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JADETHE JOURNAL OF ACADEMIC

DEVELOPMENT AND EDUCATION

EDITORIALS

UG ARTICLES

PG ARTICLE

by Dr. Christopher LittlePage 5& Jo FlynnPage 76

Articles, case studies & paper submissionsPage 17

Page 79

STUDENT EDITIONIssue 2 | October 2017

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JADETHE JOURNAL OF ACADEMIC

DEVELOPMENT AND EDUCATION

ISSN2051-3593

AboutJADE publishes articles, case-studies, papers,

reviews, teaching tips, letters to the editors, interviews and student submissions about

learning and teaching.

Author’s instructions and submission procedures are available from our website:

jadekeele.wordpress.comYou can contact us directly via our email:

[email protected]

Submitted articles are subject to peer review.

Managing Editor Dr. Russell Crawford

Associate EditorsDr. John Howlett; Dr. Cath Bücher;

Georgina Spencer; Dr. Jackie Waterfield; Lavinia Ioana Udrea and

Dr. Janet Lefroy

Layout Editor Victoria Dean

Telephone +44 (0)1782 733007

Email [email protected]

Web http://jadekeele.wordpress.com

Address 59–60 The Covert, Keele University,

Keele, ST5 5BG

EDITORIALS5 |

76 |Undergraduate Editorial Dr. Christopher Little

Postgraduate Editorial Jo Flynn

CONTENTS | ISSUE 2

POSTGRADUATE

UNDERGRADUATE

EDITOR’S EPILOGUEDr. Russell Crawford, LPDC

AbstractsPoster URLsArticle #1 Temitayo Adeyemi

Article #2 Zulekha Ahmed

Article #3 Daryl (Robert Arthur) Deal

Article #4 Raidah Gangji

Article #5 Edward Nicholas Hopkins

Article #6 Caroline Millet-Spicer

Article Homayemem Weli, Jason Cooper, & Ying Yang

Poster URLsConference AbstractsAbstracts: Three Minute Thesis HeatsAbstracts: Three Minute Thesis Final FourThree Minute Thesis Reflections #1 Fraser Philp

Three Minute Thesis Reflections #2 Hayley Gilman

8 |16 |17 |35 |43 |51 |57 |64 |

79 |84 |85 |

108 |110 |113 |115 |

118 |

The difficult second album?

2017 saw the second ever JADE Student Learning Undergraduate Conference, also known as JSLUG, take place on 12th June. As with last year’s event, this

showcase event demonstrated the incredible academic capacity of our students whilst also giving them very real things to put on their CVs - a conference presentation and their abstracts published in this very journal! Not many undergraduates finish university with those things and I really wanted JSLUG to offer these unique opportunities to our students.

Approximately 60 students joined us at Keele Hall for this year’s conference with all three faculties evenly represented again. We had papers on the economic impact of the Vikings, on the ‘War on Drugs’, the effects of standing, Brexit and many more. This great range of knowledge produced a truly interdisciplinary event that we can all be proud of. All of the papers delivered at the event were of an extremely high standard with some of our presenters even going so far as to produce full academic papers for this edition of JADE.

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Dr Christopher Little | Learning Developer &Teaching Fellow

EDITORIAL

The producers of this second album…

JSLUG continues to be my baby and I remain a proud parent. However, this year’s event would not have been possible without the Institute for Liberal Arts and Sciences. Based in Keele Hall, ILAS has graciously taken JSLUG under its wing and given us a home of real prestige at Keele Hall. I would strongly advise all of our students get involved with ILAS. Their Grand Challenges lectures are amazing, offering you a chance to come and see field-leading experts discuss their work with free coffee and wine - that’s how intellectual debates should be held!

There were also a number of other partners in this year’s event who made JSLUG17 possible. My colleagues in Student Learning continue to support and encourage my work on JSLUG. Furthermore, a lot of additional

Students are wicked. They continue to amaze me.

UNDERGRADUATE EDITORIAL

• JADE: The JADE journal accepts students work all year round, not just following the conference. If you have an idea, check out JADE first.

• The British Conference of Undergraduate Research (BCUR): This event is held once a year, usually at Easter, and is a showcase for undergraduate papers from across the country. The 2017 event is being held at the University of Sheffield with further information available at www.bcur.org.

• Undergraduate Journals: There are a growing number of national and international undergraduate journals available for you to target. For further information, visit http://www.bcur.org/undergraduate-journals/.

In conclusion, you can see that not only will JSLUG enhance your time here but also that it is easy to get involved in. I must end this foreword by stating my immense gratitude to the students that continue to make JSLUG events so special. Their intellect, enthusiasm, pride and passion for learning continue to inspire myself and all staff who have experience JSLUG. To steal the words of a senior member of staff who attended this year’s event: “Students are wicked, they continue to amaze me. Thanks students”.

Thank you to the JSLUG17 students and to those who supplied their work for this edition of JADE. I hope you enjoy it as much as myself and the JADE team have. Finally, remember JSLUG is back next year on 7th June 2018: save the date!

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support was offered, and definitely taken, from both the Learning and Professional Development Centre and Careers and Employability Services. JSLUG is also proudly supported by Professor Fiona Cownie, Pro-Vice Chancellor of Education and Student Experience, and from Professor David Amigoni, Pro-Vice Chancellor of Research and Enterprise. The campus-wide support for JSLUG demonstrates Keele’s commitment to giving undergraduates every opportunity to excel.

Why should you get involved in 2018?

In last year’s JADE edition, I noted the published evidence which demonstrates the potential of undergraduate conferences. This still rings true - undergraduate conference have been proven to develop your academic and interpersonal skills, your ability to research and present and your own critical relationship to knowledge and research (Hall, 2015; Hill et al, 2013; Hill & Walkington, 2016; Mabrouk, 2009; Potter et al, 2010; Spronken-smith et al, 2013; Walkington, Hill & Kneale, 2017). This evidence shows that getting involved in an undergraduate conference will benefit you in some way.

Since then I have been lucky enough to investigate the effects of JSLUG16 on Keele students and the results are just as encouraging. One year on from the JSLUG16 event, students who took part repeatedly reported the same benefits as above - they have developed a range of important skills, increased their confidence and, strikingly, are more likely to engage in other opportunities outside of their course such as national and international conferences and additional qualifications and training. We have had JSLUG16 presenters present at the World Congress of Undergraduate Research last November at Qatar University, funded by the Pro-Vice Chancellors of Research and Enterprise and of Education and Student Experience. Others have gone on to national and international conferences in their disciplines. Simply put, getting involved in JSLUG will be worth it!

How do I get involved?

The 2018 JSLUG event is planned for 7th June 2018, at Keele Hall. All information regarding the event can be found at www.keele.ac.uk/ilas/conferences. We will have information sessions scheduled throughout the year so please do get involved and start thinking about your 100-word abstracts for next year’s conference.

We want you to apply to the 2018 JADE Student Learning Conference, of course, but there are also other conferences and avenues for your work:

DR. CHRISTOPHER LITTLE

UNDERGRADUATE ABSTRACTS

Oral Presentations

Danielle An’Mai | Adult NursingThe Healthcare System to Ashes: Too Much Smoke in Stoke

It is bereft of redeeming health benefit, but ingrained within society. Smoking prevalence in Stoke-on-Trent in 2015 was recorded at 18.8%; below the national benchmark according to Public Health England. It’s the leading cause of preventable death, however Stoke-on-Trent is producing sub-par health outcomes; higher smoking related deaths and increased maternal smoking (Stoke-on-Trent Annual Report, 2015.) This city puffs to its detriment on the NHS doorstep, as adherents exhale by prohibition signs without fear of reprisal. With tremendous health and financial impact, one has to wonder if the healthcare sector is serious about reduction, or just playing cosmetic patty cake.

Alfred Awosanya | Computer ScienceLife in a Civilized World with an Uncivilized Brain

When we’re angry our muscles tense and fists clench preparing us to fight a perceived threat. When we’re in love our cheeks blush and eyes dilate to appear more attractive to our crush. Charles Darwin believed that emotions were beneficial for our evolution because emotions improved survival. But how useful is it to be angry while driving? Or to be in love while at work? Understanding how our emotions work and what role they play in society can give us the self-esteem we need to overcome social and personal challenges.

Richard Backhurst | Philosophy & EconomicsThe War on Drugs, how it has failed, and why everyone is better off without it

The first international drug treaty was signed in 1912. This began the war on drugs and it has failed in its goals. This war hasn’t made drugs more expensive or lowered drug usage. Furthermore, the economic logic used is extremely flawed.

Examples, past and present shows banning drugs makes drug situations worse, punishes the wrong people, and leads to gangs. From my research I have concluded that a better system would be to decriminalize personal usage of drugs, and treat drug users as addicts not criminals, such as in Portugal (2001), this has lowered drug usage and over dosages.

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Kelly Bloor | Children’s NursingWhat helps the medicine go down?

Medication adherence in paediatric patients ranges from 11-93%. Administering oral medication is a challenge for paediatric nurses and parents of sick children. Children with long term health conditions will know what medication they dislike and refuse it. This presentation will examine what evidence based practices there are within paediatric nursing to improve medication adherence. Furthermore, it will raise awareness of the anxiety children feel towards medication administration. The research in this subject area is vast, including a recent hypothesis that children are at risk of becoming antibiotic resistant due to poor adherence.

Leah Carter | PhysiotherapyThe effects of standing

Physiotherapy rehabilitation can involve various exercises depending on the outcome desired. Many rehabilitation techniques isolate movements to provide beneficial effects specific to an individual. However, a functional compound rehabilitation technique like standing can be related to the majority of populations for rehabilitation benefits. This research aims to investigate these benefits to facilitate rehabilitation and the effects on different physiological systems. It also aims to relate the effect of standing to various populations to then be adapted to their rehabilitation programme if appropriate. It utilises research from different population groups, either neurological, musculoskeletal or cardio-respiratory affected individuals.

Daryl Deal | English & SociologyJohnny Foy, Wordsworth, and Language: The Place of Intellectual Disability in Romantic Poetry

The Idiot Boy took centre piece in Wordsworth and Coleridge’s 1798 publication of Lyrical Ballads, a collection of poems that still today seems to define British Romanticism. This is a poem where Johnny Foy, the idiot boy, is sent off through the woods by his mother to fetch a doctor for an ill neighbour. A section of the poem is of the speaker’s inability to narrate Johnny’s adventures which, I argue, is overly neglected by critics for its potentiality. I will argue that Foy serves as Wordsworth’s way to engage more with his own poetic imagination and its limits.

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Christopher Jones | HistoryAn examination of Viking influence on Anglo Saxon England from the Eighth Century onwards

This presentation will examine the long-term influence that the Vikings had on Anglo Saxon England. Focusing on the Viking Kingdom of York and the Danelaw, and England as a whole under Canute; we can see how the Vikings left a distinct and lasting mark upon England. Through both socio-political and commercial/economic lenses, we can specifically explore these impacts throughout the Viking age. Finally, raids became invasions, which then led to settling in occupied lands and in 1016, Canute ruled England as an Anglo-Danish kingdom with a hybrid military aristocracy, lasting until the Norman Conquest of 1066.

Bushra Kabiri | MedicineBarriers to Maternal Healthcare Development and Access in Afghanistan

Chronic conflict has devastated the healthcare infrastructure in Afghanistan. Maternal healthcare is particularly poor, with current estimates predicting 396 deaths per 100,000 live births. Many of these deaths are preventable, but due to significant structural and cultural barriers, development and access to healthcare resources are impeded. This means most women do not receive basic maternal healthcare. This literature review will look at what is contributing to this and what is being done to combat this. Further information is required for interventions from within the country and external humanitarian corporations to reduce these high mortality rates.

Elliott Lancaster | Accounting & FinanceWhat Brexit Really Means?

Through looking into the history behind the relationship between the UK and the EU social economic characteristics will be understood, in order to understand the long-term impact of the referendum. This is done through economic theory and democratic procedure analysis into how increases in growth within sectors of the economy can be achieved. The examination into the compromise between policy making and its’ impact on the environment and electorate when conducting trade deals will be put under scrutiny, such as the changes to nuclear power.

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Owain Groves | Psychology Green exercise: Preventing relapse and accompanying treatment in adults with dual diagnosis

Green exercise utilises the effectiveness of both physical exercise and connection with nature, on improving mental health. Exercise and exposure to scenery have both been demonstrated to assist in psychological therapy for adults with mental health problems. However, the applicability of green exercise to co-morbid mental health and substance abuse is under-researched. By providing an alternative coping mechanism, it may be possible to target both the mental health issue and the underlying addiction. This paper aims to provide a qualitative insight into whether green exercise can be used to improve mental health and prevent relapse in adults with dual diagnosis.

Edward Hopkins | History A Passage to India: Imperialism, Ethnicity and the decline of the British Raj

The significance of E M Forster’s A Passage to India is its fictionalisation of colonial and ethnic tensions during the last days of empire. Characters such as McBryde and Turton allow us inside a colonial mind-set that reveals an attitude of ignorance and racial superiority. Aziz’s trial at the end of the novel is critical in bringing to boil the common racial tensions and prejudices during the Indian Independence movement of the 1920s. This clash of cultures, the growing move for independence and the portrayal of British Imperialism in fiction conceptualises the experience of colonialism in the early 20th century.

Matt Jacobs | Astrophysics with Educational Studies Developing Logical Thinking for STEM in Secondary Education

The commitment of government to controversially focus on the promotion of STEM (Science, Technology, Engineering, and Maths) subjects at secondary level is well established. It is argued in this presentation however that true progress in the education and teaching of STEM subjects is made impossible by the devotion of education policy to a knowledge-based curriculum. The nature of STEM subjects as being rooted in logical thinking is explored, and the case for explicit development of logical, deductive thinking in the curriculum is made. The scope and consequences of a skills-focused curriculum are discussed in ideological and pragmatic terms to conclude.

Kathryn Williams | NursingThe object of medicine vs. the subject of suffering: Insights from medical anthropology

Critical medical anthropology asserts that biomedicine focuses on narrow concepts of disease to the exclusion of lived experience. Clinicians operating within the medical model often assume their own understanding to be self-evident, without recognising its hegemonic characteristics, and this may lead to the silencing of the bodily expression of social distress. With recourse to ethnographic case studies, this presentation will discuss socially-mediated understandings of health and illness, interrogating the extent to which certain understandings are considered ‘culture-bound’ while others accepted as objective ‘scientific’ truth.

Poster Presentations

Temitayo Adeyemi | Pharmaceutical Science Technology & BusinessAntibiotics Resistance

Pathogens are the major causal and carrier of infectious diseases. However, before a pathogen can cause disease, it has to evade the defence mechanism of the host. Medications like antibiotics and antimicrobials have been developed and used to treat infections for over seven decades. Nonetheless, these medications have been used so widely and for so long that the infectious organisms that the antibiotics are designed to kill have adapted to them. This means antibiotics are losing their effectiveness at an alarming rate. My presentation will be based on the on-going antibiotic crises and its future predictions based on researches.

Zulekha Ahmed | Biomedical ScienceMemory: How it Works, Common Misconceptions and its Reliability in Recalling Past Experiences

Memories are a complex construction - focusing on a memory of an object, requires the brain to retrieve the feel, shape, function and sound associated with it. The brain works to reconstruct an image of the object. Attention and focus is essential for a vivid memory. Studies demonstrate how moods alter the way memories are retrieved and perceived. Showing how memories may not be as reliable as widely thought. According to studies, 63% of respondents believe memory to work like a camera, and 55% believe memories are permanent. Misconceptions regarding properties of the memory can lead to false implications.

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Caroline Millett-Spicer | MedicineThe Nocebo effect: Can the “Evil Twin” of Placebo be Harnessed in the Healthcare setting?

Much is commonly known about the suggestive power of the placebo effect less consideration has been given to its counterpart: The Nocebo effect.

For consent to be valid, the person must have capacity, it must be given voluntarily and the patient must have all the information. However by providing full information about possible negative side effects, the physician may in fact induce harm via the less well known nocebo effect. This talk will explore the concept of the Nocebo effect, its practical applications, and how we can utilize it - both in the healthcare setting and in our own lives.

Femia Thom | Biomedical scienceShould pain free be hyphenated?

True love is kind, patient, non-envious and passionate. It is given freely without restrictions and not earned. The science behind desperate love and affection of approval and attention from someone you believe to be your ‘partner for life’ is based on the unpredictable events. Unpredictable events in a bridged relationship can be small gestures of kindness which rewards the brain with the circuit of excitement. The circuit is controlled by the hormone, dopamine which is commonly associated with pleasure. Thus, does dopamine pleasure blind us from emotional pain?

Maria van Veelen | MedicineVaccine Distribution: When Cutting the Lifeline Leads to Re-emergence of Eradicable Disease

It has been almost two decades since the infamous Wakefield article that claimed there was an association between the measles, mumps and rubella (MMR) vaccine and the development of autism and gastrointestinal disease was published in The Lancet. Although later retracted, the deleterious ripples spread by one fabricated research paper still flow through modern day society. A review of the literature was conducted on the epidemiology of commonly vaccinated illnesses in the aftermath of the vaccine scare. Primary data was then incorporated to highlight the consequences of the spread of communicable disease when vaccine distribution suddenly becomes unavailable.

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Luca Filippi | History & International RelationsNorth Korea: The War of the Words

‘Securing Global Order’ – a first year international relations module I am currently taking has taught me to understand the concept of ‘security’ from multiple perspectives. I plan to use this knowledge to assess whether North Korea is really a threat in 2017, or just a popular online joke. I will combine different perspectives of understanding security – one from a military understanding and the other as a social understanding drawing on developing research into North Korean labour camps. This presentation will look at why North Korea is a popular source of jokes online, despite the severity of its human rights violations.

Raidah Gangji | Biomedical ScienceCapsuling language used for the inner voice in the deaf community

The inner voice also known as the semi-constant, conscious internal monologue within majority of the individuals. The inner voice is a ‘voice’ speaking enclosed in your head, a language you are most comfortable with, in your own voice. But, what about those people who haven’t heard a vocal voice? What language do deaf people think in? Therefore, in the analytical approach of understanding the inner voice used in deaf individuals, exploring various connotation affecting a born deaf person in terms of the inner voice language used, cultural effects and education prosperity.

Bryony James | GeographyAn investigation into water chemistries of a forest and clear-felled lake catchment

This study compares two catchments in West Wales (UK) to investigate the impacts of clear-felling on lakes. This study compares physical (pH, electro-conductivity, and water temperature) and chemical (calcium, chloride, fluoride, magnesium, nitrate, potassium, sodium, sulphate, and sulphur) properties between one lake in a clear-felled catchment and one in a forested catchment. The results show difference between the lakes, particularly in calcium, chloride and sodium concentrations in the clear-felled catchment which show statistically significant differences at 99% confidence interval. This study concludes that clear-felling does have significant impacts on the chemical and physical properties of water bodies in these catchments.

Harry Nevard | HistorySesame Credit: advantages and challenges of digital technology on the Authoritarian State

Throughout history, authoritarian regimes have suppressed and subdued their populations by means of assassinations, arrests and censorship. In the 21st century, it would be easy to say that these methods, although evolved in their execution, have remained the prime tools for such governments. However, with the announcement of the social scoring system, Sesame Credit, in China, we have reached a break from the past. This gamified system can track social media updates, purchases and online interaction to assign an individual with a tangible ‘citizen score’ which has real world consequences. This paper will explore how this would affect a population.

Jawa Rai | Neuroscience with BiochemistryConfronting the controversy of ADHD medication outside the scientific community

ADHD is well known to the general public as behavioural disorder with symptoms of inattentiveness and hyperactivity. Nonetheless, it is hard to diagnose; surveys of parents show about 11% of children are diagnosed with ADHD, while American Psychiatric Association gives the statistic at about 5%. Furthermore, common treatment like Ritalin is known to work by increasing the levels of dopamine. The knowledge of the public regarding the neurotransmitter however might be limited to dopamine rewards system associated with drugs like cocaine. In this it is easy to see the worries that arise with the public regarding ADHD medication for children.

Shreeva Sivakumar | Neuroscience with BiochemistrySeeing eye to eye: Understanding the way animals see

Our perception of the world is primarily influenced by our visual system. We benefit greatly from the ability to see and experience the environment around us. Animals have certain phenomenal adaptations in vision that allow them to see the world differently. This research delves into the visual abilities of bees and snakes that have proven to be beneficial to their survival. By identifying the effect of these on their point of view, we can compare their visual capabilities to that of our own and appreciate the many different ways to see the same world.

UNDERGRADUATE ABSTRACTS | 15

UNDERGRADUATE POSTER URLs

• https://jadekeele.files.wordpress.com/2017/08/poster-adeyemi-antibiotics-resistance.pdf

• https://jadekeele.files.wordpress.com/2017/08/poster-ahmed-memory-how-it-works.pdf

• https://jadekeele.files.wordpress.com/2017/08/poster-filippi-the-war-of-the-words.pdf

• https://jadekeele.files.wordpress.com/2017/08/poster-gangji-capsuling-language-for-deaf-community.pdf

• https://jadekeele.files.wordpress.com/2017/08/poster-james-water-chemistries-of-lake-catchment.pdf

• https://jadekeele.files.wordpress.com/2017/08/poster-nevard-sesame-credit.pdf

• https://jadekeele.files.wordpress.com/2017/08/poster-sivakumar-how-animals-see.pdf

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UNDERGRADUATE ARTICLE #1

Introduction

‘’…a child’s scratched knee from falling off their bike, common bladder infections among the elderly in care homes and routine surgery to replace broken hips could all become fatal as antibiotics are becoming increasingly useless…’’ - World Health Organisation (WHO).

Dr Keiji Fukuda, WHO’s Assistant Director-General for Health Security, wrote: “A post-antibiotic era — in which common infections and minor injuries can kill — far from being an apocalyptic fantasy, is instead a very real possibility for the 21st century.” He said: “Unless we take significant actions to improve efforts to prevent infections and also change how we produce, prescribe and use antibiotics, the world will lose more and more of these global public health goods and the implications will be devastating.”

Resistance to antibiotics has been an on-going crisis in the clinical and pharmaceutical world. Many bacterial strains are now resistant to multiple antibiotic classes; and this has emerged among the major Gram-positive and Gram-negative species which includes Neisseria Gonorrhoea, E n t e r o b a c t e r i a c e a e , Enterococcus Spp., Acinetobacter Spp., Pseudomonas Aeruginosa, and Staphylococcus Aureus. The lagging in antibiotic/antimicrobial discovery and

development in the last two decades has further aggravated the crisis of antibiotic resistance. Plasmids and transposons are the main biological method in which bacteria exchange chromosomal Information and genetic codes amongst their species. This results in the transfer of copied genetic information from one bacterium to another. The extensive use and abuse of antibiotics in clinical settings and communities have caused bacterial mutation to many antibiotics.

In the late 1960s, it was declared in many parts of the developed world that the war against antimicrobial infection had been won. During this period, antibiotics were curing previously lethal infections in a matter of days. Over the decades, the rampant misuse and abuse of antibiotics has led to the reduced efficacy of antibiotics. In many countries, antibiotics are cheap, not regulated, and freely available without prescription. If this dilemma is not controlled or put to a halt, in the next two to four decades, there will be no antibiotics left to counter bacterial infections. This would mean that even the most minor of surgeries will be so risky, that millions will die from infection.

The History of Antibiotics

It has been said that nature is a masterpiece and a super

TitleAntibiotic Resistance

AuthorTemitayo Adeyemi

[email protected]

Abstract Pathogens are the major causal and carrier of infectious diseases. However, before a pathogen can cause disease, it has to evade the defence mechanism of the host. Medications like antibiotics and antimicrobials have been developed and used to treat infections for over seven decades. Nonetheless, these medications have been used so widely and for so long that the infectious organisms that the antibiotics are designed to kill have adapted to them. This implies that antibiotics are losing their effectiveness at an alarming rate. Many strains of bacteria are now resistant to multiple antibiotics; these bacteria are called super bugs. The emergence of super bugs is now a disturbing phenomenon of concern for both clinicians and pharmaceutical industries.

ARTICLE #1 | 17

the mixing and matching of fundamental building blocks – enabled synthetic chemists to rapidly identify an immerse library of potential novel drugs. However, the ability to emulate the complex organic molecules produced in nature is still an enormous scientific struggle for human chemists. “The kind of evolution that happens in living things gives rise to unusual chemistry that is not straightforward to synthesize,” says Simon Gibbons, a medicinal phytochemist at University College London. “Nature is a super chemist. It’s been doing this for about 400 million years.” That puts people — even very smart people — at a competitive disadvantage.

