Transforming the Irish Presidency: Activist Presidents and Gender Politics, 1990-2011

The election of two energetic women in succession to the office of President of Ireland challenged the notion that the presidency was a long-service reward for retiring politicians. Mary Robinson and Mary McAleese broke the male domination of the office, interpreted its functions in a more dynamic manner, and utilised the ‘soft power’ of the presidency with skill. Yet, as individuals they were very different in political focus, experience and ideological disposition. This article charts their respective backgrounds and discusses the context in which each woman came to the presidency. It explores their vision for the office. Focusing on the potential for harnessing the soft power of the presidency, it argues that Robinson adopted a classical representative view of the office, whereas McAleese chose a facilitatory style of leadership. The article concludes that in their different ways, Robinson and McAleese contributed to reshaping the office, utilising its symbolic potential and soft power to make it a more meaningful and fit-for-purpose political institution for the twenty-first century. © 2012 Political Studies Association of Ireland.

Resource utilisation and costs of palliative cancer care in an interdisciplinary health care model

This paper presents a detailed description of health care resource utilisation and costs of a pilot interdisciplinary health care model of palliative home care in Ontario, Canada. The descriptive evaluation entailed examining the use of services and costs of the pilot program: patient demographics, length of stay broken down by disposition (discharged, alive, death), access to services/resources, use of family physician and specialist services, and drug use. There were 434 patients included in the pilot program. Total costs were approximately CAN$2.4 million, and the cost per person amounted to approximately CAN$5586.33 with average length of stay equal to over 2 months (64.22 days). One may assume that length of stay would be influenced by the amount of service and support available. Future research might investigate whether in-home palliative home care is the most cost effective and suitable care setting for those patients requiring home care services for expected periods of time. © 2009 SAGE Publications.

THE CUE-RESPONSIVITY PHENOMENON IN DEPENDENT DRINKERS - PERSONALITY VULNERABILITY AND ANXIETY AS INTERVENING VARIABLES

The cue-responsivity phenomenon to alcohol-associated stimuli in dependent drinkers was examined. In accordance with previous research, significant differences on both physiological and subjective cue-responsivity variables, between dependent and non-dependent drinkers were found. The unique contribution of this paper is two-fold. Firstly, evidence is presented which suggests that the Eysenckian personality traits of introversion and neuroticism are more predictive of cue-responsivity variance in the dependent drinkers than either severity of dependence or number of years' drinking. Secondly, within this dependent group, the relationship between cue-responsivity and 'craving' was seen to be less straightforward than traditionally thought. Specifically, it suggested that it was the extent to which autonomic cue-responsivity elicited increases in self-reported anxiety, which predicted most of the variance on the 'craving' variable. Taken together, these results raise the interesting possibility that a personality disposition akin to trait anxiety, and the degree to which cue exposure elicits state anxiety, mediated the relationship between cue-responsivity and 'craving' in dependent drinkers.

Taking as Giving, Appropriation as Access: Transfers of Land Development Rights and China’s Recent Experiments

Economic development at both the domestic and global levels is associated with increasing tensions which are inextricably linked to the meaning and allocation of property rights, which has a great impact on appropriation of resources and may lead to different paths of development. “Taking”-- the appropriation of private land for public needs -- is a typical example that exhibits those tensions, posing a challenge to the conventional conception of property as individualistic and exclusive rights of possession, use, and disposition and to the associated neoliberal model of development. Should the individual landowner be left to bear the cost of a regulatory intervention which endures to the wider benefit of the whole community? How to mitigate the tensions between private ownership and public regulation? If we take the liberal concept of property, then private property seems to be in constant conflict with public interests and wider social concerns. Meanwhile, community, situating between the state and the individuals, and community’s relationship to development rights, have not provoked enough discussion. The paper explores the different ways land development rights might be seen both in Western, essentially common law systems, and in China, especially now and in view of two case studies. An empirical example in Wugang, China reveals the importance of integrating the “community lens” proposed by Roger Cotterrell into studies of the transfer of land development rights. Reading through the community lens, taking could be giving and appropriation could also be access. This approach provides a new perspective to re-evaluate the relationship between legal appropriation and development.

