Time use, daily activities, and health-related quality of life of school-going late adolescents in Cork city and county: A cross-sectional study

Aim: This thesis examines a question posed by founding occupational scientist Dr. Elizabeth Yerxa (1993) – “what is the relationship between human engagement in a daily round of activity (such as work, play, rest and sleep) and the quality of life people experience including their healthfulness” (p. 3). Specifically, I consider Yerxa’s question in relation to the quotidian activities and health-related quality of life (HRQoL) of late adolescents (aged 15 - 19 years) in Ireland. This research enquiry was informed by an occupational perspective of health and by population health, ecological, and positive youth development perspectives. Methods: This thesis is comprised of five studies. Two scoping literature reviews informed the direction of three empirical studies. In the latter, cross-sectional time use and HRQoL data were collected from a representative sample of 731 school-going late adolescents (response rate 52%) across 28 schools across Cork city and county (response rate 76%). In addition to socio-demographic data, time use data were collected using a standard time diary instrument while a nationally and internationally validated instrument, the KIDSCREEN-52, was used to measure HRQoL. Variable-centred and person-centred analyses were used. Results: The scoping reviews identified the lack of research on well populations or an adolescent age range within occupational therapy and occupational science; limited research testing the popular assumption that time use is related to overall well-being and quality of life; and the absence of studies that examined adolescent 24-hour time use and quality of life. Established international trends were mirrored in the findings of the examination of weekday and weekend time use. Aggregate-level, variable-centred analyses yielded some significant associations between HRQoL and individual activities, independent of school year, school location, family context, social class, nationality or diary day. The person-centred analysis of overall time use identified three male profiles (productive, high leisure and all-rounder) and two female profiles (higher study/lower leisure and moderate study/higher leisure). There was tentative support for the association between higher HRQoL and more balanced time use profiles. Conclusion: The findings of this thesis highlight the gendered nature of adolescent time use and HRQoL. Participation in daily activities, singly and in combination, appears to be associated with HRQoL. However, the nature of this relationship is complex. Individually and collectively, adolescents need to be educated and supported to create health through their everyday patterns of doing.

GABRIEL URBAIN FAURÉ, THE UNSUNG MODERNIST: A PERFORMANCE SURVEY OF SELECTED LATE WORKS WRITTEN AFTER 1892 FOR PIANO SOLO, AND PIANO IN COLLABORATION WITH VIOLIN, VIOLONCELLO, AND VOICE

Gabriel Urbain Fauré lived during one of the most exciting times in music history. Spanning a life of 79 years (1845-1924), he lived through the height of Romanticism and the experimental avant-garde techniques of the early 20th century. In Fauré's music, one can find traces of Chopin, Liszt, Mendelssohn, Debussy and Poulenc. One can even argue that Fauré presages Skryabin and Shostakovich. The late works of Gabriel Fauré, chiefly those composed after 1892, testify to the argument that Fauré holds an important position in the shift from tonal to atonal composition and should be counted among such transitional composers as Gustav Mahler, Claude Debussy, Erik Satie, Richard Strauss, and Ferruccio Busoni. Fauré's unique way of fashioning harmonic impetus of almost purely linear means, resulting in a synthesis of harmonic and melodic devices, led me to craft the term mélodoharmonique. This term refers to a contrapuntally motivated technique of composition, particularly in a secondary layer of musical texture, in which a component of harmonic progression (i.e. arpeggiation, broken chord, etc.) is fused with linear motivic or thematic development. This dissertation seeks to bring to public attention through exploration in lecture and recital format, certain works of Gabriel Fauré, written after 1892. The repertoire will be selected from works for solo piano and piano in collaboration with violin, violoncello, and voice, which support the notion of Fauré as a modernist deserving larger recognition for his influence in the transition to atonal music. The recital repertoire includes the following--Song Cycles: La bonne chanson, opus 61; La chanson d'Ève, opus 95; Le jardin clos, opus 106; Mirages, opus 113; L'horizon chimérique, opus 118; Piano Works: Prelude in G minor opus 103, No. 3; Prelude in E minor opus 103, No. 9; Eleventh Nocturne, opus 104, No.1; Thirteenth Nocturne, opus 119; Chamber Works: Second Violin Sonata, opus 108; First Violoncello Sonata, opus 109; Second Violoncello Sonata, opus 117.

Hippocampus shape analysis and late-life depression.