In 1972 a new antibiotic – Vancomycin – was discovered and developed due to the numerous cases of recorded resistance to previously used antibiotics. In clinical practices, this was used for the treatment of methicillin resistance in both S. aureus and Coagulase-negative Staphylococci. It was said that bacteria will not get resistant to vancomycin as it was the drug of last resort and it was used in clinical practice only. Unfortunately, in 1979 and 1983, numerous cases of vancomycin resistance were reported in Coagulase-negative Staphylococci. The late 1960s through to the early 1980s, pharmaceutical industries further developed and introduced many new antibiotics to resolve the crisis of resistance. However, as the decade went by, the pipeline of novel antibiotics began to dry up and fewer new drugs were introduced to the market. As a result of this, in 2015, bacterial infections have again become a threat; taking scientists back to 1928 when they were first discovered.

Mechanism of Bacterial Resistance to Antibiotics

Horizontal Gene Transfer

This is the most frequent method in which a bacterium transfers a foreign DNA material to another bacterium and it is done through plasmids. These plasmids (small piece of DNA that carry genetic information especially resistance genes) are passed on and replicated in a process called horizontal gene transfer. When passed to a bacterium, it is incorporated into the genetic constituents of the bacterium along with resistant genes.

Alteration of the antibiotic molecule

Bacteria produce enzymes that add specific chemical entities to ensure that some antibiotics are completely metabolise or inactivated. This means that the antibiotic will be unable to interact with the bacterial target. Aminoglycoside modifying enzymes (AMEs) modify aminoglycoside molecule on antibiotics, causing covalent modification. This will render the antibiotic ineffective.

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chemist; its chemical embodiment creates a galaxy of extraordinarily complex - yet extremely effective - molecular structures. Bacteria have been on the planet for more than 3.5 billion years, and they have evolved in nature. A particular bacterial species will ignore, assist or obliterate its microbial neighbours in order to survive. They have learnt how to adapt to certain physical and chemical changes in nature, and they have thrived on possible extinction. As bacteria evolved, they developed an incredible array of signals, physical pathways, and luring chemicals in order to cope with their capricious existence.

As humans, we are prone to infections as long as we are exposed to our world and its surroundings. Wherever we are and in whatever we do, we are surrounded by immense communities of diverse species of bacteria. The relationships between humans and these arrays of microbes are so byzantine and volatile that they make more archetypal ecological associations. In order to regulate energy flow in environmental food chains, there are numerous symbiotic bacteria that help us to digest food, control enzymatic activities, and decompose waste/ dead organisms. However, a number of bacteria can cause infections if they gain access to the internal components of the host. When a bacterium gains access to a particular host, it causes infection and alters the normal regulatory pathways of the host.

Although, there were well-documented information on the management of microbial infections in ancient Egypt, Greece, and China; in 1928, Sir Alexander Fleming discovered penicillin and this sprang the modern era of antibiotics. During World War II, penicillin was a ground breaking medical advancement after proving to have controlled bacterial infections amongst the soldiers. However, this was short-lived as penicillin resistance became an incredibly significant clinical problem. This threatened many of the advancements made in the decade prior to it. The Golden age of antibiotic development (1940s – 1960s) led researchers and pharmaceutical companies to harvest potential antibiotics molecules from soil microbes. These molecules are then chemically manipulated and made into dozens of new and commercial available drugs. New and more reliable beta-lactam antibiotics were also later discovered and developed in response to the then dilemma, and this restored patients’ confidence in antibiotics.

Although a few antibiotics including the infamous penicillin came from fungi, however, soil bacteria were very easy to harvest that this became the heart of attraction for many pharmaceutical industries. In the 1980s, combinatorial chemistry was adopted by numerous pharmaceutical companies. This new technology – which involves

TEMITAYO ADEYEMI ANTIBIOTIC RESISTANCE

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Figure 1

Decreased intracellular antibiotic accumulation by the use of efflux pumps

This is a mechanism specific to only gram-negative bacteria. This method eliminates antibiotics in the cytoplasm of the bacteria before the dose builds up to toxic levels. Tetracyclines, βeta-lactams, and some fluoroquinolones cross the outer membrane of bacteria using protein channels called porins. Since these molecules are hydrophilic, they are affected by any slight change in permeability. Thus, the outer membrane of a bacterium when modified, restrict access to foreign bodies. Bacteria also have protein channels that actively pump out antibiotics in the cell at a faster rate than it comes in; reducing the chances of toxicity.

An alteration in the target site that reduces the binding capacity of an antibiotic

Genes encoding the target site are quickly modified and this causes a decrease in the affinity of the target for the antibiotic that would normally bind to the target site. The development of resistance to rifampin is one of the best examples of mutational resistance.

Figure 2

TEMITAYO ADEYEMIINAY ÖZEN

Causes of The Antibiotic Resistance Crisis

Over-prescription and misuse of antibiotics

The leading causes of ailments causing people to seek medical attention are rarely caused by bacteria. Acute respiratory infections (ARI), common cold, flu, gastroenteritis, chicken pox and herpes are viral infections and they do not require antibiotic treatments. Nevertheless, an implausible number of physicians prescribe them needlessly. The rate at which antibiotics are being prescribed in recent history has far exceeded the number of diagnosed clinical cases of bacterial infection. Medical practitioners in developed countries prescribe antibiotics on patients’ demand; and patients in developing countries can buy antibiotics over the counter. There have been cases and reports stating that more than 50% of antibiotic prescriptions are inappropriate.

Many reports have shown that, regardless of the education provided to medical practitioners and patients, the misuse and abuse of antibiotics is still on the rise. A study conducted in France reported that only 21% of the primary care physicians appropriately used official guidelines in prescribing antibiotic treatment for urinary tract infections. A number of physicians with inadequate knowledge were reported to have prescribed a maximal broad-spectrum treatment. At the time of a study, approximately 50% of prescriptions for nephritis were wrong. Also, primary care practitioners prescribed antibiotics to more than 70% of patients with asymptomatic bacteriuria. Similar results were found in Greece, stating that only about 55% of community physicians restricted antibiotic use for common cold, flu, and sore throat. A strep-test was used by only 26% and about 90% of theses physicians prescribed antibiotics for Chronic Obstructive Pulmonary Disorder (COPD).

The rapidly depleting pool of antibiotics will soon mean that, resistance could mark the end of the era where bacterial infections are curable.

Patients not finishing the entire antibiotic course

Patients often stop their treatment as soon as they are feeling better. However, it is very essential that all the medications are taken. If treatment is stopped too soon, the medication may not kill all the bacteria; hence, a patient may become sick again. This implies that, the remaining pool of bacteria may become resistant to the antibiotic that had just been taken. Whilst this will not happen in everyone being treated with an antibiotic, medical practitioners

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ANTIBIOTIC RESISTANCE

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cannot predict which patients can safely stop their treatment early. However, by taking the full course of the prescribed antibiotic, the chances of resistance can be reduced significantly.

Furthermore, many patients share prescribed antibiotics with their friends or family members. This will disrupt the dosing cycle and it can also result in inadequate dosing for the patient to which the antibiotic(s) was initially prescribed. Some powerful antibiotics are administered in smaller doses first and gradually built up; taking a non-prescribed antibiotic could mean taking a wrong dose of drug, thus, a higher risk of side effects. All drugs and medication come with potential adverse drug reactions (some could be very toxic). Hence, one patient’s prescription could be completely wrong for another; but the potential risks that could come with prescribed medicines are overseen and managed by the doctor. When discussing taking other people’s medication, the FDA notes, “a person can die from respiratory depression from misusing or abusing prescription painkillers; for example, opioids. Prescription sedatives like benzodiazepines can cause withdrawal seizures. Prescription stimulants such as medications for attention deficit hyperactivity disorder (ADHD) can lead to dangerous increases in blood pressure.’’ Although this is not the case for antibiotics, the potential for adverse reaction is not limited to opioids.

Patients that do not finish their last antibiotic course should not keep their antibiotics for reuse when next they get an infection. This is really critical as they do not know the cause of the infection and are not professionally trained to diagnose themselves.

Extensive use of antibiotics in agricultural setting

Till date, it is estimated that about 80% of antibiotics sold in the United States of America are used widely as growth supplements in livestock and fish farming. This is done primarily to enhance growth of animals and prevent bacterial infection. By so doing, this has been proven to improve the general health of the animals, produce better yields, and generate a higher-quality product.

When these livestock have been processed, humans (consumers) ingest them along with the antibiotics that these animals have been treated with. This is how resistant bacteria are transferred to humans. The transfer of resistant bacteria to humans by farm animals dated as far back as 35 years ago; this was the approximate time when high rates of antibiotic resistance were found in the intestinal flora of both farm animals and farmers. A study was done and it confirmed that this has occurred over series of events. The study showed that when antibiotics were used in food-producing animals, susceptible bacteria were suppressed or killed causing resistant bacteria to survive and thrive. When these animals are consumed, the resistant


bacteria were transmitted to humans and this led to serious health consequences including bacterial infection. Pesticides such as tetracycline and streptomycin are often sprayed on fruit trees, whilst this only accounts for a fraction of the overall antibiotic use; it has a considerable global effect. By doing this, many microorganisms are exposed to chemical agents that cause alteration in the ecology of the environment. This practice will kill susceptible bacteria and resistant bacteria will thrive.

Hygienic and cleaning products such as antibacterial and disinfectants are often overlooked. However, they also contribute to this problem. This is because they reduce the chances of children and adults developing immunities to bacteria. This may compromise the immune system by making it vulnerable to bacterial infection; hence, increasing the likelihood of mortality.

Only very few new antibiotics being discovered

The discovery and development of a new drug is a big investment even for a Big Pharma industry. It takes 10 years (or longer) and about $1.8 billion to get a new drug to the market. Asides this, the chances of one drug getting the FDA approval is 1 in 10, 000. Furthermore, the risks associated with the release of the drug needs to be considered; in terms of adverse drug reaction.

Many pharmaceuticals have cut back funds or totally pulled out of the antibiotic research due to the fact that; antibiotics are often used short term, hence, there is little return on the massive investment used in developing them. Also, the rapid resistance to antibiotics makes it difficult to keep investing in a diminishing field. There has been a daunting decline in antibiotic approval by the FDA as a result of fewer antibiotics discovery. This has dropped from 29 in the1980s to 9 in the early 2000s. While this is terrible, there is something more concerning. Resistance to one antibiotic often mean resistance to all the antibiotics in the same class. The similarities in chemical structure and mode of action are how antibiotics are often classified. Faced with these, the resistance crisis is said to be an impending doom.

Responsible Use of Antibiotics and Prevention of Resistance

Patients should

Take antibiotics exactly as it is prescribed by a healthcare professional. It is important to take the right doses and not skip any dose. Patients should be aware of how many days their prescriptions

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should be taken for. All prescribed antibiotics should be exhausted; this is to ensure that all of the bacteria are cleared. Patients should not share their antibiotics with anyone. Unused antibiotics should be discarded appropriately or returned to a pharmacy for safe disposal. Antibiotics leftover and unused from previous illness should not be taken for a recent infection. In case of a serious reaction or side effect a healthcare professional should be informed. Furthermore, taking the wrong medication will cause bacteria to multiply and this will delay correct treatment. Patients should not ask for antibiotics when a health professional advises them otherwise.

Healthcare professionals should

Prescribe antibiotics very cautiously, and follow the official guidelines. Healthcare professionals should ensure that antibiotics are prescribed correctly at the right doses and for the right duration. They should also keep a copy of the document of the dose and prescription to ensure that antibiotics are kept under supervision. Healthcare professionals should avoid prescribing resistant antibiotics to patients and they should educate patients of the consequences of antibiotic misuse/abuse.

Conclusion

Antibiotic-resistant infections have been a major economic burden on the health care system especially in countries like the US, UK, and many countries in Europe and Africa. Due to the extensive use of antibiotics and the presence of many vulnerable patients in the hospitals; antibiotic resistance usually starts in the hospital. Data has shown that more than two million Americans are diagnosed of hospital acquired infections every year. This leads to approximately 100, 000 deaths; most of which are resistance infections. In 2006, the US health care system spent more than $8 billion for two common hospital acquired infections (pneumonia and sepsis) that killed 50,000 Americans.

With limited health care professionals to care for them, data has shown that patients with resistance infection stay longer in the hospital. This adds collectively an extra eight million hospital days for patients in the US alone. With an average estimate of $25,000 per person, antibiotic-resistant infections have cost the US health care about $20 billion in health care costs and $35 billion in lost productivity yearly. After all of these, the threat to the antibiotics still in use is worse than ever; and this might soon become the end of an era.


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Basic Concept

Memory is a brain-wide process. There are many different areas of the brain which work together and various systems which when working accordingly provide a cohesive thought (Mastin, 2017). As you begin to learn and remember, the overall structure of the brain does not change, nor do you grow whole new batches of nerve cells – in actuality, it’s the connections between cells that change (Simons and Chabris, 2011).

The idea of a single memory may seem like a simple concept but in truth is a complex construction. For example, if you think about an object (i.e. a pen), your brain retrieves a whole variety of memories including its function, its shape, the sound when it scratches across a page. All these single memories come from different regions of the brain (Mohs, 2017).

Just trying to remember how to ride and manoeuvre a bike is reconstructed from many different areas of the brain. The memory of operating the bike comes from one area, the memory of getting from one place to the other comes from another area, the feeling you experience when a car is driving dangerously close comes from another. However, when you retrieve these separate memories, you are none the wiser that they are separate mental experiences which are coming from

different regions of the brain – this is due to how it all works together so well. Experts have found that there is no contrast between how you remember and how you think (Mastin, 2017).

Memory Encoding

When creating a memory, the first step required is encoding. Different senses and systems are associated with this (visual system, auditory system etc.). Together, all these separate sensations travel to the hippocampus, which integrates all these perceptions into one single experience. It is believed that the hippocampus and frontal cortex are responsible for analysing sensory inputs and determining if they are worth remembering (De Bono, 1991).

A memory begins with perception; however, it is only using the language of electricity and chemicals that the memory can be encoded and stored. It is at the synapse that nerve cells connect with other cells. It is at this point (synapse), that electrical pulses carrying messages travel across the gaps between cells. The electrical firing of a pulse travels across the gap and then triggers the release of neurotransmitters (chemical messengers). The neurotransmitters disperse in the spaces between the cell and then begin to attach to neighbouring cells (McDermott and Roediger, 2017). The parts of the brain cells that receive the electric

ARTICLE #2 | 35


TitleMEMORY: How it Works, Common Misconceptions and its Reliability in Recalling Past Experiences

AuthorsZulekha Ahmed

[email protected]


ZULEKHA AHMEDMEMORY: HOW IT WORKS, COMMON MISCONCEPTIONS AND

ITS RELIABILITY IN RECALLING PAST EXPERIENCES

However, sometimes you may find yourself forgetting things (unable to retrieve the information) which can be due to problems while you were encoding that information (Ratcliff, 1978).

For example, when putting your glasses somewhere, you must register and pay attention when placing them down. Once this information is retained, it can be properly retrieved later. If you have forgotten where you may have put them, this could be due to distractions, not paying attention to what you were doing, not clearly registering where you put them (not coding effectively), not retaining the information you registered, being unable to retrieve the memory etc. There are many problems which can occur and there also many reasons for each of these problems. For instance, in terms of not coding effectively, the reason for this can be that you did not even create a memory in the first place. This could be due to distractions, lack of focus and attention (Boundless, 2017).

Sometimes you may have the memory but are unable to retrieve it. It is frustrating forgetting things, but even more frustrating knowing a piece of information but being unable to recall it and even worse, when you then recall it a few hours later when it is no longer needed. The reason for this may be because of a mismatch between the retrieval cues and encoding of the information (Ratcliff, 1978).

Reliability and Ageing

The changes that occur when you process and learn new information are reinforced with use, building intricate circuits of knowledge and memory in the brain. Therefore, the more you retrieve or use this information is reflected in the strength of the connection between the synapses. For example, if you play a piece of music (guitar, piano etc.) repeatedly, then the repeated firing or particular cells in a certain order in your brain eases the ability to play the music – as the firing of these cells, will begin to come naturally. Therefore, resulting in the ability to play the music faster, with fewer mistakes and it will also become easier – practice makes perfect. However, if you stop playing for a long period, you will find difficulty in playing at the same pace as you once could. This is because the connections and strength between these synapses may have weakened over time, as they were not used for some time (Berry et al., 1989). Consequently, you would once again have to begin practising, though this time it would be easier as the knowledge is already there, you just need to build the strength between the connections of the synapses.

There are many theories that researchers have founded as to what causes the deterioration of memory such as inheriting unhealthy genes; being exposed to poisons and certain chemicals/gases;

impulses and use their feathery tips to reach out to neighbouring brain cells are known as dendrites. A single brain cell can produce thousands of links (synapses), which approximately gives an average brain around 100 trillion synapses.

These connections are not permanent or they do not occur in the same precise order – they change all the time. Although, when brain cells communicate and send signals to one another, the synapse between them gets stronger (De Bono, 1991). Therefore, if more signals are sent, the connection grows stronger, which is why when you experience something new, your brain physical structure is slightly rewired. In fact, some experts say it is how you use your brain which determines how it is organised (McDermott and Roediger, 2017).

Plasticity

Plasticity is when experiences reorganise neural pathways in the brain. With each new experience, your brain slightly rewires its physical feature (Levin et al, 1992). When we learn or memorise information, these changes that occur in the brain can become permanent - it is these changes, in the neural connections that are known as neuroplasticity (Cowan, 2000). Experts say, that neuroplasticity causes a change in the brain, in response to new situations or changes in the environment – this is done by the neurons which adjust their activities to compensate for injury and disease – it is this which would aid the brain to rewire itself, if it was ever damaged (Nelson, 2008).

It is widely assumed that changing the strength of the connections between neurons is supposedly how memories are encoded and stored in the central nervous system. However, this particular theory is still very much under scrutiny. The hypothesis (for synaptic plasticity and memory) states that activity-dependent synaptic plasticity is induced at appropriate synapses throughout memory formation, it is considered necessary for information storage underlying the type of memory mediated by the brain is which that plasticity is observed. One study showed a majority of data to support the concept of synaptic plasticity being essential for learning and memory; however the notion of sufficiency was supported by little data (Takeuchi et al., 2017).

Memory Retrieval

When you try to remember something, the information is retrieved on an unconscious level – bringing it into your conscious mind at will.


ZULEKHA AHMEDINAY ÖZEN MEMORY: HOW IT WORKS, COMMON MISCONCEPTIONS AND


may find that you are not retaining any of the information you just read. As you haven’t been able to focus and distractions have led to you being disrupted – therefore, causing you to ineffectively encode the information. So when you attempt to later recall the information you read, at a later date, you will most likely not remember much and be unable to retrieve it.

Senses

Many studies have shown the link between senses being stimulated and past memories being retrieved. Research also suggests that if one certain sense is stimulated (i.e. the sense of smell) to evoke a memory, other memories which also feature this particular smell are also triggered and so retrieved. Another study showed dysfunction in sensory brain regions, resulted in generalised fear and anxiety, as the person was unable to differentiate between certain senses linked to particular memories (Bodyak, 1999).

When sensory stimuli can lead to reliving past events, this is known as the Proust effect (Campen, 2014). A majority of people are familiar with this and it often takes people by surprise. Sometimes a certain smell can evoke an intense and emotional memory from your childhood or a certain song can remind you of your questionable music taste from your teenage years. Little is known about how this works and what connections our brain cells make, though in recent years research has begun to unfold the mystery of how sense memories work and what affect they have on people (Campen, 2014).

Sense memories are considered very different from other memories, as they are known to open doors to lost memories and can take you further back into your childhood than you would normally remember. Odour memories in particular have been proven to be more resistant to being forgotten (Bodyak, 1999). One study concerning patients with amnesia showed how they were able to retrieve memories from their childhood by a certain smell (Baddeley, 2004). Voluntary memories which are usually retrieved via verbal cues (by asking certain questions or telling a particular story), which is why they completely differ from sense memories. Sense memories are predominantly created during childhood and our teenage years. However, more research needs to be done (Campen, 2014).

Moods

Memories which are emotionally charged are more vividly remembered than other memories. Research shows, that if

smoking and drinking excessively (Josselyn and Nguyen, 2005). However, the most common and agreed upon is aging. There is also a large amount of evidence, which proves this theory to be true and very common.

The shrinkage of the brain and decreased efficiency has been shown to be a result from aging. The faltering of synapses is also linked to aging, which results in the retrieval of memories being affected. Certain areas of the brain are particularly vulnerable to aging i.e. the hippocampus, which loses 5% of its nerve cells with each passing decade from the 20’s onwards (Poon, 2014). In a region at the front of the brain, there is a major cell loss which leads to the production of acetylcholine (neurotransmitter) becoming decreased - this neurotransmitter is considered vital for learning and memory (Cabeza et al., 2000). Due to these all these proven and hypothesised theories, it can be said that memory can sometimes prove unreliable and maybe lead to false implications. Nonetheless, research has shown that this is not always the case and if you keep your brain active you can delay the decreased production of certain neurotransmitters and also postpone losing cells. So it can be delayed but you cannot undo it.

Focus and Attention

On a daily basis we encounter numerous things, however, many of these things are not deemed as significant and therefore, they are filtered out by our brain. As a result, only a few stimuli pass into your conscious awareness. Though, this is mainly due to lack of attention. Attention and focus are vital and required to properly encode a memory (Cowan, 1998). Theoretically speaking, if we paid attention to everything we noticed, our memory would be overloaded with information. However, scientists are still unsure as to whether the stimuli are screened out during the sensory stage, or if they are screened out after the brain has processed the significance of the piece of information. Though, what is very clear and well known (as research has shown), is attention is one of the most important factors in processing the information and therefore has an impact on how much you are later able to remember (Marchetti, 2014). Distractions are a major problem in terms of encoding, as when you are distracted or disrupted when encoding is or should be taking place, you will be unable to efficiently encode and as a result of this when you later attempt to recall that information or retrieve that memory, you will face difficulties (Cowan, 1998).

For example, trying to read a book in public can sometimes prove to be an impossible task. As there are so many distractions, people talking or brushing past you, cars driving past etc. As a result, you


ZULEKHA AHMEDINAY ÖZEN MEMORY: HOW IT WORKS, COMMON MISCONCEPTIONS AND


Important information is then progressively transferred from short-term to long-term memory. To aid in transferring information from short-term to long-term memory, the information should be repeated often and be used and put to practice (Goelet et al., 1986). Which is why students are advised to revise beforehand as it helps to perform better on exams (when compared to last minute revision). Long-term memory can store unlimited amounts of information indefinitely (Hochreiter and Schmidhuber, 1995).

References

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Bodyak, N. (1999). Performance of Mice in an Automated Olfactometer: Odor Detection, Discrimination and Odor Memory. Chemical Senses. [Online] 24(6), pp.637-645. [Accessed 30 Jun. 2017]. Available at: https://academic.oup.com/chemse/article/24/6/637/320329/Performance-of-Mice-in-an-Automated-Olfactometer

Boundless (2017). Memory Retrieval: Recognition and Recall. [Online] Boundless Psychology. [Accessed 18 Jun. 2017]. Available at: https://www.boundless.com/psychology/textbooks/boundless-psycho logy- textbook/memory-8/step-3-memory- ret r ieva l -56/memory-retrieval-recognition-and-recall-220-12755/

Cabeza, R., Anderson, N., Houle, S., Mangels, J. and Nyberg, L. (2000). Age-Related Differences in Neural Activity during Item and Temporal-Order Memory Retrieval: A Positron Emission Tomography Study. Journal of Cognitive Neuroscience. [Online] 12(1), pp.197-206. [Accessed 25 Jun. 2017]. Available at: http://www.jneurosci.org/content/17/1/391.short

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information is linked to something strongly emotional then you are more likely to remember it. In these particular situations, when the memory is being encoded, what is remembered is dependent on your mood (Josephson, 1996).

It is generally easier to retrieve these emotionally charged memories when you are in the same mood as when you encoded that memory, this is known as mood congruence. Mood congruence is when we are able to retrieve memories which are consistent with our mood at the time. For example, if you are in a joyful mood, the memories that you are most likely to easily recall, would be happy memories (rather than sad, depressing memories) (Eich and Macaulay, 2000). This should not be confused with mood-dependent memory, which is the probability of recalling information when in a specific mood state (Kassam et al., 2009). An example of this would be hearing a story at a funeral, the story itself is not sad, however the individual would retrieve this memory or recall this information when in a sad mood state. The story is independent of the mood, but as it is linked to the sadness of the situation, the individual will remember it as a sad memory (Pergher et al., 2006).

