This article is focused on the role of the facilitator in the professional development of mathematics teachers. It is a feature of several frameworks for using video that teachers are invited to comment on the detail of what they saw and heard, and base comments on evidence from the video. It is also a common finding that it is hard to establish ‘speaking evidentially’ as a way of working and at the same time, such an expectation is seen to be critical to making discussion productive. This article draws on a paradigmatic case of one video club, during which seven teachers met over a 3-month period, and shared video recordings of their own classrooms. The group of teachers learn how to focus on the detail of video, avoiding judgement, from the first session. The way this is achieved and what it occasions is analysed, within an enactivist methodology.kinds of comments made by teachers as well as their content. If a teacher makes a contribution that is not of the ‘kind’ required within the way of working, the facilitator is observed to highlight that the participant is not focused on the detail of events, and re-direct the group back to the intended task. This sequence of moves is not captured in current frameworks of how to facilitate video discussion. There is a suggestion that it is the very distinction between observation and interpretation or judgement that is significant for teachers and allows them to re-think their own teaching practices.The analysis of the first meeting of the video club shows how the facilitator has a focus on the kind of comment made by participants, not judging the comment’s content. The meta-focus of the facilitator seems to allow enabling contraints to be placed on discussion while letting conversation follow the interests of participants.This article aims to share awarenesses of the facilitator, concerning how it is possible to focus a group on the detail of events when using video. What the facilitator is doing, in highlighting when a norm has been breached, is making a judgement about the  Teacher J: Because that very first [meeting], I was really judgmental, but once you sort of trained us, it feels really un-inhibiting to watch anyone’s video, you do not think about it.extract from audio recording of Meeting 3].Teacher P: I was saying, this process has helped me, when I come to compare, when I come to observe now, because I have stopped now thinking about how I would do it and looked at actually what are the children doing, how are they achieving that and what is the teacher doing to get them to achieve that  … we were making judgments … but then that wasn’t really reflection’ (teacher J)‘A random selection of comments is below . Teacher names are replaced with (random) initials.Teacher N reflects on his ‘doctoring’ of what he watches, i.e. showing an awareness of how easy it is to interpret observations; similarly, teacher T talks about his difficulties in being ‘objective’, e.g. focusing on the detail of events on the video and teacher D (a senior leader in his school) makes a link to his own observation of other teachers and being non-judgmental. Teacher J explicitly refers to being judgmental in her observations. Having identified this theme, I worked through the whole dataset and any mention of judgement, or difficulties with interpretation, were transcribed with the aim of uncovering further patterns, in a systematic manner.A striking feature of the comments reported above (from meeting 6) is the number that refer back to the first meeting. It appears as though a significant shift took place during the first meeting, in relation to the move away from judgement. The first meeting is the starting point for analysis and in the next section the focus is just on that meeting. I report on three transcripts, which are all the instances where a comment from a participant gets interrupted or re-focused by the facilitator, in relation to judging or interpreting. I then worked through the data a second time, looking at evidence of change for particular individuals, i.e. instances where their responses in a similar context appeared different from an earlier time.The first meeting of the video club is the focus of this section. I report on three transcripts, which are all the instances where a comment from a participant gets interrupted or re-focused by the facilitator, in relation to judging or interpreting. Before getting to these incidents, I offer a brief outline of the time working on the first video, just in the initial ‘accounts of’ or reconstruction phase Table .Table 2Tfor what they had observed.The three incidents are all taken from the first, 6-min, discussion of the video clip shown. The clip was re-shown a further three times, with shorter and shorter sections viewed, in response to questions and disagreements from the group about what took place. At the end of close to 19 min, I moved the group on to offering an account I present the three transcripts in the form of a narrative, combining what was said with my own, stimulated-recall of the events. After the transcripts/incidents, I offer an analysis initially based on van Es et al.  and indiwww.videomosaic.org) called ‘Alan’s Infinity’. The task for students in the video is to answer the question: ‘how many numbers are there between zero and one’. The question is posed by the teacher on the video, the class appear to be students of around aged 9 and, for the duration of the clip, the students are engaged in a whole class discussion. I have used this clip before and am aware it can provoke strong responses (both positive and negative) and so hoped it would be suitable to establish the discipline  began talking. The first comment, below, refers to J (another teacher in the group) who had mentioned at the start of the meeting that he was interested in promoting more ‘independence’ in the students he teaches.P: I could not stop watching, thinking of you [P looks at J] and your independent children [Alf raises his hand towards P] and unfortunately all//the children that were not paying attention//Alf: // So, so, so//J: // Yeah, yeah//Alf: That’s an interpretation. So, at this stage, the invitation is to say what you saw, what you observed [1] so [1] how did it begin?I remember feeling taken aback that P had begun talking before any invitation from me . Following P’s comment, I offer feedback in relation to a previously stated invitation around the kinds of talk wanted at this stage of discussion. The distinction I offer here is that it is impossible to observe ‘not paying attention’. What we might observe is, say, children looking away or playing with items on a desk, or talking—from which it is an ‘interpretation’ that they are not paying attention.I was anticipating making a move consistent with ‘orienting the group to the video analysis task’ as I sat down, i.e. setting up again and re-emphasising how we would be reconstructing what occurred on the video. Given P started speaking before I began, the closest description of my ‘move’ would be ‘re-directing’ (within ‘maintaining a focus on the video and the mathematics’); however, I also interrupt P (not a move within the framework). I could be seen as ‘highlighting’, but not  pointing towards something noteworthy in the video, but rather the opposite, how P was not following the intended discussion norm. The facilitator moves, although different to those currently characterised in the literature, could fall under van Es et al.’s heading of ‘maintaining a focus on the video and the mathematics’.G: He said that it would not work if your one whole was 10?J: Yeah, I think he was talking more on the discrete nature of number, he was thinking about things being discreteAlf: So, try to avoid interpreting what you think he was saying [Alf laughs] try and stay with [1] so, what did you hear him say?My intervention, in incident 1, did not ensure that conversation thereafter remained within the detail of the events on the video (and nor would I have expected it to). After 3 min, the following interchange occurred (G and J are commenting about a student on the video clip).I recognise being attuned, when the task for the teachers is one of description, to any mention by a teacher of what might be going on in the mind of a student on the video. For me, these are the easiest comments to spot that are ‘interpretations’ and not ‘descriptions’. We cannot observe what a student may or may not be thinking, by way of explanation of what they say. So, when J suggests a student was thinking about the discrete nature of number, I am not surprised to observe myself in the transcript intervening and re-emphasising the focus for this phase on evidence from the video.As in incident 2, I can be seen re-directing attention back to the video; but, also as in incident 1, I highlight what is ‘wrong’  with J’s comment at this stage in the video club protocol (it is an interpretation). My laughter might be seen as an awareness of the social awkwardness of such highlighting in the context. As in incident 1, the result seems to be ‘maintaining a focus on the video and the mathematics’.The transcript below follows directly from incident 2 .Alf: Try to avoid interpreting what you think he was saying [Alf laughs] try and stay with his [1] so what did you hear him say?J: Something about ten objects.P: There’s ten and you cannot get zillionths if there’s just ten.N: And then something about a dust particle.Alf: Was that in the second clip or the first clip? [The ‘clips’ are a reference to the fact that the video is edited and there is an obvious break after a couple of minutes.]J: Second clip, or dust trucks I thought he said.J: I do not know what I heard.Alf: I heard dust bug.P: I think he said dust bits and then someone misinterpreted it as dust bugs.Alf: I thought I heard someone saying effectively there’ll be some unit lower than a dust particle.P: Someone talked about atoms did not they?J: That was when he said about a really long number line.J: I thought that was interesting becauseAlf: [Alf interrupts T] That// sounds like an interpretation //J: //Interpretation, yeah//Alf: Try and stay with detail, we’ll go on to that in a second. Let us try and see if we can get the chronology, so we have got, and we can go back and look, but we got something from the teacher, possibly a question, we thinkC: How many numbersAlf: OkayThere are disagreements between participants in the early part of this transcript. In line 4, N says he heard something about ‘dust particles’, in line 6, J suggests ‘dust trucks’, in line 8, I suggest ‘dust bugs’ and in line 9, P offers ‘dust bits’. The divergence of ideas here is within the realm of ‘accounts of’ what took place and I can be seen to be engaging in the discussion alongside others; indeed, from lines 2 to 13 (with the possible exception of line 5), it would be hard to distinguish the facilitator acting in any way differently to the participants. It would even be hard to see evidence of facilitator ‘moves’ here, in the sense of van Es et al. , or at lwhat happened when during the clip. The facilitator move, as in incident 1, is an interruption and a highlighting and re-directing to ‘try and stay with the detail’. In J’s re-voicing of my comment ‘Interpretation, yeah’ there could be evidence of him beginning to recognise the distinction being made here between interpretations and descriptions.However, in line 14, I intervene in a different way, in this case interrupting T’s contribution, and re-stating (line 16) the task as getting ‘the chronology of things’, i.e. can become established quickly in a group, with a facilitator prepared to intervene and make the criteria for intervention explicit to the group, so that those criteria can become ones that participants are able to apply to themselves. The facilitator moves in evidence, not captured in the van Es et al. framework but linked to ‘maintaining a focus on the video and the mathematics’, seem to centre around highlighting to the group when discussion strayed away from evidence on the video. Highlighting when something has ‘not’ happened perhaps serves to alert teachers to needing to pay attention to the kinds of things they are saying.Following the three incidents reported above, there are no others where I notice a judgement . The teacher discussion remains at the level of detail and ‘accounts of’, characterised by lines 2 to 12 in incident 3, (with three re-viewings of sections of video) before I shift to the next phase of asking for interpretations and analysis of what was seen. In the remaining meetings of the club, during the initial ‘accounts of’ phase of working with video, I make no interventions to bring discussion back to the detail of events and there is an absence of judgments or interpretations made by the teachers. In other words, there is evidence that a discussion norm (about starting off with description and not interpretation) has been established in the first meeting. After three interventions by the facilitator to flag up when discussion has moved to interpretation, no more are needed. Over 20 years of working with OU methods, there is nothing surprising or unusual about the speed with which this happened. This case points to how a focus on the detail of events how can a facilitator focus discussion away from judgement and onto the detail of events, in the context of professional development using video? And, in what ways does focusing on the detail of events occasion subsequent learning for teachers?In reflecting further on the evidence presented above, I now focus on the two questions that have guided this article, Reflecting on the way this first meeting went, there is a paradoxical sounding sense in which the facilitator’s own judgmental interpretation of the ‘kind’ of comment made by teachers supported them in moving away from their own judgmental interpretations of the video. The nature of this apparent paradox, that the facilitator appears to support participants moving away from judgement through the use of judgement, is a phenomenon I have not found reported previously and yet it is a move that, in practice, I have become convinced about in terms of effectiveness. In some contexts, ‘do as I say but not as I do’ can put humans in a bind and, when it occurs in a context where it is not possible to question the instigator, can lead to a ‘double bind’ Bateson , p. 205 not that they are making an error in the sense of choosing the wrong alternative, rather they are making an error in the set of alternatives from which they are choosing. In other words, I am not questioning the interest or validity of what they say, but what I feedback to them is that they have made an error in terms of the kind of thing they are saying—they have made a choice from the wrong set of alternatives  but these can be sorted through re-watching; differences in accounts of can generate a strong motivation to re-watch .and work with teachers, drawing on their own awareness and interest in relation to a video. The facilitator can constrain discussion at a meta-level, i.e. imposing some rules on the kind of comment allowed, while leaving the actual content of discussion to be led by the mathematics teachers, in which the facilitator can take part as another participant. The facilitator is able to offer what might be seen as an ‘enabling constraint’ via imposing a discussion norm that can occasion a re-working of the experience of viewing a video recording. Although the data above is within a particular way of working with video, the moves identified are potentially relevant to any framework that aims to start off discussion in the detail of events, or that privileges evidential comments  in what ways does focusing on the detail of events occasion subsequent learning for teachers? Answering this question entailed a re-analysis of the data, this time following the contributions of particular teachers from the first to last meeting and considering when there was evidence of differences in response over time (characteristic of learning from an enactivist stance). One relevant piece of data came from the first meeting, when participants were asked (by me) to move on to the interpretation stage, in relation to the video we had watched.Alf: Any reflections on what the teacher was doing then or what the students were doing, or any teaching strategies?P: I thought she was very controlled and very restrained. I talk far too much in my maths lessons I think. She just let them get on with it.There is only space to consider in a suggestive manner the overall effectiveness of the video club and the question, kind of comment she had made at the outset, which was about children seeming like they were not paying attention. However, the content of her view (that the children were not paying attention) was never addressed or challenged directly. Her negative evaluation of the classroom on the video, which was perhaps validated by Teacher J  might have easily led to a sense that there was little to be learned from analysis of the observed practices. It appears as though the fact of focusing on the detail of the events has been sufficient to allow the space for new thinking to emerge.There is a difference in P’s comment here, compared to incident 1, when P initially reacted to the video with the statement: ‘I couldn’t stop watching, thinking of you [P looks at J] and your independent children and unfortunately all the children that weren’t paying attention’. P appears to have shifted in her view of the teacher on the video ‘she was very controlled and very restrained’. However, what is more significant is that, whereas the comment from P in incident 1 is, in keeping with Jaworski’s  insightsAt the very beginning I found it so difficult just to be objective and I have realised that this is a direct reflection of how I am in the classroom. I listen to children and sometimes I do not listen to the question for the question’s sake, I move it on, trying to keep that pace high. And so, I am constantly making interpretations to guide their learning, sometimes that works well but in other times I can make mistakes and so it’s important I ask for confirmation ‘what do you mean?’ so if my interpretation is correct, fabulous, but if not, I can re-think what I was going to do. (Meeting 6)In terms of evaluating overall effectiveness of the club from the teacher’s comments, it would be possible to focus on any of them, and I have chosen here three of the seven participants where the evidence of learning is perhaps clearest. Teacher T’s reflections on the video club (part of which were reported earlier), are suggestive of opening himself up to new ways of being in the classroom:It would be possible to interpret T’s comments here as being a reflection, in relation to his own teaching practice, that he has been choosing from the wrong set of actions in his classroom (with a focus on pace) and that he has realised he could focus more attention on what students actually mean. He links his learning to a specific strategy that he now uses in his classroom, which is asking students what they mean.I was saying, this process has helped me, when I come to observe now, because I have stopped now thinking about how I would do it and looked at actually what are the children doing, how are they achieving that and what is the teacher doing to get them to achieve that, instead of thinking, oh that’s nice, I’ll nick that, or I’d do it that way, I have switched it back (Meeting 6)Each teacher made comments that pointed towards potential re-workings of their own practice and these were frequently linked (as teacher T did) to the discipline of starting discussion in a non-judgmental manner. A second example of this is teacher P (who has some senior leadership responsibilities in school) who commented:although it’s still sometimes painful watching yourself, you do, instead of watching yourself trying to plug your whiteboard back in, you start thinking about ‘what are those children actually saying’ and actually I realised I made a judgement, or an interpretation about what [student C] was saying but actually I do not think he did mean that and I was too busy thinking, it’s five past three and did not clarify his thinking. (Meeting 6)Here, teacher P makes a link between the process of the video club and changes this has made in how she goes about her observations in school of other teachers. The third example of this connection comes from teacher J who commented, in reflecting on the club:Here, teacher J is reflecting on his own teaching and how, in re-watching a video of his own teaching, he caught himself making an interpretation and a judgement about what a student said, rather than making an attempt to hear what was actually said. It appears as though focusing on the detail of the video and being forced to speak evidentially (as is recommended in many ways of working with video) is linked, by these teachers, to their subsequent learning from the video club. And it is the very distinction between an observation and a judgement or interpretation that appears to have been significant. Although this is one example of a video club, the sense of the power of distinguishing observation