Responding to crisis: When the telephone fails

The world is changing. Advances in telecommunications have meant that the world is shrinking – data can be moved across continents in the time it takes to send an email or access the cloud. Although developments such as these highlight the extent of scientific and technological evolution, in terms of legal liability, questions must be asked as to the capacity of our legal structures to evolve accordingly.

This article looks at how emergency telephone provision and any shift to VoIP systems might fit with existing tort liability and associated duty implications. It does so by analysing the technology through the principles that signpost UK tort law. This article recognises that as an emerging area, the legal liability implications have not yet been discussed in any great detail. The aim of this article therefore is to introduce the area, encourage debate and consider the issues that may become increasingly relevant as these types of technologies become industrial standards.

How well do midwives use skills and knowledge in examining newborns?

Physical examination of the newborn (PEN) was established as part of postnatal care in the late 1960s. The role of discharging babies within the first 72 hours of birth was traditionally undertaken by junior doctors. Currently midwives, nurses, advanced nurse practitioners, and health visitors are being trained to undertake the PEN (NHS Screening Programmes, 2010). However, only a fraction of midwives utilize their acquired skills in clinical practice. A survey by Townsend et al (2004) showed that 2% of babies in England were examined by midwives while 83% were examined by junior doctors.This study aimed to evaluate how well midwives who undertook the PEN course between 2002 and 2005 (n = 40) at a large London University utilized the skills acquired on the course. Questionnaires with a series of open and closed questions were sent out by post followed by phone and email reminders. The eight that responded were midwives. All respondents said they were appropriately trained and felt well prepared for their role to examine babies. However, they felt they were not provided with opportunities to use the skills. Guidelines based on this extended role are available in the workplace but only a few midwives seemed to have negotiated time to implement these and may need greater managerial support for the role.

Electrical characterisation of liquid crystals at millimetre wavelengths using frequency selective surfaces

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The accurate measurement of the permittivity, loss tangent and dielectric anisotropy DC bias dependence for two different liquid crystal (LC) materials in the frequency range 140-165 GHz is described. The electrical characteristics are obtained by curve fitting computed transmission coefficients to the experimental spectral response of a new class of electronically reconfigurable frequency selective surface. The periodic structure is designed to yield bandpass filter characteristics with and without an applied bias control voltage in order to measure the tunability of the LC material which is inserted in a 705 µm-thick cavity.

Rotman Lens Used as a Demultiplexer/Multiplexer

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A new type of microwave demultiplexer is proposed which combines an arrayed waveguide grating (AWG) and a Rotman lens. The dispersion property of an AWG is employed to produce different phase slope responses for different frequencies, while the Rotman lens routes the frequency components onto different ports. To optimize isolation performance, the design constraints of both the AWG and the Rotman lens are re-examined and new design criteria elaborated. The optimized design is demonstrated of being capable of achieving 15 dB channel isolation over a 25% band range centered at 10 GHz. While a design based on a conventional Rotman lens yields isolation level of around 6 dB over a 9% band range centered at 10GHz.

A Compact V-band power detector

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A compact V-band active power detector using Infineon 0.35 µm SiGe HBT process (fT/fmax =170/250 GHz) is described. The total chip area is only 0.35×0.8 mm2 including all pads. This design exhibits a dynamic range larger than 20 dB over the frequency range from 55 GHz to 67 GHz. It also offers a simple and low-power application potential as an envelop detector in multi-Gbps high data rate demodulators for OOK/ASK etc.

The marginal willingness-to-pay for attributes of a hypothetical HIV vaccine

This paper estimates the marginal willingness-to-pay for attributes of a hypothetical HIV vaccine using discrete choice modeling. We use primary data from 326 respondents from Bangkok and Chiang Mai, Thailand, in 2008–2009, selected using purposive, venue-based sampling across two strata. Participants completed a structured questionnaire and full rank discrete choice modeling task administered using computer-assisted personal interviewing. The choice experiment was used to rank eight hypothetical HIV vaccine scenarios, with each scenario comprising seven attributes (including cost) each of which had two levels. The data were analyzed in two alternative specifications: (1) best-worst; and (2) full-rank, using logit likelihood functions estimated with custom routines in Gauss matrix programming language. In the full-rank specification, all vaccine attributes are significant predictors of probability of vaccine choice. The biomedical attributes of the hypothetical HIV vaccine (efficacy, absence of VISP, absence of side effects, and duration of effect) are the most important attributes for HIV vaccine choice. On average respondents are more than twice as likely to accept a vaccine with 99% efficacy, than a vaccine with 50% efficacy. This translates to a willingness to pay US$383 more for a high efficacy vaccine compared with the low efficacy vaccine. Knowledge of the relative importance of determinants of HIV vaccine acceptability is important to ensure the success of future vaccination programs. Future acceptability studies of hypothetical HIV vaccines should use more finely grained biomedical attributes, and could also improve the external validity of results by including more levels of the cost attribute.

