Memorandum of Understanding (PDF 195 KB)

Investigating patient or client safety incidents (Unexpected death or serious untoward harm)

Coevolutionary networks: a novel approach to understanding the relationships of humans with the infectious agents

Human organism is interpenetrated by the world of microorganisms, from the conception until the death. This interpenetration involves different levels of interactions between the partners including trophic exchanges, bi-directional cell signaling and gene activation, besides genetic and epigenetic phenomena, and tends towards mutual adaptation and coevolution. Since these processes are critical for the survival of individuals and species, they rely on the existence of a complex organization of adaptive systems aiming at two apparently conflicting purposes: the maintenance of the internal coherence of each partner, and a mutually advantageous coexistence and progressive adaptation between them. Humans possess three adaptive systems: the nervous, the endocrine and the immune system, each internally organized into subsystems functionally connected by intraconnections, to maintain the internal coherence of the system. The three adaptive systems aim at the maintenance of the internal coherence of the organism and are functionally linked by interconnections, in such way that what happens to one is immediately sensed by the others. The different communities of infectious agents that live within the organism are also organized into functional networks. The members of each community are linked by intraconnections, represented by the mutual trophic, metabolic and other influences, while the different infectious communities affect each other through interconnections. Furthermore, by means of its adaptive systems, the organism influences and is influenced by the microbial communities through the existence of transconnections. It is proposed that these highly complex and dynamic networks, involving gene exchange and epigenetic phenomena, represent major coevolutionary forces for humans and microorganisms.

Nurses' and Midwives' - Understanding and Experiences of Empowerment in Ireland

Nurses’ and Midwives’ Understanding and Experiences of Empowerment in Ireland With the recently launched national health strategy (Department of Health and Children, 2001) and a tightening fiscal policy there is a requirement for a more innovative use of existing resources dedicated to healthcare in Ireland. Nurses and midwives, one of the largest professional groups within the health service, will play a critical role in developing this â?onewâ?Âù health service. Click here to download PDF 745kb

Nurses' and Midwives - Understanding and Experiences of Empowerment in Ireland

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Computational quest for understanding the role of astrocyte signaling in synaptic transmission and plasticity.

The complexity of the signaling network that underlies astrocyte-synapse interactions may seem discouraging when tackled from a theoretical perspective. Computational modeling is challenged by the fact that many details remain hitherto unknown and conventional approaches to describe synaptic function are unsuitable to explain experimental observations when astrocytic signaling is taken into account. Supported by experimental evidence is the possibility that astrocytes perform genuine information processing by means of their calcium signaling and are players in the physiological setting of the basal tone of synaptic transmission. Here we consider the plausibility of this scenario from a theoretical perspective, focusing on the modulation of synaptic release probability by the astrocyte and its implications on synaptic plasticity. The analysis of the signaling pathways underlying such modulation refines our notion of tripartite synapse and has profound implications on our understanding of brain function.

Understanding consumers repurchase in the context of online shopping: an empirical study

