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Objective: To review the available data on endocrine disorders and recurrent pregnancy loss. Findings: Our group found that most endocrine disorders do not seem to be correlated with a diagnosis of recurrent pregnancy loss (RPL). The exception to this is testing for thyroid stimulating hormone and thyroid antibodies, which is recommended due to a strong correlation with recurrent pregnancy loss and positive anti-thyroid peroxidase antibodies. Conclusion: The available literature supports testing thyroid function and antibodies in women with RPL. Testing for other endocrine disorders is only warranted if otherwise clinically indicated, independent from a history of recurrent pregnancy loss.

Despite increasing early rehabilitation and mobilisation (ERM) in paediatric intensive care, current evidence for ERM of neonatal and paediatric patients receiving extracorporeal membrane oxygenation (ECMO) is limited. The proposed benefits of ERM in neonatal and paediatric ECMO patients are multifaceted, including reduced immobility related issues and maintenance of functional ability. However, ECMO presents additional safety and logistical challenges, and currently there are no published neonatal or paediatric guidelines. A consensus document was developed to provide guidance for ERM with neonatal and paediatric ECMO patients. The document was developed by specialist physiotherapists from nine ECMO centres within the UK and Ireland, together with the UK Paediatric Critical Care Society ECMO group and members of the multidisciplinary team. The document covers key considerations and practicalities for completing ERM in this population including, acuity level measurement, activity level guidance, safety and risk assessment, and goal setting. Risk assessment and safety checklist bedside tools are also included and designed to be adapted as required to meet specific unit policies and protocols.

Introduction: Mechanical Insufflation Exsufflation (M-IE) and Lung Volume Recruitment (LVR) increase cough strength in Amyotrophic Lateral Sclerosis (ALS). Changes in respiratory measures, morbidity, physical function and outcomes; participant’s characteristics prescribed a M-IE and LVR device and their experience with devices are unknown. Finally, LVR adherence is difficult to measure. Aims/Objectives: The primary aim was to measure, respiratory measures, morbidity, physical function and outcome in an Irish ALS cohort. Secondary aims were to examine the characteristics of participants prescribed a device; to evaluate their experiences and to develop an electronic LVR adherence prototype. Methods: A prospective longitudinal observational cohort study evaluated 108 participants over one year. Respiratory measures, physical function and outcomes were measured. Characteristics were assessed at device prescription. A questionnaire evaluated experience. An electronic LVR adherence prototype was developed. Results: Participants (n=108), of mean age 62.05±11.47, were recruited. Sniff Nasal Inspiratory Pressure (SNIP), Slow Vital Capacity (SVC) percent predicted, Peak Cough Flow (PCF) and Amyotrophic Lateral Sclerosis Functional Rating Scale Revised (ALSFRS-R) declined significantly (p2O, 17.49%, 124.84L/min and 9.62 units per year respectively. One third reported a chest infection and 21 died. Participants prescribed a device had significantly lower average SNIP, SVC percent predicted, PCF and ALSFRS-R (p Conclusion: This is the first study to quantify the rate of decline of SNIP, SVC and PCF in an Irish ALS cohort and PCF in a large ALS cohort. Device prescription is detailed. This study provides a point of reference for clinicians and future trials. The electronic LVR adherence prototype has potential to be developed for clinical trials.

With the recent development of constructed wetland technology, it has become a mainstream treatment technology for the mitigation of a variety of wastewaters. This study reports on the treatment performance and pH attenuation capacity of three different configurations of small-scale on-site surface flow constructed wetlands (SFCW): T1 (Peat + Typha latifolia), T2 (T. latifolia alone), and T3 (Peat alone) treating secondary effluent from the Amherstview Water Pollution Control Plant (WPCP) for two treatment periods (start-up period and operational period). The aim of this study was to compare the nutrients removal efficiencies between the different treatments, as well as to evaluate the effects of substrate and vegetation on the wetland system. For a hydraulic retention time of 2.5 days, the results showed that all treatment systems could attenuate the pH level during both the start-up and operational periods, while significant nutrient removal performance could only be observed during the operational period. Peat was noted to be a better SFCW substrate in promoting the removal of nitrate (NO3-N), total nitrogen (TN), and phosphorus. The addition of T. latifolia further enhanced NO3-N and TN removal efficiencies, but employing T. latifolia alone did not yield effluents that could meet the regulatory discharge limit (1.0 mg/L) for phosphorus.

Beginning with the fall class of that year, a notice was put on the bulletin board announcing that a plan for class distinction of students was going to be put into effect and the ruling was to be as follows: All students who had been in the school two years and who had passed all examinations in the theory and practice of nursing, in that year, were to be given a 14-inch blue band for their caps and were to be known as Senior students. All students who had been in the school one full year and who had passed all examinations in the theory and practice of nursing were to be given long bibs and were to be known as Intermediate students. (When students enter the school, the bibs button on the shoulders.) All Preliminary students who had completed four months in the school and who had passed all examinations in the theory and practice of nursing were to be given caps and were to be known as Juniors. The effect of promotion showed a decided improvement in studies. It was therefore decided to adopt a merit system the following year in order to give students who were studious, . industrious and faithful, proper recognition, and so the following method was adopted: To create an honor roll and to give a Hartford Hospital Training School pennant and insignia in school colors to those students who won them. Points to be won for H. H. T. S. pennant 140 Points to be won for H. H. T. S. insignia 125