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ABSTRACT Filter feeding was compared in the blue mussel Mytilus edulis, Mediterranean mussel Mytilus galloprovincialis, Pacific oyster Crassostrea gigas, Chinese pleated oyster Crassostreaplicatula, Chinese scallop Chlamysfarreri, Manila clam Tapes phillipinarum, [...]

ABSTRACT Previous shellfish models have, in general, been calibrated for 1 location, unable to simulate growth across habitats that contrast in seston abundance and composition, as may vary between turbid, [...]

Background: While breastfeeding may be among the most effective ways to ensure child health and survival, breastfeeding rates in Ireland are consistently low. This study aimed to explore women's experiences of infant feeding in Ireland. Methods: Thematic analysis of feeding-related free-text comments from the National Maternity Experience Survey 2020 was undertaken. The survey collected data on the experiences of women who were 16 years or older and gave birth in one of Ireland's 19 maternity hospitals or units or had a home birth. Results: 3,204 women participated in the survey (50% response rate). In the first few days after birth, 41.9% of women breastfed exclusively, 29.0% used formula and breast milk, and 29.1% bottle fed only. 824 comments related to feeding were received. A number of themes were identified, including support and encouragement from healthcare professionals, information and education regarding feeding, and pressure and respect for personal preferences. Women highlighted that while breastfeeding was encouraged in antenatal care, this was not always the case in the postnatal ward, where formula was readily available, with an apparent lack of resources for breastfeeding women. Some women described feeling pressured to use a feeding method that was not their first preference, with some feeling pushed to breastfeed when this may not have been their wish, while women who wished to breastfeed felt pressured to supplement with formula. Staffing shortages on postnatal wards, a lack of lactation consultants and contradictory advice from healthcare professionals exacerbated difficulties with both feeding methods. Conclusions: Some women experience a lack of practical support with infant feeding, regardless of feeding method, and clear and concise information on feeding practices is needed. The addition of lactation consultants, home supports and further education and training could benefit mothers on their breastfeeding journey. Key messages: Barriers to breastfeeding included a lack of support from healthcare professionals and conflicting information. It is important to support women regardless of their chosen feeding method. [ABSTRACT FROM AUTHOR]

Reference ranges for coagulation screens in preterm infants were formulated in the 1980s. Preterm infants are at risk of hypocoagulable states due to hepatic immaturity, hypoxia, respiratory distress syndrome and sepsis. Coagulation profiles of very low birthweight (VLBW) infants were assessed and adverse outcomes recorded. A total of 32 VLBW infants had coagulation studies in the first week of life. Fibrinogen was significantly decreased on the third day of life in infants with severe intraventricular hemorrhage (IVH) compared with those with no or mild IVH. Further research on VLBW coagulation profiles may become easier with the development of point-of-care technology. [ABSTRACT FROM AUTHOR]

The electrochemical CO 2 reduction reaction (CO 2 RR) is a promising approach to achieving sustainable electrical-to-chemical energy conversion and storage while decarbonizing the emission-heavy industry. The carbon-supported, nitrogen-coordinated, and atomically dispersed metal sites are effective catalysts for CO generation due to their high activity, selectivity, and earth abundance. Here, we discuss progress, challenges, and opportunities for designing and engineering atomic metal catalysts from single to dual metal sites. Engineering single metal sites using a nitrogen-doped carbon model was highlighted to exclusively study the effect of carbon particle sizes, metal contents, and M-N bond structures in the form of MN 4 moieties on catalytic activity and selectivity. The structure-property correlation was analyzed by combining experimental results with theoretical calculations to uncover the CO 2 to CO conversion mechanisms. Furthermore, dual-metal site catalysts, inheriting the merits of single-metal sites, have emerged as a new frontier due to their potentially enhanced catalytic properties. Designing optimal dual metal site catalysts could offer additional sites to alter the surface adsorption to CO 2 and various intermediates, thus breaking the scaling relationship limitation and activity-stability trade-off. The CO 2 RR electrolysis in flow reactors was discussed to provide insights into the electrolyzer design with improved CO 2 utilization, reaction kinetics, and mass transport., (© 2023 Wiley-VCH GmbH.)

