Patient safety and communication: A new assessment for doctors trained in countries where language differs from that of the host country: Results of a pilot using a domain-based assessment

Objective

Global migration of healthcare workers places responsibility on employers to comply with legal employment rights whilst ensuring patient safety remains the central goal. We describe the pilot of a communication assessment designed for doctors who trained and communicated with patients and colleagues in a different language from that of the host country. It is unique in assessing clinical communication without assessing knowledge.

A 14-station OSCE was developed using a domain-based marking scheme, covering professional communication and English language skills (speaking, listening, reading and writing) in routine, acute and emotionally challenging contexts, with patients, carers and healthcare teams. Candidates (n = 43), non-UK trained volunteers applying to the UK Foundation Programme, were provided with relevant station information prior to the exam.

The criteria for passing the test included achieving the pass score and passing 10 or more of the 14 stations. Of the 43 candidates, nine failed on the station criteria. Two failed the pass score and also the station criteria. The Cronbach's alpha coefficient was 0.866.

This pilot tested ‘proof of concept’ of a new domain-based communication assessment for non-UK trained doctors.

The test would enable employers and regulators to verify communication competence and safety in clinical contexts, independent of clinical knowledge, for doctors who trained in a language different from that of the host country.

'A terrible danger to the morals of the country': The Irish hospitals' sweepstake in Great Britain, 1930-87

This paper examines the importance of British contributions to the success of the Irish hospitals sweepstake. In its early years, up to three-quarters of these tickets were sold in Britain, bringing millions of pounds into Ireland annually to improve and expand the state's hospitals. The vast amount of money leaving Britain in this way angered the British government and forced it to introduce new legislation to curtail the activities of the Irish sweep. The paper will highlight the extent to which the success of the sweepstake depended on the market for tickets in Britain; the threat to the sweep's survival posed by the restriction of its activities in Britain after 1935; the role of the sweepstake controversy in exacerbating further already strained relations between Britain and the Irish Free State in the 1930s; how the success of the sweep raised the issue of legalising a British lottery; and the eventual decline of the sweepstake as a force in British gambling in the post-war years.

Less of a Puzzle: a new look at the forward forex market

The two-country monetary model is extended to include a consumption externality with habit persistence. The model is simulated using the artificial economy methodology. The 'puzzles' in the forward market are re-examined. The model is able to account for: (a) the low volatility of the forward discount; (b) the higher volatility of expected forward speculative profit; (c) the even higher volatility of the spot return; (d) the persistence in the forward discount; (e) the martingale behavior of spot exchange rates; and (f) the negative covariance between the expected spot return and expected forward speculative profit. It is unable to account for the forward market bias because the volatility of the expected spot return is too large relative to the volatility of the expected forward speculative profit.

New York City: 12 December, 1980

This article compares two documentary treatments of the Central Park vigil for John Lennon in 1980: Happy Birthday to John (Jonas Mekas, 1995, 16mm, 18 min.), and Dix minutes de silence pour John Lennon/Ten Minutes Silence for John Lennon (Raymond Depardon, 1980, 16mm, 10 min.). Mekas and Depardon might seem an improbable combination but as the article demonstrates there are affinities, if not direct points of convergence, in outlook and documentary method: both sensibilities have been shaped by migrant experiences, and much of their work, for all its formal and structural differences, is preoccupied with experiences of exile and displacement, rootedness and the meaning of home, the country and the city (and in Mekas’s case, the country in the city). Mekas and Depardon are also Europeans who have developed an intimate social and artistic relationship with New York City; both are concerned with the place of autobiography in their work, using captions, inter-titles, diary entries, photographs, and 1st person commentary to complicate relations between the imaginary and the documentary. In addition to discussing the significance of these preoccupations, and differences in the manner in which both filmmakers witness the apotheosis of Lennon as cultural martyr (and natural New Yorker), the article also examines the phenomenon of public mourning, and how it often displaces its ostensible subject: associatively, in the case of Mekas; incidentally, in the case of Depardon; and intentionally, in the case of the mass media, and popular culture.

