University of Sunderland
  • Sunderland, ENG, United Kingdom
Recent publications
Entrustable professional activities (EPA) are commonly integrated within competency frameworks across many healthcare curricula but are less evident in the training of Sport and Exercise Scientists. Equipping graduates with the key knowledge, skills and professional attributes to complete practical tasks competently with minimal supervision in the workplace is essential. Entrustable professional activities are an indicator of practical competency within a field of work, enabling students to independently display specific practical expertise in an authentic workplace setting. The aim of this paper is to describe how entrustable professional activities can be implemented into Sport and Exercise Sciences teaching in Higher Education. To guide the paper, a narrative review approach was utilised to identify current EPA frameworks and processes in use. A framework and competency matrix were developed based on the accreditation criteria of the British Association of Sport and Exercise Sciences (BASES) and implemented into an introductory module. The EPA framework was evaluated by asking students (n = 47) to rank the importance of the competency action statements. The EPA framework was successfully used within a module and the framework was defined as a matrix, with statements aligned to a selection of expected graduate competencies, as EPAs were not related to specific tasks but were designed to cover the tests included in the module. EPAs offer a well-structured teaching and learning tool with clear alignment to the overall discipline of Sport and Exercise Sciences. EPAs may aid the professional development of key attributes and skills to produce work-ready Sport and Exercise Science graduates.
Whilst job satisfaction has been extensively investigated as a CSR moderator or outcome, pertinent literature is predominantly silent on the complexity surrounding the formulation of the construct. This study adopts the theory of complexity and examines the combinations of factors leading to hotel employee job satisfaction within a CSR context. Using fuzzy-set Qualitative Comparative Analysis (fsQCA), those factorial combinations that are significant in driving job satisfaction were first identified, whereas semi-structured interviews revealed the relationships that describe such configurations. Necessary Condition Analysis (NCA) was used as complementary to estimate the effects of size of the examined conditions. In total, three solutions were generated: (i) ethical issues and morality; (ii) hotel-related aspects; (iii) employee-related aspects which are supported by the qualitative data. Results indicate that job satisfaction can be stimulated by diverse combinations of hotel employees' CSR perceptions, moral identity, subjective norms and work engagement, yielding significant theoretical and managerial implications.
Chyloperitoneum and chylothorax (ChP/ChT) are rare complications after bariatric surgery. This systematic review aims to evaluate the incidence, cause, treatment, and outcome of ChP and ChT after bariatric surgery. This review investigates published English language scientific literature systematically in an attempt to answer these questions. Our literature search revealed 66 studies, of which 23 were included. There were a total of 40 patients (38, ChP; 2, ChT). Eighteen of 40 (43.9%) patients were treated laparoscopically, and one patient (2.44%) underwent thoracoscopy and ligation of the thoracic duct. Both ChP and ChT are rare complications after bariatric surgery.
Purpose To characterise the phenotype observed in a case series with macular disease and determine the cause. Design Multi-centre case series. Participants Six families (seven patients) with sporadic or multiplex macular disease with onset at 36-78 years, and one patient with age-related macular degeneration. Methods Patients underwent ophthalmic examination, exome, genome or targeted sequencing, and/or PCR amplification of the breakpoint followed by cloning and Sanger sequencing or direct Sanger sequencing. Main Outcome Measures Clinical phenotypes, genomic findings and a hypothesis explaining the mechanism underlying disease in these patients. Results All eight cases carried the same deletion encompassing the genes TPRX1, CRX and SULT2A1, which was absent from 382 control individuals screened by breakpoint PCR and 13,096 Clinical Genetics patients with a range of other inherited conditions screened by array comparative genomic hybridisation. Microsatellite genotypes showed that these seven families are not closely related, but genotypes immediately adjacent to the deletion breakpoints suggest they may share a distant common ancestor. Conclusions Previous studies had found that carriers for a single defective CRX allele that was predicted to produce no functional CRX protein had a normal ocular phenotype. Here we show that CRX whole-gene deletion in fact does cause a dominant late-onset macular disease.
