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To quantitatively understand the ecological resilience of an ecosystem with specialized habitats, we focused on deep-sea microbial communities and simulated the response of diverse microbes in specialized habitats to a pulse ecosystem disturbance - the Deepwater Horizon Oil Spill in the Gulf of Mexico. Two microbial communities with equivalent metabolic libraries were acclimated to the presence (“seep-adapted community”) or absence (“naïve community”) of natural seeps, then their metabolic and ecological responses following the disturbance were compared on both individual and community scales. Higher variability in functional metabolisms in the naïve community without selection pressure created less predictable response to the disturbance. Although spatially and temporally varying degradation rates resulted from the individual complexity of simulated degraders and their interactions with overall community, seep-adapted communities were more efficient in utilizing substrate when spatially averaged. Seep-adapted communities also had more heterogeneous diversity patterns across space and time and presented lower resistance and higher resilience in returning to baseline conditions following the disturbance. The model suggests that communities exposed to transient pulse disturbance or exchanging species with specialized habitats under selection for the disturbance may have greater sustainability in response to disturbance.

As I write this, Gaza is under attack. In violence sparked by a decision from the Supreme Court of Israel to evict six Palestinian families from the Sheikh Jarrah neighbourhood of occupied East Jer...

The increased reliance of universities on a pool of highly skilled but poorly paid casualised academic labour for teaching and research has emerged as a defining feature of higher education provision under neoliberal New Public Management. Based on seventeen visual timeline interviews with academics in the North East of England, this article augments and extends existing studies of precarity through a framing of dehumanisation and humanisation. Specifically, we suggest that casualisation is dehumanising in four ways: it renders individuals invisible; it leaves them vulnerable to exploitation; it denies them academic freedom; and it hampers them in constructing a life narrative projecting into the future. We conclude that casualisation is not simply the product of a reprehensible political economy, but that it is an afront to the very meaning and dignity of being human.

Background/objectiveColorectal cancer (CRC) screening is proven to reduce CRC-related mortality. Faecal immunochemical testing (FIT)-positive clients in the Irish National CRC Screening Programme underwent colonoscopy. Round 1 uptake was 40.2%. We sought to identify barriers to participation by assessing knowledge of CRC screening and examining attitudes towards FIT test and colonoscopy.MethodsQuestionnaires based on a modified Champion’s Health Belief Model were mailed to 3500 invitees: 1000 FIT-positive, 1000 FIT-negative and 1500 non-participants. 44% responded: 550 (46%) FIT-positive, 577 (48%) FIT-negative and 69 (6%) non-responders (NR).Results25% of respondents (n=286) did not perceive a personal risk of cancer, did not perceive CRC to be a serious disease and did not perceive benefits to screening. These opinions were more likely to be expressed by men (p=0.035). One-fifth (n=251) found screening stressful. Fear of cancer diagnosis and test results were associated with stress. FIT-positive clients, women and those with social medical insurance were more likely to experience stress.ConclusionsThe CRC screening process causes stress to one-fifth of participants. Greater use of media and involvement of healthcare professionals in disseminating information on the benefits of screening may lead to higher uptake in round 2.

The “field” has long been contested as spatially and temporally bounded. Feminist epistemologies have re-imagined and engaged field/work as shared, messy and co-constitutive, while critical more-than-human methodologies in the transdisciplinary field of the environmental humanities are further expanding our understanding of who and what counts in the production of knowledge in the field. This compendium article orbits around a collective concern for the sharedness of bodily and planetary ecologies through field/work. It brings together cross-disciplinary accounts of field encounters that critically explore what it feels like to do this work and what it entails. With a focus on practice and process, the six contributing authors—researchers, artists, practitioners, writers—consider how nonhumans share in our research, shaping the work we do, the questions we ask and the responses we craft. Together, they offer thoughtful provocations on the troubling and promising ways in which human and non-human bodies become unsettled and rearranged through field encounters.

