Looking to the future : Predicting renal replacement outcomes in a large community cohort with chronic kidney disease

Peer reviewed

Pre-eclampsia is associated with a twofold increase in diabetes : a systematic review and meta-analysis

CSK and RH are funded by National Institute for Health Research Academic Clinical Fellowships. This study was supported by a grant from the North Staffs Heart Committee.

Pre-eclampsia is associated with a twofold increase in diabetes : a systematic review and meta-analysis

CSK and RH are funded by National Institute for Health Research Academic Clinical Fellowships. This study was supported by a grant from the North Staffs Heart Committee.

An evaluation of an online peer support forum for university students with depressive symptoms

Background: Depression is the most common mental health problem among young people, particularly university students, with prevalence rates as high as 48% reported. This population however, is reluctant to seek professional help. Online interventions may be particularly appealing to students, with evidence suggesting that they use the Internet for mental health support. While there are many mental health resources on the Internet few focus specifically on the needs of young people and few have been evaluated. This research aimed to develop and pilot test an online peer support intervention for students experiencing depressive symptoms. Methods: A depression support Web site (www.losetheblues.ie) was designed specifically for 18-24. year old students. The study used a mixed method, involving quantitative descriptive, pre- and post-test and qualitative descriptive designs. Data were collected using the Centre for Epidemiological Studies Depression Scale (CES-D), a background questionnaire and online forum posts. Results: The sample consisted of 117 university students with self-reported depressive symptoms. Results from participants in the pre- and post-test element of the study, showed no statistical significance. The forum posts revealed that the participants' main difficulties were loneliness and perceived lack of socialization skills. The Web site provided a place for sharing, offering and receiving emotional and informational support. Conclusion: Developing health care interventions in an online environment presents unique challenges to the research process, however they have the potential to provide mental health care that is accessible and affordable.

Nutritional status of lactating mothers and their children 6-23 months of age in pre- and post-harvest seasons in two agro-ecological zones of rural Ethiopia

The objective of this study was to assess seasonal variation in nutritional status and feeding practices among lactating mothers and their children 6-23 months of age in two different agro-ecological zones of rural Ethiopia (lowland zone and midland zone). Food availability and access are strongly affected by seasonality in Ethiopia. However, there are few published data on the effects of seasonal food fluctuations on nutritional status and dietary diversity patterns of mothers and children in rural Ethiopia. A longitudinal study was conducted among 216 mothers in two agro-ecological zones of rural Ethiopia during pre and post-harvest seasons. Data were collected on many parameters including anthropometry, blood levels of haemoglobin and ferritin and zinc, urinary iodine levels, questionnaire data regarding demographic and household parameters and health issues, and infant and young child feeding practices, 24 h food recall to determine dietary diversity scores, and household use of iodized salt. Chi-square and multivariable regression models were used to identify independent predictors of nutritional status. A wide variety of results were generated including the following highlights. It was found that 95.4% of children were breastfed, of whom 59.7% were initially breastfed within one hour of birth, 22.2% received pre-lacteal feeds, and 50.9% of children received complementary feedings by 6 months of age. Iron deficiency was found in 44.4% of children and 19.8% of mothers. Low Zinc status was found in 72.2% of children and 67.3% of mothers. Of the study subjects, 52.5% of the children and 19.1% of the mothers were anaemic, and 29.6% of children and 10.5% of mothers had iron deficiency anaemia. Among the mothers with low serum iron status, 81.2% and 56.2% of their children had low serum zinc and iron, respectively. Similarly, among the low serum zinc status mothers, 75.2% and 45.3% of their children had low serum in zinc and iron, respectively. There was a strong correlation between the micronutrient status of the mothers and the children for ferritin, zinc and haemoglobin (P <0.001). There was also statistically significant difference between agro-ecological zones for micronutrient deficiencies among the mothers (p<0.001) but not for their children. The majority (97.6%) of mothers in the lowland zone were deficient in at least one micronutrient biomarker (zinc or ferritin or haemoglobin). Deficiencies in one, two, or all three biomarkers of micronutrient status were observed in 48.1%, 16.7% and 9.9% of mothers and 35.8%, 29.0%, and 23.5%, of children, respectively. Additionally, about 42.6% of mothers had low levels of urinary iodine and 35.2% of lactating mothers had goitre. Total goitre prevalence rates and urinary iodine levels of lactating mothers were not significantly different across agro-ecological zones. Adequately iodised salt was available in 36.6% of households. The prevalence of anaemia increased from post-harvest (21.8%) to pre-harvest seasons (40.9%) among lactating mothers. Increases were from 8.6% to 34.4% in midland and from 34.2% to 46.3% in lowland agro-ecological zones. Fifteen percent of mothers were anaemic during both seasons. Predictors of anaemia were high parity of mother and low dietary diversity. The proportion of stunted and underweight children increased from 39.8% and 27% in post-harvest season to 46.0% and 31.8% in pre-harvest season, respectively. However, wasting in children decreased from 11.6% to 8.5%. Major variations in stunting and underweight were noted in midland compared to lowland agroecological zones. Anthropometric measurements in mothers indicated high levels of undernutrition. The prevalence of undernutrition in mothers (BMI <18.5kg/m2) increased from 41.7 to 54.7% between post- and pre-harvest seasons. The seasonal effect was generally higher in the midland community for all forms of malnutrition. Parity, number of children under five years and regional variation were predictors of low BMI among lactating mothers. There were differences in minimum meal frequency, minimum acceptable diet and dietary diversity in children in pre-harvest and post-harvest seasons and these parameters were poor in both seasons. Dietary diversity among mothers was higher in lowland zone but was poor in both zones across the seasons. In conclusion, malnutrition and micronutrient deficiencies are very prevalent among lactating mothers and their children 6-23 months old in the study areas. There are significant seasonal variations in malnutrition and dietary diversity, in addition to significant differences between lowland and midland agro-ecological zones. These findings suggest a need to design effective preventive public health nutrition programs to address both the mothers’ and children’s needs particularly in the preharvest season.

