The use of natural Mn oxide-containing wastes as a contaminated land remediation strategy and their effects on soil microbial functioning

PhD ThesisThe viability of using natural manganese oxide (MnOx)-containing wastes as amendments for contaminated land remediation was examined. The success of MnOx as a viable strategy was determined via the impact that their addition had upon microbial soil functioning, in addition to their ability to immobilise and/or transform inorganic and organic contaminants within industrially polluted soils. Contaminated soils were obtained from two former industrial sites that are polluted with PAHs and metals. The intrinsic microbial functioning of these soils was assessed using a suite of microbial indicators reportedly sensitive to contamination [basal respiration (BR), potential nitrification (PNR), denitrification enzyme activity rates (DEA), microbial biomass carbon (MBC), metabolic quotient (qCO2), microbial quotient (qmic)]. The diversity and community structure of key populations related to microbial indicators were assessed using culture-independent community analysis [polymerase chain reaction (PCR)-denaturing gradient gel electrophoresis (DGGE)] to target 16S rRNA and functional genes (amoA, nirS/K). These measurements were combined with a suite of physico-chemical analyses [pH, total organic carbon (TOC), soil organic matter (SOM), moisture content (MC), water holding capacity (WHC), extractable metal and PAH concentrations] to provide a combined geochemical and molecular microbial approach. Contaminated soils were compared to a range of soils from land types defined as non-contaminated to provide a robust evaluation and define suitable microbial indicators for use in assessing soil microbial function in contaminated land and its remediation. Results showed that long term metal and PAH pollution had resulted in a microbial populations exhibiting extremely suppressed rates of BR and DEA, indicative of pollutants being bioavailable within the soil. Functional gene profiling revealed that inherent denitrifying and ammonia-oxidising community structures were significantly affected by contamination. Microbial functional processes of BR, DEA and PNR were determined to be superior indicators through their ease of use with standardised rapid and high throughput methods that could infer contaminant availability. A preliminary assessment of MnOx addition upon microbial soil functioning was investigated though 6 month microcosm trials employing BR, DEA and PNR as indictors. Microcosms employed two natural MnOx-containing wastes (mine tailings and coated sands) in a range of 0-30 % total MnOx, which were added to a low level metal contaminated soil. MnOx was found to stimulate PNR and DEA. Results implied that MnOx is not detrimental to soil microbial functioning and is capable of removing inhibitors of N-cycling, via a chemical rather than biological mechanism, ascribed to the immobilisation of bioavailable toxic metal ions by the MnOx. The potential of MnOx amendment as a viable remediation strategy was investigated through the use of 9 month outdoor lysimeter trials. Measurement of extractable PAHs, along with extractable and bioaccessible Pb and As in metal, PAH and mixed contaminated soils showed no positive effects of using a 10 % by weight MnOx-coated sand amendment for remediation. Analysis of soil microbial functional indicators (BR, DEA, PNR) showed that MnOx amendment had no detrimental effects upon the function of microbial populations in the aforementioned soils. Mn(II)-oxidising bacteria were isolated from contaminated soils and MnOx-containing wastes. This suggested that sustained and biologically enhanced redistribution of MnOx was possible in MnOx-amended soils, which may play an important role in pollutant transformation. This study provided the first demonstration of species within the genera Amycolatopsis, Sacchorothrix, Lentzea and Micromonospora as being capable of Mn(II) oxidation.Engineering and Physical Science Research Counci

Teaching Soft Skills in Healthcare and Higher Education: A Scoping Review Protocol

Background: Soft skills and the need for their development have been discussed across industries for many years, predominantly in engineering, hospitality, and IT sectors. The importance of soft skills to career success has been well-documented, but gaps exist on how to teach them. Inter-industry variability and a lack of consensus in identifying and defining important soft skills adds to the problem. New research in teaching soft skills needs to be formally incorporated into training curricula, especially within healthcare and education sectors. This scoping review will answer these research questions: How are soft skills conceptualised, taught and assessed in healthcare and higher education?   Methods/Design: A search of health, education, and social science databases will be conducted including peer-reviewed and grey literature. Data will be extracted using a combination of the PRISMA ScR and PAGER framework. Analysis will be carried out utilising the PAGER framework and will yield descriptive summaries. Discussion: The review will collate literature on teaching and assessing soft skills in healthcare and higher education. It will map evidence in relation to current practices and research, gaps, evidence for practice, and research recommendations. The findings will be discussed in the full Scoping Review along with implications for teaching. &nbsp