Survey of challenges and best practice strategies for participant recruitment to research projects in northern ireland

Participant recruitment is understood to be one of the most difficult aspects of the research process. Researchers are now devoting increasing amounts of time and resources to understand how participants decide to take part in research and what researchers can do to make their work appeal to potential participants. The purpose of the study is to assess the problems experienced by researchers in Northern Ireland when recruiting human participants into trials and studies and to gain insight into how researchers handle and overcome these issues. The main research question being addressed by this research is to develop an understanding of the problems experienced by staff when recruiting human participants to research projects. Methods used to increase study recruitment were also examined. The participants in this research are investigators and other associated staff on research studies based in Northern Ireland. Potential participants were identified through contacts with research active organizations such as the academic researchers in Queen’s University Belfast and research physicians and clinical trialists employed by the Belfast Health and Social Care Trust. Each organization forwarded on the survey request via email or newsletters. Researchers willing to take part accessed the questionnaire through the Survey Monkey website. This study utilised a cross-sectional questionnaire design.

‘Emergent reconstruction’ in grounded theory: learning from team-based interview research

Constructivist grounded theory (CGT) methods render an interpretive portrayal, a construction of reality, strengthened when the process of construction is acknowledged. An Irish team study uses CGT to explore intergenerational solidarity at individual, familial and societal levels, and their interface. The study data comprise interviews with 100 people from diverse socio-economic and
age groups. The article contributes insights on applying CGT in team-based interview research on a topic with such breadth of scope. This contrasts with the more usual focused inquiry with a defined population. Adapting the method’s guidelines to the specific inquiry involved challenges in: framing the topic conceptually; situating research participants in contrasting social contexts to
provide interpretive depth; and generating interview data with which to construct theory. We argue that interrogating the very premise of the inquiry allowed for emergent reconstruction, a goal at the heart of the method.

Mother's Narratives of Trauma: An exploratory study of how mothers' narrate the impact of trauma on their families

This study explored the narratives of 10 mothers whose families had been impacted by potentially traumatising events. The study was set in the context of Post-Traumatic Stress Disorder (PTSD), a relatively narrow psychiatric construct, which currently dominates much professional discourse and practice in traumatology, but references literature that provides a theoretical rationale for a broader approach. Narrative Interviewing methodology was employed and mothers of families referred to a specialist clinical service were interviewed prior to professional therapeutic intervention. The 10 mothers' narratives were analysed thematically via a rigorous process involving two independent analysts and the data organised into an evolving theoretical framework of themes and supra-themes. As hypothesised, PTSD symptomatology constituted a small proportion of the mothers' narratives (6.2%). The major components of the narratives included family and relational distress (35.7%), non-pathological individual distress (24.4%), resilience (16.7%) and a prior history of adversity (16.6%). Although exploratory in nature, the results of this study are sufficiently strong to warrant further investigation and raise tentative questions regarding the appropriateness of many existing therapeutic services for people impacted by trauma.

Shared decision making in patients at risk of cancer: The role of domain and numeracy

Background
Shared decision making has become an integral part of medical consultation. Research has, however, reported wide differences in individuals' desires to be involved in the decision-making process, and these differences in preferences are likely to be the result of a number of factors including age, education and numeracy.

Objective
To investigate whether patients at genetic risk for cancer had preferences for shared decision making that differed depending on medical domain (general health vs. cancer) and whether decision preferences are linked to numeracy abilities.

Methods
Four hundred and seventy-six women who consented to participate in response to an email sent by a local branch of the U.S.-based Cancer Genetics Network (CGN) to its members. Participants completed the Control Preference Scale, as well as an objective and subjective numeracy scales.

Results
Decision domain (cancer vs. general health) was not associated with women's preferences for involvement in decision making. Objective and subjective numeracy predicted a preference for decision involvement in general, and only objective numeracy was predictive with regard to cancer.

Conclusion
Participants were equally likely to state they wanted to play an active, collaborative or passive role in both medical domains (general and cancer). High-numeracy participants were more likely to express a desire for an active role in general and in case they were diagnosed with cancer.

