151 resultados para REGIONAL DISPARITIES


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Background: The telephone is an accepted and useful means of communication for the management of patient care. The Chemotherapy Telephone Helpline (CTH) service, located in a large inner-city Trust within the United Kingdom, is a unique nurse-led service within Northern Ireland.

Objective: The objective of the study was to investigate the utility, caller, and patient profile of a novel CTH.

Methods: This was a retrospective study of telephone contacts during 2007 to the CTH. Calls were categorized by caller and patient characteristics, reason for call, and subsequent action.

Results: A total of 7498 calls were made to the CTH during 2007. Of these, 25.6% occurred outside 8AM-4PM. Callers included patients (45.8%), lay carers (31%), and health care professionals (20.5%); 35.2% of calls concerned patients with polysymptomatic problems; 36.8% of calls led directly to patients being medically assessed.

Conclusions: The utility of the CTH service confirms the need of this nurse-led service. This service facilitates access to specialist advice and support for patients, their families, and allied health care professionals.

Implications for Practice: The international significance of these findings for practice includes its demonstration of the multifaceted symptom experience of patients receiving chemotherapy and highlights the importance of rapid access to specialist cancer services for patients and their lay and professional carers. In addition, it demonstrates the capacity of helplines to identify gaps in professional skills and training.

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The increasing importance placed upon regional development and the knowledge-based economy as economic growth stimuli has led to a changing role for Universities and their interaction with the business community through (though not limited to) the transfer of technology from academia to industry. With the emergence of Local Enterprise Partnerships (LEPs) replacing the Regional Development Agencies (RDAs), there is a need for policy and practice going forward to be clearly informed by a critique of TTO (Technology Transfer Office)–RDA stakeholder relationship in a lessons learned approach so that LEPs can benefit from a faster learning curve. Thus, the aim of this paper is to examine the stakeholder relationship between three regional universities in the context of its TTO and the RDA with a view to determining lessons learned for the emerging LEP approach. Although the issues raised are contextual, the abstracted stakeholder conceptualisation of the TTO–RDA relationship should enable wider generalisation of the issues raised beyond the UK. Stakeholder theory relationship and stage development models are used to guide a repeat interview study of the TTO and RDA stakeholder groupings. The findings, interpreted using combined category and stage based stakeholder models, show how the longitudinal development of the TTO–RDA stakeholder relationship for each case has progressed through different stakeholder pathways, and stages where specific targeting of funding was dependant on the stakeholder stage. Greater targeted policy and funding, based on the stakeholder relationship approach, led to the development of joint mechanisms and a closer alignment of performance measures between the TTO and the RDA. However, over-reliance on the unitary nature of the TTO–RDA relationship may lead to a lack of cultivation and dependency for funding from other stakeholders.

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A cryptotephra layer from the eruption of Hekla in 1947 has recently been discovered in Irish peatlands. This tephra layer represents the most recent deposition of volcanic ash in the UK prior to the eruption of Eyjafjallajökull in 2010. Here we examine the concentration and geochemistry of the Hekla 1947 tephra in 14 peat profiles from across Northern Ireland. Electron probe microanalysis of individual tephra shards (n?=?91) reveals that the tephra is of dacitic–andesitic geochemistry and is highly similar to the Hekla 1510 tephra, although spheroidal carbonaceous particle profiles can be used for successful discrimination of the two layers. The highest concentrations of Hekla 1947 are found in western sites, probably reflecting the pathway of the ash fall event due to the prevailing wind direction. Comparable tephra concentrations from two cores (1?km apart) from a single bog and from nearby sites may suggest that tephra shard concentrations in peat profiles reflect ash fallout densities across a specific region, rather than site-specific factors associated with peatlands. This paper firmly establishes Hekla 1947 as a useful chronostratigraphic marker for the twentieth century, although within a restricted zone.

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ABSTRACT High resolution records of mid-late Holocene hydro-climatic change are presented from Mer Bleue Bog, eastern Ontario. Past climatic changes in this region have previously been inferred from lake sediments, but rain-fed peatlands can offer additional insights into the spatial and temporal pattern of moisture availability. In this study, reconstructed water table depths are based on a testate amoeba-derived transfer function developed for the region and changes in bog surface wetness are compared with plant macrofossil and peat humification data.

