TRARESA: a tissue microarray-based hospital system for biomarker validation and discovery

Formalin fixed and paraffin embedded tissue (FFPE) collections in pathology departments are the largest resource for retrospective biomedical research studies. Based on the literature analysis of FFPE related research, as well as our own technical validation, we present the Translational Research Arrays (TRARESA), a tissue microarray centred, hospital based, translational research conceptual framework for both validation and/or discovery of novel biomarkers. TRARESA incorporates the analysis of protein, DNA and RNA in the same samples, correlating with clinical and pathological parameters from each case, and allowing (a) the confirmation of new biomarkers, disease hypotheses and drug targets, and (b) the postulation of novel hypotheses on disease mechanisms and drug targets based on known biomarkers. While presenting TRARESA, we illustrate the use of such a comprehensive approach. The conceptualisation of the role of FFPE-based studies in translational research allows the utilisation of this commodity, and adds to the hypothesis-generating armamentarium of existing high-throughput technologies.

Whose play is it anyway?: Theatre Studies, Translation Studies and translation for the stage

This article explores the historical neglect of translation as a consideration in the study and practice of theatre in the United States and Europe. While the study of literature is fairly strictly divided between English-language and Comparative Literature departments, theatre and drama have shown little concern about language as a barrier to reception of the dramatic text. Arguably, this discrepancy may be traced to a fundamental gap between the perceived status of the novel as a completed work of art and the playtext as work of art in progress, waiting to find its completion in performance.

The Supremacy of the Sequence: Key Elements and Dimensions in the Process of Change

How single organizations manage the process of change and why only some of them are able to actually reach radical change are central questions in today’s theoretical debate. The role played by the process of change and its dimensions (namely, pace, sequence and linearity), however, has been poorly investigated. Drawing on archetype theory, this paper explores: (i) whether a specific pace of radical change exists; (ii) whether different outcomes of change are characterized by different sequences of change in key-structures and systems (iii) how the three dimensions of the process of change possibly interact. As an example of organizational change the study takes into consideration processes of accounting change in three departments of two Canadian and two Italian municipalities. The results suggest the supremacy of the sequence of implemented changes over the other two dimensions of the process in order to achieve a radical outcome of change.

A Bayesian network hybrid model for representing accident and emergency waiting times

The paper introduces a new modeling approach that represents the waiting times in an accident and emergency (A&E) department in a UK based national health service (NHS) hospital. The technique uses Bayesian networks to capture the heterogeneity of arriving patients by representing how patient covariates interact to influence their waiting times in the department. Such waiting times have been reviewed by the NHS as a means of investigating the efficiency of A&E departments (emergency rooms) and how they operate. As a result activity targets are now established based on the patient total waiting times with much emphasis on trolley waits.

Unheard Voices: Stories from the Troubles

Produced in association with WAVE Trauma Centre, this short film records the experiences of six victims and survivors of the Northern Irish Troubles. Filmed and edited collaboratively, UV addresses issues of trauma, loss, justice and recovery. The story-tellers range from a police widow, to the brother of a sectarian victim, to a youth worker who lost is legs in an explosion. This film has been screened, with public discussions, between 2010 and 2012 by the Good Relations Departments of the following Borough and City Councils - Belfast, Derry/Londonderry, Lisburn, Ballymena, Coleraine, Moyle and Newtownabbey. It has also been screened at the Hallwells Contemporary Arts Centre, Buffalo, and at St Bonaventure University, NY (2012)

http://www.wavetraumacentre.org.uk/about-us/wave-projects/unheard-voices

Further Information:

This 30 minute documentary film was produced in collaboration with WAVE Trauma Centre, Belfast. Working closely with six survivors of the Troubles violence in Northern Ireland through all stages of production and exhibition, the film contributes to on-going discussions about dealing with the conflicted past in a contested present. The role of storytelling, identified by two government reports – the Bloomfield Report and the Eames-Bradley Report - as an important method of addressing the violent past, is one of the key research questions involved in the research. Public screenings and discussions have been organised by the Good Relations Departments of seven borough councils (Belfast, Lisburn, Derry, Ballymena, Newtownabbey, Coleraine and Moyle). The film has also been screened in New York State and London. One of the recurring themes brought up in these public discussions in the role and limits of storytelling alongside the legal issues of justice, prosecutions and reparations. An accompanying co-written article with PhD student, Jolene Mairs, 'Unheard Voices' in Mc Keogh, C. and O'Connel, D. (eds) (2012) Documentary in a Changing State,Cork University Press, is part of the portfolio presented for REF.

Politics, policy preferences and the evolution of Irish bureaucracy:A framework for analysis

Analysis of the Irish state's administrative system is an unaccountably neglected area of systematic academic inquiry. This is all the more difficult to account for in view of the dynamic relationship between government actors and the public bureaucracy in realizing political goals. This paper identifies some distinguishing institutional features and dominant trends in Irish politico-administrative governance, and suggests avenues for future inquiry. The paper begins with an examination of the literature on administrative system change, with a focus on the New Public Management literature. Following this, the Irish case is profiled, identifying the evolution of ministerial departments and of state agencies by successive Irish governments, including patterns of agency creation and termination over time. Particular attention is given to the period 1989-2010, which has been one of quite rapid and complex organizational change within the state's bureaucratic apparatus. © 2012 Political Studies Association of Ireland.