from judgement fits my experience of using such a way of working with other groups, over a period of 20 years.about what a teacher has said, for example ‘that’s an interpretation’. Following the highlighting of the breach of the discussion norm, there is then a re-directing back to the task (e.g. ‘let’s stay with the detail of what took place’). The sequence of moves is therefore: (interrupt), highlight/meta-comment on a breach of the discussion norm, re-direct.This article set out to contribute to thinking about the role of the facilitator of discussion of video, in particular, how discussion can be kept focused on the detail of events and what a focus on detail might occasion. Through an analysis of the results of an ESRC funded project in the UK, to establish video clubs for teachers of mathematics, some facilitator moves were uncovered that are not within the van Es et al.  frameworkind are not the kinds of comments within the discussion norm of this phase of video work. The facilitator moves are at a meta-level to the teacher comments and indicate the teacher has chosen from the wrong set of alternatives, whereas a teacher’s negative evaluation of the video is indicating their belief that, in the video clip, there was a poor choice from a set of possible actions. There is, then, no paradox in offering an evaluative interpretation (about the kind of comment being made) with the intention of stopping the teachers from evaluative interpretation of the video recording itself.It may appear that the facilitator, in making the ‘highlight/meta-comment on a breach of the discussion norm, re-direct’ sequence of moves, is making an interpretation (and judging a teacher’s comment negatively), while at the same time trying to establish a rule of not interpreting. However, it is clear there is a significant difference in the facilitator move and a teacher’s interpretation of the video. If a teacher comments about the video, for example, ‘he was railroading the kids’, this is a negative judgement and evaluative interpretation of actions seen on the video. If a facilitator interrupts with ‘that’s an interpretation’, this is not denying there is validity in the teacher’s comment but pointing out that comments of that about the discussion or highlighting what another person has said. What the facilitator does is highlight what is not within the norm, while leaving it up to participants to work on what is within the norm; and, expressed in this way, it seems clear that the problems of mimicking raised by Gaudin and Chalies  offers kinds of discussion valued within a programme, and strategies for bringing discussion back to the intended ‘kind’ of focus when it strays. And a method for doing this, implied by the research, would be a discipline of showing short clips of facilitation and focusing on the detail of events initially before moving to interpret or label. One reflection here is that we have reached a point of self-similarity in the system of students, teachers, teacher leaders, educators of teacher leaders. In other words, if we accept the importance of starting work on video by staying with the details, then the kinds of methods that teacher leaders might use to facilitate the learning of teachers would be precisely those methods used to educate teacher leaders in facilitation, through using video.There are potential implications here for working with teachers new to facilitating professional development and achieving some kind of fidelity in scaling up professional development. A suggestion from this work would be the significance of working with new facilitators to develop awareness of the Although the evidence of this article comes from a single video club, a commonality across the reflections from participants points to the very distinction between an observation and a judgement or interpretation as having been significant in terms of them re-looking at their own practice (both in the classroom and in working with other teachers). There is some suggestion here of one of the reasons why a focus on the detail of events in a video might be important, in that it forces the enactment, on the part of teachers, of the distinction between observation/interpretation. It is an awareness of the fact that we ‘doctor what [we] watch’ (in the words of teacher N) that perhaps occasions the space to open oneself up to other possibilities for interpretation and hence a route to deeper reflection than staying with initial evaluations.Although the research reported here was from one particular method of using video with teachers, the suggestions around the potential power of teachers working with the distinction between observation and interpretation offer an extra strand of possibilities for other projects and programmes. In other words, across video clubs with different and specific foci, where there is a sense of wanting to work with teacher’s evidential comments on the video, this research suggests that establishing, actively and in discussion, the distinction between observation and interpretation may in itself provide an added benefit and avenue for teacher learning.


The key clinical message of this case is that it is critical to differentiate between arachnoid cysts and spinal cord herniation. This is performed by evaluating the ventral dura to assure that it remains intact. The key clinical message of this case is that it is critical to differentiate between arachnoid cysts and spinal cord herniation. This is performed by evaluating the ventral dura to assure that it remains intact. The key clinical message of this case is that it is critical to differentiate between arachnoid cysts Figure  and spinAll authors involved in preparation of the video concur that no work resembling the enclosed video has been published or is being submitted for publication elsewhere. We certify that we have each made a substantial contribution as to qualify for authorship as follows: OC and DP: performed the procedure. OC: provided video narration. GG: performed critical video editing and preparation for publication. Strict adherence to all university, state, and federal requirements regarding patient confidentiality and care has been upheld. The authors have no personal, financial, or institutional interest in any of the materials or devices described in the video. Click here for additional data file.


However, the mechanism—or mechanisms—responsible for the generation of [Mg2+]i oscillations, and whether these are functionally conserved across taxonomic groups, remain elusive. We employed the cellular clock model Ostreococcus tauri to provide a first study of an MgtE domain-containing protein in the green lineage. OtMgtE shares homology with the mammalian SLC41A1 magnesium/sodium antiporter, which has previously been implicated in maintaining clock period. Using genetic overexpression, we found that OtMgtE contributes to both timekeeping and daily changes in [Mg2+]i. However, pharmacological experiments and protein sequence analyses indicated that critical differences exist between OtMgtE and either the ancestral MgtE channel or the mammalian SLC41 antiporters. We concluded that even though MgtE domain-containing proteins are only distantly related, these proteins retain a shared role in contributing to cellular timekeeping and the regulation of [Mg2+]i.Circadian clocks in eukaryotes involve both transcriptional-translational feedback loops, post-translational regulation, and metabolic, non-transcriptional oscillations. We recently identified the involvement of circadian oscillations in the intracellular concentrations of magnesium ions ([Mg Circadian clocks allow for the physiological anticipation of daily environmental changes (such as temperature and light) resulting from the Earth’s 24-h rotation on itself. These rhythms exist in most eukaryotes (both unicellular and multicellular organisms) and some prokaryotes . The cirOstreococcus tauri [The study of circadian clocks has mainly focused on characterising transcriptional-translational feedback loops (TTFLs) . These rus tauri . Subsequus tauri .2+ ([Mg2+]i) were investigated in depth. [Mg2+]i is low around dawn, increasing during the day to peak around dusk, and then decreasing during the night. These oscillations meet the classic hallmarks of circadian rhythms; they persist in constant conditions, have a cycle of approximately 24 h, are temperature-compensated, and entrain to relevant zeitgebers [2+ was also found to be a zeitgeber that regulates daily global translational rates through the highly Mg-sensitive mTOR [2+]i rhythms are circadian and control the transcriptional oscillator makes them a bona fide mechanistic clock component. Therefore, their in-depth study is warranted to further our understanding of conserved metabolic clocks.A further example of conserved cellular circadian rhythms came with the discovery that, in species representative of three distinct taxonomic lineages , intracellular ion concentrations undergo daily oscillations ,13. Notaive mTOR . The fac2+]i oscillations, the mechanisms responsible for them are only starting to be elucidated. The first step to study these daily ionic rhythms is to investigate the plasma membrane proteins that are responsible for temporally regulating Mg2+ transport in and out of the cell. To our knowledge, only two studies of Mg2+ transporting proteins exist within the context of circadian rhythms. Firstly, small interfering (siRNA)-mediated knockdown of the SLC41A1 gene—a gene coding for a plasma membrane Na+/Mg2+ antiporter—was found to cause an increase in circadian period in human U2OS cells [2+]i fluxes through diurnal expression i regulation in the picoeukaryote Ostreococcus.The unicellular green alga tructure , a reductructure , and a gtructure . It has tructure ,19,20,21tructure ,22,23. TOstreococcus cultures were grown under 12 h/12 h light/dark cycles at 20 °C, under a blue light filter as previously described i observed in wild-type cells at ZT0 relative to ZT12. The differential diurnal regulation of intracellular magnesium observed in the wild-type or parent line was perturbed upon OtMgtE overexpression. We believe these results verify a role for the Ostreococcus homologue in transporting [Mg2+]i.In the three eukaryotic cell types originally studied , [Mg2+]ir ICP-MS A, or a lr ICP-MS B, we ass2+ transport over biomembranes, and has previously been used to investigate the role of [Mg2+]i in the cellular circadian clock. CHA treatment dose-dependently lengthened circadian period and increased [Mg2+]i in both Ostreococcus and human cells e) caused decreased [Mg2+]i