Social determinants of older adults' awareness of community support services in Hamilton, Ontario

Community support services (CSSs) have been developed in Canada and other Western nations to enable persons coping with health or social issues to continue to live in the community. This study addresses the extent to which awareness of CSSs is structured by the social determinants of health. In a telephone interview conducted in February-March 2006, 1152 community-dwelling older adults (response rate 12.4%) from Hamilton, Ontario, Canada were made to read a series of four vignettes and were asked whether they were able to identify a CSS they may turn to in that situation. Across the four vignettes, 40% of participants did name a CSS as a possible source of assistance. Logistic regression was used to determine factors related to awareness of CSSs. Respondents most likely to have awareness of CSS include the middle-aged and higher-income groups. Being knowledgeable about where to look for information about CSSs, having social support and being a member of a club or voluntary organisations are also significant predictors of awareness of CSSs. Study results suggest that efforts be made to improve the level of awareness and access to CSSs among older adults by targeting their social networks as well as their health and social care providers. © 2011 Blackwell Publishing Ltd.

The Neolithic site of San Marco, Gubbio (Perugia) Umbria: survey and excavation. 1985-8.

Malone, C. and S. Stoddart, Papers of the British School at Rome, 1992. 60: p. 1-69.

Sound Synthesis for Contact-Driven Musical Instruments via Discretisation of Hamilton's Equations

Physical modelling of musical instruments involves studying nonlinear interactions between parts of the instrument. These can pose several difficulties concerning the accuracy and stability of numerical algorithms. In particular, when the underlying forces are non-analytic functions of the phase-space variables, a stability proof can only be obtained in limited cases. An approach has been recently presented by the authors, leading to unconditionally stable simulations for lumped collision models. In that study, discretisation of Hamilton’s equations instead of the usual Newton’s equation of motion yields a numerical scheme that can be proven to be energy conserving. In this paper, the above approach is extended to collisions of distributed objects. Namely, the interaction of an ideal string with a flat barrier is considered. The problem is formulated within the Hamiltonian framework and subsequently discretised. The resulting nonlinearmatrix equation can be shown to possess a unique solution, that enables the update of the algorithm. Energy conservation and thus numerical stability follows in a way similar to the lumped collision model. The existence of an analytic description of this interaction allows the validation of the model’s accuracy. The proposed methodology can be used in sound synthesis applications involving musical instruments where collisions occur either in a confined (e.g. hammer-string interaction, mallet impact) or in a distributed region (e.g. string-bridge or reed-mouthpiece interaction).

The frequency of gastrointestinal endocrine tumours in a well-defined population--Northern Ireland 1970-1985

The reported incidence of gastrointestinal endocrine tumours is variable. In Northern Ireland circumstances allowing such an assessment are favourable with a central diagnostic laboratory and register established to collect data on tumours from a well-defined population of 1.5 million people. From 1970 to 1985, 368 cases were recorded of which 85 per cent were carcinoid tumours. The annual incidence of carcinoid tumours was 1.3 per 100,000 of the population and the majority occurred in the appendix (61 per cent). No patients presented with the carcinoid syndrome. The annual incidence for other tumours was 0.12 per 100,000 for insulinomas; islet cell tumours of unknown type 0.07; Zollinger-Ellison syndrome 0.05; and multiple endocrine neoplasia (MEN) 0.05. There were two cases of VIPoma, one glucagonoma, one neurotensinoma and one tumour producing ACTH. It is possible that some tumours are more uncommon than others because of difficulty in diagnosis.

Vaccination and All Cause Child Mortality 1985-2011: Global Evidence from the Demographic and Health Surveys

Based on models with calibrated parameters for infection, case fatality rates, and vaccine efficacy, basic childhood vaccinations have been estimated to be highly cost effective. We estimate the association of vaccination with mortality directly from survey data. Using 149 cross-sectional Demographic and Health Surveys, we determine the relationship between vaccination coverage and under five mortality at the survey cluster level. Our data include approximately one million children in 68,490 clusters in 62 countries. We consider the childhood measles, Bacille Calmette-Guérin (BCG), Diphtheria-Pertussis-Tetanus (DPT), Polio, and maternal tetanus vaccinations. Using modified Poisson regression to estimate the relative risk of child mortality in each cluster, we also adjust for selection bias caused by the vaccination status of dead children not being reported. Childhood vaccination, and in particular measles and tetanus vaccination, is associated with substantial reductions in childhood mortality. We estimate that children in clusters with complete vaccination coverage have relative risk of mortality 0.73 (95% Confidence Interval: 0.68, 0.77) that of children in a cluster with no vaccination. While widely used, basic vaccines still have coverage rates well below 100% in many countries, and our results emphasize the effectiveness of increasing their coverage rates in order to reduce child mortality.

Delivering a Research-Enabled Multistakeholder Partnership for Enhanced Patient Care at a Population Level: The Northern Ireland Comprehensive Cancer Program

The last 20 years have seen significant advances in cancer care in Northern Ireland, leading to measureable improvements in patient outcomes. Crucial to this transformation has been an ethos that recognizes the primacy role of research in effecting heath care change. The authors' model of a cross-sectoral partnership that unites patients, scientists, health care professionals, hospital trusts, bioindustry, and government agencies can be truly transformative, empowering tripartite clinical-academic-industry efforts that have already yielded significant benefit and will continue to inform strategy and its implementation going forward.

A fase utópico-patriótica da poesia angolana (1965-1985)

O presente trabalho propõe-se analisar a poesia dos autores angolanos que publicaram entre 1965 e 1985, identificando este segmento temporal como uma fase literária da literatura angolana (designada como utópico-patriótica), a qual exprime os princípios anticoloniais e projeta um espaço utópico genuinamente angolano. Tendo em conta a evolução da literatura angolana, subjaz à produção poética dos autores estudados um certo sentido de continuidade, o qual, estimulado pela difusão do nacionalismo, passa pela poesia «da terra» dos mensageiros e continua com os versos encriptados e anticoloniais das décadas de 60 e 70. O espaço utópico projetado na primeira parte da fase utópico-patriótica encontra a sua possibilidade de concretização com a independência de Angola, em 1975, participando os escritores da construção do recém-nascido Estado-Nação. A produção poética da segunda parte da fase utópico-patriótica é, assim, caraterizada pela celebração dos heróis, na ótica de uma (re)perspetivação da história nacional. A partir de 1985, quando se torna evidente o falhanço da utopia, a poesia angolana ensaia um novo rumo pela mão da «geração das incertezas». Ao longo deste percurso, a poesia angolana publicada entre 1965 e 1985 representa um meio de consciencialização ético-política dos cidadãos e concorre para a construção da identidade político-literária da nação angolana, cuja legitimação decorre do processo de conquista da independência.