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Neural tube defects are disabling birth defects developing during the very early stages of conception. Children born with spina bifida face significant physical, psychological and social consequences. They may have bowel and urinary dysfunction, and no lower limb muscle control, resulting in lifelong wheelchair use. There is robust evidence that periconceptual folic acid supplementation prevents neural tube defects, when compared with no intervention. However, approximately 40% pregnancies in Europe are unplanned, and women may therefore not be taking prophylactic folic acid at the time of conception. There is evidence that low dose folic acid consumption via flour fortification provides further benefits in prevention of neural tube defects.

Admission to an Intensive Care Unit (ICU) in obstetrics is often used as a proxy for maternal near miss/severe maternal morbidity (MNM/SMM) events. Understanding incidence and management of pregnant or postpartum patients requiring critical care (CC) is thus important for continued improvement of maternity care. This study aims to describe provision of critical care in obstetrics in the Republic of Ireland.The national clinical audit on critical care included 15 of 19 maternity units in Ireland (2014-2016). 960 pregnant or postpartum (within 42 days) individuals who required CC were included. Data were reported on all cases requiring level 2 or level 3 CC. We calculated basic descriptive statistics for diagnosis and process of care variables, and compared characteristics of women requiring level 2 care to those requiring level 3. Outcomes included diagnoses necessitating critical care; additional complications; level of care required; care process outcomes such as length of stay, consultation with non-obstetric specialties, location of maternal critical care, and neonatal care provision.Overall, the rate of critical care in obstetrics for these hospitals was 1 in 131 live births; 900 of the 960 cases required level 2 care only. Hypertensive disorders contributed to the need for critical care for 1 in 242; hemorrhage, 1 in 422; and infections, 1 in 926. A substantial minority (15.7%) had more than one diagnosis, accounting for 40% of level 3 care. Serious complications were rare (eg, hysterectomy, 1 in 3846). Parity, hospital size, and identification as high-risk antenatally (50% cases) were associated with requiring level 3 care. Critical care was provided in multiple locations, including ICUs, HDUs, and operating theatres. Only 23.8% of patients received CC in an ICU, suggesting ICU admission is not an ideal method for identifying severe maternal morbidity.We reported rates of critical care admission and primary diagnoses within the range of other published estimates, but huge variability exists in the literature, and within our data. ICU admission in and of itself iss not a reliable proxy for having received level 2 or 3 obstetric critical care in Ireland.

Transformative teacher education can support educational experiences which provide the opportunity for pupils to develop the knowledge, skills and attitudes to contribute towards tackling the signi...

To investigate whether HE4 and CA125 could identify endometrioid adenocarcinoma patients who might most benefit from full staging surgery with lymphadenectomy.Sequential patients with a preoperative banked serum and histology of endometrioid adenocarcinoma of endometrium who had undergone surgical staging with lymph node dissection over a 5-year period between 2011 and 2016 were included from a tertiary Gynaecological Cancer Centre, Dublin, Ireland. Preoperative serum HE4 and CA125 were measured using ELISA, with the cut-offs HE4 81 pmol/L and CA125 35 U/ml. Predictive values were estimated using AUC, sensitivity, specificity and odds ratios.9.5% of the cohort had lymph node metastases. A HE4 cut-off of 81 pmol/L yielded a sensitivity of 78.6% and specificity of 53.4% for predicting lymph node metastases. Sensitivity of CA125 at 35 U/ml was 57% and specificity 91.4%. The AUC was 0.66 (0.52-0.80) for HE4 and 0.74 (0.58-0.91) for CA125. Sensitivity was 92.8% and specificity 51.1% when an elevation of either HE4 or CA125 was included, AUC was 0.72 (0.61-0.83), this combination yielded the highest NPV of 98.6%. Sensitivity was 42.9% and specificity 93.8% if both markers were elevated simultaneously, AUC was 0.68 (0.51-0.86). Preoperative clinical predictors of high-grade preoperative histology and radiology had sensitivities of 21.4% and 41.7%, respectively. Patients with a HE4 above 81 pmol/L had an odds ratio of 4.2 (1.12-15.74), p 0.05, of lymph node metastases and CA125 had an odds ratio of 14.2 (4.16-48.31), p 0.001.Serum HE4 and CA125 improved on existing methods for risk stratification of endometrioid carcinomas and warrant further investigation.

