The impact of first pregnancy and delivery on pelvic floor dysfunction

Background: The first childbirth has the greatest impact on a woman’s pelvic floor when major changes occur. The aim of this study was to comprehensively describe pelvic floor dysfunction (PFD) in young nulliparous women, and its correlation with postnatal pathology. Methods: A prospective study was performed at Cork University Maternity Hospital, Ireland. Initially 1484 nulliparous women completed the validated Australian Pelvic Floor Questionnaire at 15 weeks’ gestation and repeatedly at one year postnatally (N=872). In the second phase, at least one year postnatally, 202 participants without subsequent pregnancies attended the clinical follow up which included: pelvic organ prolapse quantification, a 3D-Transperineal ultrasound scan and collagen level assessment. Results: A high pre-pregnancy prevalence of various types of PFD was detected, which in the majority of cases persisted postnatally and included multiple types of PFD. The first birth had a negative impact on severity of pre-pregnancy symptoms in <15% of cases. Apart from prolapse, vaginal delivery, including instrumental delivery did not increase the risk of PFD symptoms, where as Caesarean section was protective for all types of PFD. The first birth had a bigger impact on pre-existing symptoms of overactive bladder compared to stress urinary incontinence. Pelvic organ prolapse is extremely prevalent in young primiparous women, however usually it is low grade and asymptomatic. Congenital factors and high collagen type III levels play an important role in the aetiology of pelvic organs prolapse. Levator ani trauma is present in one in three women after the first pregnancy and delivery. Conclusion: The main damage to the pelvic floor most likely occurs due to an undiagnosed congenital intrinsic weakness of the pelvic floor structures. PFD is highly associated with first childbirth, however it seems that pregnancy and delivery are contributing factors only which unmask the congenital intrinsic weakness of the pelvic floor support.

At the Vanguard of Design Science: First Impressions and Early Findings from Ongoing Research

Published Version

First principles simulation of amorphous silicon bulk, interfaces, and nanowires for photovoltaics

Amorphous silicon has become the material of choice for many technologies, with major applications in large area electronics: displays, image sensing and thin film photovoltaic cells. This technology development has occurred because amorphous silicon is a thin film semiconductor that can be deposited on large, low cost substrates using low temperature. In this thesis, classical molecular dynamics and first principles DFT calculations have been performed to generate structural models of amorphous and hydrogenated amorphous silicon and interfaces of amorphous and crystalline silicon, with the ultimate aim of understanding the photovoltaic properties of core-shell crystalline amorphous Si nanowire structures. We have shown, unexpectedly, from the simulations, that our understanding of hydrogenated bulk a-Si needs to be revisited, with our robust finding that when fully saturated with hydrogen, bulk a-Si exhibits a constant optical energy gap, irrespective of the hydrogen concentration in the sample. Unsaturated a-Si:H, with a lower than optimum hydrogen content, shows a smaller optical gap, that increases with hydrogen content until saturation is reached. The mobility gaps obtained from an analysis of the electronic states show similar behavior. We also obtained that the optical and mobility gaps show a volcano curve as the H content is varied from 7% (undersaturation) to 18% (mild oversaturation). In the case of mild over saturation, the mid-gap states arise exclusively from an increase in the density of strained Si-Si bonds. Analysis of our structures shows the extra H atoms in this case form a bridge between neighboring silicon atoms which increases the corresponding Si-Si distance and promotes bond length disorder in the sample. That has the potential to enhance the Staebler-Wronski effect. Planar interface models of amorphous-crystalline silicon have been generated in Si (100), (110) and (111) surfaces. The interface models are characterized by structure, RDF, electronic density of states and optical absorption spectrum. We find that the least stable (100) surface will result in the formation of the thickest amorphous silicon layer, while the most stable (110) surface forms the smallest amorphous region. We calculated for the first time band offsets of a-Si:H/c-Si heterojunctions from first principles and examined the influence of different surface orientations and amorphous layer thickness on the offsets and implications for device performance. The band offsets depend on the amorphous layer thickness and increase with thickness. By controlling the amorphous layer thickness we can potentially optimise the solar cell parameters. Finally, we have successfully generated different amorphous layer thickness of the a-Si/c-Si and a-Si:H/c-Si 5 nm nanowires from heat and quench. We perform structural analysis of the a-Si-/c-Si nanowires. The RDF, Si-Si bond length distributions, and the coordination number distributions of amorphous regions of the nanowires reproduce similar behaviour compared to bulk amorphous silicon. In the final part of this thesis we examine different surface terminating chemical groups, -H, - OH and –NH2 in (001) GeNW. Our work shows that the diameter of Ge nanowires and the nature of surface terminating groups both play a significant role in both the magnitude and the nature of the nanowire band gaps, allowing tuning of the band gap by up to 1.1 eV. We also show for the first time how the nanowire diameter and surface termination shifts the absorption edge in the Ge nanowires to longer wavelengths. Thus, the combination of nanowire diameter and surface chemistry can be effectively utilised to tune the band gaps and thus light absorption properties of small diameter Ge nanowires.

