Neuroendocrine tumors. A European view

A center in Belfast, Northern Ireland, has established a register for tumors of the gastroenteropancreatic endocrine system. Carcinoid tumors occur most frequently. Of the non-carcinoid tumors, insulinomas, gastrinomas, and unknown types have the highest incidence, with other types being extremely rare. The potentially remediable nature of the tumors is stressed, and frequently a good quality of life can be experienced even in the presence of metastatic disease. The syndromes are probably underdiagnosed as they present with clinical features for which there are more common explanations, and appropriate diagnostic methods are therefore not used. The management of the syndromes is reviewed with particular emphasis on the treatment of patients with inoperable disease. Histamine (H2)-receptor antagonist therapy has made an impact in Zollinger-Ellison syndrome, and streptozotocin and somatostatin analogues can control tumor growth and endocrine syndromes, respectively.

Risk factors for falls and injuries in a long-term care facility in Ontario

Objective: To identify risk factors for falls and injuries among seniors living in a long-term care facility. Method: Case-control study of 335 residents living at St. Joseph's Villa, Dundas, Ontario. Cases were defined as residents who fell between July 1, 1996 and June 30, 1997; controls were those who did not fall. To identify risk factors for injury, cases were defined as those with completed incident injury forms and controls as those without. Results: The most important risk factors for falls included: having fallen in the past three months; residing in a secured unit; living in the facility for two or more years; having the potential to cause injury to others; and having an illness, disease or behaviour that may cause a fall. The most important risk factor for injury among those who fell was altered mental state. Conclusion: The risk factors identified may be helpful to those planning falls prevention initiatives within long-term care settings.

An Investigation Into Features For Multi-View Lipreading

For the first time in this paper we present results showing the effect of speaker head pose angle on automatic lip-reading performance over a wide range of closely spaced angles. We analyse the effect head pose has upon the features themselves and show that by selecting coefficients with minimum variance w.r.t. pose angle, recognition performance can be improved when train-test pose angles differ. Experiments are conducted using the initial phase of a unique multi view Audio-Visual database designed specifically for research and development of pose-invariant lip-reading systems. We firstly show that it is the higher order horizontal spatial frequency components that become most detrimental as the pose deviates. Secondly we assess the performance of different feature selection masks across a range of pose angles including a new mask based on Minimum Cross-Pose Variance coefficients. We report a relative improvement of 50% in Word Error Rate when using our selection mask over a common energy based selection during profile view lip-reading.

The view from over there:reframing the OSCE through the experience of standardised patient raters

Ratings awarded by standardised patients (SPs) in UK objective structured clinical examinations (OSCEs) are typically based on humanistic (non-technical) skills and are complementary to clinician-examiner ratings. In psychometric terms, SP ratings appear to differ from examiner ratings and improve reliability. For the first time, we used qualitative methods from a constructivist perspective to explore SP experiences of rating, and consider how these impact our understanding of assessment.

Invisible from View: Leaving and Aftercare Provision in the Republic Of Ireland

The adequacy of provisions for young people leaving care and in aftercare in the Republic of Ireland have been the subject of recent policy attention. A landmark report, the Ryan Report (2009), into historic abuse in state institutions recommended strengthening provisions in this area. However, the legislative basis for aftercare remains relatively weak and services for young people leaving care remain ad hoc and regionally variable. This article outlines the current context of leaving and aftercare provision in the Republic of Ireland and traces some of the recent policy debates and recommendations in this area. A genealogical analysis of leaving care and aftercare provision highlights that this issue has historically only emerged as a concern in the context in which young people leaving the care system are perceived as a ‘threat’ to social order. It is argued that the failure to adequately reform leaving and aftercare provision is reflective of wider social inequality and of a context in which young people in care are largely invisible from view.

Young people's self-reported experiences of sexual exploitation and sexual violence: a view from Northern Ireland

The issue of young people’s experiences of sexual exploitation and sexual violence has received increasing political and media attention within recent years. However, whilst many studies have identified this to be an emerging issue of concern, the collation of prevalence data on the extent of these issues is still very much in its infancy. In this article we report on the findings of a large-scale project on the sexual exploitation of young people, undertaken in Northern Ireland from 2009 to 2011. The article primarily explores young people’s self-reported experiences of sexual violence and exploitation, collated from their responses to a module of questions placed in the 2010 Young Life and Times Survey. The quantitative dataset from the survey covers both prevalence of sexually exploitative experiences and young people’s reports about the type of individuals perpetrating these incidents. This dataset is illustrated and contextualised with reference to the qualitative findings from interviews with young people and professionals conducted as part of the wider sexual exploitation study. The article concludes with a consideration of the implications of the findings, with particular reference to the need for further preventative work in this field.