Short- and Long-Term Memory

The two different types of memory are short and long-term memory. They are encoded and stored in different ways and in different parts of the brain. Experts have said there are 3 ways in which we store our memories. They are the sensory stage; short-term memory and long-term memory. A number of sensory inputs are analysed by the hippocampus and other regions of the brain (mainly regions in the frontal cortex), it is then decided if this information is worth remembering. This ‘filter’ and other different stages in the human memory, shield us from the overload of information that we face on a daily basis (Little and Shaw, 1975).

Once the information has passed this, it is then stored in our short-term memory. However, our short-term memory has a limited capacity, as it is only able to hold ~7 items for around 20-30 seconds at a time (Goelet et al., 1986). Though, this capacity can be increased by using memory strategies and techniques i.e. brain training exercises. You can also try to memorise things in different way – a phone number is harder to remember in a whole block (123456789), however, if you break it up slightly it becomes easier to remember and thus, retrieve at a later date (123-456-789). Research shows, memory capacity can be increased by eating healthy foods (such as salmon, celery, broccoli), having a regular sleeping pattern (consisting of 8-9 hours), physical exercise, meditation etc. (Hochreiter and Schmidhuber, 1995).

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Ratcliff, R. (1978). A theory of memory retrieval. Psychological Review. [Online] 85(2), pp.59-108. [Accessed 4 Jul. 2017]. Available at: http://psycnet.apa.org/record/1978-30970-001

Simons, D. and Chabris, C. (2011). What People Believe about How Memory Works: A Representative Survey of the U.S. Population. PLoS ONE. [Online] 6(8), p.e22757. [Accessed 25 Jun. 2017]. Available at: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0022757

Takeuchi, T., Duszkiewicz, A. and Morris, R. (2017). The synaptic plasticity and memory hypothesis: encoding, storage and persistence. [Online] The Royal Society. [Accessed 27 Jun. 2017]. Available at: http://rstb.royalsocietypublishing.org/content/369/1633/20130288.short

Johnny Foy is the central character in Wordsworth’s poem, ‘The Idiot Boy’ (2010). He is a child who appears to be cognitively different: he is “still and mute” (Wordsworth 2010: 630; l. 91), “half-wise” (ibid.: 632; l. 198) and makes sounds unique to himself. Through constant iterations of Foy being called “the idiot boy” alongside other descriptions as mentioned above it becomes of little doubt that Foy has or, is perceived as having, idiocy. Here I stumble upon the diagnostic ethics of assigning a character with a cognitive or intellectual disability while having a more contemporary understanding of these terms. This is why I must refer to experts who are better versed in the historical dimensions of these terms and their linguistic transformations. While hard to define or to simply pin down, idiocy has always been associated with intelligence and, by awkward implication, with intellectual disability (McDonagh 2008). McDonagh explains that “the tension between the terms is critical to our understanding of how concepts have shifted across time and space” (McDonagh 2008: 13). While baring this tension in mind I wish to remind the patient reader that while the terms are “conceptually related”, they are most certainly “not the same thing” (ibid.) Therefore I will resist with pleasure diagnosing Foy with some form of disability and will simply and more safely understand him as signifying cognitive difference

more generally. Throughout the essay, however, I will also underline his representation in the poem as an idiot to keep within the era in which the poem was published.

This article will argue that the ‘The Idiot Boy’ (1798/2010) can be read as Wordsworth’s attempt to grasp what it is about Johnny’s cognitive abilities that make him different. I argue that this poem is an attempt to grasp the poetry of Johnny Foy and to unlock - for want of a better word - Johnny’s poetic potential. In doing so it will make links to Wordsworth’s Preface (1800/2010) to discuss what are the significant points of Wordsworth’s manifesto in relation to Johnny. This article is primarily interested in the importance of language and how Johnny - as an ‘idiot’ - augments or adds to Wordsworth’s understanding of poetry in relation to language.

First, I will demonstrate Wordsworth’s understanding of language through two essays. Keach’s (2010) essay explores the different trajectories that the philosophy of language took during the Enlightenment period that would come to impact on how language was used in Romantic poetry. Clark’s (1990) essay helps to understand the implications of finding truth within language, which Wordsworth’s own poetic language sought to achieve. I will then go on to show why Foy was a

ARTICLE #3 | 43


TitleJohnny Foy, Wordsworth, and Language: The Place of Cognitive Difference in Romantic Poetry

AuthorDaryl (Robert Arthur) Deal

[email protected]

Abstract“The Idiot Boy” took centre piece in Wordsworth and Coleridge’s 1798 publication of Lyrical Ballads, a collection of poems that still today seem to define British Romanticism. This is a poem where Johnny Foy, the idiot boy, is sent off through the woods by his mother to fetch a doctor for an ill neighbour. I argue that Foy serves as Wordsworth’s way to engage more with his own poetic imagination and its limits due to Foy’s own potential as a poet. This article discusses three main points: (1) Wordsworth’s understanding of language and its use in poetry; (2) Foy’s place as a subject in Romantic poetry with regards to contemporary assumptions and theories made about ‘idiots’; (3) a close reading of a section of the poem which is of the speaker’s inability to narrate Johnny’s adventures. This part of the poem, I would argue, is overly neglected by critics for its potentiality. The article will then close with a discussion of how this poem is more of a collaborative endeavour which involves not only Foy and Wordsworth but Betty too, Johnny’s mother.

KeywordsCognitive difference; William Wordsworth; ‘The Idiot Boy’; Lyrical Ballads.


DARYL (ROBERT ARTHUR) DEALJOHNNY FOY, WORDSWORTH, AND LANGUAGE:

THE PLACE OF COGNITIVE DIFFERENCE IN ROMANTIC POETRY

possible. Keach continues his essay by explaining the ways in which Wordsworth wanted to use poetry to overcome the arbitrariness of language.

It is important here to remember that Wordsworth saw the poetic diction of previous poetry as arbitrary and fulfilling the needs of the poet rather than the reader (Wordsworth 2010: 647). Wordsworth’s poetic language, to counteract this, was invested in emotion and feeling, and in the social aspect of language (Keach 2010: 115). Wordsworth believed that “genuine feeling can either transcend or transvalue the arbitrariness of language” (ibid.), while writing in the style of “the real language of men” (Wordsworth 2010: 640) - i.e. the social aspect of language - would help to rectify language (Keach 2010: 115). This rectification of language comes from an appeal to individuals who were commonly associated with “a Nature that exists beyond or outside language” (ibid.; emphasis added).

Johnny and Wordsworth

Gonsalves (2007) argues that Johnny has the potential, along with others who were also identified as idiots, to become a figure of divine consciousness or enlightenment (Gonsalves 2007: 125). He goes onto argue that Wordsworth would be willing to identify with Johnny, because of the idea that the idiot is assumed to know nothing, and thereby proves to be integral to particular learning experiments (ibid.). Gonsalves looks back to key philosophers to show how idiocy was beneficial in the exercise of learning: “In a series of three texts now known as the Idiota dialogues, he [Nicholas of Cusa] pitted his ... Idiot against a learned Orator in order to convince him, ... , that they both know nothing” (ibid.; emphasis in the original). Gonsalves concludes that this “process of unlearning empowers Wordsworth’s idiotic” (ibid.). Johnny Foy then has a vantage point over other characters that are the subjects of other poems in Lyrical Ballads (1798): Johnny’s noticeable cognitive difference means that he is “divine, or mystically enlightened” (ibid.). An idea that did not lose itself on Wordsworth: he said of those like Johnny that “their life is hidden with God” (Wordsworth 1935 cited in McDonagh 2008: 27).

Laville (2014) brings attention also to Wordsworth’s identification with Johnny’s consciousness in her reading of ‘The Idiot Boy’. She argues that Wordsworth’s admiration of Johnny Foy is rooted in the “characteristically romantic desire to be disburdened of consciousness in pursuit of aesthetic purity or higher knowledge” (Laville 2014: 195-6). Laville’s reading of ‘The Idiot Boy’ is based on de Man’s deconstructive analyses of particular Romantic texts. Through her reading of de Man’s work juxtaposed with her

suitable subject for Wordsworth’s poetry with a discussion of how Enlightenment and Romantic thought interpreted the consciousness of those believed to have idiocy. Third, the essay will make a critical reading of the poem and address the points of the poem where the figure of the poet appears to be more Johnny Foy than the poet-speaker of the poem. Finally, the essay will make the hypothesis that this poem is more of a collaborative endeavour that requires Wordsworth’s critical empathy with Johnny’s mother, Betty.

Wordsworth and Language

Wordsworth (2010) alludes to the finding of truth through poetry in his Preface. He separates the rational world of science from that of nature and art by insisting that “the Man of Science seeks truth as a remote and unknown benefactor; ... ; the Poet, ... , rejoices in the presence of truth as our visible friend and hourly companion.” (Wordsworth 2010: 646). For Wordsworth then truth is what scientists strive for while for poets it is something already possessed.

Lyrical Ballads (2006), therefore, is an ambition toward truth and meaning, or at least toward a truth and meaning that poetry had not explored to such a large extent. This association of language and truth has long been a discussion of both literature and philosophy before and after Wordsworth’s time. Poststructuralists, in particular, offered many analyses of language and its capacity to convey truth and meaning.

Clark (1990), in her essay ‘Language and Deconstruction’, uncovers the assumptions that the deconstructionist Paul de Man makes to reach his conclusion that “all language is figural and cannot therefore express literal truth” (Clark 1990: 83). She argues that de Man’s denial of the possibility of a literal language is based on the assumption that no language can exist without the arbitrary link between words and the thing or idea that they denote (ibid.: 87). Therefore, according to de Man, if there is no way of losing this arbitrariness intrinsic to language then there is no way of achieving a literal language and, therefore, literal truth (ibid.).

Wordsworth, however, had a different understanding of language. According to Keach (2010), Wordsworth disagreed with philosophers, such as John Locke, by appealing “to an ideal that words may be naturally rather than arbitrarily related to thoughts, and through thoughts to things” (Keach 2010: 114; emphasis added). Following de Man’s logic, as expounded by Clark, I argue that Wordsworth believed language, figural or not, was closer to achieving literal truth by rejecting the arbitrariness thesis that de Man could not see as


DARYL (ROBERT ARTHUR) DEALINAY ÖZEN JOHNNY FOY, WORDSWORTH, AND LANGUAGE:


Perhaps, one of the most obvious moments when the poet-speaker underlines his own ignorance is when he “cannot tell” (l.389) when Johnny is burring and laughing “in cunning or in joy” (l.388). Johnny’s adventures, Johnny’s potential poetry is far from the poet-speaker’s reach.

What the poet-speaker can describe, however, are the pleasant sounds that Johnny makes such as his burring, that often make their appearance when the scene is a happy one: “Burr, burr - now Johnny’s lips they burr, / ... Johnny makes the noise he loves, / And Betty listens, glad to hear it” (l.107, 110-1). It would not be too far-fetched to posit that the poet-speaker, and Wordsworth also, enjoy Johnny’s sounds; after all, any disgust that Wordsworth could possibly feel toward Johnny’s burring would limit their appearance, perhaps even to their exclusion (Wordsworth 2010: 645). Johnny’s sounds are the closest that the poet-speaker can get to Johnny’s poetry. There is a sense of freedom in Johnny’s sounds, because they are noticeably not constrained by the arbitrariness of language, like the poet-speaker’s is. What Wordsworth is acknowledging here is that Johnny’s sounds are a natural connection to his thoughts. Johnny’s language, therefore, is closer to truth than Wordsworth’s can be. The difficulty is that Wordsworth does not have access to the meanings that Johnny ascribes to his sounds. Put differently, Wordsworth can never be the poet that Johnny has the potential to be.

A Collaboration

Laville remarks that “what is remarkable about the last stanza is less that Johnny speaks words than the fact that someone records them” (Laville 2014: 197). What Laville is highlighting is that, for Wordsworth, Johnny’s story, sounds, adventures are worth recording. This is more than relevant to this essay because, put differently, Johnny Foy could not be a poet if it were not for Wordsworth’s acknowledgement of Johnny’s poetic abilities. I argue here that the ‘The Idiot Boy’ is a collaborative poem, one that requires both the potential of Johnny Foy as poet and the near poetic ability of Wordsworth.

The culmination of the poem is undoubtedly at the end when the reader learns that Johnny does speak in a language that can be somewhat understood within the realm of language (as commonly defined): “ ‘The cocks did crow to-whoo, to-whoo, / And the sun did shine so cold’ “(Wordsworth 2010: 635; l.460-1). Bewell (1989) argues that Johnny’s language comes from the instruction of nature during his time in the woods (cited in McDonagh 2008: 48). I must disagree, however, and make the claim that the recording of Johnny’s words is more due to the instruction that the poet-speaker has received. The

interpretation of ‘The Idiot Boy’, she is able to conclude with de Man that “consciousness’s loss is aesthetics gain” (De Man 1984 cited in Laville 2014: 196).

Though Gonsalves’s (2007) article may seem somewhat peripheral to this essay due to its interest in consciousness rather than language, we see from the first part of this essay that a discussion of language cannot be without a discussion of consciousness or thought. I argue that Wordsworth’s acknowledgement of Johnny’s impenetrable consciousness comes through in Wordsworth’s mediation of Johnny’s words and sounds. When Wordsworth attempts to access Johnny’s language, he is attempting to access Johnny’s consciousness and achieve a more aesthetic plain of poetry that he cannot reach alone. This can be seen by the poet-speaker’s somewhat clumsy endeavours of telling Johnny’s story.

Foy, Wordsworth, and the Poet

There are key moments in the poem that emphasise when Johnny is more poetic, or at least has more poetic potential, than the poet-speaker. For instance, a key part of the poem is when Johnny gets lost, and the poet-speaker is applying to the muses to give him the ability to “tell / But half of what to him befell” (Wordsworth 2010: 634; l. 349-50). In this same stanza, the poet-speaker states that he has “been bound, / These fourteen years” to the muses (ibid.; l. 347-8). Critics have pointed out the length of the poet-speaker’s apprenticeship as revealing the poor abilities he has a poet. McDonagh, for example, writes it is “twice the standard years allotted to apprenticeship”, leading him to note that the speaker’s capabilities and learning abilities are somewhat deficient for the job of the poet (McDonagh 2008: 30). The only one who could possibly share Johnny’s “strange adventures” is Johnny himself (Wordsworth 2010: 634; l. 351).

The poet-speaker acknowledges that he does not have access to Johnny’s language, and therefore must gloss over the moments when Johnny does speak. For instance, after Betty puts Johnny on the pony she gives him these instructions: [...] mind that you Come home again, nor stop at all, Come home again, whate’er befall (ibid.; l.68-70.)

To this Johnny makes reply “with his head, and with his hand” (l.73), and with words that “were not a few” (l.75). Though Betty is said to understand him (l.76), it is clear by the absence of these words in the poem that the poet-speaker cannot.


DARYL (ROBERT ARTHUR) DEALINAY ÖZEN JOHNNY FOY, WORDSWORTH, AND LANGUAGE:


that Wordsworth’s seeking of truth through poetry was due to his rejection of the arbitrariness thesis in place of a natural connection between words and the thoughts they denote. Second, this essay discussed how Johnny was relevant to Wordsworth’s understanding of language by uncovering Romantic assumptions that idiots were figures of divinity and transcendental consciousness that, according to Gonsalves (2007), were enviable poetic attributes. Third, this essay gave a critical reading of the poem, concluding that Johnny’s communication was not restrained by any linguistic structures such as the arbitrariness of language, and was therefore closer to achieving the kind of poetic language that was not accessible to Wordsworth.

Finally, this essay, in arguing for Johnny’s poetic potential, encourages others to think of ‘The Idiot Boy’ more as a collaborative project that requires Wordsworth’s ability to empathise with maternal sentiment. It is from there that Wordsworth can see Johnny with the dignity he deserves. The dignity he ascribes to Johnny as the potential poet, combined with Johnny’s particular attributes of consciousness and language provide Johnny with a more constitutive and essential role to Romantic poetry. Moving forward I advance that critics see the cognitively different community as having more of an active role in literature than they are often given credit for.

References

Bromwich, D. “Moral Imagination”. In Raritan, vol.27, no.4, 2008, pp.4-33.

Clark, M. “Language and Deconstruction: Nietzsche, de Man, and Postmodernism”. In Nietzsche as Postmodernist: Essays Pro and Contra, edited by Clayton Koelb. New York: State University of New York Press, 1990, pp. 75-90.

Gonsalves, J. “Reading Idiocy: Wordsworth’s ‘The Idiot Boy’”. In The Wordsworth Circle, vol. 38, no.3, 2007, pp. 121-130.

Keach, W. “Romanticism and Language”. In The Cambridge Companion to British Romanticism, edited by Stuart Curran. New York: Cambridge University Press, 2010, pp. 103-26.

Laville, C. “Idiocy and Aberrancy: Disability, Paul de Man, and Wordsworth’s ‘Idiot Boy’”. In Mosaic, vol. 47, no. 2, 2014, pp. 187-202.

McDonagh, P. Idiocy: A Cultural History. Liverpool: Liverpool University Press, 2008.

Wordsworth, W., and Coleridge, S.T., 2006. Lyrical Ballads with a Few Other Poems. London: Penguin Classics.

Wordsworth, W. “The Idiot Boy”, 1798. In The Broadview Anthology of Literature of the Revolutionary Period 1770 - 1832, edited by D.L. Macdonald and Anne McWhir. Ontario: Broadview Press, 2010, pp. 629-35.

Wordsworth, W. “Preface from Lyrical Ballads, with a Few Other Poems. In Two

question to ask next is where this instruction comes from.

Bromwich’s (2008) lecture, ‘Moral Imagination’, can help to answer this question. He posits, like this essay has suggested, that the poet-speaker’s feelings toward Johnny are akin to those that Betty has for her son. Bromwich argues that Wordsworth “thought it was possible for the reader to have feelings other than generous pity for a human aberration. Yet we come upon our feelings here through Betty Foy’s attachment to Johnny. We are made to feel as she does (Bromwich 2008: 10; emphasis in the original). According to Bromwich, by doing this Wordsworth is encouraging his readers to shift their sympathy from “a rehearsed response of pity for children like this to a sense of Johnny’s actual dignity” (ibid.). A movement that not all his readers, including John Wilson, Coleridge, and Byron, agreed with (Bromwich 2008: 10; McDonagh 2008: 24-6; Gonsalves 2007: 121-2). Wordsworth recognized that parents and caregivers have an integral role in an intellectually disabled child’s life. Bérubé (2009), a specialist in disability rights, may help us to see what Wordsworth also saw. He writes that “the surest way of recognizing their [anyone whose cognitive impairment - or difference - limits their ability to speak verbally for themselves] dignity is to recognize their guardians as people with the right and responsibility of speaking for others (Bérubé 2009 cited in Laville 2014: 193).

Wordsworth’s instruction, therefore, comes from his ability to “confound and identify his own feelings” (Wordsworth 2010: 645) not with Johnny’s, but with Betty’s. Betty’s passions, “the fluxes and refluxes of” her mind is what Wordsworth is aiming to follow (ibid.: 642). The reason why this is important is because it is through Betty that Wordsworth is able to attribute the dignity that Johnny deserves. I argue that this is how Wordsworth is able to ascribe Johnny the label of the poet that Johnny could potentially be. ‘The Idiot Boy’, therefore, is a collaborative endeavour: it requires both Wordsworth and Johnny. Johnny’s words that end the poem can therefore be read as not Johnny’s learning experience with nature, but as Wordsworth’s attempt to attach meaning to Johnny’s words, an effort toward understanding Johnny’s mind, and a lasting bid to seek truth through poetry.

Conclusion

This essay’s purpose was to explore other ways in which Johnny Foy was an important part of Wordsworth’s poetic project as set out in his Preface (1800/2010). In doing so it has argued that Johnny has more potential to be a poet than Wordsworth based on evidence related to language and consciousness. First, this essay argued

50 | JADE

DARYL (ROBERT ARTHUR) DEALINAY ÖZEN

Volumes”, 1800. In The Broadview Anthology of Literature of the Revolutionary Period 1770 - 1832, edited by D.L. Macdonald and Anne McWhir. Ontario: Broadview Press, 2010, pp. 640-51.

Acknowledgements

A great thanks should go to Dr Sarah Allison of Loyola University, New Orleans. Her ideas and encouragement initiated the direction of this project. Her continued support in the life of this project is appreciated and will not be forgotten.

Everyday life involves a process of critical thinking as an inquisitive nature, which relies on quality inputs from senses, experiences, opinions and facts to produce a dependable output. The Rational-Thinking Process is applicable in every human being focusing on a devised formula; Inputs + Process = Output (Richetti and Tregoe, 2001). The complete attention given to the quality of the input is insufficient to produce efficient output because the critical thinking process collect, organise and analyse inputs depending on self-discipline and correctness. The ability to rationally critically think is installed in every individual; however integral language plays an important factor in developing the skills required to activate the process. Therefore, to what extent does integral language used for the thinking process affect the prelingual deaf community.

The ability to rationally think in every individual was critically analysed in the Genie case study. She was 13 years and 7 months old when first discovered from isolation and neglect from her family, hospitalised for malnutrition and could not stand, chew food, speak, cry or was toilet trained. Most of her time in social isolation, Genie was confined to a potty chair or an infant crib and fed only infant food. Early linguistic developments were insignificant and she could not vocalise when first observed

in the hospital (Fromkin et al., 1974). Thus, Genie was referred to as a homo ferus; according to Linnaeus defining characteristics as a lack of speech or overt language (Taxonomicon taxonomy.nl, 2017).

Linguistic assessment carried out, demonstrated that Genie could communicate her needs through actions and tantrums, showing the ability to comprehend spoken language and expression, reflecting in a moderate scale of existent critical thinking process, in order to produce a relevant output for communication. This supports that Genie was able to comprehend the situation in terms of inputs, process through critical thinking and produce outputs such as tantrums. In relation to prelingual deaf individuals, rationally thinking without a language is validated and completely neglects the idea of prelingual deaf individuals having an idle and stale mind, which was accepted before the 1970 (Chronically Sick and Disable Persons Act, 1970). This endorses the idea that every individual has the capability to rationally think, regardless of spoken language.

What is language? Language has progressed over the times, widening horizons from spoken language to identifying multiple different types of languages. The primary languages are natural language; restricted language used for mathematics and computer programming and

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TitleCapsuling language used for the inner voice in the Deaf Community

AuthorRaidah Gangji

[email protected]

AbstractThe rational thinking process also known as the inner voice in an average hearing or semi-hearing individual is in a spoken language. The inner voice is a semi-constant, conscious internal monologue within a vast majority of the individuals. It is a ‘voice’ speaking enclosed in your head, in a language you are most comfortable with, in your own voice. However, can this be equally applied to prelingual deaf individuals, who haven’t heard a vocal voice? Can deaf individuals think rationally in a language? Everybody has an innate evolutionary trait of language engraved within them, which allows the exploitation of the complex human brain. Deaf minds compensate for their hearing part of the brain through neuroplasticity, heightening other parts of the brain to receive further detailed stimuli from other senses. Other than language, prelingual deaf individuals used imagination, sense perception, reason and emotion to overcome challenges faced as the society is immersed within spoken language. Therefore, the inner voice of a prelingual deaf individual can be categorised into various non-linguistic languages with the addition of employing ways of knowing to aid in analytical and rational thinking process.


RAIDAH GANGJI CAPSULING LANGUAGE USED FOR THE INNER VOICE IN THE DEAF COMMUNITY

and nurture play an important role in shaping a human mind. This supports the idea that every individual has a purpose of language engrained in within them as an evolutionary trait, giving the individual the capability to rationally think with a linguistic language or non-linguistic language.

A thread on reddit.com submitted 5 years ago by username ‘dubstepViking’ asked ‘if a deaf person is born deaf, what language do they think in?’ This is a very interesting perception of rational thinking, which can be analysed as evidently with reference to the case study on Genie, the capacity of thinking is present with or without a linguistic language. A prelingual deaf person with the username ‘x75tiger75x’ replied with complete sincerity, that deaf people have a different thinking process compared to hearing people. An average hearing person would have personal monologues and rational thinking thoughts in their comfort speaking language. In the response, ‘x75tiger75x’ explained that he/she can imagine sign language in first person conducting own movement or can imagine sign language in third person such as watching someone sign communicating or imagine fingerspell words or type-faced letter that are not present in his/her sign language (reddit, 2017). Thus, a deaf person manages to create a visual thinking process. A visual thinking process is the phenomenon of the ability to rationally think using images, objects and personal imagination to create the execution of critical analysis.

