Unmasking the ‘Elderly Mystique’: why it is time to make the personal political in ageing research

This article uses feminist scholarship to investigate ‘the elderly mystique’ – which contends that the potential of old age is masked by a set of false beliefs about ageing (i.e. ageism) which permeate social, economic and political life (Cohen, 1988).
The article presents a theoretical model which explores the extent to which institutionalised ageism shapes the trajectory of life after 60. The hypothesis under-pinning the model is simple: The challenge for ageing societies is not the average age of a given population but, rather, how age is used to structure economic, social and political life. An inter-disciplinary framework is used to examine how biological facts about ageing are used to segregate older from younger people, giving older people the status of “other”; economically through retirement, politically through assumptions about ‘the grey vote’ and socially through ageist stereotyping in the media and through denial and ridicule of the sexuality of older people. Each domain is informed by the achievements of feminist theory and research on sexism and how its successes and failures can inform critical investigations of ageism.
The paper recognises the role of ageism in de-politicising the lived experience of ageing. The paper concludes that feminist scholarship, particularly work by feminists in their seventies, eighties and nineties has much to offer in terms of re-framing gerontology as an emancipatory project for current and future cohorts of older people.

Rationale for and implementation of age-neutral HRM in divergent institutional contexts–examples from Britain and Germany

Owing to demographic change as well as international and national pressures,
organisations will have to abandon oftentimes prevalent youth-centric HRM practices in favour of age-neutral HRM that is inclusive of the entire workforce, regardless of age. In order to do so, organisations turn to ‘best practice’ guides. These, however, do not tend to differentiate recommendations by country and/or sector. Based on research in eight case study organisations in the chemical, steel and retail sectors as well as in public schools in Germany and Britain, this chapter argues that the rationale for and the implementation of age-neutral HRM practices differ by national institutional and sectoral context as well as by the relative influence of social partners. Hence, organisations planning to implement age-neutral HRM should take organisational, institutional and sectoral peculiarities into account when doing so.

Energy and environmental forensic analysis for public buildings.

This paper outlines a forensic method for analysing the energy, environmental and comfort performance of a building. The method has been applied to a recently developed event space in an Irish public building, which was evaluated using on-site field studies, data analysis, building simulation and occupant surveying. The method allows for consideration of both the technological and anthropological aspects of the building in use and for the identification of unsustainable operational practice and emerging problems. The forensic analysis identified energy savings of up to 50%, enabling a more sustainable, lower-energy operational future for the building. The building forensic analysis method presented in this paper is now planned for use in other public and commercial buildings.

Factors that impact on the use of mechanical ventilation weaning protocols in critically ill adults and children: a qualitative-evidence synthesis

Background:
Prolonged mechanical ventilation is associated with a longer intensive care unit (ICU) length of stay and higher mortality. Consequently, methods to improve ventilator weaning processes have been sought. Two recent Cochrane systematic reviews in ICU adult and paediatric populations concluded that protocols can be effective in reducing the duration of mechanical ventilation, but there was significant heterogeneity in study findings. Growing awareness of the benefits of understanding the contextual factors impacting on effectiveness has encouraged the integration of qualitative evidence syntheses with effectiveness reviews, which has delivered important insights into the reasons underpinning (differential) effectiveness of healthcare interventions.

Objectives:
1. To locate, appraise and synthesize qualitative evidence concerning the barriers and facilitators of the use of protocols for weaning critically-ill adults and children from mechanical ventilation;

2. To integrate this synthesis with two Cochrane effectiveness reviews of protocolized weaning to help explain observed heterogeneity by identifying contextual factors that impact on the use of protocols for weaning critically-ill adults and children from mechanical ventilation;

3. To use the integrated body of evidence to suggest the circumstances in which weaning protocols are most likely to be used.