Late-stage, primary open-angle glaucoma in Europe:Social and health care maintenance costs and quality of life of patients from 4 countries

Objective: The purpose of this study was to estimate costs and quality of life (QoL) of late-stage glaucoma patients in 4 European countries. Methods: Retrospective review of medical charts of patients with POAG who were followed in a low-vision or vision rehabilitation center in one of 4 countries for at least 1 year was used to determine patient characteristics, health status, and health care resource use. Visual impairment was measured by best-corrected visual acuity (Snellen score). Patients were also interviewed over the telephone in order to assess their health-related QoL (using EuroQol EQ-5D) and use of resources including: the number of visits to rehabilitation centers, visits to hospital and non-hospital specialists, the use of low-vision devices, medication, tests, and the use of hired home help. The costs associated with resource use were calculated from the perspective of a third-party payer of health and social care based on resource usage and unit costs in each country. Results: Patients undergoing visual rehabilitation in France (n=21), Denmark (n=59), Germany (n=60), and the United Kingdom (n=22) were identified, interviewed and had their medical charts reviewed. Annual maintenance costs of late-stage glaucoma amounted to €830 (±445) on average. Average home help costs were more than 3 times higher. QoL, on average, was 0.65 (±0.28). QoL was positively correlated with the level of visual acuity in the patients' best eye. On the other hand, visual acuity was also positively correlated to health care costs, but negatively correlated to costs of home help. Conclusions: The study was limited by its observational, uncontrolled design. The finding that late-stage glaucoma is associated with higher home help costs than health care maintenance costs suggests that potential savings from a better preventive treatment are to be found for social care payers rather than health care payers. © 2008 Informa UK Ltd All rights reserved.

Direct costs of glaucoma and severity of the disease:A multinational long term study of resource utilisation in Europe

Background: Resource utilisation and direct costs associated with glaucoma progression in Europe are unknown. As population progressively ages, the economic impact of the disease will increase. Methods: From a total of 1655 consecutive cases, the records of 194 patients were selected and stratified by disease severity. Record selection was based on diagnoses of primary open angle glaucoma, glaucoma suspect, ocular hypertension, or normal tension glaucoma; 5 years minimum follow up were required. Glaucoma severity was assessed using a six stage glaucoma staging system based on static threshold visual field parameters. Resource utilisation data were abstracted from the charts and unit costs were applied to estimate direct costs to the payer. Resource utilisation and estimated direct cost of treatment, per person year, were calculated. Results: A statistically significant increasing linear trend (p = 0.018) in direct cost as disease severity worsened was demonstrated. The direct cost of treatment increased by an estimated €86 for each incremental step ranging from €455 per person year for stage 0 to €969 per person year for stage 4 disease. Medication costs ranged from 42% to 56% of total direct cost for all stages of disease. Conclusions: These results demonstrate for the first time in Europe that resource utilisation and direct medical costs of glaucoma management increase with worsening disease severity. Based on these findings, managing glaucoma and effectively delaying disease progression would be expected to significantly reduce the economic burden of this disease. These data are relevant to general practitioners and healthcare administrators who have a direct influence on the distribution of resources.

Whose statistical reasoning is improved by information about causal structure?

People often struggle when making Bayesian probabilistic estimates on the basis of competing sources of statistical evidence. Recently, Krynski and Tenenbaum (Journal of Experimental Psychology: General, 136, 430–450, 2007) proposed that a causal Bayesian framework accounts for peoples’ errors in Bayesian reasoning and showed that, by clarifying the causal relations among the pieces of evidence, judgments on a classic statistical reasoning problem could be significantly improved. We aimed to understand whose statistical reasoning is facilitated by the causal structure intervention. In Experiment 1, although we observed causal facilitation effects overall, the effect was confined to participants high in numeracy. We did not find an overall facilitation effect in Experiment 2 but did replicate the earlier interaction between numerical ability and the presence or absence of causal content. This effect held when we controlled for general cognitive ability and thinking disposition. Our results suggest that clarifying causal structure facilitates Bayesian judgments, but only for participants with sufficient understanding of basic concepts in probability and statistics.

