Postoperative analgesic effect, of preoperatively administered dexamethasone, after operative fixation of fractured neck of femur: randomised, double blinded controlled study.

Background: Fractured neck of femur is a common cause of hospital admission in the elderly and usually requires operative fixation. In a variety of clinical settings, preoperative glucocorticoid administration has improved analgesia and decreased opioid consumption. Our objective was to define the postoperative analgesic efficacy of single dose of dexamethasone administered preoperatively in patients undergoing operative fixation of fractured neck of femur. Methods: Institutional ethical approval was granted and written informed consent was obtained from each patient. Patients awaiting for surgery at Cork University Hospital were recruited between July 2009 and August 2012. Participating patients, scheduled for surgery were randomly allocated to one of two groups (Dexamethasone or Placebo). Patients in the dexamethasone group received a single dose of intravenous dexamethasone 0.1 mg kg -1 immediately preoperatively. Patients in the placebo group received the same volume of normal saline. Patients underwent operative fixation of fractured neck of femur using standardised spinal anaesthesia and surgical techniques. The primary outcome was pain scores at rest 6 h after the surgery. Results: Thirty seven patients were recruited and data from thirty patients were analysed. The groups were similar in terms of patient characteristics. Pain scores at rest 6 h after the surgery (the principal outcome) were lesser in the dexamethasone group compared with the placebo group [0.8(1.3) vs. 3.9(2.9), mean(SD) p = 0.0004]. Cumulative morphine consumption 24 h after the surgery was also lesser in the dexamethasone group [7.7(8.3) vs. 15.1(9.4), mean(SD) mg, p = 0.04]. Conclusions: A single dose of intravenous dexamethasone 0.1 mg kg -1 administered before operative fixation of fractured neck of femur improve significantly the early postoperative analgesia. Trial registration: ClinicalTrials.gov identifier: NCT01550146, date of registration: 07/03/2012

Help-seeking behaviors and mental well-being of first year undergraduate university students

University students demonstrate poor help-seeking behaviors for their mental health, despite often reporting low levels of mental well-being. The aims of this study were to examine the help-seeking intentions and experiences of first year university students in terms of their mental well-being, and to explore these students’ views on formal (e.g. psychiatrists) and informal (e.g. friends) help-seeking. Students from a university in the Republic of Ireland (n=220) completed an online questionnaire which focused on mental well-being and help-seeking behaviors. Almost a third of students had sought help from a mental health professional. Very few students reported availing of university/online supports. Informal sources of help were more popular than formal sources, and those who would avail and had availed of informal sources demonstrated higher well-being scores. Counselors were the source of professional help most widely used. General practitioners, chaplains, social workers, and family therapists were rated the most helpful. Those with low/average well-being scores were less likely to seek help than those with higher scores. Findings indicate the importance of enhancing public knowledge of mental health issues, and for further examination of students’ knowledge of help-seeking resources in order to improve the help-seeking behaviors and mental well-being of this population group.

Guiding public protest: assessing the propaganda model of China’s hybrid newspaper industry

This dissertation presents an account and analysis of published mainland Chinese media coverage surrounding three major events of public protest during the Hu-Wen era (2003-2013). The research makes a qualitative analysis of printed material drawn from a range of news outlets, differentiated by their specific political and commercial affiliations. The goal of the research is to better understand the role of mainstream media in social conflict resolution, a hitherto under-studied area, and to identify gradations within the ostensibly monolithic mainland Chinese media on issues of political sensitivity. China’s modern media formation displays certain characteristics of Anglophone media at its hyper-commercialised, populist core. However, the Chinese state retains an explicit, though often ambiguous, remit to engage with news production. Because of this, Chinese newspapers are often assumed to be one-dimensional propaganda ‘tools’ and, accordingly, easily dismissed from analyses of public protest. This research finds that, in an area where political actors have rescinded their monopoly on communicative power, a result of both policy decisions and the rise of Internet-based media platforms, established purveyors of news have acquired greater latitude to report on hitherto sensitive episodes of conflict but do so under the burden of having to correctly guide public opinion. The thesis examines the discursive resources that are deployed in this task, as well as reporting patterns which are suggestive of a new propaganda approach to handling social conflict within public media. Beside the explicitly political nature of coverage of protest events, the study sheds lights on gradations within China’s complex, hybrid media landscape both in terms of institutional purpose and qualitative performance.