Practice implications
Health authorities' recommendations to clinicians to include patients in their medical decisions are supported by patients' desires, and clinicians should be cognizant of their patients' preferences as well as their numeracy skills.

A Randomized Controlled Trial Evaluation of an After-School Pro-Social Behavior Program in an Area of Socioeconomic Disadvantage

A randomized controlled trial was used to evaluate the effects of a pro-social behavior after-school program called Mate-Tricks for nine and ten year old children and their parents living in an area of significant socioeconomic disadvantage. The children were randomly assigned to an intervention (n=220) or a control group (n=198). Children were compared on measures of pro-social behavior, anti-social behavior and related outcome measures. The trial found adverse effects on four outcomes among the intervention group compared to the control group: anti-social behavior increased on two different measures (d=+0.20) and (d=+0.18); child reported liberal parenting increased (d=+0.16); and child reported authoritarian parenting also increased (d=+0.20). In addition, parental participation was significantly associated with several program outcomes. It was concluded, that group based after-school behavior programs may have the potential to cause iatrogenic effects and must be designed, piloted, evaluated and implemented with a high degree of care.

Serving Multiple Masters: Exploring HRD in the Context of Third Sector Partnerships for Public Service Delivery

Organisations in the Non-Profit and Voluntary (NPV) sector increasingly face challenging and uncertain times with an increasing shift from public grant funding towards contract funding. As a result many of these changes employees in such organisations have often found themselves working more closely under contract with colleagues in public sector organisations in order to provide public services. Using a multiple case study methodology and in-depth interviewing of a range of stakeholders form two large Northern Irish based Non Profit Organisations in the social care sector, the purpose of this research was to
investigate HRD and people management issues and how a turbulent environment can affect how organisations approach HRD strategy and implementation.

The research identifies the importance placed upon NPOs adopting HRD strategies and addressing the development of unique and specialised skills in order to claw back power within the relationships they serve with statutory funding bodies. However this research also notes that the manner in which HRD and its associated issues are considered within NPOs can have an impact on the loyalty and commitment of the workforce which serves them. What is of concern is that the context for the delivery of public services under contract is putting increasing strain on NPOs and this has been felt markedly by their respective workforces, and unless strong values-led leadership and managerial practice is in
place in NPOs, the voluntary-centred ethos of those who work in the sector may be significantly damaged.

A research-based approach to exploring the adoption of novel UK-based concrete test methods in Chinese construction sector

As part of a UK-China science bridge project - a UK government funded initiative linking leading universities and businesses in selective partnering countries in 2009 a collaborative research programme was initiated between Queen's University and the Research Institute of High Performance Concrete (part of the Central Research Institute of Building and Construction) in Beijing.

For further details email b.magee@ulster.ac.uk

Career choices on graduation--a study of recent graduates from University College Cork

INTRODUCTION: Irish dental graduates are eligible to enter general dental practice immediately after qualification. Unlike their United Kingdom counterparts, there is no requirement to undertake vocational training (VT) or any pre-registration training. VT is a mandatory 12-month period for all UK dental graduates who wish to work within the National Health Service. It provides structured, supervised experience in training practices and through organised study days.

AIMS: This study aimed to profile the career choices made by recent dental graduates from UCC. It aimed to record the uptake of VT and associate posts, and where the graduates gained employment.

METHODOLOGY: A self-completion questionnaire was developed and circulated electronically to recent graduates from UCC. An existing database of email addresses was used and responses were returned by post or by email. A copy of the questionnaire used is included as Appendix 1.

RESULTS: Questionnaires were distributed over an eight-week period and 142 were returned, giving a response rate of 68.90%. Responses were gathered from those who graduated between 2001 and 2007; however, the majority came from more recent classes. Overall, the majority of graduates took up associate positions after qualification (71.8%) with smaller numbers undertaking VT (28.2%). Increasing numbers have entered VT in recent years, including 54.3% from the class of 2007. Overall, the majority of graduates initially took up positions in England (43%); however, in recent times more have been employed in Scotland. Subsequent work profiles of the graduates illustrate that the majority are now working as associates in general practice (51.4%) and in Ireland (54.2%).

CONCLUSIONS: There has been an increase in the proportion of UCC graduates undertaking VT. Graduates tended to move away from Ireland initially to gain employment. There has been a shift away from employment in England towards Scotland where the majority of new UCC graduates are now initially employed. The majority of graduates returned to Ireland for employment after the initial move away.