14C specific radiocarbon ages and bulk ages accompanied by geochemical proxys from surface sediment samples in the Black Sea

Transfer of organic carbon (OC) from the terrestrial to the oceanic carbon pool is largely driven by riverine and aeolian transport. Before transport, however, terrigenous organic matter can be retained in intermediate terrestrial reservoirs such as soils. Using compound-specific radiocarbon analysis of terrigenous biomarkers their average terrestrial residence time can be evaluated. Here we show compound-specific radiocarbon (14C) ages of terrigenous biomarkers and bulk 14C ages accompanied by geochemical proxy data from core top samples collected along transects in front of several river mouths in the Black Sea. 14C ages of long chain n-alkanes, long chain n-fatty acids and total organic carbon (TOC) are highest in front of the river mouths, correlating well with BIT (branched and isoprenoid tetraether) indices, which indicates contribution of pre-aged, soil-derived terrigenous organic matter. The radiocarbon ages decrease further offshore towards locations where organic matter is dominated by marine production and aeolian input potentially contributes terrigenous organic matter. Average terrestrial residence times of vascular plant biomarkers deduced from n-C29+31 alkanes and n-C28+30 fatty acids ages from stations directly in front of the river mouths range from 900 ± 70 years to 4400 ± 170 years. These average residence times correlate with size and topography in climatically similar catchments, whereas the climatic regime appears to control continental carbon turnover times in morphologically similar drainage areas of the Black Sea catchment. Along-transect data imply petrogenic contribution of n-C29+31 alkanes and input via different terrigenous biomarker transport modes, i.e., riverine and aeolian, resulting in aged biomarkers at offshore core locations. Because n-C29+31 alkanes show contributions from petrogenic sources, n-C28+30 fatty acids likely provide better estimates of average terrestrial residence times of vascular plant biomarkers. Moreover, sedimentary n-C28 and n-C30 fatty acids appear clearly much less influenced by autochthonous sources than n-C24 and n-C26 fatty acids as indicated by increasing radiocarbon ages with increasing chain-length and are, thus, more representative as vascular plant biomarkers.