Bipartite Assertion: A New Account of Assertion, Defined in Terms of Responsibility and Explicit Presentation

Assertion is a speech act that stands at the intersection of the philosophy of language and social epistemology. It is a phenomenon that bears on such wide-ranging topics as testimony, truth, meaning, knowledge and trust. It is thus no surprise that analytic philosophers have devoted innumerable pages to assertion, trying to give the norms that govern it, its role in the transmission of knowledge, and most importantly, what assertion is, or how assertion is to be defined. In this thesis I attempt to show that all previous answers to the question “What is assertion?” are flawed. There are four major traditions in the literature: constitutive norm theories of assertion, accounts that treat assertion as the expression of speaker attitudes, accounts that treat assertion as a proposal to add some proposition to the common ground, and accounts that treat assertion as the taking of responsibility for some claim. Each tradition is explored here, the leading theories within the tradition developed, and then placed under scrutiny to demonstrate flaws within the positions surveyed. I follow the work of G.E. Moore and William P. Alston, whilst drawing on the work of Robert Brandom in order to give a new bipartite theory of assertion. I argue that assertion consists in the explicit presentation of a proposition, along with a taking of responsibility for that proposition. Taking Alston's explicit presentation condition and repairing it in order to deal with problems it faces, whilst combining it with Brandom's responsibility condition, provides, I believe, the best account of assertion.

Climate change adaptation planning under uncertainty in Ho Chi Minh City, Vietnam: a case study on institutional vulnerability, adaptive capacity and climate change governance

Climate change is expected to have wide-ranging impacts on urban areas and creates additional challenges for sustainable development. Urban areas are inextricably linked with climate change, as they are major contributors to it, while also being particularly vulnerable to its impacts. Climate change presents a new challenge to urban areas, not only because of the expected rises in temperature and sea-level, but also the current context of failure to fully address the institutional barriers preventing action to prepare for climate change, or feedbacks between urban systems and agents. Despite the importance of climate change, there are few cities in developing countries that are attempting to address these issues systematically as part of their governance and planning processes. While there is a growing literature on the risks and vulnerabilities related to climate change, as yet there is limited research on the development of institutional responses, the dissemination of relevant knowledge and evaluation of tools for practical planning responses by decision makers at the city level. This thesis questions the dominant assumptions about the capacity of institutions and potential of adaptive planning. It argues that achieving a balance between climate change impacts and local government decision-making capacity is a vital for successful adaptation to the impacts of climate change. Urban spatial planning and wider environmental planning not only play a major role in reducing/mitigating risks but also have a key role in adapting to uncertainty in over future risk. The research focuses on a single province - the biggest city in Vietnam - Ho Chi Minh City - as the principal case study to explore this argument, by examining the linkages between urban planning systems, the structures of governance, and climate change adaptation planning. In conclusion it proposes a specific framework to offer insights into some of the more practical considerations, and the approach emphasises the importance of vertical and horizontal coordination in governance and urban planning.

The institutional design of intra-party democracy through legal instruments: Turkish case

The importance of political parties for contemporary representative democracies is beyond dispute. Despite their significance for state-level democracy, political parties continue to be regarded as oligarchical and to be criticised because of their internal practices. For this reason, intra-party democracy (IPD) warrants in-depth analysis. This thesis investigates IPD in Turkey, primarily from the perspective of participatory democracy, with the purpose of suggesting reforms to the Turkish Political Parties Law (TPPL). Turkish political parties and Turkish party regulation provide an interesting case because there is a significant difference between mature democracies and Turkey regarding IPD regulation. IPD in established democracies has always been regarded as a private concern of parties and has been left unregulated. IPD in Turkey, by contrast, is provided for both by the constitution and the TPPL. Although IPD is a constitutional and legal requirement in Turkey, however, political parties in fact display a high level of non-democratic administration. The main reason is that the TPPL only pays lip service to the idea of IPD and requires no specific measures apart from establishing a party congress with a representative form of democracy. By establishing and holding party congresses, political parties are perceived as conforming to the requirements of IPD under the law. In addition, the contested nature of democracy as a concept has impeded the creation of efficacious legal principles. Thus, the existing party law fails to tackle the lack of IPD within political parties and, for this reason, is in need of reform. Furthermore, almost every Turkish party’s own constitution highlights the importance of IPD and promises IPD. However, these declared commitments to IPD in their constitutions alone, especially in countries where the democratic culture is weak, are unlikely to make much difference in practice. Accordingly, external regulation is necessary to ensure the protection of the rights and interests of the party members with regards to their participation in intra-party decision-making processes. Nevertheless, in spite of a general consensus in favour of reforming the TPPL, a lack of consensus exists as to what kind of reforms should be adopted. This thesis proposes that reforming the TPPL in line with an approach based on participatory democracy could provide better IPD within Turkish political parties, citing as evidence comparative case studies of the participatory practices for policy-making, leadership selection and candidate selection in mature democracies. This thesis also analyses membership registration and the effect of state funding on IPD, which are highly problematic in Turkey and represent impediments to the flourishing of IPD.

