An evaluation of a domiciliary blood transfusion serivce for palliative care patients in Northern Ireland

Marie Curie Cancer Care (MCCC) is a national charitable organisation which provides specialist palliative care services to patients with cancer and other life limiting illnesses. Marie Curie Nursing Service (MCNS) provides nursing services to patients in their own homes. The administration of blood transfusions to palliative care patients is required to improve symptom management and quality of life; however this procedure often results in unnecessary hospital admissions. Recognising that the majority of patients wish to be cared for and die in their own home, and with National Guidance recommending that specialist palliative care services should be provided to patients in their preferred place of care, a recent service initiative by MCNS was domiciliary blood transfusions. Whilst this is not a new service within domiciliary care, this pilot project aimed to capture patient views to evaluate this service initiative. Telephone interviews were conducted, using a questionnaire, with 11 patients who had received the service. Findings indicated positive evaluation of the service. Domiciliary blood transfusions helped to avoid unnecessary hospital admissions, the quality of life of patients and their families was improved in the palliative phase of illness and they received the service in their preferred place of care.

Diving behaviour of jellyfish equipped with electronic tags

Jellyfish are one of the most abundant and conspicuous members of our coastal marine fauna and are now known to play major trophic roles in marine systems. However, little is known about the movements and behaviour of individuals. We equipped individual compass jellyfish (Chrysaora hysoscella) (n = 15) off the Dingle coast, Ireland, with miniature time-depth recorders to log their depth over periods of a few hours. Vertical movements were extensive, with all jellyfish changing their depth during tracking. A range of vertical movements were seen including initial diving from the surface down to a maximum of 29.6 m after device attachment, some jellyfish remaining near the bottom, some moving up and down in mid-water and some moving back near the surface. These results show that jellyfish actively reposition themselves in the water column over small time-scales and open the way for more extensive studies equipping jellyfish with electronic tags.

The ocean sunfish Mola mola: insights into distribution, abundance and behaviour in the Irish and Celtic Seas

Here we provide baseline data on the distribution and abundance of Mola mola within the Irish and Celtic Seas, made during aerial surveys from June to October during 2003-2005. These data were considered in conjunction with concurrent observations of three potential jellyfish prey species found throughout the region: Rhizostoma octopus, Chrysaora hysoscella and Cyanea capillata. A total area of 7850 km(2) was surveyed over the three years with an observed abundance of 68 sunfish giving a density of 0.98 ind/100 km(2). Although modest, these findings highlight that the species is more common than once thought around Britain and Ireland and an order of magnitude greater than the other apex jellyfish predator found in the region, the leatherback turtle (Dermochelys coriacea). furthermore, the distribution of sunfish sightings was inconsistent with the extensive aggregations of Rhizostoma octopus found throughout the study area. The modelled distributions of predator-prey co-occurrence (using data for all three jellyfish species) was less than the observed co-occurrence with the implication that neither jellyfish nor sunfish were randomly distributed but co-occurred more in the same areas than expected by chance. Finally, observed sunfish were typically small (similar to 1 in or less) and seen to either bask or actively swim at the surface.

Promoting Health Behaviour Change in the Cardiac Patient

The importance of giving patients advice in relation to positive health behaviour change geared towards maximizing physical health must not be overlooked and is an important role of the cardiac nurse in contemporary health care. However, over-reliance on offering advice can often be counter-productive and less likely to achieve effective change. Patients are more likely to make positive health behaviour changes when they self-generate their own solutions to the health issues and problems that they face. In this article, the authors encourage cardiac nurses to embrace a less directive and more facilitative approach to patient health behaviour change in light of the mounting evidence that exists to the effectiveness of motivational interviewing techniques.

Propensity to Apply for Judicial Office under the new Northern Ireland Judicial Appointments System::A qualitative study for the Northern Ireland Judicial Appointments Commission October