Who We Are and Who Can Join Us: National Identity Content and Entry Criteria for New Immigrants

We argue that attitudes about immigration can be better understood by paying closer attention to the various ways in which national group boundaries are demarcated. We describe two related lines of work that address this. The first deals with national group definitions and, based on evidence from studies carried out in England and analyses of international survey data, argues that the relationship between national identification and prejudice toward immigrants is contingent on the extent to which ethnic or civic definitions of nationality are endorsed. The second, which uses European survey data, examines support for ascribed and acquired criteria that can be applied when determining who is permitted to migrate to one's country, and the various forms of national and individual threat that affect support for these criteria. We explain how the research benefits from a multilevel approach and also suggest how these findings relate to some current policy debates.

Dubai revisited: is new planned housing sustainable?

Dubai, the second largest city of the United Arab Emirates, is a fast growing hub with increasing need for infrastructure, housing and public facilities. Dubai is trying to market itself as an attractive holiday destination, which saw the launching and building of large scale planned communities, some of which are located on reclaimed land along the city's coast line. This paper reviews Dubai\'s green building agenda by examining the scale and typologies of new and planned low carbon projects, and discusses the potential of renewable sources of energy that can reduce the country's dependence on fossil fuels and improve the country's long term sustainability. It assesses the potential of solar energy, wind power, and geo-thermal energy in Dubai and the UAE in general.

A New Irish? Problems of communication in modern Irish media and new speakers.

While the Gaeltacht (Irish speaking) areas of Ireland are geographically isolated from each other and relatively small in area, it is expected that the number of second language Irish speakers throughout the country should ensure the future of the language. Nevertheless, while the official standard grammar has been established for many decades, there is still a tendency in the spoken language to give precedence to regional dialectal variants in schools and the broadcast media which often raises barriers between native speakers themselves and between learners and native speakers.
All pupils in school in the Republic and many in Northern Ireland learn Irish and there has been a great increase in the number of pupils attending immersion Irish language Gaelscoileanna. But concern has been expressed about the phonetic and structural accuracy achieved in schools, all of which contributes to communication breakdown.
This paper discusses how a greater awareness of the link between phoneme and grapheme in Irish and the proposals for the Lárchanúint (Central Dialect) in the 1980s and current discussions on Caighdeán Leathan agus Caighdeán Cúng (Broad and Narrow Standard) would mitigate these concerns.

Risk of Several Cancers is Higher in Urban Areas after Adjusting for Socioeconomic Status. Results from a Two-Country Population-Based Study of 18 Common Cancers

Some studies suggest that there are urban-rural variations in cancer incidence but whether these simply reflect urban-rural socioeconomic variation is unclear. We investigated whether there were urban-rural variations in the incidence of 18 cancers, after adjusting for socioeconomic status. Cancers diagnosed between 1995 and 2007 were extracted from the population-based National Cancer Registry Ireland and Northern Ireland Cancer Registry and categorised by urban-rural status, based on population density of area of residence at diagnosis (rural 15 people per hectare). Relative risks (RR) were calculated by negative binomial regression, adjusting for age, country and three area-based markers of socioeconomic status. Risks were significantly higher in both sexes in urban than rural residents with head and neck (males RR urban vs. rural = 1.53, 95 % CI 1.42-1.64; females RR = 1.29, 95 % CI 1.15-1.45), esophageal (males 1.21, 1.11-1.31; females 1.21, 1.08-1.35), stomach (males 1.36, 1.27-1.46; females 1.19, 1.08-1.30), colorectal (males 1.14, 1.09-1.18; females 1.04, 1.00-1.09), lung (males 1.54, 1.47-1.61; females 1.74, 1.65-1.84), non-melanoma skin (males 1.13, 1.10-1.17; females 1.23, 1.19-1.27) and bladder (males 1.30, 1.21-1.39; females 1.31, 1.17-1.46) cancers. Risks of breast, cervical, kidney and brain cancer were significantly higher in females in urban areas. Prostate cancer risk was higher in rural areas (0.94, 0.90-0.97). Other cancers showed no significant urban-rural differences. After adjusting for socioeconomic variation, urban-rural differences were evident for 12 of 18 cancers. Variations in healthcare utilization and known risk factors likely explain some of the observed associations. Explanations for others are unclear and, in the interests of equity, warrant further investigation. © 2014 The New York Academy of Medicine.

An anthropometric history of the World, 1810-1980: did migration and globalization influence country trends?