Search methods:
We used a range of search terms identified with the help of the SPICE (Setting, Perspective, Intervention, Comparison, Evaluation) mnemonic. Where available, we used appropriate methodological filters for specific databases. We searched the following databases: Ovid MEDLINE, Embase, OVID, PsycINFO, CINAHL Plus, EBSCOHost, Web of Science Core Collection, ASSIA, IBSS, Sociological Abstracts, ProQuest and LILACS on the 26th February 2015. In addition, we searched: the grey literature; the websites of professional associations for relevant publications; and the reference lists of all publications reviewed. We also contacted authors of the trials included in the effectiveness reviews as well as of studies (potentially) included in the qualitative synthesis, conducted citation searches of the publications reporting these studies, and contacted content experts.

We reran the search on 3rd July 2016 and found three studies, which are awaiting classification.

Selection criteria:
We included qualitative studies that described: the circumstances in which protocols are designed, implemented or used, or both, and the views and experiences of healthcare professionals either involved in the design, implementation or use of weaning protocols or involved in the weaning of critically-ill adults and children from mechanical ventilation not using protocols. We included studies that: reflected on any aspect of the use of protocols, explored contextual factors relevant to the development, implementation or use of weaning protocols, and reported contextual phenomena and outcomes identified as relevant to the effectiveness of protocolized weaning from mechanical ventilation.

Data collection and analysis:
At each stage, two review authors undertook designated tasks, with the results shared amongst the wider team for discussion and final development. We independently reviewed all retrieved titles, abstracts and full papers for inclusion, and independently extracted selected data from included studies. We used the findings of the included studies to develop a new set of analytic themes focused on the barriers and facilitators to the use of protocols, and further refined them to produce a set of summary statements. We used the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) framework to arrive at a final assessment of the overall confidence of the evidence used in the synthesis. We included all studies but undertook two sensitivity analyses to determine how the removal of certain bodies of evidence impacted on the content and confidence of the synthesis. We deployed a logic model to integrate the findings of the qualitative evidence synthesis with those of the Cochrane effectiveness reviews.

Main results:
We included 11 studies in our synthesis, involving 267 participants (one study did not report the number of participants). Five more studies are awaiting classification and will be dealt with when we update the review.

The quality of the evidence was mixed; of the 35 summary statements, we assessed 17 as ‘low’, 13 as ‘moderate’ and five as ‘high’ confidence. Our synthesis produced nine analytical themes, which report potential barriers and facilitators to the use of protocols. The themes are: the need for continual staff training and development; clinical experience as this promotes felt and perceived competence and confidence to wean; the vulnerability of weaning to disparate interprofessional working; an understanding of protocols as militating against a necessary proactivity in clinical practice; perceived nursing scope of practice and professional risk; ICU structure and processes of care; the ability of protocols to act as a prompt for shared care and consistency in weaning practice; maximizing the use of protocols through visibility and ease of implementation; and the ability of protocols to act as a framework for communication with parents.

Authors' conclusions:
There is a clear need for weaning protocols to take account of the social and cultural environment in which they are to be implemented. Irrespective of its inherent strengths, a protocol will not be used if it does not accommodate these complexities. In terms of protocol development, comprehensive interprofessional input will help to ensure broad-based understanding and a sense of ‘ownership’. In terms of implementation, all relevant ICU staff will benefit from general weaning as well as protocol-specific training; not only will this help secure a relevant clinical knowledge base and operational understanding, but will also demonstrate to others that this knowledge and understanding is in place. In order to maximize relevance and acceptability, protocols should be designed with the patient profile and requirements of the target ICU in mind. Predictably, an under-resourced ICU will impact adversely on protocol implementation, as staff will prioritize management of acutely deteriorating and critically-ill patients.

Dublin 1916: theatre of revolt

At Easter 1916, Dublin city centre was one of a series of sites throughout Ireland where a rebellion was staged against British rule. It was a strategic failure, swiftly crushed by superior British forces. The event, however, subsequently took a central role in the mythology of modern Ireland.

