ABSTRACT
The colonial archive offers comparatively few glimpses of the individual lives of enslaved African women and girls brought to Sierra Leone in the nineteenth century and ‘liberated’ under the ...terms of the British Abolition Act of 1807. This article sets out to do four things: first, to consider what colonial sources reveal about how women and girls experienced and responded to becoming ‘liberated Africans’, and to the ‘disposal’ practices of the Liberated African Department – including schooling, indenture and arranged marriages. Second, it considers what factors might have shaped those experiences. Third, it seeks to make a contribution to the literature on marriage in early colonial Africa by considering whether, and to what extent, British colonial policy towards liberated African women in Sierra Leone meets a modern definition of government‐led coerced or forced marriage. Finally, it evaluates the usefulness and limits of official archives, missionary records, court records and the accounts of self‐styled British Sierra Leone experts for studying the experiences of women and girls, and indicates potential avenues for further research.
Between 1808 and 1848, under the terms of the Abolition Act, thousands of liberated Africans were distributed as apprentices to private citizens in the colony of Sierra Leone. In 1847, Governor ...Fergusson described apprenticeship, by that date primarily of children, as 'a moral millstone round the necks' of the colony's population. The Liberated African Department in particular was singled out by many contemporary European critics as unable or unwilling to monitor the whereabouts of apprentice children and to police the welfare obligations placed on apprentice-holders. This article explores a policy that was identified with widespread patterns of abuse, neglect and re-enslavement, and considers contemporary critiques in terms of underlying anxieties regarding the efficacy of humanitarian governance and the possibility of a post-slavery world.
Cadaveric dissection is widely used in anatomy teaching worldwide. This method develops anatomical knowledge and practical dissection skills, as well as communication and team working. At the School ...of Anatomy, University of Bristol, two of our undergraduate units depend on dissection as a teaching tool.Social distancing guidelines brought about by COVID-19 brought challenges and meant it was not possible for all students to be present around a cadaver simultaneously. We adapted with secure, two-way live streaming, facilitated by ceiling-mounted cameras.Our units utilised the technology in slightly different ways. In a larger cohort, students were not able to attend the dissection room simultaneously and 2-4 students from each group attended, with the remainder (6-8 students) attending via Zoom. In the smaller cohort, all students attended, though only two students could be present around the cadaver, with Zoom used to stream the dissection to those distanced around the room. Those present narrated and ensured visibility of the dissection, whilst posing questions to those at home. The home group provided feedback, generated discussion, and conducted research.This chapter reflects on our experiences using this innovative teaching method. It was a valuable alternative to being in person. Whilst students might have spent less time in the dissection room, their dissection time equalled or was greater than pre-pandemic. Students developed digital confidence and built cohorts, and whilst we reflect on the need for effective communication and digital equity, we offer our best practice and solutions.Whilst in-person teaching has resumed in 2021-2022, investment in this technology enables us to rapidly pivot to a reduced in-person, or an entirely online delivery where required, and we are confident that our delivery will be effective in either case. There are also exciting opportunities for new forms of delivery as well as national and international collaborations.
Characterizing the chemical changes in fungal necromass as it degrades, particularly over short time intervals (days to weeks), is critical to clearly understanding how this organic matter source ...contributes to various belowground carbon and nutrient pools. Using a range of chemical analyses, we assessed the degradation of four types of ectomycorrhizal fungal necromass from three species differing in biochemical composition. Samples were buried in a forest in Minnesota, USA and harvested at eight time points over a 90-day incubation period (1, 2, 4, 7, 14, 28, 60, 90 days). Three of the necromass types lost greater than 50% of their initial mass in the first seven days, but mass loss plateaued for all four types at later harvests, and after 90 days, none of the samples were completely degraded. Relative to undegraded necromass, degraded necromass consistently contained a lower relative abundance of aliphatic compounds and a higher relative abundance of carbohydrates, sterols, and aromatic compounds. For three of the four necromass types, nitrogen content was lower after 90 days of degradation and FTIR spectra revealed distinct peaks broadening from day 0 to day 90. While melanin content significantly slowed degradation within species, differences in degradation rates across species were more closely aligned with initial nitrogen content. Collectively, our results indicate that the rapid mass loss of dead fungal mycelium is accompanied by a wide range of changes in necromass chemistry, likely contributing to both short-term soil nutrient and longer-term carbon pools.