Law, Rights and Reproduction: Reproductive Autonomy in Ethical Rationalism

As medical technology has advanced, so too have our attitudes towards the level of control we can expect to hold over our procreative capacities. This creates a multi-dimensional problem for the law in terms of access to services which prevent conception, access to services which terminate a pregnancy and recompensing those whose choices to avoid procreating are frustrated. These developments go to the heart of our perception of autonomy. In order to evaluate these three issues in relation to reproductive autonomy, I set out to investigate how the Gewirthian theory of ethical rationalism can be used to understanding the intersection between law, rights, and autonomy. As such, I assert that it is because of agents’ ability to engage in practical reason that the concept of legal enterprise should be grounded in rationality. Therefore, any attempt to understand notions of autonomy must be based on the categorical imperative derived from the Principle of Generic Consistency (PGC). As a result, I claim that (a) a theory of legal rights must be framed around the indirect application of the PGC and (b) a model of autonomy must account for the limitations drawn by the rational exercise of reason. This requires support for institutional policies which genuinely uphold the rights of agents. In so doing, a greater level of respect for and protection of reproductive autonomy is possible. This exhibits the full conceptual metamorphosis of the PGC from a rational moral principle, through an ethical collective principle, a constitutional principle of legal reason, a basis for rights discourse, and to a model of autonomy. Consequently, the law must be reformed to reflect the rights of agents in these situations and develop an approach which demonstrates a meaningful respect of autonomy. I suggest that this requires rights of access to services, rights to reparation and duties on the State to empower productive agency.

Estimate of the (R)USLE rainfall erosivity factor from monthly precipitation data in mainland Spain

The need for continuous recording rain gauges makes it difficult to determine the rainfall erosivity factor (R-factor) of the (R)USLE model in areas without good temporal data coverage. In mainland Spain, the Nature Conservation Institute (ICONA) determined the R-factor at few selected pluviographs, so simple estimates of the R-factor are definitely of great interest. The objectives of this study were: (1) to identify a readily available estimate of the R-factor for mainland Spain; (2) to discuss the applicability of a single (global) estimate based on analysis of regional results; (3) to evaluate the effect of record length on estimate precision and accuracy; and (4) to validate an available regression model developed by ICONA. Four estimators based on monthly precipitation were computed at 74 rainfall stations throughout mainland Spain. The regression analysis conducted at a global level clearly showed that modified Fournier index (MFI) ranked first among all assessed indexes. Applicability of this preliminary global model across mainland Spain was evaluated by analyzing regression results obtained at a regional level. It was found that three contiguous regions of eastern Spain (Catalonia, Valencian Community and Murcia) could have a different rainfall erosivity pattern, so a new regression analysis was conducted by dividing mainland Spain into two areas: Eastern Spain and plateau-lowland area. A comparative analysis concluded that the bi-areal regression model based on MFI for a 10-year record length provided a simple, precise and accurate estimate of the R-factor in mainland Spain. Finally, validation of the regression model proposed by ICONA showed that R-ICONA index overpredicted the R-factor by approximately 19%.

