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Munster Technological University

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Full-Text Articles in Medicine and Health Sciences

An Evaluation Of A Health, Wellbeing And Lifestyle Promotion Intervention Among A Cohort Of Year 1 Male Gaelic Games Student Athletes In An Irish University Setting, Anthony Casey Jan 2023

An Evaluation Of A Health, Wellbeing And Lifestyle Promotion Intervention Among A Cohort Of Year 1 Male Gaelic Games Student Athletes In An Irish University Setting, Anthony Casey

Theses

Background: The current research investigated the health, wellbeing and lifestyle behaviours of a cohort of 1st year male Gaelic Games student athletes (Study 1), and subsequently evaluated the impact of a bespoke intervention on these health, wellbeing and lifestyle behaviours in the same cohort (Study 2).

Methods: Participants were 1st year male Gaelic Games student athletes (mean age 18.6 ± 0.6 years, n=166) in a university in southern Ireland. Data were collected using a mixed-methods approach during the 2018/19 and the 2019/20 academic years. Data collection consisted of an online questionnaire (Bickerdike et al., 2018), which assessed health, wellbeing …


‘A Healthy Mtu’ A Mixed Methods Baseline Programme Of Research To Empirically Inform A Campus Health Promotion Initiative Within An Irish Higher Education Setting, Andrea Bickerdike Jan 2023

‘A Healthy Mtu’ A Mixed Methods Baseline Programme Of Research To Empirically Inform A Campus Health Promotion Initiative Within An Irish Higher Education Setting, Andrea Bickerdike

Theses

Higher Education Institutions (HEIs) have been called to lead global health promotion actions, yet there remains a dearth of empirically informed ‘Healthy University’ (HU) initiatives. This thesis constituted a baseline mixed methods needs assessment to inform a settings-based health promotion (HP) initiative (‘A Healthy MTU’) within a multi-campus ‘case’ HEI in Ireland (Cork campuses of MTU, formerly CIT). Specific aims were to (i) investigate student and staff health metrics, and (ii) identify the cultural and environmental determinants of health and wellbeing within the case HEI setting. Using a phased, mixed methodology (QUAN-QUAL), five sequential empirical studies were undertaken. Quantitative data …


The Impact Of Weighted Football Training On The Skill Acquisition Processes Of Place-Kicking In Sport, Sam Jermyn Jan 2023

The Impact Of Weighted Football Training On The Skill Acquisition Processes Of Place-Kicking In Sport, Sam Jermyn

Theses

Weighted implement training (WIT) involves performance of sport-specific motor skills with heavier-than-normal sporting implements. Typically, full range of motion (ROM) and similar kinematic characteristics of the respective motor skill are maintained concurrent to minimal changes in the force-velocity movement profile. While the majority of WIT research has been conducted in baseball, track and field, and cricket, there is a paucity of research conducted in the football codes, particularly Gaelic football. Existing observations of increased standard implement velocity and distance following the use of weighted implements infers potential benefits for Gaelic football performance, such as increasing kick-out ball velocity (BV) and …


Tailoring The Rehabilitative Environment For People With Sensory Overload, Jennifer Cotter Nov 2022

Tailoring The Rehabilitative Environment For People With Sensory Overload, Jennifer Cotter

Theses

Sensory overload is a complex sensory processing disorder which can develop post Acquired Brain Injury (ABI). The condition can be extremely debilitating and people who develop it are further hampered by lack of informational resources, sensory overload is currently under researched in the Acquired Brain Injury rehabilitation sector. This qualitative study documents participants first hand experiences of sensory overload post ABI and includes insights and observations from professionals working in the Acquired Brain Injury rehabilitation sector in Ireland. In this study, sensory overload is the focal point and a new rehabilitation tool in the form of a sensory menu is …


Elucidation Of Novel And Established Campylobacter Species With Clinical And Agricultural Significance Through Phenotypic, Genotypic, And Taxonomic Investigation, Caoimhe Lynch Jan 2022

Elucidation Of Novel And Established Campylobacter Species With Clinical And Agricultural Significance Through Phenotypic, Genotypic, And Taxonomic Investigation, Caoimhe Lynch

