Breaking down barriers with wordless picturebooks: “The Silent Books Exhibition, from the world to Lampedusa and back”

In 2012 the Italian branch of the International Board on Books for Young People (IBBY) established a library on Lampedusa Island, Italy for the use of local children but also for the many refugee children arriving there from Africa and the Middle East. The challenge was to find books to appeal to children of different ages and from diverse cultural and linguistic backgrounds – books that could provide some respite for children traumatised by displacement and conflict. Wordless picturebooks were identified as an ideal genre, given they can be enjoyed by children of all ages without the restriction of language barriers. The Lampedusa Library initiative led to the creation of a collection of wordless picturebooks, comprising more than a hundred titles, donated from over twenty countries. One set of this collection remains in Lampedusa while another has evolved into a travelling exhibition, the “Silent Books Project”. Since 2013 this exhibition has toured many countries with the aim of inviting readers from different cultural backgrounds both to engage with these picturebooks and reflect upon the reasons for the Silent Books Project’s existence in the first place. In this article I will first discuss the origins of the Silent Book project on Lampedusa Island and provide a brief overview of the IBBY organisation and its aims. Wordless picturebooks will then be situated within current academic research on picturebooks. Finally, a selection of titles chosen for the Silent Books project will be examined in more detail and some of the experiences involving the Silent Books Project’s visit to Ireland in spring 2017 will also be outlined. Highlighted in this article will be the silent power of pictures in such wordless narratives to aid child refugees in regaining some agency and to foster empathy in readers who have never been forced to leave their home

Alien Registration- Mcgillicuddy, Beatrice (Bangor, Penobscot County)

https://digitalmaine.com/alien_docs/11833/thumbnail.jp

Oral dosage form modifications for older adults: a mixed methods investigation

Introduction: Oral dosage forms (ODFs), particularly solid ODFs, are the most popular and most commonly prescribed of all medication formulations. Older adults are the highest consumers of prescription medication. However, age-related pharmacokinetic, pharmacodynamic and physiological changes can complicate the administration of oral medicines to older adults and may result in these ODFs being modified (e.g. tablets crushed or split, or capsules opened) in order to facilitate administration of the appropriate dose or to overcome swallowing difficulties. These modifications may impact on the safety and/or efficacy of the medication, which could have clinical consequences for patients. In addition, many of these modifications represent an off-licence use of the medication, which has subsequent legal implications for healthcare professionals. Despite guidelines advocating that the modification of ODFs should be avoided, it appears to be common practice. Therefore, there is a need to gain a greater understanding of ODF modifications for older adults. Aim: The overall aim of this research was to investigate ODF modifications for older adults in an Irish setting and to gain an understanding of the factors influencing this practice. Methods: A mixed methods approach, using both quantitative and qualitative research methods, was used. Initially, a quantitative systematic review was conducted to identify the available evidence on the prevalence of difficulty swallowing ODFs and the modification of ODFs to overcome swallowing difficulties amongst the older cohort. Secondly, a qualitative systematic review was undertaken to determine the knowledge, attitudes and beliefs of patients, healthcare professionals and carers about ODF modifications. The findings of these reviews served to guide the generation of research questions for the empirical, primary research studies. A retrospective audit of drug charts in one aged care facility (ACF) in Ireland was completed to provide preliminary data on ODF modifications in an Irish setting. Following this, a qualitative, semi-structured interview study was conducted with nurses working in acute and long-term care settings, to elucidate their knowledge, attitudes and beliefs about ODF modification and administration for older adults. Based on the findings of these studies, a direct observation of medication administration to older adults in five ACFs was conducted to provide more in-depth information on ODF modifications. Finally, the views and experiences of community-dwelling older adults and their carers around ODF modifications were explored using qualitative, semi-structured interviews. Results: The quantitative systematic review highlighted the paucity of studies investigating ODF modifications, with only three studies describing modifications in care settings, which when combined with the limitations of the data collection methods used, demonstrated the requirement for further research investigating this issue. The qualitative systematic review provided useful insights into the factors that influence the knowledge, attitudes and beliefs of healthcare professionals and patients about ODF modifications; highlighting that (i) the variability of individual patient’s requirements, (ii) poor communication practices and (iii) lack of knowledge about modifications, when combined with (iv) the complex healthcare environment, complicate decision-making regarding ODF modification. Results from the retrospective audit emphasised that modifications were commonly required to ensure patients’ needs could be met, particularly for fractional dosing. Whilst there was a lack of evidence-based information to support decision making around modifications, in many cases no suitable alternatives were available. This was echoed in the nurse interview study, with modifications seen to be a routine and necessary occurrence in older patient care. The nurses’ role as patient advocate however, helps to optimise formulation suitability within current limitations. The direct observation study once again demonstrated the ubiquity of ODF modifications, providing detailed insights into ODF modification practices in an Irish setting but also highlighting the challenges encountered when administering oral medicines to older adults. Finally, the challenges encountered in the community-setting were elucidated, and there is a clear need for greater engagement with the issue of ODF suitability for community-dwelling older adults. Conclusions: This thesis has made a significant contribution to understanding ODF modifications for older adults. It is clear that ODFs are not meeting the needs of the older cohort. Modifications are common and necessary, due to age-related changes combined with limitations of currently available formulations. This thesis has provided important information about current practices, but has also highlighted the complex factors that give rise to the need to modify ODFs for older adults. There is a need to prioritise engaging with this issue in order to optimise ODF suitability for older adults. This will necessitate input from a wide variety of key stakeholders, including healthcare professionals, industry and regulatory bodies, as well as patients and carers. The findings of this thesis provide direction and important insights that will guide this process

