Exploring the perspective of midwives involved in offering serum screening for Down's syndrome in Northern Ireland

Aims. To explore the perspective of midwives offering serum screening for Down’s syndrome.

Background. Previous literature has indicated that the offer and discussion of prenatal serum screening tests with women is complex, and health professionals may influence women’s decisions to accept or decline screening. Midwives are usually the key professional to offer serum screening for Down’s syndrome in the UK but their perspective is relatively neglected in the literature.

Design. An explorative qualitative interview study with 15 midwives employed in a maternity unit in Northern Ireland involved in offering prenatal screening to pregnant women. Data were collected from 1 July 2005–31 October 2005.

Methods. A focused ethnographic approach was used to explore the perspective of midwives.

Results. Midwives reported difficulty in explaining the test to women and felt unable to provide the necessary information to adequately inform women within their appointment time. The test offered (the triple test) and potential pathway of subsequent care, were identified as sources of professional and personal conflict by midwives. The expectation that midwives would provide a universal offer of Down’s syndrome serum screening but be unable to support women regarding termination of pregnancy also created dissonance.

Conclusions. The feasibility of proceeding with a universal serum screening programme for Down’s syndrome is questionable in countries which legally or culturally oppose termination of pregnancy. Professionals practising within environments such as this experience conflict in their role, which affects communication with women when discussing screening tests.

Relevance to clinical practice. As midwives are often, the primary health professional providing information to women, it is important that midwives are key participants in ongoing planning and discussions about screening policy to ensure programmes are implemented successfully.

Juxtaposition and Non-Motion: Varese Bridges Modernism and Electroacoustic Music

Edgard Vare` se’s Poe` me e´ lectronique can be viewed as a bridge between early twentieth-century modernism and electroacoustic music. This connection to early modernism is most clearly seen in its use of musical juxtaposition, a favoured technique of early modernist composers, especially those active in Paris. Juxtaposition and non-motion are considered here, particularly in relationship to Smalley’s exposition of spectromorphology (Smalley 1986), which in its preoccupation with motion omits any significant consideration of non-motion. Juxtaposition and non-motion have an important history within twentieth-century music, and as an early classic of electroacoustic music, Poe` me e´ lectronique is a particularly striking example of a composition that is rich in juxtapositions similar to those found in passages of early modernist music. Examining Poe` me e´ lectronique through the lens of juxtaposition and non-motion reveals how the organisation of its juxtaposed sounds encourages the experience of sound structure suspended time.

The Application of the Margin of Appreciation Doctrine in Freedom of Expression and Public Morality Cases

This paper discusses whether or not Strasbourg organs have created principled criteria governing the use of the doctrine within the context of free speech and public morals. The first part of the paper gives an overview of the doctrine and further examines how the doctrine has evolved within the European context. Part II focuses on the rationale behind the doctrine and discusses the legitimacy of the doctrine in light of its application to various forms of free speech. Part III covers one of the most problematic applications of the doctrine in matters concerning public morality, where Contracting States have a wide margin of appreciation. This part will discuss whether or not the “lack of European consensus” criterion is an elusive concept that might create a risk of abuse in the application of the doctrine. The paper concludes that while margin of appreciation today serves as a flexible instrument between the local necessities and the universal application of human rights, the imprecise and contradictory points might lead to its potential abuse that might endanger its future existence.

Language-universal Sensory Deficits in Developmental Dyslexia: English, Spanish, and Chinese

Studies in sensory neuroscience reveal the critical importance of accurate sensory perception for cognitive development. There is considerable debate concerning the possible sensory correlates of phonological processing, the primary cognitive risk factor for developmental dyslexia. Across languages, children with dyslexia have a specific difficulty with the neural representation of the phonological structure of speech. The identification of a robust sensory marker of phonological difficulties would enable early identification of risk for developmental dyslexia and early targeted intervention. Here, we explore whether phonological processing difficulties are associated with difficulties in processing acoustic cues to speech rhythm. Speech rhythm is used across languages by infants to segment the speech stream into words and syllables. Early difficulties in perceiving auditory sensory cues to speech rhythm and prosody could lead developmentally to impairments in phonology. We compared matched samples of children with and without dyslexia, learning three very different spoken and written languages, English, Spanish, and Chinese. The key sensory cue measured was rate of onset of the amplitude envelope (rise time), known to be critical for the rhythmic timing of speech. Despite phonological and orthographic differences, for each language, rise time sensitivity was a significant predictor of phonological awareness, and rise time was the only consistent predictor of reading acquisition. The data support a language-universal theory of the neural basis of developmental dyslexia on the basis of rhythmic perception and syllable segmentation. They also suggest that novel remediation strategies on the basis of rhythm and music may offer benefits for phonological and linguistic development.

Drug release enhancement from silicone intravaginal rings by incorporation of water soluble excipients

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Claiming and displaying national identity: Irish Travellers' and students' strategic use of 'banal' and 'hot' national identity in talk

Two complementary explanations have been offered by social psychologists to account for the universal hold of national identity, first that national identity is ideologically assumed, as it forms the ‘banal’ background of everyday life, and second that national identity is ‘hotly’ constructed and contested in political and everyday settings to great effect. However, ‘banal’ and ‘hot’ aspects of national identity have been found to be distributed unevenly across national and subnational groups and banality itself can be strategically used to distinguish between different groups. The present paper develops these ideas by examining possible reasons for these different modes and strategies of identity expression. Drawing upon intergroup theories of minority and majority relations, we examine how a group who see themselves unequivocally as a minority, Irish Travellers, talk about their national identity in comparison to an age and gender-matched sample of Irish students. We find that Travellers proactively display and claim ‘hot’ national identity in order to establish their Irishness. Irish students ‘do banality’, police the boundaries and reputation of Irishness, and actively reject and disparage proactive displays of Irishness. The implications for discursive understandings of identity, the study of intra-national group relations and policies of minority inclusion are discussed.

