‘Twiddling’ of the pacemaker resulting in lead dislodgement

Twiddler’s syndrome is a rare condition in which patient manipulation of the pulse generator within its pocket may result in coiling of the lead and lead dislodgement, thereby causing pacemaker malfunction. Retraction of the electrode may cause phrenic nerve stimulation resulting in diaphragmatic stimulation and a sensation of abdominal pulsations. As the leads are further wrapped around the generator, rhythmic arm twitching may occur as a result of pacing of the brachial plexus.1 Twiddler’s syndrome was first described by Bayliss et al in 1968 as a complication of pacemaker implantation.2 It has also been reported with implantable cardioverter-defibrillators (ICDs)3 and cardiac resynchronisation therapy (CRT).4 This is a case report of an elderly lady with Twiddler’s syndrome resulting in pacemaker malfunction secondary to lead retraction, who emphatically denied any manipulation of her device. She subsequently underwent lead repositioning and appropriate counselling.peer-reviewe

Emission of reactive oxygen species during degradation of iron gall ink

Iron gall inks are characterised by high contents of acids and transition metals, promoting degradation of cellulose due to hydrolysis and oxidation, respectively. Their chemical interaction with the environment is not well understood, especially in view of emissions of degradation products which could lead to spread of degradation processes. In order to study the emissions, we employed gas chromatography/mass spectrometry following headspace micro-extraction, and liquid chromatography following hydroxyl radical scavenging with appropriate probes. We also studied chemiluminescence of cellulose affected by ink degradation. We show that while the emissions of organic volatile degradation compounds by inks are less intense than those of surrounding paper, ink does promote the degradation of cellulose across big distances (from object to object). We were able to link this to emission of reactive oxygen species, probably hydrogen peroxide. Its emission from ink is considerably more intensive than from paper

The matching of motivations to affordances among Maltese elected local government volunteers : implications for sustaining civil society

Purpose – The purpose of this study is to both understand the motives for volunteering in local government (a strong/structured context) and determine how such motivation and other demographics interact with organisational contexts to influence volunteering outcomes. Design/methodology/approach – The study adopts a functional approach to volunteerism. The Volunteer Functions Inventory is modified to better assess the motivations of elected local government volunteers. The responses of 152 Maltese local councillors were used to answer four research questions empirically. Findings – Exploratory and confirmatory factor analyses supported the introduction of a seventh VFI dimension, namely the political function. The study provides evidence that local councillors who received greater amounts of functionally relevant benefits reported more satisfaction and a stronger intention to continue volunteering in local government. The aggregated effect of multiple motives as well as other person-based determinants (marital status and education) produced a significant impact on volunteering outcomes in this strong/structured situational context of this public sector environment. Originality/value – This study contributes to a better understanding and assessment of the motivations of elected local government volunteers. It addresses practical recommendations for sustaining civil society, while acknowledging the potential and contribution of volunteers with various demographic characteristics

Volatile aldehydes in libraries and archives

Volatile aldehydes are produced during degradation of paper-based materials. This may result in their accumulation in archival and library repositories. However, no systematic study has been performed so far. In the frame of this study, passive sampling was carried out at ten locations in four libraries and archives. Despite the very variable sampling locations, no major differences were found, although air-filtered repositories were found to have lower concentrations while a non-ventilated newspaper repository exhibited the highest concentrations of volatile aldehydes (formaldehyde, acetaldehyde, furfural and hexanal). Five employees in one institution were also provided with personal passive samplers to investigate employees’ exposure to volatile aldehydes. All values were lower than the presently valid exposure limits. The concentration of volatile aldehydes, acetic acid, and volatile organic compounds (VOCs) in general was also compared with that of outdoor-generated pollutants. It was evident that inside the repository and particularly inside archival boxes, the concentration of VOCs and acetic acid was much higher than the concentration of outdoor-generated pollutants, which are otherwise more routinely studied in connection with heritage materials. This indicates that further work on the pro-degradative effect of VOCs on heritage materials is necessary and that monitoring of VOCs in heritage institutions should become more widespread

The teaching and assessment of the content and cognitive domains of two areas of physical activities for examined physical education

