variation within and among populations, it has been used in previous studies to identify changes in morphotype and distinguish between resistant and non-resistant populations of insects. Helicoverpa Zea (corn earworm) is one of the most economically damaging pests for crops across the United States of America. Infestations of H. zea annually migrate from southern USA to the north, causing damage to almost all agricultural crops in its path. Although corn (Zea mays) is the preferred host and thus the most affected by this insect. A common strategy to manage this pest is the use of Bt Corn; genetically modified corn that produces the Bt toxins. Cry proteins (Cry1AF and Cry1B) are the most common to be produced in Bt Corn, but they are considered low dose toxic to H. zea. There are suggestions to include Vip3A by gene pyramiding corn as the combination of Vip and Cry proteins are high dose toxic to H. zea. Overtime, H. zea has evolved resistance to the Cry proteins expressed by Bt Corn making them a no longer effective control mechanism. This thesis the first study to apply the use of GM methods to the species H. zea. The aims of this thesis are to investigate the effect that resistance to Bt Corn has on wing morphology of the H. zea moth, and to determine if these changes in wing shape can be detected using GM methods. A total of 145 H. zea were provided from two locations across the USA, one in South Carolina and another in North Carolina. Moths were from four different treatments of corn; a control containing corn with no Bt toxins (Treatment 1); crops of Bt Corn containing two toxins (Cry1AB and Cry1F) with a structured refuge present (Treatment 2); crops of Bt Corn containing three toxins (Cry1AB, Cry1F, and Vip3A) with a structured refuge present (Treatment 3); crops of seed blended Bt Corn with 80% containing three toxins (Cry1AB, Cry1F, and Vip3A) and 20% not having any toxins (Treatment 5). Left and right forewings of each moth were chemically bleached, and the scales removed. Once wings were slide mounted, photographs were then taken of each wing. Fifteen type I landmarks were identified in the venation pattern of the forewing for the use of GM analyses. Preliminary tests were conducted and determined that results observed were not confounded by measurement error, bilateral asymmetry, allometry, or sexual dimorphism. A Principal Component Analysis (PCA) was conducted to visualise the whole data set, and a Canonical Variate Analysis (CVA) was done to visualise the relationship between wing shape and treatment of corn. Lastly a Discriminant Function Analysis (DFA) was done to determine the ability of wing shape to act as an indicator and biomarker for the different treatments of corn. The results determined that there was significant difference between forewing shape of susceptible and resistant H. zea individuals. The CVA identified that wing shape of moths’ resistant to Vip3A protein is significantly different from the wing shape of moths’ resistant to just the Cry proteins, thereby identifying resistance to the Vip3A protein. Practical field resistance of H. zea populations to the Vip3A protein has only been recorded once before, therefore these findings present a serious concern. If resistance to the Vip3A protein can become established within H. zea populations, it may inhibit future pest management strategies and pose a serious economic threat to future corn production within the USA. The results of the DFA showed that the forewing shape of H. zea can effectively be used as a biomarker, and that GM can be used to monitor the development and spread of resistance to both Cry proteins, and Vip3A proteins. GM methods are much cheaper and requires less expert knowledge than genetic markers, and thus will allow greater access to the monitoring of resistance within the H. zea population to a broader range of professionals

Uncivil War: Memory and Identity in the Reconstruction of the Civil Rights Movement.

Memory is constructed to solidify a certain version of the past in the collective identity. History and memory occupy a controversial role in the New South, with battles over the legacy of the Civil War and the reassertion of Confederate symbols in the wake of the Civil Rights Movement\u27s challenge to the status quo. Memory of the Civil Rights Movement is entering public conscious through cultural mediums such as films and museums, as well as through politically contentious debates over the continued display of the Confederate battle flag and the creation of a federal holiday honoring Dr. Martin Luther King Jr. The process is still taking place to construct the Civil Rights Movement within the American collective memory. What aspects of this history are commemorated, and which aspects are neglected, will have impact in American society well into the twenty-first century

Watercolor 13

One of 13 watercolor sketches by a member of the Barclay family depicting life in 1850s Jerusalem. This watercolor features a man over a yellow background

A Taster Of An Award-Winning Conflict Resolution Training Program For Pediatric Health Professionals

In 2013, the Medical Mediation Foundation and the Evelina London Children’s Hospital initiated a project to explore the nature and impact of conflict across paediatrics. Interestingly, staff were initially reluctant to name disagreements as ‘conflict’, but widespread canvassing of experience yielded a working definition of conflict which has ‘the breakdown of trust and communication breakdown’ and "impact on the ability of staff to provide optimal care to the child" at its core.  The project, based on published research with families and health professionals, provides training to staff in recognising and managing conflict and an independent mediation service available to families, patients and staff to help resolve conflict if it escalates. The Evelina Resolution Project has become a nationally recognised, award-winning training programme.  Interactive, multi-disciplinary sessions (usually half days, 12-20 staff) are co-trained, combining the expertise of a senior consultant paediatrician and an experienced accredited mediator. Six month follow up of a cohort of 313 staff found that more than half had experienced a conflict with a parent or patient since doing the training and of these,  95% reported that the training  had helped them to recognise the warning signs and 91% said it had helped de-escalate the conflict. Feedback from more than 1600 Evelina staff trained to date, provides consistently high ‘quality’ ratings (95% rated the training as excellent/very good), ‘relevance’ ratings (99% - very relevant/relevant) This workshop will offer a condensed version of the training and an opportunity for participants to practise and discuss the skills taught.