This article explores the relationship between movement and cultural politics through a long-distance walking trail – the Jordan Trail. The Jordan Trail is a 650-km trail running the length of Jordan from its northern border with the occupied Golan Heights to the Red Sea. While cultural geography has increasingly engaged with walking, the actual line that is walked along has been neglected. Lines can be violent and destructive. This is exemplified by the drawing of the borders of the Jordanian state, under the British Mandate period following the breakdown of the Ottoman Empire. Lines can impose power on a place, therefore, when defined by a state. In Jordan, these state-drawn lines have created divisions where none have previously existed and have severed movement, particularly Bedouin movement. The Jordan Trail, however, has the possibility to rethink and recapture movement, particularly movement erased by the state. This is where I suggest cultural geographical approaches to lines are important in paying attention to the more experiential and ongoing nature of place. The lines of the Jordan Trail can be created by the movement of a body over the ground, they can be invisible to the human eye and instead told through stories, or they can be the recording of Global Positioning Services (GPS) coordinates. This article is based on 12 months of ethnographic research walking on the Jordan Trail and volunteering for the Jordan Trail Association and as such argues for more embedded explorations of movement and cultural politics in Jordan. I argue that a relationship between movement and cultural politics at the embodied and everyday scale can be explored by attending to the line of a walking trail. The Jordan Trail can highlight the violence of state creation and particularly the imposition of state drawn lines in Jordan and the movements they have cut off and the Trail can also capture embodied accounts of movement and place in which Bedouin and everyday accounts matter.

The suitability of routine diagnostic HIV assays to accurately discriminate between recent and non-recent HIV infections has not been fully investigated. The aim of this study was to compare an established HIV recency assay, the Sedia limiting antigen HIV avidity assay (LAg), with the diagnostic assays; Abbott ARCHITECT HIV Ag/Ab Combo and INNO-LIA HIV line assays. Samples from all new HIV diagnoses in Ireland from January to December 2016 (n = 455) were tested. An extended logistic regression model, the Spiegelhalter–Knill–Jones method, was utilised to establish a scoring system to predict recency of HIV infection. As proof of concept, 50 well-characterised samples were obtained from the CEPHIA repository whose stage of infection was blinded to the authors, which were tested and analysed. The proportion of samples that were determined as recent was 18.1% for LAg, 6.4% with the ARCHITECT, and 14.5% in the INNO-LIA assay. There was a significant correlation between the ARCHITECT S/CO values and the LAg results, r = 0.717, p

The past 10-15 years has seen the growth of walking groups taking walkers from Amman to rural parts of Jordan at weekends and the development of the Jordan Trail. Through the narration and analysis of everyday accounts of walking, this paper explores political geographies of identity, movement, and territory in Jordan. Drawing on 12 months of ethnographic fieldwork, I suggest that at the heart of a growth of walking for leisure in Jordan are important political questions. How is walking conditioned by situated cultural politics? How can walking unearth intimate and embodied accounts of territory in Jordan? I build upon three developments in political geography to do this. First, research on political geography and walking; second research on everyday political geographies of the Middle East; third, critical and feminist work on territory. Literature on political geography and walking is developed by centring Jordanian walkers and the (post)colonial context of Jordan to explore what walking means under different political conditions and for individual bodies. In doing so I contribute to work on identity and nationalism in Jordan and the importance of the everyday to explore political geographies of the Middle East. I develop critical and feminist work on territory by arguing that walking bodies make and contest territory and in doing so calling for greater synergies between cultural and political geography. These arguments are made in two empirical sections. The first explores how different people talk about walking, the language for walking, and assumptions about walking bodies. The second explores how walking connects different bodies to territory, and creates territorial nationalist narratives, but also how walking can highlight indigenous and embodied relations with territory. This paper concludes that walking is political because it shapes and is shaped by situated political geographies and because it enables embodied and intimate accounts of territory to emerge.

