Antioxidants and periodontitis in 60-70 year- old men

Objective: The aim was to investigate the association between periodontal health and the serum levels of various antioxidants including carotenoids, retinol and vitamin E in a homogenous group of Western European men.
Materials and Methods: A representative sample of 1258 men aged 60-70 years, drawn from the population of Northern Ireland, was examined between 2001 and 2003. Each participant had six or more teeth, completed a questionnaire and underwent a clinical periodontal examination. Serum lipid-soluble antioxidant levels were measured by high-performance liquid chromatography with diode array detection. Multivariable analysis was carried out using logistic regression with adjustment for possible confounders. Models were constructed using two measures of periodontal status (low- and high-threshold periodontitis) as dependent variables and the fifths of each antioxidant as a predictor variable.
Results: The levels of a- and ß-carotene, ß-cryptoxanthin and zeaxanthin were highly significantly lower in the men with low-threshold periodontitis (p<0.001). These carotenoids were also significantly lower in high-threshold periodontitis. There were no significant differences in the levels of lutein, lycopene, a- and ?-tocopherol or retinol in relation to periodontitis. In fully adjusted models, there was an inverse relationship between a number of carotenoids (a- and ß-carotene and ß-cryptoxanthin) and low-threshold periodontitis. ß-Carotene and ß-cryptoxanthin were the only antioxidants that were associated with an increased risk of high-threshold severe periodontitis. The adjusted odds ratio for high-threshold periodontitis in the lowest fifth relative to the highest fifth of ß-cryptoxanthin was 4.02 (p=0.003).
Conclusion: It is concluded that low serum levels of a number of carotenoids, in particular beta-cryptoxanthin and beta-carotene, were associated with an increased prevalence of periodontitis in this homogenous group of 60-70-year-old Western European men.

A 4500-year proxy climate record from peatlands in the North of Ireland: the identification of widespread summer ‘drought phases’?

Mid-to-late Holocene high-resolution testate amoebae-derived water table reconstructions from two peatlands in the North of Ireland are presented. The proxy climate records are dated and correlated using a combination of AMS 14C dating, spheroidal carbonaceous particles and tephrochronology. The reconstructions start prior to the Hekla 4 tephra isochron (2395–2279 BC) and thus span the last ~4500 years. The records are compiled by the process of tuning within chronological errors, standardisation and stacking. Comparisons are made to existing palaeoclimate records from peatlands in Northern Britain and Ireland and the compiled lake-level record for mid-latitude Europe. Four coherent dry phases are identified in the records at ca 1150–800 BC, 320 BC–AD 150, AD 250–470 and AD 1850–2000. Recent research has shown that peat-derived water table reconstructions reflect summer water deficit and therefore the dry phases are interpreted as periods with a higher frequency and/or greater magnitudes of summer drought. These ‘drought phases’ occur during periods of relatively low 14C production, which may add support to the hypothesis of persistent solar forcing of climate change during the Holocene. Any relationship with the North Atlantic stacked drift ice record is less clear. © 2009 Elsevier Ltd. All rights reserved.

Using the internet to give children a voice: An Online Survey of 10- and 11-Year-Old Children in Northern Ireland

Over the years, researchers from different disciplines have used a wide variety of research methods to assess the views of children. Qualitative methods such as focus groups and small group discussions are particularly common. Much rarer are large-scale quantitative surveys that are a valuable way of comparing data from across different age groups and countries and over time. To test the feasibility of carrying out large-scale quantitative research with children, the authors undertook a pilot survey in Northern Ireland in June 2008. There were two notable innovations: First, it was a survey of all Primary 7 children (age 10 and 11 years); second, it used the Internet to gather the information, which has not been done on this scale before. This article discusses the methodology used to implement the pilot study and evaluates the use of the Internet for carrying out survey research with children.

The Impact of Ethical Orientation and Gender on Final Year Undergraduate Auditing Students’ Ethical Judgments

This study considers the possibility of auditing students’ ethical judgment being affected by two factors, namely ethical orientation and gender. While tests revealed that more idealistic students judged some unethical situations more strictly than less idealistic students, overall no significant relationship was found between ethical orientation and ethical judgment. The study also reported no significant relationship between gender and ethical judgment. Furthermore, males were as likely as females to be classified as high idealists. Overall, the findings from the current study inform auditing educators that discriminating among students on the basis of ethical orientation and gender may not assist in stimulating students’ discussion and resolution of ethical dilemmas.

