Now showing items 21-40 of 5677

    • The battle of the giants: EU law, ECHR and the Energy Charter Treaty; the rematch to protect property rights in Europe

      Potocnik, Metka; Alvarez, Gloria (University of Aberdeen, 2019-05-09)
      This article explores the various levels of compensation for expropriated investments in the European legal framework. This article is timely, because it adds to the discussion on the changing position of UK investors after Brexit and whether their international protection is equal to their protection under EU law. In order to critically evaluate the proposition that energy investors are granted equivalent protection of their investments under the EU legal framework, as compared to the legal framework of investment treaties (BITs, FTAs, IIAs), this article evaluates the existing rules on compensation under the Energy Charter Treaty, the EU law and the European Convention on Human Rights.
    • A brief report of the epidemiology of obesity in the inflammatory bowel disease population of Tayside, Scotland

      Steed, Helen; Walsh, Shaun; Reynolds, Nigel (Karger Publishers, 2009-12-17)
      Aim: Obesity in inflammatory bowel disease (IBD), particularly Crohn’s disease (CD), has previously been considered unusual (3%). CD patients who are obese tend to have increased perianal complications and a higher level of disease activity on an annual basis. Obesity in Scotland has been documented to have increased over the last decade, and over half all men and women in Scotland are now considered to be overweight. This study aims to assess obesity prevalence in the IBD community in Tayside, Scotland. Methods: All IBD patients (n = 1,269) were considered for inclusion. Inclusion criteria required a weight measurement taken from the preceding 12 months and a height measurement within the last decade. 489 patients were included in the analysis. Results: 18% of the Tayside IBD population were obese in comparison to approximately 23% of the Scottish population on a whole. A further 38% of patients were over-weight, the same percentage as the general population. In the overweight and obese ulcerative colitis patients there were higher levels of surgery, but the converse was true in the CD group, where the normal-weight group had the highest levels of surgery. There were significantly more obese men and women with CD than with ulcerative colitis (P = 0.05). Conclusion: Obesity prevalence has increased in IBD patients. This is significant because of the known increased levels of postoperative complications, perianal disease and requirement for more aggressive medical therapy. Research needs to be done to look at the effects of obesity on the co-morbid associations of other diseases with IBD, in particular colorectal cancer, and to ascertain whether or not screening frequency should be altered depending on BMI.
    • Accuracy of ECG chest electrode placements by paramedics; an observational study

      Gregory, Pete; Kilner, Tim; Lodge, Stephen; Paget, Suzy (The College of Paramedics, 2020-12-31)
      Background The use of the 12-lead ECG is common in sophisticated prehospital Emergency Medical Services but its value depends upon accurate placement of the ECG-electrodes. Several studies have shown widespread variation in the placement of chest electrodes by other health professionals but no studies have addressed the accuracy of paramedics. The main objective of this study was to ascertain the accuracy of the chest lead placements by registered paramedics. Methods Registered paramedics who attended the Emergency Services Show in Birmingham in September 2018 were invited to participate in this observational study. Participants were asked to place the chest electrodes on a male model in accordance with their current practice. Correct positioning was determined against the Society for Cardiological Science & Technology’s Clinical Guidelines for recording a standard 12-lead electrocardiogram (2017) with a tolerance of 19mm being deemed acceptable based upon previous studies. Results 52 eligible participants completed the study. Measurement of electrode placement in the vertical and horizontal planes showed a high level of inaccuracy with 3/52 (5.8%) participants able to accurately place all chest electrodes. In leads V1 - V3, the majority of incorrect placements were related to vertical displacement with most participants able to identify the correct horizontal position. In V4, the tendency was to place the electrode too low and to the left of the pre-determined position whilst V5 tended to be below the expected positioning but in the correct horizontal alignment. There was a less defined pattern of error in V6 although vertical displacement was more likely than horizontal displacement. Conclusions Our study identified a high level of variation in the placement of chest ECG electrodes which could alter the morphology of the ECG. Correct placement of V1 improved placement of other electrodes. Improved initial and refresher training should focus on identification of landmarks and correct placement of V1.
    • The origins of chemical warfare in the French Army

