Transition from Children’s to Adult Services forYoung People with Life-limiting Conditions: Findings from a Questionnaire Survey in Northern Ireland

Research aims: 
To describe service provision for the transition from children’s to adult services for young people with life-limiting conditions in Northern Ireland, and to identify organisational factors that promote or inhibit effective transition. 
Study population: 
Health, social, educational and charitable organisations providing transition services to young people with life-limiting conditions in Northern Ireland. 
Study design and methods: 
A questionnaire has been developed by the research team drawing on examples from the literature and the advice of an expert advisory group. The questionnaire was piloted with clinicians,academics and researchers in June 2013. The questionnaire focuses on components of practice which may promote continuity in the transition from child to adult care for young people with a life-limiting condition. The survey will be distributed throughout Northern Ireland to an estimated 75 organisations, following the Dillman total design survey method. Numerical data will be analysed using PASW Statistical software to generate descriptive statistics along with a thematic analysis of data generated by open-ended questions. 
Results and interpretations: 
The survey will provide a description of services, transition policies, approaches to managing transition, categories of service users, the ages at which transition starts and completes, experiences with minority ethnic groups, the input of service users to the process, organisational factors promoting or hindering effective transition, links between services, and service providers’ recommendations for improvements in services.The outcomes will be an overview of the transition services currently provided in Northern Ireland identifying models of good practice and the key factors influencing the quality, safety and continuity of care. Survey results are due early in 2014.

Diabetes management in patients receiving palliative care

A literature review revealed no evidence-based guidelines specific to managing diabetes in the context of palliative care. The purpose of the current project was to describe the management practices of doctors and nurses caring for people with diabetes and advanced disease. Palliative care doctors, palliative care nurses, endocrinologists, and diabetes nurse educators participated in this study. A two-phase project was undertaken: 1) two focus groups, and 2) a cross-sectional survey using a self-completed questionnaire. The focus group and questionnaire data identified that doctors and nurses used a range of practices and blood glucose testing frequencies to control blood glucose based on experience and not according to a robust evidence base. Implications for practice include the importance of collaboration between diabetes and palliative care specialists, and the need to develop clinical management guidelines.

An experiment in group learning technology: evaluating critical thinking in face-to-face and computer-supported seminars

Can learning quality be maintained in the face of increasing class size by the use of Computer Supported Co-operative Learning (CSCL) technologies? In particular, can Computer-Mediated Communication promote critical thinking in addition to surface information transfer? We compared face-to-face seminars with asynchronous computer conferencing in the same Information Management class. From Garrison's theory of critical thinking and Henri's critical reasoning skills, we developed two ways of evaluating critical thinking: a student questionnaire and a content analysis technique. We found evidence for critical thinking in both situations, with some subtle differences in learning style. This paper provides an overview of this work.

A content analysis method to measure critical thinking in face-to-face and computer supported group learning

This paper gives a detailed account of the content analysis method developed at Queen's University Belfast to measure critical thinking during group learning, as used in our controlled comparisons between learning in face-to-face and computer conference seminars. From Garrison's 5 stages of critical thinking, and Henri's cognitive skills needed in CMC, we have developed two research instruments: a student questionnaire and this content analysis method. The content analysis relies on identifying, within transcripts, examples of indicators of obviously critical and obviously uncritical thinking, from which several critical thinking ratios can be calculated.

Client's assessment of architects' performance in building delivery process: Evidence from Nigeria

The overall intent of this research is to provide architects with information that can be used to improve their performance so as to optimally satisfy the client's requirements and achieve high-quality overall project performance in Nigerian construction industry. Architect performance criteria were identified based on literature within the domain of architect responsibilities. The assessment of architects’ performance was carried out through a questionnaire survey of clients of recently completed building projects in Nigeria. Analysis of data includes comparison of criteria using importance–performance index analysis. Factor analysis was carried out on criteria where architects are falling below average, to group and explore the latent structure of the criteria in the data. The results showed that the architect needs to focus on management skills and ability, buildability, design quality, project communication, project integration and client focus. These results would encourage architects to perform better within their full responsibilities in the building delivery process and deliver high-quality projects within Nigerian construction industry.