We find that regional height levels around the world were fairly uniform throughout most of the 19th century, with two exceptions: above-average levels in Anglo-Saxon settlement regions and below-average levels in Southeast Asia. After 1880, substantial diver- gences began to differentiate other regions -- making the world population taller, but more unequal. During the late 19th century and 20th century, heights between world regions devi- ated significantly, when incomes also became very unequal. Interestingly, during the “breaking point period” between the two regimes, heights declined significantly in the cattle-rich New World countries, whereas they started to increase in Old Europe. We discuss in this study whether immigration was a core factor to influence the height decline in the “Anthropometric Decline of the Cowboy and Gaucho Empires”.

Old truths and new politics:Does truth commission 'publicness' impact democratization?

This article analyzes the relationship between truth and politics by asking whether the 'publicness' of a truth commission - defined by whether it has public hearings, releases a public report, and names perpetrators - contributes to democratization. The article reviews scholarship relevant to the potential democratizing effects of truth commissions and derives mechanisms that help explain this relationship. Work from the transitional justice field as well as democratization and political transition more generally is considered. Using a newly-constructed Truth Commission Publicness Dataset (TCPD), the analysis finds that even after statistically controlling for initial levels of democracy, democratic trends in the years prior to a commission, level of wealth, amnesties and/or trials, the influence of the South African Truth and Reconciliation Commission, and different cutoff points for measuring democratization across a number of models, more publicness predicts higher levels of democracy years after the commission has finished its work. The more public a truth commission is, the more it will contribute to democratization. The finding that more public truth commissions are associated with higher levels of democratization indicates particular strategies that policymakers, donors, and civil society activists may take to improve prospects for democracy in a country planning a truth commission in the wake of violence and/or government abuse. © The Author(s) 2012.

Foreign Direct Investment and Country Risk::Is There Evidence of 'Malign Investment in the Former Soviet States'

This paper examines the relationship between concepts of MNE bargaining power and broader concepts of political power. It notes that the analysis of MNE bargaining power presents a number of puzzles from the perspective of political theory. These puzzles arise, in part, from the fact that the overlap between traditional concepts of MNE bargaining power and broader concepts of political power is only a partial one. Despite these problems, it is suggested that political- theory-based approaches can add realism to our understanding of bargaining power.

Protestantism, Spectacle, Motherhood and Vice: Dublin's New Pleasure Gardens

In 1748, Bartholomew Mosse, a curious combination of surgeon, obstetrician and entertainment impresario, established a pleasure garden on the northern fringes of Dublin. Ostensibly designed to fund the construction of a maternity hospital to be located adjacently, Mosse’s New Pleasure Gardens became one of the premier leisure resorts in Dublin. This was to have a profound effect on the city’s urban form. Within a few years the gardens became an epicentre of speculative development as the upper classes jostled to build their houses in the vicinity. Meanwhile, the creation nearby of Sackville Mall, a wide and generous strolling ground, established a whole section of the city dedicated to haute spectacle, display and leisure. Like other pleasure gardens in the British Isles, Mosse’s venture introduced new, commodified forms of entertainment. In the colonial context of eighteenth-century Ireland, however, ‘a land only recently won and insecurely held’ (Foster, 1988) by the Protestant Anglo-Irish settler class, the production of culture and spectacle was perhaps more significant than elsewhere. Indeed, the form of Mosse’s gardens echoed the private city gardens of a key figure in the Anglo-Irish aristocracy, while the hospital itself was constructed in a style of a Palladian country house, symbol of colonial presence in the countryside. However, like other pleasure gardens, the mix of music and alcohol, the heterogeneous crowd culled from across social and gender boundaries, and a landscape punctuated with secluded corners, meant that it also acquired a dubious reputation as a haunt of louche and illicit behaviours. The curious juxtaposition between a maternity hospital and pleasure garden, therefore, begins to assume other, hitherto hidden complexities. These are borne out by a closer examination of the architecture of the hospital, the shape of its landscape and the records of its patrons and patients.

Beneath an Irish Sky:A new play by Kieran Kelly

A fictionalised account of one Letterkenny man's journey, questioning what made him pick up a gun to fight for his country and how one moment in his youth affected the rest of his life. Part of the 'Ireland 2016 Centenary Programme'