Courtship behaviour of western hedgehogs (Erinaceus europaeus) in a rural landscape in Ireland and the first appearance of offspring

A study was conducted to investigate the timing of the breeding season of western hedgehogs (Erinaceus europaeus) in a rural landscape in Ireland, their courtship activity and the first appearance and possible dispersal of juveniles. Between June 2008 and June 2010, 24 hedgehogs (18 ♂ and 6 ♀) were caught and monitored by radio tracking and direct following. A preponderance of males was recorded in both adults and juveniles at the study site and the sex ratio deviated significantly from a 1:1 ratio. Courtship behaviour took place between April and July and occurred almost exclusively in a nine ha pasture. An individual female paired with up to seven males in a season. The first appearance of juveniles was recorded in September (2008) and July (2009). The majority (n=22) of juvenile sightings, both alive and as road kill, occurred in July but they continued to be recorded up until November (n=3). The presence of juveniles at the study site in October 2008 and a pregnant female being found in September 2009 indicated that late litters occur in Ireland.

Synthesis and reactivity of α-diazo-β-keto sulfoxides: scope and synthetic potential

The research described in this thesis focuses on the design and synthesis of stable α-diazosulfoxides and investigation of their reactivity under a variety of conditions (transition-metal catalysis, thermal, photochemical and microwave) with a particular emphasis on the synthesis of novel heterocyclic compounds with potential biological activity. The exclusive reaction pathway for these α-diazosulfoxides was found to be hetero-Wolff rearrangement to give α-oxosulfine intermediates. In the first chapter, a literature review of sulfines is presented, including a discussion of naturally occurring sulfines, and an overview of the synthesis and reactivity of sulfines. The potential of sulfines in organic synthesis and recent developments in particular are highlighted. The second chapter discusses the synthesis and reactivity of α-diazosulfoxides, building on earlier results in this research group. The synthesis of lactone-based α-diazosulfoxides and, for the first time, ketone-based benzofused and monocyclic α-diazosulfoxides is described. The reactivity of these α-diazosulfoxides is then explored under a variety of conditions, such as transition-metal catalysis, photochemical and microwave, generating labile α-oxosulfine intermediates, which are trapped using amines and dienes, in addition to the spontaneous reaction pathways which occur with α-oxosulfines in the absence of a trap. A new reaction pathway was explored with the lactone based α-oxosulfines, involving reaction with amines to generate novel 3-aminofuran-2(5H)-ones via carbophilic attack, in very good yields. The reactivity of ketone-based α-diazosulfoxides was explored for the first time, and once again, pseudo-Wolff rearrangement to the α-oxosulfines was the exclusive reaction pathway observed. The intermediacy of the α-oxosulfines was confirmed by trapping as cycloadducts, with the stereochemical features dependant on the reaction conditions. In the absence of a diene trap, a number of reaction fates from the α-oxosulfines were observed, including complete sulfinyl extrusion to give indanones, sulfur extrusion to give indanediones, and, to a lesser extent, dimerisation. The indanediones were characterised by trapping as quinoxalines, to enable full characterisation. One of the overriding outcomes of this thesis was the provision of new insights into the behaviour of α-oxosulfines with different transition metal catalysts, and under thermal, microwave and photolysis conditions. A series of 3-aminofuran-2(5H)-ones and benzofused dihydro-2H-thiopyran S-oxides were submitted for anticancer screening at the U.S. National Cancer Institute. A number of these derivatives were identified as hit compounds, with excellent cell growth inhibition. One 3-aminofuran-2(5H)-one derivative has been chosen for further screening. The third chapter details the full experimental procedures, including spectroscopic and analytical data for the compounds prepared during this research. The data for the crystal structures are contained in the attached CD.

Interaction of additive and quantization noises in digital PLLs

Phase-locked loops (PLLs) are a crucial component in modern communications systems. Comprising of a phase-detector, linear filter, and controllable oscillator, they are widely used in radio receivers to retrieve the information content from remote signals. As such, they are capable of signal demodulation, phase and carrier recovery, frequency synthesis, and clock synchronization. Continuous-time PLLs are a mature area of study, and have been covered in the literature since the early classical work by Viterbi [1] in the 1950s. With the rise of computing in recent decades, discrete-time digital PLLs (DPLLs) are a more recent discipline; most of the literature published dates from the 1990s onwards. Gardner [2] is a pioneer in this area. It is our aim in this work to address the difficulties encountered by Gardner [3] in his investigation of the DPLL output phase-jitter where additive noise to the input signal is combined with frequency quantization in the local oscillator. The model we use in our novel analysis of the system is also applicable to another of the cases looked at by Gardner, that is the DPLL with a delay element integrated in the loop. This gives us the opportunity to look at this system in more detail, our analysis providing some unique insights into the variance `dip' seen by Gardner in [3]. We initially provide background on the probability theory and stochastic processes. These branches of mathematics are the basis for the study of noisy analogue and digital PLLs. We give an overview of the classical analogue PLL theory as well as the background on both the digital PLL and circle map, referencing the model proposed by Teplinsky et al. [4, 5]. For our novel work, the case of the combined frequency quantization and noisy input from [3] is investigated first numerically, and then analytically as a Markov chain via its Chapman-Kolmogorov equation. The resulting delay equation for the steady-state jitter distribution is treated using two separate asymptotic analyses to obtain approximate solutions. It is shown how the variance obtained in each case matches well to the numerical results. Other properties of the output jitter, such as the mean, are also investigated. In this way, we arrive at a more complete understanding of the interaction between quantization and input noise in the first order DPLL than is possible using simulation alone. We also do an asymptotic analysis of a particular case of the noisy first-order DPLL with delay, previously investigated by Gardner [3]. We show a unique feature of the simulation results, namely the variance `dip' seen for certain levels of input noise, is explained by this analysis. Finally, we look at the second-order DPLL with additive noise, using numerical simulations to see the effects of low levels of noise on the limit cycles. We show how these effects are similar to those seen in the noise-free loop with non-zero initial conditions.