Paleoecology, Diagenesis and Biological Affinity of Tetradiids in the Upper Ordovician (Sandbian) Black River Group of the Kingston Area, Ontario, Canada

Tetradiids are a group of colonial, tubular fossils that occur globally in Middle to Upper Ordovician strata. Tetradiids were first described as a type of tabulate coral; however, based on their four-fold symmetry, division, and presence of a central-sparry canal, they were recently reinterpreted as a florideophyte rhodophyte algae, a reinterpretation that is tested in this thesis. This study focused on understanding the affinity and taphonomy of this order of fossil. Research was conducted by stratigraphic and petrographic analyses of the Black River Group in the Kingston, Ontario region. Tetradiid occurrences were divided into fragment or colonial, with three morphologies of tetradiids described (Tetradium, Phytopsis and Paratetradium). Morphology is specific to depositional environment, with compact Tetradium consistently within ooid grainstones and open branching Phytopsis and chained Paratetradium consistently within mudstones. Two types of patch reefs were recognized: a Paratetradium bioherm, and a Paratetradium, Phytopsis, stromatolite bioherm. The presence of bioherms implies that tetradiids were capable of hypercalcifying. Preservation styles of tetradiids were investigated, and were compared to brachiopods, echinoderms, mollusks, and ooids. Tetradiids were preferentially preserved as molds and demonstrated complete dissolution of skeletal material. Rare specimens, however, demonstrated preserved horizontal partitions, central plates, and a double wall. Skeletal molds were filled with either calcite spar, mud or encrusted by a cryptomicrobial colony. Both calcitic and aragonitic ooids were discovered. The co-occurrence of aragonitic ooids, aragonitic crytodontids, and the evolution of aragonitic, hypercalcifying tetradiids is interpreted as representing the geochemical favoring of aragonite and HMC in a time of global calcite seas. The geochemical favoring of aragonite is interpreted to be independent to global Mg: Ca ratios, but was the result of increased saturation levels and temperature driven by high atmospheric pCO2. Based on the presence of epitheca, tabulae, septa, and the commonality of growth forms, tetradiids are interpreted as an order of Cnidaria. The evolution of an aragonitic skeleton in tetradiids is interpreted to be the result of de novo acquisition of a skeleton from an unmineralized clade.

'A Kind of Logic, A Kind of Dominant Logic': Navigating Colonialism, Honoring Black Mobility, and Thinking on Moving Through

My thesis thinks through the ways Newtonian logics require linear mobility in order to produce narratives of progress. I argue that this linear mobility, and the resulting logics, potentially erases the chaotic and non-linear motions that are required to navigate a colonial landscape. I suggest that these non-linear movements produce important critiques of the seeming stasis of colonial constructs and highlight the ways these logics must appear neutral and scientific in an attempt to conceal the constant and complex adjustments these frameworks require. In order to make room for these complex motions, I develop a quantum intervention. Specifically, I use quantum physics as a metaphor to think through the significance of black life, the double-consciousness ofland, and the intricate motions of sound. In order to put forth this intervention, I look at news coverage of Hurricane Katrina, Du Bois’s characterization of land in Souls of Black Folks, and the aural mobilities of blackness articulated in an academic discussion and interview about post- humanism.

Beyond Black and White: The grisaille exterior of the Netherlandish triptych

This thesis is a study of fifteenth- to mid sixteenth-century Netherlandish triptych exteriors, focusing on the so-called ‘grisaille’ technique. During this period, altarpieces produced in the Low Countries were typically constructed in a tripartite format with folding wings. This arrangement created the opportunity for pictorial representations on both sides of the hinged panels. Painters emphasized the distinction between the triptych’s two faces by executing the exteriors in a strikingly more subdued palette than the interiors. Particular iconographic subject matter was favoured for grisailles, which often depict the Annunciation or saints that reflect the triptych’s patronage or intended location. Jan van Eyck was notable for his emphasis on imitating stone statuary and created three important grisailles, one of which would influence triptych exteriors for years to come. Hieronymus Bosch, an artist working at the turn of the sixteenth century, also brought innovation to his grisailles, further expanding the potential of these reduced-palette paintings. This thesis examines the creative process involved in the production of grisailles and compares the underdrawings of triptych exteriors to those of the corresponding polychromatic interiors. In this study, grisailles are situated in their context as part of multifaceted artworks as well as within the broader church environment. New infrared reflectograms were generated using Queen’s OSIRIS infrared camera to document works in Belgium and the Netherlands. While some aspects of underdrawings could indicate that the figure was meant to imitate statuary, this distinction was not directly linked to triptych exteriors and was related instead to efforts at a trompe-l’oeil effect. Such attempts at mimicry can also be found on triptych interiors. Through a close examination of the underdrawing stage of these paintings it appears that this part of the creative process was not distinguished in any significant way from the underdrawings of triptych interiors.

