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Core requirements of frailty screening in the emergency department:an international Delphi consensus study
No full textIntroduction
Frailty is associated with adverse outcomes among patients attending emergency departments (EDs). While multiple frailty screens are available, little is known about which variables are important to incorporate and how best to facilitate accurate, yet prompt ED screening. To understand the core requirements of frailty screening in ED, we conducted an international, modified, electronic two-round Delphi consensus study.
Methods
A two-round electronic Delphi involving 37 participants from 10 countries was undertaken. Statements were generated from a prior systematic review examining frailty screening instruments in ED (logistic, psychometric and clinimetric properties). Reflexive thematic analysis generated a list of 56 statements for Round 1 (August–September 2021). Four main themes identified were: (i) principles of frailty screening, (ii) practicalities and logistics, (iii) frailty domains and (iv) frailty risk factors.
Results
In Round 1, 13/56 statements (23%) were accepted. Following feedback, 22 new statements were created and 35 were re-circulated in Round 2 (October 2021). Of these, 19 (54%) were finally accepted. It was agreed that ideal frailty screens should be short (<5 min), multidimensional and well-calibrated across the spectrum of frailty, reflecting baseline status 2–4 weeks before presentation. Screening should ideally be routine, prompt (<4 h after arrival) and completed at first contact in ED. Functional ability, mobility, cognition, medication use and social factors were identified as the most important variables to include.
Conclusions
Although a clear consensus was reached on important requirements of frailty screening in ED, and variables to include in an ideal screen, more research is required to operationalise screening in clinical practice
Grammar-obeying program synthesis: A novel approach using large language models and many-objective genetic programming
No full textProgram synthesis is an important challenge that has attracted significant research interest, especially in recent years with advancements in Large Language Models (LLMs). Although LLMs have demonstrated success in program synthesis, there remains a lack of trust in the generated code due to documented risks (e.g., code with known and risky vulnerabilities). Therefore, it is important to restrict the search space and avoid bad programs. In this work, pre-defined restricted Backus–Naur Form (BNF) grammars are utilised, which are considered ‘safe’, and the focus is on identifying the most effective technique for grammar-obeying program synthesis, where the generated code must be correct and conform to the predefined grammar. It is shown that while LLMs perform well in generating correct programs, they often fail to produce code that adheres to the grammar. To address this, a novel Similarity-Based Many-Objective Grammar Guided Genetic Programming (SBMaOG3P) approach is proposed, leveraging the programs generated by LLMs in two ways: (i) as seeds following a grammar mapping process and (ii) as targets for similarity measure objectives. Experiments on a well-known and widely used program synthesis dataset indicate that the proposed approach successfully improves the rate of grammar-obeying program synthesis compared to various LLMs and the state-of-the-art Grammar-Guided Genetic Programming. Additionally, the proposed approach significantly improved the solution in terms of the best fitness value of each run for 21 out of 28 problems compared to G3P.This work was supported by Science Foundation Ireland grant 13/RC/2094_P2 to Lero - the Science Foundation Ireland Research Centre for Software (https://www.lero.ie).peer-reviewe
‘It was in the Air’: Micro and macro flows in the changing soundscape of Irish traditional music in Galway, 1961 to 1981
No full textThis thesis investigates the emergence of a vibrant Irish traditional music scene in Galway City and explores changes in its soundscape, from 1961 to 1981. Changes in the world of traditional music, embedded in Irish traditional and Anglo-American folk music revival processes of the 1960s and 1970s, were also the result of societal and economic developments. Crucially, the novel playing of Irish traditional music in pubs, relocated from performances in dance halls and private spaces (homes), provided access, aided transmission and propelled music revival at local level and functioned as a fertile cultural ground. The theoretical lens of this historical ethnography focuses on micro and macro flows, and – extending anthropologist Arjun Appadurai’s concept – fluid spaces. This analytical prism enables a nuanced understanding of socio-cultural occurrences at the intersection of personal and societal spheres. Three particular stimuli emerge for Galway’s metamorphosis into an urban centre for Irish traditional music practice: revival efforts of Comhaltas Ceoltóirí Éireann, the second wave of Anglo-American folk revival, and site-specific circumstances. The latter comprise the city’s status as regional economic centre; transient and migration flows with surrounding, culturally rich rural areas; and grassroots flows with the University of Galway. Drawing an atlas of cultural practice, this thesis expands the knowledge of Irish traditional music in Galway and advances research on urban music revival. Crucially, it presents an original understanding of Galway’s cultural landscape, placing Irish traditional music at the root of Galway’s emerging festival culture, 1961 to 1981.2026-04-1