Theses

Campylobacter spp. are well-established human, veterinary and economic pathogens, with a broad host range spanning from terrestrial and marine mammalian, avian and reptilian hosts. The scope of the study includes novel and notorious species within the genus, with reference to zoonotic agents Campylobacter jejuni and Campylobacter coli - the leading cause of human bacterial gastroenteritis in the EU and Ireland, Campylobacter fetus that represents the most common campylobacter causing bacteraemia and two novel species isolated from pigs not described in the literature previously. C. jejuni and C. coli isolates (n = 350) recovered from broiler caecal and neck skin samples, …


Project Spraoi: The Implementation And Outcomes Of A Process Evaluation Of A School-Based Health Promotion Intervention, Yvonne Larrissa O’Byrne Jan 2022

Project Spraoi: The Implementation And Outcomes Of A Process Evaluation Of A School-Based Health Promotion Intervention, Yvonne Larrissa O’Byrne

Theses

Large multi-site school-based interventions are challenging to implement and difficult to evaluate due to the complex adaptive nature of schools as a research setting. This study focused on implementing a comprehensive process evaluation of a multicomponent primary school-based health promotion called Project Spraoi (PS), alongside intervention delivery, to aid the translation of outcomes and understand the moderating role of contextual factors on intervention delivery. PS is led by a physical activity (PA) specialist known as an Energizer and aims to improve children’s PA levels and reduce sedentary time by delivering 20 minutes extra daily moderate to vigorous PA (MVPA) during …


Defining The Potential Of Gene Therapy With Bone Morphogenetic Proteins As A Novel Therapeutic Approach In Parkinson’S Disease, Susan Rebecca Goulding Jan 2021

Defining The Potential Of Gene Therapy With Bone Morphogenetic Proteins As A Novel Therapeutic Approach In Parkinson’S Disease, Susan Rebecca Goulding

Theses

Parkinson’s disease is a neurodegenerative disorder, characterised by the progressive degeneration of midbrain dopaminergic neurons, and the intracellular aggregation of the α-synuclein protein in neurons throughout the nervous system. These changes result in the characteristic motor impairments in Parkinson’s disease. Current treatments are solely symptomatic and therefore there is an unmet clinical need to develop new disease-modifying therapies that can alter disease progression. For over 25 years, one proposed experimental therapy has focused on the delivery of proteins called neurotrophic factors to the brain to prevent dopaminergic neuron degeneration. However, to date, clinical trials using the most well-known neurotrophic factors …


An Investigation Into The Technical And Running Performance Metrics Of Gaelic Football Training Andmatch-Play To Inform The Design Of A Novel Tactical Periodisation Training Model, Shane Mangan Jan 2020

An Investigation Into The Technical And Running Performance Metrics Of Gaelic Football Training Andmatch-Play To Inform The Design Of A Novel Tactical Periodisation Training Model, Shane Mangan

Theses

Background: Carefully planned and implemented training programmes are essential for optimal sports performance. In depth knowledge of both the technical, tactical and physical demands of the sport are critical to informing these training programmes. Gaelic football, an amateur intermittent field sport, is one of the most popular sports in Ireland. Limited previous research has attempted to extensively analyse and interpret key findings from the literature to formulate practical recommendations for Gaelic football training and match preparation. The purpose of this research is to objectively analyse Gaelic football performance at the elite and sub-elite levels and to use this data to …


Role Of Sodium And Potassium In The Diet Of School-Aged Children In Ireland: Findings From The National Children’S Food Survey Ii, Eoin James Morrissey Jan 2020

Role Of Sodium And Potassium In The Diet Of School-Aged Children In Ireland: Findings From The National Children’S Food Survey Ii, Eoin James Morrissey

Theses

A high sodium to potassium intake ratio (Na:K) resulting from a diet high in sodium and low in potassium can increase the risk of elevated blood pressure or hypertension in children, potentially leading to increased CVD in adulthood. The objective of this thesis was to estimate sodium and potassium intakes and Na:K in school-aged children (5-12y) in Ireland using data from the nationally representative National Children’s Food Survey II (NCFS II) (2017-18). The thesis study collected detailed dietary intake data for 600 children using 4-d food records and also collected spot urine samples from 95% of these participants. Sodium and …


Living With Pku: The Lived Experience Of Irish Adults With Early Diagnosed Phenylketonuria On Long Term Dietary Therapy, Mary-Ellen O'Shea Jan 2020

