A history of the Irish Red Cross Society, 1939-1971

This research is concerned with assessing from a national perspective the role, work and historical impact of the Irish Red Cross Society (IRCS) between 1939 and 1971. During this period the IRCS discharged three primary functions: it provided first aid services both in war-time and peace-time; it pioneered public health and social care services; and acted as the State’s main agency for international humanitarian relief measures. Although primarily a national organisational history of the Society, it is not a history in isolation. A broader perspective demonstrates that the work undertaken by the IRCS has relevance to the medical, social, religious, cultural, political and diplomatic history of twentieth century Ireland. This study assesses the impact of a number of significant public health and social care initiatives which the IRCS implemented and developed since its inception and how most of these were subsequently developed independently by the State. During the early 1940s, the Society’s formation of a national blood transfusion service ultimately laid the foundations for the establishment of a national blood transfusion service. The Society’s steering of a national anti-tuberculosis campaign in the 1940s brought the issue of the eradication of TB to the fore and helped to change public attitudes towards the disease. The concept of caring for the needs of the elderly in Ireland was largely unknown until the IRCS began addressing the issue in the 1950s and, for more than two decades, was effectively the only organisation in the State that campaigned and introduced innovative services for the aged. The IRCS made a significant impact in terms of its commitment to the needs of refugees and the provision of international humanitarian relief from Ireland. The Society’s donation in 1945 of a fully equipped hospital to the population of Saint-Lo in France, its war-time overseas relief efforts and its post-war work for child refugees earned Ireland significant international recognition and prestige and, more importantly, justified Ireland’s war-time policy of neutrality. With Ireland’s admission to the UN, the government became more dependent on the IRCS to consolidate that position.

Response to the review of the white paper on Irish aid. The urbanisation of poverty: drawing on the skills and techniques of spatial planning to support the aid programme

Submission on behalf of UCC to the Government Consultation on the White paper on Irish Aid

Development of a decision aid to inform patients' and families' renal replacement therapy selection decisions.

BACKGROUND: Few educational resources have been developed to inform patients' renal replacement therapy (RRT) selection decisions. Patients progressing toward end stage renal disease (ESRD) must decide among multiple treatment options with varying characteristics. Complex information about treatments must be adequately conveyed to patients with different educational backgrounds and informational needs. Decisions about treatment options also require family input, as families often participate in patients' treatment and support patients' decisions. We describe the development, design, and preliminary evaluation of an informational, evidence-based, and patient-and family-centered decision aid for patients with ESRD and varying levels of health literacy, health numeracy, and cognitive function. METHODS: We designed a decision aid comprising a complementary video and informational handbook. We based our development process on data previously obtained from qualitative focus groups and systematic literature reviews. We simultaneously developed the video and handbook in "stages." For the video, stages included (1) directed interviews with culturally appropriate patients and families and preliminary script development, (2) video production, and (3) screening the video with patients and their families. For the handbook, stages comprised (1) preliminary content design, (2) a mixed-methods pilot study among diverse patients to assess comprehension of handbook material, and (3) screening the handbook with patients and their families. RESULTS: The video and handbook both addressed potential benefits and trade-offs of treatment selections. The 50-minute video consisted of demographically diverse patients and their families describing their positive and negative experiences with selecting a treatment option. The video also incorporated health professionals' testimonials regarding various considerations that might influence patients' and families' treatment selections. The handbook was comprised of written words, pictures of patients and health care providers, and diagrams describing the findings and quality of scientific studies comparing treatments. The handbook text was written at a 4th to 6th grade reading level. Pilot study results demonstrated that a majority of patients could understand information presented in the handbook. Patient and families screening the nearly completed video and handbook reviewed the materials favorably. CONCLUSIONS: This rigorously designed decision aid may help patients and families make informed decisions about their treatment options for RRT that are well aligned with their values.

Real-time decision aid display

Gemstone Team Future Firefighting Advancements

Development and usability testing of a Web-based decision aid for families of patients receiving prolonged mechanical ventilation.

