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The correlation between static and dynamic facial dysmorphology in unilateral cleft lip and palate (UCLP)
Get PDFObjective – The objective of this study was to assess the correlation between static (3D) facial dysmorphology at both rest and maximum smile and dynamic (4D) facial dysmorphology as represented by the frame of maximum asymmetry during a maximum smile in unilateral cleft lip and palate (UCLP). When maximum asymmetry occurs during a maximum smile was also analysed.
Design and setting – This study was designed as a retrospective cross-sectional study utilising quantitative methodology to assess a cohort of patients with a diagnosis of non-syndromic unilateral cleft lip and palate (UCLP). Patients had 4D imaging carried out at Glasgow Dental Hospital and School for audit purposes and as part of their routine care by the local cleft team working under the Managed Clinical Network (MCN) Cleft Care Scotland.
Materials and Methods – Thirty-one (31) patients between the ages of 13 to 17 years old with a diagnosis of non-syndromic unilateral cleft lip and palate (UCLP) had 4D images based on passive stereophotogrammetry captured at 60 frames per second (fps). Each patient was captured performing a maximum smile three times over a three second window. Data processing involved the conformation of a generic mesh containing over 7000 vertices or quasi-landmarks to the facial surface before tracking all the vertices during the facial expression. Partial ordinary Procrustes analysis was utilised to calculate an asymmetry score for each frame during the expression. The rest frame (3D), frame of maximum smile (3D), and frame of maximum asymmetry (4D) were used to determine the correlation between static and dynamic facial dysmorphology.
Results – Asymmetry scores were higher at maximum smile than at rest and maximum asymmetry was most frequently observed during the relaxation phase following a maximum facial expression (N=27/31; 87.1%). Asymmetry scores for maximum smile were less than but comparable to maximum asymmetry scores. Static (3D) asymmetry at rest and maximum smile was strongly correlated to dynamic (4D) facial asymmetry represented by the frame of maximum asymmetry during a maximum smile. The strongest correlation was seen with analysis using the frame of maximum smile focussing on the nasolabial region.
Conclusions – The use of 4D imaging combined with mesh conformation and dense correspondence analysis provides a valid objective measure of facial asymmetry. The fact that asymmetry scores for maximum smile were less than but comparable to maximum asymmetry scores highlights that assessment of facial asymmetry at maximum smile is still a valid assessment of facial dysmorphology despite not depicting the full extent of the asymmetry. Static (3D) asymmetry at rest and maximum smile is strongly correlated to; and likely highly predictive of, dynamic (4D) facial asymmetry represented by the frame of maximum asymmetry during a maximum smile. The strongest correlation is seen with analysis using the frame of maximum smile focussing on the nasolabial region. Future research could use linear regression modelling to predict dynamic (4D) asymmetry scores using static (3D) images
What constitutes fruitful continuing ministry development for Baptist ministers in Scotland?
Get PDFThis thesis presents a series of discoveries about what has contributed to the continuing development of Baptist ministers in Scotland. Previous scholarship has focused on the initial training of ministers (eg Reber and Reber 2010, Goodliff 2017) and the impact of initial ministry education on ministerial practice in the early years (eg Scharen and Campbell-Reid 2016). Denominations have produced guidance for ministers on how to pursue continuing development (eg Archbishop’s Council 2010a, Church of Scotland 2017, Methodist Church 2018) which has been the focus of some evaluative studies (eg Hamill 2010, Wilkin 2014, Clinton, 2016, Denton and Thomas 2017). This research uses narrative inquiry to listen to the way practising ministers describe what has actually been developmental for them over the years and decades of their ministries. Key themes that emerge are the desire for practical wisdom, the importance of communal learning, the impact of development dialogues and the significance of habits. In the light of these discoveries I propose a new way of defining Continuing Ministry Development and make recommendations as to how these could be reflected in the practice of denominations and networks of churches
The use of translation in English for specific academic purposes classes in Saudi Arabia
Get PDFThe use of translation in second language pedagogy has long been a topic of controversy, discussion and debate. Translation was omnipresent as a language teaching method, with its dominance well-documented in the scholarly literature concerned with foreign language teaching (Kelly, 1969). However, the end of the 19th century marked a watershed moment, which saw translation fall from grace owing to critics representing the Reform Movement, who voiced a chorus of disapproval of its excessive emphasis on the written form of language to the detriment of oral proficiency. This gave rise to a host of alternative teaching methods, e.g. the Direct Method, the Berlitz Method, and the Natural Method, prioritising the development of oral competence, which translation was thought to impede, and thus was only deemed attainable if second language teaching followed a monolingual approach. Consequently, much criticism, controversy and scepticism surrounded the use of translation, with the credo that English is best taught through English prevailing as an axiom that permeated the theoretical discourse, despite relying on assumptions rather than being evidence-based (G. Cook, 2010). Since the recent turn of century, however, a growing, revived interest in translation has been observed, in conjunction with a flurry of publications and academic research advocating a return to bi/multilingual teaching, so much so that it has been termed the translation turn (Carreres & Noriega-Sánchez, 2021).