Visual thinking process is a phenomenon that only some candidates can experience exclusively without any interruption of spoken language. Recent study on the deaf brain has decoded compensatory neuroplasticity of visual location in auditory cortex (Bates, 2012). This can be explained by sensory responsibilities heighten to process for missing information from one of the senses (Good, Reed and Russo, 2014) (Almeida et al., 2015). Enhancement of visual and vibrotactile skills in deaf individuals may strongly suggest the correlation in the visual thinking process.

Nevertheless, visual language is not the only aspect that helps the prelingual deaf individuals to carry out a rational thinking process; ways of knowing such as imagination, sense perception, reason and emotion play equally an important part. Imagination as a faculty of forming concepts without reference to external object to the sense, help the prelingual deaf individuals in their thinking process. Imagining sign language as first person or third person is categorised as a type of imagination. According to many statements from deaf individuals, different type of creative ways are used to transcribe their thinking such as thinking in words without associated sounds or dreaming in voices without lip movement or sign language

spoken language; natural language used in day-to-day life which could be divided into two subtypes – linguistics and non-linguistic communication. As language is defined as a system of communication; linguistic communication includes spoken and written language established through a group of people example English, French. On the other hand non-linguistic communication involves characteristics accepted by the society used for communication such as body language, body gestures and abstract.

A system of communication manages a wide spectrum of languages in terms of delivering, processing and responding the message. This introduces a new ideology of the acquisition of language diving into the Nature vs. Nurture debate in particular aspects whether language is either inherited with genetics or acquired through learning or behavioural osmosis. Noam Chomsky, an American-born linguist strongly believed in an innate pre-acquisition of language known as the theory of Universal Grammar. The theory of Universal Grammar suggested that humans were born with a pre-obtained rules and patterns of grammar; a subject, a verb and an object denomination, which can be traced in spoken languages around the world (Dabrowska, 2015). The proposed evolution of language started with a mutated sequence forkhead box protein P2 (FOXP2) also known as the language gene, proved to be beneficial for humans as s survival for the fittest trait (Andreadis, 2013). This absolutely supports that language has some correlation with predisposed nature traits.

However, many sturdily believe language is a necessary trait forced to be adapted by humans because we are social animals and live in large social entities. The nurture aspect of language is defined as social bonding and grooming with other humans. Dunbar, a British anthropologist claimed that language was also an evolutionary trait, as an ecological species human travelled in larger group size in numbers to reduce risk of predator attacks, protecting its members (Dunbar, 2004). As a result of movement in larger groups for protection purposes, sociality was forced to occur, compromises for one another as short term objectives to elongate protection for the long term aim (Brown, 2008). Sociality then selective based environment where having a language would allow faster learning, message transmission and decisions, adapting a self-created, safe environment where communication allowed you to be part of the social group.

Both parties at opposite ends on the Nature vs. Nurture debate believe in a core principle of evolutionary trait; either the mutation of FOXP2 gene or the force monument of sociality for protection. Hypothetically, people under the same household would have equally abilities in language, but that is not true because nature


RAIDAH GANGJIINAY ÖZEN CAPSULING LANGUAGE USED FOR THE INNER VOICE IN THE DEAF COMMUNITY

different but complement each other. Mentioned early, both these ways of knowing are separately involved in their respective industries extenuating their complete differences. But how do they complement each other? For a scientist to creative formulate a hypothesis, he/ she must have had a ‘hunch’, a strong guess based on an inner feeling. The ‘hunch’ is an emotion which would lead the scientist to further investigate the strong guess using various methods and techniques of reasoning to produce a reliable or definitive solution. Additionally, to understand personal feelings or somebody else’s feelings, rational reasoning is employed. In order to identify the emotions one must be able to compare and categorise similar feelings which require rational reasoning. Reason and emotion are both utilised in prelingual deaf individuals. The rational thinking process requires continuous categorisation and inductive and deductive reasoning in order to analyse the situation without similar spoken language to an average hearing person. Therefore, reason and emotion as a way of knowing are integrated but not miscible solutions.

In conclusion, prelingual deaf individuals are not mentally handicapped under any circumstances. They may not have access to spoken language for their respective rational thinking process, however, can carry out non-linguistic language rational thinking. In addition; ways of knowing such as imagination, sense perception, reason and emotion aid in the process of rational thinking. Hence, prelingual deaf individuals can think, but in what language – there is no absolute definitive answer.

References

Almeida, J., He, D., Chen, Q., Mahon, B., Zhang, F., Gonçalves, Ó., Fang, F. and Bi, Y. (2015). Decoding Visual Location From Neural Patterns in the Auditory Cortex of the Congenitally Deaf. Psychological Science, 26(11), pp.1771-1782.

Andreadis, A. (2013). The “Language” Gene and Women’s Wagging Tongues. [online] Scientific American Blog Network. Available at: https://blogs.scientificamerican.com/guest-blog/the-language-gene-and-womens-wagging-tongues/ [Accessed 13 Jul. 2017].

Taxonomicon.taxonomy.nl, (2017). [online] Available at: http://taxonomicon.taxonomy.nl/TaxonTree.aspx?id=1005386&src=1002 [Accessed 17 Jul. 2017].

Bates, M. (2012). Super Powers for the Blind and Deaf. [Blog] Scientific American. Available at: https://www.scientificamerican.com/article/superpowers-for-the-blind-and-deaf/ [Accessed 14 Jul. 2017].

Brown, H. (2008). Principles of language learning and teaching. White Plains, NY: Pearson Longman.

Curtiss, S., Fromkin, V., Krashen, S., Rigler, D. and Rigler, M. (1974). The Linguistic Development of Genie. JSTOR, Vol. 50(No. 3), pp.4 - 28.

Dąbrowska, E. (2015). What exactly is Universal Grammar, and has anyone seen it?. Frontiers in Psychology, 6.

(Fernyhough, 2014). Hence, the usage of imagination is absolutely important in the process of rational thinking present in every individual but imagination just like an extensive mind map cannot sustain without inputs from other ways of knowing.

Sense perception is a primary and direct method of interacting with the world using the five senses. Heightened visual sensory compensates for the poor hearing sensory in the brain (Segalowitz, 2003). However, human perception is both impeding and limiting our understanding of the external world based on cultural and physiological indulgent catered for each individual. Humans can associate a smell to a situation and can be easily identified because of connotation to personal memory. Americans can easily identify; coffee, peanut butter, chocolate, familiar smells that provoke personal memory associate with that particular smell. On the other hand, Americans that have visited the Malay Peninsula could additional identify bat droppings and leaf of ginger root (Luhrmann, 2015). This shows how sense perception is restricted solely based on our personal experiences, upbringing, and traditional and cultural roots shaping an individual with individuality; personalising everyone’s rational thinking.

Reason and emotion are two ways of knowing that are completely different but complement each other in a unique manner. An on-going debate between reasoning which refers to a strict cause, explanation and vindication and emotion which is defined as unlimited human nature effects in varied time and duration. Reasoning is used to make a rational decision depending on instincts based on previous experience. It is highly employed in the science and technology industry where a logical objective is set in place. The objective is then scrutinised to arrive at a decision using inductive reasoning such as generalisation and/ or deductive such as arriving to a secondary conclusion based on influence or experience.

However, emotion as a way of knowing depends on the feeling and relationship considering rationality to grasp the complexity of human nature. Emotions are an evolutionary trait with a main purpose of protection in order to react quickly to a dangerous stimulus. A scenario using fear as an emotion, when faced with a predator as a human fear as an emotion kicks in through the release of adrenaline as the flight or fight response. The emotional system helps induce fast responses to vulnerability (Simons, 2009). Emotion is commonly exploited in the arts and media industries as expression of human feelings are the theme, making it appealing and relatable to the audience.

Comparing reason and emotion as a way of knowing; completely

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Dunbar, R. (2004). Gossip in evolutionary perspective. Review of General Psychology, 8(2), pp.100-110.

Elkind, D. (1994). Book Review Secret of the Wild Child VHS Videocassette, Running Time 60 Min. Boston, NOVA Star of Science Television/WGBH, 1994. $19.95. This video will be broadcast on public television on October 18 at 8 p.m. Eastern Time. New England Journal of Medicine, 331(15), pp.1030-1031.

Fernyhough, C. (2014). Do Deaf People Hear an Inner Voice?. [Blog] Psychology Today. Available at: https://www.psychologytoday.com/blog/the-voices-within/201401/do-deaf-people-hear-inner-voice [Accessed 14 Jul. 2017].

Fromkin, V., Krashen, S., Curtiss, S., Rigler, D. and Rigler, M. (1974). The Development of Language in Genie: a Case of Language Acquisition beyond the “Critical Period.” American Psychological Association, pp.81 - 107.

Good, A., Reed, M. and Russo, F. (2014). Compensatory Plasticity in the Deaf Brain: Effects on Perception of Music. Brain Sciences, 4(4), pp.560-574.

Harris, J. (2001). One principle and three fallacies of disability studies. Journal of Medical Ethics, Vol. 27(No. 6).

Jones, M. (2002). Deafness as Culture: A Psychological Perspective. Disability Studies Quarterly, Vol. 22(No. 2).

Kuhl, P. (2010). Brain Mechanisms in Early Language Acquisition. Neuron, 67(5), pp.713-727.

Luhrmann, T. (2015). Can’t Place That Smell? You Must be American. The New York Times. [online] Available at: https://www.nytimes.com/2014/09/07/opinion/sunday/how-culture-shapes-our-senses.html?_r=0 [Accessed 16 Jul. 2017].

reddit. (2017). If a deaf person is born deaf, what language do they think in? • r/AskReddit. [online] Available at: https://www.reddit.com/r/AskReddit/comments/qc6zu/if_a_deaf_person_is_born_deaf_what_language_do/ [Accessed 14 Jul. 2017].

Richetti, C. and Tregoe, B. (2001). Analytic processes for school leaders. Alexandria, Va.: Association for Supervision and Curriculum Development.

Segalowitz, S. (2003). Handbook of neuropsychology. 2nd ed. Amsterdam: Elsevier, p.Chapter 4.

Simons, I. (2009). Why Do We Have Emotions?. [Blog] Psychology Today. Available at: https://www.psychologytoday.com/blog/the-literary-mind/200911/why-do-we-have-emotions [Accessed 16 Jul. 2017].

The National Archives (1970). Chronically Sick and Disabled Persons Act. Legislation.gov.uk.

Context and Objectives

The essay is considering Forster’s A Passage to India, first published in 1924, which follows a number of characters, both Indian and British, and their experiences with Anglo-India. The racial prejudices illustrated parody Forster’s experiences of Anglo-India, culminating in the accusation and trial of the Indian Dr Aziz. The essay will focus on Forster’s description of Chandrapore and interactions between several Anglo-Indian characters, Turton, McBryde, and Fielding, and the Indian population.

The objectives begin with an investigation into the context of the novel. Forster based the location and characters of A Passage to India on his own experiences in the country. Indeed, “before writing a Passage to India Forster had twice visited India” (Parry, 1998: 228). The different responses from the British and the Anglo-Indian press towards the publication of the novel are also revealing. “Reviewers in the British-Indian Press were deeply critical”, (Childs, 2007: 190), and publication was met with “indignation at the portrayal of the British in India”, (Childs, 2007: 190); the portrayal of Anglo-India had definitely touched a nerve.

The characters and location of the novel are an amalgamation “of Forster’s impressions on his two visits”, (Childs, 2007: 189), providing further evidence

to argue that the book does make it possible to experience the realities of colonial rule.

Methods

The essay will firstly investigate the location of the novel, the fictional city of Chandrapore, considering the themes of isolation and cultural separation in order to establish the mind-set of the Anglo-Indian population through the physical landscape of their surroundings. Secondly, the essay will consider the character of Turton, his attitude of occupational superiority, and to argue that the Anglo-Indian attitude is more complex than outright racial dislike. Thirdly, to consider how characters such as McBryde and Heaslop are examples of the worst aspects of British rule in India, including absolute notions of racial inferiority. Finally, an investigation of the character of Fielding will provide a contrasting notion of British rule in India. This therefore suggests that it is possible to experience the realities of colonial rule through the novel.

Geographical isolation

The cultural separation between Indian and British Chandrapore described in the novel emphasises the racial and social prejudices of the Anglo-Indian administrators. Indian Chandrapore is described as a city where “the streets are mean, the temples ineffective”, (Forster, 1961: 31),

ARTICLE #5 | 57


TitleA Passage to India: Imperialism, Ethnicity and the decline of the British Raj

AuthorEdward Nicholas Hopkins

[email protected]

AbstractThe focus of this study is to investigate the relationships between the Anglo-Indian cast of E. M. Forster’s, A Passage to India, and the native population that they rule over. The essay will attempt to investigate whether characters such as McBryde, Turton and Fielding, as well as the description of the fictional city of Chandrapore can be used to conceptualize the experience of colonialism at the beginning of the twentieth century. The essay will explore the description of Chandrapore and geographical isolation, Turton and occupational superiority, McBryde and irrational rationale as well as Fielding and the exaggerated critique. A detailed analysis of these characters suggests that these realities of colonial rule can be found through an investigation of each of these sections. This leads to the conclusion that it is possible to realise the realities of colonial rule through an investigation of each of both the location and characters of A Passage to India.

KeywordsOccupational Superiority, Irrational Rationale, Geographical and Cultural isolation, Characters of Critique


EDWARD NICHOLAS HOPKINS A PASSAGE TO INDIA: IMPERIALISM, ETHNICITY AND THE DECLINE OF THE BRITISH RAJ

Gist’s argument that these barriers created by social isolation were generated to “maintain social distances between individuals and collectivities”, (Gist and Wright, 1973: 22), as well as the separation of social class and identity. This suggests that the social isolation felt by the Anglo-Indian community would ‘necessitate’ the exaggeration of their fragile identity in response to what they perceived to be a threat to their identity. This continues throughout the novel, as it states that “the English always stick together”, (Forster, 1961: 235), further highlighting their sense of cultural isolation.

Occupational Superiority

The role of the District Collector of Chandrapore is “to portray colonial law and rule” (Mendenhall, 2010: 2). Presenting an image of occupational superiority, he represents the link with colonial rule. Turton presents a complex paradox between British colonialism and Anglo-Indian prejudices; as Mendenhall argues, he is presented as being “a site and symbol of British power but also of British mercy and tolerance” (Mendenhall, 2010: 12). During the trial of Aziz at the end of the novel, “he comes down on the side of the English”, (Mendenhall, 2010: 19); suggesting that “India transforms the English”, (Mendenhall, 2010: 7), and they all become the same.

The complex attitude of the District Collector contrasts the more overtly prejudicial views held by his fellow Anglo-Indians. When Mrs Turton argues that “it’s ridiculous to pretend they don’t hate us”, (Forster, 1961: 217), Turton states “’I don’t hate them, I don’t know why’” (Forster, 1961: 217). ‘Hating’ the Indian population is the natural attitude for an Anglo-Indian. He states that if he adopted the same racial attitudes, then it would “condemn his own career as a bad investment”, (Forster, 1961: 217), suggesting that his apparent willingness to engage with the native population may arise from ambition alone. Although overtly less hostile, his social position prevents him from interacting with the Indian population. He is “revealed like a god in a shrine”, (Forster, 1961: 172) – appearing as such not only to the Indian population but also his British contemporaries. The Turtons are presented as acting as if they were, “little gods”, (Forster, 1961: 50), due to the ‘occupational superiority’ of the role of District Collector. The attitude of the Anglo-Indians, as Dewey argues was generated by the “difficulty of understanding India”, (Dewey, 1993: 4), because “it was so alien, so diverse, so immense” (Dewey, 1993: 4). This reinforces the concept that “they constituted a ruling class, a class apart”, (Dewey, 1993: 5), emphasising their detachment and increasing the sense of isolation and separate identity. This, Gist argues, “gave them a feeling of superiority over other Indians”, (Gist and Wright, 1973: 39), and it is this that motivated their interaction

while the city and the people that inhabit it are described as “mud moving” (Forster, 1961: 31). By contrast, the civil station is described as having “nothing hideous in it, and only the view is beautiful” (Forster, 1961: 32). Even its description as “sensibly planned, with a red brick club on its brow”, (Forster, 1961: 32), suggests that it is built solidly as a place from which to rule India.

Edwards agrees that the description of Chandrapore is conducive towards explaining “the racial division that the novel partly deals with”, (Edwards, 2002: 27), suggesting that the racial prejudices encountered through interactions between British and Indians, can be explained in the physical landscape of Chandrapore. Colonial isolation is generated in response to an apparent threat to identity. The Anglo-Indian world is “cut off from the realities of the native culture”, (Edwards, 2002: 27), demonstrating that the civil station and the club are islands of cultural isolation. The civil station serves as a blank template onto which, as Kenny argues, the “Anglo-Indians could create a familiar landscape”, (Kenny, 1995: 694-695) – based on British values and prejudices. Racial attitudes towards native Indians were generated to maintain a distinct identity, as Kenny argues, suggesting that “race endures as a key discursive device for defining difference” (Kenny, 1995: 696). The most prominent form of this as Kenny argues, is “the characterization of imperialism as a homogenous ideology accompanied by a homogenization of racism”, (Kenny, 1995: 696), suggesting that imperialism and racism were synonymous. The numerical inferiority of the Anglo-Indians, as well as their isolation, suggests that as “Anglo-Indians are numerically in the minority”, (Gist and Wright, 1973: 78), then their identity was generated, as Gist argues, by the “uncertainties that Anglo-Indians faced concerning their own position in India”, (Gist and Wright, 1973: 77) emphasised their isolation on the periphery of the Empire.

The club emphasises the separateness between the British and the local population. As Crane argues, the club “is both territorially and racially other”, (Crane, 2011: 19), it is where the Anglo-Indians are reminded that they are isolated from everything that is English. Desperate to maintain their identity, they have created the club, where Indians, even as guests, are not allowed to enter. It is where the “enormity of colonialism is revealed”, (Crane, 2001: 19), including the existence of “social divisions that separated the ‘elite’ from the lower classes” (Crane, 2011: 19). The playing of the national anthem “reminded every member of the club that he or she was British and in exile” (Forster, 1961: 47), reinforcing the idea that they were inhabiting islands of Britishness in India. The “bridge party, emphasises the idea of the club as an island” (Crane, 2011: 22). Interactions between British and Indian are presented as being “grotesque parodies of social meetings” (Parry, 1985: 33). These social parodies support



world, as Mannsaker argues, “however small numerically, posed special problems”, (Mannsaker, 1980: 33); Indians were viewed as “fundamentally barbarous and savage” (Mannsaker, 1980: 35). Continual references to “1857”, (Forster, 1961: 194), shows the impact on racial and cultural attitudes of the Indian Mutiny of that year, as it “served to confirm the mutual distrust which had been growing up between rulers and ruled for over twenty years” (Bolt, 2013: 158).

Heaslop, the City Magistrate further illustrates this. He “doesn’t have to try consciously to dehumanise Indians: he does it naturally” (Edwards, 2002: 88). This can also be seen through interactions with Fielding, reinforcing the idea that there is an innate Anglo-Indian attitude towards the native population. Heaslop represents the “sheer irrationality of the Anglo-Indian posture towards Indians”, (Edwards, 2002: 88), especially when he breaks up the interaction between Miss Quested, Dr Aziz and Professor Godbole. Heaslop’s attitude is reinforced by “the dehumanising power of his position” (Edwards, 2002: 88). Like the Turtons, he occupies a position of social and occupational superiority. It would be difficult for anyone in the group to act differently; as McBryde tells Fielding “the man who doesn’t toe the line is lost” (Forster, 1961:180). The message is always to remain part of the group and remain aloof; exemplified when Callendar tells the British that “you can’t run with the hare and hunt with the hounds, at least not in this country” (Forster, 1961: 194).

The Critique of Anglo-India

The character of Fielding, the Principal of the government-run college, represents “culture, tolerance and kindness”, (Parry, 1998: 227), in sharp contrast to other characters. The characters and location Forster creates are, as Parry argues, “cruelly parodied” (Parry, 1985, 28). Fielding completely contrasts the “obtuse, coarse, arrogant and bellicose deportment of Anglo-Indians as realised in the novel” (Parry, 1985, p. 34). These characteristics are “the very negation of those decencies defined through Fielding” (Parry, 1985: 34). Other characters are written almost as a parody of the worst aspects of Anglo-India and the relatively tolerant attitude of Fielding emphasises the parody further. But this very tolerance, as Mahood argues, “so effective in the first part of the book, is enfeebled and rendered hapless in the second”, (Mahood, 1977: 79); suggesting that ultimately, “friendship between Englishman and Muslim”, (Mahood, 1977: 79), or any other native subject, “could not withstand the racial antagonisms of those around them” (Mahood, 1977: 79). While Fielding initially supports Aziz, ultimately he has to fall into line and agree that Aziz is an Indian, and so, continued friendship is impossible. The group mentality prevails. He questions himself,

with Indians, “whom their regarded, stereotypically, as an inferior order of humanity” (Gist and Wright, 1973: 39). This reinforced the prejudicial assumptions held by the Anglo-Indian population, that “European civilization, in their judgement, was superior to Indian civilization” (Gist and Wright, 1973: 39). The occupational superiority of the Anglo-Indians, as Childs argues can be found through their “conceited self-image” (Childs, 2007: 194). In the novel, Turton states that he had “never known anything but disaster result when English people and Indians attempt to be intimate socially” (Forster, 1961: 173-174). The idea of occupational superiority reinforces the supposition, as Parry argues, that “by social position and temperament the Anglo-Indians are outsiders”, (Parry, 1998: 225), suggesting that the social snobbery presented by the Anglo-Indians means that the novel presents a “definitive picture of Anglo-India and India” (Parry, 1998: 225).

Irrational Rationale

The character of McBryde, the District Superintendent of Police, stands, as Mendenhall argues, “for all that is absolute in British culture” (Mendenhall, 2010: 21). He represents the worst aspects of British rule in India, including the “absurdity of English assumptions about the nature of Indian men” (Mendenhall, 2010: 21). However, McBryde and Heaslop adopt different methods to preserve their own fragile identity. While McBryde adopts a pseudo-scientific racism, the character of Heaslop prefers ignorance over racial demonisation of native Indians. Edwards argues that this has become “characteristic of the Anglo-Indian world”, (Edwards, 2002: 87), suggesting that almost wilful ignorance enabled the Anglo-Indian community to preserve their identity.

Despite McBryde’s position of irrational rationale, he is not presented as a bad person, suggesting that the racial antagonisms he supposes to be universal were ‘normal’ enough to be unnoticed. He holds a pseudo-scientific rationale for his prejudices, stating that “the darker races are physically attracted by the fairer, but not vice versa”, (Forster, 1961: 222), in order to justify his position in the trial towards the end of the novel. The prejudices held by the Anglo-Indians, as Kenny argues, were in “the hold of pseudo-scientific racism” (Kenny, 1995: 700). Examples of this abound – for instance, McBryde says “he had expected these outbursts of insolence” (Forster, 1961: 225). He justifies his own attitude by saying “they are the natural gestures of an inferior race” (Forster, 1961: 225). This is linked to the occupational superiority that facilitated the maintenance of the identity of the British group, and a consequent “belief in British racial supremacy” (Mannsaker, 1980: 35). The insertion of natives into the Anglo-Indian



Bolt C, (2013), Victorian Attitudes to Race, Abingdon: Routledge

Childs P, (2007), ‘A Passage to India’, in D. Bradshaw, (Ed.), The Cambridge Companion to E M Forster, New York: Cambridge University Press, pp. 188-208

Crane R, (2011), ‘Reading the Club as Colonial Island in E. M. Forster’s A Passage to India and George Orwell’s Burmese Days’, Island Studies Journal, Vol. 6 Issue 1, pp. 17-28

Dewey C, (1993), Anglo-Indian Attitudes: The Mind of the Indian Civil Service, London: The Hambledon Press

Edwards M, (2002), E. M. Forster: The Novels, Basingstoke: Palgrove

Forster M E, (1961), A Passage to India, Harmondsworth: Penguin Modern Classics

Gist N and Wright R, (1973), Marginality and Identity: Anglo-Indians as a Racially-Mixed Minority in India, Leiden: E J Brill

Kenny J, (1995), ‘Climate, Race and Imperial Authority: The Symbolic Landscape of the British Hill Station in India’, Annuls of the Association of American Geographers, Vol. 85 Issue. 4, pp. 694-714

Mahood M, (1977), The Colonial Encounter: A Reading of Six Novels, London: Rex Collins Ltd

Mannsaker F, (1980), ’East and West: Anglo-Indian Racial Attitudes as reflected in popular Fiction, 1890-1914’, Victorian Studies, Vol. 24 Issue. 1, pp. 33-51

Mendenhall A, (2010), ‘The Oft-Ignored Mr Turton: The Role of District Collector in A Passage to India’, Libertarian Papers, Vol. 2, pp. 1-28

Parry B, (1985), ‘The Politics of representation in a Passage to India’, in J. Beer, (Ed.), A Passage to India: Essays Parry in Interpretation, Basingstoke, The Macmillan Press Ltd, pp. 27-43

Parry B, (1998), Delusions and Discoveries: India in the British Imagination, 1880-1930, London: Verso

asking if he would “defy all his own people for the sake of a stray Indian”, (Forster, 1961: 313), in itself a slightly pejorative phrase. The whole episode illustrates how difficult it was to deviate from the accepted view of the Anglo-Indian community.