ObjectivesTo determine the incidence of venous thromboembolism (VTE) and the incidence of hospital-acquired VTE (HA-VTE) arising within the population served by the Ireland East Hospital Group (IEHG).Design/home/user/Documents/Sathish Kumar G/RFO/June/21-06-2019/bmjopen_iss_9_7_20190621_1/ A retrospective observational study was conducted using hospital discharge data obtained from the hospital inpatient enquiry data reporting system. In this system, VTE events recorded as ‘primary diagnosis’ represented the reason for initial hospital admission, whereas VTE recorded as a ‘secondary diagnosis’ occurred following admission and were therefore used as an approximation of HA-VTE. These data were used to estimate the overall incidence of VTE and the proportion of these events which were hospital-acquired.SettingThe IEHG is the largest hospital group in the Irish healthcare system and serves a population of over 1 million individuals.ParticipantsData were generated from records pertaining to the 2727 patient admission episodes where a diagnosis of VTE was made during the 22-month study period.ResultsDuring the study period, 2727 VTE events were recorded within the IEHG (which serves a population of 1 036 279) corresponding to an incidence of 1.44 (95% CI 1.36 to 1.51) per 1000 per annum. 1273 (47%) of VTE events were recorded as secondary VTE. The incidence of VTE was highest among individuals over 85 years of age (16.03 per 1000;95% CI 12.81 to 19.26) and was more common following emergency hospital admission.ConclusionThese data suggest that HA-VTE accounts for at least 47% of all VTE events arising within a hospital group serving a population of over 1 million individuals within the Ireland. Given that HA-VTE is a well-recognised source of (potentially preventable) hospital deaths, these findings provide a compelling argument for prioritising strategies directed at reducing the risk of VTE among hospital patients served by the IEHG and within the Ireland as a whole.

Background: The growth of the fetus is a complex process, influenced by genetic and environmental factors. Longitudinal patterns of fetal growth are required to fully understand this process, however to date, a paucity of data exists in this area.Objective: To identify fetal growth trajectories in-utero and to assess their association with maternal and child characteristics up to 5 years postnatal.Methods: Data from 781 mother-child pairs from the ROLO longitudinal birth cohort study were analyzed. The ROLO study was a randomized control trial of a low glycemic index diet in pregnancy to prevent recurrence of macrosomia. Fetal ultrasound measurements were recorded at 20 and 34 weeks gestation, and birth weight was recorded. Abdominal circumference (AC), weight (fetal weight, or birth weight), a standardized proxy for length (femur length or birth length, individually standardized), and AC:length ratio were examined for trajectory classes using latent class trajectory mixture models. Two-, three-, four-, and five-class models were evaluated for fit, using a linear (first order) trajectory over three time-points. ANOVA and chi-square tests were applied to test associations between trajectory membership and maternal and child characteristics up to age 5.Results: For AC, two fetal growth trajectories were identified, with 29% of participants on a "slow" trajectory and 71% on a "fast" trajectory. Those on a fast trajectory had higher rates of maternal impaired glucose tolerance (28.7 versus 16.5%, p

Background Inflammatory spinal disease is one of three inflammatory musculoskeletal manifestations which frequently occur in PsA. There is very limited data about the axial involvement in PsA, especially as regards treatment, with treatment guidelines based largely on data from AS trials. The efficacy of corticosteroids in PsA patients with inflammatory back pain has not been studied to date. Objectives In this controlled trial, we aimed to investigate the comparative performance of corticosteroids for active axial-PsA (AxPsA) versus those with active AS. Methods PsA patients (fulfilling CASPAR criteria), and AS as per the 1984 Modified New York Criteria, were suitable for inclusion. Among them, patients with active AxPsA and active AS ((naive to biologic therapies) were recruited. The active disease was defined as patients with inflammatory back pain, with spinal pain score of ≥4 and BASDAI score ≥4 despite taking NSAIDS. Furthermore, only those AxPsA and AS patients with an MRI proven sacroiliac joint bone marrow oedema (MRI of sacroiliac joints performed within the 6 months prior to recruitment) were considered for inclusion. Hence, all recruited patients with AxPsA and AS had not only clinically active disease, but also had bone marrow oedema on MRI of sacroiliac joints. Moreover, we recruited a control group of non-inflammatory lower back pain. All patients received a single, intra-muscular dose of depot corticosteroid injection (Triamcinolone Acetonide 80 mg) at baseline. The intra-muscular corticosteroid option was used to overcome any drug compliance issues. Clinical outcome assessments were made at following time points: baseline, week-2, and week-4. The primary efficacy end point was the mean change in Ankylosing Spondylitis Disease Activity Score (ASDAS) at week-2. Key secondary outcome were the mean change of BASDAI, BASFI and ASQoL at week-2 and week-4. Results In total, 40 patients were recruited – AxPsA=15, AS=15, control=10. At week-2 following corticosteroid treatment, patients with AxPsA had significantly higher improvements in the mean ASDAS compared to patients with AS (1.43±0.39 vs. 1.03±0.30, p=0.004), and the same was the case when compared to controls (p Conclusions Axial inflammation in PsA potentially responds significantly better to corticosteroids than in patients with AS. This furthers the argument and adds to the growing evidence that AxPsA and AS are distinct entities. Future studies should further investigate the use of corticosteroids and of sDMARD usage among patients with active IBP in PsA. Disclosure of Interest M. Haroon Grant/research support from: Abbie, Pfizer, Speakers bureau: Abbie, Pfizer, UCB, M. Ahmad: None declared, N. Baig: None declared, O. Mason: None declared, J. Rice: None declared, O. FitzGerald: None declared