Against this backdrop, this thesis seeks to explore the attitudes of Saudi university English for specific academic purposes (ESAP) teaching staff and students to translation, the purposes for which they use it and the factors leading to its use, in addition to investigating their actual use of translation in practice. A mixed-method approach, employing classroom observations, surveys and interviews, is employed to gain an in-depth understanding of the topic under study. The results of the inquiry provide evidence of widespread use of translation in ESAP classes, despite the teaching staff being strongly in favour of an English-only approach. This offers yet another indication of the complex relationship between what teachers believe and what they actually do repeatedly reported in the literature, in this case concerning the difference between teachers’ attitudes to the use of translation and what actually occurs in their practice. The findings further show an appreciation of the merits of translation among both teachers and students, which is primarily drawn upon when issues of students’ low proficiency arise, as well as when teaching and learning complex ESAP vocabulary and grammar
Exploring and visualising the purpose, concepts and development of hospices in England from the perspective of hospice chief executives
Get PDFThis study sheds new light on the purpose, concepts and development of independent charitable hospices in England serving adults. Hospices in the UK are the largest charity group sharing a combined annual income of over £1.6 billion. The majority emerged in the late twentieth century to meet the needs of dying people that had been neglected by the NHS. Today, over 200 hospices function in very different health and socio-economic contexts across the UK. Hospice chief executives (CEOs) have oversight of all aspects of hospice operations and this is one of the first studies to identify their varied perspectives about why hospices are here, their conceptual basis, dynamic construction and developing contribution to end-of-life living, dying and death.
Adopting a qualitative methodology, 31 hospice CEOs were interviewed during 2019/20 with 17 taking place during the beginning of the Covid-19 pandemic in England. Their responses were analysed using thematic analysis and a social constructionist approach that drew on Gergen’s concept of intelligibility nuclei and his application of Greimas’s semiotics with context provided from hospice history, organisation, business and leadership studies. The study found a kaleidoscope of views amongst respondents which revealed awareness of tensions between science and humanity, medical and social needs, intimacy and scale. There was a consensus that society is still not dealing well with death and that many people are still missed by the system. Revealing the complexity of the hospice mission, the concept of hospice was understood in a variety of ways, for instance as: a vehicle to deliver care; a safe place to do things differently; a quality of care; a philosophy and belief; a community resource and a social movement. The study showed that hospices have many potential and actual strategic roles, such as those of provider, exemplar, collaborator, empowerer, explorer, agent, broker and disrupter. Significant obstructions to development, including physical threats to CEOs, were also identified.