Challenges in the management of juvenile idiopathic arthritis with etanercept

Biologic agents have been designed with the help of immunological studies to target particular areas of the immune system which are thought to play a role in the pathogenesis of disease. Etanercept is a soluble anti-tumor necrosis factor alpha (TNF-α) agent licensed for the treatment of active poly-articular juvenile idiopathic arthritis (JIA) in children aged 4 to 17 years who have failed to respond to methotrexate alone, or who have been intolerant of methotrexate. The safety and efficacy of etanercept in this patient group has been established by one randomized controlled trial and several longitudinal studies. This, together with the fact that until recently etanercept was the only anti-TNF licensed in JIA, has made it the most common first choice biologic for many clinicians. However, there are still many unanswered questions about etanercept, including its efficacy and safety in different subtypes of JIA, in children under 4 years of age and in those with uveitis. There are still concerns about the long term safety of TNF antagonists in the pediatric age group and unanswered questions about increased risks of malignancy and infection. Although adult studies are useful to improve understanding of these risks, they are not a substitute for good quality pediatric research and follow-up studies. Adult trials often include greater numbers of patients. However, they evaluate a different population and drug behavior may vary in children due to differences in metabolism, growth and impact on a developing immune system. In addition, rheumatoid arthritis is a different disease than JIA. Clinicians need to carefully weigh up the risk benefit ratio of anti-TNF use in children with JIA and push for robust clinical trials to address the questions that remain unanswered. This article summarizes the evidence available for use of etanercept in children with JIA and highlights aspects of treatment in need of further research

Teaching Soft Skills in Healthcare and Higher Education: A Scoping Review Protocol

Background: Soft skills and the need for their development have been discussed across industries for many years, predominantly in engineering, hospitality, and IT sectors. The importance of soft skills to career success has been well-documented, but gaps exist on how to teach them. Inter-industry variability and a lack of consensus in identifying and defining important soft skills adds to the problem. New research in teaching soft skills needs to be formally incorporated into training curricula, especially within healthcare and education sectors. This scoping review will answer these research questions: How are soft skills conceptualised, taught and assessed in healthcare and higher education?   Methods/Design: A search of health, education, and social science databases will be conducted including peer-reviewed and grey literature. Data will be extracted using a combination of the PRISMA ScR and PAGER framework. Analysis will be carried out utilising the PAGER framework and will yield descriptive summaries. Discussion: The review will collate literature on teaching and assessing soft skills in healthcare and higher education. It will map evidence in relation to current practices and research, gaps, evidence for practice, and research recommendations. The findings will be discussed in the full Scoping Review along with implications for teaching. &nbsp

Engagement of Parents in Child-focused Iinterventions

Background: Parent engagement in interventions for their children is considered necessary to the success of many allied health services. Currently, however, the concept of engagement is poorly defined and minimally understood. While literature on engagement is emerging, a coordinated overview of the topic from related disciplines is notably absent. Without this, it is difficult to translate insights of parent engagement into practical strategies for clinicians. The aim of this review is to systematically search the literature to identify factors relevant to parent engagement in child-focused interventions. Methods/Design: This review will follow a systematised literature review procedure, with a focus on comprehensive searching as well as application of quality appraisal and analysis steps. A search of five electronic databases will be undertaken, alongside citation tracking and hand searching of literature. Articles will be screened for relevance in a two-stage process (exclusion by title/abstract and exclusion at full text review), aligned with inclusion and exclusion criteria consistent with the review question. Included literature will be assessed for quality using a tool relevant to the study methods (quantitative or qualitative). Data analysis will include narrative synthesis for quantitative studies, and thematic synthesis for qualitative studies. Discussion: This review will explore literature on parent engagement across related child-focused interventions, to better define the concept of engagement and identify factors which contribute to parents being engaged in the treatment of their children. This information may guide further research on engagement of parents, and support practitioners working to develop interventions that maximally engage parents for optimal child outcomes

Teaching and Assessing Soft Skills for Health and Education Professionals: A Scoping Review

Soft skills are a collection of abilities instrumental to one being a successful professional. Soft skills are knowing why, what, when, and where to perform specific technical, hard skills. Traditionally, universities and other professional training providers have focused on teaching hard skills, relying on graduates to learn necessary soft skills on the job or through personal experiences. With more professional training requiring tertiary education and less work experience, a skills gap has developed between labour markets and professional training providers. A scoping review was conducted to answer two research questions: How are soft skills conceptualised and taught to health and education professionals? How are soft skills assessed for health and education professionals? The PAGER framework was utilised to present and synthesise the scoping review results. Eight themes emerged from the patterning analysis and data synthesis: Lack of definitions of soft skills; What soft skills are taught; Methods of teaching soft skills; Curriculum: Embedded vs. stand-alone courses; Use of digital tools; Assessment of soft skills; Variation of assessment tools; Limited regard for cultural competency, diversity, equality, and inclusion. These themes are discussed in relation to advances, gaps, evidence for practice, and research recommendations