Educational policies increasingly emphasise early childhood science engagement. As key influencers in children’s early learning, parents (n=85) attending a science workshop in three urban schools in Ireland were surveyed regarding their attitudes towards science. Seventy per cent of parents believed that science education should begin in the pre-school years, before the age of four. Despite high levels of education, at least half of the parents expressed some lack of confidence in talking about, and in doing science with, their young children. Parents who reported less confidence in doing science activities with their children also reported reduced frequency of activities for five out of the seven science learning opportunities listed. Mothers, compared to fathers, reported less confidence in doing science activities with their children. Findings indicate that parents’ confidence in science may impact early science experiences and highlight parents as a key support for increasing early science engagement.

Context.— A severe third wave of COVID-19 disease affected Ireland in the first 3 months of 2021. In this wave, 1 second-trimester miscarriage and 6 stillbirths were observed in the Irish population because of placental insufficiency as a result of SARS-CoV-2 placentitis. This observation was at odds with the country's previous experience with COVID-19 disease in pregnant mothers. Objective.— To describe the clinical and pathologic features of these pregnancy losses. Design.— Retrospective review of clinical and pathologic data of cases of second-trimester miscarriage, stillbirth, or neonatal death identified by perinatal pathologists as being due to SARS-CoV-2 placentitis during the third wave of COVID-19 in Ireland. Results.— Clinical and pathologic data were available for review in 6 pregnancies. Sequencing or genotyping of the virus identified SARS-CoV-2 alpha (B.1.1.7) in all cases. Three of the 6 cases had maternal thrombocytopenia, and fetal growth restriction was not prominent, suggesting a rapidly progressive placental disease. Conclusions.— The identification of SARS-CoV-2 alpha in all these cases suggests that the emergence of the variant was associated with an increased risk of fetal death due to SARS-CoV-2 placentitis when compared with the original virus. Maternal thrombocytopenia may have potential as a clinical marker of placentitis, but other inflammatory markers need investigation. Three of the 6 women had been assessed for reduced fetal movements in hospital some days before the fetal deaths actually occurred; this could suggest that there may be a window for intervention in some cases.

Background Considering the shared aetiology of Human Papillomavirus infections in oropharyngeal and cervical cancers and the possible role for sexual transmission, several key aspects of the relationship between cervical and oral infections merit investigation, including prevalence of concomitant oral HPV infection and type-specific concordance with concurrent cervical infections. Methods A cross-section study was performed on women referred to colposcopy clinics with cytological abnormalities and a cervical HPV infection. An oral rinse sample was taken from the participants at their baseline visit for HPV testing, and a demographic and risk factor questionnaire was also administered. HPV DNA testing was carried out on the Cobas 4800 platform and extended genotyping was carried out with the INNO-LiPA HPV Genotyping Extra II assay. HPV genotyping was also carried out on the concurrent cervical tissue samples on all women who had a positive oral HPV infection. Results The prevalence of oral HPV infections was 10.0% (95%CI:5.9-13.7) in the study population. HPV18 was the most frequent genotype (7.0%). Concordant oral and cervical HPV infections were detected in 28.6% of women. Age (P = 0.005) and level of education (P = 0.02) were are significantly associated with a prevalent oral HPV infection. Conclusion Concomitant oral HPV infections were present in 10.0% of women referred to colposcopy with a pre-existing cervical HPV infections and cytological abnormalities. Although mild type-specific concordance was observed between oral and cervical HPV infections, findings suggest that infections at these sites may not be independent of each other.

