Unilateral Forgiveness and the Task of Reconciliation

Although forgiveness is often taken to bear a close connection to the value
of reconciliation, there is a good deal of scepticism about its role in situations where there is no consensus on the moral complexion of the past and no admission of guilt on the part of the perpetrator. This scepticism is typically rooted in the claims that forgiveness without perpetrator acknowledgement (1) aggravates the risk of recidivism; (2) yields a substandard and morally compromised form of political accommodation; and (3) comes across as patronizing and offensive to the recipient, thereby causing further alienation. In this article, my aim is to show, firstly, that none of these arguments is decisive and, secondly, that forgiveness is a suitable object of political concern in the
absence of cross-community consensus on the rights and wrongs of a conflict. In this way, I aim to demonstrate that forgiveness deserves to be taken seriously as a means to civic reconciliation in a broader range of situations than many have allowed.

Lest we forget: Remembering the consequences of child neglect - A clarion call to "feisty advocates"

It is widely acknowledged that, across the United Kingdom and the USA, childcare practitioners often struggle with cases of child neglect, because of the difficulties involved in attempting to define the problem at hand, and balancing these cases with others in the caseload that may appear more pressing, such as physical abuse. Consequently, in an attempt to refocus the lens of professional policy and practice, this article will profile a number of research studies that have highlighted the profound developmental deficits that neglect can cause, relative to other forms of child maltreatment, and a range of interventions that have proven to be effective with these types of cases. The article concludes with a discussion of the potential negative impact of the current financial crisis for neglected children.

Autologous limbal transplantation in patients with unilateral corneal stem cell deficiency

Aim - To describe a surgical technique for autologous limbal stem cell transplantation and the outcome of a series of patients with unilateral stem cell deficiency. Methods - A report of six consecutive patients who underwent autologous limbal stem cell transplantation is presented. The primary diagnosis included alkali burn (n = 3), conjunctival intraepithelial neoplasia (CIN) (n = 1), recurrent pterygium (n = 1), and contact lens induced keratopathy (n = 1). The autologous transplanted tissue consisted of peripheral cornea, limbus, and conjunctiva obtained from the contralateral eye. Three of the above patients underwent penetrating keratoplasty in association with autolimbal transplantation. A significant modification to established techniques was the close monitoring of conjunctival epithelial migration in the immediate postoperative period. If conjunctival epithelium threatened to migrate on to the corneal surface, it was mechanically removed at the slit lamp and prevented from crossing the limbus. This was required in three patients. Results - The mean follow up was 18.8 months. The outcome was satisfactory in all cases: a stable corneal surface was restored and there was a substantial improvement in vision and symptoms. One patient had a primary failure of the corneal allograft associated with glaucoma, and 6 months later developed a retinal detachment. No complications were noted in the donor eye with the exception of one patient who developed filamentary keratitis along the edge of the donor site. Conclusion - Autologous limbal transplantation with corneal, limbal, and conjunctival carriers was found to be useful for ocular surface reconstruction, over a mid-term follow up, in patients with unilateral stem cell deficiency. Close monitoring of the migration of conjunctival epithelium in the immediate postoperative period, and preventing it from crossing the limbus, ensured that the corneal surface was re-epithelialised exclusively from epithelial cells derived from the transplanted limbal tissue. This approach should improve the success of this procedure.

Older People's Conceptualisation of Elder and neglect

Purpose

To be effective, definitions of elder abuse should be informed by the perspectives of older people themselves.

Methods

This qualitative study used data from eight focus groups involving 58 people aged over 65 years in both urban and rural settings across Northern Ireland and the Republic of Ireland. Following training, four older people assisted in facilitation and analysis as ‘peer-researchers'.

Findings

Increasing lack of respect within society was experienced as abusive. The vulnerability of older people to abuse was perceived as relating to the need for help and support, where standing up for themselves might have repercussions for the person's health or safety. Emotional abusiveness was viewed as underpinning all forms of abuse, and as influencing its experienced severity. Respondents' views as to whether an action was abusive required an understanding of intent; some actions that professionals might view as abusive were regarded as acceptable if they were in the older person's best interests.

Implications

Preventing abuse requires a wide-ranging approach including re-building respect for older people within society. Procedures to prevent elder abuse need to take into account the emotional impact of family relationships and intent, not just a description of behaviours that have occurred.

Clinical Characteristics of Reticular Pseudodrusen in the Fellow Eye of Patients with Unilateral Neovascular Age-Related Macular Degeneration

Purpose: To describe associations between reticular pseudodrusen, individual characteristics, and retinal function.

Design: Cohort study.

Participants: We recruited 105 patients (age range, 52–93 years) who had advanced neovascular age-related macular degeneration (AMD) in only 1 eye from 3 clinical centers in Europe.

Methods: Minimum follow-up was 12 months. The eye selected for study was the fellow eye without advanced disease. Clinical measures of vision were distance visual acuity, near visual acuity, and results of the Smith-Kettlewell low-luminance acuity test (SKILL). Fundus imaging included color photography, red-free imaging, blue autofluorescence imaging, fluorescein angiography, indocyanine green angiography, and optical coherence tomography using standardized protocols. These were used to detect progression to neovascular AMD in the study eye during follow-up. All imaging outputs were graded for the presence or absence of reticular pseudodrusen (RPD) using a multimodal approach. Choroidal thickness was measured at the foveal center and at 2 other equidistant locations from the fovea (1500 μm) nasally and temporally. Metrics on retinal thickness and volume were obtained from the manufacturer-supplied automated segmentation readouts.