An Observational Study of Blood Concentrations and Kinetics of Methyl- and Propyl-Parabens in Neonates

Purpose: Systemic exposure to parabens in the neonatal population, in particular propyl-parabens (PPB), remains a concern. Blood concentrations and kinetics of methyl-parabens (MPB) and PPB were therefore determined in neonates receiving medicines containing these excipients.

Methods: A multi-centre, non-interventional, observational study of excipient-kinetics in neonates. ‘Dried Blood Spot’ samples were collected opportunistically at the same time as routine samples and the observations modelled using a non-linear mixed effects approach.

Results: A total of 841 blood MPB and PPB concentration data were available for evaluation from 181 pre- and term-neonates. Quantifiable blood concentrations of MPB and PPB were observed in 99% and 49% of patients, and 55% and 25% of all concentrations were above limit of detection (10 ng/ml), respectively. Only MPB data was amenable to modelling. Oral bioavailability was influenced by type of formulation and disposition was best described by a two compartment model with clearance (CL) influenced by post natal age (PNA); CL_{PNA<21 days} 0.57 versus CL_PNA>21days 0.88 L/h.

Conclusions: Daily repeated administration of parabens containing medicines can result in prolonged systemic exposure to the parent compound in neonates. Animal toxicology studies of PPB that specifically address the neonatal period are required before a permitted daily exposure for this age group can be established.

The evaluative nature of the folk concepts of weakness and strength of will

This article examines the evaluative nature of the folk concepts of weakness and strength of will and hypothesizes that their evaluative nature is strongly connected to the folk concepts of blame and credit. We probed how people apply the concepts of weakness and strength of will to prototypical and non-prototypical scenarios. While regarding prototypical scenarios the great majority applied these concepts according to the predictions following from traditional philosophical analyses, when presented with non-prototypical scenarios, people were divided. Some, against traditional analyses, did not apply these concepts, which we explain in terms of a clash of evaluations involving different sorts of blame and credit. Others applied them according to traditional analyses, which we explain in terms of a disposition to be reflective and clearly set apart the different sorts of blame and credit involved. Still others applied them in an inverse way, seemingly bypassing the traditional components resolution and best judgment, which we explain in terms of a reinterpretation of the scenarios driven by an assumption that everyone knows deep inside that the best thing to do is to act morally. This division notwithstanding, we claim that our results are largely supportive of traditional analyses (qua analyses of folk concepts).

Clinical and Cost-Effectiveness of Procalcitonin Test for Prodromal Meningococcal Disease-A Meta-Analysis

BACKGROUND: Despite vaccines and improved medical intensive care, clinicians must continue to be vigilant of possible Meningococcal Disease in children. The objective was to establish if the procalcitonin test was a cost-effective adjunct for prodromal Meningococcal Disease in children presenting at emergency department with fever without source.

METHODS AND FINDINGS: Data to evaluate procalcitonin, C-reactive protein and white cell count tests as indicators of Meningococcal Disease were collected from six independent studies identified through a systematic literature search, applying PRISMA guidelines. The data included 881 children with fever without source in developed countries.The optimal cut-off value for the procalcitonin, C-reactive protein and white cell count tests, each as an indicator of Meningococcal Disease, was determined. Summary Receiver Operator Curve analysis determined the overall diagnostic performance of each test with 95% confidence intervals. A decision analytic model was designed to reflect realistic clinical pathways for a child presenting with fever without source by comparing two diagnostic strategies: standard testing using combined C-reactive protein and white cell count tests compared to standard testing plus procalcitonin test. The costs of each of the four diagnosis groups (true positive, false negative, true negative and false positive) were assessed from a National Health Service payer perspective. The procalcitonin test was more accurate (sensitivity=0.89, 95%CI=0.76-0.96; specificity=0.74, 95%CI=0.4-0.92) for early Meningococcal Disease compared to standard testing alone (sensitivity=0.47, 95%CI=0.32-0.62; specificity=0.8, 95% CI=0.64-0.9). Decision analytic model outcomes indicated that the incremental cost effectiveness ratio for the base case was £-8,137.25 (US $ -13,371.94) per correctly treated patient.