and dose-dependently lengthened the circadian period in Ostreococcus cells [2+]e and the overexpression of OtMgtE. Ostreococcus cells are normally grown in artificial seawater at a concentration of 50 mM [Mg2+]e; we tested how the circadian period of both lines was affected when incubated at 20 (2.5 mM [Mg2+]e) or 400 (0.125 [Mg2+]e) times less extracellular Mg2+ (2+]e (0.125 mM) caused an increase in the circadian period in the parent line. Similarly, the effect on the OtMgtE-OX line was also a ~2-h period increase. This result suggests that the effect of OtMgtE on intracellular Mg2+ is not strong enough to counteract the extreme treatment of depleting [Mg2+]e 400-fold. Note that the absolute values of free-running period differ between experiments in Ostreoccoccus and might result from batch-to-batch variations in the relative ionic composition of growth media, or from differences in the ages of cultures between experiments.We previously showed that decreased extracellular Mgus cells . We testlar Mg2+ . As seen2+-transporting proteins based on a MgtE domain (Pfam10769) shared with bacterial MgtE proteins (Chondrus crispus), or brown seaweed , red algae (Cyanidioschyzon merolae), diatoms , and multicellular green algae (Ulva mutabilis)  A. A maxi species B. MgtE dOstreococcus tauri homologue does not transport magnesium via Na+ antiporter activity. Amiloride is a commonly used compound to inhibit Na+-dependent Mg2+ transport i, a clear possibility is that the effects on timekeeping are mediated directly through differential [Mg2+]i. To our knowledge, extraneous to circadian clocks, not only is this the first study of a protein containing a MgtE domain outside prokaryotes or animals, it is also the first of any putative Mg2+ transporter in Ostreococcus. We provide evidence that additional, unidentified proteins are involved in regulating circadian rhythms via [Mg2+]i, providing an avenue for future studies to increase our understanding of the cellular mechanisms underlying daily Mg2+ fluxes.All results together imply that


G-representation contains a rigid type. This is a generalization of the unitarity criterion of Barbasch and Moy for representations with Iwahori fixed vectors.We prove that for every Bushnell–Kutzko type that satisfies a certain rigidity assumption, the equivalence of categories between the corresponding Bernstein component and the category of modules for the Hecke algebra of the type induces a bijection between irreducible unitary representations in the two categories. Moreover, we show that every irreducible smooth  F denote a non-Archimedean local field with finite residue field. Let G be the F-points of a connected reductive algebraic group F. Fix a Haar measure G. Let G, i.e., G-representation and this induces an equivalence between the category G-representations and the category of nondegenerate Let K in G. Then e as its identity element. Let G-representations and let e is self-adjoint, i.e., G  with the Plancherel measure G-representations. Denote by S of Let l et al.  give an G-representations with unitary G-representations.) In complete generality, this is clearly false, as seen, for example, by taking V is any irreducible representation with a It is natural to ask if in fact  induces e, define e is special if G-subquotients. This is equivalent K-signaturoved in , 19. We ras from .K-signature character of a Hermitian G-representation and adapt Vogan’s signature theorem to our setting. The main result of the section is Theorem We give a brief outline of the paper. In Sect. K-character and signature K-character for an admissible G-representation K is a compact open subgroup, and explain an analogue of a formula of Vogan for the signature character [In this section, we recall the definition of the multiplicity entclass1pt{minimaharacter .p-adic group G. A star operation V such thatV is Hermitian if it has a nondegenerate We begin by recalling the idea of the Grothendieck group of modules with nondegenerate Hermitian forms from . As in tK is a compact open subgroup of G. Every smooth irreducible K-representation K-invariant form K-representations. If V is admissible, denote by V, and byV has an invariant Hermitian form, let V is admissible, let V is irreducible, V has a nondegenerate Suppose entclass1pt{minimaU is an U in V with respect to If R is any admissible module, define the hyperbolic form on If V is a smooth admissible U is an V and R is the radical of the form U, we haveK, we have a well defined signature homomorphismFun denotes the set of functions.[L ranges over the irreducible Hermitian The following result expresses the Hermitian form of an admissible module in terms of the Hermitian forms of its composition factors.As in , a betteentclass1pt{minimaV can be written uniquely in K, the K-signature character of V is[V is positive definite fi the coefficient of s in the signature is zero.In this notation, a nondegenerate Hermitian form F. Let F. We will denote by F-points of F-points of P, A) is defined by a standard parabolic F-split torus in the center of P, A), we regard G. Let i.Fix a minimal parabolic subgroup c. As in , §XI.1, G, denote by N-coinvariants). Let M, an open normal subgroup of M. Let R(G) the Grothendieck group of admissible G-representations. We may regard For a standard parabolic subgroup M-representation, and G-action given by right translations.If P, A) is a standard pair, p-adic case, and summarizes [A Langlands datum is a triple P.g on compacta, and it is an intertwining operator with respect to the G-actions.The integral operator Let G-representation. Then there exists a Langlands datum Let Suppose Let G-representations is well known. The p-adic case, see for example [From now on, we restrict to the case of Hermitian representations with respect to the natural star operation  example , §5, is A in G, such thatw in the normalizer Let M be a Levi subgroup of G with the subgroup M.We recall the definitions of the Bernstein center and the inertial equivalence class. Let M is a Levi subgroup and M. Define the relation of equivalence such pairs: G.Consider the set of pairs Define the weaker relation of inertial equivalence on the same pairs: As it is well known, if M of a standard parabolic subgroup P, let The Bernstein center G). From , one dec by \ies, see , §2.4.loc. cit. that for every e such that We call the inertial class mentclasspt{minimasults of , 3.6) saK be a compact open subgroup. The goal is to express the K-signature of an irreducible smooth G-representation in terms of that of tempered modules. A first step is the simpler result for K-multiplicity functions.Let G-representation in G-representations K,Let G-representations, all in Set Suppose Now let p-adic analogue.We summarize the necessary results about the Jantzen filtration and the signature character, see , §3, 2,,2, §14, X. Explicitly, let K, the restriction of K is independent of t.Let X such thatX;n at for all Define a Hermitian form The Hermitian forms [G-representations.K-signature.The radical of the form For small For small Equivalently,K-signature of With the notation as above, the Jantzen filtration Before we get to the signature theorem, we need a lemma which will insure that the inductive algorithm terminates  Let n∈W (see ) such thloc. cit., except that we need to explain in our setting the independence of K, the Bernstein component The proof is the same as in V in terms of the Langlands classification as V is:Write ,m.As in , 3.38, tY which have a nondegenerate Hermitian form, then it holds for Y itself. This is because of Proposition One remarks, as in [V as well, by  denotes the G-representations.Recall that G . The Hecke algebra K-biinvariant functions, where K ranges over a system of good compact open subgroups . For exy–Prasad  filtratiDefine P ranges over the set of parabolic subgroups, (cf. ) Let \doG is semisimple, this is the same notion as that of the rigid quotient from [In the case when ent from .G-representations.The space R(G) is spanned by the Langlands standard modules G. By the Langlands classification, The elliptic representation space is example .G-representations. LetLet  example , §2.2.p-adic groups proved in [The following result is essentially the abstract Selberg principle for roved in .(see [The map K ranges over the compact open subgroups of G and The space We will not need these finer results.More is known about d in the  thatThe (i)M-representation For every standard Levi subgroup (ii)K such that There exists a compact open subgroup Denote by R(G). The following is the classical trace Paley–Wiener theorem.As in , §1.2, a The mapU(G) denote the inverse limit algebraU(G) has the equivalent description as the convolution algebra of essentially compact distributions:U(G) by settingU(G). The Bernstein center U(G). This also gives an action of R(G) via infinitesimal characters (on each irreducible representation), see Sect. We need to look at the action of the Bernstein center. Let is known , see alsis known , the alg[For every idempotent element Here, we think of For every Bernstein component The map The first part is immediate from Theorem R(G) spanned by the irreducible objects in Now suppose that V not in If The restriction of the trace map The category mentclasspt{minimaLet rigid if the composition of the natural mapsWe say that a pair (not necessarily a type) In Sect. We are now in position to prove Theorem Firstly, we can sharpen Theorem G-representation with inertial support V admits a K, the K-signature of V is(The signature theorem II) Let Notice that, in this version, we cannot say that the scalars K-character of every irreducible tempered representation K) of In light of Theorem p-adic groups, we may decompose ).As in , §4.4, d[W is a unitary In particular, we have a natural bijection between the unitary modules for the two algebras. Finally, the correspondenceWe retain the notation from Sect. I be an Iwahori subgroup and Let If I. Since G-conjugacy classes of maximal compact open subgroups of G, the natural mapLet K-type of positive level is rigid.A Moy–Prasad unrefined minimal This is immediate from Proposition K-type of positive level is a Bushnell–Kutzko type. This proves Theorem G-representations which contain a Moy–Prasad type of positive level. By [G-representation contains a level zero type.By [loc. cit. for the necessary structural results from Bruhat–Tits theory, in particular, about parahoric subgroups. Fix an Iwahori subgroup I, and recall the Bruhat decompositionW is the Iwahori–Weyl group and G of w. Let I and W of elements of length zero. Let W generated by the reflections W(J) is a subgroup of W.We now look at the case of level zero types –34. We rA level zero type is a pair w of minimal length in w has finite order in W. Therefore the compact cocenter of w has finite order, the subgroup W is finite. By the Bruhat–Tits fixed point theorem [G and The main result of  is a desEvery level zero type Notice that now the proof of Theorem As shown in , §7.3, tputed in , §7.11. Here The algebra p-adic group G is equivalent with the classification of the unitary dual of the Hecke algebras in Theorem G is adjoint and In other words,  Lusztig  gives a When the cocycle lable by , 25.G. In this case, there exists a unique conjugacy class of maximal compact open subgroups. Let Suppose now that D is a F-algebra, GL) and [If  work of  (for GL( F)) and  (in gene