L'utilisation de l'Internet comme medium pour faire ses courses et achats a vu une croissance exponentielle. Cependant, 99% des nouveaux business en ligne échouent. La plupart des acheteurs en ligne ne reviennent pas pour un ré-achat et 60% abandonnent leur chariot avant de conclure l'achat. En effet, après le premier achat, la rétention du consommateur en ligne devient critique au succès du vendeur de commerce électronique. Retenir des consommateurs peut sauver des coûts, accroître les profits, et permet de gagner un avantage compétitif.Les recherches précédentes ont identifié la loyauté comme étant le facteur le plus important dans la rétention du consommateur, et l'engagement ("commitment") comme étant un des facteurs les plus importants en marketing relationnel, offrant une réflexion sur la loyauté. Pourtant, nous n'avons pu trouver d'étude en commerce électronique examinant l'impact de la loyauté en ligne et de l'engagement en ligne ("online commitment") sur le ré-achat en ligne. Un des avantages de l'achat en ligne c'est la capacité à chercher le meilleur prix avec un clic. Pourtant, nous n'avons pu trouver de recherche empirique en commerce électronique qui examinait l'impact de la perception post-achat du prix sur le ré-achat en ligne.L'objectif de cette recherche est de développer un modèle théorique visant à comprendre le ré-achat en ligne, ou la continuité d'achat ("purchase continuance") du même magasin en ligne.Notre modèle de recherche a été testé dans un contexte de commerce électronique réel, sur un échantillon total de 1,866 vrais acheteurs d'un même magasin en ligne. L'étude est centrée sur le ré-achat. Par conséquent, les répondants sélectionnés aléatoirement devaient avoir acheté au moins une fois de ce magasin en ligne avant le début de l'enquête. Cinq mois plus tard, nous avons suivi les répondants pour voir s'ils étaient effectivement revenus pour un ré-achat.Notre analyse démontre que l'intention de ré-achat en ligne n'a pas d'impact significatif sur le ré-achat en ligne. La perception post-achat du prix en ligne ("post-purchase Price perception") et l'engagement normatif en ligne ("Normative Commitment") n'ont pas d'impact significatif sur l'intention de ré-achat en ligne. L'engagement affectif en ligne ("Affective Commitment"), l'attitude loyale en ligne ("Attitudinal Loyalty"), le comportement loyal en ligne ("Behavioral Loyalty"), l'engagement calculé en ligne ("Calculative Commitment") ont un impact positif sur l'intention de ré-achat en ligne. De plus, l'attitude loyale en ligne a un effet de médiation partielle entre l'engagement affectif en ligne et l'intention de ré-achat en ligne. Le comportement loyal en ligne a un effet de mediation partielle entre l'attitude loyale en ligne et l'intention de ré-achat en ligne.Nous avons réalisé deux analyses complémentaires : 1) Sur un échantillon de premiers acheteurs, nous trouvons que la perception post-achat du prix en ligne a un impact positif sur l'intention de ré-achat en ligne. 2) Nous avons divisé l'échantillon de l'étude principale entre des acheteurs répétitifs Suisse-Romands et Suisse-Allemands. Les résultats démontrent que les Suisse-Romands montrent plus d'émotions durant l'achat en ligne que les Suisse-Allemands. Nos résultats contribuent à la recherche académique mais aussi aux praticiens de l'industrie e-commerce.AbstractThe use of the Internet as a shopping and purchasing medium has seen exceptional growth. However, 99% of new online businesses fail. Most online buyers do not comeback for a repurchase, and 60% abandon their shopping cart before checkout. Indeed, after the first purchase, online consumer retention becomes critical to the success of the e-commerce vendor. Retaining existing customers can save costs, increase profits, and is a means of gaining competitive advantage.Past research identified loyalty as the most important factor in achieving customer retention, and commitment as one of the most important factors in relationship marketing, providing a good description of what type of thinking leads to loyalty. Yet, we could not find an e-commerce study investing the impact of both online loyalty and online commitment on online repurchase. One of the advantages of online shopping is the ability of browsing for the best price with one click. Yet, we could not find an e- commerce empirical research investigating the impact of post-purchase price perception on online repurchase.The objective of this research is to develop a theoretical model aimed at understanding online repurchase, or purchase continuance from the same online store.Our model was tested in a real e-commerce context with an overall sample of 1, 866 real online buyers from the same online store.The study focuses on repurchase. Therefore, randomly selected respondents had purchased from the online store at least once prior to the survey. Five months later, we tracked respondents to see if they actually came back for a repurchase.Our findings show that online Intention to repurchase has a non-significant impact on online Repurchase. Online post-purchase Price perception and online Normative Commitment have a non-significant impact on online Intention to repurchase, whereas online Affective Commitment, online Attitudinal Loyalty, online Behavioral Loyalty, and online Calculative Commitment have a positive impact on online Intention to repurchase. Furthermore, online Attitudinal Loyalty partially mediates between online Affective Commitment and online Intention to repurchase, and online Behavioral Loyalty partially mediates between online Attitudinal Loyalty and online Intention to repurchase.We conducted two follow up analyses: 1) On a sample of first time buyers, we find that online post-purchase Price perception has a positive impact on Intention. 2) We divided the main study's sample into Swiss-French and Swiss-German repeated buyers. Results show that Swiss-French show more emotions when shopping online than Swiss- Germans. Our findings contribute to academic research but also to practice.

The PHA message is clear for World COPD Day - smoking is bad for your lungs

In 2011, 31,574 people were registered as having Chronic Obstructive Pulmonary Disease (COPD) in Northern Ireland. The most common cause of COPD is smoking and to mark this year's World COPD day, which takes place on Wednesday 16 November, the Public Health Agency is encouraging all smokers to make a decision to stop smoking today and reduce their risk of developing the disease.COPD refers to a group of diseases which includes emphysema, chronic bronchitis, and in some cases asthma. With COPD, the airways in the lungs become damaged, causing them to become narrower, therefore restricting airflow and thus making it harder to breathe. The most common symptoms of COPD are breathlessness, wheezing, abnormal sputum (a mix of saliva and mucus in the airway), and a chronic cough often mistaken for a 'smokers' cough'. Symptoms can range from mild to severe, depending upon how advanced the disease is. In advanced cases, daily activities, such as walking up a short flight of stairs, can become very difficult.There is no cure for COPD. Stopping smoking is the single most effective wayto reduce your risk of developing COPD and avoid any further damage to the lungs. Gerry Bleakney, Head of Health and Social Wellbeing Improvement, PHA, said: "Smoking causes the lining of the airways to become inflamed and damaged and is the biggest cause of COPD. The risk of developing COPD increases the more an individual smokes and the longer they smoke. "The good news is that making changes to your lifestyle can reduce your risk of developing COPD. Stopping smoking reduces the risk of developing COPD and also slows down its progression. There is support available to help you quit and I would encourage everyone thinking about stopping smoking to log on to our Want 2 Stop website www.want2stop.info and order a 'Quit Kit' free of charge. Alternatively contact the Smokers' Helpline on 0808 812 8008 for help on planning to stop smoking or to find out where your nearest Stop Smoking Service is. "The Health Minister Edwin Poots said: "The impact of living with COPD can place a considerable strain on the lives of those suffering from the condition and their families. I understand that most smokers want to quit but it is not always easy to succeed and that several attempts are frequently necessary. I would therefore urge all smokers on world COPD day, to make that commitment to stop smoking. Professional help and support are readily available. There are almost 650 smoking cessation services provided all over Northern Ireland, mostly in community pharmacies, but also in GP surgeries, hospitals, community halls and schools."