RÉSUMÉ Nous présentons les enregistrements hautes résolutions des variations hydrologique durant la second moitié de l’Holocène pour les tourbières Mer Bleue á l’est de l'Ontario. Précédemment, les changements climatiques de cette région ont été dérivés à partir de prélèvement de sédiments de lac. Mais ils s’avèrent que les tourbières ombrotrophes offrir un éclairage supplémentaire sur les schémas de répartition spatiale et temporelle de la disponibilité de l'humidité. Dans cette étude, des profondeurs reconstruites de nappe phréatique sont basées sur un modèle de function de transfert d’amibes (Arcellinida) et des changements de l’humidité de surface de la tourbière sont comparés avec les macrofossils et au humification de tourbe dans une analyse multi-proxy.

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Several studies have shown social differences in alcohol consumption, and social inequalities of harm related to alcohol use and abuse. However, relationships between the position in the socio-economic spectrum, alcohol use, and alcohol-related health problems are not clear cut. While there is some evidence of social gradients or associations between indicators of deprivation and some adolescence outcomes (e.g. externalising behaviour), the evidence regarding associations between socio-economic status and alcohol-related problems in adolescence is more conflicting. A major problem in studying socio-economic inequalities in adolescent health is related to the paucity of measures of socio-economic status in adolescence that are both conceptually and methodologically sound.
The aims of this study were to investigate socio-economic differences in pathways from onset to establishment of drinking patterns in adolescence, assess the consequences of these pathways in terms of alcohol related harm, and to consider the causal mechanisms that may contribute to socio-economic differences in drinking pathways and outcomes

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Abstract. With this paper we discuss the differences between sustainability-related media agendas across different countries and regions. Utilising a sample of 115 leading national newspapers covering forty-one countries, we show that typically no homogeneous global trends exist with regard to sustainability-related media agendas. Instead, significant differences exist regarding the national-level prioritisations of sustainability-related issues in the countries under review. To some extent, these observed differences can be attributed to different levels of socioeconomic development as measured by Human Development Index scores and gross domestic product per capita. Here, generic differences can be identified between newspapers from the Global North and South, with a range of issues such as climate change emerging as typically Northern issues, whereas issues such as corruption and poverty show significantly higher levels of coverage across newspapers from the Global South. We conclude with a discussion of the results in the context of global environmental governance.

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During various periods of Late Quaternary glaciation, small ice-sheets, -caps, -fields and valley glaciers, occupied the mountains and uplands of Far NE Russia (including the Verkhoyansk, Suntar-Khayata, and Chersky Mountains; the KolymaeAnyuy and Koryak Highlands; and much of the Kamchatka and Chukchi
Peninsulas). Here, the margins of former glaciers across this region are constrained through the comprehensive mapping of moraines from remote sensing data (Landsat 7 ETM+ satellite images; ASTER Global Digital Elevation Model (GDEM2); and Viewfinder Panorama DEM data). A total of 8414 moraines
are mapped, and this record is integrated with a series of published age-estimates (n = 25), considered to chronologically-constrain former ice-margin positions. Geomorphological and chronological data are compiled in a Geographic Information System (GIS) to produce ‘best estimate’ reconstructions of ice extent during the global Last Glacial Maximum (gLGM) and, to a lesser degree, during earlier phases of glaciation. The data reveal that much of Far NE Russia (~1,092,427 km2) preserves a glaciated landscape (i.e. is bounded by moraines), but there is no evidence of former ice masses having extended more than 270 km beyond mountain centres (suggesting that, during the Late Quaternary, the region has not been occupied by extensive ice sheets). During the gLGM, specifically, glaciers occupied ~253,000 km2, and rarely extended more than 50 km in length. During earlier (pre-gLGM) periods, glaciers were more extensive, though the timing of former glaciation, and the maximum Quaternary extent, appears to have been asynchronous across the region, and out-of-phase with ice-extent maxima elsewhere in the Northern Hemisphere. This glacial history is partly explained through consideration of climatic-forcing
(particularly moisture-availability, solar insolation and albedo), though topographic-controls upon the former extent and dynamics of glaciers are also considered, as are topographic-controls upon moraine deposition and preservation. Ultimately, our ability to understand the glacial and climatic history of this region is restricted when the geomorphological-record alone is considered, particularly as directly-dated glacial deposits are few, and topographic and climatic controls upon the moraine record are difficult to
distinguish.