Clostridium difficile ribotypes have been associated with complex disease phenotypes including recurrence and increased severity, especially the well-described hypervirulent RT027. This study aimed to determine the pattern of ribotypes causing infection and the association, if any, with severity.Certain C. difficile testing between 2011 and 2013 were subject to routine testing and culture. All C. difficile isolates were ribotyped, and associated clinical and demographic patient data were retrieved and linked to ribotyping data.All faecal samples submitted to a large diagnostic laboratory for C. difficile. RT002 and RT015 were the most prevalent . Only five isolates (0.7%) were hypervirulent RT027. Ninety of 450 (20%) patients with clinical information available died within 30 days of C. difficile isolation. RT220, one of the 10 most common ribotypes, was associated with elevated median C-reactive protein and significantly increased 30-day all-cause mortality compared with RT002 and RT015, and with all other ribotypes found in the study.In total, 86 distinct ribotypes were identified from 705 isolates of C. difficile ribotypes were responsible for C. difficile infection presentations. Although C. difficile-associated mortality has reduced in recent years, expansion of lineages associated with increased severity could herald increases in future mortality. Enhanced surveillance for emerging lineages such as RT220 that are associated with more severe disease is required, with genomic approaches to dissect pathogenicity.A wide range of  Clostridium difficile infections (CDI) remain a significant cause of mortality and morbidity per seC. difficile isolates, and evaluate the impact of this surveillance on infection prevention strategy and management of outbreaks. As part of the study, linked, routinely collected clinical, demographic and microbiological data with ribotype results were analysed to determine if any particular ribotype was associated with an adverse outcome in patients.A two-year project was undertaken to implement routine ribotyping of all C. difficile testing. Between August 2011 and June 2013, all faecal samples from patients aged >2 years with diarrhoea that tested positive using routine tests for C. difficile were included in the study. Confirmation of a C. difficile episode required detection of glutamate dehydrogenase (GDH) and C. difficile toxin B gene by polymerase chain reaction (PCR)  in stool. Stool samples submitted for C. difficile testing that were received within 28 days of a previous positive result were not included in this study. Stool samples from confirmed C. difficile episodes obtained after April 2012 also underwent toxin enzyme immunoassay (EIA) testing  following a change in UK guidelines Stool samples from five major West London acute hospitals and associated primary care centres were submitted to a single diagnostic laboratory, that serves a population of approximately 2 million people, for C. difficile episode was cultured using the alcohol shock method, followed by culture on Brazier's C. difficile selective agar C. difficile isolates were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry  and stored as glycerol stocks at -80oC. Samples that failed to grow were recultured. If a sample failed to grow when recultured, or if there was inadequate sample to reculture, they were recorded as such and excluded from the final analysis. Confirmed C. difficile isolates were subsequently characterized using standard PCR ribotyping Each sample obtained from a C. difficile episodes were linked to routinely collected demographic, microbiological and clinical data, where available, via electronic databases prior to anonymization. Patient location at time of sampling, length of hospital admission, medical speciality , International Classification of Diseases (ICD)-10 coding, toxin EIA production, C-reactive protein (CRP) (mg/L), leukocyte count (x109/L), albumin (g/L), creatinine (μmol/L) and mortality data were collected. Patients with known renal disease were excluded from analyses where creatinine level was a variable. Biomarkers of severity, namely CRP, total leukocyte count, albumin and creatinine, measured within 48 h of C. difficile sampling (date of sample ± 24 h) were recorded. Mortality records were traced on 27th September 2016 and were de-duplicated.C. difficile were considered to represent a separate episode when identified more than 28 days apart. Recurrence was defined as any additional C. difficile episode in the same patient beyond 28 days. In those patients with a recurrence, a relapse of infection was defined as re-isolation of the same ribotype more than 28 days after the original C. difficile episode C. difficile that were submitted more than 72 h after admission to hospital were considered as hospital-onset. Samples submitted on admission to hospital or within 72 h of admission were considered as community-onset in line with national guidelines at that time Individual isolates of The primary outcome measure was 30-day all-cause mortality from date of detection of GDH and positive toxin B PCR result. Secondary outcome measures were mean length of hospital stay in days  and biomarkers associated with disease severity C. difficile ribotype. Covariables considered were age and sex. Preliminary data analysis revealed that RT220 was associated with increased mortality compared with the other most frequently  isolated ribotypes, warranting further analysis  test: RT220 was compared with the two most frequently isolated ribotypes in this study, RT002 and RT015, and with all other ribotypes isolated. In doing so, RT002/RT015 and the heterogeneous group of all other ribotypes (which included some rare ribotypes) acted as separate, large control groups. After ensuring the proportional hazard assumptions were met, a multi-variable Cox regression analysis was performed to assess associations between ribotype and all-cause mortality within 30 days. The model was adjusted for sex and age to account for potential sources of confounding.U-test were used to compare biomarkers between groups. Prevalence of ribotypes and proportions for categorical variables were compared using Chi-squared test. Additional variables, where available, compared between groups included toxin EIA, source of infection  and modified Elixhauser score (a method of categorizing comorbidities of patients based on ICD diagnostic codes) P-values were based on a two-tailed test with P<0.05 considered to indicate significance. Data were recorded in Excel  and analysed using GraphPad Prism Version 7.0 .One-way analysis of variance was used to compare the mean length of hospital stay between the three groups, and Kruskall–Wallis test and Mann–Whitney The collection and analysis of bacterial isolates and linked anonymized clinical data from patients was approved by the West London NHS Research Ethics Committee (Ref. 06/Q0406/20). Methods were in accordance with the specified approved protocol and regulations.C. difficile episodes were identified in the study period, from which 705 C. difficile isolates were ribotyped (C. difficile ribotype was reported was 74 years (interquartile range 60–83 years).In total, 758 GDH and PCR toxin-B-positive Eighty-six different ribotypes were identified . The 10 C. difficile sampling. No difference was detected in the prevalence of specific ribotypes or toxin positivity between patients for whom mortality data were available and those for whom mortality data were unavailable.Mortality records were available, where NHS number was recorded, for 463 of 705 (65.6%) episodes with ribotypes, representing 450 individual patients. Of the 450 patients with mortality data available, 90 (20%) died within 30 days of P=0.049), and all other ribotypes (P=0.006) (P=0.096). Half of the C. difficile episodes with ribotypes had hospital-onset CDI; RT220 episodes were no different to episodes with other ribotypes  within the study population, survival analyses demonstrated a reduced 30-day survival for CDI episodes caused by RT220 (P=0.006) . There wP=0.006) . Where dibotypes . Multi-vibotypes .Figure 2P=0.95) (P=0.08). Biomarker results such as CRP, total leukocyte count, albumin and creatinine were available for 441 of 705 (62.6%), 446 of 705 (63.2%), 362 of 705 (51.3%) and 483 of 705 (68.5%) episodes, respectively (P=0.008) and a trend towards reduced albumin (P=0.07) compared with RT002/RT015 and all other ribotypes at the time of stool sampling, although differences in creatinine levels (P=0.36) and leukocyte count (P=0.22) were not apparent (Modified Elixhauser comorbidity scores were available for 57% of episodes with RT220 (13/23) and RT002/RT015 (91/159); there was no significant difference in comorbidity scores identified between episodes associated with RT220 or RT002/RT015 (P=0.95) . RT220 wapparent .P=0.001); and median albumin 22 g/L (toxin positive) vs 25 g/L . Toxin production was not associated with differences in leukocyte count or creatinine: median leukocyte count 11.5 vs 11.15 x109/L (P=0.28); and median creatinine 76 vs 66 μmol/L (P=0.3). Thirty-day mortality (where available) was 24% (31/129) in episodes associated with toxin-positive samples, compared with 17.1% (31/181) in episodes associated with toxin-negative samples (P=0.12).Toxin EIA detection across all ribotypes was associated with elevated CRP and reduced albumin compared with toxin-negative samples: median CRP 126 mg/L (toxin positive) vs 58.5 mg/L  (P<0.05). Thirteen ribotypes were responsible for relapse: RT005 ; RT078 ; RT002, RT015 and RT023 with two patients; and RT011, RT012, RT014, RT020, RT076, RT220, RT263 and RT293 with one patient each. RT220 was responsible for three C. difficile episodes in one patient. These three episodes occurred over a six-month period; in all, toxin