Participation of 8-12 year old children with cerebral palsy: a cross-sectional European Survey

Objectives
To evaluate how involvement in life situations (participation) in children with cerebral palsy varies with type and severity of impairment and to investigate geographical variation in participation.

Design
Cross sectional study. Trained interviewers visited parents of children with cerebral palsy; multilevel multivariable regression related participation to impairments, pain, and sociodemographic characteristics.

Setting
Eight European regions with population registers of children with cerebral palsy; one further region recruited children from multiple sources.

Participants
1174 children aged 8-12 with cerebral palsy randomly selected from the population registers, 743 (63%) joined in the study; the further region recruited 75 children.

Main outcome measure
Children’s participation assessed by the Life-H questionnaire covering 10 main areas of daily life. Scoring ignored adaptations or assistance required for participation.

Results
Children with pain and those with more severely impaired walking, fine motor skills, communication, and intellectual abilities had lower participation across most domains. Type of cerebral palsy and problems with feeding and vision were associated with lower participation for specific domains, but the sociodemographic factors examined were not. Impairment and pain accounted for up to a sixth of the variation in participation. Participation on all domains varied substantially between regions: children in east Denmark had consistently higher participation than children in other regions. For most participation domains, about a third of the unexplained variation could be ascribed to variation between regions and about two thirds to variation between individuals.

Conclusions
Participation in children with cerebral palsy should be assessed in clinical practice to guide intervention and assess its effect. Pain should be carefully assessed. Some European countries facilitate participation better than others, implying some countries could make better provision. Legislation and regulation should be directed to ensuring this happens.

The effects of a volunteer mentoring programme on reading outcomes among eight- to nine-year-old children: A follow up randomized controlled trial

This article presents the findings of a randomized controlled trial evaluation of the effects of a revised version of the volunteer mentoring programme, Time to Read. Participating children received two 30-minute mentoring sessions per week from volunteer mentors who carried out paired reading activities with the children. The current trial involved 512 children aged eight to nine years from 50 primary schools. The programme was found to be effective in improving decoding skills (d=+.15), reading rate (d=+.22) and reading fluency (d=+.14) and there was some evidence of a positive effect in relation to the children’s aspirations for the future (d=+.11). However, no evidence was found of the programme having an effect on reading comprehension or reading confidence and enjoyment of reading. The article concludes by suggesting that mentoring programmes using non-specialist volunteers can be effective in improving foundational reading skills but would appear to be less effective in terms of improving higher-order skills such as comprehension. The article also suggests that such programmes are likely to be most effective if concentrating on core reading activities rather than attempting to address reading outcomes indirectly through improving children’s confidence or wider enjoyment of reading.

Testate amoebae as indicators of hydroseral change: an 8,500 year record from Mer Bleue Bog, eastern Ontario, Canada.

Testate amoebae have been used widely as a proxy of hydrological change in ombrotrophic peatlands, although their response to abiotic controls in other types of mire and fenland palaeo-environments is less well understood. This paper examines the response of testate amoebae to hydroseral and other environmental changes at Mer Bleue Bog, Ontario, Canada, a large ombrotrophic peatland, which evolved from a brackish-water embayment in the early Holocene. Sediments, plant macrofossils and diatoms examined from a 5.99 m core collected from the dome of the bog record six stages of development: i) a quiet, brackish-water riverine phase (prior to ca. 8500 cal BP); ii) a shallow lake (ca. 8500–8200 cal BP); iii) fen (8200–7600 cal BP); iv) transitional mire (7600–6900 cal BP); v) pioneer raised mire (6900–4450 cal BP); and vi) ombrotrophic bog (4450 cal BP-present).

Testate amoebae, notably small (<25 µm diameter) specimens of Centropyxis aculeata type, first appear in low abundances in sediments ascribed to the lacustrine phase. Diatoms from the same horizons record a shallowing in water depth, a decline in salinity and the development of emergent macrophytic vegetation, which may have provided favourable conditions for testate amoeba colonization. The testate amoeba communities of the inferred fen phase are more diverse and include centropyxids, cyclopyxids, Arcellidae and Hyalospheniidae, although the assemblages show some differences to those recently reported in modern European fen environments. The Fen–Bog Transition (FBT) is also dominated by C. aculeata type. The change in testate amoeba communities around this key transition is apparent in the results of Detrended Correspondence Analysis (DCA), and appears to reflect a latent nutrient gradient and a secondary moisture gradient. DCA analyses of plant macrofossil remains around the FBT show a similar trend, although the sensitivity of the two proxies to the inferred environmental changes differs. Comparisons with other regional mid-Holocene peatland records confirm the important influence of reduced effective precipitation on the testate amoeba communities during the initiation and development of Sphagnum-dominated, raised bog communities.