      Krause, Jonathan (SAGE Publications, 2013-11-01)
      Following the Germans’ first use of chlorine gas during the second battle of Ypres, the Entente had to develop means of protection from future poison gas attacks as well as systems for retaliation. This article, through the analysis of heretofore unexamined archival sources, considers early French attempts at engaging in chemical warfare. Contrary to the existing historiography, the French army aggressively adapted to, and engaged in, chemical warfare. Indeed, the French army would be the first to fire asphyxiating gas shells from field guns and, by June 1915, would pioneer the use of gas as a neutralization weapon to be used in counter-battery fire, as opposed to unleashing gas via canisters to engage enemy infantry. Such innovation invites a rethinking not only of French gas efforts but also of the role and evolution of the French army as a whole on the Western Front, a topic which the Anglophone world is in great need of examining further.
    • Postdigital artistic positionality and its potentials for cultural education

      Hayes, Sarah; Jandrić, Petar (Springer, 2020-12-31)
      In 2002, in Culture in Bits, Gary Hall described challenges to the ‘identity’ of cultural studies, pointing to the debate between political economy and cultural studies. Rapid technological change has distracted us since, but these challenges remain. Furthermore, recent developments surrounding the Covid-19 pandemic have also revealed complex interconnections across viral biology and information science, with the global lockdown giving rise to related postdigital artistic activities. In Algorithmic Culture Ted Striphas discussed a delegation of the work of culture to computational processes, which significantly alters the practice, experience, and understanding of culture. This article examines to what extent postdigital art practices offer a form of resistance to political economic ‘illusions’ of democratic forms of public culture found across the Internet, and at which price. If humans and technology are acknowledged as part of a collaborative artistic process, can this address issues pertaining to power, exploitation, and emancipation, in our postdigital age? We conclude that when artists engage with their personal postdigital positionality, this brings such possibilities a little closer in these uncertain times.
    • A qualitative investigation of the therapeutic relationship in the facilitation of empowerment in psychological therapy for adults with learning disabilities

      Chadwick, Darren; Wesson, Caroline; Alonso, Phoebe (University of Wolverhampton, 2019-11)
      Background Many authors in the field of adult learning disabilities have described the challenges experienced by clinicians in obtaining evidence regarding the effectiveness of psychological therapies for this particular client group (e.g. it can be a costly, lengthy, time-consuming process) (Taylor, Lindsay, Hastings & Hatton, 2013). Gaps also exist in the area of social justice and empowerment in relation to this population, which has historically experienced significant inequalities. This research intended to contribute to the current information available for researchers and psychological practitioners and to focus upon particular practical issues highlighted as important to the service-users, therapists and support workers within a single UK NHS service. The aims of this research project were: 1. To investigate what factors clients with learning disabilities find most helpful and empowering in the psychological therapy received from psychological therapists. 2. To ascertain how the therapeutic relationship affects psychological well-being within a learning disabled population, as facilitated by their therapists and support workers. 3. To explore the importance of support workers’ involvement in providing support with psychotherapeutic work for PWLD. 4. To consider how empowerment is experienced and conceptualised by the main stakeholders in the therapeutic encounter, between PWLD, their therapist and their support worker. Method Five triads were interviewed, each consisting of a person with learning disabilities, a psychological therapist and a support worker. Qualitative methodology was used to analyse the data obtained, via Interpretative Phenomenological Analysis (IPA). Findings The resulting research findings highlighted the importance of four super-ordinate themes: i) Values, Stigma & Social Equity; ii) Building Relationships, Collaboration & Trust; iii) Coping & Adaptations and iv) Positive Outcomes. Implications for various key groups including counselling psychologists, were considered and findings were contextualised with prior research findings. Conclusions The researcher’s original contribution to knowledge relates to the inclusion and exploration of the experiences and perspectives of three related stakeholder groups, including previously under-represented participants with learning disabilities, in order to voice what was important to them in terms of the therapeutic relationship and the facilitation of empowerment through psychological therapy.
    • AmpliTaq Gold improves short tandem repeat amplifications of highly degraded DNA

      Hummel, Susanne; Burger, Joachim; Rameckers, Jens; Lassen, Cadja; Schmerer, Wera; Herrmann, Bermd (PE Biosystems, 1996-01-01)
    • Investigating future pharmacists' understanding of vaccines and myths surrounding vaccination