was detected by EIA. Two of the three episodes occurred in the community; however, laboratory biomarkers were only taken during hospital admission. This patient survived.Thirty-seven (5.2%) patients had a recurrent Two hospital wards accounted for two RT220 cases each; in one ward, there was a gap of 18 days between cases, and in the other ward, the gap between cases was >365 days.C. difficile RT220 as a ribotype associated with increased 30-day mortality and enhanced acute phase response compared with other dominant ribotypes. Importantly, the previously identified severity-associated RT027 was not prevalent; in this study, the most frequently identified ribotypes were RT002 and RT015.To the authors' knowledge, this is the first large-scale study to report C. difficile episodes in the two-year study period. Furthermore, as the laboratory serves a population of over 2 million people under the care of primary and secondary care providers across a wide area of West London, the data represent an inclusive and substantial urban sample.A strength of this study is the inclusion of all clinically diagnosed The possibility that the association of severity with RT220 might be the result of confounding factors (e.g. increased age) was considered; however, this was not detected. Comorbidity data were not available for many of the patients, but modified Elixhauser scores did not differ significantly between the groups. Review of primary ICD-10 diagnoses among RT220 patients did not reveal an alternative explanation for the high mortality rate, such as specific malignancy. The possibility that RT220 isolates could be associated with an outbreak was considered; however, RT220 isolates were identified over the entire study period, and from multiple locations and specialities, including some samples submitted from the community. Genome sequencing of the RT220 isolates did not demonstrate relatedness between isolates, confirming that these isolates were not from an outbreak, however analysis is still in progress. RT220 demonstrated a trend towards detectable toxin EIA production, consistent with other ribotypes reported to be linked to severe disease The dominance of RT002 and RT015 in clinical disease was striking, although this is not fully understood. The predominance of RT002 has been reported elsewhere in the UK, Europe and Asia C. difficile in the adult population. In support of previously published work The total recurrence rate in this study (relapse or re-infection) was just 37 of 705 (5.2%), which is lower than a previously reported rate of 20% P=0.208).Biomarkers such as CRP and leukocyte count have also been closely associated with toxin production and adverse outcome C. difficile ribotype and disease recurrence or severity have been sought by several investigators with variable findings C. difficile multi-locus sequence type (ST) 2 lineage that also includes RT020, RT014 and RT076 tcdA) and toxin B (tcdB), but not the binary toxin CDT locus.Associations between C. difficile management, the data are consistent with nationally reported mortality over that period Overall mortality at 30 days was 19% in this study, with mortality rates of 17.1% among toxin-negative cases and 23% among toxin-positive cases. Although these data are from 2011–2013, prior to enhanced national guidance regarding C. difficile were not examined in this study, although antimicrobial resistance has been implicated in the previous emergence of RT027 C. difficile cases during the study period.This study was limited by the number of samples that were acquired during the study period, and the fact that mortality data were only available for those samples with complete case identification data. Comorbidity and biomarker data were only available for those admitted to the university hospital. Despite the small sample of patients with RT220, a power of approximately 60% was used to explore a difference in mortality between RT220 and all other ribotypes. The authors were unable to examine individual case notes, so data on treatment given during the episode and prior antibiotic or healthcare exposures were not collected, and the authors were unable to confirm specific causes of mortality among the patient cohort. Comorbidities of those with infections caused by RT002, RT015 and RT220 were examined, where available; modified Elixhauser scores did not reveal any significant differences between the groups that could explain the high mortality rates. The recurrence of RT220 in one female patient may account for the predominance of RT220 episodes in females observed in this study. This recurrence did not lead to death, and biomarkers were only taken on one occasion so did not skew mortality or biomarker parameters. Antimicrobial susceptibilities of C. difficile cases in the study region, although it is not known if there is an ongoing association with severity. Whether genomic elements in RT220 confer enhanced pathogenicity or toxicity is unclear, and this is the subject of ongoing research. The identification of RT220 as a ribotype associated with more severe disease and its persistence as one of the more common ribotypes isolated in the study region indicates that ongoing prospective surveillance remains essential.RT220 is among the leading 10 ribotypes causing infections in the study region and has persisted as a cause of symptomatic disease despite improvements in infection control practices and stewardship. Indeed, in 2018, RT220 accounted for 3.3% (9/268) of


The study further showed that significantly greater proportion of the study participants in the far from the communities perceived that their water had colour (65%) and they did not drink water from any other source (63%) apart from their stream. The study demonstrated that generally, inhabitants within the study communities perceived the construction of the Bui Power Project has negatively affected their drinking water quality.Large dams play an important role in promoting economic and social development in many countries. However, the construction of such dams can have a detrimental effect on the environment. The aim of this study was to investigate perceptions of drinking water quality among inhabitants of selected communities within the Bui Dam environs. With the help of questionnaires, 100 respondents from communities “near to the dam” were randomly selected and interviewed. Their responses were compared with another 100 respondents selected from “far from the dam” communities. These were augmented with in-depth interviews, focus group discussion, and personal observation. Analysis of the results showed that, there were greater proportions (31%) of the participants who lived in “near communities” within the age category 20–25 compared to 19% of their “far communities” counterparts. There were significantly greater proportions of female respondents in the “near to the dam” (57%) compared to respondents in the “far from the dam” communities (52%). The study further showed that the perception of risk of consuming contaminated drinking water was more common among “far from the dam” communities (odds ratio = 4.57). The perception of the quality of water based on some physical properties was investigated as part of our study. Analysis of the results showed that significantly greater proportion of the “far from the dam” communities (35%) perceived their water had an objectionable smell compared to 7% of inhabitants of their other counterparts ( Development of rivers for large dams have emerged as one of the most significant and visible tools for the management of water resources . Large dFor some time now, flooding of dam has created a plethora of disturbances in the ecosystem, varying from enormous ecological and productivity related changes . This maSince 1965, the government of Ghana started the construction of Akosombo Dam, forming Lake Volta, the largest water storage reservoir in Africa and even the world . This daThe study was carried out within some selected communities upstream and downstream of the Bui Dam environ in the Bole district (northern region) and the Banda-Ahenkro district (Brong-Ahafo Region) in north-western Ghana, approximately 150 km upstream of Lake Volta. The study area lies between latitudes 8˚09′-8°.16′ North and 2˚01′-2°. 15′ longitude West. The vegetation in the Bui area consists of about 60% savannah woodland, 10% riparian forest, and 30% grassland. There are about 45 communities surrounding the Bui Hydropower project with an estimated population of about 29,287. The most dominant occupation of the inhabitants is fishing [Communities for the study were systematically selected based on their farness or closeness to the dam. These included Agblekame South, Bongase Nsuo-Ano (Banda-Ahenkro), and Agblekame North, Gyama Nsuo-Ano (Bole Bamboi), as shown in The study adopted a longitudinal study approach with responses from respondents domiciled in close communities compared with those of their far community counterparts. On the basis of this, Agblekame South and Agblekame North were designated to be the “far communities” while Gyama Nsuo-Ano and Bongase Nsuo-Ano were designated as “near communities.”The study used a combination of desk studies, checklists, and interviews to collect primary data. With the help of house to house visits, respondents were randomly selected and interviewed. Structured questionnaires designed for respondents included both open and closed-ended. A total of 200 questionnaires were administered to respondents from the 4 communities with an approximate population size of 2,400 inhabitants during the entire study. Hundred (100) questionnaires were administered randomly to interview respondents selected from the near communities whose responses were compared with another 100 selected from their far communities counterpart. The questions asked were based on sociodemographics, household water usage patterns, and households' hygienic behaviour as perceived by respondents . These were augmented with in-depth interviews, focus group discussions (FGDs), and personal observation. The use of multiple complimentary methods made it possible to triangulate and eliminate bias that could occur if only one method was employed . The study was conducted between January and June 2015. Respondents were interviewed in Twi , and these were later transcribed into English language.p value ≤ 0.05 considered significant. Using Linear regression odds ratio (OR), the “perceptions” in terms of the measure of association between a possible exposure and a perceived risk were estimated.Data from answered questionnaires were