The study is unique in having mapped this intricate and varied social construction of hospices through Gergen’s application of semiotic squares. This visual device enables the variety of perspectives held within hospices and the landscape in which they are embedded to be presented in a way that has not been seen before. It therefore has relevance for the future development of hospices both locally and nationally, and for their impact on British society in the twenty-first century
The co-operative movement in Scotland 1945-1973: profits, principles, and politics
No full textAbstract not currently available
Assessing success in large law firm mergers: a neo-configurational approach
Get PDFThis study identifies configurations of antecedent conditions that are consistent with success in large law firm mergers. Practitioner perspectives concerning merger motives and factors causal of success are distilled into propositions and conditions reflective of those and tested using fuzzy set qualitative comparative analysis (fsQCA). The study analyses 73 mergers that took place from 2002 to 2017 in which at least one firm was headquartered in the U.S. or U.K., the target firm consisted of ≥100 lawyers and the combined firm of ≥500 lawyers.
Merger success in extant literature is typically defined and measured through use of stock market metrics, or otherwise through methods that are poorly aligned with the organisational logics of pure PSFs. This study hence, of necessity, includes a novel multidimensional model to define and assess merger success in the context of large law firms, specifically.
Two iterations of analysis were performed, the first based primarily on data drawn from league tables published on law firm performance and reputation, and involving six conditions that would typically exist in and/or between law firms contemplating a merger. These conditions are: (1) a high-performing acquiror firm; (2) a target firm exhibiting high necessity for the merger; (3) power asymmetry in favour of the acquiror firm; (4) a high degree of relatedness between the firms; (5) a multi-dimensional strategic opportunity underpinning the merger; and (6) the combined firm adopting a unitary (as opposed to dispersed) approach to governance. In the second iteration of analysis, the first and third conditions were conflated and rubrics used to supplement the data used in the first.
The study is undertaken through the lens of the resource based view (RBV). The selected conditions therefore relate to VRIO resources that are enhanced or acquired through the mergers, following previous research that define VRIO resources consistent with sustainable competitive advantage in PSFs.
Several pathways to successful mergers are identified and described. A multidimensional strategic opportunity is shown to be, of itself, both necessary and sufficient for success under almost all circumstances, overriding in importance several other factors that practitioners typically consider to be of at least equal importance. Three types of merger are identified that the study shows to be consistently successful. These are assortative mergers (in which the merging firms have a high degree of relatedness to each other, in configuration with a multidimensional strategic opportunity), white knight mergers (where a strong acquiring firm combines with a poorly performing target firm) and leapfrog mergers (where a target firm that is not poorly performing combines with a larger firm with which it has a high degree of relatedness.
Power and participation in humanitarian aid assemblages: a case study of a paediatric Noncommunicable Disease Unit in Lebanon
Get PDFOver time, the humanitarian healthcare sector has evolved into a complex system of specialised organisations, shaped by geopolitical, cultural, social, and economic forces, that influence global social and political decision-making. Humanitarian healthcare settings can be spaces of great power inequity. This study took place in Lebanon, a conflict-affected state reliant on international humanitarian healthcare due to compounded shocks and state neglect. I explore how a pandemic, a terrible explosion and an economic collapse impacted people in one paediatric Noncommunicable Disease (NCD) unit. This research contributes to the wider debate on the necessity for long-term NCD treatment in humanitarian contexts, often offering temporary care.
This thesis explores power and participation in aid assemblages, investigating the relationships and connections between ideas, the international headquarters and on the ground project implementation. The objective was to develop the understanding of the power formation processes in humanitarian healthcare, tracing project decisions and their consequences, and whether participatory socio-culturally responsive methods support in decentering power in lowresource spaces of aid. While participatory approaches are well-studied in supporting patients and healthcare workers in the ‘Global North’, their application in the Middle East and North Africa (MENA) remains less understood. This study was conducted with Syrian families who accessed Médecins Sans Frontières (MSF) services for paediatric NCD care and MSF staff, with an independent Syrian researcher, Belal Shukair. Methods included audio diaries, interviews, document analysis and codevelopment groups, fostering a social justice-oriented methodological approach.