Study Abroad Course Development: Pre-Departure Sessions

Study abroad is a highly encouraged component of the undergrad business program at Bella Lake University, with the large majority of undergraduate students choosing to study and live in a foreign country to expand on their international experiences. Currently, there is no learning structure or learning outcome expectation for students that will participate in the study abroad experience. This project focuses on the development of a course that supports students in the pre-departure phase of their study abroad journey and prepares them to set goals, understand the learning process and the practices of experiential learning to encourage students to achieve both personal and professional goals, and encourage the development of intercultural competence. The discourse surrounding the perceptions and efficacy of the course development is based on a self-assessment survey completed by 121 undergraduate business students that participated in the pre-departure sessions prior to leaving for study abroad in March 2016. The self-assessment results overall showed that the course achieved its aims with the majority of students rating that they were more likely to understand and engage in experiential learning, set goals for their study abroad experience and felt more prepared for study abroad after attending the pre-departure sessions. The project concludes that in order for the pre-departure course to maintain its value, the conversation with students surrounding experiential learning in study abroad needs to continue with further course development focusing on both during and post-study abroad. Further exploration can also be done to find varying ways to motivate different students to engage in the learning potential of study abroad.

Biological Impacts and Uses of Black Bass Competitive Fishing Tournaments on Large Lake Systems

Recreational fisheries in North America are valued between $47.3 billion and $56.8 billion. Fisheries managers must make strategic decisions based on sound science and knowledge of population ecology, to effectively conserve populations. Competitive fishing, in the form of tournaments, has become an important part of recreational fisheries, and is common on large waterbodies including the Great Lakes. Black Bass, Micropterus spp., are top predators and among the most sought after species in competitive catch-and-release tournaments. This study investigated catch-and-release tournaments as an assessment tool through mark-recapture for Largemouth Bass (>305mm) populations in the Tri Lakes, and Bay of Quinte, part of the eastern basin of Lake Ontario. The population in the Tri Lakes (1999-2002) was estimated to be stable between 21,928-29,780, and the population in the Bay of Quinte (2012-2015) was estimated to be between 31,825-54,029 fish. Survival in the Tri Lakes varied throughout the study period, from 31%-54%; while survival in the Bay of Quinte remained stable at 63%. Differences in survival may be due to differences in fishing pressure, as 34-46% of the Largemouth Bass population on the Tri Lakes is harvested annually and only 19% of catch was attributed to tournament angling. Many biological issues still surround catch-and-release tournaments, particularly concerning displacement from initial capture sites. In the past, the majority of studies have focused on small inland lakes and coastal areas, displacing bass relatively short distances. My study displaced Largemouth and Smallmouth Bass up to 100km, and found very low rates of return; only 1 of 18 Largemouth Bass returned 15 km and 1 of 18 Smallmouth Bass returned 135 km. Both species remained near the release sites for an average of approximately 2 weeks prior to dispersing. Tournament organizers should consider the use of satellite release locations to facilitate dispersal and prevent stockpiling at the release site. Catch-and-release tournaments proved to be a valuable tool in assessing population variables and the effects of long distance displacement through the use of mark recapture and acoustic telemetry on large lake systems.

‘Black Settlers’: Hybridity, Neoliberalism and Ecosystemic Change Among Tonga Farmers of Southern Zambia, 1964-2008