A comparative study of nursing attitudes towards young male survivors of brain injury: A questionnaire survey.

Background The attitudes members of the nursing profession hold towards survivors of brain injury may impact on the level of help, and degree of involvement they are willing to have. Given that the manner in which an individual receives their brain injury has been shown to impact on public prejudices, the importance of exploring nursing attitudes to this vulnerable group, and the subsequent impact this may have on the caring role, requires investigation. Objective To investigate the attitudes held by members of the nursing profession towards young male survivors of brain injury whose behaviour either contributed, or did not contribute, to their injury. Design Independent groups design. Setting and participants Ninety trainee and sixty-nine qualified nurses respectively drawn from a university in the south west of England and the emergency, orthopaedic and paediatric Departments of the Royal Devon and Exeter Hospital, UK. Methods Participants were randomly assigned to one of four fictional brain injury scenarios. A young male character was portrayed as sustaining a brain injury as a result of either an aneurysm, or through drug taking, with their behaviour being either a contributory or non-contributory factor. On reading these, participants were asked to complete the prejudicial evaluation scale, the social interaction scale and the helping behaviour scale. Results Analysis of variance showed that qualified nurses held more prejudicial attitudes than student nurses towards survivors of brain injury. Mean scores indicated that individuals seen as contributing towards their injury were likely to experience more prejudice (blame total = 42.35 vs. no blame total = 38.34), less social interaction (blame total = 37.54 vs. no blame total = 41.10), and less helping behaviour (blame total = 21.49 vs. no blame total = 22.34) by both groups. Conclusions Qualified nurses should be mindful of the impact their attitudes and judgements of survivors of brain injury may have on the subsequent care they provide. Greater emphasis on the effects of negative attitudes on patient interactions during training may provide nurses with the understanding to recognise and avoid challenges to their caring role in the future.

Group Design-Build-Test Projects as the Core of an Integrated Curriculum in Product Design and Development

The School of Mechanical and Aerospace Engineering at Queen’s University Belfast introduced a new degree programme in Product Design and Development (PDD) in 2004. As well as setting out to meet all UK-SPEC requirements, the entirely new curriculum was developed in line with the syllabus and standards defined by the CDIO Initiative, an international collaboration of universities aiming to improve the education of engineering students. The CDIO ethos is that students are taught in the context of conceiving, designing, implementing and operating a product or system. Fundamental to this is an integrated curriculum with multiple Design-Build-Test (DBT) experiences at the core. Unlike most traditional engineering courses the PDD degree features group DBT projects in all years of the programme. The projects increase in complexity and challenge in a staged manner, with learning outcomes guided by Bloom’s taxonomy of learning domains. The integrated course structure enables the immediate application of disciplinary knowledge, gained from other modules, as well as development of professional skills and attributes in the context of the DBT activity. This has a positive impact on student engagement and the embedding of these relevant skills, identified from a stakeholder survey, has also been shown to better prepare students for professional practice. This paper will detail the methodology used in the development of the curriculum, refinements that have been made during the first five years of operation and discuss the resource and staffing issues raised in facilitating such a learning environment.

'Murder or Mercy?' an innovative module helping UK medical students to articulate their own ethical standpoints regarding end-of-life decisions

