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.

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.

Assessing the extent to which temporal changes in waterbird community composition are driven by either local, regional or global factors.

1. Lough Neagh and Lough Beg Special Protection Area (SPA, hereafter Lough Neagh) is an important non-estuarine site in Britain and Ireland for overwintering wildfowl. Multivariate analysis of the winter counts showed a state-shift in the waterbird community following winter 2000/2001, mostly due to rapid declines in abundance (46–57% declines in the mean mid-winter January counts between 1993–2000 and 2002–2009) of members of the diving duck guild (pochard Aythya ferina, tufted duck Aythya fuligula and goldeneye Bucephala clangula) and coot (Fulica atra), a submerged macrophyte feeder.
2. Only pochard showed correlations between declines at Lough Neagh and those of overall species flyway population indices to suggest that global changes could contribute to declines at the site. However, indices from the Republic of Ireland showed no overall decline in the rest of Ireland. Tufted duck indices at the site were inversely related to indices in Great Britain. Lough Neagh goldeneye indices were positively correlated with indices in the Republic of Ireland and Great Britain, suggesting that short-stopping could contribute to declines at the site. Coot declines at Lough Neagh did not correlate with trends elsewhere, suggesting local factors involved in the decline.
3. These analyses indicate that although there are potentially different explanations for the dramatic declines in these four waterbird species at this site, the simultaneous nature of the declines across two feeding guilds strongly
suggest that local factors (such as loss of submerged macrophytes and benthic invertebrates) were involved. An assessment of the food supply, local disturbance and other factors at Lough Neagh is required to find an explanation for the observed adverse trends in wintering numbers of the affected species.
4. This study highlights the potential of waterbird community structure to reflect the status of aquatic systems, but confirms the need to establish site-specific factors responsible for the observed changes in abundance of key waterbird species at a site.

The use of Ecological and Carbon Footprint Analysis in regional policy making: application and insights using the REAP model

This paper builds on and extends previous research to contribute to ongoing discussion on the use of resource and carbon accounting tools in regional policy making. The Northern Visions project has produced the first evidence-based footpath setting out the actions that need to be taken to achieve the step changes in the Ecological and Carbon Footprint of Northern Ireland. A range of policies and strategies were evaluated using the Resources and Energy Analysis Programme. The analysis provided the first regional evidence base that current sustainable development policy commitments would not lead to the necessary reductions in either the Ecological Footprint or carbon dioxide emissions. Building on previous applications of Ecological Footprint analysis in regional policy making, the research has demonstrated that there is a valuable role for Ecological and Carbon Footprint Analysis in policy appraisal. The use of Ecological and Carbon Footprint Analysis in regional policy making has been evaluated and recommendations made on ongoing methodological development. The authors hope that the research can provide insights for the ongoing use Ecological and Carbon Footprint Analysis in regional policy making and help set out the priorities for research to support this important policy area

The spatial ecology of the whiskered bat (Myotis mystacinus) at the western extreme of its range provides evidence of regional adaptation

Although widespread, the ecology of the whiskered bat, Myotis mystacinus in Europe remains poorly understood. Ireland is positioned at the most western extreme of this species' range. To ascertain the ecology of M. mystacinus at its geographic range extreme, the roosting behaviour, home range and habitat use of females in a maternity roost in Ireland was investigated by radio-tracking. M. mystacinus were active in a diversity of habitats: namely, mixed woodland, riparian vegetation, arable land and rough grassland. However, only mixed woodland and riparian habitats were selected as core foraging areas. This is in contrast to a previous study from Britain where only pasture was utilised but is in agreement with data from Slovakia, where woodland was also selected, whilst riparian areas were also utilised by this species in Germany. A high degree of overlap in the foraging areas of individuals was observed. A total of seven roosts were utilised by tracked bats and roost switching behaviour was observed. We discuss our contrasting results in respect to range limitations, regional variability in landscape structure and the composition of bat communities. The present results have implications for the conservation of M. mystacinus within Ireland and other parts of its range, highlighting the need for range wide ecological studies. Regional variability in the ecology of bats related to landscape factors is an important consideration for bat conservation and therefore must be incorporated into future management plans. (C) 2012 Deutsche Gesellschaft fur Saugetierkunde. Published by Elsevier GmbH. All rights reserved.

Histopathologists’ approach to keratoacanthoma: a multisite survey of regional variation in Great Britain and Ireland

Introduction: This survey examines regional variation in the diagnosis of keratoacanthoma (KA).

Methods: Twenty-three departments from Great Britain and Ireland were invited. The number of cases coded as KA or cutaneous SCC in the previous 12 months was retrieved. An SCC: KA ratio was calculated. Participants also provided free text responses.

Results: Seventeen departments replied. A total of 11 718 cases were included with a breakdown of 998 KA and 10 720 SCC. The mean SCC:KA ratio was 10.7:1, range (2.5:1 to 139:1). Free text responses are presented.

Discussions: An extreme variation in approach is highlighted by this survey. We believe a multidisciplinary team approach to the diagnosis of KA is essential. There seems to be a need for a carefully considered clinicopathological study, backed up by molecular studies, to better understand the natural biology of this diagnosis.