AUDIT OF ANTIBIOTIC USAGE IN A MEDIUM-SIZED GENERAL-HOSPITAL OVER AN 11-YEAR PERIOD - THE IMPACT OF ANTIBIOTIC POLICIES

The objective of the present study was to evaluate trends in antibiotic expenditure over an 11-year period (1982-1992) in a 370-bed district general hospital in Northern Ireland and to examine the impact of two separate antibiotic policies on antibiotic usage. A further objective was to examine the attitudes of prescribers to the second policy. Drug utilization review was used to collect information on antibiotic expenditure and usage before and after introduction of separate antibiotic policies in 1985 (not intensively monitored) and 1989 (intensively monitored). A mail questionnaire was used to determine the attitudes of prescribers. The first policy (1985) showed no benefits with regard to the number of antibiotic entities stocked (45 before, 45 after), number of dosage units issued (9.35 increase) or expenditure (33.35 increase). The 1989 policy led to significant reductions in the number of antibiotic entities stocked (28.9%), number of antibiotics issued (11.9%) and expenditure (6.1%). Expenditure began to spiral upwards when active monitoring of the second policy was suspended. The majority of prescribers (87.2%) who responded to the questionnaire (56.5% response rate) felt that the 1989 policy made a positive contribution to antibiotic usage in the hospital.

The application of the ecological footprint in two Irish urban areas: Limerick and Belfast

The ecological footprint is now a widely accepted indicator of sustainable
development. Footprinting translates resource consumption into the land area
required to sustain it, and allows for an average per capita footprint for a region
or nation to be compared with the global average. This paper reports on a project
in which footprints were calculated for two Irish cities, namely Belfast in
Northern Ireland and Limerick in the Republic of Ireland for the year 2001. As
is frequently the case at sub-national scale, data quality and availability were
often problematic, and in general data gaps were filled by means of population
proxies or national averages. A range of methods was applied to convert
resource flows to land areas. Both footprints suggest that the lifestyles of citizens
of the cities use several times more land than their global share, as has been
found for other cities.

The effect of a healthy lifestyle programme on 8-9 year olds from social disadvantage

Aims: This study assessed the efficacy of a school-based healthy lifestyle intervention (Sport for LIFE) for increasing physical activity, decreasing sedentary behaviour, reducing screen time behaviour, encouraging healthy attitudes and behaviour to nutrition, and reducing body mass index (BMI) in 8–9-year-old primary school children from lower socioeconomic backgrounds in Northern Ireland.

Methods: A non-randomised controlled trial of 416 children from 24 schools took part. Schools were randomly assigned to one of two groups, an intervention or control group with 12 schools in each group. The intervention group received a 12-week school-based programme based on social cognitive theory. At baseline and follow-up, groups completed questionnaires assessing physical activity, screen time behaviour and dietary patterns. On each occasion anthropometric assessments of height and weight were taken. Physical activity and sedentary behaviour were measured by accelerometry.

Results Significant effects were observed for vigorous, moderate and light activity for the intervention group at follow-up. Sedentary behaviour was significantly reduced for the intervention group but not for the control group. No significant effects of the intervention on BMI, screen time behaviour or attitudes to nutrition, with the exception of non-core foods, were shown.

Conclusions: The programme was effective in increasing physical activity and reducing sedentary behaviour, however no significant changes in screen time behaviour and attitude to nutrition, with the exception of non-core foods, were observed. Future research ideas are offered for tackling low levels of physical activity in children.

Moving to evidence-based practice in long-term care:the role of a Best Practise Resource Centre in two long-term care settings.

In this article, the authors provide an overview on the development of a Long-Term Care Best Practise Resource Centre. The results of both a feasibility study and the outcomes of a 1-year demonstration project are presented. The demonstration project involved a hospital as the information service provider and two demonstration sites, a home care service agency and a nursing home that used the services of the Centre. The goals of the Centre were threefold: provide access to literature for staff in long-term care (LTC) settings; improve the information management skills of health care providers; and support research and the integration of best practices in LTC organizations. The results of the pilot study contributed to the development of a collaborative information access system for LTC clinicians and managers that provides timely, up-to-date information contributing to improving the quality of care for adults receiving LTC. Based on this demonstration project, strategies for successful innovation in LTC are identified.