Understanding the Economics of Investments in the Social Determinants of Health

Briefing 9 - Understanding the economics of investments in the social determinants of health This document, commissioned by Public Health England, and written by the UCL Institute of Health Equity, examines how to use measures of economic investment to improve and increase local investment in the social determinants of health. The paper provides information to support decision-making on actions to address the social determinants of health and the development of business cases for investment. It supplements the evidence reviews in this series, which include information on the economic impacts of actions on health inequalities, and should help the reader to be an intelligent customer and commissioner of economic analyses and to understand their limitations. The paper covers: - The rationale for understanding, measuring and taking into account the economic impact of decisions and interventions that impact on the social determinants of health.- The benefits and limitations of various ‘economic measures of impact’ – commonly used terms which can be confusing, sometimes leading to misinterpretation of which measure of economic impact is appropriate for what purpose.- What is currently known about the economic impact of intervening in the social determinants of health.- Good practice and further resources which will support better decisions. The briefing is available to download above. This document is part of a series. An overview document which provides an introduction to this and other documents in the series, and links to the other topic areas, is available on the ‘Local Action on health inequalities’ project page. A video of Michael Marmot introducing the work is also available on our videos page.

Space-time within general relativity : a structural realist understanding

ABSTRACT This dissertation investigates the, nature of space-time as described by the theory of general relativity. It mainly argues that space-time can be naturally interpreted as a physical structure in the precise sense of a network of concrete space-time relations among concrete space-time points that do not possess any intrinsic properties and any intrinsic identity. Such an interpretation is fundamentally based on two related key features of general relativity, namely substantive general covariance and background independence, where substantive general covariance is understood as a gauge-theoretic invariance under active diffeomorphisms and background independence is understood in the sense that the metric (or gravitational) field is dynamical and that, strictly speaking, it cannot be uniquely split into a purely gravitational part and a fixed purely inertial part or background. More broadly, a precise notion of (physical) structure is developed within the framework of a moderate version of structural realism understood as a metaphysical claim about what there is in the world. So, the developement of this moderate structural realism pursues two main aims. The first is purely metaphysical, the aim being to develop a coherent metaphysics of structures and of objects (particular attention is paid to the questions of identity and individuality of these latter within this structural realist framework). The second is to argue that moderate structural realism provides a convincing interpretation of the world as described by fundamental physics and in particular of space-time as described by general relativity. This structuralist interpretation of space-time is discussed within the traditional substantivalist-relationalist debate, which is best understood within the broader framework of the question about the relationship between space-time on the one hand and matter on the other. In particular, it is claimed that space-time structuralism does not constitute a 'tertium quid' in the traditional debate. Some new light on the question of the nature of space-time may be shed from the fundamental foundational issue of space-time singularities. Their possible 'non-local' (or global) feature is discussed in some detail and it is argued that a broad structuralist conception of space-time may provide a physically meaningful understanding of space-time singularities, which is not plagued by the conceptual difficulties of the usual atomsitic framework. Indeed, part of these difficulties may come from the standard differential geometric description of space-time, which encodes to some extent this atomistic framework; it raises the question of the importance of the mathematical formalism for the interpretation of space-time.

Your guide to Understanding Alzheimer's Disease and other dementias

��The purpose of this booklet is to give you general information about Alzheimer's Disease and other dementias, and to highlight their early signs and symptoms.It offers a number of tools that can be helpful in establishing whether you or someone you care for is experiencing memory problems, and there is a diary at the back of this book to help track and record various changes that you or the person you love maybe experiencing.This booklet also contains details of what steps to take next if you are concerned about someone, how a diagnosis is made, what to do if you or someone close is diagnosed with Alzheimer's Disease, and outlines the various treatments that are available.Understanding Alzheimer's Disease also focuses on the importance of the role of the carer, explains carer stress, and offers some useful suggestions for reducing the stress that can build up when caring for someone full-time.It is hoped this booklet will give you answers to the more frequently asked questions and therefore give you a better understanding of Alzheimer's Disease and dementia.��