Background CRP and ESR are the most commonly and probably the most studied inflammatory markers among patients with inflammatory arthritis. In contrast to rheumatoid arthritis, however, these markers are raised in less than 50% of people with psoriatic arthritis (PsA). Little is known about the long term significance of elevated inflammatory markers during the course of PsA disease. Objectives In a well characterised PsA cohort with a long term follow up, we examined the association of CRP and ESR over the disease course with demographics, clinical and radiographic features, patient reported outcome measures and the number of comorbid conditions. Methods A cohort of 283 PsA patients all meeting CASPAR criteria and attending rheumatology clinics were evaluated. All underwent detailed skin and rheumatologic assessments, along with cardiovascular risk factor evaluation. Moreover, we documented the presence/absence of comorbidities using the Charlson Comorbidity Index (CCI). All of these patients had CRP and ESR laboratory values assessed along with the other routine laboratory parameters during the disease course. For each patient, we documented CRP and ESR values at 3 different time points: firstly, at the time of the initial diagnosis; secondly, the highest value of CRP and ESR recorded during the disease course; and thirdly at the time of full assessment for this study. Cumulative inflammation over time was represented by the cumulative averages of CRP (ca-CRP) and ESR (ca-ESR) which were calculated from the AUC (Area Under the Curve) of the 3 documented measurements divided by the total number of months of follow-up. Variables significantly associated at a Bonferroni-corrected p-value were included in the multiple linear regression modelling CRP and ESR. Results A total of 283 PsA patients [mean age 54.6±12 years; 52% female; mean PsA duration of 19±9 years; 25% with sacroiliitis; 44.5% with peripheral joint erosions; 60% of patients requiring TNFi for PsA] attended for detailed assessments. The median (IQR) and mean (SD) Ca-CRP was 8.8 (4.6–14.8) and 11.72 (10.52), respectively. The median (IQR) and mean (SD) Ca-ESR was 13.8 (7.8–20.1) and 15.78 (10.46). The variables were also checked for multicollinearity. On multiple linear regression, erosions, sacroileitis, and the CCI were most significantly associated with Ca-CRP (unstandardised coefficient B=6.4, 2.9, 1.05, respectively, p Conclusions PsA is a heterogeneous disease with Disclosure of Interest M. Haroon Grant/research support from: Abbvie, Pfizer, Speakers bureau: Abbvie, Pfizer, UCB, M. Ahmad: None declared, O. Mason: None declared, O. FitzGerald Grant/research support from: Pfizer, Abbvie, MSD, Roche, UCB, Janssen and Cellgene

Parents reported experiences of support for diabetes management in schools are variable. Recent data from European countries are sparse and experiences in the Irish primary school setting have not been described previously. To describe parents’ experiences of support for diabetes management in primary schools in Ireland. Questionnaires were distributed through nine regional and tertiary paediatric diabetes services to parents of children aged 4–13 years with type 1 diabetes attending primary school. Data sought included patient demographics, treatment regimens, diabetes education of school staff, assistances received, and interactions between the school and family. Responses were received from 418 parents of primary school children with type 1 diabetes. Twenty-six percent of children were not on intensive insulin therapy. Children on a multiple daily injection regime who were unable to self-administer insulin had administration facilitated by attendance of a parent in 95% of cases. Seventy-eight percent of parents were phoned by the school regarding diabetes management, particularly those of younger children (p