Discussion

In exploring whether it is possible to encounter the realities of colonial rule in A Passage to India, Beer argues that the novel “can offer no more than a partial account of so vast a subject” (Beer, 1985: 135). Focusing on a single novel meets the essay’s objective in the sense that examining the location and characters of a Passage to India allow us to investigate the realities of colonial rule, particularly as we know the novel was based on Forster’s own experience. This paves the way for more detailed analysis of the essay’s themes as well as developing new ideas.

One of the major criticisms of this theory is that the novel intentionally presents a cruel parody of British rule in India; the locations and characters are wildly exaggerated to make a political point. However, Beer argues that this can be used to stimulate discussion as “Forster himself did not aim at total accuracy” (Beer, 1985: 136). This could lead to further investigation of how colonial fiction can be used to provide illustration of genuine historical facts.

Conclusion

Through an understanding of the context of the novel, as well as an analysis of the characters and location of A Passage to India, it is possible to encounter the realities of late colonial rule. The description of Chandrapore is fundamental towards understanding the mind-set of Anglo-India during the early twentieth century. The ideas of separation and isolation, demonstrated through the club and the civil station suggest that this would sustain the social and racial prejudices of Anglo-India in order to maintain their identity. Characters such as Turton contribute to the thesis of this essay, providing a fictional illustration of the ‘occupational superiority’ typical of the Anglo-Indian view. Other characters such as McBryde reinforce other aspects of this and are contrasted with the character of Fielding to illustrate the realities of the colonial encounter.

References

Beer J, (1985), ‘Conclusion: A Passage to India and the Versatility of the Novel’, in J Beer, (Ed.), A Passage to India: Essays in Interpretation, Basingstoke, The Macmillan Press Ltd, pp. 132-152

Introduction

The word placebo, from the Latin “placeo - I shall please”, has commonly entered the public lexicon from the scientific community to define the well-documented phenomenon whereby the administration of an inert substance (such as a sugar pill) results in an improvement of symptoms due to the patient’s psychological beliefs acting on various bio psychological pathways. It is logical to see how the less well known, but mirror opposite, sibling Nocebo was named by Walter Kennedy in 1961 – “I shall harm”.

Placebo and nocebo are said to be nonspecific effects of treatment. Any pharmacological or non-pharmacological treatment can be said to have two effects – those attributed to the active treatment leading to specific effect and nonspecific effects resulting from patient knowledge about the treatment and the clinical procedure (Figure 1). Like placebo the effects of nocebo are modulated by factors such as personality type and psychiatric history but, whereas placebo refers to the positive nonspecific effect of treatment, nocebo effect accounts for the harmful nonspecific effects.

Studies show the Nocebo effect to be potent in two main areas of healthcare – the clinical treatment setting and in clinical research.

Figure 1: Every treatment has a specific and nonspecific effect. During treatment simulation with a placebo the nonspecific effects of a drug can be measured. The beneficial effects are called the placebo phenomenon whereas the adverse effects are attributed to a nocebo effect.

Randomised double blind placebo control (RDBPC) trials are employed to allow clinical trials to account for the effects of this placebo effect. However, the non-specific effects of nocebo are less accounted for both in clinical trials and in the clinical setting. This narrative literature review aims to address the available information around the nocebo effect, frame it

JADE | 64


TitleWhat is the Nocebo Effect and how can the “Evil Twin” of Placebo Be Addressed in the Healthcare Environment?

AuthorCaroline Millet-Spicer

AbstractA definition of placebo first occurred in medical literature in 1811 and since its original use in a trial in 1863 placebo control trails have become an essential part of good clinical trial design. This shows that the scientific community has long been aware of the real phenomenon of placebo however, more recently the impact of nocebo for individuals, clinical trials and public health is becoming apparent.

Nocebo is often described as the sinister sibling or “evil twin” of nocebo. If placebo describes beneficial effects not related to active treatment, nocebo describes adverse non-specific effects - the mirror image of placebo. These effects have been shown to be particularly evident in the suggestion of hyperalgesia during treatment via negative phrasing and by inducing non-specific side-effects during prescribing. The understanding of the nocebo effect is important clinically, for public health and in trails as it can lead to skewed trial results and low adherence in patients.

Techniques for minimising the nocebo effect in the healthcare environment are available. The role of contextualised informed consent in the nocebo effect of informed consent (NEIC) is a current ethical debate in an attempt to reduce the harm caused by health carers’ words.

ARTICLE #6 | 65

WHAT IS THE NOCEBO EFFECT AND HOW CAN THE “EVIL TWIN” OF PLACEBOBE ADDRESSED IN THE HEALTHCARE ENVIRONMENT?

in the context of these two settings and critically discuss current recommended methods caregivers can manage and minimise the Nocebo effect.

Methods

Narrative literature review of PubMed, Embase, Medline and the Cochrane Central Register of Controlled Trials (CENTRAL) during the period February – March 2017. Search terms included Nocebo, nocebo effect, placebo, and adverse effects. This was supported by further review of the references to key articles plus supporting evidence from related bodies such as the General Medical Council (GMC) and the British Medical Association (BMA).

Discussion

Evidence of the Nocebo effect

A classic paper in 1987 was one of the first to illustrate the nocebo effect. This study found that in a trial of aspirin or sulfinpyrazone across three centres, at two centres included possible minor gastrointestinal side effect on the consent form, this resulted in a six-fold increase in the number of patients withdrawing from the trial because of the mentioned side effects compared to the control centre. Importantly, at all three centres the number of patients withdrawing because of major gastrointestinal complaints or other side effects was the same. They hypothesised that the inclusion of these possible side effects, in the aim of obtaining informed consent, may have increased the likelihood of the patients associating these side effects to the drug treatment and withdrawing from the clinical trial. This was a double blind randomly controlled trial so widely accepted to provide high quality evidence.

This not only affects the individual patients but the accuracy of the clinical trials and cost. This is a current issue with statins and Statin-associated muscle symptoms (SAMS) where the impact of nocebo SAMS on adherence is reducing adherence and putting patients at risk. This power of suggestion is also present in the illation of nocebo hyperalgesia. This is the true paradox of the nocebo effect and informed consent for the clinician.

Implications of the Nocebo Effect

The Ethical DilemmaThe General Medical Council in its guidance to good medical practice states that the process informed consent should be a partnership


CAROLINE MILLET-SPICERWHAT IS THE NOCEBO EFFECT AND HOW CAN THE “EVIL TWIN” OF PLACEBO

BE ADDRESSED IN THE HEALTHCARE ENVIRONMENT?

Figure 2: Examples of Unintended Negative Suggestions (Nocebo Warnings) in Clinical Practice. Use of phrases like these is an example of negative framing and can cause a stronger nocebo effect.

supported with gentle positive words (placebo warning). Although these women were in a situation felt to be threatening (labour) so were in a state of heightened suggestibility. Research supports the nocebo effect and its measurable action through known biological pathways. For example, an antagonist of the pain mediator cholecystokinin (proglumide) blocks the suggestion effect of nocebo pain increase proposing cholecystokinin-dependent increase of anxiety as a mechanism for nocebo hyperalgesia. This indicates a pathway through which patients can be harmed through the action of caregivers’ words.

between doctor and patient. The physician should explain the potential benefits, risks and side effects of each option allowing the patient to decide with guidance. Patient autonomy is paramount and paternalism – characterised as the antithesis of autonomy – is considered by medical ethicists not to have a place in modern medicine. This can be a moral enigma for the caregiver. through describing the hypothetical harmful possibilities to the patient, in order to gain an informed consent partnership, the caregiver could be increasing the chance of these possibilities becoming actualities. Thus causing harm. Do no harm is a founding principle of medicine repeated from the Hippocratic Oath to the Declaration of Geneva carried forward into the Duties of a Doctor. This is the dilemma of the nocebo effect of informed consent (NEIC).

The Nocebo in clinical trialsThe first placebo-controlled trial was conducted in 1799 and based on research since, randomised double blind placebo control (RDBPC) trials have been considered the “gold standard” in intervention-based studies. This is in part because of a series of trials in the 1980/90s which, for example, showed that for post-operative pain relief an overt injection of a saline solution is as strong as 6-8mg of morphine due to the placebo effect. In 2004, Colloca et al also showed that hidden infusions required more morphine to be infused to reduce the pain by 50% (placebo effect) but that open interruption of a morphine infusion resulted in a faster and stronger pain relapse - nocebo effect. When patients knew the treatment was being stopped it lead to an increase in anxiety, which had a hyperalgesic effect. This shows the psychological suggestive power of the nocebo effect can affect the accuracy of clinical trials leading to patients withdrawing or over-reporting of symptoms which can skew results. In a review of statin trials it was found the same amount of people in the placebo to the active statin group discontinued related to side effects (10-28%). This effects the accuracy of the trial and future progress of the drug in question.

Also almost 20% of healthy participents in drug trails on placebo leave due to side effects. Patients reporting high levels of nonspecific adverse events are likely to leave trials.

The Impact of Nocebo on Individual Patient and Population HealthThe nocebo effect of pain suggestion can be induced and effect patient experience through negative framing of the procedural information. Figure 2 shows some common unintended nocebo generating suggestions. This has been shown in trials particularly around the expectation of pain – for example in one study women requiring labour epidural local analgesia told to expect “a bee-like sting” (nocebo warning) reported higher pain scores than those




choices about treatment, often different drugs can treat the same condition, while protecting them from the potential of nocebo-induced effects. Evidence shows informed patients, who feel in control of their health decisions actively participate in their care, which improves adherence. For example, re-challenge with statins for patients reporting SAMS is usually successful after consultation, although though the authors recognise that this is not normally with the same statin or at the same dose.

However, seen another way CIC can be thought of as the doctor choosing to withhold information about their treatment from a patient because the doctor has decided this is in the patients’ best interest, under the guise of therapeutic benefit. This is a move away from a “consent partnership” back to a paternalism model. Widespread access to information about side effects and treatments available on the internet means that patients have more access than ever to information. This can be used in a positive way to educate, although some studies show that this can perpetuate nonspecific effects in the “worried well”. The issue is that if clinicians are withholding information, which the patient then becomes aware of anyway, this could not only increase the suggestive effect but foster mistrust in health carers.

Conclusion

The nocebo effect and its measurable potential to harm though identified pathways clearly indicates words can hurt. The way doctors frame their consultation with patients will and does change the clinical outcome, independent of the ethical dilemma of NEIC, due to the suggestive aspect of the placebo pain response. The power of positive framing on reducing pain during procedures is significant and all healthcare providers should be aware of, and educated in, techniques to reduce nocebo responses.

Secondly, and a more problematic ethical question, is weighing up the harm done by placebo nonspecific side effects vs the importance of patient autonomy when considering the future role of contextualised informed consent. In clinical trials, this can have a significant impact on the result. In the clinical environment, nonspecific side effects contribute to non-adherence and increased health care costs, which could lead to doctors stopping a successful treatment or needing to treat the side effects with secondary drugs. From a critical appraisal of the sources, general consensus indicates that, as physicians cannot help but frame the information they provide to patients, then tailoring the information to each patient is a good way to minimise the nocebo effect without impacting patient autonomy, however, clinicians must carefully balance this with respect for patient autonomy. Making

Management of the Nocebo effect: How can physicians simultaneously obtain informed consent and minimize nocebo-related risks

Management and minimisation of the nocebo effect in clinical practices hinges on the moral dilemma described previously – the nocebo effect of informed consent (NEIC). This is the balance between the basic principle of current bioethics and the GMC of informed consent, respect for person and transparency weighed against the ethical consideration of the caregiver to do no harm. One of the main proposals presented in multiple papers is the idea of contextualised informed consent (CIC).

This proposal uses the some of the concepts in Table 1, and places responsibility on the health care provider to tailor the information to the patient in order to balance transparency of care with non-maleficence through nonspecific nocebo effects. Suggestibility of the nocebo effect can be dependent on age, gender and mental health linked to prospect theory (Figure 3). Interestingly patients knowing that they are taking a medication may monitor more closely their health and be more likely to report nonspecific symptoms. Table 2 shows factors known to affect patients’ susceptibility to the nocebo effect that could be considered for patient tailored information.

Figure 3: Prospect Theory. Some ways for clinicians to frame information in a way so patients can make informed decisions.

An important factor for the clinician to consider is the potential side effect. Nocebo side effects are described as nonspecific, this commonly includes nausea, fatigue and vague ill health, described in clinical trials as placebo response adverse events. Whereas drug-specific side effects are more life threating and not commonly related to nocebo. By telling the patient about the drug-specific effect this allows individuals to make informed




Table 2: Factors that Influence Individual Susceptibility to Nocebo Effects. Trials have shown that a number of different factors influence the strength of the nocebo effect on an individual. When healthcare providers are tailoring information, using the information techniques in Figure 3, Table 2 presents some of the factors they should consider in order to minimise nocebo related adverse effects.

consultation specific to each patient not only facilitates successful communication but is also good medical practice.

The current limitations to contextualised informed consent are that, as this is a theoretical proposal, none of the current papers addresses the legal ramifications so more research is required into its application. The current research into the nocebo effect however does indicate some good additions to medical practice that can be implemented currently to minimise non-specific nocebo related harm, particularly in the case of procedural pain (Table 1).

Nocebo and placebo effects will always be present in clinical practice due to basic human nature of healthcare interactions. Medicine is often described as both a science and an art and it is the responsibility of the healthcare provider to tread that balance and appreciate how their words and actions can minimalize nocebo while also respecting patient autonomy. Looking forward, further research is necessary into the nocebo effect to provide more guidance on NEIC for prescribing and the possible ethical legal ramifications of full CIC. Currently, it is important for the good practitioner to remember that words can harm and essentially – “truthful information can be given in different ways.”

Table 1: Information Techniques to Minimise Nocebo. Truthful information about adverse effects of drugs can be explained in different ways. Table 1 presents some methods to reduce the possible impact of the nocebo effect on patients.




placebo-controlled clinical trials. Pharmacoepidemiology and Drug Safety. 2017 Jan 1.

Epstein RM, Alper BS, Quill TE. Communicating evidence for participatory decision making. Jama. 2004 May 19;291(19):2359-66.

Colloca L, Finniss D. Nocebo effects, patient-clinician communication, and therapeutic outcomes. Jama. 2012 Feb 8;307(6):567-8.

Koeteles, Ferenc, et al. “Somatosensory amplification as a possible source of subjective symptoms behind modern health worries.” Scandinavian journal of psychology 52.2 (2011): 174-178.

Crichton F, Petrie KJ. Accentuate the positive: Counteracting psychogenic responses to media health messages in the age of the Internet. Journal of psychosomatic research. 2015 Sep 30;79(3):185-9.

Wells RE, Kaptchuk TJ. To tell the truth, the whole truth, may do patients harm: the problem of the nocebo effect for informed consent. The American Journal of Bioethics. 2012 Mar 1;12(3):22-9.

Miller FG, Colloca L. The placebo phenomenon and medical ethics: Rethinking the relationship between informed consent and risk–benefit assessment. Theoretical medicine and bioethics. 2011 Aug 1;32(4):229-43.

Levine JD, Gordon NC. Influence of the method of drug administration on analgesic response. Nature. 1984 Dec 20;312(5996):755-6.

Rief W, Avorn J, Barsky AJ. Medication-attributed adverse effects in placebo groups: implications for assessment of adverse effects. Archives of internal medicine. 2006 Jan 23;166(2):155-60.

Table and figure references

Williams JB, Sade RM, D’Amico TA. Framing for success: Nocebo effects in thoracic surgery. The Annals of thoracic surgery. 2013 Jan;95(1):9.

Planès S, Villier C, Mallaret M. The nocebo effect of drugs. Pharmacology research & perspectives. 2016 Apr 1;4(2).

Kahneman D, Tversky A. Prospect theory: An analysis of decision under risk. Econometrica: Journal of the econometric society. 1979 Mar 1:263-91.

General Medical Council Good Medical Practice 2013, 2014, 2016, March/16, General Medical Council, http://www.gmc-uk.org/guidance/good_medical_practice.asp

Barsky AJ, Borus JF. Functional somatic syndromes. Ann Intern Med. 1999;130(11):910–921. doi: 10.7326/0003-4819-130-11-199906010-00016

Colloca L, Finniss D. Nocebo effects, patient-clinician communication, and therapeutic outcomes. Jama. 2012 Feb 8;307(6):567-8.

Colloca L, Miller FG. The nocebo effect and its relevance for clinical practice. Psychosomatic medicine. 2011 Sep;73(7):598.



Evans RW, Rogers MP. Headaches and the nocebo effect. Headache: The Journal of Head and Face Pain. 2003 Nov 1;43(10):1113-5.

References

Text references

Price, D.D., Finniss, D.G. and Benedetti, F., 2008. A comprehensive review of the placebo effect: recent advances and current thought. Annu. Rev. Psychol., 59, pp.565-590.

Colloca L, Lopiano L, Lanotte M, Benedetti F. Overt versus covert treatment for pain, anxiety, and Parkinson’s disease. The Lancet Neurology. 2004 Nov 30;3(11):679-84

Planès S, Villier C, Mallaret M. The nocebo effect of drugs. Pharmacology research & perspectives. 2016 Apr 1;4(2).

Myers M, Singer J. The Consent Form As A Possible Cause Of Side-Effects. Inclinical And Investigative Medicine-Medecine Clinique Et Experimentale 1985 Jan 1 (Vol. 8, No. 3, Pp. A58-A58). 1867 Alta Vista Dr, Ottawa On K1g 3y6, Canada: Canadian Medical Association.

Tobert JA, Newman CB. The nocebo effect in the context of statin intolerance. Journal of Clinical Lipidology Volume 10, Issue 4, July–August 2016, Pages 739–747

Pollard BJ. Autonomy and paternalism in medicine. The Medical Journal of Australia. 1992 Dec;159(11-12):797-802.

General Medical Council Good Medical Practice 2013, 2014, 2016, March/16, General Medical Council, http://www.gmc-uk.org/guidance/good_medical_practice.asp.

Cohen, S., 2014. The nocebo effect of informed consent. Bioethics, 28(3), pp.147-154.

Misra, S., 2012. Randomized double blind placebo control studies, the “Gold Standard” in intervention based studies. Indian journal of sexually transmitted diseases, 33(2), p.131.

Preston RA, Materson BJ, Reda DJ, Williams DW. Placebo-associated blood pressure response and adverse effects in the treatment of hypertension: observations from a Department of Veterans Affairs Cooperative Study. Archives of internal medicine. 2000 May 22;160(10):1449-54.

Varelmann D, Pancaro C, Cappiello EC, Camann WR. Nocebo-induced hyperalgesia during local anesthetic injection. Anesthesia & Analgesia. 2010 Mar 1;110(3):868-70.

Colloca L, Miller FG. The nocebo effect and its relevance for clinical practice. Psychosomatic medicine. 2011 Sep;73(7):598.

Benedetti F, Amanzio M, Casadio C, Oliaro A, Maggi G. Blockade of nocebo hyperalgesia by the cholecystokinin antagonist proglumide. Pain. 1997 Jun 30;71(2):135-40.

Ogden J. Do no harm: Balancing the costs and benefits of patient outcomes in health psychology research and practice. Journal of health psychology. 2016 May 31:1359105316648760.

Barsky AJ, Borus JF. Functional somatic syndromes. Ann Intern Med. 1999;130(11):910–921. doi: 10.7326/0003-4819-130-11-199906010-00016

Mahr A, Golmard C, Pham E, Iordache L, Deville L, Faure P. Types, frequencies, and burden of nonspecific adverse events of drugs: analysis of randomized

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CAROLINE MILLET-SPICER

Hahn RA. The nocebo phenomenon: concept, evidence, and implications for public health. Preventive medicine. 1997 Sep 30;26(5):607-11.

Klosterhalfen S, Kellermann S, Braun S, Kowalski A, Schrauth M, Zipfel S, Enck P. Gender and the nocebo response following conditioning and expectancy. Journal of psychosomatic research. 2009 Apr 30;66(4):323-8.

Casper RC, Tollefson GD, Nilsson ME. No gender differences in placebo responses of patients with major depressive disorder. Biological psychiatry. 2001 Jan 15;49(2):158-60.

Treadwell JR, Lenert LA. Health values and prospect theory. Medical Decision Making. 1999 Aug;19(3):344-52.

T he ILAS postgraduate conference Crossing Paths took place in Keele Hal l on Apri l 28th 2017. With over 100 attendees, 46 posters from 12 schools , i t was an energis ing day which celebrated the range and diversi ty of postgraduate work in the

Universi ty and I am del ighted to introduce the work presented in this student JADE edit ion.

Whilst postgraduates have a range of opportunit ies to meet , ta lk and present their work both in their schools and beyond the universi ty, the ILAS conference offers something di f ferent . Here postgraduates are invited to share their work with peers from di f ferent d iscipl ines; people with a d iverse range of interests , specia l isms and backgrounds and the chal lenge is to communicate in an accessible and engaging way to an informed, but non-specia l ist audience.

76 | JADE

Jo Flynn | Institute of Liberal Arts and Sciences Manager

EDITORIAL

Interdisciplinary conversations

In addition to strengthening students’ skills and confidence in communicating their work, interactions with peers from different fields and alternative perspectives can stimulate fresh ideas. In this way the conference encourages interdisciplinary conversations which spark new insights and alternative ways of thinking about their own subjects.

On the day, posters on malaria, memory and mobile phones vied with back pain, bullying in HE and the absurd in Checkov and the cross disciplinary judging team had a challenging task to assess their relative merits. They were looking for accessibility and visual appeal and importantly, how effectively the students communicated the relevance and significance of their subject and its potential impact on people’s lives.

...the conference encourages

interdisciplinary conversations...

POSTGRADUATE EDITORIAL

[email protected]

The People’s Prize celebrated the interdisciplinary conversations taking place throughout the day and conference attendees were encouraged to vote for the person and poster from whom they had learned most. In addition, a number of presenters were highlighted to work with Keele’s Marketing and Communication team to produce a short video about their work. These Love Your Thesis videos are now in production and a number can be seen on the Keele YouTube channel here: https://www.youtube.com/playlist?list=PLm6S_-wsxg6C5MxTQGb1o7C_oqcn9J-ip.

Three Minute Thesis

The conference also included a heat of the University wide Three Minute Thesis competition (3MT®). This is an international academic competition developed by the University of Queensland, Australia and its success has led to the establishment of local and national competitions in several countries. In the 3MT® students must present their doctoral research using just one slide in three minutes ,no props, no poems, no raps, sound or video are allowed. This is demanding undertaking and a tense and exciting event for participants and the audience alike; four presenters took up the challenge at the PG conference and their abstracts are included here.

The University final took place at the KPA Bob Beattie Awards evening on June 20th with four finalists competing to represent Keele in the National competition. Stories from two of the finalists, the Keele winner, Psychology student, Hayley Gilman and Fraser Philp (School of Health and Rehabilitation and Institute of Technology and Medicine) about their experiences of taking part are included here. They are passionate and persuasive about the benefits and strongly encourage all doctoral students to consider getting involved. Both highlight that they now have an answer to that all important and very tricky ‘what’s your PhD about again?’ question and in Fraser’s case ‘Even his Dad.. .’ now knows what he is doing!