Major depression in the elderly is associated with brain structural changes and vascular lesions. Changes in the subcortical regions of the limbic system have also been noted. Studies examining hippocampus volumetric differences in depression have shown variable results, possibly due to any volume differences being secondary to local shape changes rather than differences in the overall volume. Shape analysis offers the potential to detect such changes. The present study applied spherical harmonic (SPHARM) shape analysis to the left and right hippocampi of 61 elderly subjects with major depression and 43 non-depressed elderly subjects. Statistical models controlling for age, sex, and total cerebral volume showed a significant reduction in depressed compared with control subjects in the left hippocampus (F(1,103) = 5.26; p = 0.0240) but not right hippocampus volume (F(1,103) = 0.41; p = 0.5213). Shape analysis showed significant differences in the mid-body of the left (but not the right) hippocampus between depressed and controls. When the depressed group was dichotomized into those whose depression was remitted at time of imaging and those who were unremitted, the shape comparison showed remitted subjects to be indistinguishable from controls (both sides) while the unremitted subjects differed in the midbody and the lateral side near the head. Hippocampal volume showed no difference between controls and remitted subjects but nonremitted subjects had significantly smaller left hippocampal volumes with no significant group differences in the right hippocampus. These findings may provide support to other reports of neurogenic effects of antidepressants and their relation to successful treatment for depressive symptoms.

Genome-wide scan of copy number variation in late-onset Alzheimer's disease.

Alzheimer's disease is a complex and progressive neurodegenerative disease leading to loss of memory, cognitive impairment, and ultimately death. To date, six large-scale genome-wide association studies have been conducted to identify SNPs that influence disease predisposition. These studies have confirmed the well-known APOE epsilon4 risk allele, identified a novel variant that influences disease risk within the APOE epsilon4 population, found a SNP that modifies the age of disease onset, as well as reported the first sex-linked susceptibility variant. Here we report a genome-wide scan of Alzheimer's disease in a set of 331 cases and 368 controls, extending analyses for the first time to include assessments of copy number variation. In this analysis, no new SNPs show genome-wide significance. We also screened for effects of copy number variation, and while nothing was significant, a duplication in CHRNA7 appears interesting enough to warrant further investigation.

North atlantic deepwater temperature change during late pliocene and late quaternary climatic cycles

Variations in the ratio of magnesium to calcium (Mg/Ca) in fossil ostracodes from Deep Sea Drilling Project Site 607 in the deep North Atlantic show that the change in bottom water temperature during late Pliocene 41,000-year obliquity cycles averaged 1.5°C between 3.2 and 2.8 million years ago (Ma) and increased to 2.3°C between 2.8 and 2.3 Ma, coincidentally with the intensification of Northern Hemisphere glaciation. During the last two 100,000-year glacial-to-interglacial climatic cycles of the Quaternary, bottom water temperatures changed by 4.5°C. These results show that glacial deepwater cooling has intensified since 3.2 Ma, most likely as the result of progressively diminished deep-water production in the North Atlantic and of the greater influence of Antarctic bottom water in the North Atlantic during glacial periods. The ostracode Mg/Ca data also allow the direct determination of the temperature component of the benthic foraminiferal oxygen isotope record from Site 607, as well as derivation of a hypothetical sea-level curve for the late Pliocene and late Quaternary. The effects of dissolution on the Mg/Ca ratios of ostracode shells appear to have been minimal.

CONSERVATIVE AND PROGFESSIVE ASPECTS OF THE SONATA FROM LATE BEETHOVEN TO PROKOFIEV

The term 'sonata' arose in the early seventeenth-century Baroque period and was originally used to distinguish instrumental (sonata) music from vocal music. Later. the sonata style, as a reliable yet flexible compositional framework, was extensively shaped and utilized throughout the Classical period. Subsequently, in the Romantic period, freer creative, individualistic. and expressive musical elements began to be preferred by composers in their use of harmonj., tone color, form, and rhythm. However, even during the revolutionary Romantic period in music. the compositions which did not have a pre-defined format (character pieces, etc) were often comfortably framed and limited within the recognizable boundaries provided by the Classical sonata style. The sonata format, when used as a tool in musical composition, provides logical boundaries that may serve to organize any unexpected emotional expressions on the part of the composer. Yet the sonata framework is also flexible enough to allow freedom of expression. In the Romantic period and beyond, composers had relied, some more than others, upon the sonata's adaptable blend of stability and flexibility. In my opinion, it is more persuasive to express oneself musically within the framework of an established musical style. Thus, I have chosen my dissertation topic as the performance of six pieces incorporating elements of the reliable and flexible sonata style. The sonata of each composer that I have selected clearly demonstrates a tension between logic and emotion expressed within the sonata framework. However, the compositions can be divided interestingly into two groups, such as 'conservative' and 'progressive' group. The 'conservative' group consists of composers who seemed to strive for greater freedom of self-expression within the constraints of the traditional sonata form. On the other hand, the 'progressive' group consists of composers who seemed more to rely upon the sonata form to rein in and add stability to their highly individual and emotional musical ideas. It is my hope that this project will provide a stimulating viewpoint from which to consider the evolution and utilization of the sonata style especially as it is applied to the composition and performance of these six diverse and interesting pieces.