Research suggests that innovative and engaging professional development is instrumental in supporting teachers in developing their competence and confidence in teaching sustainability. An international initiative was developed to explore whether a competencies-oriented Education for Sustainable Development (ESD) professional development model was transferable across three different international contexts (Ireland, Germany and Mexico). This paper reports on the adaptation of this model within the Irish context, through the development of an innovative professional development programme for primary teachers. Through a mixed-methods approach which gathered data via pre- and post-programme surveys, teachers’ reflective journals and post-programme group interviews, the paper explores Irish primary school teachers’ experiences of, and attitudes towards, teaching sustainability through science education after participation in a professional development programme. The findings suggest that this programme, structured around the existing evidence for effective professional development in science education and ESD, positively influences teachers’ self-efficacy, supports teachers’ critical engagement with sustainability competencies and promotes the development of transformative pedagogies for sustainability through Inquiry-Based Science Education.

Objective To assess major obstetric haemorrhage incidence, management and quality of care in Irish maternity units. Design In collaboration with Irish maternity units the National Perinatal Epidemiology Centre (Leitao et al., 2020) carried out a national clinical audit and surveillance of major obstetric haemorrhage (MOH). Methods MOH was defined as blood loss of at least 2500 ml, transfusion of five or more units of blood or documented treatment for coagulopathy. Co-ordinators in maternity units completed detailed case assessment forms. The denominator data obtained from the individual units was restricted to live births and stillbirths of babies weighing at least 500 g. International Classification of Diseases diagnostic codes from hospital discharge records were used to identify cases of postpartum haemorrhage (PPH) and blood transfusion. Results During the time period, 2011–2018, there was a 54 % increase in MOH, a 60 % increase in PPH and a 54 % increase in blood transfusion. For 497 reported cases of MOH in 2011–2013, the median estimated blood loss was 3000 ml (range: 600-13,000 ml) and uterine atony was the most common cause. At least one uterotonic agent was used to arrest the bleeding in 94 % of the 477 MOH cases associated with a vaginal or caesarean delivery. A blood transfusion was received in 93 % of cases. Regarding quality of care, the vast majority of reported cases were described as receiving appropriate care and were well managed. Conclusion Internationally, obstetric haemorrhage and especially PPH and its increasing trend remains a major challenge for service providers and clinical staff. A standardisation of definitions of PPH/severe PPH/MOH and agreed approaches to quantitation of blood loss would be valuable developments to allow better investigation and shared learning. Reducing the burden of this morbidity through improvements in care should be a real focus of maternity services.

Continuing professional development (CPD) offers a strong opportunity to transform schools quickly enough to support today’s students in developing the capacity to address urgently needed sustainability solutions. While there have been some efforts in these directions, so far attempts have not been made to demonstrate whether these approaches to sustainability CPD can be scaled up internationally to the level necessary to meet the need to integrate sustainability across subjects and grade levels. Through this multi-national collaboration, we shared a model and implemented it across three very different contexts. The results of this two year project are reported and the important contextual factors for the competence development of teachers are identified. The model utilized here demonstrated success despite significant barriers at each implementation site. We identify three universal features that will create transformative sustainability CPDs: 1) Sufficient contact hours 2) Solutions not problems and 3) Competencies not content.

This paper explores the effect teachers’ participation in a targeted inquiry-based/nature of science (NoS) continuing professional development programme had on Irish primary children’s experiences of scientific inquiry and developing conceptions of NoS. Data were gathered from 459 children from 10 Dublin schools. The findings revealed that their teachers’ engagement with the targeted professional development programme had positive effects on the children’s experiences of scientific inquiry and on their developing NoS conceptions. It was apparent that professional development methodologies were effectively implemented throughout the school year. which led to a significant increase in these children’s engagement with more child-led inquiry-based approaches and a significant decrease in engagement with more teacher-led methodologies. Furthermore, engagement with the professional development methodologies resulted in the children developing more elaborate conceptions regarding ‘general aspects’ of NoS. The findings are significant in that that they add to the growing body of literature that asserts that pedagogy regarding ‘general aspects’ of NoS is an appropriate starting point in supporting the development of young children’s NoS conceptions. Furthermore, engagement with the programme methodologies during school science enabled the children to make sense of science in their everyday lives. Science education policy documents worldwide highlight the importance of scientific literacy and suggest that if students are to become scientifically literate it is essential that they develop their understanding about the processes of science and the type of knowledge science produces and have the ability to apply this scientific knowledge in every day contexts. The findings in this study are significant in that it is apparent that engagement with inquiry-based and NoS pedagogies appeared to have been a very good starting point in supporting the development of these young children’s scientific literacy skills.