Objectives This student selected component (SSC) was designed to equip United Kingdom (UK) medical students to respond ethically and with sensitivity to requests they might receive as qualified doctors in regard to euthanasia and assisted dying. The aim was to expose students to relevant opinions and experiences and to provide opportunities to explore and justify their own views and rehearse ethical decision making in a safe learning environment. Method The module is delivered by specialists from a number of disciplines including law, theology, medicine and nursing, each providing students with a working knowledge allowing them to actively discuss cases, articulate their own views and practise ethical reasoning through group and individual study. Visits to local intensive care units, palliative care wards and hospices are integrated effectively with theory. Student assessment comprises a dissertation, student-led debate and reflective commentary. Module impact was evaluated by analysis of student coursework and a questionnaire. Results Students found the content stimulating and relevant to their future career and agreed that the module was well-structured and that learning outcomes were achieved. They greatly appreciated the clinical context provided by the visits and opportunities to apply ethical reasoning to real cases and to debate ethical issues with peers. Students reported an increased discernment of the ethical and legal position and practical considerations and a greater awareness of the range of professional and lay viewpoints held. Student perceptions were confirmed on analysis of their submitted coursework. Many participants were less strongly in favour of euthanasia and assisted dying on module completion than at the outset but all felt better equipped to justify their own viewpoint and to respond appropriately to patient requests. Conclusions The multi-disciplinary nature of this course is helpful in preparing students to deal effectively and sensitively with ethical dilemmas they will encounter in their medical career. Use of an integrated, learner-centred approach equips students to actively engage with their peers in discussion of such issues and to formulate and defend their own position.

Indigenous rights in Chile: National identity and majority group support for multicultural policies

We examine support for policies affecting indigenous ethnic minorities in Chile. Specifically, we examine the role of national group definitions that include the largest indigenous group—the Mapuche—in different ways. Based on questionnaire data from nonindigenous Chilean students (N = 338), we empirically distinguish iconic inclusion, whereby the Mapuche are seen as an important part of Chile's history and identity on the one hand, from egalitarian inclusion, which represents the Mapuche as citizens of equal importance to the nonindigenous majority on the other. Both forms of inclusion positively predict support for indigenous rights, independent of participants' political affiliation, strength of national identification, and social distance. A second study (N = 277) replicates this finding whilst controlling for right-wing authoritarianism, social dominance orientation, blind patriotism, and constructive patriotism. It also finds iconic inclusion to be predictive of a pro-Mapuche position regarding the unrest over the issue of ancestral land in 2009. We conclude that understanding how national identity affects attitudes about minority rights necessitates appreciating the importance of particular meanings of nationality, and not only the strength of identification.

The Role of Work Group in Individual Sickness Absence Behavior

The purpose of our two-year follow-up study was to examine the effect of the social components of the work group, such as group absence norms and cohesion, on sickness absence behavior among individuals with varying attitudes toward work attendance. The social components were measured using a questionnaire survey, and data on sickness absence behavior were collected from the employers' records. The study population consisted of 19,306 Finnish municipal employees working in 1,847 groups (78% women). Multilevel Poisson regression modeling was applied. The direct effects of work group characteristics on sickness absence were mostly insignificant. In contrast, both of the social components of a work group had an indirect impact: The more tolerant the group absence norms (at both individual- and cross-level) and the lower the group cohesion (at the individual level), the more the absence behavior of an individual was influenced by his or her attitude toward work attendance. We conclude that work group moderates the extent to which individuals with a liberal attitude toward work attendance actually engage in sickness absence behavior.

The WR content of IC10 - first detection of WC9 stars in a low metallicity environment?

We present deep, narrow-hand photometry of the Local Group starburst galaxy IC10. Our dedicated photometric system provides detection of 13 new Wolf-Rayet (WR) stars and allows spectral subtypes to be assigned. Three of these new stars appear to be WC9 subtypes. If confirmed, these would be the very first WC9 stars ever detected in a low metallicity environment, hence putting strong new constraints on the formation and evolution models of massive stars. Eight of the new WR stars are of the WC subtype, which does not significantly modify the anomalously high WC/WN ratio in IC10. However it is likely that a number of Wolf-Rayet stars of the WNE and WC spectral subtypes are still to be discovered in the heart of the galaxy.