Identification of late larval stage developmental checkpoints in Caenorhabditis elegans regulated by insulin/IGF and steroid hormone signaling pathways.

Organisms in the wild develop with varying food availability. During periods of nutritional scarcity, development may slow or arrest until conditions improve. The ability to modulate developmental programs in response to poor nutritional conditions requires a means of sensing the changing nutritional environment and limiting tissue growth. The mechanisms by which organisms accomplish this adaptation are not well understood. We sought to study this question by examining the effects of nutrient deprivation on Caenorhabditis elegans development during the late larval stages, L3 and L4, a period of extensive tissue growth and morphogenesis. By removing animals from food at different times, we show here that specific checkpoints exist in the early L3 and early L4 stages that systemically arrest the development of diverse tissues and cellular processes. These checkpoints occur once in each larval stage after molting and prior to initiation of the subsequent molting cycle. DAF-2, the insulin/insulin-like growth factor receptor, regulates passage through the L3 and L4 checkpoints in response to nutrition. The FOXO transcription factor DAF-16, a major target of insulin-like signaling, functions cell-nonautonomously in the hypodermis (skin) to arrest developmental upon nutrient removal. The effects of DAF-16 on progression through the L3 and L4 stages are mediated by DAF-9, a cytochrome P450 ortholog involved in the production of C. elegans steroid hormones. Our results identify a novel mode of C. elegans growth in which development progresses from one checkpoint to the next. At each checkpoint, nutritional conditions determine whether animals remain arrested or continue development to the next checkpoint.

No association between TGFB1 polymorphisms and late radiotherapy toxicity: a meta-analysis.

BACKGROUND: Transforming growth factor-beta 1 (TGF-β1) protein may be multifunctional and related to the development of fibrosis, induction of apoptosis, extracellular signaling and inhibition of proliferation in response to radiation-induced DNA damage. Several studies have investigated associations between single nucleotide polymorphisms (SNPs) in the TGFB1 gene and risk of late radiation-induced injury of normal tissue, but the conclusions remain controversial. METHODS: We searched three electronic databases (i.e., MEDLINE, EMBASE and EBSCO) for eligible publications and performed a meta-analysis assessing the association of three commonly studied SNPs in TGFB1 (i.e., rs1800469, rs1800470 and rs1800471) with risk of late radiation-induced injury of normal tissue. RESULTS: We finally included 28 case-only studies from 16 publications on aforementioned SNPs in TGFB1. However, we did not find statistical evidence of any significant association with overall risk of late radiotherapy toxicity in the pooled analysis or in further stratified analysis by cancer type, endpoint, ethnicity and sample size. CONCLUSIONS: This meta-analysis did not find statistical evidence for an association between SNPs in TGFB1 and risk of late radiation-induced injury of normal tissue, but this finding needs further confirmation by a single large study.

Adjunctive albuterol enhances the response to enzyme replacement therapy in late-onset Pompe disease.

Effective dosages for enzyme replacement therapy (ERT) in Pompe disease are much higher than for other lysosomal storage disorders, which has been attributed to low cation-independent mannose-6-phosphate receptor (CI-MPR) in skeletal muscle. We have previously demonstrated the benefit of increased CI-MPR-mediated uptake of recombinant human acid-α-glucosidase during ERT in mice with Pompe disease following addition of albuterol therapy. Currently we have completed a pilot study of albuterol in patients with late-onset Pompe disease already on ERT for >2 yr, who were not improving further. The 6-min walk test (6MWT) distance increased in all 7 subjects at wk 6 (30±13 m; P=0.002), wk 12 (34±14 m; P=0.004), and wk 24 (42±37 m; P=0.02), in comparison with baseline. Grip strength was improved significantly for both hands at wk 12. Furthermore, individual subjects reported benefits; e.g., a female patient could stand up from sitting on the floor much more easily (time for supine to standing position decreased from 30 to 11 s), and a male patient could readily swing his legs out of his van seat (hip abduction increased from 1 to 2+ on manual muscle testing). Finally, analysis of the quadriceps biopsies suggested increased CI-MPR at wk 12 (P=0.08), compared with baseline. With the exception of 1 patient who succumbed to respiratory complications of Pompe disease in the first week, only mild adverse events have been reported, including tremor, transient difficulty falling asleep, and mild urinary retention (requiring early morning voiding). Therefore, this pilot study revealed initial safety and efficacy in an open label study of adjunctive albuterol therapy in patients with late-onset Pompe disease who had been stable on ERT with no improvements noted over the previous several years.