      Zahid, Sidrah; Morrissey, Hana; Ball, Patrick (Innovare Academic Sciences, 2020-09-18)
      Objective: The United Kingdom has lost its measles, mumps and rubella free status due to a decline in vaccination uptake. There are several beliefs such as safety concern and media influence that discourage people from having vaccinations. To identify gaps in knowledge of vaccination within 3rd year pharmacy students, and to observe whether they can spot myths about vaccines, in particular the measles, mumps and rubella vaccine. Methods: A questionnaire-based approach was used after gaining ethical approval which included a range of open and closed questions. Results: None of the participants could identify the six common myths reported by the World Health Organisation and 40% failed to accurately identify the type of vaccine of the measles, mumps and rubella vaccine. There were clear gaps in knowledge on vaccines in participants particularly from black, Asian and minority ethnic group participants compared to white students. Educating participants about the myths could have positive future implications on their scientific knowledge when they work as pharmacists. Conclusion: Many students did not accurately identify the myths surrounding vaccines and were provided informative leaflets to enhance their scientific knowledge. The gaps in knowledge identified, demonstrates that further teaching sessions should be implemented to cover the grey areas, allowing them to appropriately recommend vaccinations in the future.
    • COVID-19 in haematology patients: A multi-centre West Midlands clinical outcomes analysis on behalf of West Midlands Research Consortium

      Morrissey, Hana; Ball, Patrick; Mandal, Anandadeep; Nevill, Alan; Paneesha, Shankara; Basu, Supratik; Karim, Farheen; Imran, Mohammed; Phillips, Neil; Khawaja, Jahanzeb; et al. (Wiley-Blackwell, 2021-12-31)
    • Survey of nurses’ knowledge and practice regarding medication administration using enteral tubes

      Tillott, Harry; Barrett, Diane; Ruan, Jingjing; Li, Vincent; Merrick, Sue; Steed, Helen; Morrissey, Hana; Ball, Patrick (Wiley, 2020-09-20)
      Aim and objectives The aim was to identify the practice variation of the individual practitioners in medications’ formulation modification for patients using enteral feeding tubing; to support health practitioners involved in this process. Background Blockage of enteral tubes is a common problem that can sometimes be resolved but may require replacement of the tube. Medications are a common culprit. Design A survey of 73 registered nurses’ practices around medication administration via enteral feeding tubes. Methods A questionnaire study was undertaken within a district general hospital across a broad variety of wards to explore nurses’ experiences of medication administration via enteral tubes. The study is reported in accordance with the SQUIRE 2.0 guidelines from the EQUATOR network. Results Seventy‐three nurses responded. Twenty‐six percent reported never checking about drug modification for administration via a tube, 12% check every time and 61% when unsure about a new drug. The volume of fluid flushes administered after medication ranged from 7.5‐150mls. Seventy‐one percent of participants reported stopping feed when medications are required, varying from 1‐60 minutes. Sixty percent had experienced a blocked tube and 52% the tube being removed for these reasons. The clinical nurse specialist was the commonest first point of call to help. Staff named 15 medications as the most problematic to administer, lactulose and omeprazole were the top two. Conclusions Practice varies significantly amongst nurses around medication administration. Theoretically this may contribute to blocked tubes and excessive fluid administration to some patients. Barriers to medication administration were thematically grouped into: time, difficulty modifying medication, medication interactions and knowledge. Areas identified to support staff include training, devices to crush medications, medication suitability, multidisciplinary approach to streamline care and quick reference guides. Relevance to clinical practice Health professionals may use these results to reduce and ultimately avoid problems with administering medications through feeding tubes. Organisations may use these results to develop their local practice pathways for prescribing, dispensing and training around administration of medications through enteral tubes. In a community setting, this paper may improve the awareness of patients, caregivers and prescribers of the possible implications of tubing blockages.
    • Patient, carer and health service outcomes of nurse-led early discharge after breast cancer surgery: A randomised controlled trial