Living With Pku: The Lived Experience Of Irish Adults With Early Diagnosed Phenylketonuria On Long Term Dietary Therapy, Mary-Ellen O'Shea

Theses

Phenylketonuria (PKU) is a rare genetic condition affecting the body’s ability to metabolise the amino acid phenylalanine (PHE). A build-up of PHE in the blood and brain can result in irreversible intellectual disability and developmental delays. Ireland has one of the highest prevalence rates of PKU in Europe and some of the earliest treated patients with PKU in the world. However, little is known about their lived experience with PKU. Furthermore, cost-benefit analysis of treatments for rare diseases in Ireland is principally based on quantitative data. More qualitative data is needed to highlight the quality of life experienced by people …


The Positive Effects Of Exercise On Active Transplant Recipients And Its Impact On Medication Adherence, Travane Morrison Jan 2020

The Positive Effects Of Exercise On Active Transplant Recipients And Its Impact On Medication Adherence, Travane Morrison

Theses

Organ failure is a life-threatening condition (Daugirdas et al, 2014). Non-adherence to medication is one of the main causes of the failure of a transplanted organ (Oberlin et al, 2016). In an effort to combat non-adherence to medication, research had employed intervention studies to tackle the main cause of non-adherence (Chisholm-Burns, 2013). The aims of this project are three fold. Firstly it aims to find if complications associated with organ transplant affect the individual’s medication adherence. Secondly, it explores the connections between exercise and medication adherence. Thirdly the research explores if exercise assists with possible complications associated with an organ …


An Investigation Into The Role And Function Of Athlete Monitoring And Its Impact On Training Practice And Performance Among Elite Gaelic Football Players, Jason Hugh Mcgahan Jan 2019

An Investigation Into The Role And Function Of Athlete Monitoring And Its Impact On Training Practice And Performance Among Elite Gaelic Football Players, Jason Hugh Mcgahan

Theses

Background: Ensuring adequate rest and recovery is critical for the avoidance of overtraining and the achievement of optimal performance, therefore it is recommended that training load and recovery be continually monitored throughout the training year. The purpose of this research was to investigate training load and markers of wellness among elite Gaelic footballers to assist the regulation of such loading to optimise performance in an amateur sports setting.

Methods: Participants were selected from two elite Gaelic football teams (Division 1 and 3 respectively) where training load data (global positioning system (GPS), session rating of perceived exertion (s-RPE) and wellness markers) …


Does A Step Back Approach To The Implementation Of Project Spraoi Affect The Health And Fundamental Movement Skill Proficiency Of Irish Children?, Conor Hemmersley Sep 2018

Does A Step Back Approach To The Implementation Of Project Spraoi Affect The Health And Fundamental Movement Skill Proficiency Of Irish Children?, Conor Hemmersley

Masters

Title: Does a step back approach to the implementation of Project Spraoi affect the health and fundamental movement skill proficiency of Irish children? Background: Project Spraoi is an intervention which attempts to positively influence the overall health of Irish primary school children. Previous iterations of Project Spraoi have been labour intensive with an Energiser working with a maximum of two schools to deliver the intervention. The purpose of this research was to evaluate the effectiveness of the intervention on fundamental movement skills (FMS), and markers of health of Irish primary school children using a step back approach. The step back …


The Role Of The Public Health Nurse In Rural Areas Of Kerry And Cork, Hannah Healy Jan 2018

The Role Of The Public Health Nurse In Rural Areas Of Kerry And Cork, Hannah Healy

Theses

Aim of Research: To understand and gain insight into the role of the Public Health nurse in rural communities in Kerry and Cork.

Background: Public health nursing is the single largest group in community care, current figure employed by the HSE stands at 1,438. Demographic, changes such as the increase in population coupled with the shift in care from the acute sector to primary care has provided many challenges to the PHN service .

Objective: Whilst there have been substantial reviews on the role and workload of the PHN in Ireland, there is limited qualitative research available on what the …


Designing And Evaluating The Impact Of An Inclusive Aquatics Training Programme For Aquatic Tutors And Teachers, Lucy Cush Jan 2018

Designing And Evaluating The Impact Of An Inclusive Aquatics Training Programme For Aquatic Tutors And Teachers, Lucy Cush

Theses

Every human has a fundamental right to physical education, physical activity and sport without discrimination. To achieve quality physical education, physical activity and sport, the associated support personnel, professionals and volunteers alike should be appropriately enabled through suitable training. For people with disabilities, aquatic activities are a recognised method of developing physical and motor skills, social skills and developing selfesteem (Getz, Hutzler and Vermeer, 2006). Hence, aquatics being the most popular physical activity for people with a disability (Irish Sports Monitor, 2015).