•Mass loss is rapid but best modeled as having both fast- and slow-degrading pools.•Melanin content affects the rate of degradation within a species.•Nitrogen content affects the rate of degradation between species.•During degradation, aromatic content increases and aliphatic content decreases.•Fungal necromass chemically resembles soil after 3 months–4 years.
Abstract
Background
Delirium is a medical emergency and is associated with increased risk of mortality, in-hospital complications, length of stay and institutionalisation. Delirium screening is ...recommended for patients at risk on admission. Despite this, delirium screening is frequently not undertaken in the acute setting leading to undiagnosed delirium and sub-optimal clinical care.
We aim to investigate the prevalence of delirium in patients aged ≥75 years attending the Emergency Department (ED) of a tertiary referral centre.
Methods
Patients aged ≥75yrs presenting to the ED between 08.30 and 18.30, Monday- Friday were assessed by an interdisplinary gerontological service using a standardised assessment tool including the 4AT to screen for delirium. Data was collected and analysed via Excel.
Results
Of 163 patients screened over a 4 week period 47.9% (78/163) were male with a mean age of 81.8 years (SD 2.7). Twenty three percent (34/148) scored ≥4 indicating a possible delirium. Patients with delirium were older (85 yrs vs. 80 yrs, P<0.001), were more likely to score ≥4 on Clinical Frailty Scale (97% vs. 56%, P<0.001), and at risk of, or have malnutrition (MNA SF score <12) (86% vs. 40%, P<0.001).
Conclusion
Routine screening of patients in the acute setting detected a high rate of delirium at a level which is consistent with previous studies. Patients with delirium were older, more frequently frail and at risk of malnutrition. Our results support the evidence for routine screening for delirium in the acute setting.
Abstract
Background
The physical phenotype of frailty shows significant overlap with sarcopenia, and sarcopenia phenotype is associated with malnutrition. Integrating screening of these interrelated ...conditions, could help identify those most vulnerable in the Emergency Department (ED) setting.
Methods
Patients ≥75 were screened in the Emergency department (ED) by an interdisciplinary Gerontological ED team using a standardised assessment tool, incorporating the Clinical Frailty Scale (CFS) and the mini-nutritional assessment short form (MNA-SF). Patients at risk of malnutrition ( MNA-SF <12) were referred for Dietetics assessment and screened for sarcopenia, using the European Working Group on Sarcopenia in Older People (EWGSOP2) algorithm for case finding, followed by grip strength and calf muscle measurement.
Results
In a convenience sample of patients referred to dietetics following initial screen in ED, 57% were female (25/44) and the mean age was 83 years (range 75-94). Eighty-eight percent (39/44) were at risk of malnutrition/malnourished and 25% (11/44) were diagnosed with malnutrition (MNA-SF score 0-7). Seventy-three percent (32/44) scored ≥4 on the CFS. Fifty-two percent of all patients (23/44) had a Sarc-F ≥ 4, suggestive of sarcopenia, while 45% (20/44) had a probable diagnosis of sarcopenia and 39% (17/44) met diagnostic criteria for sarcopenia.
Risk of malnutrition was more commonly observed in those patients with a CFS score ≥4 (94% vs. 75%), as was risk of sarcopenia (81% vs. 17%). Fifty percent (22/44) of all patients screened positive for suspicion of both frailty and sarcopenia (frailty score≥4 and Sarc-F score≥4).
Patients with a probable diagnosis of sarcopenia and concomitant frailty had more ED attendances, falls and longer lengths of stay.
Conclusion
Frailty, malnutrition and sarcopenia are frequently observed in older patients in the acute setting. The integration of screening measures for malnutrition, frailty and sarcopenia in clinical practice can facilitate the identification of patients for multi-component targeted interventions.