Videos from the conference and the Three Minute Thesis final can be seen on the ILAS website: https://www.keele.ac.uk/ilas/institutevideos/.

Undoing Single Perspectives (USP): A Listening Project

Some feedback from conference participants suggested that whilst there was ‘lots of helpful stuff about the posters... more structured guidance on how to verbally communicate your work’ would also be useful. For the 2018 conference there will be a sharper focus on this

POSTGRADUATE EDITORIAL | 77

https://www.youtube.com/playlist?list=PLm6S_-wsxg6C5MxTQGb1o7C_oqcn9J-ip

https://www.youtube.com/playlist?list=PLm6S_-wsxg6C5MxTQGb1o7C_oqcn9J-ip

https://www.keele.ac.uk/ilas/institutevideos/

https://www.keele.ac.uk/ilas/institutevideos/

78 | JADE

aspect and we are working closely here with Keele’s Listening Project. This exciting new project focuses on building and strengthening skills in listening and questioning in order to understand someone else’s perspective. It will provide spaces and tools to encourage active listening and effective dialogue and offers opportunities for students to develop these essential communication skills which are often overlooked or taken for granted. You can find out more about the Listening project and how you can get involved on their webpages here: https://www.keele.ac.uk/listeningproject/.

I hope you enjoy the work from Crossing Paths 2017 and that it inspires you to start planning now to get involved on April 19th 2018, when we look forward to more proposals and posters from an even bigger range of schools and subjects. You’ll find an extensive programme to support you in all aspects of your preparation on the LPDC website (https://www.keele.ac.uk/lpdc/) and news about the conference on our webpages and social media: #KeeleILASPGC18.

JO FLYNNIntroduction

Glycation is a process in which proteins, fats and nucleic acids in body tissues are non-enzymatically modified with reducing sugars and it typically occurs over months or years (1). It predominantly affects extracellular matrix (ECM) collagen and elastin because they have slow turnover rates within the ECM (2). Glycation results in stiffer, less digestible proteins and can permanently alter connective tissue properties (3). Advanced glycation is implicated in ageing and many diseases including gynaecological disorders such as pelvic organ prolapse and urinary incontinence (4,5). Pelvic tissue glycation has been the focus of recent studies on pelvic organ prolapse since the observation of higher amounts of insoluble collagen or glycation products in prolapsed vaginal wall by Jackson et al in 1996 (Jackson et al. 1996). Therefore identification of vaginal wall glycation may be a useful predictive, diagnostic and further management tool in pelvic organ prolapse. The vaginal tissue however is poorly accessible and obtaining a vaginal biopsy may be inconvenient and invasive. The skin, on the contrary, is easily accessible and skin fluorescence can be measured non-invasively to reflect its advanced glycation levels (7). It is therefore useful to assess skin glycation in relation to vaginal tissue

glycation. We hypothesized that skin advanced glycation levels are predictive of pelvic tissue glycation content.

Methods

Animals

Full thickness skin and vaginal tissue from 6-8 month old pregnant (E15-E18) and 4 non-pregnant female Sprague Dawley outbred rats were obtained following local ethical approval by the Animal Welfare & Ethical Body Review and in accordance with the 2006 Animal Act. Skin segments from the left dorsal surface of the rats were used.

Advanced glycation detection

The advanced glycation marker, pentosidine, formed by the reaction of arginine and lysine with a pentose sugar (8), was chosen for detection due to its fluorescence property (9). Samples were lyphoilised and hydrolysed in 6 M Hydrochloric acid at 110oC. High performance liquid chromatography (HPLC) separation and quantification was performed using a C-18 250mm (length) x 4.60mm (width) analytical column and ultraviolet (UV) detector. Standard pentosidine purchased from Caymann Chemical was used for the creation of a standard curve for quantification. Pentosidine was eluted at 9.6 minutes in a 30 minutes run using gradient ratios of 0.1% triflouroacetic acid and 80% acetonitrile.

POSTGRADUATE ARTICLE | 79

POSTGRADUATE ARTICLE

TitleSkin advanced glycation in pregnancy is predictive of vaginal tissue glycation

AuthorsHomayemem Weli, Jason Cooper, and Ying Yang

[email protected]

AbstractBackground: The advanced glycation content of prolapsed vaginal wall is elevated in pelvic organ prolapse and this makes it a significant disease association. Early detection of vaginal wall glycation will therefore be relevant in the prevention and management of pelvic organ prolapse. A vaginal wall biopsy would be ideal but it is invasive. This necessitates the use of a more accessible organ such as skin for biopsy. The aim of this study was therefore to assess if skin glycation is reflective of vaginal glycation in the same subjects.

Methods: Pentosidine, an advanced glycation product was quantified in the skin tissue of pregnant and non-pregnant Sprague Dawley rats and correlated with pentosidine content in the vaginal tissues of the same rats.

Results: Skin pentosidine was decreased in pregnancy and a strong positive association was noted between skin and vaginal wall pentosidine.

Conclusion: Skin pentosidine is predictive of vaginal wall pentosidine and can be a useful tool in the management of pelvic organ prolapse.

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HOMAYEMEM WELI, JASON COOPER, & YING YANGSKIN ADVANCED GLYCATION IN PREGNANCY

IS PREDICTIVE OF VAGINAL TISSUE GLYCATION

Figure 2: Correlation between skin and vaginal tissue pentosidine. R2=0.8469433

Discussion

Advanced glycation is a cause of ageing that has gained significant attention in recent times (8). Glycation considerably affects various aspects of the skin. It results in increased skin stiffness, decreased elasticity and improved resistance to matrixmetalloproteinase enzyme degradation (10) which enables connective tissue remodeling. Glycation induces inflammatory responses intracellularly and extracellularly (2). Advanced glycation end products can initiate DNA damage and stimulate cellular injury through their receptors, Receptor of Advanced Glycation End products, RAGE (11).

In this study, glycation was lower in the skin during pregnancy. This is congruent with a previous study noting reduced skin glycation-induced auto-fluorescence, in pregnancy (7). Recently, vaginal tissue glycation was noted to be lower in pregnancy through influences on ER-α and glyoxalase I, an AGE lowering antioxidant (12). Another study has observed reduced glycation in vaginal tissues under oestrogen therapy (13). Oestrogen has also been found to influence blood vessel glycation. These, in conjunction with the present finding of reduced skin glycation in pregnancy suggest that pregnancy effects on glycation may be reflected in multiple body tissues and organs.

Detection of pentosidine occurred at 325nm wavelength.

Statistics

Means of the pregnant and non-pregnant groups were compared using an unpaired T test. Significance level was set at a p value of 0.05. Data are expressed as mean and standard error of mean. Pearson correlation test was performed to study relationship between vaginal and skin pentosidine.

Results

The average skin pentosidine was obtained per gram dry tissue. Pentosidine was 0.007mg/g and 0.014 mg/g in the pregnant and non-pregnant skin tissues respectively. There was minimal variability within groups and the difference was significant with a p value of 0.000199.

Pentosidine was higher in the vaginal tissue than in the skin of the same rats. A strong correlation was present between the pentosidine content of vaginal and skin tissues of the same rats.

Figure 1: Pentosidine in pregnant and non-pregnant skin tissues. P=0.000***

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HOMAYEMEM WELI, JASON COOPER, & YING YANGSKIN ADVANCED GLYCATION IN PREGNANCY

IS PREDICTIVE OF VAGINAL TISSUE GLYCATION

Fluorophores from aging human articular cartilage. J Biochem.1991 ;110(5):714–8.

10. DeGroot J, Verzijl N, Wenting-Van Wijk MJ, Bank R a, Lafeber FP, Bijlsma JW, et al. Age-related decrease in susceptibility of human articular cartilage to matrix metalloproteinase-mediated degradation: the role of advanced glycation end products. Arthritis Rheum. 2001;44(11):2562–71.

11. Bucciarelli LG, Wendt T, Rong L, Lalla E, Hofmann MA, Goova MT, et al. RAGE is a multiligand receptor of the immunoglobulin superfamily: implications for homeostasis and chronic disease. Cell Mol Life Sci. 2002 Jul 1;59(7):1117–28.

12. Weli HK, Akhtar R, Chang Z, Li W-W, Cooper J, Yang Y. Advanced glycation products’ levels and mechanical properties of vaginal tissue in pregnancy. Eur J Obstet Gynecol Reprod Biol. 2017;214:78–85.

13. Jackson S, James M, Abrams P. The effect of oestradiol on vaginal collagen metabolism in postmenopausal women with genuine stress incontinence. BJOG An Int J Obstet Gynaecol. 2002 Mar;109(3):339–44.

14. Mikulikova K, Eckhardt A, Kunes J. Advanced glycation end-product pentosidine accumulates in various tissues of rats with high fructose intake. Physiol.. 2008;57(1):89–94.

A positive relationship between vaginal and skin tissue glycation content was also noted in this study. Advanced glycation ageing has been studied in different tissues in the body because it is believed to be global by occurring at reasonably similar rates in various sites of the body. Research quantifying pentosidine in tissues from rats with high fructose intake found that accumulation in the tendon, skin and aorta occurred differently, with pentosidine increasing more in the skin and aorta than in tendons when 10% fructose was given (14).

Conclusion

The effect of pregnancy on advanced glycation can also be observed in the skin and skin glycation correlates with vaginal wall glycation. This strongly suggests that skin glycation is predictive of vaginal tissue glycation, which is implicated in pelvic floor disorders. Skin glycation is a potentially useful marker in the prediction and diagnosis of glycation-associated pelvic floor diseases, with a view towards promoting preventive lifestyle.

Acknowledgement

KUAF, Rivers State Government, Nigeria.

References

1. Luevano-Contreras C, Chapman-Novakofski K. Dietary advanced glycation end products and aging. Nutrients. 2010 Dec;2(12):1247–65.

2. Gkogkolou P, Böhm M. Advanced glycation end products: Key players in skin aging? Dermatoendocrinol. 2012 Jul 1;4(3):259–70.

3. Singh R., Barden A., Mori T, Beilin L. Advanced glycation end-products: A review. Diabetologia. 2001;44(2):129–46.

4. Kerkhof M, Hendriks L, Brölmann H. Changes in connective tissue in patients with pelvic organ prolapse—a review of the current literature. Int Urogynecology. 2009;20(4):461–74.

5. Chen Y, Huang J, Hu C, Hua K. Relationship of advanced glycation end products and their receptor to pelvic organ prolapse. 2015;8(3):2288–99.

6. Jackson S, Eckford S, Abrams P. Changes in metabolism of collagen in genitourinary prolapse. Lancet. 1996 ;1658–61.

7. de Ranitz-Greven WL, Kaasenbrood L, Poucki WK, Hamerling J, Bos DC, Visser GHA, et al. Advanced glycation end products, measured as skin autofluorescence, during normal pregnancy and pregnancy complicated by diabetes mellitus. Diabetes Technol Ther. 2012;14(12):1134–9.

8. Bailey A. J. Molecular mechanisms of ageing in connective tissues. Mech Ageing Dev. 2001;122(7):735–55.

9. Uchiyama A, Ohishi T, Takahashi M, Kushida K, Inoue T, Fujie M, et al.

POSTGRADUATE POSTER URLs

• https://jadekeele.files.wordpress.com/2017/09/ilas-amy-coquaz.pdf

• https://jadekeele.files.wordpress.com/2017/09/ilas-emma-green.pdf

• https://jadekeele.files.wordpress.com/2017/09/ilas-emma-harrison.pdf

• https://jadekeele.fi les.wordpress.com/2017/09/ilas-homayemem-weli.pdf

• https://jadekeele.files.wordpress.com/2017/09/ilas-jamie-adams.pdf

• https://jadekeele.files.wordpress.com/2017/09/ilas-rebecca-burn.pdf

• https://jadekeele.files.wordpress.com/2017/09/ilas-rebecca-laycock.pdf

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POSTGRADUATE CONFERENCE ABSTRACTS

Jamie Adams | School of PsychologyAre obsessive-compulsive checkers better or worse at making predictions about their own memories?

Individuals with obsessive-compulsive disorder (OCD) typically have poor confidence about their memories, but findings regarding predictions about future memory performance have been inconsistent. The aim of this study was to explore the relationship between OC tendencies and metacognitive prediction accuracy in a Judgment-of-Learning (JOL) task. People who reported high and low OC checking behaviours studied word pairs and, for each pair, made a JOL concerning the likelihood that, on the cued-recall test, they would recall the second word when shown the first. High and low checkers did not differ either in their memory performance or in their overall JOL confidence. However, the two groups did differ in how accurate their JOLs were at predicting their later memory performance. Contrary to predictions, high checkers were more accurate in making JOLs that were predictive of later recall compared to low checkers. This group difference was enhanced when levels of worry about memory abilities was controlled for. Results are discussed in relation to cautious decision-making and conservative risk-taking in OCD. Joseph Ainsworth | School of Geography, Geology and the EnvironmentAn initial ground penetrating radar (GPR) study of buried sedimentary geology at Spireslack Mine, Scotland

Ground Penetrating Radar (GPR) is a near-surface geophysical technique, and has been used to obtain 3D structure of both modern and ancient river deposits. Obtaining multiple 2D profiles behind outcrop exposures should allow 3D structure to be extracted and then used to create 3D numerical models. This research has collected a GPR dataset at Spireslack quarry in Glenbuck, Ayrshire, Scotland. Spireslack quarry is an ex-open coal mine and is designated as SCARP (Scottish Carboniferous Research Park), an educational resource exposing Carboniferous geology. This study collected 2D profile behind the cliff face exposing river channel features; here the soil was thinnest, giving the best chance of good signal penetration. A Sensors&Software PulseEKKO™ 1000 system was used to collect 50 MHz and 100 MHz frequency radar data, to determine the optimal equipment, resolution and depth. Results imaged a river channel and a point bar set within the cliff. Penetration depths were up to 20m deep, depending upon antenna frequency. A limestone bed dominated below these structures. Study implications suggest GPR is promising at this location to allow the capture of 3D sedimentary structures, although recommendations are to collect further data using lower (25 MHz) frequency profiles and where overlying soil is removed.

POSTGRADUATE ABSTRACTS | 85

Wafaa Al-Jasim | Institute for Science & Technology in Medicine (ISTM)Detecting preeclampsia using protein signatures

Preeclampsia (PE) is a common pregnancy complication, affecting around 1 in 20 first-time mothers. We do not yet fully understand why some women get this condition, and unfortunately PE, if not caught early enough, can be life-threatening. Women with PE have high blood pressure and protein in their urine. The baby is affected due to reduced blood supply via the umbilical cord. Many of the babies experiencing this low blood supply do not grow properly, and are said to be ‘growth restricted’. The only treatment once PE has developed is to deliver the (small, premature) baby; this has lifelong health and social implications for these children. To date, no clinical tests can predict which women will develop PE, in order to provide treatment and increased monitoring. Urine is a readily-available substance for clinical tests, accepted by most patients. Our project uses urine sample taken from pregnant women to analyse proteins as potential PE biomarkers. We will examine proteins in urine using analytical chemistry methods, comparing samples from normal pregnant women with those from women who went on to develop PE. A urine-based test could enable timely use of simple treatments such as low-dose aspirin, which can reduce disease risk and severity. Sama Al-Shaheeb | Institute for Science & Technology in Medicine (ISTM)More like home

Microglia are the immune cells in your brain. They can adopt several modes in the brain. Mostly, they are in a monitoring mode where they are continually scanning for signs of infection or trauma. If found, microglia change to an activated mode, and begin to release molecules to destroy the infection. Once the danger is removed, microglia adopt a repair mode and release molecules which de-activate the microglia, and help to promote regeneration in your brain. They then change back to their monitoring mode.Studying microglia, and the different modes they adopt, is vital to understand and treat infections and diseases that affect the brain. At present, scientists are investigating microglia and how they interact with infections, but they are studying them in a false environment using a serum that is not found in the brain. This means that any results they find will not be a true representation of what really happens in the brain. Therefore, we are developing a system to test microglia in their natural, serum-free, environment.

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Zainab Alfatlawi | School of ChemistryGeneration of hydrogen from natural gas using new catalyst synthesized by low-cost preparation method

With increasing demand on limited oil, the hydrogen generation from the waste by using special catalyst becomes important method to produce electrical power.

Deactivation of the catalyst due to carbon deposition and catalyst cracking are the major problems associated with the hydrogen generation from the waste. Mixed metal oxides as Pyrochlore have been used as catalyst in hydrogen preparation due to their ability to resist the temperature, which is necessary in hydrogen generation condition and they are less sensitive to deactivation from the waste.

The new Nickle Pyrochlore catalyst was synthesized by hydrothermal method, which uses high pressure and low temperature. This catalyst displayed high resistance to deactivation and high selectivity toward Hydrogen with low carbon formation comparing with traditional alumina catalyst, which makes it ready for industrial use. Ibrahim Ali | Institute for Science & Technology in Medicine (ISTM)Designing new drugs to treat malaria

Autophagy, a common cellular process that results in “self-eating”, is an essential mechanism employed by many cells to promote survival under stress as well as supporting a wide variety of normal cell functioning. As the autophagy pathway is incomplete in the parasite that causes the most virulent form of malaria in humans, there is debate about the role of this incomplete pathway. Conservation of two key parts of this pathway, proteins ATG8 and ATG3, in the malaria parasite, however, led us to explore whether compounds that may potentially interfere with their interaction with each other may lead to parasite death. We have identified two closely related compounds that apparently kill the malaria parasite through a disruption of the ATG8-ATG3 interaction by docking to ATG8. Importantly, these compounds are much more toxic to the parasite than to humans. Imaging studies support our hypothesis that blocking ATG8-ATG3 interactions inhibits the normal functioning of the autophagy pathway in the parasite. These compounds are both potential hits for further development as antimalarial drugs as well as chemical probes that will allow us to explore more closely the normal function of autophagy in the malaria parasite.

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Ahmad Al-Shallawi | Institute for Science & Technology in Medicine (ISTM)Selection predictors of prediction recovery arm after stroke

Loss of arm function after stroke is common and this can severely affect a person’s life. A model which allows the predicting recovery, concerning arm function after stroke could inform clinical decision making processing and rehabilitation. To achieve this, we need to select the best subset variables of candidate variables set. Selecting variables is an essential step in developing models. The method described in this study have had a significant effect on improving the predictive accuracy. The aim of this study was to apply modern method of variables selection which is called Lasso. Lasso method which can shrink the number of variables that are non-informative. Additionally, it can be used when the number of variables is large. A candidate set of variables was derived from a retrospective study. It was included 80 variables comprised of categorical and continuous variables. We applied lasso methods to select variables of developing predicting recovery upper model. Lasso reduced the 80 variables to the seven variables. In conclusion, the lasso method is superior method in selecting variables and improving model accuracy specifically when the numbers of variables are large.

Nana Efua Andoh | School of Life SciencesInvestigating the effects of malaria-infected red blood cells on the blood brain barrier in cerebral malaria

Malaria affects over 200 million people worldwide and is caused by the Plasmodium falciparum parasite, transmitted to humans through an infected mosquito. During cerebral malaria (CM), a severe form of malaria, binding of the parasite to the blood brain barrier (BBB) is associated with BBB breakdown. CM survivors are left with long term brain damage including seizures and speech impairment. The BBB is composed of endothelial cells lining the blood vessels of the brain and specialised cells of the brain tissue known as astrocytes that wrap themselves around endothelial cells. We believe that damage to astrocytes during CM is linked to this neurological damage. We developed a human model of the BBB in the laboratory where brain endothelial cells and astrocytes are grown in close proximity. This model is being used to investigate whether factors produced by the endothelial cells when infected red blood cells (iRBC) accumulate in the blood vessels of the brain, cause changes to the BBB. Our preliminary results show that binding of iRBC to the BBB causes the BBB to become leaky and also causes detrimental changes in astrocytes. Understanding the mechanisms involved in BBB damage during CM could lead to the development of therapies that can help reduce neurological damage observed in survivors of CM.

Luke Bellamy | School of Geography, Geology and the EnvironmentEnhanced coal bed methane: a carbon negative fossil fuel?

Coal bed methane is a method of extracting methane gas from coal seams which may otherwise be economically unexploitable. A significant advantage of coal bed methane extraction is the opportunity to simultaneously use these coal seams to sequester carbon dioxide, whilst also enhancing the extraction of usable methane gas. Carbon dioxide is capable of bonding with carbon at twice the rate to that of methane, which offers potential for onsite gas-fired power generation and emission sequestration. This research reviews the literature on enhanced coal bed methane with carbon dioxide injection, and investigates its potential as a carbon negative fossil fuel. Rebecca Burn | School of HumanitiesBetween Speech and Silence: The Absurd in Anton Chekhov’s ‘Three Sisters’

The Russian writer Anton Chekhov (1860-1904) is best known in Western Europe for his major plays, including The Seagull (1895), The Cherry Orchard (1903) and Three Sisters (1900). Chekhov’s early plays and stories exhibit elements of the absurd through exaggeration, parody, and the grotesque, as well as demonstrating social and cultural criticism. In turn, Martin Esslin defines the absurd as ‘out of harmony with reason or propriety; hence incongruous, unreasonable, or illogical’ (2001,14). In critical discourse, the absurd in Chekhov’s major plays is rarely considered. My research project investigates how the absurd is revealed in the work of Chekhov as juxtapositions of speech and silence, the trivial and the serious, and the (dis)embodiment of the rational and irrational. Chekhov’s work has relevance today as it foregrounds concepts that resonate with contemporary social and cultural issues, particularly notions of identity, belonging, and loneliness. In our modern age of globalisation, ironically, the world appears more fractured than ever, socially and politically. This poster presentation will show how the absurd is manifested in Three Sisters, defined by Chekhov himself as ‘a drama’. Time passing and the inability to act (or take action) are central themes in Three Sisters, concepts which mirror present anxieties.

Amy Coquaz | School of Humanities ‘The Trip’ - A fictional walk through Grand-Mére, Québec

Grand-Mére’s station turned out to be a crossing. I stepped out onto the road and the train pulled away – can’t block off a crossing for too long.


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The above is an extract from the journal I kept during a research trip to Montréal, Canada in September 2016. During this trip, I conducted valuable library research and carried out interviews with leading critics and authors in the fields I’m interested in. In this poster, I would like to focus on a particular aspect of this trip: the two days I spent in Grand-Mére, Québec and the writing which resulted from it. Juxtaposing extracts from ‘The Trip’, a key chapter in my novel, with reflections on and photos of my own trip, I hope to highlight the link between research and creative practice. Creative writing is a relatively new research method and this poster, in its self-consciousness of the writing process, will shine light on Creative Writing as an academic discipline, on the possibilities it presents. My reflections will focus on the relationship between theme and setting and will, by extension, explore our relationship to place, how we relate, daily, to our environment. Robin Dearden | School of Geography, Geology and the EnvironmentThe potential for power generation from below the ground at Keele University

In 2010 a pilot drilling project took place here at Keele to extract coal bed methane with the additional possibility of a Geothermal source. IGas and Nexen drilled an exploratory well on the new development site at Keele University. The coal lies in thick sequences and it is a particularly gaseous coal. This was overseen by Professor Peter Styles (who created the MSc Environmental Sustainability and Green Technology). There are advantages as a new resource but also environmental issues and social effects all of which are open to debate. IGas found it impossible however, to drill for any substantial length horizontally initially. It could be of interest to resume or at least look into the project once again. Coal bed methane exploitation for power generation in general involves a mixture of oilfield and coal mining practices. At the time this seemed to be an opportunity for IGas and for Keele to provide an energy source for Keele and possibly for the Nation. The poster is going to cover/show: What coal bed methane is and methods of extraction, the history of the extraction project at Keele, future possibilities, its viability at Keele, and advantages/benefits from any extracted gas and disadvantages. Raad Eissa | School of Geography, Geology and the EnvironmentDetermining optimal electrical resistivity surveys to detect buried foundations

The “Electrical resistivity method” is a geophysical technique that is used widely for subsurface imaging. It can be applied to civil engineering and site investigation studies. This study has investigated a site on campus where a buried wall has been generated. Successive

electrical resistivity surveys have collected various datasets over it to determine which survey configuration gives optimal results. This has important applications for near-surface geophysical surveys of such targets, commonly encountered in geotechnical surveys. Outcomes suggest Wenner and dipole-dipole arrays are optimal.