Background The efficacy of corticosteroids in patients with psoriatic arthritis (PsA) and inflammatory back pain has not been studied to date. In this controlled trial, we aimed to investigate the comparative performance of corticosteroids in patients with active axial-PsA (AxPsA) versus those with active ankylosing spondylitis (AS). Methods Patients with AxPsA and AS (naïve to biologic therapies), who not only had clinically active disease, but also had bone marrow oedema on magnetic resonance imaging of the sacroiliac joints, were recruited. Clinically active disease was defined as inflammatory back pain (fulfilling Assessment of Spondyloarthritis International Society (ASAS) expert criteria), with spinal pain score (numerical rating scale 0–10) ≥4 and Bath AS Disease Activity Index (BASDAI) score ≥4 despite taking nonsteroidal anti-inflammatory drugs. Moreover, we recruited a control group of patients with non-inflammatory lower back pain. All patients received a single, intra-muscular dose of depot corticosteroid injection (triamcinolone acetonide 80 mg) at baseline. The intra-muscular corticosteroid option was used to overcome any drug compliance issues. Clinical outcome assessments were made at the following time points: baseline, week 2, and week 4. The primary efficacy end point was mean change in Ankylosing Spondylitis Disease Activity Score (ASDAS) at week 2. Key secondary outcomes were mean change in the BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI) and Ankylosing Spondylitis Quality of Life (ASQoL) at weeks 2 and 4. Results In total, 40 patients were recruited (15 with AxPsA, 15 with AS, and 10 controls). At week 2 following corticosteroid treatment, patients with AxPsA had significantly greater improvement in the mean ASDAS compared to patients with AS (1.43 ± 0.39 vs. 1.03 ± 0.30, p = 0.004), and also when compared to controls (p