How far the zone of heat-induced transient block extends beyond the lesion during RF catheter cardiac ablation
No full textPurpose While radiofrequency catheter ablation (RFCA) creates a lesion consisting of the tissue points subjected to lethal heating, the sublethal heating (SH) undergone by the surrounding tissue can cause transient electrophysiological block. The size of the zone of heat-induced transient block (HiTB) has not been quantified to date. Our objective was to use computer modeling to provide an initial estimate. Methods and materials We used previous experimental data together with the Arrhenius damage index (Ω) to fix the Ω values that delineate this zone: a lower limit of 0.1–0.4 and upper limit of 1.0 (lesion boundary). An RFCA computer model was used with different power-duration settings, catheter positions and electrode insertion depths, together with dispersion of the tissue’s electrical and thermal characteristics. Results The HiTB zone extends in depth to a minimum and maximum distance of 0.5 mm and 2 mm beyond the lesion limit, respectively, while its maximum width varies with the energy delivered, extending to a minimum of 0.6 mm and a maximum of 2.5 mm beyond the lesion, reaching 3.5 mm when high energy settings are used (25 W–20s, 500 J). The dispersion of the tissue’s thermal and electrical characteristics affects the size of the HiTB zone by ±0.3 mm in depth and ±0.5 mm in maximum width. Conclusions Our results suggest that the size of the zone of heat-induced transient block during RFCA could extend beyond the lesion limit by a maximum of 2 mm in depth and approximately 2.5 mm in width.This work was supported by Spanish Ministerio de Ciencia, Innovación y Universidades/Agencia Estatal de Investigación IMCIN/AEI/10.13039/501100011033 (Grant RTI2018-094357-B-C21).peer-reviewe
Deepening the theatre experience for young audiences: Mapping the aims and impact of extended performance engagement
No full textTheatre for Young Audiences (TYA) commonly uses engagement practices to extend the theatrical experience for children and adults before and/or after a theatrical event. These are often referred to as wrap-around activities and are ancillary to the performance, which is considered the main part of the event. In this thesis I name and define these activities as extended performance engagement (EPE), examining their value as an integral part of the entire theatrical event and after. The EPE practices I focus on are commonly used by TYA organisations and include pre-performance workshops, teacher resource guides, question and answer sessions, lobby displays, and post-performance workshops. However, there is limited evidence about how and why arts practitioners and primary school teachers use EPE to engage child audiences before and after performance and what impact these practices have. Many have written about the value of theatre for young audiences, however few focus on the aims, practical use, and assessment of these engagement activities. Additionally, there is limited research on who is responsible for creating and facilitating these activities and which arts education policies support their use. Therefore, this thesis argues that a better understanding of what types of EPE exist, how the activities are created, how they are used, and who creates them is necessary to better understand their overall impact. This thesis names and defines EPE practices before, during, and after a global pandemic and deepens understanding of the potential, use, value, and future capacity of this form of engagement across the TYA field. I first provide case studies of current EPE practices from a range of TYA organisations located in Ireland, the USA, and the UK. I then respond to the Irish policy which addresses EPE and the array of roles that create and facilitate EPE in schools and theatres. In the research I report on a practice-based study in which I created and facilitated EPE in an Irish primary school, interviews with teachers and children involved in the field work, and the findings from an international online survey directed at TYA arts practitioners. The results of this study demonstrate the value of EPE from the perspective of children in Ireland, teachers in Ireland, and international arts practitioners, both before, during, and after the pandemic as a way for young audiences to make meaning out of a theatre event. Analysis of the field work data suggests that extended post-performance drama sessions in an Irish primary school led to children strengthening relationships among peers, had the potential to provide opportunities for the students to use their voices and imagination, exposed children to new forms of drama and theatre, and helped students build their confidence. The data suggests that the success of EPE relies on clear communication of goals and a commitment by both the