manually entered in Microsoft Excel (2013). With the help of GraphPad Prism 5 software, categorical variables were analysed using chi-square at 95% confidence interval with p value = 0.0006) as shown in In this study, the social demography of respondents was assessed based on ones' location with respect to the Bui Dam. Analysis of the results showed that there were greater proportions (31%) of the participants who lived in “near communities” that fell within the age category 20–25 compared to 19% of their “far communities” counterparts . A greatp=0.012) with an odds ratio of 3.8 (p=0.022) as shown in Analysis of the level of education of respondents based on whether a respondents was living near or far from the Bui dam was assessed. Results of the analysis showed that, fewer proportions of respondents in the Banda-Ahenkro (far from the dam) (25%) had some form of basic education (primary education) compared to their Bole district counterpart (near to the dam) (47%) and this was significant (o of 3.8 . The stuo of 3.8  (p=0.022The study further showed that the perception of risk of consuming contaminated drinking water was more common among “far from the dam” communities due to their location from the dam (odds ratio = 4.57) compared to those of the “close to the dam” communities .p value = 0.0008). With respect to the reason for their choice of drinking water sources, 39% of “far from the dam” inhabitants' perceived proximity as the deciding factor compared to only 23% of inhabitants from the “near to the dam” communities  and Bole district in the Brong Ahafo (near to the dam) and Northern regions, respectively. To achieve this, the study investigated the source of water for drinking and for domestic purposes of respondents from both near and far communities. Analysis of the responses showed that a greater proportion (87%) of the “far from the dam” communities relied on water from streams in their communities compared to of their “near to the dam” counterparts (67%) as shown in munities .When respondents in the study were asked whether or not their source of drinking water was treated, the results showed that respondents from the “far from the dam” communities were perceived to be about 5 times at risk (Odds ratio 4.8) due to failure to treat drinking water . The quep value = 0.001). The study further showed that significantly greater proportion of the study participants in the far from the communities perceived their water had colour (65%) and they did not drink water from any other source (63%) apart from their stream  perceived that their water had an objectionable smell compared to 7% of inhabitants, their other counterparts (r stream .p=0.004). Majority of the “far from the dam” communities (97%) also perceived that the siting of the dam had a negative effect on their health compared to those living in the “near to the dam” (86%)  had daily contact with their stream compared with just 5% of the individuals from the “near to the dam,” and this was significant (m” (86%)  below. Tm” (86%) . Our invm” (86%) .p=0.022; OR = 0.52). Analysis of the responses on “how many times one visited the bathroom' showed that there were no significant differences in this particular behaviour based on ones' location  as seen in p=0.0004; OR = 4.94).Although inhabitants from both locations engaged in habitual hand washing at least 2 times a day, greater proportion of “near to the dam” dwellers (93%) washed their hands before eating with bare hands compared to their “far from the dam” counterparts (65%), and this was significant with .The study also analysed the feacal discharge management practices of the participants. It was evident from the results that majority “near to the dam” respondents (66%) defecated openly compared to only 27% of their counterpart as shown in Our study showed a high number of females in the “near to the dam” communities than “far from the dam” counterparts, although there was no significant difference in their perception of the quality of drinking water. The high number of females in “near to the dam” could be due to the emergence of new female-friendly business opportunities in the area. Some studies have found that women tend to perceive a higher risk than men, particularly in cases of technological health and safety implications of risks , 12. HowIn this study, respondents from “near to the dam” communities who had formal education had a higher degree of knowledge of understanding on the potential impact of dams on their drinking water. They were also well abreast with activities in their environment that could result in damaging their drinking water quality. It is generally known that people who are more educated tend to be more water quality conscious. The findings of this study are however different from those of a study conducted by Larson and Edsall, where the level of education did not commensurate with knowledge of water quality concerns . HoweverThe present study also showed that the main occupational activity of both “near to the dam” and “far from the dam” communities was fishing. Some perception studies, especially those focusing on the difference in views among rural and urban residents about particular environmental aspects, take into consideration the role of place-dominant activities. For example, Salka found that as the percentage of workers in the natural resource industry increased, environmental initiatives faced more opposition . SimilarOur study further showed that the “far from the dam” communities relied heavily on streams as sources of drinking water as opposed to their “near to the dam” communities who had other sources such as sachet and bottled water. This phenomenon could be because the “near to the dam” communities were generally more enlightened than their “far from the dam” counterpart, thus increasing their access to better drinking water. The sustainable development goal 6 seeks to ensure universal access to safe and affordable drinking water for all by 2030 , though This study again showed that majority of “far from the dam” respondents did not treat their drinking water compared to their upstream counterpart. Without safe public water supplies, households' health and well-being are at risk. Domestic water treatment has been shown to be one of the most effective means of reducing the risks and costs associated with preventing water-borne diseases, especially diarrhea . HoweverThis result confirmed the important role perceived risk plays in changing health behaviour, as found in earlier studies that provided risk information , 29. TheOur findings on respondent perception of the quality of water with respect to the construction of the Bui dam based on some physical properties showed that significantly greater proportion of the “far from the dam” communities perceived their drinking water had an objectionable smell compared to “near to the dam” communities counterpart. Inhabitants perceived that the creation of the Bui Dam had caused great loss to vegetation and caused aquatic and terrestrial organisms to be submerged. However, the deterioration of the water quality in the downstream of the Bui subbasin could be attributed to the decay of dead animals and plants in the water from the time the research was being carried out. The physicochemical parameters of some dams and reservoirs have been studied in pre- and postimpoundment conditions . HoweverBilhazia disease) schistosomiasis  [The perceived high prevalence of water-related diseases in younger children and older females could be due to their regular visit to their source of water, fetching with buckets for drinking and/or other domestic purposes (older women) or to swim for younger children. In the Black Volta basin of Bui Dam, inhabitants perceived that impoundment of Bui River created the opportunity for growth of aquatic weeds in some areas and also the influx of immigrants  . The ecostosoma) . Similarstosoma) .Onchocerca volvulus. The burden of the disease has been reduced by prevention efforts, including control of the fly vector and periodic ivermectin therapy in at-risk individuals.From our study, “far from the dam” dwellers reported relatively low biting frequency of the black fly insects after the construction of the Bui Dam. This is positive because Black Volta basin of the Bui Dam is known to be heavily infested with black fly insects. The reportedly reduced abundance of the black fly population could be attributed to the Bui river impoundment in the Bui subbasin of the Black Volta. These black flies breed along fast-flowing rivers and streams, close to remote villages located near fertile land where people rely on agriculture . The blaPlasmodium type [This study also proved that “far from the dam” inhabitants' perceived they were 4 times more at risk of getting sick with malaria than their “close to the dam” counterparts. This could be attributed to the fact that the people living in the “near to the dam” communities resided closer to the Bui Dam where there was a high possibility that inhabitants could have contact with mosquitoes. Malaria is a mosquito-borne infectious disease affecting humans and other animals caused by parasitic protozoans (a group of single-celled microorganisms) belonging to the ium type , 38.Further, our study also showed that the practice of environmental hygiene was better in “far from the dam” communities as against their “near to the dam counterpart” counterparts. Though “near to the dam counterpart” inhabitants had containers they could dispose their solid waste into, they often disregarded this activity by disposing their solid waste directly in their environs with key examples being fishmongers. The worst offenders of these were fishermen who lived closer to the river banks and depended on this source of water for their livelihood. Hygiene has been found to be a primary preventive measure against diarrhea . Even thThis study sought to investigate the perceptions of the participants about the impacts of the construction of the Bui Dam on their communities. The study demonstrated that generally, inhabitants “near to the dam” communities perceived the construction of the Bui Power Project has negatively affected their drinking water quality as well as their health. The perception of the negative impacts of the dam increased with proximity to the dam site. However, since perceptions of risks do not translate into empirical evidence on the actual impact of the dam, it is important to urgently carry out studies needed to ascertain whether these perceptions are the reality so that remediating measures could be put in place.