Enacting care amid power relations : The role of ‘veiled care’ in organisational life

Traditional understandings of care-giving assume care practices are clear to others and unambiguously altruistic, reflective of the selfless and humane bearing of care professionals. However, a range of organisational research has noted the complex and often contradictory ways in which enactments of care are interwoven into organisational relations of power and control. Through a narrative analysis of interview data, our paper focuses upon practices of inaction and concealment as ‘veiled’ care set within the power-laden complexities and contested meaning-making of organisational life. Our notion of veiled care extends debates about care as a social practice in everyday work relations in two ways. Firstly, it provides a greater focus on the less discernible aspects of care-giving which are significant but possibly overlooked in shaping subjectivities and meanings of care in work relations. Secondly, it develops the discussion of the situated ambiguities and tensions in enacting care that involves overcoming care-recipient resistance and an arguably less heroic but nonetheless important objective of non-maleficence, to avoid, minimise or repair damage

Formal Verification of Synchronisation, Gossip and Environmental Effects for Wireless Sensor Networks

The Internet of Things (IoT) promises a revolution in the monitoring and control of a wide range of applications, from urban water supply networks and precision agriculture food production, to vehicle connectivity and healthcare monitoring. For applications in such critical areas, control software and protocols for IoT systems must be verified to be both robust and reliable. Two of the largest obstacles to robustness and reliability in IoT systems are effects on the hardware caused by environmental conditions, and the choice of parameters used by the protocol. In this paper we use probabilistic model checking to verify that a synchronisation and dissemination protocol for Wireless Sensor Networks (WSNs) is correct with respect to its requirements, and is not adversely affected by the environment. We show how the protocol can be converted into a logical model and then analysed using the probabilistic model-checker, PRISM. Using this approach we prove under which circumstances the protocol is guaranteed to synchronise all nodes and disseminate new information to all nodes. We also examine the bounds on synchronisation as the environment changes the performance of the hardware clock, and investigate the scalability constraints of this approach

Resilience in the Health Professions: A review of recent literature

All health professions face numerous stressors within their clinical practice, including time pressures, workload, multiple roles and emotional issues. Frequent workplace stress can impact on the physical and mental wellbeing of health professionals and result in burnout and, in some cases, traumatic stress-like symptoms. These outcomes can impact not only on the wellbeing of health professionals but also on their ability to practise effectively. It is therefore imperative that a preventive approach is adopted. Developing resilience-promoting environments within the health professions can be explored as a means to reduce negative, and increase positive, outcomes of stress in health professionals.This literature review seeks to elucidate the processes and characteristics (both individual and contextual) that enhance resilience in the health professions. It explores relevant literature from five health professions (nursing, social work, psychology, counselling and medicine) to identify the individual and contextual resilience-enhancing qualities of each profession.Commonalities and differences between the disciplines are identified in order to arrive at a definitive explanation of resilience across health professions. Implications for clinical practice and recommendations for further research are also discussed.

Blockade of tumor necrosis factor in collagen-induced arthritis reveals a novel immunoregulatory pathway for Th1 and Th17 cells

IL-17 is implicated in the pathogenesis of rheumatoid arthritis (RA) and has previously been shown to be induced by tumor necrosis factor (TNF) in vitro. The aim of this study was to assess the impact of TNF inhibition on IL-17 production in collagen-induced arthritis, a model of RA. TNF blockade using TNFR-Fc fusion protein or anti-TNF monoclonal antibody reduced arthritis severity but, unexpectedly, expanded populations of Th1 and Th17 cells, which were shown by adoptive transfer to be pathogenic. Th1 and Th17 cell populations were also expanded in collagen-immunized TNFR p55−/− but not p75−/− mice. The expression of IL-12/IL-23 p40 was up-regulated in lymph nodes (LN) from p55−/− mice, and the expansion of Th1/Th17 cells was abrogated by blockade of p40. Treatment of macrophages with rTNF also inhibited p40 production in vitro. These findings indicate that at least one of the ways in which TNF regulates Th1/Th17 responses in arthritis is by down-regulating the expression of p40. Finally, although TNF blockade increased numbers of Th1 and Th17 cells in LN, it inhibited their accumulation in the joint, thereby providing an explanation for the paradox that anti-TNF therapy ameliorates arthritis despite increasing numbers of pathogenic T cells