This dissertation examines a process of indigenous accumulation among Tonga farmers in Zambia’s Southern Province. In the 1970s multiple authors concluded that capitalist farmers had emerged among Tonga agro-pastoralists, predominantly within private titled holdings. Relying on archival research, newspapers, secondary sources and extensive oral testimony this thesis fills a 35-year gap on the topic, providing insights into the social and environmental impacts of neoliberal policy among African peasants and capitalist farmers. In contrast to dominant narratives of the post-independence period, this study argues that Zambia did experience a developmental process post-independence, which saw significant achievements made in the agricultural sector, including the doubling of national cattle stocks. The data reveals a painful process of disarticulation beginning in the late 1980s. Following neoliberal adjustment, we observe significant heterogeneity in production systems, some regional specialization, and processes of migration. Most importantly, the thesis uncovers processes of overwhelming ecosystemic change that contributed to livestock epidemics of severe scale and scope. Amazingly, this went largely undocumented because of the simultaneous crisis of the state, which left the national statistics office and other state bodies incapable of functioning from the late 1980s into the 2000s. In response, the Zambian state has introduced a number of neodevelopmental initiatives in the sector, yet the lack of animal traction remained up to 2008 and agricultural production declined, while more capitalized farmers (largely white, and/or with foreign direct investment) have become more significant players in the country. This thesis provides compelling evidence to challenge dominant economic thinking of the Washington institutions as well as many of the common Marxian formulations.

Ecophysiology of Adonis distorta, a high-mountain species endemic of the Central Apennines

Morphological, anatomical and physiological plant and leaf traits of A. distorta, an endemic species of the Central Apennines on the Majella Massif, growing at 2,675 m a.s.l, were analyzed. The length of the phenological cycle starts immediately after the snowmelt at the end of May, lasting 128 ± 10 days. The low A. distorta height  (Hmax= 64 ± 4 mm) and total leaf area (TLA= 38 ± 9 cm2) associated to a high leaf mass area (LMA =11.8±0.6 mg cm−2) and a relatively high leaf tissue density (LTD = 124.6±14.3 mg cm−3) seem to be adaptive traits to the stress factors of the environment where it grows. From a physiological point of view, the high A. distorta photosynthetic rates (PN =19.6 ± 2.3 µmol m−2 s−1) and total chlorophyll content (Chla+b = 0.88 ± 0.13 mg g−1) in July are justified by the favorable temperature. PN decreases by 87% in September at the beginning of plant senescence. Photosynthesis and leaf respiration (RD) variations allow A. distorta to maintain a positive carbon balance during the growing season becoming indicative of the efficiency of plant carbon use. The results could be an important tool for conservation programmes of the A. distorta wild populations.

Validación de dos herramientas para la evaluación de cambios en las actitudes de alumnos en situaciones frecuentes en cuidado paliativo

Objective: To determine the psychometric properties of two scales designed to examine attitudes regarding palliative care: Comfort Scale in Palliative Care (CSPC, Pereira et al.) and Tanatophobia Scale (TS, Merrill et al.)Method: Seventy-seven students who completed an online course on psychosocial aspects of palliative care offered by the Latin American Association of Palliative Care participated in the study. They also completed the scales before and after the course. Construct validity and reliability of the CSPC and the TS were assessed using a Principal Components Analysis, internal reliability coefficient and test-retest reliability. Further, comparative statistics between the pre-course and post-course results were obtained in order to determine changes in attitudes.Results: The Principal Components Analysis showed satisfactory fit to the data. 3 components were extracted: two for the CSPC and one for the TS, which explained 55.37% of the variance. Internal consistency coefficients were satisfactory in all cases and Cronbach´s Alphas were satisfactory for all the scales, particularly for the CSPC. Test-retest reliability in t1 and t2 was found to be non significant, indicating that measures were not related in time. Regarding pre-course/post-course comparisons, significant changes in comfort assisting patients (p = 0.004) and comfort assisting families (p = 0.001) following the course were identified, but changes in thanatophobia were non significant (p > 0.05).Conclusions: both scales are valid and reliable. Attitudes regarding the practice of palliative care and how they change, particularly regarding psychosocial issues, can be accurately measured using the examined scales.

Daughter of Eve, "Femme Fatale", and Persecuted Artist: The Mythic Transgressive Woman in Oscar Wilde's and Richard Strauss's "Salome"

Historically, Salome was an unexceptional figure who never catalyzed John the Baptist's death. However, in Christian Scripture, she becomes the dancing seductress as fallen daughter of Eve.  Her stepfather Herod promises Salome his kingdom if she dances for him, but she follows her mother’s wish to have John beheaded. In Strauss’s opera, after Wilde's Symbolist-Decadent play, Salome becomes independent of Herodias’ will, and the mythic avatar of the femme fatale and persecuted artist who Herod has killed after she kisses John's severed head.  Her signature key of C# major, resolving to the C major sung by Herod and Jokanaan at her death, represent her tragic fate musically.