The study of representation and participation in the judiciary is hardly novel. There have been substantial studies in a number of countries – often these have preceded the setting up of judicial appointment commissions – which have looked at the continuing problem of female representation in judicial posts. Prior to the setting up of the Northern Ireland Judicial Appointments Commission a study carried out by Dermot Feenan for the Commissioner for Judicial Appointments for Northern Ireland also looked into this topic and produced a large number of recommendations. What differs from the Feenan project, in this project, has been the number of individuals consulted in interviews and focus groups. This has allowed us to provide a detailed qualitative attitudinal perspective to enhance the questionnaire study undertaken as Stage 1 in this research project. Further, we have carried out this study after many of the recommendations made in previous research have been implemented.
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Our interviews and focus groups covered a broad range of individuals – solicitors outwith and within Belfast (private and public service), barristers in private practice and public service and also barristers no longer in practice. We also sought responses from student lawyers. In total there were 71 respondents, with a typical interview/focus group length of 60 minutes. The group included candidates who had little interest in applying for judicial office, those who might consider this in future, and candidates who had applied for one or more judicial posts and who may or may not consider reapplication. We did not seek the views of successful candidates for judicial posts under the new NIJAC process.
The timing of this project, with interviews and focus groups held between December 2007 and March 2008, offers an early perspective on the whether the creation of a NI Judicial Appointments Commission has affected, and if so, in what way, the decision to apply for a judicial post. Generally, we found that there was a significant impact upon attitudes to judicial application which had arisen from the creation of NIJAC and that this was more positive than negative.

Coronary heart disease: health knowledge and behaviour

Objective To determine the current level of knowledge and understanding of CHD in the general public in Northern Ireland and to identify factors that are associated with higher knowledge levels. Setting Six provincial centres in Northern Ireland. Methods The data in the present study were collected using an interview administered questionnaire. 1,000 members of the general public were interviewed face-to-face. CHD knowledge was computed as a continuous variable, i.e. higher score represents better CHD knowledge. Main outcome measure CHD knowledge in the general public in Northern Ireland. Results Study respondents displayed limited knowledge and understanding of CHD. Study respondents who achieved higher CHD knowledge scores were more likely to report: exercising for 30 min three times or more per week, paying attention to their diet, being overweight, having a family history of CHD, living in a higher socioeconomic area (according to postcode) and having attended tertiary education. Respondents in the present study while recognising the role that community pharmacists had to play in helping patients manage their prescribed medicines, did not recognise the community pharmacists' role in other aspects of CHD detection or management. Conclusion The deficit in CHD knowledge could translate into inadequate preventative behaviour patterns and suboptimal clinical outcomes. If community pharmacists wish to become increasingly involved in public health delivery relating to CHD they need to develop effective and accessible services and promote these to the public who at present do not recognise this role of the community pharmacist.

Realising political equality: the European Court of Human Rights and positive obligations in a democracy'

The European Convention on Human Rights (ECHR) speaks of the importance of an “effective political democracy” in its Preamble, though it is only in Article 3 of Protocol 1 (P1-3) that we find a right to free elections. This paper discusses the role of “positive obligations” under P1-3. This paper outlines the positive obligations in P1-3 focusing on obligations where the state is required to do more than just change the law. This may mean providing resources or facilities, adopting regulatory frameworks or creating new institutions. The paper highlights specific positive obligations that need to be further developed in the jurisprudence of the European Court of Human Rights (ECtHR). Sometimes these can be developed by analogy with positive obligations recognised in other areas of ECtHR jurisprudence. However, beyond these cases, states should ensure that members of vulnerable and disadvantaged minorities are able to participate in the electoral process and should ensure that dominant political groups cannot abuse their political power to exclude other parties unfairly. This is necessary to realise equal political rights. The second section of this paper sketches some preliminary points about the Strasbourg institutions’ approach to P1-3. After that, the third section identifies circumstances where the ECtHR should apply a more intense scrutiny in P1-3 cases. The fourth, fifth and sixth sections look at positive obligations relating to the right to vote, the right to run for election and the regulation of political parties.

Residential segregation and health in Northern Ireland

Patterns of residential segregation in Northern Ireland reflect historic sectarian conflict as well as current animosities. A number of indices of segregation are examined in this paper and their relative merits in capturing localised societal divisions are discussed.The implications of such divisions on health as mediated through conflict-related stress are then considered. Costed datasets of hospital, community and anxiety/depression prescribing data havebeen assembled and attributed to local geographies.The association between geographical variations in these costs and levels of segregation was modelled using regression analysis.It was found that the level of segregation does not help to explain variations in costed utilisation of acute and elderly services but does explain variations in the costs of prescribing for anxiety and depression with controls for socio-economic deprivation included. Results in this paper would indicate that strategies to promote good relations in Northern Ireland have positive implications for mental health.

Is dieting behaviour decreasing in young adolescents?