Cu-based catalysts hold promise for electrifying CO 2 to produce methane, an extensively used fuel. However, the activity and selectivity remain insufficient due to the lack of catalyst design principles to steer complex CO 2 reduction pathways. Herein, we develop a concept to design carbon-supported Cu catalysts by regulating Cu active sites' atomic-scale structures and engineering the carbon support's mesoscale architecture. This aims to provide a favorable local reaction microenvironment for a selective CO 2 reduction pathway to methane. In situ X-ray absorption and Raman spectroscopy analyses reveal the dynamic reconstruction of nitrogen and hydroxyl-immobilized Cu 3 (N,OH-Cu 3 ) clusters derived from atomically dispersed Cu-N 3 sites under realistic CO 2 reduction conditions. The N,OH-Cu 3 sites possess moderate *CO adsorption affinity and a low barrier for *CO hydrogenation, enabling intrinsically selective CO 2 -to-CH 4 reduction compared to the C-C coupling with a high energy barrier. Importantly, a block copolymer-derived carbon fiber support with interconnected mesopores is constructed. The unique long-range mesochannels offer an H 2 O-deficient microenvironment and prolong the transport path for the CO intermediate, which could suppress the hydrogen evolution reaction and favor deep CO 2 reduction toward methane formation. Thus, the newly developed catalyst consisting of in situ constructed N,OH-Cu 3 active sites embedded into bicontinuous carbon mesochannels achieved an unprecedented Faradaic efficiency of 74.2% for the CO 2 reduction to methane at an industry-level current density of 300 mA cm -2 . This work explores effective concepts for steering desirable reaction pathways in complex interfacial catalytic systems via modulating active site structures at the atomic level and engineering pore architectures of supports on the mesoscale to create favorable microenvironments.

Introduction: This study explored patient experiences of shared decision making (SDM) in public acute hospitals in Ireland., Methods: Quantitative and qualitative data from three years of the Irish National Inpatient Experience Survey were analysed. Survey questions were mapped to definitions of SDM and subjected to principal components analysis. Three SDM subscales (care on the ward; treatments; discharge) and one overall SDM scale were created. Differences in experiences of SDM by aspects of care and patient group were assessed. Thematic analysis of qualitative responses was undertaken., Results: 39,453 patients participated in the survey. The mean SDM experience score was 7.60 ± 2.43. Experience scores were highest on the treatments sub-scale, and lowest during discharge. Patients who had a non-emergency admission, those aged 51-80 years and men had more positive experiences than other groups. Patient comments highlighted that opportunities to clarify information and facilitation of families/caregivers in SDM were found to be lacking., Conclusion: There were differences in experiences of SDM by aspects of care and patient group., Practice Implications: Efforts to improve SDM in acute hospitals are required, particularly at the time of discharge. SDM may be improved by facilitation of more time for discussion between clinicians and patients and/or their families/caregivers., Competing Interests: Declarations of Competing Interest None., (Copyright © 2023 Elsevier B.V. All rights reserved.)

The microbiota-gut-brain axis (MGBA) has been the subject of much research over the past decade, offering an exciting new paradigm for the treatment of psychiatric disorders. In this review, the MGBA is extended to include skeletal muscle and the potential role of an expanded "muscle-gut-brain axis" (MuGBA) in conditions such as anxiety and depression is discussed. There is evidence, from both preclinical and human studies, of bidirectional links between the gut microbiome and skeletal muscle function and structure. The therapeutic role of exercise in reducing depressive and anxiety symptoms is widely recognised, and the potential role of the gut microbiota-skeletal muscle link is discussed within this context. Potential pathways of communication involved in the MuGBA including the tryptophan-kynurenine pathway, intestinal permeability, immune modulation, and bacterial metabolites such as short-chain-fatty-acids are explored., (© 2023 Wiley-VCH GmbH.)