Integrating geophysical data and upscaling techniques to support regional groundwater flow modelling: A practical example of the Lagan Valley, Northern Ireland

When studying heterogeneous aquifer systems, especially at regional scale, a degree of generalization is anticipated. This can be due to sparse sampling regimes, complex depositional environments or lack of accessibility to measure the subsurface. This can lead to an inaccurate conceptualization which can be detrimental when applied to groundwater flow models. It is important that numerical models are based on observed and accurate geological information and do not rely on the distribution of artificial aquifer properties. This can still be problematic as data will be modelled at a different scale to which it was collected. It is proposed here that integrating geophysics and upscaling techniques can assist in a more realistic and deterministic groundwater flow model. In this study, the sedimentary aquifer of the Lagan Valley in Northern Ireland is chosen due to intruding sub-vertical dolerite dykes. These dykes are of a lower permeability than the sandstone aquifer. The use of airborne magnetics allows the delineation of heterogeneities, confirmed by field analysis. Permeability measured at the field scale is then upscaled to different levels using a correlation with the geophysical data, creating equivalent parameters that can be directly imported into numerical groundwater flow models. These parameters include directional equivalent permeabilities and anisotropy. Several stages of upscaling are modelled in finite element. Initial modelling is providing promising results, especially at the intermediate scale, suggesting an accurate distribution of aquifer properties. This deterministic based methodology is being expanded to include stochastic methods of obtaining heterogeneity location based on airborne geophysical data. This is through the Direct Sample method of Multiple-Point Statistics (MPS). This method uses the magnetics as a training image to computationally determine a probabilistic occurrence of heterogeneity. There is also a need to apply the method to alternate geological contexts where the heterogeneity is of a higher permeability than the host rock.

An examination of regional policy implications pertaining to SME E-Business adoption in South-East Wales

Regional policy frameworks need to focus on strengthening the ICT infrastructure, clarifying market rules to build user confidence, developing networks, facilitating ICT-enabled clustering and infrastructure sharing.

Regional integration of biogas – developing an intersectoral research action plan for Northern Ireland

Bioenergy is a key component of the European Union long term energy strategy across all sectors, with a target contribution of up to 14% of the energy mix by 2020. It is estimated that there is the potential for 1TWh of primary energy from biogas per million persons in Europe, derived from agricultural by-products and waste. With an agricultural sector that accounts for 75% of land area and a large number of advanced engineering firms, Northern Ireland is a region with considerable potential for an integrated biogas industry. Northern Ireland is also heavily reliant on imported fossil fuels. Despite this, the industry is underdeveloped and there is a need for a collaborative approach from research, business and policy-makers across all sectors to optimise Northern Ireland’s abundant natural resources. ‘Developing Opportunities in Bio-Energy’ (i.e. Do Bioenergy) is a recently completed project that involved both academic and specialist industrial partners. The aim was to develop a biogas research action plan for 2020 to define priorities for intersectoral regional development, co-operation and knowledge transfer in the field of production and use of biogas. Consultations were held with regional stakeholders and working groups were established to compile supporting data, decide key objectives and implementation activities. Within the context of this study it was found that biogas from feedstocks including grass, agricultural slurry, household and industrial waste have the potential to contribute from 2.5% to 11% of Northern Ireland’s total energy consumption. The economics of on-farm production were assessed, along with potential markets and alternative uses for biogas in sectors such as transport, heat and electricity. Arising from this baseline data, a Do Bioenergy was developed. The plan sets out a strategic research agenda, and details priorities and targets for 2020. The challenge for Northern Ireland is how best to utilise the biogas – as electricity, heat or vehicle fuel and in what proportions. The research areas identified were: development of small scale solutions for biogas production and use; solutions for improved nutrient management; knowledge supporting and developing the integration of biogas into the rural economy; and future crops and bio-based products. The human resources and costs for the implementation were estimated as 80 person-years and £25 million respectively. It is also clear that the development of a robust bio-gas sector requires some reform of the regulatory regime, including a planning policy framework and a need to address social acceptance issues. The Action Plan was developed from a regional perspective but the results may be applicable to other regions in Europe and elsewhere. This paper presents the methodology, results and analysis, and discussion and key findings of the Do Bioenergy report for Northern Ireland.

Situated regional university incubation: A multi-level stakeholder perspective

From a macro perspective, it is widely acknowledged that University incubation models within a region are important stimulants of economic development through innovation and job creation. With the emergence of quadruple helix innovation ecosystems, universities have had re-evaluate their University incubation activity and models to engage more fully with industry and end users. However, within a given region, the type of University may influence their ability to engage with quadruple helix stakeholders and consequently impact their incubation activity. To date there is a scarcity of research which explores this 'meso' environment and its subsequent impact on University incubation models. Therefore, the aim of this paper is to use a stakeholder lens to explore University Incubation models within unique regional and organisational characteristics and constraints. The research methodology employed was based on a comparative case analysis of incubation of two different Universities within a UK peripheral region. It was found that variances existed in relation to the two universities incubation models which were found to result from both regional (macro environment) and organisational (meso environment) influences (i.e. university type). This research contributes to both regional and national agendas by empirically illustrating the need for appropriate design and tailoring of university incubation models (via acknowledgement of quadruple helix stakeholder influence) to incorporate contextual influences rather than adopting a best practise approach.