Recent research suggests that patterns of alcohol consumption are passed on from generation to generation, particularly from parents to children. Higher levels of alcohol consumption in parents have been found to be associated with higher levels of consumption in offspring (Rossow et al., 2015) with monthly episodic drinking in adolescents influenced by parenting styles as well as parental attitudes and behaviours towards alcohol (Stafstrom 2014). Parental provision of the first drink potentially reduces subsequent alcohol-related risks compared to introduction to alcohol by friends and other sources (Kelly et al. 2012). A scoping review showed that, in around two out of three studies, parental drinking was predictive of adolescent alcohol use (Rossow et al., 2015). Such parental influences are related to age in that the drinking styles of parents are more likely to influence younger children, whereas older children are principally influenced by the mother’s drinking style (Otten et al. 2008). Moreover, intergenerational influences are bi-directional in that older children’s alcohol consumption can later influence the drinking styles of both parents, though this direction of influence is weaker (Otten et al. 2008).
Objective: This study assessed the intention and predictors of accepting the corona virus disease 2019 (COVID-19) vaccine in Jordan. Method: A national-level online survey was conducted among adults (≥18 years) in Jordan between June and September 2021. Descriptive analyses were performed to report vaccination intent. In addition, bivariate and multivariate logistic regression analyses were done to evaluate the association between vaccination intent and its predictors. Results: A total of 2307 adults participated. Most of them (83.7%) expressed an intention to receive a COVID-19 vaccine. Their vaccination intention was significantly (p < 0.001) associated with male gender (aOR: 2.6), residence in the Amman region (aOR: 51.8), and no history of COVID-19 infection (aOR: 6.0). In contrast, individuals aged 50-64 years (aOR: 0.2, p < 0.001), Jordanians (aOR: 0.7, p = 0.038), and those with an occupation designated as "other" (unemployed, general workers, housewives) (aOR: 0.2, p < 0.001) were less likely to have a positive vaccination intent. Among the health belief model constructs, perceived future (aOR: 2.8) and present (aOR: 5.0) susceptibility to COVID-19 infection; severity of complications (aOR: 9.9); and benefits (aOR: 100.8) were significantly (p < 0.001) associated with a higher likelihood of having a vaccination intent. On the other hand, individuals who are concerned about the efficacy (aOR: 0.2) and side effects (aOR: 0.2) of the vaccine were less likely to have a positive vaccination intent (p < 0.001). Conclusion: Despite having high rates of intention to receive a COVID-19 vaccine, Jordanians, older adults and housewives, general workers and unemployed individuals were less likely to be vaccinated. These findings highlight that need-based public health campaigns are necessary to ensure maximum COVID-19 vaccination uptake in Jordan.
Ever since the existence of financial markets, predicting stocks’ movement has been crucial for investors in order to increase their investment returns. Despite the plethora of research, the outstanding literature provides mixed results concerning the choice of model. Are Artificial Intelligence systems valid techniques in predicting stock prices? Do deep learning models outperform machine learning models? Through developing different machine and deep learning models, the overall findings reveal that deep learning techniques (i.e., ANN and LSTM) outperform machine learning techniques (i.e., SVR) in price prediction. The results are validated using different accuracy measures.