The Pico de Navas slump (Burgos, Spain): a large rocky landslide caused by underlying clayey sand fluidification

The Pico de Navas landslide was a large-magnitude rotational movement, affecting 50x106m3 of hard to soft rocks. The objectives of this study were: (1) to characterize the landslide in terms of geology, geomorphological features and geotechnical parameters; and (2) to obtain an adequate geomechanical model to comprehensively explain its rupture, considering topographic, hydro-geological and geomechanical conditions. The rupture surface crossed, from top to bottom: (a) more than 200 m of limestone and clay units of the Upper Cretaceous, affected by faults; and (b) the Albian unit of Utrillas facies composed of silty sand with clay (Kaolinite) of the Lower Cretaceous. This sand played an important role in the basal failure of the slide due to the influence of fine particles (silt and clay), which comprised on average more than 70% of the sand, and the high content presence of kaolinite (>40%) in some beds. Its geotechnical parameters are: unit weight (δ) = 19-23 KN/m3; friction angle (φ) = 13º-38º and cohesion (c) = 10-48 KN/m2. Its microstructure consists of accumulations of kaolinite crystals stuck to terrigenous grains, making clayey peds. We hypothesize that the presence of these aggregates was the internal cause of fluidification of this layer once wet. Besides the faulted structure of the massif, other conditioning factors of the movement were: the large load of the upper limestone layers; high water table levels; high water pore pressure; and the loss of strength due to wet conditions. The 3D simulation of the stability conditions concurs with our hypothesis. The landslide occurred in the Recent or Middle Holocene, certainly before at least 500 BC and possibly during a wet climate period. Today, it appears to be inactive. This study helps to understand the frequent slope instabilities all along the Iberian Range when facies Utrillas is present.

Sedimentology of a Middle Jurassic Base-of-Slope environment, Cutri Formation, Mallorca

The Cutri Formation’s, type location, exposed in the NW of Mallorca, Spain has previously been described by Álvaro et al., (1989) and further interpreted by Abbots (1989) unpublished PhD thesis as a base-of-slope carbonate apron. Incorporating new field and laboratory analysis this paper enhances this interpretation. From this analysis, it can be shown without reasonable doubt that the Cutri Formation was deposited in a carbonate base-of-slope environment on the palaeowindward side of a Mid-Jurassic Tethyan platform. Key evidence such as laterally extensive exposures, abundant deposits of calciturbidtes and debris flows amongst hemipelagic deposits strongly support this interpretation.

Strength of the Iberian intraplate lithosphere: Cenozoic deformations and seismicity

Previous studies about the strength of the lithosphere in the Iberia centre fail to resolve the depth of earthquakes because of the rheological uncertainties. Therefore, new contributions are considered (the crustal structure from a density model) and several parameters (tectonic regime, mantle rheology, strain rate) are checked in this paper to properly examine the role of lithospheric strength in the intraplate seismicity and the Cenozoic evolution. The strength distribution with depth, the integrated strength, the effective elastic thickness and the seismogenic thickness have been calculated by a finite element modelling of the lithosphere across the Central System mountain range and the bordering Duero and Madrid sedimentary basins. Only a dry mantle under strike-slip/extension and a strain rate of 10-15 s-1, or under extension and 10-16 s-1, causes a strong lithosphere. The integrated strength and the elastic thickness are lower in the mountain chain than in the basins. These anisotropies have been maintained since the Cenozoic and determine the mountain uplift and the biharmonic folding of the Iberian lithosphere during the Alpine deformations. The seismogenic thickness bounds the seismic activity in the upper–middle crust, and the decreasing crustal strength from the Duero Basin towards the Madrid Basin is related to a parallel increase in Plio–Quaternary deformations and seismicity. However, elasto–plastic modelling shows that current African–Eurasian convergence is resolved elastically or ductilely, which accounts for the low seismicity recorded in this region.

First Triassic tetrapod (Sauropterygia, Nothosauridae) from Castilla y León: evidence of an unknown taxon for the Spanish record

Several vertebrae of a sauropterygian specimen have been recovered in Fuencaliente de Medinaceli (Soria Province, Castilla y León, Spain). The remains come from Middle–Upper Triassic Muschelkalk Facies. This finding represents the first documented evidence of a Triassic tetrapod in Castilla y León. The vertebrae belong to Nothosaurus, a sauropterygian genus found in Europe, Middle East, North of Africa and China. This genus is poorly-known in the Iberian record. The new remains constitute the first evidence of the species Nothosaurus giganteus, or a related taxon, in the Iberian Peninsula. This study reveals the occurrence of at least two species of the sauropterygian Nothosaurus in the Spanish record.