A key factor that determines the success of an inclusive aquatic programme is the aquatic instmctor (Conaster et …


Optimisation Of Ion Exchange Chromatography Purification Protocols For A Staphylococcal Peptidoglycan Degrading Hydrolase Enzyme, Fiona Maher Jan 2018

Optimisation Of Ion Exchange Chromatography Purification Protocols For A Staphylococcal Peptidoglycan Degrading Hydrolase Enzyme, Fiona Maher

Theses

Bacteriophage (phage) are the most abundant biological entities on earth and were first discovered by d’Herelle in 1917. They are found wherever their hosts live and, like all viruses they do not have the ability to make their own protein. Therefore, in order to reproduce, phage must invade and infect bacterial cells. This project focused on the optimisation of Ion Exchange Chromatography purification protocols for a staphylococcal peptidoglycan degrading hydrolase enzyme (CHAPk). The project objective was to obtain the greatest yield of enzyme from the growth of the E.coU XL 1-Blue expression system into which the vector pQE60 was previously …


A Mixed Methods Sequential Explanatory Study Of Male Farmers' Health Beliefs, Attitudes And Practices In Rural Kerry, Chrystal O'Brien Jan 2018

A Mixed Methods Sequential Explanatory Study Of Male Farmers' Health Beliefs, Attitudes And Practices In Rural Kerry, Chrystal O'Brien

Theses

Aim/Background: Beliefs and attitudes about health directly and indirectly influence concomitant behaviours, practices and health outcomes. In Ireland, male farmers are experiencing a disproportionate burden of ill health in preventable lifestyle diseases, yet there is a lack of behavioural research in relation to male farmers and their health. Therefore, the purpose of this study was to examine the health beliefs, attitudes and practices of male farmers in rural Kerry, and to explore healthcare professionals' insights of male farmers' health beliefs, attitudes and practices.

Methodology: The study adopted a mixed methods design. Phase one of the study involved structured interviews with …


The Ernie Els #Gameon Autism™ Golf Program For Young People With Autism: An Interpretative Phenomenological Analysis, Jerrome Suganthy Selvaraj Jan 2018

The Ernie Els #Gameon Autism™ Golf Program For Young People With Autism: An Interpretative Phenomenological Analysis, Jerrome Suganthy Selvaraj

Theses

The first evaluation of the #GameON Autism^^ Golf Program was conducted outside of the USA by the UNESCO Chair, I.T. Tralee in conjunction with the Els for Autism Foundation in partnership with LD Golf Ltd. The central aim of this research study was to evaluate the efficacy of the #GameON Autism^ Golf Program on young people with autism (ASD), their families, PGA golf coach, and volunteers. The two main objectives of the research were to analyse the impact of the program on the socia/communication, motor, and golf skills of individuals with autism and to assess the potential for the #GameON …


Readiness For Assisted Decision-Making: An Exploratory Qualitative Study, Kay Cronin Jan 2018

Readiness For Assisted Decision-Making: An Exploratory Qualitative Study, Kay Cronin

Theses

Background: Ireland has recently enacted the Assisted Decision-Making (Capacity) Act 2015. The enactment of the legislation has allowed Ireland to ratify the United Nations Convention on the Rights of People with Disabilities (2008). The convention obliges all member states to assist people with disabilities to make their own decisions, with their will and preference taking precedence over what others deem to be in their best interests. Implementation of this legislation requires a change in working practice among health and social care providers to promote autonomy and decision-making among service users. To date, this topic has not been researched in Ireland. …


Assessment Of Clinical And Blood Gas Parameters In Healthy And Diarrhoeic Calves, Patrick Dillane Jan 2018

Assessment Of Clinical And Blood Gas Parameters In Healthy And Diarrhoeic Calves, Patrick Dillane