Governing Ireland:From Cabinet Government to Delegated Governance

The structures of Irish government were once considered reliably stable, professional and efficient. The economic crash of 2008 swept away all such sureties. How did we fail to foresee the challenges and avert a crisis that has undermined the state in every respect? Initial explanations have focused on the absence of robust mechanisms to challenge policy, a lack of imagination and expertise in policy design, and inadequacies in policy implementation and evaluation. Others still have pointed to the inability of traditional structures of decision-making and oversight to manage the multidimensional nature of modern policy problems, as well as an increasingly complex administrative system.

This new book offers a fresh and sustained scrutiny of the Irish system of national government. It examines the cabinet, the departments of Finance and the Taoiseach, ministerial relationships with civil servants, the growth and decline of agencies, the executive's relationship with Dáil Éireann and other monitoring agencies, the impact of the European Union, the courts, the media and social partnership. Distinguished academics are brought together in this volume to reassess Irish governance structures in the context of much greater diversity in policy processes and delegation in government. The book is essential reading for anyone interested in how the Irish state is governed, including practitioners and students of Irish politics.

Substituting home care for hospitalization:The role of a quick response service for the elderly

The purpose of the present study was to examine the role of a rapid access home-based service as a means for the elderly to avoid admission to an acute-care hospital. The setting for the study included emergency departments in three acute care hospitals and a home care program in a mid-size Canadian city. Multiple sources of information were obtained to evaluate the service. Hospital emergency department records and home care records were reviewed. Patients who participated in the service (n=96) and physicians and nurses (n =119) who had involvement with the service were surveyed appraising the service in terms of relevance, access, quality and coordination. Study results revealed that elderly women with multiple health problems who lived alone were the most frequent users of the service. The majority of the patients admitted to the service presented with problems of a functional nature that were the result of a fall or mobility problems. The results indicated that the service did avert hospital admissions and facilitated a process by which patients could avoid the intermediate step of hospitalization before placed in a higher level of care or returning to previous levels of functioning. Economic analysis indicated that the value of the service stemmed from the benefits to patients and caregivers rather than from cost savings offered to acute care hospitals.

Socio-economic deprivation and visual acuity at presentation in exudative age-related macular degeneration

Aim: To evaluate the influence of socio-economic factors on visual acuity (VA) at presentation in exudative age- related macular degeneration (AMD). Methods: The medical records of all consecutive patients with newly diagnosed exudative AMD examined at the Ophthalmology Departments of Grampian University Hospitals-NHS Trust, Aberdeen, and Gartnavel General Hospital, Glasgow, between July 2004 and June 2005, were reviewed. Demographics, duration of symptoms, VA in study and fellow eye, exudative AMD characteristics, status of fellow eye and patient home address, used to determine the Scottish Index of Multiple Deprivation (SIMD) score, were recorded. The effect of these parameters on VA at presentation was investigated using general linear modelling. Results: Two-hundred and forty patients (median age 79 years) were included in this study; 44 (18.3%) belonged to the lowest 20% SIMD score (most deprived). Age and location and type of the choroidal neovascular- isation were statistically significantly associated with VA at presentation (p = 0.003, p

Improving Patient Safety Through Formal and Informal Learning Networks

This paper explores a novel perspective on patient safety improvements, which draws on
contemporary social network and learning theories. A case study was conducted at a Portuguese
acute university hospital. Data collection followed a staged approach, whereby 46 interviews
were conducted involving 49 respondents from a broad array of departments and professional
backgrounds. This case study highlights the importance of two major interlinked factors in
contributing to patient safety improvements. The first of these is the crucial role of formal and
informal, internal and external social networks. The second is the importance and the possible
advantage of combining formal and informal learning. The analysis suggests that initiatives
rooted in formal learning approaches alone do not necessarily lead to the creation of long-term
grounded internal safety networks, and that patient safety improvements can crucially depend on
bottom-up initiatives of communities of practice and informal learning. Traditional research on
patient safety places a strong emphasis on top-down and managerialist approaches and is often
based on the assumption that „safety? learning is primarily formal and context-independent. This
paper suggests that bottom-up initiatives and a combination of formal and informal learning can
make a major contribute to patient safety improvements.

Risks to patient confidentiality when communicating health information to blind and partially sighted patients.

The research reports on a survey of 228 blind and partially sighted persons in 15 health authorities across Scotland. The survey reports data on patient experience of receiving health information in accessible reading formats. Data indicated that about 90% of blind and partially sighted persons did not receive communications from various NHS health departments in a format that they could read by themselves. The implications for patient privacy, confidentiality and wider impact on life and health care are highlighted. The implications for professional ethical medical practice and for public policy are also discussed. Recommendations for improved practice are made.