Crossing the Threshold: Mysticism, Liminality, and Remedios Varo’s Bordando el manto terrestre (1961–2)

In this article we propose to take up the question of the painter’s work in connection with liminality more explicitly. We will argue that the limen Varo’s heroines cross is a psychological one that takes them through a process culminating in a rebirth of the self, and that to the extent they are in-between identities and involved in a process of initiation, they can be considered liminars (Turner). We will also argue that in order to develop this theme, which culminates in her most autobiographical work, the triptych Bordando el manto terrestre (1961–2), the artist needed to find a way conceptually to bridge surrealism and her interest in mysticism. She would have found a sympathetic approach in Jung, one of the founders of psychoanalysis, who turned explicitly to the question of religion in the troubled thirties, though, as we shall see, she revised his androcentric approach. We will suggest that Jung’s writing helped the artist make a transition from surrealism to esoteric spirituality.

Judicial Rehabilitation and the ‘Clean Bill of Health’ in Criminal Justice.

Drawing on an important survey of European and Australian policies toward ‘judicial rehabilitation,’ this article makes the following arguments. First, the rehabilitation movement should return to the origins of the word ‘rehabilitation’ and focus at least as much on efforts to remove and relieve ex-prisoner stigma as on treatment and reform efforts. There will be no ‘rehabilitation revolution’ without this. Second, these efforts should involve active, not passive redemption. Rehabilitation processes that require almost a decade or more of ‘crime-free’ behaviour before forgiving an individual for his or her crimes are just and fair, but they miss the point of rehabilitation. Policies should encourage, support and facilitate good behaviour and not just reward it in retrospect. Third, rehabilitation should not just be done, but be ‘seen to be done,’ ideally in a ritualised format. This sends an important message to the individual and wider society. Finally, I argue that it may be better to forgive than forget past crimes. That is, rather than burying past crimes as if they never happened, states should instead acknowledge and formally recognise that people can change, that good people can do bad things, and that all individuals should be able to move on from past convictions.

Monitoring and repair of an impact damaged prestressed bridge

This paper details the monitoring and repair of an impact damaged prestressed concrete bridge. The repair was required following an impact from a low-loader carrying an excavator while passing underneath the bridge. The repair was carried out by preloading the bridge in the vicinity of the damage to relieve some prestressing. This preload was removed following the hardening and considerable strength gain of the repair material. The true behaviour of damaged prestressed concrete bridges during repair is difficult to estimate theoretically due to lack of benchmarking and inadequacy of assumed damage models. A network of strain gauges at locations of interest was thus installed during the entire period of repair. Effects of various activities were qualitatively and quantitatively observed. The interaction and rapid, model-free calibration of damaged and undamaged beams, including identification of damaged gauges were also probed. This full scale experiment is expected to be of interest and benefit to the practising engineer and the researcher alike.

Solid-state sodium-selective sensors based on screen-printed Ag/AgCl reference electrodes

The potentiometric and AC impedance characteristics of all solid-state sodium-selective electrodes based on planar screen-printed Ag/AgCl electrodes are described. Two solid-state designs have been investigated. The first was based on the deposition of a sodium-selective PVC membrane directly on top of a screen-printed Ag/AgCl electrode, The second design included a NaCl doped hydrogel layer, between the PVC and Ag\AgCl layers. The hydrogel provides a mechanism to relieve any blockage to charge transfer occurring when PVC membranes are used directly on top of Ag/AgCl and also improves adhesion between the two layers. Results suggest the electrodes display Fast ion exchange kinetics, low noise and drift. The performance compares favorably to that of a conventional ion-selective electrode with internal filling solution.

Living and coping with Parkinson's disease: Perceptions of informal carers

A review of the literature highlights the important role informal carers play in the provision of palliative care in the community. In order to explore the caring experience of relatives with Parkinson's Disease (PD), interviews were conducted with 26 informal family caregivers. Interviews were taped, transcribed and subjected to content analysis. All caregivers were spouses, the majority female (n=17) and all were responsible for providing physical, social and emotional care in the home. Although they viewed care giving as their role and duty, the results highlight the widespread burden of providing care on the emotional and physical health of the caregivers. The financial implications for providing care were outlined, with many reporting difficulty in accessing benefits. From the point of diagnosis, which had a huge emotional impact on relatives and carers, carers did not feel health professionals integrated them within the caring journey. Since diagnosis, carers commented on the lack of continued and coordinated care plans for relatives, resulting in symptoms being mismanaged and care opportunities for relatives and carers missed. Stereotypes of the meaning and timing of palliative care were common with many viewing it as being synonymous with cancer and not applicable to a person with PD. As the well-being of the informal carer directly influences the care of the person with PD, support interventions are required to relieve their burden, maximize outcomes and ensure targeting of services. © The Author(s) 2010.

Health professionals' and service users' perspectives of shared care for monitoring wet age-related macular degeneration: a qualitative study alongside the ECHoES trial

Objectives: To explore the views of eye health professionals and service users on shared community and hospital care for wet or neovascular age-related macular degeneration (nAMD).