Aims Early repolarization (ER) has been linked to poorer outcomes in idiopathic ventricular fibrillation (IVF). The role of family screening in IVF is not clear. Our aim was to review predictors for poorer outcomes and evaluate the role of family screening in IVF. Methods and results This was a retrospective multicentre cohort study including all patients diagnosed with IVF. Data were collected on baseline characteristics, ECG findings, and recurrence of ventricular arrhythmia (VA) during follow-up. Electrocardiogram findings were reviewed in first-degree relatives that were screened. A total of 66 patients were included with male predominance (42/66, 64%) and Caucasian ethnicity (47/66, 71%). Mean age at cardiac arrest was 38 years ± 11. Thirty-one patients had ER (47%) predominantly with J-point amplitude ≥2 mm and horizontal ST segments (18/31, 58%). Recurrent VA was seen in 13 patients (20%). Horizontal ST segments were associated with increased rates of VA recurrence (OR 11, 95% CI 2.7–43.7; P = 0.0007). Early repolarization was seen in 20% of the 72 first-degree relatives and was more common if the proband had persistent ER pattern (OR 10.7, 95% CI 2.2–51.5; P = 0.003). Conclusion Ventricular arrhythmia recurrence was lower than previously reported. Early repolarization was common in this IVF cohort, and horizontal ST segments were suggestive predictor for poorer outcomes. Persistent ER in proband was associated with ER in first-degree relatives. With better understanding of its predictive value and the relationship to IVF, this information could potentially be used to guide family screening and identify new mutations using family members with persistent ER.

This paper reports on a national study that explored primary pupils’ attitudes towards and experiences of school science in the Republic of Ireland. The study focussed on collecting data from children and in doing so recognises the importance of children’s views as an essential part of reviewing curriculum implementation. The findings of this large-scale study are based on an analysis of data gathered from observations of 15 primary classrooms, 1,149 children’s questionnaires and 11 group interviews. In this paper the findings regarding the extent to which the children appear to be engaging in ‘deductive’ (didactic) and ‘inductive’ (inquiry-based) approaches in their science classes, and their attitudes towards school science are presented. Encouragingly, evidence from all parts of the study revealed that in general Irish children are very positive towards learning science in school and are being provided with some opportunities to engage in hands-on inquiry in science, commonly via group work. However, there were also indications that, for some pupils, hands-on science experiences were infrequent, and for a few did not appear to be happening at all. It was not especially evident that pupils were being afforded opportunities to lead their own scientific investigations. Teacher explanation, teacher demonstration, reading and writing featured frequently in pupils’ responses and while the pupils expressed mixed feelings about these methodologies, one thing was apparent: hands-on inquiry based approaches to science had far greater appeal to the children. The significance of the findings of this study are considered in light of the findings and recommendations from recent national and international reports on inquiry-based approaches in science education.

Stroke occurring during pregnancy and the postnatal period is a rare but potentially catastrophic event. The aim of this study was to examine the incidence and outcomes of pregnancies complicated by maternal stroke in a single centre. This is a prospective study of over 35,000 consecutive pregnancies over a four-year period at the National Maternity Hospital in Dublin from 2004 to 2008; in addition we also retrospectively examined all cases of maternal mortality at our institution over a 50-year period from 1959 to 2009. We prospectively identified eight cases of strokes complicating pregnancy and the postnatal period giving an overall incidence of 22.34 per 100,000 pregnancies or 24.74 per 100,000 deliveries. There were no stroke-related mortalities during that time. Retrospective analysis of maternal mortality revealed 102 maternal deaths over a 50-year period, 19 (18.6%) of which were due to cerebrovascular accidents. In conclusion, strokes complicating pregnancy and the puerperium remain a rare event and though there appears to be evidence that the incidence is increasing, the associated maternal mortality appears to be falling.