CONCLUSIONS: Procalcitonin plus standard recommended tests, improved the discriminatory ability for fatal Meningococcal Disease and was more cost-effective; it was also a superior biomarker in infants. Further research is recommended for point-of-care procalcitonin testing and Markov modelling to incorporate cost per QALY with a life-time model.

Late effects of cancer and cancer treatment-the perspective of the patient

PURPOSE: Understanding the experience of late effects from the perspective of cancer survivors is essential to inform patient-centred care. This study investigated the nature and onset of late effects experienced by survivors and the manner in which late effects have affected their lives.

METHODS: Sixteen purposively selected cancer survivors participated in a qualitative interview study. The data were analysed inductively using a narrative schema in order to derive the main themes that characterised patients' accounts of late effects.

RESULTS: Individual survivors tended to experience more than one late effect spanning a range of physical and psychological effects. Late effects impacted on relationships, working life, finances and the ability to undertake daily activities. Survivors reported experiencing psychological late effects from around the end of treatment whereas the onset of physical effects occurred later during the post-treatment period. Late effects were managed using formal health services, informal social support and use of 'wellbeing strategies'. Survivors engaged in a process of searching for reasons for experiencing late effects and struggled to make sense of their situation. In particular, a process of 'peer-patient comparison' was used by survivors to help them make sense of, or cope with, their late effects. There appeared to be an association between personal disposition and adaptation and adjustment to the impact of late effects.

CONCLUSIONS: Cancer survivors identified potential components for supported self-management or intervention programmes, as well as important considerations in terms of peer comparisons, personal disposition and making sense of experienced late effects.

Measuring critical thinking skills and dispositions in undergraduate students

This thesis investigates critical thinking with a particular focus on measurement in undergraduate students. A higher education context was chosen because many regard critical thinking development as a primary goal for third level education. Nine studies, both cross-sectional and longitudinal in design, were conducted with undergraduate psychology students (N=387), using the California Critical Thinking Disposition Inventory (CCTDI) and the California Critical Thinking Skills Test (CCTST). Studies 1-3 revealed psychometric weaknesses in the CCTDI and revised the scale with factor analysis and reliability analysis to form the CCTDI United Kingdom revision (CCTDI-UK). Study 4 investigated convergent validity and showed significant inter-correlation between the sub-scales of the CCTDI-UK, and significant correlations with the Openness scale of the NEO Personality Inventory (NEO PI-R). The study also provided evidence for improvement in scores on three of the six sub-scales in the CCTDI-UK (Truth-Seeking, Inquisitiveness, Open-Mindedness) during the course of an undergraduate degree. Study 5 explored a two factor structure for critical thinking dispositions. Study 6 used reliability analysis to revise the CCTST to produce the CCTST-UK. Study 7 showed that the CCTST-UK had a moderate correlation with degree attainment and a slightly higher correlation with a test of non-verbal intelligence (Raven’s Advanced Progressive Matrices short form); in addition, the study showed that scores on the CCTST-UK improved during the course of the degree. Studies 8 and 9 investigated the potential of critical thinking for predicting degree attainment. A-levels predicted approximately 10% of the variance of degree attainment while entry level scores on the CCTST-UK predicted an additional 5%. Exit level scores on the CCTST-UK and the Inquisitive sub-scale of the CCTDI-UK were found to be predictors of degree attainment The main conclusions of the thesis were that these tests had significant potential for predicting degree attainment and that they measured a substantial proportion of the theoretical constructs identified by the major authors in critical thinking.

Waiting for International Political Sociology: A Field Guide to Living In-Between

This paper explores the in-between positionality of International Political Sociology (IPS) and offers a field guide to help scholars, students and thinkers embrace this disposition more energetically. It makes the case for a more balanced transdisciplinarity that attends to the international, the political and the social at the same time and in equal measure. The power of this in-between approach is that it forces thinkers in IPS to constantly look at the horrors of our contemporary world without turning away. Through the ambivalent position of the ‘happy wreck’, the paper explores the need to do something about these horrors (e.g. diagnose, act, intervene) while fully acknowledging that such actions always produce new forms of violence and exclusion. To help thinkers in IPS inhabit this challenging space of inquiry more confidently, the paper makes four suggestions: (i) broadening our emotional responses to the horrors of the world; (ii) resisting resolution through non-cathartic dispositions; (iii) pursuing slow research to contest dominant rhetorics of crisis and emergency; and (iv) re-imagining shared conditions of vulnerability.