Unrestrained anthropogenic activities have severely disrupted the global natural nitrogen cycle, causing numerous energy and environmental issues. Electrocatalytic nitrogen transformation is a feasible and promising strategy for achieving a sustainable nitrogen economy. Synergistically combining multiple nitrogen reactions can realize efficient renewable energy storage and conversion, restore the global nitrogen balance, and remediate environmental crises. Here, we provide a unique aspect to discuss the intriguing nitrogen electrochemistry by linking three essential nitrogen-containing compounds (i.e., N 2 , NH 3 , and NO 3 - ) and integrating four essential electrochemical reactions, i.e., the nitrogen reduction reaction (N 2 RR), nitrogen oxidation reaction (N 2 OR), nitrate reduction reaction (NO 3 RR), and ammonia oxidation reaction (NH 3 OR). This minireview also summarizes the acquired knowledge of rational catalyst design and underlying reaction mechanisms for these interlinked nitrogen reactions. We further underscore the associated clean energy technologies and a sustainable nitrogen-based economy., (© 2022 Wiley-VCH GmbH.)

Background: Assessing and measuring the experience and quality of care provided is central to the improvement of care delivery of all healthcare systems. This paper reports on the development of a survey instrument to capture the experiences of care at end of life from the perspective of bereaved relatives in the Republic of Ireland., Methods: A multi-method, multi-stakeholder, sequential approach was adopted for this study. Items for inclusion in the survey instrument bank were identified through (1) a feasibility study and scoping literature review, (2) expert panel programme board review, (3) focus groups and (4) gap analysis. The following steps were undertaken to prioritise the items for inclusion in the final survey instrument: (1) a Delphi study (2) technical expert panel review (3) cognitive interviews with bereaved relatives and an (4) expert panel programme board review., Results: Following an iterative process with key stakeholders, a survey instrument was developed with sections focusing on the provision of care at home, in the last nursing home / residential care facility, hospice and hospital, as well as care experience in the last 2 days of life, the relative's experiences of care and support, the circumstances of care surrounding death and demographic information. In total, a bank of 123 questions were prioritised to be included in the National End of Life Survey instrument., Conclusion: The survey will provide a standardised national approach to capturing the experience of care of those who have died, from the perspective of bereaved relatives in the Republic of Ireland. This will allow health service providers, policy makers and regulators to gather important insights into the experiences of care at end of life and will help fulfil the requirement of healthcare services to ensure they are providing high-quality care., (© 2023. The Author(s).)

Nitrogen-coordinated single-cobalt-atom electrocatalysts, particularly ones derived from high-temperature pyrolysis of cobalt-based zeolitic imidazolate frameworks (ZIFs), have emerged as a new frontier in the design of oxygen reduction cathodes in polymer electrolyte fuel cells (PEFCs) due to their enhanced durability and smaller Fenton effects related to the degradation of membranes and ionomers compared with emphasized iron-based electrocatalysts. However, pyrolysis techniques lead to obscure active-site configurations, undesirably defined porosity and morphology, and fewer exposed active sites. Herein, a highly stable cross-linked nanofiber electrode is directly prepared by electrospinning using a liquid processability cobalt-based covalent organic polymer (Co-COP) obtained via pyrolysis-free strategy. The resultant fibers can be facilely organized into a free-standing large-area film with a uniform hierarchical porous texture and a full dispersion of atomic Co active sites on the catalyst surface. Focused ion beam-field emission scanning electron microscopy and computational fluid dynamics experiments confirm that the relative diffusion coefficient is enhanced by 3.5 times, which can provide an efficient route both for reactants to enter the active sites, and drain away the produced water efficiently. Resultingly, the peak power density of the integrated Co-COP nanofiber electrode is remarkably enhanced by 1.72 times along with significantly higher durability compared with conventional spraying methods. Notably, this nanofabrication technique also maintains excellent scalability and uniformity., (© 2022 Wiley-VCH GmbH.)