Adiponectin multimers, body weight and markers of cardiovascular risk in adolescence: Northern Ireland Young Hearts Project:Northern Ireland Young Hearts Project

Background:Research examining the relationship between adiponectin (AN) isoforms, body weight and cardiovascular (CV) risk factors is limited, particularly in younger populations. Objectives:To investigate the inter-relationships between AN isoforms and CV risk factors, and their dependence on body weight status, in adolescents. Design:Blood samples from 92 obese, 92 overweight and 92 normal weight age- and sex-matched adolescents were analysed for traditional cardiovascular disease (CVD) risk biomarkers and also total, high molecular weight (HMW), medium and low molecular weight (LMW) AN. Results:A significant inverse association was observed between total and HMW AN and waist-hip ratio (P=0.015, P=0.006, respectively), triglycerides (P=0.003, P=0.003, respectively) and systolic blood pressure (P=0.012, P=0.024, respectively) and a significant positive association with high-density lipoprotein (P<0.001, P<0.001, respectively) in multi-adjusted analyses. There was no evidence of a relationship between multimeric AN and high-sensitivity C-reactive protein. There was also little evidence of a relationship between LMW AN and CVD risk factors. There was a strong, body mass index (BMI)-independent, association between AN, CVD biomarkers and the hypertriglyceridemic waist phenotype. Conclusion:Prominent, BMI-independent associations between total and HMW AN, but not LMW AN, and CVD risk factors were already evident in this young population. This research in adolescents supports the contention that AN subfractions may have different biological actions. These associations in apparently healthy adolescents suggest an important role for AN and its subfractions in the pathogenesis of metabolic syndrome traits and indicate that the potential for total or HMW AN to act as early universal biomarkers of CV risk warrants further study.

If Music Be the Food of Love:An Acoustic ‘Fourth World’ in Ong Keng Sen’s Awaking”

Staged as an attempt to ‘bring together Shakespeare’s plays and Tang Xian Zu’s classical Kunqu opera, The Peony Pavilion,’ (Ong, Programme Notes) Awaking stands as Singapore Director Ong Keng Sen’s most recent and prominent attempt at engaging issues of the intercultural through music and sound. While Ong’s previous intercultural projects sought to explore the politics of intercultural performance through the exchange, layering, confrontation and inter-mixing of Asian performance modes as visual aesthetics, Awaking is a performance at the borders of theatrical and musical conventions, as it features the music and musicians as central performative devices of staging the intercultural. Northern Kunqu opera, Chinese classical music and Elizabethan folk tunes from Shakespeare’s plays were re-moved, re-contextualised, and juxtaposed to explore ‘differing yet connected philosophies on love, death, and the afterlife’ (Awaking, Publicity). These humanist and ‘universal’ themes found expression in the ‘universal’ language of music. Through a study of the musicalities and sonic expressions of Awaking, the paper seeks to explore the implications of such cultural-musical juxtapositions. The paper engages, specifically, with the problematics and possibilities of music as a ‘universal language’ as implied by Ong’s concordance of Eastern and Western sounds in the final act. It further considers the politics of an intercultural soundscape and the acoustemologies of such an intercultural approach.

Developing tomorrow's leaders-Evidence of global talent management in multinational enterprises

Organizations are becoming relentless in managing and developing their key talent. This is a view, however, largely based on anecdote rather than reliable empirical evidence. Utilizing data from 260 multinational enterprises (MNEs), this paper helps redress this deficit. Specifically, this paper explores the extent to which MNEs engage in global talent management (GTM) and deciphers some of the factors which may explain the use and non-use of GTM practices. In so doing, we find that although a significant number of MNEs have systems and mechanisms in place to strategically identify and develop their talent many more seemingly adopt an ad hoc or haphazard approach. For instance, less than half of all MNEs have both global succession planning and formal management development programs for their high-potentials. Consequently it seems that there is a considerable distance yet to be travelled to arrive at a universal appreciation of the need to strategically manage one's key employees. We find the size of the MNE has a significant effect on GTM system usage-larger MNEs are more likely to undertake GTM. Other significant, positive influences include whether products or services are standardized regionally or globally, and if the MNE has a global human resources policy formation body. Of considerable interest is the finding that MNEs operating in the low-tech/low-cost sectors are significantly more likely to have formal global systems to identify and develop high-potentials. © 2009 Elsevier Inc. All rights reserved.

The Ocho Poetas Mexicanos and the marginalisation of Catholic authors in post-revolutionary Mexico

The group known as the Ocho Poetas Mexicanos were marginalised in post-revolutionary literary circles and remain largely forgotten by literary history because they were dismissed as Catholic authors by a literary establishment which favoured nation-building literature at a time when Catholicism was excluded from official constructions of nationhood. This article draws attention to the significant contribution made by group members to contemporary cultural life and re-evaluates the work they published in the 1955 anthology which announced their arrival onto the literary scene. An analysis of this collection demonstrates that there was scant justification for labelling the group as Catholic poets and suggests that they are best understood with reference to the “universal” strand of Mexican literature and as heirs to groups such as the Contemporáneos. The treatment of the Ocho Poetas provides important evidence of the way in which Catholic authors were marginalised in mid-twentieth century Mexico, even if they did not express religious beliefs in their work, and draws attention to the non-literary criteria which can come into play when evaluating texts.