Abstract Objective: To report trends in underweight, overweight and obesity in 12–15-year-old adolescents and examine changes in dieting behaviour, which have been less well documented. Design: Comparison of two independent representative cross-sectional surveys. Setting: Northern Ireland. Subjects: Weight and height were objectively measured in 1324 boys and 1160 girls in 1996 and 1274 boys and 1374 girls in 2007. Participants reported whether they were following any particular diet including a self-proposed or prescribed weight-reduction diet. Results: Overweight and obesity increased in girls from 15% to 23% and 2% to 6%, respectively. Increases were more modest in boys with overweight increasing from 13% to 18% and obesity from 3% to 6%. The proportion of underweight adolescents decreased from 9% to 6% in girls and 8% to 5% in boys. Evidence of social disparity was observed in girls from a manual socio-economic background, with overweight/obesity prevalence rates increasing from 21% to 36% compared with 15% to 26% in girls from a non-manual background. Despite these trends fewer adolescents, in particular girls, reported following weight-reduction diets (14% of overweight/obese girls in 2007 v. 21% in 1996; 8% of boys in 2007 v. 13% in 1996). Of these girls, the proportion from a manual background following weight-reduction diets decreased from 25% to 11%. Conclusions: Overweight and obesity are continuing to increase in adolescents despite government and media awareness strategies. There also appears to be reduced dieting behaviour, despite increasing body weight, particularly in girls from manual socio-economic backgrounds.

Self-esteem and self-efficacy: Associations with alcohol consumption in a sample of adolescents in Northern Ireland

Cross-sectional and longitudinal studies have reported equivocal findings regarding the association between self-esteem, self-efficacy and adolescent alcohol use. Data were collected from a sample of 11-16-year olds in Northern Ireland (n = 4088) over two consecutive academic years measuring global self-esteem, academic, social and emotional self-efficacy and alcohol involvement. Results showed a domain-specific association between alcohol involvement and self-efficacy, with more problematic alcohol use associated with higher social self-efficacy but lower emotional and academic self-efficacy. Additionally, regression analyses revealed that all self-concept measures significantly predicted drinking group membership. The results are discussed in terms of reported drinking behaviour, interventions with adolescent groups and general development.

Sharing Classes between Separate Schools: a mechanism for improving inter-group relations in Northern Ireland?

One manifestation of division and the history of conflict in Northern Ireland is the parallel education system that exists for Protestants and Catholics. Although recent decades have seen some advances in the promotion of integrated education, around 95% of children continue to attend schools separated on ethno-religious lines. In 2007 a programme for sharing education was established. Underpinned by intergroup contact theory, and reflecting educational priorities shared by all school sectors, the programme seeks to offer children from different denominational schools an opportunity to engage with each other on a sustained basis. In this article the authors adopt a quantitative approach to examining the impact of participation in the Sharing Education Programme on a range of outcomes (out-group attitudes, positive action tendencies and out-group trust) via, first, intergroup contact (cross-group friendships) and, second, intergroup anxiety. Their findings confirm the value of contact as a mechanism for promoting more harmonious relationships, and affirm the Sharing Education Programme as an initiative that can help promote social cohesion in a society that remains deeply divided.

Nathusius' pipistrelle bats (Pipistrellus nathusii, Keyserling & Blasius 1839) breeding in Ireland

We describe the most westerly known maternity colony of Nathusius' pipistrelle bats (Pipistrellus nathusii). The bats were identified by using morphometric measurements and analysis of time-expanded echolocation and social calls. The roost, containing approximately 150 individuals, was located in a mid 19th century farm stable block and store house situated in parkland in County Antrim, Northern Ireland. The roost was visited on 30 April, I May and 22 June 1997. Over this period, 11 bats were caught: one adult male, five pregnant females, four lactating females and a juvenile male. Direct observation of behaviour patterns suggests that mating groups of P. nathusii may occur in Ireland as late as May. The migratory nature of this species is discussed.

Evidence of hantavirus in wild rodents in Northern Ireland

A survey of evidence of rodent hantavirus infection in County Down, Northern Ireland was carried out by using immunofluorescence to detect virus antigen and antibody. Antibodies to hantavirus (R22 strain of Seoul virus and Hantaan 76-118) were found in 11/51 (21.6%) brown rats (Rattus norvegicus), 1/31 (3.2%) field mice (Apodemus sylvaticus) and 17/59 (28.8%) house mice (Mus domesticus). Seven rodents had evidence of hantavirus antigen in lung tissues. Antibody positive animals were significantly more likely to be adults than juveniles (P = 0.04) but and there was no sex difference between antibody positive and negative animals. House mice were more likely to be antibody positive if captured inside farm outbuildings (P = 0.08). Attempts to culture virus from the rodent material were unsuccessful. This work demonstrates a substantial rodent reservoir for hantavirus in Northern Ireland.