Anatomy and variability of "Cuvierichelys parisiensis", a geoemydid turtle that crosses the Eocene-Oligocene boundary in Belgium

Abundant material of turtles from the early Oligocene site of Boutersem-TGV (Boutersem, Belgium), is presented here. No information on the turtles found there was so far available. All the turtle specimens presented here are attributable to a single freshwater taxon that is identified as a member of Geoemydidae, Cuvierichelys. It is the first representative of the ‘Palaeochelys s. l.–Mauremys’ group recognized in the Belgian Paleogene record. This material, which allows to know all the elements of both the carapace and the plastron of the taxon, cannot be attributed to the only species of the genus Cuvierichelys so far identified in the Oligocene, the Spanish form Cuvierichelys iberica. The taxon from Boutersem is recognized as Cuvierichelys parisiensis. Thus, both the paleobiogeographic and the biostratigraphic distributions of Cuvierichelys parisiensis are extended, its presence being confirmed for the first time outside the French Eocene record. The validity of some European forms is refuted, and several characters previously proposed as different between Cuvierichelys iberica and Cuvierichelys parisiensis are recognized as subjected to intraspecific variability.

Fossil associations from the middle and upper Eocene strata of the Pamplona Basin and surrounding areas (Navarre, western Pyrenees)

Fossil associations from the middle and upper Eocene (Bartonian and Priabonian) sedimentary succession of the Pamplona Basin are described. This succession was accumulated in the western part of the South Pyrenean peripheral foreland basin and extends from deep-marine turbiditic (Ezkaba Sandstone Formation) to deltaic (Pamplona Marl, Ardanatz Sandstone and Ilundain Marl formations) and marginal marine deposits (Gendulain Formation). The micropalaeontological content is high. It is dominated by foraminifera, and common ostracods and other microfossils are also present. The fossil ichnoasssemblages include at least 23 ichnogenera and 28 ichnospecies indicative of Nereites, Cruziana, Glossifungites and ?Scoyenia-Mermia ichnofacies. Body macrofossils of 78 taxa corresponding to macroforaminifera, sponges, corals, bryozoans, brachiopods, annelids, molluscs, arthropods, echinoderms and vertebrates have been identified. Both the number of ichnotaxa and of species (e. g. bryozoans, molluscs and condrichthyans) may be considerably higher. Body fossil assemblages are comparable to those from the Eocene of the Nord Pyrenean area (Basque Coast), and also to those from the Eocene of the west-central and eastern part of South Pyrenean area (Aragon and Catalonia). At the European scale, the molluscs assemblages seem endemic from the Pyrenean area, although several Tethyan (Italy and Alps) and Northern elements (Paris basin and Normandy) have been recorded. Palaeontological data of studied sedimentary units fit well with the shallowing process that throughout the middle and late Eocene occurs in the area, according to the sedimentological and stratigraphical data.

Strontium isotopes and sedimentology of a marine Triassic succession (upper Ladinian) of the westernmost Tethys, Spain

Chemical Stratigraphy, or the study of the variation of chemical elements within sedimentary sequences, has gradually become an experienced tool in the research and correlation of global geologic events. In this paper 87Sr/ 86Sr ratios of the Triassic marine carbonates (Muschelkalk facies) of southeast Iberian Ranges, Iberian Peninsula, are presented and the representative Sr-isotopic curve constructed for the upper Ladinian interval. The studied stratigraphic succession is 102 meters thick, continuous, and well preserved. Previous paleontological data from macro and micro, ammonites, bivalves, foraminifera, conodonts and palynological assemblages, suggest a Fassanian-Longobardian age (Late Ladinian). Although diagenetic minerals are present in small amounts, the elemental data content of bulk carbonate samples, especially Sr contents, show a major variation that probably reflects palaeoenvironmental changes. The 87Sr/86Sr ratios curve shows a rise from 0.707649 near the base of the section to 0.707741 and then declines rapidly to 0.707624, with a final values rise up to 0.70787 in the upper part. The data up to meter 80 in the studied succession is broadly concurrent with 87Sr/86Sr ratios of sequences of similar age and complements these data. Moreover, the sequence stratigraphic framework and its key surfaces, which are difficult to be recognised just based in the facies analysis, are characterised by combining variations of the Ca, Mg, Mn, Sr and CaCO3 contents