A ten year retrospective audit of clinical psychology referrals within a paediatric CF team

Objective: This retrospective audit was undertaken to explore the nature of referrals made by the paediatric CF team to the Clinical Psychologist over a period of 10 years. The aim of the audit was to identify patterns or trends related to difficulties referred by the team.
Methods: A database consisting of all referrals received over a ten year period from 2001-2010 was created. A coding template was then created by KR and AC, which allowed for the categorisation of referrals into three main themes: Mood disturbance; CF related events; and non-CF related events. The same coding template was used to categorise referrals to the adult CF service. Descriptive statistics were used to interpret the data.
Results: Over the ten year period, 106 young people with CF were referred to psychology, representing 266 referrals. On average, a referral was made every two weeks. The most common reason for referral was for CF related events (i.e. adherence, living everyday life with CF). Referrals were found to increase with age. Both genders were equally likely to be referred, with females being re-referred most frequently, indicating increased psychological morbidity. The majority of referrals (79%) were repeat referrals, indicating that psychology input is focused upon a small number of young people but over a period of time. In a typical year (09-10), only 16% of all young people with CF were able to access psychology services. Conclusion: This audit identified patterns related to inequality of access, gender differences, and the identification of common concerns across age groups. The audit also highlighted areas where early intervention and training efforts could be targeted.

The cemented custom femoral stem--a 10 year review

We report a series of 706 patients (759 hip implants) with an average follow up of 10.5 years (range, 10-11 years) following total hip replacement (THR) using a cemented custom-made femoral stem and a cemented HDP acetabular component. The fate of every implant is known. One hundred and seventy-four patients (23%) were deceased at the time of their 10-year review all died with a functioning THR in situ. Four hundred and sixty-two patients (61%) were subsequently reviewed. One hundred and twenty three patients (16%) were assessed by telephone review, as they were too ill or unwilling to attend. Kaplan-Meier survival analysis (all components) demonstrated a median survival at 10 years of 96.05% or 95% Confidence Intervals (CI) for median survival of (94.41% to 97.22%). Revision surgery occurred in 30 cases (3.9%). Seventeen had full revisions (2.2%) and 13 (1.7%) socket revisions only. Twenty-one out of 30 revisions were for infection or dislocation. There were 2 cases (0.3%) of revision for aseptic loosening of the stem. The 10-year results of the custom femoral titanium stem are encouraging and compare well with other cemented systems.

Impact of a play-based curriculum in the first two years of primary school: literacy and numeracy outcomes over seven years

In 2000–2002 an innovative early years curriculum, the Enriched Curriculum (EC), was introduced
into 120 volunteer schools across Northern Ireland, replacing a traditional curriculum similar to
others across the UK at that time. It was intended by the designers to be developmentally appropriate
and play-based with the primary goal of preventing the experience of persistent early failure in
children. The EC was not intended to be a literacy and numeracy intervention, yet it did considerably
alter pedagogy in these domains, particularly the age at which formal reading and mathematics
instruction began. As part of a multi-method evaluation running from 2000–2008, the research
team followed the primary school careers of the first two successive cohorts of EC children, comparing
them with year-ahead controls attending the same 24 schools. Compared to the year-ahead control
group, the findings show that the EC children’s reading and mathematics scores fell behind in
the first two years but the majority of EC children caught up by the end of their fourth year. Thereafter,
the performance of the first EC cohort fell away slightly, while that of the second continued to
match that of controls. Overall, the play-based curriculum had no statistically significant positive
effects on reading and mathematics in the medium term. At best, the EC children’s scores matched
those of controls.

A-level Mathematics Module Choice and Subsequent Performance in First Year of an Engineering Degree

The A-level Mathematics qualification is based on a compulsory set of pure maths modules and a selection of applied maths modules. The flexibility in choice of applied modules has led to concerns that many students would proceed to study engineering at university with little background in mechanics. A survey of aerospace and mechanical engineering students in our university revealed that a combination of mechanics and statistics (the basic module in both) was by far the most popular choice of optional modules in A-level Mathematics, meaning that only about one-quarter of the class had studied mechanics beyond the basic module within school mathematics. Investigation of student performance in two core, first-year engineering courses, which build on a mechanics foundation, indicated that any benefits for students who studied the extra mechanics at school were small. These results give concern about the depth of understanding in mechanics gained during A-level Mathematics.