Innovative Approaches to Involving Service Users in Palliative Care Social Work Education

Service user involvement in social work education is now a firmly established concept in UnitedKingdom.As a result, it is common practice for service users to occupy central roles the education and training of social work students and staff in both qualifying and postqualifying programmes. This paper describes an initiative, undertaken inNorthern Ireland, which compares two methods of user involvement employed with undergraduate and postqualifying social work students. In both situations the students firstly observed discussedDVDexcerpts of narratives from people affected by cancer and secondly observed live facilitated interview with a 25-year-old male service user who shared his experiences being diagnosedwith cancer at a young age.Understanding the social work role in palliative care is crucial as all social workers, regardless of practice context, will have some degree involvement in helping individuals and families to address end-of-life care issues. paper compares the findings of evaluations from two student groups which may help inform social work educators about the effectiveness of different teaching methods used achieve meaningful and effective user involvement with seldom heard groups.

Histamine release from bronchoalveolar lavage cells from asthmatic subjects after allergen challenge and relationship to the late asthmatic response

Background


Metachromatic cells obtained from asthmatic subjects demonstrate increased spontaneous and stimulated histamine release in vitro. Their ability to synthesize and store proinflammatory cytokines has focused renewed interest on their role in asthma.


Objective: The late asthmatic response provides a useful model of clinical asthma. The aim of the study was to examine metachromatic cell derived mediators and histamine releasability in vitro after in vivo allergen exposure in atopic subjects with and without asthma and relate them to the type of physiological response observed.

Methods: Bronchoalveolar lavage (BAL) cells were obtained 4 h after challenge from asthmatics exhibiting a single early response (EAR, n = 5), a dual response (LAR, n = 7), unchallenged (basal, n = 5), atopic non-asthmatic (ANA, n = 6) and non-atopic non-asthmatics (normal, n = 5). BAL histamine and tryptase concentrations and in vitro histamine release (HR) after stimulation with anti-IgE, allergen, A23187, conconavalin A and substance P were compared.

Results:Metachromatic cell numbers were lower in normal controls compared with all asthmatic groups and in LAR compared with EAR. Metachromatic cell derived mediators were higher in asthmatic compared with normal subjects. Spontaneous HR in LAR (20.5 ± 5.0%) was lower than EAR (29.5 ± 3.9%) and ANA (30.2 ± 1.4%) (P < 0.05). No differences were seen in stimulated HR between EAR and LAR. HR in ANA stimulated with anti-IgE was greater than LAR (P < 0.05). HR in ANA stimulated with anti-IgE was greater than LAR (P < 0.05). After stimulation with ionophore A23187 (1 μM), release was greater in LAR compared with basal (P < 0.05) and no different at 5 μM. All subject groups responded to substance P (SP) but was significantly more in the asthmatic subjects compared to normal controls (P < 0.05). Allergen challenge did not modify the response of asthmatic subjects to SP.

Conclusion: Functional differences in metachromatic cell reactivity are present in atopic subjects 4 h after in vivo allergen exposure which relate to the physiological response observed after this time and suggest that there is ongoing metachromatic cell degranulation subjects who subsequently develop LAR.

Holocene deposits from Neptune’s Cave, Nordland, Norway: Environmental interpretation and relation to the deglacial and emergence history of the Velfjord–Tosenfjord area

Neptune’s Cave in the Velfjord–Tosenfjord area of Nordland, Norway is described, together with its various organic deposits. Samples of attached barnacles, loose marine molluscs, animal bones and organic sediments were dated, with radiocarbon ages of 9840+/-90 and 9570+/-80 yr BP being derived for the barnacles and molluscs, based on the superseded but locally used marine reservoir age of 440 years. A growth temperature of c. 7.51C in undiluted seawater is deduced from the d13C and d18O values of both types of marine shell, which is consistent with their early Holocene age. From the dates, and an assessment of local Holocene uplift and Weichselian deglaciation, a scenario is constructed that could explain the situation and condition of the various deposits. The analysis uses assumed local isobases and sea-level curve to give results: that are consistent with previous data, that equate the demise of the barnacles to the collapse of a tidewater glacier in Tosenfjord, and that constrain the minimum extent of local Holocene uplift. An elk fell into the cave in the mid-Holocene at 510070 yr BP, after which a much later single ‘bog-burst’ event at 178070 yr BP could explain the transport of the various loose deposits further into the cave.

The potential for human exposure, direct and indirect, to the suspected carcinogenic triphenylmethane dye Brilliant Green from green paper towels

Triphenylmethanes - Malachite Green (MG), Crystal Violet (CV) and Brilliant Green (BC) are dyes with known genotoxic and carcinogenic properties. Apart from being illegally used in aquaculture for treatment of fish diseases they are also applied in industry such as paper production to colour paper towels widely used in hospitals, factories and other locations for hand drying after washing. The present study provides evidence that the triphenylmethane dye (BC) present in green paper towels can migrate through the skin even when the exposure time is short (30-300 s). The transfer of the dye from the towel to food (fish) was also studied and a high amount of colour was found to migrate during overnight exposure. The risk to humans associated with these two dye transfer studies was assessed using a 'margin of exposure approach' on the basis of the toxicological data available for the closely related dye MG and its metabolite Leucomalachite Green. The data indicated that the risk associated with the use of triphenylmethane containing paper towels is of a similar proportion to the risk associated with consumption of fish contaminated with these dyes due to the illegal application in aquaculture. (C) 2011 Elsevier Ltd. All rights reserved.

Europe’s Information Society project and Digital Inclusion: universal service obligations or social solidarity?