Mufuliat Toyin Famodimu | Institute for Science & Technology in Medicine (ISTM)Killing the malaria parasite quickly – a new approach to support antimalarial drug discovery

Screening of massive chemical libraries (>6M compounds) for antimalarial activity have identified thousands of compounds that kill the blood stage of the parasite that is responsible for malaria. This research has been critical in identifying candidates to take forward for development of future antimalarial drugs to help control, and ultimately eradicate this devastating tropical disease in an era of widespread drug resistance. The next challenge is prioritizing which of these thousands of compounds to take forward for development.One key attribute that would support taking a compound forward is that it kills the parasite quickly. This is important as rapidly reducing the parasite burden alleviates symptoms and the risk of death. Previous work at Keele University resulted in the development of a laboratory test that allows a compound’s initial killing effect to be quickly and reliably measured. This project uses genetically-modified parasites that can produce light when they are alive, and stops doing so when killed. My PhD project explores how this assay can be further simplified, taking this assay from its current format that is suitable for screening of hundreds of compounds, to one that can be used to test the thousands of potential antimalarial compounds which will be provided by GlaxoSmithKline.

Arthur Gallimore | Keele School of MedicineInvestigating the relationship between the tibial width, length, height, and bodyweight

The study aimed to ascertain whether there is any correlation between the width of the knee and the length of the tibia (the shin), total height and bodyweight. Many dimensionless biomechanics measurements are derived using height; previous research has found these groups to be unsatisfactory. We believe that there is little, or no, correlation between the width of the knee and height. The results of this study will either confirm or disprove this hypothesis. If confirmed this study could lead to new definitions for biomechanical dimensionless groups, thus helping to improve accuracy and efficacy in surgery for osteoarthritis when carrying out corrective or replacement procedures. The width of knees, from live and cadaveric


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subjects, was measured. Subject demographics were also collected such as age, gender, tibial length, weight and height. The cadaveric study allowed for the assessment of error caused by soft tissues. The live study was carried out on medical student volunteers, serving as a healthy study group. A full analysis between the measurements has not yet been conducted but early indications suggest that our hypothesis is correct: there is no link between knee width and body height.

Martin Goodhead | School of HumanitiesA preliminary discourse-based framework for examining contemporary Working Class subjectivity within British Literature (2008 -) in relation to popular-culture stereotypes and contested social imaginaries.

My master’s research is responding to contradictory media depictions of working-class subjects - from “strivers to skivers” ( Skeggs) - and the cultural/legislative politics of these depictions (including resistance and revolt) as elucidated by Imogen Tyler et al.

The application of class-orientated analysis to contemporary British literature is rare and my work will look at 2008 works, specifically metropolitan and Regional English working-class themed novels, as exploring the creation of – whilst also creating - political imaginaries; emancipatory or otherwise.

My framework is informed by discourse theory, in particular Laclau & Mouffe. It sees the field of social language (and metalanguage) as predicated upon contestation, from “work” to “democracy”; it seeks to explain how concepts like class – i.e. what values are assigned to class and what “chains of assemblage” or metonymy contingently underpin them - are discursively assembled and reproduced, whilst also responding to the Real of lived material conditions (including unemployment and discrimination). Readings will also draw upon newer sociological conceptions of structural class (including Guy Standing’s Precariat) and class-interests.

Presently I am focusing on Lisa Blower’s 2016 novel Sitting Ducks, set in Stoke amidst the 2010 election, but will shortly apply my framework to writers from Anthony Cartwright to Martin Amis. Emma Green | Institute for Science & Technology in Medicine (ISTM)Can vitamins be used to create brain cells to replace those lost in Parkinson’s Disease?

Parkinson’s disease is a progressive brain disease. Common symptoms include uncontrollable shaking, rigidity and slowness

of movement. These are caused by the loss of dopamine neurons from the midbrain. Current treatment is typically medication, and although this reduces symptoms, it produces side effects, does not halt disease progression and cannot restore the lost neurons. A possible new treatment, cell transplantation, aims to replace the dopamine neurons that are lost using stem cells. Clinical trials have shown that this is feasible, however work is required to standardise the treatment and ensure it is effective. One major challenge is reliable production of dopamine neurons, in large numbers and at 100% purity. Current methods involve culturing stem cells with complex mixtures of expensive supplements, given at specific time points, to convert these non-specialised cells to dopamine neurons. The use of certain vitamins to generate dopamine neurons could make this culture process cheaper and less complex. Particular vitamins are already known to promote the development of neurons and are sometimes contained within culture ingredients. From the literature, I have identified vitamins that are likely to be effective at producing dopamine neurons from stem cells and will study the effects they have on their development.

Yifan Gu | School of Geography, Geology and the EnvironmentQuantification of the environment impacts of wastewater treatment plants considering a water-energy nexus perspective

Wastewater treatment plants (WWTPs) are central to water-energy interactions as they consume energy to remove pollutants and thus reduce the human wastewater footprint on the natural water environment. The additional climate impact associated with the energy use in wastewater treatment should be considered due to the enormous annual wastewater discharge. In this work, we quantified energy consumption in 9 different WWTPs in south China, with different treatment processes, objects, and capacities. The energy intensity in most of these WWTPs is in the range of 0.4~0.5 kWh/m3 in 2014. Footprint methodologies were used to provide insight into the environmental changes that result from WWTPs. On average, 6.78 m3 wastewater footprint is reduced when 1 m3 domestic sewage is treated in WWTPs in China. 13.38 L freshwater are required to produce the 0.4 kWh electrical input needed for treating 1 m3 domestic wastewater, and 0.23 kg CO2 is emitted during this process. The wastewater characteristics, treatment technologies as well as management systems have a major impact on the efficiency of energy utilization in reducing the wastewater footprint via these WWTPs.


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James Hall | Institute for Primary Care & Health SciencesAn exploration of the use of Economic decision models in the assessment of cost-effectiveness of stratified care in low back pain and sciatica

Low back pain (LBP) is a major public health problem in the Western world. The condition places a significant burden upon individuals and society due to disability, reduced wellbeing, workplace absence, and high healthcare usage. Keele University developed the STarT Back tool to stratify LBP patients according to their risk of persistent disability, and match treatments to individual risk. A clinical trial and parallel economic evaluation with twelve month follow-up, showed this stratified care model to be clinically and cost-effective, leading to greater quality-adjusted life years (QALYs), lower NHS costs, and reduced time off work. Yet, the longer-term cost effectiveness of this approach is unknown, despite the condition being characterised by recurrent “flare-ups” of symptoms over time. Extrapolating costs and outcomes over the lifetime will require decision analytical modelling, yet there are no prior models around a stratified care approach to LBP. By systematically reviewing current modelling approaches to both LBP and general stratified care interventions, this PhD aims to develop a methodology which can then be applied to develop the first decision model of stratified care for LBP. The me principles will also be applied to build a decision model for stratified care model for patients with sciatica. Hamza Hameed | Institute for Science & Technology in Medicine (ISTM)The potential of temperate zone plants – against activity of leishmania parasites in Christmas trees!

Leishmaniasis is a tropical disease caused by infection by a parasite introduced following a bite from a sandfly. Some 350 million people are at significant risk of infection by this leishmanial parasite, with 0.9–1.3 million new cases and 20000 to 30000 deaths occurring annually. Antimonial drugs are the current first line of treatment, with a drug called amphotericin-B as the second line of treatment. These treatments have been used for many years despite being toxic and/or expensive. Their continued use, however, faces a significant challenge due to the emergence and spread of drug resistance. Natural products could play an important role in the discovery and development of a new anti-leishmanial therapy. Here we describe the search for natural products from temperate zone plants that kill the leishmanial parasite. I have screened a library of novel and pure natural products, provided by Phyto-Quest Ltd. I report here the identification and properties of a series of triterpenes isolated from the No bel Fir (Abies procera), a tree that is commercially grown for Christmas trees, which shows potent anti-leishmanial activity.

Emma Harrison | School of PsychologyBullying Within Higher Education

Bullying is characterised as repeated aggressive behaviour against a victim who is unable to defend him/herself; it is a continual problem within schools, and attention has also been directed towards workplace bullying. Notably, victim or bully roles can remain throughout life, suggesting personality characteristics could be linked with being targeted; if one is bullied in school, there is a likelihood of being bullied later, e.g. in the workplace, but also possibly the phase in between school and work – Higher Education (HE). There is little research within HE to date. Thus, the first aim of this research is to use focus groups to explore how undergraduates define ‘bullying’, what behaviour they think it entails, and whether it is happening on campus. This initial data will later be used for the creation of a novel scale to measure bullying in HE on a wider scale. Attending university does not only lead to the acquisition of qualifications, it also influences morals, values, and attitudes which are carried throughout life. Students should be sufficiently prepared to apply themselves to graduate jobs and contribute to society to the best of their ability on graduating, and not have to deal with the psychological effects of bullying. Sarah Harrisson | Institute for Primary Care & Health SciencesIs the clinical course of patients with low back-related leg pain with neuropathic pain worse compared to those without?

Low back pain (LBP) patients with related leg pain (LBLP) experience higher levels of disability and pain compared to those with LBP alone. Some LBLP patients experience shooting, stabbing and electric-shock-type pain, all characteristics of neuropathic pain that may be caused by damage to nerves. These patients tend to do worse over time but there is limited research to support whether this is the case. This research describes clinical course of LBLP patients with and without neuropathic pain in terms of pain intensity and LBLP-related disability over 3-years, this is important to inform both LBLP patients and their clinicians. A prospective observational treatment cohort of 606 LBLP primary care patients was used. Data on neuropathic pain, pain intensity, LBLP-related disability were collected at baseline, 4-months, 12-months and 3-years. Mixed effect models were used to compare pain intensity and disability over the 3-year follow-up between those with and without neuropathic pain at baseline. Patients with neuropathic pain at baseline reported more severe pain intensity and more LBLP-related disability over a 3-year period compared to those without. The clinical course of LBLP patients with neuropathic pain is worse compared to those without, future research will investigate what factors influence this outcome.


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Muqdad Hmoud | Institute for Science & Technology in Medicine (ISTM)Exploring the potential of heparins as a future adjunct therapy for malaria

Whilst deaths and illness from malaria have fallen over the last two decades, there are an estimated 212 million clinical infection and 429,000 deaths annually. Antimalarial drugs play an important role in controlling malaria, however, the emergence of parasites resistant to frontline drugs demand that new drugs are developed. Heparins are widely used as an anticoagulant (blood-thinning) drug. Heparins have also been shown to block the invasion of the malaria parasites into red blood cells. This invasion-blocking activity has been exploited in clinical trials exploring whether heparins can be used as an adjunct therapy (a therapy that complements the use of drugs that directly kill the parasite). These trials failed due to the adverse risks of bleeding. Heparins, however, can be chemically modified or fractionated (broken down) to reduce their anticoagulant risk, whilst still retaining their invasion-blocking effect. Moreover, plant-derived complex sugars have also been shown to block parasite invasion of red blood cells. My PhD project aims to determine the extent that fractionated or chemically modified heparins or the plant-derived complex sugars block parasite invasion into red blood cells. To support this work I have developed a novel assay that uses genetically modified parasites that generate a light signal in my assay. Determining the invasion-blocking activity of these compounds and correlating this with their anticoagulant activity may provide future avenues to rejuvenate the potential of heparins as a potential future adjuvant therapy for malaria.

Samuel Holder | School of LawThe Flint Water Crisis: Environmental racism and the hidden American third world

In April 2014, Michigan governor Rick Snyder made the historic decision to switch the water supply for Flint, Michigan – a city struggling to recuperate from the auto industry decline in the 70s and 80s – from the Detroit Water Treatment Department to the Flint River. Despite intense concerns over contamination, primarily regarding industrial waste from the manufacturing sector, the Flint City Council approved the switch in an overwhelming 7-1 vote. Thus, tens of thousands of city residents are now enduring the consequences of debilitating lead poisoning. While the governor and city officials are quick to suggest solutions, they refuse to acknowledge the creeping racism of environmental action in the invisible American Third World. Franz Fanon, a Mauritanian psychiatrist and philosopher, described the condition of violence in colonized spaces as “atmospheric.” This

poster will attempt to illustrate three central concepts: 1) the role of “environmental violence” in urban and rural spaces where poverty is rampant; 2) how this type of violence reproduces conditions in municipal governments reminiscent of 19th century colonialism; and 3) how solidarity can be built across state lines (and international borders, including the UK, where several similar scenarios will be mirrored) to “decolonize” these poorer, minority areas.

Saumu Ibrahim | School of Geography, Geology and the EnvironmentChallenges and opportunities for the use of agricultural best management practices for climate change adaptation by small-holder farmers in the Kilimanjaro region, Tanzania

The use of agricultural best management practices has been reported to have huge potential for helping small-holder farmers cope with climate change impacts. Although small-holder farmers have been practicing some of these techniques, they do not necessarily optimize the benefits embedded in these techniques so that they can build resilience against climate variability, through sustaining agricultural productivity and accessing additional income from diversified farming. The best management practices referred to here include agroforestry, techniques for soil water management and the application of supplemental irrigation, and techniques for soil fertility management. The study will use the Kilimanjaro region as a case study to explore farmers’ intention to use and optimize benefits of different agricultural best management practices for climate change adaptation, and the challenges and opportunities associated with these strategies across the lowland, midland and highland zones. The study is expecting to make use Theory of Planned Behavior (TPB) which helps to predict the intention to perform a particular behaviour or adopt an innovation. The study will also use stakeholder analysis tools to identify challenges and opportunities available for enhancing the use of best management practices, along with interviews with farmers and government officials. Wen Jiang | School of Geography, Geology and the EnvironmentCan coal really be green?

Coal is the most carbon-rich fuel in the world and has been used for at least 4000 years. However, the world’s intractable addiction to coal as an energy source has been a major cause of global climate change. “Clean coal” is not a special type of coal, it refers to the technology that used to clean the emissions after the coal has been burned or treat the coal before it being burned, such as Carbon Capture, Use and Storage/Sequestration Technologies, Cleaner Coal Technologies and High Efficiency, Low Emissions Technologies. However, these technologies are expensive to develop and it is


integrated sustainable waste management system is required; the study will examine both the physical and the governance aspects to establish a locally, affordable and tailored system that fits specifically to the local conditions of Cairo.

Majida Khazaal | School of Chemical and Physical SciencesFuel from waste: Hydrogen production for a sustainable energy future

For many years hydrogen gas has been highlighted as one of the potential sustainable fuels of the future. This has mainly been due to the only by-product of combustion being water and therefor eliminating greenhouse gas emissions. However, the majority of current hydrogen production occurs via the steam reforming of natural gas, which will become unsustainable as resources dwindle. An alternative method of hydrogen production is the catalytic reforming of waste biogas, which has the potential to lower some greenhouse gas emission. Biogas is a complex mixture of methane, carbon dioxide and impurities that are often released from landfill sites in to the atmosphere as a waste product. By taking this waste product and flowing it over a metal catalyst at high temperatures, a mixture of hydrogen and carbon monoxide is produced that can be used in a wide range of industrial processes and as a fuel. In this presentation we will describe the development of a catalyst for this process that not only can be produced sustainably at very low temperatures, but also shows exceptional catalytic performance and stability for biogas reforming. Rebecca Laycock | School of Geography, Geology and the EnvironmentCan boundary objects be used for collaboration across timescales? Hope for grassroots sustainability initiatives with transient participants

In an increasingly mobile world, voluntary initiatives are faced with transient organisers/participants which can be detrimental to project continuity. ‘Boundary objects’ are abstract or physical things (ie. common language, documents/maps/diagrams) that are plastic enough to be interpreted differently, but robust enough to retain a common identity, enabling different groups of people operating over a common time period to create coherent understandings for collaboration on a common task. This paper explores if/how boundary objects are can be used to support initiatives with transient organisers/participants that are temporally asynchronous. This paper draws on a 2.5-year research project with student gardeners exploring the challenges of irregular participation and high turnover, and how students have used the physical garden space, a common


uncertain to work. The fact is that so far, “clean coal” technology do not have any appreciable or significant scale to reduce the emissions, at least not in 2017.

Panashe Kanyuchi | School of Geography, Geology and the EnvironmentNuclear Energy: Big Opportunity or Big Risk

It has been generally accepted that global energy consumption will increase, at the least, for the next 40-50 years. Energy generation from non-renewable sources currently dominates the global market, with oil and coal meeting around 60% of the world’s demand. Generating energy from sources such as coal and oil releases vast amounts of carbon dioxide into the atmosphere. Carbon emissions have been proven to be the driving force behind climate change and global warming. Energy generation alone contributes around 30% of all global carbon emissions. As a result, generation from more sustainable and renewable sources such as wind, solar and tidal has grown significantly this century. However, one sustainable energy generation technology that has yet to take off is Nuclear. Nuclear is seen by many as the answer to non-renewables such as coal, but on other hand many have argue that the technology is a risk not worth taking. The information presented in this poster will aim to present both sides of this argument and answer the question; is Nuclear Energy a big risk or a big opportunity.

Yesmeen Khalifa | School of Geography, Geology and the EnvironmentWhat are the prospects for integrated resource management for urban sustainability in the Global South’s mega-cities?

Cities can make a significant contribution to the global sustainability challenges if were managed and developed in a way that grew in harmony with nature (United Nations Urban Agenda, Oct. 2016). Sustainable development requires tailored strategies to fit successfully in a particular place, as each region, country or city has its own characteristics, features and it’s Urban Carrying Capacity (UCC) that differs from one place to another and shapes its unique identity. To move towards more sustainable development and improve the quality of life in Egypt (Cairo), this study will tackle two major problems of a fast growing city: the excessive use of non-renewable energy resources and the increased generation of solid waste. Both have massive environmental impact; an integrated study will be presented to examine the potential of renewable energy resources in Egypt and will focus on the utilization of organic waste that presents 56% of total generated waste to produce biogas by anaerobic digestion. To maximize the use of organic waste, an

potential of South America, which also favours other countries such as Colombia, Venezuela and Paraguay, the development of shale gas resource has several constraints that put in doubt its viability. Among this limitations can be found the access to technology require for extraction, the low price in the market due to the high offer, also the regulatory framework of some of the countries and one of the most relevant is the environmental impact cause by the hydraulic fracking use for the extraction of the shale gas and the potential leaking in the system that can highly contribute to the climate change. All these issues are main obstacles difficult to overcome but might chance if the technology and market improves.

Marwan Merkhan | Institute for Science & Technology in Medicine (ISTM)Restoration of in vitro immune response in IL10-devoid MSCs secretome

Background: The immunomodulatory capacity of the hMSCs is paracrine in nature indicating that the reparative potential is linked to soluble factor release rather than their functional incorporation. However, the identification of the definitive biomolecule(s) mediating this paracrine activity remains elusive. This study aimed to identify candidate biomolecule(s) specifically responsible for immunomodulation in the hMSCs secretome. Methods: hMSCs were isolated from bone marrow, their identity was confirmed, conditioned media (CM) collected and constituent components of CM determined. The immunosuppressive activities of CM and individually identified cytokines with prominent anti-inflammatory activity (IL4, IL10, and IL13) were tested using IL2 secretion from a T cell line (Jurkat) as an in vitro inflammatory response marker. Cytokine-driven responses were individually determined via addition of specific neutralising antibodies. Results/conclusion: Activated T cell IL2 secretion was blocked by CM itself and IL4, IL13, and IL10 when individually added to non-conditioned media. When these cytokines were neutralised individually in CM with their specific antibodies, the immune response was restored in IL10-devoided CM. This property might be harnessed to produce acellular biotherapy; which has immunomodulatory actions similar to hMSCs, the production of such biological products will reduce the cost/complications of cell-based therapy. Saja Mohammed | Institute for Science & Technology in Medicine (ISTM)The (ATP6V1E1) protein regulates cell survival in breast cancer

Cancer cells contain an enzyme which regulates their acidity. This protein (called a vacuolar ATPase) occurs on the plasma membrane,


‘vision,’ records of achievement as boundary objects between ‘waves’ of participants. The application and understanding of ‘boundary objects’ across timescales presents unique theoretical and practical challenges, such as how collaboration and communication can take place, and how/if consensus can be achieved given limited overlap between ‘waves’ of participants. The understanding and effective use of ‘cross-temporal boundary objects’ has the potential to support grassroots and voluntary initiatives with transient participants to make positive changes in their communities.

Sarah McKevitt | Institute for Primary Care & Health SciencesThe effectiveness of exercise interventions in adults with Osteoarthritis and comorbidity: methods for a systematic review

Osteoarthritis (OA) is common and associated with high prevalence of coexisting long-term health conditions in older adults. The focus of OA treatment is to control pain, and improve function and quality of life. Clinical guidelines recommend exercise as a core OA treatment. However, most of the evidence underpinning these guidelines is based on trials of exercise interventions in people with OA excluding comorbidity. This systematic review aims to summarise the clinical effectiveness of exercise interventions specifically in people with OA and comorbidity. Included studies will comprise randomised controlled trials investigating exercise interventions in people with OA and one or more comorbidity and measuring at least one of the following outcomes: pain, physical function, global health and quality of life. Multiple electronic databases will be searched by two reviewers. Included studies will be assessed for risk of bias using the Cochrane ROB tool and key data on trial components and outcomes will be extracted. Clinical outcome data will be synthesised using either meta-analysis or narrative synthesis depending on study heterogeneity. Planned outputs from the systematic review will include the first section of a PhD thesis, a prospectively published protocol and a research paper in a relevant high impact journal. Gina Marcela Peña Martínez | School of Geography, Geology and the EnvironmentShale gas in South America: its potential and constraints

The growing need for alternative sources of fuels to maintain energy security and the boom of natural gas consumption in the market has boosted the exploration and exploitation of shale gas worldwide. In this context South American countries have great potential for shale gas, reaching more than a quarter of the world’s total supply, with Argentina and Brazil leading the charts for technically recoverable shale gas resources, according to U.S Energy Information Administration - EIA studies. Despite the production


despite the immense potentials given the country’s thermal gradient. GSHP technology is largely affected by high initial costs, consumer awareness and policy frameworks especially in relation to reducing of CO2 emissions; its adoption however, can be enhanced by provision of incentives, infrastructural development, strong market base and well established research and developments. Anya Osborn | School of Life SciencesDevelopment of a novel cell replacement therapy to treat age-related hearing loss

Hearing loss is a global issue that affects ~360 million people. One form of age-related and metabolic hearing loss, known as presbycusis, is thought to result from fibrocyte degeneration in the cochlear lateral wall. This project attempts to demonstrate that cultured fibrocytes possess similar physiological properties to native fibrocytes. It may then be possible to develop a novel cell replacement therapy that could be tested in an animal model of age-related hearing loss. In this project, fibrocytes have been successfully grown on a 3D collagen gel allowing the cells to resemble their native appearance. Moreover, immunolabelling methods and electrophysiological recordings indicate similar characteristics between the cultures and native fibrocytes. This study demonstrates that these cultures of fibrocytes express native-like morphology and possess features in line with their potassium transport function. Further characterisation will enable a direct comparison and provide evidence whether these cells are suitable for transplantation in an attempt to treat age-related hearing loss. If successful this would provide evidence that these cells are suitable for transplantation into the lateral wall of the cochlea in an attempt to treat age-related hearing loss. Tianqi Pan | School of Geography, Geology and the EnvironmentIs shale gas the solution to our energy security?

Shale gas is nature gas which was trapped in the shale layer. Compared to other fossil fuels such as coal and oil, natural gas will release less greenhouse gases and nitrogen sulfide when it is burning. Different from conventional nature gas, ordinary drilling of gas has low effect. The method which was widely used to exploit is hydraulic fracturing. However, this technology exists many issues such as need plenty of water supply and will take lots of land use. Also, in the UK, shale gas distribution is uneven and the amount of existence is difficult to detect and lots of waste water produced in the mining process. If it has not been dealt with rationally, it can pollute nearby groundwater system because the chemical agents used in the exploiting process. In general, shale gas can be used to make up for short-term demand but not likely become future long term solution.

a layer which surrounds the cells and which extrudes particles called protons outside them which reduces their internal acidity. The aims of this study are to investigate the role of this enzyme in the death and survival of breast cancer cells and understand the mechanisms underlying it because it could help in treating cancer. I will manipulate the amount of this protein in the cells to determine whether this can control the cell death or survival. Thus we will see how V-ATPase is involved in promoting invasion and migration of cancer cell through tissue and we will investigate the importance of this gene in breast cancer by seeing how it can effect in breast cancer.