Alien Registration- Mcgillicuddy, Loretta (Bangor, Penobscot County)

https://digitalmaine.com/alien_docs/11834/thumbnail.jp

Do Trichodesmium spp. populations in the North Atlantic export most of the nitrogen they fix?

Author Posting. © American Geophysical Union, 2014. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Global Biogeochemical Cycles 28 (2014): 103-114, doi:10.1002/2013GB004652.A new observational synthesis of diazotrophic biomass and nitrogen fixation provides the opportunity for systematic quantitative evaluation of these aspects in biogeochemical models. One such model of the Atlantic Ocean is scrutinized, and the simulated biomass is found to be an order of magnitude too low. Initial attempts to increase biomass levels through decreasing grazing and other loss terms caused an unrealistic buildup of nitrate in the upper ocean. Two key changes to the model structure facilitated a closer match to the observed biomass and nitrogen fixation rates: addition of a pathway for export of diazotrophically fixed organic material and uptake of inorganic nitrogen by the diazotroph population. These changes, along with a few other revisions to existing model parameterizations, facilitate more accurate simulation of basin-scale distributions of diazotrophic biomass, as well as mesoscale variations contained therein. The resulting solutions suggest that the Trichodesmium spp. populations of the North Atlantic export the vast majority of the nitrogen they fix, a finding that awaits assessment through direct observation.Support of this research by the National Science Foundation and the National Aeronautics and Space Administration is gratefully acknowledged.2014-08-2

Formation of intrathermocline lenses by eddy–wind interaction

Author Posting. © American Meteorological Society, 2015. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Journal of Physical Oceanography 45 (2015): 606–612, doi:10.1175/JPO-D-14-0221.1.Mesoscale intrathermocline lenses are observed throughout the World Ocean and are commonly attributed to water mass anomalies advected from a distant origin. An alternative mechanism of local generation is offered herein, in which eddy–wind interaction can create lens-shaped disturbances in the thermocline. Numerical simulations illustrate how eddy–wind-driven upwelling in anticyclones can yield a convex lens reminiscent of a mode water eddy, whereas eddy–wind-driven downwelling in cyclones produces a concave lens that thins the mode water layer (a cyclonic “thinny”). Such transformations should be observable with long-term time series in the interiors of mesoscale eddies.Support of this research by the National Science Foundation and National Aeronautics and Space Administration is gratefully acknowledged.2015-08-0