The introduction of assessments and examinations in Physical Education led to a shift from a recreational to an educational ideological base in the subject (Carroll, 1994). This resulted in the development of modes of assessment of the practical coursework for GCSE and ‘A’ level PE and Sport Studies that challenged the principles of validity and reliability of assessments. Further to this, teaching the content and cognitive domains (Bloom’s taxonomy) of the practical coursework in the gym and class-based environments, as suggested by the examiners (MEG, 1993) still resulted in unsatisfactory learning outcomes. This led to a study which investigated the teaching of an athletic type and a game type activity to high school students (16-18) in three environments, practice-based classes (n=32), practice-based classes with discussions of a handout at the end of each session (n=27), and class-based sessions (n=38). The teachers’ and pupils behaviours of the three experimental teaching units (ETUs) were analysed using the systematic observation technique CAFIAS. A second study examined the impact of the teaching environments on the assessment of the content (techniques, tactics and rules) and cognitive (knowledge and comprehension, application and analysis, and synthesis and evaluation) coursework of the two activities using an unseen written paper with diagrams and a video based unseen written paper. The first study showed that the time spent on content emphasis was higher in the class-based ETUs, and that more time was spent on giving direction in the practice-based sessions. The class-based sessions provided more opportunities for teachers and students to communicate verbally. From the second study, ANOVA and MANOVA (repeated measures) procedures revealed statistically significant scores for all teaching environments (p<0.05) of both activities. However, the class-based athletic type activity yielded higher scores on the video based assessment for techniques, tactics, rules, knowledge and comprehension, and application and analysis, while evaluation was best assessed using the written paper to narrow the gap of gender inequalities in assessment. When the game type activity was taught in a practice-based class, the unseen written paper was found to yield higher scores for techniques, tactics, rules, and application and evaluation questions. Nevertheless, a practice-based class did not adequately prepare students for a video-based assessment in game type activities, except for the knowledge cognitive domain. The class-based, and practice and handout groups achieved statistically significant (p<0.05) better scores on techniques, tactics, rules, knowledge and evaluation questions of the video based papers. The findings of these studies are limited to the performance coursework of athletic type and game type activities of GCSE and ‘A’ Level PE and Sport Studies

Higher education in sports related disciplines: insights into teaching and research

In recent years, many universities have argued the importance of enhancing the relationship between teaching and research. The synergy of the two provides transformation, innovation, creativity and criticality in the curricular and co-curricular provision. This session explores the latest thinking on innovation in teaching in sport related disciplines and flipped learning. Diversity is a strength of the higher education sector – and research-informed teaching can vary widely. What does it look like? How can teachers in higher education engage more with research and publications? Promoting a community of innovative and research led teaching and culture, whatever its form, transforms the student experience, promotes graduate attributes and enhances employability

Perceptions and experiences of youth footballers registered in nurseries (13-15)

Background: Football nurseries for youths have historically served to expand grassroots football to develop talent. Research on youth footballers has focused predominantly on elite youth football (Reeves et al, 2009; Sieghartsleitner et al, 2019) and a study explored youth development in football nurseries in Malta (Cassar and Gauci 2015). Notwithstanding these contributions, it is timely that the experience of youth football and talented player development is explored further by capturing the voice of young footballers in nurseries. Building on recent research on the Developmental Model of Sport Participation (Côté and Vierimaa 2015) and the Long-Term Athlete Development model (Balyi et al. 2013), this study explored the perceptions and experiences of coaching sessions of youth (13-15) registered in football nurseries in Malta. Research: The key research questions were: What are the experiences of youth footballers during the sessions? What are the perceptions and experiences of youth footballers regarding their relationships with the coach and peers? Mills et al. (2012) identified a series of factors perceived to either positively or negatively influence youth football player development, while Flores-Aguilar et al. (2021) emphasised the impact of peer relations. The study will explore how youth footballers develop during their coaching sessions in relation to awareness of themselves and awareness of others; resilience to cope with feedback, and setbacks; and sport-specific attributes such as perceptions of coaching sessions and competitiveness. Methodology: At the time of the study, twelve from fourteen top division senior football league clubs in Malta had well-organised and resourced Youth Football Club Nurseries (YFCN) for boys; two had provision for girls (Youth Football Association 2015). A stratified random sample of six out of the fourteen top division football clubs in Malta was selected as a fair representation of the population. An in-depth semi-structured focus-groups was held at each of the six YFCN. Forty-two youth footballers from six nurseries volunteered to participate. All were boys. Focus groups offered ‘deeper’ understanding of social phenomena through dynamic group in-depth discussion conversations and deliberation of thoughts, beliefs, and perspectives. Thematic analysis (Braun et al, 2019) was used to analyse the data. Key findings: The coach, sessions and environment emerged as key themes. Youth footballers experienced and affirmed that they wanted coaches that are fair, remain calm, are caring, do not shout and encourages all participants. The coaching style impacted resilience, motivation, mental-wellbeing, and decisions for dropouts. Most youth footballers preferred to play and have fun, rather than win every game and not play. All participants shared the belief that success and the development of game strategy development were important, however, a focus on winning was perceived important to some of the youth footballers. Peer relationships were positive, but subgroups and micro aggressions contributed to self-esteem issues. This study recommends a similar study for girls’ youth football. When individual youth footballers are bullied, or feel excluded by their peers, coaches have a role to play to prevent and eradicate adverse experiences in youth football. Training for coaches to manage peer and coach relationship is desirable as part of a coaches’ continuous development. Also, youth football nursery programmes should signpost phases of transitions of continued participation at recreational and high levels of performance for youth footballers

Curricular innovation in physical education sport and exercise sciences: entrepreneurship and employability

Information on the innovative curricular dimensions and initiatives emerging in higher education to stimulate the employability of graduates in the physical education and sports sector