James Mothershaw | School of Geography, Geology and the EnvironmentUK-Iceland geothermal energy transfer potential

Geothermal energy comes from beneath the ground. The heat is generated from either radioactive decay of the earths crust, or from heat that has passed through the mantle to the crust from the earths core. As geothermal is a renewable source of energy, it is important to understand whether it is a sustainable source that could meet the required needs of the United Kingdom (UK). With the UK planning to harness the geothermal energy that Iceland produces, through its sub level volcanic activity that produces vast amounts of heat. It is important to understand whether the planned ‘Icelink’ interconnector would help to meet the UK’s energy needs by transferring the electricity produced in Iceland to the UK. Junior Nuwahereza | School of Geography, Geology and the EnvironmentThe potential for indigenous power generation from below the ground in the UK/Europe for ground source heat pumps

With continued global threat to our future from climate change driven mainly by fossil fuel burning for energy that release greenhouse gases especially CO2 resulting in global warming, many countries have now shifted their energy resource investment into renewable and carbon-free technologies in order to reduce their contribution to carbon emissions and commit to the pledge of achieve 2˚c global warming limit. Ground source heat pumps (GSHP) technologies provide an efficient, viable, carbon-free and renewable energy technology which utilises natural earth’s ground heat to generate energy for heating the buildings. It is one of the fastest growing renewable technology worldwide with approximately 10% growth per year with almost 80% of the plants in USA and Europe. European countries such as Sweden, Switzerland, Finland and German have more than 30% installed capacity of GSHP plants. GSHP adoption in the UK compared to other European countries is still relatively low


Nicholas Sheldon | School of Politics, Philosophy, International Relations and Environment (SPIRE)Absolute Pacifism: Dead, or missing in action?

Absolute pacifism, the belief that violence is always wrong under any circumstances, has almost vanished from popular debate, yet in the 1930s was politically mainstream. My research explores the spectrum of pacifism and focuses on the logical conundrums which appear to prevent absolute pacifism, the most extreme form of pacifism, from existing. Why does this matter? Absolute pacifism has been dismissed as a “fantastic, corrupting illusion”, but this is on the basis that it is a separate category to ‘contingent pacifism’, which prescribes the conditions under which a violent response is permissible. By demonstrating that the version of pacifism called absolute is in reality an extreme form of contingent pacifism, it may re-stimulate research in this area.

Ieuan Smith | School of Politics, Philosophy, International Relations and Environment (SPIRE)Does Wales still vote left-wing?

In 2015 Leanne Wood, leader of Plaid Cymru (Party of Wales), stated that Wales has never returned a Conservative government, but how true is this statement? This work takes election results from General and Welsh Assembly elections and assesses the share of the vote left-wing and right-wing parties received. The analysis concludes that left-wing parties do receive the biggest share of the vote, however in General Elections in recent years the right-wing vote is at its highest in 30 years whilst in Welsh Assembly Elections the left-wing vote consistently makes up over 50% of the vote.

Oliver Timmins | School of Geography, Geology and the EnvironmentIs shale gas the ideal alternative source of energy for Canada?

With the growing concern of future climate change becoming more prominent it is essential for countries to move to less damaging sources of energy, in order to lower emissions and to reduce the greenhouse effect which is warming the planet. Shale gas is becoming an increasingly popular source of energy in regions such as Canada due to newly discovered reserves and the depletion of other non-renewable energies. While this source of energy is argued to be cleaner than alternate fossil fuels (such as coal) there are still major environmental concerns surrounding the extraction, transportation and combustion of shale gas. This poster will look back on Canada’s previous history of gas extraction and identify the distribution of shale gas reserves across the country. It will then analyse the different methods of extraction and discuss the

Fraser Philp | School Health & RehabilitationValidating the methods that underpin the modelling of injury risk factors in football

Approximately 200,000 professionals and a further 240 million amateur male and female participate in association football or soccer worldwide. Associated with the high levels of participation in football is a high level of injury risk. My research project is aimed at identifying if injury in football can be predicted and subsequently prevented. This was achieved by providing numerical values to a commonly used exercise screening test (the Functional Movement Systems (FMS) screen). This was achieved by comparing the FMS against a video motion capture system, Vicon (©Vicon Motion Systems Ltd). The FMS is partly made up of 7 exercise tests, in which the quality of the movement is scored by an assessor and the participant is given a score for each test. The final score is then used to identify injury risk, with a lower score indicating a higher risk of injury. Alongside this we monitored a football team over one competitive season and investigated whether there is a link between the measurements we took and the injuries they sustained. Within this analysis we also developed a model to help us identify which of the in season or preseason measures were more indicative of injury. Leanne Savigar | School of Social Science & Public PolicyWhat are you talking about? Understanding legislation and policing of mobile phone use while driving

It has been an offence to use a handheld mobile phone while driving in the UK since December 2003, however, recent increases in the penalties associated with the offence have been necessitated as the action continues to be adopted by drivers. Despite this, little exploratory research has been conducted regarding police experiences of identifying offenders and public experiences of being caught committing the offence. 43 interviews with police officers, caught offenders and non-caught offenders were conducted to gain an understanding of how mobile phone use while driving was understood by the police and the public, how mobile phone behaviours are performed by drivers, and how interactions between the police and the public are experienced by both parties. The results highlighted an incomplete and inconsistent understanding of what it means to use a mobile phone while driving, for both the public and those policing the roads. This influences the interaction between the police and the public. The findings have implications for legislation targeted at developing technology, the way such legislation is enforced and future traffic offending behaviour.


will explore the most technically feasible technologies in each of these three areas. Homayemem Weli | Institute for Science & Technology in Medicine (ISTM)How pelvic organ prolapse happens: an insight from changes in the tissues’ structure, organisation, strength and collagen age

Pelvic organ prolapse is a downward descent of one or more pelvic organs through the vaginal wall. It occurs in many women as they age. Although it is a common health problem, there is a poor understanding of its cause and development. We aimed to understand pelvic organ prolapse development by studying chemical, mechanical and structural changes within the prolapsed tissues. We studied prolapsed tissues taken out during surgery, using a chemical separation technique (high performance liquid chromatography, HPLC) and multiple specialized methods for determining structure and mechanical strength. HPLC enabled the assessment of collagen age by quantifying an age-related sugar modification of collagen, pentosidine. We investigated the strength distribution within the tissues in relation to an understanding of the effect of collagen ageing in the various regions of the tissues. Results obtained were analysed and compared with controls within the same chronological age group. The collagen fibers were notably older in the prolapsed tissues. They contained higher amounts of pentosidine. There were consistent and notable differences in structure, organisation and strength of the prolapsed tissues in comparison to controls. The distinct localisation of some of these changes within the tissues gave further insight into how prolapse happens.

environmental concerns associated with them. After assessing all components of the shale gas consumption process the positives and negatives will be weighed up, whereby a conclusion can be drawn; identifying whether or not shale gas is an appropriate alternative fuel to other non-renewable sources.

Christianne Tipping | School of Geography, Geology and the EnvironmentFracking in Lancashire: Separating the rhetoric from the reality

Fracking - the fracturing of deep sedimentary rock formations called ‘shales’ by injecting pressurised fluids down wellbores to release trapped natural gas - is a contentious issue in the UK. Unfortunately, the quality of the debate has been undermined by widespread public confusion and exaggerated claims from both sides. Proponents maintain that shale gas is a cleaner energy source than coal and oil, and that the exploitation of reserves would improve energy security, reduce energy costs and generate jobs. Opponents argue that the environmental risks of hydraulic fracturing are too great, that burning shale gas will do little to help reduce carbon dioxide emissions globally, and that investment in shale exploitation will hinder the development of renewable alternatives. The UK’s embryonic fracking industry faces strong resistance in areas where exploratory wells have been drilled or planning permission has been granted. Central government intervened last year to allow Cuadrilla to drill and frack new wells in Lancashire, overturning the local authority’s previous planning refusal decision. Using Lancashire as a case study, this poster examines some of the technical, political, socio-economic and environmental arguments made by both supporters and detractors of fracking to try to separate the rhetoric from the reality.

Nathan Walker | School of Geography, Geology and the EnvironmentTechnologies of clean coal

With energy needs increasing globally and finite resources peaking and becoming more scarce daily, coal could be a value commodity as it has been for centuries. It is one of the most energy dense materials available to humans so using this fossil fuel and making it ‘clean’ to the local and global environment would be incredibly useful. Furthermore, coal still plays a significant part in global energy production, for example, 41% of the world’s electricity generation is sourced from coal (IEA, 2015), so clean coal technologies could help protect environmental concerns quickly, particularly in developing countries. The technologies available to reduce the negative impacts of coal production vary greatly, they can be split up into HELE (high efficiency, low emissions) technologies, cleaner coal technologies and carbon capture and storage technologies. The research poster

ABSTRACTS: THREE MINUTE THESIS HEATS

Shaima Ibraheem Jabbar | Institute for Science & Technology in Medicine (ISTM)Identification of Muscle and Tendon Properties from Ultrasound Scan Automatically

Computerized modelling of the arm and shoulder have the power to assist in the development of treatment for disabled people; it has been involved in the movement analysis. It is hard to estimate internal forces of skeletal muscles directly by using external loads. The musculoskeletal model offers a way to estimate this information by analyzing the functional capacity of muscles and tendons. The model design criteria based upon some measurements like tendon length, and muscle volume. Currently, these measurements have been taken from cadavers (donated bodies after death). However, this data allows us to make a generic statement about the function of the musculoskeletal system, but this is not enough to get accurate data and timely for each patient. This project aims to deal this problem by acquiring musculoskeletal model parameters from the individual using non-invasive ultrasound scanning. Shape and size parameters were evaluated manually (based on device measurements) and automatically (based on computer measurements). Automated measurements consist of three stages: increasing the quality of the ultrasound images, isolation of the musculoskeletal components alone in separated images (for example: isolate tendon in one image) and image analysis. Advanced and novel methods have been used in automated measurements of ultrasound images. Homayemem Weli | Institute for Science & Technology in Medicine (ISTM)How pelvic organ prolapse happens: an insight from changes in the tissues’ structure, organisation, strength and collagen age

Pelvic organ prolapse is a downward descent of one or more pelvic organs through the vaginal wall. It occurs in many women as they age. Although it is a common health problem, there is a poor understanding of its cause and development. We aimed to understand pelvic organ prolapse development by studying chemical, mechanical and structural changes within the prolapsed tissues. We studied prolapsed tissues taken out during surgery, using a chemical separation technique (high performance liquid chromatography, HPLC) and multiple specialized methods for determining structure and mechanical strength. HPLC enabled the assessment of collagen age by quantifying an age-related sugar modification of collagen, pentosidine. We investigated the strength distribution within the tissues in relation to an understanding of the effect of collagen ageing in the various regions of the tissues. Results obtained were analysed and compared with controls within the same chronological age

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group. The collagen fibers were notably older in the prolapsed tissues. They contained higher amounts of pentosidine. There were consistent and notable differences in structure, organisation and strength of the prolapsed tissues in comparison to controls. The distinct localisation of some of these changes within the tissues gave further insight into how prolapse happens.

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ABSTRACTS: THREE MINUTE THESIS FINAL FOUR

Bushra Bibi Health literacy and diabetes management in South Asians in the UK: a mixed methods studyLead supervisor: Dr Emee Estacio, School of Psychology

This research aimed to explore the health literacy needs of South Asians, in particular reference to diabetes management and consists of two studies: 1) a survey that examines health literacy levels and 2) study two photovoice that explore to explore cultural perspective in daily management of diabetes and health literacy needs. In study 1 (N=350), completed a face to face survey using standardised health literacy and diabetes measures. Findings indicated the majority of participants have limited functional health literacy (61%). In the study 2, eleven of the participants from study 1 were recruited for photovoice project and thematic analysis of participant’s accounts and images indicated three main themes. 1) Illustration of self-management of diabetes in day-to day life, 2) NHS access and utility, 3) Quality of life. The consideration of health literacy within a particular community’s cultural perspective can have the potential to maximise the assets of that community. In increasing such a level of awareness and contributing towards the evidence of health literacy as an asset approach, made it possible to use the distributed resources of the social networks and can be one strategy to improve health literacy that can reduce the health disparities in the ethnic communities.

FNS Prize-winner

Hayley Gilman | PsychologyThe effects of celebrity advertising and scepticism to advertising on adults’ and children’s brand preferencesLead supervisor: Dr Martin Rowley; Other supervisor: Dr Sue Sherman

Research suggests that as children develop so too does their ability to identify the persuasive nature of advertisements that use celebrities. The ability to recognise advertising and understand its persuasive and commercial intent (i.e. realising that ads aim to influence us) has been seen as providing children with protection against advertising’s potential adverse effects. Because it has been assumed that such skills require the ability to consciously process information about advertising, most research investigating the development of advertising literacy skills has examined explicit knowledge of advertising - knowledge that is available to conscious reflection. It may be, however, that implicit processes (our automatic response) also have a part to play in decision-making. Recently, researchers have begun to question whether being sceptical of advertising and the tactics they use (e.g. celebrity pairings) actually does make individuals less

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susceptible to the effects of advertising. There is still some dispute about exactly when children’s advertising literacy skills emerge and become ‘adult-like’ and whether being sceptical of advertising could provide individuals with protection against advertising’s potential adverse effects. My research examines how and when celebrities advertising brands influence brand judgments in children and adults, and also examines whether scepticism to advertising influences these decisions.

Fraser Philp | School of Health and Rehabilitation/Institute of Science & Technology in Medicine (ISTM)Validating the methods that underpin the modelling of injury risk factors in footballLead supervisor: Prof Anand Pandyan

Approximately 200,000 professionals and a further 240 million amateur male and female participate in association football or soccer worldwide. Associated with the high levels of participation in football is a high level of injury risk. My research project is aimed at identifying if injury in football can be predicted and subsequently prevented. This was achieved by providing numerical values to a commonly used exercise screening test (the Functional Movement Systems (FMS) screen). This was achieved by comparing the FMS against a video motion capture system, Vicon (©Vicon Motion Systems Ltd). The FMS is partly made up of 7 exercise tests, in which the quality of the movement is scored by an assessor and the participant is given a score for each test. The final score is then used to identify injury risk, with a lower score indicating a higher risk of injury. Alongside this we monitored a football team over one competitive season and investigated whether there is a link between the measurements we took and the injuries they sustained. Within this analysis we also developed a model to help us identify which of the in season or preseason measures were more indicative of injury.

FNS Symposium People’s Choice Prize winner

Emma Whittle | Life SciencesAsthma and the Blood Microbiome: A Preliminary InvestigationLead supervisor: Dr Dan Tonge, Other supervisor: Dr David Watson

Asthma is a major public health concern, affecting 300 million people worldwide. It is a disease of the airways that is the result of an incorrect immune response to allergens such as dust. In the past 50 years the numbers of asthma cases have been rapidly rising. It is thought that this is the result of reduced exposure to bacteria during childhood. This is an essential part of childhood as it teaches the immune system to correctly respond to foreign material, such

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as bacteria and allergens. My project aimed to determine whether the bacterial populations in the blood differ in asthmatic individuals compared to non-asthmatics. This was achieved by sequencing a gene found in all bacteria, which is slightly different in each type of bacteria. The sequenced gene data was then compared to that of known bacteria species to determine which bacteria were present in the blood samples. The bacterial populations present in the blood of asthmatic individuals were then compared to the populations observed in the non-asthmatics. Statistical analysis found that in the asthmatic individuals there was significant increase in Firmicute bacteria that was associated with a decrease in Proteobacteria.

THREE MINUTE THESIS REFLECTIONS #1

As a PhD student you’re often asked “So what’s your PHD on?”. When asked by a person familiar with your area of research, this question poses no challenges! However if the person asking is not familiar with your research area, or even research at all, you may find this a rather challenging question. The reason it’s challenging is this; if you’re anything like me, it’s at this point you debate in your own head whether to inundate them with the innermost workings of your research, (it’s at this point you see their eyes glaze over following your lengthy but brilliant description of Bayesian regularisation and Fourier transformations), or give a brief but vague description of your work, after which they are none the wiser and you feel as though you’ve done your hard work a disservice. This was certainly my experience, until recently when I entered the Three minute thesis challenge.

The Three Minute Thesis is a competition in which doctoral candidates have to present a compelling spoken presentation on their research topic and its significance to a lay audience (in only three minutes). Being able to effectively communicate your research topic and its impact is an essential skill necessary for your viva, conferences, teaching and dissemination of your work to the public. As a PhD student, you want your work to have a real impact on the world and you want people to engage

with it and share it. These are fundamental parts of the research process and are often questions that may get asked when presenting your work at a scientific conference or on grant applications. The Three Minute Thesis is a fantastic process for developing these academic, presentation, and research communication skills. It challenges you to identify the key components of your research and present it in a format that captivates a non-specialist audience without losing the engagement of a specialist in the audience. The presentation format is different to traditional academic presentations, with only three minutes and a single slide to convey your thesis. The removal of the traditional academic “homely comforts” pushes you to be more innovative and find alternate ways of delivering your work. There is a big emphasis on engaging the audience “leaving them wanting more”. You are penalised equally for using specialist terminology AND not being specific enough about your research. You have to make your words and the time count, as failure to keep to your allocated three minutes results in disqualification!

The skills gained from this experience have been extremely beneficial and I would strongly advocate taking up the Three Minute Thesis challenge to any PhD student. The opportunity to present in differing settings and to different audiences

Fraser Philp

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has complimented my presentation skills. The ability to engage any audience has improved my confidence in presenting, whether it be on a conference stage or standing next to my poster at a conference. Additionally, being able to clearly articulate my research and its impact has helped in scientific presentations, viva preparation and grant applications. Finally, after four years, even my Dad knows what my PhD involves!

After completing my MSc degree in the School of Psychology at Keele I was given the opportunity to present my research at a British Psychological Society conference. I anxiously took along a research poster with my supervisor and dreaded the thought of anyone talking to me about my work! Five years later I’m about to start my first lectureship position and am now writing up my PhD thesis - my confidence has grown and over the years I’ve presented oral presentations at numerous different conferences and at many different events.

When I researched what the Three Minute Thesis (3MT®) Competition entails, it said “it challenges PhD students to present a compelling spoken presentation on their research topic to entertain and inform an academic, but non-specialist audience”. I have many family members who, at family gatherings, always politely ask “so what’s your PhD about again?”, yet in all the years I’ve been doing my PhD I’ve never been able to concisely verbalise my research in a way quick enough to maintain their interest! After many years of presenting my research at formal conferences I knew this competition was a challenge I wanted to tackle - and if nothing else I’d have a short, succinct answer to the famous family question!

I decided to register my interest in the competition and present my three minute thesis at the

Faculty of Natural Sciences Symposium (May, 2017). I naively thought it would be a simple challenge – surely a three minute presentation is easier to write and prepare than a fifteen minute formal talk, right? Wrong! Apparently an 80,000 word thesis takes approximately nine hours to present, and I soon realised it would be a tough challenge to condense six research studies into three minutes! I signed up to a workshop at the Learning and Professional Development Centre and designed my single slide to take along. I hadn’t rehearsed what I was going to say, I just had a vague idea of what I might say and was semi-confident that three minutes would be a reasonable amount of time to discuss my research. It’s funny – three minutes is actually quite a long time when you watch it pass by on a clock, but when talking it flies by! The workshop was invaluable, and the first lesson I quickly learned is that preparation and rehearsal is crucial!

Before the conference I followed the advice given at the workshop and rehearsed my talk numerous times, remembering only the five key points I wanted to make rather than a script. Each time I rehearsed my dialogue was different, but that didn’t matter - I felt that each time I had discussed my main points in adequate detail. It took time to consider what my key points were – it’s surprisingly difficult to condense down years of work into only a few

Hayley Gilman

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HAYLEY GILMAN

to be a useful experience and will have learned many things about their thesis and research that they may not have considered to be important before. Without a shadow of a doubt I would encourage anyone to take part in this competition in future years, if only to allow themselves the benefits of thinking carefully about the main messages within their research and the way in which it can be most effectively communicated.

Whilst I didn’t make it past the National semi-final I am delighted to have been Keele’s representative and more than anything it gave me a massive confidence boost! So, have any of my family asked about my PhD since? Well, no – but next time they do I now have a three minute recording I can show them!

points! But, this process was hugely worthwhile, and whilst preparing for the competition I also gained more structure to my thesis and found that certain elements of my writing needed more focus than I had given them before. The big day arrived – the stage was set, the countdown timer in prime position and my slide presented behind me. I’d practiced over and over and was happy that I could finish within three minutes – but the adrenaline and nerves kicked in and I finished with only 7 seconds to spare. Still, I finished and received some excellent feedback from the audience and the judge and was selected as the winner of the Faculty heat, put through to Keele’s final during the Bob Beattie Awards night. I was elated to win but once again overcome with nerves – I’d have to do it all over again!

Between winning the Faculty heat and presenting at the final I kept rehearsing, again speaking about the main points of my argument without trying to script my talk. I found that this constant consideration of the main points focused and developed my thinking and in the process I re-drafted a plan of how I envisage the final thesis to form. On the evening of Keele’s final I was excited to once again be able to present my research to an audience that knew nothing about my research. The winner of this final at Keele was to be entered as Keele’s representative in the National semi-finals so this time we were all recorded when we gave our talks – slightly terrifying but in three minutes you really don’t have time to think about it all that much! I was delighted to have been voted as Keele’s representative, and thrilled to hear the positive comments about my talk.

The three minute thesis requires the presentation of research to an audience who knows little or nothing about your area of study, which means that creating a talk that has enough (but not too much!) background content is necessary for the audience to understand. I was therefore mentally sifting through lots of literature to verbalise the necessary content – much like I imagine would be necessary for a Viva interview. I believe that competing in the three minute thesis competition has been hugely worthwhile for me as a student in the last stages of the PhD – being able to condense down hours of literature, studies, findings and conclusions to a few minutes definitely makes you consider the most important aspects of the research. Being able to express this to an audience not familiar with the topic or research area is an important skill that I believe is important for all researchers to develop.

All of the competitors, both in the heats and the final were able to successfully engage the audience and present their PhD research effectively, and they’re all to be commended on doing such a fabulous job! I am sure that they will also have found this competition

Last year was the first year the JSLUG conference ran and I noted in my editorial at that time that the event was both impressive and that the quality of the work was high. One year later and not only are these assertions still true, but the

event itself has grown in scale and scope. On the scene now are the ILAS team as well as the original driver still at the wheel of the JSLUG project, Dr Chris Little.

The venue this year was prestigious Keele Hall and a number of the impressive rooms were put to work on the day to showcase a diverse range of undergraduate works. I have been teaching at Keele for around 10 years and it still impresses ever this jaded (pun intended!) teacher just how excellent some of our undergraduate research and communication skills actually are. From year 1 to final year students, the quality and enthusiasm on display right across the day was infectious. From Memory to Vikings and everything in between, presentations and posters virtually assaulted the senses with each and every participant bringing their best works to share with each other.

At this point, you will also hopefully have noticed that this special edition of JADE is different too. For the first time, we have a dedicated section for the ILAS postgraduate conference and an associated paper coming out of that event which was held just before the JSLUG event. Having been present at both conferences, it struck me just how unique each event was when compared with the other despite the formats being extremely similar and the actual venue being the same! The ILAS postgraduate conference had a theme of “interdisciplinarity” and took the approach of presenting posters in an impressive gauntlet of colour and information whereas JSLUG opted for short presentations in parallel sessions with fewer posters. The take home message from seeing both these events was that it really didn`t matter what the format was, quality is quality and in both cases, it was fully on display.

Doubtless, these events will both keep on evolving, as will this special associated edition of JADE to keep up with them. Whether they grow or shrink, look outside Keele or stay inward facing, sharing student work and building student confidence are always firmly at the heart of what is being done. Until the next edition, I hope you have been inspired to take part and to come along to both events next year and who knows… maybe even write something!

Dr. Russell CrawfordManaging Editor of [email protected]

EDITOR’S EPILOGUE

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Learning and Professional Development CentreKeele University, Keele, ST5 5BG, United Kingdom

http://jadekeele.wordpress.com

Open Call for SubmissionsThe Learning and Professional Development Centre is pleased to announce an open call for submissions on any aspect of teaching, learning or assessment for the next issue of J.A.D.E.

For those interested in publishing their educational research in J.A.D.E there is a short video introduction to the journal and full instructions for authors available at:

http://jadekeele.wordpress.com

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