Theses

Neonatal calf diarrhoea (NCD) is a major problem to calf health worldwide. Metabolic acidosis, electrolyte imbalances are common complications of NCD, consequently, blood gas analysis is regarded as the gold standard test to assess of severity of these abnormalities in diarrhoeic calves. The objective of this research was to develop blood gas reference ranges for neonatal calves accounting for influencing physiological and environmental factors. As this disease is commonly treated by primary producers, previously published clinical assessment scoring chart was also analysed and compared to gold standard blood gas, in addition to next- generation biomarkers for severity diagnosis for NCD. …


The Effectiveness Of School-Based Interventions On The Fundamental Movement Skill Proficiency Among A Cohort Of Irish Primary School Children, Lisa Bolger Jan 2018

The Effectiveness Of School-Based Interventions On The Fundamental Movement Skill Proficiency Among A Cohort Of Irish Primary School Children, Lisa Bolger

PhDs

Background: Fundamental movement skills (FMS) are basic observable patterns of movement such as running and jumping. FMS facilitate participation in physical activity and sport. The ability to perform FMS correctly (i.e. FMS proficiency) is associated with numerous health benefits and is important for the holistic development of children. FMS proficiency among primary school children worldwide is low. Thus, interventions aimed at improving FMS levels among children are warranted. Therefore, this thesis aimed to assess the FMS proficiency among a cohort of Irish primary school children and examine the effectiveness of a physical activity (PA) (Year 1) and a multicomponent FMS …


An Investigation Into Te Relationship Between Fundamental Movement Skill Proficiency And Markers Of Health Among A Cohort Of Irish Primary School Children, Linda Bolger Jan 2018

An Investigation Into Te Relationship Between Fundamental Movement Skill Proficiency And Markers Of Health Among A Cohort Of Irish Primary School Children, Linda Bolger

PhDs

Background: Fundamental movement skills (FMS) are basic observable patterns of movement. Although FMS are positively associated with health, FMS levels among children worldwide are low. Interventions to improve FMS and markers of health among children are warranted. Thus, the purpose of this research was to firstly evaluate the FMS proficiency and markers of health of Irish primary school children, and to design and implement a programme of interventions to improve both.

Methods: Two interventions (1 Physical Activity [PA] and 1 FMS) were implemented and evaluated using children from 3 primary schools in Cork. Children (N=217, mean age: 7.98±2.00 years) …


Project Spraoi: The Effectiveness Of A Nutrition And Physical Activity Intervention On The Dietry Intake, Dietary Patterns, Nutritional Knowledge And Markers Of Health Of Irish Primary School Children, Alison Merrotsy Jan 2018

Project Spraoi: The Effectiveness Of A Nutrition And Physical Activity Intervention On The Dietry Intake, Dietary Patterns, Nutritional Knowledge And Markers Of Health Of Irish Primary School Children, Alison Merrotsy

PhDs

Aim: To implement and evaluate the effectiveness of a nutrition and physical activity (PA) intervention (Project Spraoi) on dietary intake (DI), dietary patterns (DP), nutritional knowledge (NK), cardiorespiratory fitness (CRF), blood pressure (BP) and markers of health of Irish children in one primary school in Cork. The relationship between DP and NK, CRF, BP and anthropometric data will also be examined.

Design: Cross-sectional and longitudinal study. Food diary, NK questionnaire and 550m walk/run test were used to assess DI, DP, NK and CRF, respectively. BP, body mass index (BMI) and waist to height ratio (WHtR) were also calculated.

Setting: Two …


Microbiota, Diet And Medication In Human Gut Disorders, Adam Clooney Jan 2017

Microbiota, Diet And Medication In Human Gut Disorders, Adam Clooney

Theses

The microbiota, a community of micro-organisms in a particular environment, have been intensely researched in the past decade and interest appears to continue to increase. The human body is richly populated with bacterial cells (3.8x10'^) and alterations in these communities are associated with disease. The work presented in this thesis explores aspects of microbiota research methodologies with regard to optimisation and concerns over a lack of reproducibility. Additionally, we investigated the effects of medication, in particular Proton Pump Inhibitors, on the human gut microbiota, along with comparisons between the microbiota of patients with active and inactive Inflammatory Bowel Disease.