MARYANN GIALANELLA VALIULIS (Ed.) Dublin: Irish Academic Press, 2008 Pp. vii + 244. £19.95. ISBN 978 0 7165 2963 7 JAMES M. SMITH Manchester: Manchester University Press, 2008 Pp. ix + 275. £18.99....

This study explored the effects that the incorporation of nature of science (NoS) activities in the primary science classroom had on children’s perceptions and understanding of science. We compared children’s ideas in four classes by inviting them to talk, draw and write about what science meant to them: two of the classes were taught by ‘NoS’ teachers who had completed an elective nature of science (NoS) course in the final year of their Bachelor of Education (B.Ed) degree. The ‘non-NoS’ teachers who did not attend this course taught the other two classes. All four teachers had graduated from the same initial teacher education institution with similar teaching grades and all had carried out the same science methods course during their B.Ed programme. We found that children taught by the teachers who had been NoS-trained developed more elaborate notions of nature of science, as might be expected. More importantly, their reflections on science and their science lessons evidenced a more in-depth and sophisticated articulation of the scientific process in terms of scientists “trying their best” and “sometimes getting it wrong” as well as “getting different answers”. Unlike children from non-NoS classes, those who had engaged in and reflected on NoS activities talked about their own science lessons in the sense of ‘doing science’. These children also expressed more positive attitudes about their science lessons than those from non-NoS classes. We therefore suggest that there is added value in including NoS activities in the primary science curriculum in that they seem to help children make sense of science and the scientific process, which could lead to improved attitudes towards school science. We argue that as opposed to considering the relevance of school science only in terms of children’s experience, relevance should include relevance to the world of science, and NoS activities can help children to link school science to science itself.

Objective: To assess the prevalence and causes of severe maternal morbidity in Dublin over a two year period from 2004 to 2005. Study design: A prospective cohort study from January 2004 to December 2005 was undertaken in the three large maternity hospitals in Dublin, which serve a population of 1.5 million people. All are tertiary referral centres for obstetrics and neonatology and have an annual combined delivery rate of circa 23,000 births. Cases of severe maternal morbidity were identified. A systems based classification was used. The primary cause of maternal morbidity and the number of events experienced per patient was recorded. Results: We identified 158 women who fulfilled the definition for severe maternal morbidity, giving a rate of 3.2 per 1000 maternities. There were two maternal deaths during the time period giving mortality to morbidity ratio of 1:79. The commonest cause of severe morbidity was vascular dysfunction related to obstetric haemorrhage. Eclampsia comprised 15.4% of cases. Intensive care or coronary care admission occurred in 12% of cases. Conclusion: The prevalence of severe maternal morbidity in this population is 3.2/1000 maternities. Obstetric haemorrhage was the main cause of severe maternal morbidity.

This study examined the multiple factors that contribute to the school readiness and early school progress of children living in an urban disadvantaged area. Structured interviews were undertaken with parents of children who had recently started school to elicit information about those aspects of children's health, and their home and neighbourhood contexts that may influence their school readiness. Questionnaires were administered to these children's teachers to assess the children's cognitive and socio-emotional school readiness and to identify influences on children's subsequent progress in their first year at school. Findings indicated that while the majority of children were ready for school, over one-third evidenced difficulties in relation to their cognitive abilities and socio-emotional skills. Regression analyses indicated that factors predictive of school readiness included parental living situation, parenting skills and preschool attendance. The factors cited as important in influencing children's subsequent school progress included children's characteristics, their home context, school and neighbourhood environment. Implications for policy and practice, notably preventive intervention programme development are discussed.