The first visual representations were of the conflict’s aftermath: photographic journeys through landscapes of ruin. From the distance of the camera, we see none of the pockmarks of shell bursts, nor the etchings of machine guns. Instead, traces of life in the city seem to have been swept aside by an unseen hand: the passing of millennia or a violent action of nature. Architecture alone has witnessed and recorded its presence. Amongst the fragments, the shell of the General Post Office (G.P.O.) in Sackville Street is one of the few buildings still wholly recognizable. The remnants of its classical form, portico and pediment, columns and entablature seem to transcend its prosaic modern functions and allude to something more ancient. The bewilderment of city’s inhabitants is also recorded. Dubliners have become inquisitive tourists in streets which hitherto were the locus of everyday life. They wander around aimlessly in a landscape as alien and picturesque as Pompeii. This shift in perception was captured by the Irish poet W.B. Yeats who hinted that Dublin, purged of modern commercialism had transcended its petty inadequacies to revive a slumbering heroic past.

‘I have met them at the close of day
Coming with vivid faces
From counter or desk among grey
Eighteenth-century houses [.]’
All is changed, changed utterly:
A terrible beauty is born.’

His comments were prescient. Initially unpopular, the republican leaders, executed by the British, slowly became recast as heroic martyrs. Similarly, the spaces where their heroism was forged became venerated. The G.P.O. and Sackville Street, however, already had a republican history. It was originally conceived in the eighteenth century as part of a series of magnificent urban spaces to provide an arena of spectacle and self-celebration for the colonial Anglo-Irish and their vision of a Protestant republic. O’Connell/Sackville Street became the temporal, geographical and mythical hinge upon which two different versions of Irish republicanism waxed and waned. Its recasting after independence as a space of Catholic Nationalism bore testimony to its consistency in providing a backdrop for the production of ritual and myth. In the 1920s and 30s, as the nascent country, beset with economic stagnation and political tensions, turned to spectacle as a salve for it social problems, O’Connell Street and the G.P.O. provided its most sacred sites. Within the introduction of new myths, however, individual as well as national identities were created and consolidated. The emerging identity of modern Ireland became inextricably linked with that of one ambitious politician. His uses of the G.P.O. in particular revealed a perceptive understanding of the political uses of classical architecture and urban space.

The effectiveness of disaster risk communication: a systematic review of intervention studies

INTRODUCTION: A disaster is a serious disruption to the functioning of a community that exceeds its capacity to cope within its own resources. Risk communication in disasters aims to prevent and mitigate harm from disasters, prepare the population before a disaster, disseminate information during disasters and aid subsequent recovery. The aim of this systematic review is to identify, appraise and synthesise the findings of studies of the effects of risk communication interventions during four stages of the disaster cycle.

METHODS: We searched the Cochrane Central Register of Controlled Trials, Embase, MEDLINE, PsycInfo, Sociological Abstracts, Web of Science and grey literature sources for randomised trials, cluster randomised trials, controlled and uncontrolled before and after studies, interrupted time series studies and qualitative studies of any method of disaster risk communication to at-risk populations. Outcome criteria were disaster-related knowledge and behaviour, and health outcomes.

RESULTS: Searches yielded 5,224 unique articles, of which 100 were judged to be potentially relevant. Twenty-five studies met the inclusion criteria, and two additional studies were identified from other searching. The studies evaluated interventions in all four stages of the disaster cycle, included a variety of man-made, natural and infectious disease disasters, and were conducted in many disparate settings. Only one randomised trial and one cluster randomised trial were identified, with less robust designs used in the other studies. Several studies reported improvements in disaster-related knowledge and behaviour.

DISCUSSION: We identified and appraised intervention studies of disaster risk communication and present an overview of the contemporary literature. Most studies used non-randomised designs that make interpretation challenging. We do not make specific recommendations for practice but highlight the need for high-quality randomised trials and appropriately-analysed cluster randomised trials in the field of disaster risk communication where these can be conducted within an appropriate research ethics framework.

Psychological interventions for children and young people affected by armed conflict or political violence: a systematic literature review.