      Wells, M; Harrow, A; Donnan, P; Davey, P; Devereux, S; Little, G; McKenna, E; Wood, R; Chen, R; Thompson, A; et al. (Springer Science and Business Media LLC, 2004-08-16)
      Patients with breast cancer who require axillary clearance traditionally remain in hospital until their wound drains are removed. Early discharge has been shown to improve clinical outcomes, but there has been little assessment of the psychosocial and financial impact of early discharge on patients, carers and the health service. This study aimed to evaluate the effectiveness of a nurse-led model of early discharge from hospital. Main outcome measures were quality of life and carer burden. Secondary outcomes included patient satisfaction, arm morbidity, impact on community nurses, health service costs, surgical cancellations and in-patient nursing dependency. A total of 108 patients undergoing axillary clearance with mastectomy or wide local excision for breast cancer were randomised to nurse-led early discharge or conventional stay. Nurse-led early discharge had no adverse effects on quality of life or patient satisfaction, had little effect on carer burden, improved communication between primary and secondary care, reduced cancellations and was safely implemented in a mixed rural/urban setting. In total, 40% of eligible patients agreed to take part. Nonparticipants were significantly older, more likely to live alone and had lower emotional well being before surgery. This study provides further evidence of the benefits of early discharge from hospital following axillary clearance for breast cancer. However, if given the choice, most patients prefer to stay in hospital until their wound drains are removed. © 2004 Cancer Research UK.
    • Association between environmental tobacco smoke exposure and dementia syndromes

      Chen, Ruoling; Wilson, Kenneth; Chen, Yang; Zhang, Dongmei; Qin, Xia; He, M; Hu, Zhi; Ma, Ying; Copeland, John R; School of Health Administration, Anhui Medical University, Hefei, China. ruoling.chen@kcl.ac.uk (BMJ, 2013-01-01)
      Objectives: Environmental tobacco smoke (ETS) has a range of adverse health effects, but its association with dementia remains unclear and with dementia syndromes unknown. We examined the dose-response relationship between ETS exposure and dementia syndromes. Methods: Using a standard method of GMS, we interviewed 5921 people aged ≥60 years in five provinces in China in 2007-2009 and characterised their ETS exposure. Five levels of dementia syndrome were diagnosed using the Automated Geriatric Examination for Computer Assisted Taxonomy instrument. The relative risk (RR) of moderate (levels 1-2) and severe (levels 3-5) dementia syndromes among participants exposed to ETS was calculated in multivariate adjusted regression models. Results: 626 participants (10.6%) had severe dementia syndromes and 869 (14.7%) moderate syndromes. Participants exposed to ETS had a significantly increased risk of severe syndromes (adjusted RR 1.29, 95% CI 1.05 to 1.59). This was dose-dependently related to exposure level and duration. The cumulative exposure dose data showed an adjusted RR of 0.99 (95% CI 0.76 to 1.28) for >0-24 level years of exposure, 1.15 (95% CI 0.93 to 1.42) for 25-49 level years, 1.18 (95% CI 0.87 to 1.59) for 59-74 level years, 1.39 (95% CI 1.03 to 1.84) for 75-99 level years and 1.95 (95% CI 1.34 to 2.83) for ≥100 level years. Significant associations with severe syndromes were found in never smokers and in former/current smokers. There were no positive associations between ETS and moderate dementia syndromes. Conclusions: ETS should be considered an important risk factor for severe dementia syndromes. Avoidance of ETS may reduce the rates of severe dementia syndromes worldwide.
    • From the playing fields of Rugby and Eton: the transnational origins of American rugby and the making of American football

      Burns, Adam (Human Kinetics Publishers Inc., 2021-03-31)
      Some studies date the origins of US intercollegiate football – and, by extension, the modern game of American football – back to a soccer-style game played between Princeton and Rutgers universities in 1869. This article joins with others to argue that such a narrative is misleading, and goes further to clarify the significance of two “international” fixtures in 1873 and 1874, which had a formative and lasting impact on football in the United States. These games, contested between alumni from England’s Eton College and students at Yale University, and between students at Canada’s McGill University and Harvard University, combined to revolutionize the American football code. Between 1875 and 1880, previous soccer-style versions of US intercollegiate football were replaced with an imported, if somewhat modified, version of rugby football. It was the “American rugby” that arose as a result of these transnational exchanges that is the true ancestor of the gridiron game of today.
    • Performance evaluation of analytical methods for parameters extraction of photovoltaic generators