Introduction Venous thromboembolism (VTE) remains a major contributor to global disease burden and is a leading cause of cardiovascular death worldwide. Hospital-acquired VTE (HA-VTE; VTE diagnosed during hospital admission or within 90 days of discharge) accounts for a significant proportion of all VTE events. Data from countries where the use of specific VTE risk assessment tools and appropriate thromboprophylaxis is mandatory (and incentivized) have demonstrated that the implementation of these strategies significantly reduces mortality as a result of HA-VTE. Despite the evidence that these measures save lives, an ad hoc approach to the use of VTE risk assessment/thromboprophylaxis is frequently adopted. Moreover, in many healthcare systems very few data describing incidence of HA-VTE have been reported and consequently the magnitude of this potentially preventable source of hospital deaths is likely to be underestimated. We aimed to determine the incidence of VTE and of HA-VTE within the population served by the Ireland East Hospital Group (IEHG; the largest hospital group within the Irish healthcare network) as a first step towards promoting the implementation of a mandatory VTE risk assessment policy on a national level. Methods A retrospective observational study was conducted where data pertaining to the diagnosis of VTE during the period January 2016 to October 2017 were collected. The IEHG is comprised of 11 hospitals serving a population of over 1 million individuals from urban and rural areas, affluent areas as well as economically disadvantaged areas and includes large tertiary academic centers as well as smaller community hospitals and the national maternity hospital. Data were obtained from NQAIS Clinical (National Quality Assurance Intelligence system - Clinical), an online reporting tool which is populated by anonymised data extracted from the hospital in-patient enquiry system (HIPE; a reporting tool which compiles diagnostic data on all patients by ICD-10 code at the time of discharge from hospital). In NQAIS clinical, VTE events are categorised as primary if they represented the reason for hospital admission or secondary if they were diagnosed during the period of hospitalisation. The term secondary VTE can therefore be understood to represent a surrogate-marker for HA-VTE; however, this methodology would be predicted to underestimate the total number of HA-VTE events as VTE diagnosed following discharge but within 90 days would be incorrectly categorised as primary events. Currently, no measures exist within our current data recording systems which can accurately capture post-discharge HA-VTE. Results During the 22-month study period, 2727 VTE events were reported. Using population data derived from the 2016 census, we then estimated the annual incidence of VTE within the IEHG catchment area (population 1,036,279) at 1.44 per 1000 person years (95% CI 1.36-1.51). VTE incidence by gender was similar for all age groups however a progressive increase in VTE incidence was observed (predictably) with increasing age, with the highest incidence reported among individuals aged over 85 years (16.03 per 1000 person years; 95% CI 12.81-19.26). The majority of VTE events were diagnosed in the two large academic teaching hospitals of the IEHG (1620 VTE events; 59.4%). The vast majority of cases were reported in the context of an emergency hospital admission (89.2%). Of the total number of VTE events diagnosed during the study period, 1273 (47%) were reported as secondary events (i.e. diagnosed during the period of hospital admission) and, as such, this figure represents an approximation but most likely a significant underestimation of the total proportion of hospital-acquired events. Within this category of HA-VTE/secondary VTE diagnoses, the most frequently reported primary diagnoses leading to the initial hospital admission were cancers (16.4%) followed by respiratory disease (14.6%) and cardiovascular disorders (13.5%). Conclusion Within a population of over 1 million individuals, where formal VTE risk reduction strategies have yet to be implemented universally, at least 47% of all VTE are hospital-acquired. Given the compelling evidence which has shown that HA-VTE is a leading source of (preventable) hospital mortality, these findings provide a clear rationale for implementing formal VTE risk reduction strategies at hospital-group and national level. Disclosures Kevane: Leo Pharma: Research Funding. Ni Ainle:Leo Pharma: Research Funding; Actelion: Research Funding; Bayer: Research Funding; Bayer: Membership on an entity's Board of Directors or advisory committees; BMS: Membership on an entity's Board of Directors or advisory committees; Daiichi Sankyo: Membership on an entity's Board of Directors or advisory committees; Boehringer: Membership on an entity's Board of Directors or advisory committees.

Objectives In the UK, men9s alcohol-related morbidity and mortality still greatly exceeds women9s, despite an increase in women9s alcohol consumption in recent decades. New UK alcohol guidelines introduce gender-neutral low-risk alcohol consumption guidance. This study explores how UK newspaper and online news represent women9s and men9s ‘binge’ drinking to identify opportunities to better align reporting of harmful drinking with evidence. Design Quantitative and qualitative content analysis of 308 articles published in 7 UK national newspapers and the BBC News website between 1 January 2012 and 31 December 2013. Results Articles associated women with ‘binge’ drinking more frequently than men, and presented women9s drinking as more problematic. Men were more frequently characterised as violent or disorderly, while women were characterised as out of control, putting themselves in danger, harming their physical appearance and burdening men. Descriptions of female ‘binge’ drinkers9 clothing and appearance were typically moralistic. Conclusions The UK news media9s disproportionate focus on women9s ‘binge’ drinking is at odds with epidemiological evidence, may reproduce harmful gender stereotypes and may obstruct public understandings of the gender-neutral weekly consumption limits in newly proposed alcohol guidelines. In order to better align reporting of harmful drinking with current evidence, public health advocates may engage with the media with a view to shifting media framing of ‘binge’ drinking away from specific groups (young people; women) and contexts (public drinking) and towards the health risks of specific drinking behaviours, which affect all groups regardless of context.

Pure cultures, including Desulfovibrio vulgaris and Methanococcus maripaludus, were combined with model oil samples and oil/diesel mixtures to optimize extraction techniques of signature lipids from oil in support of investigation of microbial communities in oil deposit samples targets for microbial enhanced hydrocarbon recovery. Several techniques were evaluated, including standard phospholipid extraction, ether linked lipid for Archaeal bacterial detection, and high pressure extractiontechniques. Recovery of lipids ranged from 50-80percent as compared to extraction of the pure culture. Extraction efficiency was evaluated by the use of internal standards. Field samples will also be tested for recovery of signature lipids with optimized extraction techniques.