Over the past few years, the computation capability of field-programmable gate arrays (FPGAs) has increased tremendously. This has led to the increase in the complexity of the designs implemented on FPGAs and to the time taken by the FPGA back-end flow. The FPGA back-end flow comprises of many steps, and routing is one of the most critical steps among them. Routing normally constitutes more than 50% of the total time taken by the back-end flow and an optimization at this step can lead to overall optimization of the back-end flow. In this work, we propose enhancements to the routing step by incorporating a reinforcement learning (RL)-based framework. In the proposed RL-based framework, we use the ϵ-greedy approach and customized reward functions to speed up the routing step while maintaining similar or better quality of results (QoR) as compared to the conventional negotiation-based congestion-driven routing solution. For experimentation, we use two sets of widely deployed, large heterogeneous benchmarks. Our results show that, for the RL-based framework, the ϵ-greedy greedy approach combined with a modified reward function gives better results as compared to purely greedy or exploratory approaches. Moreover, the incorporation of the proposed reward function in the RL-based framework and its comparison with a conventional routing algorithm shows that the proposed enhancement requires less routing time while giving similar or better QoR. On average, a speedup of 35% is recorded for the proposed routing enhancement as compared to negotiation-based congestion-driven routing solutions. Finally, the speedup of the routing step leads to an overall reduction in the execution time of the back-end flow of 25%.
Aims: Little research has examined factors underlying COVID-19 vaccine hesitancy or refusal in Black and Asian individuals in England, among whom hesitancy tends to be higher than in the general population. This qualitative study aimed to gain an understanding of factors affecting hesitancy in Black and Asian individuals in England, to help address concerns about having the vaccine. Method: Ninety-five participants (51 women, 42 men, 2 other; 58% were aged between 30 and 49) recruited via a market recruitment agency, local Healthwatch networks and using a snowballing method, participated in four activities on an online engagement platform, sharing their attitudes towards the COVID-19 vaccine roll-out, and factors shaping their beliefs and concerns, over five weeks April-March 2021. Results: Inductive thematic analysis revealed five themes: 1. A variety of views on the COVID-19 vaccine, 2. Targeted messaging for Black and Asian people as counterproductive, 3. Confusion over the purpose of the vaccine roll-out, 4. Hesitancy to take the vaccine, and 5. Local networks as a trusted source of information. Conclusions: Our findings suggest that respecting individuals’ agency, transparency of information provided, and the independence of the bodies providing this information, is important. Instead of targeted messaging, local networks should be used in campaigns to increase COVID-19 vaccine uptake among Black and Asian individuals.
Background: Sexual and gender-based violence (SGBV) is highly prevalent in Uganda and its link with HIV infection and compromising access to HIV/AIDS services is known. However, current evidence is controversial. Most of the studies indicate a positive relationship but a few indicate otherwise. Moreover, there is no research examining the effects of community-level SGBV on HIV infection. Objectives: This research explores the association between SGBV and vulnerability to HIV infection. Methods: Multilevel binary logistic regression is applied to secondary data of Uganda AIDS Indicators Survey conducted in 2011. The survey data comprises 12,153 women and 9588 men. Results: SGBV significantly increases the likelihood of HIV infection, with victims having 34%, 1.34 [1.06–1.70] higher odds than non-victims. At the community level, wealth, and pre-sex alcohol abuse are important determinants. Conclusions: Vulnerability to the risk of HIV infection in Uganda is associated with individual-level and community factors. Effective HIV prevention policies need to pay attention to victims of SGBV using individual- and community-level strategies.
Deregulated polyamine biosynthesis is emerging as a common feature of neuroblastoma and drugs targeting this metabolic pathway such as DFMO are in clinical and preclinical development. The polyamine analog verlindamycin inhibits the polyamine biosynthesis pathway enzymes SMOX and PAOX, as well as the histone demethylase LSD1. Based on our previous research in acute myeloid leukemia (AML), we reasoned verlindamycin may also unblock neuroblastoma differentiation when combined with all- trans -retinoic acid (ATRA). Indeed, co-treatment with verlindamycin and ATRA strongly induced differentiation regardless of MYCN status, but in MYCN-expressing cells, protein levels were strongly diminished. This process was not transcriptionally regulated but was due to increased degradation of MYCN protein, at least in part via ubiquitin-independent, proteasome-dependent destruction. Here we report that verlindamycin effectively induces the expression of functional tumor suppressor—antizyme via ribosomal frameshifting. Consistent with previous results describing the function of antizyme, we found that verlindamycin treatment led to the selective targeting of ornithine decarboxylase (the rate-limiting enzyme for polyamine biosynthesis) as well as key oncoproteins, such as cyclin D and Aurora A kinase. Retinoid-based multimodal differentiation therapy is one of the few interventions that extends relapse-free survival in MYCN-associated high-risk neuroblastoma and these results point toward the potential use of verlindamycin in this regimen.