      Anani, Nader; Ibrahim, Haider (MDPI AG, 2020-09-15)
      This paper presents a succinct exploration of several analytical methods for extracting the parameters of the single-diode model (SDM) of a photovoltaic (PV) module under standard test conditions (STC). The paper investigates six methods and presents the detailed mathematical analysis leading to the development of each method. To evaluate the performance of these methods, MATLAB-based software has been devised and deployed to generate the results of each method when used to extract the SDM parameters of various PV test modules of different PV technologies. Similar software has also been developed to extract the same parameters using well-established numerical and iterative techniques. A comparison is subsequently made between the synthesized results and those obtained using numerical and iterative methods. The comparison indicates that although analytical methods may involve a significant amount of approximations, their accuracy can be comparable to that of their numerical and iterative counterparts, with the added advantage of a significant reduction in computational complexity, and without the initialization and convergence difficulties, which are normally associated with numerical methods.
    • Data for development: shifting research methodologies for Covid-19

      Traxler, John; Smith, Matthew (Commonwealth of Learning, 2021-03-31)
      Successful and appropriate informal digital learning can help individuals and communities build sustainable and meaningful livelihoods, strengthen social cohesion and resilience, preserve and enhance cultural traditions and engage constructively and robustly with the wider world. Building digital learning that embodies participative and collaborative development and community ownership and control rests on the work of educators who understand these individuals and communities and their cultures, which may be very distant and different from global norms and the mainstream of their countries. These educators may however be reliant on research tools and techniques that are inappropriate or inadequate in these different settings and situations. This paper sets out a brief critique of these established tools and techniques as the prelude to reviewing a range of more innovative and eclectic ones drawn from a variety of disciplines. This is timely because COVID-19 has increased the barriers that separate educators from would-be learners whilst also increasing the education that these people and communities need.
    • The hidden burden of community enteral feeding on the emergency department

      Barrett, D; Li, V; Merrick, S; Murugananthan, A; Steed, Helen (Wiley, 2021-03-31)
      Abstract Background Enteral feeding tubes are associated with their most serious complications in the days and weeks after insertion, but there is limited published data in the literature on late complications and the implications for the healthcare service. Methods Retrospective observational study of attendances to a UK hospital emergency department with enteral tube complications as the primary reason for attendance. Results Over 24 months 139 attendances were recorded. Dislodged tubes and blocked tubes accounted for the majority of complications and subsequent admissions, with a mixture of enteral tube types being associated with both. Thirty-five percent were admitted and the average healthcare cost per attendance was $1071. Conclusions Enteral tube complications can place a hidden burden on the patient, on ED and on healthcare costs. More work on education and supporting carers to resolve problems themselves could reduce the burden on busy emergency departments.
    • Linguistic expression and perception of personality in online dating texts and their effect on attraction

      Fullwood, Chris; Kirwan, Gráinne; Connolly, Irene; Morris, Neil; Fox Hamilton, Nicola (University of Wolverhampton, 2020-02)
      Online daters report difficulties, frustration and anxiety in conveying their desired impression of themselves and from their lack of ability in perceiving another dater’s personality accurately. There is a lack of research on how expression of personality traits in profiles impacts on perception and on assessments of attractiveness. This thesis aims to fill this gap by exploring the expression and perception of personality traits in online dating profile texts, and to examine whether textually expressed personality affects attractiveness. The first two studies employed a linguistic and content analysis approach to determine how personality was expressed in dating profiles across different dating platforms and a comparison creative story text. There was considerable variation in expression indicating that language may not be a reliable indicator of personality. A lens model approach, using Funder’s Realistic Accuracy Model, was taken in the third study where accuracy of personality perception was examined in two contexts to determine whether dating profiles provided more salient trait-related cues to personality. The linguistic and content cues utilised by judges in making personality assessments were investigated. While some accuracy of perception was possible for emotional stability in online dating profiles, it was context dependent and unreliable, and few cues were utilised accurately. The effects of actual and perceived personality, and similarity of personality, on attractiveness were investigated and had not been examined previously in this context. This research shows that actual traits and similarity only affect attraction when it is perceivable, whereas perceived traits and similarity can affect attraction without accurate perception. This thesis illustrates the complexity of accuracy of interpersonal perception in text, and how context drives a considerable amount of the variation in achievement of accuracy. Additionally, the results offer some practical implications for online daters.
    • Development of a model for health and safety management in Saudi Arabian oil and gas construction projects