Reducing healthcare conflict: outcomes from using the conflict management framework

Objective To test a new conflict management framework (CMF) to help staff identify and de-escalate conflict between staff and patients/families. Design Before/after study that reports staff quality of life, frequency/severity of conflicts and qualitative interviews on using the framework. Data were collected from May 2017 to September 2017. Setting A paediatric oncology department day-patient and 23-bed inpatient ward. Intervention A two-stage CMF used by staff during daily handovers to identify and then manage conflict cases with families. Results Staff found the CMFto be helpful in identifying and de-escalating conflicts. The number of conflicts reported decreased by 64% from baseline to follow-up. Communication regarding conflict identification improved. Reports of staff burn-out decreased between the two time-points (n=55 at baseline, n=31 at follow-up; p=0.001). Scores on compassion and secondary traumatic stress did not change. Conclusions The CMF substantially reduces the incidence of conflicts and is an acceptable approach for staff. Continued use of the framework would require it to be fully integrated into the working of the ward, which would need to include senior medical buy-in. Further refinements to the framework have been made and will be tested in four UK sites in 2018/2019

The Evelina Resolution Project: the story of a UK children's hospital's programme to resolve conflicts with families

When a consultant paediatrician at the Evelina London Children's Hospital made a phone call to a mediator one Friday afternoon in 2012 asking for help to manage an escalating conflict between a family and the health professionals treating their daughter, neither knew that their meeting would lead to the development of the first conflict resolution and mediation training programme in a National Health Service children's hospital.  The Evelina Resolution Project has gained international recognition for training health professionals to recognise and manage conflicts between families and health professionals.  In this presentation, the doctor and the mediator describe how one case led to a programme of change which is now being trialled in 4 specialist UK children's hospitals with the aim of supporting families and health professionals to have conversations without conflict

Watercolor 12

One of 13 watercolor sketches by a member of the Barclay family depicting life in 1850s Jerusalem. This watercolor features a scene with three women

Watercolor 11

One of 13 watercolor sketches by a member of the Barclay family depicting life in 1850s Jerusalem. This watercolor features a building with a tall steeple near a body of water

The difference an End of Life diagnosis makes: a qualitative study of community care providers’ perspectives

Background Increasing numbers of people die of the frailty and multimorbidity associated with old age, often without receiving an End-of-Life diagnosis. Compared to those with a single life-limiting condition such as cancer, frail older people are less likely to access adequate community care. To address this inequality, guidance for professional providers of community healthcare encourages them to make End-of-Life diagnoses in more such people. These diagnoses centre on prognosis, making them difficult to establish given the inherent unpredictability of age-related decline. This difficulty makes it important to ask how care provision is affected by not having an End-of-Life diagnosis. Aim To explore the role of an End-of-Life diagnosis in shaping the provision of healthcare outside acute hospitals. Design and Setting Qualitative interviews with nineteen healthcare providers from community-based settings including nursing homes and nursing services. Method Semi-structured interviews (nine individual, three small group). Data were analysed thematically and using constant comparison. Results In our participants’ accounts, it was unusual and problematic to consider frail older people as candidates for End-of-Life diagnosis. Participants talked of this diagnosis as useful to them as care providers, helping them prioritise caring for people diagnosed as “End-of-Life” and enabling them to offer additional services. This prioritisation and additional help were identified as excluding people who die without an End-of-Life diagnosis. Conclusion End-of-Life diagnosis is a first-class ticket to community care; people who die without such a diagnosis are potentially disadvantaged as regards care provision. Recognising this inequity should help policy-makers and practitioners to mitigate it

Conflict escalation in paediatric services: Findings from a qualitative study

Objective: To explore clinician and family experiences of conflict in paediatric services, in order to map the trajectory of conflict escalation. Design: Qualitative interview study, employing extreme-case sampling. Interviews were analysed using an iterative thematic approach to identify common themes regarding the experience and escalation of conflict. Participants: Thirty-eight health professionals and eight parents. All participants had direct experience of conflict, including physical assault and court proceedings, at the interface of acute and palliative care. Setting: Two teaching hospitals, one district general hospital and two paediatric hospices in England, in 2011. Results: Conflicts escalate in a predictable manner. Clearly identifiable behaviours by both clinicians and parents are defined as mild, moderate and severe. Mild describes features like the insensitive use of language and a history of unresolved conflict. Moderate involves a deterioration of trust, and a breakdown of communication and relationships. Severe marks disintegration of working relationships, characterised by behavioural changes including aggression, and a shift in focus from the child's best interests to the conflict itself. Though conflicts may remain at one level, those which escalated tended to move sequentially from one level to the next. Conclusions: Understanding how conflicts escalate provides clinicians with a practical, evidence-based framework to identify the warning signs of conflict in paediatrics