Neuroimaging assessment of early and late neurobiological sequelae of traumatic brain injury: implications for CTE.

Traumatic brain injury (TBI) has been increasingly accepted as a major external risk factor for neurodegenerative morbidity and mortality. Recent evidence indicates that the resultant chronic neurobiological sequelae following head trauma may, at least in part, contribute to a pathologically distinct disease known as Chronic Traumatic Encephalopathy (CTE). The clinical manifestation of CTE is variable, but the symptoms of this progressive disease include impaired memory and cognition, affective disorders (i.e., impulsivity, aggression, depression, suicidality, etc.), and diminished motor control. Notably, mounting evidence suggests that the pathology contributing to CTE may be caused by repetitive exposure to subconcussive hits to the head, even in those with no history of a clinically evident head injury. Given the millions of athletes and military personnel with potential exposure to repetitive subconcussive insults and TBI, CTE represents an important public health issue. However, the incidence rates and pathological mechanisms are still largely unknown, primarily due to the fact that there is no in vivo diagnostic tool. The primary objective of this manuscript is to address this limitation and discuss potential neuroimaging modalities that may be capable of diagnosing CTE in vivo through the detection of tau and other known pathological features. Additionally, we will discuss the challenges of TBI research, outline the known pathology of CTE (with an emphasis on Tau), review current neuroimaging modalities to assess the potential routes for in vivo diagnosis, and discuss the future directions of CTE research.

Two Cases of Late Shone Syndrome With Pulmonary Hypertension: Heart-Lung Transplant or Valve Surgery?

Two cases of Shone syndrome with severe mitral and aortic valve problems and pulmonary hypertension were referred for heart-lung transplantation. Severely elevated pulmonary vascular resistance (PVR) was confirmed as was severe periprosthetic mitral and aortic regurgitation. Based on the severity of the valve lesions in both patients, surgery was decided upon and undertaken. Both experienced early pulmonary hypertensive crises, one more than the other, that gradually subsided, followed by excellent recovery and reversal of pulmonary hypertension and PVR. These cases illustrate Braunwald's concept that pulmonary hypertension secondary to left-sided valve disease is reversible.

Spaces of observation and obscurity: cinematic prisons of light and dark

In The Eye of Power, Foucault delineated the key concerns surrounding hospital architecture in the latter half of the eighteenth century as being the ‘visibility of bodies, individuals and things'. As such, the ‘new form of hospital' that came to be developed ‘was at once the effect and support of a new type of gaze'. This was a gaze that was not simply concerned with ways of minimising overcrowding or cross-contamination. Rather, this was a surveillance intended to produce knowledge about the pathological bodies contained within the hospital walls. This would then allow for their appropriate classification. Foucault went on to describe how these principles came to be applied to the architecture of prisons. This was exemplified for him in the distinct shape of Bentham's panopticon. This circular design, which has subsequently become an often misused synonym for a contemporary culture of surveillance, was premised on a binary of the seen and the not-seen. An individual observer could stand at the central point of the circle and observe the cells (and their occupants) on the perimeter whilst themselves remaining unseen. The panopticon in its purest form was never constructed, yet it conveys the significance of the production of knowledge through observation that became central to institutional design at this time and modern thought more broadly. What is curious though is that whilst the aim of those late eighteenth century buildings was to produce wellventilated spaces suffused with light, this provoked an interest in its opposite. The gothic movement in literature that was developing in parallel conversely took a ‘fantasy world of stone walls, darkness, hideouts and dungeons…' as its landscape (Vidler, 1992: 162). Curiously, despite these modern developments in prison design, the façade took on these characteristics. The gothic imagination came to describe that unseen world that lay behind the outer wall. This is what Evans refers to as an architectural ‘hoax'. The façade was taken to represent the world within the prison walls and it was the façade that came to inform the popular imagination about what occurred behind it. The rational, modern principles ordering the prison became conflated with the meanings projected by and onto the façade. This confusion of meanings have then been repeated and reenforced in the subsequent representations of the prison. This is of paramount importance since it is the cinematic and televisual representation of the prison, as I argue here and elsewhere, that maintain this erroneous set of meanings, this ‘hoax'.