Youths exposed to armed conflict have a higher prevalence of mental health and psychosocial difficulties. Diverse interventions exist that aim to ameliorate the effect of armed conflict on the psychological and psychosocial wellbeing of conflict affected youths. However, the evidence base for the effectiveness of these interventions is limited. Using standard review methodology, this review aims to address the effectiveness of psychological interventions employed among this population. The search was performed across four databases and grey literature. Article quality was assessed using the Downs and Black Quality Checklist (1998). Where possible, studies were subjected to meta-analyses. The remaining studies were included in a narrative synthesis. Eight studies concerned non clinical populations, while nine concerned clinical populations. Review findings conclude that Group Trauma Focused-Cognitive Behavioural Therapy is effective for reducing symptoms of posttraumatic stress disorder, anxiety, depression and improving prosocial behaviour among clinical cohorts. The evidence does not suggest that interventions aimed at non clinical groups within this population are effective. Despite high quality studies, further robust trials are required to strengthen the evidence base, as a lack of replication has resulted in a limited evidence base to inform practice.

Thermal environments and comfort in dementia friendly dwellings

This study follows on from a research project that developed guidelines for the Universal Design (UD) of Dementia Friendly Dwellings for People with Dementia, their Families and Carers. Research findings point to the need for thermal environments that support people with dementia and do not provoke stress, agitation or anxiety. Using semi-structured interviews and qualitative analysis of people with dementia this paper aims to provide insight into the questions of appropriate thermal environments. The qualitative analysis is supported by example simulated indoor environment studies that investigate comfort in common thermal environment provision scenarios in the homes of people with dementia. This paper focuses on the thermal environment, its impact on people with dementia, its therapeutic value, and its role in encouraging engagement in every day activity.
Findings from the interviews emphasize that control over their own internal environment is a priority for people with dementia. A strong preference for naturally or passively conditioned environments over mechanical conditioning is evident. Preferences are expressed for naturally ventilated environments enabling occupant instigated air movement. Repeated emphasis is placed on familiar elements including the fire and hot water bottle. Little desire is expressed for information feedback or technological displays.

Adaptable housing design for climate change adaptation

It is predicted that climate change will result in rising sea levels, more frequent and extreme weather events, hotter and drier summers and warmer and wetter winters. This will have a significant impact on the design of buildings, how they are kept cool and how they are weathered against more extreme climatic conditions. The residential sector is already a significant environmental burden with high associated operational energy. Climate change, and a growing population requiring residence, has the potential to exacerbate this problem seriously. New paradigms for residential building design are required to enable low-carbon dioxide operation to mitigate climate change. They must also face the reality of inevitable climate change and adopt climate change adaptation strategies to cope with future scenarios. However, any climate adaptation strategy for dwellings must also be cognisant of adapting occupant needs, influenced by ageing populations and new technologies. This paper presents concepts and priorities for changing how society designs residential buildings by designing for adaptation. A case study home is analysed in the context of its stated aims of low energy and adaptability. A post-occupancy evaluation of the house is presented, and future-proofing strategies are evaluated using climate projection data for future climate change scenarios.

Systematic Review of the Measurement Properties of Tools Used to Measure Behaviour Problems in Young Children with Autism

Background
Behaviour problems are common in young children with autism spectrum disorder (ASD). There are many different tools used to measure behavior problems but little is known about their validity for the population.

Objectives
To evaluate the measurement properties of behaviour problems tools used in evaluation of intervention or observational research studies with children with ASD up to the age of six years.

Methods
Behaviour measurement tools were identified as part of a larger, two stage, systematic review. First, sixteen major electronic databases, as well as grey literature and research registers were searched, and tools used listed and categorized. Second, using methodological filters, we searched for articles examining the measurement properties of the tools in use with young children with ASD in ERIC, MEDLINE, EMBASE, CINAHL, and PsycINFO. The quality of these papers was then evaluated using the COSMIN checklist.

Results
We identified twelve tools which had been used to measure behaviour problems in young children with ASD, and fifteen studies which investigated the measurement properties of six of these tools. There was no evidence available for the remaining six tools. Two questionnaires were found to be the most robust in their measurement properties, the Child Behavior Checklist and the Home Situations Questionnaire—Pervasive Developmental Disorders version.

Conclusions
We found patchy evidence on reliability and validity, for only a few of the tools used to measure behaviour problems in young children with ASD. More systematic research is required on measurement properties of tools for use in this population, in particular to establish responsiveness to change which is essential in measurement of outcomes of intervention.

PROSPERO Registration Number

CRD42012002223