Background Bariatric and Metabolic Surgery (BMS) is a popular weight loss intervention worldwide, yet few scientific studies have examined variations in preoperative practices globally. This study aimed to capture global variations in preoperative practices concerning patients planned for BMS. Methods A 41-item questionnaire-based survey was designed and the survey link was freely distributed on social and scientific media platforms, email groups and circulated through personal connections of authors. The survey included eight parts: basic information; criteria for BMS; preoperative nutritional screening; preoperative weight loss; preoperative diets for liver size reduction; preoperative glycemic control; other laboratory investigations and preparations; decision making, education, and consents. Descriptive statistics were used to analyse data and graphs were used for representation where applicable. Results Six hundred thirty-four bariatric healthcare professionals from 76 countries/regions completed the survey. Of these, n = 310 (48.9%) were from public hospitals, n = 466 (73.5%) were surgeons, and the rest were multidisciplinary professionals. More than half of respondents reported using local society/association guidelines in their practice (n = 310, 61.6%). The great majority of respondents routinely recommend nutritional screening preoperatively (n = 385, 77.5%), mandatory preoperative diets for liver size reduction (n = 220, 53.1%), routine screening for T2DM (n = 371, 90.7%), and mandate a glycemic control target before BMS in patients with T2DM (n = 203, 55.6%). However, less than half (n = 183, 43.9%) recommend mandatory preoperative weight loss to all patients. Most respondents (n = 296, 77.1%) recommend psychological intervention before surgery for patients diagnosed with psychological conditions. Variations were also identified in laboratory investigations and optimisation; and in the aspects of decision making, education and consent. Conclusions This survey identified significant global variations in preoperative practices concerning patients seeking primary BMS. Our findings could facilitate future research for the determination of best practice in these areas of variations, and consensus-building to guide clinical practice while we wait for that evidence to emerge.
Background Additive Manufacturing due to its benefits in developing parts with complex geometries and shapes, has evolved as an alternate manufacturing process to develop implants with desired properties. The structure of human bones being anisotropic in nature is biologically functionally graded i,e. The structure possesses different properties in different directions. Therefore, various orthopedic implants such as knee, hip and other bone plates, if functionally graded can perform better. In this context, the development of functionally graded (FG) parts for orthopedic application with tailored anisotropic properties has become easier through the use of additive manufacturing (AM). Objectives and Rationale: The current paper aims to study the various aspects of additively manufactured FG parts for orthopedic applications. It presents the details of various orthopedic implants such as knee, hip and other bone plates in a structured manner. A systematic literature review is conducted to study the various material and functional aspects of functionally graded parts for orthopedic applications. A section is also dedicated to discuss the mechanical properties of functionally graded parts. Conclusion The literature revealed that additive manufacturing can provide lot of opportunities for development of functionally graded orthopedic implants with improved properties and durability. Further, the effect of various FG parameters on the mechanical behaviour of these implants needs to be studied in detail. Also, with the advent of various AM technologies, the functional grading can be achieved by various means e.g. density, porosity, microstructure, composition, etc. By varying the AM parameters. However, the current limitations of cost and material biocompatibility prevent the widespread exploitation of AM technologies for various orthopedic applications.