Developing a health and wellbeing platform in a living lab setting: An action design research study

The world’s population is rapidly aging, which affects healthcare budgets, resources, pensions and social security systems. Although most older adults prefer to live independently in their own home as long as possible, smart living solutions to support elderly people at home did not reach mass adoption, yet. To support people age-in-place a Living Lab is established in one of the metropolitan areas in the Netherlands. The main goal of the Living Lab is to develop an online health and wellbeing platform that matches service providers, caretakers and users and to implement that platform in one particular city district. In this paper we describe the narrative of the action design research process that will give researchers insight how to deal with complex multi-stakeholder design projects as well as cooperation issues to develop an artifact in a real-life setting.

Biased group decision-making and the effect of computer-mediated communication: separating the effects of anonymity, voting and blind picking

The influence of communication technology on group decision-making has been examined in many studies. But the findings are inconsistent. Some studies showed a positive effect on decision quality, other studies have shown that communication technology makes the decision even worse. One possible explanation for these different findings could be the use of different Group Decision Support Systems (GDSS) in these studies, with some GDSS better fitting to the given task than others and with different sets of functions. This paper outlines an approach with an information system solely designed to examine the effect of (1) anonymity, (2) voting and (3) blind picking on decision quality, discussion quality and perceived quality of information.

Action design research: a comparison with canonical action research and design science

This research in progress paper addresses the IS issue in relation to conducting relevant research while keeping academic rigor. In particular, it contributes to the ongoing academic conversation around the investigation on how to incor-porate action in design science research. In this document the philosophical underpinnings of the recently proposed methodology called Action Design Re-search [1] are derived, outlined and integrated into Burrel and Morgan’s Par-adigmatic Framework (1979)[6]. The results so far show how Action Design Research can be considered as a particular case of Design Science Research (rather than a methodology closely related to Action Research) although they can assume two different epistemological positions. From these philosophical perspectives, future works will involve the inclusion of actual research projects using the three different methodologies. The final goal is to outline and structure the divergences and similarities of Action Design Research with Design Science Research and Canonical Action Research.

Effectuation and its implications for socio-technical design science research in information systems

We study the implications of the effectuation concept for socio-technical artifact design as part of the design science research (DSR) process in information systems (IS). Effectuation logic is the opposite of causal logic. Ef-fectuation does not focus on causes to achieve a particular effect, but on the possibilities that can be achieved with extant means and resources. Viewing so-cio-technical IS DSR through an effectuation lens highlights the possibility to design the future even without set goals. We suggest that effectuation may be a useful perspective for design in dynamic social contexts leading to a more dif-ferentiated view on the instantiation of mid-range artifacts for specific local ap-plication contexts. Design science researchers can draw on this paper’s conclu-sions to view their DSR projects through a fresh lens and to reexamine their re-search design and execution. The paper also offers avenues for future research to develop more concrete application possibilities of effectuation in socio-technical IS DSR and, thus, enrich the discourse.

Practice-based personas: integrated user and practice models

Practices are routinised behaviours with social and material components and complex relationships over space and time. Practice-based design goes beyond interaction design to consider how these components and their relationships impact on the formation and enactment of a practice, where technology is just one part of the practice. Though situated user-centred design methods such as participatory design are employed for the design of practice, demand exists for additional methods and tools in this area. This paper introduces practice-based personas as an extension of the persona approach popular in interaction design, and demonstrates how a set of practice-based personas was developed for a given domain – academic practice. The three practice-based personas developed here are linked to a catalogue of forty practices, offering designers both a user perspective and a practice perspective when designing for the domain.

ITSM ProcessGuide – a longitudinal and multi-method field study for real-world DSR artifact evaluation

Process guidance supports users to increase their process model understanding, process execution effectiveness as well as efficiency, and process compliance performance. This paper presents a research in progress encompassing our ongoing DSR project on Process Guidance Systems and a field evaluation of the resulting artifact in cooperation with a company. Building on three theory-grounded design principles, a Process Guidance System artifact for the company’s IT service ticketing process is developed, deployed and used. Fol-lowing a multi-method approach, we plan to evaluate the artifact in a longitudinal field study. Thereby, we will not only gather self-reported but also real usage data. This article describes the development of the artifact and discusses an innovative evaluation approach.

Designing and evaluating an interactive assessment instrument to improve the process for mobile service application innovation

Published Version