A Pupil Baseline Study in Northern Ireland: Reported Willingness to Challenge Sectarian Bullying in School

Topic Background: Peace education initiatives in schools are often based on social psychological theories assuming that social identity affects ingroup and outgroup attitudes and, in turn, behaviors relating to relevant outgroups. However, research evidence on the role of children's social identity has often failed to take account of different social identity dimensions or to conceptualise behavior in the context of children's understandings of the social world. While recent research relating to bullying and bystander behavior amongst children has addressed the latter point, this has rarely been considered in conjunction with a differentiated view of social identity. This paper is therefore distinctive as it will address the role of social identity dimensions with regards to reported behavior as captured in bystander scenarios relating to outgroup derogation. This is particularly important in the context of divided societies, where peace education initiatives are crucial in promoting positive community relations for the future and where such initiative may be hampered by communities' concerns about loss of identity. In the context of Northern Ireland, a divided society emerging from conflict, social identity, outgroup attitudes and behaviours have been key concepts addressed by peace educators
for many years.

Research questions: This paper therefore set out to investigate the relationship between social identity, measured as affiliation with the group and exploration of its meaning for the child, sectarian attitudes and pupils' reported willingness to challenge sectarian bullying in their school environment in Northern Ireland.
Research methods: The findings are based on the analysis of a baseline survey, which forms part of a randomised control trial of an intervention aimed at promoting community relations and reconciliation. The trial includes 35 primary and post-primary schools and about 800 pupils from 8-11 years old who completed an online questionnaire at the start of the programme. Main instruments for this study included adapted scales measuring identity affiliation and identity exploration, sectarian attitudes and scenarios capturing pupils' intentions in bystander situations relating to sectarian bullying.

Analytical framework: Results are analysed using regression analysis and additionally investigate gender and religious differences.

Research findings and/or contribution to knowledge: Results are discussed in the light of the role of social identity dimensions and their relationship to outgroup attitudes and willingness to challenge outgroup derogation. The paper concludes with potential implications for peace education initiatives in Northern Ireland and beyond.

Cognitive functioning in subjects with recent-onset psychosis from a low-middle-income environment: Multiple-domain deficits and longitudinal evaluation

Cognitive deficits are a key feature of recent-onset psychosis, but there is no consensus on whether such deficits are generalized or confined to specific domains. Besides, it is unclear whether cognitive deficits: a) are found in psychotic patients in samples from outside high-income countries; and b) whether they progress uniformly over time in schizophrenia and affective psychoses. We applied 12 tests organized into eight cognitive domains, comparing psychosis patients (n = 56, time from initial contact = 677.95+/-183.27 days) versus healthy controls (n = 70) recruited from the same area of Sao Paulo, Brazil. Longitudinal comparisons (digit span and verbal fluency) were conducted between a previous assessment of the subjects carried out at their psychosis onset, and the current follow-up evaluation. Psychosis patients differed significantly from controls on five domains, most prominently on verbal memory. Cognitive deficits remained detectable in separate comparisons of the schizophrenia subgroup and, to a lesser extent, the affective psychosis subjects against controls. Longitudinal comparisons indicated significant improvement in schizophrenia, affective psychoses, and control subjects, with no significant group-by-time interactions. Our results reinforce the view that there are generalized cognitive deficits in association with recent-onset psychoses, particularly of non-affective nature, which persist over time. (C) 2009 Elsevier Ireland Ltd. All rights reserved.

An Evaluation of the Effectiveness of an FE/HE Partnership in the Delivery of a Preparation for Practice Module within an Undergraduate Social Work Degree Programme

The Preparation for Practice module at the University of Ulster is delivered to 170 first year students via a collaborative arrangement between higher and further education institutions. In each of the five sites, students receive large group and small group teaching facilitated by social work training agency workers and academic tutor dyads. An evaluation of the module sought the perceptions of the agency and academic facilitators regarding the overall collaborative arrangement and the model of co-teaching involving social work academics and agency partners. Respondents were asked to complete a semi-structured questionnaire, which generated data from a Likert scale and also invited qualitative commentary. The Likert scale data were analysed via SPSS and the qualitative information was scrutinised using a manual thematic analysis technique. Findings indicated that continuous communication, consistency in programme content and the acknowledgement of the differences in organisation resources were key to a successful collaborative arrangement. It was also noted that a co-teaching model should be viewed as a positive vehicle for achieving module objectives in a safe learning environment.