This research documents the micro-processes of the everyday discrimination, mechanisms and assumptions about power hierarchies in aid assemblages. There were significant methodological differences between staff and service users. Staff engaged to collectively improve the NCD service, while service prioritised concerns beyond thalassemia treatment. Lebanon’s crises exposed stark inequalities. This study details the decision-making processes and consequences of MSF’s service redesign in response to the crises, how staff resisted and reformed the structures of aid. Syrian service users described the increasingly constrained healthcare access and the tactics they used to secure care. All participants expressed a shared sense of loss amid crises. Amid the economic collapse, participants debated the value of healthcare. The analogy of a collapsing tent illustrated aid-induced precarity. While their experiences differed, their meanings were expressed in similar ways.
The aid sector, relying on precarious staff contracts and project funding, responds to healthcare needs in spaces of crises but often neglects a biosocial approach to long-term care for NCDs. I evidence that Western-centric value system construct the humanitarian healthcare sector, as value was often interpreted as value for money. Postcolonial systems erase the complexity of health, shaping how people see healthcare needs and service design. I argue that considering the value of what the healthcare means to individuals who receive it, alongside considering what it accomplishes at a macro epidemiological level, will achieve a localised, way of understanding health, reducing cultural collisions. Moreover, it will meet the increasingly needed permanent, continuity-focused health care aid to ensure that NCDs treatment is not compromised in humanitarian contexts. Taking this approach enables a move beyond traditional practices of meeting basic needs for survival towards enhancing lives.
This work is a response to the critique of humanitarian healthcare structures, the call for improved accountability, sustainability and patient centred care. This research contributes to the understanding of chronic illness management in conflict-affected settings and whether participatory approaches may prove to be a useful method in developing long-term care in humanitarian healthcare settings
Modulating the local innate immune response in the central nervous system to protect against progressive multifocal leukoencephalopathy
No full textMultiple sclerosis (MS) is a chronic disease of the central nervous system (CNS) characterised by inflammation and demyelination. As a leading cause of disability in adults, several disease modifying therapies are now available. Many of these work by suppressing the immune system which, while effective, can leave people with MS susceptible to opportunistic infections. One of the most severe of these is progressive multifocal leukoencephalopathy (PML), a rare but often fatal infection of oligodendrocytes by Human Polyomavirus 2, more commonly known as John Cunningham virus. There currently are no antivirals or vaccines for PML, therefore the only treatment option involves stopping immunosuppressive treatments, leaving patients at risk of further MS-related inflammatory events. As a result, there is a need to develop antivirals that work in conjunction with immunosuppressive treatments.
A subset of MS patients synthesise intrathecal lipid-reactive IgM, the presence of which has been associated with a reduced incidence of PML. This is compatible with our lab’s recent observation that the murine lipid-reactive IgM antibody clone O4, when added to murine myelinating cell cultures, induces the expression of interferon beta (IFN-β). As IFN-β is produced in response to viral infection, these data could explain why individuals with lipid-reactive IgM seem protected from PML.
These findings prompted our investigation into the effect of IFN-β treatment on the major cell types of the CNS; the oligodendrocytes, microglia, neurons, and astrocytes. Using murine CNS cell cultures, we utilised fluorescence activated cell sorting (FACS) to separate out the individual cell types of the CNS for RNAseq analysis. This way we characterised the unique transcriptional profile of each individual cell-type following IFN-β treatment. Importantly, several oligodendrocyte-unique genes were upregulated including Il10ra, the gene encoding IL-10R. It was deduced through RT-qPCR, plaque assays, and fluorescence microscopy that treatment with IFN-β or blocking IL-10R was able to decrease infectivity of a model neurotropic virus both in vitro and in vivo.
The data presented in this thesis provides evidence of innate antiviral activity of oligodendrocytes which can be manipulated pharmacologically to protect against viral infection. This research will aid in the development of future therapeutics to decrease the infectivity of JCV in the CNS. This would allow MS patients to remain on their effective therapeutics without being at increased risk. Further investigation of the IFN-β response of the CNS could lead to the development of an antiviral therapy that can be used as a cotreatment in MS or as a broad-spectrum antiviral for viral encephalitis
Meat, gender, and capital in contemporary Scottish fiction
No full textAbstract not currently available
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