facilitator and classroom teacher to be present and engaged during the partnership. The survey data reveals the disparate connector roles responsible for making EPE happen as well as varying, and some nonexistent, assessment methods for EPE, and the reality that the pandemic made EPE more visible while maintaining relationships between theatres and their audiences at a time when it was not possible to attend live TYA performances. The research communicates the multiple modes of extending engagement surrounding a performance which draw from TYA, Drama in Education, and Theatre in Education: three methodologies that, when drawn from have the potential to more clearly define the impact of EPE for children to connect with others, take on the role of artist, and make deeper meaning out of a theatrical event. This study provides evidence that EPE is essential to the continued personal and professional growth of TYA organisations, primary school teachers, and students. The thesis claims that the connector role which bridges the gap between arts organisations and schools can unify the varying practices of EPE. The research then provides cohesive evidence for arts practitioners and policymakers arguing for more resources to be dedicated to this area of practice to better understand its impact.2026-04-0
An investigation into the factors influencing venom potency in snakes and spiders
No full textA fundamental question in ecology and toxicology is why some venomous species have more potent venoms than others. While there is great interest in venomous species from a medical perspective due to envenomation cases globally, from an ecological perspective, venom is still relatively poorly understood despite its key role in predator-prey interactions. To address this fundamental question, I investigate the role of factors associated with diet and prey capture in the evolution of venom potency in snakes and spiders, two diverse venomous predator groups, using both data collated from the literature and data collected in the field and lab over the course of my PhD. Additionally, my research investigates different venom extraction methods as a factor influencing how venom potency is measured. I investigate the role these factors play in venom potency across four research chapters that represent stand-alone publications consisting of: “Diet Breadth Mediates the Prey Specificity of Venom Potency in Snakes.”; “Spider Venom Potency is Prey-specific but does not trade-off with Body Size or Silk Hunting Strategy.”; “The Relationship between Median Lethal dose (LD50) and Median Effective Dose (ED50) in Spider Venoms” and “Venom Extraction Method Influences Venom Composition and Potency in the Giant House Spider Eratigena atrica (C. L. Koch, 1843)”. In Chapter 2, I use phylogenetic comparative approaches to show that the evolution of preyspecific venom potencies in snakes is contingent on the breadth of a species’ diet, only observing preyspecific patterns in species with taxonomically narrow diets (specialists). In Chapter 3, I extend this phylogenetic comparative approach to spiders and show that they have evolved prey-specific venom potencies and that surprisingly the degree of silk use in prey capture does not trade-off with venom potency. In Chapter 4, I use spider venom bioassay experiments to determine the relationship between different venom potency measures LD50 and ED50, showing that they have a near isometric relationship. Finally in Chapter 5, I demonstrate through venom bioassays and Coomassie-stained SDSPAGE gel electrophoresis that using different venom extraction methods, electrical stimulation and venom gland removal, on the same spider species (Eratigena atrica) can result in venom samples with significantly different potencies and visibly different protein compositions. Throughout this thesis I demonstrate the importance of including factors pertaining to diet and prey capture in the analyses of predator venom evolution along with factors relating to measuring the toxicity and functionality of venom. By investigating and comparing the multitude of factors potentially influencing venom evolution in future research, especially those pertaining to the natural targets of species venoms, we will gain a deeper understanding of the processes surrounding toxin evolution and why some species venoms are deadlier than others.2025-03-2
Gradient-index lenses: Symplectic ray tracing and optical testing
No full textThe chief objective of this thesis is to provide an introduction to symplectic numerical methods and how they may be applied to optical problems, particularly for tracing rays within gradientindex (GRIN) optics. Specifically, we investigate how symplectic methods compare in terms of accuracy with well-established numerical integration techniques such as Euler’s method and the fourth-order Runge-Kutta method (RK4). As a near-term application, symplectic methods are used to render a test image which requires nonlinear ray tracing. The accuracy of implicit numerical methods is also considered, in addition to the derivation of algebraic iteration schemes for lenses with separable index profiles thereby removing the need for root solvers when using implicit methods. Finally, the pyramid wavefront sensor, a component commonly employed in adaptive optics systems, is considered as a means of measuring aberrations present within GRIN elements and is proposed as a tool to undertake the characterisation and optical testing of same