Harms from intimate partners' (IP) drinking range from frustration because the partner has not performed their role to assault.To describe the prevalence and persistence of alcohol‐related harms to IPs and assess which respondents are more likely to report discontinuation of this harm.n = 2649) and follow‐up (n = 1106) alcohol's harm to others telephone surveys in 2008 and 2011  were used to elicit harms to respondents from their IP's drinking (by gender and relationship). To examine discontinuation, a sub‐sample of 83 respondents was analysed in detail.Cross‐sectional  reported no harm from IPs although 3% reported harm in both surveys. No significant correlates of discontinuation of harm were identified.Drug Alcohol Rev 2017;36:72–79]Many Australian relationships are affected in a range of ways because of the drinking of their IPs. A minority of respondents were affected by their IP's drinking, yet over half (57%) of those harmed in 2008 continued to experience harm in 2011. Additionally, half (46.9%) of those who were not harmed in 2008 but did live with a heavy drinking IP did go on to be harmed in 2011. More research on the role of alcohol‐related harm from IPs with larger samples is required to examine predictors of change. [Laslett A‐M, Jiang H, Room R. Alcohol's involvement in an array of harms to intimate partners.  The effects of heavy drinking upon intimate partners (IP)—including partners, ex‐partners or boyfriends/girlfriends—extend to poor performance of one's role, ignoring partners' needs, disregard for their feelings, serious arguments, verbal abuse, and physical and sexual harm. Heavy drinking also causes health, financial and relationship problems for the drinker that extend to create substantial negative ripple effects for their IPs This study aims to measure the baseline prevalence in Australia of alcohol‐related harms to IPs, including violence, and further describe the experience of respondents affected by a partner's drinking, at a later time point.Alcohol is involved in a substantial proportion of cases of harm to IPs both in and outside the household across many countries Research on IP violence in Australia has identified many of the difficulties female spouses living with heavy drinkers experience, including being verbally berated, intimidated, physically hurt, financially disadvantaged and isolated et al.The role of alcohol in IP violence is still contested What is the baseline prevalence of alcohol‐related harms to IPs, including violence?Does this prevalence vary by gender and type of intimate relationship?What percentage of respondents continued to experience harm from an IP's drinking in a follow‐up survey?Among those negatively affected by a partner's drinking at baseline, which groups of respondents were more likely to no longer experience this harm in 2011?Less is known about other common relationship problems linked to alcohol that affect female and male IPs in the general population n = 2304), and 1106 respondents were finally interviewed.Cross‐sectional and follow‐up alcohol's harm to others surveys undertaken in 2008 and 2011 were used to track harms from others' drinking. In 2008, 2649 Australians aged 18 years or older were telephone interviewed. The sample was based on a national random sample generally representative of the national population of Australians aged 18 years or older Thus, the response rate for the follow‐up survey was 42% . The study received ethics approval from Eastern Health Research and Ethics Committee in 2008 and 2011.In both surveys, IPs were defined as including spouses, partners, ex‐partners and boyfriends/girlfriends. The primary harm outcome variable used in Table Demographic information on the respondent, such as age, gender, neighbourhood affluence and employment status, was also collected. Neighbourhood affluence was measured using the Socio‐Economic Index for Areas for Disadvantage stata version 14. stata's tests of proportion were used to test differences between two groups, that is, whether gender (of the respondent) was associated with having been negatively affected by an IP, and whether the group who experienced harm in both years was different from the group that experienced harm in 2008 and then again in 2011 (or not in 2011). Bivariate logistic regression analyses were also used to examine correlates of continuation (and discontinuation).Our 2008 Survey estimates use sampling weights and post‐stratification weighting. However, in the follow‐up analyses of 2008 and 2011 survey data, unweighted data were used to predict whether harm to the respondent from an IP's drinking was present in 2011. Given the response rate of the 2011 survey, it was deemed inappropriate to apply sampling weights to these data. Table A total of 14% of the 2008 survey sample reported having a partner, ex‐partner or boyfriend/girlfriend who drank heavily  in the last 12 months ;Not harmed by an IP in either year ;Harmed in 2011 but not in 2008 —discontinued harm;Harmed in 2008 but not in 2011 —continued harm.Harmed in both years  and those who are continuing to be harmed—to see if there is anything in their experience in 2008 that could predict their experience of harm in 2011.n = 197), what proportion went on to be harmed in 2011?’. However, this was a small group, and only 64 completed the survey in 2011, with 30 of these reporting being harmed in 2011. In other words, almost half (46.9%) of those who were not harmed in 2008 but lived with a heavy drinker did go on to be harmed in 2011. This group was not analysed further because of small numbers.As can be gathered from this, the majority of the sub‐sample (56.6%) harmed in 2008 reported that they were harmed by an IP in 2008 and again in 2011. The data also enabled us to answer the question, ‘Of those living with heavy drinking IPs who were not harmed in 2008  of the population. There are several possible ways of interpreting why things have not changed for this group. Presumably, neither the respondent nor the partner left the relationship in the interim, although it is possible that a few respondents may have left one relationship and taken on a new partner whose drinking is also harmful for them. Any efforts from either side of the relationship to make changes so that the harm ceases seem to have been unsuccessful.Women reported negative effects from their IP's drinking more often than men at baseline. However, women were not  significantly more likely than men to report continuation of harm in the 2011 assessment period. Younger respondents were also no more likely than older participants to report continuation of being negatively affected by the harmful drinking of an IP. There was also no significant evidence that the respondent drinking five or more drinks at least monthly was associated with more or less reported harm from an IP's drinking despite the fact that concordant drinking between IPs has been previously shown to be linked to greater relationship satisfaction A range of harms were commonly reported by those adversely affected by the drinking of IPs in 2008, but our study did not find statistically significant differences in reported discontinuation of harm by presence of particular types or numbers of types of problems. Thus, these findings are not very helpful in identifying whether some groups of respondents are more or less likely to reduce, tolerate, leave or ‘escape’ these harmful situations caused by their IPs. With larger sample sizes, studies of this type may be able to illuminate predictors of these changes. Using smaller samples, in depth qualitative studies would detail how IPs effectively manage or reduce the harms they experience, including whether they have done so by removing themselves from the situation or by asking their IPs to leave. Qualitative studies would also provide information on the types of services that respondents think may assist them either to stay and enable them to protect themselves and other family members or, alternatively, help them to separate or minimise contact with people who are harming themselves and their families.For a small number of the items that were less specific , variability and subjectivity in individual responses—based upon alcohol expectancy, personal beliefs about alcohol use, self‐use, etc.—may have been introduced, assessing emotional states rather than the effects of alcohol in particular situations. However, the survey was designed to gain insight into the respondent's attribution of the event to alcohol. Alternative framings of the question, such as ‘did this occur while you were drinking’ are likely to give rise to higher counts of incidents that occurred while the respondent was drinking but not because of the drinking. For instance, in the Personal Safety Survey conducted in Australia in 2006, a smaller percentage of cases described attribution to alcohol than were described as occurring when the person held responsible was intoxicated n = 83) was small but was used to explore an important outcome.While the data used in this study provide a unique perspective on the harms that people experience that are attributable to the drinking of others, the complex nature of social and familial networks dictates that there are limitations to what we can surmise from survey data. More detailed information about the respondent's relationship/s with intimate partners (e.g. when they started and finished and why) would enhance future surveys. In the case of this study, we know that our sample of interest experienced harm from an IP in 2008 that was attributed by the respondent to their partner's drinking and that some of these people reported the same thing in 2011. We do not know if this was because of the same IP, nor can we assume that the respondent left the drinker or anything else about their circumstances, instead we can just report on what it is we know; the correlates of this harm. There is also the possibility that the harms had escalated to the point that the respondent no longer felt safe enough to disclose the abuse. This scenario may have contributed to loss of sample, as suggested by Manton and Maclean These findings underline the prevalence and nature of harms that occur in IP relationships, particularly to women, when the IP drinks heavily. These findings inform policy‐makers and advocates that almost half of the population group who experience harms from their IPs' drinking, continue to experience such harms over time. These harms include emotional harms, serious arguments, physical harm and inadequate role performance. No correlates predicted the discontinuation of harm but larger quantitative and additional qualitative studies are required to inform governments and non‐government agencies about who to focus on and how to act to reduce the harms experienced because of the heavy drinking of IPs.