Objective: To explore women's experiences of initiating and continuing breast or formula feeding shortly after birth in Ireland's maternity hospitals and units, as well as at home after birth., Design: Mixed methods secondary analysis of qualitative and quantitative data from the Irish National Maternity Experience Survey 2020., Setting: All 19 maternity hospitals and units in the Republic of Ireland and the national home births service. Women were asked about their maternity care experiences, including antenatal care, care during labour and birth, feeding, and care at home after birth., Participants: A total of 3,205 women who gave birth in October or November 2019 participated in the study (50% response rate)., Measurements: Free-text comments related to women's experiences of initiating and continuing breast or formula feeding were analysed using thematic analysis. Quantitative data were described using means (SD) and frequencies and percentages., Findings: In the first few days after birth, 41.9% of women breastfed exclusively, 29.0% used formula and breast milk, and 29.1% bottle-fed only. Seven-hundred and twenty women (22.5%) made 824 comments related to feeding. Four themes were identified: (1) support and encouragement from healthcare professionals, (2) information and advice regarding feeding, (3) Pressure to feed in a particular way and (lack of) respect for personal preferences, and (4) hospital environment and resources., Key Conclusions: Some women experienced a lack of support with feeding their babies, regardless of feeding method. Clear and concise information on feeding practices and home supports could help to support mothers with breast or formula feeding., Implications for Practice: It is important that healthcare professionals provide evidence-based information and support, while respecting women's choices. Lactation consultants could offer training and consistent information to healthcare professionals as well as providing specialist support to mothers who experience problems with breastfeeding during their hospital stay and in the postnatal period., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Antipsychotics (APs) increase weight, metabolic syndrome, diabetes and cardiovascular disease. Guidelines recommend cardio-metabolic monitoring at initial assessment, at 3 months and then annually in people prescribed APs., Aim: To determine the rates of cardio-metabolic monitoring in AP treated early and chronic psychosis and to assess the impact of targeted improvement strategies., Methods: Medical records were reviewed in two cohorts of first-episode psychosis (FEP) patients before and after the implementation of a physical health parameter checklist and electronic laboratory order set. In a separate group of patients with chronic psychotic disorders, adherence to annual monitoring was assessed before and 3 months after an awareness-raising educational intervention., Results: In FEP, fasting glucose (39% vs 67%, p=0.05), HbA1c (0% vs 24%, p=0.005) and prolactin (18% vs 67%, p=0.001) monitoring improved. There were no significant differences in weight (67% vs 67%, p=1.0), BMI (3% vs 10%, p=0.54), waist circumference (3% vs 0%, p=1.0), fasting lipids (61% vs 76% p=0.22) or ECG monitoring (67% vs 67%, p=1.0). Blood pressure (BP) (88% vs 57%, p=0.04) and heart rate (91% vs 65%, p=0.03) monitoring dis-improved. Diet (0%) and exercise (<15%) assessment was poor. In chronic psychotic disorders, BP monitoring improved (20% vs 41.4%, p=0.05), whereas weight (17.0% vs 34.1%, p=0.12), BMI (9.7% vs 12.1%, p=1.0), fasting glucose (17% vs 24.3%, p=0.58) and fasting lipids remained unchanged (17% vs 24.3%, p=0.58)., Conclusions: Targeted improvement strategies resulted in a significant improvement in a limited number of parameters in early and chronic psychotic disorders. Overall, monitoring remained suboptimal., (© 2021. Royal Academy of Medicine in Ireland.)

The growing population of older people has increased demand to meet their complex healthcare needs, including in emergency departments (EDs). This study explored the experiences of people aged 65+ in Irish EDs, involving secondary analysis of quantitative and qualitative data from the 2019 National Inpatient Experience Survey (NIES). Experiences in the ED and overall hospital experiences were dichotomized as poor to fair or good to very good. Logistic regression was used to model quantitative data. Free text comments relating to EDs were thematically analyzed. Of 12,343 survey participants, 4,442 (39.9%) were aged 65+ years and used the ED. Longer waiting times, completion of the questionnaire by another person either with or on behalf of the patient, and having both a medical card and private health insurance were predictors of poor to fair ED experiences. Patients aged 85+ years were more likely to report good to very good ED experiences. Poor experiences in the ED were associated with poorer overall hospital experiences (odds ratio [OR]: 2.19, 95% confidence interval [CI]: 1.76 to 2.73, p  < .001). Thematic analysis revealed that long waiting times and unpleasant waiting conditions, including lack of communication, privacy, and personal care were important challenges encountered in the ED, with some older patients noting their preference for separate ED services. There is a need to reduce waiting times and integrate user perspectives in the planning, organization, and delivery of ED care to improve experiences and quality of care for a growing older population., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)