Country-level heterogeneity in foreign institutional investment horizons and firm value
No full textExtant literature on the influence of short- or long-term foreign institutional investors on corporate valuation and strategic decisions implicitly assumes their monitoring role to be homogeneous across all portfolio countries. This paper examines the valuation impact of country-level heterogeneity in foreign institutional investment horizons using a large sample from 32 countries. Our findings show that foreign institutional investors with longer country-level investment horizons enhance firm value, especially in countries with less effective investor protection and firms with higher information asymmetry and susceptibility to agency problems. The results also indicate that the country-specific informational scales attained through longer horizons within a portfolio country enable foreign institutional investors to bridge the information gap between themselves and local institutions. Overall, this study underscores the importance of recognizing the differential monitoring role played by foreign institutional investors across different countries within their portfolios.peer-reviewed2026-01-2
‘Right an turn agadsa’: The reflexivity between language socialisation and child agency in exploring ‘success’ in FLP
No full textThe article explores the mutual relationship—or reflexivity— between language socialisation and child agency. It discusses two respective models developed to: (a) better theorise successful language acquisition in a ‘Family Language Policy’ context (b) conceptualise how children construct their agency through language. These models are implemented in analysing interactions in a family in which the mother is making concerted efforts to transmit the autochthonous minority language Scottish Gaelic to her children. It shows how although initially her attempts in fostering her son Billy's Gaelic linguistic development appear to be ‘unsuccessful,’ later in the interaction, Billy actively uses Gaelic in playing a card game, evidencing his linguistic competency and his embedded knowledge of the power of language in achieving certain interactional functions.The research for this article was supported by the Irish Research Council Government of Ireland Postdoctoral Fellowship entitled ‘The Challenges of Minority Language Maintenance: Family Language Policy in Scotland and Ireland’ (GOIPD/2016/644). The development of the saibhreas and child agency models respectively were supported by projects with Smithsonian Center for Folklife and Cultural Heritage ‘Sustaining Minoritized Languages in Europe (‘SMiLE’) initiative and Marie Skłodowska-Curie Actions ‘Languages, Families, and Society’ (Grant No: 794800).peer-reviewed2024-09-0
Visiting the unsafe: The bibliotherapeutic potential of literature about mental illness
No full textBibliotherapy – broadly defined as the use of reading material to promote personal development and emotional growth – is centered around the notion that literature can have a positive influence on the lives of readers. Although some bibliotherapists argue against the use of potentially distressing texts in bibliotherapy, there is evidence to suggest that literature which directly confronts mental health issues can have a cathartic or therapeutic effect on readers by allowing them to “visit the unsafe”. This thesis therefore explores fictional and (semi)autobiographical texts about mental illness through a bibliotherapeutic lens, positing the idea that reading about mentally ill protagonists could facilitate bibliotherapeutic dialogue. In order to explore this hypothesis, I align the three core stages of bibliotherapy as identified by Caroline Shrodes – identification, catharsis, and insight – with three strands of literary criticism, which are applied to the following texts: Sylvia Plath’s The Bell Jar (1963), Ken Kesey’s One Flew Over the Cuckoo’s Nest (1962), Shirley Jackson’s Hangsaman (1951), and Susanna Kaysen’s Girl, Interrupted (1993). Firstly, this thesis explores how each of the core texts depict mentally ill protagonists who are stigmatised and marginalised as a direct result of their mental illness, which, I argue, could facilitate identification among readers experiencing mental health issues. Next, I examine the literary techniques which elucidate the protagonists’ inner experience of their mental illness and which contribute towards the formation of a consistent stylistic pattern known as mind style. I argue that analysis of mind style could assist the reader with attaining insight during bibliotherapy and could, moreover, help therapists and readers to collaborate in forming a shared language which communicates difficult feelings. Finally, I enquire into the ways in which mentally ill protagonists seek catharsis and recovery by analysing episodes of laughter, self-harm, suicidality, and storytelling within the texts. The thesis concludes that the core texts have therapeutic potential and communicate realities pertaining to lived experiences of mental illness