Method: Using maximum variation sampling, 5 focus groups and 10 interviews were conducted with 23 service users and 24 eye health professionals from across the UK (consisting of 8 optometrists, 6 ophthalmologists, 6 commissioners, 2 public health representatives and 2 clinical eye care advisors to local Clinical Commissioning Groups). Data were transcribed verbatim and analysed thematically using constant comparative techniques derived from grounded theory methodology.

Results: The needs and preferences of those with nAMD appear to be at odds with the current service being provided. There was enthusiasm among health professionals and service users about the possibility of shared care for nAMD as it was felt to have the potential to relieve hospital eye service burden and represent a more patient-centred option, but there were a number of perceived barriers to implementation. Some service users and ophthalmologists voiced concerns about optometrist competency and the potential for delays with referrals to secondary care if stable nAMD became active again. The health professionals were divided as to whether shared care was financially more efficient than the current model of care. Specialist training for optometrists, under the supervision of ophthalmologists, was deemed to be the most effective method of training and was perceived to have the potential to improve the communication and trust that shared care would require.

Conclusions: While shared care is perceived to represent a promising model of nAMD care, voiced concerns suggest that there would need to be greater collaboration between ophthalmology and optometry, in terms of interprofessional trust and communication.

Effect of radium-223 dichloride on symptomatic skeletal events in patients with castration-resistant prostate cancer and bone metastases: results from a phase 3, double-blind, randomised trial

BACKGROUND: Bone metastases frequently cause skeletal events in patients with metastatic castration-resistant prostate cancer. Radium-223 dichloride (radium-223) selectively targets bone metastases with high-energy, short-range α-particles. We assessed the effect of radium-223 compared with placebo in patients with castration-resistant prostate cancer and bone metastases.

METHODS: In this phase 3, double-blind, randomised ALSYMPCA trial, we enrolled patients who had symptomatic castration-resistant prostate cancer with two or more bone metastases and no known visceral metastases, who were receiving best standard of care, and had previously either received or were unsuitable for docetaxel. Patients were stratified by previous docetaxel use, baseline total alkaline phosphatase level, and current bisphosphonate use, then randomly assigned (2:1) to receive either six intravenous injections of radium-223 (50 kBq/kg) or matching placebo; one injection was given every 4 weeks. Randomisation was done with an interactive voice response system, taking into account trial stratification factors. Participants and investigators were masked to treatment assignment. The primary endpoint was overall survival, which has been reported previously. Here we report on time to first symptomatic skeletal event, defined as the use of external beam radiation to relieve bone pain, or occurrence of a new symptomatic pathological fracture (vertebral or non-verterbal), or occurence of spinal cord compression, or tumour-related orthopeadic surgical intervention. All events were required to be clinically apparent and were not assessed by periodic radiological review. Statistical analyses of symptomatic skeletal events were based on the intention-to-treat population. The study has been completed and is registered with ClinicalTrials.gov, number NCT00699751.

FINDINGS: Between June 12, 2008, and Feb 1, 2011, 921 patients were enrolled, of whom 614 (67%) were randomly assigned to receive radium-223 and 307 (33%) placebo. Symptomatic skeletal events occurred in 202 (33%) of 614 patients in the radium-223 group and 116 (38%) of 307 patients in the placebo group. Time to first symptomatic skeletal event was longer with radium-223 than with placebo (median 15·6 months [95% CI 13·5-18·0] vs 9·8 months [7·3-23·7]; hazard ratio [HR]=0·66, 95% CI 0·52-0·83; p=0·00037). The risks of external beam radiation therapy for bone pain (HR 0·67, 95% CI 0·53-0·85) and spinal cord compression (HR=0·52, 95% CI 0·29-0·93) were reduced with radium-233 compared with placebo. Radium-223 treatment did not seem to significantly reduce the risk of symptomatic pathological bone fracture (HR 0·62, 95% CI 0·35-1·09), or the need for tumour-related orthopaedic surgical intervention (HR 0·72, 95% CI 0·28-1·82).

INTERPRETATION: Radium-223 should be considered as a treatment option for patients with castration-resistant prostate cancer and symptomatic bone metastases.

FUNDING: Algeta and Bayer HealthCare Pharmaceuticals.

The impact of hydrogeology on the instability of a road cutting through a drumlin in the North of Ireland

This paper describes the hydrogeological processes which caused unexpected instability and quick conditions during the excavation of a 25m deep cutting through a drumlin in County Down, Northern Ireland. A conceptual hydrogeological model of the cutting, based on pore pressures monitored during and after the excavation demonstrates how quick conditions at the toe of the cutting caused liquefaction of the till. Stability of the cutting was re-established by draining the highly permeable, weathered Greywacke which underlies the drumlin, through the use of a deep toe drain. In spite of this drainage, the cutting was only marginally stable due to the presence of a low permeability zone in the till above the bedrock which limits the reduction of elevated pore pressures within the upper to mid-depths of the drumlin. The factor of safety has been further improved by the addition of vertical relief drains at the crest and berm of the cutting to relieve the pore-pressures within the upper till by intercepting the weathered bedrock. The paper also highlights the importance of carrying out an adequate site investigation compliant with Eurocode 7 and additional monitoring in excavations in stiff, low permeability till.