Carbapenemases of Serratia fonticola UTAD54

As carbapenemases, serínicas e metalo-β-lactamases (MBLs), formam um grupo cada vez mais importante de β-lactamases capazes de tornar as bactérias resistentes a antibióticos β-lactâmicos, incluindo carbapenemos utilizados como antibióticos de último recurso no tratamento de infecções causadas por bactérias multirresistentes. De modo a compreender melhor a relação estrutura-função deste grupo de enzimas, prosseguimos com a caracterização bioquímica e estrutural das carbapenemases SFC-1 e Sfh-I específicas de Serratia fonticola UTAD54, uma estirpe ambiental isolada previamente de águas de consumo não tratadas no Nordeste de Portugal. Ambas as β-lactamases foram sobre-expressas em Escherichia coli e purificadas por cromatografia líquida. A SFC-1 recombinante, uma carbapenemase serínica, hidrolisa eficientemente antibióticos β-lactâmicos de todas as classes e exibe, comparativamente a enzimas relacionadas (ex. KPC), uma maior eficiência contra a ceftazidima e uma menor susceptibilidade aos inibidores convencionais das β-lactamases. As estruturas do cristal da SFC-1 nativa e de complexos de mutantes, obtidos por mutagénese dirigida, com o meropenemo não hidrolisado e na forma de acetilenzima foram determinados por substituição molecular utilizando cristalografia de raios-X. A estrutura da SFC-1 contém todas as características conservadas do centro activo das carbapenemases de classe A. Nas estruturas dos mutantes o meropenemo aparece orientado no centro activo por Thr236 e Thr238, posicionando-o próximo da Ser130 para a transferência do protão. Nas enzimas de classe A inibidas por carbapenemos, a interacção com a Arg244 impõe uma orientação diferente do meropenemo ligado, prejudicando a transferência do protão. Estas constituem as primeiras estruturas de uma carbapenemase de classe A com um carbapenemo no centro activo e revelam que estas enzimas alteram a orientação do meropenemo ligado para promover a catálise, sem alteração significativa da estrutura geral. A Sfh-I, tal como as outras MBLs da subclasse B2, apresenta um perfil de substratos reduzido, que inclui maioritariamente os carbapenemos. A Sfh-I hidrolisa imipenemo e meropenemo com um kcat de 51 e 109 s-1 e um KM de 79 e 215 μM, respectivamente. A Sfh-I liga um equivalente de zinco, como demonstrado por espectrometria de massa. Contrariamente a enzimas da subclasse B2 previamente caracterizadas, a Sfh-I hidrolisa a cefepima, mostrando que a Sfh-I é uma MBL da subclasse B2 com propriedades únicas. Por espectroscopia de fluorescência mostrou-se que a Sfh-I é capaz de ligar até 3 equivalentes de zinco (Kd2 = 95 μM; Kd3 = 2.3 mM). A estrutura do cristal da Sfh-I, determinada por substituição molecular utilizando a CphA como modelo, é a primeira para uma MBL da subclasse B2 não ligada. Esta estrutura revela a disposição das moléculas de água no centro activo corroborando um mecanismo catalítico para as MBLs da subclasse B2 no qual a His118, em vez do Asp120 proposto anteriormente, activa a molécula de água nucleofílica.

Sex-related invariance across cultures in an online role-playing game

This study examines the Social Dominance Orientation of players of the online roleplaying game World of Warcraft. The World of Warcraft offers an opportunity to investigate social dominance and biological sex differences in an environment where there is no cultural dominance of one sex over another. Social Dominance Orientation has been found to be different between males and females, with males scoring higher. However, this might be the consequence of social context. To this end sex differences between male and female players were investigated in the World of Warcraft environment, as well as the effects of chosen character sex. Player sex and character sex were found to have effects on Social Dominance Orientation. These results add further support to claims that Social Dominance Orientation has the characteristics of a sexually selected disposition to acquire resources and out-compete rival groups.