'Marginal gothic': mediating the monstrous in British romanticism

In this paper I look at texts from the Romantic Period which strategically employ elements of the Gothic genre in what I describe as a `marginal` relationship with the Gothic canon. My intention is both to explore the way the boundaries of the genre might be extended, and to cast fresh light on some of the texts discussed, specifically in relation to the ways in which the `monstrous` is perceived and portrayed as villainy. In the first half of the paper, using Burke’s Philosophical Enquiry on the Sublime and the Beautiful as a starting point, I consider Burke’s Reflections on the Revolution in France, Godwin’s Caleb Williams, Radcliffe’s The Italian, and Blake’s The Marriage of Heaven and Hell as all in various ways examples of `marginal Gothic` that present evil doing as monstrous aberrations, also noting the contemporary reception of Beckford’s Vathek, praised in 1786 for its `accuracy and credibility`. In addition, I suggest that Wordsworth’s `Tintern Abbey` and Book VI of The Prelude provide evidence of marginal, but significant, Gothic influence that references Radcliffe’s and Burke’s explorations of a terror of the unknown. In the second half of the paper I focus on Scott’s Guy Mannering, or The Astrologer (1815) as an important example of a `marginal` Gothic novel. Scott’s reference to Vathek at a key point in his plot suggests that he had read Beckford’s novel as entirely `Gothic`. This discussion incorporates a comparison between Mannering’s youthful enthusiasm for astrological divination, and themes to be found in Shelley’s Frankenstein, notably with respect to the nature of Victor Frankenstein’s response to `old` and `new` science and medicine, and to the creation and control of Gothic monstrosity. In these and in other instances, it will be argued that the `marginal Gothic` of Scott’s novel may be read as a precursor to Shelley’s work. [From the Author]

The use of fluorescence microscopy to define polymer localisation to the late endocytic compartments in cells that are targets for drug delivery

Macromolecular therapeutics and nano-sized drug delivery systems often require localisation to specific intracellular compartments. In particular, efficient endosomal escape, retrograde trafficking, or late endocytic/lysosomal activation are often prerequisites for pharmacological activity. The aim of this study was to define a fluorescence microscopy technique able to confirm the localisation of water-soluble polymeric carriers to late endocytic intracellular compartments. Three polymeric carriers of different molecular weight and character were studied: dextrin (Mw~50,000 g/mol), a N-(2-hydroxypropyl)methacrylamide (HPMA) copolymer (Mw approximately 35,000 g/mol) and polyethylene glycol (PEG) (Mw 5000 g/mol). They were labelled with Oregon Green (OG) (0.3-3 wt.%; <3% free OG in respect of total). A panel of relevant target cells were used: THP-1, ARPE-19, and MCF-7 cells, and primary bovine chondrocytes (currently being used to evaluate novel polymer therapeutics) as well as NRK and Vero cells as reference controls. Specific intracellular compartments were marked using either endocytosed physiological standards, Marine Blue (MB) or Texas-red (TxR)-Wheat germ agglutinin (WGA), TxR-Bovine Serum Albumin (BSA), TxR-dextran, ricin holotoxin, C6-7-nitro-2,1,3-benzoxadiazol-4-yl (NBD)-labelled ceramide and TxR-shiga toxin B chain, or post-fixation immuno-staining for early endosomal antigen 1 (EEA1), lysosomal-associated membrane proteins (LAMP-1, Lgp-120 or CD63) or the Golgi marker GM130. Co-localisation with polymer-OG conjugates confirmed transfer to discreet, late endocytic (including lysosomal) compartments in all cells types. The technique described here is a particularly powerful tool as it circumvents fixation artefacts ensuring the retention of water-soluble polymers within the vesicles they occupy.

The palaeoenvironment and stratigraphy of Late Cretaceous Chalks

Since the publication of Hancock's ‘the Petrology of the Chalk’ there have been numerous developments in our appreciation of the palaeoenvironment and stratigraphie correlation of the UK Chalk. This work presents a review of some of the key developments over the last 30 years. Our detailed understanding of Chalk lithostratigraphy and advances in our understanding of chalk sedimentation indicate that large-scale mass transport and re-sedimentation of chalks by low-angle suspension flows is required to explain the observed thickness variations. The provenance of clay minerals and the process of flint and granular phosphate formation are discussed. The growing importance of isotopic studies in high resolution stratigraphy and improving our understanding of the late Cretaceous oceans and climate are emphasized. Developments in lithostratigraphic studies and recent proposals for a new stratigraphie division of the Chalk in the UK are evaluated.