In the context of global pandemic Coronavirus disease 2019 (COVID-19) that threatens life of all human beings, it is of vital importance to achieve early detection of COVID-19 among symptomatic patients. In this paper, a computer aided diagnosis (CAD) model Cov-Net is proposed for accurate recognition of COVID-19 from chest X-ray images via machine vision techniques, which mainly concentrates on powerful and robust feature learning ability. In particular, a modified residual network with asymmetric convolution and attention mechanism embedded is selected as the backbone of feature extractor, after which skip-connected dilated convolution with varying dilation rates are applied to achieve sufficient feature fusion among high-level semantic and low-level detailed information. Experimental results on two public COVID-19 radiography databases have demonstrated the practicality of proposed Cov-Net in accurate COVID-19 recognition with accuracy of 0.9966 and 0.9901, respectively. Furthermore, within same experimental conditions, proposed Cov-Net outperforms other six state-of-the-art computer vision algorithms, which validates the superiority and competitiveness of Cov-Net in building highly discriminative features from the perspective of methodology. Hence, it is deemed that proposed Cov-Net have a good generalization ability so that it can be applied to other CAD scenarios. Consequently, one can conclude that this work has both practical value in providing reliable reference to the radiologist and theoretical significance in developing methods to build robust features with strong presentation ability.
Background The increase in and complexity of health challenges has necessitated the need for multi-professional approaches to healthcare and the integration of care services. This study aims to gain an understanding of the role of interprofessional education (IPE) in the integration of care services. Methods A systematic review was conducted using the Discover platform to search databases including MEDLINE, CINAHL, Education Research Complete, Psychology & Behavioural Service Collection to identify publications on interprofessional education in health care services. Results Evidence supports IPE as a useful tool to enhance collaborative efforts in disease management and improve patient-centred healthcare delivery. IPE also leads to an overall improvement in diagnosis, treatment and quality of care. Conclusion We found that IPE enhances collaboration, cohesion and communication in pursuit of optimal patient-centred results, and reduced rigid professional perspectives that can lead to poorer outcomes for patients.
Abstract Background Laparoscopic surgery has almost replaced open surgery in many areas of Gastro-Intestinal (GI) surgery. There is currently no published expert consensus statement on the principles of laparoscopic GI surgery. This may have affected the training of new surgeons. This exercise aimed to achieve an expert consensus on important principles of laparoscopic GI surgery. Methods A committee of 38 international experts in laparoscopic GI surgery proposed and voted on 149 statements in two rounds following a strict modified Delphi protocol. Results A consensus was achieved on 133 statements after two rounds of voting. All experts agreed on tailoring the first port site to the patient, whereas 84.2% advised avoiding the umbilical area for pneumoperitoneum in patients who had a prior midline laparotomy. Moreover, 86.8% agreed on closing all 15 mm ports irrespective of the patient's body mass index. There was a 100% consensus on using cartridges of appropriate height for stapling, checking the doughnuts after using circular staplers, and keeping the vibrating blade of the ultrasonic energy device in view and away from vascular structures. An 84.2% advised avoiding drain insertion through a ≥10 mm port site as it increases the risk of port-site hernia. There was 94.7% consensus on adding laparoscopic retrieval bags to the operating count and ensuring any surgical specimen left inside for later removal is added to the operating count. Conclusion Thirty-eight experts achieved a consensus on 133 statements concerning various aspects of laparoscopic GI Surgery. Increased awareness of these could facilitate training and improve patient outcomes.
Research shows that bystander training has the potential to reduce violence and abuse. It is not clear how and why the training works. We evaluated bystander training to find out what works. We found that interactive techniques, such as group discussions, ‘the video’, and the use of real‐world examples were the best ways of delivering the training because they stood out and were remembered by participants. These findings add to the paucity of research on what works in bystander training, and in doing so, raises implications for the design and delivery of future training.
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Rosaleen Joy Anderson
  • Sunderland Pharmacy School
Salla Marttonen-Arola
  • Faculty of Engineering and Advanced Manufacturing
Noel M Carter
  • Faculty of Health Sciences and Wellbeing
John Storey
  • Centre for Research in Media and Cultural Studies (CRMCS)
Kalliopi Dodou
  • Faculty of Health Sciences & Wellbeing
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