Abstract
Background
Dysphagia, frailty and negative patient outcomes are interlinked1. Changes in communication may result from the ageing process, chronic conditions, and/or neurologic conditions ...presenting in later years2. However, unlike other cohorts, including stroke, frail older patients are not routinely screened for swallowing/communication difficulties in acute settings. We investigated the proportion of Speech and Language Therapy (SLT) referrals generated for older patients attending our Emergency Department (ED) following use of a swallowing/communication screening tool and their association with Clinical Frailty Scale (CFS) scores.
Methods
A retrospective analysis of data collected over a four week period was completed. Older patients presenting to ED were screened by the interdisciplinary gerontological ED team using a screening tool, including a locally developed swallow/communication screen. Statistical analyses were performed using STATA Version 12.
Results
Of 176 patients screened (mean age 81.8 years, SD 5.9 years), median CFS score was 5 (IQR 3-6). Thirty-seven percent (66/176) of patients were referred for SLT assessment following initial screen. SLT referrals were more commonly required in patients with a CFS score of ≥4 (46.2% vs. 19.3%, P=0.001) and likelihood of requiring SLT referral increased with greater CFS score (P<0.0001).
Conclusion
Results suggest that screening for swallowing and communication difficulties in older patients yields a high level of SLT referrals, with a higher frequency of SLT referrals observed with increasing frailty scores. Further research is required to determine the optimum swallowing/communication screening tool in the acute setting. Future research will focus on evaluating outcomes of SLT assessments completed and determining the prevalence of swallowing and/or communication difficulties in this cohort.
Abstract
Background
Older admitted patients are at risk of deconditioning related to immobility. “Fit to Sit” is a simple change in the Emergency Department (ED) culture and attitude, promoting ...independence, maximizing well-being and improving health outcomes. We aim to describe the prevalence of patients deemed “Fit to Sit” who were in hospital gowns and lying on trolleys in our ED prior to the commencement of the “Fit to Sit” pilot.
Methods
An observational study was conducted prospectively, over five working days, to determine the proportion of patients present who were dressed and sitting out on a chair, opposed to wearing pyjamas (PJs) and lying on a trolley. Nursing staff familiar with each patient were asked whether or not the patient was fit to sit out in a chair. Statistical analysis was conducted with Microsoft Excel using the chi squared test to calculate differences between the two groups.
Results
Data was collected on 147 patients, median age 66 years (IQR 47-74). 82% were on a trolley and 18% in a chair. 33% were in their clothes, the remaining 67% were in PJs or hospital gowns. 45% of those deemed “Fit to Sit” were on a trolley. Patients 65 and older were more likely to be wearing PJs (p= 0.03), but not more likely to be on a trolley (p= 0.23). Patients in ED for greater than 12 hours were also more likely to be in PJs (p= 0.001) and on a trolley (p= 0.057).
Conclusion
Our study suggests that a significant proportion of ED patients are lying on trolleys despite being deemed to be “Fit to Sit”. Introduction of an ED “Fit to Sit” programme may alleviate deconditioning and promote patient independence.
Purpose - Pupils with autism spectrum disorders (ASD) face many challenges to achieving their educational potential, including difficulties with social interaction, communication, flexibility of ...thought and anxiety management. Handheld interactive technologies such as iDevices (iPods, iPhones and iPads) could offer a non-stigmatising tool that could be used to complement or replace existing support strategies. This study aims to investigate how iDevices could be used by teaching assistants (TAs) to support pupils with ASD in a mainstream secondary school.Design methodology approach - The project used an action research approach. Six TAs used the iDevices and selected applications (apps) in their work with pupils with ASD. The TAs commented on how the iDevices supported their role and the usefulness of different apps and features by using daily diary sheets. The apps supported pupils in the following ways: curriculum support, visual structure, organisation, communication, social interaction, anxiety reduction, relaxation, reward, and motivation.Findings - A thematic analysis of the diary sheets showed that the most frequent uses of the iDevices were to develop communication, practise key skills, increase independence and to offer alternative activities. Quantitative analysis showed that TAs considered the iDevices to be very useful or useful on the overwhelming majority of occasions.Practical implications - Future considerations of implementing interactive technological interventions in schools include the provision of training, IT support and individual planning to ensure iDevices are best utilised to address individual pupil needs.Originality value - The paper shows some of the ways that TAs can use this increasingly popular technology to support ASD pupils in mainstream schools.
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