The sinoatrial node, or sinus node, of humans is the principal pacemaker of the heart. Over the last century, studies have unraveled the complex molecular architecture of the sinus node and the expression of unique ion channels within its specialized myocytes. Aim of this review is to describe the embriology, the anatomy, the histology and the electrophisiology of the sinus node.

This article reports on the evaluation of a pilot project which tested the utility of a framework for the Assessment of Vulnerable Children and their Families in five health board (local authority) areas in the Republic of Ireland. The framework had been developed following a consultancy process with practitioners and managers from a number of disciplines. The evaluation sought to establish whether (1) use of the framework helped to standardise practice across a range of organisational environments, (2) the framework was effective in a range of family situations and circumstances, (3) the process of assessment was transparent, (4) the framework advanced collaboration between disciplines and (5) the materials were user‐friendly. The methods used for evaluation were: semi‐structured interviews, a review of case records, a postal survey of practitioners, an action learning set and consultation with an expert group. Findings indicated that the framework was largely successful in its aims, with weaknesses demonstrated principally in two areas, namely inadequate use of evidence for decision‐making and deficiencies in documented information about children.

This article reports on the outcomes of a study that compared implicit and explicit teaching approaches on the development of contemporary conceptions of the nature of science (NoS). The sample comprised two groups of prospective primary teachers in the Republic of Ireland, all non-specialists in science. Research has shown that contemporary conceptions of NoS can be developed through implicit means—that is, by hands-on participation in scientific activities and by applying the process (scientific) skills in scientific inquiry. International research studies indicate that primary and secondary teachers, in general, do not hold contemporary (elaborate) conceptions of the NoS. This article reports on the outcomes of a comparative study that examined 148 prospective Irish primary teachers’ conceptions of NoS. Seventy-four of these students were taught about aspects of NoS through explicit approaches during a science methodology course. The study compares the effectiveness of implicit and explicit approaches ...

This study investigates how a two-year continuing professional development (CPD) programme, with an emphasis on teaching about science through inquiry, impacted the experiences of, approaches to and attitudes towards teaching science of 17 primary teachers in Dublin. Data sources included interview, questionnaire and reflective journal strategies. Data gathering focussed primarily on enabling teachers to reflect on their experiences of teaching about science through inquiry while implementing the Irish primary science curriculum. Teachers were also asked to consider their own changes in teaching science, as change in practice is a key indicator of successful professional intervention. Encouragingly the findings have shown that participation in this CPD programme appears to have been central to empowering these Dublin teachers to break away from rather traditional, didactic, theory-laden views of science teaching and to tackle more child-led, openended modes of learning. The data also revealed a number of aspects of the CPD model which the teachers perceived to be beneficial at translating inquiry into their classrooms, in particular: the active, hands-on approaches; the collaboration and the duration of the CPD itself. Based on the findings of this study, implications for professional development are considered.

Gillian McIntosh and Dianne Urquhart, Dublin, Irish Academic Press, 2010, 232 pp., €27.95 (paperback), ISBN 9780716530602 Irish Women at War: The Twentieth Century presents an interesting collectio...

This article examines the relationship between the various Irish women's suffrage societies and the Christian churches. It looks at the attitudes of particular suffragists, organised groups and the clergy to the questions of not only granting women the vote but wider feminist issues as well. It argues that neither the women nor the clergy were predictable. There were suffragists who were anti-church and there were suffragists who formed organisations which closely reflected their religious affiliations. Some members of the clergy spoke out against the cause, but there were also a number who gave it their backing, though not always for feminist reasons.

In Ireland, new science curricula were introduced at primary and early post- primary levels in 2003, in an effort to reverse declining interest and enrolment in science. This paper reports on a national study that explored first year post-primary students’ experiences of and attitudes towards school science under these new curricula. Data were gathered from 366 pupils using survey and case study approaches. Findings revealed broadly positive attitudes towards post-primary school science, especially the experimental work that is at the heart of the new curriculum. However, it would appear that students were not conducting open-ended investigations or using information and communications technology [ICT] to any great extent; moreover, there was some evidence of traditional teaching methods being utilised. Pupils were highly critical of previous primary school science experiences, reporting a lack of ‘hands-on’ activities, didactic methodologies and, for a significant minority, a paucity of any memorable primary science at all. Improvements in curricular implementation are proposed.

