Northern Ireland Infant Death Thematic Review 2015

Co-Sleeping and bed sharing are considered the social norm for approximately 90% of the world's population, with two-thirds of the world's cultures habitually practicing mother-infant co-sleeping on the same bed. Although international studies show that the practice of co-sleeping is common, it is controversial in the public health community, as many consider it a significant risk for Sudden Infant Death Syndrome (SIDS), accounting for 50% of SIDS deaths in the UK. The report offers an international review of the evidence and provides important debates and critical knowledge for both health professionals, parents and all those organisations working to support the safety of infants in their first perinatal year.

Environmental selection on transcriptome-derived SNPs in a high gene flow marine fish, the Atlantic herring (Clupea harengus)

High gene flow is considered the norm for most marine organisms and is expected to limit their ability to adapt to local environments. Few studies have directly compared the patterns of differentiation at neutral and selected gene loci in marine organisms. We analysed a transcriptome-derived panel of 281 SNPs in Atlantic herring (Clupea harengus), a highly migratory small pelagic fish, for elucidating neutral and selected genetic variation among populations and to identify candidate genes for environmental adaptation. We analysed 607 individuals from 18 spawning locations in the northeast Atlantic, including two temperature clines (5-12 °C) and two salinity clines (5-35‰). By combining genome scan and landscape genetic analyses, four genetically distinct groups of herring were identified: Baltic Sea, Baltic-North Sea transition area, North Sea/British Isles and North Atlantic; notably, samples exhibited divergent clustering patterns for neutral and selected loci. We found statistically strong evidence for divergent selection at 16 outlier loci on a global scale, and significant correlations with temperature and salinity at nine loci. On regional scales, we identified two outlier loci with parallel patterns across temperature clines and five loci associated with temperature in the North Sea/North Atlantic. Likewise, we found seven replicated outliers, of which five were significantly associated with low salinity across both salinity clines. Our results reveal a complex pattern of varying spatial genetic variation among outlier loci, likely reflecting adaptations to local environments. In addition to disclosing the fine scale of local adaptation in a highly vagile species, our data emphasize the need to preserve functionally important biodiversity.

Indications for an influence of hot Jupiters on the rotation and activity of their host stars

Context. The magnetic activity of planet-hosting stars is an importantfactor for estimating the atmospheric stability of close-in exoplanetsand the age of their host stars. It has long been speculated thatclose-in exoplanets can influence the stellar activity level. However,testing for tidal or magnetic interaction effects in samples ofplanet-hosting stars is difficult because stellar activity hindersexoplanet detection, so that stellar samples with detected exoplanetsshow a bias toward low activity for small exoplanets.

Aims: Weaim to test whether exoplanets in close orbits influence the stellarrotation and magnetic activity of their host stars.

Methods: Wedeveloped a novel approach to test for systematic activity-enhancementsin planet-hosting stars. We use wide (several 100 AU) binary systems inwhich one of the stellar components is known to have an exoplanet, whilethe second stellar component does not have a detected planet andtherefore acts as a negative control. We use the stellar coronal X-rayemission as an observational proxy for magnetic activity and analyzeobservations performed with Chandra and XMM-Newton.

Results: Wefind that in two systems for which strong tidal interaction can beexpected the planet-hosting primary displays a much higher magneticactivity level than the planet-free secondary. In three systems forwhich weaker tidal interaction can be expected the activity levels ofthe two stellar components agree with each other.

Conclusions:Our observations indicate that the presence of Hot Jupiters may inhibitthe spin-down of host stars with thick outer convective layers. Possiblecauses for this effect include a transfer of angular momentum from theplanetary orbit to the stellar rotation through tidal interaction, ordifferences during the early evolution of the system, where the hoststar may decouple from the protoplanetary disk early because of a gapopened by the forming Hot Jupiter.

Multiuser relaying over mixed RF/FSO links

A multiuser dual-hop relaying system over mixed radio frequency/free-space optical (RF/FSO) links is investigated. Specifically, the system consists of m single-antenna sources, a relay node equipped with n≥ m receive antennas and a single photo-aperture transmitter, and one destination equipped with a single photo-detector. RF links are used for the simultaneous data transmission from multiple sources to the relay. The relay operates under the decode-and-forward protocol and utilizes the popular V-BLAST technique by successively decoding each user's transmitted stream. Two common norm-based orderings are adopted, i.e., the streams are decoded in an ascending or a descending order. After V-BLAST, the relay retransmits the decoded information to the destination via a point-to-point FSO link in m consecutive timeslots. Analytical expressions for the end-to-end outage probability and average symbol error probability of each user are derived, while closed-form asymptotic expressions are also presented. Capitalizing on the derived results, some engineering insights are manifested, such as the coding and diversity gain of each user, the impact of the pointing error displacement on the FSO link and the V-BLAST ordering effectiveness at the relay.

The role of societal norms in portion size related behaviour in Denmark and on the Island of Ireland

Purpose:
Social norms influence eating behavior, but little is known about their role in portion size-related behavior. This study
explored the role of social eating norms in Denmark (DK) and the Island of Ireland (IOI) in relation to portion size-related
behavior.