Microbiota …


An Analysis Of The Physiological And Psychological Wellbeing Of Irish Naval Service Personnel, Cliodhna Sargent Jan 2017

An Analysis Of The Physiological And Psychological Wellbeing Of Irish Naval Service Personnel, Cliodhna Sargent

Theses

Whilst all military cohorts have been seen to experience both physiological and psychological stressors during occupational duties, the naval service experience different stressors due the prolonged periods of time spent at sea. Research has analysed some of these stressors however many them have focused on how individuals are affected because of time spent in combat zones. The Irish Naval Service (INS) is an organisation under the Irish Defence Forces organisation and as such many of its physiological and psychological assessment procedures have come from the Defenee Forces. Very limited researeh has been carried out in relation to the INS as …


Integrating A Code Of Professional Conduct And Ethics: An Action Research Approach, Ciara Kissane Jan 2017

Integrating A Code Of Professional Conduct And Ethics: An Action Research Approach, Ciara Kissane

Theses

A new version of the Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (NMBI, 2014a) was published in 2014. A nurse’s fitness to practice, and the associated patient experience, is determined by the extent to which the nurse accords with the duties outlined in the Code. Professional misconduct among members of the nursing profession has been highlighted within recent reports and enquiries. The failure to act on unethical care is also a feature. The literature suggests that Codes are poorly understood and can be problematic to integrate in practice. This study sought to; explore the impact …


Reliability Of Micro Mechanical Low Frequency Energy Harvesters For Implanted Cardiac Pacemakers, Sunny Jay Jan 2017

Reliability Of Micro Mechanical Low Frequency Energy Harvesters For Implanted Cardiac Pacemakers, Sunny Jay

Theses

The aim of this project was to develop methods to assess the suitability and reliability of silicon-based piezoelectric micro-electro-mechanicai systems (MEMS) energy harvesters to capture the kinetic energy of the heartbeat in an implanted cardiac pacemaker. The major challenges of the work were that harvesters for vibration frequencies below 100 Hz have not been widely reported and the system requires reliable operation over a long lifetime. In this work device modelling was used for harvester design assessment. Experimental test methods and equipment were developed to produce data to validate the device models and to assess device reliability. A 2D analytical …


Nutritional Labelling Providing Education On Its Usage Could It Impact On Patient's Food Choice Selection For Those In The Obese Classification?, Celia Lane Jan 2017

Nutritional Labelling Providing Education On Its Usage Could It Impact On Patient's Food Choice Selection For Those In The Obese Classification?, Celia Lane

Theses

A build-up of too much body fat can cause significant health risks and development of medical conditions and disabilities (National Institute Clinical Excellence (NICE), 2014). The causes of obesity involve the disproportionate intake of calories that are not utilised (World Health Organisation (WHO), 2016). The rising trend towards obesity threatens to bankrupt medical systems (Heifer and Shultz, 2014). There has been a heighten awareness from the general public in the last decade of the affiliation between health and nutrition (Irish Universities Nutrition Alliance (lUNA), 2011). In light of the ever increasing obesity trend, individuals still desire to take control of …


Intelligent Profiling Of Blood Donors In Ireland, Joanna Kossakowska Jan 2017

Intelligent Profiling Of Blood Donors In Ireland, Joanna Kossakowska

Theses

The demand for blood products in Ireland is constantly rising due to population growth and population ageing. It is believed that within the next decade these two factors will present challenges to blood donor recruitment and the availability of blood supplies. Improving the retention of blood donors will have a positive impact on the availability of blood products. Identification of suitable donors with the potential for long-term donating can potentially enhance the predictability of blood supply levels.

This research proposes that the patterns of blood donation behaviours of donors can be isolated from blood donor databases held by blood collecting …


Farm Deaths And Injuries: Changing Farmer Attitudes And Behaviour On Farm Safety, Kieran O'Connell Jan 2017

Farm Deaths And Injuries: Changing Farmer Attitudes And Behaviour On Farm Safety, Kieran O'Connell

Theses

While the Irish agricultural sector accounts for just 6% of the working population of Ireland, it consistently has the highest proportion of fatal incidents of any sector - generally ranging from between 35% and 45% of all workplace fatalities in any given year (Health and Safety Authority, 2015). This was again evident in 2014 where 55% (30 of the 56) of the fatal workplace incidents were in the agricultural sector (Health and Safety Authority, 2015). Agriculture has an ageing workforce with the average age of an Irish farmer now standing at fifty-seven and farmers are eight times more likely to …