BACKGROUND: Web-based decision aids are increasingly important in medical research and clinical care. However, few have been studied in an intensive care unit setting. The objectives of this study were to develop a Web-based decision aid for family members of patients receiving prolonged mechanical ventilation and to evaluate its usability and acceptability. METHODS: Using an iterative process involving 48 critical illness survivors, family surrogate decision makers, and intensivists, we developed a Web-based decision aid addressing goals of care preferences for surrogate decision makers of patients with prolonged mechanical ventilation that could be either administered by study staff or completed independently by family members (Development Phase). After piloting the decision aid among 13 surrogate decision makers and seven intensivists, we assessed the decision aid's usability in the Evaluation Phase among a cohort of 30 surrogate decision makers using the Systems Usability Scale (SUS). Acceptability was assessed using measures of satisfaction and preference for electronic Collaborative Decision Support (eCODES) versus the original printed decision aid. RESULTS: The final decision aid, termed 'electronic Collaborative Decision Support', provides a framework for shared decision making, elicits relevant values and preferences, incorporates clinical data to personalize prognostic estimates generated from the ProVent prediction model, generates a printable document summarizing the user's interaction with the decision aid, and can digitally archive each user session. Usability was excellent (mean SUS, 80 ± 10) overall, but lower among those 56 years and older (73 ± 7) versus those who were younger (84 ± 9); p = 0.03. A total of 93% of users reported a preference for electronic versus printed versions. CONCLUSIONS: The Web-based decision aid for ICU surrogate decision makers can facilitate highly individualized information sharing with excellent usability and acceptability. Decision aids that employ an electronic format such as eCODES represent a strategy that could enhance patient-clinician collaboration and decision making quality in intensive care.

Encouraging clean energy investment in developing countries: what role for aid?

A large portion of foreign assistance for climate change mitigation in developing countries is directed to clean energy facilities. To support international mitigation goals, however, donors must make investments that have effects beyond individual facilities. They must reduce barriers to private-sector investment by generating information for developers, improving relevant infrastructure, or changing policies. We examine whether donor agencies target financing for commercial-scale wind and solar facilities to countries where private investment in clean energy is limited and whether donor investments lead to more private investments. On average, we find no positive evidence for these patterns of targeting and impact. Coupled with model results that show feed-in tariffs increase private investment, we argue that donor agencies should reallocate resources to improve policies that promote private investment in developing countries, rather than finance individual clean energy facilities.

Predictions of segregation of granular material with the aid of PHYSICA, a 3-D unstructured finite-volume modelling framework

In this paper a continuum model for the prediction of segregation in granular material is presented. The numerical framework, a 3-D, unstructured grid, finite-volume code is described, and the micro-physical parametrizations, which are used to describe the processes and interactions at the microscopic level that lead to segregation, are analysed. Numerical simulations and comparisons with experimental data are then presented and conclusions are drawn on the capability of the model to accurately simulate the behaviour of granular matter during flow.

Can density functional theory (DFT) be used as an aid to a deeper understanding of tandem mass spectrometric fragmentation pathways?

Prediction of tandem mass spectrometric (MS/MS) fragmentation for non-peptidic molecules based on structure is of immense interest to the mass spectrometrist. If a reliable approach to MS/MS prediction could be achieved its impact within the pharmaceutical industry could be immense. Many publications have stressed that the fragmentation of a molecular ion or protonated molecule is a complex process that depends on many parameters, making prediction difficult. Commercial prediction software relies on a collection of general heuristic rules of fragmentation, which involve cleaving every bond in the structure to produce a list of 'expected' masses which can be compared with the experimental data. These approaches do not take into account the thermodynamic or molecular orbital effects that impact on the molecule at the point of protonation which could influence the potential sites of bond cleavage based on the structural motif. A series of compounds have been studied by examining the experimentally derived high-resolution MS/MS data and comparing it with the in silico modelling of the neutral and protonated structures. The effect that protonation at specific sites can have on the bond lengths has also been determined. We have calculated the thermodynamically most stable protonated species and have observed how that information can help predict the cleavage site for that ion. The data have shown that this use of in silico techniques could be a possible way to predict MS/MS spectra. Copyright (C) 2009 John Wiley & Sons, Ltd.

Can Pickering emulsion formation aid the removal of creosote DNAPL from porous media?

The purpose of this investigation was to examine the proposition that creosote, emplaced in an initially water saturated porous system, can be removed from the system through Pickering emulsion formation. Pickering emulsions are dispersions of two immiscible fluids in which coalescence of the dispersed phase droplets is hindered by the presence of colloidal particles adsorbed at the interface between the two immiscible fluid phases. Particle trapping is strongly favoured when the wetting properties of the particles are intermediate between strong water wetting and strong oil wetting. In this investigation the necessary chemical conditions for the formation of physically stable creosote-in-water emulsions protected against coalescence by bentonite particles were examined. It was established that physically stable emulsions could be formed through the judicious addition of small amounts of sodium chloride and the surfactant cetyl-trimethylammonium bromide. The stability of the emulsions was initially established by visual inspection. However, experimental determinations of emulsion stability were also undertaken by use of oscillatory rheology. Measurements of the elastic and viscous responses to shear indicated that physically stable emulsions were obtained when the viscoelastic systems showed a predominantly elastic response to shearing. Once the conditions were established for the formation of physically stable emulsions a "proof-of-concept" chromatographic experiment was carried out which showed that creosote could be successfully removed from a saturated model porous system. (C) 2007 Elsevier Ltd. All rights reserved.