Methods:
In a survey DK (n=1063) and IOI (n=1012) respondents rated social eating norms (11 items) and portion size-related behavior
(3 items) on a 7-point scale (1=strongly disagree to 7=strongly agree). The 3 items relate to: 1) anticipating how
much will be eaten at the beginning of a meal, 2) clearing the plate, and 3) clearing the plate even when full. Sociodemographics
and eating attitudes (e.g. cognitive restraint) were measured as background variables

Results:
Two social eating factors were identified: The ‘limit intake’ norm (6 items) and the ‘plate cleaning’ norm (3 items). The
DK participants reported stronger ‘limit intake’ norms and weaker ‘plate cleaning’ norms than IOI. In both countries
females reported stronger ‘limit intake’ norms while males reported stronger ‘plate cleaning’ norms. In DK, age was
positively correlated with both social eating norm factors. The ‘limit intake’ norm had stronger association with anticipating
how much will be eaten at the beginning of a meal, but the ‘plate cleaning’ norm had stronger association with
clearing the plate. Only the ‘plate cleaning’ norm was associated with clearing the plate even when full.

Conclusions:
The social eating norms vary significantly between countries and genders. The ‘limit intake’ and ‘plate cleaning’ norms
play a role in consumers’ reported portion size-related behavior.

Gendered Candidate Selection and the Representation of Women in Northern Ireland

In an attempt to account for the exceptionally low levels of female representation in Northern Ireland, this paper provides an analysis of the contemporary candidate selection procedures of the region's five main political parties. Drawing on evidence gathered from 29 elite interviews, plus official internal party documents, the study finds that the localised nature of the parties' selection procedures may disadvantage women aspirants. Also important are ‘supply-side’ factors influencing legislative recruitment and female participation rates, namely the strongly embedded social norm of female domestic responsibility, a masculinised political culture and the lack of confidence of potential female candidates.

Dynamic State Estimation of Power Systems with Quantization Eects: A Recursive Filter Approach

In this paper, a recursive filter algorithm is developed to deal with the state estimation problem for power systems with quantized nonlinear measurements. The measurements from both the remote terminal units and the phasor measurement unit are subject to quantizations described by a logarithmic quantizer. Attention is focused on the design of a recursive filter such that, in the simultaneous presence of nonlinear measurements and quantization effects, an upper bound for the estimation error covariance is guaranteed and subsequently minimized. Instead of using the traditional approximation methods in nonlinear estimation that simply ignore the linearization errors, we treat both the linearization and quantization errors as norm-bounded uncertainties in the algorithm development so as to improve the performance of the estimator. For the power system with such kind of introduced uncertainties, a filter is designed in the framework of robust recursive estimation, and the developed filter algorithm is tested on the IEEE benchmark power system to demonstrate its effectiveness.

Novel methods of drug administration for the treatment and care of older patients

The number of older people globally is increasing, contributing to a growing burden of morbidity and mortality. With this shift in population demographic, comes a new challenge in terms of appropriate healthcare for the over 65 years age group. As medication is the principal therapeutic intervention, it is essential that it be fully optimised, to meet the needs of this heterogeneous population. The most common routes of drug administration are oral and injectable, which may display some limitations for older people, in cases of dysphagia or frailty for example. This review considers alternative methods of drug delivery to the norm, specifically discussing the nasal, pulmonary and transdermal routes, as well as novel orally disintegrating tablets. The changing physiology as ageing occurs must be considered in the development of novel drug delivery devices. This review considers the various aspects of ageing that will influence future drug formulation design and development.

The design and implementation of a study to investigate the effectiveness of community vs hospital eye service follow-up for patients with neovascular age-related macular degeneration with quiescent disease

Introduction
Standard treatment for neovascular age-related macular degeneration (nAMD) is intravitreal injections of anti-VEGF drugs. Following multiple injections, nAMD lesions often become quiescent but there is a high risk of reactivation, and regular review by hospital ophthalmologists is the norm. The present trial examines the feasibility of community optometrists making lesion reactivation decisions.

Methods
The Effectiveness of Community vs Hospital Eye Service (ECHoES) trial is a virtual trial; lesion reactivation decisions were made about vignettes that comprised clinical data, colour fundus photographs, and optical coherence tomograms displayed on a web-based platform. Participants were either hospital ophthalmologists or community optometrists. All participants were provided with webinar training on the disease, its management, and assessment of the retinal imaging outputs. In a balanced design, 96 participants each assessed 42 vignettes; a total of 288 vignettes were assessed seven times by each professional group.The primary outcome is a participant's judgement of lesion reactivation compared with a reference standard. Secondary outcomes are the frequency of sight threatening errors; judgements about specific lesion components; participant-rated confidence in their decisions about the primary outcome; cost effectiveness of follow-up by optometrists rather than ophthalmologists.

Discussion
This trial addresses an important question for the NHS, namely whether, with appropriate training, community optometrists can make retreatment decisions for patients with nAMD to the same standard as hospital ophthalmologists. The trial employed a novel approach as participation was entirely through a web-based application; the trial required very few resources compared with those that would have been needed for a conventional randomised controlled clinical trial.

Paramountcy, family rights and contested adoption: does contact with birth relatives balance the scales?

This article combines practitioner insight and research evidence to chart how principles of partnership and paramountcy have led to birth family contact becoming the expected norm following contested adoption from care in Northern Ireland. The article highlights how practice has adapted to the delay in proposed reforms to adoption legislation resulting in the evolution of increasingly open adoption practices. Adoption represents an irrevocable transfer of parental responsibility from birth to adoptive parents and achieves permanence and legal security for children in care who cannot return to their birth family. Its enduring effect, however, makes public adoption a contentious field of child welfare practice, particularly when contested by birth parents. This article explores how post-adoption contact may be viewed as reconciling the uneasy interface between paramountcy principles and parental rights to respect for family life. The article highlights the complexity of adoptive kinship relationships following contested adoption from care, and how contact presents unique challenges that mitigate against meaningful and sustainable connections between the child and their birth relatives. In conclusion, a call is made for sensitive negotiation and support of contact arrangements, and the development of practice models that are informed by an understanding of the workings of adoptive kinship.