Objective To compare early home biofeedback physiotherapy with pelvic floor exercises (PFEs) for the initial management of women sustaining a primary third-degree tear. Design Single centre, randomised trial. Setting National Maternity Hospital, Dublin, Ireland. Population A total of 120 women sustaining a primary third-degree tear. Methods Women were randomised in a one to three ratio: 30 to early postpartum home biofeedback physiotherapy and 90 to PFEs. Main outcome measures Differences in anorectal manometry results, Cleveland Clinic continence scores and Rockwood faecal incontinence quality of life scale scores after 3 months of postpartum treatment. Results The mean anal resting pressure was 39 ± 13 mmHg in the early biofeedback physiotherapy group and 43 ± 17 mmHg in the PFE group. The mean anal squeeze pressure was 64 ± 17 mmHg in the biofeedback group and 62 ± 23 mmHg in the PFE group. There was no significant difference in anal resting and squeeze pressure values between the groups (P = 0.123 and P = 0.68, respectively). There were no differences in symptom score and quality of life measurements between the groups. Conclusions This study demonstrates no added value in using early home biofeedback physiotherapy in the management of women sustaining third-degree tears. Poor compliance may have contributed because women found it difficult to designate time to using biofeedback.

Introduction We describe the use of a ablating system to compartmentalise and regionally isolate the atria in paroxysmal and persistent atrial fibrillation (AF). Methods 40 patients were studied, 25 paroxysmal AF and 14 persistent AF. One patient enrolled was later found to be in left atrial flutter and was excluded. The Cardima Revelation® TX catheter system with Intellitemp® Radiofrequency (RF) energy control device and a Medtronic Atakar® RF generator were used to place wide area circumferential ablations to achieve conduction block into the left and right sided pulmonary veins. Roof lines and mitral isthmus lines were also performed. In patients with persistent AF and in repeat procedures, right atrial compartmentalisation was performed with an anterior superior vena cava (SVC) to inferior vena cava (IVC) line and a septal SVC to IVC line. Results At 6 months, 18 of the 39 patients were asymptomatic, 10 had improved symptoms and 22 were in sinus rhythm. In the paroxysmal group, 11 were asymptomatic, 7 had improved symptoms and 16 (64%) were in sinus rhythm. In the persistent group, 7 were asymptomatic, 3 had improved symptoms and 6 (43%) were in sinus rhythm. The total group AF burden was 37.8 ± 5.4 hrs pre-procedure and 23.1 ± 5.1 hrs at 6 months post procedure. Mean temperature, impedance and power recorded at each pole demonstrated effective power delivery at all poles. No catheter charring was observed, complication rates were comparable to standard AF ablation technique. Conclusion Linear ablation in the left and right atria to mimic Cox’s Maze is feasible and safe using this ablating system.

Many primary school teachers have insufficient content and pedagogical knowledge of science. This lack of knowledge can often lead to a lack of confidence and competence in teaching science. This article explores the impact of a year-long science methodology (curriculum science) course on second year Bachelor of Education (BEd) students' conceptual and pedagogical knowledge of science and on their attitudes towards teaching science in the primary classroom. A questionnaire, containing closed and open questions, was administered to students at the beginning and end of their science methodology course. The findings revealed that the science course had a positive impact on developing students’ scientific content knowledge. While the students were positive about the prospect of teaching science, insufficient scientific content knowledge was a concern for many of them, as were concerns over various teaching methodologies and classroom management issues in teaching science. The findings of this study are worrying, as it is likely that high percentages of these students will enter the teaching profession with similar inaccurate conceptions of science as the students they will be teaching.

(1993). Suffragists and nationalism in early twentieth-century Ireland∗. History of European Ideas: Vol. 16, No. 4-6, pp. 1009-1015.