Utility, Caller, and Patient Profile of a Novel Chemotherapy Telephone Helpline Service Within a Regional Cancer Centre in Northern Ireland

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.

'Trusting the numbers': mineral prospecting, raising finance and the governance of knowledge

Mineral prospecting and raising finance for ‘junior’ mining firms has historically been regarded as a speculative activity. For the regulators of securities markets upon which ‘junior’ mining companies seek to raise capital, a perennial problem has been handling not only the indeterminacy of scientific claims, but also the social basis of epistemic practices. This paper examines the production of a system of public warrant and associated knowledge practices intended to enable investors to differentiate between ‘destructive’ and ‘productive’ varieties of financial speculation. It traces the use of the notion of ‘disclosure’ in constructing and legitimizing the ‘juniors’ market in Canada. It argues that though the work of ‘economics’ may be necessary in the construction of markets, it is by no means sufficient. Attention must also be given to the ways in which legal models of ‘the free-market’ can be translated and constantly re-worked across the sites and spaces of regulatory practice, animating the geographies of markets.

Crucial silences: When Accountability Met PFI and Finance Capital

During recent years, a wide spectrum of research has questioned whether public services/infrastructure procurement through private finance, as exemplified by the UK Private Finance Initiative (PFI), meets minimum standards of democratic accountability. While broadly agreeing with some of these arguments, this paper suggests that this debate is flawed on two grounds. Firstly, PFI is not about effective procurement, or even about a pragmatic choice of procurement mechanisms which can potentially compromise public involvement and input; rather it is about a process where the state creates new profit opportunities at a time when the international financial system is increasingly lacking in safe investment opportunities. Secondly, because of its primary function as investment opportunity, PFI, by its very nature, prioritises the risk-return criteria of private finance over the needs of the public sector client and its stakeholders. Using two case studies of recent PFI projects, the paper illustrates some of the mechanisms through which finance capital exercises control over the PFI procurement process. The paper concludes that recent proposals aimed at “reforming” or “democratising” PFI fail to recognise the objective constraints which this type of state-finance capital nexus imposes on political process.

Accountability and Value for Money: A Framework for Exploring the Relationship in Private Finance Initiative Contracts

There is an implicit assumption in the UK Treasury’s publications on public-private partnerships (PPP) – also more commonly known in the United Kingdom as private finance initiative (PFI) - that accountability and value for money (VFM) are related concepts. While recent academic studies on PPP/PFI (from now on as PFI) have focused on VFM, there is a notable absence of studies exploring the ‘presumed’ relationships between accountability and VFM. Drawing on Dubnick’s (Dubnick and Romzek, 1991, 1993; Dubnick, 1996, 1998, 2003, 2005; Dubnick and Justice, 2002) framework for accountability and PFI literature, we develop a research framework for exploring potential relationships between accountability and VFM in PFI projects by proposing alternative accountability cultures, processes and mechanisms for PFI. The PFI accountability model is then exposed to four criteria - warrantability, tractability, measurability and feasibility. Our preliminary interviews provide us guidance in identifying some of the cultures, processes and mechanisms indicated in our model which should enable future researchers to test not only the UK Government’s claimed relationships between accountability and VFM using more specific PFI empirical data, but also a potential relationship between accountability and performance in general.

The development of University Technology Transfer stakeholder relationships at a regional level: Lessons for the future

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.

The Hekla 1947 tephra in the North of Ireland: regional distribution, concentration and geochemistry.

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.

Mid to late Holocene hydrological change in continental eastern Canada: assessing regional trends from ombrotrophic peat records.

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.