The importance of digital inclusion to Europe is obvious: as we move towards an ever more internet-communicating society the lack of access to basic digital infrastructures for a significant segment of the population is both problematic for those individuals without access and also problematic for those providing services which should be efficient and fully utilised. The EU’s ‘Information Society’ project has been the central plank of the European attempt to build a European digital marketplace, a concept which necessitates digital inclusion of the population at large. It is a project which prefers universal service obligations to achieve inclusion. If that is to be the preferred solution I suggest that we must consider exclusion from the banking system, given that the Information Society is at root an economic community.

However, universal service obligations are not the only method whereby digital inclusion can be encouraged and I posit we may need to reconsider the role of the state as supplier of services through the concept of ‘social solidarity’.

Comparison of teleconsultations and face-to-face consultations:preliminary results of a United Kingdom multicentre teledermatology study

The objective of this multicentre study was to undertake a systematic comparison of face-to-face consultations and teleconsultations performed using low-cost videoconferencing equipment. One hundred and twenty-six patients were enrolled by their general practitioners across three sites. Each patient underwent a teleconsultation with a distant dermatologist followed by a traditional face-to-face consultation with a dermatologist. The main outcome measures were diagnostic concordance rates, management plans and patient and doctor satisfaction. One hundred and fifty-five diagnoses were identified by the face-to-face consultations from the sample of 126 patients. Identical diagnoses were recorded from both types of consultation in 59% of cases. Teledermatology consultations missed a secondary diagnosis in 6% of cases and were unable to make a useful diagnosis in 11% of cases. Wrong diagnoses were made by the teledermatologist in 4% of cases. Dermatologists were able to make a definitive diagnosis by face-to-face consultations in significantly more cases than by teleconsultations (P = 0.001). Where both types of consultation resulted in a single diagnosis there was a high level of agreement (kappa = 0.96, lower 95% confidence limit 0.91-1.00). Overall follow-up rates from both types of consultation were almost identical. Fifty per cent of patients seen could have been managed using a single videoconferenced teleconsultation without any requirement for further specialist intervention. Patients reported high levels of satisfaction with the teleconsultations. General practitioners reported that 75% of the teleconsultations were of educational benefit. This study illustrates the potential of telemedicine to diagnose and manage dermatology cases referred from primary care. Once the problem of image quality has been addressed, further studies will be required to investigate the cost-effectiveness of a teledermatology service and the potential consequences for the provision of dermatological services in the U.K.

Joined-up government in Ireland:From un-strategic choices to patriotic imperatives

Over the last decade, joined-up government has assumed a prominent place in the study and practice of public management. In this article, drawing on the Irish case we adopt an institutionalist approach to the issue of joining-up government and bureaucratic reform. We explore how the period of sustained and rapid economic growth in Ireland during the 1990s was also characterised by a fragmentation of the public service and proliferation of agencies. Subsequently, as a consequence of the sharp contraction in public spending brought about by the global financial crisis, we find an accelerated process of public sector recentralisation, retrenchment and de-agencification. Much of this is occurring in an unplanned manner but under the generic banner of 'joining up' government. We identify the drivers behind these dynamics and how they have manifested themselves, as well as the changes to politicaladministrative relationships brought about by new initiatives, the power imbalances they expose, and ultimately their consequences on public service delivery. © Taylor & Francis Group, LLC.

FROM ASCRIPTION TO ACHIEVEMENT - ORIGINS, EDUCATION AND ENTRY TO THE LABOR-FORCE IN THE REPUBLIC OF IRELAND DURING THE 20TH-CENTURY

This paper examines the relationship between class of origin, educational attainment, and class of entry to the labour force, in three cohorts of men in the Republic of Ireland using data collected in 1987. The three cohorts comprise men born (i) before 1937; (ii) between 1937 and 1949; and (iii) between 1950 and 1962. The paper assesses the degree of change over the three cohorts in respect of (a) the gross relationship between origins and entry class; (b) the partial effect (controlling for education) of origin class on entry class; (c) the partial effect of education (controlling for origins) on class of entry. In broad terms the liberal theory of industrialism would imply a movement, over the three cohorts, towards (a) increasing social fluidity; (b) a weakening of the partial effect of origin class; (c) a strengthening of the partial effect of education. These latter two trends should be particularly noticeable in the youngest cohort, which would, to some degree, have benefited from the introduction of free post-primary education in Ireland in 1967.

Our results provide almost no support for these hypotheses. We find that patterns of social fluidity in the origin/entry relationship remain unchanged over the cohorts. The partial effect of class remains relatively constant; and, while the partial effect of education on entry class changes over the cohorts, the most striking result in this area is the declining returns to higher levels of education. While the average level of educational attainment increased over the three cohorts, the advantages accruing to the possession of higher levels of education simultaneously diminished. Taken together our results suggest that, in Ireland, those classes that have historically enjoyed advantages in access to more desirable entry positions in the labour market have been remarkably adept at retaining their advantages during the course of industrialization and through the various educational and other labour market changes that have accompanied this process.

A defeasible reasoning model of inductive concept learning from examples and communication

This paper introduces a logical model of inductive generalization, and specifically of the machine learning task of inductive concept learning (ICL). We argue that some inductive processes, like ICL, can be seen as a form of defeasible reasoning. We define a consequence relation characterizing which hypotheses can be induced from given sets of examples, and study its properties, showing they correspond to a rather well-behaved non-monotonic logic. We will also show that with the addition of a preference relation on inductive theories we can characterize the inductive bias of ICL algorithms. The second part of the paper shows how this logical characterization of inductive generalization can be integrated with another form of non-monotonic reasoning (argumentation), to define a model of multiagent ICL. This integration allows two or more agents to learn, in a consistent way, both from induction and from arguments used in the communication between them. We show that the inductive theories achieved by multiagent induction plus argumentation are sound, i.e. they are precisely the same as the inductive theories built by a single agent with all data. © 2012 Elsevier B.V.