      Oduoza, Chike; Alamri, Reem (University of Wolverhampton, 2019-09)
      Health and safety is regarded as the foundation of the construction and production process in the oil and gas sector. However, in the Saudi Arabian oil and gas construction industry, this very foundation is threatened by the proliferation of work-related hazards that leave workers permanently or temporarily incapacitated. In comparison with other industrial sectors, workers on oil and gas construction sites are at greater risk of facing a variety of health and safety related risks, and that is the reason why it is essential to prevent the increasing level of accidents on these sites. Although, efforts were made to minimize exposure to such risks in the Saudi oil and gas sector, there is still a need for radical changes in the way the sector approaches health and safety issues. In this regard, this study examines the effectiveness of existing health and safety measures followed in Saudi Arabia, while looking at critical areas that require immediate attention as well as new measures that can be implemented to improve in those areas. To achieve this, both quantitative and qualitative research methods were used. For the quantitative research, questionnaires were designed and distributed to 300 respondents who work in construction companies in Saudi Arabia. For the purposes of obtaining answers from relevant respondents, construction companies who have experience from working on oil and gas construction projects were targeted. A total of 200 questionnaires were completed and returned. The quantitative data was analysed by descriptive and inferential statistics using Statistical Package for the Social Sciences (SPSS) software. For the qualitative data, semi-structured interviews were conducted with nine professionals purposely selected due to their knowledge, years of experience and familiarity with health and safety policies and standards on oil and gas construction sites. The analysis of the qualitative data was achieved using qualitative data analysis software QSR Nvivo. During qualitative data analysis, thematic analysis was adopted to build themes from the data which formed the basis for the presentation of the results from this research. Findings from the research suggest that all participants are of the view that oil and gas construction projects have more health and safety issues compared to average construction projects. It was found that the nature of the oil and gas industry coupled with the risky nature of construction activities presented higher risk which led to increased health and safety issues when constructing in the sector. The results also indicated that there was a low level of involvement from the construction site teams and workers in the development of health and safety policies for oil and gas construction projects. It was also identified that there was very poor adherence to health and safety standards and regulations on oil and gas construction sites due to little or no understanding of requirements andprocedures, as well as the advantages of adhering to such. Poor enforcement of government legislation was also identified to be another major cause for the poor health and safety performance of oil and gas construction projects. Based on the aforementioned results and the findings obtained from literature, a framework was developed to ensure that health and safety was properly institutionalised throughout the processes undertaken by construction firms during project management. The framework recommends both corporate level and project level policies that could facilitate the adoption and implementation of health and safety guidelines on construction projects in the oil and gas sector. An implementation guide was equally presented alongside the framework in view that it would ensure that users covered all the necessary areas in terms of health and safety and that all parties were involved in the process. The research concludes that construction projects in the oil and gas sector are riskier and demand approaches and strategies specific to the type of projects undertaken. The study finally recommends that further research should be undertaken to propose alternative models and national level legislative framework for enhanced health and safety guarantee especially in the Saudi oil and gas construction industry.
    • Defining the molecular, genetic and transcriptomic mechanisms underlying the variation in glycation gap between individuals