Main Outcome Measures: Presence of RPD, distance visual acuity, near visual acuity, SKILL score, choroidal thickness, retinal thickness, and retinal volume.

Results: Reticular pseudodrusen was found in 43 participants (41%) on 1 or more imaging method. The SKILL score was significantly worse in those with reticular drusen (mean score ± standard deviation [SD, 38±12) versus those without (mean score ± SD, 33±9) (P = 0.034). Parafoveal retinal thickness, parafoveal retinal volume, and all of the choroidal thickness parameters measured were significantly lower in those with reticular drusen than in those without. The presence of RPD was associated with development of neovascular AMD when corrected for age and sex (odds ratio, 5.5; 95% confidence interval, 1.1–28.8; P = 0.042). All participants in whom geographic atrophy developed during follow-up had visible RPD at baseline.

Conclusions: Significant differences in retinal and choroidal anatomic features, visual function, and risk factor profile exist in unilateral neovascular AMD patients with RPD compared with those without; therefore, such patients should be monitored carefully because of the risk of developing bilateral disease.

Impact of abuse and neglect on the health and wellbeing of children:Child sexual abuse

During the past 30 years, the focus on the extent and nature of child abuse and neglect has been coupled with an increasing interest in the impact on children’s development, health and mental wellbeing. Child maltreatment is both a human rights violation and a complex public health issue, likely caused by a myriad of factors that involve the individual, the family, and the community. Child abuse includes any type of maltreatment or harm inflicted upon children and young people in interactions between adults (or older adolescents). Such maltreatment is likely to cause enduring harm to the child.
The different forms of abuse and neglect often occur together in one family and can affect one or more children. These include, in deceasing level of frequency: neglect; physical abuse and non-accidental injury; emotional abuse; and sexual abuse (Cawson et al, 2000; 2002). Recently, bullying and domestic violence have been included as forms of abuse of children.
There is a sizeable body of literature on the relationship between types of child maltreatment and a variety of negative health and mental health consequences. These include biological, psychological, and social deficits (for reviews, see Crittenden, 1998; Kendall-Tackett, 2001; 2003). Aside from the serious physical and health consequences of child maltreatment, several emotional and behavioural consequences for children have been noted in the literature.

Ireland after Rapid Immigration:The consequences of neglect

Essay review of:
Immigration and Schooling in the Republic of Ireland: Making a Difference?, by Dympna Devine . Manchester, UK: Manchester University Press, 2012. 186pp. $24.95 paper. ISBN: 9780719081026.
Immigration and Social Cohesion in the Republic of Ireland, by Bryan Fanning . Manchester, UK: Manchester University Press, 2011. 202pp. $24.95 paper. ISBN: 9780719084799.
Understanding Immigration in Ireland: State, Capital and Labour in a Global Age, by Steven Loyal . Manchester, UK: Manchester University Press, 2011. 283pp. $24.95 paper. ISBN: 9780719078316.

The inclusion of open-ended questions on quantitative surveys of children: Dealing with unanticipated responses relating to child abuse and neglect

Web surveys have been shown to be a viable, and relatively inexpensive, method of data collection with children. For this reason, the Kids’ Life and Times (KLT) was developed as an annual online survey of 10 and 11 year old children. Each year, approximately 4,000 children participate in the survey. Throughout the six years that KLT has been running, a range of questions has been asked that are both policy-relevant and important to the lives of children. Given the method employed by the survey, no extremely sensitive questions that might cause the children distress are included. The majority of questions on KLT are closed yielding quantitative data that are analysed statistically; however, one regular open-ended question is included at the end of KLT each year so that the children can suggest questions that they think should be asked on the survey the following year. While most of the responses are innocuous, each year a small minority of children suggest questions on child abuse and neglect. This paper reports the responses to this question and reflects on how researchers can, and should, deal with this issue from both a methodological and an ethical perspective.

The relationship between poverty, child abuse and neglect: an evidence review.

The review aimed to investigate two central issues.
1.To what extent is there evidence that poverty increases the amount of child abuse and neglect (CAN), and/or affects the nature of child abuse and neglect? How does this occur, how large are these effects and to whom do they apply?
2.To what extent is there evidence that CAN increases poverty later in life, how large are these effects and to whom do they apply?
Within these two issues evidence about equality and diversity, and cost were considered throughout.

''Setting 'Em Up'': Personal, Familial and Institutional Grooming in the Sexual Abuse of Children

The term ‘grooming’ has been used to describe the offender’s actions during the preparatory stage of sexual abuse. This paper will argue that current discourses on grooming have created ambiguities and misunderstandings about child sexual abuse. In particular, the popular focus on ‘stranger danger’ belies the fact that the majority of children are abused by someone well known to them, where grooming can also occur. Current discourses also neglect other important facets of the sex offending pattern. They fail to consider that offenders may groom not only the child but also their family and even the local community who may act as the gatekeepers of access. They also ignore what can be termed ‘institutional grooming’ – that sex offenders may groom criminal justice and other institutions into believing that they present no risk to children. A key variable in the grooming process is the creation and subsequent abuse of trust. Given that the criminal law may be somewhat limited in its response to this type of behaviour, ultimately concerted efforts must be made to foster social and organisational awareness of such processes in order to reduce the offender’s opportunity for abuse.