'Small places like St Helena have big questions to ask': the inaugural lecture of a Professor of Island Geography

This publication takes the form of a written version of my inaugural lecture, which was presented at Queen’s University Belfast on 10 March 2010. It is more personal and considerably more self-indulgent than would normally be acceptable in an article, with more of my own experiences and also my own references than would usually be considered proper. However, the bestowal of such a title as Professor of Island Geography is something of a marker of the maturity not just of myself but maybe also for island studies. After a section describing my path into island geography, the lecture deals with the negativities of islands and the seeming futility of studying them only then to identify a new or at least enhanced regard for islands as places with which to interact and to examine. Reference is made to islands throughout the world, but with some focus on the small islands off Ireland. The development of island studies as a discipline is then briefly described before the lecture concludes with reference to its title quotation on St Helena by considering that place’s islandness and how this affected/affects it in both the 17th and 21st centuries.

Marine reservoir corrections: St Helena, South Atlantic Ocean

We present the first marine reservoir age and Delta R determination for the island of St. Helena using marine mollusk radiocarbon dates obtained from an historical context of known age. This represents the first marine reservoir a.-c and Delta R determination in the southern Atlantic Ocean within thousands of kilometers of the island. The depletion of C-14 in the shells indicates a rather larger reservoir age for that portion of the surface Atlantic than models indicate. The implication is that upwelling old water along the Namibian coast is transported for a considerable distance, although it is likely to be variable on a decadal timescale. An artilleryman's button, together with other artifacts found in a midden, demonstrate association of the mollusk shells with a narrow historic period of AD 1815-1835.

Improved detection of acute myocardial infarction in patients with chest pain and significant left main stem coronary stenosis.

Background: Non-invasive diagnosis of acute myocardial infarction (AMI) associated with significant left main stem (LMS) stenosis remains challenging.

Methods: Consecutive patients presenting with acute ischaemic-type chest pain from 2000 to 2010 were analysed. Entry criteria: 12-lead ECG and Body Surface Potential Map (BSPM) at presentation, cardiac troponin T (cTnT) =12?h and coronary angiography during admission. cTnT =0.03?µg/l defined AMI. ECG abnormalities assessed: STEMI by Minnesota criteria; ST elevation (STE) aVR =0.5?mm; ST depression (STD) =0.5?mm in =2 contiguous leads (CL); T-wave inversion (TWI) =1?mm in =2 CL. BSPM STE was =2?mm in anterior, =1?mm in lateral, inferior, right ventricular or high right anterior and =0.5?mm in posterior territories. Significant LMS stenosis was =70%.

Results: Enrolled were 2810 patients (aged 60?±?12 years; 71% male). Of these, 116 (4.1%) had significant LMS stenosis with AMI occurring in 92 (79%). STEMI by Minnesota criteria occurred in 13 (11%) (sensitivity 12%, specificity 92%), STE in lead aVR in 23 (20%) (sensitivity 23%, specificity 92%), TWI in 38 (33%) (sensitivity 34%, specificity 71%) and STD in 51 (44%) (sensitivity 49%, specificity 75%). BSPM STE occurred in 85 (73%): sensitivity 88%, specificity 83%, positive predictive value 95% and negative predictive value 65%. Of those with AMI, 74% had STE in either the high right anterior or right ventricular territories not identified by the 12-lead ECG. C-Statistic for AMI diagnosis using BSPM STE was 0.800 (P?<?0.001).

Conclusion: In patients with significant LMS stenosis presenting with chest pain, BSPM STE has improved sensitivity (88%), with specificity 83%, over 12-lead ECG in the diagnosis of AMI.