      Dunmore, Simon; Naseem, Fakhra (University of Wolverhampton, 2019-10)
      The discrepancy between HbA1c and fructosamine estimations in the assessment of glycaemia has frequently been observed and is referred to as the glycation gap (G-gap). This could be explained by the higher activity of the fructosamine-3-kinase (FN3K) deglycating enzyme in the negative G-gap group (patients with lower than predicted HbA1c for their mean glycaemia) as compared to the positive G-gap group. This G-gap is linked with differences in complications in patients with diabetes and this potentially happens because of dissimilarities in deglycation. The difference in deglycation rate in turn leads to altered production of advanced glycation end products (AGEs). These AGEs are both receptor dependent and receptor independent. It was hypothesised that variations in the level of the deglycating enzyme fructosamine-3-kinase (FN3K) might be as a result of known Single Nucleotide Polymorphisms (SNPs): rs1056534, rs3848403 and rs1046896 in FN3K gene, SNP in ferroportin1/SLC40A1 gene (rs11568350 linked with FN3K activity), differentially expressed genes (DEGs), differentially expressed transcripts or alternatively spliced transcript variants. Previous studies reported accelerated telomere length shortening in patients with diabetes. In this study, 184 patients with diabetes were included as dichotomised groups with either a strongly negative or positive G-gap. This study was conducted to analyse the differences in genotype frequency of specific SNPs via real time qPCR,determine soluble receptors for AGE (sRAGE) concentration via ELISA, finding association of sRAGE concentration with SNPs genotype, and evaluate relative average telomere length ratio via real time qPCR. This study also aimed at the investigation of underlying mechanisms of G-gap via transcriptome study for the identification of the DEGs and differentially expressed transcripts and to consequently identify pathways, biological processes and diseases linked to situations in which DEGs were enriched. The relative length of the telomere was normalised to the expression of a single copy gene (S). Chi-squared test was used for estimating the expected genotype frequencies in diabetic patients with negative and positive G-gap. Genotype frequencies of FN3K SNPs (rs1056534, rs3848403 and rs1046896) and SLC40A1/ferroportin1 SNP (rs11568350) polymorphisms within the studied groups were non-significant. With respect to genotypes, the rs1046896 genotype (CT) and rs11568350 genotype (AC) were only found in heterozygous state in all the investigated cohorts. No association between sRAGE concentration and FN3K SNPs (rs3848403 and rs1056534) was observed as the sRAGE concentration was also found not to be different between the groups. Similarly, the relative average telomere length was not different in both groups. Plasma sRAGE levels were not different in the cohort studied even though the Wolverhampton Diabetes Research Group (WDRG) previously reported that AGE is higher in positive G-gap. The latter is a more likely consequence of lower FN3K activities. In this study, it was found that SNPs in the FN3K/ferroportin1 gene are not responsible for the discrepancy in average glycaemia. The transcriptomic study via RNA-Seq mapped a total of 64451 gene transcripts to the human transcriptome. The DEGs and differentially expressed transcripts were 103 and 342 respectively (p < 0.05, fold change > 1.5). Of 103 DEGs, 61 were downregulated in G-gap positive and 42 were upregulated in positive G-gap individuals while 14 genes produced alternatively spliced transcript variants. Four pathways (Viral carcinogenesis, Ribosome, Phagosome and Dorso-ventral axis) were identified in the bioinformatics analysis of samples in which DEGs were enriched. These DEGs were also found to be associated with raised blood pressure and glycated haemoglobin (conditions that coexist with diabetes). Future analysis based on these results will be necessary to elucidate the significant drivers of gene expression leading to the G-gap in these patients.
    • What do therapists perceive are the enablers and barriers to working with transgender clients?

      Gutteridge, Robin; Thomas-Gray, Lisa (University of Wolverhampton, 2019-07)
      This research aimed to explore what therapists perceive are the enablers and barriers which can arise when working with transgender clients. Some research studies have previously been carried out exploring the client’s experiences of the therapeutic process, with a large proportion finding the counselling profession to be wanting. However, there is a dearth of literature exploring the reasons behind this from a clinical perspective, including potential ways of addressing the issues raised. This qualitative study explored the perspectives of five experienced clinicians, from varying backgrounds who work therapeutically with transgender clients. The participants recognised that while there is positive work occurring within the field, there remains room for growth and improvement across all services including medical, social, psychological and legal. Due to the role and impact of individuation, personal beliefs and experiences, background and therapeutic approach, a Thematic Analysis as carried out on the data gathered from semi-structured interviews. The resulting themes highlighted the role of self-disclosure, training, the theoretical approach utilised and the use of language were all considered to be key elements; which can have a significant impact on the therapeutic relationship and subsequent outcomes. These themes were considered with reference to the implications both as an enabling and barrier on therapeutic outcomes and for Counselling Psychology practice.